Thèse d'exercice : Pharmacie : Nantes : 2007. / Bibliogr.

Ceci est une étude de cohorte rétrospective, monocentrique, évaluant la sécurité de la mise en place d'une prothèse parastomale prophylactique (PPP) et son efficacité pour prévenir la survenue d'une hernie parastomale (HPS) lors de la création d'une stomie permanente. Pour étudier cette question, 185 patients ayant eu une stomie permanente créée entre 2015 et 2018 ont été divisés en deux groupes selon l'utilisation ou non d'une PPP. Au cours de la période de l'étude, 144 colostomies et 41 iléostomies ont ainsi été créées. Une PPP a été mise en place chez 79 patients. Aucune différence n'a été observée entre les deux groupes en ce qui a trait au temps opératoire, à la durée d'hospitalisation, à la réintervention chirurgicale précoce ou à la réhospitalisation pour une complication liée à la stomie. Aucun patient n'a présenté d'infection de prothèse ou n'a nécessité un retrait de celle-ci. Un taux d'incidence plus faible de HPS a été observé chez les patients ayant une colostomie permanente suivant la mise en place d'une PPP. En revanche, un taux d'incidence plus élevé de HPS a été constaté chez les patients porteurs d'une iléostomie permanente avec une PPP. La mise en place d'une PPP nous apparait donc être une approche sécuritaire et efficace pour réduire l'incidence de HPS chez les patients porteurs d'une colostomie permanente. / This is a retrospective, single-center, cohort study evaluating the safety and efficiency of prophylactically placing mesh to prevent parastomal hernia (PSH) during the creation of a permanent stoma. To address this question, 185 patients who had a permanent stoma created between 2015 and 2018 were divided into two groups according to the use of prophylactic parastomal mesh (PPM) or not. During the study period, 144 colostomies and 41 ileostomies were therefore created, including 79 PPM placed. There was no difference between groups in terms of operative time, length of hospital stay, need for early surgical reintervention or rehospitalization for stoma-related complications. No patients experienced infection of the mesh or required prosthesis removal. A lower incidence rate of PSH was observed in patients with permanent colostomy with PPM placement. In contrast, a higher incidence rate of PSH was observed in patients with ileostomy and PPM. Parastomal prophylactic mesh placement to prevent PSH is a safe and efficient approach to reduce the incidence of PSH in patients requiring a permanent colostomy.

No description available.

Thèse d'exercice : Médecine : Nancy 1 : 2009. / Titre provenant de l'écran-titre.

No description available.

Basic theoretical background: Stoma as a part of the surgical treatment of digestive tract diseases usually radically affects the life of the patient and his relatives. The patient has to face not only the severe diagnosis but also the result of the surgery concerning one of the most intimate human spheres. A significant part in the return to a full life is the acceptance of the stoma by the patient and his ability of being active when taking care of stoma. The theoretical part in the introduction describes the Theory of self-care deficit. The second part of the theoretical work summarizes basic information regarding the issue of derivation of intestinal stoma and the issue of acceptance of the changed body image and self-care. Objectives and hypotheses: The aim of this work is to find out differences in the acceptance of stoma and care for stoma among patients after intestinal surgery. To achieve the objective of the work, there were set three hypothesis. H1: Patients with a permanent stoma experience major changes in the psychosocial area than patients with temporary stoma. H2: In the postoperative period, women approach practising the stoma care differently than men. H3: Patients under 55 have more information about living with stoma than older patients. Methodology: The research part of the work has been carried out through quantitative research. The form of data gathering was an anonymous questionnaire. The only criterion of the selection of the respondents was the state of health after the intestinal surgery with the subsequent stoma. During the search of the respondents were addressed organizations joining the patients with stoma, stoma and proctologic ambulances of selected hospitals, hospices and homes for elderly people. The obtained data were processed by descriptive statistics in graphs by the help of Microsoft Office Excel 2010. Further on, the statistical evaluation of hypotheses was carried out. Hypotheses were tested by chi-square test in a PivotTable, the average values were compared by T-test. The chosen significance level was 5 %. Conclusion: The work provides a comprehensive look at the issue of acceptance of stoma self-care after intestinal surgery. Creating of stoma, regardless of age or sex of the patient and also regardless of its eventual duration radically influences the patient's life. This is necessary to remember all the time from the long lasting preoperative preparation to aftercare when the stoma patient should be provided by comprehensive care by nurses. The nurse should also help the patient to return to a normal life.

Abstract Reality of cooperation of a stoma nurse with shift nurses Pernicious diseases of intestines and rectum often lead to creation of a temporary or permanent intestinal outlet alias stoma. Having been diagnosed, the patient is confided to the care of healthcare workers, in particular nurses, who endeavour to provide the patient with the highest possible quality care in the most intensive manner. At present, almost every hospital has a specially trained stoma nurse who should play the role of an advisor or coordinator in the nursing team. Regrettably, non-cooperation between shift nurses and the stoma nurse harm in particular the patient. Five hypotheses were raised. The first hypothesis was to confirm whether the shift nurses on surgical wards cooperate with the stoma nurse more efficiently than the shift nurses in other than surgical wards. This hypothesis was confirmed. The second hypothesis was to confirm whether the stoma nurse provides the shift nurses with regular information on developments in the concerned area. This hypothesis was not confirmed. The third hypothesis was to confirm whether the shift nurses cooperate with the stoma nurse as early as in the period before the operation; this hypothesis was aimed at surgical nurses and was not confirmed. The fourth hypothesis was to verify whether the shift nurses have sufficient information from the stoma nurse so that they could substitute her adequately when she is absent. This hypothesis was not confirmed. The fifth hypothesis verified whether the shift nurses ask the stoma nurse to provide them with information concerning correct handling of the stomal equipment. This hypothesis was not confirmed. The data were collected in the quantitative research supplemented with an interview with the stoma nurse. The shift nurses in surgical and non-operational wards obtained anonymous questionnaires. The research was conducted in seven hospitals in the Region of South Bohemia. The objectives were fulfilled. The information will be provided to deputy managers for the nursing care and stoma nurses. We believe that our results may contribute to higher efficiency of the cooperation between nurses, which will have a positive impact on provision of comprehensive care of patients with a stoma.

Stoma nurses and their contribution to work with self-help groups of patients. The diploma thesis dealt with the cooperation of stoma nurses with self-help groups of stoma patients in ten regions of the Czech Republic. The aim was to find out if stoma nurses recognize the importance of self-help groups for stoma patients, how their work contributes to self-help groups, if stoma nurses cooperate with self-help groups and if they inform stoma patients about the existence of self-help groups. Another objective was to determine the level of significance stoma patients give to self-help groups. The goals of the work were met. The theoretical section addresses the issues of self-help groups, the history, benefits, risks, stoma nurses and their education. Cooperation between doctors, stoma nurses and the club of patients is also mentioned. The contexts of a stoma - preoperative and postoperative care, nursing care complications, the stoma aids - are involved in the conclusion of the thesis. In the practical section an investigation through qualitative in-depth interviews with stoma nurses on the base of five research questions was carried out. Do stoma nurses consider self-help groups important in the life of a stoma patient? What information do stoma patients ask for when stoma nurses participate in self help groups? What is the cooperation of stoma nurses with self-help groups in individual regions? Do stoma patients take part in activities within self-help groups? Which age groups of patients, according to stoma nurses´ opinion, prefer to work in self-help groups? On the basis of a qualitative research hypotheses were established for a quantitative investigation. This quantitative research survey through questionnaires was conducted in patients with a stoma, also in ten regions. H1: Stoma nurses recognize the importance of self-help groups for patients with a stoma. H2: Stoma nurses cooperate with self-help groups of stoma patients. H3: Stoma nurses inform stoma patients about self-help groups. H4: The biggest benefit of stoma nurses for stoma patients in self-help groups is giving information about the use of aids. H5: Stoma patients consider self-help groups very important. All hypotheses were confirmed. Stoma nurses as well as stoma patients consider self-help groups very important in their lives. Currently stoma nurses cooperate with self-help groups in all regions, they inform new stoma patients about opportunities to take part in self-help groups and do not forget to give advice about aids and stoma nursing, which is the most valuable information for the stoma patient especially at the beginning of treatment. The results were consistent in both investigations and will be offered to individual stoma nurses for improvement of mutual cooperation. And in the regions where self-help groups do not exist yet or are being established, I firmly believe that the results of this thesis will help in self-help groups activities. The research survey has proved that the stoma nurses´ work is meaningful owing to its results and goals. Stoma nurses have a large share of the self-help groups work.

Person with stoma is any handicapped human with temporarily or permanently drawn hollow organ out onto body surface. The most common it concerns colon, small intestine or urinal system. Uncontrollable emptying of faecal matter or urine happens by innatural way with necessary use of stoma appliances. In stomas sphere the most important factor is informedness not only of the patient himself but of nurses as well. Sufficient education of a patient and ability of a nurse to treat stoma is the base of good nursing care. The aim of the thesis was to find out to what degree the stoma patients are informed on ways of stoma treatment and how they are satisfied with the quality of given nursing care. The work is divided on contemporary state and methodological procedures. Contemporary state includes especially pre-operation, post-operation, home and out-patient care, clients´ education, importance of stoma nurse and association of stoma patients, kinds of stoma appliances, specifics of stoma patients´ nutrition, social problems of stomas etc. For the research part six hypotheses were established. They concerned the quality of nursing care, problems of stomas treating, cooperation with nurse and club of stoma patients. It was found out that 81% addressed people are satisfied with the quality of given nursing care, 98% are familiar with problems of stomas treating, 99% were able after six months after setting of stoma to take care of stoma themselves,72% are members of the club and 90% cooperate with a stoma nurse. On the base of the research all hypotheses were confirmed and the aim of the thesis was fulfilled.In the thesis a method of quantitative research was chosen. The research proceeded in Hospital České Budějovice, Inc. in clubs of stoma patients in Tábor and Příbram. The technique of data collecting was anonymous questionnaire established for clients with a stoma. 100 respondents were addressed. The research proceeded on the base of personal contact and cooperation with stoma patients, therefore the return of questionnaires was 100%. Two questionnaires were from the reason of incompleteness taken out. The results are given in percentages and diagrammatized.

I this thesis anatomical, physiological and functional information of certain parts of the human body organ systems after the damage of which a stoma must be performed is given. A stoma is indicated either after an injury, an illness or a loss of functionality and patency, It constitutes management of a life threatening situation and facilitates life restoration. Basic types of stoma are described, and since the most common type are colostomy and ileostomy, a greater attention is given to the disease and its treatment in the small and large intestine at the ends of which the stoma is created. The thesis also deals with the stoma aids, leisure time activities, psychological aspects of the disease, social problems and awareness of patients with a stoma. One of the objectives was to find out how patients with a stoma spend their leisure time and if they tend to isolate themselves from society because of their handicap. Another objective was to determine if persons with a stoma are sufficiently informed about leisure time activities they could pursue and where to get the information. The data needed to carry out this survey were obtained through studying professional materials available. The quantitative research method of interviewing was chosen, the data collection technique was an anonymous questionnaire aimed at a certain set of respondents as well as semi-standardized interviews with professionals who were given questionnaires for the respondents. The research set was formed by respondents with a type of a stoma mentioned in the questionnaire. It has been found out that the most common type of a stoma is ileostomy, predominantly in men. The research has shown that persons with a stoma isolate themselves from society and are not sufficiently informed about leisure time activities they could pursue. The research results should bring a better cooperation among professionals and thus enhance awareness and improve care not only for persons with a stoma. The outcomes of the thesis could make professionals produce literature concerning the life of persons with a stoma and update the existing information with new experience, advice and recommendations.