|
|
Evolving needs of patients with chronic obstructive pulmonary disease
KAŠPAROVÁ, Iveta
Nowadays chronic obstructive pulmonary disease (COPD) is considered to be a global and all society problems. COPD interferes in all aspects of patient´s life. It implicates limitations to physical aspect which is the cause of psychological and social effects. The disease changes the present way of patient´s life, the patients have to change their lifestyle, adapt themselves and learn new habits which can also mean changes of their needs during the COPD. The thesis deals with the problems of COPD patient´s needs. The thesis is divided into two main parts. The theoretical part focuses on characteristic of the disease, classification and hierarchy of human needs, the effects of COPD on biological, psychological, social and spiritual needs and next on the nursing care for patients with COPD. The practical part of the thesis includes the processing and next the evaluation of the dates obtained during the research. The aim of the thesis was to findout how the patient's needs differ in particular stadium of the disease. To get the aim there were determined six research questions:1) What is the knowledge level of COPD patients? 2) How different are their needs in particular stadium of the disease? 3) Which needs predominate in individual stadium of the disease? 4) Which activities can COPD patients do? 5) Which limitations and problems do COPD patients have? 6) Which needs does a COPD patient have in the field of home oxygen therapy? The method of qualitative research was used for the research. The technique of non-standardized interview was used for the data gathering. The research complex was formed by 15 COPD patients from the first to the third stadium of the disease. There were five patients in each chosen stadium. The evidence of the individual patients were divided according to their specific stadium into particular categories: knowledge of the disease, respiration, sleep, lifestyle, profession, check-ups. The research shows that the need changes did not directly depend on the level of the disease stadium, but mainly on the patient´s facing up to the disease, their total state of health and based on their individual needs. The firstand second stadium patients gave as the most common need to have their medicines permanently at their disposal, next the bigger need of sleep and rest and last but not least the need of being more independent. The progress of needs in the third stadium was different according to using of home oxygen the therapy or not. The patients who use home oxygen therapy coincided that the therapy helped them to improve their life. Now the main need is to increase their independence in household activities and to besurrounded by their family. Some COPD patients have demonstrable common symptom of depression which consequently influences physiological needs such as sleep, rest, independence and also their total self-realization. The need changes significantly affected the field of life habits, regime,lifestyle and leisure time activities. First of all there has been the absence of cigarettes and alcohol among their life habits and regime. There have been some limitations such as fishing, riding a bike, mushroomingin leisure time activities. The lifestyle was affected the changes in family and work life. The patients often suffer from dyspnoea, which subsequently limits walking, household activities, self-service,for example: shopping, meal preparing, dressing or doing personal hygiene. Despite various limitations the patients do various activities like walking dogs, strolling, reading books, watching TV, visiting clubs and other interesting culture events. The research results pointed to insufficient level of knowledge of the COPD patients. Due to the low level of the patients´ knowledge of the disease an information material with basic information about the disease was prepared.
|
|
|
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
|
|
|
Health and social issues in patients ventilated at home
FENEŠOVÁ, Lucia
An outstanding progress in pulmonary ventilation was documented recently when artificial pulmonary ventilation was introduced for home care. In-home pulmonary ventilation is meant for patients who suffer from serious progressive diseases. In most cases, such state is irreversible and obstructs patient`s ability to breathe consciously. Those patients benefit a lot from the newly introduced ventilation. It helps them live a regular life in natural background for a few more years. The target of the thesis was to identify the most frequent health and social issues in patients ventilated at home; to determine advantages of home care and possible risks in ventilated patients; and to elaborate a nursing standard to be followed when taking care of ventilated patients at their homes. The qualitative research was carried out by means of two half-structured interviews. One interview was made with 5 pre-selected nurses working for a home-care agency; the other interview was made in the same agency with 5 patients on artificial pulmonary ventilation that are looked after by the same agency. The outcome of the interviews is that the most frequent health problem in ventilated patients reported both by patients and nurses is obstruction of tracheostomic cannula. Another finding was that ventilated patients do not feel socially isolated which is in total contradiction to what the nurses claimed. The interviews taken with the patients showed that in-home care benefits mainly from the fact that the patients are at home, and the risk of receiving home care is that such care is dependant basically on one person and is time consuming. The objectives of the thesis have been met. The outcomes of the research will be made available to the company named Home health-care services Eva Šafránková, which was the venue of the research. The nursing standard can be used as a source of additional information for ventilated patients and to improve care provided to patients ventilated at their homes. It is recommended that nurses should further educate themselves in pulmonary ventilation. Training seems to be an appropriate solution in this case. Nurses would certainly also benefit from a visit to a place providing artificial pulmonary ventilation. Another recommendation is to carry out a follow-up research that would observe advantages of artificial pulmonary ventilation provided at home compared with benefits of artificial pulmonary ventilation provided in health care centres.
|
guest ::
