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Maternity hospital
Kolář, Vojtěch ; Stehlík, Ondřej (referee) ; Mléčka, Jan (advisor)
A new concept of maternity hospital creates a place, where future mother is not stressed and where she feels free. A place, where birth is perceived as a common part of everyday life. It searches a compromise between birth at classical hospital environment on one side and birth at home on the other. Both aforementioned possibilities bring certain risks that are intended to be minimized using this concept. The idea is based on practice from birth facilities from Germany and creates new concept of so called „birth houses“ that is consistent with law in the Czech Republic. Design of maternity hospital should not be based solely on meeting technical requirements of a bulding, but first of all comfort of mothers should be taken into account to make them feel home.
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Midwife Care for Woman with Endometriosis
DVOŘÁKOVÁ, Nikola
This bachelor thesis deals with the topic of midwife care for a woman with endometriosis. The thesis is divided into theoretical and practical part. The theoretical part is mainly focused on the endometriosis disease. The theoretical part describes the definition of endometriosis, its causes, diagnosis, manifestations, treatment options and midwife care. For the practical part, two objectives were chosen. The first aim was to find out how women with endometriosis perceive midwife care. The second aim of the thesis was in turn to find out how midwives perceive the whole issue of this disease. The bachelor thesis had three research questions. The first research question focused on how women with endometriosis perceive midwives' care. The second research question explored how the lifestyle of women with the condition has changed. The third research question looked at how midwives perceived the issue of endometriosis. The aforementioned objectives were achieved through a qualitative research investigation in the form of semi-structured anonymous interviews. Data collection for the research inquiry took place from January to March 2023. In the practical part, two research sets were chosen. The first research set consisted of six midwives who encountered women who had been diagnosed with endometriosis during their practice. To preserve their anonymity, the midwives were referred to as PA1 to PA6. The second research group consisted of eight women with endometriosis who were referred to as Ž1 to Ž8 in the thesis. The data collected was transcribed and then further analyzed using text coloring. Main categories and sub-categories were established for data analysis, these are further described in the research section of the thesis. The first research set consists of two main categories and four subcategories. Two main categories and six subcategories were obtained from the informants' statements of the second research set.
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Urinary Incontinence After Delivery
JANDOVÁ, Markéta
The bachelor thesis is focused on the topic of urinary incontinence in women after childbirth. The thesis is composed of a theoretical and practical part. The theoretical part of the bachelor thesis describes the anatomy and physiology of the urinary tract and micturition. Furthermore, attention is paid to urinary incontinence, its classification, risk factors, diagnosis, and incontinence aids. Finally, the treatment of urinary incontinence is briefly summarized. One goal was set for the practical part of the bachelor thesis. To determine the frequency of urinary incontinence in women who have had their last childbirth 2-15 years ago. Five hypotheses were formulated for this goal. H1: Women who suffered from obesity during childbirth (body mass index equal to or greater than 30.0) do not suffer from urinary incontinence after childbirth more often than women who did not suffer from obesity during childbirth. H2: Women who gave birth to a child with a birth weight over 3,500 g suffer from urinary incontinence more often than women who gave birth to a child with a birth weight under 3,500 g. H3: Women after vacuum extraction or forceps delivery do not suffer from urinary incontinence more often than women who did not give birth using these methods. H4: Women who had birth injuries do not suffer from urinary incontinence more often than women who did not have any injuries during childbirth. H5: Women who gave birth more than 8 years ago were less educated about urinary incontinence by the midwife than women who gave birth less than eight years ago. The goal was achieved through a quantitative research survey using their own online questionnaires. The questionnaire contained 21 questions. Sixteen questions were closed, three semi-closed questions where it was possible to mark more answers including "other:" and two open questions. Statistical processing of all questionnaires took place in Microsoft Excel. The research sample consisted of 393 women who gave birth to their last child more than two years ago and no more than fifteen years ago. Of the total of 393 respondents, 217 women reported experiencing urinary leakage and 176 women reported no urinary leakage. The research survey showed that more than half of the respondents, i.e. women 2-15 years after childbirth, experience urinary leakage. It was also found that women are very poorly educated about this issue by the midwife. Of the total of five hypotheses, only hypotheses H1, H3, and H4 were confirmed. Hypotheses H2 and H5 were not confirmed. No dependence was demonstrated for any of the hypotheses. It was found that the level of information was the same for women who gave birth less than eight years ago and for women who gave birth more than eight years ago, and it was very low.
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Birth Positions, Formerly and Today
ROBAUSCHOVÁ, Magdaléna Anna
This bachelor thesis focuses on comparing the used birthing positions in the past and present. The thesis is divided into two main parts, theoretical and practical. The theoretical part describes the evolution of obstetrics and the development of birthing positions used from prehistoric times to the present day. The physiological process of childbirth is briefly described, including the stages of labor. The thesis also includes a description of the role of a midwife during childbirth. Some alternative methods in obstetrics are also mentioned. The thesis also provides a more detailed description of the individual positions that can be used during childbirth. Two main goals were defined for the practical part. The first goal was to find out which positions women are interested in during childbirth today. The second goal was to compare the difference in the choice of positions during childbirth today compared to positions used in the past. A quantitative research survey was used to achieve the set goals through a self-constructed questionnaire, which was distributed in paper form. The questionnaire consisted of a total of 21 questions, of which 15 were closed, 2 were open, and 4 were semi-closed. Data processing, along with graphical and tabular evaluation, was subsequently performed using Microsoft Excel. The research sample was one and consisted of women who had given birth at least once in their life, but not by caesarean section. The respondents were then divided into three categories to compare their answers in a defined time frame. The first category consisted of women who gave birth between 2018 and 2023. This group was represented by 62 women out of a total of 176 respondents. The second group included women who gave birth between 1994 and 2017, which included 49 women. The last category consisted of women who gave birth at least 30 years ago, in 1993 or earlier. This category included 65 women. Based on the defined goals, three hypotheses were then established. Only two groups of women were compared in the evaluation due to the wording of the hypotheses. The first group consisted of women who gave birth between 2023 and 2018, and the second group included women who gave birth in 1993 or earlier. H1: Women today have the opportunity to choose their own birthing positions compared to women who gave birth thirty years ago. H2: Women who gave birth thirty years ago did not have information about birthing positions in the first stage of labor compared to women giving birth today. H3: Women giving birth nowadays are more interested in using various positions during the second stage of labor than women who gave birth thirty years ago. Based on the results of the research survey, hypotheses H1 and H3 were confirmed, and hypothesis H2 was rejected.
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Prevention of Postoperative Complications in Women after Caesarean Section
MUNKOVÁ, Eliška
The bachelor thesis deals with the prevention of postoperative complications in women after caesarean section. The thesis was divided into theoretical and practical parts. The theoretical part of the bachelor thesis explains the problems of caesarean section and its definition, history, indications, surgical techniques and types of anaesthesia that could be used during this operation. Last but not least, the thesis focuses on possible postoperative complications associated with caesarean section and on preventive steps for postoperative complications. At the same time, the theoretical part deals with the care provided by the midwife to the woman before, during and after the procedure. The aim of the qualitative research part was to find out what is the prevention of post-operative complications in a woman after caesarean section. One research question was set and that was: what care midwives provide to women after caesarean section in the prevention of post-operative complications. The data collection was done during the month of February and March 2023. Two research sets were set. The first research set was midwives working in the six-week care unit, providing care to women after caesarean section. The second research set was women who had a history of but-at least one caesarean section. Midwives PA1-PA9 and women I1-I8 agreed to provide a semi-structured interview. In the semi-structured interview, midwives were asked a total of 10 questions regarding the preventive measures they provide to women in their post-operative care. Women were asked 15 questions and were asked about their experiences of the post-operative care provided. After the interviews were transcribed verbatim, they were analysed by colouring the text. The midwives' and women's responses were coded and the main categories and their sub-categories emerged from the data analysis. The categories of midwives' data were titled: Care of the woman after SC and Postoperative complications. The women's data categories were called: Pre-operative phase, Post-operative phase, and Care provided. The research findings revealed that midwives working in the six-week care unit care for the woman after surgery by monitoring her health status to prevent postoperative complications along with education. As part of their continuing education, they regularly attend seminars on the prevention of post-operative complications and the care to be given to women after a caesarean section. This bachelor thesis could provide midwifery students with inspiration to improve the quality of care provided to the woman. Despite the significant positives of the results obtained, the research part also revealed shortcomings in the care provided after caesarean section. The shortcomings were mainly found in ineffective communication between the midwife and the woman, as well as inadequate education.
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Education of Women by Midwife in the Preoperative Period
TRUXOVÁ, Natálie
The bachelor thesis focuses on the education of women by midwife in the preoperative period. The thesis is divided into a theoretical and a practical part. The theoretical part includes the topic and classification of gynecological surgeries, as well as the division of the perioperative period, with a detailed focus on the preoperative period, its organization, course, and procedures associated with it. Finally, the theoretical part deals with the concept of education, educational methods, goals, and the relationship between the midwife and the educated women. The practical part of the thesis aimed to determine, how midwives educate women in the preoperative period. Qualitative research was conducted using anonymous semi-structured interviews. The research was carried out from February to March 2023 and data was collected from gynecology units in hospitals in České Budějovice, Liberec, and Jablonec nad Nisou. Two research samples were used: the first sample consisted of midwives who educate women in the preoperative period, and the second consisted of women who underwent gynecological surgery. Interviews with the informants were conducted with their expressed consent and were anonymous. The interviews were recorded on audio. The interviews consisted of eight basic questions and additional follow-up questions for midwives, and ten basic questions and additional follow-up questions for women. The acquired data were transcribed and subsequently analyzed using color coding. To evaluate the data, main categories and subcategories were established and included in the research section of the bachelor thesis. The first research sample consists of main categories (Education, Process of Education in the Preoperative Period) that contain subcategories (Importance of Education, Development of an Educational Plan, Education in the Preoperative Period, Women's Cooperation during Education, Feedback from Women after Education). In the second research sample, there are main categories (Education, Behavior of woman), which are further divided into subcategories (Process of Education, Change in Women's Attitude after Education, Perception of Education from the Midwife Assistant). The first research question aimed to investigate how women evaluate the knowledge they acquire. Informants Ž2, Ž3, Ž4, Ž5 were very satisfied with their education as a midwife and considered the acquired knowledge to be sufficient. The information was communicated to them clearly. However, informant Ž1 who received education from a midwife was dissatisfied. Informant Ž1 did not receive education in the preoperative period, which had a negative impact on her mental state. The overall communication between her and the midwife was also problematic. The second research question focused on how midwife educate women in the preoperative period. In the preoperative period, most of informants stated that they first educate about the functioning of the department, its equipment, and spaces. All informants further described how their education in the preoperative period proceeded. The education provided by all midwives was consistent and included all necessary aspects. The education of midwives included information regarding nutrition, elimination, hygiene, sleep, and pre-medication.
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Midwife and Reproductive Health
KUBIŠOVÁ, Kristýna
The bachelor thesis focuses on reproductive health with the coherence of midwife's work. The thesis is divided into theoretical and practical parts. The theoretical part deals with the definition of reproductive health, the physiology of human reproduction, the menstrual cycle, and the need for sex and reproductive education. Furthermore, the function of the public health service system is explained as well as the prevention as part of primary care in the Czech Republic. The midwife's doing is clarified along with her competence and her meaning in the prevention topic. The factors which influence reproductive health such as age, diet, recreational drug use, stress, etc. Are described in detail. The bachelor thesis also centers on family planning, a healthy conception, and types of contraceptive methods of birth control and some information about infertility is mentioned as well. The practical part aimed to discover upper-secondary and tertiary education students' opinions about reproductive health. Further, two hypotheses were determined, which were formulated as follows. Hypothesis n. 1: The tertiary students perceive the need for reproductive health education from a midwife more than upper-secondary students. Hypothesis n. 2: Women perceive the need for reproductive health education more than men. Qualitative data collection was chosen on which the questionnaire was based. The questionnaire contained 41 questions (31 closed, 8 mid-closed, and 2 open ones). It was spread in online form through Google Forms application. The research aggregate consisted of 210 respondents from upper-secondary education students (3rd and 4th years) and tertiary students from various occupations. The research sample was composed of students between the age of 17 to 27 from numerous regions of the Czech Republic. Fisher exact test was used for data analyses of the formulated hypotesis. The level of significance was stated as follows alpha = 5 % (0.05). H1 was not confirmed. It was proven that interest in reproductive health education is not dependent on students´ education; either upper secondary or tercially education degree. Also, it was not confirmed that the reproductive health education is required to be performed by midwife. H2 was confirmed. Based on the analysis was proven that women require reproductive health education to be performed by midwife more than men. According to 87 % (182) respondents of our survey the reproductive health education should be included in upper-secondary and tertiary education but 5 % (11) of respondents would not include it at all and 8 % (17) was not sure. The survey has shown that the ideal learner should be an externally educated person in reproductive health. This person would suit 78.5 % (124) of respondents, 8.2 % (13) of students would like to have a doctor for education in this topic. However, 6,3 % (9) of students would like to have teacher from their school and only for 5.1 % (9) of students the midwife would be suitable. The rest of the students, 1.9 % (3) would like to have somebody else. The Bachelor thesis and the survey could be used for purpose of educational plans and materials in topic of reproductive health education for students.
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Attitude of midwives towards physiotherapeutic interventions during pregnancy, childbirth and puerperium
BÁRTOVÁ, Anna
The purpose of this thesis investigates the attitude of midwives towards physiotherapeutic interventions during pregnancy, labour and puerperium. Two goals were defined for the thesis. The first goal was to investigate the midwives' interest in the inclusion of the selected methods to their practice and the second objective was to verify the midwives' interest in multidisciplinary cooperation with a physical therapist. The conducted research was based on a quantitative survey via a questionnaire of author's own construction. The questionnaire was distributed in electronic form. The research group consisted of 196 respondents, of which 195 were women and 1 of which was a man. Most respondents belonged to the age group between 25 and 36 years. 75 % of the respondents had a university degree, 11,2 % respondents stated that they graduated vocational school and 13,8 % respondents stated that that their highest reached level of education was highschool. The research showed that midwives are interested in inclusion of the methods in their practice and in multidisciplinary cooperation with a physical therapist. The midwives younger than 35 years showed higher interest in increasing their education than midwives older than 35 years. Correlation between the respondent's age and use of the individual methods was not proven by the research. The results showed that 94 % of the respondents considered multidisciplinary cooperation as important. 79,6 % respondents were interested in multidisciplinary cooperation with a physical therapist. The physical therapists that worked on the respondents' workplace mostly dealt with verticalization and scar care in women after caesarean section and in women after gynecological operations. The respondents themselves used the excercises of getting up sideways the most (93,9 %), verticalization (86,7 %) and breathing excercises. Respondents stated that they felt the greatest increase in the involvement of midwives in rehabilitation care is neeeded in birth injury and scar care (115x). The results can be presented at professional conferences for midwives.
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Obstetric operations and the role of a midwife
LÁNÍKOVÁ, Alena
This work deals with operations performed in connection with pregnancy, childbirth and the postpartum period. It is divided into a theoretical and a practical part. The theoretical part describes individual surgical interventions, their indications and the role of midwifes in them. It also opens up the topic of awareness of women and midwifes in these areas, which is followed by a research section that focuses on students of this field and their awareness and readiness to perform their role and education. The research part, in the form of a questionnaire survey, was aimed at midwifery students from five universities in the Czech Republic. It was focused on the competence of midwives to instrument caesarean sections. The research group consisted of a total of 80 female respondents. All students were female and were studying second or third year midwifery.
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Pregnancy with positive diagnosis of preeclampsia and the role of a midwife.
HUSÁROVÁ, Nela
This bachelor thesis deals with pregnancy and positive diagnosis of pre-eclampsia. The thesis describes the role of a midwife and the needs of pregnant women during hospitalization. The aim of this thesis was to find out how midwives perceive the care of pregnant women diagnosed with pre-eclampsia and a further aim was to find how the needs of women diagnosed with preeclampsia have changed. The thesis is divided into two parts, theoretical and empirical. In the theoretical part the characteristics of pregnancy, hypertension, etiopathogenesis and the role of a midwife with a woman diagnosed with pre-eclampsia are described. Two aims were chosen for the empirical part of this thesis, namely, to find out how midwives perceive the care of pregnant women diagnosed with pre-eclampsia and how the needs of women diagnosed with pre-eclampsia have changed. We were interested in finding out how midwives care for pregnant women diagnosed with pre-eclampsia and the needs of these women during hospitalization. Based on these objectives, two research questions were established. How do midwives perceive the care of pregnant women diagnosed with pre-eclampsia and how have the needs of pregnant women changed during the provision of care. A qualitative research investigation was carried out by means of semi-structured interviews with midwives and women who have experienced the disease during pregnancy. The first research group consisted of five midwives working in the obstetrics and gynecology department. The second research group consisted of eight informants with personal experience of pre-eclampsia and whose delivery took place less than a year ago. The first research question investigated how midwives perceive the care for pregnant women diagnosed with pre-eclampsia. The research survey showed that all the midwives interviewed agreed on increased monitoring of the client's general condition, especially monitoring of blood pressure, swelling, laboratory testing of blood and urine, subjective feelings of the client and further observation of the heart rate of the fetus using a doppler. Furthermore, the midwives emphasized the importance of client education during hospitalization. Most frequently the women were educated about resting regimen, limiting TV and phone screen time, having a semi-dark room, bedrest, signaling devices and getting enough sleep and rest. Only some midwives mentioned educating women about the proper technique of urine collection in 24 hours. Information regarding bowel movement and constipation prevention was mentioned only by midwife PA3. The second research question examined how pregnant women's care needs have changed. The research survey showed that informants most frequently experience disruption of psychosocial needs, namely separation from family and loved ones, fear and concern for their unborn child, homesickness and sadness. Furthermore, the informants reported disruption of sleep due to hospitalization and change of environment. Some informants mentioned limited dietary choices and only informant I8 mentioned a problem of obstipation due to long-term hospitalization and resting regimen. Furthermore, the informants mentioned an information deficit in the area of self-education due to not attending antenatal classes as a result of hospitalization and the previous epidemiological situation. Pregnant women undergoing long-term hospitalization do not have the opportunity to visit antenatal courses outside the medical ward which results in information deficit in the area of self-education. This bachelor thesis has shown that there is a need for more consistent education for women during hospitalization. The findings of this thesis may be used as a source for professional seminars and lectures for midwives.
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