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Specifics of nursing care of patients with hemophilia
HOUSKOVÁ, Tereza
This bachelor thesis is divided into two parts. The topic is the specificities of nursing care of patients with hemophilia. The aim of theoretical part is to sum up in detail the issues connected to inherited coagulopathy, in this case hemophilia. It provides and discusses the definition, severity, causes, manifestations, diagnosis, complications, and therapy of the given disorder. Nursing care is an area not to be omitted when discussing hemophilia, especially due to the character of the disorder, which is highly specific and includes complex care. The empirical part of this bachelor thesis is based on the results of conducted qualitative research. The main goal of this research is to identify the specificities of nursing care of patients with hemophilia, including their specific needs. Further, this research sets to identify in what way are people diagnosed with hemophilia affected by this disorder. For this purpose, three targets were selected. First target is connected to the specific needs of the hemophiliacs. Second target is to map which parts of daily life of the patients are most influenced by hemophilia. Third and the last target cover the specificities connected directly to the nursing care of patients with hemophilia. The research questions were devised according to the aforementioned targets. Semi-structured interviews were used as the qualitative research method in order to fulfill the set targets. Semi-structured interviews were conducted with two peer groups, first group chosen for the purpose of this research were five nurses with experience in care of patients with hemophilia. Second group interviewed comprised of five hemophiliacs. The semi-structured interviews with the nurses aimed to identify the specificities of nursing care of patients with hemophilia, including their needs. The interviewees with hemophilia were asked mostly about their activity in daily life. The interviews were recorded and afterwards manually transcribed. Interviews were properly coded and categorized into specially devised categories. The results of the conducted research show that all the nurses identified as the most important specificity in nursing care of patients with hemophilia regular application of coagulation factor, which is usually done twice a week. However, they further note that during hospitalization, in most cases the time interval is shorter between individual applications. This is due to the planned procedures. The research concludes that due to the character of the disorder such as hemophilia, it is necessary to check on the patient more frequently in his room and monitor bleedingand last but not least the pain. All the nurses further stated that pain is one of the most important factors connected to fatigue. Therefore, heighten need for sleep can be observed in patients with hemophilia. A significant specificity in nursing care of patients with hemophilia, pointed out by the nurses, is that no intermuscular injection can be applied to such patients due to the high risk of bleeding into the muscle. Another contradiction is administration of drugs containing acetylsalicylic acid, which has a negative impact on aggregation of blood cells. All the nurses agreed that in terms of hygiene it is crucial to consider joint stiffness and their swelling, which are often accompanied by strong pain. Pain was also noted by many respondents as a factor that most often have a negative influence on their daily life activities. Contact sports or extreme sports are unsuitable for such patients, as they involve high risk of injury and consequent open or inner bleeding. Further, the respondents felt limited in terms of possible career choices, affected by their bleeding disorders. Based on this research an informational pamphlet was created. This pamphlet can be used as a source of basic information for patients with hemophilia and people close to them as well as for students of medical courses.
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