Dissertations / Theses on the topic 'Nursing praxis'

This study explores the meaning of praxis in nursing programs at Kwantlen Polytechnic University. My inquiry arose from teaching praxis seminars, where I discovered that there was little consistency in its meaning by consulting colleagues, by researching university archives, and by reviewing the nursing literature. Through a philosophical exploration, however, I learned that praxis involves making moral decisions about how to act well in the world, making praxis a key concern for nursing educators in their efforts to foster such conduct. Praxis, so understood, involves embracing the particulars of the situation and their relationship to universals. My confusion about praxis was, in part, explained by the 2400-year history of the concept. Socrates, Plato and Aristotle were all concerned with ethical action and the relationship between knowledge and experience (the general and particular), but each with a different emphasis. Plato emphasized the acquisition of certain forms of knowledge in helping people to act well; Aristotle claimed that ethical conduct (understood as praxis) depends partly on experience in the world. Over the centuries either Plato or Aristotle’s formulation has been preferred at different times. I have relied largely on the work of the neo-Aristotelian Hans-Georg Gadamer who develops a philosophical hermeneutics circle for praxis, especially the idea of how the general, shaped by our history and traditions, can be dialectically connected to the particular, that is, our experiences, by dialogue. I have critically analyzed dialogues from my practice using the concepts and conditions of understanding proposed by Gadamer. Gadamer provides important resources that can assist nursing educators and nurses in understanding nursing practice as moral action. A Gadamerian approach encourages nurse educators to be alert to the differences in our students and their prior experience and knowledge as they approach interpretive encounters. It requires operating in the space between the particular and the general through dialogue. We can create this space and the curiosity to address moral issues that nurses confront in their practice of praxis by asking questions that support students’ understanding, motivations and prejudices, and by being humble about our conclusions.

The majority of women's health nurses in this study work in generalist community health centres. They have developed their praxis within the philosophy and policies of the broader women's health movement and primary health care principles in Australia. The fundamental assumption underlying this study is that women's health nurses possess a unique body of knowledge and clinical wisdom that has not been previously documented and explored. The epistemological base from which these nurses' operate offers important insights into the substantive issues that create and continually shape the practice world of nurses and their clients. Whether this represents a (re)construction of the dominant forms of health care service delivery for women is examined in this study. The study specifically aims at exploring the practice issues and experience of women's health service provision by women's health nurses in the context of the provision of cervical cancer screening services. In mapping this particular group of nurses practice, it sets out to examine the professional and theoretical issues in contemporary nursing and women's health care. In critically analysing the powerful discourses that shape and reshape nursing work, the study raises the concern that previous analyses of pursing work tend to universalise the structural and social subordination of nurses and nursing knowledge. This universalism is most often based on examples of midwifery and nursing work in hospital settings, and subsequently, because of these conceptualisations, all of nursing is too often deemed as a dependent occupation, with little agency, and is analysed as always in relation to medicine, to hospitals, to other knowledge forms. Denoting certain discourses as dominant proposes a relationship of power and knowledge and the thesis argues that all work relations and practices in health are structured by certain power/knowledge relations. This analysis reveals that there IX are many competing and complimentary power/knowledge relations that structure nursing, but that nursing, and in particular women's health nurses, also challenge the power/knowledge relations around them. Through examining theories of power and knowledge the analysis, argues that theoretical eclecticism is necessary to address the complex and varied nature of nursing work. In particular it identifies that postmodern and radical feminist theorising provide the most appropriate framework to further analyse and interpret the work of women's health nurses. Fundamental to the position argued in this thesis is a feminist perspective. This position creates important theoretical and methodological links throughout the whole study. Feminist methodology was employed to guide the design, the collection and the analysis. Intrinsic to this process was the use of the 'voices' of women's health nurses as the basis for theorising. The 'voices' of these nurses are highlighted in the chapters as italicised bold script. A constant companion along the way in examining women's health nurses' work, was the reflexivity with feminist research processes, the theoretical discussions and their 'voices'. Capturing and analysing descriptive accounts of nursing praxis is seen in this thesis as providing a way to theorise about nursing work. This methodology is able to demonstrate the knowledge forms embedded in clinical nursing praxis. Three conceptual threads emerge throughout the discussions: one focuses on nursing praxis as a distinct process, with its own distinct epistemological base rather than in relation to 'other' knowledge forms; another describes the medical restriction and opposition as experienced by this group of nurses, but also of their resistance to medical opposition. The third theme apparent from the interviews, and which was conceptualised as beyond resistance, was the description of the alternative discourses evident in nursing work, and this focused on notions of being a professional and on autonomous nursing praxis. This study concludes that rather than accepting the totalising discourses about nursing there are examples within nursing of resistance—both ideologically and X in practice—to these dominant discourses. Women's health nurses represent an important model of women's health service delivery, an analysis of which can contribute to critically reflecting on the 'paradigm of oppression' cited in nursing and about nursing more generally. Reflecting on women's health service delivery also has relevance in today's policy environment, where structural shifts in Commonwealth/State funding arrangements in community based care, may undermine women's health programs. In summary this study identifies three important propositions for nursing: • nursing praxis can reconstruct traditional models of health care; • nursing praxis is powerful and able to 'resist' dominant discourses; and • nursing praxis can be transformative. Joining feminist perspectives and alternative analyses of power provides a pluralistic and emancipatory politics for viewing, describing and analysing 'other' nursing work. At the micro sites of power and knowledge relations—in the everyday practice worlds of nurses, of negotiation and renegotiation, of work on the margins and at the centre—women's health nurses' praxis operates as a positive, productive and reconstructive force in health care.

Using the SFU project as a starting point, this study explores the conditions for increased participation and self-determination for people with developmental disabilities who live in group homes. The study was carried out in one municipality in a sparsely populated area in northern Sweden.Two qualitative methods were combined. Eight of the staff and three relatives were interviewed and fieldwork was performed in a group home for people with developmental disabilities before and after the project. The fieldwork provided a view of the everyday meetings and the social interaction in the given context and even provided knowledge of the possibilities for the service users to participate thereby increasing their self-determination. The interviews were intended to uncover deeper answers to the following research questions: What does participation and self-determination mean for the staff and the relatives of the service user? How does the municipality work to realize these goals and how do they succeed? Is there any opposition to work towards realizing these goals? If there are, what are the most important?The predominant impression was that the staff was very insecure about the content of the concepts participation and self-determination and the importance for the service user to exercise these possibilities. After the project was finished, some respondents noted that they had started a "user council" in one of the group homes. Another change was that the "climate" at the group home had become more open after all of the staff had received education, the main intervention in the project. A paradox was that the informants meant that it is important that the service user is allowed to participate and exercise selfdetermination; however, it is the staff who mainly make the decisions and the staff believed that they respected the users more. In addition, the staff are afraid the service user will begin to have too much control if they are allowed to decide about some questions and the staff believed that the service users do not participate and make decisions because a lack of self-confidence.The most important obstructions that inhibited self-determination were the character of the organization, the social situation, and the communication. Obstructions included the organization's lack of management and support and disruption about the needs of a plan and a structure of the work. There was a strong collective praxis in the organisation that work should avoid routines and that the routines are difficult to change because they provide safety. This could be one of the reasons that the education, which was the main intervention of the project, did not provide the impact that was intended. The goal of the project was to increase the service users' possibilities to practice self-determination and to encourage them to demand more complicated challenges than offered by the education. One way to reach the goals can be to encourage cooperation with the relatives and support and raise the enthusiasm for several of the staff to develop ways to work so they take care of and respect the choices that the service users make. When this happens, the service user will experience more self-determination and independence.
Syftet med studien var att med utgångspunkt i SFU-projektet studera villkor och förutsättningar, för ökad delaktighet och självbestämmande, för utvecklings-störda som bor i gruppbostad. Studien genomfördes i en glesbygdskommun i norra Sverige och data genererades genom fältobservationer på en gruppbostad för utvecklingsstörda och intervjuer med åtta personal och tre gode män, före och efter projektets genomförande. Avsikten med fältobservationerna var att få insyn i de vardagliga mötena och den sociala interaktionen i den givna kontexten, samt en möjlighet att få kunskap om brukarnas möjligheter till delaktighet och självbestämmande. Intervjuerna genomfördes för att få ytterligare och fördjupade svar på forskningsfrågorna som var: Vilka innebörder har begreppen delaktighet och självbestämmande för personal och brukarnas företrädare, gode män? Hur går kommunen till väga för att realisera dessa mål och hur lyckas de? Finns det några motkrafter för att arbeta mot att dessa mål, och i så fall, vilka är de viktigaste? Det övervägande intrycket av intervjuerna var att det fanns en stor osäkerhet hos personalen om innebörden i begreppen delaktighet och självbestämmande, och betydelsen av att brukarna skulle ha dessa möjligheter. Exempel på konkreta förändringar som intervjupersonerna ansåg hade skett efter projektet avslutats var att de hade startat ett "boenderåd" och att klimatet på gruppbostaden hade blivit mera tillåtande. En paradox var dock att intervjupersonerna ansåg att det var viktigt att brukarna får vara med och bestämma samtidigt som det var personalen som i stor utsträckning bestämde. Dessutom ansåg de att personalen har börjat respektera brukarna mera. Ett annat motsägelsefullt uttalande var att personalen var rädda för att brukarna skall börja "styra" för mycket om de fick bestämma i vissa frågor, samtidigt som de menade att brukarna inte var med och bestämde därför att de har så dåligt självförtroende. De mest betydande hindren för brukarnas möjligheter till självbestämmande var av organisatorisk, social och kommunikativ karaktär. De organisatoriska hindren var exempelvis oklara roller, brist på ledning och handledning samt behovet av planering och struktur av arbetet. Det visade sig också att det fanns en stark kollektiv praxis, som bland annat innebar att arbetet var rutinstyrt, och de rutiner som hade skapats var svåra att förändra eftersom de upplevdes som en trygghet. Det kan vara en av anledningarna till att utbildningen, som var den största interventionen i projetet inte fick den avsedda effekten.
Godkänd; 2007; 20070523 (ysko)

This qualitative study critically examined nurses' perception of nursing qua nursing in an American Nurses Credentialing Center Magnet^® re-designated healthcare system in Albany NY. Watson's Theory of Human Caring is used by many Magnet^® hospitals, including the site for this study, to inform and guide nursing practice. Watson's Theory supports concepts and practices of integral health, holism, caring, healing, and the education and integration of complementary health care modalities as independent therapeutic nursing interventions. This study aimed to understand the nurse's emancipatory experience, comportment and self-agency as she/he participated in a theory guided practice; and illuminate the nurses' acquisition, understanding and utilization of knowledge and power as required for engaging independent therapeutic nursing interventions in the unitary-transformative health paradigm.

Eight nurses from the Oncology Unit self-selected to participate without recidivism from August to October 2012. The study was conducted in two parts: 1) A questionnaire was developed by the researcher to collect demographic and educational data from participants including: age, ethnicity, level of academic education, years of experience in nursing and in specialty, education to nursing theory, including education specifically to Watson's Theory of Human Caring and to holistic nursing and Complementary and Alternative Modalities (CAM), and CAM use in practice and self-care; and 2) Kim's (1999, 2007, 2010) Critical Narrative Inquiry Method was used to collect and analyze narrative data in three phases: 1) descriptive 2) reflective; and 3) critical-emancipatory. Written and audio data from in-person interviews were transcribed and analyzed by the researcher. Data was validated by participants and used to answer four research questions: 1) What are the emancipatory experiences of nurses in a Magnet^® re-designated healthcare system that promotes Human Caring Theory; 2) What are the patterns that facilitate nurses' comportment and self-agency to fully embody and practice integral nursing qua nursing in a Magnet^® re-designated healthcare system; 3) What are the patterns that create barriers to nurses' comportment and self-agency to fully embody and practice integral nursing qua nursing in a Magnet ^® re-designated healthcare system; and 4) How does the organization support nurses control over their nursing practice within this one ANCC Magnet ^® re-designated healthcare system? Findings gleaned from the patterns that occurred most frequently in the narrative data included: 1) Nurses used Human Caring and Integral Nursing theoretical concepts to inform and conduct their practice; even though they reported limited education to the theories. Elements of the theories that manifested in their practice and self-care included: advocating, educating, counseling, creating a caring-healing environment by honoring the patient and family's space and wishes, approaching patients and families non-judgmentally with an open mind and loving kindness, using complementary modalities of humor, prayer, intention, authentic presence, music, imagery, touch, and obtaining complementary therapy, palliative and spiritual care consults for patients; 2) Facilitators to practice included: the support of their manager, colleagues and team members, optimal staffing patterns, resource nurses and competent, self-motivated care technicians and support staff; and 3) Nurses in the study confirmed their Magnet^® healthcare system values: a) Supportive and participative nursing management; b) Advanced education by providing tuition reimbursement and flexible scheduling; c) Participation in and use of the most current nursing research in their practice; and d) A strong nursing mentoring culture, where nurses empower each other to provide ethical care and advocate for patients' and nurses' rights. Opportunities for nursing education and leadership include: 1) The need to revise academic and continuing education curricula to adopt integral theory guided practice at all levels; 2) The need for advanced practice nurses to translate conceptual models into practice and help nurses to articulate the value and power of nursing to impact integral health and healing.

Suggested Keywords: nursing, holistic, integral, human caring, theory guided practice, emancipatory praxis, critical narrative inquiry, ANCC Magnet^®.

Bakgrund: Öppenhet om psykisk ohälsa är något som har fått allt mer medial uppmärksamhet. Konceptet öppenhet är brett och innefattar flertal definitioner såsom transparens, som i att vara ärlig och inte gömma information, samt ett förhållningssätt som präglas av bland annat tolerans och förmågan att acceptera nya perspektiv och idéer. Öppenhet avhandlas i denna studie från perspektivet av sjuksköterskor med egen erfarenhet av psykisk ohälsa. Syfte: Denna studie syftar till att utforska sjuksköterskors upplevelser och erfarenheter av öppenhet gällande psykisk ohälsa samt att avtäcka öppenhetens meningsbärande enheter utifrån ett omvårdnadsperspektiv. Metod: Studien har en kvalitativ studiedesign med en fenomenologisk hermeneutisk forskningsansats. Information samlades in via semistrukturerade intervjuer. Resultat: Analysen resulterade i 3 övergripande teman: öppenhet som transparens, öppenhet som förhållningssätt och öppenhetens kraft och fundamentala växelverkan. Helhetstolkningen  visade att öppenhet är en förutsättning för all typ av medmänsklig interaktion och kommunikation. Att dela med sig av erfarenheter av psykisk ohälsa är transparens med intentionalitet kopplat till både strävan efter en bättre värld och ett sätt att visa omsorg. Helhetstolkningen mynnade ut i att sjuksköterskors öppenhet gällande egen erfarenhet av psykisk ohälsa i hög grad påverkades av upplevd stigma. Slutsats: Öppenhet har en inre självförstärkande kraft: öppenhet leder till öppenhet. Att dela med sig av egna erfarenheter av psykisk ohälsa ter sig har en stor potential i att skapa relationer präglade av ömsesidighet och medmänsklighet. Att bemöta med öppenhet är nyckeln till att ge transparensen en möjlighet att skapa en mer humanistisk och rättvis vård.
Background: Openness around mental health issues has gained increased media attention. The concept of openness is vast and includes multiple definition like transparency, as in to be honest and not hiding information, and also an approach characterized by, among others, tolerance and the ability to accept new perspectives and ideas. In this study openness is presented from the perspective of nurses with own experience of mental health issues. Aim: This study aims to explore nurses’ experiences and knowledge of openness regarding mental health issues and also uncover the meaning entities within the concept of openness from a nursing perspective. Method: The study uses a phenomenological hermeneutical method. Information was gained through semi-structured interviews. Findings: The analysis resulted in 3 main themes: openness as transparency, openness as an approach and the power and fundamental interactions of openness. The comprehensive understanding exposed openness as a postulate to all human interaction and communication. To share own experiences of mental health issues is transparency with intentionality including striving for a better world and mediate caring. The comprehensive understanding also indicated that nurses’ openness in sharing own experiences of mental health issues was impacted negatively by stigma experiences. Conclusion: Openness has an inner amplifying power: openness leads to openness. To share experiences regarding mental health issues appears to possess a great potential in creating relationships characterized by mutuality and compassion. To approach with openness is the key to give transparency the ability to create a more humane and just health care.

Esta é uma pesquisa qualitativa cujo objeto de estudo é a Copa da Inclusão, mais precisamente a ação dos trabalhadores na Copa da Inclusão (seus processos de trabalho), o sentido do seu saber e do seu fazer, buscando compreender se tal ação leva em consideração a complexidade do objeto de intervenção, ou seja, a vida real do usuário de serviços de saúde mental. Tem a finalidade de contribuir para a efetivação e consolidação da Reforma Psiquiátrica brasileira e do campo psicossocial, por isso se propôs os seguintes objetivos: a) Caracterizar o perfil profissional do trabalhador responsável pela organização da Copa da Inclusão; b) Compreender seus processos de trabalho na Copa da Inclusão; c) Analisar se estes processos de trabalho produzem transformações no cotidiano do serviço. O cenário de estudo é a Copa da Inclusão. Participam deste estudo seis sujeitos, trabalhadores responsáveis pela coordenação das atividades relacionadas à Copa da Inclusão em seis serviços da Prefeitura Municipal de São Paulo (um Centro de Atenção Psicossocial Álcool e Drogas - CAPS AD -, quatro Centros de Atenção Psicossocial II - CAPS II - e um Centro de Convivência e Cooperativa - CECCO). Os dados empíricos foram coletados por meio de entrevista semi-estruturada e analisados segundo a técnica de análise de enunciação. Os resultados apontam importantes transformações na vida dos usuários coerentes com as finalidades dos processos de trabalho definidas a priori pelos trabalhadores, ou seja, ampliação da rede social, desenvolvimento da autonomia, melhoria na qualidade de vida e resgate da cidadania dos usuários. Também é possível verificar que os instrumentos utilizados (pessoais, institucionais e intersetoriais), estão adequados para atingir tais finalidades. Além disso, existe coerência na eleição do objeto de trabalho, considerado uma pessoa ativa na construção de sua cidadania. As transformações na vida dos serviços confirmam que na relação dialética entre os meios de trabalho (instrumentos) e os objetos de trabalho ambos são transformados, ou seja, de um lado o objeto passa a apresentar demandas mais complexas, por outro lado o serviço é convocado a desenvolver instrumentos de intervenção mais sofisticados. Tais transformações dizem respeito à ampliação das ações do serviço no território, maior entrosamento entre os trabalhadores dos serviços possibilitando o trabalho em equipe com características interdisciplinares, organização e planejamento das ações de saúde relacionadas à Copa, mudança no papel (poder) do trabalhador na relação com os outros trabalhadores e com os usuários e a incorporação de novos atores com seus saberes no campo psicossocial. As transformações na vida da sociedade, relacionadas à cultura e imaginário coletivo sobre a loucura, apontam para uma maior participação de pessoas da comunidade nas atividades relacionadas à Copa e a diminuição do estigma social da loucura, fruto das atividades preparatórias da Copa da Inclusão. A Copa da Inclusão prova que as atividades intersetoriais com a participação da comunidade são um trabalho vivo em ato, utiliza instrumentos de intervenção potentíssimos no resgate e construção da cidadania das pessoas portadoras de transtornos mentais. As transformações (finalidades dos processos de trabalho), neste caso, podem estar ocorrendo porque o projeto de intervenção não é mais centrado na doença, ou seja, o objeto de trabalho destes serviços foi ampliado e complexificado. Por fim, conclui-se que à medida que os trabalhadores (força de trabalho), frente às dificuldades para a realização de seus processos de trabalho, mobilizam-se para superá-las, criam meios para a consolidação do modelo de atenção psicossocial e superação do modelo asilar. O trabalhador necessário ao campo psicossocial é aquele que tem consciência práxica do seu fazer, é aquele que produz e reproduz conhecimentos com a finalidade clara de transformar as realidades
This is a qualitative research in which the object of study is the Inclusion Cup, more precisely the action of the workers in the Inclusion Cup (their praxis), the meaning of their knowledge and their practice, looking for the understanding if such action takes into consideration the complexity of the object of intervention, in short, the real life of the users of mental health services. It has the purpose of contributing for the effectiveness and consolidation of the Brazilian Psychiatric Reform and the psychosocial field, so it has been proposed the following objectives: a) Defining the professional profile of the worker responsible for the organization of the Inclusion Cup; b) Understanding their praxis in the Inclusion Cup; c) Analyzing whether these working praxis produce transformation in the daily job. The scenery of study is the Inclusion Cup. Six people participate on this program, workers responsible for the coordination of the activities related to the Inclusion Cup in six services of Sao Paulo City Hall (a Psychosocial Attention Center of Alcohol and Drugs – CAPS AD -, four Psychosocial Attention Centers II – CAPS II – and a Center of Acquaintanceship and Cooperative – CECCO). The empirical data were collected by semi structured interview and analyzed according to the technique of enunciation analysis. The results point out important changing in the users’ lives coherent with the aims of the praxis defined firstly by the workers, in short, the extension of the social network, the development of the autonomy, the improvement in the quality of life and the rescue of the citizenship of the users. It’s also possible to verify that the tools used (personal, institutional and inter-sector) are adequate to achieve such aims. Besides, there is coherence in the selection of the object of work, considering an active person in the construction of their citizenship. The transformation in the lives of the services confirm that in the dialectical relation between the resources of work (tools) and the objects of work both are transformed, in short, on the one hand the object starts to present more complex demand, on the other hand the service is called to develop instruments of intervention more sophisticated. Such changes concern to the extension of the actions of the service in the territory, more connection among the workers of the services making possible the team work with interdisciplinary characteristics, organization and planning of the actions in health related to the Cup, changes in the worker’s role (power) in the relationships with the other workers and the users and the incorporation of new actors with their knowledge in psychosocial field. The transformations in life in society, related to culture and collective unconscious about madness, indicate a bigger participation of the people from the community in the activities related to the Cup and the reduction of the social stigma of madness, result from the preparatory activities for the Inclusion Cup. The Inclusion Cup proves that the inter-sector activities with the participation of the community are a live work in attitude, it uses mental tools. The transformations (the purpose of the praxis), in this case, can be happening because the project of intervention is not centralized on the disease, in short, the object of praxis of these services has been extended and made developed more complex. Finally, it could have been concluded that as the workers (labor force), facing difficulties to accomplish their praxis, they mobilize to surmount them, create ways for the consolidation of the psychosocial attention model and surmount the asylum model. The needed worker to the psychosocial field is the one who has clear definition of the praxis, the one who produces and reproduces knowledge with the clear purpose of changing realities

Bakgrunn: Mangelen på intensivsykepleiere kan påstås å være allment kjent i helsevesenet. Kravet om kompetanse er stigende, som igjen stiller høyere krav til utdanningsstedene. I løpetav studiet skal sykepleierstudentene gjennomføre klinisk praksis, og skal her knytte teori ogpraksis sammen, for å selvstendig kunne møte kompetansekravet som venter. Hensikt: Å finne ut sykepleierstudenter som har praksis på intensivavdelingen, sin opplevelse av miljøets betydning for læring. Metode: For å fange sykepleierstudentens perspektiv, er det gjort en integrativ litteraturstudie, hvor det sammen med bibliotekar systematisk er søkt etter forskning, som svarer til hensikten. Studiet består av seks kvalitative artikler, der data er analysert og systematisert.Resultat: Resultatet viser at intensivmiljøet er ett krevende sted å være i praksis, og mange følelser oppstår hos sykepleierstudentene. Opplevelsene til sykepleierstudentene som hadde betydning for læringen i intensivmiljøet, er presentert i 3 kategorier. Kategoriene viser at miljøet oppleves som krevende, men lærerikt, at det er viktig med ett god samspill og relasjon med veileder og at miljøet oppleves som stressende, dystert og høyteknologisk. Konklusjon: Miljøet i intensivavdelingen er krevende for læringen, men til tross for dette er det et bra sted å knytte teori og praksis sammen. Å ha en god relasjon til veileder virker å være essensielt for ett godt læringsmiljø. Samtidig viser studien til viktigheten av å være forberedt på hva intensivmiljøet innebærer. Med denne kunnskap kan studiesteder og praksissteder gjøre en forbedring.
Background: The lack of ICU nurses, can be claimed to be widely known in the health caresystem. The demand for high competence is rising, which puts a higher demand on the educational institutions. During the nursing program there is a time of practical training, where the goal is to link theory and practice together, in order to become an independent nurse who can meet the competence that is required. Aim: The aim of this study was to look at the nursingstudents' perceptions on how the environment impacts the learning, through practice in the intensive care unit. Method: In order to capture the nursing student´s perspective, an integrativeliterature study has been carried out, and together with a librarian, a systematic search for research have been done, which corresponds to the authors intension. The study consist of six qualitative articles, where the data was analyzed and systematized. Results: The results shows that the ICU is a demanding place to be in practice, and many emotions arise in the nursing students. The mainfactors in the environment that have impact on the nursing students learning, are presented in 3 categories. The categories shows that the environment is demanding, but educational, the importance of a good relation with the mentor, and that the environment is stressful, gloomy and high-tech. Conclusion: The environment in the ICU is demanding for learning, but despite this, it is a good place to link theory and practice together. Having a good relationship with the supervisor seems to be essential for creating a good learning environment. At the same time, the study points out the importance of being prepared for the ICU environment. With this knowledge, study institutions and internships can make an improvement.

碩士
國立陽明大學
臨床暨社區護理研究所
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Chemotherapy is the most common treatment regimen for cancer with significantly annual increased incidence and mortality rates in Taiwan. Nurses exposed to high toxic materials while caring for cancer patients. The Regulation of Cancer Care Quality Assurance Measures established in 2008 demands the actions taken to ensure the safe environment for nurses and patients. Various clinical practical guidelines (CPG) have been developed based on the regulation in the name of evidence-based medicine (EBM) which has been promoted vigorously over the past decade in Taiwan. The objectivity and neutrality of scientific evidence has been the central theme in EBM which makes standardization of nursing practices possible. The clinical observations indicated that nurses have not used personal protective equipments properly. This study explores (1) how data sources produced from diverse clinical setting and context claim to be legitimacy evidence (2) how invisible and uncertain toxicity of chemotherapy clinical practices transformed and represented in standardized clinical guideline protocols (3) how nursing clinical practices represented the meaning of enacted toxicity and protection of chemotherapy interpreted by nurses. Ethnography was applied and data collection included participant observation and ethnography interviews. Nurses providing chemotherapy in the oncology wards at the hospitals in the southern and central Taiwan were invited to participate. Data were transcribed verbatim and analyzed by the constant comparison method. The results showed that patterns of nursing judgments of various cancer patient conditions were normalized and disciplined as scientific evidence. The perfection of nursing skills in infusion and delivery of chemotherapy drugs becomes the power to mitigate the toxicity. In addition, the will to maintain professional relations with patients and family members keeps nurses away from their mandatory personal protective equipment. In conclusion, experiences in daily practices should be accounted as good evidence and integrated as nursing exemplars in clinical practice guideline.

Nursing documentation became an important part of work of a general nurse / a midwife. The nursing documentation differs in individual hospitals. The clinic management is responsible for the documentation contents in given hospital and general nurses / midwives at least participate in its development. The nursing documentation serves as the work aid for the nursing staff, being the material providing important information for other medical staff and institutions. The documentation objectively informs the medical team members about the health conditions of the given individual. Recently, significant stress started to be put on education activities of a nurse and its documenting. New examination methods or therapeutic procedures are being introduced into practice, which should help in treatment of clients. Regardless modern progress, the number of chronically ill clients increases ? for example diabetes mellitus, chronic renal insufficiency, asthma bronchiale etc. That is why nurses in the positions of educators play very important rules. The graduation thesis / diploma work aims at nursing documentation in practice. The aim of the graduation thesis / diploma work was to map the efficiency of nursing documentation and to find out what an importance attach the nurses to nursing documentation keeping. Another aim was to find out whether education plans make a part of nursing documentation. My last aim was to find out whether an education nurse is a member of the nursing team. For the research part of this work, a combination of qualitative and quantitative research solution was used. A semi-structured interview was used s the data collection technique for the qualitative part, while there were interviewed the chief nurses working in a hospital in Plzeň region. A questionnaire was used as the data collection technique for the quantitative part and it was designed for general nurses working in the faculty, regional and district hospitals in Plzeň region, in standard department, intensive care unit and in consequent care unit. The aims of the work were reached. Four hypotheses were set for the quantitative research. 1. Nurses perceive the efficiency of nursing documentation in case of being kept by an appointed nurse. 2. The shift nurses consider nursing documentation keeping to be rather a stress instead of an expression of professional activities of a nurse. 3. A part of standard equipment of nursing documentation is reserved for education activities. 4. The system of nursing care provision in the hospital departments does not allow application of education process, even though its keeping in nursing documentation is required. The first two hypotheses were confirmed, the third and fourth hypotheses were not confirmed. Five chief nurses expressed their interest in results of our research and investigations. They are interested in results obtained in their departments. We continue our co-operation as the output of the work is a draft of documentation for education of a client, the education standard and a seminar or course of education activities of a nurse.

The main objective of the thesis was ascertaining of realization of the Nursing Care Concept issued by the Ministry of Health in 2004, in Czech hospitals. To achieve results a quantitative research method was used. While collecting data we used a questioning method, by means of questionnaires. The questionnaires were intended for staff nurses/deputies of nursing care in Czech hospitals. As a research sample we chose hospitals in the Czech Republic which provide acute ward (bed) care. The found out data should clarify what is the actual status of realization of the Nursing Care Concept in Czech hospitals.

As a consequence of the quick development of information technologies there has been a natural and gradual transition to the electronic data storage in nursing. The firstversions of the software application for such documentation have been developed in cooperation with professionals dealing with information technologies in the States of the European Union and it is the nurses who decide what the content of the nursing documentation will be. Therefore it is very important that the nurses {--} as the main users of this software {--} are actively involved in the creation process of the electronic nursing documentation. The advantage of introducing the electronic nursing documentation is filing of the important data about a client in the NIS where it is possible to retrieve the history anytime. In contrast to the traditional records, it is easier to read these records and it is not possible to cross any information out or lose it. Further, it saves nurses{\crq} time, it automatically records time and name of the medical worker who logged in the NIS and it meets the recommendations of the accreaditation standards. A qualitative research was used in the research part of this thesis. A semi-standardized interview with the head nurses and a structured interview with the senior staff nurses and ward sisters of the departments of internal medicine and of surginal wards of the selected hospitals were used to collect the data. Further, the method of content analysis was used to compare the electronic nursing documentation in the individua surveyed hospitals. The structured interview with the senior staff nurses and ward nurses was not done in the Hospital České Budějovice, a.s. because the programme of the electronic nursing documentation has not been started there. Case reports are created based on the gained interview results. The case reports comprise the research base on which categorized charts in which the research results are recorded are based. The research was conducted from January till June 2009. The surveyed group consists of head nurses, two senior staff nurses and two ward sisters of the departments of internal medicine and of surginal wards of the selected hospitals of the chosen regions of the Czech Republic. The research was conducted in the South Bohemian Region {--} the Hospital České Budějovice, a.s., the Pilsen Region {--} the Teaching Hospital Plzeň, the South Moravian Region {--} the Teaching Hospital Brno and the Vysočina Region {--} the Hospital Jihlava, p.o. Four research questions were defined at the beginning of our research in order to achieve our goal. The research questions 1: Does the electronic nursing documentation contain all phases of the nursing process (anamnesis, diagnosis, care plan and assessment)? The research questions 2: Is the nursing taxonomy a part of the electronic nursing documentation of each patient? How is the record of the nursing diagnosis created (crossing x filling in)? The research questions 3: Which nursing model has become the basis for the nursing anamnesis of the electronic nursing documentation? The research questions 4: Can the nurses take an active part in the preparation process of the electronic nursing documentation? All our research questions have been answered. We defined the following hypotheses based on the results of our research: H1: The electronic nursing documentation contains nursing anamnesis based on the Marjory Gordon{\crq}s conceptual model. H2: The nurses are offered to cooperate in the creation process of the electronic nursing documentation. H3: There is a taxonomy part in the nursing documentation. H4: The electronic nursing documentation covers all phases of the nursing process. We belive that the results of he

Increasing the education of nursing staff is a society-wide issue, influenced by continuous development of medicine and medical technologies. The provision of nursing care is rightly demanding. The only way to keep up with new trends is lifelong nursing education. Nursing education in a particular workplace primarily aims at addressing current problems of the department and nurses? needs. The theoretical part deals with the influence of education on the quality of nursing care. We present a structure of education of paramedical professions. We define and clarify terms such as pedagogy, didactics, education and learning. We deal with the specifics of education, didactic principles and principles of adult education. In addition, we specify instructional strategies for nursing staff. For the purposes of this thesis, four objectives were set. In the first one we wanted to find out what the system and process of nursing education in the department looks like. The research showed that educational events are held in all departments. The organizing departments mostly report irregular or monthly frequency. The aim of the second objective was to obtain an opinion on the effectiveness of education in the department. We found disparity between the views of ordinary nurses and head nurses. The third objective was to answer the question of whether the organized educational events are initiated by the nurses? requests. Based on the answers of head nurses and ordinary nurses, we found out that this is not always the case. The last objective was to determine whether nurses implement the knowledge and skills gained to routine nursing care. The questionnaires showed that ordinary nurses try to incorporate the knowledge and skills to routine nursing care. For the purposes of this thesis, the combination of qualitative and quantitative research was selected. In order to carry out the qualitative part of the research, the method of questioning, using the technique of semi-structured interview with open questions was chosen. For the issue of quantitative research, the method of questioning, using the questionnaire technique with closed and semi-closed questions was used. For qualitative research, we set two research questions. In the first research question we wanted to find out what impetus the management uses when planning education in the hospital and the department. We found out that most often it is initiated by head nurses and ward nurses. In the second research question, we examined what obstacles the management sees to the effectiveness of education and implementation of the knowledge and skills gained into practice. Head nurses identify a problem in the actual participation in education in the department. For quantitative research, we set five hypotheses. Hypothesis 1 was: Nursing education in the workplace is an activity organized by the management regardless of the ordinary nurses? requests. The hypothesis was not confirmed. Hypothesis 2 was: Management, unlike ordinary nurses, sees the effectiveness of education in the workplace positively. The hypothesis was not confirmed either. The third hypothesis was: Education is seen as a necessary, routine activity, not as motivating factor for improving the quality of nursing care. The hypothesis was not confirmed. The last hypothesis was: Implementation of the knowledge gained from the educational events into nursing care is monitored by the management. The hypothesis was not confirmed, the implementation of knowledge is monitored, but not to the extent we expected. When evaluating the results we came across other very interesting facts, which we believe deserve more attention. Finally, it is surprising that the organization of educational events does not reflect nurses? shifts. One of the reasons for this might be the fact that some head nurses do not prepare the plan and time schedule for nursing education. We tried to propose the time schedule of nurses education in deparments.

The aim of this study was to survey evaluation and measurement techniques that are used in practice. I have chosen this topic because demands on individual work of nurses are increasing and evaluation techniques and rating scales may help nurses in their work.Through the quantitative survey using questionnaires, opinions of 354 nurses at the bedside, and 61 nurse managers from 22 hospitals in the Czech Republic were surveyed. We wanted to identify the most common scales used in our hospitals and to find the reason why those specific scales are used. What problems nurses find in evaluation by scales, or what benefits the scales bring about. The respondents were also asked questions relating to risk management and the use of scales in this field. If prevention is the primary objective by which nurses try to anticipate more serious complications, what benefits the system brings to patients. The results of the investigation could be a clue to the efficient use of scales in practice and suggestions for managerial decisions when choosing suitable, acceptable parameters that will meet patients´ as well as medical staff members´ requirements.

The ward sister round presents an integral part of the nursing profession. The ward sister round comprises a regular visit of the nurse directly at the patient´s bed. Its objective consists in determining and satisfying the unsaturated needs of patients, further in ensuring and providing a high quality and efficiency nursing care in a close link with medical care. Nursing handover can be divided into two main sections: written and oral handover. The oral handover takes place directly in the patients´/clients´ room under the use of nursing documentation. Its advantage consists in the direct involvement of the patient/client in the handover process. The written handover is then entered by the nurses into the Handover Book. The significance of my diploma work consists in increasing the nurses´ standard of knowledge related to the modernization of ward sister rounds and nursing handover as an integral part of the nursing profession.

The research included quantitative as well as qualitative elements. The aim of the thesis was to find out the attitude of the nurses in internal medicine and surgical sections to a practical nursing process. The inquiry and questionnaire method was used for data collection. The second aim was to find out the possibilities of the improvements of nursing process in practical conditions in relation to the particular depatment. The qualitative research was held with head nurses and ward sisters in internal medicine and surgical depatments with the use of halfstrukture interview. The research file in a quantitive research was represented by nurses working in internal medicine and surgical departments in České Budějovice Hospital, PLC . In these departments 200 questionnaire forms were at nurses´ disposal, 180 of them being completed. 90 nurses work in departments connected with internal medicine and 90 nurses come from specialized surgical departments. The first two questions had the identification character, the other four questions were focused on the nurses´education and the rest of the questions concerned the satisfaction with carrying out the nursing anamnesis, with making a nursing diagnosis, with keeping administrative materials of nursing, with planning to put nursing care into practice. The questionnaire provided possibilities for expressing the nurses´views and opinions suggestions for improving the existing situation. The last seven questions were connected with the sphere of the nurses´motivation. For this quantitative research five kinds of hypotheses were outlined. H1 - The nurses in internal medicine departments are more satisfied with the practical nursing process than the nurses in surgical departments. H2 - The nurses with the university education background are more satisfied with the nursing process compared to nurses without university education background. H 3 - The nurses are not satisfied with recording the nursing diagnosis, as it is done in a practical way. H4 - The nurses in surgical departments would welcome fewer documentation materials compared to the nurses from internal medicine departments. H 5 - The nurses are more satisfied with the nursing process in a well-working section compared with the section with a longlasting dismal situation. The qualitative research file included 8 ward and head nurses working in České Budějovice Hospital, PLC. 4 leading nurses were from departments connected with internal medicine and 4 leading nurses were frodepartments connected with internal medicine and 4 leading nurses came from departments with surgical specialization. The interview took place in the particular departments and started with the research question about the ways of improving the nurses´ satisfaction with the nursing process in practical activities in České Budějovice Hospital,PLC. The aim of the thesis was to find out the attitude of the nurses from the departments connected with internal medicine and surgical treatment to the nursing process in practical activities. The results of the quantitative research show that the nurses express dissatisfaction with recording the nursing diagnosis, they require unified brief form, the completing of which would not take much time from their nursing duties. Another kind the nurses´dissatisfaction is related to the way of recording the nursing anamnesis.

Medical staff and therefore also nurses may currently more and more often meet patients from foreign countries. It is beyond question that these clients have their own specific biological, psychological and social needs which the nurses should respect. Theoretical part of this assignment describes the issue of trans-cultural nursing, defines it and explains its importance and historical development. It also deals with some of the multi-cultural care models, i.e. the models by Leininger, Giger-Davidhizar, Campinhy-Bacote and Bloch's Ethnic Nursing Care. In general it also mentions conceptual nursing models, their definitions, origin and importance. The following goals were set for this dissertation: Goal 1: Map the issues related to the Leininger's and Giger-Davidhizar's models and their practical use in selected hospitals in the Czech Republic. Goal 2: Find out if nurses use aspects of multi-cultural nursing within their nursing care for foreign patients. Goal 3: Find out how the nurses benefit from using the trans-cultural nursing models for foreign patients within their nursing process. Goal 4: Formulate nursing documents suitable for application of nursing care for foreign patients. Based on the above goals, several research questions were defined: 1. What nursing models are used in selected hospitals in the Czech Republic? 2. How do nursing documents in selected hospitals in the Czech Republic respect nursing process specifics when foreign patients are concerned? 3. Are nurses aware (and in what scope) of the principles of the Leininger's and Giger-Davidhizar's models? 4. How do nurses use trans-cultural nursing models when caring for foreign patients? 5. How do nurses, in their opinion, satisfy foreign patients' biological, psychological and social needs with respect to their cultural differences? 6. How do nurses educate themselves in multi-cultural care? In practical part of the work, nursing documents or anamneses from selected hospitals in the Czech Republic were collected and their content was analysed with focus on multi-cultural aspects identification. Gathered results were then plot in charts. In the next phase of the investigation, semi-structured interviews were held with ten nurses working in standard wards of selected health-care facilities which provided nursing anamneses. Each of the nurses worked in different hospital. The outcome of my dissertation is a draft of nursing anamnesis based on the Leininger's model which is suitable for data collection from patients coming from different cultural backgrounds.

One of the key factors influencing the quality of nursing care practice is the research applied within nursing processes. Therefore it is vital for theory to be closely linked with practice. To perform research and apply its results in practice is one of the conditions which lead to the development of evidence-based practice. Research applied in nursing care is a key strategy resulting into the unification of the human educational and scientific aspects of nursing care. This thesis focuses on the nursing care research and its application in practice together with the role of senior nurses within this process. The aim was to investigate whether and how the nurses are actually involved in nursing care research plus to examine whether ordinary nurses are willing to accept any changes associated with the introduction of the results of nursing care research into nursing practice. Besides this, also to determine whether nurses are encouraged to implement the results of nursing research into nursing practice, to observe nursing care deputies and leading nurses experience in respect to the implementation of the nursing care research results into practice in different types of hospitals plus to determine whether and how nurses introduce the results of nursing care research into practice. The final objective of this thesis was to determine whether the head nurses manage to introduce the results of the nursing care research into their nursing practice. In quantitative survey performed, the research sample consisted of nurses who work in inpatient departments at clinics and regional hospitals - public limited companies of the Central, South, West Bohemia, and Prague. 350 questionnaires were distributed. The research involved 186 questionnaires. Qualitative research data collection involved 12 respondents, out of which there were 3 head sisters employed at clinics and 3 nursing care deputies plus 3 head nurses from regional hospitals - public limited companies. All interviews were entirely anonymous. According to the survey findings, most of the nurses replied that they are not actively involved in the nursing care research. Nurses generally follow published results of nursing care research, but on the other hand, it is obvious, that they follow nursing care research outcomes randomly and without particular focus. Nurses not only that they refuse any changes, but they do not see any benefits of the implementation of research findings into the nursing care practice. The qualitative survey performed met objectives and all questions were answered. Any of the responses can serve for further quantitative research, especially when the results of the implementation of the nursing care research into practice at clinics and regional hospitals are compared.

Although it is relatively easy to study and learn about a practice discipline in the safe environment of an academic institution, it is far more complex to make sense of what has been learned when faced with the real world of practice. Practitioners need to think on their feet and have to find new ways of managing complex problems which do not fit directly into the theoretical frameworks learned in a more formal setting. Knowledge of what the various disciplines say is not in itself sufficient, experiential knowledge is necessary. The key to learning in the experiential domain is critical reflective practice and emancipatory learning, which empower practitioners to explicate their implicit theories. If autonomy is the goal of professional education, the key is to help adult learners to distance themselves from their own values and beliefs in order to entertain more abstract modes of perception. The purpose of this inquiry was therefore, to construct a model for facilitation of critical reflective practice, based on thorough analysis of the main concepts (critical thinking and reflection), related viewpoints, models and theories; and the data gathered and analyzed during, the naturalistic inquiry. The inquirer sought to. develop each participant through Socratic & Learning Through Discussion (Dialogical) Technique, Critical Incident Reporting and participation in Critical Reflective Exercises. The constructed model for facilitation of critical reflective practice evolved from empirical observations, intuitive insights of the inquirer and from deductions combining ideas from several fields of inquiry. The model for facilitation of critical reflective practice postulates that practitioners have the inherent potential to change from auto-pilot practice to critical reflective practice. The purpose of the model is the facilitation of heightened awareness of the self, to enable health care professionals to consciously meet community needs and expectations. The desired outcome is transformative intellectuals who will strive to empower others to become critical reflective learners and practitioners.
Health Studies
D.Litt. et Phil. (Nursing Science)

The thesis on the topic "Implementation of Elements of the Code of Ethics for Nurses and Patients' Rights in Practice" has the characteristics of a research. The thesis is divided into two parts, theoretical and practical. There were four objectives in the practical part of the thesis, the purpose of which was to determine the following: whether patients receive enough understandable information about the diagnostic, therapeutic and nursing care from doctors and nurses, whether intimacy and patients´ feelings of embarrassment are being respected by doctors and nurses, whether patients have the space to voice their views and decisions for therapeutic, diagnostic and nursing care, and whether patients perceive the approach of medical staff to other patients as dignified.

Diseases of affluence are those that accompany any given society at any given time. The best "treatment" for diseases of affluence is prevention, which in nursing practice can be achieved by using appropriate teaching methods. One of the diseases of affluence is tooth decay. Recent studies have shown a significant decrease in oral hygiene amongst children. The result is an increase in tooth decay which has a negative impact on the secondary dentition. Prevention should include increasing children?s awareness of their own health and learning effective teeth cleaning with the help of their parents. The role of nurses in primary prevention of oral health of children is indispensable and includes various educational activities. This thesis is focused on the use of appropriate teaching methods of tooth decay prevention in nursing practice. The aim of this study was to evaluate the impact of a prevention programme called ?A Healthy Tooth?. This programme was aimed at children in kindergarten and pupils in the first four years of primary schools. Its aim was to increase their skills and knowledge of preventing tooth decay. It was also aimed at parents of the children who were trained in this programme. To achieve the purposes of this thesis we used a methodological triangulation technique which enabled us to examine the impact of the programme by applying several different methods. The following methods were used: a questionnaire for parents and children, interviews with children and direct observation of children while they were cleaning their teeth. The questionnaire for parents and children consisted of six closed questions about the issue of tooth decay prevention. The questionnaires were anonymous and were compiled for the purposea of this thesis. The questionnaires were distributed to the children with a written consent from their parents. The research sample for the quantitative survey of parents included parents of children from kindergartens and primary schools in Jindřichův Hradec. 130 questionnaires were distributed, 128 (98 %) of completed questionnaires were returned and none of them were discarded. The research sample for the quantitative investigation of children included children from kindergartens and the first four years of primary schools in Jindřichův Hradec. With the consent of the parents, 24 children from kindergartens and 108 children from primary schools were interviewed. 132 (100%) questionnaires were classified for further evaluation. The data were evaluated using Microsoft Excel charts. To verify the hypotheses, we used a test of independence ? chi-square ? using a PivotTable. For the semi-structured interviews with children, we created a schedule of questions. The central topic of the interview was tooth decay and its prevention. Interviews with children were conducted with the written consent of their parents and were anonymised. Direct observation of children during toothbrushing was conducted to explore the method and sequence of cleaning their teeth. It was noted in the answer sheet and photographs were taken with the consent of the parents of the respondents. The research sample for the qualitative survey consisted of ten children ? five children from kindergartens in Jindřichův Hradec and five children from primary schools in Jindřichův Hradec. The data were processed in the SmartArt diagrams and tables using Microsoft Office Word 2007. The results of the survey helped determine the depth of knowledge and skills in the tooth decay prevention of children. It showed some positive effects of the use of appropriate teaching methods in the effectiveness of the prevention programme in nursing practice. It also contributed to the improvement of dental health in the child population.

The aim of this paper was to find out the specifics of nursing care in clinical and community practice in Roma minority. Furthermore, to find out which of these specifics are missing in the J. N. Giger and R. E. Davidhizar nursing model and modify the nursing documentation based on this conceptual model accordingly. A combination of qualitative and quantitative research was used to achieve the set goals. The whole research was carried out within the framework of the team research project of GAJU No. 048/2015/S. Within the qualitative survey, 8 interviews with members of the Roma minority were carried out to verify the context of individual areas of the conceptual model. Furthermore, the focus group technique was used with nurses from clinical and community practice to verify the use of modified nursing documentation. The quantitative research used a non-standardised questionnaire based on the conceptual model areas for 600 respondents from the Roma minority. The research carried out has shown that health is one of the highest values in life for Roma people. Although health comes first, their way of life does not match this finding. This mainly concerns the area of substance abuse and disease prevention. Health care is influenced by their education. The more educated the individual is, the more they visit a doctor, they keep the treatment regimen and more generally they look after their health. The Roma minority is a relatively closed group of inhabitants, which to this day is difficult to assimilate into the majority society. Nevertheless, there is a gradual loss of some specific features. Above all, it is the loss of knowledge of the Roma language or the failure to observe some traditional Roma customs and traditions. This is mainly influenced by the social environment of the individual. All information obtained is clearly presented in the proposed documentation according to the Model of thoughtful and adapted care. Using this model provides us with a comprehensive assessment of the individual and the ability to better plan nursing care according to the needs of each individual.

The theme was chosen on the basis of their own experience, when new treatments, tools and nurses appear in the workplace, which are also required to constantly improve the quality of nursing care. The state approach to the patient forms the philosophical basis of nursing care. To give nurses of quality pastry about the bio-psycho-social and spiritual needs of the patient, it is necessary to have the knowledge, conditions and personal relationship to provide holistic care. At present, it is not possible that these are health and safety risk factors. Aims, research questions and hypotheses: The subject of the research is to find out the interest of nurses to apply a holistic approach in practice considering the current situation in nursing. Three objectives were set based on the subject of the research. Goal 1: Find out, if nurses are interested in providing modern nursing care based on patient needs. Goal 2: Identify nurses' personal views on providing holistic care. Goal 3: Determine the satisfaction level among nurses about the nursing care provided with regard to the current situation in practice. Methods and research file: Quantitative data collection method was used for the research. Anonymous questionnaire was distributed to nurses in selected healthcare facilities (Liberec Hospital, Turnov Hospital, Jablonec nad Nisou Hospital). The survey sample size is 180 respondents. Findings and conclusion: It follows from the research, that more than half of the respondents have already encountered the concept of holistic nursing care and they also understand what needs should be met by patients/clients and how to satisfy them. Some of them have already used the help of a social service or psychologist. However, it has turned out, that more than half of the responding nurses are not interested in spiritual needs. It has not been confirmed, that nurses' interest in providing this modern nursing care based on patient needs would depend on capacity of staff. The survey also shows, that the holistic care is provided in their hospitals according to one third of responding nurses. Nevertheless, the respondents think, that a holistic approach cannot be applied in their workplace because of lack of time, lack of staff and time consuming administration. Based on the results of Hypothesis 2, we can confirm, that nurses' opinion on the implementation of noursing care provided is influenced by the workload of nurses. The holistic approach moderately affects the job satisfaction level of nurses according to the survey. However, more than half of the responding nurses are satisfied with care they provide at their workplace, because they can see satisfied patients/clients. Hypothesis 3 has not proved any relationship between the satisfaction level of nurses and current situation in health care, where a holistic approach can be effectively applied. There will be a seminar for general nurses within the lifelong learning of nurses focusing on holistic care as an outcome of this diploma thesis.

The diploma work is focused on students of first year General Nurse who do not have medical high school education. These students during the preparation have to be familiar with significant amount of specialized curriculum before their first professional practice. The work investigated how this demanding preparation could be improved. The research showed that these students would welcome such optional course focused on practical training of nursing skills. This optional subject could result in a reduction of negative feelings from the first professional practice.

The aim of the dissertation was to find out the specifics of nursing care in clinical and community practice with patients with colorectal cancer using the model of M. E. Levine. Furthermore, to find out which of these specifics are missing in the mentioned nursing model and to modify the nursing documentation according to the chosen conceptual model of M. E. Levine. In the empirical part we used a combination of qualitative and quantitative research which was carried out as part of the grant project GAJU 048/2015/S. The pre-research, conducted interviews with 8 informants was used to identify the key data for answering research questions and creating a custom-designed questionnaire. A non-standardized questionnaire was distributed across the Czech Republic to 300 patients with colorectal cancer. We also designed nursing documentation, which was verified by focus group with 35 nurses from clinical and community practice. The results show that patients are limited in areas of contact with friends, normal traffic, traveiling, and fear for themselves and their loved ones to maintain social integrity. In the principle of maintaining structural integrity, problems with diet, alcohol consumption, diarrhea, current treatment management, stoma and stoma type have been identified. In the field of energy conservation the influence of length of diagnosis and colonoscopy performed as part of preventive examination, pain sensation, and enough energy for normal daytime life have been confirmed. In the principle of conservation personality integrity, we have found that the length of time determines the fear of getting stoma, learning individuals with the same disease, experiencing negative feelings, and limiting private life. The work provides a comprehensive framework of the issue of patients with colorectal cancer. It provides evidence of the possibility of using M. E. Levine's conceptual model in colorectal cancer patients.

The thesis attempts to outline the extent to which the decision-making role of nurses is utilized, and the main factors that affect decision-making of nurses within the scope of provision of nursing care. The research has found out that nurses utilize their decision-making role to an insufficient extent hence the sense and purpose of decision-making must be emphasised again. This task may be assumed by managing nurses. Managing nurses may also contribute by more effective defending of competences of nurses. From the factors needed by nurses for effective decision-making, attention should be paid particularly to education. It is necessary to make possible for nurses to extend their knowledge and thus to obtain theoretical insight (e.g. in respect of decision-making) to be used by them while providing care to a patient/client.

Abstract This diploma thesis deals with the position of nursing mentor and her cooperation with shift nurses. The theoretical part of the thesis is divided into seven chapters, and focuses on the current nursing profession that is also interconnected with education and legislature. The work is further dealing with the role of the nursing mentor and her cooperation with the nursing team. Last but not least, the theoretical part is devoted to the important role of ethics and morality in the nursing profession that is undoubtedly of central importance. We are also addressing the Certified Course for Mentors that we regard as rather positive as one of the forms of lifelong education. The nurses completing the course will acquire new skills and knowledge, but also knowledge in the field of psychology, law, didactics and other fields. The role of a nurse-mentor is rather important as she can pass the acquired knowledge further and positively influence the students in this way over the course of professional training facilitating their adaptation when they start their professional career. It was the main objective of this work to map the current position of a nurse? mentor, what her experience is with cooperation with other shift nurses as part of practical education in the workplace, and whether the nurses direct and sufficiently motivate the students to become interested in the profession of general nurses or midwifes. The section on research employed two methods. The first method consisted in quantitative research in the form of questionnaires. We employed two questionnaires, one targeted the nurses-non-mentors, while the second was intended for nurses-mentors. As a second method, qualitative research was carried out using semi-structured interview conducted with selected head and ward (charge) nurses. Using the qualitative survey approach, we tested the following working hypotheses. H1: the general nurses know what the role of a nurse-mentor is in the health-care team, H2: the nurses-mentors motivate their students to raise their interest in the profession of general nurse, H3: the nurses-mentors are not always occupying leading positions, H4: the nurses-mentors are perceived positively by the shift nurses,

Pressure ulcers are one of the quality indicators of nursing care, their presence reduces the quality of life of the patient, leads to a prolongation of hospitalization, increases costs of care and affects the budget of a health care facility. European Pressure Ulcer Advisory Panel or the European Advisory Board on issues of bedsores (EPUAP) leads and supports all European countries in their efforts to prevent and treat pressure sores. EPUAP working group has developed guidelines for the prevention and treatment of pressure ulcers. One of the important factors in providing the highest quality of nursing care is the ability of nurses to practically use the research results in the nursing process. This thesis deals with the effective use of the latest advances in the prevention of pressure sores and their treatment in the intensive care in Czech Republic. The main objective of this thesis is to explore the latest methods of prevention of pressure sores and care, according to Evidence-based practice principles EPUAP and analyze their practical implementation in selected intensive care wards. Quantitative research was conducted through an anonymous questionnaire in the population of nurses working in intensive care. The results of the research show that nurses working in intensive care, implement...

The thesis named "Current practice and possible ways of implementing clinical supervision in nursing" is the first doctoral dissertation establishing the concept of supervision in the Czech nursing environment. Itscentralresearch questionis as follows: How do nurses and university educators in nursing construct, interpret and practically apply theconcept ofclinical supervision and the supervisor's role in the context of nursing education at specific institutions of tertiary education and clinical nursing practice in the Czech Republic? The author draws on international theoretical literature and local empiricalevidence.Her qualitative research took the form of 26 semi-structured interviews with academic nursingeducators from the entire Czech Republic. In justified cases those are supplemented with qualitative data obtained through the study of legislative, policy and strategic documents in nursing and health care, including publicly available information and sources on clinical supervision, in order torefine the resulting picture of her interpretation of current clinical supervision practice in Czech nursing. A shift to the constructivist paradigm enabled one to conceive the term "clinical supervision" mainly in relation to learning, training and professional development of supervisees, also in the context of transformation of education and supervision not only of nurses but also of supervisors themselves in the Czech Republic. The author also focuses on the philosophical and theoretical foundations of clinical supervision and application of the postmodern approach in egalitarian clinical supervision. The empirical part of this dissertation is based on the qualitative research conducted. The author gradually presents her results as individual categoriesand relations between them that ensued from the analysed data in the process of open coding. The author draws a link between the category of implementation of clinical supervision in the context of nurses' professional education andexternal conditions, the environment and a broader professional and social-cultural context. Clinical supervision in nursing is constructed mainly as a unidisciplinaryconcept and a part of the nursing profession. The university nursing educatoris typically constructed as a role professional, but there is also an ongoing process ofdiversification, stratification, profiling and professionalization of non-academic nursing educators. Based on a content analysis of documents and post-modern philosophical-theoretical foundations and strategies of legitimizingclinical supervision, the author views the concept of clinical supervision in nursing as socially constructedand discursively legitimated. The author also defines the limitations of her research that arise from the choice of a qualitative research design. In the conclusion she outlines some future trends of clinical supervision in particular educational institutions that can be interesting and inspiring not only for supervisors but also for teachers of supervision themselves. Based on the results of her empirical analysis the author emphasises the need to integrate the theory and practice of education, clinical supervision and nursing. A comprehensive structure and methodology of system-wide implementation of clinical supervision, based on the situation of clinical nursing practice and supervision needs in the Czech Republic,should in future formthe basis of innovation of existing university programmes in nursing and approaches to the education and training of supervisors, as well as the subject of new research in clinical supervision.

This diploma thesis is focused on the influence of teaching students of the Faculty of Health and Social Studies of the University of South Bohemia in Czech Budejovice on a mentor nurse´s attitude to nursing care provision. In the first chapter of the theoretical section the term nurse is introduced, and it is dealt with her duties, roles, attitudes, it is explained who a mentor nurse is and what topics a pilot certified course contains. The next four chapters are focused on a supervisor´s personality, supervision issues, teachers and their non-traditional roles and the didactic skills of a mentor. The description of a mentor´s didactic skills is divided into education, student diagnostics, teaching goals and classroom practices. The sixth part deals with student clinical practice mentors, their role in clinical practice, assessment and feedback and mentorship as an advancement of nurses´ work. The seventh chapter of the theoretical section introduces the issue of communication as an integral part of nursing practice teaching and in the last section we have focused on the issue of evidence-based nursing. The aim of this thesis was to investigate the impact of nursing practice teaching on a mentor nurse´s attitude to nursing care provision and students´ evaluation of a mentor nurse´s achievements in nursing care provision. The outcomes of the quantitative research, conducted by using a questionnaire method, confirm the hypothesis 1 suggesting that students regard mentor nurses´ nursing procedures as standards for their future practice. We can also confirm the hypothesis 3 suggesting that students believe that a mentor nurse considers the correct information registration into nursing documentation as necessary, and also the hypothesis 2 suggesting that students believe that a mentor nurse can communicate more effectively than other staff nurses was confirmed. Mentor nurses´ attitudes to nursing care provision were identified by using qualitative investigation by asking research questions. Out of the six nurses interviewed, four mentor nurses consider mentorship as knowledge contribution to the field of communication with people, four mentor nurses consider mentorship as stimulation for improving their own expertise, four mentor nurses would be willing to introduce new knowledge into practice and provide nursing care in accordance with the EBN. The knowledge gained form this research work may serve as a suggestion and aid for students planning to carry out clinical nursing practice at a clinic, for nurses who have been working or have been preparing to work as clinic mentor nurses, and certainly for all of those who wish to learn more on this issue and to understand the mentor nurse job.