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Prostatic cancer and possibilities of prediction of early success of radical prostatectomy
Svačina, Jakub ; Hanuš, Tomáš (advisor) ; Zachoval, Roman (referee)
Classification of adenocarcinoma prostatae is very important for the treatment. I have described the disease, its treatment and classification in the introduction. I have analysed a sample of 52 patients from the Urological Clinic of General Faculty Hospital. Simple statistics was used for comparing and analysing of relation of preoperative classification and postoperative development of PSA. I have compared preoperative and operative Gleason's score. Preoperative Gleason score underscores the operative score. PSA decrease is significantly higher in patients with high initial PSA and in patients with classification T2N0M0. PSA one month after surgery does not differ in patients with classification T1C and T2 and it does not correlate with the preoperative characteristics of patients. The decrease of PSA is perhaps dependent only on the surgical treatment. Effect of operation cannot be predicted by Gleason score and by age. These results are valid only for patients undergoing radical prostractomy
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Nursing care of the operation area before and after the operation
KRATOCHVÍLOVÁ, Michaela
Theoretical outcomes The preparation of the operating field is an important part of all preoperative preparation. Preoperative preparation, before surgical intervention, cannot be neglected. In most cases, the doctor will not perform an operation without proper preoperative preparation. The only exception is urgent surgical intervention for which only the most basic preoperative preparation is provided. Preoperative preparation can be categorized as long-term, short-term, or immediate. A thorough and proper preparation of the operating field reduces any development of postoperative wound complications. The aim of thorough preoperative preparation of the operating field is to reduce any risk of developing postoperative wound complications. Postoperative care prevents postoperative complications. It is aimed at controlling the state of a patient's current health after surgical intervention, but also the surgical wound and its dressing. Both nurses and doctors are obliged to perform these controls. In the early postoperative period, the client stays in the ward or in the postoperative room. In the case of arising complications during surgical intervention, the client is moved to the ICU/ARO. The Aims of the Thesis The aim of the thesis is to map the differences in preoperative preparation of the operating field among surgery departments, and to find the differences between preparation in the operating field before a scheduled and an urgent surgical intervention. Furthermore, the aim is to find out if nurses perform preoperative and postoperative care properly. The following questions were chosen: What are the differences in preoperative preparation of the operating field among surgery departments? How do nurses perform preoperative and postoperative care of the operating field? Implemented methods In order to gain the desired information, a qualitative form of research was chosen, namely an in-depth interview method, a method of questioning, and an observational method. Observation was implemented using the hidden observation method. The respondents in the research were the nurses from the urology and the surgery departments at a hospital in Vysočina. Data collection was conducted from February to March, 2014. The acquired data was then analyzed through an open coding method. Results The subsequently transcribed interviews and observations were carefully analyzed using the 'pencil & paper' method and open coding. Eventually, five categories were created: preoperative preparation before a scheduled surgical intervention, preoperative preparation before an acute or urgent surgical intervention, preparation of the operating field, postoperative wound care, medical documentation. Conclusion The research suggests that nurses are well aware of the complete preoperative and postoperative care. What is, however, surprising is how adherence to the principles of barrier care and the client's intimity vary in the course of providing this care.The conclusions in this thesis should aim at an improvement of preoperative and postoperative care of a client and to eliminate any discovered shortcomings in the provided nursing care. The practical outcome of this thesis will be an article in a professional magazine for nurses.
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The Role of Nurse in the Prevention of Disease of Civilisation
PAVLOVÁ, Martina
The current state Prevention is a complex care of a patient when we are trying to prevent from the occurrence or development of a disease, or when we want to prevent from its consequences and mitigate them. Recommendations for prevention set by a doctor must be on a scientific basis, and they must be a part of all branches of medicine. Their effectiveness depends on the cooperation between patients and medical staff. The basic and most efficient method of prevention is the health promotion and health education, which is closely associated with it. The term health promotion involves a set of activities and precautions for the purpose of making health better and sustaining it. Diseases of civilisation (hereinafter "DoC") are groups of diseases which are distinguished by their association to our lifestyles. Human body is more and more threatened from unfavourable influences of external environment, such as the quality of atmosphere, work environment and environment itself, the lack of physical movement, unhealthy diet, smoking, and alcohol consumption. The list of diseases of civilisation varies and changes together with our society and the development of our lifestyles. Among the most common or frequent diseases of current time are cardiovascular diseases, which involve atherosclerosis, hypertension, myocardial infarction, stroke, coronary artery disease and obesity. Furthermore, between civilization diseases include diabetes mellitus type 2 or cancer, etc. The goal of the thesis There are two goals set for this paper. The first goal was to find out what the role of a nurse in the prevention of diseases of civilisation was. The second goal was to find out what the above mentioned role of a nurse was from the point of view of patients. Methodology For the purpose of the research part of this thesis, qualitative research using semistructured interviews was carried out. Respondents were divided into two groups; the first one consisted of eight nurses working at internal medicine and neurological department of the hospital in České Budějovice and a nurse working in a private office of a general practitioner for adult patients. The second group consisted of eight patients of the above mentioned health facilities. Results According to our findings, nurses and patients have different oppinions on the role of a nurse. Nurses in disease prevention see themselves as an equivalent to a doctor when undertaking this practice and giving guidance. The patient speaks only to the nurse who emphasized what they were told by the doctor and reiterated the main points. They make available to them leaflets and brochures or Internet resources. In contrast, most patients see a nurse as a more important source of information than the doctor. Patients have the feeling that the doctor does not have enough time or does not want to be botherd with questions. Rather the patient turns to his nurse, which they sees as more appropriate and someone to whom they can confide in without bothering. Summary The goal of the thesis was to focus on prevention, DoC, and the role of a nurse in the prevention of such diseases, as well as to study this issue, look at it from the point of view of patients and nurses via the interviews carried out in this paper, and to analyse such information. Based on this analysis are published recommendations for nurses and patients.
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Communication of medics with the parents of a child patient.
ŽÁKOVÁ, Nikola
The theoretical part is divided into eleven chapters. The first chapter deals with the definition of communication. The second chapter describes the kinds of communication, including verbal and nonverbal. The third chapter discusses the communication skills of nurses. In the fourth chapter we expanded on the communication of the nurse with a child patient. The fifth chapter describes the basics of communication between nurses and parents of child patients. The sixth chapter discusses a situation where the nurse communicates with parents of a disabled and dying child. The seventh chapter describes the communication of nurses at the pediatric department. The eighth chapter contains the specifics of the children's department. In the ninth chapter is divided into childage. The tenth chapter discusses communication as a part of nursing care. A final chapter describes the process of hospitalization of children and their parents. The thesis is divided into theoretical and empirical parts. Much of the theory is described above whereas the empirical section describes the results of the research. Objectives and research questions The first objective of this thesis was to investigate how the nurse communicates with the parents of a child patient. The second objective was to determine whether a parent understands the information given by the sister and the final objective was to determine any errors that the nurse makes when they communicate with parents of child patients. Research questions: 1. How the nurse communicates with the parent of a child patient? 2. How does the nurse inform parents of a child patient? 3. How a parent of a child patient assesses the clarity of the information provided by the nurse? 4. What mistakes nurse makes in communication with the parents of a child patient? Methodics For the research a survey was chosen to provide qualitative information, which was obtained via interviews. The second methodology used in this work is called participant observation. Data for the first part of the survey was obtained through semi-structured interviews with the parents of hospitalized children. Interviews were conducted on the basis of questions prepared in advance. If necessary, the interview was supplemented with other issues. The interview was to determine how children were admitted to the children's department, what information reached parents about the examination of the child, and also the overall impression of the nurses on the ward. We asked parents about the verbal and nonverbal communication of sisters. They described the errors they found in the communication and behavior of nurses. The second part of the research was anonymous on the pediatric ward of the hospital where nurses evaluated verbal and nonverbal communication skills. The research group The research set for the first part of the survey consisted of seven mothers of children hospitalized in the pediatric ward. The mothers were in different hospitals in the Czech Republic. The research set for the second part of the investigation, which was carried out by observation technique, consists of six nurses employed at the pediatric ward of a state hospital. Nurses were selected randomly. They are of different ages and they have different length of practice and other training.
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Oxygen therapy after cardiothoracic surgery from the point of view of nurses and patients
VRCHOTOVÁ, Klára
Cardiac surgeries are very serious surgical procedures with considerable specific features. This bachelor thesis focuses on oxygen therapy from the viewpoints of nurses and patients. Its theoretical part describes physiology of breathing and the oxygen therapy as such. It describes individual sources of oxygen and indications for oxygen administration. It also describes principles to be observed during oxygen administration. Specific aids are used for oxygen administration, particularly oxygen masks or oxygen goggles. Quality pulmonary rehabilitation is also necessary to make oxygen therapy more effective. Pulmonary rehabilitation is particularly important for patients after a cardiac surgery and it should be practiced even before the surgery. This approach is critical because in the post-surgery period the therapy makes it possible for the patient to breathe and to expectorate properly. Pulmonary rehabilitation is practiced with patients by general nurses at the cardio surgery ward, as well as by physiotherapists. There are various techniques available to determine efficiency of oxygen therapy and pulmonary rehabilitation. The techniques may be classified as invasive and non-invasive; the most frequently used non-invasive method is pulse oxymetry and the most frequently used invasive technique is blood collection for ABR. Two objectives were set for the thesis. The first objective was to map knowledge of nurses about how to provide care to patients treated with oxygen therapy. The second objective was to determine how the patients feel after a cardiac surgery. Two hypotheses and two research questions were formulated. The first hypotheses were: Nurses working at the resuscitation care station have more knowledge about oxygen therapy than nurses working at the intermediate care station. The second hypothesis was: Nurses working at the resuscitation care station have more knowledge about pulmonary rehabilitation than nurses working at the intermediate care station. The first research question was: How do the patients feel during oxygen therapy and pulmonary rehabilitation? The second research question was: How are the patients after a cardiac surgery informed about oxygen therapy and pulmonary rehabilitation? In the research part of the bachelor thesis I have used both quantitative and qualitative research methods. Quantitative processing of data was used for questionnaires filled out by nurses working in the hospitals Nemocnice České Budějovice a.s., Nemocnice na Homolce in Prague and in the faculty hospital Královské Vinohrady in Prague. The method was used for evaluation and assessment of knowledge of nurses working at the resuscitation and intermediate care wards. Quantitative methods were used for processing of data obtained through semi-structured interviews with patients after a cardiac surgery. The data were transcribed and coded using a pencil and paper method. The data were categorized based on the identified codes. Two categories were created: oxygen therapy and pulmonary rehabilitation. Each of the categories was further divided into three sub-categories. Two categories were created for the research oxygen therapy and pulmonary therapy. Three sub-categories were subsequently created for the oxygen therapy and the pulmonary therapy. The quantitative research has shown that the knowledge of nurses about oxygen therapy is higher among the nurses working at the resuscitation care ward. However, the situation is different in case of their knowledge about pulmonary rehabilitation. In this case the knowledge of nurses working at the intermediate care ward was higher. The processed data from the qualitative research have shown that patients do have sufficient information about post-surgery oxygen therapy, as well as about pulmonary rehabilitation. For all patients in the post-surgery period after a cardiac surgery the frequency of pulmonary rehabilitation was higher than 1 per day.
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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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Palliative care is provided by patient's family at home
KUČEROVÁ, Tereza
The thesis, titled Palliative Care Provided by Patient's Family in Home Environment, discusses the specific care needs of a terminally ill patient in his/her own home. Caring for an ill person in a home environment is beginning to be a growing trend in home care, but also it is an increasingly common wish of the patients themselves. The family is therefore required to have enough theory and practical knowledge in order to deliver a highly demanding personal care for their close family members. The aim of the thesis is to summarize the current situation of delivering palliative care in home environment in Czech Republic whilst concentrating on the specific needs of the patient and the needs of their family. The objectives of the research were to determine whether family members were introduces to the specifics of palliative care of terminally ill patients; to map their skills in delivering palliative care in home environment and to reveal the most common issues that family members come across in that home environment. The final objective was to map out services in regions of Central Bohemia and Liberec that are accessible to family members whilst caring for a terminally ill patient. The research part of the thesis was completed employing a method of qualitative investigation using semi-structured interviews with patient's family members and nurses providing hospice care in home environment. It emerged from the analytical interviews that the family's knowledge level regarding support for palliative care in home environment is very limited and in hospitals families are only given minimal or no support or information. As a final document for the thesis an informative educational brochure was created based on the results of aforementioned research, primarily targeting patient's family; its core objective is to improve information and collate the specifics of care that would allow the patient a dignified end to their life.
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Nursing care in a hygienic and epidemiological regime from the patient's perspective.
KŘEPELOVÁ, Lenka
Considering contemporary lifestyle and possibility of travelling imported infections accrued and some illnesses come back that have not occurred nearly at us more. Not only haemorrhagic fevers and other highly infectious illnesses but also hospital multiresistant bacterial strains that mean high risk for patients constitute a threat. The number of nosocomial infectious grows still. The patient is in the case of suspicion or already diagnosed infectious illness isolated and treated in the infectious department or in the tribal department in the room with increased hygienic-epidemiologic regime. The patient is saved in a single room, the possibility of visits is reduced and the staff uses personal protective equipment. The man is holistic being and it can come due to isolation to lack of satisfaction of his/her bio-psycho-social needs. The aim of this thesis is to identify unsatisfied bio-psycho-social needs of patients in increased hygienic-epidemiologic regime and to describe changes in needs of the patient depending on the time of hospitalisation. The theoretic part describes the problematics of infectious illnesses, system of the care for the patient with infectious illness and changes in human needs in the period of the illness. The empiric part of the thesis deals with unsatisfied bio-psycho-social needs of isolated individual through quantitative research. The research suite was made up of 10 patients who were hospitalised in the room with increased hygienic-epidemiologic regime. The survey was carried out in the Hospital Jihlava by semistructured interview and the results of the survey were processed by opened coding by method paper and pencil. It is emphasized that the most needs of the patient have biological, psychical, social and even spiritual aspects. The rate of satisfaction with caregiving depends on the health condition and personality of the patient. Not small influence has the length of the hospitalisation, too. It was found out during the survey that the patients have not enough information about specifics of the care in the infectious department and that is why there is often a misunderstanding of necessity of barrier measures. It is possible to avoid useless misunderstanding through timely and suitable education. It was created an educational material with the title "Guide for patients hospitalised in the infectious department of Hospital Jihlava" for this purpose. Employees of the infectious department of Hospital Jihlava were informed with results of the research during a workshop, too.
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