This diploma thesis deals with the topic of malnutrition, its causes and prevention. The aim of this thesis is to find out, wheter the respondetns of the questionnaire survey prevent by their habits the development of malnutrition. The number of participants of this survey is 347 in productive age, women are 212 and men are 135. In the theoretical part of this thesis, there is a desription of the importance of nutritents (macronutrients and micronutrients), there are also desription od nutrition intake disorder and their causes (health, psychical, social, lifestyle factors) and prevention, especially nutritional recommendations. The practical part of this thesis analyzes data obtained by the survey using quantitative method. The questionnare is devided into three parts: anthropometric, factors of life-style, factors of health status. Based on the results of analysis of questionare, it was found that most of the respondents neither men nor women do prevent the development of malnutrtion by behavioral habits, women are better in terms of lifestyle factors. Key words Nutrition, malnutrition, obesity, undernutrition, prevention

Current status: Although it was developed and published in many studies pointing to the impact of malnutrition and its relationship to the patient and the economy of the health systems, malnutrition remains a silent guide of hospitalized patients. In the year of 2014, the authors of the study group feedM.E. indicate in their articles the worldwide prevalence of malnutrition as a common and a costly (especially for the elderly). The rate of prevalence of malnutrition in a group of hospitalized patients is around 50%, according to this working group. Objectives: The goal of the project was to describe the methods for screening the patients with nutritional needs interventions by the nurses, the continuity of the care for patients in the risk of malnutrition, transmitting the information about the nutritional status of the patient during his hospitalization and delivery of care to another provider of health services and interdisciplinary co-workers involved in the care of patients in the risk of malnutrition. Methods: The research investigation conducted by the method of the qualitative research. The research subject was the process of detecting malnutrition and continuity of nutritional care for recipients of health services from the perspective of persons providing these services. The research method was chosen a depth interview. The sample of respondents was intentional and the file size was determined by saturation of the collected data. For data processing was used open coding and following categorization of the data which was obtained from interviews. The results were interpreted by using the "showdown". Participants: The request to facilitate the initiation of research has been mostly refused and addressed to the health service providers. Selection of interviewees was intentional by the circle of my former colleagues. With research have expressed their consent five nurses and five dietitians, which are working in the Czech Republic. Results: For identification of patients at the risk of malnutrition, all respondents have described the identification of patients at the risk of malnutrition on admission to the hospital by collecting of nursing history. During the interviews, the respondents have reported the problems both with the absence the reports including detection of patients at the risk of malnutrition from some stations at hospitals, as well as the jurisdictional disputes about the role of the dietitians in patient nutrition at intensive care unit, the complications with material and technical equipment of nursing stations and its applicability for use in specific patients. Also expressed the ignorance of screening tools which are used at the sites of all respondents, including dietitians. The inaccurate ideas of some respondents were in the terms of the skills and the competencies of individual professionals which are involved in the care of patients in the risk of malnutrition. Three nurses of the five indicated that information about the nutritional balance of the patient and their needs should affect the assessment of the patient's overall condition and could lead to changes in the nursing care plan or risk assessment (eg. the risk of pressure ulcers, etc.). Conclusion: The method of providing nutritional care in hospitals, in which respondents are employed, is headed toward pursuing the recommendations of the professional associations. In detail, however, they differ and are often close to the boundaries defined as a legal standards. Breaks are noticeable in continuity of the care, or are put excessive approval procedures, which can lead to delay of required nutritional interventions. Here is a lack of information about the various screening tools and their applicability to the certain groups of patients. Therefore I recommend issuing guidelines by professional society, in the direction of the definition of screening tools and their using in the certain groups of patients, for the healthcare providers in

Nutrition plays a major role in the treatment and preventing the progression of renal disease. Malnutrition is the determining factor for morbidity and mortality in dialysis patients. Patients with renal disease tend to have reduced food intake, due to loss of appetite, depression, but also as a consequence of chronic inflammation or lack of antioxidant mechanisms. Poor nutritional status of these patients must be recognized early and treated. It is important to ensure adequate intake of energy, protein and calcium, and at the same time to reduce intake of potassium, sodium, phosphate and fluids. A supplementation of vitamins and micronutrients may be appropriate. The nutritional status should be checked regularly. The research part demonstrates the dependence of laboratory values on nutritional status and a positive effect of education on patients' compliance with the recommended diet.

This Master's Thesis "The Role of a Nurse in the Care of a Patient's Nutrition" is written in a purely theoretical plane, deals with the basic pillar of the existence of the human organism the correct and sufficient nutrition of a human, and studies the extent of an involvement of the general nurse in satisfying biological, psychological aspects of patient's nutrition in the nursing process. The topic of nutrition plays an important part of the complete spectrum of each medical expertise. The satisfaction of patient's need for nutrition in all of the stages of his life is a part of a nurse's job in a nursing process not only in Intensive Care Units, Resuscitation Care Units and Standard Care Departments, but even in Geriatric Units and Social Care Institutes. The thesis is methodically divided into separate parts, each logically following its preceding one. In the Introduction we define malnutrition as a global medicinal and social problem, introduce principles and theoretical starting points of an organisation of an optimal nutrition care and introduce international activities, which contribute to creating guidelines using the Evidence Based Practice method, and implementation of effective methods in providing complex care of a patient's nutrition in medical facilities and institutes of social care. We follow with the summarisation of basic nutrients, emphasising their importance for the right function of a human body, and negative effects of their insufficiency in the food intake. The thesis presents an algorithm of an evaluation of a patient's nutrition state in a nursing process, comparing available screening standardised questionnaires, which are usable in detecting sings of a malnutrition. We present the possibilities of food fortification, specify targets of nutritional support in medical facilities, focusing on indications, benefits, risks and paths of application of enteral and parenteral nutrition, and provide complete summary of nutritional interventions in the context of nursing care, which is oriented on ensuring the food intake. In the Conclusion, we identify those aspects of the patient's nutrition care, which are hard to fulfil and realise, and those psychological and social-cultural aspects, which the nurse can in the nursing process satisfy only when using holistic and empathetic approach. The altruistic, but controversial and ethical-philosophical topic represents not initiating or ending the interventions of nutritional support, where this decision respects principles of beneficence and non-maleficence of The Hippocratic Oath, the quality of a patient's life and human dignity.

This diploma thesis deals with the topic of hidden malnutrition in patients with advanced stage of ovarian carcinoma. Tumor diseases are often accompanied by malnutrition. In the case of ovarian cancer, malnutrition may be hidden, primarily due to ascites, which can distort body weight. Out of the patients included in this study 32 % had ascites. The basic nutritional status test in hospitals is the nutritional screening performed on each hospitalized patient to detect the risk of malnutrition. Other methods such as anthropometric measurements, laboratory values, bioimpedance analysis, or less commonly, imaging processes can also be used to detect malnutrition. The aim of this thesis was to evaluate whether nutritional screening and regular weight control in patients with advanced ovarian cancer is sufficient to diagnose malnutrition. The results have shown that the inclusion of anthropometric measurements between routine screening can be beneficial in detecting a greater number of malnourished patients. Also shifting the BMI threshold in nutritional screening for patients over 65 would greatly increase the capture of patients at risk of malnutrition. The secondary focus was to find whether the presence of ascites can be a determining factor in malnutrition being left undiagnosed, and which simple...

Introduction: Crohn's disease is an illness of the digestive tract with an uncertain etiology which threatens the nutritional state of patients and in addition to other problems results in a worsening of the disease in reaction to primary treatment. The possibilities of optimizing the nutritional state are several: changing diet, enteral or parenteral nutrition or combination of both. It is necessary to arrange an entirely individual approach for ensuring the highest measure of attention and nutritional effectiveness. Methods: The influence of enteral nutrition was monitored during a course of Crohn's disease. 84 patients with malnutrition and with an active form of Crohn's disease were included in this study. They were divided into 2 groups according to the type and dosage of enteral nutrition. The first group included patients who used partial enteral nutrition in the form of sipping with an energy value of 1200 kcal daily. Patients covered the remaining energy needs with a low-residue diet enriched by soluble fiber. The second group included patients who were given exclusive oligomeric enteral nutrition with a nasojejunal tube for a period of eight weeks. The amount of enteral nutrition in both groups was individually adjusted and calculated, according to the Harris-Benedict equation. The...

Objectives: The aim of this non-interventional observational study was to determine the nutritional statu s of long-term hospitalized pacients in a psychiatric hospital using anthropometric indicators of nutritional status. Assess the presence of overweight, obesity and pathological waist circumference in patients with schizophrenia. Evaluate the incidence of malnutrition and risk of its development in patients with dementia. Methods: The data were obtained by measuring the selected patients in Psychiatric hospital Kosmonosy, were collected data on body weight, arm circumference, waist and calf. Data were completed by information from nursing records - body height of the patient, age, length of hospital stay and used antipsychotic medication. The data of weight and height were used to calculated BMI. Results: The study included a total of 121 patients, of whom 56 (46.28 %) men and 65 (53.72 %) women. Patients were divided into two groups by diagnosis, the first group of schizophrenia, and schizoaffective disorders (93 patients) and another group with a diagnosis of dementia (28 patients). In the first group, the incidence of overweight was present in 26.88 % of patients, obesity in 25.81 % of patients and abdominal obesity was present in 79.57 % of patients. The highest average BMI, the prevalence...

Diabetic foot syndrome is a serious chronic complication of diabetes mellitus, caused by a number of factors such as neuropathy, angiopathy, infection, and above all, this syndrome is consequence of a poor diabetes compensation and cardiovascular risk factors. It is characterized by particularly impaired wound healing and a higher tendency to chronicity, which can often be a reason for disability of the patient. Nutrition plays a very important role in a patient hospitalized with diabetic foot syndrome, as adequate coverage of energy and nutritional needs is essential for successful treatment and healing of ulcers. The theoretical part of this diploma thesis first mentions diabetes mellitus, its basic characteristics and briefly describes the types of diabetes that are associated with diabetic foot syndrome. Acute and chronic complications of diabetes are also discussed, followed by a more extensive chapter on the diabetic foot syndrome itself. This is the very definition of the term, epidemiology, pathogenesis, classification, diagnosis, treatment and prevention of this syndrome. The last chapter deals briefly with general nutritional recommendations for diabetics and the nutritional status of patients in which they are most often found when they are admitted to hospital, which is malnutrition,...

The diploma thesis is devoted to complications of enteral nutrition in patients with idiopathic inflammatory bowel diseases. The incidence of these diseases has increased in recent years. Nutritional support is an important part of the treatment and the possibility of improving the nutritional status of patients, which plays an important role in responding to other forms of treatment itself or in pre-operative preparation. All forms of artificial nutrition might also cause certain complications. The subject of this work is to observe the complications of enteral nutrition, their solutions and the possibilities of their prevention.

Master thesis summarizes latest knowledge in the field of special nutrition for patients with liver condition. Theoretical chapters describe liver physiology and etiology of selected liver diseases e.g. hepatitis, cirrhosis, chemical-driven liver damage. Given the fact the main cause of chronic liver disease is globally considered alcohol, a special chapter is dedicated to this topic which describes pathogenesis of alcoholic liver disease, the effect of chronic alcohol consumption on hepatocytes and other non-parenchymal liver cells. The thesis provides a comprehensive view on the issue of malnutrition and nutrition recommendations in specific liver disease. Practical part of the thesis involved complex questioning of healthcare providers - doctors and nurses - from selected hospital and presents overview of healthcare providers knowledge regarding latest nutrition recommendations in specific liver disease. Key words: liver damage, malnutrition, alcohol, nutrition, diet, cirrhosis, liver physiology