This thesis deals with neonatal pain and possibility of its reduction during three most painful interventions, to which newborns are exposed. The interventions were selected based on the study of literature, among them belongs collection of capillary blood for screening of newborns, insertion and removal of a gastric tube and airway suctioning of the newborn. Pain has protective reasons as it shall protect us from harming tissues. But sometimes it is necessary to cause pain for the purpose of performing a diagnostic or medical treatment. But there are some ways how to reduce pain at newborns. The theoretical part describes the basic facts about pain, its origin and transfer, importance and types of pain. This thesis also describes the specifics of fetus nervous system maturation during pregnancy. Furthermore, it mentions evaluation of pain manifestation and ways of treating it. Another sub-chapter contains a description of selected medical treatments and ways of palliating pain during their implementation. The last section is dedicated to clinical recommended procedures. The practical part of the work was carried out in four neonatal intensive care units. There were intentionally selected three respondents in each unit, with whom were led guided interviews which are recorded in chapter 4.2. Results of interviews with each respondent are summarized in transparent tables. This thesis had three objectives. The first objective was to compare the method of implementation of selected painful procedures at newborns in theory and practice. We wanted to know whether nursing procedures carried out in selected neonatal units correspond with procedures described in literature. By questioning and observation was found out that some respondents did not follow recommendations. The differences are described in chapter "Results and discussion". The second objective was to determine whether nurses at selected wards have selected performance standards and whether they are also interested in latest procedures of palliating pain at newborns. All respondents stated that performance standards are selected, but not all are prescribed only for newborns. Almost all respondents (except one) have stated that they were interested in new ways of reducing pain, but not all methods are listed in the standards. The third objective was to determine whether nurses abide selected nursing care standards and whether they employ their most recent knowledge about neonatal pain reduction in practice. By observiation was not found non-observance of standards, but also was not found implementation of new procedure knowledge that respondents stated in an interview. At the same time the respondents (except two) reported that there was no need to change the standards at selected performances. The outcome of this work is a new standard for each performance which was dealt with in this thesis. Standards were created eventhough the respondents stated that there was no need to change them. It is necessary to verify new standards in practice.

This diploma thesis deals with the onset of full breastfeeding in preterm infants and with the possible influence of alternative feeding methods on breastfeeding in immature newborns. Based on the study of literature, research questions were identified to find out in which gestation week full breastfeeding is taking place in premature babies and to what extent alternative feeding methods affect the onset of full breastfeeding in premature babies. They also had to find out whether feeding the infant bottles actually leads to unsuccessful breastfeeding. Three objectives were set for the diploma thesis. The first was to find out in which gestational week full breastfeeding is taking place in premature babies, provided the mother has enough breast milk. The second goal investigated the extent to which alternative feeding methods affect early pregnancy, provided the mother has enough breast milk. The third objective was to find out whether feeding a baby bottle actually leads to unsuccessful breastfeeding. To achieve the objectives of my thesis, I chose qualitative research, which was done in two groups of respondents, namely preterm newborns and their mothers. For each group of respondents, I chose different research techniques. For research on premature newborns, I chose structured observation. In a research survey among mothers of preterm babies, I chose a semi-standardized interview.

Neonatology is a field of medicine in which immense progress has been seen during the past two decades. As the frontiers of this area are shifting forwards, ethical problems and issues regarding the quality of life of the rescued infants and children grow in importance. Now it is clear that the development and health of children that were endangered in the perinatal period should continue to be followed up by healthcare professionals, sometimes for many years. Ideally, this care should seamlessly follow hospital care. It was the aim of this work to examine how this continuity of care of high-risk newborns is implemented in practice. This Thesis consists of 2 parts: theoretical and practical. The theoretical part analyses the differentiation of newborn care as outlined in the Bulletin of the Czech Ministry of Health; defines the categories of newborns; and explains the basic terms used in the specific domain of high-risk newborns. Foreign experience in the provision of medical care at hospitals as well as in the continuing care after discharging from the hospital for home care is outlined. The empirical part of the Thesis was compiled based on qualitative research survey, accomplished with 3 aims in mind. The first aim was to map what type of care is provided to high-risk newborns at the Intensive Care & Resuscitation Unit of the Plzeň Teaching Hospital and who provides it. The second aim was to ascertain how the parents perceived their role during in-patient care of their babies and how they were educated and engaged in providing the care. And the last aim was to ascertain how the parents appreciated and liked the follow-up system at the Developmental Care Centre. It was found by the survey that the responders (mothers) appreciated most the comprehensiveness of the care provided by the Centre. They found the care adequate, beneficial and motivating. In their view, the desired care continuity had been achieved. The results attained within the empirical part will be presented at a workshop of the perinatology centre.

The importance of this thesis lies in finding about the current state of pain assessment and palliation at neonatal and infant wards of selected hospitals, in finding out about the extent of use of standardized rating scales for pain, in identifying the obstacles in pain assessment and non-pharmacological pain palliation, and particularly in the development of a standard for pain assessment and pain palliation for neonatal and infant hospital wards.

The dissertation objective on the theme {\clqq}Interpersonal relationship development between children's nurse and mother in the neonatology department by means of the H. E. Peplau model`` is to chart individual phases utilization in the process, professional relationship development between children´s nurse and mother according to the H. E. Peplau model. Further through created documentation to find out differences at the approaches during professional relationship connecting between children´s nurse and mother in the neonatology department in the Hospital JSC in České Budějovice. To meet these objectives the dissertation is divided into theoretical part which focuses on differences at the care of developed and underdeveloped infant, nursing model H. Peplau including its application into practice. The second, practical part is divided into quantitative and qualitative parts. The quantitative part concentrates on factors finding out which influence professional relationship between children´s nurse and mother in compliance with the H. E. Peplau model and concurrently specifies individual nurse roles changing during professional relationship children´s nurse and mother. The data of the quantitative research part have been learned by means of questionnaire disquisition. By the dissertation results summarizing I found out facts regarding H. E. Peplau model individual phases utilization at the children nurse {--} mother relationship establishing in neonatology. Hypothesis 1 {\clqq}Children nurses with own children establish faster the professional relationship with mother`` {--} has come true. Hypothesis 2 {\clqq}Children nurse practice length influences the ability to establish the professional relationship with mother`` {--} has come true. Hypothesis 3 {\clqq}Children nurses undertake the role of the mentor in most cases`` {--} hasn´t come true. The data of the qualitative research part were identified by observation, conversation with children nurse, creating of the documentation own proposal at the mothers of prematured children hospitalized by ROOM IN system and its application in practice. Mothers were divided into two groups, the common way of the interpersonal relationship establishing with mother was used in the first group, the way of the interpersonal relationship establishing with mother according to the H. E. Peplau model was applied in the second one. At the quasiexperiment it has been identified the interpersonal relationship establishing with mother proceeds better at the nursing H. E. Peplau model utilisation. The dissertation knowledge can be partly utilised by neonatology department of the Hospital JSC in České Budějovice, in particular by children nurses to master the abilities for professional relationship establishing with mother and to provide subsequently mother and child with the complex nursing care. Further to students and other interested people in this issue.

It is now after leaving the hospital breast-fed infants and 4.5% only 34% of infants are breastfed for longer than six months. If the mother is unable or unwilling to breastfeed her child, comes the work of children's nurses, which should comprehensively educate mothers on the artificial feeding. This work focuses on the problem of feeding the newborn. Its task is to map the role of pediatric nurses in the education of artificial infant feeding, as well as identify the reasons for mothers to stop lactation and the transfer of their children - infants to artificial feeding. We tried to find out what are the errors in the application of artificial infant feeding, which is committed by mothers, and whether it is possible to eliminate these errors led education process of children's nurses. The research part of our work was the method of quantitative-qualitative research. For qualitative research, data collection technique was used semistructured interview. The interview was anonymous. Quantitative research was conducted through interviews. The questionnaire was anonymous. It contained 23 questions. Research files of qualitative research, mothers are mothers who use feeding their newborn infants artificial nutrition products. This set of nine respondents were selected in the Region. The research sample consisted of quantitative research for pediatric nurses, working in the department of physiological neonatal hospital South Bohemia. The results of our work we want to move the broader public, mothers who have decided, at its discretion, that are unwilling or unable to breast-feed. We created educational material to make the children's nurses working at the department of physiological and pathological newborn, as well as nurses in primary care.

Diploma thesis "Interaction in multisystemic problems of bronchopulmonary dysplasia - effects of physiotherapy upon lung functions of immature infants" deals with relevant questions about care of immature newborns both during hospitalization at NICU and after discharge, inclusive of examination at Center for comprehensive care for risk newborns. Especially deals with possibilities of physiotherapy of newborns with bronchopulmonary dysplasia pathology and demonstrates the necessity of tight cooperation among physiotherapists, nurses and doctors during daily care of these children. Powered by TCPDF (www.tcpdf.org)

Maternal smoking causes serious health danger for a mother but especially for a baby. Cigarette smoking produces complex steroidogenesis changes during the whole life of a woman. To study the influence of smoking on fetoplacental unit focusing on steroid hormons it was important first to concentrate on changes of the chosen steroids around the delivery. The first part of the thesis is dedicated to observe some chosen steroid hormons in peripartal period (37th week of the pregnancy, first stage of labor of mothers and mixed umbilical blood of their neonates) and to look for relations to the age of mother, the increase of the weight during the pregnancy, the type of the delivery and the sex of the baby. It was interesting to compare steroids in the relation to the type of the delivery: vaginal delivery versus planned caesarean section. Non-smoking women who delivered a boy spontaneously had significantly higher level of 17-OH-pregnenolone, progesterone, cortisol, corticosterone and significantly lower level of estradiol in comparison with non-smoking women who delivered a boy by a planned Caesarean section. In the maternal blood in the 37th week of the pregnancy there were found differences between steroids in accordance to the sex of the fetus but they were not found in the neonates' case. The age...

Women in childbearing age are often affected by autoimmune diseases (AD) associated with the presence of antiphospholipid antibodies (aPL) that may influence further develop-ment of their children. The primary objective of our prospective study was to determine the presence of the following aPL: anti β2 glycoprotein I (anti-β2GPI), anticardiolipin (aCL), antiphosphatidylserine, antiphosphatidylinositol, antihospha- tidylethanolamine, antiphosphatidylglycerol, antiphosphatidic acid, antiannexin V in mothers with defined AD and their children after birth, at 6 and 12 months of life, and to compare the incidence of aPL with a control group. A secondary objective of the study was a 2-year follow-up of children born to aPL negative and aPL positive mothers with AD in order to detect the possible impact of maternal AD on the health of the offspring. In children, we analysed anthropometric data, blood cell count, cerebral and abdominal ultrasound examination, transient evoked otoacoustic emission test (TEOAE), electrocardiograph (ECG), the presence and kinetics of aPL. At the age of 2 years the Bayley Scales of Infant Development (BSID-II) were used for children's assessment of motor, language and cognitive development. 31 mothers from the total examined 82 aPL positive women with AD delivered 34 neonates...

The thesis is focused on premature newborn thermomanagement. It is focused particularly on very premature and extremely premature newborns which suffer the highest level of thermolability. The theoretical part deals with the particularities of premature newborn thermoregulation, newborns' reactions to thermal stress, thermomanagement in the delivery room and providing a thermoneutral environment in the incubator. The thesis describes a method of servo-control mode of body temperature, which has not been utilised for premature newborns in Czech Republic. The aim of the thesis is to start using this method and compare it with the method of manual control. Based on the total time not meeting the standard, number of failures and other parameters to assess which method is more suitable for body temperature regulation. The research sample consists of 47 newborsn who were born between the 24th and 32nd gestational week. Quantitative data collection at one-minute intervals was conducted in the 72 hours after birth. The method choice was random. Statistically important differences between the two methods were measured regarding the total time not meeting the standards. The incidence of hyperthemia was higher during manual method, hypothermia when servo-control. Total failure amount was 19%. However, the...