This thesis deals with the question of meeting the criteria for provision of nursing care. The theoretical part covers the most important areas related to the provision of the nursing care. These are as follows: 1. the nursing process, 2. standards, 3. audits, 4. ethical code, 5. documentation. It is the nursing process with all its steps, its quality and its three dimensions of management and assessment that is most important of all. Audits and its conclusions help to meet standards for ensuring quality patient care. Following health care ethical code and respecting patients' rights are necessary for patients' satisfaction. In addition to that the nurse is supposed to keep records of individual patients in the nursing documentation and create classification systems (NANDA domains) based on patient's care. Cooperation between doctors and nurses and the overall working atmosphere are important as well. The empirical part of this work was compiled as quantitive research. The basic goal was identified for the purposes of the diploma work. It is to find how certain criteria of nursing care, provided by the nurse in general medicine in real conditions, is met. The main research question was formulated in advance - "How the criteria of nursing care are met, especially the quality of provided nursing care and time spent with the patient from the patient's perspective." The empirical part also includes six hypotheses. The first theory that the criteria of nursing care is fulfilled, occur more frequently at university hospitals than in other hospitals, has not been proven. The patients deem the quality of care in all three hospitals rather identically. The second theory assumes that the most important criterion of nursing care for patients is the nurse's attitude. This hypothesis has not been proven. Half of the respondents think that the nurse's attitude is important and the second half the collaboration with the doctor. The third hypothesis was supposed to find if the nurse's reaction to patient's special requests is fast enough. Namely nurse's reaction to treating the pain and using the signal equipment. The hypothesis has been confirmed. Half of the patients are satisfied with the nurse's reaction to ease the pain as well as the use of the signalling. The fourth hypothesis focuses on nurses of general medicine. The hypothesis is the number of nurse of general medicines on duty is insufficient. This hypothesis has not been confirmed. The fifth hypothesis assumes that the quality of provided care depends on the nurse's mental state. This hypothesis has not been proven. Half of the nurses admit being stressed but they argue that it doesn't affect their quality of work. The sixth hypothesis presumes that the time devoted to documentation will take more of the working time. This hypothesis has not been confirmed. 93 % of the nurses of general medicine responded that they spend half or less than half of the working time on documention and the other 7% spend half or more working time. The purpose of this thesis is to analyse and synthesise the results of the research question. The results will be presented at the participating clinics and other places. They might contribute to improvement of the nursing care.

The aim of this work is to find out the effectiveness of comprehensive spa treatment therapy focused on the musculoskeletal system. I tried to map out the influence of medical methodologies used in spa facilities, specifically in Berta Spa Třeboň, and patients´ return to work. In the past few years spa treatment is a frequently discussed topic not only because of the recent change in the list of indications. At present there are 35 spas in the Czech Republic which have to fulfill strict requirements to ensure maximum beneficial effect in rehabilitation, resocialization, prevention and supportive treatment. Lately many people are seeking spa facilities rather only for relaxation and so the spas are losing the primary purpose. Spas have mainly curative effect and are used as a prevention as well as a treatment. Spa treatment is or should also be the last treatment before the end of incapacity. Incapacity is a significant topic in the current health and social issues. The average incapacity/sick leave then becomes also an important economic factor.

Theoretical background: Peripheral arterial disease is a serious disease of Loir limb arteries which originates from atherosclerosis. The theoretical part deals with the lifestyle. There are mentioned basic risk factors of chronic forms. Further described are the pathophysiology changes generated on the basis of atherosclerosis and related causes for the origin of the disease. Subsequently there are explained methods of classification, developed clinical symptoms, diagnosis and therapy. This section also looks at the role of a nurse in the care of patients with peripheral arterial disease. Objectives: The aim of this work was to evaluate how patients with peripheral arterial disease changed their lifestyle after invasive vascular surgery. There were provided the following research questions: How do patients with peripheral arterial disease approach to the prevention of risk factors? What is in patients with peripheral arterial disease the main impuls for the possible change of their lifestyle? What influences surgery patient's attitude to risk factors for peripheral arterial disease? How crucial is a lifestyle change in patients after surgery for peripheral arterial disease? Methods: The theoretical part is processed using expert sources. The empirical part of the theses was processed using qualitative research. The chosen technique for data collection was semi-structured interviews with patients, with prepared open questions. The research was done in several phases - the first interview was conducted at the patient admission department (before surgery), followed by the next phase after three months, and 6 months after surgery. The interviews were recorded on a prepared form, then transcribed into electronic form and analyzed by open coding method. Results: The research showed that surgery can sometimes be triggered by changes in the patient's lifestyle. The first interviews in the preoperative period focused on how respondents felt, what was their lifestyle before surgery for atherosclerotic changes of the lower extremities. One of the questions was focused on patient knowledge about risk factors for the development of PAD and possible prevention. The second phase of interviews took place 3 months after the surgery. It dealt with the question about the respndents´ lifestyle, the respondents in the postoperative period, whether there were any changes. Some positive changes occurred in eating and there were some changes in doing physical activity. The third stage was carried out six months after surgery, again in order to detect changes in lifestyle. Minor changes came in smoking habits, the issue of diet and physical aktivity. Questions were also focused on the psychological level. We found out who helped patients and what was most motivating in implementing changes. In the conclusion/summing up question the patients marked themselves ow they managed to make a change. Conclusion: The number of patients with peripheral arterial disease and other cardiovascular diseases is increasing. The basis is the start to modify risk factors, namely tobacco use,dietary habits, physical activity. The medical staff members participate on changes in patients´ lifestyle by appropriate education. The problem occurs when the patient despite the support of close people can not cope to carry a twist in their life. There should a medical staff member offer a professional help to deal with this important step. Practical use: The aim is to draw attention to the expansion of education about lifestyle changes for patients diagnosed with PAD also in the postoperative period. Patients who are released to home care should receive enough information that would convince them to change their attitude towards their health, and that surgery is only one of the ways to prevent further attacks and complications. Results can improve communication with patients and focus on increasing their awareness and possibly offer assistance.

A touch is an inseparable part of the mutual contact between a nurse and a patient.The more a patient depends on the assistance of the others in common daily activities, the more a nurse uses physical contact in the care, not only in relation to the professional ortherapeutic acts, but also to the expression of compassion, sympathy, encouragement or calming a patient.Despite the fact that a touch is so important in patient care, it only receives a marginal attention.The goal of the thesis was to examine the reasons for and the obstacles to the application of a touch in nursing care, and if a touch belongs to the present nursing care.Research questions were set to achieve the goals:How do nurses perceive a touch in the present nursing care?How do patients perceive a nurse's touch in the treatment?Three hypotheses were formulated in dependence on the above set goals:H1:Nurses perceive a touch more as a part of the direct (physical)care than a therapeutic intervention.H2:Nurses rather use a touch as an unintentional method than as an intentional therapeutic intervention.H3:Nurses use a touch rather intuitively, not realizing the risk that a touch can be perceived negatively.The theoretical part of the thesis was elaborated on the base of literature sources.The empiric part was implemented on the base of a qualitative and quantitative research.The data for the qualitative research was gained by means of semi-structured interviews with ten patients.A questionnaire research for general nurses was used for the data collection in the quantitative research.On the base of the results the hypotheses were evaluated as follows:H1 Nurses perceive a touch more as a part of the direct (physical) care than a therapeutic intervention unconfirmed.H2:Nurses rather use a touch as an unintentional method than as an intentional therapeutic intervention unconfirmed.H3:Nurses use a touch rather intuitively, not realizing the risk that a touch can be perceived negatively unconfirmed. It is obvious from the results we achieved in the research that a touch has been and will always be an inseparable part of the mutual relation between a nurse and a patient.The research has shown that nurses perceive a touch as a part of the direct care as well as a therapeutic intervention.And if nurses use a touch as a therapeutic intervention, they do it intentionally, mostly to build confidence, to calm a patient, to create the feeling of safety, certainty and understanding.More than a half of the nurses replied that they used a touch instinctively, not realizing that they are touching the patient, on the other hand, more than a half of the nurses replied that they cared about at what points a patient perceived a touch negatively.Although the nurses replied that a therapeutic touch was not time consuming, it is not applied frequently in the therapeutic care.The research has also shown that patients accept a touch within the care and they accept it resignedly.When nurses touch patients, the patients are glad if such a touch is accompanied by words.The interviews revealed that a nurse should not underestimate a handshake at the first contact, as patients perceive this act as a feeling of interest and creation of confidence.The research shows indisputably that a touch is a very important holistic nursing interventionin patient care. It has confirmed that although a touch and its perception is something so intimate, individual and indispensable in nursing care, it only receives a marginal attention.This thesis might serve as study material for numerous nurses, so that a touch is used as an effective intervention by a nurse that perceives a patient as a holistic being and has a sympathy for him/her in his/her uneasy life situation.This thesis might initialize a more extended research combining more research methods.An application of hidden observation for deeper understanding of the use of a touch in nursing care might be particularly interesting.

The topic of this diploma thesis is ?The Nurse?s Contribution to the Management of Pain Treatment of Patients with a Malignant Disease?. The first objective is to ascertain whether nurses know the specifics of care of patients suffering from a cancer pain. The second objective is to ascertain whether nurses use an analogue score to assess the cancer pain. The third objective is to ascertain whether nurses document the pain intensity. The fourth objective is to ascertain whether nurses use non-pharmacological techniques to relieve cancer pains. The fifth objective is to ascertain whether nurses know the strategy of the WHO?s pain relief ladder. The research was conducted in the form of questioning while using the technique of anonymous structured questionnaires completed by the research set consisting of nurses in selected clinical wards with a high probability of occurrence of patients with an oncologic diagnosis. The total of 360 questionnaires was distributed, of which 198 completed questionnaires were returned. 105 questionnaires (53 %) came from the regional hospital in České Budějovice, 51 (26 %) from the St. Anne?s University Hospital in Brno and 42 (21 %) from the district hospital in Tábor. The research took place in March 2012. The results were assessed under the criteria preset by the author of the thesis. Hypothesis 1: Nurses are able to provide specific nursing care to patients suffering from a cancer pain, was confirmed. Hypothesis 2: Nurses assess the pain under the available analogue scores, was confirmed. Hypothesis 3: Nurses document the pain intensity, was disconfirmed. Hypothesis 4: Nurses use non-pharmacological techniques, especially physical ones, was confirmed. Hypothesis 5: Nurses know the strategy of the WHO?s pain relief ladder, was confirmed. In connection with the addressed issue, an educational leaflet about pain monitoring was drawn up for non-medical healthcare workers. This material describes the most frequently used methods of pain assessment and will serve as an overview of individual procedures including their specifics and application possibilities. The diploma thesis may serve for extending the knowledge of nurses in the field of pain treatment management.

This diploma thesis dealt with the issue of awareness of a patient and his or her opportunity to co-decide during hospitalization at an internal department. There were set three targets. The first one was to find out the level of the awareness of the patient during hospitalization about a care plan. From the result of a research is evident that patients feel lack of clear information about the care plan. The second target was to find out whether the patient has a chance to co-decide about a provided care during hospitalization. Comparing results from particular investigations there was a contrary between opinions of patients and medics. Patients think that the opportunity to co-decide is given to them. However, medics think that the opportunity of the patient to co-decide is limited. The third target was to find out, which questions in connection with a process of hospitalization patients ask nurses. Results of the investigation show that the most frequent questions are about the length of hospitalization. The diploma thesis is divided into two parts-theoretical and empirical. The theoretical part describes issues of the process of hospitalization of the patient since his/her income until his/her discharge from hospital. The investigative part was implemented by combination of a quantitative and a qualitative research. For the quantitative part of the investigation there was chosen the method questionnaire with a technique of half-structured interview offering open questions. Into the research file was involved 15 patients hospitalized at the internal department involved. There were set three investigatory questions. 1. What obstacles do exist in order to provide clear information during hospitalization of the patient? The research found out that the most frequent obstacle of intelligibility is a large amount of given information and frequent usage of terminology. 2. What obstacles do exist in order to make the patient an active participant when giving information? The investigation surprisingly resulted that that is not a misunderstanding or lack of empathy from the medic?s position or lack of interest from patient?s position. The main problem to make the patient the active participant during giving information is lack of medic?s time on patients. 3. Does the level of awareness of the patient saturate his or her need of certainty and security? The investigation showed that by the level of awareness is saturated the need of certainty and security. To gain data for the chosen issue of the quantitative research we used the method of questioning by a questionnaire. The questionnaire consisted of 17 questions, 14 closed questions, 2 half-opened questions and 1 open question which offered to show a personal opinion. Respondents that were asked were students of paramedic assistant, nursing and paramedic resque worker, furthermore working nurses from both ambulant and bed sector, nurses from management and teacher of praxis. For the quantitative research we had two hypotheses: 1. Frequency of asking questions about the length of hospitalization equals to asking about the health condition. From the research was found out, that frequency of asking about the length of hospitalization is much higher than questions about the health condition. The first hypothesis was not verified. 2. During giving information nurses take for granted to include needs of the patient. The investigation showed that nurses during the hospitalization take for granted to include also patient?s opinions expressing his or her needs. The second hypothesis was verified. Results of our investigation gained in this diploma thesis will be used as sources for a distribution of informative materials for patients. We also think that it would be useful to inform nurses working at internal departments about the results. The results could also be interesting for students of high schools or universities preparing themselves for jobs of medical workers.

Diploma thesis entitled Healthcare Risks in Acute Forms of Coronary Heart Disease is divided into a theoretical and a practical part. The theoretical part is divided into parts dealing with medicinal aspects, risk management and nursing care. The medicinal part defines the term coronary heart disease and describes its acute forms. The nursing care part describes how to care about a patient with acute CHD. It also points out the risky spheres in caring about a patient with acute CHD and describes possibilities of education provided by a nurse before discharging a patient to home care. The next part lists examples of diagnoses according to NANDA II that a nurse determines in patients with acute CHD. The research was performed with nurses from the cardiology department of the České Budějovice Hospital. Twelve nurses participated in the research in the qualitative research form based on semi structured interview. Three aims were set for the diploma thesis. The first aim was to find out whether nurses knew the risks that might occur in nursing care of acute CHD forms. The next aim of the thesis was to find out how nurses prevent the risks in nursing care of acute CHD forms. And the third aim was to find and compare differences in knowledge and skills between nurses from a Cardiac Intensive Care Unit and those from a standard cardiology department in nursing care of acute CHD forms. Six research questions were based on the aims. 1: Do nurses know the risks that might occur in nursing care of acute CHD forms? 2: Do nurses know complications that might arise from the risks in nursing care of acute CHD forms? 3: Do nurses know how to proceed in a situation when a mere risk changes into a real problem? 4: Do nurses from the Cardiac Intensive Care Unit (CICU) know how to proceed against the risks in acute CHD forms better than the nurses from the cardiology ward (CW)? 5: Are the CICU nurses able to prevent the risks better than the CW nurses? 6: Are the CICU nurses better aware of the risks that might occur in nursing care of acute CHD forms? I have managed to find answers to the research questions and thus to fulfil the aims set for the diploma thesis. It was found in the research, particularly by comparison of the knowledge and skills of the nurses from the Cardiac Intensive Care Unit and those from the standard cardiology ward that the knowledge among the nurses from both the stations is comparable. Only the results of the standard cardiology ward nurses and their answers suggest that they try to concentrate on patient's psychological condition apart from provision of nursing care. The following conclusions were finally drawn from the research questions set for the research: Nurses are aware of the risks that might occur in nursing care of acute CHD forms. Nurses are aware of the complications that might arise from the risks in nursing care of acute CHD forms. Nurses know how to proceed in a situation when a mere risk changes into a real problem. Nurses from the Cardiac Intensive Care Unit know how to proceed against the risks in acute CHD forms better than the nurses from the standard cardiology ward. Nurses from the Cardiac Intensive Care Unit are able to prevent the risks better than the standard cardiology ward nurses. Nurses from the Cardiac Intensive Care Unit do not know the risks that might occur in nursing care of acute CHD forms better than the nurses from the standard cardiology ward. Study material for secondary and tertiary students summarizing how to care about a patient with acute CHD was prepared as a result of the thesis, with regard to the research with the nurses, who personally faced the patients with acute CHD and are experienced in the care both with and without complications.

The thesis deals with the issue of devaluation of persons by medical and paramedical employees. Health service is the field in which the human dignity should be respected. The devaluation of men/women occurs during social contacts and even in health service, situations leading to devaluation may occur due to unconscious and unaware communication. For mutual contacts of the (para)medical employee and the patient, not only a good knowledge of psychology, but first of all the ability to apply adequately communication skills in practice is necessary. The patient should not represent for medical staff only diagnosis, but first of all he/she should be seen as a human being. Behavior of (para)medical employees should be supporting and strengthening, it should not only contribute to a quick recovery, but also to the psychological balance and well-being of patients. Three goals were postulated for the purposes of this thesis. The first goal was to find out if the devaluation of men/women by a (para)medical employee occurs during the hospitalization. It follows from the results of the research that situations of patient devaluation by the medical employee occur really. The purpose of the second goal was to find out the ways of person devaluation during the hospitalization. It follows from the investigation that the devaluation may take place in different ways. The research questions cover practically with this goal. The most frequent way of devaluation is unsuitably conducted communication of medical employees. The third goal was to find out if the medical staff has an impact on the devaluation of man. Patients do not have experience with an arrogant behavior but consider it as devaluing. It was found out by the investigation that the personal staff has an affects the devaluation of man because individual members of the nursing team contributes to the devaluation of the patient. These, was confirmed by the answers of patients in quantitative research. The respondents believe that the number of the medical staff rather does not support evaluation of the patients. It can be concluded that the personal staff in some way affects the devaluation.

The thesis deals with the realization of the criteria for saturation of the patient's needs. In the current system of nursing care, the principles of modern nursing are failing to realize and therefore we want to find out the main obstacles of this situation and the possibilities of their removal. For the purpose of the thesis there were set three objectives. The first of them has set the objective of finding out the most common problems in meeting the criteria for saturation of the patient's needs. The research showed that the nurses see the problem in a lack of staff at the wards, a lack of time, excess of documentation, excessive demands for nurses. The purpose of the second objective was to find out what supports the realization of the criteria for saturation of the patient's needs. Results have shown that what helps nurses is a positive work environment, motivation, nurse´s personality, own scale of values, salary, good leadership, organization, nursing care. The third objective was to find out the opinion of nurses on meeting the criteria for saturation of the patient's needs. It turned out that the majority of respondents think that nurses do not effectively satisfy all the needs of patients for a number of reasons: there are few nurses and they are overloaded, the nurses do their best but still cannot satisfy all the patients´ needs. We also found out that the higher patients´ needs are omitted. Less than a third of the nurses indicated that nurses effectively meet all the patients´ needs. For the qualitative part of the research, we set two research questions in advance. Which criteria nurses use in patients´ needs saturation? The research showed that time, which is very valuable for nurses and very often is in short supply, is an important criteria for the saturation of the patient's needs. Furthermore, it is knowledge and manual dexterity when nurses additionally reported a lack of education of some nurses especially within the nursing process. As the next criteria, it was mentioned the cooperation with the patient as it is necessary to engage patient himself in care planning. The next criteria is monitoring of the patient´s response, which is included in every phase of the nursing process. Furthermore, the nurses agreed on criteria, which include communication as a key skill of every nurse, then individual care, a suitable environment and utilities, education, critical thinking, effective nursing process and empathy. The second research question tried to find out which obstacles prevent nurses in effective saturation of the patients´ needs. We found out that nurses are concerned about a lack of staff at wards and the excess of administrative load, which is related to a lack of time for patients. These three factors are also obstacles for nurses and prevent them from effective satisfying of the patients´ needs. The next obstacles in satisfying the needs are burnout, reluctance of nurses to work, excessive demands for nurses, poor workplace relationships, a lack of evaluation both in a form of praise and appreciation, and finance. We also found a lack of information, which is related to a lack of time, as nurses do not have a chance to collect all the information concerning the patient. As another possible obstacle, nurses also mentioned personal problems. The results of the thesis can be used as a small contribution to currently ongoing effort of the Czech Association of Nurses.

It is inconceivable for only one person to take care of ill people in a health care. To achieve the aim which is in particular maintenance of the highest life quality of specimens in health or in disease, is important mutual cooperation of professionals in the branch, where every single ensure care for a patient on the basis of his own knowledge and skills. It is about team co-operation, where every single member of the team has his own obligations, but also rights and authority. The term multisiciplinary care means co-operation of more scientific branches. Hemodialysis patients'nursing care is about team of professionals, who are fully involved in satisfying patients' needs. This co-operation enables primarily the unitary communication, reduction of patient's issue analysis, unified and consecutive nursing care, complete documentation and quality evaluation of provided nursing care of these patients. The aim of the dissertation was to chart multidicsiplinary care's issues at hemodialysis, on the basis of available literature. The dissertation is based on theoretically processed topic by the method of documents' content analysis and method of review and synthesis. Information is obtained from domestic but also foreign science books, scientific magazines, and internet sources. Findings from the 42nd international conference EDTNA/ERCA, which topic was Innovation of renal care through multi-professional leadership, which took place in Malmö, Sweden, from 31st of August to 3rd of September 2013, also contributed. The dissertation is divided into three basic chapters. The first part is focused on team characteristic. There are definitions, types, features, building, composition, roles, conflicts within a team and elemental description of multidisciplinary co-operation. The second chapter deals with a history and hemodialysis as a medical extracorporal method. The third, and the broadest section, is focused on multidisciplinary co-operation at the centre of hemodialysis. It is divided into several sub-chapters. In each of them the information descend from general field to concrete needs of hemodialysed patient and continue to the description of each member of a multidisciplinary team. The result is comprehensive view on provision of multidisciplinary care in the centres of hemodialysis. The output of the dissertation is a draft of the nursing care algorithm within the purview of multidisciplinary care at the centres of hemodialysis. Multidisciplinary care is necessary requirement for assumption of effective, high quality and continuous medical and nursing care at all the centres.