Darbo tikslas – ištirti psichosocialinių paslaugų organizavimą slaugos ligoninėje paliatyvių ligonių artimiesiems. Darbo uždaviniai: 1. Ištirti paliatyvių ligonių artimųjų esamų psichosocialinių paslaugų poreikį. 2. Įvertinti psichosocialinių paslaugų poreikio tenkinimą. 3. Išsiaiškinti naujų psichosocialinių paslaugų poreikį. Tyrimo metodika: Tyrimo objektas – psichosocialinių paslaugų organizavimas slaugos ligoninėje paliatyvių ligonių artimiesiems. Tyrimo metodas – anoniminė paliatyvių ligonių artimųjų (n=67) anketinė apklausa. Duomenų analizė atlikta naudojant statistinės duomenų analizės SPSS 13.0 for Windows versiją ir Microsoft Exel programą. Rezultatai. Didžiajai daliai tiriamųjų sąveikos su sveikatos priežiūros darbuotojais (88,4 proc.), ligoniui teikiamos priežiūros ir procedūrų kokybės (89,1 proc.), informacijos ir pagalbos (81,2 proc.) bei psichologinės paramos (68,0 proc.) poreikiai yra svarbūs. Lyčių ir slaugymo patirtį turinčių/neturinčių tiriamųjų poreikių svarba skyrėsi: sąveikos su sveikatos priežiūros darbuotojais ir psichologinės paramos poreikis svarbesnis moterims ir artimąjį slaugiusiems asmenims, o ligoniui teikiamos priežiūros ir procedūrų bei informacijos ir pagalbos poreikis svarbesnis moterims ir artimojo neslaugiusiesiems. Tiriamųjų poreikiai patenkinami nevienodai. Sąveikos su sveikatos priežiūros darbuotojais poreikis patenkinamas (49,7 proc.), tačiau labiau užtikrinamas moterims ir slaugymo patirtį turintiesiems. Priežiūros ir procedūrų... [toliau žr. visą tekstą] / Aim of the study - to analyse the management of psychosocial services for the relatives of palliative care patients at nursing hospital. Objectives: 1. To determine the demand for existing psychosocial services for the relatives of palliative care patients. 2. To evaluate supply of this demand. 3. To establish the demand for new psychosocial services. Material and methods. The study object – management of psychosocial services for the relatives of palliative care patients at nursing hospital. The survey implied the anonymous questionnaire (n=67) for the relatives of palliative care patients. Statistical data analysis was performed using statistical package „ SPSS 13.0 for Windows“ and „Microsoft Excel“ software. Results. The majority of responders pointed out, that the needs to interact with health care staff (88.4%), to receive high quality of health care and procedures (89.1%), information and aid (81.2%), and psychological support (68.0%) all are relevant. The analysis of demands' perception regarding to gender and prior experience of care (experienced subjects and non-experienced subjects) demonstrated following differences: relevance of interaction with health care staff and of psychological support was higher for women and experienced subjects, while the quality of care and procedures as well as information and aid were more relevant for women and non-experienced subjects. The coverage of demands was different. The needs of interaction with health care staff was... [to full text]

Darbo tikslas: Įvertinti paliatyvios pagalbos paslaugų poreikį besigydantiems Kauno miestą aptarnaujančiose slaugos ir palaikomojo gydymo ligoninėse . Tyrimo metodika: Išanalizuota trijų Kauno miesto slaugos ligoninių 2008 metais visos gydytojų užpildytos išvykusio iš stacionaro asmens statistinės kortelės formos Nr.066/a-LK (n=1689). Gauti rezultatai pagal TLK-10 ligos kodą ir gydymo profilį palyginti su Lietuvos Respublikos sveikatos apsaugos ministerijos įsakymu nustatytomis paliatyvios pagalbos teikimo indikacijomis. 2009 metų vasario-kovo mėnesiais atlikta šių trijų slaugos ligoninių pacientų artimųjų anoniminė anketinė apklausa. Atsako dažnis 70,2%(n=151). Abiejuose tyrimo dalyse į atskirą grupę išskirti demenciški ligoniai. Duomenys išanalizuoti naudojant 13 versijos SPSS programinį paketą. Rezultatai: Į slaugos ligonines guldytiems su išemine širdies liga paliatyvi pagalba reikalinga 14,6% pacientų, sergantiems piktybiniais navikais - 10% pacientų, pagal spinalinė raumenų atrofija ir su ja susiję sindromai - 0,1% pacientų, demielinizuojančios centrinės nervų sistemos ligos – 0,6% pacientų, anoksinis smegenų pažeidimas, koma - 0,2% pacientų, lėtinis kepenų funkcijos nepakankamumas-0,8%, lėtinio inkstų funkcijos nepakankamumo terminalinė stadija - 0,2% slaugomųjų reikėjo paliatyvios pagalbos. Iš anketinės apklausos valstybės skirto 120 dienų slaugai termino neužteko 70,2%.Speciali medicininė priežiūra ir slauga reikalinga 83% slaugomųjų. Artimojo susirgimas sparčiai... [toliau žr. visą tekstą] / Aim of the study: to evaluate the demand for palliative care services among patients at nursing and supportive care hospitals, that serve Kaunas city. Methods. The study started with patients' data from year 2008, personal statistical card form No. 066/a-LK (n = 1689), which were fulfilled by physicians at patients' discharge and obtained from 3 nursing hospitals in Kaunas. The findings as coded according to ICD-10 and therapeutical profile were compared with indications defined in national legislation for palliative care. During February–March 2009 the anonymous survey including the relatives of the patients was conducted in the hospitals using questionnaires. Sample size was 151, response rate 70.2%. Dementia patients were analyzed separately. Statistical data analysis was performed using software „SPSS for Windows 13.0“. Results. In nursing hospitals the palliative care was needed by 14.6% of patients with ischemic heart disease, 10.0% – with malignant tumours, 0.1% – with G12 (spinal muscular atrophy and related syndromes), 0.6% – with G35–G37 (demyelinating diseases of the central nervous system), 0.2% – with G93 (anoxic brain damage), 0.8% – with K70–71 (chronic liver insufficience), 0.2% – with N19 (unspecified renal failure). The questionnaire revealed, that nursing term of 120 days as defined by state was insufficient for 70.2% of cases. Special medical care and nursing was necessary for 83.0% of patients. 56% of relatives stated that the disease is progressing and... [to full text]

There is a question: what can happen to person in the society, which tends to ignore or to avoid death? What kind of factors increase (and do they increase) concern felt about death? What should be constantly changing medicine like: a human, respectable job or a new kind of science, which does not pay attention to person and does not try reduce his pains, but to prolong his life? Purpose of this final master work – to estimate the view of a dying person of the students of the Nursing faculty. Tasks of the research: · to estimate the studies’ view of the most frequent physiological, psychological, social, spiritual problems of a dying patient in the palliative care; · to compare the differences of the view of a dying person between the students of the Nursing faculty of KMU of different study programs in the first and the fourth course; · to estimate the need of the knowledge about a dying person in the students’ opinion; · to prepare a booklet about dying people’s conception for the students. The agreement of the bioethical Committee of KMU was received to do this research, the research was confidential. 125 students of the 1st and 4th course of the Nursing faculty of KMU were researched. They were given the questionnaire with question about palliative care and problems of bad ill and dying patients. The received results were estimated by using of a statistical analysis. After analyzing the received answers the view of the main care problems of dying people was estimated. The... [to full text]

The idea about human’s merit, his worth, unique and oneness comparing him with things or other living creatures – that’s the phylosophy of human dignity in bioethics and biolaw. The aspect of principle of human dignity in bioethics and biolaw is analyzed invoking characters of human and his free will. Solving bioethical and biolaw problems, concepts of the beginning and the end of the life help us to reveal the importance of human dignity principle. In Bioethics and biolaw the principle of human dignity is read as a position which requires recognition of personality and free self-determination. / -.

Kiekvienos valstybės viena iš prioritetinių politikos krypčių yra visuomenės ir asmens sveikata. Tačiau, kad ir stengiamasi užtikrinti žmogaus sveikatos apsaugą, kiekvieną dieną visame pasaulyje žmonės neišvengiamai susiduria su mirtimi. Kai kuriose valstybėse, kalbant apie nepagydomai sergančius ligonius, kurie kenčia didelius skausmus ar apie komos ištiktus žmones, vis dažniau iškeliamas eutanazijos klausimas, kuris dažnai apibrėžiamas kaip sąmoningas žmogaus gyvybės atėmimas kiek įmanoma švelnesnėmis priemonėmis, atliekamas vien marinamojo labui. Vis dėlto eutanazijos įteisinimo klausimas yra opus ir visada lydimas aršių debatų tarp jos šalininkų bei priešininkų. Šio darbo tikslas yra aptarti eutanazijos įteisinimo aspektus bei ištirti Lietuvos visuomenės požiūrį aprašomo reiškinio atžvilgiu. Visas pirmasis darbo skyrius skirtas teorinio modelio aprašymui. Šio skyriaus poskyriuose, atliekant mokslinės literatūros analizę, aptariami viešosios politikos formavimo ir interesų grupių teoriniai modeliai, kuriais grindžiamas šis darbas. Antroji dalis skirta eutanazijos politikai apžvelgti. Poskyriuose aptariamas eutanazijos reiškinys, jos rūšys ir interesų grupių argumentai už ir prieš eutanazijos politiką. Taip pat analizuojami ir lyginami eutanazijos įteisinimo atvejai Nyderlanduose ir Belgijoje. Trečioji dalis skirta praktinei darbo pusei aprašyti. Pristatomas Lietuvoje atliktas empirinis kiekybinis tyrimas, kuriuo buvo siekiama ištirti Lietuvos visuomenės – medikų... [toliau žr. visą tekstą] / Public and personal health is one of the priority policies of every state. However, despite the attempt to ensure the protection of human health, every day people in all over the world inevitably come face to face with death. While talking about the incurable patients, who suffer from severe pain or are in coma, some countries raise the question of euthanasia, which is often defined as the intentional taking of a person‘s life for the good of that person by the means as delicate as possible. However, the legitimation of euthanasia is a sensitive issue, always accompanied by the savage debates between its supporters and opponents. The aim of this work is to discuss the aspects of the legitimation of euthanasia and to investigate the attitude of Lithuanian society towards the described phenomenon. The first part of this paper discloses the theoretical description of the model. Using the analysis of scientific literature, the subchapters discuss the theoretical models of public policy formation and interest groups, on which this work is based. The second part reviews the policy of euthanasia. The subchapters discuss the phenomenon of euthanasia, its types and the arguments of interest groups for and against the policy of euthanasia. Moreover, the cases of the legitimation of euthanasia in the Netherlands and Belgium are analyzed and compared. The third chapter is devoted to the practical part of the work. The quantitative empirical study accomplished in Lithuania, which has... [to full text]

Euthanasia is frequent phenomenon in modern society and that is why the number of discussions on the subject increases. The aim of the paper is to answer the question after having analyzed the legal acts of various contries: is euthanasia a crime or a justifiable way of killing. In the beginning the concept of euthanasia is educed and it is marked off from the non-practice of the stubborn treatament. The experience of the states that have legitimated euthanasia, prohibited euthanasia, legalized suicides assisted.

Summary Aim of the study: to assess the need for palliative care services in care hospital and to examine the possibilities of satisfying patients need for palliative care. Objectives: 1.) to analize patients applying for services according to social, demographic and medical factors; 2.) to assess patients relatives oppinion about the quality of received services; 3.) to analise financial side of applied services and to realistically assess costs of services; 4.) to compare recourses granted by government with actual costs of services 5.) to analize the possibilities of applying palliative care services in palliative care hospital. Methods: the research was executed with the help of qualitive and quantitive methods in few stages: I. patients applying for services were analised according to social, demographic and medical factors using data from KCH registering books of year 2001- 2003. II. Patient's relatives oppinion about the palliative care and quality of received services were analised. The relatives of patients in last stages of oncological and neuromothorical illnesses received questionnaires concerning this research. Research was executed 2004 July - December. 46 questionnaires were distributed. The response rate – 95,7%. The biggest part of respondens were women (61,4%). Data analysis was performed with the help of the statistical package SPSS 10.03. Statistical procedures: chi- square's test c2, the degree of freedom (df) and statistical value (p). The results... [to full text]

Vakarų pasaulio šalys, dažnai laikomos pasiekusiomis aukštą kultūrinį lygį ir liberalumo bei laisvės skelbėjomis, įteisino eutanaziją valstybinais įstatymais, leisdamos nužudyti žmogų dėl ligos ar senatvės. Lietuvoje kaip ir daugumoje Senojo Žemyno šalių, mažėjantis gimstamumas, senstanti visuomenė ir besikeičiantis jos požiūris į gyvybę, į senatvę, į ligą, į kančią verčia liberalią visuomenę diskutuoti apie įvairias mirties formas ir ypač eutanaziją. Gyvenimo tempams bėgant beprotišku greičiu ir dėl to žmogui patiriant daugybę įvairių traumų, kurios dažnai padaro žmogų neįgaliu; ligos, kurios vis dar lieka nepagydomomis, verčia atkreipti dėmesį į silpnuosius ir reikalingus pagalbos, jiems siūlant ne mirtį, o gyvenimą. Silpnųjų pusėn tokioje situacijoje ir stoja paliatyvioji pagalba kaip alternatyva eutanazijai. Temos problematiškumas kyla iš bandymų įteisinti eutanaziją, teismuose įrodyti „teisę numirti“ nepateikiant jokios kitos išeities tokiai pozicijai. Plintant tokiai laikysenai, pridengtai gailestingumu, alternatyva randama paliatyvioje pagalboje ir slaugoje. Lietuva yra paskutinė valstybė Europoje, kuri įteisino paliatyvią pagalbą – ligonio, sergančio pavojinga gyvybei, nepagydoma, progresuojančia liga, ir jo artimųjų gyvenimo kokybės gerinimo priemones, užkertančias kelią kančioms ar jas lengvinanti, padedanti spręsti kitas fizines, psichosocialines ir dvasines problemas. Ši tema ypatingai aktuali įrodyti, kad liga ir senatvė nesunaikina asmens ir todėl neleista jo... [toliau žr. visą tekstą] / The western countries often considered as those, which had achieved high cultural level and that are the announcers of liberalism and freedom, have legitimized euthanasia with national law by allowing killing a person for a disease or old age. In Lithuania as in the majority of countries of the Old Continent, the decreasing rate of birth, the obsolescent society and its changing attitude towards life, old age and pain force a liberal society to discuss about various forms of death and particularly euthanasia. As the life pace is running in a breathtaking speed causing many human traumas, which often make a person disabled; the diseases that still remain incurable force us to pay attention to the weak people who need help by providing them not with death but life. In this case the palliative help as an alternative to euthanasia stands for the weak. The problem of the topic rises from the intentions to legalize euthanasia, to prove „the right to die“in the court without submitting any other solutions to such a position. When spreading such the posture covered by mercy, the alternative is found in palliative help and care. Lithuania is the last country in Europe, which legalized palliative help – the tools of life quality improvement of the patient suffering from the dangerous, incurable and progressing disease and his relatives. These tools prevent from torment and palliate them, help to solve other physical, psychosocial and spiritual problems. This topic is particularly... [to full text]