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Nursing in children with diarrhoeal diseases
HEČKOVÁ, Šárka
This thesis deals with the problems of nursing in children with diarrhoeal diseases. Diarrhoea ranks the second most common disease in children and is often the reason for hospitalization because of its serious complications. Apart from the basis disease, admission to hospital represents a huge psychical stress for both a child and a family. Handling the situation depends also on the nursing personnel in a large extent. In the theoretical part you can find the division and specification of the most common causes, symptoms and basic treatment of diarrhoea. The theory is followed by the most common nursing problems developed during the nursing of children with diarrhoreal diseases. They include dehydration, pain, disrupted dermatic integrity, hyperthermia, loss of appetite, fear and anxiety. The possible causes of the occurence of nursing problems and their following solution are practically explained there. In the empirical part we dealt with the question if the presence of company leads to the hospitalization time shortening. For this purpose ten nursing records were noted. In five records the attention is paid to children hospitalized with the company of parents and further, five records of children hospitalized without the company of a close person are taken. After the analysis of the nursing records the following hypothesis resulted. Hypothesis 1: Permanent care to the limit of two nurses positively influences the adaptation of a child. Hypothesis 2: Presence of a company in a handicapped child leads to the hospitalization time shortening. Hypothesis 3: Nurses can influence the experience of children for their lifetime by their nursing. The nursing also includes the assesment and solution of nursing diagnoses. From the analysis of nursing documentation of hospitalized children (to the age of ten), the most common nursing diagnoses occuring in children with diarrhoeal diseases resulted. The presupposed hypothesis that the most often stated nursing diagnosis is the shotage of body fluids was proved. This result includes the fact that the need of fluids in babies and toddlers is considerably higher than in children and adults. Finally, it is possible to say that the results of the thesis advert to nursing problems which are solved during the care of children with diarrhoeal diseases. They can also help nurses realize the mistakes they make during the nursing of children with diarrhoeal diseases and improve the quality of nursing these children.
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Social, legal and psychological aspects of substitutional family care and institutional upbringing
Lušňáková, Petra ; Poláčková, Věra (referee) ; Vítečková, Michaela (advisor)
This diploma work dissert on substitacional family care and institutional upbringing from point of view nowadays. We can clarify this questions considering three views - points: juridical, psychological and social. The theme of substitacional family care and institutional upbringing is connected with many painful questions which are not too pleasant for our society to answer and to solve them. Although this theme is very serious and complicated, it is still not a priority of political interests. It is visible more than enough that this apathy causes the tragedy of abused, ill- treated and neglected children. This bitter primacy is proved by many researches, which discovered that it is just a the top of an iceberg, should mobilize human effort to create many steps serving as a protection for victims and also izolate and remedy the people who caused this crimes.Those people who are guilty should sorely feel the justice. This guilty people should feel the justice, however, it is not working this way. It is almost tragical that this problematics interest only people from non- profit organisations, this fact is not blandish for a state activity. The ignorating lawgivers are behaving as wrong farmers, omiting the question of human participation in the tragedy of individual destiny. The institutional upbringing...
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Coping strategies in children´s fear and pain in relation to nursing care
PROCHÁZKOVÁ, Zuzana
For the nurse, taking care of hospitalized children is important not only pediatric nursing knowledge, personal and social preconditions, but also the theoretical and practical competency of methods and techniques, which are used for identification and effective influencing of pain and fear. The aim of this thesis was to identify the main sources of fear of the hospitalized preschool and young school age children and to find out the effective methods and principles of the cooperation with children, alternatively with their accompanying parents in order to moderate the fear of the small patient. Then the thesis tried to chart the nursing diagnostic and evaluation procedure of the pain and get the most used nursing methods of non-pharmacological pain relief. To obtain the necessary data, the qualitative research was used with a semi-structured interview as a research instrument. The first research group consisted of 12 nurses, the second group consisted of 12 children ´s patients of preschool and young school age. The majority of the asked nurses thinks, that children´s patients are afraid especially of non-familiar environment, then of the awaited pain and of the solitude without parents. However, the most patients said, that they were afraid especially of pain, then of non-familiar environment, restriction of their needs, hostile attitude of the medical staff and of the other neighbouring patients. They were also frightened of the death and of the darkness. Most reported nurses mean, that the most effective solution of the children ´s fear is the friendly attitude of the medics. They also mentioned the fact of taking the focus off the fear and the presence of the parents is also beneficial. The nurses ´ answers were in conformity with patients opinion in two fields - friendly attitude of the medics and taking the focus off the fear. Then the children mentioned abiding of their specifics in connection to falling asleep and the demand of beying treated by the same sister or by few same sisters. All respondents also talked about the benefit of parents presence. Regarding the principles of the cooperation, nurses answered the importance of united medical procedures, especially the proper way of information transfer. Then the respondents nurses mentioned the psychical and emotional support for children and their accompaniments, the atmosphere of confidence and the value of well done education. Also the need of calm, silence and privacy was stated. Unlike nurses, children and their parents regarding to principles of the cooperation prefer the psychical and emotional support, then the importance of enough information was mentioned. The fourth research question bears on the methods used for children pain monitoring. The nurses said, that the intentional interview with the patients or with the parents was used as a main technique, that was stated by patients as well. Research question number five said: What are the most used nursing methods of non-pharmacological pain relief at children? Most responded nurses mentioned the distraction of children attention from the painful incentive, then the importance of physical methods, relief position and purposeful preparation for the unpleasant intervention. Nurses also named the helpful contribution of the parents, relaxing exercises and the method of imagination. Regarding the pain treatment, it was noted, that all patients prefered the analgesic therapy. Then they quoted the distraction of their attention from the painful incentive, the friendly attitude of the medics, using the ice compress and the relief position. In the pain acute phase, children required mostly calm, comfort and privacy. All children also considered the presence of parents as very helpful. The theoretical and empirical part of the thesis are suitable for being studied by nurses taking care of children and it can be helpful for nursing quality improvement at children ´s wards in hospitals.
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The role of human heat shock protein HSP70, HSP60 and mycobacterium bovis HSP65 in pathogenesis of graft versus host disease and rheumatoid/juvenile idiopathic arthritis
Nguyen, Thi Thu Hien ; Hromadníková, Ilona (advisor) ; Tučková, Ludmila (referee) ; Stříž, Ilja (referee)
We investigated IgG antibodies against Mycobacterium bovis heat shock protein 65 (M. bovis Hsp65) fragments produced by cleavage with cyanogen bromide (CNBr) in 10 healthy controls, 11 patients with juvenile idiopathic arthritis (JIA) and 10 children with various malignant and non-malignant diseases before allogeneic stem cell transplantation (SCT) by using Western blotting (WB). CNBr cleaved M. bovis Hsp65 to three larger fragments: Pl-163, molecular weight (Mw) 17.1 kDa; P191-285, Mw 10.4 kDa and P290-534, Mw 25.3 kDa. Humoral reactivity against M. bovis Hsp65 derived fragments differed on a case-by-case basis. The sera either of JIA patients ar those befare SCT reacted with individual M. bovis Hsp65 fragments more frequently when compared with healthy controls. While IgG anti-Hsp65 antibody levels showed no significant differences between the small studied cohorts, significantly higher levels of antibodies against M. bovis Hsp65 epitopes were observed in patients befare SCT and JIA patients when compared with healthy controls. Comparing WB reflectance densities (DRl and DR2), significantly elevated antibodies against Pl-163 (DRl: p=0.014; DR2: p=0.022) and P290-534 (DRl: p=0.009; DR2: p=0.003) epitopes were found in patients befare SCT. Similarly, significantly increased DRl and DR2 values of antibodies...
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Imaging methods in assesment of the scoliotic children spine deformities
HLADÍKOVÁ, Ilona
Long-term effects of static load and lack of physical activity in children leads to the formation of poor posture, which is nowadays more and more often. Orthopedic deformity arising in childhood is usually reflected the after-effects in adulthood. It is useful and important these deformities early recognition and capture in order to prevent the progression of many diseases. In that radiology has an irreplaceable role. The work entitled " Imaging the investigation scoliosis spinal child deformity" approaching the issue of damage to children´s spine scoliosis mainly children, and thein investigation by imaging methods. At the beginning of my work, I reminded the anatomy and physiology of the spine. Then I described the division and types of scoliosis. The rapid development of imaging techniques and new in the last few decades have brought about changes in imaging the spine. I described the principle of the methods that are applied in the examination of the spine. Great progress for the entire radiology and changes in working practices radiology assistants brought digitization. Therefore, for the mention in my work and I compare it with conventional analog radiology. Investigation of children have thein own characteristics and pediatric radiology I devoted a separate chapter. In chapter radiation protection, I described the basic principles of protection against harmful ionizing radiation, I mentioned the valid legislation, the basic units and quantities in radiation protection. The aim of my thesis is to test children´s scoliosis spine, to compare the frequency of examination methods of diagnosis. As the second goal I set to compare the radiation exposure in children´s spine examination on an analog meter compared to tests on digital devices. The first objective is building on the hypothesis that even today, despite the development of new diagnostic methods such as CT, MR, ultrasound, radiographic examination remains the priority children´s spine. The second objective I hypothesized that due to the digitization of the radiation dose to the patient during the examination decreased. Quantitative research was conducted at University Hospital Motol. Number of examined children´s backbone has shown that the vast majority of children with deformities of the spine radiography was investigated. Hypothesis number one is hereby confirmed. To meet the second objective, I selected group of 30 children diagnosed with idiopathic scoliosis, which in 2008 was on the unit Chiralux 2 (6a) conducted an analog image of the spine. In the same way, I chose a group of 30 children examined in the first half of 2013 on the same site digital radiography unit at Siemens Ysio 2 Fluorospot Compact. This was possible because in 2009 there was a baby Radiodiagnostics FN Motol direct digitization. The parameters used in tests I averaged a further mathematically processed. Hypothesis number two was also fulfilled, since calculations have shown that the examination of the spine digital radiography, radiation to the child about 31,3% lower. In my work I have in addition included the calculation of radiation doses received by the mammary gland during radiographic examination of the spine in the AP and PA projection. It turned out that the values are significantly different. This finding is in terms of radiation protection relatively important, since the ICRP in its recommendation to increase the value of tissue weighting factor for the mammary gland. Investigation of children imaging using ionizing radiation is the radiation dose to the child. Radiology assistant by its qualified work experience and contribute to this burden is as low as possible.
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Primary, Secondary and Tertiary Prevention in Children with Coeliac Disease.
PAPOUŠKOVÁ, Helena
Celiac disease is a lifelong disorder characterised by permanent intolerance to gluten and typical inflammatory changes in the small intestine. These changes lead to malabsorption of all nutrients, minerals, vitamins and water. The first attack of this disorder mostly occurs in childhood because the small intestine is greatly stressed by other nutrition supply. The only effective treatment is a lifelong gluten-free diet. This thesis, called Primary, secondary and tertiary prevention in children with celiac disease, consists of two parts; a theory part for which both professional publications and internet have been used and an empirical part, that comprises research itself with its results. The research target of this thesis was the sector of celiac disease occurring in children. Within the research, there were determined four objectives. The first objective was about to find out how primary, secondary and tertiary prevention is provided to children with celiac disease in GP ambulances for children and teenagers. Another task was to trace what profits the regime education brings to parents of children having celiac disease. We also dealt with the impact of the disease on the life of the child, his/her family and surrounding society. Then we investigated whether respondents take the help from outside, state support, institutions and in-kind assistance. In the empirical part of the thesis we used a method of qualitative research. For this research we chose a method of questionings through individual semi-structured interviews with two groups of respondents. The first group was made of nine nurses working in GP ambulances for children and teenagers having celiac disease. The second group was formed by nine children with celiac disease and their parents. The outcome of the research indicates that for quality health care supply it is important to obtain family anamnesis, carry out regular physicals in stated intervals within growth measurement monitoring and breastfeeding education and add other nutrition to diet. Monitoring suspicious symptoms, such as failure to thrive, inexplicable weight loss, growth retardation, abdominal pain, recurrent diarrhoea, digestive discomfort, dermatitis, stomatitis, anaemia, can soon detect celiac disorder. The secondary prevention is expressed by the work of nurses, such as biological material analysis, education, advice, help and support. Great urgency is given to risk factor monitoring, such as diabetes mellitus, Down syndrome, thyroid disorder, or genetic predispositions. The tertiary prevention is focused on the adaptation support of the child and his/her family to this chronic disorder, normal growth, and whole constitution examining and complication prevention. The outcomes indicate that the biggest problem of celiac people is financial burden of gluten-free food and also frequent limits in out-of- home eating. The financial burden of the diet influences, for example, vacation planning. It is necessary for the society to respect their disease, for example, canteens and teachers should have knowledge of the diet restrictions and provide suitable feeding. Furthermore, our findings show that only few families use financial support, because they are afraid of negative allowance examination because of their comfortable income. They mainly use allowance from Health Insurance Companies. On the grounds of the acquired information has been created an informative handout for the parents of the children with the celiac disease. The results of our research will be provided to the nurses who work in general practitioner ambulances.
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Psychological violence and abuse of children in South Bohemia- current issue
HÁJKOVÁ, Michaela
Psychological violence, also called invisible, is one of the forms of a syndrome of ill-treated, abused and neglected child. It causes wounds that are not visible; this, however, does not mean that mental pain is less serious just because of its non-measurability. Psychological violence often includes abuse, threats, humiliation, isolation, denial of emotional response and, last but not least, no concern about child's health. Undoubtedly, the most tragic result of psychological violence is a child's suicide. The bachelor thesis deals with psychological violence against children and adolescents in South Bohemian Region. It depicts the factors of its origin such as family background, parents' education and addiction to addictive substances. The thesis is divided into two parts - theoretical and empirical.The theoretical part is divided into eight sections. The goal of the thesis is defined at the beginning of the empirical part. The main goal has been to find out how much adolescents experience or have experienced psychological violence. The strategy of a quantitative research was used to collect the data and the method of questionnaire was selected. In addition, the research was complemented by the qualitative strategy and the method of questioning was selected. The results of the research have been compared with the opinions of other authors dealing with the issue in question in the discussion. The research suggests that every 8.5 child has become a victim of psychological violence during his/her adolescence. Further it is obvious that the family background affects occurrence of psychological violence against children; the occurrence of mentally abused children increases in incomplete families and stepfather families. Education of the abusing parents belongs among the significant results; parents with higher education abused their children more often than people with elementary education. The conducted research outlines the ratio of the adolescents who experience or have experienced psychological violence in South Bohemian Region.
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Impact of the change in providing spa care according to the ordinance 267/2012 to the physiotherapy conception in the spa surrounding
PRAŽÁKOVÁ, Eva
My bachelor thesis deals with problems, that occurred after the cancellation of the Decree No. 58/1997 Coll. and the adoption of the Decree No. 267/2012 Coll. establishing a new indicator list for the Spa sanatorium rehabilitation care for adults, children and adolescents, when there have been significant changes in the area of Spa care. Significant changes occurred, for example in the length of stay in treatment, that was shortened to 14 days or 21 days and to changes in the overall indication of the spa treatment, when some disease it was not possible to draw a spa care at all. This resulted in serious problems for both the spa facilities, as well as for patiens. Physiotherapy as an important part of balneotherapy has a very close relationship to the overall concept of the Spa treatement and its effect depends to a large extent on the presence and frequency of other treatments. The first part of the theoretical work deals with a spa treatment, legislation of Spa care and impact which has occurred after the adoption of Decree No. 267/2012 Coll. The second theoretical part deals with the therapeutic methods in the Spa. The aim of the work was charting of physiotherapeutic procedures in the context of Spa care pursuant to decree 58/1997 Coll. and 267/2012 Coll.. For the processing of a qualitative research strategy was used the method of the personal case study. Research file consisted of three patients who have completed the three-week comprehensive spa treatment in Bertiny lázně in Třeboň. One patient was treated with rheumatoid arthritis and two patients with Bechterew's disease. All the listed patients visited the spa facilities regularly and repeatedly. For these respondents was conducted the subscription history, input and output kinesiological analysis. Input and output of kinesiological analysis contained the examination of aspects, palpation, examination of walk, antropometric examination, goniometric examination and examination of distance on the spine. Six individual therapies was done and a subjective evaluation of the results of therapy at the end. Physiotherapy treatment was evaluated according to the above regulations. For these three treated patients was noted a difference in the effect of the spa treatment in the three-week and the four-week stay. Extended stay brought the longer-term pain relief, improve mobility and overall had a long-term effect, thanks to the greater number of balneotherapy treatment and the greater number of physiotherapy. It also had a better effect on the psyche of the patient when the patient could rest during the longer stay and managed to learn exercises and consolidate new friendship. The good news is the adoption of the new law, when from 2015 the length of the Spa stay was set back to four weeks. In my bachelor thesis I'd like to point out the problems that caused the adoption of Decree No. 267/2012 Coll. Furthermore, public awareness on this issue could be improved in this way.
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The social counseling during a divorce in the family
UHLÍKOVÁ, Jana
My choice of dissertation subject was influenced by the fact that there is a increasing number of divorces in recent years. This fact is supported by data from the Czech Statistical Office, which imply that every second marriage ends in divorce. It is impossible to define a clear-cut cause of the trend, because the decision to get divorced is influenced by many factors. These include the increasing pace of social changes, different approaches to problem-solving and to life in general, a specific argument between the partners that leads to a deep and lasting disharmony between them and many others. A divorce is a painful matter for all those involved. It influences broad areas of everyday life and has consequences for the adults as well as for the children (in the case of a divorce where children were born during the marriage). When the family situation is so unsettled that a compromise is difficult to find, it is possible to use an institution or a facility, which can offer social counselling according to law no. 108/2006 of the Collection of Laws on social services, in full wording. We differentiate between basic and professional social counselling. In the case of divorce, professional counselling is appropriate and can be accessed for example via counselling units for families, marriages and interpersonal relations which have this service properly registered within their remit. The extent of the use of these services was the research subject of this dissertation. The aim of this dissertation was to ascertain if families going through a divorce are accessing social counselling to resolve their situation and with what effect. To accomplish the stated aim, three investigative questions were chosen. 1.From what sources are the families informed about the possibility to take advantage of social counselling? 2.How does taking advantage of social counselling help families undergoing a divorce to resolve the life situation? 3.What do the families gain as a result of taking advantage of social counselling? A qualitative research strategy was chosen to collect the necessary information, using a survey method. Two techniques were used firstly the questionnaire containing closed questions and secondly the technique of in-depth interviews of selected respondents. The research was split into two phases. During the first phase a questionnaire with closed questions was used to establish which of the families took advantage of social counselling during divorce. During this phase the basic research set S1 was formed by the subset of respondents that went through divorce. This totalled 47 respondents chosen by the "snowball sampling" method. Using this method the chosen subject recommends further respondents that fulfil the conditions of the research. All 47 respondents agreed to fill in the questionnaire. The second phase of the research involved interviews with respondents forming the selective subset S2. This subset was created using quota selection from respondents who answered YES to the first question of the questionnaire.This select set was formed by 5 respondents. The interviews were transcribed into a recording form and the gathered data was further classified based on predefined questions or areas of the research enquiry, followed by analysis and comparison with the answers of other respondents. The purpose of this dissertation was to show, based on research carried out, if and to what extent the service of social counselling is used, which opportunities it offers and how it benefits the people taking advantage of these services. It was clear from the results, that the utilisation of these services is limited by the fact that a significant number of divorcing families, for whatever reason, does not look for this help. Conversely, the respondents that used social counselling benefited from this service whilst solving problems associated with their divorce, often simplifying the process.
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Urinary tract infections in children from the perspective of nursing care.
BUDÍNOVÁ, Eliška
The bachelor thesis is focused on urinary tract infection in children from the perspective of nursing care. Despite the fact that the quality of prevention and nursing care are constantly improving, urinary tract infection continues to rank among one of the most common childhood diseases. For this reason, it is very important to introduce the problems of this disease, familiarization with nursing care of a child and all of its specifics regarding the work of a nurse. The theoretical part deals with the actual disease, urinary tract infection in children, from the anatomy and symptoms to diagnosis and treatment. It also focuses on the work of nurses taking care of a child with a urinary tract infection. In the survey there were two main objectives. The first objective was to map the nursing problems of children with urinary tract infections. The second goal was to determine the principles of nursing care of a child with IMC, both goals were set from the point of view of nurses and parents. The empirical part of the thesis was determined by qualitative research. The used method was non-standardized semi-structured interview. The research sample consisted of 10 respondents. The first half of the respondents consisted of nurses working at a children's hospital and the other half of parents of children with urinary tract infections. During the interviews a method of open coding was used, especially method of pencil and paper. The survey was based on 4 research questions. Research question 1: What are the principles in the context of nursing care of children with urinary tract infections? Research Question 2: What basic knowledge have parents about urinary tract infection? Research Question 3: What nursing problems have children with urinary tract infection? Research Question 4: What knowledge have parents about the nursing care of children? Results of the research showed the most common nursing problems which were further subdivided according to respondents' answers. From the results of interviews of nurses emerged the 3 most common nursing problems. It was an issue of hyperthermia, acute pain and a risk of infection. In relation to this issue the solutions were similar. This mainly involved the administration of analgesics and antipyretics, according to the doctor and compliance with barrier nursing care for prevention of infection.From the interviews with parents emerged the most common problems related to the child. These were mainly pain and hyperthermia. Furthermore, there also appeared a trouble-free urinary tract infection. With this topic were also connected ways of solving the problem, the most frequent response was targeted antibiotic therapy for urinary tract infection. From the research came out principles of nursing care provided to a child with a urinary tract infection. These results are also divided according to respondents' answers. Nurses consistently stated that for a child with a urinary tract infection are not specific policies for nursing care. The care is performed in the same manner as for children with other diseases. The interviews also showed specific procedures in nursing care such as hygiene, medication administration, measurement of body temperature, urine and blood collection, drinking regime and patient enrollment in the documentation, etc. An interesting part is a part about the education of patients and parents. Nurses stated that they don´t educate patient´s parents. Only a doctor does that kind of care. According to the survey majority satisfaction regarding care, education, etc., is obvious from both the nursing staff and the family. However, these results could serve to a partial change especially in improving nursing education. In the future this change could cause even greater satisfaction for patients and their families and reduce the incidence of this disease in children.
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