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Zelenikova R.,Ustav Osetrovatelstvi a Porodni Asistence | Ziakova K.,Univerzita Komenskeho | Jarosova D.,Ustav Osetrovatelstvi a Porodni Asistence
Bolest | Year: 2010

Delivery of quality nursing care depends on the ability of nurses to diagnose the patients' problems accurately and to set the effective interventions. Acute pain is one of the most frequently identified nursing diagnoses. The aim of the article is to analyse the results of choosen validation studies of nursing diagnosis Acute pain, this means which defining characteristics were identified as major and which as minor by nurses - experts or patients. In order to achieve the set aim the elementary thought processes were selected: analysis and comparison. 4 validation studies were selected based on 2 set criterias: nursing diagnosis Acute pain or Pain was validated in the study and full text article was published with the results of validation and determination which defining characteristics are major and which minor. Validation studies were selected from the first twelve conference proceedings NANDA (North American Nursing Diagnosis Association) International and from the official journal of international organization NANDA International - International Journal of Nursing Terminologies and Classifications in the period 1990-2010. These parametres were investigated in the choosen studies: the year of the study, the methodology, the subjects of evaluation and the defining characteristics. The oldest study in the sample of studies was from 1987, the youngest was from 2000. The following methods of the validation of nursing diagnoses were used in choosen studies: the Fehring's content validity model, the Fehring's differential diagnostic validation model and the clinical validation. The defining characteristics were validated by the nurses in 3 studies, in 1 study defining characteristics were validated by the patients. Only 2 markers were identified as major defining characteristics in all 4 validation studies: "verbal report of pain" and "facial mask of pain". A defining characteristic "protective behaviour" was identified as a major defining characteristic in 3 studies. The pain is always subjective, therefore the statement of the patient regarding the pain is one of the most reliable indicator of pain. The results of 4 choosen validation studies will compare with the results of validation in Slovak and Czech Republic, that will realize in the international project The issue od nursing diagnosis - theoretical background and application in clinical practice APVV SK-CZ-0151-09, MŠMT MEB 0810029.

Aim: The analysis of special nursing care focusing on arterial sheath removal at interventional sites in the Czech Republic. Methods: The empirical data was collected by means of a questionnaire created by us for the purposes of this article. The questionnaire consisted of seven questions (six closed, dichotomous; one open). According to the National Register of Cardiovascular Interventions (NRKI) of the Czech Republic, there are 22 centres performing cardiovascular interventions. All of them were approached with a request to fill in the questionnaire. The questionnaire was distributed through official e-mail addresses. The results for each monitored item were put into a chart showing absolute frequency. Results: The analysis showed that the most common approach in the Czech Republic is via radial artery, in up to 78% of cases. Sheath decannulation from the arterial basin is performed by nurses at 16 centres, 10 of which have implemented the specialised nursing standard. Nurse training for professional performance takes place at four centres only, which is disproportionate to the number of decannulations carried out by nurses. Conclusion: The introduction of the nursing standard for sheath removal is not a condition for a nurse to perform it, despite the fact that it is carried out quite routinely at 16 centres. According to the data obtained, the management of sheath decannulation in the Czech Republic is very disunited.

Valusova D.,Zdravotnicka zachranna sluzba Moravskoslezskeho kraje stanoviste Ostrava | Jarosova D.,Ustav osetrovatelstvi a porodni asistence
Pediatrie pro Praxi | Year: 2013

Aim: The aim of the work was to determine how the quality of nursing care is evaluated by parents of child patients hospitalized in Ostrava hospitals. Methodology: The survey group was comprised of 227 respondents, there of 71 parents from University Hospital Ostrava, 90 from Municipal Hospital Ostrava, 66 respondents were from Vítkovice hospital. The survey was carried out by standardized evaluation tool of Picker's dimensions of quality, modified by for persons accompanying hospitalized child patients. Results: In all studied hospitals assess quality of care parents mostly as good. The problem areas included noisiness at night time, insufficient cleanliness of the rooms, toilets and shower baths. Some parents were also dissatisfied with the quality of food, lacked publication of the menu, perceived the time of putting the child to hospital bed during admission as too long, there was also a problem with availability of services. Conclusion: Parents of hospitalized children are an important part of the treatment regimen of children, so it is important to know their satisfaction with the care provided to respond to the identified shortcomings and, if possible, eliminate them.

Kabarova I.,Ustav Osetrovatelstvi a Porodni Asistence | Buzgova R.,Ustav Osetrovatelstvi a Porodni Asistence
Bolest | Year: 2014

The aim of the research was to determine the quality of life, adaptation to chronic pain and social coping in the elderly with chronic pain. Then, to determine the influence of pain intensity, adaptation and social coping on the quality of life of elderly people. The study group included 186 individuals older than 60 years with chronic pain. The collection 4 assessment tools were used: a/ World Health Organization questionnaire for assessing quality of life WHOQOL-BREF, b/ questionnaire for the evaluation of adaptation on chronic pain ACPQ (Adaptation on Chronic Pain Questionnaire), c/ questionnaire to assess social coping with chronic pain SCCPI (Social Coping with Chronic Pain Inventory), d/ visual analogue scale VAS-I for assessment of pain intensity. Patients with chronic pain were least satisfied with their physical health. They rated all domains of quality of life significantly worse than the general population (p <0.01). When evaluating social coping with chronic pain patients demanded more social support than they perceived they were receiving. When evaluating the adaptation to chronic pain, most patients indicated changes in self-assessment in the context of pain (a self-perception scale) and worse pain experience during stressful situations (a perception tolerance scale). There was no statistically significant difference in the quality of life, social coping and adaptation to chronic pain by sex. However, a correlation between the quality of life in all domains and social coping with chronic pain, adaptation to chronic pain and pain intensity was found (r = 0.2-0.7; p<0,05). The elderly who perceived in the context of chronic pain greater limitations, changes in self-esteem and higher pain intensity assessed their quality of life worse.

Buzgova R.,Ustav Osetrovatelstvi a Porodni Asistence | Stolicka M.,Ustav Osetrovatelstvi a Porodni Asistence
Ceska a Slovenska Neurologie a Neurochirurgie | Year: 2015

Aim: The aim of this study was to examine psychometric properties of the Czech version of the QUALID scale for evaluating the QoL in patients with severe dementia, to assess suitability of its use in the Czech Republic and to establish whether there is a change in the QoL during hospitalization. Sample and methods: The sample consisted of 184 patients with severe dementia who were hospitalized at the University Hospital Ostrava. The QUALID was translated into Czech using standard methodology. To evaluate psychometric properties of the questionnaire, reliability, namely internal consistency (Cronbach's alpha) and inter-rater reliability (Cohen's kappa, ICC), was assessed. Construct validity was verified using the Spearman correlation coefficient for the total QUALID score and its domains and for SM-EOLD items. Results: Good internal consistency of the QUALID (a = 0.820) was proved using Cronbach's alpha. Inter-rater reliability was found to be high (ICC = 0.8317; p < 0.01). Assumed mean dependency between QUALID and SM-EOLD (r > 0.3) was found for the discomfort domain and for the QUALID total score. Multivariate regression analysis found a correlation between lower QoL and pain, skin disorder, anxiety, fear and concern. During hospitalization, QoL was significantly improved in patients with severe dementia (p < 0.01). Conclusions: the Czech version of the QUALID was found to have good reliability as well as satisfactory construct validity. The scale is suitable for the use in the Czech Republic. A correlation was found between burdensome symptoms and lower QoL.

Buzgova R.,Ustav osetrovatelstvi a porodni asistence | Havelkova K.,Hospic sv. Lukase
Casopis Lekaru Ceskych | Year: 2012

Background. The aim of palliative care is the solution of bio-psycho-social and spiritual problems of patients and achievement of the highest possible quality of life. This is related to a need of understanding the patient and his needs. The aim of our research was to determine bio-psychosocial- spiritual needs of patients in hospice care in conjunction with the quality of life and rate of their saturation. Further then to determine, whether the needs vary depending on length of stay in hospice, gender, age and religion. Methods and results, The sample consisted of 36 patients from the hospice of St. Luke in Ostrava. For data collection we used modified questionnaire for the identification of needs PNPC and questionnaire for assessing the quality of life EORTC QOL-C30. As the most important need patients considered the privacy (4,80), the opportunity to make their own decisions (4,77), treatment with respect and dignity (4,75) and pain relieve (4,72). The most frequently reported problem was fatigue, sleep and fear of addiction. Patients have positively rated pain prevention. In repeated measurements were reported significant improvements of assessment of saturation needs in 10 items (p<0.05). The patients evaluated overall quality of life rather positively. A relationship between quality of life and saturation of needs in the area of autonomy and physical needs (p<0.05) was found. Conclusions. During the stay in hospice patients' satisfaction with saturation of some needs and overall assessment of quality of life increased. © Ceská lékarská spolecnost Jana Evangelisty Purkyne, Praha 2012.

Kozakova R.,Ustav Osetrovatelstvi A Porodni Asistence | Skrivankova E.,Ustav Osetrovatelstvi A Porodni Asistence | Jarosova D.,Ustav Osetrovatelstvi A Porodni Asistence
Prakticky Lekar | Year: 2010

Scale for assessment of nutritional status (MNA), Subjective global assessment (SGA) and nutritional risk screening (NRS) are screening and evaluation tools to detect malnutrition and risk of malnutrition. The aim of this study was to determine what is the nutritional status of older people in hospitals. We verified the applicability and sensitivity of these instruments in patients older than 65 years. Testing of measuring instruments, MNA, SGA, and NRS conducted in elderly hospitalized on internal, neurological and surgical inpatient wards of two hospitals in Ostrava. The study included 101 patients (57 women and 44 men, average age 73.2 years). Statistical analysis was performed by SPSS software version 17.0. For testing relationships and dependencies were used the following tests: -ANOVA test, and - Pearson's correlation coefficient. AU tests significantly correlated with body mass index (BMI) of patients. At the same time confirmed a statistically significant relationship between length of stay, and these tests evaluating malnutrition. MNA test revealed several risk patients or patients at risk of malnutrition (70.3%) than test SGA (31.7%) or NRS (38.7%).

Children and adolescents with cognitive disorder are a heterogeneous group of children with different aetiology of disability and also with a higher risk of pain. These children and adolescents are not often able to verbalize the presence of pain nor they are able to score the intensity of pain using the self-assessing scales. Detection of pain in children can be improved by providing methods of pain assessment, which correspond to their development and cognitive abilities, and can assist in the understanding of adults and subsequent care. This paper presents the results of a systematic analysis of literary sources. The aim was to review the reliability of the recommended measurement tools for assessing pain intensity in children with cognitive impairment at the age of 3-19 years, appropriate for the pain assessment by a paediatric nurse. Search selected studies confirming the reliability of measurement instruments have been made by methods practice based on evidence. For searching of valid sources were used licensed professional database and freely accessible databases - Medline, ProQuest, Google, Google Scholar, Web of Science, Springer, Wiley, Science Direct, Cochrane Library. For a systematic analysis the period of 1990-2010 was selected. Criteria for inclusion: included were randomized controlled studies and nonrandomized studies. Only 16 studies have met the selected criteria focus of the study and underwent assessment quality as per adopted methodological filter. None of the studies have demonstrated a level of evidence 1 or 2. Analysis of the results did not demonstrate unambiguously the reliability of a single measurement instrument. Review study, of which the level of quality was defined as level 3 and focused on measuring instruments recommended by the Royal College of Nursing and Royal College of Paediatrics and Child Health to measure pain in children with cognitive disabilities, showed some evidence confirming the reliability of the recommended assessment tools. Selected studies also included the self-assessment of children using a simplified (three-) facial scale. Most of the results coincided with the clinical significance of observational scales measuring pain, using indicators of behavioural and physiological pain. From the analysis of results implies that the best information value of measuring instruments is Face, Legs, Activity, Cry, Consolability Scale (FLACC), the Non-Communicating Children's Pain Checklist-Revised (NCCPC-R), Non-Communicating Children's Pain Checklist-Post-Operative Version (NCCPC-PV). As the results show, the assessment of movement of the limb in the stated methods is the least reliable indicator for pain assessment. Recommended range of tools and measuring instruments of the intensity of pain resulting from the systematic analysis, however, cannot be understood as standard, which provides precise guidance rating of pain intensity in children, because it is not possible to ignore the individuality and uniqueness of each child and situation. Nurses' and paediatric nurses' future efforts should aim to increase professional awareness of pain in children with cognitive disabilities, to establish practice guidelines, and initiate research in this area.

Chroma J.,Ustav Osetrovatelstvi A Porodni Asistence | Sikorova L.,Ustav Osetrovatelstvi A Porodni Asistence
Cesko-Slovenska Pediatrie | Year: 2015

Children with severe multiple disabilities express pain in any other way than the common population of children. Experiencing pain, its symptoms, effects, adaptive behavior, coping and its assessment is different in different stages of childhood, depending on gender, type of pain, and the type or severity of the disability of the individual. These children manifested through pain: motor skills, facial expressions and grimaces, stereotyped movements, voice expressions, changes in appetite or sleep, social behavior, physiological changes, immune, endocrine and humoral functions, which often stems from the socio-communication deficits. As a result of this deficit is then pain assessed by carer/healthcare professionals often ignored or underestimated. In the literature, there are a number of found evidence showing that health professionals have difficulties in non-verbal assessment of pain in these children. Evaluation of these behavioral parameters may contribute to the proper identification and subsequent improvement of pain treatment for children with severe multiple disabilities.

Zelenikova R.,Ustav Osetrovatelstvi a Porodni Asistence | Kozakova R.,Ustav Osetrovatelstvi a Porodni Asistence | Jarosova D.,Ustav Osetrovatelstvi a Porodni Asistence
Prakticky Lekar | Year: 2015

Aim: The aim of the review is to summarize the existing evidence about the form and effectiveness of interventions for preventing falls in the elderly in institutions. Methods: The electronic databases PubMed, Cochrane and Science Direct were searched using the key words fall, accidental fall, prevention, elderly. The search aimed to identify studies of the highest quality (systematic reviews, meta-analyses, randomized controlled trials) published in peer reviewed journals in the period from 2004 to 2013. Results: Twenty five systematic reviews and meta-analyses and twenty four randomized controlled trials met the inclusion criteria. This review includes twenty four randomized controlled trials. Of these, seventeen focused on single interventions and seven focused on multiple interventions. The results of the studies analysed confirmed that single interventions were effective in six studies while multiple interventions were effective in four studies. Conclusion: Evidence to support the effectiveness of interventions for preventing falls in the elderly in hospitals and other long term care facilities is insufficient and inconsistent. Judging from the current results of randomized controlled trials, one of the most effective interventions is a well prepared multidisciplinary programme for preventing falls in the elderly.

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