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Specifics of nutrition in hospice care
Turková, Jana ; Starnovská, Tamara (advisor) ; Novák, Ondřej (referee)
Introduction: Hospice palliative care is provided to patients in the terminal phase of life with the aim of ensuring quality of remaining life with an emphasis on their individual needs and wishes. An integral part of palliative care is nutritional care and ensuring the patient's adequate nutrition. The theoretical part of the thesis describes the principles, standards and concept of development of palliative care, and provides a comprehensive overview of the types and forms of hospice care currently provided in the Czech Republic, and concludes with a consideration of nutrition and hydration in the terminal phase of the disease. In the practical part, the results of the questionnaire study are processed and presented. Objective of the thesis: The main objective of my bachelor's thesis is to determine whether an individual approach is applied to nutrition in the inpatient care of a selected hospice. The secondary objective is to discover whether patients in inpatient hospice care are satisfied with the nutrition and meals provided. Methodology: The project deals with research into the inpatient care of St. Štěpán's Hospice in Litoměřice. The research is designed as a questionnaire study. The data source is my own semi-structured questionnaire with 30 questions; 15 questions are closed, 13...
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Nutritional specifics in hospice care
Macinauerová, Romana ; Starnovská, Tamara (advisor) ; Holubová, Barbora (referee)
Palliative care is an approach focused on improving or maintaining quality of life for patients and their families who suffer from terminal illness in an advanced stage. Hospices are most commonly associated with palliative care, where hospitalized patients are expected to live less than six months. The aim of this work is to introduce the issue of palliative care and the nutritional approach in hospices from a nutritional therapist's perspective. The theoretical part is focused on the general issues of palliative care and its division. It presents the needs and life values of patients and their families, introduces the issue of nutrition and hydration in the terminal phase of the disease, possible interventions and symptoms that affect food intake. The main objective of the empirical part of the research, which was conducted in the form of semi-structured interviews, is to find out among the patients at the Hospic u Dobrého Pastýře in Čerčany their favorite food and dishes. The sub-objectives were to find out the preferred consistency, quantity and texture of food, identification of situations and symptoms affecting patient's food intake in hospices and to find out through a questionnaire survey in inpatient hospices in the Czech Republic the importance of a nutritional therapist. Based on the...
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The role of the nutritional therapist for people living with HIV
Tomanová, Michaela ; Starnovská, Tamara (advisor) ; Procházka, Ivo (referee)
Nutrition is one of the prognostic, predictive and also modifiable risk factors for the development of civilization diseases, which unequivocally cause the highest mortality in our territory. Obesity, metabolic syndrome, cardiovascular disease, hypertension, and type 2 diabetes mellitus have been shown to progress earlier and more progressively among people living with human immunodeficiency virus (PLWH) rather than in the HIV-negative population. Thanks to the modernization of antiretroviral therapy (ART), the incidence of wasting or lipodystrophic syndrome among adherent individuals is very low, if not zero. However, HIV infection together with the ART and unhealthy lifestyle now represent a certain risk of undesirable comorbidities in the form of civilization diseases. The complex topic of nutritional care for PLWH should be part of the professional knowledge of every nutritional therapist. Questionnaire surveys intended for qualified nutritional therapists and educational institutions, which were applied for the first section of the practical part of this thesis, confirmed all formulated hypotheses. The result of this part is the finding of insufficient education and the absence of deeper knowledge in the field of nutrition for PLWH among almost 95 % of the interviewed nutrition therapists,...
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The influence of social factors on the nutritional status of dialysis patients
Boček, Petr ; Povolná, Pavla (advisor) ; Janečková, Hana (referee)
Aim of the thesis: The aim of this thesis was to find out what social factors influence the nutritional status of dialysis patients. The theoretical part deals with nutritional therapy as a part of complex care, linking the social sphere and human health, including a separate chapter on dialysis patients. The practical part then examines the aforementioned influence of social factors on the nutritional and overall health status of patients. Methods: A qualitative methodology of semi-structured interviews with six informants from a hemodialysis center and one social worker from the same facility was used for the research. An open coding technique was used followed by sorting into categories. Results: According to the interviews and follow-up categories, each core theme is discussed using specific quotes from informants, including the social worker's perspective on the issue. Conclusion: The discussion concludes with recommendations for practice that could improve and streamline the overall care of dialysis patients from a social-health perspective, such as interpersonal competence education, greater use of the social worker's offer, standardization of social care in the field, or the creation of support materials for patients. Keywords: social factor; nutritional care; dialysis; nutritional and...
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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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Nutritional Consultancy within the Framework of Crafts
Šimončičová, Renáta ; Prošková, Eva (advisor) ; Pírková, Vendula (referee)
Introduction: Bachelor thesis is focused on nutritional consultancy within the framework of crafts and its providing. Further subject is exploration of patients/clients satisfaction with nutritional consultancy. Object: Bachelor thesis target is to familiarize readers with forms of providing nutritional consultancy and regulations in this activity. Practical part is focused on exploration of patients/clients satisfaction with nutritional consultancy and comparison between consultancy provided by dieticians and nutrition counsellors. Methods: Research was in form of anonymous on-line questionnaire. Obtained data is displayed in form of graphs. One thesis part is devoted to data analysis. Results: Theoretical part clearly point to the fact that current legislation regulating activity of nutritional consultancy is not adjusted correctly. As emerged from the questionnaire most of respondents are partly satisfied with process of nutrition research. Greater proportion of respondents mentioned larger satisfaction with work of dieticians compared with nutritional counsellors. Conclusion: Nutritional consultancy within the framework of crafts is important area in health care. Due to the fact that activities of nutrition counsellors/dieticians have impact on overall human health rules who and under what...
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Nutritional care and eating habits of people living with HIV
Tomanová, Michaela ; Starnovská, Tamara (advisor) ; Procházka, Ivo (referee)
The relationships between nutritional status, infectious diseases, and the immune system suggest that nutrition is an indisputable cofactor in the progression of human immunodeficiency virus (HIV) infection. One of the main complications of HIV infection is multifactorial malnutrition, however, overweight and obesity have become more frequent. A specialized nutritional intervention should be an integral part of routine medical care for people living with HIV. It has been shown that the incidence of wasting syndrome and critical malnutrition among people living with HIV has significantly decreased simultaneously with the side effects of modern antiretroviral drugs. The side effects of modern antiretroviral therapy are much less common than previous generations of drugs. On the other hand, the prevalence of obesity and other chronic diseases associated with it has increased significantly among people living with HIV. The practical part describes and evaluates the monitoring of eating habits of 10 people living with HIV. The aim of this work was to provide a summary of information about proper nutritional care for this population, to evaluate the eating habits of the respondents and to come up with a potentional nutritional intervention and education. Lack of macro and micronutrients and poor eating...
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Nutricional care for patients with TBC
Vlášková, Lenka ; Zlatohlávek, Lukáš (advisor) ; Svačina, Štěpán (referee)
The thesis deals with the nutritional care for patients with TBC. The theoretical part describes the history of the disease, its etiology, pathogenesis, treatment and epidemiology. The tuberculosis current care of patients in the Czech Republic, the incidence of tuberculosis in our country and in the world and the specifics of nutricional care for patients with tuberculosis. In the practical part i deal with nutritional care in five case reports and interpret the records from the patient's medical records. I suggest to each patient an optimal diet based on the calculated nutritional need. Keywords: tuberculosis, nutritional care, disease, nutrition, diet
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Nutricional care for patients with TBC
Vlášková, Lenka ; Střítecká, Hana (advisor) ; Kaláb, Josef (referee)
The thesis deals with the nutritional care for patients with TBC. The theoretical part describes the history of the disease, its definition, epidemiology, clinical presentation, diagnosis, and treatment. The tuberculosis surveillance system in the Czech Republic, the incidence of tuberculosis in our country and in the world and the specifics of nutricional care for patients with tuberculosis. In the practical part i deal with nutritional care in five case reports and interpret the records from the patient's medical records. I suggest to each patient an optimal diet based on the calculated nutritional need. Keywords: tuberculosis, nutritional care, disease, nutrition, diet
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Nutritional status and food intake for clients in retirement home
ZEMENOVÁ, Pavlína
This bachelor thesis called Nutritional status and food intake for clients in retirement home endeavours to map general nutritional status of the elderly. It is concentrated on the elderly living in retirement home without nutritionist in South Bohemian region. Evaluation of nutritional status was performed by standardized screening form, monitoring food intake, follow-up calculations and laboratory testing due to blood vitamin D content. The thesis is typically divided into two parts. Theoretical and practical. Theoretical part is patterned on definition of age and ageing. These two phenomena are analysed on demographic and prognostic aspect. It is focused on retirement home and legislation associated with presence nutritionist in retirement home by reason providing medical nutrition. It is analysed dietetic system and project called External Evaluation of Nutritional Care Quality in Rest Homes. This project is one way how to implement professional and guaranteed nutritional care. About this issue, the thesis is concentrate on evaluation of nutritional status by using various instruments and on physiological changes of organism in later life. And it does not forget to nutrition recommendation for the elderly. A foundation of practical part of thesis sets five research targets and two research question. Twenty clients of retirement home participate in research. It was seventeen women and three men. Basic assessment of nutritional status of the elderly was performed by form called "Mini Nutritional Assessment ", which reveals danger of commencement of malnutrition at four clients and direct danger of malnutrition at two clients. Calculations of offered food and real food intake were made by software called "Nutriservis Profesional". Offered food contains acceptable number of proteins in major part of researched diet (basic diet, diabetic diet and resting diet). It was 15 % proteins (85-90 grams) from the whole energetic food intake per day. The number of carbohydrates of all researched diet was almost 45 % (255 g) from the whole energetic food intake per day. Average fat intake of all researched diet was 40 % (100 g). All these values were not in Česká asociace sester, Sekce nutričních terapeutů ´s opinion about right medical nutrition. Most clients did take in all offered food. But their needs were satisfied, because they eat more than their optimal energetic intake. Not surprisingly, a blood vitamin D content was low at almost all of clients. Average vitamin D intake from food was 4,4 micrograms. Average numbers in blood was about 11,43 micrograms/l. It is not possible to cover recommended daily allowance of vitamin D by food. Because of minimal movement of clients on sunlight it is impossible achieve required figure without vitamin D supplementation. Nutritionist presence would help to implement functional diet system in the retirement home. This system guarantees harmless offered food and helps search for malnutrition clients. And it can turn away, moderate or does not develop danger of malnutrition.
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