|
Cooperation between a Home Care Nursing Agency and Family Members in the Care for Patients after Cerebrovascular Accident
SILOVSKÁ, Petra
Cerebrovascular accident means acute vascular brain damage. It may have various causes. This includes either blocking of a vein with a blood clot, vasoconstriction or combination of the aforementioned causes. Frequent symptoms of CVA are paralysis, weakness, loss of sensitivity in face or on one side of a limb. Another symptom may be speech disturbance. Cerebrovascular accident may be identified as brain ischemia and hemorrhagic ictus. The thesis includes characteristics and symptoms of the aforementioned types. Furthermore, the thesis describes examination methods and treatment for CVA. Consequences of CVA may include some forms of paresis or plegia, which brings limitation of self-sufficiency for a client. Thus, it is necessary to start timely rehabilitation which shall engage the affected body parts. If the client suffers from speech disturbance as a consequence of CVA s/he should be treated by a speech specialist. If the client does not stay in hospital facilities the family may use service of a home care agency. If the client's health allows s/he may stay at his/her home and a nurse from the home care agency may come to his/her home regularly and helps the client's family. The nurse performs all the required activities and s/he also makes the family engaged in the care. Communication forms an inseparable part of the care. The thesis called Cooperation of nurses and family members within care for a patient who suffered from cerebrovascular accident used qualitative research. The interviews were taken with nurses from home care agency and with family members who take care for a patient who suffered from cerebrovascular accident. The survey was categorized and charted to make it more illustrative. The aim of the thesis was to identify the extent of cooperation between nurses from home care agency and family members taking care for a patient who suffered from cerebrovascular accident, and then to define in which activities the family members may be engaged, and finally to describe how the nurse from home care agency communicates with the family. The nurses' point of view has shown the same positive results and they were satisfied with family's engagement in care for the patient. The revealed results of the survey may be provided to the home care agency to allow assessment of the effect of nurses' work on the overall condition of the clients.
|
|
Nursing care of the patient with cerebral vascular accident
Jíšová, Lenka ; Holubová, Jana (advisor) ; Pojikarová, Iveta (referee)
Cílem mé bakalářské práce je zpracování ošetřovatelské případové studie nemocného s ischemickou cévní mozkovou příhodou. Onemocnění touto chorobou postihuje populaci vyššího a středního věku, ale můžeme se setkat i s pacienty mladších věkových skupin. Cévní mozkové příhody jsou onemocnění závažná medicínsky i společensky. V oboru neurologie jsou nejčastější příčinou úmrtí i invalidity nemocných. Bakalářská práce je složena ze dvou částí, klinické a ošetřovatelské. V klinické části se zabývám anatomií cévního zásobení mozku a fyziologií mozkového krevního zásobení, popisuji radiodiagnostické a ultrazvukové metody v diagnostice cévních mozkových příhod, dále se v této části zabývám léčbou akutního stadia CMP, prevencí primární i sekundární. Také jsem v této části zpracovala základní údaje o nemocném, popisuji výsledky provedených vyšetření a farmakologii léků užitých při terapii nemocného. V ošetřovatelské části se věnuji popisu charakteristiky ošetřovatelského procesu a "Modelu funkčního zdraví" podle Marjory Gordonové. Podle tohoto modelu provádím hodnocení nemocného. Informace jsem získala od nemocného, jeho rodiny , vlastním pozorováním a od členů zdravotnického týmu. Následně jsem po konzultaci s nemocným stanovila ošetřovatelské diagnózy a sestavila plán ošetřovatelské péče. Popisuji realizaci a...
|
|
Communication problems of nurses in pacients after stroke
PECKOVÁ, Jana
The bachelor thesis "Problems in nurses´ communication with patients after cerebral vascular accident? deals with the knowledge of nurses in communication with patients with aphasia after an ictus. Right communication belongs to key points of the subsequent treatment of this disease. A cerebral vascular accident ? a stroke - can negatively affect the life of a person affected by the disease. Other negatives symptoms are provoked by acquired disorders of cognitive function. Phatic failure is of a concern in the nurse-patient communication. Patients are not usually able to express themselves properly or understand others. During their hospitalization the role of a nurse is therefore very important. Nurses should be sufficiently educated in communication and to know the specifics of this disease. Compensation aids to facilitate and improve communication with patients after a stroke should also be available and used by nurses. The objective of this thesis was to determine whether nurses follow the correct procedures in communication with patients after a stroke, and to map the most frequent communication problems between nurses and patients after a stroke. The empirical part of this study consisted of quantitative research, using an anonymous questionnaire that was designed for nurses in neurological and internal wards of the hospitals in Příbram, Písek and České Budějovice. The questionnaire contained a total of 24 questions. 107 questionnaires were distributed and the research was processed with 90 questionnaires, i.e. 84% of the original number. Three hypotheses were stated. The first hypothesis assumed that nurses know principles of good communication with patients after a stroke. This hypothesis has been confirmed. The second hypothesis assumed that nurses use aids to improve communication with patients after a stroke. This hypothesis has been confirmed. The third hypothesis assumed that nurses are interested in further upgrading skills in communicating with patients after a stroke. This hypothesis has also been confirmed. The objectives have been met on the basis of confirmed hypotheses. This bachelor thesis can serve as educational material for nurses working with patients with aphasia after a stroke.
|
|
Comprehensive Nursing Care for Clients after Cerebrovascular Accidents
KOVAŘÍKOVÁ, Jaroslava
Cerebrovascular accidents (CVA, a stroke) mean a major burden for both the patient and his family and caregivers. It is necessary to focus intensively on the care for patients already diagnosed with a stroke. Provision of quality nursing care of patients increases patients´ chance of their recovery and return to the normal life. Based on these facts, the bachelor thesis "Comprehensive nursing care for clients after a stroke" was prepared and presented. The objective was to find out what theoretical knowledge and practical skills are required from nurses who look after the clients after CVA. The theoretical part of the thesis is focused on the description of CVA and the issue of the nursing care. The research part is based on the quantitative data collection. The research methods applied were: a semi-structured interview, an involved observation and a survey. The research sample consisted of ten clients after CVA who had been hospitalized in Hospital for follow-up care in the town of Humpolec and ten nurses who looked after these clients. Based on the information obtained from the interviews with clients, case studies were compiled, which revealed specifics of nursing care and these were formulated into individual nursing problems. Clients after CVA mostly need help with mobility, food and drink intake, at discharge, hygiene and tidying up. The attention to the issue of speech therapy should be paid. The involved observation and the survey revealed theoretical knowledge and practical skills, which nurses looking after the CVA clients should have. As to the question whether the nursing staff has enough knowledge and skills to provide quality nursing care for clients after CVA, it was found out, that there are some gaps both in theoretical knowledge of CVA and in practical skills of provided nursing care for these clients. As for the theoretical knowledge, the gaps were found out in the approach to clients after CVA and in describing the principles of communication in clients with aphasia. As for the practical skills, gaps in speech therapy were revealed. Gaps were also revealed in the support of the self-sufficiency of the clients. Self- sufficiency is not supported in the maximum possible extent. The results of this work can contribute to improvement of nursing care for clients after CVA. The output of this bachelor thesis is a nursing care plan with emphasis on the most frequent nursing diagnosis.
|
|
The Work of the Nurse at the Stroke Unit
BROŽÁKOVÁ, Žaneta
The theme of the Bachelor degree work ?The Work of the Nurse at the Stroke Unit? was chosen as it deals with the interesting issue of the development of neurology medical branch which is closely connected with building ictus stroke units. These new units provide for modern treatment and nursing care in particular to patients suffering from the acute vascular cerebral accident ? stroke (ictus). The development of these units also supposes higher requirements for nurses both in the sphere of the theoretical knowledge and the practical skills. The theoretical part of the work deals with the general issue of ictus in the form of symptoms, diagnostics and treatment. Further, it informs us about the organization of the cerebral-vascular care in the Czech Republic and nurses´ competences in the selected nursing performances. Next, there is described the intervention of the nurse at the acute reception of the patient suffering from ictus and particularly the complex nursing care at the ictus/stroke unit accompanied with nursing diagnoses which occur at the patient suffering from ictus. The aim of the work was to find out specific features of the nurse´s work at the ictus unit from the nurse´s point of view and to map out nurse´s knowledge at the ictus unit from the nurse´s point of view. To accomplish both aims there were answered research questions. VO1: What nursing procedure is specific for the work of the nurse at the ictus unit? VO2: What nursing diagnoses are specific for patients at the ictus unit? VO3: What knowledge is required form the nurses working at the ictus unit? VO4: How does the nurse gain necessary knowledge for the work at the ictus unit? The practical part of the work provides a lot of information on the work of the nurse at the ictus unit from the nurse´s point of view. This detailed information was found out by means of the research investigation, the qualitative method in the form of interviews with nurses at the selected ictus units. The results of the research work are used for the compilation of the nursing standard of the care for the patient suffering from ictus during thrombolytic therapy. This standard provides nurses complex information and helps the patient to get high-quality and safe nursing care.
|
|
Kinesiotherapy in the third trimester of pregnancy and childbirth preparation
HANZALOVÁ, Edita
The bachelor thesis deals with kinesiotherapy in the 3rd trimester of pregnancy and subsequent preparation for birth. Pregnancy is a physiological state when the body nourishes two organisms. Because of the baby nourishment pregnancy is certain strain for pregnant woman?s organism. Kinesiotherapy at the final stage of pregnancy is very important. The theoretical part describes physiological changes in female organism during pregnancy. Changes particularly occur in the respiratory system, circulatory system, musculoskeletal system and in body weight. From physiotherapeutic point of view particularly the changes in the postural system and selected muscles are described. Sudden weight growth affects the overall body posture and the structure of pregnant woman?s foot arch. The theoretical part also describes physiological birth, its phases and their length. The last chapter of the thesis theoretical part focuses on the most frequently applied kinesiotherapy methods. These are Ludmila Mojzisová method, Pilates method and gravidyoga. Outline of further kinesiotherapy methods then follows. The bachelor thesis has two aims and one research question set. The first aim is to introduce motion therapy among women in the 3rd semester of pregnancy. The second aim is to prepare pregnant women for the birth by means of kinesiotherapy. The research question deals with finding whether kinesiotherapy has positive influence on the birth progress. Quantitative research method in the form of elaboration of case studies from three respondents was applied to meeting the goals in the practical part. The respondents attended pregnancy exercise and birth preparation classes. Case history was taken from of each pregnant woman to get the necessary data. The interview included information on accidents, operations, painful states, sport activities both before and during pregnancy. Static and dynamic check-up of aspections was then performed. The static check-up focused on overall body posture in back, side, and front views and was documented. The dynamic check-up monitored backbone development and hypermobility test. The practical part then describes individual therapies. An individual kinesiotherapeutic plan is described for all three respondents. The practical part is concluded in an output kinesiological analysis several days after the birth. The output examination also includes an interview on the birth progress and mental state of the respondents. The research confirmed that kinesiotherapy was beneficial for pregnant respondents in the 3rd trimester of pregnancy. The locomotor system problems caused by pregnancy changes in female organism were reduced or eliminated. The clients describe mental well-being during motion activities as well as between the visits. Birth preparation in the form of breathing in the individual birth phases and training of relief position was included into the therapy near the end of pregnancy. The women used the relief position on the big ball in the first birth period and as well as breathing specific for the individual birth phases. The research did not confirm whether kinesiotherapy influences the birth progress. Two of the three respondents delivered without significant complications. The delivery of the woman No. 1 was on the due date. The woman No. 3 delivered less than 3 weeks before the due date. The delivery was without serious complications in both the women. However there were complications in the respondent No. 3 caused by wrong position of the child. Caesarean section in epidural anaesthesia followed. The woman had no problems after the anaesthesia and was transported to the postpartum ward the next day after the intervention. This bachelor thesis may be used as educational material for students and graduates in physiotherapy. It is also suitable for the public, particularly for women in
|
|
Physiotherapy in patients after injuries of the spine and spinal cord
HAJNÁ, Petra
In connection with our lifestyle every year in our country but also abroad there is a growing number of people with spinal cord injuries. The spinal cord injury usually occurs while a spinal injury, where the spinal canal is compressed by luxated vertebra or bone fragments. Affected are more often young people, especially men. The most common causes are falls from height, accidents and sports injuries. A person with this condition not only has limitations in terms of loss of movement or sensitivity but is often threatened by various health complications. Therefore a complex care and intensive rehabilitation is very important, which is in the Czech Republic secured by the spinal program lasting 6-9 months. Rehabilitation is needed not only in the acute period after injury, but has a unique place in the chronic stage of spinal cord injury as well. The aim of this thesis was to explore issues of trauma and spinal cord injury from the perspective of physiotherapy. Based on the defined targets following research questions have been determined. What kinds of physiotherapy procedures may be used onpatients in the subacute stage and what procedures in the chronic stage of spinal cord lesion. A qualitative research in the form of case reports has been executed. Data was obtained from interviews, observation, document analysis and kinesiological analysis. Standard tests related to the spinal lesion were performed, only the most relevant tests and the results that were found during therapy in case reports were entered. The sample included four patients. Two patients in the subacute and two patients in the chronic stage of spinal cord injury lesion etiology. The research was conducted at the Spinal Unit Department of Traumatic Surgery, University Hospital Brno and at the Rehabilitation and restoration center Borovany. Physiotherapy in subacute phase of spinal cord injury is directed at the prevention of pressure sores, contractures, pain, maintaining optimal mobility of joints, focusing on respiratory rehabilitation, maintenance and strengthening of preserved motor potential, activation of the motor transient spinal cord lesion with efforts to activate the motor skills in the most distally way, improving the overall physical condition. The aim is to use and support functional ability of the patient to the fullest extent and quality with the subsequent effort to develop alternative mechanisms.Of the special methods the ones on the neurophysiological basis are the most commonly used treatment methods. An important part is the gradual verticalization of the patient, training equilibrium reactions such as training seat, support for upper limb, keeping in certain positions and functional training, thus the mobility on the bed, self-care, transfers, training wheel chair control, practicing functional replacement grip. Patients return to life with a big handicap, are often dependent on the assistance of others, learn to use a wheelchair and other aids. They have years of life ahead in which they have to cope with the conditions subsequent their injury. In the chronic period, it is important to maintain physical fitness, preventpossible complications, especially pressure sores and joint contractures. Physiotherapist addresses the consequences of overloading the exposed muscles, monitors the vertebral problems, joint pain or muscle imbalance. During this period, patients can attend ambulant physiotherapy or use maintenance stays in rehabilitation centers. The purpose of the study was to mention the basic and the most important areas in the care of spinal patients and to highlight the importance of physiotherapy comprehensive care not only within the spinal program, but also from the perspective of the long-term care of these patients as the rehabilitation should accompany the patient's whole life.
|
| |
|
Physicaltherapy of acute stadium cerebrovascular accident CVA
Techmanová, Petra ; Puršová, Martina (advisor) ; Muchová, Zuzana (referee)
BAKALÁŘSKÉ PRÁCE Jméno Petra Techmanová Obor Fyzioterapie, rok imatrikulace: 2008 Vedoucí práce: Mgr. Martina Puršová Počet stran: 99 Title: Physicaltherapy of acute stadium cerebrovascular accident CVA Abstract: This Bachelor's Thesis deals with physicaltherapy of acute stadium cerebrovascular akcident. The Thesis is divided into theoretical and practical part. The former is concerned with mostly with remedial therapy - both acute and subacute. The latter includes a qualitative treatment of two casuistries in which the combination of PNF method and Dr. Václav Vojta's principle was applied within the therapy. For verification, the results from the examines carried out before and after the therapy were compared. Key words: CVA, Cerebrovascular accident, neurorehabiliation, rehabilitation of hemiparesis, neurology, physicaltherapy for CVA.
|
|
The effect of regular training in Locomat system changing the stereotype of gait of patient after cerebrovascular accident
Lang, Michal ; Malá, Jitka (advisor) ; Pavlů, Dagmar (referee)
Title: The effect of regular training in Locomat system changing the stereotype of gait of patients after the cerebrovascular accident Objectives: The purpose of this thesis is to evaluate whether it is appropriate to use the Locomat system in therapy of gait of patients after the cerebrovascular accident, what is the effect of regular training of these patients in the Locomat system on their stereotype of gait and whether the training in the Locomat system of patients after the cerebrovascular accident is more effective in comparison with other physiotherapeutic practices. Methods: The thesis was processed in the Kladruby Rehabilitation Centre on 14 probands, who were divided after the entrance examination in order to form two equivalent homogenous groups. The first group of seven members was experimental, the second one was control. At the beginning of the study the rate of gait disorder was specified at each proband using standardized method of Wisconsin Gait Scale, they also underwent 10 - Meter Walk Test and 6 - Minute Walk Test. Afterwards all the probands absolved a three-week lasting standard regime of rehabilitation. The probands of research groups absolved except the rehabilitation regime during this time period regularly 5x times a week fifteen 30-minute lasting therapy units in the...
|
guest ::
