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The role of the nurse in the prevention of immobilization syndrome after stroke at the department of neurology.
HOLUBCOVÁ, Eliška
Bachelor?s thesis The Role of a nurse in prevention of immobilization syndrom after stroke at the Deprartment of Neurology dwells on the problem of nursing care and prevention of immobilization syndrom of the patients after stroke. The theoretical part of the thesis is aimed at prevention, treatment and examination, which the patient has to go through after stroke and the role of the nurse during these performances. The immobilization syndrom is also described in detail at the thesis. At the conclusion of the theoretical part the author concentrates on the treatment which ought to be performed as a prevention of the immobilization syndrom of the patient after stroke. One of the chapters deals with health care, nutrition, defecation, skin care, mental state and communication with the patient after stroke. The practical part of the bachelor?s thesis focuses especially on qualitative research performed just at the Department of Neurology. The aim of the above mentioned research was to evaluate the role of the nurse in the care of the patient after stroke at the Department of Neurology. In the research the author stated the following question: What is the role of the nurse in the prevention of immobilization syndrom of the patient after stroke? This part also includes interviews with nurses conducted just at the Department of Neurology and the same nurses were also observed during nursing care. The results of the research show that the nurse plays crucial role in the care of the patient after stroke, either as a provider of nursing care or as a communicator, and to a smaller extent as an educator. The thesis also contains a map of nursing care, which describes the correct process during the care of cavity. The nurse can influence the course of disease by correctly performed nursing performances, such as dehydration, malnutrition and dekubital ulcer.
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Rehabilitation Treatment of Patient with Stroke
BŘEZOVSKÁ, Lucie
This bachelor thesis is on the topic of rehabilitative nursing of stroke patients. It is analysing how the issue is dealt with in the rehabilitation department and Department of Neurology. The bachelor thesis is divided into two separate chapters, theoretical and practical. The theoretical part focuses on the causes, symptoms, diagnosis and Treatment of patients after a stroke and the current state of rehabilitative care. One of the parts of rehabilitative care is the collaboration of the nurse and the multidisciplinary team. Furthermore, the thesis describes the possible complications that may occur from the stroke. These complications include mainly pressure sores and immobilization syndrome. Rehabilitative treatment of patients with strokes include positioning, communication, passive movements, active movements, verticalization, breathing exercises. Other methods used in rehabilition nursing, application of heat and cold and basal stimulation. The thesis also includes chapters dealing with nursing management, medical documentation and evaluating the scale of a patient after a stroke. For the practical part there was a set goal, determine the working conditions for nurses who provide the patients rehabilitative treatment after a stroke. There were four main hypotheses defined, which were the subject of an anonymus questionnaire: Hypothesis - H1: There are only positioning aids available for nurses to provide rehabilitative treatment. Hypothesis - H2: Nurses are documenting the rehabilitative treatment regularly used in the nursing process. Hypothesis - H3: Nurses state that the problem of providing rehabilitative care is the lack of time. Hypothesis-H4: Results of rehabilitative nursing care are monitored by the nursing management. As additional research investigation case reports have been formulated with the Barthel index in four patients. Results of the research shows that nurses are using not only positioning aids, but other available tools as well. Rehabilitative care nurses regularly document treatments, especially in nursing documentation. Nurses stated that there is lack of time for providing rehabilitative nursing and nurses state that the treatment is monitored by nursing management.
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Investigative CT algorithms for the early diagnosis of ischemic brain lesions
VOHNOUTOVÁ, Markéta
Stroke is the second most often cause of death in the Czech Republic after heart attack. It is not to say that older people are afflicted in particular. In the last period of ten years there are more often cases of stroke and ictus for people at the age of 40. The aim of this bachelor work is processing of knowledge acquisition in summary. The main point of this work is to evaluate the asset of new software programmes of multidetector computed tomography during early diagnostic of sudden strokes. In part of Present state there are following terms described in detail. It is etiology, aethiopathogenesis, risk factors of stroke. The next part is centred on anatomy of brain vascular supply and computed tomography Nowadays, software programmes have been improved enough for early diagnostics of ischaemic brain lesion. It is caused with continual improvement of diagnostic imaging and its digitalization. In many medical fields it has been spoken about new field of imaging - digital radiography. The computed tomography represents star part in the diagnostics, scanning of non-enhanced brain is the first period of the diagnostics, this algorithm shows us if it concerns haemorrhage or non-haemorrhage centre, continuing perfusion of brain which represents chat percent of tissue is damaged forever and it is finished with diagnostic process Angiography. The following part is focused on processing of data acquisition from České Budějovice Hospital, Inc. and Masaryk Municipal Hospital in Jilemnice. In these hospitals there are the numbers of patients examined CT compared. My hypotesis is confirmed and I can say that usage of new software programmes for early diagnostic of sudden strokes reduces per cent of complications during their cure.
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Prevention and therapy of spasticity in patients after cerabral apoplexy
TÁBORSKÁ, Žaneta
Spasticity is a manifestation of many neurological diseases, for example an infantile cerebral palsy, a traumatic injury of brain and spinal cord, a multiple sclerosis and a stroke. A genesis of the spasticity is not yet completely clarified and many definitions try to explain it. The spasticity can deepen a disability of patients even with a minimal paresis. The spasticity has a different clinical picture at various diseases of the central nervous system, but even at different patients with the same diagnosis, it also varies in the course of time at one and the same patient. The biggest problem in the treatment of the spasticity is the fact that the treatment, efficient at one patient, can completely fail at the other. A goal of this thesis was to give an overview of current options in a treatment of the spasticity. Therapeutic approaches to reduce the spasticity are usually a part of special kinesio-therapeutic methodologies, which are for example an anti-spastic positioning, a volitionary relaxation, passive movements, an anti-spastic placing (Bobath´s conception), relaxation techniques (PNF), an application of splints, a long-term effect of the heat, an icing and others. On the contrary, it is intensified by pain, pressure sores, a sub-luxation position most often of the shoulder joint, a psychical stress, urinary tract infections etc. In the theoretical part I focused on a control of the muscle tone, pathophysiology, clinical symptomatology, diagnostics and especially prevention and the treatment of the spasticity. In the practical part I investigated an effectiveness of an anti-spastic therapy through the qualitative research. For the data collection it was used an anamnesis, observations (kinesiological analysis), case reports and a secondary data analysis. The research was made at two probands with a brain damage on the vascular basis. I was finding out an effectiveness of selected therapies for individual probands {--} and at the same time its suitable combination. I focused on the area of the upper extremity. At the first patient there was a success, by a suitable combination of individual methods, to positively affect the spasticity and an active momentum of the upper extremity. At the second patient in a chronic stage of spasticity it was managed to influence it always only for a short term and results varied considerably in the course of time. The treatment of the spasticity must be preceded by a thorough knowledge of pathophysiological mechanisms, a neurophysiology and above all a complex kinesiological analysis. The therapeutic approach should be always individual, to respond appropriately to changes in the clinical picture and to use suitable combinations of therapeutic approaches. If the treatment of the spasticity is successful, it positively affects the motor deficit and reduces the patient's disability.
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Special physiotherapeutic procedures as a part of the recovery for patients after stroke
KŘIVÁČEK, Jan
The thesis deals with {\clq}qSpecial physiotherapeutic procedures as a part of the recovery for patients after stroke.`` While in the most developed countries there was, in last 10 - 20 years, recorded a significant decline in a mortality of stroke thanks to a consistent prevention, the Czech Republic still belongs among countries with the high mortality. Nevertheless a large part of strokes is a result of an improper lifestyle in a combination with a lack of the physical activity and other factors. Just a use of an aerobic training is often a neglected part of the convalescence, although there is an obvious link of the cardiovascular performance with a function of the neuro-musculo-skeletal apparatus as well as psychological features. A goal of this bachelor thesis was to verify a relevance and effectiveness of the aerobic training as a part of physiotherapy at patients after stroke. The thesis deals, in the theoretical part, with an etiology, risk factors, a prevention and a clinic symptomatology of stroke and individual approaches to a subsequent complex rehabilitation. Then there are pointed out principles of a stress diagnosis, a reaction of the organism to the stress, changes of cardiovascular, ventilatory functions and the aerobic training.In the experimental part I used a quantitative research with methods: an interview,anamnesis, status praesens, evaluation of hemiplegia after Chedoke, a direct observation, case reports and a secondary data analysis. The research was conducted at patients after stroke hospitalized in Neurological a Rehabilitation wards of the Hospital in České Budějovice. Results of the research showed a certain trend of measured values within a meaning of the adaptability to the training programme and a positive contribution to the overall rehabilitation process. The thesis could be used as a study and information material for the general public as well as for students of medical and paramedical disciplines, last but not least as a preventive measure against stroke.
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Social services used by the elderly after having a cerebral hemorragie
SOUKUPOVÁ, Barbora
My bachelor thesis focuses on senior citizens after a stroke, their family members and their opportunities to use social services. The thesis examined also the awareness of such services and their availability in the Příbram district. The topic is very pressing as the occurrence of strokes worldwide is fairly high and in developed country it is causing a serious medical, social and economic problem. Senior citizens and their family members should know about the possibilities to utilize social services, so that they can achieve the highest possible level of independence and self {--} sufficiency in the home environment or so that their carers are provided with professional assistance. The theoretical part covers the issues of senior citizens and old age, stroke related issues, conditions, provision, funding and remuneration of social services, methods of care provided by the family and an overview of providers of social services for senior citizens in the district of Příbram. The research part of the bachelor thesis used a qualitative research, method of interviewing by means of questionnaires and standardized interviews. The research sample consisted of senior citizens or their family members who were approached by means of questionnaires. 120 questionnaires were distributed and 102 of them were returned, i.e. 18 questionnaires were not filled in. The return rate was 85 %. Interviews were conducted with 15 senior citizens at my workplace in the centre of care for long {--} term bedbound patients. The purpose of my work was to map the availability of the social services in the district of Příbram and the level of awareness of such services and their utilization among senior citizens. Hypothesis H: Senior citizens after a stroke are informed about the social services they can utilize. H1: Senior citizens after a stroke with the level of dependence 3 and higher prefer social services provided in residential facilities. It was found out that certain social services are missing in Příbram and some of the existing ones do not have sufficient capacities. The availability of social services is sufficient. The level of awareness among senior citizens and their family members is also at a good level. The evaluated questionnaires and interviews imply that senior citizens with the level of dependence 3 and higher mostly use the services provided in residential facilities. Based on the results the postulated hypotheses were positively confirmed and thus also the objective of this thesis.
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Options of physiotherapy treatment in patients after stroke.
KUBÁTOVÁ, Radka
The topic of this thesis is Options of physiotherapy treatment in patients after stroke. The objective of the thesis is to survey physiotherapy-nursing care for patients after stroke and to describe current possibilities and quality of physiotherapy care for patients after stroke The thesis deals with possibilities of physiotherapy treatment and cooperation between nursing and physiotherapy staff. One of the targets is description of physiotherapy care for patients after stroke which is documented by patients{\crq} medical records. The other target is physiotherapy care monitoring supported by the quantitative research using the questionnaire method. The aim of this thesis was to develop an appropriate methodology to be used as an instrument for physiotherapy care for patients who had sustained acute stroke. Another objective was to determine the level of cooperation and awareness of staff members involved in the physiotherapy-nursing process. To meet the objectives the method of quantitative research was used. The methods of participated observation, semi-standardized interview and documents evaluation were included. Complementary data were obtained by the quantitative research using the questionnaire method. The research was conducted in patients after stroke who were hospitalized at the neurological department in Ceske Budejovice hospital. Additional quantitative research, using the questionnaire method, was conducted at the neurological and internal departments in hospitals in Ceske Budejovice, Cesky Krumlov and Pribram. On the basis of the research results, methodology of physiotherapy care for patients after stroke in acute condition was developed and the lack of awareness and cooperation of physiotherapy and nursing staff was found. The thesis will be used as a study and information material for all members of the medical staff involved in treatment of patients after stroke, but also for general public. Information can be forwarded through lectures, leaflets, etc.
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Nurse´s view on speech disorders of patiens cured from stroke
TALÁROVÁ, Libuše
This bachelor thesis deals with cerebrovascular accidents (CVA)and their serious effects on the pacient. Special attention has been paid in this thesis to speech disturbances that are the second most frequent effect of CVA. The objective of the survey was to find out whether nursing staff are informed about the speech disturbance issue, are willing to work with the client according to clinical speech therapis´ts recommendations, and whether the nursing staff have adequate conditions for work with the client. All of the objectives mentioned above have been achieved. Quantitative methods have been used for the survey, namely the analysis of the speech disturbance number to the CVA number from July 2008 to February 2009, and a questionare for the nursing staff. The survey was carried out in internal diseases and neurology departments of the Blansko Hospital. The results of investigation showed that nurses do not have information about disorders of speech and that each deparment should be designated at least one worker who was trained by clinical speech therapist and in cooperation with him, he devoted himself to the care of patients.
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Period hospitalization cancerning autarchy development of patient cured from stroke.
KALUŽOVÁ, Lenka
Stroke (celebrovascular accident CVA) is caused by a disturbance of the blood supply to the brain and today represents a medical, social and economic problem. It is the third most frequent cause of death and the most common cause of mental and physical handicap nowadays. In the thesis mechanisms of stroke development are introduced, risk factors that are involved in the disease development are described. Manifestation of stroke according to specific types of disablement is also mentioned. The research was conducted by a quantitative method. Self-sufficiency of patients was evaluated using a standardized test of self-sufficiency (Bartel´s test) and observation techniques. The Bartel´s test was made at the patient´s admission as well as his (her) discharge from hospital. Patients from the research database were monitored every day of hospitalization and their success or failure in training self-sufficiency were processed in twelve casuistics. The presupposed objective of this work was to determine the average time of patient´ hospitalization required to achieve self-sufficiency in daily activities. The results of the thesis result in the following hypotheses: 1. In younger patients the average period of hospitalization is longer than in elder ones. 2. The return to self-sufficiency is faster when nurses support patients to exercise daily activities by themselves. 3. Faster return to self-sufficiency is achieved in patients with prospects of being discharged from hospital to home care.
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