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Journal Article 2014; 35(Suppl 1): 67-79 PubMed PMID: 25433357 Citation  Keywords:  Adult, Czech Republic, Delivery of Health Care, Integrated:methods, Emigrants and Immigrants, Female, Humans, Infant, Newborn, Middle Aged, Midwifery:methods, Patient Satisfaction, Postnatal Care:methods, Pregnancy, Prenatal Care:methods, Surveys and Ques.   

OBJECTIVES: To compile a proposal of the system of taking complex prenatal, perinatal and postnatal care of pregnant immigrants in the Czech Republic with taking into account medical and salutogenic approaches.

MATERIAL AND METHODS: The research was implemented by the form of a controlled interview and was based on a questionnaire comprising 50 questions focused on the evaluation of taking the prenatal, natal and postnatal care of immigrants. The data were accumulated among immigrants from Vietnam, Mongolia and Ukraine.

RESULTS: It is possible to conclusively state that no principal dissatisfaction with taking care of pregnant women in the Czech Republic compared to native countries was demonstrated. There is a difference in a more considerable participation of midwives in the prenatal and natal care compared to the native countries. Failures in taking care of mothers-immigrants in the Czech Republic are considered to be the poor communication, particularly in association with the language barrier, limited possibilities of the participation of family members in the delivery and persisting unsuitable behaviour of certain healthcare professionals.

CONCLUSION: In the Czech Republic, the medical care is at a higher level compared to native countries. For the improvement of the salutogenic attitude, it is necessary to take into consideration certain results and provide their application to practice....

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Journal Article 2014; 35(Suppl 1): 59-66 PubMed PMID: 25433356 Citation  Keywords:  Cooperative Behavior, Humans, Models, Organizational, Patient Care Team:organization & administration, Physicians:organization & administration, Social Work:organization & administration,.   

OBJECTIVES: This paper addresses the issue of interdisciplinary collaboration between medical and non-medical professions in health and social care. The introduction defines basic terms such as interdisciplinary cooperation, interdisciplinary team, and health and social care. Additionally, it highlights the significance and contribution of interdisciplinary collaboration in the care of the patient/client in health and social care. The aim of the paper is to identify factors influencing the process of interdisciplinary collaboration between, in particular, social workers and physicians. In compliance with the main goal of the research, the following partial goals were included: 1) to identify factors that limit the process of interdisciplinary collaboration between social workers and physicians, and 2) to identify factors which support the process of interdisciplinary collaboration between social workers and physicians.

METHODS: Based on the research goals, a systematic review was selected as the research method for the paper. The research dataset consisted of articles obtained from the following databases: EBSO, PUBMED/MEDLINE, SCIENCE DIRECT and SCOPUS. The databases were search using the following keywords: interprofessional cooperation, interdisciplinary, collaboration, social work, and physicians/doctors.

RESULTS: Using the results, the following factors supporting interdisciplinary collaboration were identified: acknowledgement of colleagues' expertise, recognition of roles, positive level of communication, and mutual respect. Factors that limit interdisciplinary processes included the following: varying professional perspectives, theoretical differences, lack of knowledge, and poor communication....

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Journal Article 2014; 35(Suppl 1): 49-53 PubMed PMID: 25433354 Citation  Keywords:  Aged, Aged, 80 and over, Anxiety:nursing, Atrial Fibrillation:nursing, Cardiovascular Nursing:methods, Catheter Ablation:nursing, Depression:nursing, Female, Humans, Male, Middle Aged, Nurse-Patient Relations, Quality of Life,.   

: The importance of nursing and patient quality of life is a top concern for medical professionals. Therefore, participation by medical professionals in raising awareness and continuously supporting improvements in nursing care is an essential part of improving patient quality of life. Modern medical techniques and procedures are changing rapidly, particularly in the field of cardiology. This has resulted in changing roles and increased responsibility for nurses and confirms the necessity for changing the perception of nurses relative to their role in the medical environment and to patient care. This paper presents the results from the first phase of a research project and focuses on quality of life and problematic areas associated with the needs of patients with atrial fibrillation before and after radiofrequency catheter ablation. Atrial fibrillation is one of the most common supraventricular arrhythmias. Its incidence in the general population has risen significantly over the last twenty years. The objective of this research was to assess those areas, which are considered by patients to be problematic before therapeutic intervention. The research was realized through a quantitative survey using a modified questionnaire. Results showed that AF reduced the quality of life both physically and psychologically (i.e. increased levels of anxiety and depression). Results also showed that radiofrequency catheter ablation was able to alleviate symptoms associated with AF and was also able to increase patient quality of life....

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Journal Article 2014; 35(Suppl 1): 40-48 PubMed PMID: 25433353 Citation  Keywords:  Aged, Aged, 80 and over, Death, Sudden, Cardiac:prevention & control, Defibrillators, Implantable, Female, Follow-Up Studies, Humans, Long-Term Care, Male, Middle Aged, Monitoring, Physiologic:methods, Outpatients, Pacemaker, Artificial, Prospective Studi.   

OBJECTIVE: The increasing number of patients with implantable cardiac devices raises the need for more efficient outpatient follow-up care. Due to technological progress in communication and transmission systems and in the implantable devices themselves, telemonitoring can be widely used as an important part of care for patients and devices. Our objective was to evaluate the benefits of continuous remote monitoring using the BIOTRONIK Home Monitoring® (HM) system compared to standard outpatient follow-ups.

METHODS: 198 patients with single- or dual-chamber implantable cardioverter-defibrillator (ICD) implanted for primary or secondary prevention of sudden cardiac death were randomized into a group of patients followed through standard outpatient visits ( HM-) and a group telemonitored by the HM system (HM+). Planned and emergency visits, ICD-related hospitalizations, and delivered shocks and their appropriateness were evaluated in the respective groups.

RESULTS: A significant reduction was achieved in the number of planned (by 48%, p<0.001) and total visits (by 45%, p<0.001) during a three-year evaluation. A comparable number of patients experienced one or more shocks. Mortality rates were equivalent, as was the number of patients hospitalized in relation to their ICD. However, there was a significant reduction in the number and proportion of inappropriate shocks delivered in the HM+ patient group: by 80% (p=0.002) in outpatient follow-up care and by 90% (p<0.001) when multiple shocks requiring hospitalization were included.

CONCLUSIONS: The HM system was an effective and safe method of follow-up in patients with an implanted ICD. Remote monitoring reduces the number of outpatient visits and inappropriate shocks....

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Journal Article 2014; 35(Suppl 1): 19-25 PubMed PMID: 25433350 Citation  Keywords:  Activities of Daily Living:psychology, Adolescent, Adult, Crohn Disease:nursing, Czech Republic, Female, Humans, Male, Nursing Staff:standards, Patient Satisfaction, Quality of Life:psychology, Social Support, Surveys and Questionnaires, Young Adult,.   

OBJECTIVES: To determine the quality of life of patients with Crohn's disease and to determine if this is reflected by the quality of nursing care.

METHODS: For the purpose of this research, we used a generic standardized questionnaire of the quality of life, published by the World Health Organization (WHOQOL-100). The questionnaire was distributed among 100 patients with Crohn's disease and among 1456 and members of healthy population. To analyze the results, we used the SPSS program and appropriate statistical methods.

RESULTS: The comparison of the domain scores of population standards in the Czech Republic and the respondents with Crohn's disease revealed a difference in the domain "physical condition", where the mean value was at the limit of the lower interval of the standard, and in the domain of "independence".

CONCLUSION: The results given in this study define the possibilities of nurses and their functioning associated with altered quality of life. An evaluation of the most affected areas allows nurses to determine an appropriate intervention. Providing nursing care, in accordance with the latest knowledge, must be based on the quality of life. This newly incorporated area offers healthcare professionals a new dimension for assessing and determining subsequent interventions....

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Journal Article 2014; 35(Suppl 1): 5-10 PubMed PMID: 25433348 Citation  Keywords:  Adolescent, Adult, Cross Infection:prevention & control, Czech Republic, Data Collection, Female, Health Knowledge, Attitudes, Practice, Hospitalization, Humans, Inpatients:psychology, Interviews as Topic, Male, Middle Aged, Patient Participation:psycholo.   

OBJECTIVES: The study examined the extent to which patients in the Czech Republic are involved in decisions regarding their treatment and whether they are interested in ensuring safety during hospitalization.

METHODS: Patients were interviewed to determine their perspectives regarding the previously stated objectives. The sample consisted of 514 patients who had been admitted to hospital for a minimum of three days.

RESULTS: It is clear that patients in the Czech Republic are unaware of safety issues associated with provided care, but 52.2% of respondents expressed a desire to be more involved in decisions pertaining to their treatment. Widowed patients, as well as those hospitalized for more than six days, expressed less of a desire for such involvement. Half of the patients enrolled in the study stated that health care professionals had encouraged them to ask questions about their treatment. With regard to errors associated with surgical reversals, 58.3% of respondents stated that nursing staff had performed checkups to avoid confusion in surgery. Another patient safety issue is nosocomial infection acquired through improper hand-washing techniques of medical personnel. 73.5% of patients said they would not have the courage to ask medical staff (doctors or nurses) whether they had washed their hands prior to examination.

CONCLUSION: Patients in the Czech Republic are unaware of the safety issues associated with provided care, but more than half expressed a desire to be more involved in decisions that pertain their treatment.

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Journal Article 2014; 35(2): 149-153 PubMed PMID: 24878977 Citation  Keywords:  Aged, Aged, 80 and over, Carotid Artery Diseases:complications, Carotid Artery, Internal:pathology, Cerebral Infarction:complications, Euthyroid Sick Syndromes:complications, Female, Humans, Inpatients:statistics & numerical data, Male, Middle Aged, Nervo.   

OBJECTIVES: The low triiodothyronine (T3) syndrome indicates poor prognosis for patients with cerebral infarction. It is unknown, however, whether basic conditions or severities in the patients with the low T3 syndrome are different compared to those without the low T3 syndrome.

METHODS: We compared the risk factors and the severity of the disease using the National Institutes of Health stroke scale (NIHSS) score at the worst condition for cerebral infarction in patients with or without the low T3 syndrome in order to better understand the characteristics underlying the worse prognosis in patients with the low T3 syndrome.

RESULTS: We found that cerebral infarction patients with the low T3 syndrome were significantly older (p<0.001) and significantly more likely to be female (p=0.002) and had hypertension (p=0.04) or homocystinemia (p=0.001), but less likely to smoke (p=0.008), compared to patients without the low T3 syndrome. The proportion of NIHSS score ≥8 in the patients with LAA-ICA-associated cerebral infarction accompanied by the low T3 syndrome was significantly higher than in those without the low T3 syndrome (p=0.001).

CONCLUSION: We concluded that increased numbers of risk factors for cerebral infarction and more severe neurological deficits may be important causes for worse prognosis in the patients with the low T3 syndrome which may more likely occur in patients with LAA-ICA cerebral infarction. Intense secondary prevention in cerebral infarction especially in older women are needed....

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Clinical Trial 2013; 34(8): 798-801 PubMed PMID: 24522016 Citation  Keywords:  Acute Pain:diagnosis, Biopsy, Fine-Needle, Biopsy, Large-Core Needle, Female, Humans, Male, Middle Aged, Patient Acceptance of Health Care:psychology, Preoperative Care, Thyroid Neoplasms:diagnosis, Thyroid Nodule:diagnosis,.   

OBJECTIVE: A crucial problem in the non-operative diagnosis of thyroid nodules is the significant amount of non-diagnostic biopsies. This is a challenge for practicing endocrinologists especially when the results of the repeated biopsies remain non-diagnostic. The lack of a concrete preoperative diagnosis may result in unnecessary thyroidectomies in patients. Alternatively, it may also lead to the delayed diagnosis of cancer. One method of biopsy specimen acquisition that could potentially increase the diagnostic accuracy of thyroid biopsies is the application of core-needles. The aim of the study was to compare the diagnostic value and patient tolerability of core-needle aspiration biopsies (CNAB) with fine-needle aspiration biopsies (FNAB).

PATIENTS AND METHODS: The study included patients with thyroid nodular goiter in whom previous conventional FNAB yielded non-diagnostic results. CNABs were performed using 22G core-needles. The control group consisted of patients undergoing conventional FNAB with 25G fine-needles. Pain during core-needle biopsies of thyroid nodules was assessed using the 10-point visual analog scale.

RESULTS: There were a total of 30 lesions in 26 patients undergoing CNAB (22 women, 4 men, mean age 48.3) and a total of 59 lesions in 40 patients undergoing FNAB (34 women, 6 men, mean age 57.3). 56.6% of CNABs and 50.8% of FNABs were diagnostic (p=0.60). When assessing pain via the visual analog scale, the median score for biopsies performed with core-needles was four. 60.0% of patients considered the pain of core-needle aspiration biopsies to be similar to the pain experienced during the previous conventional fine-needle aspiration biopsies, while 40% of patients claimed that the pain was more intense.

CONCLUSIONS: CNAB did not prove to be superior to FNAB. Despite the larger needle gauge used during core-needle biopsies, the patients' tolerability was comparable to conventional fine-needle biopsies....

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