This diploma thesis called "Need of non-pharmacology pain relieving for patients afflicted by Arthritis rheumatic" has been created as a next step of a previous pilot research. Respondents of the previous investigation expressed their interest in non-pharmacology pain relieving. It is very important to relief pain caused by Arthritis rheumatic as chronic disease in balance manner by usage of both approaches pharmacology and non-pharmacology. The goal of this study has been to investigate possibilities of non-pharmacology pain relieving among patients afflicted by Arthritis rheumatic and how these patients cooperate with nurses. The research comprises following goals: 1. Ascertain, whether patients afflicted by Arthritis rheumatic prefer pharmacology to non-pharmacology pain relieving. 2 Ascertain, which method of non-pharmacology pain relieving is mostly used. 3 Ascertain the interest of patients to relief pain by usage of non-pharmacology methods. 4 Ascertain the nurses' influence on the non-pharmacology pain relieving. The theoretical part is focused on pathophysiology of the disease, the issue of chronic pain and quality of patient life. The second, empirical part, is dedicated not only to actions of the investigation itself, but also its characteristics and results. There were issued 130 questionnairs for qualitative analisis. 102 of 130 questionairs has been retrieved and filled in properlly. Data from questionairs was compiled and hypotheses were tested by usage of Chi-squared test. 3 hypotheses have been built: H1 Patients afflicted by Arthritis rheumatic prefer pharmacology pain relieving to non-pharmacology. This hypothesis H1 was affirmed only for patients in acute stage of Arthritis rheumatic. H2 Patients afflicted by Arthritis rheumatic prefer thermotherapy to rehabilitation when considering non-pharmacology pain relieving. This hypothesis H2 was not confirmed due to low number of respondents. H3 Patients achieved higher education degree express higher interest in non-farmacology pain relieving. Higher education degree of patients has only impact on method in acute stage of Arthritis rheumatic. Qualitative investigation was carried out by half-structured interview with 7 respondents working on inpatient department and also outpatient department. Several statements could be concluded out of qualitative investigation: Nurses have been persistently educating by passive or active participation on various seminars or congresses. They have been trying to convey information about non-pharmacology treatment to their patients. They cobnsider non-pharmacology treatment as a indiscerptible part of a treatment. Investigation results will ne provided to all collaborative departments to support improvement in cooperation between nurses and patients.

Theoretical Foundations Ageing and old age are natural parts of every individual during their lives. Most of the population wants to live an active life of the best quality possible. Nutrition is a factor that influences healthy aging most significantly. Adequate nutrition plays an important role in maintaining the quality of life and good physical condition. Nutritional needs of the elderly are highly specific. The nutritional needs of the elderly are defined mainly by changes in the organism and a wide range of influencing factors resulting from a person's lifestyle. An important role is played especially by eating habits, social and cultural environment, education, social status, economic standards and, ultimately, health and psychological condition of a person. Proper nutrition of the elderly contributes to their health and wellbeing; it is also important for recovery from the illnesses to which the elderly are more vulnerable. When providing nutrition to the elderly in hospitals, the role of nurses is important. Objective of the Thesis Four objectives were specified for the thesis: 1 To find out whether nurses follow the principles of providing nutrition to the elderly. 2 To identify the most common factors that affect nutrition of the elderly in hospitals. 3 To map the most common nutritional disorders in the elderly occurring in hospitals. 4 To find out what diet is the most common in the elderly staying in hospitals. Methodology The research qualitative inquiry was conducted in the form of covert observation. The objects of observation were the nurses working at a department of aftercare, which were observed in serving food to the elderly. The covert observations were complemented with depth interviews, also with the observed nurses working at the department aftercare. The observations were processed in Microsoft Excel in the form of tables and the interviews were processed in the Atlas.ti programme. Results The observations of the nurses in serving of food to the elderly showed that all the observed nurses failed to comply with the principles of providing nutrition to the elderly in the hospital. More or less each of the observed nurses made some mistakes. The most frequently occurring mistakes were as follows: While serving food, the nurses did not use aprons or serving overalls; the nurses did not prevent direct hand contact with the food. Almost half of the observed nurses did not provide the patients with sufficient time and the support to the patients while serving the food by the observed nurses was also inadequate. Further, nearly half of the observed nurses did not wish a Bon appetite to the patients. Also noteworthy is the latest most frequent mistake: nearly half of the nurses did not put away their aids after serving food. In the interviews, the nurses surveyed identified the most frequent factors influencing nutrition of the elderly in hospitals as follows: biological changes in old age, various types of dementia, psychological condition of the individual, co-morbidities, medication use, eating habits of the individual, the state of dentition (dental prosthesis), and the influence of the family. The most common nutritional disorders identified were as follows: absence of appetite, dehydration, excess weight, obesity and malnutrition. The most common diets eaten by the elderly in hospitals were identified as follows: diets no. 3, 9, 4, 0 and also diets in ground form, puree form and food served through an NGS (nasogastric tube). Conclusion Based on the research survey and the review of expert literature, a standard of nursing care, called "Serving food to patients with deficient self-care in nutrition", was designed for nursing staff. Nursing staff will have the opportunity to use the manual that will serve them as good practice when serving food to patients with deficient self-care in nutrition, and nurses will not consider the activity as a routine procedure.

This thesis deals with the effectiveness of use of aids intended for incontinent ill people in subsequent care. The thesis is divided into a theoretical part and experience part. The experience part of the thesis has been implemented by means of qualitative research. The data have been obtained on the basis of two different half pen and paper interviews with patients/clients who are using incontinence aids prescribed by a doctor on a coupon or by a matron or a ward sister from the subsequent care department in hospitals with the state-funded organization and in hospitals with the joint-stock company organization. The result of the qualitative research showed, that both groups of respondents use mostly only plastic pants or nappies out of the whole assortment of aids. For patients/clients living at home the reason is that on the basis of anamnesis the general doctors prescribe the incontinence aids only in the most serious incontinence cases. At the subsequent care department the situation is caused by a big number of immobile fully incontinent patients/clients. The results show, that the quantity of absorb aids prescribed by general doctors is insufficient. It does not reach the quantity limits given in the documents by VZP (Public Health Insurance Company). Taking into consideration the low income of seniors, the respondents have to pay considerable amounts of money for incontinence aids which are necessary for them. There is an absolute lack of absorption aids in the hospital with the state funded organization. The incontinence aids are financed by three different ways. Patients/clients themselves have to get and pay the absorption aids at the Geriatrics department I and subsequent care department 2. The hospital provides them only with one-off mats and hygienic aids free of charge. The reason for this is a low limit of material. The respondents regard this system of financing negatively. It burdens patients/clients and nurses too. If patients/clients do not have the aids, the hospital has to lend the aids, make a list of debts and collects them back. On this account conflict situations often arise in families. At these departments there are reserved five social beds which enable patients/clients the prescription of aids by a doctor on a coupon likewise the patients who are ill and cure at home. At the stopgap department patients/clients pay a monthly fee; this includes the costs on incontinence aids too. At the subsequent care department 2A, B of the hospital with the join-stock company organization the aids are fully paid by the hospital. There is available a sufficient assortment and quantity of absorb and hygienic aids, which enable an individual attitude.

Current status: The recurrence of urinary stones is common, according to research results. Prevention of urolithiasis, especially of recurrent cases, is essential. Information about the disease, causes of urolithiasis and preventive regime are the basic principles. The patient should not only be informed about drinking and dietary regime after removal of the stone, but he should be motivated to fulfil these recommendations. Metaphylaxy is complex treatment regime; aim of whist is prevention of stone recurrence Methods: The research part was based on quantitative survey. Questionnaire, consisting of 22 questions, was used for survey.. The survey was performed at the Department of Urology, Region Hospital Ceske Budejovice since January 2011 till December 2013. Patients, where first stone was diagnosed, were involved. SPSS programme was used to evaluate results of quantitative survey. Medical recodes was used for secondary analysis of data of primary stone patients treated at the Department of Urology, Region Hospital Ceske Budejovice since 2009 till 2013. Microsoft Office Excel 2007 and SPSS programme was used for statistical analysis. The hypotheses were tested by using of Chí quadrat test. Patients: The patients with primary urinary tract stones, diagnosed in 2012 and 2013, were selected for survey. There were included 184 patients in 2012 and 102 patients in 2013. 150 patients had been addressed by questionnaire and 123 patients responded. The secondary analysis of data of patients treated for primary urinary stones at the Department of Urology, Region Hospital Ceske Budejovice since 2009 till 2013, was performed on 644 patients. Results: 644 patients were found as patients treated for primary stone at the Department of Urology, Region Hospital Ceske Budejovice since 2009 till 2013. This is in concordance with research goal: "Find, how many urinary stones patients were diagnosed at the Department of Urology, Region Hospital Ceske Budejovice since 2009 till 2013". The second research goal was: "Identify differences in dietary habits in urinary stones patients." There was fund a difference in meat intake between men and women. Decreasing trend in meat intake according to age was found, too. No difference in sugar intake was found intake between men and women. The third research goal was: " Identify the fluid intake in in urinary stones patients." There was found average fluid intake per day of 1 922 ml in women and 2 127 ml in men. The last research goal was: " Identify willingness of the patients to change their drinking and dietary regime." The willingness to to change drinking and dietary regime is affected by age of the patient, profession, way of stone removal and quality of information about to change their drinking and dietary regime. Conclusions: The drinking and dietary regime, in context with life style information, is basic for prevention of urinary stones. Fluid intake, dietary habits, physical activity, weight reduction, stress release are essential factors. The motivation, including clear and detailed information of the patient is important for compliance. The results of the theses will be offered for publishing in peer reviewed journal Urologie pro praxi.

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.

The diploma thesis deals with the quality of life with rheumatic diseases. The thesis focuses on patients suffering from rheumatoid arthritis (RA) in particular, since the rheumatic diseases are the most common chronic inflammatory rheumatoid disease spread worldwide. The aim of the diploma thesis is to explore the physical quality of life with RA of selected patients aged from 19 to 70 years. The theoretical part offers a literature review on the stated topic with focus on the quality of life with RA. The second part offers the results of a quantitative research which was conducted using a questionnaire in a rheumatologist´s office in Saint Anna Faculty Hospital in Brno and in the Hodonin Spa. The HAQ-DI index; GARS questionnaire; a visual-analogical scale rating the intensity of pain and DAS28 score assessing the activity of hospitals were used to achieve the aim. Two research hypotheses were proposed in order to conduct the research: 1. The patients who have been suffering from RA for up to five years will achieve significantly more positive score; 2. The differences between genders in the physical quality of life will be statistically more important. The hypotheses were statistically verified using the IBM SPSSS Statistics 24 software. The results of the thesis suggest, that the quality of life with RA is influenced by pain, which is more intense for women. We also claim that the patients suffering from RA might be less self-reliant, therefore, most of them are dependent on help of others or they need to use various devices. Furthermore, the results show that gender provides statistically crucial differences in the physical quality of life. The outcomes found by this thesis can be used for patients suffering from RA; to raise awareness of the disease and its impact on life.

From the nursing care point of view, health represents one of the most basic terms. Many authors claim as priority, that nurse is endowed with knowledge concerning health, illness, patients' as well as her own values on the understanding effective managing of the skills from the fields of systematic observation, effective communication, the ability to show willingness to help and permanent recording of patients´ state of health. As well as many theoreticians, every individual recalls something else under the term "health". Therefore, it is needed to be patterned on the definition of health, helping to understand human actions and human own health. Aim of the research method was to find out, what specific interventions can be used by nurses in the field of the hospitalised patients' health on the basis of this value disruption. To reach this aim, it was necessary to divide the research into several fields, namely how the value of health is perceived by the hospitalised patients, what is their scale of values when they are hospitalised, what values were significant for the patient before his hospitalisation and how does the hospitalisation affect the patients´ scale of values during the hospitalisation in view on the future life after the discharge. From the patients´ point of view, it was crucial to recognize, what aspects within nurses´ nursing activity are the most essential in connection with hospitalisation and his state of health and also what options nurse has got to saturate the value of health. The other group of respondents was concentrated on nursing staff. Crucial intention was to discover, how do the nurses perceive possible affection of patients´ scale of values in connection with hospitalisation and how do they perceive their own possibilities in saturation of this value. Methodology: For the research method, the method of qualitative research and data analysis has been chosen by using half-structured interviews. The first part of the interviews was aimed at patients, who have been admitted on surgical, rehabilitation and traumatological ward without any even more specific determination. The second parts of the interviews were held with nurses in same wards. The data collecting took place in January and February 2018 directly in medical facility. After data satiety, categorisation has been proceeded by using opened coding namely by method "paper-and-pencil". Results: On the basis of qualitative method of research, several interesting findings came out. Only one respondent perceives his health from a holistic point of view, as being stated in the worldwide respected WHO definition of health. It was also confirmed, that the value of health is not for every patient the priority value in comparison with other values. Also the value of health perception from time point of view relates to it. It has been proved, that the hospitalisation on its own or development of problems leading to hospitalisation, has caused a change in a positive way in perceiving the value of health within almost one half of the respondents. But there were individuals among the respondents, who do not feel any difference and do not assume one. Asked patients have also proved that the hospitalisation is a crucial event, leading them to being aware of the circumstances causing the hospitalisation. Consequences of the experienced emotions are different expectations from themselves and nurses. It was also discovered, that the patients demand different approach and interest of the nurse, so that the most effective saturation of value of health can be achieved. Nurses did acknowledge the value of health as priority, even though they could not find any feasible solution, how to attend properly to this value also in practice. Although they perceive the value of health a

The aim of the presented thesis is to map the influence of heart arrhythmia on patients´ lives and the possibility of using the conceptual model by Imogen King into the nursing care at the patient with arrhythmia. The set goals were accomplished on the basis of the empirical research which was processed by both quantitative and qualitative research methods. The first part of the research was performed by the quantitative method of collecting data from the survey. The aim of this survey was to map the quality of life of patients with the heart arrhythmia. The second part of the research was performed by the qualitative method of collecting data from the interview with the patient. Total of 127 of valid questionnaires were evaluated for the quantitative part of the research and 20 interviews with the patients with heart arrhythmia were performed for the qualitative part of the research. Based on the qualitative research was found out that the most significant symptom of arrhythmia is fast or irregular heartbeat, usually causing faintness, anxiety and uneasiness. The patients with arrhythmia are mostly limited during physical activities. There have not been found out any statistically significant differences between the persistence of arrhythmia and the health condition and the quality of life of the patient. That means that the persistence of arrhythmia in the researched group of patients does not influence the health condition and the life quality of the patients who took part in the survey ASTA. There was also monitored the relation between uneasiness (anxiety) and selected indicators (how the patients are able to work or study, concentrate or do physical activity). In this case were proven statistically significant differences. The qualitative research complemented the qualitative data. The quality of lives of the respondents was evaluated according to Imogen´s King conceptual framework and the responses of the respondents were ordered according to the framework system: personality system, interpersonal system and social system. As emerged from the responses of the respondents, the most negatively perceived symptom of arrhythmia is palpitation which causes anxiety, uneasiness and leads to sleeping disorders and lower physical activity. In contrast to the restrictions that have to be taken up in connection with the heart arrhythmia are only temporary and do not influence interpersonal and social relationships. The thesis brings a complex view of the problematics of the life quality of patients suffering from arrhythmia when this is not only a medical problem but it also influences patient´s mental and social well-being. The very important element which influences the successful cooperation of the arrhythmia patient and the doctor is the nurse who thanks to the emphatic attitude helps to build the faith in the good results of the medication - recovery and keeping the life quality. Using the conceptual framework in nursing, specifically during the treatment of arrhythmia patients helps to provide individualized nursing care and achieving improvement of the quality of the care provided and also the patient´s satisfaction.

The goal of the presented study is to assess patient safety during nursing care from two different points of view. The first view represented the opinions of the staff working in direct contact with patients, and the second view represented the management`s opinions of activities leading to quality improvement and care safety. The combination of a quantitative and qualitative study was used to meet the purpose of the thesis. The quantitative part used standardized questionnaires called The Hospital Survey on Patient Safety Culture (HSOPSC) developed by the Agency for Healthcare Research and Quality (AHRQ), and Systems of Quality Improvement in European Hospitals designed for quality managers and coordinators within the project called Deepening of our Understanding of Quality Improvement in Europe (DUQuE) while this part was complemented by a qualitative study using a semi-structured dialogue. The sample consisted of 427 respondents (331 non-medical healthcare professionals working in direct contact with patients and 96 non-medical healthcare managers. The study using the HSOPSC tool showed that the respondents did not perceive patient safety at their workplace as problematic. They did not expect that patient safety would be put at risk during information handovers and patient transfers. Similarly, the management`s activities leading to patient safety improvement were assessed positively, which is one of key elements of ensuring safety culture. Higher attention should be paid to team cooperation across hospital wards, which influences the care coordination, and also to the personnel measures that influence the management of workload and development of errors. It was studied using the DUQUeE tool which sources and methods were the most common for quality improvement and care safety. Clinical audits and monitoring of work of individual staff nurses were mentioned as the most common systematic activities. Improvement efforts should be focused on the area of supporting information technologies and training dealing with internal peer review, and further projects of quality improvement. The sample of the qualitative study consisted of 9 respondents ? managers responsible for the coordination of quality improvement activities. The qualitative study used a semistructured dialogue, and complemented the quantitative study by the information on the ways of putting some areas into practice. Among others, it was found out that the range and quality of evaluated results corresponded with the absence of training in particular methods at the level of management of non-medical healthcare professions. This thesis has produced both theoretical and practical benefits. The practical benefit includes the recommendation of a suitable combination of testing methods for hospital self-assessments within the concept of safe care. The involvement of staff nurses and management will contribute to more effective promotion of safety and the whole process of continuous improvement, and repeated assessments will enable monitoring of the effect of safety measures. In the theoretical area, this study can extend the approach to management education since it provides various innovative views of safety problems and care quality.

Creating conditions for the effective healthcare provision in cooperation with the patient is one of the main missions of today's healthcare. A cardiac surgery is a difficult life situation for patients. Being informed, as the basic premise for the patient to become an active part of the entire healing process. The main aim of my thesis was to evaluate the awareness of patients who underwent a cardiac surgery, to map the problematic areas and to propose solutions. A combination of qualitative and quantitative method was used for the research. The qualitative part was carried out by means of semi-structured interviews with three interviewees. The quantitative part had the form of the questionnaire presented to 52 respondents. The results of both researches have been analyzed. The results show that the patients seem to have been provided with adequate information at the clinic. Impact of patients' awareness on their cooperation with healthcare professionals was proven, in particular in rehabilitation. A medical doctor remains the main source of information for patients, but they often seek to obtain additional information from other sources. The use of multiple sources and different forms of information seems to be advisable. I identified the groups of patients requiring a specific approach when...