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School achievement in pupils with phenylketonuria
NENADÁLOVÁ, Lucie
The diploma thesis called "School Achievement in Pupils with Phenylketonuria" tries to outline the lives of people who have to face up to a hereditary metabolic disorder - phenylketonuria, subjective and objective level of school success of these individuals. The theoretical part of this thesis offers the explanation of this term, introduces its diagnostics in general, the way of treatment, the specific diet and the impact of phenylketonuria on the development of individuals. Furthermore, the theoretical part describes the school achievement in pupils with phenylketonuria, the self-view of individuals with phenylketonuria and the quality of life of these people supported by the already conducted researches. The practical part of the thesis is devoted to the case studies of individuals suffering from phenylketonuria and emphasizes their school achievement, cognitive difficulties at higher levels of phenylalanine. More generally, it follows the level of acceptance of these people to the wider environment and tries to explain how the phenylketonuria has influenced their life. The aim of this work is to map the impact of phenylketonuria on the school achievement of respondents, their inclusion in the school team and the degree of influence on their life with phenylketonuria.
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The diet for phenylketonuria
CHYŠKOVÁ, Michaela
There is currently no known method to cure PKU completely. With a disorder and a special type of metabolism that accompanies this disease, the individual will meet his / her whole life. This is a specific genetic notation that makes a given diagnosis in humans. For PKU is an incurable metabolic disorder, it is necessary to follow a lifelong diet that will allow normal physical, intellectual and neurological development. It has been known for more than fifty years that diet must contain a low amount of phenylalanine, thereby significantly reduces the risk of brain damage in childhood when it develops vigorously. The diet is indicated by the attending physician in cooperation with the nutritional therapist according to the tolerance values of phenylalanine in the blood. Specific blood values are determined at regular intervals, and according to phenylalanine values, the dietary plan of the individual is subsequently adjusted to suit his / her requirements and does not pose any risk to his / her health. The aim of my bachelor thesis is to map the common diet of children's patients with phenylketonuria, where each child has a different tolerance value of phenylalanine. As a result, the diet must be individually adapted and assembled. At the same time, I will be interested in possible problems and limitations that the patient may encounter and in the impacts not only on the individual, but also on the family and surroundings in which the child lives and grows up. To elaborate the practical part of my bachelor thesis I have chosen a qualitative research method in which I focused on 3 respondents. Specifically, 3 children with phenylketonuria, in the presence and cooperation of their legal representatives. I conducted an unstructured interview with them in which I was looking for detailed information about the health of the children and their eating habits. Then, I evaluated the information obtained and described it. The bachelor thesis could serve as an information material for medical staff or patients who face this disease. I found out from the interviews that no mother was prepared to have a phenylketonuria offspring. For everybody it was a shock and a new life situation, and both the whole family and the children themselves had to and still have to somehow cope with it. There is a new life stage in life, where the proper nutrition of the child is being solved for the proper development. There is a very important dietary treatment and cooperation with doctors and nutritional therapists. Diet is more expensive because special phenylketonuric products are more expensive than commonly available foods, but must be followed systematically and best with lifelong delivery of medications. If the child eats as recommended by the doctor, the development is in order and the risks of health complications are minimized.
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The diet for phenylketonuria
CHYŠKOVÁ, Michaela
There is currently no known method to cure PKU completely. With a disorder and a special type of metabolism that accompanies this disease, the individual will meet his / her whole life. This is a specific genetic notation that makes a given diagnosis in humans. For PKU is an incurable metabolic disorder, it is necessary to follow a lifelong diet that will allow normal physical, intellectual and neurological development. It has been known for more than fifty years that diet must contain a low amount of phenylalanine, thereby significantly reduces the risk of brain damage in childhood when it develops vigorously. The diet is indicated by the attending physician in cooperation with the nutritional therapist according to the tolerance values of phenylalanine in the blood. Specific blood values are determined at regular intervals, and according to phenylalanine values, the dietary plan of the individual is subsequently adjusted to suit his / her requirements and does not pose any risk to his / her health. The aim of my bachelor thesis is to map the common diet of children's patients with phenylketonuria, where each child has a different tolerance value of phenylalanine. As a result, the diet must be individually adapted and assembled. At the same time, I will be interested in possible problems and limitations that the patient may encounter and in the impacts not only on the individual, but also on the family and surroundings in which the child lives and grows up. To elaborate the practical part of my bachelor thesis I have chosen a qualitative research method in which I focused on 3 respondents. Specifically, 3 children with phenylketonuria, in the presence and cooperation of their legal representatives. I conducted an unstructured interview with them in which I was looking for detailed information about the health of the children and their eating habits. Then, I evaluated the information obtained and described it. The bachelor thesis could serve as an information material for medical staff or patients who face this disease. I found out from the interviews that no mother was prepared to have a phenylketonuria offspring. For everybody it was a shock and a new life situation, and both the whole family and the children themselves had to and still have to somehow cope with it. There is a new life stage in life, where the proper nutrition of the child is being solved for the proper development. There is a very important dietary treatment and cooperation with doctors and nutritional therapists. Diet is more expensive because special phenylketonuric products are more expensive than commonly available foods, but must be followed systematically and best with lifelong delivery of medications. If the child eats as recommended by the doctor, the development is in order and the risks of health complications are minimized.
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Psychical problems of people suffering from phenylketonuria
NENADÁLOVÁ, Lucie
The bachelor thesis called "The psychical problems of people suffering from phenylketonuria" attempts to introduce the life of the people who were born with phenylketonuria diagnosis. The theoretical part of this thesis implies the explanation of the term phenylketonuria, diagnostics of this disease including treatment options. Furthermore, the theoretical part deals with psychical problems associated with phenylketonuria and its impact on education and family field. In the practical part there are examined the case studies of people who suffers from this metabolic defect. The thesis observes the quality of their lives, mentions eventual mental problems they have to cope with and describes their strategies of dealing with phenylketonuria. The aim of this thesis is to examine the impact of phenylketonuria on the psyche of the individuals and the strategies of coping with this metabolic defect.
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Phenylketonuria and the Life with the Disease.
JÁNSKÁ, Karin
Phenylketonuria is an autosomal hereditary metabolic disorder of amino acids caused by insufficient activity of liver enzyme phenylalanine hydroxylase, which is necessary for metabolism of the essential amino acid phenylalanine to tyrosine. Obligatory newborn screening aimed at detection of the disease before development of clinical symptoms was introduced in Czechoslovakia in 1975. Increased level of phenylalanine in blood leads to an irreversible damage of the nerve system, mental retardation. Phenylketonuria is an incurable, however treatable disease, where diet with low phenylalanine content is still the only treatment. As amino acids are the building units of proteins, patients have to take proteins in the form of amino-acid products without phenylalanine. Although high phenylalanine levels lead to irreversible damages it cannot be completely eliminated from nourishment as it is necessary for the growth and development of a human. Phenylketonuria prevalence is 1:5338 in the Czech Republic as of 2013. Patients with this disease have to be dispensarized for the whole life. Women that want to become pregnant should be much more careful in adherence to the diet as sudden increase of phenylalanine in mother's blood threatens healthy development of the foetus. The thesis named Phenylketonuria and the Life with the Disease is elaborated on theoretical base by scientific methods of explanation, modelling and induction. The aim of elaboration of this topic was to map the problems related to phenylketonuria, including nursing care and the life obstacles to patients with the diagnosis. Medicine journals, e.g. Československá pediatrie, Metabolík, Výživa a potraviny, Medicína a umění, where the latest findings based on recent studies are published, were another important source of information. After studying literature specialized in the topic our task was to provide important information. The present thesis is divided into four chapters. The first chapter provides basic information on phenylketonuria. We learn how the diagnosis is classified, what its nature is, the occurrence of phenylketonuria in individual countries is described here. It outlines the history, diagnostics and developing symptoms of untreated phenylketonuria. Lifelong diet with low phenylalanine content is the basic treatment, other treatment methods are still in the research phase. The second chapter focuses on the nursing care of a patient with phenylketonuria, it outlines the role of a nurse in the care of hospitalized patients. The problems of anaesthesia are also marginally mentioned here. We can find a list of metabolomic workplaces specialized in the care of these patients in the Czech Republic. Deficits linked to adherence to low protein diet are also mentioned. The third chapter deals with diet for patients with phenylketonuria at various life stages. The last chapter describes the economic-ethical problem and current contributions of health insurers to diet products. The assigned bachelor thesis might serve as informational material in practice, as it is suitable for all those interested in the issue. If the assigned bachelor thesis outlined the nature of phenylketonuria and an individual founds answers to his/her questions there, the thesis would meet its purpose. More than eighty years have passed since the explanation of the phenylketonuria nature. Diagnostics methods have developed from the napkin test with ferric chloride to newborn screening where a blood drop is taken from new-born baby's heal on a filter paper and the phenylalanine level is consequently evaluated in a laboratory. The treatment principle however remains the same, namely consistent adherence on low protein diet to reach the optimum phenylalanine concentration in patient's blood.
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