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Application of the principle of autonomy in the field of death and dying of seniors in the Czech Republic
D´mello, Petra ; Fošum, Jan (advisor) ; Svoboda, David (referee)
Diploma thesis "Application of the principle of autonomy in the field of death and dying of seniors in the Czech Republic" primaly deals with issues related to the right to self-determination, human dignity and desires associated with the end of life. It seeks to answer the question of the extent to which the autonomy of the individual can be respected and to participate in end-of-life healthcare decisions through the legal concept of living will, even if the person is in a position that does not allow to express the will. Although this institute is firmly rooted in the legal order of the Czech Republic, awareness of this legal concept is insufficient among the public and rarely used, unlike the Federal Republic of Germany, where the institute is usually applied by seniors. The aim of the work is to reflect the current issues of dying and death from an ethical point of view and provide comprehensive information on the current possibilities of exercising the right to self-determination, which can significantly support the quality of human care in the terminal phase of life.
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Business Plan for Starting a Home Care Agency
Buďová, Radka ; Rašticová, Martina (referee) ; Chlebovský, Vít (advisor)
This thesis deals with essential steps that are necessary to start-up home care agency. The goal is to determine whether it is nowadays a lucrative business to provide health and social care in this way. In terms of specificity of health care, the thesis includes both a detailed analysis of current state of the health care market and the theoretical knowledge of legislative and legal regulations associated with the establishment of home care agency.
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Dysthanasia
Johnová, Eliška ; Gallus, Petr (advisor) ; Janečková, Hana (referee)
The BA thesis titled "Dysthanasia: Home care as one of the prevention methods of dysthanasia" deals with the issue of prolonged death and proposes solutions to prevent it. The theoretical part introduces to readers the basic concepts related to the finiteness of life. It discusses death from both medical and theological perspectives, and further describes in detail the concept of dysthanasia as one of the ways of dealing with death. The thesis defines the problems associated with dysthanasia and proposes palliative care as the best approach to prevent this issue. It also mentions organizational forms of specialized palliative care to follow up on the chapter describing home care for the dying, which is not only the best solution in preventing a negative approach to death and dying, but also meets the wishes of the majority of the population who wish to die in a familiar environment close to their family or friends. The last chapter mentions supportive services that help caregivers in caring for the dying. The practical part focuses on the closer examination of home care for the dying and its function in practice. This section is based on qualitative research and information obtained through semi-structured interviews. Keywords Finitude of life, death, dying, dysthanasia, palliative care, home care,...
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Low microbial diet after bone marrow transplantation
PALOUDOVÁ, Karolína
Bone marrow transplantation is a complex intervention in the human organism that requires a few pre- and post-operative regimen measures. Regime measures also include a low-microbial diet, which is indicated for a period of 3-6 months. This is a strict dietary measure, about which the patient should be informed by a nutritional therapist or attending doctor. Adherence to a low-microbial diet includes strict hygienic and technological requirements for food preparation, but also a very limited food selection. The theoretical part discusses the bone marrow transplantation, types of transplantation, the course of treatment and possible complications. Following on from the most common complications, another section is devoted to food-borne infections and other gastrointestinal problems. The final section focuses purely on the low microbial diet. Individual nutrients, procedures for the technological preparation of dishes and other options for nutritional care are detailed here. The practical part, which is carried out in the form of qualitative research, is divided into two parts. The first part is devoted to case reports, where the basic information and eating habits of the patients, obtained based on an interview, are mentioned. In the second part, the respondents' answers and their weekly meal records are evaluated. The research shows that all seven respondents followed a low-microbial diet for at least 100 days after the transplant. The analysis of the menus shows that most of them do not meet their daily energy needs. A big problem is the monotony of the menu, which can be caused by a diet, a limited choice of food, the disease itself, or lack of appetite. The work can raise awareness of this diet and, based on the booklet created, help people who have been indicated for a low-microbial diet.
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Caring for a child with a cochlear implant in the home environment.
LOVĚTÍNSKÁ, Michala
Cochlear implants have been used in the Czech Republic since 1993. The cochlear implant gives deaf individuals the opportunity to receive auditory sensations. Cochlear implantation is a procedure where the implant is inserted under the skin and connected to a series of electrodes that are inserted into the cochlea. This procedure is performed by a surgeon which is specializes in ear, nose and throat. After long - term rehabilitation, the individual is able to understand spoken language and can even make phone calls without reading. With a cochlear implant, most users canintegrate into main stream society, among the normal hearing population. Children go to mainstream school, play sports, and communicate with others, all with out the use of sign language. Cochlear implants are currently operated in the Czech Republic at the Motol Hospital in Prague, the St. Anne's Hospital in Brno and the Ostrava Hospital. The first aim was to find out and describe how the child experiences the cochlear implant fitting, the second aim was to find out what problems parents perceive after fitting the cochlear implant in a child, and the third aim was to find out what barriers parents perceive in caring for a child with cochlear implant. The research investigation was carried out by qualitative research, using the method of semi-structured interview. The research sample consisted of ten adult informants, specifically parents, and five child informants. Parents and children come from different regions of the Czech Republic. The interviews took place from February to March 2023. Subsequently, all responses from the interviews with parents of children with cochlear implants users were listed. The results of the responses are divided into categories and their subcategories. The analysis of the results shows that the perception of the cochlear implant is different in children. The research found a fourth group of children who react to the first programming by crying. It was found that the child's experience of CI programming can be influenced by parents. As such, barriers to caring for a child with a cochlear implant have not been identified. Rather, parents perceived shortcomings of the cochlear implant, such as the speech processor slipping off the child's head, difficulty in obtaining a helmet, and perceived sweat as a deficiency with CI. The results show that children's perception of cochlear implant fitting is very individual, depending on many factors. Parents can influence the child's perception by training individual sounds in the home environment. Problems following cochlear implant programming in a child should be minimal, with a chech-up by a clinical engineer. The difficulties perceived by parents in caring for a child with a cochlear implant do not come out as prominently as CI deficiencies. It is very important to treat the child individually. Each child has different characteristics and abilities. From the results of the research investigation, we want to provide comprehensive information for parents of children who experience hearing loss or deafness in their child, and their possible solution is a cochlear implant. The results of the bachelor thesis were presented before an expert jury at the student competition of the ZSF JČU in České Budějovice. Furthermore, the results will be published in a professional journal for nurses.
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The possibilities of home care from the perspective of nurses and the general public
PEŇÁSOVÁ, Petra
This bachelor thesis is focused on the awareness of nurses and the general public about the services of home health care agencies. The work is divided into two parts, theoretical and practical. The theoretical part includes the issue of home care and the characteristics of the role of nurses in home care. The results obtained in the research investigation are processed and evaluated in the practical part. Four objectives have been chosen for the bachelor thesis which focus on the awareness of nurses and the general public about the possibilities of home care. The research part was divided into four groups. First two groups were focused on nurses, where nurses from inpatient sectors were in the first group of respondents and nurses from outpatient sectors were in the second group. The other two groups were aimed at the general public, with the third group of respondents being the general public and the fourth group being clients currently treated by a home care agency. To meet the objectives, a semi-structured interview was chosen which included eighteen questions for nurses and twelve questions for patients. It is evident from the results focused on the group of nurses, that only nurses who are directly involved in the process, have detailed information about home care options. Furthermore, in the inpatient wards, nurses perceives lack of time and unresolved contractual relations with insurance companies as major barriers in the process of referring clients to home care agencies. From the results aimed at a group of the general public who have never personally encountered the service, awareness is very marginal. In contrast, clients treated by a home care agency have a greater awareness. Submitted thesis provides a better understanding of home care, identifies gaps in awareness among nurses and the general public, highlights the problems encountered during the collaboration between the home care agency and the referring facility.
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The physical handling of the patient with self-sufficiency impairment in home care.
ZAVADILOVÁ, Leona
The Bachelor thesis deals with the physical handling of a patient with a self-sufficiency disorder in home care. It defines physical handling as part of everyday nursing care. It presents the care of patients with self-sufficiency impairment in rehabilitation treatment using the kinaesthetic concept and handling aids. Unskilled handling carries risks that can negatively influence the physical and psychological well-being of all involved. The aim of the study was to investigate the use of handling aids in home care when physically handling a patient with impaired self-sufficiency. The research questions focused on the handling aids available to home caregivers and the complications of physical handling. The implementation of qualitative research using a semi-structured interview method with eight home care nurses provided information on the handling aids used as well as complications of physical handling in the home care setting. Five categories were created by categorizing the data using the pencil-paper method. Research shows that information for safe handling is provided to the patient's family by the nurse. Caregivers use a positioning mat for care. Very important, but sometimes unavailable, in home care is the reclining bed. Physical handling then becomes risky. Nurses do not use a slide sheet. Two of them do not know the aid at all. Complications of physical handling that occur to nurses and patients include musculoskeletal or skin injuries. The results of the research show the need to popularize the topic of safe physical handling. A leaflet has been produced for agencies involved in physical handling research. Another way to prevent the risk factors of physical handling in home care and to make it safe for the patient and the caregiver are courses and conferences with theoretical and practical content on safe physical handling for professionals and lay people.
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Community Approaches to health care during and after crisis situation
KUČEROVÁ, Barbora
This thesis deals with issues of community care with regard to community health care during and after emergencies. The theoretical part aims to introduce the general topic of community care. The first chapters of this thesis are dedicated to community care and utilization of community nursing care, including the history and development of community care in the Czech Republic as well as outside its territory. The thesis further provides a summary of institutions, health and social services within community care, including the possibility of home care. It also deals with the role of community nurses and their involvement in the process of community planning. Another important part of this thesis is the issue of emergencies where the term "emergency" is defined, and divisions of emergencies and the cooperation of integrated response system are described. The thesis furthermore concentrates on the procedures of the ambulance service during emergencies including emergencies with polytrauma and the subsequent treatment in health-care facilities. One of the goals of this thesis is to describe the role of medics during emergencies and the role they play in caring for patients coming from different communities. Further chapters deal with specific community health care: elderly people, children, people with disabilities, groups of different cultures - ethnic and national minorities. It also deals with the specifics of providing health care from the point of view of religion. The practical part is dedicated to quantitative survey of knowledge of medics in issues of community health care across different levels of education and different ranks. A research question was determined: What is the understanding and professional level of medics in the community care setting during and after an emergency? The respondent data was obtained in the form of a questionnaire and results are shown in diagrams. The questionnaires aimed to find out whether the respondents had ever heard the term "community care" and to find out their theoretical knowledge on this issue. However, the main point was to evaluate how vast is their practical experience.
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Nurse in home care during the Covid-19 pandemic
HESSOVÁ, Johana
The aim of the thesis was to determine the situation of the home care nurses during Covid-19 pandemic and their ability to take care of their patients. The influence of the government restrictions on the home care nurses is covered as well. There is a practical part that consists of 12 interviews, out of which 10 are with the nurses and 2 with the directly affected patients. The interview was done either face to face or by phone depending on the working schedule or distant location of the interviewees. The research was done in depth using "the deep interview technique" questions that allow the best qualitative results. The questions were pre-prepared. The overall result showed that despite the difficult situations, the nurses were able to unite and provide to their patients the best care possible. The occupation of the home care nurse is truly challenging, not only physically but also mentally. This thesis allows us to understand the duties, needs and feelings of the nurses during the Covid-19 pandemic. The nurses were working very hard, carefully and with precision as they were dealing with the most vulnerable group of individuals that they wanted to protect and do not expose to any risks. We are reffering to the senior population. Many times the home care nurses are their only social link and connection with the outside world.
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