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Problematics of transferring the patient onto home artificial pulmonary ventilation
HRBKOVÁ, Lenka
Home artificial lung ventilation (DUPV) is very current topic these days. It provides great hope for the possible return of a patient permanently dependent on artificial lung ventilation back to the home environment. Due to injuries or the development of the disease, some patients are permanently dependent on the support of artificial lung ventilation (UPV). Staying at home with the support of DUPV brings many benefits for these patients. The theoretical part of the diploma thesis is divided into six parts. The first part is devoted to a historical view of the development of artificial lung ventilation. The second part describes the respiratory system. The third part is devoted to artificial lung ventilation, where in the subchapters the indications for connection to UPV, physiological goals, clinical goals and also the subsequent intensive care are analyzed in more detail. The third part comprehensively describes DUPV. The subchapters are devoted to indications for connecting the patient to DUPV, there are described organizations dealing with DUPV. It describes the application for the implementation of DUPV, preparation before the patient goes home, provided nursing care and equipment and medical supplies necessary for implementation. The fourth part focuses on an overview of social benefits and the fifth part on the implementation. Two goals were set for the diploma thesis: 1. To find out, with what problems, including artificial nursing care, do patients face with artificial lung ventilation. 2. Identify what problems, including nursing care, patients experience with home artificial lung ventilation. To meet the objectives, three research questions were created: 1. What problems, including nursing care, occur to patients dependent on artificial lung ventilation in the Follow-up Intensive Care unit? 2. What problems, including nursing care, occur to patients dependent on home artificial lung ventilation? 3. What are the changes in the quality of life and nursing care of patients dependent on ventilator in the hospital and patients dependent on ventilator at home? The empirical part of the diploma thesis is processed in the form of a qualitative research survey. The method of semi-structured interview with NIP general nurses of an unnamed district hospital, caregivers and patients at DUPV was chosen. The method of self-observation and examination of decurses was also used. The interviews were conducted on the basis of pre-arranged questions with four nurses, three caregivers and three patients. The "pencil and paper" method and the open coding method were used to analyze the interviews. For grater clarity, the categories and subcategories were visualized in graphic diagrams. They were also used to compile three case studies. The results of the research survey show that general nurses deal with nursing care, respiratory care and also listen appropriately to the needs of patients. The most common problem that was mentioned was the implementation of personal hygiene, due to the mental and physical dufficulty for patients. Furthermore, problems with defecation, immobility and problems with gestures and communication. An unpleasant problem was also the irritation of the airways during suction. Patients 'and carers' responses show that the most common problem is dependence on the carer for personal hygiene and excretion. Also problems with falling asleep. Social isolation and deteriorated possibility of communication are also problems. A change in the quality of life and nursing care of UPV-dependent and DUPV-dependent patients at home was also found. The answer to this question is that a hospital stay is physically and mentally demanding. It has been said that being at home is real luck. The opportunity to be with family and be able to do everything by yourself. I believe that the work could serve to improve the awareness of family members of patients at DUPV. The work could be used to collaborate in a GAIA grant project.
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The issue of education of family members caring for patients with home mechanical pulmonary ventilation
Polášková, Veronika ; Kordulová, Pavla (advisor) ; Hocková, Jana (referee)
Introduction: The number of patients dependent on prolonged mechanical ventilation is still increasing (Chau et al., 2017). Once the child's condition is stabilized, it is possible for him to be discharged to home care and transferred to a home mechanical ventilator. The care of this patients is very difficult, therefore, it is important to prepare family caregivers on all necessary care (Borought a Dougherty, 2016). The aim of thesis: The aim of this thesis was to find out what is included in the educational process in intensive care unit. Secondarily, to get opinion of caregivers on the quality of the education process and finally to present problems, that family caregivers face at home. Methodology: The research was based on the qualitative study. Data collection was conducted by semi-structured interviews with family caregivers, who take care of children on home mechanical ventilation. A total of 9 respondents participated in the research survey. Data analysis was performed in open coding steps followed by categorization and subcategorizations. Result: The research identified important aspects about the education of family caregivers. We found that caregivers perceive the education very positively. However, they also met with several problems - lack of staff time to educate them in hospital, or...
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Education of parents of children on prolonged mechanical ventilation
Holá, Barbora ; Vaicová, Karolína (advisor) ; Hladká, Petra (referee)
The main topic of this work is to evaluate education of parents with children dependent on long term artificial lung ventilation. In praxis we meet children who are dependent on mechanical ventilation for all life. Thanks to modern approaches in therapy and progress in medical technology these children could be dismissed from hospital to home care. Their parents must be introduced to many new information and they must be taught to many new skills essential for providing necessary nursing care. The role of a nurse is irreplaceable in this process and the quality of education of the nurse should be on the highest level. Theoretical part of this work is focused on pedagogy, education, communication, basic terms and psychological aspects which influence families of such disabled children. Final topics of the theoretical part follow up a problematics of mechanical ventilation and securing airways in pediatrics population. Empirical part of this work is focused on quality of education provision to these parents on specific hospital departement. The aim of this work is to observe conditions and ways of providing this education to parents on the departement. keywords: artifical lung ventilation, care, education, family, child, tracheostomy
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Philosophical justification of human diginity
NOVÁKOVÁ, Lucie
Philosophical justification of human dignity In the 20th century the transformation into the information society took place. The development of information technologies has brought enormous freedom, on the other hand a decline of the institution of family has quickened rapidly, the character of mutual relations in the society has changed. Thus contemporary science interferes in human naturalness. In the field of medicine technologies which enable lengthening of human life have been developed; however, this evokes the question of dignity of life like this. Current conception of human dignity is also affected by a number of recent tragedies. Consequently a huge development of protection of human rights attempting to prevent such situations in the future has taken place. Respecting human dignity is the basis of the profession of health and social workers, who together with other groups and organisations help disabled people. The project of home artificial pulmonary ventilation (DUPV) is intended for severely handicapped citizens who are dependent on a respirator for the whole life. The aim of my work was mapping the attitudes of DUPV to their own dignity. The research was carried out by a qualitative method; the monitored group consisted of seven DUPV respondents who were chosen by random sampling and by "snow ball sampling". As a method of data collection used a biographic dialogue, followed by standardized asking of 20 questions concerning the determined research questions. Based on the results of individual dialogues the casuistries were formed, obtained data were summarised in charts and tables. Three research questiond were determined: 1.How severely handicapped people with DUPV perceive their dignity? 2.Which non-material factors support dignified life of DUPV patients? 3.Which material factors improve the quality life of DUPV patients? All these questions were answered by the research. We want to mediate the results of the work to professionals, especially to the Centre for DUPV in Brno. The respondents, too, will be sent the results of our research and information from thechapter dealing with social security as well as the contacts with helping organisations.
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