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The need of confidence and safety at selected pediatric departments
ŠKRAŇKOVÁ, Jana
Hospitalization means a lot of changes for a child. A child does not feel well, is isolated from home, friends, and comes to a new unknown environment full of white coats, fear, and different illnesses. After coming to hospital, a child loses the feeling of safety and is afraid. Fulfilling the child´s needs of certainty and safety is crucial for the child´s healthy development that is why the thesis deals with this topic. The aim of the thesis is to map to what extend the needs of safety and certainty of children are fulfilled in chosen departments. The thesis aims to find out in what way the asked children adapt to the hospital environment and to map the nurses´ approach to the children in the context of fulfilling the needs of safety and certainty as well. In the theoretical part, classification of children´s needs is described and the needs of certainty and safety are characterized. This part deals with adaptation of a child to the hospital environment and cooperation with the family, the role of parents during child´s hospitalisation, and the issue of hospitalism. For the empirical part, qualitative research was chosen via a method of semi-structured interviews with hospitalized children and nurses. The research sample was created by 17 children of younger school age and 6 nurses in the same ratio from three children´s department of Motol University Hospital. When interviewing children, we were finding out how they feel at hospital, what they experience, if they have visitors, if they are not afraid, and how they are informed about the diagnosis, check-ups, and the length of hospitalization. We were interviewing nurses about ensuring the needs of certainty and safety, decreasing fear and pain, common hospitalization of parents and children, and preparation of children for check-ups. On the basis of the analysis of results, we made a conclusion that the needs of safety and certainty are fulfilled to a great extend at children. Children generally adapt to the hospital environment well. Nurses treat them with love and try to devote themselves to them, encourage them and substitute their parents if they are not hospitalized with them. We think, however, that they do no devote enough time to psychosocial anamnesis and that is why an adaptation questionnaire was created which will serve nurses after admitting a child to hospitalization.
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Hospitalism prevention in preschool children
URBANOVÁ, Eva
Disease is a very burdensome and unfavorable situation for every person in his life, which, in some cases is connected with necessary hospitalization. Althought there is an attept at hospitalizing individuals only for necessary time, there are still situations where this period of hospital stay is very long for some patients. Particularly child patients who does not fully understand why he can not be at home in his environment with his closest ones. The aim of all healthcare professionals is to provide hospitalized children with an environment that would eliminate negative psychological and physical manifestations in connection with their involuntary stay in the hospital. Nowadays, however, many other professions are involved in the care of hospitalized children than they did before. The aim of the research was to identify pre-emptive measures of preventing hospitalism manifestation of pre-school children used by selected childrens departments. We also found out how these measures are for doctors, nurses, hospitalized children and their parents. Theoretical part of diploma thesis is prepared on the base of professional sources. A qualitative method was chosen for the empirical part, using semi-structured interwievs with doctors, nurses, pre-school aged hospitalized children and their mothers. The interwievs were conducted in February and March 2017 at two childrens departments of hospitals in the South Bohemian and Moravian-Silesian regions. The obtained data were then analyzed by the open encoding method. The analysis procedure was divided into three individual phases. In the first phase interwievs with medical staff were prepared. In the second phase, data from mothers were analyzed. The third phase consist of a detailed analysis of interviews with children. From the results of the research survey, it is obvious, that elimination of the negative cosequences of the pre-school children hospitalization is done mainly by fulfillment of the Charter of Children's Rights in the Hospital. The main focus is on the lenght of hospitalization, the elimination of unnecessary healing and nursing procedures and, last but not least, the creation of conditions for joint hospitalization with the parents, who then become more active participants in the entire healing process. Parents are provided with enough information, they can do basic nursing care, and, most importantly, as they are all the time with the children, they may be sure that children gets the best care. At the same time, healthcare professionals, especially nurses, gets time that they need not only for their professional activities, but also for children who are hospitalized without their parents. Nurses and doctors can wear colorful uniforms, which certainly have a major effect on appropriate child adaptation and can relieve their anxiety. Kiwanis dolls are being used for examination. They may also serve as a mean of healing and nursing procedures demonstration. Kiwanis dolls, accompanying pre-school child during his hospitalization, also serve for demonstration of feelings or as a mean of creative activity or a game. The analysis of the research results shows that teachers, volunteers, and various organizations have also been involved in the care of hospitalized children in the children departments, which brings many ideas, possibilities and projects. This effective and well coordinated cooperation can be of great importance in the care of hospitalized children, moreover it can also make a major contribution to the quality of nursing care in pediatrics. By taking part in department, they create space for the healthcare professionals, who will gain time for their professional work. They also participate in the humanization of department. At the same time, they create programs for children and parrents that will make their time spent in the hospital more pleasant and allow them to forget of their stay in the hospital.
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Risk factors of institutional education in relation to using illegal drugs - case studies
Votava, Tomáš ; Kalina, Kamil (advisor) ; Reichelová, Lenka (referee)
The objective and main task of this thesis is to ascertain, in the individual case studies of users of illicit addictive substances who underwent institutional care, what risk factors occurred in the examined persons, which of them were represented by the greatest number and what life event or events were associated with the beginning of drug abuse career of the examined persons. The theoretical part of the thesis first describes the institutional care with regard to its function, legislative and statutory regulations applicable in the Czech Republic and the reasons for placing children into institutional care. The thesis further deals with institutional care with regard to formation of human personality and describes the individual risk factors of institutional care in relation to development of personality which follow from the current theoretical knowledge of this phenomenon where the main attention is paid to psychological deprivation in childhood in connection with institutional care. This thesis is concerned with qualitative research in the form of case studies and the data for the purposes of this thesis were collected using the method of semi-structured interview. The results of this thesis indicate that the examined persons manifested, to a certain degree, all the described risk factors of...
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Client´s support through social services - the path to independence or dependence?
LEJSKOVÁ, Lucie
This work aims to find out how the former long-term users orphanages solve problems in different areas of their lives after leaving from these devices. The theoretical part describes the system of alternative care for children and adolescents in the Czech Republic and also I have focused on the characteristics of children's homes and departures from them. The survey was carried out through interviews with former long-term users of orphanages. To achieve the goals I set out general indicators arising from theoretical knowledge. Most of the findings coincided with the theoretical part, only the area of housing has not been evaluated by respondents as problematic. Investigations pointed to the lack of user awareness of possible participation in projects and related services that would initially be helpful.
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Leaving the institutional substitute care and the first year after
Štanclová, Tereza ; Čabanová, Bohumila (advisor) ; Orságová, Petra (referee)
Bachelor thesis "Leaving the institutional substitute care and the first year of independence" deals with young people, who are leaving residential care because of their adulthood, and are becoming independent. The author observes the circumstances under which the clients are leaving institutional care and attention is also paid to after-care that allows a smoother transition from full service to life outside the institutional care. The theoretical basis is the concept of social exclusion representing the first risk threatening care leavers because of their often lower education levels and lower competitiveness in the labor market and nonfunctional social network of their family and absence of social connections. Part of the bachelor thesis is qualitative research which includes recorded interviews with clients of residential care and aftercare, as well as with experts in the field. The purpose of the research is to provide a reflection of the parties involved and to illustrate the situation of these young people.
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Children´s rights and the Charter of rights of hospitalised children; their knowledge and observance from the perspective of a person accompanying a hospitalised child to the bed department of the paediatric ward in Klatovy hospital,a.s.
MÁDLOVÁ, Čestmíra
The theoretical part deals with the basic terms used in the Bachelor´s work such as the rights of children in hospital, their observation, awareness of the Charter and hospitalism. In the practical part two questionnaires were prepared. The first one contained twenty questions for small patients to respond and the other contained 20 questions to ask persons accompanying them and 12 questions of directed interview with the head of the children´s department in this hospital. The data were collected from October to November 2008. Eighty-five parents accompanying their children and 30 unaccompanied children, 15 boys and 15 girls, in the children department of the hospital in Klatovy respond the questionnaires. Hypothesis 1``The rights issued from the Charter for Children in Hospitals are observed in the children department of the hospital in Klatovy`` has been confirmed. Hypothesis 2 ``The persons accompanying children in hospital know the children rights`` has not confirmed. The aim of the Bachelor´s work was to find out if the rights of children in hospital are observed and if parents or other persons accompanying children are informed on the rights as they are stated in the Charter for Children in Hospitals in the children department in Klatovy. The aim of the work has been fulfilled.
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Often hospitalization of children and its affect on his need of safety and sureness
TREPPESCHOVÁ, Adéla
The need is the manifestation of absence, lack of something or infringement of internal balance and influence the individual to the behaviour that should again create the balance. The need of certainty and safety is dominant need especially for small children. It is need to avoid jeopardy and danger and express oneself by the general human tendency to eliminate the anxiety and it is possible to meet the needs by reliable and sure interpersonal relationship. The feel of certainty and safety enables obtaining of confidence, life worth, reliability, independency, orientation in human community as well as in material value. The hospitalization of a child means significant interference with person life. In the hospital a child is separated from the family and its home environment. A child is hamper in movement, lay up and invest with foreign people in foreign environment with different daily routine. We speak about hospitalism when the conditions in hospital or in another institute, where is the child on the long- term basis hospitalize, are so unfavourable that the child is harmed in its development. From the medical point of view has a child hospitalization also positive aspect such as pernament medical supervision and professional care. The aim of my bachelor thesis is to find out whether an often hospitalized child meet the needs. I have appointed two different hypothesis: The need of certainty and safety is not fulfil in an often hospitalized child (H1). The nurse cooperation with child dependents is minimal during the time of child hospitalization (H2). Any of the above hypothesis where proven. Quantitative research was used for processing of practical part of my bachelor thesis called: ``Often hospitalization of children and its affect on his need of safety and sureness.{\crqq} Controlled interview, observation and questionaire were used as technique of data collection and as a research collection I used patients of children's ward and its dependent from hospital in České Budějovice and Písek. The results shows that during a child hospitalization a child has only a low rate of anxiety from staying in hospital, its environment and medical staff. In the contrary a great number of children are sorrowful in the hospital. They miss both parents and friends, pet or their toys. During the hospitalization more than half of parents is accomodated together with their child. Average period of hospitalization of a child is in about sixty percents cases only one week, in twenty-five percents cases two to four weeks, in ten percents cases five or more than five weeks. Only small percentage of informants did not reply this question. Information about a disease that caused hospitalization of a child was in more than half of the cases supplied by attending physician, in twenty percents cases by parents and less than ten percents of informants did not reply this question. I would like this thesis to serve as a textbook and as an instructive material for both medical staff and parents of hospitalized children.
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A nurse´s role in looking after clients spare time in the course of their hospitalization
RATAJOVÁ, Radka
Nurse{\crq}s role in making use of the clients{\crq} free time when hospitalized at the ECD Nurses{\crq} mission in the society is to satisfy client{\crq}s immediate needs and to reach the maximum physical, mental, and social satisfaction possible. This can be achieved by a holistic attitude towards the client which comprises of the whole personality, compact human being with all the aspects of his or her personal lifestyle. No less important is the communication with the patient himself, either verbal or non-verbal, because the client{\crq}s psyche is totally changed inside the hospital. The way the patient deals with the hospitalization can be very much affected by a nurse with her correct attitude towards the patient. Especially with the long-term client it is very important to think about cooperation with their families and that way to prevent the negative consequences of the hospitalization, keep the clients engaged throughout their free time and support their self-containment. For these purposes, nurses use all sorts of techniques which are comprised in this thesis. The objective of this thesis was to find out whether nurses devote to the patients in their free time sufficiently, whether they have the means to do that and what options they have. If possible, find out the client{\crq}s feedback on their possibilities of make use of their fee time in the hospital. Based on the information gathered, theoretical knowledge and practical experience the thesis tries to suggest improvement for the situation on the departments given. The survey was applied using questionnaire quantitative data collection method. Two survey files were created: nurses at ECD and ECD clients. Two suppositions were assessed, which were supposed to either confirm or rebut the lack of time for client{\crq}s activities within their free time during their hospitalization and clients{\crq} dissatisfaction with making use of the free time during their hospitalization. The first supposition has confirmed that nurses do not have lack of time for clients{\crq} activities within their free time during their hospitalization. The second supposition did not confirm clients{\crq} dissatisfaction with making use of the free time during their hospitalization. The results of the survey has proved that nursed would like to spend more time with the clients in their free time but the crucial problem is the lack of staff. It is therefore impossible to devote to the clients as they would wish for. Another problem is the lack of financial assets. Nevertheless, nurses proposed plenty of suggestions which would make the clients{\crq} stay in the hospital more likeable. On the other hand, clients{\crq} dissatisfaction with making use of the free time during their hospitalization was a marginal one, especially thanks to their family relatives. They do not expect nurses to spend the free time with them due to their recognized work load. It would be most suitable to provide a sufficient amount of staff and volunteers for the clients{\crq} free-time activities during their hospitalization. If possible, extend the range of the limited options of making use of the clients{\crq} free time and introduce these options to them because the present patients do not expect such options at all.
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