Nowadays chronic obstructive pulmonary disease (COPD) is considered to be a global and all society problems. COPD interferes in all aspects of patient´s life. It implicates limitations to physical aspect which is the cause of psychological and social effects. The disease changes the present way of patient´s life, the patients have to change their lifestyle, adapt themselves and learn new habits which can also mean changes of their needs during the COPD. The thesis deals with the problems of COPD patient´s needs. The thesis is divided into two main parts. The theoretical part focuses on characteristic of the disease, classification and hierarchy of human needs, the effects of COPD on biological, psychological, social and spiritual needs and next on the nursing care for patients with COPD. The practical part of the thesis includes the processing and next the evaluation of the dates obtained during the research. The aim of the thesis was to findout how the patient's needs differ in particular stadium of the disease. To get the aim there were determined six research questions:1) What is the knowledge level of COPD patients? 2) How different are their needs in particular stadium of the disease? 3) Which needs predominate in individual stadium of the disease? 4) Which activities can COPD patients do? 5) Which limitations and problems do COPD patients have? 6) Which needs does a COPD patient have in the field of home oxygen therapy? The method of qualitative research was used for the research. The technique of non-standardized interview was used for the data gathering. The research complex was formed by 15 COPD patients from the first to the third stadium of the disease. There were five patients in each chosen stadium. The evidence of the individual patients were divided according to their specific stadium into particular categories: knowledge of the disease, respiration, sleep, lifestyle, profession, check-ups. The research shows that the need changes did not directly depend on the level of the disease stadium, but mainly on the patient´s facing up to the disease, their total state of health and based on their individual needs. The firstand second stadium patients gave as the most common need to have their medicines permanently at their disposal, next the bigger need of sleep and rest and last but not least the need of being more independent. The progress of needs in the third stadium was different according to using of home oxygen the therapy or not. The patients who use home oxygen therapy coincided that the therapy helped them to improve their life. Now the main need is to increase their independence in household activities and to besurrounded by their family. Some COPD patients have demonstrable common symptom of depression which consequently influences physiological needs such as sleep, rest, independence and also their total self-realization. The need changes significantly affected the field of life habits, regime,lifestyle and leisure time activities. First of all there has been the absence of cigarettes and alcohol among their life habits and regime. There have been some limitations such as fishing, riding a bike, mushroomingin leisure time activities. The lifestyle was affected the changes in family and work life. The patients often suffer from dyspnoea, which subsequently limits walking, household activities, self-service,for example: shopping, meal preparing, dressing or doing personal hygiene. Despite various limitations the patients do various activities like walking dogs, strolling, reading books, watching TV, visiting clubs and other interesting culture events. The research results pointed to insufficient level of knowledge of the COPD patients. Due to the low level of the patients´ knowledge of the disease an information material with basic information about the disease was prepared.

Abstract Dyspnoea associated with respiratory infection is a common symptom in infancy and early childhood. Inspiratory stridor is the main symptom in cases of croup and expiratory wheezing in cases of bronchiolitis, obstructive bronchitis and acute asthma exacerbations. Dyspnoea associated with respiratory infection is a common cause of emergency department visits and unplanned hospital admissions among infants and preschool children. The assessment of dyspnea associated with acute childhood respiratory infection is largely subjective, and evidence regarding the severity of acute dyspnoea is needed in order to target hospital admissions more accurately. Wheezing associated with respiratory infection in infancy has been recognized as an important predictor of recurrent wheezing and asthma at school age. The aims of this study were to determine the risk factors for croup, to evaluate factors that reliably predict the need for hospitalizing children with acute wheezing and to find out whether respiratory infection with wheezing during infancy has a positive association with the development of asthma during childhood. The work included two register-based surveys and one prospective cohort study. It is concluded that a family history of croup is an exceptionally strong risk factor for croup and its recurrence in childhood. The early phase of bronchiolitis is unstable in infants below 6 months of age. These infants are most likely to need medical interventions in the first 5 days after onset of the disease. A positive respiratory syncytial -virus test result, a fever of more than 38°C and low initial oxygen saturation are predictors of the need for hospitalization and medical interventions. An initial oxygen saturation >93% effectively identifies children aged more than 6 months with mild wheezing, and this limit can be used to avoid unplanned hospital admissions. There is an association between early respiratory syncytial -virus infections and subsequent wheezing and asthma, in that such infections select children who are prone to wheezing and asthma before school age, but the symptoms tend to decrease with time and an early respiratory syncytial -virus infection will not permanently alter bronchial reactivity. / Tiivistelmä Hengitysvaikeus on yleinen oire lapsilla virusten aiheuttamien hengitystieinfektioiden yhteydessä. Kurkunpäätulehdukseen liittyy sisäänhengitysvaikeus. Ilmatiehyttulehdukseen, ahtauttavaan keuhkoputkentulehdukseen ja akuuttiin astmakohtaukseen liittyy uloshengitysvaikeus. Hengitystieinfektioihin liittyvä hengitysvaikeus on yksi yleisimmistä syistä päivystyspoliklinikkakäynteihin ja äkillisiin sairaalahoitojaksoihin lapsipotilailla. Hengitystieinfektioiden taudinkulun tuntemisella ja hengitysvaikeuden vaikeusasteen arvioinnilla on tärkeä merkitys näiden potilaiden hoidon toteuttamisessa. Hengitystieinfektioon liittyvää hengitysvaikeutta on pidetty riskitekijänä astman kehittymiselle. Tämän tutkimuksen tarkoituksena oli selvittää kurkunpäätulehduksen riskitekijöitä ja sairaalahoitoon vaikuttavia tekijöitä hengitystieinfektioon liittyvän uloshengitysvaikeuden hoidossa sekä varhaislapsuudessa sairastetun hengitystieinfektion yhteyttä myöhempään astma- ja allergiasairastavuuteen. Tutkimukseen sisältyi kaksi rekisteriaineistoa ja yksi seurantatutkimusaineisto. Tutkimuksessa todettiin, että kurkunpäätulehduksen uusiutuminen on erittäin tavallista ja sisarusten ja vanhempien sairastama kurkunpäätulehdus on merkittävin riskitekijä kurkunpäätulehdukselle ja sen uusiutumiselle. Alle 6 kuukauden ikäisillä lapsilla ilmatiehyttulehduksen taudinkuva on epävakaa ensimmäisen 5 oirepäivän aikana. Kuume, matala happisaturaatioarvo ja respiratory syncytial -virusinfektio ennustavat osastohoidon ja invasiivisten toimenpiteiden tarvetta ilmatiehyttulehduksen yhteydessä. Yli 6 kuukauden ikäisillä lapsilla happisaturaatioarvo > 93 % ennustaa lievää taudinkuvaa hengitystieinfektioon liittyvän uloshengitysvaikeuden hoidossa. Käyttämällä tätä happisaturaatioarvoa raja-arvona, kun arvioidaan sairaalahoidon tarvetta, voidaan merkittävästi ja turvallisesti vähentää sairaalahoidon tarvetta lasten hengitystieinfektioon liittyvän uloshengitysvaikeuden hoidossa. Alle 6 kuukauden iässä sairastettu respiratory syncytial -virusinfektio on riskitekijä varhaislapsuudessa ilmeneville astmaoireille, mutta tämä riski vähenee iän myötä ja 8 vuoden iässä ei ole havaittavissa eroja astma- ja allergiasairastavuudessa, kun verrataan näitä potilaita muun hengitystieinfektion sairastaneisiin potilaisiin ja terveisiin kontrollipotilaisiin.