This diploma thesis deals with the attitudes of neonatologists and nurses to the ethical aspects of the treatment of extremely immature infants. The aim was to capture and interpret the attitudes of health professionals to the ethical issues of intensive neonatal care and their role in the decision-making process. The data were gathered through qualitative methodology using semi-structured and informal interviews with five neonatologists and five nurses. Data analysis was performed using open coding and data categorization. The results of the research are presented in individual categorical units by interpreting and retelling the received information. In conclusion, the attitudes of health professionals to selected ethical problems and the roles of individual members of the multidisciplinary team in decision-making about treatment procedures are discussed separately. The evaluation of results leads to the formulated recommendations for practice, which include several proposed solutions to the interpersonal problems associated with ethical issues of care for immature infants. Key words: immature infant, medical ethics, ethical decision making, perinatology, nursing, qualitative approach, interviews

I initially explored historic figures of European accoucheur of the 17. and 18. century. Beyond this I focused on a period called "Pobělohorská" in Czech countries. I summarized the health conditions of the population during this period, and described medical professions, midwifery and emergency Christening ceremonies. One chapter discusses partnerships and considers women who hid their pregnancy to avoid the prospect of caring for their children in the future. For this reason I present questions relating to how women hid their pregnancy during the Early Modern period. In the next chapter I discuss aspects of the process of giving birth, the locations where women gave birth and the moments thereafter. I present the circumstances of the death of the baby and the possible causes of death. The process of investigation of the scene, an assessment of the body and the search for the mother of the baby (as a potential murderer) are all considered. The assessment of the body was in the hands of the regional physiciusurgeon and a midwife. In my work I describe how the body was assessed, how they judged the maturity of the newborn baby and if the baby was born dead or alive. Further chapters explain the treatment of the umbilical cord, the inquisition of the witnesses and the suspect, and the next steps of...

Bonding is an emotional and biological process that creates a bond between a mother and her child and is among others important for easier breastfeeding, faster recovery of the mother etc. It is important to support it by an early contact between the mother and her newborn child. The diploma thesis aims to compare the discourse regarding mother-infant bonding and its support in our country around the year of 1980, when the rooming-in system appears, up to the present, with the milestone between 1998 and 2000, when the Centre of Active Birth was established as a result of changes in birth care that occurred then and which started to offer a different kind of care from the model that was known and used in the Czech Republic at that time. Emphasis will be put on the development of the discourse, changes in birth and after-birth care it has brought and changes of its participants and the role which women have as receivers of care. The theoretic part introduces the relatively little-known term 'bonding' and its support from the biological and social points of view, then discourse analysis will be applied in the methodological and experimental parts of the thesis. Analysed materials included media communication both in printed and electronic forms available at each analysed period. Keywords:...

This diploma thesis should sketch quantitative research of early enteral nutrition at newborns with low birth weight under 1500 grams at specialized department - neonatology in České Budějovice. Research in this diploma thesis is focused on evaluating of implemetation level according to current recommendations neonatology for the start of early enteral nutrition at premature babies. In the theoretical part of the diploma thesis we try to describe all things that include the issue of premature babies care. Next chapters deal with differences of premature baby in relation to nutrition. The nutrition of the newborn with very low birth weight is provided immediately after parenteral delivery. Quantitative research definately prefers the start of enteral nutrition in the first few hours after delivery. Goal of this strategy is to completely replace the parenteral nutrition as soon as possible. Goal of this diploma thesis is to descibe quantitative research with implementing of the enteral nutrition at newborns with birth weight under 1500 grams at specialized neonatology departments and to identify the most important differences from current recommendations for this field of care. Considering the set goal there was used the quantitative research for this diploma thesis. To get the data to create the research, secundar analysis of the data from nursing documentation of our research team was used. Through the quantitative research we try to demonstrate lack of starts with early enteral nutrition at premature babies with birth weight under 1500 grams in the 2012 and 2013. Secundar analysis of the date was made during my working experience at neonatology department in České Budějovice. Data needed for this research were systematically written into prepared chart created in Microsoft Excel. After entering all necessary data in the table, they were subsequently created graphs that reflect the real situation examined issues. After identifying the most significant differences from the current recommendations for this area of care deficiencies are subsequently provided to the department of neonatology in the České Budějovice for future improvement strategy early initiation of enteral nutrition in premature infants in this weight category, was written Decalogue of practical recommendations for optimization of enteral nutrition for preterm infants nurses working in the neonatal intensive care. The research file was created by 139 respondents (newborns with low birth weight under 1500 grams). This file is created by newborns born from 1 January 2012 to 31 December 2013 which means during two years.

We have dealt in this thesis with problems of nursing care of the newborn from the perspective of standardized classification systems NANDA, NIC and NOC which offer many opportunities for streamlining, simplifying and improving of the quality of care. The theoretical part of this thesis focuses on nursing care of physiological newborn during the first moments after the birth until leaving hospital. Furthermore, the common nursing language which is included in standardized classification systems NANDA, NIC and NOC.The empirical part of the thesis was prepared with the help of qualitative - quantitative strategy. We chose to collect valid data a research method of content analysis of documents, modelling, thought experiment and a structured interview. The first aim of the research was to identify the use file from various classification systems related to nursing care of physiological newborn. We selected 9 nursing diagnoses from the publication NANDA International Taxonomy II through content analysis, 9 nursing interventions from Nursing Interventions Classification (NIC), 5 expected results related to the care of physiological newborn from the publication Nursing Outcomes Classification (NOC). We worked out a research form and submitted it in the way of a specific questionnaire to the validation of respondents ? who were experts in the field of nursing care of the newborn, it was made from the selected NANDA nursing diagnoses, NIC interventions and expected results of NOC. The second aim was to verify the usability of the selected files from the classification systems NANDA, NIC and NOC in clinical practice. The results of validation of NANDA nursing diagnoses were done by Diagnostic Content Validity Model ? DCV by Fehring. We determined the absolute and relative frequency of their designation within classification systems NIC and NOC. Nurses working at neonatal wards were our basic research populations; we created a targeted selection of two research samples divided by educational attainment. The first research sample consisted of 20 nurses with university education. The second research group was represented by 18 nurses with secondary education. The survey was realised in the time from January to March 2013 in the neonatal wards of the Hospital České Budějovice, a.s. Hospital Strakonice, a.s., Hospital Písek, a.s. Our third aim was to determine the attitudes of neonatal nurses to usage of classification systems in daily practice. We focused questions directed to the respondents on the knowledge and source of acquired knowledge, their attitude and possible reasons preventing the implementation of classification systems into clinical practice. The results showed nurses are reluctant to the usage and implementation of new standardized classification systems into clinical practice. The output of this thesis is the basic concept of nursing diagnosis according to NANDA-I, NIC and NOC focused on nursing care of physiological new-born in the area of the Czech Republic. 12 NANDA nursing diagnoses taxonomies was verified with 128 characteristics, 9 NIC nursing intervention taxonomies with 183 activities and 5 results of NOC nursing care with 72 areas of evaluation. There was selected in this survey 100 characteristics of NANDA taxonomy (62 %). It was chosen as being applicable in practice 130 from 9 selected files of NIC (71 %). It was selected 39 indicators (54 %) within 5 files of expected NOC results. The survey brought a lot of interesting information and also revealed even the lacks in the area of nursing care of physiological new-born; research also showed the lack in the area of nursing care of physiological newborn.

BACKGROUND: The most numerous group from children due to perinatal burden is a group of prematurely born children and whose number continues to increase constantly. The children have higher probability of health problems and they are at risk of a complex threat to their successful development. Premature childbirth is a complicated difficult life situation for parents. Strongly reduced mental well- being is often developed at these parents and sometimes even some clinical symptoms (especially depression, anxiety, posttraumatic stress disorder). Such parenting (as well as other factors) greatly diminishes the overall interaction and communication with the child (especially their sensitivity and responsiveness) which can also be reflected in the parental style. AIM: The aim of the empirical part was to describe the occurrence of individual educational styles in healthy preterm infants 8-12 years old. METHODS: A Questionnaire of parental styles for children between the ages of 8 and 12 was used for this purpose (Čáp, Čechová & Boschek, 2000). RESULTS: A sample of 35 children showed that the most perceived parental style was a style characterized by a negative emotional relationship combined with a strong direction. CONCLUSION: The importance of the results can be seen in the practical application for...

Changes in bone and mineral metabolism and the role of vitamin D in very low birth weight infants. Firstly, the aim of dissertation work was to estimate physiological parathyroid hormone (PTH) levels and their relationship with bone metabolism parameters in otherwise healthy preterm newborns with birth weight 1000-1500 g. Secondly, to evaluate vitamin D status in mothers and their very low birth weight infants (VLBW) at birth and at discharge with currently recommended supplementation of vitamin D. Thirdly, to compare clinical outcomes of VLBW infants with 25-hydroxy vitamin D [25(OH)D] levels ≤ and > 25 nmol/l in umbilical cord blood and finally to evaluate umbilical cord vitamin D as a risk factor for respiratory distress syndrome in preterm infants. It is a set of prospective observational studies involving immature newborns with birth weight below 1500 g. The parameters of mineral and bone metabolism were analysed in umbilical cord blood and newborn serum and urine during hospitalisation (PTH, 25-hydroxy vitamin D, S-Ca, S-P, ALP, U-Ca, U-P) and in pregnant women before delivery (25-hydroxy vitamin D). Bone mineralization was evaluated by bone densitometry. In a pilot study, from the total 134 examined serum samples for PTH levels the estimated reference range was 1.6 - 9.3 pmol/l. From the...

UNIVERZITA KARLOVA V PRAZE KATOLICKÁ TEOLOGICKÁ FAKULTA Katedra Teologické etiky a spirituální teologie Magdalena Chvílová Weberová Baby boxy - etická dilemata plošného zavádění schránek na odkládání dětí v ČR Diplomová práce Vedoucí práce: MUDr. ThLic. Jaromír Matějek, PhD., Th.D. Konzultant: MUDr. František Schneiberg Praha 2014 Prohlášení 1. Prohlašuji, že jsem předkládanou práci zpracovala samostatně a použila jen uvedené prameny a literaturu. 2. Prohlašuji, že práce nebyla využita k získání jiného titulu. 3. Souhlasím s tím, aby práce byla zpřístupněna pro studijní a výzkumné účely. V Havlíčkově Brodě, dne 3. 12. 2013 Magdalena Chvílová Weberová Bibliografická citace Babyboxy - etická dilemata plošného zavádění schránek na odkládání dětí v ČR [rukopis]: Diplomová práce /Magdalena Chvílová Weberová vedoucí práce: MUDr. ThLic. Jaromír Matějek, Ph.D., Th.D. Praha, 2014 --184 s. -- Abstract Baby box is a box for anonymous postponement of unwanted newborns. The existence of baby boxes is being justified by it is declared purpose - saving human lives. Newborn's life is highest good and even just delivered newborn is a bearer of human rights. The work discusses the claim of saving the life of the newborn within the context of the best interests of the child and within the context of the incidence of...