Thesis (M.S.)--University of Michigan, 1981.

Thesis (M.S.)--University of Michigan, 1981.

Incidence of injury is currently the third leading cause of death in the Czech Republic. A good link between pre-hospital emergency care and hospital care becomes a priority. Nurses play an important role during an acute admission of patients with trauma to in-hospital care, they are the connecting link of all members of the multidisciplinary team, whose common mission is the patient and saturation of his /her needs. With the changing role of nurses in the modern concept of nursing, nurses become equal partners of physicians and other health care professionals. To be accepted by other members of the team and to be able to work with the full extent of her sphere of action in the acute phase of a trauma patient admission, she has to know perfectly her competencies under the applicable legislation. In the theoretical part the roles and responsibilities of nurses under the applicable legislation are defined. There are also chapters dealing with individual injuries and the organization of care for patients with trauma. In the final section of the theoretical part there is a chapter dealing with the holistic care for patients, including ethical care issues, the role of a patient and the importance of cooperation with the family of the trauma patient who is acutely admitted into the hospital. In the empirical part of the thesis three objectives were stated. To determine the cooperation of nurses with other members of the multidisciplinary team, as well as to find out whether the nurses involved in the admission of a trauma patient into hospital know their own competencies under the Decree No. 424/2004 Coll. The third objective was to determine how trauma patients perceive the process of admission to the hospital. Based on these objectives two hypotheses and two research questions were established. The objectives were successfully met, both hypotheses were confirmed and the questions answered. The research was conducted on the basis of a quantitative qualitative survey at departments of selected hospitals where the patients with acute trauma emergency were directed by emergency medical services. For the quantitative research the interviewing method using questionnaires was selected. Interviews with patients were conducted by the qualitative research method. The respondents were 117 nurses and 5 patients.

Breathing is one of the basic life functions and for its proper functioning it is necessary to have the airways free and clear. One way to maintain free and open airways is the tracheostomy. Tracheostomy may be performed either by surgical or puncture method. Nursing care and its quality in patients with tracheostomy are important factors that can significantly affect postoperative complications, their course and overall clinical outcome of treatment of patients. Sufficiently qualified, knowledgeable and experienced nurse applies her knowledge in practice with a holistic view of the patient and his needs. The theoretical part of the thesis introduces us to the anatomy of the respiratory tract, the history of tracheostomy, individual methods of tracheostomy - surgical versus puncture and nursing care for adult patients with tracheostomy for intensive care. Methods: In the empirical part, the data obtained on the basis of a quantitative survey in the form of a questionnaire will be evaluated. The sample of respondents will be nurses working in the intensive care department for more than 1 year with experience in nursing care for tracheostomy. Aim of the work: Analysis of nurses awareness about different tracheostomy methods - surgical versus puncture, role of nurse in these methods, their experience...

Bakgrund: SBU (2006) efterfrågade mer evidens för Acceptance and Commitment Therapy, (ACT) mot långvarig smärta då det både är en stor orsak till lidande och en dyr samhällskostnad (87,5 miljarder kr, år 2003). Enheten för Långvarig Smärta – Avdelning, (ELS-A) är den enda vårdavdelningen i Sverige som behandlar långvarig smärta med ACT. Syfte: Att undersöka hur patienter, som för minst ett år sedan genomgått ACT-behandling på en slutenvårdsavdelning med långvariga smärttillstånd som specialitet, upplevde behandlingsmetoden och dess resultat samt sjuksköterskans roll vid behandlingen. Metod: Kvalitativ forskningsintervju med semi-strukturerade frågor tillämpades för datainsamling. Fem färdigbehandlade patienter intervjuades och därefter analyserades intervjuinnehållet i en analysmodell. Resultat: Patienterna ställde sig väldigt positiva och tacksamma till både ACT-behandlingen och resultatet av den. Alla patienter upplevde en minskning av smärtproblematik, medan själva smärtnivån inte påverkats något nämnvärt. Efter avklarad sexveckorsbehandling valde två av fem av patienterna att fortsätta vidareutbilda sig i ACT på egen hand. Patienterna upplevde både positiva och negativa delar med ACT som gruppbehandling, medan ingen ställde sig negativ till individuell träning. Sjuksköterskans roll uppfattades som väsentlig och vital för avdelningens dagliga arbete. Det mest uppskattade med sjuksköterskan var hennes höga kompetens i form av vidareutbildning och yrkeserfarenhet samt hennes ständiga närvaro på avdelningen. Slutsats: ACT som behandlingsmetod uppskattades främst för det multiprofessionella arbetet. Behandlingen gav goda resultat gällande smärtupplevelsen för patienter med diagnosen långvarig smärta. ACT var uppskattat och intervjupersoner fortsatte därför egenbehandlingen efter utskrivning från ELS-A. Sjuksköterskan var en uppskattad person med sin höga kompetens och dagliga närvaro på avdelningen. / Background: SBU (2006) has requested more evidence-based research about the efficiency of Acceptance and Commitment Therapy on chronic pain, a disease that cost Sweden 87,5 million Krona in 2003. ELS-A is today the only department in Sweden where patients diagnosed with chronic pain can enroll for treatment. The treatment at the clinic is based on the philosophy of Acceptance and Commitment Therapy (ACT). Aim: To examine how patients diagnosed with chronic pain, one year after finalized treatment at ELS-A, evaluated the method of treatment, their level of pain today, and what role the nurse had during the enrollment. Method: Qualitative research interviews with semi-structured questions were applied for data collection. Five patients were interviewed and the data was analyzed. Results: The patients were very supportive and grateful both towards the experience of the ACT treatment itself, and the results of said therapies. All five patients experienced a reduction in how their pain previously negatively affected their lives, however the level of pain they felt remained the same. After the six weeks of clinical treatment two out of five of the interviewed patients continued studying the ACT-method independently. The patients all had both positive and negative experiences from the group interactions, and found greater appreciation for the individual treatment. The nurse played an important role in the department's everyday order of business. The nurse's performance during these days of testing was excellent. Her level of higher education, work experience and work ethic during the program was most appreciated by all. Conclusion: ACT treatment was appreciated mainly for the multi-professional team. The treatment gave good results in terms of pain perception in patients with a diagnosis of chronic pain. ACT was appreciated and interviewees therefore continued self-treatment after discharged from ELS-A. The nurse was a popular team-member with her high knowledge and daily presence at the department.

Nursing develops and becomes a field with scientific base and well-educated employees. Thanks to that, nursing care is safer and of better quality. Nurses obtain prestige, importance and autonomy. The aim of this thesis is to map haw the nurses perceive their the features and skills and what is the view of patients of the same features and skills of nurses. The research was performed using the quantitative method in the form of a non-standardised questionnaire. The research was aimed at opinion of nurses and patients and so the first research set consisted of general nurses and the second set consisted of patients of hospital wards and ambulances. There were used two types of questionnaires ? one of them designed for general nurses and the other one for patients. The questionnaires contained identical questions so as we could perform a comparative analysis of answers from nurses and patients. The data analysis proved that general nurses assess their practical and communication skills better than the patients. It was also established that patients consider the communication skills of nurses to be the most important skill, while nurses stated for their practical skills to be the most important part of nursing care. When comparing the results, significant differences were established in answers of both of the groups. It concerned mainly the field of communication skills of nurses. The patients selected negative answers to questions whether nurses ask the patients for their opinions and whether the nurses know how to communicate with families of nurses. The negative findings confirmed that the communication field remains to be a problem in nursing and that more attention should be paid to it. It is significant to train the communication skills of nurses.

The research has shown that the need to empty urine with the wetting problem, the need for certainty and security with the feeling of shame not only among enuretic children but also their parents, the need for liquid intake with the problem of not meeting the sufficient intake during morning and early afternoon hours and subsequent feeling of thirst are the most frequently unmet needs of enuretic children. According to nurses their role is based on education of parents and their enuretic children in the field of liquid intake regime and emptying the urine, and basic urine examination. The nursing care provided by nurses in surgeries of paediatric practitioners to enuretic children is sufficient; nurses are aware of the problems with the needs of enuretic children and try to solve them. However they educate enuretic children and their parents badly in the treatment regime principles, they do not require a feedback and are not interested in adherence on the rules they recommend. The nurses? knowledge is particularly poor in terms of the correct drinking regime rules the principles of the correct hygienic regime and application of hygienic aids to older children, the rules of waking children up for urination by their parents and particularly the knowledge of physiologic development of a child in urination regulation and its upbringing in 7 steps. Knowledge of the treatment regime is quite sufficient among parents. They probably gain correct information from practitioners, nephrologists and further sources, like the Internet. However the knowledge in the field of enuresis problems (the term, causes, age limit of wetting pathology) and of the child development in urination regulation and its upbringing in 7 steps is insufficient. Parents sit their children on the potty early, mostly before 1 year of age which contributes to the occurrence of enuresis. The parents unfortunately consider their knowledge insufficient.

The diploma thesis deals with problems of depression in older people. Mainly the work is focused on identifying and analyzing the role of nurses in screening for depression in older people in primary care, acute care, long-term care and home care. This thesis was focused on theoretical direction and was used the method of design and demonstration. In this thesis was set one main goals with five research questions. The main goal was to identify and analyze the role of nurses in screening for depression in the elderly. RQ 1: What is the role of the nurse in screening for depression in the elderly? RQ 2: What is the role of the nurse in the primary care in screening for depression in the elderly? RQ 3: What is the role of the nurse in screening for depression in hospitalized patients in acute care? RQ 4: What is the role of the nurse in screening for depression in seniors in long-term and home care? RQ 5: What rating scales and methods are used in screening for depression in the elderly? The thesis introduce the concept of depression. The following are specified the causes of and the important factors that affect depression in the elderly. It also deals the differences in the clinical symptomatology of depression in old age. It explains possibilities and various barriers in the diagnosis of depression. Another chapter introduces complete geriatric examination, diagnostic classification systems, possible screening methods and scales for detection of depression in the elderly population. It also deals methods of pharmacological and non-pharmacological treatment and its possible complications associated with older age. By reason of increased suicide rate caused by depressive disorder the issue of suicidal behavior in the elderly is introduced. The next chapter deals with the nursing process, which is used by nurses in practice. It consists of the evaluation of the patient's health condition, making nursing diagnosis, creating nursing plan and subsequent implementation and evaluation. The nursing process is also needy for providing quality care. The nursing process in the stage of nursing diagnosis, introduces possible nursing diagnosis for a patient suffering from depression, which are based on the latest classification. Finally is described the role of nurses in screening for depression in the elderly in different health facilities and their contribution to the timely evaluation of depression in the elderly. This chapter introduces the role of nurses, nursing screening and collaboration with a physician. The role of nurses in screening for depression in different medical facilities is based on the first phase of the nursing process of assessment. On the basis of objective and subjective information, the nurse will assess the overall health and mental condition of the patient. Primarily, it was investigated what is the role of the nurse in screening for depression. On the basis of content analysis and synthesis it was necessary to used and processed domestic and foreign literature. A number of relevant sources are the results of various studies and Meta-analyzes, mostly from abroad, but also from the Czech Republic. The thesis can serve as a basis for nurses. The result of this thesis is to create e-learning material available for students in the Faculty of Health and Social Sciences of South Bohemia in Ceske Budejovice in the tutorial called Moodle.