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Possibilities of evaluating changes by women during the period of menopause and their effects on the quality of life
BELEŠOVÁ, Romana
Menopause is a period, which is perceived as a natural part of female lifecycle. The way how women experience this period is individual, it differs in the intensity of the experience which is influenced by a variety of factors. Among the most important factors belong the biological as well as genetic factors, lifestyle, family environment, relationships between people, job as well as ethnical and cultural influences. The above-mentioned factors contribute to the occurrence of symptoms and changes connected in the life of a female. Standardised tools that are used and helpful in the clinical practice should be reliable, sensitive, and specific to certain symptoms. The objective of this doctoral theses is to map the use of evaluating tools with women in the period of menopause, to analyse symptoms influencing the quality of life, to create educational program for women and to find out if education has an impact on the knowledge of women on the menopause issues. The research was carried out in combination of two research methods - quantitative and qualitative. The quantitative research was designed as a descriptive cross-sectional study. The design of the descriptive qualitative study was used for the qualitative research. For the methodology of the qualitative research the Standards for qualitative research were applied. For the quantitative research a research sample I was set up. It was composed of women with a permanent residence in the southbohemian region in the ages of 45-65. For these respondents three types of questionnaires were designed, the standardised WHOQOL-BREF, WHQ and the unstandardised questionnaire. The data analyses were executed via SASD programmes (Statistical data analyses) and SPSS (Statistical Package for the Social Sciences). The qualitative research was realised in two phases. The first part of the research was carried out before the educational programme was realised and the second part took place 3 month after finishing the educational programme. For the purposes of the qualitative research analyses elements of embedded theory using open and axial coding were applied. There were two research samples that were subject to the qualitative study. The research sample II was composed of women in the ages 45-55. The research sample III composed of midwives working in the primary care. In midwifery in the clinical practice no measuring tools are used to evaluate the quality of life and health of women in menopause. Nowadays the evaluating scales are applied in research studies rather than in the clinical practice. In our quantitative study women evaluated the quality of life primarily as good. While evaluating the individual domains via the WHOQOL-BREF tool, women rated their physical condition the best and on the contrary the environment they live in the worst. When qualifying their health condition based on comparison of individual dimensions using the standardised WHQ tool, women mentioned the vasomotor symptoms as bothering and on the contrary, they rated anxieties/worries as not so bothering. In the qualitative part of the research women qualified the following symptoms as the most frequent: hot flashes, night sweats, mood swings, corrupted sleep, gaining weight, mental and cognitive changes. Conclusion: In the framework of the study based on the results an educational brochure for women was created. The aim of this brochure is to provide information about the problematic of the menopause period, about the symptoms, about the diagnostics, about the therapy and about the regime precautions. At the same time as a part of the research an educational programme for women was prepared. This programme focused on climacteric symptoms, diagnoses, therapy and the use of regime precautions leading to relief from the menopause difficulties. In this field, midwives still play a significant role. Midwives should lead women to accept the positive approach to the issues of menopause period.
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Managing the Quality of Health in the Czech Republic
Křížek, Josef ; Durdisová, Jaroslava (advisor) ; Krebs, Vojtěch (referee)
A large number of attitudes and methods of dealing with health service, or, more precisely, health, occur in theory and practice. The aim is to examine the efficiency of the implementation of the current projects, i.e. efficient application of tools of managing the quality of health. Theoretical rationales characterize understanding of conception of the quality of health especially in the sphere of health service. Moreover, this part introduces selected tools of managing the quality of health. The analytical part is focused on the institutional environment in connection with current challanges of eHealth implementation. The Central Repository of electronic prescriptions as the tool of managing the quality of health and the basis for ePrescription is one of the mentined challenges. The final part concerns with future trends in the Central Repository of electronic prescriptions and international projects, e.g. epSOS project. The EU is established on the principle of benchmarking, among other things. Possible future advances need to be considered in the context of foreign projects. For this reason, the Danish eHealth situation is included in the conclusion.
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