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Physiotherapist - patient relationship
FORMANOVÁ, Miroslava
The bachelor´s work The relation between the patient and the physiotherapist engages in the character of this relation, how both sides evaluate it and the factors influencing a good relation. The aim was to monitor what the relation means for physiotherapists and patients, to describe some important aspects and factors that can influence it. The theoretical part is focused at psychology and communication in medical care, further at specialities of treating children, seniors, worried and aggressive patients. The work explains the meaning of words like empathy, cooperation, burnout syndrome and other aspects which may influence the patient ? physiotherapist relationship. The practical part is divided into two parts. The first one contains dialogues with patients undergoing some therapy. The second part presents interviewing some physiotherapists. The dialogues are half-structured and subsequently processed with the help of qualitative analysis - the answers to the research questions are then obtained. The results prove that a good patient ? physiotherapist relation is essential for quality physiotherapy care and substantially influence it. Reciprocal trust is necessary: the patient´s confidence in the physiotherapist´s ability and readiness to help, and the physiotherapist´s trust in the patient´s good will to contribute to the improvement of his/her health condition. The relation is influenced by the physiotherapist´s communication skills, which have to be adjusted to each patient´s individuality. Other factors like the sex and the age can influence the relationship, too. The outcomes of the work may be useful for students and medical workers. They offer the insight into how some patients and colleagues think, which may be inspiring for them.
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The readiness of students of the first grade of nurse to meet with the dying person
BOLKOVÁ, Ilona
Title: Preparation of First-Year Students of the General Nurse Field of Study for Dealing with a Dying Patient. Theoretical foundations: Vocational preparation for a career as a nurse is not among the easiest. Beside the considerably difficult theoretical courses, the students must also undergo many hours of practical training. During the training, the students deal with child, adult and elderly patients. Each patient experiences different problems; usually, the patients reach full recovery or at least a significant improvement. Unfortunately, even in these highly advanced times, medicine is not all-powerful and students often have to deal with a terminal patient, a patient who is dying. This situation is undoubtedly very complicated, especially for a young person. Death, as the final stage of a human life, both directly and indirectly influences life around us, and encountering death makes every person feel differently. The study of nursing care has recently transitioned to the university level. The undertaking of this type of qualification studies strives to establish an educational programme that is comparable to other countries of the European Union and to secure more efficient care for the sick. It is assumed that the higher age of the students and their higher maturity will facilitate a more mature perspective on the studies. The goal of this work: The principal goal of the bachelor thesis was to offer a comprehensive overview of the area of vocational preparation of first-year students of the General Nurse Field of study for dealing with a dying patient. Two research questions were established: How prepared are first-year students of the General Nurse Field of study for encountering a dying patient, what is their theoretical knowledge of the issue of dying? What is their assessment of their preparedness for dealing with a dying patient? With the help of these questions we aimed to find out whether the students encountered a dying patient during their first practical training and obtain an assessment of their current knowledge gained during the first semester at the Faculty of Health and Social Studies. Methodology used: To obtain information, a qualitative research was carried out that used non-standardized semi-structured interviews. The interviews were based on 18 research questions prepared up front. Ten first-year students of the General Nurse Field of study at the Faculty of Health and Social Studies in České Budějovice were approached. Before starting the interviews, the respondents were assured that their anonymity was guaranteed and that the interviews would be recorded on a voice recorder. Afterwards, they were placed into separate categories and subcategories. The research was carried out in March, 2014. Results: The results of the bachelor thesis show the real degree of preparedness of first-year students of the General Nurse Field of study for dealing with a dying patient. Answers to the main research questions were processed in detail in the research section, the set goal was met. The results showed that the theoretical knowledge of the students has significant shortcomings. Most of them lack a basic understanding of the stages of dying, of certain and uncertain signs of death and of taking care of a dead body. Nor are they sufficiently prepared for communication with a terminal patient and his or her family. Acquiring these skills should be a matter of course for exercising the profession of a nurse. Yet, the majority of the students stated that they find their training sufficient and that they consider its extension unnecessary. Most of them think that they will learn the right approach towards a dying patient while carrying out their duties and from their own experience; nonetheless, it is certainly worth considering whether it would be desirable to at least partially expand the scope of education in this particular area. Conclusion: The principal benefit of the bachelor thesis
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The Difference between Planed and Real Measured Dose under the Bolus Made of New Material
KUKAČKOVÁ, Lucie
The first chapter of the theoretical part of the bachelor's thesis outlines radiotherapy in general. Radiotherapy is a clinical treatment using ionising radiation to treat malignant and benign diseases. It is one of the youngest medical disciplines. The development of radiotherapy began in November 1895, when Wilhelm Conrad Röntgen discovered X-rays. Radiotherapy became an independent medical specialty in 1922. The second chapter describes planning in radiotherapy. Irradiation plans for radiotherapy are created on the basis of a planning system. ECLIPSE planning system is used in the oncology department in České Budějovice Hospital. Phantoms are the theme of the third chapter. Phantoms are materials whose radiation absorption corresponds to human tissue. Water is a basic universal phantom material. In addition to water, also other materials are used, such as polystyrene, plexiglass, paraffin, PMMA etc. The last, fourth chapter of the theoretical part, deals with boluses. Boluses are tissue-equivalent materials that are put on the patient's skin during irradiation when it is needed to increase the surface dose and at the same decrease the depth dose. Moreover, bolus is used to compensate the missing tissue. Bolus is most often used to diagnose patients after mastectomy due to breast cancer. The most important characteristic of boluses is their ability to absorb radiation. In the oncology department in České Budějovice Hospital, bolus from dental wax Ceradent had been used before. A bolus made from this material was hard and uneasy to shape. That is why it did not fit tightly to the chest wall of the patient. For this reason a new line of boluses was obtained for the oncology department, from gel material supplied by CIVCO company with dimensions 30 x 30 cm and thickness 0.3 cm, 0.5 cm and 1 cm, in "skin" and "skinless" version. These new boluses stick easily to the patient's skin and copy the shape of the body. The first objective of my bachelor's thesis was to compare the doses planned and measured under the bolus from the new material. This objective is elaborated in the practical part of the bachelor's thesis in chapter presenting the results. Another objective was to elaborate the principles for the use of bolus. These principles are described in the theoretical part of the bachelor's thesis in chapter describing the use of bolus in radiotherapy. The following hypothesis was suggested in the thesis: "It can be assumed that the generated bolus in the planning system corresponds to the scanned bolus on the CT with patient and that there is a difference between the planned dose and measured one." To confirm or refute the working hypothesis, measuring was executed in the oncology department in České Budějovice Hospital. Data about individual doses were collected boluses generated in the Eclipse planning system of different width (0.3 cm, 0.5 cm, 1 cm) on phantoms. Three types of phantoms from PMMA were used for the purposes of this measuring. First, the measuring was executed on phantom in the shape of the chest wall of a patient after breast ablation. Then, the tabular phantom and universal IMRT verification phantoms were used. The measurement was executed on the Clinac 2100 C/D linear accelerator, later on the new TrueBeam 2.5. linear accelerator. All these doses were measured by ionisation chamber from PTW company with volume of 0.125cm3. The obtained data were processed in tables and deviations of individual doses were calculated. Based on this measurement it was found out that the deviations of all doses are less than 3%. And therefore also the hypothesis of the thesis was confirmed. There really is a difference between individual doses, but not so significant to affect the size of dose during the planning. As for the practical outcome, generated boluses will be used as standard in the oncology department in České Budějovice Hospital.
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Selfmonitoring of Type 1 Diabetes mellitus in adolescents
KORELOVÁ, Andrea
Type 1 diabetes mellitus is a chronic, lifelong disease. The younger the patient, the more seriously the disease affects his (her) childhood. The disease brings about a lot of changes, it involves the loss of freedom and independence. Diabetes makes the normal troubles of adolescence even more difficult. Adolescence is a hard stage of life for patients with the type 1 diabetes mellitus because it is a period when the compensation of diabetes is more difficult than in the previous and following stages of life. Regular self-monitoring is one of the crucial tasks. The selfmonitoring is important for the overall compensation of diabetes and also for the clinical results of treatment. Self-monitoring is the process of monitoring and measurement of one´s own glycemia and ketones in blood and sugar and ketones in urine. It enables the diabetic patient a better orientation in the disease and a certain level of independence. Self-monitoring helps parents gain confidence in cure of their children suffering from diabetes. The theoretical part of my thesis deals with the questions of the type 1 diabetes mellitus and the method of self-monitoring. The objective of the practical part was to survey the subjective view of adolescents with the type 1 diabetes mellitus on self-monitoring and the level of their self-reliance. I set hypotheses suggesting that adolescents perceive self-monitoring to be uncomfortable and cannot cope with the procedures independently. These hypotheses were not confirmed in my research. To get relevant data, I used the questionnaire method. I handed out questionnaires to young patients with diabetes aged 13{--}18 years. A letter for patients´ parents asking for their written consent with the research was attached to the questionnaire.
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Perioperative nursing care from the perspective of the patient
LHOTSKÁ, Jana
The bachelor's thesis deals with the nursing care which is provided to the patients before, during and after the surgery until discharge to home care. In the research nurses of surgery and their cooperation in the perioperative nursing care are also included. The theoretical part is focused on the issue of the perioperative nursing care, on the preoperative preparation and the postoperative care and how the patient perceives the time just before the surgery when he/she is passed to the operating room. In the theoretical part there is also the task of the nurses included providing the perioperative care and their mutual cooperation. The first aim of the thesis was to find what is the level of continuity of the care in the perioperative time from the perspective of the patient. The other aim of the thesis was to find the cooperation of healthcare workers in the perioperative care. The survey was conducted through the qualitative research, through the method of questioning. The data collection technique were the depth individual interviews with the patients and nurses. The choice of the patients was intentional, the patients had to be after a surgery and already in home care. The choice of the nurses was intentional, too, the surgical nurses had to care for patients after surgeries, the nurse anesthetists had to work in the surgical operating theatres. The results of the survey show that in the preoperative time the patients see the biggest problem in giving lack of information about the postoperative care. In ensuring the intraoperative care the nurse anesthetist introduced herself/himself only to one patient at the first contact. In the postoperative time none of the patients were in contact with the nurse after full awakening, they only had signalling device. Further the interviews with the patients show that no patients were instructed on the first postoperative getting out of bed and further postoperative rehabilitation. Out of the results of interviews with the surgical nurses and nurse anesthetists we find out that the nurse anesthetist participates in the preoperative preparation just on the day of surgery. The problem in the cooperation of the surgical nurses and nurse anesthetists is transmission of the information and documentation during the transfer of the patient from the operating room. In the postoperative rehabilitation the nurse can cooperate with the physiotherapist but only on weekdays. The results of my bachelor's thesis could be submitted to the head nurse of the hospital but especially to the head nurses of the surgical and anestheziology department to have opportunity to agree on better cooperation and communication. Because I work in the surgical postoperative department I suppose then it would be appropriate to consult together possible improvement of providing the nursing care with the colleagues in the department throughout the perioperative period, or to organize seminars focused on the issue of nursing perioperative care. The nurses can only point out that the establishment of a sleep-in room would be a benefit both for patients and for nurses however its establishment is not real. Then my bachelor's thesis could be used as an information resource for nurses working in surgical fields.
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Issue of nursing care within patiens reliant on domestic oxygen therapy and inhalation therapy.
ŠTEFLOVÁ, Karolína
Theory basis: Oxygenotherapy is a method using the oxygen for the treatment. In present time is not usable only in the medical facilities, but also in the home enviroment. Important fact is, that there's a certain life quality improvement at all aspects due to home oxygen therapy. This thesis is focused on issues of the nursing care of the patients dependent on home oxygen therapy and inhalation treatment. Theoretical part of thesis starts with enlightenment of oxygen therapy, utilization of the oxygen and its source. Other chapters of thesis are focused on terms such as oxygen therapy, diseases treated by this method and patients indication for the home oxygen therapy, followed by available sources of the oxygen in the Czech republic, nurse procedures for oxygen application, oxygen therapy equipment and important regulations and policies for oxygen manipulation. There's also mentioned procedure to approach a proper effect of the oxygen therapy and knowledge given by a nurse with the patient release into the home environment. One chapter is dedicated to the nursing care of the patients dependent on home oxygen therapy and inhalation treatment. There's a section in this part touching a care problems with patients. Theoretical part of thesis is closed by a chapter about inhalation treatment, which is used by the patients dependent on home oxygen therapy. Two objectives of the research, and two research questions were defined for this thesis. First goal was to determine which informations are given by nurses to the patients dependent on home oxygen therapy and inhalation treatment. Second goal was to determine what are the most common problems of patients dependent on home oxygen therapy and inhalation treatment. The method of research: Empirical part of this thesis is done by qualitative method in the form of half-structured interview. Results: Three main categories were defined based on data retrieved from interviewees. Categories are divided into subcategories. In the first main category, named "Nurses cooperation", was found, that nurses are cooperating with patient's family, practitioner, pulmonologist, physiotherapist, technical support and homecare agency. From the second main category, named "The range of the patient's awareness", research show us, that nurses inform patients about policies for oxygen manipulation, strict smoking prohibition and the need of periodical check from practitioner. Subcategories in this category are "Introduction to oxygen concentrator", "Oxygen therapy equipment", "Policies for oxygen manipulation" and "Methods of breathe rehabilitation". In subcategory "Introduction to a oxygen concentrator" was found, that nurses are not informing patients. In subcategory "Oxygen therapy equipment" was found, that most interviewed nurses are using informational leaflets except one of the nurses, which is not using any helpful materials. In subcategory "Policies for oxygen manipulation" was found, that nurses are informing patients about restrictions to work with greasy hands, avoiding open fire and strict smoking prohibition. Some of nurses also mentioned policies for the oxygen concentrator, which was a surprise for us. In last category, named "Methods of breathe rehabilitation", research show us, that nurses are recommending aids such as Treshold PEP, Accapela and breathe trainer. We also found, that one of the nurses is not recommending and aids. Third main category, named "Nurses recommendation", consist of
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A Patient with Tracheostomy at an Intensive Care Unit and a Standard Ward
HLOCHOVÁ, Denisa
Tracheostomy is a surgical operation where a permanent or temporary opening is made in the trachea to ensure passability of the air passage. The aim of tracheostomy is to provide oxygen to the lungs, to improve breathing, to reduce consciousness sedation, and to improve the tracheal toilet. The bachelor thesis mainly focuses on nursing care of a patient with tracheostomy at an intensive care unit and at a standard ward. The theoretical part explains the problem of tracheostomy, aids and types of tracheostomy cannulas. It also focuses on the nursing care of tracheostomy. It deals with mouth hygiene and care of the air passages. The care of the air passages includes humidification, lavage and tracheostomy suction. The theoretical part of the thesis also deals with rehabilitation, diet and communication with patients with tracheostomy. The subject of the thesis was to map what the nursing care of patients with tracheostomy is like and how the needs of a patient with tracheostomy are satisfied. Three goals were set to meet the goal: Goal 1: To find out the specifics of the nursing care of patients with tracheostomy at an intensive care unit and at a standard ward. Goal 2: To find out the level of satisfying the needs of patients with tracheostomy at an ICU and at a standard ward. Goal 3: To map the level of adherence to the principles of nursing care of a patient with tracheostomy at an ICU and at a standard ward. Three research questions were set in relation to the goals. 1: What are the specifics of nursing care of a patient with tracheostomy at an ICU and at a standard ward? 2: What is the level of satisfying the needs of patients with tracheostomy at an ICU and at a standard ward? 3: What is the level of adherence to the principles of nursing care of a patient with tracheostomy at an ICU and at a standard ward? Qualitative research, namely the techniques of semi-structured interview and concealed observation, was employed in the practical part of the bachelor thesis. Six nurses from the České Budějovice Hospital were invited to the interview. The first part contains identification data, the second deals with the opinions on the specifics of nursing care of patients with tracheostomy among nurses, it also focuses on the level of satisfaction of the needs of patients with tracheostomy and the last part deals with adherence to the principles in nursing care of patients with tracheostomy. At the beginning of the interviews the nurses were informed on anonymousness of the interviews and they are numbered in the thesis. The research sample consisted of nurses from intensive care units and nurses from an otorhinolaryngology department. The data obtained from the interviews were processed by means of the "paper & pencil" and "card reading" methods into three categories, which were consequently subcategorized. The obtained data were processed into graphic schemes by means of XMind 2013 software. The information obtained from the observation was processed into graphs in Microsoft Excel 2010. The results from the interviews and the observation show that patients with tracheostomy are provided with relatively quality nursing care. The nurses showed good knowledge of the nursing care of a patient with tracheostomy. The nurses consider communication with a patient with tracheostomy the most frequent problem. All the set research goals were met in the research. The subject of the bachelor thesis was to show the weak points of the nursing care provided to patients with tracheostomy. This thesis may serve for improvement of the nursing care of patients with tracheostomy and may also be helpful to student as an additional study material. Elaboration of a brochure for patients with tracheostomy was the result of the thesis.
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Need for self-actualization in patients during hospitalization
VACHTOVÁ, Ivana
Human personality is a dynamic and organized set of characteristics which are in a special relation. Personatity is thought to be determined largely by either genetics and heredity, or by environment and experience, or both. The personal needs are dependent on sex, age, education and differ in different generations. The personality is developed through interaction of life situation, life conditions and the place. Self-fulfillment means to fulfill one´s potencial. It refers to ability to realize one´s own needs and plans. According to Maslow the need of self-actualization belongs to growth needs. Self-realization evokes feelings of happiness and joy. It surpasses everyday routine, it is a spiritual need. The first objective of my thesis was to examine the need of self-realization in hospitalized patients. The second objective was to compare the needs of patients hospitalized in intensive care units to those of patients admitted to planned medical interventions and to those of patients in long-term care facilities. The third objective was to find out nurses´ attitude to hospitalized patients with needs of self-realization. To find relevant data patients hospitalized in intensive care units, patients in long-term care facilities and patients with planned medical interventions were addressed. Nurses taking care of those patients were also asked to take part in the research . Data were collected by the questionnaire method. The hypothesis I suggests that patients treated in intensive care units prefer the treatment which leads to feelings of security and alleviates pain. This hypothesis was confirmed. The hypothesis II suggests that patients admitted to planned medical intervention have more intensive needs of self-realization than patients treated in intensive care units. This hypothesis was not confirmed {--} patients expecting interventions feel the same need of security and pain management as patients hospitalized in intensive care units. The hypotesis III that patients admitted to planned interventions have more intensive needs of self-realization than patients staying in long-term care facilities was not confirmed. According to the data collected, patients in long-term care facilities need pain management and feelings of security, but they also need to be respected as personalities. They prefer to have the strength to fight the disease to the need of having the bed properly made. The hypothesis IV that nurses do not show enough interest in hospitalized patients´needs of self-realization was not confirmed. Nurses are informed enough about patients´ needs. They usually try hard to find the time to talk to patients. The results should make nurses be more aware of the need of lifelong learning despite their enormous workload and care for their own mental and physical health by following principles of mental hygiene. Key words: needs self- fulfillment patient environment relations communication
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The Specifics of Nurse´s work on a Psychiatric Ward
HŘEBEJKOVÁ, Blanka
Theoretical background Psychiatry belongs to fundamental branches of medicine. Its task consists of diagnostics, treatment and prevention of mental diseases. Psychiatry includes adult psychiatry, child psychiatry and adolescent psychiatry, gerontopsychiatry, psychiatric addictology, psychiatric sexulogy with psychiatric rehabilitation. Nowadays, importance of the psychiatric branch is increasing; according to epidemiologists, we can see a slightly upward trend in the number of psychiatric patients. Work of a nurse in the department of psychiatry differs considerably from work in other standard departments. Such work is demanding both physically and mentally. In the department of psychiatry, it is extremely necessary that the nurse builds up a close relationship with the patient and acquires their confidence. Goals of the thesis The goal of the thesis was to map differences relating to work of a nurse working in the department of psychiatry, to find out what communication skills a nurse working in the department of psychiatry must have and in addition, to find out what the possibilities of further education within the framework of life-long education for nurses working in the branch of psychiatry are available. Methodology The qualitative methodology was applied to the research. The data were obtained by the interview method. Prior to execution of the research as such, the staff nurse was asked for permission and she agreed with execution of the research concerned. In cooperation with the charge nurse and the head nurse of the department of psychiatry, seven interviews with the nurses were made. The interview consisted of twelve questions and was absolutely anonymous. The written records of the interviews were analysed and the results were divided into categories and sub-categories subsequently. Results Based on the research, it was discovered that work of nurses in the department of psychiatry is much different from work thereof in other departments. The nurse working here should be interested in the field and should have good knowledge of the psychiatry-related issues. The nurse working in the department of psychiatry should be competent, resourceful and should be well informed of the patients to be able to perceive early possible changes in their behaviour. In the psychiatric nursing care it is important in particular to communicate correctly with various types of patients. Therefore, it is vital for the nurse to be well versed in mental diseases and symptoms thereof. Behaviour, perception and communication of the psychiatric patient are often affected by the disease as such. There are various communication barriers which the nurse has to cope with. Therefore, the nurse should be able to use all components of verbal as well as non-verbal communication correctly. Preparation for incidents consists of in particular regular training in the area of occupational safety and protection of health at work, fire protection and study of methodological guidelines and standards of the department of psychiatry. Certain preparation for incidents is included as well. There are sufficient possibilities of further education in psychiatric nursing care available. As it followed from the research, the nurses show active interest in education and search therefor independently. The nurses are sufficiently supported by their superiors in the search for suitable educational projects. Conclusion Considering the overall view of the thesis results, it is possible to say that the research questions were answered and the set goals of this thesis were achieved. The results of this bachelor's thesis may serve as supporting source material for lectures on nursing care in departments of psychiatry. In addition, the thesis may serve students as study and source material for their own studies and work.
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Protection of the privacy of patients in Gynaecology and Maternity department
Zajíčková, Markéta ; Haškovcová, Helena (advisor) ; Zelenková, Jana (referee)
This presented master's thesis deals with the protection of the privacy of patients in hospitals. This thesis is divided into two chapters. The first one is called Literature part, and deals with the explanation of such terms like patient, description of the relation between a patient and a doctor, and description of historical development of this relation. It also deals with the problems connected with the stay of patient in hospital and with explanation of the term of privacy. It is interested in protection of privacy in Czech legislative norms and profession ethics codeces, witch are connected with the rights of patients. The second chapter is Practical part and it describes the process of determination of the real status of the protection of privacy of patients at Gynaecology and Maternity of one hospital in the Czech Republic.There were used the technics of quantitative research for gathering datas from this department such as questionnaire, observation and unformal dilogues. This research was aimed at two populations The first one was formed by paramedics and the second one by patients. This research coclusion was that all the paramedics taking part in this project, know the etics codex The Rights of Patients, but almost half of them does not know the document The Convention on Human Rights and...
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