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Procedural Pain Relief in Premature Neonates
DUDARCOVÁ, Terezie
This Bachelor's thesis deals with the topic of procedural pain management in preterm newborns. Procedural pain is caused during medical procedures. Long-term exposure to pain has a variety of consequences, which is why it is very important to pay attention to the procedural pain prevention management. The first aim of the thesis was to explore the possibilities of assessing procedural pain in premature neonates. The second aim was to map the available methods of procedural pain management, followed by the final goal to identify the possibilities of involving mothers of premature neonates in the procedural pain prevention management. The research part of the paper was based on a qualitative investigation by means of questioning and observation. Data collection was carried out using in-depth interviews with paediatric nurses and mothers of premature neonates. Next part of the research involved observation of paediatric nurses during painful procedures. The information obtained was logged in observation sheets. Research has shown that there is currently a great effort to reduce the number of painful procedures that preterm newborns have to undergo. It was found that when evaluating procedural pain, all circumstances must be taken into account and not evaluated only according to a given scale. According to the research, the most effective of the non-pharmacological methods of pain relief is direct contact between mother and child. Pharmacological methods of pain relief are used in rare cases. It was also confirmed that there is currently a great effort to involve parents in the care of preterm newborns, but this needs to be further intensified and fathers need to be engaged more, for example. The results obtained from the research can be used in the education of paediatric nurses. An educational leaflet for mothers has also been developed.
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The importance and benefits of skin to skin contact in care of extremely premature newborns
NEJDROVÁ, Tereza
Introduction: The term "skin to skin contact" is a term for a method of contact between a mother and her child. The early contact of the newborn with the mother's skin in the shortest time after birth has very positive effects for the newborn but also for the mother herself. In most maternity hospitals, the newborn is placed on the mother's bare abdomen or chest immediately after birth without being dried. This method has a positive effect on the mental and physical needs of the newborn. Children are happier, cry less, gain weight faster, and their body temperature, heart rate, and breathing stabilize. It also matters to his parents. Objectives of the work: Our first goal was to identify the effect of the skin-to-skin method on thermoregulation, lactation, and mental and physical needs in the newborn and also in the mother. The second goal was to find out what possibilities there are to support skin-to-skin contact in severely and extremely premature newborns. The last goal was to reveal the reasons that most often prevent the provision of skin-to-skin contact in severely and extremely premature newborns. Methodology: The research part of the work was processed by the method of qualitative research, using in-depth and semi-structured interviews with nurses. The research group consisted of nine nurses from the Department of Neonatology at the Hospital of České Budějovice a.s.. The interviews were divided into four categories and subsequent subcategories. All data are shown in clear diagrams for individual categories. Results: Based on the obtained analyzed data, it follows that the skin-to-skin contact method has more benefits than risks that would prevent the development of a parent-child bond. At present, the reasons and potential risks that would prevent skin-to-skin contact have rapidly diminished. The research shows that the most serious risk remains the unstable condition of the newborn. The cooperation of the nursing team and the newborn's parents is important. If the child could not be kangarooed, there are alternative methods that help to create an emotional bond between mother and child. The nursing staff allows kangaroo care for fathers if the mother is unable, due to her health condition. Conclusion: As a result, the skin-to-skin method reduces crying and stress in children. Newborns are calmer and sleep better and thrive. This method also strengthens the relationship between mother and newborn. Premature newborns are usually placed in incubators, connected to monitors and hoses, often with respiratory support. All of these factors often make parents feel guilty, failing, disappointed, or lonely. It is important to be able to participate in the care of their newborn. In this way, they also obtain information about the child's health condition. During kangarooing, the emotional bond deepens. The results of the research survey can be used to improve nursing care for premature newborns, as well as in the lifelong education of nurses and in teaching in the field of pediatric nursing. The results will be presented in an article in the journal Pediatrics for Practice.
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Palliative care in neonatology from a nursing perspective
PAJTLOVÁ, Caroline
The aim of the research diploma thesis was to find out about the system of children's palliative care with a focus on the neonatal period and to compare the opinions of health professionals on the system of palliative care in neonatology. The aim of the research part was also to evaluate the readiness of nursing professions to cooperate with the public in the field of care for premature newborns at the end of life. The theoretical part presents current knowledge in the field of perinatal palliative care. Furthermore, the theoretical part maps the current knowledge about the possibilities of support and further education of health professionals and defines the possibilities of saying goodbye to the child after perinatal loss. The empirical part presents the results of a qualitative research survey using standardized in-depth individual interviews with neonatal nurses in five perinatology centers in the Czech Republic.
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Quality of life in children with retinopathy
Stejskalová, Kateřina
This work is drafted with the needs of current theory and practice of special education for visually impaired persons. The basic ideological pillar is a subjective evaluation of the impact of retinopathy of prematurity (ROP) on the quality of life of individuals with emphasis on the pediatric population. The central aim of this work is based on longitudinal qualitatively oriented research to extend the theoretical basis of special education for visually impaired persons, that has not reflect the issue of quality of life of persons with ROP yet. Another aim is to open up space for applied research. Scientific phenomenon to assess the quality of life is in the sphere of interest of many scientific disciplines, focused on the broadest sense of human. Currently, emphasis is laid mainly to subjective assessment of quality of life of specific client group in order to ensure adequate level of support and optimization of complex scale intervention. In this context was created a concept of evaluation of the quality of life in children's population with ROP, which is currently a main cause of childhood blindness in developed and moderately developed countries. The knowledge gained should be ideally reflected at several levels - at the theoretical level to enrich the theoretical bases of special education for...
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Nursing care of the women with imminent premature labour
Trtková, Eliška ; Endlicherová, Jana (advisor) ; Šmatláková, Lenka (referee)
The bachelor thesis focuses on the problem of premature labour and the nursing care of the woman at risk of premature labour. The thesis consists of a theoretical and clinical part. In the introduction of this work, the progress of pregnancy, causes, risks, diagnosis and the therapy of premature labour and the characteristics of premature newborns are described. The last chapter of the theoretical part is focused on the psychology of pregnant woman with imminent premature labour. The clinical part is done in the form of case reports and the method of the nursing process according to Marjory Gordon for its processing is used. The study also deals with the emergence of the nursing process, its history and determining nursing diagnoses. The characteristics of the nursing model of health and domains used in this study is also described. In the casuistry, the history of the pregnant woman, the course of hospitalization and the assessment of current and potential nursing diagnoses are mentioned. In the conclusion of the thesis, the process of the delivery and the status of the newborn are described. Keywords: nursing care, premature labour, pregnancy, premature newborn
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Influence of alternative feeding methods on the breastfeeding of premature neonates born in 30-35. week of gestation.
ŠEVČÍKOVÁ, Kateřina
This diploma thesis deals with the onset of full breastfeeding in preterm infants and with the possible influence of alternative feeding methods on breastfeeding in immature newborns. Based on the study of literature, research questions were identified to find out in which gestation week full breastfeeding is taking place in premature babies and to what extent alternative feeding methods affect the onset of full breastfeeding in premature babies. They also had to find out whether feeding the infant bottles actually leads to unsuccessful breastfeeding. Three objectives were set for the diploma thesis. The first was to find out in which gestational week full breastfeeding is taking place in premature babies, provided the mother has enough breast milk. The second goal investigated the extent to which alternative feeding methods affect early pregnancy, provided the mother has enough breast milk. The third objective was to find out whether feeding a baby bottle actually leads to unsuccessful breastfeeding. To achieve the objectives of my thesis, I chose qualitative research, which was done in two groups of respondents, namely preterm newborns and their mothers. For each group of respondents, I chose different research techniques. For research on premature newborns, I chose structured observation. In a research survey among mothers of preterm babies, I chose a semi-standardized interview.
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Importance of thermomanagement in the care of premature newborn
Stránská, Monika ; Hocková, Jana (advisor) ; Kordulová, Pavla (referee)
The thesis is focused on premature newborn thermomanagement. It is focused particularly on very premature and extremely premature newborns which suffer the highest level of thermolability. The theoretical part deals with the particularities of premature newborn thermoregulation, newborns' reactions to thermal stress, thermomanagement in the delivery room and providing a thermoneutral environment in the incubator. The thesis describes a method of servo-control mode of body temperature, which has not been utilised for premature newborns in Czech Republic. The aim of the thesis is to start using this method and compare it with the method of manual control. Based on the total time not meeting the standard, number of failures and other parameters to assess which method is more suitable for body temperature regulation. The research sample consists of 47 newborsn who were born between the 24th and 32nd gestational week. Quantitative data collection at one-minute intervals was conducted in the 72 hours after birth. The method choice was random. Statistically important differences between the two methods were measured regarding the total time not meeting the standards. The incidence of hyperthemia was higher during manual method, hypothermia when servo-control. Total failure amount was 19%. However, the...
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Psychosocial factors influencing the experience of parents of premature babies
Stránská, Monika ; Pavlíková, Pavla (advisor) ; Houšťková, Hana (referee)
The thesis is focused on psychological experience of premature newborns parents. The theoretical part deals with psychosociological factors: stress, social environment of a newborn resuscitacion department, needs of parents and their emotion, nurse-parent relationship, parent-child relationship developement, communication and psychological parent support. To provide a complex view of the problemacy, one single chapter deals with premature birth, premature newborn and ilnesses that put the newborn due to the premature birth into major risk. The empirical part aim were findings concerning: what factors influence the parent experience of newborns most, how an healthcare team and a premature newborns department affect parents. The research was also aimed at finding if men and women experience this demanding life situation the same way or not and how can the healthcare team help to improve the psychological condition of paretns. To implement the researcch a non-standardized questionnaire method was applied. The research sample contained 43 respondents. The findings show clear differencies between men and women concerning settling with a premature birth of a child and in needs of psychological support. There were found reserves on the side of medical workers.
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The role of the lactation expert in nursing team in the care of premature newborns.
TALAŠOVÁ, Dana
In the first part of the diploma thesis we describe current state of taking care of newborns with special regard to mother's and newborn's needs and to the individual developmental care. We pay attention to the composition of the nursing team and to the conditions for its effective functioning. We cope with the importance of breast milk, breastfeeding and whole-community-based activities supporting breastfeeding. In the chapter about lactation consultancy we look into the history and present day to give a sense of this topic. The aim of the thesis is to make the description of the role of lactation consultant in the multidisciplinary team which takes care of premature newborns. We try to assess contribution of his presence to mothers of newborns and to nurses in the perinatal centres and at the same time to identify the problems lactation consultant are facing. We applied a qualitative research method of semi-structured interview for purpose of the study. We conducted the interviews with mothers of preterm infants, with nurses from the nursing team and with lactation consultants in ÚPMD in Prague and in České Budějovice Hospital. We investigated the rate of integration of lactation consultants into the nursing team within all perinatal centres in the Czech Republic. Lactation consultant provides mothers help with the stimulation of milk production and with the long-lasting breastfeeding maintenance. Lactation consultant supports mothers in breastfeeding and resolves problems related to breastfeeding a premature newborn. This help includes the psychological support. In relation to nurses, lactation consultant takes part in mothers' education in breastfeeding, manages human colostrum and mediates the mother-and-child contact when mother is separated from her baby. Nursing team is enriched with special knowledge and skills of lactation consultant. There were several problems identified: a lack of time for consultancy, the language barrier along with different cultural habits within minorities and the negative influence of layman discussion forums in the internet. Related to collaboration in the nursing team we encountered the problem of poor communication among lactation consultants and other team members. Mothers together with other team members, they all benefit from presence of lactation consultant in the nursing team.
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