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Nutrition of patients in oncology departments
FOUSKOVÁ, Diana
The title of my bachelor thesis is Nutrition of Patients in Oncology Departments. In the theoretical part, I focused on the characteristics of malnutrition cancer, its symptoms, types of tumor malnutrition, its causes and consequences. Then I mentioned and described the various changes in metabolism of an oncology patient and a diagnosis of malnutrition. In the next part I described various types of nutritional support. In the theoretical part, I also focused on cancer therapy, where I described types of cancer treatment, various side effects of cancer therapy associated with intake of food and beverages and for every undesirable side effect I stated dietary recommendations. In the last part I mentioned risk factors and prevention of cancer. The goal of the practical part of my bachelor thesis was to determine the nutritional status of hospitalized patients in oncology departments in the context of anticancer therapy. I responded to three research questions: 1. "How does the antitumor therapy affect quality and quantity of consumed food?" 2. "How often must parenteral and enteral nutrition be applied to these patients?" 3. "How does the antitumor therapy affect the patient's weight?" The method quantitative and qualitative research was used for processing of the research part. The research was conducted by creating a week's records of diet, which were recorded by hospitalized patients in two departments of oncology. The research sample consisted of 50 oncology patients. Week's records of diet were recorded by 30 patients at University Hospital in Olomouc and by 20 patients at the University Hospital in Motol, Prague. The results were processed by Nutriservis software. Values of energy, protein, fat and carbohydrates calculated by Nutriservis software were compared with the recommended values corresponding with weight and age of the patient. I also examined the number of cases of parenteral and enteral nutrition and weight loss during cancer therapy by having records of the patient's weight at the beginning of anticancer treatments and their current weight. All patients were in the second half of anticancer treatment. I learned this information from patient documentation. To be allowed to have a look into the patient's documentation I prepared informed consent form, which I had consequently signed by the patients. The processed data are interpreted using tables and graphs, which are always accompanied by commentary. I have divided patients into groups according to diagnoses for evaluation. The results show that most patients have an inadequate intake of energy and essential nutrients. Food intake of patients has shown to be dependant on the type of tumor. Patients with carcinomas of the upper digestive tract, colon and carcinomas of liver, gall bladder and pancreas have larger deficiency of energy, proteins, fats and carbohydrates in comparison to patients with genital carcinomas. Patients with carcinomas of the kidney and urinary tract have also shown a significant deficit of energy, protein, fat and carbohydrates. The nutritional support was very common, particularly to patients to whom the tumor caused obstruction of some part of their digestive tract. As for carcinomas of the upper digestive tract, PEG is implemented to most patients. Very common was providing of sipping as an addition to their normal diet and in case of major nutrition complications parenteral nutrition was also often applied. The weight loss was apparent on most the patients. How significant was the weight loss depended on the type of tumor. Adequate intake of energy, nutrients and drinks during anticancer treatment is very important for patients. In the case of formation or developement of tumor malnutrition or developement of complications associated with food intake, nutritional support should be ensured timely according to patient's individual condition.
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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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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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Genetic Aspects of Sporadic Ovarian Cancer
Jančárková, Natalia ; Freitag, Pavel (advisor) ; Rokyta, Richard (referee) ; Kohoutová, Milada (referee)
58 9. SUMMARY Molecular biological parameters, including genetic alterations, present new and perspective direction in diagnostics, prediction of prognosis, monitoring and possible therapeutic approaches in oncological disease. The results presented have to do with the project, which is concentrated upon chromosomal rearrangements in ovarian and cervical cancer and their correlations with available parameters of both molecular biological and clinical characteristics. Sixty patients with ovarian cancer and twenty patients manifesting cervical cancer were included into the study. The histological type and grade, MIB-1 and p53 (using immunohistochemical method) were estimated by histopathologist. Both conventional karyotyping and molecular-cytogenetic methods (fluorescent in situ hybridization and comparative genomic hybridization) were applied to reveal chromosomal aberrations. The results were subjected to statistical evaluation, using analysis of variances and χ2 test. There were correlated parameters of quantitative and qualitative character - age, stage, histological type, grade, CA 125 before and after treatment, MIB-1, p53, surgical residuum, lymphadenectomy, response rate, chromosomal rearrangements. Analyses accomplished in ovarian cancer group revealed typical amplifications on chromosomes 1q, 3q and...
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Problems of renal tumours in patiens with terminal stadium of renal failure
Ürge, Tomáš ; Hora, Milan (advisor) ; Novák, Jaroslav (referee) ; Zachoval, Roman (referee) ; Morávek, Petr (referee)
Objective: Risk of renal carcinoma is minimal 10 x higher in group of patients in terminal stadium of renal failure (end stage kidney disease - ESKD). We have only some information about chromosomal changes in renal tubules, from which rise renal carcinoma, and about pathogenesis of renal carcinoma, which seems to be different from carcinoma in common population. Aim of the study: In clinical part we valorize characteristic signs of renal carcinoma in ESKD by using of statistic methods. In experimental part we can explain pathogenesis of this carcinoma by analysis of selective chromosomal aberations. Material, methods: In 2000 - 2007 were 184 patients with ESKD in care of transplant centre and nephrologic ambulation of Faculty hospital Plze_. In 15 patients we diagnose renal carcinoma. In this group we valorize: age, gender, causation of renal failure and dialysis duration. Age, gender and type of renal carcinoma we confront with carcinoma in common population. In experimental part we valorize numerical aberations in chromosome 7, 17 and Y of tubular epithelium using fluorescent hybridization in situ (FISH). Results: We have 15 patients in average age 55.7 ± 11.5 years, long of during dialyzation was 78 ± 54 months. We do not find dependence between causation of renal failure and genesis of renal...
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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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Nutritional care about immobile patient on standard department of internal type
AMBLEROVÁ, Michaela
Nutritional care for immobile clients at a standard department of internal type becomes still more important, because nutritional care is important for maintaining good health and supporting quality of life. Nutritional status of immobile clients is very important to diagnose as early as possible in order to avoid all risks of potential complications. Adequate nutrition is also very important to maintain good mental health. The central objective of this work was to explore the specifics of nursing care in the field of nutritional care for immobile client at a standard department of internal type. Following this goal, three research questions were set up: How is the nutritional status of patients at a standard department of internal type assessed? What are the possibilities of application of nutrition for immobile client at a standard department of internal type? What are the specifics of nursing care in the fields of nutrition of immobile client at a standard department of internal type? The empirical part of the thesis was processed using qualitative research, which was realized through semi-structured interview technique. The interview contained 3134 questions, which focused on nutrition care for immobile clients on standard unit of internal type. The research sample consisted of nurses working in the standard department of internal type in the České Budějovice Hospital, a.s. Overall, this study leads to two findings, both positive and negative. Within the positive findings we can say that nurses provide adequate care in the application of nutrition per os. Negative findings relates to the fact that the interviewed nurses provide only basic care in case of the introduction of enteral and parenteral nutrition. They do not know more detailed specifics of enteral and parenteral nutrition. Based on this finding, we think it would be useful to organize regular seminars and trainings for nurses to expand their knowledge about this type of care, or at least remind it. This thesis can serve as an informational material for nurses in practice or students of other health professions. This work can serve also as a basis for further research.
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A nursing issue: peripheral venous catheter
TOMÁNKOVÁ NOVÁKOVÁ, Monika
Peripheral venous catheter is used to access the venous system. It is one of the most commonly used invasive procedures in health care facilities. This procedure falls within the competence and daily tasks of nurses. Therefore this type of nursing care is susceptible to risk of proceeding routinely which might result in conscious or unconscious errors. Peripheral venous catheter needs to be introduced into the patient's vein in the following cases: planned parenteral nutrition, infusion or transfusion therapy, application of intravascular medication or contrast media, rehydration, blood sampling (which can be performed immediately after introducing the peripheral venous catheter and before administrating medication) and also during an emergency care for critically ill (such as cardiopulmonary resuscitation). Nurses should be as knowledgeable as possible about this issue so that the peripheral venous catheter can be introduced well and fulfil its purpose. It is important to ensure that nurses obtain all the necessary information about their patients before inserting the catheter and that they are able to properly inform the patients about the procedure and to communicate with them. Next, nurses should be familiar with the correct procedure for inserting catheters, they should be informed about possible contraindications and know how to choose the correct type of catheter as well as where to place it. Furthermore, nurses should care for this vascular access correctly and provide the patient with enough information about taking care of the catheter after the procedure. Finally, nurses should be aware of their own potential errors and also of possible complications. Therefore they should employ aseptic technique so that they can eliminate nosocomial infections. The thesis is divided into a theoretical and an empirical part. The theoretical part focuses on the history of peripheral venous catheters and their types, indications and contraindications, necessary equipment, nursing care, complications, etc. The empirical part consists of a research. The aim of the thesis was to map the use of peripheral venous catheters in hospitals as well as to identify factors that may lead to problems among the patients with peripheral venous catheters. Four research questions were assigned to these aims. 1. What is the procedure prior to inserting a peripheral venous catheter? 2. What are the standards of caring for patients with an inserted peripheral venous catheter? 3. In which steps of caring for peripheral venous catheters do the nurses lack knowledge? What equipment do the nurses prepare in order to insert a peripheral venous catheter? The Bachelor's thesis was conducted using a qualitative research survey. The methods of collecting data included semi-structured interviews and participant observations. The research was carried out only in one hospital ward and it was anonymous. First, the data were collected by means of a semi-structured interview. The nurses were asked 14 questions (see Appendix 8). During this interview, several more subquestions were added. The results of the interviews were then grouped into several categories for the sake of clarity. The second method of collecting data was participant observation. The observed facts were recorded into an observation sheet (see Appendix 9). The same nurses who were interviewed were also observed. This Bachelor's thesis has been written in order to provide a basic overview of the peripheral venous catheters. It could be used as an information source for more experienced as well as novice nurses. The practical output of this Bachelor's thesis is a nursing care standard concerning peripheral venous catheters. This standard was missing in the hospital ward and could help the nurses to take care of these vascular accesses, to proceed correctly and eliminate possible errors (see Appendix10).
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