There is a new trend of shifting the provision of health care from hospitals to the patient?s natural environment. We are increasingly aware of the expensive and sometimes ineffective late hospital treatment; therefore, there are stronger efforts for early diagnosis, prevention and health education from an early age. It is necessary to keep the future generations focused on their health and the health of their family members who live in the community. The initiative must originate not only in families but also in the school environment in which children find themselves almost every day. A school nurse is an expert in the field of community care working in school environment. The work load of the school nurse rests in maintaining and improving physical and mental health. The school nurse supports pupils in their responsibility for their health and she creates a system of formalized school activities, prepares and implements the school?s educational program focused on prevention. The data in the research part of the thesis was obtained through quantitative and qualitative research survey. The quantitative research was carried out using the technique of an anonymous questionnaire. The questionnaire was intended for general practitioners for children and adolescents, as well as nurses working with general practitioners for children and adolescents. The qualitative research data was collected through semi-structured interviews with the head teachers of elementary and secondary schools on the basis of which casuistries were created resulting in categorized charts. The objective of this thesis was to find out about the position of general practitioners for children and adolescents, and paediatric nurses working with general practitioners for children and adolescents on introducing the function of school nurses in the healthcare system of the Czech Republic. The research in this thesis showed a low level of awareness about the position of school nurses. The primary controversies related to the introduction of school nurses can be described as follows: the method of financing, the issues of authority of such nurses, and the way of preparing for this occupation. The main positive aspect of school nurses can be seen by the respondents in comprehensive care for pupils, prevention and better public education. School head teachers, general practitioners and nurses believe that school nurses should be placed in schools according to the number of school pupils and school head teachers assume greater use school nurses in primary schools than in secondary ones. The method of financing school nurses should be, according to the respondents, from multiple sources. This thesis may be used as a basis for further research work focused on the position of school nurses, and also as a proposal of establishing the school nurse position in the healthcare system of the Czech Republic, or as informative material for professional as well as lay public.

Diploma thesis entitled focuses on acute pain in general, as well as on post-operation pain, which is one of the types of acute pain. The first part of the thesis deals with acute pain as such and its characteristics. The second part deals with intensive care units (ICU). The third part contains description of post-surgery pain, treatment thereof, and the nurse?s role in taking care of clients suffering post-surgery pain. Three goals have been outlined. Goal 1: Identification of the techniques that nurses use at ICUs to sooth clients? pain. Goal 2: Map the monitoring the pain of clients hospitalized at ICUs. Goal 3: Find out whether the techniques for reducing pain of clients hospitalized at ICUs are effective. A quality-oriented research was applied for evaluation of the results, using a method of non-standardized interview with nurses and clients.The results can be used as a comparative overview of the most common pain-reducing techniques and proof of their effectiveness for clients.

Paediatricians and nurses belong to primary health care providers in the in child care while nurses have been taking over a key role in the primary health care. Their position is becoming stronger under the conditions of growing demands in the current health system. This survey was carried out as a combination of quantity and quality research. A questionnaire and an interview for nurses and parents was worked out as a major tool of the research. The survey included 102 nurses in paediatricians' offices. 112 parents and five nurses were interviewed in the range of the research work. There were six objectives set for the thesis. The first objective was to find out whether nurses in primary paediatricians' offices use nursing procedures. The hypothesis set up for the first objective was as of the following: nurses in primary paediatricians office do not use nursing procedures. This was proven on the grounds of the answers received in the survey. The second objective was to find out whether nurses keep their own nursing books and records. The second hypothesis set up was worded as of the following: Nurses in primary paediatricians' offices do not keep their own nursing records. This hypothesis was proven as well. The third objective was to find out whether nurses from primary paediatricians' offices visit families as a part of their service to families. The hypothesis for the third objective was worded as of the following: Nurses from primary pediatricians' offices visit patiens in their homes. The hypotehsis was proven on the groundsof the survey. The fourth objective was to find out whether nurses in primary paediatricians' office observe children in familes with bad socio-economic backgrounds. The hypothesis was worded as of the following: nurses observe children in familes with bad socio-economic;backgrounds. This hypothesis was proven as a fact. The fifth objective was to find out whether nurses are informed about community care. The fifth hypothesis was worded as of the following: nurses in primary paediatricians' offices are not informed about community care. This hypothesis was not proven. The sixth and the seventh objectives were to find out what the range of awareness about community care in parents' minds exists and whether parents are satisfied with nursing care provided by paediatricians and nurses. The hypotheses were worded as of the following: parents are not aware of community care and they consider paediatricians' and nurses' care substantial. The sixth hypothesis abot the range of parents' awareness of commuinity care was not proven, while the seventh hypothesis about satisfaction of nursing care by paediatricians and nurses was proven. In the frame of quality reasearch and on the grounds of four research questions two hypothese were set up. The first one is worded as of the following: Paediatric nurses in primary paediatric care consider community care as necessary and inevitable to provide a thourough care in familes with bad socio-economic backgrounds. The second one is worded as of the following. Paediatric nurses consider cooperation with nurses in other fields of the system as necessary and that eduaction towards well-being is desperately needed. Nurses should be aware of their roles within the health care system. They are no longer just nurses providing care and doers of doctors' commands. They have to learn how to operate successfully in other roles such as: managers, researchers, legislative assistants, advisors, educators and etc.

This thesis is called "Working conditions of nurses at acute medical units." The intensive care medicine was chosen as the main focus of research. It pervades all branches and it became a very interesting multidisciplinary part of medicine. Another subject is non-medical staff, as demands made on them are really high. First, the thesis deals with intensive care medicine and relates it with nursing. Then it describes the role of nurses, mentions their system of education, changes which has happened and the peculiarities for intensive medicine. The operation of second internal clinic of General University Hospital in Prague from the nursing point of view including related internal and legal regulations is described in more detail in the empirical part, for better understanding wider context. Out of consideration for the fact that a coronary unit (whose staff are the research sample) is on the verge of offering resuscitation and higher intensive care, it is also aimed at and its specifications too. Individual factors making working execution harder can be influenced, although partly they are determined by a human factor and have their limits whose exceeding or change can become a problem. The diploma project investigates the working conditions of nurses at acute medical units because that is what can be both positively and negatively affected and it is measurable. A qualitative enquiry in the form of non-standard interview was used for collecting the data. Overall fifteen nurses working at acute medical units of General University Hospital in Prague were addressed. Their personal situation is briefly outlined, but the main focus follows the aims in the thesis, i.e. findings of the nurses' opinions at acute medical units on their working conditions; findings of which factors make their working conditions difficult; ways of eliminating these factors and how to improve the quality of nursing. Altogether ten research questions were formulated so that interviews with respondents could be categorized and analyzed. The thesis came to the conclusion that improvement in the area of working conditions while providing nursing at acute medical units is possible. Most suggested solutions are not able without the help of management, or are dependent on it fully. However, even today the provided nursing care is at an excellent level.

Current status Obesity is a disease characterized by the increased proportion of fat in the body over a certain limit (Müller 2009). According to the World Health Organization in 2014, more than 1.9 billion people suffered from overweight, of which more than 600 million people were obese (WHO 2015). Subject The aim of the work is the definition of competence nurses have in the aftercare of bariatric patients. Determination of preparation, care, patient awareness and procedures for patients undergoing bariatric treatment. And findings of specific needs of bariatric patients undergoing treatment for obesity. Three research questions have served towards these targets: What competences do nurses have in the aftercare of bariatric patients? How are patients informed throughout the bariatric treatment? What are the needs of patients undergoing bariatric treatment of obesity? Methods Qualitative research techniques were used to obtain the necessary data for the practical part. The practical part was realized through individual semi-structured interviews with nurses working on surgical wards and patients who had undergone bariatric treatment. At the beginning of each interview, the nurse and the patient were apprised of the reason of the research conducted and were assured of anonymity in the processing of the dialogue. The central theme was the assertion of nurses in the subsequent care of bariatric patients and to determine the specifics of these patients. Participants The sample consisted of nine nurses working in a specialized center, where bariatric procedures are performed and seven patients who had undergone bariatric surgery. The survey was conducted from February to March 2015 Results: Before the operation patients undergo surgical, internal, nutritional and psychological examinations. Blood is collected for hematological and biochemical laboratory tests. Among other examinations clients go through gastroenterology, pulmonary testing, also examination in a sleep laboratory and swabs are taken from the throat and nose. Before the particular operation clients should reduce weight on a doctor's recommendation. It was also found that patients are informed about the preoperative and postoperative care, as well as about the need for dispensarisation, the frequency of follow-ups and possibilities of participation in bariatric clubs and associations. Nurses cover the following competences. Before the surgery, the nurse educates the clients about the preoperative and postoperative care, takes their blood, fulfills what the doctor prescribes and motivates the patient. After the surgery, the nurse provides general nursing care, monitors physiological functions, and educates patients about their diet and carries out the doctor´s prescriptions. The nurse must know the dietary restrictions, when it is determined by the general procedure, which varies in some detail according to the type of surgery and the patient's condition. The research showed that nurse cares more about the biological needs of the patients, rather than their psychosocial needs. Patients lack psychological support and motivation in aftercare. Patients undergoing bariatric treatment need to prepare for surgery (weight loss) and acquire post operation eating habits. Their other needs are psychological support and motivation conveyed by nurses. Conclusion: As the number of people suffering from overweight and obesity at present is constantly growing, obesity treatment becomes a necessity. Currently, bariatric surgery is widely used for patients suffering from obesity of the II. and higher degree, so it is advisable to know the needs, knowledge, practices in patient care before and after such an operation and, ultimately, which competences do nurses have during them.

Wound care is an important part of the daily work of nurses in all facilities like hospitals, institutes for long-term patients, social care institutions, or ambulances. In recent years, the treatment of wounds puts more and more emphasis on modern methods, mainly in the Czech Republic (CR) and Ireland. As already mentioned, nursing is constantly evolving, and possibilities for wound treatment are wide. Our aim will be to compare the ways and methods of wound treatment in three different countries. We will focus on the General Nurse, as a nursing care provider. In the theoretical part, the work was focused on characteristic of wounds, their distribution, general healing as well as concrete treatment in the countries concerned, specifically according to the competence of nurses. A major part was devoted to the education of nurses The main purpose of the research was focused on the way nurses treat wounds in Namibia, Ireland and the Czech Republic. Based on the research subject the following research questions and goals were set: Identify and describe how nurses treat wounds in the selected countries. How are wounds healed in Namibia, Ireland and the Czech Republic? How is the wound care in Namibia, Ireland and the Czech Republic? What kind of education does a nurse have to have in the countries concerned, in connection with the wound care? For the empirical part of the thesis, a qualitative approach was selected. A semi-structured interview with nurses from the selected countries was used. Further records of the wound treatment were used. These were obtained during the internship in Namibia, a personal visit to Ireland and my experience during my studies in the Czech Republic. Respondents were recruited by purposive sampling, the condition of which was wound care requiring hospital treatment. The interviews were conducted using a range of questions addressing nurses in those countries during their working hours and if needed, supplementing the required information via Skype. The research sample consisted of nine respondents - nurses from Namibia, Ireland and the Czech Republic and then records of the wound treatment of 9 patients from Namibia, the Czech Republic and Ireland were drawn. The countries have their competencies relating to this issue. In Ireland, Czech Republic there is a re-bandaging nurse, who creates a nursing plan and, if needed, consults everything with the physician. In Namibia, due to lack of nurses and physicians, only competences of local nurses which they acquired during their university studies, are sufficient. These competences lead to decisions and choice of care and wound treatment. In the Czech Republic, nurses shall consult the healing process and the course of treatment with the physician. In the area of education of nurses from the surveyed countries in connection with wound care the research investigation showed that university education is required in Namibia, in the Czech Republic as well as in Ireland. The third mentioned research question related to methods of care with clients suffering from acute or chronic wounds. Wound care in Namibia, Ireland, and in the Czech Republic does not differ in some specific procedures; however, in most cases it is very different. In severe cases of wounds, for many patients it is an unforgettable memory, which requires a professional approach, consisting of knowledge and experience. The nurse provides a unique support to the patient, education is therefore very important and unconditional in order to enable the patient coping with the situation. The results of this thesis can serve as information and study material to other grades of the surgical block and for further research on a similar topic.

Celiac disease is a lifelong disorder characterised by permanent intolerance to gluten and typical inflammatory changes in the small intestine. These changes lead to malabsorption of all nutrients, minerals, vitamins and water. The first attack of this disorder mostly occurs in childhood because the small intestine is greatly stressed by other nutrition supply. The only effective treatment is a lifelong gluten-free diet. This thesis, called Primary, secondary and tertiary prevention in children with celiac disease, consists of two parts; a theory part for which both professional publications and internet have been used and an empirical part, that comprises research itself with its results. The research target of this thesis was the sector of celiac disease occurring in children. Within the research, there were determined four objectives. The first objective was about to find out how primary, secondary and tertiary prevention is provided to children with celiac disease in GP ambulances for children and teenagers. Another task was to trace what profits the regime education brings to parents of children having celiac disease. We also dealt with the impact of the disease on the life of the child, his/her family and surrounding society. Then we investigated whether respondents take the help from outside, state support, institutions and in-kind assistance. In the empirical part of the thesis we used a method of qualitative research. For this research we chose a method of questionings through individual semi-structured interviews with two groups of respondents. The first group was made of nine nurses working in GP ambulances for children and teenagers having celiac disease. The second group was formed by nine children with celiac disease and their parents. The outcome of the research indicates that for quality health care supply it is important to obtain family anamnesis, carry out regular physicals in stated intervals within growth measurement monitoring and breastfeeding education and add other nutrition to diet. Monitoring suspicious symptoms, such as failure to thrive, inexplicable weight loss, growth retardation, abdominal pain, recurrent diarrhoea, digestive discomfort, dermatitis, stomatitis, anaemia, can soon detect celiac disorder. The secondary prevention is expressed by the work of nurses, such as biological material analysis, education, advice, help and support. Great urgency is given to risk factor monitoring, such as diabetes mellitus, Down syndrome, thyroid disorder, or genetic predispositions. The tertiary prevention is focused on the adaptation support of the child and his/her family to this chronic disorder, normal growth, and whole constitution examining and complication prevention. The outcomes indicate that the biggest problem of celiac people is financial burden of gluten-free food and also frequent limits in out-of- home eating. The financial burden of the diet influences, for example, vacation planning. It is necessary for the society to respect their disease, for example, canteens and teachers should have knowledge of the diet restrictions and provide suitable feeding. Furthermore, our findings show that only few families use financial support, because they are afraid of negative allowance examination because of their comfortable income. They mainly use allowance from Health Insurance Companies. On the grounds of the acquired information has been created an informative handout for the parents of the children with the celiac disease. The results of our research will be provided to the nurses who work in general practitioner ambulances.

The diploma thesis is structured into a theoretical part and an empirical part. The theoretical part consists of four chapters. The empirical part of the diploma thesis is based on qualitative research. The data were collected via semi-structured interviews with the senior citizens and the nurses. The replies were processed into clearly arranged charts and categories with brief descriptions. Another research method applied was observation. The interviews were followed by a detailed analysis of the documentation, which involved the analysis of the medical records of the senior citizens with a focus on medical diagnosis, chronic medication, and processing of the fall risk and its evaluation. The diploma thesis pursued three objectives by means of four related research questions. The first objective was to ascertain the extent of the clients' awareness of fall risks. The second objective was to assess the discomfort associated with usage of the special device preventing hip joint injuries resulting from falls during common everyday activities of the senior citizens. Finally, the third objective was to obtain the opinions of the healthcare staff on working with clients wearing special devices preventing the hip joint injuries. Four research questions were formulated in connection with these three objectives. Research question No. 1: What is the quality of information provided by the healthcare staff as part of the preventive intervention regarding the falls? Research question No. 2: How willing are the clients to accept changes contributing to fall prevention? Research question No. 3: To what extent is the comfort of the client affected by using special devices preventing fall-related hip joint injuries? Research question No. 4: To what extent is the work of the healthcare staff affected if their clients use devices preventing fall-related hip joint injuries? The results of the qualitative research suggest that the extent of information provided by the healthcare staff as part of the preventive intervention regarding the falls is insufficient in terms of awareness of the risky places. In particular, the research revealed that the nurses fail to sufficiently monitor the effects of chronic medication which may contribute to psycho-motor inhibition of the senior clients. As far as mobility aids are concerned, the nurses offer these devices sufficiently. The nurses demonstrated very good knowledge of all the mobility aids which may facilitate self-reliance of the senior clients. Another problematic issue is the safety of the rooms, particularly in terms of various protrusions and unevenness in the bathrooms. The results of the research do not show any unwillingness of the clients to accept changes contributing to fall prevention. Nevertheless, two of the respondents failed to engage in the activities and maintain physical fitness by regular exercise in the Retirement House. Furthermore, the results do not show any limitation of the clients' comfort resulting from using special devices preventing fall-related hip joint injuries. Finally, according to the research the healthcare staff does not feel restricted in any way when working with senior clients using such device. The results of the research will be used for repeated meetings with the senior clients and particularly with the nurses. The management of the Retirement House, together with the healthcare staff, are working on a new educational material which would indicate risky places with increased probability of falls. These results could be beneficial also for other facilities where healthcare staff takes care of senior citizens. Last but not least, the results are of interest also to the health insurance companies which could provide this special device with at least partial subsidy as part of the primary prevention programme.

Nursing care for paediatric terminally ill patients in the Czech Republic is continuously evolving and developing. It is important for the nurses to learn to use suitable communication. Theoretical part of this work includes information on terminal stages of illnesses in children and the corresponding care that should be provided. It further focuses on communication with the child and his/her parents. The theoretical background for this work is the conceptual Callista Roy Adaptation model for nursing applied on a paediatric terminally ill patient. The main aim of this work was to focus on revealing features in nurse communication with a child patient with regard to his/her medical diagnosis. We have focused on mapping medical diagnosis for paediatric patients in terminal stage of their illness that evoke communication barriers in nurses involved with the patients. Further step of this research was obtaining the information about the type of barriers the nurses evolve. Another aim was to create educational material for nurses based on information obtained from the research that would lead to improved communication between the nurse and the terminally ill child. A personal aim was also set in this work to gain necessary information and experience for the starting carrier as a paediatric nurse. Five research questions were posed to reach the aims of this work aimed at identifying communication barriers with regard to medical diagnosis child patient in the terminal stage of the disease, barriers in communication with a child patient in the terminal stage of the disease, evaluation of the quality of nurse communication with terminally ill child patients, use of communication aids in nursing care for these patients and we also wanted to know what changes in the communication with the terminally ill children the nurses experienced since the beginning of their working practice. The practical part is divided into two qualitative research investigations. In the first phase of this research eleven nurses working at paediatric oncology wards and eight nurses from hospice care aimed at child patients participated. Half-structured interview technique was used for the research. Based on the practical aim, second phase of the research consisted of evaluation of the impact educational material created as a result of the first phase of the research had on the nurses. The first phase of the research showed that the communication barriers are evoked in nurses by the following diagnoses: bone tumours, brain tumours and multiple sclerosis. Further barriers found in nurses regarding communication with terminally ill patients included: children above 12 years of age, lack of knowledge about suitable communication and about the patient, unsolved issues with own mortality, fear and embarrassment of possible mistakes and the patient personality. Nurses use many means of communication. Nurses noticed changes in communication that happened during their carrier; they mentioned more reassurance, more knowledge, better assessment of the children and suitable timing. They also feel better during the time of mourning, understanding the role of the parents; they feel more humble and respectful towards life itself. Nurses evaluate their level of communication with child patients very positively and have a will to educate themselves further. The nurses showed signs of psychological load. It was also revealed that a psychologist is not functional or altogether missing in their place of work. The second phase of the research showed that nurses welcomed and appreciated the educational material created for them, they found it useful in their nursing practice, they evaluated it as useful for beginner nurses. Based on this material a children book was purchased for the ward. The recommendation for practice is the use of the Callista Roy Adaptation model for nursing. I have personally gained both wide theoretical knowledge and experience from the interviewed nurses.

The thesis titled Securing airways in pediatric patients on ARD deals with the specifics of nursing care of airways. Care of airways of children hospitalised at the Anaesthetic Resuscitation Department is an integral part of comprehensive nursing care. Each nurse must have a sufficient theoretical and practical knowledge, as well as experience to independently perform nursing care of airways of pediatric patients. Free and patent airway is a prerequisite for ensuring one of the basic life functions. The aim of the theoretical part of the thesis was to summarise the issue of securing airway in children and to focus on nursing care for airways in pediatric patients. The aim of the research was to determine the specifics of nursing care for children hospitalised at the Anaesthetic Resuscitation Department due to impaired breathing. Based on the aim of the thesis, the author set out four research questions: 1. What nursing activities are performed by nurses when securing an airway in a child? 2. How nurses treat airways of intubated children? 3. What nursing care do nurses provide for children before, during and after extubation? 4. What nursing care do nurses provide for children with a tracheostomy? In the empirical part of the thesis the author employed qualitative research. Data collection was performed by the use of individual interviews with nurses. The survey was conducted at a pediatric ICU and a children's Anaesthetic Resuscitation Department. Based on the research questions and information obtained from literature sources the author drew up the basic points for interviews with nurses. The interviews were supplemented by an observation performed on a children's Anaesthetic Resuscitation Department. Interviews and observation were complemented with two case reports of pediatric patients. The reports were processed in accordance with Henderson's model. The thesis's results show specifics and difficulties of nursing care of pediatric patients hospitalised at an Anaesthetic Resuscitation Department. The thesis maps nursing care for pediatric patients when securing airway, it focuses on intubation, tracheostomy tube, extubation, aspiration, and care for oral and nasal cavities. The objective of the thesis is to show not only the specifics of this kind of nursing care and also to demonstrate the importance of communication and emotional support to pediatric patients before, during, and after the medical intervention. The intensive nursing care is continuously improving thanks to new methods and devices. The results will be provided to the nursing management of the pediatric ICU and the children's Anaesthetic Resuscitation Department. They will also be presented at professional seminars and in professional journals.