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The Role of Nurses in Colorectal Surgeries
ŠULCOVÁ, Jana
Theoretical basis: The problems in rectal and anal diseases have had rising tendency, especially haemorrhoidal diseases, on which we put emphasis in our bachelor thesis. 37% of adult population suffers from this disease so we may line it up to civilization illnesses. Their treatment involves wide range of medical methods, from the conservative therapy to semi invasive ways of treatment. The semi invasive treatment is well withstood by patients and it can help up to 90% of clients. This bachelor thesis is concerned with specifics of nursing duties in a colorectal surgery. It links with topics like taking faecal specimen, basic methods of endoscopy, communication with patients and giving them information about lifestyle. The theoretical basis describes haemorrhoidal disease and gives brief introduction into causes of its developing, most common symptoms and possible treatments. The aim of the thesis: From the practical point of view we set two tasks. The first one is aimed at specifics of nursing job in a colorectal surgery and the second one tries to monitor how nurses in colorectal surgeries inform patients about healthy lifestyle. We asked two research questions regarding these aims. The first research question is: What are the specifics of the nursing job in the colorectal surgery? The second question concerns how nurses in colorectal surgeries provide information to their patients about healthy lifestyle. Methodology: Regarding the bachelor thesis we decided to choose a form of a qualitative research with using semi structural interviews with practical nurses working in colorectal surgeries. The interviews took place from February 28 2014 to March 15 2014 in five colorectal surgeries in following towns: České Budějovice, Písek, Strakonice, Jindřichův Hradec a Třemošná u Plzně. The focus group was created of 6 nurses working in colorectal surgeries. The interviews were performed and recorded with the consent of all practical nurses involved in the research. All extracted data was arranged and categorised into groups that were consequently analysed. The interviewer´s questions were prepared in advance and some extra questions were asked during the interview. The interview was divided into five areas: Identification questions, role of a nurse, examination methods, recommendation and giving information about lifestyle. Results: The results show the specifics of nursing in colorectal surgeries. We found out that nurses working in colorectal surgeries deal mainly with preparing special medical instruments and devices needed for endoscopic examination. Then they assist doctors during a medical examination and with treatment methods of RBL (Barron´s rubber band ligation) and Hemoron, they manipulate with devices in a surgery, check hygiene measures, do administrative work and keep surgery office running. In other conversation areas practical nurses mostly mentioned sampling of biological materials, mainly blood and faecal specimen taking to be given up to histological examination, preparing patients for an endoscopic exam, communication with patients and attending to the intimacy of patients. Consequently we found out that more than half of the practical nurses pay attention to psychological conditioning of the patient before rectoscopy. The research also revealed some weak spots. More than half of the nurses in the focus group do not inform patients about preparations before anoscope exam. Barely one third of the group said that they inform patients about the natural emptying before the exam. Regarding the issue of giving information about lifestyle, we came to the conclusion that practical nurses, even though they do not have enough time, try to inform patients about physical activities, hygiene care and quality of eating and they do it in sufficient rate. But because of the time constrain they put emphasis only on the essential information.
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Carpal tunnel syndrome in spinal patients
Zmeškalová, Petra ; Špaňhelová, Šárka (advisor) ; Lepšíková, Magdaléna (referee)
The aim of this work is confirming of incidence carpal tunnel syndrom in patients with spinal cord lesion. This ailment stem from repetitive loading of hands on propulsion of mechanical wheelchair. Work contains the causes of biginning, risk factors for patients, prevention, conservative and operation therapy. Thesis involves characteristic of patient after spinal cord injury, seat and wheelchair propulsion. The practice task contains case report of patient and suggestion of therapy for her. Powered by TCPDF (www.tcpdf.org)
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Rehabilitation treatment at the spinal unit. Theoretical basis and practical experience
Punčochářová, Lenka ; Smolíková, Libuše (advisor) ; Špaňhelová, Šárka (referee)
After spinal cord injury occur a lot of complication, with resulting from neurological picture. These can be central, peripheral or mix paresis in some cases even plegie. Often an autonomic nervous system can be demaged, causing complication practice in nearly all body systems. Rehabilitation attend belongs to basic care of paretic patients and is closely connected with basic with basic nursing methods from which the physiotherapy of these patients arise. This survey gives a summary of procedures and methods of physiotherapy , which help the patient to prevent and better respond to the complication treatment e.g. on respiratory and movement apparatus. Complex physiotherapeutic treatment concentrates mainly on prevention of complications. The physiotherapist must anticipate formation of complications and adapt the comlexity of the treatment. Powered by TCPDF (www.tcpdf.org)
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Locomat and its use in patients with the spinal cord injuries
Krulík, Jan ; Oplatková, Lenka (advisor) ; Spáčilová, L. (referee)
The improve of the care of patients attend with coming of modern technologies and developments of the medicine science. Concrete instance is Lokomat System, that have risen by multidisciplinary cooperation of a specialists from technical and medical branches. In this thesis will be in detail described not only Lokomat but also advantages and disadvantages of its use to patients and medical personnel. Powered by TCPDF (www.tcpdf.org)
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The influence of spinal patients regular training in Locomat System on chosentime and space parametres of their walk
Strnadová, Helena ; Oplatková, Lenka (advisor) ; Strapková, Zuzana (referee)
Diploma thesis "Influence of regular training of spinal cord patients in Lokomat system on particular spatio-temporal parameters of their walk." is a theoretical-empirical case report. Theoretical part deals with the neuroanatomy of the spinal cord, control, analysis and possibilities of check up of physiological walk. This part is concluded by the summary of entries about the Lokomat system, its basic technical equipment, advantages / disadvantages, indications/ contra-indications of its use in practice. The empirical part deals with the examination of the influence of the training in Lokomat system on the walk of the patients with incomplete spinal cord lesion. The main subject of the research is to monitor the changes in particular spatio-temporal parameters of walk (gait speed, stride length, stride time, single support time). Powered by TCPDF (www.tcpdf.org)
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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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Lifestyle of patients with peripheral arterial disease before and after surgery
REZKOVÁ, Helena
Theoretical background: Peripheral arterial disease is a serious disease of Loir limb arteries which originates from atherosclerosis. The theoretical part deals with the lifestyle. There are mentioned basic risk factors of chronic forms. Further described are the pathophysiology changes generated on the basis of atherosclerosis and related causes for the origin of the disease. Subsequently there are explained methods of classification, developed clinical symptoms, diagnosis and therapy. This section also looks at the role of a nurse in the care of patients with peripheral arterial disease. Objectives: The aim of this work was to evaluate how patients with peripheral arterial disease changed their lifestyle after invasive vascular surgery. There were provided the following research questions: How do patients with peripheral arterial disease approach to the prevention of risk factors? What is in patients with peripheral arterial disease the main impuls for the possible change of their lifestyle? What influences surgery patient's attitude to risk factors for peripheral arterial disease? How crucial is a lifestyle change in patients after surgery for peripheral arterial disease? Methods: The theoretical part is processed using expert sources. The empirical part of the theses was processed using qualitative research. The chosen technique for data collection was semi-structured interviews with patients, with prepared open questions. The research was done in several phases - the first interview was conducted at the patient admission department (before surgery), followed by the next phase after three months, and 6 months after surgery. The interviews were recorded on a prepared form, then transcribed into electronic form and analyzed by open coding method. Results: The research showed that surgery can sometimes be triggered by changes in the patient's lifestyle. The first interviews in the preoperative period focused on how respondents felt, what was their lifestyle before surgery for atherosclerotic changes of the lower extremities. One of the questions was focused on patient knowledge about risk factors for the development of PAD and possible prevention. The second phase of interviews took place 3 months after the surgery. It dealt with the question about the respndents´ lifestyle, the respondents in the postoperative period, whether there were any changes. Some positive changes occurred in eating and there were some changes in doing physical activity. The third stage was carried out six months after surgery, again in order to detect changes in lifestyle. Minor changes came in smoking habits, the issue of diet and physical aktivity. Questions were also focused on the psychological level. We found out who helped patients and what was most motivating in implementing changes. In the conclusion/summing up question the patients marked themselves ow they managed to make a change. Conclusion: The number of patients with peripheral arterial disease and other cardiovascular diseases is increasing. The basis is the start to modify risk factors, namely tobacco use,dietary habits, physical activity. The medical staff members participate on changes in patients´ lifestyle by appropriate education. The problem occurs when the patient despite the support of close people can not cope to carry a twist in their life. There should a medical staff member offer a professional help to deal with this important step. Practical use: The aim is to draw attention to the expansion of education about lifestyle changes for patients diagnosed with PAD also in the postoperative period. Patients who are released to home care should receive enough information that would convince them to change their attitude towards their health, and that surgery is only one of the ways to prevent further attacks and complications. Results can improve communication with patients and focus on increasing their awareness and possibly offer assistance.
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Pick´s disease and the specifics of the nursing care of a patient with this disease
KOPKAŠOVÁ, Lenka
Pick's disease is a degenerative-atrophic process that primarily affects the frontal and temporal lobes of the brain. Besides Alzheimer's disease, it is a lesser known form of dementia which affects people of younger age. Although the exact range of Pick's disease occurrence varies in the literature, the average reported age is between 50-60 years. The disease can change eating habits, cause emotional swings, inappropriate behaviour and sloppy appearance of the patients. The behaviour to others is often selfish, the patients are unable to listen to others and ignore their surroundings. Pick's disease is also characterized by inappropriate sexual behaviour. Globally, the number of dementia patients is still growing and according to expert guesses the increase will continue. Nursing care for patients with dementia is therefore becoming a very actual topic as dementia is called a quiet epidemic of our century. Nurses in their departments quite frequently encounter patients suffering from dementia of various origins at different stages of disability and the staff at healthcare facilities often regard these people as a burden. The aim of this thesis, which is called Pick's Disease and Specifics of Nursing Care for Patients with this Disease, is, based on the theoretical knowledge, to map definitions and diagnosis of Pick's disease, to define the needs of such a patient, and to list the most common problems in the nursing care. It focuses on people with dementia within medical facilities. For proper understanding of the problem, the thesis starts with the anatomy and physiology of the brain and the description of cognitive functions which are affected by the dementia syndrome and the definition of dementia. Based on the studied literature, dementia is divided according to various criteria. It has been found out that dividing dementia is not entirely uniform, but the essential facts and overall opinions of the authors do not diverge. Pick's disease belongs to a group of frontotemporal dementia and its position in this group has changed over time, as it is recorded in the literature. The thesis includes recommendations resulting from the studied literature in the approach to patients with dementia and emphasizes personal communication with the patients and empathetic and humane approach. Although medicine cannot prevent dementia, an early diagnosis of a specific type of dementia and correctly targeted treatment can increase the quality of life not only of the patients but also of their families. I have chosen this topic because I find it very current and interesting. During my nursing practice at the Surgery Department and Aftercare Department, I have met patients suffering from dementia and I did not know how to properly and efficiently communicate with them. For the theoretical part of my work, the methods of explanation, synthesis and induction on the basis of Czech and foreign information sources have been used. The most frequently quoted Czech authors in my thesis are doc. MD. Roman Jirák, PhD., the head of the center for diagnosis and therapy of Alzheimer's disease at the psychiatric clinic of the General University Hospital in Prague, the 1st Medical Faculty of Charles University. This thesis can serve as an informational and educational source both for nurses and the general public who may experience the disease within their families. It would be considered a great success if it helped nurses or family members to diagnose Pick's disease or other dementia at an early stage.
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Nutrition in hospitals as part of comprehensive nursing care
ZELENKOVÁ, Klára
A nutrition of high quality should be an integral part of the complex therapy in all hospital facilities, disregarding these premises results in the decrease of the whole quality of the nursing care. A complex nursing care detects actual and potential health problems, determines priorities and defines the role of the nurse providing those. Nothing but a highly qualified and plan-based nursing care enables the nurse to satisfy the patients´ / clients´ needs. The purpose of this Bachelor thesis is to discover and determine the demands of the clients hospitalized in hospital facilities for alterations of the nutrition system, to map clients´ satisfaction with the food served and to find out , if the meals served in the hospital facilities complies with the clients´ needs. The research was realized in the Hospital Strakonice, inc.c. in the internal, surgery and gynaecological ward, in the form of a questionnaire inquiry. Six hypotheses have been determined, of which 5 were confirmed and one was refuted. The first hypothesis tested, whether the clients hospitalized in hospital facilities would appreciate an alteration in the nutrition composition. On the basis of a questionary investigation, the hypothesis was comfirmed. The second hypothesis estimated, if the clients hospitalized in hospital facilities would appreciate the possibility of the choice of the meals, according to the results, it is obvious that this possibility is welcomed by the clients and thus this hypothesis was confirmed. The aim of the third hypothesis was to find out, whether the clients are satisfied with the food served. The results point out to the fact, that for the most of the respondents, the taste, satiety and quantity of individual meals was inconvenient, the results concerning the satisfaction with the temperature of the served meals proved the patients´/clients´ satisfactuion. The third hypothesis was confirmed, because the larger part of the answers proved the dissatisfaction with the food served. The four hypothesis, whether the clients have different demands on the served meals according to their age categories was, after detailed comparison of the results, confirmed and the results point out to a definite difference with the older and with the younger respondents. The fifth hypothesis estimated, whether the clients evaluate the served food as inadequate to their needs. From the results it is obvious, that the sufficiency is superior to the insufficiency and therefore, the fifth hypothesis was not confirmed. The sixth hypothesis evaluated, if the clients have the need to provide themselves with the food outside the hospital facility, from the results it is evident that the clients really have this need and the sixth hypothesis was proved and confirmed. I will hand deliver the results achieved to the head nurse of the Hospital Strakonice, inc.c. and together we will try to realize these alterations that would increase the satisfaction of the patients/clients with the nutrition and meals in this hospital.
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