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Importance and impact of phthalates during peritoneal dialysis and current possibilities of their replacement
Nohelová, Gabriela ; Zlámalová Gargošová, Helena (referee) ; Čáslavský, Josef (advisor)
This thesis deals with the importance and influence of phthalates in peritoneal dialysis (PD) and the current possibilities of their replacement. The information about phthalates – esters of phthalic acid - was completed with focus on the most commonly used plasticizer in medical material, bis(2-ethylhexyl) phthalate (DEHP) and its effects on the human organism and the environment. The possibilities of substitution of PVC in peritoneal dialysis were searched and their advantages and disadvantages were evaluated. As the evidence of phthalates absorbed by the human body in carrying out peritoneal dialysis selected studies performed in Germany and in our country, dealing with this issue, were used. High performance liquid chromatography (HPLC) with UV detection at 224 nm or gas chromatography - mass spectrometry (GC / MS) was used here for the determination of phthalates in the blood and dialysate in peritoneal dialysis. Extraction of sample with the suitable solvent and purification of the extract predates the actual analytical determination of sample.
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The needs of patients in the dialysis program and the role of the nurse in this issue
CHYTRÁČKOVÁ, Aneta
This bachelor's thesis focuses on the needs of patients in a dialysis program and the role of the nurse in this issue. Two objectives were established for this bachelor's thesis: To map the needs of patients in a dialysis program, and to determine the role of the nurse in patients undergoing dialysis. The work is divided into a theoretical and empirical part. In the theoretical part, the anatomy of the kidneys is briefly described, as well as the reasons for kidney failure. Subsequently, various elimination methods are described and explained, along with nutritional and exercise measures. The transplantation procedure is also briefly described. Attention is paid to the needs of patients, nursing care, and education. The empirical part was processed using qualitative research through semi-structured interviews focused on patients undergoing dialysis and nurses working in the dialysis center. The research sample consisted of 13 patients and 9 nurses. To achieve the set objectives, five research questions were created: What are the bio-psycho-social-spiritual needs of patients in a dialysis program? How does dialysis treatment affect patients' lives? What is the level of patient education before starting dialysis treatment? What is the role of the nurse in satisfying the needs of patients in a dialysis program? What is the role of the nurse in providing information to patients in a dialysis program? Our research has shown that dialysis generally has a negative impact on the quality of life of most of our respondents. Respondents are most negatively affected by thirst, the time demands of dialysis, poor sleep quality, changes in social needs, and overall fatigue after dialysis. Additionally, our research has shown that nurses in the dialysis center primarily fill the role of provider of nursing care, educator, and advisor who also provides emotional support. The results of the research serve as informational material for patients in the predialysis program and as potential recommendations for nurses working in dialysis centers.
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Adherence to treatment regime of patients with chronic kidney disease
FOUSKOVÁ, Jitka
Introduction: Chronic kidney disease in the progressing stage can significantly affect the quality of the patients' lives. It is estimated that more than 10 % of the worldwide population suffer from this disease. Proper nursing care, lifestyle modification and following proper medical treatment could significantly slow down the progression of disease. The main aim of the bachelor thesis was to find out the level of adherence to the treatment regime of patients with chronic kidney disease. Methodology: Quantitative research was chosen to process the practical part. Results were collected using a standardised questionnaire containing 50 questions to determine the attitude of haemodialysis centre patients towards adherence to dialysis plan, medication, fluid restriction and diet. Collected data was analysed and statistically processed using Microsoft Excel programme. Results: The research sample was made up by 94 respondents. The results show that 58,5 % patients undergoing haemodialysis treatment have an adherent attitude to the treatment. Keeping therapy treatment is influenced by the attitude of nursing staff. For most of the respondents, it is important to follow a treatment regime, so that their health does not deteriorate or because they realise that the condition of their kidneys requires them to follow experts' advice. Conclusion: The results of our thesis highlight the importance of nurses paying attention to patients with chronic kidney disease. Patients with whom nursing staff regularly talk about their treatment follow recommendations more conscientiously. The most frequent problem among patients is misunderstanding treatment and recommendations.
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The effect of dialysis on activities of daily live
Kolaříková, Jaroslava ; Nikodemová, Hana (advisor) ; Jirkovský, Daniel (referee)
The aim of this bachelor's thesis entitled "The effect of dialysis on activities of daily life" is to provide a brief overview of relevant basic knowledge of hemodialysis and peritoneal dialysis using existing and already published litarature and try to determine the influence of the dialysis on activities of daily life. The thesis is devided into theoretical and empirical part. The theoretical part is focused on kidney disease, hemodialysis and peritoneal dialysis, principles of dialysis therapy, their differences, complications, dietary measures and approaches to dialysis. Further attention is paid to the comparison of the advantages and disadvantages of both methods of dialysis among themselves. Part of the work deals with human needs and activities of daily life. The empirical part consists of an exploratory survey, which was given to patients in dialysis centers Fresenius Medical Care Prague 5 - Motol, Prague 10 - Vinohrady, Prague 4 - Krc, Prague 9 - Vysočany, Slaný, Louny, Chomutov, Most and dialysis center department of Internal Medicine Strahov Všeobecná fakultní nemocnice in Prague. The obtained data are presented in tabular and in graphic reports. Keywords hemodialysis, peritoneal dialysis, renal failure, activities of daily life, disease impact
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Comparison between the quality of life of the patients with peritoneal dialysis in the year of 2004 and 2012
Fauová, Magdalena ; Mellanová, Alena (advisor) ; Podaná, Jana (referee)
The Bachelor Thesis looks into the standard of quality of life of patients undergoing peritoneal dialysis. The aim of my work was to determine if the quality of life of the patients treated within the period of eight years moved towards any progress. Whether the patients have any problems at work, in their personal life, and if their illness allows them to enjoy leisure activities and last but not least, if they perceive any change in applying this treatment and how. In the theoretical part of my thesis, I am focused on summarizing the information related to anatomy and physiology of kidney, renal failure and compensation of renal function. The comprehensive description of the quality of life of these patients undergoing peritoneal dialysis forms an integral part of my work. In the empirical part, I have used quantitative research and data I obtained via questionnaire survey. In my further investigation I applied comparative research and its results were compared with the research undertaken in 2004. The results have showed that the quality of life has improved in comparison to the year of 2004 in all of the mentioned dimensions. Powered by TCPDF (www.tcpdf.org)
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Differences in the quality of life in patients undergoing hemodialysis, peritoneal dialysis and kidney transplantation
Horníková, Dita ; Di Cara, Veronika (advisor) ; Vaňková, Milena (referee)
The literature indicates that treatment by means of elimination methods is extremely challenging for patients, bringing a fundamental change to their lives. The aim of the thesis was to identify and describe the challenges of treatment in patients with renal failure and how a given method of treatment affects the patient's quality of life and needs, as well as to understand the subjective difficulties and problems. A data collection method in the form of non-standardized semi-structured interviews was selected for qualitative research. The surveyed sample consisted of six patients of a dialysis centre. The respondents taking part in the qualitative research were informed in advance of the course, circumstances and ethical aspects of the research. The obtained data was analyzed, colour-coded and then sorted into subcategories. The results were interpreted using the "showdown" technique. The interviewed sample of respondents was subjected to multiple elimination methods in the treatment of their disease. Kidney transplant patients subjectively evaluated the quality of their lives as very high, talking about "a life of a normal man". Peritoneal dialysis patients also evaluated their quality of life as relatively high, highlighting a certain feeling of independence. Haemodialysis patients describe...
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New diets for patients on dialysis
Kubíková, Kristýna ; Matějková, Miroslava (advisor) ; Zakiyanov, Oskar (referee)
The bachelor thesis focuses on new diets for dialysis patients. The aim is to create a new dietary regime system that meets the dietary requirements during dialysis treatment and also make the work of nutritional therapists easier. The old system was based on "common rational diet no. 3" and the food was selected individualy for every patient in order to avoid unsuitable meals in the dietary regime. This system was rather time consuming and the nutritional values did not meet the requirements of a dialysis diet. The anatomy and physiology emphasis is placed especially on chronic renal insufficiency. The privotal point of this chapter is the dialysis treatment and a description of dietotherapy in this stage of kidney failure. The practical part looks as the methodology of creating a new dietary regime. The result part compares the improvement in nutritional values with the original "rational diet no.3" and also looks at the methodology of creating new dietary regimes. The main research goal of the questionnare was to find out the patient's satisfaction with the new dialysis diet. Another goal was to discover the nutritional balance of individual dishes and the willingness to continue the diet after hospitalization. Finally, I would also like to mention that theoretically prepared dietary regime was put...
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Nursing Care for Patients with Peritoneal Dialysis.
HRUŠKOVÁ, Barbora
Peritoneal dialysis, together with hemodialysis, is one of the options for the renal function replacement. These days is the treatment with the help of peritoneal dialysis being used by more and more patients. One of the big advantages of peritoneal dialysis is the ability to care for yourself in the comfort of home, and that the patient doesn´t have to visit the center for dialysis several times a week. Theoretical part of this thesis is dedicated to peritoneal dialysis. Its physiology and types, types of peritoneal catheter and care of the floating tip. All the aids the patient needs for peritoneal dialysis are described here. You can find here description of the possible infectious on non-infectious complications. The last part is devoted to role of nurse in care of patients with peritoneal dialysis. The empirical part of this thesis was processed with help of a qualitative research. Our goal was to find out the most common problems of the peritoneal dialysis patient in their home environment. Based on the objective, there were made semi-structured interviews, that were performed with patients, who have or who used to have peritoneal dialysis. Information received from the patients was analyzed and divided into categories. The results of the research showed the most common problems of the patient with the peritoneal dialysis. The most common problems include the first reconciliation with peritoneal dialysis, fear of infection, but also fear of being able to go to work and others. This bachelor thesis could be helpful to the patients, who already experienced some kidney diseases or are just starting the medical treatment with help of peritoneal dialysis or are being treated by hemodialysis and are considering this option. This thesis may be also helpful to the students or already graduated nurses, who start working in hemodialysis center.
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Differences in the quality of life in patients undergoing hemodialysis, peritoneal dialysis and kidney transplantation
Horníková, Dita ; Di Cara, Veronika (advisor) ; Vaňková, Milena (referee)
The literature indicates that treatment by means of elimination methods is extremely challenging for patients, bringing a fundamental change to their lives. The aim of the thesis was to identify and describe the challenges of treatment in patients with renal failure and how a given method of treatment affects the patient's quality of life and needs, as well as to understand the subjective difficulties and problems. A data collection method in the form of non-standardized semi-structured interviews was selected for qualitative research. The surveyed sample consisted of six patients of a dialysis centre. The respondents taking part in the qualitative research were informed in advance of the course, circumstances and ethical aspects of the research. The obtained data was analyzed, colour-coded and then sorted into subcategories. The results were interpreted using the "showdown" technique. The interviewed sample of respondents was subjected to multiple elimination methods in the treatment of their disease. Kidney transplant patients subjectively evaluated the quality of their lives as very high, talking about "a life of a normal man". Peritoneal dialysis patients also evaluated their quality of life as relatively high, highlighting a certain feeling of independence. Haemodialysis patients describe...
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The Needs of Patients Undergoing Dialysis Treatment.
HORNOVÁ, Klára
This thesis intents on patients with chronic kidney diseases. In the theoretical part I sum up basic informations about kidney failure which is a state when kidneys stop to secrete waste ingredients from the body. Then I describe common treatment methods which are hemodialysis, peritoneal dialysis and transplantation. Nevertheless, the most important is to diagnostic the disease at the early stage and start the therapy as soon as possible. This part of thesis also describes physiological, psychical and social needs of the patient. The nursing staff has to know about all these needs which are connected, therefore neglecting one part may influence the others in a negative way. On the other hand, when all needs are satisfied the patient feels comfortable and the therapy can be successfull. When we get understand the specific needs of every single patient the quality of nursing care enhance radically. The practical part of the thesis explores all the needs through half-structured interviews with nine patients under hemodialysis treatment. We may sum up the outcome briefly as follows: the most important for the patient is the painless state, enough sleep and rest and sufficient fluid intake security. The psychical support is important no less. Unsatisfying these needs may lead to frustruation and deprivation of the patient. On the contrary, satisfaction makes him contented and peaceful and motivates him for getting cured. This thesis may help people with recent diagnosis of chronic kidney disfunction and also people who are already set in dialysis therapy to get more informations. The research may be a source of informations also for students and nurses in practice as well. Hopefully may lead to understanding the needs and limitations of the patients under dialysis treatment and thus to provision them a better care.
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