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Analysis of Costs Associated with Acute Myocardial Infarction in Znojmo Hospital
Senciová, Monika ; Lešetický, Ondřej (advisor) ; Střítecký, Rudolf (referee)
The objective of the dissertation is analysis of costs that are connected with acute myocardial infarction in the Znojmo Hospital. It is about the bill of costs of this diagnosis with the use of analysis "Cost of Illness". Cost of Illness is one of many kinds of analysis examining the costs of illnesses. At work, I have tried to capture all relevant costs of this diagnosis, especially the cost of diagnosis, therapy and hospitalization of patients with the diagnosis of acute myocardial infarction.
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Vital capacity of lungs after operation hearts IKEM Prague
CHVOJKOVÁ, Lenka
Cardiovascular diseases in the Czech Republic represent the main cause of death and significantly contribute to the sickness rate and premature disability. Possibilities of treatment of cardiovascular diseases keep developing increasingly these days. An important part is the follow up spa treatment as well as sufficiently performed effective cardio rehabilitation. The theoretical part characterizes functional examination of the lungs and stress tests in cardiology. Simultaneously it describes early spa treatment and defines quality of life. The aim of the diploma thesis, which deals with the vital capacity of the lungs, was to prove positive effect of early spa treatment on the vital capacity of the lungs and on improvement of quality of life, specifically with respect to positive perception of one´s overall physical health. Hypotheses - H1: An early spa therapy positively affects spirometry values. H2: Patients with an early spa therapy better perceive their overall physical health. A form of quantitative research was chosen, in order to verify the determined aims and hypotheses of the diploma thesis. A standardized international Short Form SF - 36 questionnaires on quality of life was used for the data collection. Spirometry was utilized for ascertaining objective functional parameters. Values of spirometry examination were used for comparison. 32 patients after cardiovascular surgery were included in the research, who were transferred to Lázně Poděbrady on the 6th - 8th day after the surgery, 22 of them being men (69%) and 10 women (31 %). The average age of patients under research was 66,06 + 11,48 years. The check group consisted of 10 healthy volunteers. 8 women (80 %) and 2 men (20 %) at the average age of 37,1 + 13,3 years were included in the research. It follows from the spirometry results measured before the heart surgery at IKEM cardio center that a difference in results between the second and third spirometry occurred. The second and third spirometrical examination is the period of time, when the respondent undergoes the early spa treatment. After the heart surgery spirometry values worsen and improve in the course of the spa therapy. The research showed that the perception of overall physical health after the heart surgery is subject to perception of pain, which negatively affected sense of overall perception of physical health. H1 was confirmed and H2 was not confirmed. In order to improve current situation, it would be suitable to devote not only to cardio rehabilitation but also to improvement of perception of pain, e.g. by means of psychotherapy (art therapy, music therapy?). It is also important to widen a possibility of outpatient cardio rehabilitation in each cardio center for patients after heart surgery.
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Use of Educational Programs in the Care of Cardiac Patients.
SOUKUPOVÁ, Lenka
The topic of the bachelor´s work is Utilization of the educational plans in the care of cardiac patients. Heart & blood vessels diseases belong to the civilisation diseases. Circular system diseases are the most frequent cause of death in the advanced countries of the western civilisation, including the Czech Republic. The theoretical part is focused on heart and blood vessels anatomy, ischemic cardiac disease, education, the methods and forms of education of cardiac patients, where dietary measures, physical burden in cardiac patients, the possibility of balneotherapy and other recommendations for cardiac patients are described. The bachelor´s work has two goals Goal 1. To find out whether education of cardiac patients is being done in selected cardio centres, who provides the education, whether they have educational plans in the selected cardio centres and whether they utilize them and what is the effect of the education. Goal 2. To create and realize an own educational plan in cardio centre at hospital in České Budějovice. For these goals, 6 research questions have been set. RQ 1. Is education of cardiac patients being done in the selected cardio centres? RQ 2. Does the nurse participate in the education? RQ 3. Do they have an educational plan in the selected cardio centres? RQ 4. Do they utilize the educational plan in the selected cardio centres? RQ5. Does the education of cardiac patients have a positive effect in keeping regime and curative measures? RQ 6. Is the created educational plan going to have an effect on the knowledge and skills of a patient? A qualitative form of research, by the technique of semi-standardised interview has been used for the achievement of the goals. The research set consisted of 8 selected cardio centres and 8 cardiac patients who were hospitalized at hospital in České Budějovice. After the qualitative research has been conducted, answers were acquired. Answer 1: Education of cardiac patients is being done in all cardio centres. Answer No.2: General nurse takes part in the education of cardiac patients. Answer No.3: Only 3 out of 8 selected cardio centres have an educational plan created. Answer No.4: Most of the cardio centres don´t have an educational plan created. An educational plan is utilized only in 3 cardio centres where they have created it. Answer No.5: The education of cardiac patients has a positive effect in keeping curative and regime measures. Answer No.6 The created educational plan has a positive influence on the knowledge and skills of patients. There was only 1 patients where the educational plan had no effect, 4 patients started to change their food habits. It is very important that the people know the risk factors of ischemic heart diseases and the possibilities of prevention. A properly conducted education will mediate this information to people and therefore it would be suitable to train the medical staff working in the cardio centre at Hospital in České Budějovice, for an education of cardiac patients. I think that the created educational plan could be used for the education of cardiac patients at Hospital in České Budějovice
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Analysis of effectiveness of preventive interventions in patients with ischemic heart disease
ZLATINSKÁ, Sandra
Preventive interventions represent an important part of treatment of ischemic heart disease (IHD). Proper observation of preventive interventions results in faster recovery, earlier resumption of normal lifestyle and particularly prevention of early or late complications. The objective of this bachelor thesis was to determine how effective are the preventive interventions provided by healthcare personnel in the secondary prevention of ischemic heart disease. To meet the objective, the following four research questions were formulated: 1. Is the secondary prevention in patients with IHD effective? The secondary prevention is not effective as the respondents failed to change their lifestyles and they continued to manifest high rates of behavioral risk factors for IHD. 2. Do the patients with IHD observe recommendations given within the preventive interventions? Results of the research survey indicate that the respondents are aware of the IHD risk factors, however, they observe only certain secondary prevention recommendations. 3. What prevents the patients from observing regimen principles set by the secondary prevention? The patients find it difficult to change their established lifestyles which need to be altered in order to observe the principles. Results of the research survey indicate that the respondents find it particularly difficult to change their eating habits and sedentary lifestyle. 4. Is the observation of preventive measures dependent on the period of time after the disease attack? Interviews conducted with 10 respondents treated for different periods of time after the disease attack failed to confirm this hypothesis. Results of the research survey indicate that differences in observation of preventive interventions among the respondents were negligible. 10 respondents with ischemic heart disease were selected as a research sample. The data were collected by means of a qualitative research using two structured interviews with open questions. The first round of interviews with IHD patients was conducted in January 2009 at the cardiology department of the hospital in České Budějovice. The second round of interviews was conducted after the hospitalization treatment stage {--} three month after the patients were discharged from the hospital. This thesis may enhance the knowledge of healthcare workers in secondary prevention of IHD and become a basis for further investigations in this field.
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Problems of Keeping Non Pharmacological Treatment Measures by Clients with Arterial Hypertension
FUKOVÁ, Jitka
Hypertension is a very common cardiovascular disease. About 20-25 % of population in developed countries suffer from this problem. Long-term hypertension involves higher risk of myocardial infarction, celebrovascular accident, renal failure or eye problems. The treatment starts from non-farmacological measures connected with healthy living. The patients should stop smoking, reduce sodium, alcohol and animal fat intake, lose weight, avoid stress and improve physical training. The aim of this work is to find out if hypertensive patients know non-pharmacological measures and if they follow them. Two hypotheses were stated at the beginning: A questionnare as a quantitative research strategy was used in this work. The questionnaire consisted of 25 questions. The results were grafically processed. The questionnaire was distributed to hypertensive patients of hospital wards in Písek, cardiological clinic in Písek and general practitioners in Písek and Milevsko. The number of respondents involved in the research was 111. Hypothesis 1: Hypertensive patients do not know non-pharmacological treatment measures. Hypothesis 2: Hypertensive patients do not follow non-pharmacological measures. Analysing the data, hypertensive patients know the non-pharmacological measures very well, hypertensive patients do not follow them. Hypothesis 1 was refuted and hypothesis 2 was proved. The analysis will be offered to cooperative hospital wards and general practitioners so that it can contribute to better secondary prevention of hypertensive patients.
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Use of Nurses' Competencies in Preventive Care of a Patient with Ischemic Heart Disease
MATSCHEOVÁ, Linda
Ischemic heart disease belongs to the most frequent diseases in developed countries. I have chosen this topic not only because I am interested in this issue but also because I work at emergency ward of internal medicine and majority of patients there suffer from this disease. There are two parts in my thesis {--} the theoretical and the research part. The theoretical part deals with heart anatomy and physiology, with epidemiology and aetiology, with risk factors, with classification, clinical picture, diagnostics, with treatment and prevention of ischemic heart disease. Further, the thesis survey educational process, roles, mission, function and competences of a nurse. The first objective of the thesis was to find out the awareness of nurses´ competences in the area of secondary preventive care in patients with ischemic heart disease. The second objective was to find out, whether nurses are able to apply their competences in the area of secondary preventive care in patients with ischemic heart disease. The third objective was to find out involvement of management (head nurses, departmental nurses, shift nurses) in the secondary preventive care in patients with ischemic heart disease. The fourth objective of the thesis was to find out whether nurses use their knowledge of secondary prevention in patients with ischemic heart disease. Four hypotheses were set for the above mentioned objectives. H1: Nurses are aware of their competences in the area of secondary preventive care in patients with IHD. H2: Nurses are able to apply their competences in the area of secondary preventive care in patients with IHD. H3: Shift nurses, motivated by head nurses, are more involved in the secondary prevention in patients with IHD. H4: Nurses use their knowledge in the area of secondary prevention in patients with IHD. A questionnaire was made up to achieve the objectives and to prove or to disprove the hypotheses of this research. The questionnaire contained 24 questions {--} closed and semi-closed. The research sample was formed from nurses from South Bohemian and central-Bohemian regions. 377 questionnaires were handed out. 242 questionnaires returned and 230 of them were applicable to the research. The first, second and fourth hypotheses were proved. Shift nurses are more involved in secondary prevention in patients with IHD, however, not on the basis of motivation by head nurses, thus, the fourth hypothesis was not proved. I also revealed that nurses do not have sufficient knowledge in the area of secondary preventive care in patients with IHD. On the grounds of these results we created mental maps on ischemic heart disease and its prevention. These maps might enhance nurses´ knowledge and improve the life of patients with ischemic heart disease.
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