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Trust of citizens in health care system CR
Bauerová, Lucie ; Háva, Petr (advisor) ; Kružík, Lubomír (referee)
Thesis "Citizens' trust in health system CR" discusses the current state of czech health system, how is perceived by the citizens. In this thesis the focus is on the functioning of modern medicine. The theoretical part is devoted to the wider context of the problem of trust in the health care system. This section is trying to describe the changes in society which has been changing relationship of a doctor and patient. Most significant changes that affect this relationship are represented by the development of information society, as well as commercial and system pressure on the doctor. It also highlighted the importance there is the of human rights related to health and patient rights. The empirical part focuses on the research results and their discussion. The research method was applied in the form of qualitative interviews, which were then rewritten and clarified schematically using tables. Research results did not confirm the assumption that citizens lose trust in medicine as a science (lege artis). Problems of the health system respondents associate more with its wrong settings, which can be blamed for the Ministry of Health. Citizens were fairly unsatisfied with the current political situation and this is surely reflected the results of the decreased trust in state institutions.
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Enactment of the health sector in the new Civil code and comparison with the Civil services law
JANOŠŤÁKOVÁ, Iveta
Numerous separate legal norms dealing with the individual spheres of everyday life exist in the Czech Republic at present; some acts mutually overleap and complement one another. Provision of healthcare and healthcare services is regulated by numerous international and national regulations in compliance with adherence to the basic human rights. The healthcare law issues are particularly dealt with by Act No. 372/2011 Col. on healthcare services and the conditions of their prevision, which became effective on 1 April 2012 and substituted Act No. 20/1966 Col. on people health care. Acceptance of the Healthcare Service Act completed the post-revolution changes in healthcare. The Act represents a relatively comprehensive system of rules, among others it regulates the rights and obligations of patients, healthcare providers and healthcare staff in provision of healthcare services. Recodification of the private law was completed in 2012. Act No. 89/2012 Col., the Civil Code was passed within that. It became effective on 1 January. This thesis is divided into five chapters including the conclusion. The first chapter tries to outline the development of the legal norms in healthcare and social sphere in our country. The development of the social-healthcare policy of the state from the late 19th century was later slowed down by the world economy crisis, the Second World War and the consequent normalization. The second chapter gives a brief introduction in the healthcare issues and is divided into several subchapters. It defines the basic terms health and disease. It specifies the individual models of human approach to health, the structure of the Czech healthcare; a part of the chapter deals with the physician-patient relation, particularly with its modification from the paternalistic approach of a physician to a patient to the partnership relation, in which a physician and a patient become equal partners. The third chapter introduces the international and national regulations forming a part of the current healthcare legislation. This legal norm expresses the willingness of the society not only in the Czech Republic to protect the basic values of a human being in healthcare provision. The fourth part of the thesis focuses in detail on selected spheres of provision of healthcare and healthcare services under the effectiveness of Act No. 372/2011 Col. on Healthcare Services and the newly passed Act No. 89/2012 Col., the Civil Code. The new regulation introduces a new type of contractual relation, a contract of healthcare, which should regulate the legal mode of the healthcare provision, including the position of a healthcare provider and a patient in healthcare provision. It also includes a complex regulation of intervention into natural person's integrity and the necessity of his/her agreement with such an intervention. This part of the thesis examines the relation between the Healthcare Service Act and the new Civil Code. The aim of the thesis was to map the previous and the new healthcare legislations and to specify the basic differences in the legal norms, and to assess the consequences of the changes in the regulations for a patient upon comparison of both the legal norms. This thesis is a theoretical one, based on detailed studying and on a content analysis of particularly regulations, specialized literature and further available sources. The conclusion, i.e. the fifth chapter summarizes selected problems of provision of healthcare and healthcare services. The new civil code is based on the requirements of the modern society and provides much higher improvement of patient rights. This levels the legal positions of both the involved subjects, the physician and the patient. Healthcare provision is however primarily regulated by the Act on Healthcare Service Provision and the Conditions of their Provision, namely in more detail than by the new Civil Code, which is in the subsidiarity relation to the special regulation.
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Patient's status and rights during emergency medical services
ZRŮSTOVÁ, Simona
It is necessary to consider each patient to be a unique entity and respect his or her rights. This position requires an individual approach of paramedics. They should give the client a sense of security, certainty of assistance and take into account the fact that the patient is exposed to stress, which can change his behaviour. The paramedic must cope with these facts, he cannot be influenced, he must know how to prevent conflicts and behave according to the rules of medical ethics. The aims of this thesis was to map out the level of knowledge of patients in the area of their rights, and to find out their views on the attitude and behaviour of the paramedics during an intervention of a medical rescue service. The third part of this bachelor thesis deals with the knowledge of paramedics in the area of the patients' rights and their observance of these rights. Three research questions were set up. Whether the legal awareness among patients regarding the intervention of medical rescue services is sufficient and how patients evaluate the attitude and behaviour of paramedics during the intervention. A research question was also set up for the third aim of this thesis: what is the point of view of paramedics on respecting the patients' rights during pre-hospital emergency care. In the theoretical part I focused on explaining of the basic concepts of the medical ethics issues, its history and development. The most important part of the thesis is the ethic of emergency medicine and the issues of the rights of patients during prehospital emergency care. The thesis also discusses the ethical dilemmas that paramedics deals with during their responses and an equally important area is focused on different patients' rights, including legal standards that modify them. The research part consists of interviews with two groups of respondents: eight paramedics of the Ambulance Service of Pardubice Region and eight patients who used their services. The research showed that the legal awareness of patients is inadequate. At first glance, all patients were satisfied with the intervention of the medical rescue service and had no objections. After targeted questions targeted on the compliance of individual patient's rights, I concluded that in some cases the right to privacy and dignity of the patient was not respected. The patients were not sufficiently informed about their health and procedures that paramedics performed. None of the interviewed paramedics complied the patient's right to know the name of the medical staff member who treated him. The paramedics themselves commented on the issue of the rights of patients during the pre-hospital emergency care in the sense that they try to comply these rights, but they had problems with is not always possible. They are aware of the ethical code of the rights of patients, but they had problems with telling its content. The most frequent reason for non-compliance of the rights of patients was reported in connection with responses to people under the influence of alcohol, drugs or to patients with disorders of consciousness. The surprising result of the research was the finding that half of the responding paramedics have used violence against a patient during their practice. Among the groups of patients, to whom the responding paramedics do not like to drive, are mostly Romani people, homeless people and repeatedly calling patients. This bachelor thesis will contribute to a better awareness of paramedics and the general public about the respecting the rights of patients. Paramedics can use the observations of patients and by that remove the deficiencies they have been committing during their responses.
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The informed consent procedure from the patients´ perspective
FRAŇKOVÁ, Květoslava
In 2001, the Czech Republic ratified the Convention on Biomedicine. This convention is based on a strategy of partnership between physician and patient. This strategy is being implemented by informing patients of their rights in health care. The patients who are adequately informed of the nature, purpose, risks and consequences of treatment may freely decide whether they want to undergo a treatment or not. The thesis is divided into two parts, theoretical and practical. The theoretical part deals with the legislation in force on the informed consent and its various aspects. The practical part gives a survey of the knowledge of the rights that result from the informed consent and the implementation of those rights into practice. The objective of this section is to determine the legal awareness of the issue of the informed consent, especially from the patients´ {--} citizens´ perspective. The hypothesis 1 assumes that respondents with higher education are better aware of their rights arising form the informed consent than respondents with lower education. Hypothesis 2 assumes that respondents with higher education better employ the rights derived form the informed consent than respondents with lower education. The investigation was conducted in citizens living, working or studying in České Budějovice. To verify the hypotheses the quantitative research, carried out through a questioning method using the questionnaire technique, was conducted. The objective was achieved. On the basis of obtained data that were evaluated in percentage terms, the hypothesis 1 was refuted and the hypothesis 2 was confirmed. The research outcomes show that knowledge of the rights arising from the informed consent is almost identical for both groups of respondents, but in practice these rights are being claimed more likely by respondents with higher education. These results showed the need of focusing attention on informing patients about the practical application of their rights arising form the informed consent.
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Patient´s laws in gynecological - obstetric department focused on problems of disgrace and privacy
BROŽOVÁ, Pavlína
There are historical learning of Patient{\crq}s rights from all over the world and from Czech Repuplic in the part of theory. I also mentioned legal regulations connected with Patient{\crq}s rights. Below I commented on Patien{\crq}s rights separatelly as it is written in Ethic`s Code. The rights of a women and a foetus are said in a speciál fraction. The patien{\crq}t rights are extraordinary huge theme not relating only to patients but also relating to hospital staff. I have mentioned ethics codes of nurses and midwifes too. Last but not lest I wrote about the feasibility how to ensure the privacy in a labour ward and about a midwife{\crq}s unique role in a labour ward. In the experimental section I used a method of the checklists. I asked two groups {--} midwifes and patiens hospitalized on gynecological-obstetrician ward. The aim of my study was to analyse the observance of Patient{\crq}s rights in the gynecological-obstetrician ward. So I made out two hypothesi. The first one was if the patiens notice thein rights and the second one was if the nurses follow the rules. Both of them were verified. The results are that patiens are interested in their rights and they know that rights. More important is patients think their rights are respected by staff. The next result is not only that staff know and respect patient{\crq}s rights but also that staff try to adapt to each women separately.
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