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The possibilities of use of the robotic system da Vinci for treatment of localized prostate tumor
Podzimek, Michal ; Kočárek, Jiří (advisor) ; Kolombo, Ivan (referee)
Cancer of prostate is the most frequent male malignity and also it is the second most common cause of death in Europe and in the USA. There are 2 228 new cases reported in the Czech republic per year. The probability of occurrence of this disease is one to six during whole life. There is a good success in detection of his disease in the early stage due to development of screening methods. In such case the radical prostatectomy is very successful method of treatment. Besides of operation methods like open radical prostatectomy and laparoscopic prostatectomy there is a new operation method using robotic system da Vinci. The aim of this machine is to bring the advantages of the miniinvasive surgery together with keeping intuitive handling like in open surgery. First da Vinci system was bought and installed in the Central military hospital in Prague, Czech republic in 2005. The common knowledge about using this method is very low in both general public and specialists. Nor patients, neither their doctors often know about possibility of surgery using da Vinci system. The main objective of this thesis is to evaluate almost three years of experience of treatment localized prostate tumor using da Vinci system, and to describe its possibilities, benefits and disadvantages. Collection of 255 patients files aged...
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Utilization of the database applications in clinical research
Telička, Zdeněk ; Jiskra, Jan (advisor) ; Doležal, Tomáš (referee)
The Diploma Thesis "Utilization of database applications in clinical research" deals with development of client-server database application for 3rd Medical Department, 1st Faculty of Medicine, Charles University in Prague. Application's aim is to store structured data of patients' examinations, treatments and biochemical results. Purpose of the application is to facilitate data processing for clinical research, which is very difficult, because information stored in hospital information system doesn't contain detailed records from medical examinations. Also, searching for several entries is slow. As well, application allows import patient identification data from hospital information system. This function provides physicians wide range of possibilities in data processing 4 and comparison in relation to treatments. Effective feature of this application is faster writing medical reports stored in information system because they are automatically generated from application's database.
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Psychometric characteristics of Youth Self-Report in clinical sample
Urbánek, Tomáš ; Čermák, Ivo ; Štěpánek, Petr ; Schmidtová, Jana
The paper deals with reliability and validity analyses of the Youth Self-Report questionnaire by Thomas M. Achenbach. It is a method comprising eleven subscales, mostly syndromes of pathological conduct of children and adolescents. The data were obtained from the psychiatric patients (girls) from 12 to 18 years, most of them were exposed to family violence and abuse. The analyses of internal consistency and correlation analyses supporting the empirical validity of scales were conducted.
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Carpal tunnel syndrome in spinal patients
Zmeškalová, Petra ; Špaňhelová, Šárka (advisor) ; Lepšíková, Magdaléna (referee)
The aim of this work is confirming of incidence carpal tunnel syndrom in patients with spinal cord lesion. This ailment stem from repetitive loading of hands on propulsion of mechanical wheelchair. Work contains the causes of biginning, risk factors for patients, prevention, conservative and operation therapy. Thesis involves characteristic of patient after spinal cord injury, seat and wheelchair propulsion. The practice task contains case report of patient and suggestion of therapy for her. Powered by TCPDF (www.tcpdf.org)
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The influence of spinal patients regular training in Locomat System on chosentime and space parametres of their walk
Strnadová, Helena ; Oplatková, Lenka (advisor) ; Strapková, Zuzana (referee)
Diploma thesis "Influence of regular training of spinal cord patients in Lokomat system on particular spatio-temporal parameters of their walk." is a theoretical-empirical case report. Theoretical part deals with the neuroanatomy of the spinal cord, control, analysis and possibilities of check up of physiological walk. This part is concluded by the summary of entries about the Lokomat system, its basic technical equipment, advantages / disadvantages, indications/ contra-indications of its use in practice. The empirical part deals with the examination of the influence of the training in Lokomat system on the walk of the patients with incomplete spinal cord lesion. The main subject of the research is to monitor the changes in particular spatio-temporal parameters of walk (gait speed, stride length, stride time, single support time). Powered by TCPDF (www.tcpdf.org)
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Specifics of nursing care in patients after transapical aortic valve implantation.
VOTRUBOVÁ, Nataliya
Transcatheter aortic valve implantation (TAVI) is a new and an attractive method in cardiology and as well as in cardiac surgery. It is constantly evolving method which has been developed as an alternative to standard open surgery, especially in patients with severe symptomatic aortic stenosis with unacceptably high perioperative risk or patients who are not suitable for conventional open heart surgery because of age and comorbidities.A teamwork is very importantfor this new method and approach. The choice for TAVI is discussed by the institutional multidisciplinary heart team, typically consisting of interventional cardiologists, imaging-specialists, cardiac surgeons and anaesthesiologists. The first implant in a human being was performed by Cribierin 2002. In Czech Republic this method was first used in 2008. Transcatheter aortic valve implantation (TAVI) was accepted as a minimally invasive alternative to open surgery. This method does not require the use of cardiopulmonary bypass, and cardiac arrest. Other several benefits includinglower risks of bleeding and stroke events, better wound healing, less pain, as well as more rapid early recovery due to preservation of continuity of the sternumthat result in shorter durations of stay in the hospital, earlier rehabilitation and faster returns to normal life. In the presented work was used a combination of qualitative-quantitative methods of investigation. The data was obtained by using the quantitative research. The main technique was using the questionnaires designed for nurses working at the Department of Cardiac Surgery, Hospital Czech Budejovice, a. s. These results were backed up by the implementation of qualitative research, which investigated the patients and physicians view on monitored issues. Questioning method using a semi structured interview technique was used for qualitative research. The results of the survey were processed using descriptive statistics charts in LibreOffice Calc and using diagrams created in LibreOffice Writer. Qualitative results of the research were transcribed from audio recordings and coded, and the base code was created nine categories of interviews with clients/patients and three categories of interviews with doctors. The aim of this work was to explore the specific problem of nursing care about the clients / patients after transapical aortic valve implantation. On the base of our obtained data it is evident, that the client/patient after TAVI may be positioned sideways, the use of surgical drains are less frequently, so the care about the surgical wounds is simpler, patients report less pain in the surgical wound and postoperative rehabilitation and recovery is shorter. H1 - The nurses take care about the clients/patients after transapical aortic valve implantation in the same way as about the clients/patients after open aortic valve replacement, without realizing the differences between the patients treated with different approaches, was not confirmed. The nurses'sees/reported major differences in invasiveness and extent of providing care, rehabilitation, convalescent, in the duration of the hospitalization and better cosmetic effect. The results of the research can serve as a basis for creating the standards of nursing care or educational material for clients/patients. It is also possible to present the results of this work at a specialized seminar for non medical healthcare workers and results can also increase the quality of nursing care about the clients/patients after transapical aortic valve implantation.
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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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Nursing care management of patients after intrapleural chemical pleurodesis
KIESEWETTEROVÁ, Renáta
The pleurodesis is a treatment method for patients suffered from the symptomatic malignant pleural effusion. The goal of the pleurodesis is to close a pleural area by connection of visceral and parietal pleura in order to reduce or terminate production of pleural effusion. The sterile talc powder is the world's most used agens within a practice. After a parental analgesic is the powder (as a sllury) either applicated into a pleural cavity through the chest drainage or surgically dispersed over the treated (via abrasion, decortication) pleural space during the thoracoscopy/thoracotomy. This diploma thesis focuses on the treatment technique of bedside talc-pleurodesis through the chest drainage. The nurse has an irreplaceable role in the whole process from a preparation of patient to assistance by intrapreural application, to care of patient after the operation or serves as a physical support during potential complications. The aim of the presented work is to detect priorities in nursing care and find out whether patients need increased care after intrapleural therapy. The qualitative research method was chosen for the analysis where semi-structural interview with open questions were used. We created case reports analysed with the adaptive model of Callista Roy as well. The research sample contained patients chosen with respect to specialization of researched problem. We set two basic focal stimuli according to the analysis of respondents´ reactions. These stimuli serve as a basis for determination of priority parts of the nursing care by patients after bedside pleurodesis. We defined the need to be without pain and the need to ensure safety and certainty as a central focus of the nursing care. Among secondary fields of nursing care were identified sleep disturbances and limited mobility, which leads to reduction of self-care in getting dress, hygiene as well as in defection and miction. We found out within the second goal identical intensity of the nursing care before and after bedside talc-pleurodesis. This statement is based on comparison of interventions before and after aplication analysed via adaptive model by Roy. Nevertheless, causes of interventions were modified to a certain extent. The main goal of diploma thesis was to map requirements for high-quality nursing care related to bedside talc-pleurodesis via chest drainage. The work should extend theoretical basis not only for nurses in clinical practice.
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