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Patients with implanted cardioverter defibrillators
HEŘMANSKÁ, Marie
This Bachelor Thesis deals with the issue of implantable cardioverter defibrillator usage, namely with the impact of implantable cardioverter defibrillator on patient life and the details of nursing care in scope of implantation of these devices. The implantable cardioverter defibrillator (hereinafter referred as to "ICD") enables to prevent or avert heart failure which affects approximately 2 % of population. Nearly 3/4 of cases of sudden death take place at home and 2/3 of these cases are witnessed by other person. Indications for the ICD implantation are severe malignant ventricular tachycardia (ventricular tachycardia, fibrillation and chamber flutter) which rapidly lead to the circulation failure, unconsciousness and, finally, death. The rapid termination of such arrhythmias by ICD saves the life of its holder. The diagnostics shall commence by the standard electrocardiogram (ECG). The field study of the Bachelor Thesis includes results of the qualitative research based on the semi structured interview. The research group contained thirteen patients with implantable cardioverter defibrillator, residing in Středočeský kraj (Central Bohemia Region) and Jihočeský kraj (South Bohemia Region), who have had their ICD at least for a year. All respondents were asked ten basic questions as a part of the interview. The interviews were recorded over voice recorder and subsequently were directly transcribed to text. The interviews were processed while using the open coding, paper and pencil method. The data analysis produced five categories: Difficulties before the implementation of ICD, Changes in lifestyle after the implementation of ICD (with subcategories of Life certainties, Common activities, Employment, Driving and State of mind), Defibrillator shock, Nursing care and Importance of ICD for patients. The research shows that patients are predominantly satisfied with the nursing care. Nearly all respondents do not feel the need for increased nursing care while being in hospital. Patients greatly appreciated the wound care all respondents were satisfied with this precise type of care as no complications did occur while healing and the wounds healed per primam. I see imperfections in the patient education although ten patients state that they were duly informed, they were informed only by their doctor. Only one patient states that he was given "certain" information from the nurse. However, these results may be misrepresented by patients due to the time lapse (from the hospitalization). Furthermore, the research shows that ICD device does not influence common activities of majority of respondents. Nearly all respondents experience mental relief and the improvement of life quality. The respondents do not consider the restriction connected to the ICD usage to be negative. The majority of them try to observe given advices (in scope of driving, travelling, magnetic security systems, etc.) which do not restrict them in their common life significantly. Even though their disease is severe and endangers their life, the patients with these devices may travel abroad, do sports, work and live their normal life with less risk of sudden heart failure. Twelve respondents out of thirteen consider the ICD to be of great significance to their life. The outcome of this Bachelor Thesis is the Guide for ICD Patients.
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Patient's Informed Consent, Medicine Doctors' Responsibility, Patient's Protection
Hronová, Marie ; Hejda, Jan (advisor) ; Skalická, Pavlína (referee)
ABSTRACT Patient's Informed Consent, Medicine Doctors' Responsibility, Patient's Protection This diploma thesis analysis the informed consent of patient, which is manifestation of the patient's right to decide about his own health freely. The main aim is to describe what laws is the informed consent based on, what it should contain, in which situations the doctor is allowed to act without the consent and what the consequences of acting without consent, in cases, in which the informed consent is required by law, are. Further problems, which are not adequately treated by the law, are also mentioned, and the obtaining of the informed consent in children and the informed consent in practice were described. It was found out, that registration of complaints should be kept by each medical facility separately in the Czech Republic. Except that, the complaints department is established at each regional office. Czech laws do not impose to register complaints or claims in national unified register. Number of complaints between 2008-2010 were obtained from the Czech Medical Chamber, Control Department of the Ministry of Health, Medical Department of Regional Office and from Prague City Hall. It can be stated, based on the study of all related resources and after comparing of the recquired information with the reality, that even if all regulations are abided, it is impossible for the doctor to inform patient about all risks and possible complications to avoid the complaints completely. The questionnaire survey shows, that the legal awareness of doctors in the issue of informed consent is inadequate and it is important to improve it.
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Mobbing in the Health Workplace
Bloščicová, Zuzana ; Hiršová, Miloslava (advisor) ; Syrovátka, Oldřich (referee)
This thesis focuses on the presence of mobbing and its forms in a chosen health care facility, its aim is to prove awareness of this phenomenon by the superiors and their knowledge about solution techniques. The goal of this thesis is to find out the influence of mobbing on the atmosphere at a working place (efficiency), eventually if its presence is observed by patients.
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Problematics of General Nurses in Health Service
BABKA, Jakub
Currently, nursing is mostly taken as a profession for women with the title generel nurse. According to the Law of the Ministry of Health of the Czech Republic Nr. 96/2004 Sb. Is the man who successfully completed degree course nurse, would be called a general attendant. Therefore was for processing selected work entitled Problems of general nursing in health care. In the theoretical part of it is elaborated in detail their involvement in the care of patients from past to present. Next, there are mentioned competence of general attendant in the theoretical part, nursing as an independent science and syndrome of burnout. The aim of the work was to determine patients satisfaction with general attendant, to determine which departments give priority general nurses and identify problems of general attendants. Based on it, they were established four hypotheses and one research question. H I: General attendants better handle physically demanding work than the nurses. H II: Patients give priority general attendants to general nurses in wards for male patients. H III: General attendants in urgent wards more often then in the standard wards work. H IV: Patients perceive positively general attendants in the hospital. Research question: What problems have general attendants? Investigation was carried out by means of questionnaires and interviews. Questionnaires were addressed to patients, in the wards where general attendants work, in hospital in Písek, Prachatice, České Budějovice and Český Krumlov. Interview were made with 11 general attendants working in different wards of chosen hospitals. The questionnaire showed results that the general attendants better handle physically demanding work in a hospital and he is perceived positively. It follows that the hypothesis number 1 and 4 were confirmed. Interviews with general attendants pointed out that the general nurse works on the department of emergency care more frequently that on the standard wards. This confirms our hypothesis H3. It is obvious that the biggest problem is the designation of men in the field of general nurse as a general nurse. This designation is considered degrading. Other problems include dissatisfaction with the financial rewards and administration. We can draw following conlusions and hypotheses: 1) The biggest perceived problem is a general indication of the nursing profession, 2) general attendants are dissatisfied with their financial rewards; 3) General administrative work abstains general attendants of exercise of their profession. Work should help in resolution and answer of problem of general attendants, open wider and fruitful discussion. If it is possible.
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Possibilities of regulation of economical subjects behavior on health care market
Valtr, Jan ; Maaytová, Alena (advisor) ; Maaytová, Alena (referee)
The bachelors theses deals with settings of the health care financing. It explains reasons for government interventions to the health care market, describes possible models of health care system, defines economical subjects of health care market and analyses possibilities how to regulate their economical behavior. The healt care system is affected mainly by interests groups, who push their particular aims at the expense of others. By asserting their interests they affect other subjects of health care market as well as the entire health care system. It is impossilbe to choose the exactly correct settins of health care system. Settins of each individual regulatory mechanism has no optional value, it have to match locally and temporally given specific economical and social conditions. The selection of concrete parametres of regulation is always determinated by application of public choice.
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The employment of disabled persons
Byrtusová, Martina ; Spirit, Michal (advisor) ; Andruchová, Jana (referee)
Cieľom tejto práce je popísať a zmapovať situáciu pri zamestnávaní zdravotne postihnutých osôb zo strany zamestnávateľa i zamestnanca, priblížiť vývoj a trendy v tejto problematike. Súčasťou práce je analýza roznych aspektov aktívnej politiky zamestnávania zdravotne postihnutých občanov na trhu práce. Súčasťou práce je i dotazník, ktorý vyplňovali pacienti Psychiatrickej nemocnice v Michalovciach.
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