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Nursing care about patient in terminal stage at the ward follow-up and in Hospic.
PETROVICOVÁ, Eva
The bachelor thesis called "Nursing care of the patient in the terminal stage at the aftercare department and at a hospice" deals with the issue of nursing care for patients in the terminal stage at the aftercare department (AD) and at the hospice. Caring of a dying person is still a current topic, since each one will die and before the inevitable moment occurs, we will wish that it happens with dignity. The aim of the work was to examine the differences in nursing care and meeting the needs of patients in the terminal stage at the AD and in a hospice. To prepare the thesis, a qualitative research with the help of unstructured interviews with general nurses and patients in the terminal stage, who only complemented for less strain information from nurses. The talks took place in Strakonice Hospital and The Hospice of St. John Neumann of Nepomuk in Prachatice. Research file was made up of three general sisters and three patients from the aftercare department and three general sisters and three patients from the hospice. Patients with whom the interviews were conducted at the aftercare department were familiar with their own diagnosis, so the interview could be more open. Patients at the hospice were acquainted with their own diagnosis as well. Afterwards, the records have been processed into categories according to the research questions. The results show that among these facilities there are a lot of differences in the provision of nursing care and meeting the needs of patients in the terminal stage. The first research question related to the differences in nursing care of patients in the terminal stage. This area showed the differences in the current day mode, especially in times of waking of the patients, hygiene and breakfast. In addition, a difference in the area of food and fluid intake appeared. The second question dealt with ways how to control pain at the patients in the terminal stage. At the hospice, prevention from pain is at first place. Either with the help of analgesics, opiates or dispensers. From the conversations with nurses and patients from the AD there is an apparent lack of control of pain. The third question touched the issue of communication of nurses with patients in the terminal stage. From conversations with patients (AD and hospice) the feeling of a lack of communication arises. Nurses stop at the patients and talk, but some of the patients would welcome more opportunities to have a conversation. At the hospice, the presence of the nurse attendants or nuns is of benefit to patients. The fourth question related to the psycho-social needs. These needs, including the spiritual one, are fully provided at the hospice. The patients mentioned the students help, mass celebration or volunteers who fill a day. This fact is presented in contrast to the AD, in which patients can fill a day only with the visits that are allowed continually at both facilities. Spiritual care is adequately provided there as well. The fifth question dealt with communications of staff with relatives of the patients. At both institutions this occurs frequently. The nurses involved the family in the care of the patient and talks about the family as important. They highlight the need to know the patient's background and home. The final question discussed how they farewell the deceased. At the AD it occurs in a hospital room, whereas at the hospice with more dignity in a farewell room, which is decorated. The deceased is dressed in festive clothes that nurses request from the family before the death. The bereaved are also supported afterwards by the hospice staff through meetings or by sending cards. This bachelor thesis could serve as a learning resource for students with the major of General Nurse, but also for the general public or as a guide to those who care of their relatives in the future. I believe that knowledge of the bio-psycho-social and spiritual needs is an essential part of the comprehensive care about the dying.
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