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Nasal Fixation by Methamphetamine Users
VĚTROVSKÁ, Lucie
The diploma thesis theme, which I have chosen, Addiction to the nasal use of pervitin, is based on my long-term interest in this subject.One of the factors that may be important in the study of any drug problem is the ritual. Rituals here may appear on several levels - it may contribute to the formation and maintenance of a dependency, in the application itself (creation of "lines" on the mirror, the use of identity cards, sniffing with a rolled banknote, etc.) and can take various forms (e.g., group or individual) (Holzbachova, 1999). For my thesis, I have chosen the method of qualitative research. The basic approach of qualitative research includes the grounded theory. The aim of the thesis is to analyze and describe the different aspects of ritual behavior of nasal drug users. The research question was to discover, which aspects of ritual occur in nasal drug users. As it is described in literature, all drug users ritualize the drug application to some extent. This represents stylized and routine behavior that occurs during drug use. There are situations, like the procurement of drugs, methods of taking, activities following the use of drugs and the ways to prevent the negative effects of drugs (Grund, 1993). During an interview, two of the interviewees said the word "ritual". Cyril considers it a ritual and the activities precede sniffing. These are activities associated with the hunt for the drug, the journey to the drug and the nervousness "before trip", which according to him is stronger than the feeling of drug application. Dana describes the application procedure as a ritual. However, she describes as ritualistic her behavior during the purchase of a sufficient supply of cigarettes for intoxication or when applying the drug on the toilet seat, wiping the toilet boards before the actual preparation of the drug for application. Although the other two interviewees did not use the word ritual in their answers directly, some ritualistic elements signaled a routine behavior in conducting the drugs process by them as well. In general, we assume that the thesis can contribute to the discussion about the ritual aspects of drug users. This work brings in new information about the rituals of nasal drug users. We anticipate publication in a professional periodical.
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Consent in hospital - theory and practice
SÝKOROVÁ, Marta
The diploma thesis is divided into a theoretical and a practical part. The first part describes the current state of the issue of informed consent in a general context and related topics. To obtain the data, I used the qualitative research, the method of questioning, and the data collection technique of a semi-structures interview. The research sample group consisted of 11 patients and two doctors. The objective of the thesis was to identify and describe the differences between the theory and the practice of informed consent in the hospital, and to find out whether there has been any shift in the mistakes and errors associated with informed consent as stated by Haškovcová (2007). The research results have shown that the interviewed patients are not familiar with the concept of informed consent. The knowledge of the informed consent concept was more accurate by doctors as presumed. On the issue of viewed benefits of informed consent, it is clear from respondents? answers that informed consent is viewed primarily as doctors? legal protection against any complaints or lawsuits made by the patients in the performance of their profession by making the patient familiar with any complications that may occur during the performance. This benefit is perceived by both patients and doctors. Doctors see its benefit also as the protection of patients. Another benefit viewed by doctors is the written informed consent form. Six of the interviewed patients stated that informed consent was submitted to them to sign by the nurse/male nurse without proper instructions. Furthermore, doctors? answers show that the timing of instructions depends on the nature of the surgery, whether it is planned or acute. However, some patients said that they were not even instructed with the sufficient time after giving informed consent even when related to a planned procedure. The most stated form was the combination of written and oral instructions, so the patient was first instructed orally and then he was also handed a detailed description of the particular procedure in the written form. There was no uniformity about the question of the amount of submitted information among the interviewed patients as well as doctors ? some of them prefer just basic information, some of them want to know all the information. One of the interviewed doctors favored just the adequate informed consent and saw the detailed informed consent as problematic, another doctor preferred introduction of all the details, although in the written form, mainly because of legal protection. In terms of quality of the provided information, it is clear from the statements of the patients that two most important facts for them are that the performance is in their benefit and the duration of hospitalization. All patients have agreed on the fact that it is very good that they are informed about the procedure which will be performed on them. However, they were not united regarding the issue of participation in the decision ? two patients stated that not even the properly informed patient should participate in the decision about their treatment. Only one doctor expressed his stance to the patient?s participation in the decision stating that he tries to persuade his patients that his proposed solution is the optimal. The standard for the patients is to ask questions when they are concerned about something or interested in it. However, the statements showed that they do not always get the answer they are satisfied with. When the patients stated that they do not ask their doctors about anything, their reasons were enough information, lack of staff and a feeling of unwillingness on the part of doctors. If the patients did not receive enough information from the medical staff, they looked for it in other sources of information. This thesis points to the broader psychosocial context of informed consent, so its results may help during the training of staff in the assisting professions.
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The treatment of pain in patients in terminal stage on the ward of follow-up care from the nurse point of a view
KUNEŠOVÁ, Martina
This bachelor's thesis is focused on chronic pain in dying patients at the aftercare department. The theoretical part focused on chronic pain description and its division, chronic pain treatment possibilities, characterization of a terminal stage and work done by nurses at the aftercare department. This part is supposed to present the most important information concerning chronic pain in dying patients. The practical part provides results of a gualitative research. This research had four objectives. The first objective was to identify the benefits of nursing care provided to dying patients with chronic pain in palliative care. The second objective focused on the attitude of nurses towards the patients in the terminal stage. The third objective was to identify the nursing methods used during the provision of care to a patient with pain in palliative care. The fourth objective was to assess the knowledge of nurses working at the aftercare department regarding the up-to-date treatment of pain in palliative care. Four research questions were established based on these four goals: What is the benefit of nursing care in treatment of pain in palliative care? What is the attitude of nurses towards the patients in the terminal stage? Which new nursing methods possibilities can palliative care provide to patients with pain? What information on treatment of pain in palliative care do nurses have? The research was performed using an in-depth structured interview, which is a method of the gualitative research. The research samlpe consisted of eight practice nurses working at the Aftercare Department in Nemocnice České Budějovice a. s. The interview was aimed at information on benefits of nursing care, the attitude of nurses towards dying patients, nursing procedures used and also knowledge of the nurses working at the aftercare department. The interviews were recording in writing. The records were analysed and coded using an open coding method. Six categories were established as follows: Nursing care procedures in treatment of chronic pain in dying patients, Effectiveness of chronic pain treatment in dying patients, Benefits of nursing care, Attitude of nurses towards dying patients with chronic pain, Collaboration with families and Nurses' knowledge. It was found out during the research that the benefit of nursing care is enormous, the care brings satisfaction of patients, safety, communication, sufficient amount of information, ensuring of basic needs, contact, information on current changes in the state of health, offer of better care, psychological support, better collaboration between nurse and a patient and a family, and also promixity of personnel. Thereforte, I think it is possible to consider the nursing care to be very beneficial. Furthermore, the following attitudes of nurses towards the dying patients were discovered: Trust or distrust of nurses in ability to display pain, active interest by nurses, approach to patients and communication. The research also discovered the following nursing procedures used in treatment of chronic pain in dying patients: positioning, heat application, cold application, massages and refraining from needless manipulation. The knowledge of nurses regarding the current treatment of pain in palliative care contains extensive information on principles of analgesic and opiate administration, which are applied by the nurses working at the aftercare department. A practical output of this thesis is a handbook called Administration of Opiates and Usage of Intoxicants Record, which is intended for use by practice nurses.
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The system of deployment of provided rescue humanitarian assistence abroad.
SOJKA, Hynek
This thesis deals with humanitarian assistance from the Czech Republic abroad. The issue of humanitarian assistance is viewed in terms of its own management system and by providing this assistance. The humanitarian assistance has not been compiled into a comprehensive publication before. The constant increasing importance of this problem comes mainly from an increase in the number of disasters caused by the nature on the one hand, and human activities on the other.The issue of the thesis was to define, describe and evaluate the system of management of rescue humanitarian assistance that is provided by Czech Republic abroad and possibly propose some changes in management with the aim to make the humanitarian assistance most effective and fastest to be provided in the affected country. The next issue is to recommend changes in the structure of management to be useful in the praxis and also that the thesis will be appropriate for studying mentioned problems. The research question was if it´s possible to make more effective the procedure of providing rescue humanitarian assistance to the country which was striken by disaster. In relation to the described theory the folllowing assumption was introduced: is it possible to realize the providing and managing of the rescue humanitarian assistance abroad?Research work with the focus on solving practical problem was selected as a processing type of the thesis, it will results in more effective proceeding operation in the mentioned sphere. In this point of view of methodology it´s ?mixed research? in its simple way, qualitative and quantitative research is combined. The analysis of case study and nonstandarized dialogue were applied for solution of research question. The form of analysis, comparation and description in the theoretical part of the thesis was choosen from general to concrete. The first part, mainly characterizes two basic concepts ? The Humanitarian assistance and The Emergency, including definitions of legislation of this issue from the perspective of the European Union and the Czech Republic. There are also identified and described the major practical mechanisms of the assistance - The civil protection modules which send the member states of The European Union, including the Czech Republic, to countries affected by the emergency.This theoretical part of the thesis is followed by a research based on real case studies - provided humanitarian assistance during the floods in Poland in 2010, identifies and defines the system of strategic and operational management, supplement with data and own knowledgement from sphere of service execution ? operation officer of Fire and Rescue Service - procedure of management is formed and followed with the identification of 15 issues from solved sphere. The solution is own proposal which gives with its followed proceeding steps manual (instructions) to crisis managment how to proceed in the first level of management. This procedure is shown here in the form of a practical document that can serve as a ?check-list events? the Checklist. The important point here is a summary of the steps that must not be omitted during proceeding and management of this mechanism, with the only aim ? to provide the humanitarian assistance quickly and efficiently to the affected area.In the chapter titled the Discussion are into the context given knowledges about described issue.In the end of the thesis the outcomes and results are formulated, the research question if it´s possible to make more effective the procedure of providing rescue humanitarian assistance to the country which was striken by disaster is affirmatived answered with the confirmed assumption. Finally the author´s principle is mentioned which is useable for crisis manager´s work in early decision procedure of providing humanitarian assistance and other recommended steps in this procedure.
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The impact of the electric power outage in the Pardubice region
KRÁLOVÁ, Kateřina
The title of my thesis is The impact of the electric power outage in the Pardubice region. Danger, coming from prolonged power outage, as the one area of critical infrastructure, is large and has extensive implications, since electricity has been currently necessary for human civilization and its existence. In the Czech Republic, the critical infrastructure is addressed in Act no. 240/2000 Coll., on crisis management and amending certain acts, where the Council Directive 2008/114 / EC on the identification and designation of European Critical Infrastructures and the assessment of needs to improve their protection was applied to this law. I decided to write a thesis about the impact of a power outage, because I have been very interested in the issue of blackouts and I think it is a very important up-to-date topic. I chose the area of Pardubice region because I come from this region, so I am personally attached to this area. In the first part, I decided to introduce critical infrastructure, its legislative grounding and protection, there is also description of electrical energy, its production, transmission and distribution. Finally, I dealt with replacement power sources, energy security and blackout in the theoretical part. I used basic scientific procedures: analysis and synthesis or induction and deduction for the needs of my thesis. The aim of the thesis, was to use research part to map the effects of the power outage in the Pardubice region. I chose a qualitative data collection and interviews with experienced professionals in the crisis management as a method of my research. The research question was: "Which of the consequences of the power outage is essential to conversely marginal?". The evaluation of the research was done by SWOT analysis, which identifies strengths, weaknesses, opportunities and threats in the Pardubice region in the event of a power outage. The results of the thesis will be provided to the Fire Rescue Service of the Pardubice region, which can use these data in crisis planning. The thesis will also be used as study material for students of the University of South Bohemia in České Budějovice.
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Readiness analysis of HZS Pardubice region to extraordinary events solution with CBRN substances
KOŽENÝ, Petr
HAZMAT team of the Fire Rescue Services of the Czech Republic (HZS CR) plays a significant role in those cases where CBRN were used. Firefighters - technicians of the HAZMAT team in the regions fulfil the tasks involving extraordinary events where dangerous substances can be found. They provide the maintenance of special equipment, special training, information support, inspections, decontaminations, marking of dangerous zones etc. To be successful in fulfilling their tasks they have to undergo continuous training and updating of knowledge. Regular professional training is necessary for operability of the crew as a whole but it should be organised according to classification of the firefighters. The training of the rank of assistants working as firefighters should respect the fact that the professional competence is verified every five years. The aim of this work is to asses professional knowledge of firefighters - technicians of the HAZMAT team in particular regions and to summarise the results of the professional training especially by using tests. The work is divided into two parts: theoretical and empirical with the hypothesis and methodology. There is a description of the CBRN term, tasks and tools for cooperation and coordination of the Integrated Rescue System (IZS) as well as the role of the Fire Rescue Services (HZS) dealing with CBRN NOx extraordinary events The last part of this work mentions special technical equipment of the Fire Rescue Services in the Pardubice Region used for dealing with CBRN. Especially protective equipment, detection equipment and analysers. Part of this work analyses whether professional knowledge of the technicians of the HAZMAT team of the Fire Rescue Services of the Pardubice Region complies with the requirements of the standards of the supreme authorities (MV - GR HZS CR). To prove or disapprove the findings, the content analysis of the professional intranet training module of the Fire Rescue Services of the Pardubice Region and evaluation of the results of tests for firefighters - HAZMAT team were used. Testing and practical examinations are part of the annual verification process of the FRS (HZS) of the Pardubice Region. The assessment of the professional knowledge itself was carried out using analysis of the testing results, which are in accordance with the HAZMAT team regulations. Testing questions are sorted out regarding wrong answers of the HAZMAT teams from the local regions since 2012 when the first testing was carried out. Also the subgroups of questions were taken into consideration. The results show differences between particular local regions of the Pardubice Region. The structure of the testing tasks itself shows essential flaws. The structure and headings of the testing sets are not chosen appropriately and neither are number of questions a their distribution in subgroups and their updating. Current testing questions don't check necessary and required knowledge of firefighters efficiently. The findings resulted in submitting a proposal of unified procedure concerning intranet module of professional training of the FRS (HZS) of the Pardubice Region. This newborn methodical procedure should solve competences and unified approach in creating of new teaching materials and testing tasks and also specify guarantors for making and updating of the professional training. New structure of the sets of questions, their professional focus and the number of questions generated in testing tasks is proposed for the testing of the members of the HAZMAT team. The new proposal of the sets of questions is going to be well structured, it should allow to start better professional training and provide basis for demanding checking of professional competence
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Possibilities and Limits of School Website Usage for Students and Teachers at Primary Schools
NÁDVORNÍK, Václav
This thesis deals with the issue of primary school websites and the potentials of their usage by students and teachers. Recently, websites became very common means of communication and educational platform. The aim of the thesis is to determine the potentials and limits of using websites in primary education. The thesis is divided into three main chapters and it has four appendices. The introductory chapter introduces the aims and the concept of the thesis. The part dedicated to the current state of the problem describes the development of Internet usage by children in the Czech Republic and other countries. This chapter deals with statistic data from the survey carried by the Czech Statistical Office and from a National Educational Institute project Škola21, in which the leaderships of various schools answered questions about the ways of using the school website as a part of self-evaluation. In this chapter, there is also a division of the target groups of school web users, short overview that demonstrates the development of school website in the last ten years, and a description of the parts that it, in some cases, contains. Special part is dedicated to evaluation tools of school website and other resources that can help determine the criteria of a high quality website and thus its potentials and limits. The second chapter, which is the main part of the thesis, is a research of school website and Internet usage in general by students and teachers and presents the basic research questions that were being answered. The main research question that is later divided into sub-questions is "How do students and pedagogical employees use the Internet and school website?" The main tool for collecting the answers were questionnaires designed according to a pre-research. The questionnaires collected the answers about the usage of the school website from students and teachers. The answers are statistically elaborated and the results are being compared by classification of fist and second degree. Here, the ways of students' and teachers' work with the website are compared and relations that can designate the potentials of the school website are looked for. The answers were further compared according to the respondents' school location, frequency of the school website visits, Internet access and other criteria. The results of the research were further discussed in interviews with groups of students and teachers. These interviews were focused on discovering the reasons for the respondents' answers. The thesis summarizes the results of the research and puts them into context with previously published work on this topic. Using these findings, the third chapter defines and explains recommended content of a school website and thus, sets the basic limits and potentials of its usage. On the basis of the information from the overview of current studies on this topic and using the research data, the thesis suggests a school website evaluation tool, which can answer the question about how the potentials of a school website are utilized. Computational algorithms and procedures of creating the evaluation tool are described in the research part of the thesis as well as the results of its testing on two primary schools in the Czech Republic.
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Nursing care for patient after lung surgery
PECHOVÁ, Lenka
The operation of the lungs is being performed on the base of a variety causes, among which the most common causes are cancer, inflammatory diseases, accidents and a variety of complications of diagnostic and therapeutic procedures. After the surgery, patients are taken to the intensive care unit (ICU). The nurse must meet the patient´s biological, psychological, but also laboratory and medication needs. The attainment on this thesis which is titled as "Nursing care for patients after lung surgery" was to determine the method of nursing care for patients after lung surgery. Three research questions were also asked to achieve this. The necessary information were obtained through qualitative research, semi-structured interviews with nurses from the Department of Surgical Intensive Care Unit, Hospital Czech Budejovice a.s. The research was conducted during March 2015. Three categories were generated from an analysis of data: Specific care for patients after lung surgery, Education, Rehabilitation. This research suggests that nurses meet frequently with this specific care for patients after lung surgery that means several times a month. Further information from this research is that the patient after surgery gets parenteral nutrition first, on the second day starts with a liquid diet and the nurses are following the care with most commond diets as diet no 0, 1, 3, and diet no 9 if the patient is a diabetic. After the surgery, the oxygen is being provided to a patient. The results showed that the nurses must always check to see if the airways are clean, that the patient does not have any mucus in the lungs and that he's able to cough without problems. Nurses are checking the blood gas values by using a Pulse Oximeter. Emphasis is placed on the post-surgery rehabilitation to allow patient to be fully ventilated. For a different lenght of times the indwelling urinary catheter (hereinafter PAK) is fed to patients with respect to the operating performance. It depends on the patient's health condition. The nurses must check the functions of the thoracic drains which are often inserted after surgery. First, the patient has an active suction or active mobile suction, then Bülauov drainage. Frequency of change of the surgical wound dressings is mainly set by the doctor. Postoperative pain is monitored in a verbal way. Prescribed medication is administered also by using the epidural line. Subsequently, the patient receives painkillers IM inj. According to the nurses the post-surgery complications are breathing problems, bleeding from wounds, pain, risk of infection, high waste of chest tubes, the inability of the lungs to maintain a vacuum and subsequent collapse of the lung. The education of the nurses is very multidirectional and each one applies different methods to enrich their knowledge. Physical Therapists are responsible for the rehabilitation of patients after lung surgery. Nurses have a very good knowledge in a nursing care which is applied in their practice. However in some ways the information obtained from the nurses disagree with the procedures set forth in the literature. The conclusion of this work should be aimed to the improvement of nursing care for patients after lung surgery and to correct the shortcomings in the providing of nursing care. This work can be used as educational material for nurses starting job at the Department of Surgical Intensive Care Unit, Hospital Czech Budejovice a.s.
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Education of children in the hospital before the surgery at the Department of ear, nose, throat.
EKHARDTOVÁ, Miroslava
The aim of this study was to uncover phenomena in the effective education of children in the hospital before the surgery at the Department of Otorhinolaryngology and to create a functional educational material, using elements of game therapy. The theoretical part contains information about the problems of hospitalized children, their perception of illness and hospitalization and brings facts about the negative reactions of children in this difficult period. This part of study describes the education of children at the hospital and introduces simple instructions how to communicate with the child. This part of study also describes the nurse's work at the Department of Ear, Nose, and Throat and describes the most frequent procedures with children at this department. Another part of this study is focused on the preoperative preparation and the last part of this study is focused on the gaming therapy. Following research questions were provided to achieve the main aims of this study: 1. How is the children education provided in the Department of ETH in the chosen hospital? 2. What kind of children's educational strategies is used at the pre-operative care at the Department of Otorhinolaryngology at the chosen hospital? 3. What are the effectiveness of educational strategies applied on the principle of game therapy? This research was based on qualitative survey. The research was divided into three parts. The results of the research are in the practical part of this study. Data were collected between December 2014 and March 2015 at the Otorhinolaryngology department at the hospital in Jindřichův Hradec. The first part of the research was focused on interviews with the nurses. Interviews were semi-structured and contained eight questions. The second part of the research was focused on seven questions of semi-structured interviews with hospitalized children's deputy. These two parts of the research was supplemented by direct structured observation focused on the children and children's deputy education at the hospital before the surgery. Due the working department management the direct structured observation was carried out at the moment of hospital admission because there is the education most extensive and the most important. Based on the results of the first two parts of the research of this study the new education materials were created and applied in the third part of the research of this study. One of the new created education materials was an electronic Power Point presentation used in hospital's tablets. The second new applied educational material was a Teddy Bear. The results of these interviews showed that the main source of information is mainly a doctor. The nurse completes the education. Interviewed nurses realize the importance of education for children and their parents. First, the education is carried out at the hospital Infimary Room based on verbal and individual way. Then the education is carried out in the Hospital Room or in the Surgery Room before the surgery if the patient's condition allows children can for example touch the respirator etc. The education is more focused on children's deputy. The big advantage for children is a fact, than they can be accompanied by their deputy. The children's deputy can stay till the child fall asleep before the surgery. The effectivity of the education is controlled by nurses. There is one alarming result of the survey. One of the nurses believes that non educated child feels just the same as educated. However, this result wasn't confirmed. There is only minimal occurrence of the game therapy at the department. Nurses express positive opinion about the education with occurrence of the game therapy but negative phenomenon of this strategy they find in the lack of the time. The observed fact is those interviewed deputies were very satisfied with the education in most of the cases. The practical part of this study is focused on application of educational material.
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The Role of a Nurse in after care about bariatric patient
DUŠIČKOVÁ, Tereza
Current status Obesity is a disease characterized by the increased proportion of fat in the body over a certain limit (Müller 2009). According to the World Health Organization in 2014, more than 1.9 billion people suffered from overweight, of which more than 600 million people were obese (WHO 2015). Subject The aim of the work is the definition of competence nurses have in the aftercare of bariatric patients. Determination of preparation, care, patient awareness and procedures for patients undergoing bariatric treatment. And findings of specific needs of bariatric patients undergoing treatment for obesity. Three research questions have served towards these targets: What competences do nurses have in the aftercare of bariatric patients? How are patients informed throughout the bariatric treatment? What are the needs of patients undergoing bariatric treatment of obesity? Methods Qualitative research techniques were used to obtain the necessary data for the practical part. The practical part was realized through individual semi-structured interviews with nurses working on surgical wards and patients who had undergone bariatric treatment. At the beginning of each interview, the nurse and the patient were apprised of the reason of the research conducted and were assured of anonymity in the processing of the dialogue. The central theme was the assertion of nurses in the subsequent care of bariatric patients and to determine the specifics of these patients. Participants The sample consisted of nine nurses working in a specialized center, where bariatric procedures are performed and seven patients who had undergone bariatric surgery. The survey was conducted from February to March 2015 Results: Before the operation patients undergo surgical, internal, nutritional and psychological examinations. Blood is collected for hematological and biochemical laboratory tests. Among other examinations clients go through gastroenterology, pulmonary testing, also examination in a sleep laboratory and swabs are taken from the throat and nose. Before the particular operation clients should reduce weight on a doctor's recommendation. It was also found that patients are informed about the preoperative and postoperative care, as well as about the need for dispensarisation, the frequency of follow-ups and possibilities of participation in bariatric clubs and associations. Nurses cover the following competences. Before the surgery, the nurse educates the clients about the preoperative and postoperative care, takes their blood, fulfills what the doctor prescribes and motivates the patient. After the surgery, the nurse provides general nursing care, monitors physiological functions, and educates patients about their diet and carries out the doctor´s prescriptions. The nurse must know the dietary restrictions, when it is determined by the general procedure, which varies in some detail according to the type of surgery and the patient's condition. The research showed that nurse cares more about the biological needs of the patients, rather than their psychosocial needs. Patients lack psychological support and motivation in aftercare. Patients undergoing bariatric treatment need to prepare for surgery (weight loss) and acquire post operation eating habits. Their other needs are psychological support and motivation conveyed by nurses. Conclusion: As the number of people suffering from overweight and obesity at present is constantly growing, obesity treatment becomes a necessity. Currently, bariatric surgery is widely used for patients suffering from obesity of the II. and higher degree, so it is advisable to know the needs, knowledge, practices in patient care before and after such an operation and, ultimately, which competences do nurses have during them.
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