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Positioning and application of orthoses in patients after acute brain damage
Barborková, Marie ; Dlouhá Maršálková, Alexandra (advisor) ; Angerová, Yvona (referee)
OF THE BACHELOR'S THESIS Author: Marie Barborková Supervisor: MUDr. Alexandra Dlouhá Maršálková Opponent: Title of bachelor's thesis: Positioning and application of orthoses in patients after acute brain damage. Abstract: The thesis is dealing with positioning and application of orthoses to patients after a brain damage, especially to those recovering from a stroke. The first part of the thesis is theoretical and is based on literature research and supported by foreign case studies. The general information about stroke and motor neurone syndrome is defined there together with information on positioning of a hemiparetic patient after a stroke and applying orthoses to prevent contractures, their treatment and effect on spasticity. The practical part of the thesis includes a study case of a patient who used the splint at night to hold the ankle in a neutral position. Using the theoretical information the practical part observes the effect of using the splint on spasticity and passive range of motion of the foot in dorsiflexion. The aim of the theoretical part is to review the knowledge about positioning and use of orthoses and splints for patients after a stroke, mainly oriented on prevention of contractures. The goal of the practical part is to compare the theoretical knowledge and gained information...
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Issues of nursing care in prevention of contractures of immobile persons
KULAJEC, Lilija
Contractures as one of the physical symptoms of immobilization syndrome influence further components of a personality and the life quality. This is why prevention of the occurrence of contractures is one of the roles of a nurse. She does it by means of the rehabilitation treatment elements, i.e. positioning, mobilization, verticalization, in cooperation with a multidisciplinary team. The aim of the thesis was to examine to what extent nurses are informed on contractures in immobile persons and to learn about the role of a nurse in prevention of contractures in immobile persons and to examine the level of cooperation between a nurse and a physiotherapist on the prevention of contractures in immobile persons. To meet the goals, we chose qualitative research in the form of semi structured interviews with nurses and physiotherapists. We analysed the results by means of open coding, the pencil and paper method. The results processed this way were categorized. They have shown that the questioned nurses consider their theoretical knowledge and practical skills in prevention of contractures sufficient and they mainly achieved them through the practice. Nevertheless, some unclear points that might affect the provided care appear in some replies. The results indicate that insufficient attention is paid to contractions by the interviewed nurses. They particularly prevent them by positioning, but mobilization and verticalization stand aside. Some of the respondents add the elements of the basal stimulation. The questioned nurses except others cooperate with a physiotherapist, which leads to overleaping of their functions, particularly in positioning and verticalization. The work has revealed insufficient orientation of the nursing care to the prevention of the occurrence of contractions among the questioned nurses. This finding as well as the other results of the research might be used as an input for a seminar tailored to this topic.
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Comparison of chosen nursing in prevention of immobility syndrome in a senior nursing home in Germany and the Czech Republic for lying immobile patients.
ČERNÁ, Lucie
As the population is getting older there is increased number of geriatric patients. However there is also increased number of immobile seniors, who are not able to take care of themselves. Comprehensive health and social security is being provided in homes for elderly, which fulfil the role of long-term institutional care. Nurses must be trained for this highly professional and knowledgeable nursing care aimed at geriatric problems. For geriatric clients of home for elderly it´s important realization of prevention, treatment and social measures in the form of an individual approach. That these measures can be implemented it is necessary to evaluate the health status of seniors, their physical performance, self-sufficiency and mental functions in connection with the social situation and to formulate a nursing diagnosis. As a result of long-term bed rest can lead to health complications affecting all body systems, so-called immobilization syndrome. How to prevent secondary damage that threatens the patients White Theo arge already ill is focused rehabilitation nursing. Among rehabilitation resources in the prevention of immobilization syndrome in nursing practice arge included: positioning, verticalization, mobilization. Inseparable part of prevention measures is preventing health complications in case of immobile clients homes for the elderly arge suitably selected positioning aids, mobilizing resources, well-equipped bed with antidekubitus system. In the thesis there were two objectives. To Compare keeping preventive measures which prevent the formation of pressure ulcers and muscle contractures in nursing care for immobile patients in the Czech and German retirement homes. To map out the possibilities of aids in the prevention of complications in immobile clients in the Czech and German retirement homes. Bachelor thesis has been made by using qualitative research. For collection of data was used a method in-depth interviews with four Czech and four German nurses. This method involved non-standardized interviews through open-ended questions that were recorded by dictaphone and transcribed verbatim. The data analysis was carried out by hand coding or using a pencil and paper. By analyzing the data four categories were created, each divided into the home for the elderly in the Czech Republic and the home for the elderly in Germany: 1.Nurses knowledge ,2.Implementation of preventive measures , 3.Equipment for immobile clients, 4.General knowledge related to immobile clients. Research survey found out that there is not a big difference in adherence to preventive measures to prevent the formation of decubitus and muscle contractures in nursing care for immobile patients in Czech and German homes for the elderly and comparable are also the possibilities of using tools to prevent complications in case of immobile clients. The biggest gap in nursing care for clients is bad knowledge of contractures in both homes for the elderly. Also keeping documentation and records relevant to the implementation of preventive measures in the Czech home for the elderly is not satisfactory. Mobilization record is missing and positioning record should be more detailed. We therefore propose the creation of positioning and mobilization recording modeled according to the German retirement home and handing it to the leadership of retirement home in the Czech.
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