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Management of the patient´s role conflict exploiting C. Roy nursing care model
PLZENSKÁ, Dagmar
Management of the Patient´s Role Conflict Exploiting C. Roy Nursing Care Model Any change in health state of a man, who represents a holistic unit, is a stresful situation, to which he/she has to respond to accommodation changes. An irreversible change becomes a stigma for an individual. It changes or affects his actual way of life and often leads to changes in value scale of personality and may end in a role conflict. A nurse´s role becomes irreplaceable because she is the person who gives direction to nursing care, works with instigations, support them or suppress them. Ideal care should complete an idea of individual attitude to a patient to support and make the adaptation easy to his full-value and satisfied life. My diploma work is intented on using the C. Roy Nursing Care Model, on an adequate adaptation achievement of a client, on prevention of a role conflict. In the theoretic part we write about personality problems interaction and problems of setting during the role implementation influenced by irreversible changes. We studied the C. Roy model and its importace when it is used in a prevention of a role conflict with clients with irreversible changes. In the practical part we made up nursing documentation according to the C. Roy and asked nurses´ opinions because they worked with the documentation. Next we concentrated on nursing diagnoses evaluation of patients with irreversible changes in adaptation systems: self {--} concept, self confidence, role playing and interdependence. Then we concentrated on improving the quality of an adaptation level and clients´ satisfaction. The goals of the work: 1. Using the C. Roy Nursing Care Model for prevention of a role conflict in clients with irreversible changes- in a primary, secondary and tertiary role sphere. 2. To evaluate client´s roles before his affection. 3. To find out client´s adaptation level. We conducted a quasiexperiment and interview in the Regional Hospital Příbram and the Hořovice Hospital. We asked 10 clients. The goals of our work were achieved. We hope that our work may help to increase quality of nursing care given to clients with irreversible changes.
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Promotion of self-sufficiency in patients with rheumatoid arthritis in selected daily activities at the home environment
TÜRKOVÁ, Věra
Promotion of self-sufficiency in patients with rheumatoid arthritis in selected daily activities at the home environment The topic of my bachelor thesis is promotion of self-sufficiency in patients with rheumatoid arthritis. Rheumatoid arthritis is a chronic inflammatory autoimmune disease the main symptom of which is damage of mainly small joints, muscles, ligaments, but it may also manifest itself in internal organs of the body. This leads to significant motion limitation and thus greatly deteriorates the quality of life and self-sufficiency of affected people. Since it is women who suffer from this disease most, we concentrated on the area of cooking, eating and personal hygiene. The role of nurses is to lead patients to self-sufficiency. There are more possibilities how to provide the patients with limited self-sufficiency with support, but the thesis is focused on the aids to promote self-sufficiency in cooking, eating and personal hygiene. To carry out the research survey we stated six goals. The first goal was to find out what aids to promote self-sufficiency the patients with rheumatoid arthritis have at their disposition for cooking food and eating. The second objective was to determine what aids to promote self-sufficiency the patients with rheumatoid arthritis have at their disposition in the area of personal hygiene. The third objective was to determine what aids to promote self-sufficiency the patients with rheumatoid arthritis miss in the area of cooking and eating. The fourth goal was to find out what aids to promote self-sufficiency the patients with rheumatoid arthritis miss in the area of personal hygiene. The fifth objective was to create a brochure to promote self-sufficiency of patients with rheumatoid arthritis in cooking, eating and personal hygiene. The sixth goal was to apply the booklet on patients with rheumatoid arthritis. The goals of the thesis were met. At the turn of February and March 2011 the qualitative research survey was conducted. For data collection the method of questioning, the non-standardized interview technique was used. Using pre-prepared questions we interviewed the respondents with rheumatoid arthritis who are treated on an outpatient basis. Based on information and available aids mapping, a booklet to promote self-sufficiency in patients with rheumatoid arthritis was created and subsequently tested. The research group consisted of six respondents suffering from rheumatoid arthritis. The respondents were selected according to predetermined criteria, which were the suffering from rheumatoid arthritis, disease stages II., III., IV, when self-sufficiency is strongly influenced and monocyclic, polycyclic and progressive course of rheumatoid arthritis is present. The research sample for an inquiry was selected by the same criteria, and it consisted of 10 respondents. The thesis revealed which specific aids are available to patients with rheumatoid arthritis and which are missing. Based on obtained information and the aids mapped, a booklet to promote self-sufficiency of patients with rheumatoid arthritis in the area of cooking, eating and personal hygiene was created. We believe that steps to improve self-sufficiency in patients with rheumatoid arthritis in the areas of cooking, eating and personal hygiene at home environment involve the booklet provision to outpatient and inpatient departments of rheumatology. To address the widest possible population of rheumatics with damaged self-sufficiency and on the basis of positive responses to the booklet, we accepted the offer to publish a series article about promotion of self-sufficiency in patients with rheumatoid arthritis in the magazine ?REVMATIK?. In our opinion, positive contribution could also be organization of an information seminar on aids to promote self-sufficiency for patients and nurses in rheumatology units and for members of the Rheumatism - league and students of ZSF.
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Multiple sclerosis and its influence on an individual and his surroundings
HRUBÁ, Ludmila
In this bachelor thesis I focused on the problem of the multiple sclerosis. It is an autoimmune neurological disorder manifesting itself by an emergence of inflammatory foci in the white matter of the brain and spinal cord, which destroys a container of nerve fibres so called myelin. The nerve fibre undresses and a neurotransmission slows down. Scars remain in the place of the myelin damage. An onset of the disease is usually between 20 and 40 years. At present, in the Czech Republic there are approximately 15 000 people with multiple sclerosis, 60% of them are women and 40% are men. The thesis consists of a theoretical and a practical part. In the theoretical part I focused on the current state of the problem. In individual chapters I present for example a history, a theory of the emergence or a communication with people with this disability. The theoretical part should provide basic information about multiple sclerosis. The practical part consists of a methodology I used for gathering information for the research and an evaluation of results. The information was collected by a technique of a qualitative research, a method of a semi-structured interview. Experimental samples were two. The first one was compound of people who have multiple sclerosis, the second one were close people, i.e. friends, family members. I conducted the research with clients from St. Joseph´s Home in Žireč, with clients of MS Centre in České Budějovice and with my close people and friends. Results of the research are presented in the section Results and Discussion. An aim of this thesis was to determine the influence of multiple sclerosis on an individual and his surroundings and to familiarize the people with the disease and the problems which this disorder can bring. During my research I focused on issues of housing, employment, culture life and an awareness of this problem.
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The issue of nursing care of patients after thyroid gland operation
MARŠÁLKOVÁ, Pavla
The developed countries, our Republic not excluded, have a relatively high incidence of thyroid diseases (5 % to 30 % of population). Females develop the diseases five times oftener than males, mostly in their middle or higher age. The thyroid diseases are curable, but they require that proper diagnostics is applied, effective treatment administered by a professional team, and the patients behave responsibly. A nurse at a Surgery Department has to stand ready to cater instantaneously to the needs of patients awaiting the surgery; to properly handle any possible complications; to provide the after-surgery care; and to take care of what is required for the recovery. In providing the nursing aftercare to the thyroid surgery patients, the nurses serving at the Surgical Department were found to act purposefully and prevent possible complications; they were ready to respond to the already developed complications as may accompany the thyroid diseases. The research questions have been answered. Patients having undergone the thyroid surgery and hospitalized at the Surgery Department were found satisfied with both the overall approach of the nursing staff and the nursing care provided immediately after the surgery. Hypothesis 1: "Patients having undergone thyroid surgery and hospitalized at the Surgery Department are satisfied with the nursing care" have been confirmed.
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Deficit of nurse - educator in nursing profession or patients after amputation of lower limb.
BLAFKOVÁ, Šárka
My thesis deals with the deficit of educating nurses who serve post-amputation patients in nursing practice. Five goals were defined in the thesis. Some of them deal with post-amputation care of the patient and others with post-amputation education of the patient in nursing practice. Goal 1: To map nursing care of the amputation stump from a nurse's perspective. Goal 2: To find out whether nurses educate the patient after leg amputation according to the education plan. Goal 3: To find out whether obstacles exist preventing nurses from educating the patient after leg amputation. Goal 4: To find out the most common post-amputation problems according to patients. Goal 5: To find out how patients view the post-amputation education. All goals were met. Hypotheses and research questions were also defined. Three hypotheses were defined. Hypothesis 1: When caring for the patient after leg amputation, nurses adhere to the rules for amputation stump nursing - Confirmed. Hypothesis 2: When educating the patient after leg amputation, nurses utilize the education plan {--} Confirmed. Hypothesis 3: When educating the patient after leg amputation, the most common obstacle stated by nurses is a time deficit {--} Not confirmed. Three research questions were defined as well. Research question 1: What are the common post-amputation problems according to patients? Answer 1: The most common problems according to patients are movement and learning to walk. Research question 2: When do post-amputation patients require the assistance of nurses? Answer 2: Post-amputation patients require nurse assistance during physical activities, mainly during movement. Research question 3: Do patients view the post-amputation education as a benefit? Answer 3: Patients view the post-amputation education as a benefit. The benefit consists in being taught certain activities or having them explained. The result of this thesis is an education plan specifically tailored for patients after a leg amputation. It describes the individual educational steps for post-amputation patients.
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Parenteral nutrition in nursing care
KIŠŠOVÁ, Katarína
Parenteral nutrition is a method whereby all necessary nutritional elements are supplied to patients most often directly into the bloodstream, bypassing the digestive tract. Parenteral nutrition, though, represent a non-physiological route for the supply of all essential elements. It is a method that benefits patients and improves their nutritional status at a time when they are unable to use their digestive tract. Nonetheless, parenteral nutrition is not the best option for patients. It involves a number of disadvantages and complications. The nurse plays a fundamental role in patient nutrition. She should thus have the necessary knowledge regarding patient nutrition. She should keep in mind that by administering parenteral nutrition she is ensuring that the patient receives an adequate caloric and nutritional intake at a time when he/she cannot use his/her digestive tract. Quantitative research with the aid of questionnaires was used to expound the bachelor degree work entitled ``Parenteral nutrition in nursing care{\crq}q. The anonymous standardized questionnaire technique was used to collect data. The questionnaires were distributed to nurses working in standard and intensive care wards in the Czech and Slovak Republics. Two goals were set. The first was to determine the degree of adherence to all the principles of preparation and administration by nurses in the Czech and Slovak Republics. The second goal was to chart the issue of parenteral nutrition in nursing care in the Czech and Slovak Republics. Five hypotheses were thus set out on the basis of these two goals, which were both met. Of these, four hypotheses were confirmed and one was disproved. The first hypothesis assessed whether nurses in the Czech Republic have greater experience with the administration of parenteral nutrition compared to nurses in the Slovak Republic. Based on the results of the questionnaire-based investigation, this hypothesis was confirmed. The second hypothesis assessed whether the nurse knows how to prepare all-in-one parenteral nutrition. Although the results of the questionnaire-based investigation were not always satisfactory, this hypothesis was confirmed. Most nurses do know how to prepare all-in-one parenteral nutrition. The third hypothesis assessed whether nurses adhere to all the principles of parenteral nutrition administration. Despite certain errors in the principles of parenteral nutrition administration, this hypothesis was confirmed. The fourth hypothesis assessed whether nurses prefer administering parenteral nutrition to administering enteral nutrition. This fourth hypothesis was also confirmed on the basis of the investigation results. The fifth hypothesis - ´a greater number of nurses appreciates the positive rather than the negative aspects when administering parenteral nutrition´ - was not confirmed. Processing of the questionnaires showed that nurses are more aware of the negative rather than the positive aspects when administering parenteral nutrition. Although most nurses often do not know what is a positive and what is a negative aspects when administering parenteral nutrition to patients. The Head Nurse of Motol Teaching Hospital has requested that we provide her with the research results. These results will also be sent to the head nurses of two teaching hospitals in the Slovak Republic. It will be possible to use the results of this research to further the quality of nursing care.
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Preparing and administering medicaments by hand or by an instrument
ŠEBENDOVÁ, Jana
I found out in this thesis the way nurses handle medicaments. What preparing and administering medicaments is like, and whether they prefer their own hands or an instrument in their work. This subject started to attract me for the reasons of an untraditional view of nurses{\crq} everyday work because they get in contact with preparing and administering medicaments several times a day. It was also interesting to compare the theoretical part with the practical aspects of the matter. In the theoretical part I outlined the entire knowledge nurses are to have not to endanger themselves or the patients in the course of handling medicaments. Nurses have to know the terminology related to medicaments, further what forms of medicaments there are, what effects may be expected, they are also supposed to know the manner of the application of medicaments, the manner of preparing and administering medicaments, what mistakes nurses may meet with when working with medicaments and what roles nurses have when administering medicaments. I am focusing especially on administering medicaments orally. The objectives of my thesis was to survey in what way nurses conduct hand hygiene before preparing and administering medicaments, whether they use aids intended for handling medicaments, in what way medicaments are prepared and administered to patients. To obtain results, I used the qualitative research. In total, 2 techniques were used. The first technique was hidden observation based on an observation list prepared beforehand, with activities connected with the subject in question. This observation was completed with a second technique {--} a structured conversation with open questions. Both the observation and the structured conversation were conducted in the intern section of the České Budějovice Hospital, a.s. The results may be given to the management of the hospital in which the research was conducted. They may also serve as a basis for a new standardisation of the subject in question.
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Problems of treating of sicks with the compartment syndrom on crus injuries
WICHTOVÁ, Zdeňka
Compartment syndrome is a syndrome of clinical signs that arise due to the increased blood pressure within a confined space. For some time, this pressure increase is balanced by the flexibility of fascia. But when the mechanism becomes exhausted, the development of ischemia occurs and the compartment syndrome turns up. The treatment is aimed at saving the extremity and the patient. The role of a nurse is to closely observe the patient´s overall condition and clinical symptoms of the compartment syndrome, to carry out auxiliary examinations, to assist in taking the intrafascial pressure in the affected part of the body and to take part in the demanding treatment of the complication. A nurse is in a constant contact with the patient, provides him/her with education and support and notifies the doctor of all alterations in the patient´s condition. The objective of the thesis was to learn if nurses are informed enough on the causation of the compartment syndrome on the crus injury. The other objective was to find out if nurses are familiar with the specifics of the care for patients with the compartment syndrome on the crus injury. Three hypotheses were stated: H I: Nurses have knowledge of causes of the compartment syndrome on the crus injury. This hypothesis was confirmed. H II: Nurses are not able to recognize the onset of the compartment syndrome on the crus injury on due time. This hypothesis was rejected. H III: Nurses have knowledge of specifics of the nursing care in patients with the compartment syndrome on the crus injury. The research was conducted by the quantitative method. The data necessary to achieve the objectives were gathered by the questionnaire method. The research was anonymous and it was voluntary to fill in the questionnaires. The research was conducted in the České Budějovice hospital in the Orthopaedic unit and in the Department of Accident and Plastic Surgery. The findings of the research may be useful to medical staff members in practice or in workshops.
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Helping hand in crossing over
LASCHOVÁ, Daniela
The thesis deals with palliative and hospice care. The thesis is divided into two parts - theoretical and practical. In the theoretical part there are provided with basic information about palliative care, it describes aspects of palliative care in terms of spiritual, social, psychological and physical. There are also recorded information on facilities that provide palliative care, their characteristic, mission and goals. The thesis is also reported on problems of dying, suffering and death. The work also records a pastoral and social care about dying seniors, a description of a multidisciplinary team of hospice care. The practikal part of the thesis is reported on a detection rate of awareness of palliative and hospice care at the clients of caritas Týn nad Vltavou. Next the research found out the respondents opinion of dignified dying in a domestic care
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Comparison of paliative care by clients in hospice establishment and oncology department
KADLECOVÁ, Ivana
Comparison of palliative care for patients in a hospice and at an oncology ward This thesis was focused on the various aspects of palliative care for oncological patients. Palliative care and its principles have been defined and it seems crucial to apply these principles not only in hospices but also at hospital wards where there are patients indicated for palliative care. The objective of this thesis was to find out whether the care provided to hospice clients and to dying patients at hospital oncological wards corresponds to the methods and procedures defined for palliative care and to find out whether there are any significant differences between the nursing care provided to the dying in a hospice and the dying at an oncology hospital ward. Four survey questions were formulated and the question dealt with maintaining palliative care standards, differences in providing palliative nursing care for the dying at the individual institutions, whether the dying clients{\crq} needs are answered in a holistic and humane way, and the nurses{\crq} approach to the dying at the individual institutions. The carried out research is a qualitative one. The research part {--} data collection {--} was carried out in the form of uncontrolled interviews with selected members of nursing teams in a hospice and at an oncology ward. Observations and case reports were used in case of several patients in at the individual institutions. The research was carried out in St Stephen Hospice in Litoměřice and at the oncology ward of an undisclosed health care institution by which information was provided in exchange for absolute anonymity. The research part resulted in the finding that the palliative care provided in the hospice corresponds to the methods and procedures defined for palliative care. There are efforts at the oncology ward to provide as perfect care for their dying patients as possible but this care does not correspond to the methods and procedures defined for palliative care. There are problems in providing palliative care especially in inadequate spatial conditions, equipment, shortages, high workloads, and strictly specialized focus of the personnel and these clients need very individual care that cannot be frequently provided under everyday operating conditions at a standard ward that concentrates primarily on curative care. The results of this thesis will be provided to those who may be interested in the various aspects of palliative care.
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