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Midwife´s comunity care requirement within the sphere of district Domažlice
HOJDOVÁ, Martina
The central subjects of midwifery are a woman and a fetus {--} a new-born child. The task of taking care of a woman and her child is to look after not only their physical health but also to look after them in sense of the psycho-social sphere. The care should be holistic, complex and individual, preserving its continuity. All this fulfils the midwife{\crq}s community care. Going from the theoretic world and also Czech materials we could suppose that midwife{\crq}s community care plays an important role in woman{\crq}s and child`s care. Practically however, midwives meet obstacles. The main aim of this thesis was to find out women{\crq}s interest in midwife{\crq}s community care within the district of Domažlice. The next aim was to find out the opinion of those women who made use of a midwife{\crq}s fieldwork. The further aim was to find out the opinion of the community midwives{\crq} requirement of this care and also the interest of gynaecologists-practitioners in cooperation with a midwife working in the field. For the processing of the problem given, both quantitative and qualitative research was used. Hypothesis 1 ``Women in the district of Domažlice are interested in midwife{\crq}s community care in pregnancy{\crq}q was affirmed. The women were mostly interested in antenatal preparation and pregnancy exercises. Hypothesis 2 ``Women in the district of Domažlice are interested in midwife community care after childbirth{\crq}q was affirmed. The interviewees were mostly interested in the visiting service, breast-feeding consultations. Hypothesis 3 ``Women in the district of Domažlice mention at least 3 specific spheres that they would use the care of a midwife in the field{\crq}q, was affirmed. Mostly they were interested in the visiting service, antenatal preparation and pregnancy exercises. The research question 1 ``Are the midwife{\crq}s community care services regarded as useful by the women who used it?{\crq}q was answered explicitly positively by all of the interviewees. The research question 2 ``Is the community care regarded as useful by midwives who have experience with it?{\crq}q Was answered positively by 5 out of 6 midwives. To the research question 3 ``What spheres of woman{\crq}s care do the gynaecologists-practitioners regard as a possibility of cooperation with a midwife in the field?{\crq}q The practitioners explicitly expressed themselves for psycho prophylaxis and pregnancy exercises. This thesis is intended for a further support of development of the community midwife{\crq}s care in the Czech Republic.
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View therapist of necessity for an ad'vancement community health care in Czech Republic
NAGYOVÁ, Věra
Community nursing services provide health care services in communities outside health care institutions. They are targeted at the sick people in their own home environments, especially providing disease prevention, health support and health care assistance. The goal of community health services is to improve the whole community health, especially of those people who are exposed to risky lifestyles and who are under risk of petting sick, or of dech, and to provide a specific care to them. The introductory part of my thesis contains the theory and elementary parts and types of the health care system in the CR as well as categorized structures and functions of the World Health Organization. It also includes the primary health care goals as well as the goals of the European Union and of the Czech Ministry of Health for the health care system development. In the second part the theory deals with the meaning of the community care, its foundations, the past and the present in the CR. It also describes the nurses´ job descriptions. In the course of the quantitative research I chose the technique of a questionnaire on the grounds of a stratified selection. It was made up by questions used in interviews with nurses. In the frame of qualitative research I chose a method used in interviews with workers in health insurance companies in which I used a guided interview. The goal of my thesis was to find out whether health care workers are aware of health care deficits. I asked for the workers´ opinions on the necessity of community care development in the CR. The goals of my work were reached. The research question was used to find out what the of health care insurance companies representatives´ opinions on the necessity of the community care in the CR are. On the grounds of the questionnaire it was found out that the representatives of health care insurance companies have a positive opinion on the necessity of the community care development in the CR. I did not prove the first hypothesis which stipulated that nurses working outside hospitál facilities do not feel any deficit in providing health care services referring to the provided care. The second hypothesis was proven stipulating that nurses working in hospital facilities can see the most serious deficit in the the fact that people lack their interest in their own health. The third hypothesis was proven, too. The health care workers´ opinions on the the necessity of the community care in the CR are positive.
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Community care versus nurses in primary pediatric care
VAŇKOVÁ, Soňa
Paediatricians and nurses belong to primary health care providers in the in child care while nurses have been taking over a key role in the primary health care. Their position is becoming stronger under the conditions of growing demands in the current health system. This survey was carried out as a combination of quantity and quality research. A questionnaire and an interview for nurses and parents was worked out as a major tool of the research. The survey included 102 nurses in paediatricians' offices. 112 parents and five nurses were interviewed in the range of the research work. There were six objectives set for the thesis. The first objective was to find out whether nurses in primary paediatricians' offices use nursing procedures. The hypothesis set up for the first objective was as of the following: nurses in primary paediatricians office do not use nursing procedures. This was proven on the grounds of the answers received in the survey. The second objective was to find out whether nurses keep their own nursing books and records. The second hypothesis set up was worded as of the following: Nurses in primary paediatricians' offices do not keep their own nursing records. This hypothesis was proven as well. The third objective was to find out whether nurses from primary paediatricians' offices visit families as a part of their service to families. The hypothesis for the third objective was worded as of the following: Nurses from primary pediatricians' offices visit patiens in their homes. The hypotehsis was proven on the groundsof the survey. The fourth objective was to find out whether nurses in primary paediatricians' office observe children in familes with bad socio-economic backgrounds. The hypothesis was worded as of the following: nurses observe children in familes with bad socio-economic;backgrounds. This hypothesis was proven as a fact. The fifth objective was to find out whether nurses are informed about community care. The fifth hypothesis was worded as of the following: nurses in primary paediatricians' offices are not informed about community care. This hypothesis was not proven. The sixth and the seventh objectives were to find out what the range of awareness about community care in parents' minds exists and whether parents are satisfied with nursing care provided by paediatricians and nurses. The hypotheses were worded as of the following: parents are not aware of community care and they consider paediatricians' and nurses' care substantial. The sixth hypothesis abot the range of parents' awareness of commuinity care was not proven, while the seventh hypothesis about satisfaction of nursing care by paediatricians and nurses was proven. In the frame of quality reasearch and on the grounds of four research questions two hypothese were set up. The first one is worded as of the following: Paediatric nurses in primary paediatric care consider community care as necessary and inevitable to provide a thourough care in familes with bad socio-economic backgrounds. The second one is worded as of the following. Paediatric nurses consider cooperation with nurses in other fields of the system as necessary and that eduaction towards well-being is desperately needed. Nurses should be aware of their roles within the health care system. They are no longer just nurses providing care and doers of doctors' commands. They have to learn how to operate successfully in other roles such as: managers, researchers, legislative assistants, advisors, educators and etc.
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Option of nursing care for incurables
JANEČKOVÁ, Zuzana
The paper subject covers Nurse Care Options for Incurables. A theoretical paper of the Diploma Thesis is something like a comprehensive summary of potential nurse care options for incurable people. Based on data gathered herein, I tried to create a schematic layout making the above options clearer. It forms the Annex No.1 to the paper. A practical part is prepared as a quality {--} quantity survey. I concentrated on the Czech Republic legislative and statistic data related to the subject as well as the informedness level of patients/clients and general nurse of nurse care options for incurable people. One of hypotheses related to the issue determined by me ( ``The nurse care options for incurable people in the Czech Republic meet their needs{\crq}q) was confirmed; other two options ( ``All nurse care options provided to incurable people are available to them{\crq}q and ``Incurable people are informed of the nurse care options available to them in the frame of their illness{\crq}q) were disproved. I determined three essential objectives in my paper: 1. Identify nurse care options for incurable people in the Czech Republic; 2. Determine the availability of the nurse care for incurable people in the Czech Republic; and 3. Find the informedness level of incurable people regarding potential use of nurse care suitable for them, that I met. My theoretical part defines nurse care options for incurable people in the Czech Republic; my quality and quantity survey resulted into a conclusion that the nurse care availability for incurable people in the Czech republic doesn not meet their needs, and the informedness level of incurable people of suitable nurse care availability to them is insufficient. The Diploma Thesis findings result into following recommendations: To continue in development of the palliative care and start to perceive it not only as care for oncology terminal ill people; aim to improvement in the informedness of incurable people of the nurse care options available to them (currently a social nurse, general nurse, as well also voluntary workes, in the future a case manager nurse {--} advisor), and promote development of community nursery in the Czech Republic.
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Midwifery home visiting from the point of view of the public
DUŠKOVÁ, Marcela
Due to the Czech Republic's health care system, the need for medical care during pregnancy - even when it is progressing physiologically - has become deeply-rooted in the mind of the public. The theoretical part of this work deals with midwifery in relation to community care. The general theoretical section sums up the roles and competencies of midwives and the forms of their education, both qualifying and lifelong. The following section deals with actual procedures in the care provided by midwives during home visits, according to valid standards issued by CKPA (Czech Midwife Confederation). The questionnaire method, one of quantitative research methods, has been selected for the research part of the work. The questionnaire used consisted of 28 questions and has been processed during April 2009. The sample group was a large group of non-professionals with no limitations by age, gender or place of residence. A total of 150 respondents have been asked for cooperation, and 126 filled questionaries were returned to the researchers. The main goals of the work were determining the public opinion on home visiting by midwives and its necessity. Futhermore, determining the public knowledge of midwife competencies and awareness of the range of midwife services covered by health insurance. The following hypotheses have been examined by the researchers: Hypothesis 1: Expectant mothers prefer gynecologist's care to midwifery. This hypothesis has been confirmed. Hypothesis 2: Women are not interested in home visiting by midwife after the birth. This hypothesis has been refuted. Hypothesis 3: Most of all, women expect high-quality prenatal courses from a midwife. This hypothesis has been refuted as well. Hypothesis 4: Men do not consider home visiting by midwife as valuable for women. This hypothesis has not been confirmed. Hypothesis 5: Women with no access to medical care in their place of residence are in greater need of home visiting by midwife than women with such access. Because of the non-representative distribution of respondents in the sample group, this hypothesis has been neither confirmed nor refuted. Hypothesis 6: The public has no knowledge of the actual competencies of midwives. This hypothesis has been confirmed . Hypothesis 7: The public has no knowledge of the range of midwife care covered by health insurance. This hypothesis has been confirmed as well. This work is of informative nature. It sums up the opinions and knowledge of the public about midwifery. It also helps to outline the uncertainties of the public in this field. The work can be used for public education or as a starting point for future research.
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Differences in the therapeutic and psychosocial rehabilitation activities of psychiatric asylum patients according to their diagnoses
ZELENKOVÁ, Markéta
Abstract Differences in the therapeutic and psychosocial rehabilitation activities of psychiatric asylum patients according to their diagnoses As the main topics of my bachelor{\crq}s thesis, I am investigating psychosocial rehabilitation and therapeutic activities and their use within the framework of rehabilitation of people with a diagnosis within a range of psychotic disorders, neurotic disorders and organic disorders. A chapter on community care represents an important part; it is closely related to the complex rehabilitation system in the treatment of mental disorders. On the last pages I focus on specific communication with people suffering from dementia, psychosis and neurosis. The first goal of the thesis was to find out the differences in therapeutic activities according to diagnoses within a range of psychotic disorders, neurotic disorders and organic disorders. There was a hypothesis linked to the given goal in which I thought that the therapeutic activities realized with the patients would differ according to their diagnoses. The second goal was to find out whether professional staff consider it important to use the possibility of extramural (community) care within the framework of caring for the mentally ill. For this purpose a hypothesis was set up in which I assumed that the professional staff of a psychiatric asylum had a negative view towards using extramural (community) care. The goals of the thesis were achieved. Information was obtained through a quantitative survey, by the method of questioning and the technique of data collection {--} through a questionnaire. The first monitored group consisted of 20 therapists and the second monitored group was made up of 84 nurses working at the Jihlava psychiatric asylum. The survey{\crq}s results confirmed the first hypothesis. The second hypothesis was not confirmed. The findings of this thesis could be used as a source of information, particularly for work therapists and other therapists who, within the framework of psychosocial rehabilitation and therapeutic activities, use many activities such as supporting treatments for mental disorders. The thesis provides an overview of the activities applied in treating mental illnesses. Furthermore, therapists and nurses can use the findings about community care and subsequent services for patients with mental disorders. Not only social workers, but also physicians, therapists and nurses can be the intermediaries of this information for patients and their family members.
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Special aspects of nursing care of clients in the Nursing home for disabled people in Zběšičky
LHOTECKÁ, Markéta
In the Nursing home for disabled people in Zběšičky nursing care for persons with combined disabilities who need specific nursing care is provided. Nursing activities are focused on meeting the clients´ needs. The mission of the Nursing home is to create another home for the disabled and make the disabled clients´ lives similar to those of healthy people. The main effort of the nursing staff in the Nursing home is to make clients self-sufficient in daily routine - with respect to their individual abilities. The aim of the research is to determine the level of nursing care in the Nursing home and to analyse the care provided to the clients. Using the results of the research we can point out the possible inadequacies in nursing care so that the quality of nursing could be improved. The research was conducted by the quantitative method. The techniques used in the research were observation, interview and analysis of documents. During the observation the main attention was focused on meeting the clients´ needs. Relevant medical records were analysed. The research database 1 was composed of four Nursing home clients with combined disabilities, who were chosen randomly. Semi-standardized interviews were conducted with all the nurses of the Nursing home (seven nurses) who formed the research database 2. The results of the research and the medical records analysis show that clients´ needs are met to the extent limited by the clients´ condition. If the needs are met only partially it is caused by the client´s serious disability the nurses try to compensate. During the observation special aspects of nursing care were determined: these are especially meeting the clients´ needs concerning activity and rest. Nurses take part in physiotherapeutic and activating exercises. Another special aspect of nursing is basal stimulation which significantly improves meeting needs in communication, perception and cognition. In meeting the needs concerning hygiene, excretion and nutrition the care is similar to that in immobile clients in other health care facilities. Nursing staff members were interviewed to find the level of adherence to the health and social standards set for nursing homes for disabled clients. The care provided in the Nursing home is community care and the standards correspond to the principles of thit type of care. These principles are: complexity, respecting human rights, health recovery in society, continuous education and standardization of the process. On the basis of the research a following hypothesis was stated: the nursing care provided to clients with combined disabilities corresponds to health and social standards applied in the Nursing home for disabled people in Zběšičky. Some inadequacies were found in abiding by the principle of complexity. There is a lack of medical diagnostics in the nursing process. The objectives of the thesis were accomplished. The results obtained by the research will be provided to the Nursing home for disabled people in Zběšičky and can be used to improve the nursing care. It is advisable to organize a seminar on the nursing process for the nursing staff in the Nursing home.
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Task of nurse in support of care about ill senior in a family
MRÁZOVÁ, Lucie
Old age is a natural part of our lives. Poetically, it is considered to be its autumn. Aging is a natural process and in nature it can be observed at every living creature. Everything is aging, and also we are becoming old. These days, longevity is an indicator of how much civilized each country is. As a result of quality health care and the development of society, people are living to higher age. These days, men are on average expected to live up to 79 years, women up to 74 years {--} figures that would have been considered unthinkable in the past. Taking into account these figures, several questions arise: Are we adequately prepared? Do we have, today, a system of care for the elderly to assure a respectable life for us and our parents in future? In the most ideal world, it would be the family or a close relative who would look after the old, ill or the person with limited self-sufficiency. However, this is a very demanding claim on family environment in these nervous and fast-pacing days. My bachelor thesis analyses the question of old age and all the problems it brings. I have attempted to look deeper into the role of a nurse in homecare. The practical part aims to map the role of a nurse in a home-based care and to determine her possibilities (on the basis of a questionnaire technique) in treating the elderly with health problems at home. Another partial goal of this thesis is to ascertain what needs do the ill elderly people have at home and in what ways can the nurse satisfy these needs, and to determine the physical and social strain it creates on the caregiver. After analyzing the results, my conclusion is as follows: The role of a non-professional caregiver is very significant. Family has and will always have an irreplaceable place in the care for its dependant members. There is no way any medical organization can replace the role of a family in the care for its ill family members. Care, especially long-term care, can be both mentally and physically demanding and puts an enormous strain on the caregiver. Caregivers are threatened by the deterioration of family ties, loss of friends, limited social contacts leading up to social isolation, they are prone to suffer from health problems and, in many cases, great exhaustion. The solution is to make use of a home-based care: professional nursing care provided by professional nurses. The purpose of a home-based care is to leave the patient in his/her home environment as long as possible and, at the same time, to provide professional nursing care. This care is complementary to family care; the nurse is helping the caregiver - family member. Based on my analysis, it's a very gratifying fact that nurses working in this line of work provide it gladly and with loving care. The care for the elderly is based on the principle of gratefulness, love, on the principle of sharing mutual feelings and the joys of small improvements. If we manage to increase the quality of life of caregivers with an adequate help, we will also enable the elderly or ill people to lead a contended and better quality life.
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Problems of the psychiatric patients-direction by means of emergency medical service and alternative possibilities
PETRŮ, Michal
Treatment, direction, transport and placing psychiatric patients in hospitals have been proved as the most problematic activity of Emergency Medical Service (EMS). The range of health facilities is limited. Psychiatric cases belong to the most difficult diagnoses which ambulance crew can meet. Even if they can profit from the attendance of a patient family members they work under time pressure and cannot prolong the treatment of the patient as there can be other casualties in emergency. Non-indicated admission to mental hospital can harm the patient. On the other hand, omitting professional psychiatric intervention of indicated patient can cause his death (depression, suicidal tendency). The aim of this work consists in the analysis of community care for psychiatric patients within EMS compared to its potential and suggestions of possible ways in their alternative placing in the framework of labelling prevention. The attitude of EMS staff to psychiatric patients and their knowledge of community treatment were under observation. The students of a study course of Paramedic were chosen as a reference group. The thesis is based on quantitative study, via questionnaire technique. The potential of community treatment use within EMS is low but it exists. Respondent comments on the necessity of helpline teams which could assist relatives in case of sudden death (especially children) were inspiring. Some research outputs are surprising, e.g. hardly any negative attitude to psychiatric patients. Valuable asset of this work lies in the fact that all findings can be implemented into EMS and can also be used in further research into this problematics, e.g. how much the emergency dispatch uses helpline system or how often an ambulance crew contacts crisis centers.
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A client with non specific intestinal inflammations in community care
DOLEŽALOVÁ, Jana
Non specific intestinal inflammations, including Crohn´s disease and ulcerous colitis, belong to so called civilization diseases. Their cause is not completely clear. There is a common factor of both the diseases, that they attack mainly young people between 20 and 30 years of age. These diseases affect mainly physical, but also mental and social aspects of client´s lives. A client needs to have sufficient information on his/her disease and its treatment to be able to cooperate with medical staff actively and thus contribute to improvement of his/her health condition. A nurse plays an important role here as well. Nurse are those who are in permanent contact with a patient and patiens often ask them questions they would be embarrassed to ask a physician. Support of family and friends is also of great importace. Patient organizations that support and help patiens suffering from non specific intestine inflammations and also support their family members may also play an important role. The aim of the bachelor thesis is to find out how patiens with non specific intestine inflammations may benefit from patient associations, to find out how nurses participate in keeping the clients informed and to compile material for clients with non specific intestine inflammations. The qualitative research method was used in the practical part of the thesis. Data collection was performed by means of a semi-structured interwiew. The research sample consisted of selected clients with non specific intestine inflammations, members of IBD CROCODILE Club České Budějovice, participants of seminars of CroCus Patient Club České Budějovice and a civil association of patiens with idiopathic intestine inflammations in Prague. Case studies were elaborated upon interviews with the indiviual respondents. The case studies formed a base for categorization tables in which the most important research results were summarized. Apart from the set goals the research results showed problems the patiens and thein families have to cope with on daily basis. The disease has the most serious impact on their lives in the fields of nourishment, physical activities and travelling. The elaborated information material may be used in seminars of patient organizations, but also in classes at medical school. The research result might be published at specialized lectures and conferences.
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