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The use of lymph drainage in patients with lymphedema
DĚKANOVÁ, Klára
For my bachelor thesis I chose the theme ?Utilisation of the lymph drainage at patients with lymphedema?. In the Czech Republic the lymph drainage is a relatively new method which is used in medical facilities only since the year 1992. Efforts to introduce this method in the area of the Czech Republic came already before, since the seventies of the 20th century this problems was dealt by MUDr. Miroslav Bechyně CSc. Thanks to him in 1992 the first course of manual lymph drainage was realised in the Czech Republic. In the same year MUDr. Bechyně contributed to the foundation of the League against swelling and he made a motion to the birth of the Czech society of lymphology. The aim of my thesis was to acquaint patients with the possibilities of the use of the lymph drainage in the health care, to find out to which extent it is possible to influence the lymphedema and above all how this method affects the global state of patients. In the theoretical part of the bachelor thesis I summarized the findings dealing with this problems. I engaged myself in the history of lymph drainage and in the research of the lymph system in the world and in our country. In my thesis I defined the notion of lymphedema and I sorted it according to its origin into primary and secondary. Next in the thesis I present the diagnosis of lymphedema and the possibilities of his conservative and chirurgical treatment. Among possibilities how to treat the lymphedema I chose in particular manual and instrumental lymph drainage. I present also indications and contraindications of the lymph drainages. In the thesis I dealt as well with the use of lymph taping. This method is more and more popular at patients with the chronical lymphedema. The application of the lymph tape has many advantages, for example it does not limit patients in move. In the last chapter of the theoretical part I dealt with possibilities of the spa treatment at patients with lymphedema. The practical part of my thesis was realised by the qualitative research strategy and the results were treated by the form of case interpretations. The research sample was constituted by four probands who had the diagnosis of lymphedema and whose therapy took place in the rehabilitation department of the health centre Poliklinika Jih MEDIPONT s.r.o. in České Budějovice. The sample was chosen from clients with various kinds of lymphedema who were willing to cooperate on my bachelor thesis. The chosen sample was constituted by one client with primary lymphedema and three clients with secondary lymphedema. Clients with the secondary lymphedema had diagnoses venous insufficiency, postoperative and post-traumatic lymphedema. All probands underwent 10 therapies of the manual and instrumental lymph drainage. At the beginning and at the end of the therapy the lower limb circumferences were measured. With the patient´s consent I have used their health documentation, I have elaborated their detailed anamnesis and I have realised a structured dialogue with all probands. The dialogue contained both closed-ended and open-ended questions in order to chart proband´s health state and the contribution of the implemented therapy. After the end of the therapy the probands had possibility to express their subjective opinions on the undergone treatment. All probands found out lymph drainage as a very pleasant procedure. Three of four probands have noticed improvement of their health state and a visible swelling reduction. At the fourth patient, who was treated with the lymphedema caused by the venous insufficiency the improvement did not take place yet. But this patient says that she did not observe regime measures. The doctor proposed to the patient to continue with the treatment. The results of my bachelor thesis may be used by other physiotherapists for the needs of education or for a further research.
The Subjective Evaluation of a Patient´s Overall Health State at the End of the Reduction Phase of Lymphedema Treatment
PLACATKOVÁ, Petra
The graduation thesis is focused on Lymphedema patientś problems. It addresses how the patient values his or her own health state. The differences between a patientś health state before therapy and after finishing its reduction phase have been compared. The following aspect have been valued: limited movement, pain and mental stress. All of them were improved after the reduction phase. Thus Hypothesis 1 has been confirmed: "At the end of the Reduction Phase of Lymphedema therapy the overal health state of the patient is improved." Out of above meditioned three aspect, the mental stress improved at a lowest rate. Differences between patients with and without good social background were demonstrated. Patients with bad social background valued mental stress caused by Lymphedema before and after the therapy as significantly higher then patients with good social background. Thus Hypothesis 2 was also confirmed: "Patients with good social background cope with their disease in a better way." In order to test the hypotheses the quantitative research was done. The technique was standardised integration.

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