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Nursing care for clients with surgical wound healing using vacuum therapy in gyneacological and obstetric practice.
VOPÁLKOVÁ, Natálie
This thesis deals with nursing care for clients with healing of operation wounds using negative-pressure wound therapy in gynaecology-obstetrics practice. Negative-pressure wound therapy is a modern wound-healing method that has spread to other areas of medicine. One of them is the field of gynaecology and obstetrics. The thesis is divided into two parts, theoretical and empirical. The theoretical part contains a description of the history of wound healing and negative-pressure wound therapy, skin anatomy, classification and phases of wound healing and current trends in wound healing. The theoretical part also offers a description of the use of negative-pressure wound therapy in wound healing in gynaecology and obstetrics and the role of the midwife in care for a client using negative-pressure wound therapy. Two goals were selected in the empirical part - to outline the experience of midwives with the use of negative-pressure wound therapy in gynaecology-obstetrics practice and to discover the features specific to nursing care for clients with applied negative-pressure wound therapy. We wanted to find out whether midwives had experience with negative-pressure wound therapy and whether they knew the concrete features specific to nursing care for these clients. Based on these two goals we designated two research questions. What experience midwives have with the use of negative-pressure wound therapy in gynaecology-obstetrics practice, and what features specific to nursing care for clients with applied negative-pressure wound therapy they mention. The research investigation was conducted in a qualitative form using a semi-structured interview. The research cohort consisted of 10 informants working in gynaecology-obstetrics departments. The first research question considered what experience midwives have with the use of negative-pressure wound therapy in gynaecology-obstetrics practice. The research investigation showed that all the informants asked had experience with the use of negative-pressure wound therapy in gynaecology-obstetrics practice, most often for abdominal laparotomies, specifically for operation wounds following abdominal hysterectomies, caesarian sections, wound dehiscenses, and poorly healing wounds in the abdominal area. The second research question was to find out what specific features midwives mention for nursing care of clients with applied negative-pressure wound therapy. The research investigation showed that mobility, hygiene, diet and care for operation wound have specific features for the nursing process for clients with applied negative-pressure wound therapy. So the research investigation showed that all the informants asked were familiar with negative-pressure wound therapy, and they had experience with nursing care for these clients. But only some could describe the preparation of all the necessary aids for first application and dressing of an operating wound with negative-pressure wound therapy. Some informants could not describe the actual process for dressing of an operating wound with negative-pressure wound therapy. They also struggled to name the restrictions that clients have with this therapy and explain their solutions. The reason for this may be the fact that this method for healing non-healing operation wounds is not used routinely and on a day-to-day basis in gynaecology-obstetrics practice.This thesis resulted in two information maps for midwives working at gynaecology-obstetrics departments. The first information map shows the preparation of aids for the first application and redressing of negative-pressure wound therapy, and the second information map shows comprehensive nursing care for clients with applied negative-pressure wound therapy, including instruction. The results of this thesis may also be used as the basis for expert lectures, conferences and seminars for midwives.
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Space as a socially constructed form of oppression: the transformation of an asylum for women with mental handicap in the Usti Region
Růžičková, Kamila ; Kolářová, Kateřina (advisor) ; Ezzeddine, Petra (referee)
In my thesis I deal with the representations of mental handicap in the Czech context. The theoretical base I found in the field of disability studies and its model of disability, which I have enriched with the approaches of poststructuralist authors and also with the Czech authors who see the mental handicap from a different perspective than the "majority society". The representation of mental handicap in the Czech context I show at the example of a home for people with disabilities, specifically for the mentally disabled women, which is located in the Usti Region. This institution is involved in the project called The support of planning the transformation of social services in the Usti Region. In the thesis I deal with the issue how are these planning changes communicated with clients and what connotations are given to the planned change of living space. In the empirici section, I talk through the semi-structured interviews with five woman clients of the institution and ask them about their current life. Then I analyze the types of spaces Theky mentioned. Their questions are completed with an interview with the manager of the institution, who talks about the motives that led to the transformation process. Keywords disability, client, citizenship, human rights, space, gender, social service,...
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Women's pains after gynecological operations.
HUFEISLOVÁ, Jolana
The first aim of this bachelor?s thesis was to determine whether clients are informed about possibilities of painkilling after hysterectomy. The results show that clients are informed about possibilities of pharmacological, non-pharmacological and alternative treatment of post-operation pain. This bachelor?s thesis also aimed to study the level of clients? contentment with attitude of the nurses to problems with post-operation pain. The survey showed that clients are content with midwives? procedures when soothing post-operation pain. The survey part of the thesis was carried out in form of questionnaires. The collection of data was performed from January to March 2012. The author of the thesis approached clients indicated for a hysterectomy type of gynaecological operation. The clients were hospitalized at the Gynaecological post-operation ward and the Ward of conservative gynaecology at the University Hospital in Pilsen. The survey group was formed by 110 respondents. The results of the survey will be compiled into an information leaflet that will be available to clients not only at the gynaecological post-operation ward but also at the consulting rooms, so the clients are informed well ahead of the planned surgery. The results of the thesis can also be used in order to improve the quality of post-operation pain soothing process within the framework of the nursing process.
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Keeping client´s intimacy in gynecological ambulance.
BRAUNOVÁ, Václava
The concept of intimacy, is defined as privacy, confidentiality, comfort and intimacy, in dictionary of foreign words. Intimacy is not only in everyday life, but also in nursing. With increasing requirements for quality care holistic care become needed. This care includes all client's needs in gynecological ambulance. Intimacy can be included into the needs of self conception and self esteem. The midwife as a provider of nursing care should meet all the client's needs in the gynecological clinic. Therefore a client who attended gynecological ambulance expects compliance with its intimacy. The theoretical part deals with the client's needs, especially the need of self conception and self-esteem and the need for certainty and security. Knowledge of history of nudity and intimacy is included. It focuses not only on the client and her personality, but also on the midwife. Midwife acts here as an educator, controls hers communication skills and respects the client's rights. The theoretical part also includes the specifics of nursing care in the gynecological ambulance. To handle the practical part of the thesis method of quantitative research was used. Interviews were used for quantitative research method. For this purpose two questionnaires were developed. One was intended for midwives and the other for clients of all ages. The questionnaires were mapped for area of intimacy and its observance in the gynecological ambulance. The aim of this study was to determine whether and how is the client's intimacy in gynecological ambulances. Objective 1 was met. Based on the selected targets were set hypotheses. H1: Midwives provide intimacy with clients in gynecological ambulances. Hypothesis H1 was confirmed. H2: Clients who attend ambulances for preventive gynecological examinations, expressed greater satisfaction than to comply with client's intimacy that comes with health's problems. Hypothesis H2 was not confirmed. H3: In the gynecological outpatient clinics is provided by physical rather than psychological intimacy. Hypothesis H3 was not confirmed. Results of the research thesis can be applied to some of the conferences of the Regional Hospital in Usti nad Labem. Part of the thesis is an information leaflet - intended for clients in the gynecological ambulances.
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Specificity of midwife care in children gynecology
HAMERNÍKOVÁ, Pavlína
Children{\crq}s gynecology is mainly focused on preventive care, as timely treatment of gynecological diseases, determining congenital defects and promoting healthy physical and sexual maturity contribute towards healthy woman population. Girl clients is a very specific group od gynecological patients and a midwife nurse is supposed to consider all the specifics during the medical examination. The theoretical part of the thesis contains all information concerning the history of children{\crq}s gynecology, the development of female genital organs, examination in children{\crq}s gynecology, nurse care for gynecological girl patient and sexual abuse and rape. Some more information dealing with intimate hygiene, contraception and sex education are also included. To fulfil the aims of the bachelor{\crq}s work, both quantitative and qualitative research strategies were used. A questionnaire as a method of the quantitative research for collecting data was prepared. It consisted of 26 questions. The research was completed in March 2008 when the questionnaires were sent to children{\crq}s gynecological outpatient departments in the Czech Republic. Forty questionnaires were handed out to midwife nurses working in these departments. About 92.9 % questionnaires were sent back. Within the qualitative research were used the techniques of observing girl clients and a guided interview with girl parents present in the department. This qualitative research was realised in children{\crq}s outpatient department in Děčín in June 2008. Six girl patients and six mothers were interviewed there. The main aim of the thesis was to identify gynecological disorders of girl patients. The other aim was to set up and verify the nurse diagnoses within the NANDA TAXONOMY II. The third aim was to find out how much the midwife nurses know about the specifics of girl patients. The fourth aim consisted in detecting needs of life-long education for midwife nurses working in children{\crq}s gynecological outpatient departments. All aims were accomplished. The following hypotheses were stated in the practical part of the thesis. Hypothesis 1: Mothers (or other people accompanying the girls) are not informed enough to prepare girls for gynecological examination. This hypothesis was proved. Hypothesis 2: Midwife nurses know all specifics of gynecological girl clients. This hypothesis was proved. Hypothesis 3: children{\crq}s gynecology midwife nurses need lifelong education. This hypothesis was proved. The research findings can be applied into practice. The work will help midwife students and nurses in all gynecological departments. They will find here basic principal attitudes to girl clients and learn more about nurse diagnoses which occur within children{\crq}s gynecology. Midwife nurses can also use it as a source of information for their nursing care.
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