Závěrečná práce NCO NZO
1 svazek : tabulky, grafy ; 30 cm
Background: Burns in children represent a significant public health issue due to their high frequency and potential for severe physical and psychological consequences. This study aims to describe the clinical characteristics of burns in hospitalized children and adolescents in the Republic of Srpska between 2018 and 2020. Methods: A multicenter retrospective study was conducted, collecting data from the national e-base of the Agency for Certification, Accreditation and Quality Improvement of Health Care of the Republic of Srpska for patients aged ≤19 years hospitalized for burns. ICD-10 codes were used to identify burns, from which demographic and clinical characteristics were extracted. Results: A total of 70 patients were identified, with a median age of 1 year [interquartile range (IQR3): 1-4 years]. The majority were children aged 0 to 9 years (84.3%), and 67.1% were boys. Most burns occurred during winter (34.3%), and the median hospital LOS was 6.5 days (IQR: 5-9 days). Scalds from hot liquids were the most common type (84.3%), primarily affecting the lower extremities (31.4%) and head and neck (25.7%). Statistically significant differences were observed in the causes of burns, affected anatomical regions, and age groups (p < 0.05). The burned body surface area ranged from less than 10% to 29% TBSA, with 61.4% having less than 10%, and no significant differences based on age, gender, or cause of hospitalization (p > 0.05). Conclusion: Burns from hot liquids and contact burns are the main causes of injuries in hospitalized children aged 1 to 4 years in the Republic of Srpska, highlighting the need for targeted prevention strategies.
- MeSH
- Child, Hospitalized * statistics & numerical data MeSH
- Child MeSH
- Epidemiologic Studies MeSH
- Inpatients statistics & numerical data MeSH
- Humans MeSH
- Adolescent MeSH
- Burns * epidemiology etiology pathology MeSH
- Routinely Collected Health Data MeSH
- Check Tag
- Child MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Female MeSH
- Publication type
- Multicenter Study MeSH
- Geographicals
- Serbia MeSH
Vydání první 274 stran : ilustrace, portréty ; 21 cm
Publikace obsahuje osobní vyprávění autora i jeho pacientů o zdraví, nemocech a společenských tématech Určeno široké veřejnosti.; Jan Hnízdil i tentokrát přichází s knihou, která svědčí o mimořádné šíři jeho záběru. V tematicky nesourodých kapitolách poutavě řeší nejen příběhy svých pacientů, lásku ke zvířatům, ale i příběhy svého života a otázky celé společnosti. Síla příběhů spočívá v tom, že na jednotlivých situacích ukazuje, že i v dnešní době se lze složitostem života postavit autonomně, bez přetvářky, a hlavně s velmi originálním humorem. S Janem Hnízdilem nemusí každý souhlasit, ale nemůže mu upřít poctivou snahu o otevřenost bez dogmat, hledání odpovědí na komplikované otázky a víru v mezilidské porozumění a přátelství. MUDr. Jan Hnízdil, internista a rehabilitační lékař (*1958), autor publikací: Mým marodům, Zaříkávač nemocí, Příběhy obyčejného uzdravení, Ako sa nestať pacientom, O bolesti zad: Všechno, co jste kdy chtěli vědět, ale báli jste se zeptat, Všichni jsou psychopati jenom já jsem letadlo, Kronika doby covidové a dalších. V roce 2013 založil pracoviště komplexní psychosomatické medicíny Hnízdo zdraví, o které v roce 2024 přišel. Je držitelem Zlatého bludného balvanu Klubu českých skeptiků Sisyfos za rok 2015. Pro hrubé porušení lékařské odbornosti a etiky v době covidizmu vyloučil v roce 2024 Českou lékařskou komoru ze svojí společnosti a přešel na pozici zdravotního poradce.
- MeSH
- History, 21st Century MeSH
- Patients MeSH
- Attitude MeSH
- Psychosomatic Medicine MeSH
- Social Problems MeSH
- Health MeSH
- Check Tag
- History, 21st Century MeSH
- Publication type
- Personal Narrative MeSH
- Geographicals
- Czech Republic MeSH
- Conspectus
- Fyzioterapie. Psychoterapie. Alternativní lékařství
- Biografie
- NML Fields
- psychologie, klinická psychologie
- rehabilitační a fyzikální medicína
- About
- Hnízdil, Jan, 1958- Authority
Aim: The aim is to determine how fully the needs of patients with cancer and those of patients with advanced chronic disease are met in palliative care and how needs differ in importance between the two groups. Design: A cross-sectional study. Methods: The study population consisted of patients with advanced chronic disease and cancer patients admitted either to cancer wards or a hospice. The study period was from January 2023 to May 2023. A valid and reliable tool, the Patients' Needs Assessment in Palliative Care, was used to assess the needs of patients. The total number of respondents was 126. Results: Physical needs are most important to patients with advanced chronic illness. Autonomy needs are most important to cancer patients. For patients with advanced chronic illness, the highest level of needs fulfilment was in the area of social needs. The highest rate of fulfilment for cancer patients was in the area of social needs. Conclusion: Needs assessment of patients in palliative care is essential since it allows healthcare professionals to better understand the individual needs of patients in their final phase of life.
Aim: The main objective was to determine how hospitalized patients subjectively perceive sleep disturbances. The study also assessed the influence of selected factors (physiological, physical, environmental, and psychological) and clinical and demographic variables on sleep disruption. Design: A multicenter descriptive study. Methods: Conducted in seven Czech hospitals from February to May 2023, the study included 397 patients in general wards. Data were collected using a modified questionnaire on sleep disturbances, and the results were analyzed using non-parametric statistical tests. Results: The sample comprised 193 males (48.6 %) and 204 females (51.4%). Females reported more sleep disturbances than males (p = 0.023). Psychological and physical factors had a greater impact on females. Younger patients reported poorer sleep quality (p = 0.015). Pain was the strongest clinical factor that negatively affected sleep (Ra = 0.730). Environmental factors were the leading cause of sleep disturbance in patients (Ra = 0.836). The variability associated with all the factors studied (environmental, psychological, physiological, and physical) accounted for 97.6% of the total variability in sleep disturbance. Conclusion: Females and younger patients experienced more sleep disturbance. Pain and environmental factors were the primary causes of disrupted sleep. Differences were noted in the factors affecting sleep between genders.
- MeSH
- Child, Hospitalized * psychology MeSH
- Humans MeSH
- Parents psychology MeSH
- Family MeSH
- Residential Facilities MeSH
- Check Tag
- Humans MeSH
INTRODUCTION: PAdverse Childhood Experiences (ACEs) are associated with an increased risk of mental health issues in general, but their relationship with panic disorder (PD) and obsessive-compulsive disorder (OCD) has received less attention compared to borderline personality disorder (BPD). Dissociative experiences are significant predictors of increased symptoms, reduced treatment adherence, and poor prognosis in several psychiatric conditions, including PD, OCD, and BPD; still, their impact remains underexplored. This part of the study focuses on the overall efficiency of psychotherapeutic programs on treatment-resistant patients diagnosed with PD, OCD, and BPD (or combined), as well as the relationship between ACEs, dissociation rates, and treatment results. METHOD: The study was conducted under standard conditions in an inpatient psychotherapy unit that specialized in anxiety, affective disorders, and personality disorders. Patients were hospitalized for 6 weeks and treated with a comprehensive CBT program and pharmacotherapy. The study included patients diagnosed with PD, OCD, or BPD (or combined). Two independent psychiatrists confirmed the inclusion and exclusion criteria. Patients were assessed using the Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI-II), Clinical Global Impression Scale - Severity (CGI-S), Dissociative Experience Scale (DES), and Childhood Trauma Questionnaire (CTQ-SF). RESULTS: A total of 349 out of 357 patients completed the study. The average age of patients was 33.33 ± 11.59 years. After the 6 week treatment, there was a statistically significant decrease in mean scores across all assessed scales. Changes in any scale during treatment did not correlate with the total CTQ-SF score or sub-scores. The relative change in CGI-S showed a statistically significant negative correlation with the total dissociation score on the DES scale at the beginning of treatment but not with pathological dissociation assessed by the DES-T questionnaire. Statistically significant decreases in mean CGI-S scores were observed in patients with a single diagnosis of PD, OCD, and BPD. Among comorbid groups, significant changes were observed only in patients with comorbid OCD and BPD. No statistically significant change in mean BDI-II scores was observed in patients with comorbid PD and OCD or comorbid OCD and BPD. CONCLUSIONS: Our analysis showed that treatment led to a significant decrease in the severity of depressive symptoms assessed by BDI-II and anxiety symptoms assessed by BAI in patients with PD, OCD, and BPD. This decrease was not statistically significant in patients with comorbid disorders, suggesting that the presence of multiple diagnoses may affect treatment efficacy. ACEs did not correlate to treatment results, but dissociation rates were linked with poorer treatment outcomes.
- MeSH
- Dissociative Disorders * therapy psychology MeSH
- Adult MeSH
- Inpatients MeSH
- Borderline Personality Disorder * therapy psychology MeSH
- Cognitive Behavioral Therapy * methods MeSH
- Combined Modality Therapy MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Obsessive-Compulsive Disorder * therapy psychology MeSH
- Panic Disorder * therapy MeSH
- Treatment Outcome MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
The use of virtual reality (VR) in medicine is rapidly expanding, particularly in areas like pain management, surgical training, and mental health therapy. This study examines the implementation and effects of the Cold River VR application, a fully immersive tool designed to help manage pain and anxiety during dressing changes for burn trauma patients in a Czech hospital. The Cold River application immerses patients in a peaceful, interactive virtual environment, utilizing eye-tracking technology to engage them without the need for physical controllers, which could interfere with wound care. The study included 67 participants and found that Cold River effectively distracted patients, making the often painful and anxiety-provoking dressing changes more bearable. While stakeholder interviews indicated that the VR application was generally well-received and seen as a valuable tool in reducing patient discomfort, challenges such as lengthy calibration and occasional issues with nausea and headset discomfort were noted. Importantly, the Cold River application increased patient engagement and reduced the psychological burden associated with burn care, though it also highlighted the need for customization based on individual patient preferences and conditions. Overall, the experience with Cold River suggests that immersive VR holds significant potential for improving patient care during burn treatment, particularly when tailored to specific patient needs and contexts.
- Keywords
- Cold River,
- MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Pain Management methods MeSH
- Young Adult MeSH
- Patients psychology MeSH
- Burns * nursing psychology therapy MeSH
- Attitude of Health Personnel MeSH
- Aged MeSH
- Virtual Reality Exposure Therapy * methods instrumentation MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Young Adult MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Clinical Study MeSH
- Research Support, Non-U.S. Gov't MeSH
Psychiatrická oddělení jsou místa, kde se setkává celá řada faktorů, které mohou vyústit v nejrůznější formy konfliktů či nežádoucího až ohrožujícího chování. Každý konflikt negativně ovlivňuje celkovou atmosféru na oddělení, má vliv na prožívání personálu a jeho pracovní výkon a také na pacienty, kteří napjatou atmosféru přirozeně vnímají. Příčinám konfliktů na psychiatrických odděleních a jejich spouštěčům se dlouhodobě věnoval tým prof. Lena Bowerse v UK. Výzkumníci se snažili pochopit a popsat základní zdroje konfliktů na psychiatrických odděleních, jejich spouštěče a možné reakce personálu. Na základě rozsáhlých výzkumů pak navrhli určité intervence, jejichž cílem je minimalizovat výskyt konfliktů, nežádoucích událostí a používání omezovacích opatření. Metodika Safewards je v současné době využívána na mnoha pracovištích v celé řadě evropských zemí, např. v Německu, Velké Británii, Dánsku, Švýcarsku, Holandsku, Polsku, Švédsku. Dosavadní zkušenosti s její implementací jsou velmi pozitivní a výsledky byly publikovány v mnoha odborných časopisech.
Psychiatric wards are places where many factors come together that can result in various forms of conflict or unwanted or challenging behaviour. Each conflict has a negative impact on the overall atmosphere of the ward, affecting the experience of staff and their work performance, as well as the patients who naturally perceive the tense atmosphere. The causes of conflicts in psychiatric wards and their triggers have long been the focus of prof. Len Bowers' team in the UK. Researchers have been trying to understand and describe the underlying sources of conflicts on psychiatric wards, their triggers and possible staff responses. Based on extensive research, they then proposed certain interventions aimed at minimising the occurrence of conflicts, adverse events and the use of restraint. The Safewards methodology is currently used in many workplaces in a number of European countries, e.g. Germany, UK, Denmark, Switzerland, the Netherlands, Poland, Sweden. The experience with its implementation so far has been very positive and the results have been published in many professional journals.
- Keywords
- Safewards,
- MeSH
- Behavioral Symptoms prevention & control MeSH
- Mental Disorders psychology therapy MeSH
- Inpatients psychology MeSH
- Conflict, Psychological MeSH
- Humans MeSH
- Conduct Disorder prevention & control MeSH
- Primary Prevention * classification methods organization & administration MeSH
- Problem Behavior * MeSH
- Psychiatric Department, Hospital MeSH
- Professional-Patient Relations MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
