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Epidural anesthesia during labour nowadays
LAŠTOVKOVÁ, Aneta
Current Obstetric Epidural Analgesia Labour pain belongs to every physiological childbirth. Enormous pain, however, was proved to affect a woman in labour and a child negatively so satisfactory pain relief should be provided. Current obstetric analgesia aims at/seeks for/strives after observing a physiological childbirth process. Epidural analgesia is the safest and most effective method of labour pain relief available today. Epidural analgesia is used in case of pain in labour and delivery, on request of the woman in labour and in prolonged delivery. Epidural analgesia could be also provided in preeclampsy, breech delivery, multiple pregnancy, premature delivery and cardiotocographic abnormalities. Although epidural analgesia is very popular and safe, no complication should be omitted. Good hospital care provided by obstetricians, anesthesiologists and nurse midwives could prevent most complications. Obviously, professional care in labour with epidural analgesia can only be provided by well-educated and experienced obstetric staff. The theoretical part of the thesis deals with information concerning delivery pain and pain relief methods. Together with epidural method, its indication, contraindication and complications, also spinal anatomy is mentioned in this part. All professional and communicative steps of midwife care about the woman in labour with epidural analgesia are described here. To fulfil the aim of the thesis, qualitative and quantitative research strategies were used. The women in labour with and without epidural analgesia were observed for collecting data in qualitative method. The same clients were consequently asked about their information and attitudes to epidural analgesia. Altogether eight casualties were formed. To collect data for quantitative method, the questionnaire of thirteen questions was prepared and send out to maternity hospitals. Eighty-six questionnaires were sent out and twenty- eight (25, 7 %) were sent back. The main aim of the thesis was to find out how available the epidural analgesia in labour is in our maternity hospitals. The next aim was to monitor the women in labour with and without epidural analgesia. The aims were accomplished through the research questions: How available is epidural analgesia used in labour in Czech maternity hospitals? What diffferences are there in labour with and without epidural analgesia? This work can be applied as a source of information for midwife students and nurses.
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Nursing care obout women with ar assistant reproduction
HEDBÁVNÁ, Kateřina
Conception may seem to be the most trivial thing but in fact it is not true. Nowadays, about 15% couples are infertile. Human infertility is considered to be an illness according to the World Health Organisation. Current modern procedures in assisted reproduction have fundamentally changed attitudes to human infertility. Assisted reproduction is one of the most progressive and also the most popularized branches of medicine. Only women are involved in it and regardless of whether they are healthy or not they undergo physically demanding procedures and make use of all techniques available. Nursing care is essential for a woman after assisted reproduction. While taking care of such a woman, a midwife should be attentive to her needs and possible health problems. The care for women who have undergone assisted reproduction is individual and specific. The first issue I deal with in the theoretical part of my thesis is infertility. I also describe methods and techniques of assisted reproduction and I mention the ova and sperm donation, the reimbursement of assisted reproduction, the law No 227/2006 on the research of human embryos. Nursing care for a woman who has undergone assisted reproduction is covered in this part as well. The aim of the thesis was to find out if women who have undergone assisted reproduction are satisfied with nursing care in the hospital in České Budějovice, Inc. and in the hospital in Třebíč, allowance organization. The hypothesis that women who have undergone assisted reproduction are satisfied with the care was stated. The empirical part of the thesis was carried out by the quantitative research questionnaires were handed out to pregnant women who had undergone assisted reproduction and were hospitalized at risk pregnancy units in hospitals in České Budějovice, Inc. and Třebíč, allowance organization. The questionnaire was anonymous and consisted of 31 questions {--} both open and closed. The research showed that women who have undergone assisted reproduction were satisfied with nursing care. I suppose the hypothesis was confirmed. I would like this thesis to provide future midwives and infertile couples, who decided to undergo assisted reproduction, with information on this technique.
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Specificity of midwife care in children gynecology
HAMERNÍKOVÁ, Pavlína
Children{\crq}s gynecology is mainly focused on preventive care, as timely treatment of gynecological diseases, determining congenital defects and promoting healthy physical and sexual maturity contribute towards healthy woman population. Girl clients is a very specific group od gynecological patients and a midwife nurse is supposed to consider all the specifics during the medical examination. The theoretical part of the thesis contains all information concerning the history of children{\crq}s gynecology, the development of female genital organs, examination in children{\crq}s gynecology, nurse care for gynecological girl patient and sexual abuse and rape. Some more information dealing with intimate hygiene, contraception and sex education are also included. To fulfil the aims of the bachelor{\crq}s work, both quantitative and qualitative research strategies were used. A questionnaire as a method of the quantitative research for collecting data was prepared. It consisted of 26 questions. The research was completed in March 2008 when the questionnaires were sent to children{\crq}s gynecological outpatient departments in the Czech Republic. Forty questionnaires were handed out to midwife nurses working in these departments. About 92.9 % questionnaires were sent back. Within the qualitative research were used the techniques of observing girl clients and a guided interview with girl parents present in the department. This qualitative research was realised in children{\crq}s outpatient department in Děčín in June 2008. Six girl patients and six mothers were interviewed there. The main aim of the thesis was to identify gynecological disorders of girl patients. The other aim was to set up and verify the nurse diagnoses within the NANDA TAXONOMY II. The third aim was to find out how much the midwife nurses know about the specifics of girl patients. The fourth aim consisted in detecting needs of life-long education for midwife nurses working in children{\crq}s gynecological outpatient departments. All aims were accomplished. The following hypotheses were stated in the practical part of the thesis. Hypothesis 1: Mothers (or other people accompanying the girls) are not informed enough to prepare girls for gynecological examination. This hypothesis was proved. Hypothesis 2: Midwife nurses know all specifics of gynecological girl clients. This hypothesis was proved. Hypothesis 3: children{\crq}s gynecology midwife nurses need lifelong education. This hypothesis was proved. The research findings can be applied into practice. The work will help midwife students and nurses in all gynecological departments. They will find here basic principal attitudes to girl clients and learn more about nurse diagnoses which occur within children{\crq}s gynecology. Midwife nurses can also use it as a source of information for their nursing care.
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Childbirth formerly and today
SVOBODOVÁ, Kateřina
This bachelor paper deals with the development of obstetrics since the very beginnings when all connected with birthgiving was tinged with something ``mysterious, empirical{\crqq} up to the present day when obstetrics is grounded on many facts. The care for the birthgiving woman is continuously innovated. First, the birthgiving woman was taken care of by older women of her family who had already given birth to their children and had therefore experience they could pass further. Nowadays it is the midwives who take care of the woman during her delivery. As well as in the past women close to the birthgiving woman the midwives are with the woman and they try to make the delivery easier for her. The development is still progressing but there is still the fact that a delivery is a situation when health is at stake, for both the newborn and the woman. The survey aimed at drawing an outline of the development of the care provided to the birthgiving woman. The methodology of the paper is a semi conducted interview. The first variant of the interview was prepared for woman who gave birth 50 years ago, 20-25 years ago and for woman who gave birth 7 years ago. The second variant was prepared for midwives without the difference of age. When interviewing women having given birth 20-25 years ago I was very surprised by their unified opinion. They agreed on the fact that the care for them and the attitude of the medical personal was inadequate to them. They were very malcontent. Mostly they complain about the first stage, when they had to lie on the bed, mostly with a drip-feeding. On the other hand women having given birth 50 years ago were satisfied with the care they had during their delivery. The greatest satisfaction is however declared by women who gave birth 7 years ago, who consider the medical personnel obliging and regardful. Especially they speak about the possibility of movement which was not allowed to women 20 years ago. The interviews with midwifes confirm that the development in obstetrics is progressing. Midwives who entered their employment after 1990 claim that competencies are increasing while older midwives claim the contrary, they say that at the beginning of their carreer their competences were greater than they are today. However all midwives agree that women nowadays are more informed on delivery than they used to be. Unfortunately, they are sometimes overinformed so that they do not know what to choose. Therefore the midwives recommend prenatal courses organised by the materninty clinic where it is the midwife of the particular clinic who informs women on possibilities and procedures which are recommended and carried out at the clinic. The survey has therefore shown, that the care for birthgiving woman is improving. And women are very satisfied at present.
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Low informatik about the process of child bearing
PISCHEKOVÁ, Markéta
The bachelor thesis describes current problematics of information provided to the first-time-paras on the childbirth course. The birth today is an issue very much promoted in the media, being particularly interesting for the pregnant women as well as for the whole society. Paras can find the new findings in magazines concentrating on this topic, in books designed directly for the pregnant women or, for example, in the antenatal courses lead by midwives. The most accessible source of information of today is Internet, where the expectant mothers can find all knowledge, starting with theoretical one and ending up with consultations of experts or chat with other paras. Thanks to the high level of general public awareness on the childbirth course, alternative ways of childbirth become more common. From the analysis of data it ensued that state of first-time-paras{\crq} awareness and their interest to get new information grows up disregarding the fact, if they are before or after the childbirth. It is the training institutions for medical staff in gynaecology and midwifery that has the significant influence on this result. The knowledge got here can be used in the areas of gynaecology and midwifery, either in primary care of obstetricians, or in midwifery institutions, as well as during training of students
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Course of antepartum preparation
KASTENMAJEROVÁ, Lucie
This bachelor{\crq}s work is divided into practical and theoretical section. The theoretical part describes history of antenatal preparation and its current conception. Next it deals with courses of antenatal preparation, mission of midwife in their leading and with preparation of persons who accompany the mother to the childbirth. The objectives was managed to fulfill. First hypothesis - pregnant women don{\crq}t have enough information about antenatal preparation courses - wasn{\crq}t confirmed. Second hypothesis {--} courses of antenatal preparation are financially accessible for pregnant women {--} was confirmed. Third hypothesis {--} courses of antenatal preparation are accessible for the women in their area of living {--} was confirmed.
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Knowledgeableness of patients before and after an operation of the intervention
PRSKAVCOVÁ, Hana
Based on the information within the Bachelor{\crq}s thesis titled {\clqq}Knowledgeableness of patients before and after an operation of the intervention``, which was aimed at the knowledge women have about pre-operative care before planned and acute caesarean section and about post-operative care, hypothesis 1. Women consider themselves to be well informed before the planned caesarean section. According to my research, this hypothesis was confirmed. Hypothesis 2. Before the caesarean section, women do not feel to be properly informed about the surgery. However, research did not confirm this second hypothesis. Hypothesis 3. Women that underwent the caesarean section are comfortable with the way they have been informed about the operation. The quantitative research method through questionnaires was used for data collection. The questionnaire contained 24 queries and was anonymous. The questionnaires were determined for women after the caesarean section and were issued at the Puerperium ward of the general hospital in České Budějovice. A total of 114 questionnaires were handed out and 111 of them were returned filled out, from which 103 of these were used within the final processing procedure. The results clearly show that women consider themselves as sufficiently informed before planned as well as acute caesarean section and consider themselves sufficiently informed of post-operative care.
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Satisfaction of women in childbed with nursing care on obstetric auditorium
MAŠKOVÁ, Jitka
The nursing care has in the care for health unreplaceable position. The attribute of the present nursing are individualized care and an independent working of the obstetricians centred on the prevention and on the support of the patients health. The satisfying and the dissatisfying of the patients needs reverberates in their consciousness as subjectively felt content or discontent with the care. The effort of the obstetricians has been the focus on the client. The new philosophy of the health services is to meet patients wishes and achieve therethrough their contentment. The patient{\crq}s satisfaction with the nursing care is an important information which predicate about the functioning of the individual departments in the health care institutions. {\clqq} The patient{\crq}s notifications is an valuable advice as well as an important motivating step to the improvement of the care quality.{\crqq} The nursing sees the patient with all the negative as well the positive sides and therethrough the patient{\crq}s contentment is understood as the priority objective wich cannot be marginalized. The satisfied patients have more confidence in the physicians in the nurses. They also much better cooperate during the labour. The objective of this thesis has been to state if the patients are satisfied with the nursing care on the labour ward. The supposal saying that ``The patients are satisfied with the nursing care on the labour{\crqq} ward has been stated. The supposal should be confirmed or disproved on the basis of the executed research. Hereat has been chosen the quantitative research in the questionnaire form. The question forms have been given to the mothers after the physiological labour on the confinement department in the hospital in České Budějovice, Tábor and Jindřichův Hradec. For research it has been used the set of 145 properly filed questionnaire forms. The research has proved that from the total number of questioned mothers 145 (100 %) the number of 142 mothers (97,9 %) were satisfied ewith the nursing care on the labour ward. The supposal has been confirmed by the research, the patients are satisfied with nursing care on the labour ward. The thesis shall be used within the tuition in the University of South Bohemia, published in the specialized publications and on the internet. An absolute majority of the patients has been satisfied with the nursing care on the labour ward. It is very pleasant conclusion of this thesis. In formed times to the patient has been often dictated what should or should not be done and therethrough the possible effect on the labour has been limited. Present is many respects different. It is more disposed for the changes in the nursing and puglic health in general. There is bigger space for the cooperation between the obstretricians group and the patient. It creates the safe enviroment in which both the patients and the nursing taff feel considerably better.
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Need visiting service of midwife near mothers in post partum period
BRABENCOVÁ, Iveta
Midwifes in visiting service are specialists for all problems, that annoy women and children in their lying-in. Full care of midwifes at mother{\crq}s house comes immediately after the medical care and provides health services trying to ensure well-timed and professional help. According to our law of health insurance is the care of midwifes provided usually 1 visit before and 3 visits after the birth of a child.
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Midwife´s opinion onto labours at domicilary environment
PRŮCHOVÁ, Dominika
Delivery at home is not a non {--} standart way to due, but that is also not legal. Someone who is helping with due at home on his own is absolutely responsible for all and he is support to answer all aftermacht if some complication will come. This is a decision of Czech gynekology-delivery copany and this decision is full law binding. Childbearing at home doesn´t the alternative for every woman. We thing that childbearing has plenty of merits, but we must know risks of childbearing at home for para and baby. The survey was quantitative by the way of questioners. My goal was to find what do midwifes thing about delivery at domicilary environment. This one says, midwifes have negativ position to delivery at home. They rate this way like dangerous. The inference is confirmed, all midwifes said the best place to delivery is Materna hospital. This work can be use for education and source informations for people, students and midwifes.
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