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Why the analysis of selected determinants in persons of pre-retirement age? The age is a reflection of the whole life, but the period 50 plus is of importance. By prolonging the time for retirement, the average age will be shifted to older age groups (60 plus). By the retirement, the whole still existing way of life, stereotypes, is changed. The way of life in pre-senior age considerably affects the life after retirement and consumption of health care. In accordance with demographic prognoses, in average, women and men will live after their retirement for 20 years and about 17 years, respectively.
How to enjoy this time in a quality manner? Taking rest or activity - different opinions, certainly in accordance with demands of the senior, will offer a spectrum of possibilities with emphasize on NO FORCING in the case of the absence of interest.

The profession of midwives is as old as the human being history. As soon as in the Old Testament, we can meet a description of practice of Egyptian women and Jewish women, who assisted the women in labour.
The training and education of women being prepared for the profession of midwife was affected and is being affected by many social effects (as e. g. religion, culture, politics, economic effects, development of medicine, knowledge in the field of pedagogy and many others.
The moment of the birth is undoubtedly the most important event in the human life, and it is an experience of big happiness for the whole time of the human being existence, but on the other hand, it is also a danger of death for the mother as well as for her child delivered.
The name of the occupation of women helping in the delivery describes a practice or personality in certain nations. For example the English name "midwife", which comes from Anglo-Saxon words "mid wives", expresses their assistance in the course of the labour. The Danish name "Jordmor", translated as "mother - earth", emphasizes the requirement occurring in many cultures that the midwives themselves should be mothers. The French word "Sage-femme", i.e. "clever woman", puts the role of the assistant in the delivery into the hand of women.
In the history of obstetrics and midwifery, we can find a number of names of women, who dealt with this profession. The names were based on the activity or characteristics of these women. The activities were for example cutting of the umbilical cord or bathing of children and the characteristics were wisdom, maturity, cleverness, respectability, reliability.
The contribution is aimed at certain historical points of interest in the field of the education of midwives. It familiarizes the reader with the contemporary position of the midwife in the healthcare system in the Czech Republic based on legal regulations. The integral part of this system is also building of a professional organization of midwifes.

In general, the palliative care is defined as a complex nursing and medicinal care provided for incurable patients who cannot be healed by using tools of contemporary medicine. For adult patients, this care is most typically provided in hospices or at departments of hospitals, which are adjusted to this care and equipped with technological background as well as professional human sources. It is currently possible to state that in each region of the Czech Republic, there is a hospice providing incurable patients with palliative and hospice care. Specialized palliative care is provided here for patients and their families.
However, severely and incurably diseased patients also include children. Unfortunately, this cannot be changed by generally accepted desire that children should not die. In all the age categories, there are still diseases, which cannot be healed by methods of modern medicine. Under our conditions, these children are most frequently hospitalized in hospital institutions. Members of the personnel attempt to provide them with this specialized care. In the Czech Republic, the Foundation Klíček is currently most considerably involved in these health and social problems, and also manages an only hospice institution for children in the Czech Republic territory.
The present article attempts to elucidate principles of providing children with the palliative and hospice care based on knowledge resulting from taking care of adults. The basic principles are very similar, but in certain aspects, they are contrastingly different and quite specific for paediatric patients and their families.

In recent years, the social prestige of a job of nurses has been increasing. Her profession requires fairly high qualification and has benefits for the society. This requires increased working saturation and reduced fluctuation of nurses. Therefore, motivational strategy should be based on trends of their job satisfaction. Herzberg's motivation theory clearly explains "what motivates people to work" and is methodologically worked out in details. The basic principle of the research design was double evaluation of 16 factors of working environment. These factors were created according to Herzberg's theory and were completed by experts in nursing in pilot studies. First, nurses ordered them according to their own value preference, followed by the degree of their fulfilment of the employer. Mutual comparison of arithmetic averages of individual factors then clearly shows the greatest divergence between the desire and the reality in nurses in the working place. The first extensive survey was worked out in 2006, the second - representative - in 2011 by the way of interviewer's sheet. The research repetition shows the trends of job satisfaction in nurses. The target group of the research was created by nurses working in hospitals of the Czech Republic. In 2006, 3,081 respondents participated in the research, in 2011, 1,992 respondents didn't reject the interview. The first four factors (Wage/Salary, Patient care, Job certainty, Cooperation) are preferred in both surveys in the same order. A significant shift in 2011 survey is the factor of Prestige of the profession. The importance of the profession perceived by the general nurses themselves is in harmony with traditional and contemporary preference of a job content itself (patient care), with increased education of nurses and also with the trend of increasing prestige of nurses.

Implementation of the standardized classification system Alliance 3N to nursing practice has belonged among indispensable steps leading to higher quality care for individuals, families or communities.
The objective of the paper is to bring summary of found findings regarding efficiency and impact of the applied classification system Alliance 3N in clinical nursing practice.
To meet the objective of the paper a search strategy was chosen for the period 1998-2010, in the databases Medline - PubMed, EBSCOHost, Cochrane, ProQuest and Google Scholar while using the key search words. Criteria for involvement the found studies were: documentation of nursing diagnosis with application of Alliance 3N, accuracy of the documented nursing diagnosis and impact of Alliance 3N on patient's final condition. Several papers (results of primary studies, overview papers - systematic review and abstracts) were found out. From the found results of research studies follow clear statistical improvement of knowledge and critical thinking together with utilization of NANDA nursing diagnostics not only in students of nursing but also in already working registered nurses who practise and improve their basic knowledge and abilities using the classification system Alliance 3N in clinical practice. Registered nurses are able to determine nursing diagnosis, choose suitable nursing intervention and reach the expected nursing results of care for patients/clients using the classification system Alliance 3N much more effectively and accurately.

The paper aims to nursing diagnosis of Chronic confusion (00129) from NANDA-I (North American Nursing Diagnosis Association International) in conditions of selected workplaces. The sample was made up of 93 experts. An expert was considered to be a nurse with minimum 4 points according to modified Fehring criteria for the Czech Republic and Slovakia.
The Ferhing Diagnostic Content Validity Model was used for content validity. Importance of defining characteristics was analyzed by the validity instrument containing 13 items (9 defining characteristics of Chronic confusion (00129) from NANDA-I, 3 items of MMSE (Mini-Mental State Examination: Folstein test and 1 neutral characteristic).
The nurses - experts considered changes in time orientation, space (0.88), long-term cognitive disorder (0.82), progressive cognitive disorder (0.79) and disturbed stimulation interpretation and reaction to them to be the main defining characteristics. Two items - absent concious disorder (0.41) and rapid thinking (a neutral item) (0.31) were excluded. The total score of chronic confusion was 0.67. The detailed analysis showed that expert's item score influences the evaluation of defining characteristics to the main ones and the secondary ones.
The study confirmed the validity of eight defining characteristics of chronic confusion from NANDA-I and that's way this nursing diagnosis can be considered as a valid one. The proper selection of expert sample is an important step in the process of validity of nursing diagnosis.

The aim of this contribution is to present pilot research of accuracy of clinical balance in teaching students the particular steps of nursing process. The pilot study includes set of 15 full-time students of the Bachelor study branch General Nurse. For each step of the nursing process were prepared sets of records whose content and structure were motivated by principles OPT model of clinical balance of the authors Pesut and Herman. The protocols were used to record defining characteristics, relating or risk factors NANDA International, which were concluded by students from the patient's description (case interpretation). Further to recorded diagnostic conclusion students recorded chosen NOC areas for evaluating the patient and chosen NIC of nursing intervention. As a supporting instrument they obtained files of NOC areas for evaluating the patient and NIC interventions in Czech language. In total, there were prepared four sets of files following different patient description. Set of protocols following the description of the same patient was included at the beginning and at the end of practice. This set was marked as testing one. In testing protocols the accuracy of records was monitored. In order to put the rate of accuracy was used the evaluating instrument OPT model which was modified by the authors of the research. The reliability of this instrument was assessed by Coeficient Cronbach alfa. To judge test-retest reliability was used Spearman correlation coefficient. Obtained data were analysed by Student pair t-test and Wilcoxon pair test level of significance 0.05. It is interesting that in contrast to foreign studies conducted by the authors Kautz, Barlett or Bland the significant difference between the students' results before and after exercise block was proved only in one evaluating area.

The contribution is concerned with the issue of human rights. In the contribution prevails the legal aspect of human right determination with the emphasis on the sphere of social work.
The aim of the work is to identify common attributes and differences of human right determination in the laws related to social work in the following countries: the United Kingdom of Great Britain and Northern Ireland, the Slovak Republic, the Republic of Indonesia and the Republic of South Africa.
For data acquisition we used the qualitative content analysis of documents. Prior to the beginning of the analysis we created a professional literature based on a priori categories of human rights. Consequently we coded the segments related to the a priori created categories.
The methods of data recollection lead to achieve pieces of information that were later compared by means of the comparative analysis. For each inspected country we created diagrams that show the current state of the a priori created categories in its legal system. Consequently we compared the diagrams and looked for differences and common attributes of human right determination.
In connection with human right determination we realised that in all inspected countries laws pay attention to the civil rights. Among the inspected countries we found out most differences in the sphere of social rights. The economic rights are mentioned only in the legal system of the Slovak Republic. Cultural rights are present in the laws of the Slovak and the Indonesian Republic. Both countries pay attention to the right to education.
We detected reference to human rights in all inspected laws. It follows that human rights and their observance is crucial for the social work.

Physical activity should be the natural part of the way of life in school children and adolescents. Physical activity has a positive impact on health of adolescents. Project Health Behaviour in School-Aged Children (HBSC) is one of the first international cross sectional studies focused on health of adolescents and their behaviour relating to health. The aim of the article is to present the incidence of physical activity in school-aged children and adolescents in the area of Central Slovakia. The data collection was carried out at 25 primary schools and two eight-year grammar schools in regions of Žilina and Banská Bystrica in the period May to June 2010. The set of respondents consisted of 1 187 pupils in three age categories: age of 11 (313 respondents), age of 13 (442 respondents), age of 15 (432 respondents). For data collection was used standardized questionnaire created for the needs of HBSC study. Data collection also included demographic data: gender, grade, age. Significant interaction of two variables was assessed by chi-square test. In 13-year and 15-year-old boys we found out significantly higher incidence of physical activity (p = 0.001). In the group of 11-year-old respondents these differences were not statistically significant (p = 0.115). The results point to inadequate physical activity in the set of respondents. Higher level of knowledge about the importance of physical activity in children of school age and adolescence is an important part of a healthy lifestyle.

At present, foreigners form over four percent of the Czech population. According to the Czech Statistical Office, nearly six thousand of them are immigrants from Mongolia. The reason for this migration is usually the possibility of getting a job and therefore improving their economic situation. The aim of the research, which is part of the project entitled "Social Determinants of Health in Selected Target Groups", was to analyze the relationship between a set of selected social characteristics and characteristics of health. The paper refers to immigrants from Mongolia who are living in South Bohemia. The qualitative survey was performed by interviewing nineteen respondents. After the interviews and analysis of the data, major semantic categories and subcategories were identified. This paper focuses on the current health status of immigrants, the type of health insurance, experience with doctors, and their level of satisfaction with receiving healthcare. The results helped to reveal numerous problems concerning the health of immigrants, and the use of healthcare in our country. Respondents reported health problems such as chronic backache, headaches, fatigue and hearing impairments. These problems were all associated with an unsuitable work environment. While receiving healthcare, the respondents met with a negative attitude from medical staff. According to the respondents, the most common causes of this were language barriers, and doctors and nurses prejudice toward foreigners.

The irreplaceable role in enjoyment of active and worthy old age is associated with mutual communication between seniors and their surroundings. It supports their personal identity, motivates them for social connections, facilitates solution of their problems, potentiates their education, contributes to entertainment, etc. The activization of seniors is also considerably enhanced by the society and by their institutions, since through the mediation of interaction and aimed communication they provide a legal, economical, cultural, educational and social-health framework important for the senior life quality itself. In the life of the older generation, there is also an important role of the communication initiated on the part of the family and institutions providing the health and social care. The communication initiated by social subjects opens for the senior space and conditions for their active participation in the life of the society and for its development.

The article presented here considers in its theoretical part the problem of euthanasia. It indicates the current condition of prevalent attitudes of the western society to the death in terms of the depersonalisation and taboos. On the one hand, it reflects the attitude and medical consideration of the death, where the human life is being extended thanks to the technical advances in science and technology. On the other hand, voices calling for "worthy termination of the human life" are being considerably increased in number.
In its first part, the article considers the description of the situation of and attitude to the euthanasia in the Netherlands, which is a country where the euthanasia was legalized. In the introduction, it defines the basic terminology used - active euthanasia, passive euthanasia. Next to this, the article describes the historical development in the legislative process of accepting the euthanasia in the Netherlands.
In a further part, the authors consider opinions concerning the euthanasia in the Czech Republic, which are subsequently supported by their own research in the practical part. Opinions concerning problems of the euthanasia are mapped in students of the Faculty of Health and Social Studies and Agricultural Faculty of the University of South Bohemia in České Budějovice, mainly from the standpoint of the agreement with the legalization of some of the types of the euthanasia in the Czech Republic. The responses exert more than half the number of voices for the agreement of respondents with the euthanasia legalization in the Czech Republic. The numbers are different in the method of performing the euthanasia, where for example assisted suicide is characterized by a significantly lower proportion of positive answers. However, only lower percent of subjects inquired would agree with performing the euthanasia in their close relatives.

The evaluation of the satisfaction of clients with the institutional care is one of parameters of the quality of the services granted. The target of the research was to find what is the evaluation of the satisfaction by the clients of homes for seniors in the Moravian-Silesian Region and what are the factors affecting this satisfaction. The research sample included 488 clients from 12 old people's homes sponsored by the Moravian-Silesian Region and Ostrava City Council. A questionnaire of the satisfaction of inhabitants with the home for seniors was used for the data accumulation, which was presented to clients by the form of a standardized interview. The questionnaire was directed to the following areas: satisfaction with behaviour and professional quality of nurses and caregivers, satisfaction with so called hotel services (manner of accommodation, sanitary utilities, cleanness and order, catering), satisfaction with inter-human relationships and coexistence with other inhabitants, satisfaction with the possibility to be active and to participate in activation programmes. The sample included clients of selected facilities (regional selection) adhering to the following criteria: age over 60 years, ability of communication, orientation in time and space, willingness to participate in the interview. The clients positively evaluated the nursing care; the satisfaction with catering, individual interest of nurses and caregivers and relationships between clients was somewhat smaller. Hypotheses considered association between the satisfaction of clients with the old people's home and duration of the stay of the client, his/her age, gender, self-sufficiency, evalaution of his/her own life situation and rate of visits of family members. The results of the research demonstrated that particular partial items of the satisfaction of the clients are affected by different factors. All the spheres of the satisfaction considered are markedly affected by the general self-evaluation of the client life situation.

Rheumatoid arthritis (RA) is a chronic inflammatory disease of joints involving as much as 1 % of the population. Rheumatoid arthritis exerts permanent progress and very frequently causes disability. This inflammatory disease particularly involves joints, but it can also involve other organs and systems, as e.g. the myocardium, lungs, muscles, tendons or white of the eye. The quality of life of these patients is affected by the activity of their disease and extent of damage to the joints. Patient organizations play an important role here. The Rheumatics-League associates patients with rheumatic diseases and all the persons, who are interested in helping these patients.
The target of the work was to provide more information about these patients, to determine the extent of their information about their disease, their needs, suffering and importance of their membership in the Rheumatics-League for them and, based on the information acquired in this way, to compile an educational plan aimed at the most frequently occurring needs of these clients.
The qualitative method of the research was employed in the work. The group investigated included 10 clients with rheumatoid arthritis, members of the Rheumatics-League in České Budějovice. The data accumulation technique was based on a semi-structured interview comprising 32 questions. Particular interviews were arranged in case reports, based on which, total of 12 categorization groups were established.
Our research showed the association of citizens Rheumatics-League to be very beneficial and important for our clients. This was demonstrated in all the respondents inquired - members of the Rheumatism-League in České Budějovice.
Based on the results, an educational plan for patients with rheumatoid arthritis was compiled, which could be employed for the work of members of newly originating branches throughout the country. The fact was also supported that the organization Rheumatism-league fulfils needs of our clients inquired.

Oncological diseases present a permanent danger, they permanently increase in number in our country and they are the second most important cause of the death, next to cardiovascular diseases. The situation in the occurrence of malignant gynaecological tumours in the Czech Republic is not beneficial compared with surrounding advanced West-European countries. The malignant disease hits the women in the most productive period of their life (the most frequent occurrence between 35 and 65 years of age) and has a principal impact on the family, working and social life of woman. Causes of this increasing rate of occurrence are very complex with all the health, social and economic impacts not only on the woman but also for the whole society. The frequency of the cancer disease occurrence reflects the living standard of the society, health awareness of the population and level of the health care in the field of prevention. It also depends on the social, health and economic environment of the woman and on her living style. Taking care of woman health is ever a topical problem in our society. Well organized preventive care for woman is necessary in the field of gynaecology and obstetrics, which should be well attainable for women and supported by the state healthcare policy. The main attention should be aimed at the primary prevention. The system of preventive examinations is rather declared by the state than implemented by women in practice. Among other factors, low level of information of women about cancer diseases in general and mainly about their prevention brings a contribution to this fact. The improvement of the prevention, screening, timely diagnostics and treatment must become a prestigious matter in our society. The success of combat against this problem depends on every woman. The attitude of women to their own health is reflected in forming positive relationships to the health itself and lifelong responsibility for support and protection of health towards herself as well as towards the others. Within the scope of her own self-concept, the woman should form responsible, non-endangering and non-damaging behaviour towards herself and towards the others. The woman should be her own good manager in the sense of taking care of her own health.

Based on the international project "E-learning in community care", a special correspondence educational programme is being prepared for nurses and midwives involved in the community care. This project is implemented within the programme Leonardo da Vinci with cooperation of partners from Slovakia, Hungary, Poland and France. The programme prepared will be subjected to pilot testing in groups of 30 nurses and 30 midwives in the Czech Republic, Hungary, Poland and Slovakia. Based on the analysis, which was implemented among the above listed countries, it is possible to consider that in these countries the community care is being developed at about the same level and that there are no educational programmes, which could provide effective preparation of staff members in this field. Thus, there is a realistic assumption for mutual combination of the study and subsequent recognition of the specialty in the field of the community care. The project reacts to the absence of educational programmes in the field of providing services aimed at support and maintenance of individual and community health. The target is the possibility to provide the natural combination and interconnection with the module arrangement of the specialized education in the community care and simultaneously to offer a suitable alternative for students, who cannot attend the regular form of the teaching process.
This is the field of healthcare, to which high attention is being paid in a number of advanced countries because of its undoubtedly enormous social importance. Thus, it is necessary to prepare an educational programme for nurses and midwives in a form providing its efficacy and simple admission for everybody. One of possibilities is the implementation of the educational programme by the e-learning form.

The contribution presents results of a survey focused on monitoring principles of saving intimacy of patients in selected hospitals in Ostrava. The survey was implemented at departments of surgery, internal medicine, gynaecology and central admission. The target of the examination was to find how the patients and healthcare professionals perceive adhering to the intimate nature during the communication patient-healthcare professional and how the patients and healthcare professionals consider adhering to the patient intimacy in the course of the care provided in the environment of healthcare institutions. The survey was performed in the first quarter of 2010. A method of the questionnaire examination was employed for this purpose. Two versions of questionnaires were compiled: one version for patients and second version for healthcare professions. The results of the examination were specified through the mediation of the descriptive statistics. One hundred and twenty-one patients and 82 healthcare professionals participated in the research examination. The opinions concerning the intimacy in selected healthcare institutions were considerably different between the group of healthcare professionals and that of patients, where the healthcare professionals evaluated their own behaviour more positively. Patients evaluated negatively degree of adhering to principles of intimacy in the communication between the healthcare professional and patient in the examination room as well as in the patient room compared to the healthcare professionals (according to opinions of 42% of patients and 4% of healthcare professionals, the care givers typically adopt no precautions for saving the intimacy in the interview). Non-adhering to the privacy in providing hygienic care at the patient room was expressed by 41% of patients but by 25% of care givers only. Total of 32% of patients criticized the use of screens during a care or medical intervention, but 80% of healthcare professionals have always used the screens in these situations. Necessary uncovering of the body, adhering to as short time for this purpose as possible during rounds and providing conditions fit for human beings during patient transfers beyond the department where the patient is hospitalized, was positively evaluated by healthcare professionals as well as patients.

The communication presented here acquaints the reader with the development of the number of live-births from all-state and regional view points. In addition to the newborn mortality, it is aimed at an adverse trend in the incidence of newborns with low birth-weight and at its main causes. In the next part, the attention is paid to the level of taking care of newborns of extreme birth-weight. In the last part, the authors also bring information on the development of children having birth-weight under 1500 g at their corrected age of 24 months.
The work is based on a secondary analysis of data from national data bases of the JE Purkyně Czech Neonatological Society and partially also of the Perinatological Section of the JE Purkyně Czech Gynaecological-Obstetric Society.
Since 2008, in Czech Republic, the number of live-births was stabilized at a limit of 118,000 children, and no considerable decrease has been yet observed. In 2010, the newborn mortality was of 1.44‰ (the South-Bohemian Region exerts a value of 2.2‰). The Czech Republic ever belongs to advanced countries with the highest occurrence of newborns of birth-weight under 2.500 g. A proportion of 7.7% of these children were born in 2010 (in the South-Bohemian Region 8.2%). In the Czech Republic, total of 493 children with a weight under 1000 g were born in the last year. Four hundred and one children were dismissed from hospital. In the South-Bohemian Region, total of 38 children of this weight were born, 30 of them being dismissed from hospital.
The work includes a conclusive statement that in terms of the situation of the whole republic, there is a deterioration of certain parameters of taking the specialized care of newborns.

Echocardiography is a basic examination in cardiology used to assess the anatomy and function of the heart. An echocardiography nurse is a health care specialist who is able to use echocardiographic equipment to obtain images of the heart. Standards for echocardiography personnel vary widely between countries. In the Czech Republic, there is no training program for nurses to carry out echocardiograms and the work is done almost exclusively by physicians. In many other countries, including the United Kingdom and the USA, specialist nurses carry out and report echocardiograms independently. In this article, we compare requirements for echocardiography nurses in different countries.

The classic division of the tasks of doctors and nurses to "cure" and "care" is no longer valid. Nevertheless, medical ethics, more oriented towards treatment, has a long-term tradition and is more theoretically elaborated. The reason can be seen in the traditional dominance in the medical field, but a bigger factor is obviously the difficulty to grasp the theoretical concept of the word "care". In the game there are at least two players who can equally fail. Not only their attitudes but also their real activities are accented. An important part of the care is the relationship; a phenomenon that also cannot be described by simple definitions.
To approach the understanding of the concept of care, a possibility is through the theoretical resolution of different paths of the moral development of man, elaborated by Carol Gilligan. It is possible to use the existential analysis of the "stay" of a human by Martin Heidegger, especially his concept of "coexistence" and his definition of worry or care about another person. It is possible to apply the definition of care according to Berenice Fisher and Joan Tronto and its consequences in the moral sphere. Deborah Fingfeld-Connett elaborated her own concept of nursing care, which is not based on abstract definitions or concepts, but it is a "meta-synthesis" of available qualitative studies that deal with the issue of care conceptualization in nursing. Nursing care depends not only on what the nurse does, but also on her personality. Therefore it is not possible to avoid the ethics of virtues, inspired either by the classic in this area - Aristotle, or by contemporary authors, such as the Australian philosopher Stan van Hooft.
The elaboration of ethics of care should help nurses to be more successful in their demanding profession. Also, adequate understanding of what I am doing leads to personal growth and to greater life satisfaction. Executives and managers will find an incentive for equipment and the organization of health facilities so that good care will be feasible.

The study focuses on the potential use of conceptual models of cultural competences in the nursing profession.
The research was designed as a summary study and based on content analysis of studies published within the scientific databases EBSCOhost, PubMed and Scopus, by using the key words: cultural competence, model and nursing.
The study points out the influence of globalization as a spontaneous uncontrolled process of integration of countries around the world in a single system, and the subsequent need for cultural competence. The most frequently cited cultural competences are knowledge, skills, attitudes, the ability to react in a kind and efficient manner to people from all cultures, recognition, respect and responsibility, provision of qualified care and the long-term process of self-education. The conceptual models presented in this article and characterized by cultural competence include the Great Theory of Nursing by Madeleine Leininger, the model of Irena Papadopoulus, Mary Tilki and Gina Taylor of the development of cultural competence, the model of development of cultural competence by Josepha Campinha-Bacote, and the model of cultural competences by Larry D. Purnell.
The results showed that cultural competence constitutes an indispensable component of the modern nursing profession in connection with transcultural nursing. The analysis of the published works pointed out that the above stated models are essential for the field of nursing.

Objectives: Public health nurse (PHN) perceptions of using standardized care plans to translate evidence-based guidelines into family home visiting practice have not been examined. The purpose of this study was to evaluate PHN experience and awareness of cognitive processes while using evidence-based care plans in family home visiting practice.
Design: This qualitative study used content analysis of PHN interviews.
Sample: A purposive sample of PHNs in a local public health agency who were experienced in the use of care plans in electronic documentation.
Measures: The qualitative study utilized content analysis methods. Semi-structured interviews examined their cognitive experience transitioning from usual practice care plans to evidence-based care plans. Interviews were transcribed and analyzed using a thematic analysis approach. Themes were developed and revised following several reviews of the transcripts.
Results: Four themes from PHN interviews revealed a complex dynamic process of knowledge management: 1. PHN thinking is separate from the care plan. 2. PHN thinking is supported by the care plan. 3. PHN thinking is stimulated by the care plan. 4. PHN documentation distress is minimized when the care plan matches PHN thinking.
Conclusion: While using the evidence-based FHV care plan, PHN cognitive processes were related to their own knowledge and expertise, their individual clients, and the entire client population or program. Evidence-based care plans supported and stimulated PHN thinking about evidence-based interventions and their application in practice. A good fit of the care plan knowledge schemata with a PHN's own knowledge schemata may decrease documentation distress. Further research is needed to evaluate the impact of using evidence-based care plans in other disciplines and settings.

In the Czech Republic the Roma belong to one of the most numerous groups. The health condition of this minority is a sphere requiring more research studies and especially follow-up measures including illness prevention. The given paper tries to map studies considering the health condition of the Roma in the Czech Republic and other European states. It also deals with the approach of the Roma minority to health care in the Czech Republic. The database EBSCO, PubMed, Scopus, Web of Science etc., were used in order to map this subject. As the analysis of the available source shows, the Roma population in Europe generally has a worse health condition than the majority society. This was also pointed out by the European Commission. The socio-cultural determinants of health and especially the fact that the Roma population remains at the periphery of the majority society seem to be the main reasons. Although these problems are the subject of many studies on a local as well as European level, it can be stated there is only minimal progress, and not only in relation to the improvement of the health condition of this minority. In view of the above stated results it becomes more important to create specific preventive programmes reflecting the specific requirements and needs of the target group, and to support the active cooperation of the Roma population in caring for their health.

The article explores capacity in elderly care homes in the South Bohemian region. The aim is to map the current state and the potential future capacity up to 2030. The need to ensure there are sufficient elderly care homes is linked to expectations that life expectancy will continue to increase, and that the top-heavy age structure of the population will lead to an increase in the number and proportion of elderly people in the total population. Existing population forecasts indicate that the number of elderly people in South Bohemia will have increased by more than 40% by 2030. Elderly care home capacity is now full and - given the large numbers seeking placement - it is also insufficient. Despite this, the available information suggests there are no plans to increase capacity substantially in the near future. It is thus assumed that the problem regarding elderly institutional care will grow worse in the near future. According to the authors' calculations, if the proportion of elderly people in the population residing in care homes remains at the same level, it will be necessary, depending on the model used, to increase capacity by around 80% by 2030. If not, the number of elderly people per care home vacancy in South Bohemia will rise from the current 37 to 53 by 2030, which may cause considerable problems.

Aim: Nursing students face both physical and psychosocial risks such as job stress at work during the training period. The aim of the study was to determine the academic and clinical stress, and the ways first-year nursing students cope in their first clinical practice.
Methods: A descriptive, cross-sectional design was used. This study was carried out in the nursing department of Giresun University in Giresun, Turkey. The sampling consisted of 109 nursing students who agreed to participate in this study in the 2014-2015 academic spring term. A Personal Information Form, Ways of Coping Inventory (WCI) and Nursing Education Stress Scale (NESS) were used for gathering data.
Results: Students generally had moderate levels of academic and clinical stress. Among the academic stressors, the highest frequencies were given to the preparing for the exam (67.9%). Among the clinical stressors, the highest frequencies were given to being criticized by teachers in clinical environments (56.0%), followed by encountering a dying patient (52.3%) and the fear of making practice errors (51.4%). While students mostly used self-confident and optimistic approaches, the social support seeking approach was employed less. The nursing education stress level varied in students according to gender (p < 0.05).
Conclusion: In summary, the academic and clinical practice stress levels of nursing students were moderate in the first clinical practice. Therefore, it is suggested that a mentoring programme should be used to manage and regulate their academic and clinical practice stress level and to increase their positive coping strategies in nursing schools.

Objective: Conduct and evaluate system-level evidence-based practice intervention for deep vein thrombosis (DVT) prevention.
Design: One group post-intervention survey evaluation.
Setting: A mother-baby unit in a tertiary hospital.
Interventions/measurement: Educating nurses, implementing an evidence-based deep vein thrombosis (DVT) prevention guideline in the mother-baby unit, and recommending policy changes. Outcomes were measured using Omaha System Knowledge, Behavior, and Status scales (1 = lowest - 5 = highest) for nurse DVT knowledge and practice behavior, and implementation of policy recommendations.
Results: Twenty nurses (80%) completed the evaluation survey. The nurses reported that their knowledge increased significantly (3.70 vs. 4.40; p < 0.001). Behavior was variable in DVT guideline adherence. After training, most nurses (65%) usually or always assessed women for DVT risk, and some (35%) usually or always applied compression boots for DVT. The majority of nurses (70%) reported that women refused compression boots. Nurses who did not usually or always assess patients were statistically less likely to apply boots (p = 0.022). The nurses who reported discomfort with the procedure (30%) were statistically less likely to apply stockings (p = 0.028). Policy implementation to support evidence-based DVT prevention increased significantly (p = 0.008).
Conclusion: Comprehensive evidence-based interventions resulted in practice and system change to prevent DVT. Nurses' knowledge about DVT prevention increased and some nurses consistently assessed for DVT and applied compression boots. The facility supported the implementation of the guideline and implemented unit/facility policy changes.

The submitted study dealt with the influence of education in the area of motor activities (MA) on the modulation of health. The selected research method was an experiment which included a total of 54 purposely selected respondents from the age of 20-71 years. The experimental group was divided into an experimental group of 20 respondents and a control group of 34 respondents. Within 6 months of the research the respondents of the experimental group performed the predefined MA. All participants of the research survey underwent an analysis of human body constitution by means of bioelectric impedance, before and after the experiment. The assessed indices were the content of body fat, active body mass with water content and without water content, basal metabolism and water content. The results show a statistically significant increase of active body mass in the experimental group compared with the control group. Favourable results are also found in the area of basal metabolism, which increased after the targeted intervention in the experimental group. The values of BMI and the content of body fat decreased after six months as predicted. It can also be stated that a very general education of nurses in the area of MA has a significant and positive impact on the constitution of the human body.

The aim of this paper is to define strategic resources and strategy design of preventive measures for the Roma minority in the South Bohemian Region to reduce obesity and overweight. Quantitative research was conducted via a controlled semi-structured interview concerning the eating behaviour of the respondents, their mental state, stress, self-reflection, physical activity, smoking, alcohol consumption, socioeconomic condition, primary prevention and the approach of medical professionals. The research sample included 600 respondents (302 from the Roma minority and 298 from the majority population). The sample of the Roma minority and the majority population can be considered representative in terms of gender. There were statistically significant differences between the respondents from the minority and the majority population. The lifestyle of the Roma minority can cause obesity and overweight, and consequently influence the health of individuals. These are differences in eating behaviour, including the composition of diet, physical activity, smoking, or the money spent on food for an adult family member per month. The results obtained in this representative research survey within the SWOT analysis, which represents the weaknesses of the life style of the Roma minority, laid the foundations of a strategy for preventive measures for the Roma minority, which aims to reduce the risk factors affecting obesity and overweight in the Roma minority living in the South Bohemian Region.

Aim: The research aim was to map attitudes and knowledge of nurses regarding the issue of geriatric age and to find the influence of selected determinants influencing nurses' knowledge.
Design: The work has a design of a cross-sectional quantitative study that is performed based on a questionnaire survey.
Methodology: The research group was formed of 100 nurses who were classified in the sample based on intentional selection. The quantitative research was performed with the help of two methodologies. The nurses' attitudes towards seniors were measured based on the Fraboni Scale of Ageism (FSA); we gathered information regarding the nurses' knowledge about the issue of geriatric age by the means of a questionnaire of our own structure. The influence of the selected determinants influencing the nurses' knowledge of the geriatric age issue was verified based on the statistical tests: the Kruskal-Wallis test and the Spearman correlation coefficient.
Results: With the help of the FSA questionnaire we found that 72% of the nurses have a slightly positive view of the elderly, i.e. almost no ageist attitudes. We found a medium level of ageist attitudes and thus slightly negative views of the elderly in 28% of the nurses. The knowledge level regarding the geriatric age issue in 14% of the nurses was excellent, in 36% of them it was very good, 29% had good knowledge, it was satisfactory in 12% and dissatisfactory in 9%. Based on the statistical tests, we found a correlation between the age (p = 0.009), length of professional practice (p = 0.017), and education (p = 0.007) of the nurses and their knowledge of the geriatric age issue.
Conclusion: The research results point to the need of comprehensive education for nurses in the area of geriatrics and gerontology with an emphasis on an individual approach and non-generalisation of individuals within the whole senior population.

Health literacy is defined as a person's ability to act upon information about health and to effectively use such information to improve their health. The aim of this paper is to map the possibilities of applying this concept in contemporary nursing and to reveal the conditions for and against its use in the nursing profession. We used a content analysis of documents to process the presented study. The scientific databases of EBSCO, ProQuest, Pubmed, ScienceDirect and Scopus were used for the material search between April and May 2016. Based on the analysis of the found sources, we can generally claim that the concept of health literacy can be applied in today's nursing. Thanks to their large representation in the medical population, nurses may therefore significantly contribute to improving the health literacy of the general public and may effectively influence the health care system. A necessary step to maximize health literacy in the nursing profession is a more intense integration of the mentioned issue into educational curricula. This step, however, is not the only solution. An unavoidable condition is the existence of nurses, with both the personal-social and emotional competence, equipped with skills such as communication, empathy, listening and the willingness to devote more time to a patient. However, it is necessary to note that there was not a single Czech study dealing with the presented topic from the perspective of nursing. This fact seems to be a great challenge for all professionals in nursing and clinical practice.