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FRAGILITY AS A TOPICAL NURSING PROBLEM
ŽÁKOVÁ, Jaroslava
Introduction: Frailty within geriatrics is still more viewed as a current problem in the world than in the Czech Republic and it is more commonly mentioned. We can say that in the Czech Republic this problematic is still developing, updates and is trying to find its place in nursing as such. Objective: The objective of the presented thesis is to find out if frailty is perceived as a current problematic in the current geriatric nursing. Further, we focused on the geriatric nursing and specifics of nursing care in this field; on what is the awareness of medical staff at aftercare department about geriatric frailty and in which way, within nursing care, they apply their gained knowledge in practice. Methodology and research sample: To achieve the set objective the qualitative research conducted using the technique of semi-structured interview with nurses at aftercare department was used. The basis of this interview was 24 open questions which were predetermined and are documented in attachments (attachment 1) of the thesis. During the interview these questions were extended as needed by additional questions. The interviews were conducted with 10 general nurses at aftercare department of one unnamed South Bohemian hospital. The analysis of interviews was done using open coding paper-and-pencil and the individual information were classified into categories and subcategories. The results grant us comprehensive overview on the nursing care at aftercare departments within the geriatric nursing, utilization of knowledge of nurses about geriatric frailty within their practice and whether nurses perceive the concepts such as geriatric patient, geriatric syndromes and the already mentioned geriatric frailty. It was found out that some addressed nurses at aftercare department of one unnamed South Bohemian hospital never heard some of the mentioned terms and never registered them during their practice either. Other nurses say that they only heard those terms during their college studies, but they also agree that they never met them during their practice. Despite that, all nurses were able to accurately and aptly characterize the terms geriatric patient, geriatric syndromes and geriatric frailty based on their experience and knowledge. Furthermore, it was proven that they realize frailty during the care for patient and can apply their knowledge in nursing care. Conclusion and practical use: The results of the submitted thesis will serve as a template for educational seminar.
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Nutritional and functional status of clients living in homes for the elderly
Dvořáková, Tereza ; Vágnerová, Tereza (advisor) ; Mádlová, Pavla (referee)
Objectives: The aim of this cross-sectional study was to assess the nutritional status and physical performance of the individuals over 65 years living in home for the elderly and as the main research question to assess whether there is a correlation between impaired nutritional status and worsened physical performance in older adults. Also tests whether the unwanted weight loss for the last 3 month affects impaired results in a standardized SPPB test and handgrip test. And finally, verify whether the optimal BMI valided for the elderly predispozes a good physical performance and considered as a protective factor in case of frailty - on functional status. Methods: The research was executed by a quantitative method with the investigation of respondents as a data collection technique. To elaborate the practical part and answer the research questions were used outputs from nutritional status testing (BMI, nutritional status according to MNA-FF, SMI) and functional evaluation (dynamometry, SPPB battery). The results of these variables diagnosed seniors in the norm, at risk and with pathology. Results: The resulting research sample consisted of 40 seniors, of whom 29 were women (72,5 %) and 11 were men (27,5 %). The normal nutritional status was found in the majority of participants - 67,5 %, the risk...
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The assessment of nutritional status in the comprehensive diagnosis and management of geriatric frailty
Klbíková, Tereza ; Topinková, Eva (advisor) ; Meisnerová, Eva (referee)
Objectives: The aim of this non-interventional observational study was to determine the prevalence of frailty in a cohort of 200 elderly patients and its correlation and dependence in relation to nutritional status and to evaluate the correlation of the items in the MNA - SF and SPPB test batteries and determine whether the weight loss is related to poor results in the evaluation of geriatric frailty, and to evaluate whether cognitive function affects nutritional status and if nutritional status in such circumstances affects subjects' self- sufficiency. Methods: Data was sourced from the results of standardized tests in Comprehensive Geriatric, Assessment, CGA at the 1. LF UK Geriatric Clinic, which include the assessment of selfsufficiency (ADL) and condition (SPPB), cognitive functions (MMSE) and the assessment of nutritional status (MNA - SF). Patients were also measured for bodyweight, height and BMI. Results: The study included a total of 200 patients, of whom 46 (23%) were men and 154 women (77%). Geriatric frailty was diagnosed in 59.5% of patients, with 21.5% of patients being classified as "pre-frailty" and 19 % of good physical condition. In this group 15.5% of patients were malnourished, 37.5% were at risk of malnutrition and 47 % were in a good nutritional condition. A statistically...
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The issue of nursing care about patients with geriatric fragility.
ŠINDELÁŘOVÁ, Renata
Bachelor thesis titled The issue of nursing care about patients with geriatric fragility is a theoretical work, that tries to catch and describe the most information about geriatric frailty and specifics of nursing care for geriatric patients, who are withering away. Geriatric frailty has significant influence on quality of seniors life who currently live longer. Because the population is getting older and number of geriatric patients is increasing and it will be stil in the future, the geriatrics and the gerontology began to focus on geritraic frailty in their research. The geriatric frailty is called "The Holy Grail" of this medicine that tries first to maintain the longest possible psychical and physical senior activity and to turn away institutionalization of geriatric patient mainly by appropriate interventions in the provision of comprehensive nursing care. The aim of great effort in this work was to map and find out all details not only about geriatric frailty, but also about areas with influence on the emergence and development of the geriatric frailty and also on quality of senior life. Geriatric frailty does not have set definition yet and it is not now known if it is a syndrome, a symptome or a medical diagnosis. Involution, that goes along and has significant influence on men's life, causes natural biological aging process of organism, which is manifested by decrease or loss of functional human reserves. If these reserves are also influenced by inner factors for example multimorbidity or undesirable effects of medicaments or external factors, where we put malnutrition, sarcopenia, cognitive deficit, inactivity, instability but also loneliness, excessive load, inappropriate housing and insufficient financial income, than the "spiral of deteriorating" is developing and heading towards disability, immobility and danger of senior life. It is necessary to add that senior with geriatric frailty may not be always ill but he wither away. So effort of my thesis is to bring meaning and impact of "geriatric frailty" and "spiral of deteriorating" in the seniors life, that are not in the awareness of medical staff who provide nursing care to seniors (Kalvach, 2008). Geriatric frailty is getting worse by its progressivity and causes emergence of other syndromes, of which the most serious are immobilization syndrome and terminal geriatric deterioration followed by death. We need the presence of three basic characteristic of five to diagnose geriatric frailty in the eldery. It is malnutrition, sarcopenia, self-reported exhaustion, reduced level of mobility and weakness. As already said geriatric frailty is now the main theme of geriatric medicine, gerontologists and geriatrists, and because it can meaningfully contribute to providing of nursing care with propriate interventions, I tried in my thesis to determine specifics of nursing care focusing on areas, which have significant influence on emergence and development of geriatric frailty. It is primarily nutrition, rehabilitation nursing and motivation of frailty seniors, but also decubitus, falls and injuries of patients, inappropriate communication with elements of ageism or sleep disturbances can affect the emergence of frailty. The result from acquired information is that the main goals of nursing care for patients with geriatric frailty are to make eat, get to go and motivate patient. Effort this thesis is not to disparage present nursing care for geriatric patients, but to explain and give information about the necessity of greater focus of nursing care on risks mentioned above. Nursing care will have to make certain changes, as well as the geriatric medicine is adapting to the population aging and geriatric frailty. If this bachelor thesis will enrich awareness of nurses and other members of multidisciplinary team with problem of geriatric frailty, specifics of nursing care of patients with geriatric frailty, attitude and motivation of these risk patients, then the.
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