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Quality of life of patients after kidney transplantation
Nováková, Monika ; Jirkovský, Daniel (advisor) ; Haluzíková, Jana (referee)
Bachelor thesis "Quality of life in patients after kidney transplant" deals with issue of patient´s quality of livfe before and after transplantation. The objective of this thesis was to map quality of life before and after kidney transplantation in several dimensions - physical functioning, physical limitation, general health, vitality, social functioning, emotional issues and mental health. In theoretial section is presented overview of kidney diseasees, proces of transplantation and quality of life. In empirical section are presented methods of data collection, realisation of survey and results of this investigation. Chosen Method was standardized questionaire SF-36 supplemented with soci-demographic and health related information questionaire devised by autor. It was distributed among patients of nefrological ambulantory practice in IKEM which underwent kidney transplantation. Results: Quality of life of patients after udergoing tranplantation of kidney was better then before transplantationin these areas: perception of one`s own health, walking up the stirs one and more floors, walking hundred meters, managing worload, lesser difficulities in activities of daily living. Pain was lesser obstacle in managing work. Positive shift occured in feeling of pep, nervousness, depression, calm and peace,...
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Nursing care of a patient with a hemodialysis catheter in a chronic dialysis program
Horniková, Renata ; Hromádková, Jaroslava (advisor) ; Jirkovský, Daniel (referee)
This bachelor's thesis is focused on the treatment of hemodialysis catheters. A hemodialysis catheter is an integral part of every elimination method, and without a functional hemodialysis catheter, hemodialysis is not possible. The aim of the bachelor's thesis was to find out whether and how care for hemodialysis catheters differs at individual workplaces. The theoretical part of the thesis presents knowledge about the anatomy and physiology of the kidneys, pathophysiology of the kidneys, elimination methods, vascular approaches and specifically describes hemodialysis catheters and their nursing care. The empirical part of the work presents the results of our own questionnaire survey, which took place at selected workplaces of the Motol University Hospital and at selected Fresenius Medical Care centers. The target group of respondents were nurses working at these workplaces. At the end of the investigation, 75 duly completed questionnaires were included in the statistical data processing. The obtained data are presented in pie and bar graphs and tables, and these data are subsequently compared with hypotheses oriented to the type of workplace and the level of education of the respondents. The results of the questionnaire survey revealed that there were statistically significant differences,...
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The needs of patients in the dialysis program and the role of the nurse in this issue
CHYTRÁČKOVÁ, Aneta
This bachelor's thesis focuses on the needs of patients in a dialysis program and the role of the nurse in this issue. Two objectives were established for this bachelor's thesis: To map the needs of patients in a dialysis program, and to determine the role of the nurse in patients undergoing dialysis. The work is divided into a theoretical and empirical part. In the theoretical part, the anatomy of the kidneys is briefly described, as well as the reasons for kidney failure. Subsequently, various elimination methods are described and explained, along with nutritional and exercise measures. The transplantation procedure is also briefly described. Attention is paid to the needs of patients, nursing care, and education. The empirical part was processed using qualitative research through semi-structured interviews focused on patients undergoing dialysis and nurses working in the dialysis center. The research sample consisted of 13 patients and 9 nurses. To achieve the set objectives, five research questions were created: What are the bio-psycho-social-spiritual needs of patients in a dialysis program? How does dialysis treatment affect patients' lives? What is the level of patient education before starting dialysis treatment? What is the role of the nurse in satisfying the needs of patients in a dialysis program? What is the role of the nurse in providing information to patients in a dialysis program? Our research has shown that dialysis generally has a negative impact on the quality of life of most of our respondents. Respondents are most negatively affected by thirst, the time demands of dialysis, poor sleep quality, changes in social needs, and overall fatigue after dialysis. Additionally, our research has shown that nurses in the dialysis center primarily fill the role of provider of nursing care, educator, and advisor who also provides emotional support. The results of the research serve as informational material for patients in the predialysis program and as potential recommendations for nurses working in dialysis centers.
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The patient healing hemodialysis at home by the paramedic´s perspective
KŘIVÁNEK, Martin
This bachelor's thesis focuses on the issue of domestic haemodialysis with special attention to the role of paramedics in dealing with acute problems associated with this procedure. The work is intended as theoretical, without the author´s own research. It aims at reviewing treatment options for kidney failure, describing the principle of home haemodialysis, its benefits and disadvantages for patients and their families. Special attention is paid both to potential risks brought about by this method of dialysing blood and to ways of addressing the complications from the perspective of pre-hospital care. To achieve its goals, the work outlines and compares current attitudes towards these issues both in this country and abroad. Its introductory part summarizes the structure and functions of kidneys, the most frequent causes of renal diseases as well as their possible therapies. Further on, it introduces in greater details both general and specific procedures applied by emergency medical squads in case of complications during domestic haemodialysis. The main scientific contribution of the work consists in the very synthesis of the present knowledge and methods of treatment and - at the same time - in defining the so far unresolved issues. The part of the thesis devoted to home haemodialysis, which still represents a relatively rarely used method, underlines particularly the fact that emergency medical procedures responding to specific complications connected with this treatment have not been sufficiently defined yet. The thesis therefore comes to the conclusion that paramedics facing acute problems associated with domestic haemodialysis have to rely mainly on general procedures determined for providing pre-hospital care. That is why this field still remains open for further theoretical research. Detailed potential practical steps aimed specifically at complications during home haemodialysis are in demand as well.
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Nutrition of dialysis patient
BOHÁČOVÁ, Kristýna
Bachelor thesis "The Diet of Dialyzed Patients" deals with the nutrition of patients, who regularly receive the dialysis treatment. The aim of this work is to map the awareness of a diet regime and patients' compliance with it. The theoretical part describes the anatomy and physiology of kidneys, then it mentions the kidney failure and the elimination methods. Most of the space in this part is given to the nutrition, where the basic nutrients, vitamins and minerals are described. Their amount is specific for the dialyzed patients. The end of this part is aimed at suitable and unsuitable foodstuffs for dialyzed patients. The practical part uses the quantitative method of structured questionnaire, which contains 34 questions. 30 respondents, who regularly receive the dialysis treatment, participated in it. The results of the research showed that 17 out of 30 patients adhere to the diet measures for dialyzed patients. 57% is not a satisfying result given the availability of the education nowadays. The reason for this result might be that the respondents were not informed about the diet regime from a nutritional therapist. The work suggests the presence of a nutritional therapist for regular check-ups and so-called big blood samples that are done once a month to check the amount of minerals and other substances. Nutritional therapist could then decide, which substances are abundant or deficient, and they could then suggest an adjustment of the patient's diet.
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The nutrition of patients undergoing dialysis
MARTÍNKOVÁ, Barbora
The bachelor thesis "The nutrition of patients undergoing dialysis"(whose count is around 6000 in the Czech Republic), deals with the nutrition of patients who regularly undergo treatment by dialysis. The theoretical part focuses on the anatomy and physiology of kidneys. Moreover, the stages of kidney failure and the possibilities of compensation of the kidney function are discussed. Furthermore, the theoretical part of the thesis focuses on dietary measures by patients undergoing dialysis, suitable and unsuitable groceries and their technological adjustment. The aim of the thesis is to map out the awareness of the patients and their families about the diet of a patient undergoing dialysis and to evaluate the menus of the patients, mainly the presence of basic nutrients potassium, phosphor and calcium in their diets. The practical part of the thesis was carried out by qualitative research. Six respondents who are regularly treated by dialysis participated in the research. On the basis of the evaluation of weekly menu of each respondent and counting guideline daily amounts the result was very negative. All respondents have received less amount of energy then what was counted for them. The same applied for basic nutrients. A positive finding was, that all of the respondents have been successful in reducing potassium and most of them have been able to reduce phosphor. Only one respondent fitted in the recommended amount of calcium for patients undergoing dialysis. From the results is obvious, that only one respondent abides by dietary recommendations. Most of the patients couldn't say which groceries are suitable for them and which are not. Unfortunately, the cause of this is, that not one of the respondents listed a nutrition therapist as a source of dietary measures.
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The Needs of Patients Undergoing Dialysis Treatment.
HORNOVÁ, Klára
This thesis intents on patients with chronic kidney diseases. In the theoretical part I sum up basic informations about kidney failure which is a state when kidneys stop to secrete waste ingredients from the body. Then I describe common treatment methods which are hemodialysis, peritoneal dialysis and transplantation. Nevertheless, the most important is to diagnostic the disease at the early stage and start the therapy as soon as possible. This part of thesis also describes physiological, psychical and social needs of the patient. The nursing staff has to know about all these needs which are connected, therefore neglecting one part may influence the others in a negative way. On the other hand, when all needs are satisfied the patient feels comfortable and the therapy can be successfull. When we get understand the specific needs of every single patient the quality of nursing care enhance radically. The practical part of the thesis explores all the needs through half-structured interviews with nine patients under hemodialysis treatment. We may sum up the outcome briefly as follows: the most important for the patient is the painless state, enough sleep and rest and sufficient fluid intake security. The psychical support is important no less. Unsatisfying these needs may lead to frustruation and deprivation of the patient. On the contrary, satisfaction makes him contented and peaceful and motivates him for getting cured. This thesis may help people with recent diagnosis of chronic kidney disfunction and also people who are already set in dialysis therapy to get more informations. The research may be a source of informations also for students and nurses in practice as well. Hopefully may lead to understanding the needs and limitations of the patients under dialysis treatment and thus to provision them a better care.
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Nursing process in patients with hemodialysis
STACHOVÁ, Klára
Chronic kidney disease is often symptomless and painless. It is often late for some patients when they realize that there is something wrong with their bodies, namely the kidney function. Kidney failure causes a complex metabolic failure and water and electrolyte imbalance. Unfortunately this phenomenon is irreversible and a lot of the patients have to undergo hemodialytic therapy, which only substitutes the function of the kidneys but does not treat the kidneys. However dialytic technology is nearly at the perfection level at present. Nevertheless dialysis brings the risk of numerous complications for the patient. The dialysis principle is based on blood cleaning by means of a dialytic apparatus. Life rescue is the patient's priority so he/she has to visit a hemodialysis centre several times a week. The hemodialytic therapy is particularly physically and psychically demanding for the patient and his/her close relatives. This therapy significantly affects the patient's life. It has a substantial influence on patient's lifestyle and values. The therapy is accompanied by various treatment and nursing recommendations adherence to a diet with significant limitation of liquids, regular intake of medicines, stress regulation etc. from physicians and the healthcare staff. The aim of the bachelor thesis called "Nursing Process in Patients with Hemodialysis" was to map the problems of the nursing process in a hemodialysed patient on the base of specialized literature. The topic is elaborated theoretically by the review and synthesis method. The information was obtained from Czech and foreign specialized literature as well as from journals specialized in this issue. Hemodialysis is one of the most demanding elimination treatment methods of long-term character. Nursing care plays a very important role on hemodialysis. It must be effective, of high quality and particularly continuous as the patient only visits the hemodialysis centre on some days of a week. The nursing care has an irreplaceable role in healthcare. The patient before, during and after hemodialysis depends on quality nursing care provided by a nurse. Nursing process based on knowing the patient and active identification of his/her needs is a characteristic feature of modern nursing care. It stresses elaborate continuity, complexity and individuality of the patient, the sequence of the care and satisfaction of needs in partial steps of the nursing process. The nursing process requires continuous interaction between the nurse and the patient. Flexibility, currency, modification and repeated evaluation of the process are advantageous not only for nurses but also for the patients and often leads to timely solution of problems and satisfaction of patient's needs. The theoretical work reveals that hemodialysis is very closely related to the nursing process and contributes to patient's substantial satisfaction. It points out the importance of planning and preparation of nursing diagnoses. A feedback, not only for a nurse, but also for the patient for possible changes or preparation of a new care plan is also an important aspect of preparation of the nursing care plan. The obtained information on the nursing process in a hemodialysed patient are dealt with by the individual chapters of this bachelor thesis. This bachelor thesis is a guide in planning the nursing process and focusing on the most important problems during hemodialytic therapy not only for experienced nurses but also for tertiary school students. It also contributes to recognition of the necessity to create and apply the nursing process in the care of hemodialysed patients. A comprehensive view of the issue in question is the result. This study material for tertiary school students is the result of careful and thorough study of specialized literature.
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Crush syndrom in prehospital care
JENDŘEJASOVÁ, Tereza
The issue of the Crush syndrome in pre-hospital care is not a topic into which new findings are often brought by science workers. All the currently known and available knowledge about the Crush syndrome has not changed for decades. In part this is caused by the difficulty in pre-hospital emergency care to determine whether the condition signifies the Crush syndrome or also a hypovolemic shock resulting in kidney damage. In the Czech Republic there are neither big earthquakes, fortunately nor major landslides, and yet from time to time such an event occurs. That is why today it is more and more desirable that paramedics should be theoretically well prepared for such interventions. The purpose of this study was to survey and compare theoretical knowledge of paramedics working at the Emergency Medical Service of the South Bohemian and the Central Bohemian regions, including the ability to utilize this knowledge in practice. In the study quantitative and qualitative research was used. The quantitative part of the research mapped, using anonymous structured questionnaires, the theoretical knowledge of paramedics working at the Emergency Medical Service of the South Bohemian and the Central Bohemian regions in terms of the Crush syndrome issue. The results of the quantitative research have proved very good knowledge of the Crush syndrome issue in both regions and thus the hypothesis has been verified. The qualitative part of the research identified, through structured interviews with three respondents from the Central Bohemian region and three respondents from the South Bohemian region, the practical connection of theoretical knowledge directly in the field in a client with developing Crush syndrome. The knowledge was assessed as sufficient to provide quality pre-hospital emergency care. The results of this study have shown that paramedics in the South Bohemian as well as the Central Bohemian regions are well familiar with the theory for providing high-quality pre-hospital care for clients with developing Crush syndrome.
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