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Permanent Vascular Access in Dialysis Patients from the viewpoint of Nurses and Patients.
ŠVÁBOVÁ, Veronika
The issue of chronic renal failure and cannulation of permanent venous accesses in patients treated at haemodialysis centres is a topical and widespread problem of these days. According to generally accessible resources the incidence of terminal stage of renal failure, and thus the necessity to treat a patient by means of elimination methods, is very high, it reaches four individuals per thousand inhabitants according to the statistics. It is obviously a widespread nursing problem. The theoretical part of the thesis is divided into a summary and description of the present situation in chronic renal failure, particularly a brief insight into the chronic renal failure and its causes and syndromes. It also deals with the topic of the present treatment possibilities with stress on patient treatment at nephrologic outpatient clinics and in haemodialysis centres. The next chapter of the thesis describes the development from haemodialysis history up to the present advanced elimination methods. The present elimination methods bring the necessity of functional provision of venous access, particularly cannulation of AV fistulas, it is a very frequent nursing operation provided by nurses treating chronically affected patients at haemodialysis centres. This chapter is concluded by general knowledge of the techniques of cannulation of permanent venous accesses, possible occurrence of complications during the cannula penetration itself in relation to the physical phase of nursing treatment about patients with chronic renal failure. The practical part of the thesis was aimed at discovering or possible confirmation of the hypotheses discussed in the theoretical part. The practical research was based on searching for problems among dialyzed patients related to the permanent venous access, on finding the approach of nurses working at dialysis centres to cannulation of permanent accesses and on mapping the access of patients with permanent venous access to nurses with short time experience at a dialysis centre. Research questions were determined for this purpose and were processed within qualitative research into case reports upon depth interviews with nurses working at the dialysis centres of České Budějovice Hospital, Český Krumlov Hospital and Písek Hospital and their patients. The research data were processed into charts, where responses from patients and those from nurses were assessed separately. Occurrence frequency of the individual answers was particularly monitored in the individual output tables, however the responses were not processed by means of standard statistic methods because of the chosen methodology and thus a low number of respondents, but the output data served for drawing conclusions and preparing recommendations for application of nursing methods. The thesis conclusion summarizes the obtained knowledge and recommends possible procedures of solving the problems of cannulation of permanent venous accesses in patients with chronic renal failure treated at haemodialysis centres.
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Treatment of vascular input for patients on hemodialysis department as a nursing problem
ŠTRBOVÁ, Kateřina
The bachelor?s thesis focuses on current problems of dialyzed patients with a dialysis catheter. A properly functioning catheter and minimum complications during its use form essential preconditions of the dialysis treatment. Emphasis is put on observance of aseptic approach when handling the dialysis catheter. The aim of the thesis is to find out whether nurses observe the treatment standard when treating the blood vessel entries and if the nurses of a standard ward find the handling of the catheter for hemodialysis problematic. The objective is also to map the most problematic area of blood vessel entries from the nurses? view. The following research queries result from the objectives set above. 1. Do the nurses observe the treatment standard when treating the blood vessel entries? 2. Do the nurses of a standard ward find the handling of the hemodialysis catheter problematic? 3. What is the most problematic area of blood vessel entries treatment from the view of the nurses? The qualitative research was carried out by means of hidden observation. Participants of the research included 5 nurses from the dialysis centre of Fresenius Medical Care in Benešov and 5 nurses from the internal medicine ward of Nemocnice Rudolfa a Stefanie a.s. (Hospital of Rudolf and Stefanie) in Benešov. The observation was supplemented by an anonymous survey carried out also at the dialysis centre and at a standard internal medicine ward. Hypotheses can be set based on the obtained results. The medical treatment standard for treatment of blood vessel entries is not observed by all nurses, the standard ward nurses find handling the hemodialysis catheter difficult and the most problematic area of the treatment of blood vessel entries is the failure to observe the aseptic procedures during the treatment as well as the fact that patients do not get extra bandage material for home use. The research results shall serve for preparation of a draft for the medical treatment standard ??Medical treatment for dialysis catheter??. The draft can be presented to medical management of the given wards to achieve higher quality of treatment of patients with dialysis catheter.
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Health Related Quality of Life (HRQoL) of dialysis patients, with regard to age
VANCLOVÁ, Romana
The dissertation entitled ?Health Related Quality of Life (HRQoL) in Dialysed Patients with Respect to Age? contains a theoretical and practical part. The theoretical part describes chronic kidney disorder and the treatment of this disease. It mentions the causes, repercussions and complications of this disease. It also suggests the form of treatment as the method of replacing the function of the kidneys which includes haemodialysis, peritoneal dialysis and transplantation. I have attempted to elaborate their principle, history and current form, benefits, negative aspects and complications. The practical part describes the actual research. Health Related Quality of Life (HRQoL) was ascertained in a group of patients undergoing haemodialysis at one dialysis centre. Questionnaire SF 36 was used which allows for a quantified assessment of the quality of life in eight domains. The results were statistically assessed and clearly depicted using tables and graphs. The quality of life was compared in the monitored group with the general population and also based on age and gender. The results found show a reduced quality of life of dialysed patients compared with the standard population. A difference was also found in the assessment of the quality of life in some age groups. No difference in results was proved with regard to gender.
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Demans put on nurses work when providing nursing care on hemodialysis department.
KADLEČKOVÁ, Aneta
Abstrakt In our Bachelor Diploma Work we dealt with the problems of the difficult of the work of nurses in the department of haemodialysis. We have chosen this topic because of the growing higher demands made on the nurses. It can be said that the profession of a nurse is very demanding, they are even jeopardized both by the psychological and physical influences. Because of that there are several advices the nurses should know and observe them. The professional literature encourages the nurses in the department of haemodialysis to find at lest a short moment to learn how to rest and to relax. Unfortunately it is not like that in reality. In the theoretical part we focused on the haemodialysis characteristics, on its indications, contra-indications, on the nursing care in this department and naturally on the psychological and physical impacts on the nurses in the department of haemodialysis. For the research investigation I used a semi-structured discussion. It contained 21 questions, the nurses had to answer. The data collection took place during March 2009. The total numer of enquired nurses was 16. The topic was based on the three targets. To find out what demands have been made on the treatment care for the patiens in the department of haemodialysis, to find out, what impact the care has on nurses in the department of haemodialysis and to find out whether the nurses in the department of haemodialysis suffer from the burn-out syndrome. Based on my Bachelor Diploma Work we would like to organize a seminary for the nurses, working in the department of haemodialysis, focused on the burn-out syndrome and correct relaxation.
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The position of a social worker in a dialysis team
KUDĚJOVÁ, Martina
The diploma work surveys the social impacts of ill people in dependence on dialysis treatment. The whole dialysis team?s interest is the effort to take care of the ill people in a way for them to feel at their best and for the chronic illness to have the least impacts on their common life. The aim of the treatment is not only their stabilized health condition, mental satisfaction and sanity but also the help with solving the social impacts that are brought with by the chronic kidney disease. Work of medical social worker in the dialysis team contributes not only to better understanding the dialysed people?s needs but it also influences mutually cooperation between clients and medical staff and thereby contributes to efficiency of the treatment.
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Quality of Life of Haemodialysed Seniors in Prachatice Region
ZELENKOVÁ, Božena
In the bachelor thesis I deal with the quality of life of haemodialysed seniors in Prachatice region and many aspects that change and affect their lives. The first part of my thesis is a professional one and it describes an anatomical structure of reins, their physiology and in general also diseases leading to an acute or chronic renal failure, especially the diabetes mellitus 2nd type. The professional part is concluded by a treatise on methods of the renal function replacement, so called a method of the blood purification {--} the haemodialysis. In the second, practical part, I focused on the research of the quality of life. I chose the following set criteria: a retirement, an age over 65 years, a renal failure due to the diabetes mellitus 2nd type. For detecting the quality of life I used the method of SEIQoL with the technique of an observation and a questioning. There were selected five respondents who meet the given criteria, the group consists of two men and three women in the age range 66-83 years. The research showed that a common feature of the respondents is the fact of declaring a higher quality of life in comparison with their intended degree of a satisfaction with their life. The respondents also agree that their health problems are multiplied by secondary phenomena accompanying the haemodialysis. Furthermore, it shows how important is a need of a social support for the respondents, their desire for a self-realization and a meaningful fulfilment of their leisure time.
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The quality of life of dialysed children
LASTOVECKÁ, Mária
The B.A. thesis on "The Quality of Life of Dialyzed Children" deals with issue of children being involved in the chronic dialysis programme. The aim of the thesis was to analyse the impact and the load of the disease not only on the overall physical condition, but also on the psychical and social sphere with respect to the holistic concept of the unity of the human being.
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Optimization of Providing Dialysis Care to Patients in a chosen Heath Care Facility
Michalík, Jiří ; Mlčák, Jan (advisor) ; Doubravová, Alena (referee)
This thesis deals with the profitability of sales of the dialysis care provider. The main aim of the work was to optimise the dialysis care in Jindrichuv Hradec hospital. Mentioned proposed solution concerns personnel and technical aspects and particular elimination methods. Another aim of the work was to clarify the reimbursement system of the particular dialysis methods, to compare economic results with the profitability of the dialysis care in the years 2006 and 2007. The author endeavoured to create possible ways of the development based on the knowledge of the number of patients and the insurance company reimbursement system. Necessary data and information were acquired from Jindrichuv Hradec hospital reports. This work is thought to contribute to enrich the practical usage and its results can be used by the hospital management or anybody interested in the dialysis care and its economic aspects.
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