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The transplantation of hemopoietic cells is a modern treatment modality in the biomodulating anti-cancer treatment of hematological malignities and solid tumors. It is also employed in the treatment of non-cancer and hereditary diseases. Similarly as other treatment methods, the transplantation of hemopoietic cells also affects a further course of the disease and thus also the quality of life. The author describes possibilities of estimating the quality of the life of patients after the transplantation of hemopoietic cells.

In developed countries including the Czech Republic, tumours are the second most frequent cause of death in children. Advances achieved in the treatment of tumour diseases in children are very dramatic and belong to the greatest achievements of medicine. The bone marrow transplantation belongs to the most modern treatment methods and is employed not only in the treatment of haematological malignant conditions but also in the treatment of solid tumours. The first target of our contribution is a brief specification of the problems of the quality of life. We offer different definitions of the quality of life by different authors and point out that this phenomenon concerns a number of scientific disciplines and thus, its delimitation by a definition is very difficult. The second target was to acquaint the expert public with the transplantation of haemopoietic cells and to offer an outline of particular types of transplantations and stages of the transplantation therapy. The third target, which is not of inferior importance, is to show a re-socialization programme for children and their families within the South-Moravian Region who experienced the oncologic therapy. The Endowment Fund of Paediatric Oncology Krtek attempts to provide this help. The activity of the fund Krtek is focused on supporting complex care for oncologic paediatric patients, who experienced the oncologic treatment at the Department of Paediatric Oncology, Faculty Hospital in Brno. Establishing of the community of oncologic patients and subsequent opening of this collective to external contacts provides the children with a possibility of a stepwise return to their original environment. Domestic as well as foreign camps, relaxation programmes and weekend actions implemented by the endowment fund Krtek are immediately associated with following and measuring the quality of life and taking advantage of free time. The possibility of shared experiences, joy and sorrow associated with the oncologic diagnosis is inestimable and offers the parents with opportunity for the mutual support and establishment of closer relationships. We also choose this theme to point out the fact that the malignant disease enormously hits the life of the whole family and child surroundings and means a definite change in the still existing scale of values. The whole contribution conclusively shows that the task of healthcare professionals is to provide the necessary education and to be able to grant the children and their parents necessary advice and help and answer their questions.

Aim: The aim of the research was to demonstrate the effect of genetic counseling on depression, anxiety and knowledge level among diabetes mellitus patients. Design: Quasi-experimental study. Methods: A quantitative study that used a questionnaire instrument to assess participants' levels of depression, anxiety, and knowledge. A total of 38 diabetes mellitus patients who met the inclusion criteria were studied for two months at the Lakbok Public Health Center with genetic counseling. Outcomes were measured before and after the counseling intervention provided. The statistical analysis was performed using the IBM SPSS version 25.0 software. Results: The results showed that the majority of participants (76.3%) had moderate depression prior to the genetic counseling intervention. However, after the intervention, most of the participants (73.7%) experienced mild depression, with a change in mean ± standard deviation (SD) pre-post 26.3 ± 3.1 to 17.6 ± 2.6. The anxiety level of most participants was moderate (73.7%). After the intervention, most participants experienced mild anxiety (86.8%) with a change in mean ± SD 16.7 ± 3.3 to 11.3 ± 2.3. In addition, before the intervention the knowledge level of the majority of the participants was satisfactory (86.8%). After the intervention, the knowledge level of the majority of the participants became good (52.6%) with a change in the mean ± SD of 12.8 ± 1.4 to 16.1 ± 2.3. Conclusions: Changes in the level of depression, anxiety and knowledge in different categories are real evidence of the consistency of the intervention's effect on these very significant factors that have implications for health services in various health facilities such as hospitals and public health centers. Therefore, serious efforts are needed so that health policies encourage the presence of genetic counseling services for DM patients and patients of other genetic diseases.

Objective: Determine the results for inter-rater reliability for items in two delirium screening measuring instruments (Delirium Observation Scale, Nursing Delirium Screening Scale). Design: Prospective comparative study of measuring instruments. Methods: Data were collected between August 2018 and August 2019 at the Trauma Clinic, Teaching Hospital, Olomouc, Czech Republic. Study sample included 50 patients with locomotive apparatus trauma, assessed by two raters - general nurses. To assess the inter-rater reliability the study used Cohen's kappa (κ) method. Results: For the Delirium Observation Scale, the agreement between the two raters for two of the items was 98% (κ = 0.790); for all other items the agreement was 100% (κ = 1.0). The percentage rate of agreement between both raters using the Nursing Delirium Screening Scale was 100% (κ = 1.0) for all five items. Conclusions: For both screening measuring instruments a high level of reliability has been established. Nevertheless, the highest agreement between the raters has been achieved for the Nursing Delirium Screening Scale. The recommendation is to further test the screening delirium measuring instruments in a Czech clinical setting.

Introduction: In the 21st century, the number of chronic diseases has increased significantly. Doctor Wagner and his team presented the most influential theoretical model of care for the chronically ill - the Chronic Care Model - CCM. Design: The presented paper analyses the results obtained by quantitative research. Objective: The objective of this quantitative research was to find out the effectiveness of individual elements of Wagner's model (CCM) in the care of patients with diabetes mellitus, depending on the type of treatment. Methods: The total sample consisted of 1,511 respondents. The selection of respondents was based on stratified selection. The data collection tool used was the standardized PACIC+ questionnaire. Results: By examining the effectiveness of evaluation of care for DM patients (depending on the type of treatment) we found that there is a significant relationship among variables. Patients, who use an insulin pump, positively evaluate most of the elements of CCM. On the contrary, patients treated with anti-diabetics report the worst rating. The greatest differences were found in patients' satisfaction with the overall organization of care. Patients with an insulin pump were most satisfied (mean 3.60), patients on insulin pens were less satisfied (mean 3.33), and the least satisfied were patients treated with PAD (peroral anti-diabetics) (mean 3.17). Conclusion: Wagner's model has the potential to improve the efficiency of care for patients with diabetes mellitus without an adverse effect on patient outcomes.

Objective: Out-of-pocket payments for medications take a substantial part of Czech households' expenditure for health, which could have a negative impact on medication adherence. Therefore, the objective of this study is to explore the impact of prescription medications related to specific health conditions on patients' out-of-pocket payments and cost-related medication non-adherence. Methods: We used the data from the second wave of the European Health Interview Survey. Running the analyses in hierarchical stages, our main interest was the influence of medications related to 21 health conditions. A conventional regression method with robust standard errors was used for the investigation of out-of-pocket payments for prescription medication. Predictors of cost-related medication non-adherence were identified using a logistic regression model. Results: We found that medications for stroke, asthma, myocardial infarction, chronic lung disease, chronic kidney disease, and diabetes contribute to high co-payments. Moreover, cost sharing for stroke, asthma and myocardial infarction medications might have serious implications for desirable consumption as they are associated with medication non-adherence. Conclusions: We conclude that prescription practices and reimbursement policies in relation to medications for stroke, asthma and myocardial infarction should be carefully explored and physicians should be motivated to prescribe medications covered fully or with low co-payments.

Aim: This article analyzes the tendency of reported dorsopathies (dorsalgias and intervertebral discs) of the lumbar region in the general population of the Czech Republic. Methods: Retrospective analysis of data from health registries of the Czech Republic. The participants in the research were individuals who were diagnosed with dorsalgias (MKN codes M54.1, M54.4, M54.5) or with intervertebral disc diseases (ICD codes M51.0, M51.1) in the period from 2010 to 2018. We studied the total number of cases, and the number of hospital admissions and outpatient treatments. The numbers of patients were divided according to sex, age categories and the regions of the patients' place of residence, adjusted per 100,000 citizens of the respective age group or region. Results: The total number of patients with dorsalgia and intervertebral disc disease showed a growing tendency. The increase in the number of patients with back problems did not manifest itself in the number of hospitalizations. The treatment is transferred to the outpatient sector, and the number of outpatient contacts in patients suffering from backache has been growing over the last eight years. Conclusions: During the analysis we found out that the number of persons suffering from lower back pain in the general population in the Czech Republic was increasing; the care for persons with proved diagnoses of dorsalgia and intervertebral discs diseases is transferring from hospital treatment to outpatient care; and the relations between the occurrence of back pain and a specific profession may not be found in the national health registries.

Introduction: Long-term stress is generally considered to be one of the psycho-social factors that negatively affect the academic performance of nursing students. Objectives: To discover the sources of stress, degree of stress, and coping strategies used as a reaction to stress in nursing students of the bachelor program. Methods: Over the course of three academic years, students in each year of the bachelor in nursing program were monitored after completing the clinical practice for the given academic year. Questionnaires regarding the Perceived Stress Scale; Physio-Psycho-Social Response Scale, and Coping Behaviour Inventory were used to gather data. In the first year, 44 students were included, in the second year there were 39 students, and in the final year 40 students took part in the research. Results: The most significant source of stress appears to be a lack of knowledge and relevant skills. The highest degree of stress was recorded at the beginning of a student's studies, after which it decreased. In the third year, when students were required to work due to the covid pandemic, the stress again reached the levels of the first year. The stress manifested mainly in emotions and problem solving was the most frequently used coping strategy. Conclusions: The results of the longitudinal study confirmed how the COVID-19 pandemic affected the perception and manifestation of stress in students during their studies. The perception of the degree of clinical and academic stressors showed that no clear descending tendency was identified. The use of coping strategies was stable, with no significant differences throughout the study.

Falls in the elderly result in injuries of various levels of severity. At present, more attention is devoted to the psychological consequences of the fall, which lead to a reduction in activity and social participation, a reduction in the independence and quality of life, and are collectively referred to as fall-related concerns (FRC). The aim of this study was twofold. First, to study the prevalence of fall-related concern among community dwelling older Czech adults. Second, to describe the impact of fall-related concerns on activities of daily living. The study was designed as a cross-sectional quantitative study that uses the Czech version of the standardized Fall Efficacy Scale-International. The research showed that fall-related concerns are a major health problem among the elderly who live in communities. These concerns are present in the elderly who fell, but also in older women who have not fallen in the last year. The elderly who repeatedly fell in the last year showed a statistically more significant level of concerns associated with the falls in individual activities of daily living, as well as a higher overall score related to falls. A fall is a significant, but at the same time preventable, risk factor for fall-related concerns.

One of the basal aspects determining the health of the individual is the behavioural and axiological attitude towards one's own health. The quality of life comprises not only the problem of health, but also the phenomenon of existentional meaningfullness.
The meaning of life in its contents comprises a set of aims, values and beliefs, that give man a sense of value and purposefulness of his life. It is possible to allocate to the determinants that regulate the quality of life, satisfaction with one's life, sense of well being, also concepts such as: the meaning of life, hapiness, comfort, sense for integrity, democracy, justice, healthy life style, positive experiences, life philosophy, attitudes and expectations, aspirations, hope, etc.
Besides the theoretic interpretation the submitted work also includes an analysis of the mentioned phenomenon from the perspective of college students, on the basis of empirical findings conducted using Snyder's Hope scale. People with a high level of hope have more goals, are more successful, are subjectively happier, have a greater sense of existential meaningfulness and a greater satisfaction with life (Snyder, 1995).
Noted results are the first data analysed by the research.
The results predict, that the health state of our youth is not as "good" as initially assumed, or as it is being alleged within society in general.

The article deals with the question of relationship between traditions and chosen aspects of everyday life and socio-demographic characteristics of Romani communities in the Czech Republic and the Slovak Republic. The article presents partial results of field research GAČR No 403/07/0336 called "The quality of life, mean life expectancy from aspect of health determinants in Romani population in the Czech Republic and the Slovak Republic", where 313 respondents, ethnic Romani people from the Czech Republic and the Slovak Republic were asked.
The aim of this article is to point out to links between keeping traditions at present and past and everyday life of Romani people.
The results point out that Romani customs are still held by lower socially stratificated families, with low education, living mostly in Romani villages in Slovakia compared to higher stratificated families from urban environment and from the Czech Republic. This group heads towards keeping Czech traditions, but at the same they do not speak Romani language. This group defines itself against some Romani groups more strongly compared to other respondents. So we can say that customs in this sense of the word represent variable of assimilation tendencies.

Chronic obstructive pulmonary disease is one of the most common chronic lung diseases today and is a serious health, economic and social problem. It is characterized by a progressively worsening airway obstruction leading to respiratory insufficiency, even to death. Co-morbid mental disorders such as depression and anxiety are very common in patients with this condition and are associated with increased morbidity. Although they generally impair quality of life, they are rarely examined in the context of the clinical treatment of such patients. Studies indicate that the prevalence of clinically significant depressive symptoms and anxiety is around 50%. This study deals with the prevalence of depression in patients with chronic obstructive pulmonary disease, and gives an overview of the instruments used for assessing the extent of such depression.

Background: Sleep disorders are very frequent among all intensive care unit patients, and disturbed sleep quality has clear and straightforward negative consequences for patients' recovery and level of distress. To promote sleep, nurses must have instruments for observing and evaluating patients' sleep. Objective: The objective of the research was to determine the internal consistency of the Richards-Campbell Sleep Questionnaire (RCSQ) and to compare the selected relationships between the variables (gender, age, type of admission) in the Czech clinical environment of the intensive care unit. Design: Cross-sectional study. Methods: The RCSQ has been translated according to the translation and cultural adaptation manual. The quality of sleep was assessed using the Czech version of the RCSQ. The sample consisted of 105 patients hospitalised in an interdisciplinary intensive care unit. The quality of sleep was measured using a visual analogue scale (0-100). Results: The internal consistency (Cronbach's α) of the Czech version of the RCSQ is 0.89. The average RCSQ score in the sample was 53.2 (SD 20.1). Return to sleep was the lowest rated item at 51 (SD 24.2), while sleep quality was the highest rated item at 55.6 (SD 26.4). There was no statistically significant relationship (p < 0.05) between sleep quality and selected variables: age (F = 0.1; p = 0.736), gender (F = 0; p = 0.929), type of admission (F = 1.8; p = 0.183). Conclusions: The study demonstrates that the Czech version of the RCSQ is rated as a reliable tool and can be used to subjectively assess sleep quality in critically ill patients. The association between sleep quality and selected variables has not been statistically proven and its perception is very individual.

Objective: The case study aims at answering the following question: "What are the effects of a psychotherapeutic programme on its participants?" The psychotherapeutic programme under examination is intended for people with severe mental illness (SMI) experience and falls under community psychiatric care. The psychotherapeutic programme subject to this research can be an alternative to, or directly follow after, psychiatric hospitalisation, or can also be preventive. Methods: Both quantitative and qualitative methods and techniques were used; the participants were monitored over a period of one year. More specifically, data were obtained through participant observation, field notes, by analysing documents and using the SIS (Social Integration Survey) questionnaire, which was translated from the English original in co-operation with Dr. Jane Scott-Lennox, head of the team of authors at the Piedmont Research Institute. Results: The programme has a positive effect on improving communication, activation and increasing awareness in the sense of understanding the illness, treatment, self-discovery and insight, while respecting the participants' individual potential. In terms of recovery, it gives hope, contributes to developing and maintaining competences and skills, and promotes empowerment and restoration of social roles. Conclusions: The data obtained have confirmed that participation in a psychotherapeutic programme contributes to the participants' social integration.

Introduction: Mental health is an important component of overall health. Adolescence is one of the critical life periods for the development of mental illness. Quality of life among patients with mental health problems is significantly affected by stigmatization. This study aims to explore the perception and attitudes toward mental health disorders among adolescents in Slovakia. Methods: The Mental Illness Stigma Scale was used for assessing the attitudes related to mental illness. The questionnaire was administered to 550 students at six high schools in Slovakia. The average age of respondents was 17.45 ± 0.95 (60.18% females). ANOVA, Student's t-test, and correlational analysis were used for statistical analysis. Results: In particular, higher levels of stigmatizing attitudes towards mental illness were found in the areas of Professional efficacy, Treatability and Recovery, as well as Poor Hygiene. There were no significant socio-demographic differences in the stigmatization attitudes, with the exception of the Poor Hygiene subscale, with male respondents scoring higher (t = -3.71, p ≤ 0.001). Conclusion: Our results indicate a relatively high prevalence of negative attitudes toward professional efficacy of mental health professionals and toward possibilities of effective treatment of mental health disorders among high school students. An educational intervention or campaign to reduce stigma toward mental illnesses and improve knowledge targeted at this specific age group would be beneficial.

Introduction: When children are undergoing hospital care, psychological support is important. This includes providing a child-friendly environment and care, information and preparation for the examinations appropriate to the child's age, stress reducing methods applied according to the child's intellectual level, and the presence of parents. Objectives: In the course of the study, we examined the psychological preparation and support provided during hospital care in Hungary on the basis of parental opinions. Our goal was to get to know the activities of children's nurses in connection with the psychological preparation and support of children. In light of the results, another goal of the research was to prove the need to adapt a support system, already widespread internationally and with proven positive effects, in Hungary. Methods: A descriptive and multivariate analysis of the results of the online, quantitative questionnaires filled in by the parents of children between the ages of 0 to 14 who spent at least three days in hospital. Results: Based on the opinions of the 566 parents who filled in the questionnaires, the psychological preparation of children was carried out in a minimal number of cases in Hungarian hospital care. During the hospital treatment, parents evaluated their own anxiety level as higher than that of their children and stated that they would have liked psychological support themselves. Conclusions: In Hungarian paediatric care, psychological support given to children and parents is inadequate. The work of Child Life Specialists is essential within the childcare system, and it is essential to work out how to introduce and involve such specialists in caring for children

Objective: The purpose of the research was to explore nurses' professional well-being at work and its differentiating factors. Methods: The tool of the cross-sectional, quantitative, descriptive research was a questionnaire, which included questions referring to sociodemographic characteristics, along with validated questionnaires widely used in the international research literature (Maslach Burnout Inventory (hereafter MBI), Beck Depression, Diener Quality of Life) and questions focusing on the exploration of the workplace climate. Following a simple, non-random sampling procedure, the responses of 581 professionals working in nursing job positions were included in the analysis. Results: Examining burnout, it has been found that the nurses involved in the survey show a more unfavourable picture in the dimensions of depersonalization and emotional exhaustion, compared to MBI normal values. On the other hand, the average value of personal accomplishment proved to be higher among them, which means that the respondents feel their efforts to be more successful and more positive at work. The organizational characteristics of the workplace (F = 2.875; p = 0.009), along with the social appreciation of the job position (F = 4.275; p < 0.001) significantly influence overall satisfaction with life. Conclusions: The promotion of well-being at work is of utmost importance among health professionals (who are increasingly exposed to stress and burnout), especially among nurses directly participating in inpatient care.

Introduction: Self-awareness deficit is a complex cognitive-behavioural disorder that is typical of patients after acquired brain injury. Deficiency of self-awareness in these patients causes reduced motivation for rehabilitation or unrealistic expectations. It leads to poorer results in therapy and problems in engaging in activities in the wider community and in employment. Aim: The aim of this review study is to describe the definitions and theoretical models of self-awareness and to summarize the conclusions of research on how to assess self-awareness in adult patients after acquired brain injury in the last 15 years. Methods: Review with elements of systematization using PRISMA methodology. The search was performed in bibliographic and multidisciplinary electronic databases (Web of Science, CINAHL, MEDLINE, EBSCO, ScienceDirect, Scopus). The work includes studies published from 2005 to 2020 inclusive. Results: A total of 544 sources were found. The final research included 14 studies that fall into one of three categories: definition of self-awareness, self-awareness models, and self-awareness assessment. Conclusions: The research shows that self-awareness is a complex concept that is part of metacognition. Its definition is inconsistent. Most often, self-awareness is conceptualized as the ability to objectively perceive and assess one's own situation while maintaining a certain subjectivity in understanding its importance to a person. Only two of the sought-after objective self-awareness assessments assess all its levels.

Background: Enabling people to return to independent living following Acquired Brain Injury (ABI) is a challenge for rehabilitation. In co-operation with the Department of Rehabilitation Medicine, Prague, Czech Republic, the non-governmental organization Rehalb holds week-long rehabilitation camps (RC). These deliberately take people from the hospital setting to a more demanding environment in order to encourage attendees to become more independent. Aim: This study aimed to uncover and describe the personal experiences of rehabilitation camp participants. Methods: A phenomenological approach was used. Data were gathered from 6 in-depth interviews. Results: The RCs seem to provoke enhanced opportunities within the participants' changed capacities. The camp's activities provided opportunities for easier re-integration into society; significant progress was being observed in related aspects. Six themes, which incorporated several categories, were identified: "Doing more"; "Escaping stereotypes"; "Discovering hidden potential"; "Finding independence"; "Transferring to normal life" and "Building relationships". Conclusions: The natural and constantly stimulating rehabilitation environment of the camps can be considered a very appropriate setting for interdisciplinary stimulation of independence skills of the ABI clients. In that matter, the RCs could be considered an important component of the rehabilitation process for people with the ABI diagnosis.

After the age of 60 many elderly people experience increasing health problems and have an increased need for social and health care services. Slovakia will experience an aging population and the aim of this study was to assess their future needs and analyze access to social and health care services in Slovakia. Qualitative and quantitative data was obtained by a survey based on closed and open questions and interviewing two focus groups. Data was gained from 59 mayors of the South Gemer Region (Slovakia). The qualitative data was analyzed by phenomenological analysis and the quantitative data by descriptive statistical analysis. Our data showed a severe capacity challenge at various public retirement homes; additionally, the national and municipal services are not fully integrated. Furthermore, we detected that the needs of elderly people are often fulfilled by next of kin. We conclude that in the years to come there will be insufficient social and health care services in Slovakia. We recommend that the coordination of social and health care services for the elderly takes place at a national and regional level.

The periods of pregnancy, childbirth and becoming a mother are some of the most important moments in a woman's life - and they are usually experienced within a healthcare institution. However, contact with the healthcare system during these periods can bring a number of difficulties and barriers for women with other nationality than Czech and affect interactions between them and healthcare professionals. The aim of this text is to explain how the category "foreigner" is established, and what "strangeness" means for healthcare professionals in relation to women within the context of perinatal care. The qualitative research was focused on healthcare professionals' experiences with women of different nationality. During the research, several in-depth interviews, non-participant observations and informal interviews were conducted. Healthcare professionals distinguish two categories of women who were not born in the Czech Republic - "our foreigners" and "migrants" - with regard to geographical and cultural proximity within their everyday practice. Foreign-born women are perceived by healthcare professionals as "obedient" patients who don't disrupt the routine of everyday medical practice. However, "strangeness" is not interpreted by healthcare professionals on the basis of a different nationality, but mainly due to problematic communication, non-cooperation, mistrust, and challenging women.

Introduction: The chronic, degenerative and progressive character of Parkinson's disease (PD) is reflected in the living experience of patients - and it also has an impact on their dignity. Aim: The aim of the study was to increase the understanding of the lived experience of outpatients with PD and its impact on their dignity. Methods: The study design is explorative using interpretative phenomenological analysis (IPA). Semi-structured interviews were held with 11 participants with PD between February-May 2018. Interviews were conducted as individual face-to-face interviews, in privacy with no involvement of family members according to the interview protocol. Data analysis was performed according to IPA process using the ATLAS.ti 8.0 program. Results: Our study identified five themes that reflect the lived experience of outpatients with PD: Me and my Parkinson's: losses, acceptance and coping; The Need to Remain Self-sufficient versus the Fear of Dependence; How Do Others See Me: Scorn versus Acceptance; Lack of Information versus the Need to Be Informed; Lack of Respect versus the Accommodating Approach of Healthcare Professionals. We discovered their impact on dignity, especially in the areas concerning autonomy, self-esteem, self-worth, identity, respect, and other people's appreciation. Conclusions: Patients with PD are confronted with many serious changes on a daily basis, which significantly influence their dignity. This fact must be known and respected by health care professionals when providing patient-oriented care.