Lucie Sikorová

The needs of mothers to newborns hospitalised in intensive care units.

OBJECTIVE The aim of the survey was to identify the needs of mothers to infants hospitalized in intensive care units (ICUs) and second, to assess the level of parental support provided by the health personnel. METHODS The sample consisted of 147 mothers to infants hospitalized in ICUs. The research was conducted over six months in ICUs for newborns at two hospitals in Ostrava. The study used two standardized questionnaires: The parental stressor questionnaire scale: Neonatal Intensive Care Unit which measures the degree of stress in parents of hospitalized infants and the questionnaire The Nurse Parent Support Tool which evaluates the level of parental support provided by nursing staff. RESULTS The highest level of stress was identified in the parental role. Specifically, the inability to help the child remain separate from the mother, a feeling of helplessness and inability to protect the child from painful procedures and the inability to feed her baby. Mothers evaluated the support of nursing staff in most of these areas as high. Top were rated the ability of the caring staff to respond well to the questions of parents and the mothers willingness to engage in childcare. CONCLUSION Intensive care units for the newborn obviously need to be family-centered care and at the same time they must be aware of all the factors that can be sources of stress for the parents.Only in this way can stress be eliminated with positive impact on the relationship between mother and child.

Assessing Patients' Palliative Care Needs in the Final Stages of Illness During Hospitalization.

This study aimed to explore the palliative care needs of inpatients in the final stages of illness and to analyze the factors that influence them. The survey comprised 349 inpatients in the terminal stage of disease. Needs were assessed with the Patient Needs Assessment in Palliative Care (PNAP) questionnaire; mental status was evaluated using the Hospital Anxiety and Depression Scale (HADS) questionnaire. The importance of needs varied with respect to patients’ diagnosis, age, gender, religion, and their levels of anxiety and depression. Most frequently, predictors of needs importance were lower age, poorer functional status, higher anxiety, and lower depression scores. Unmet needs were more likely to be indicated by nonreligious patients with better functional status and higher anxiety and depression scores.

The nurses’ role in promoting relations between parents and premature newborns in the concept of Family-Centered Care

Aim: The aim of the following review is to analyze the role of nurses in promoting relations between parents and premature newborns according to the concept of Family-centered care. Design: The type of study – review. Methods: Both licensed and free-access electronic databases were used to search relevant studies from Czech and foreign sources for the period 2000– 2015: CINAHL EBSCOhost, SCOPUS, PubMed and Medline. The selection criteria for the studies to be analyzed were as follows: both quantitative and qualitative studies taking into account parents aged 19–44 with premature newborns from 24–36 weeks of gestation. Experimental studies and imprecisely defined studies were eliminated. Only 21 of the 49 research studies considered met the selection criteria. This review involves seven of the studies: three quantitative studies – one randomized study, two cross-sectional studies, and four case studies. Results: Based on analysis of the studies, it appears that Familycentered care should be considered an essential means of support for parents of premature newborns. The role of nurses in promoting relations between parents and their premature newborns was highly appreciated in the areas of therapeutic communication, efficient work organization and choice of appropriate interventions. Conclusion: Studies focusing on the application of the principles of Family-centered care stress its advantages for parents, premature newborns, and medical staff. The conclusion of most of the studies is that nurses play a unique role in eliminating the degree of trauma experienced by parents, and in promoting relations between parents and premature newborns according to the concept of Family-centered care.

Pain coping strategies in pediatric dental care

Cil: Zjistit, jake strategie využivaji děti s bolesti k jejimu zvladani při zubnim osetřeni. Design: Jednorazove průřezove dotaznikove setřeni u 199 děti ve věku 10-17 let. Metodika: Použitý byl dotaznik The Waldron/Varni Pediatric Pain Coping Inventory (W/V - PPCI). Interpretaci výsledků předchazela explorativni faktorova analýza a ortogonalni rotace metodou Varimax. Pro statistickou analýzu výsledků o uživaných copingových strategiich bylo využito deskriptivni statistiky: průměr, směrodatna odchylka, median, k porovnani kvantitativnich parametrů dvou výběroveho t-testu, Mann-Whitney a Kolmogorov-Smirnova testu. Hladina významnosti ve vsech testech byla α = 0,05. Výsledky: Výsledky byly interpretovany na zakladě analýzy 25 položek strukturovaných do pěti faktorů modifikovaneho dotazniku odhalujiciho uživane copingove strategie děti, ktere jsou jimi využivany ke zvladnuti bolesti a děti je vnimaly jako efektivni. Nejcastějsimi uvaděnými strategiemi byly kognitivni sebe-instrukce. Mladsi děti oproti starsim považovaly za efektivni využiti socialni opory, divky strategie soustředěne na pasivni relaxaci, chlapci kognitivni sebe-instrukce. Hospitalizovane děti oproti ambulantně osetřeným deklarovaly castějsi potřebu socialni opory, podobně jako děti, ktere podstupovaly zubni osetřeni v doprovodu rodiců. Zavěr: Rozdily v uvedeni uživani copingových strategii byly zaznamenany s ohledem na věk děti, jejich pohlavi, hospitalizaci a doprovod rodicem. Rutinni doporuceni dětem, jak mohou bolest během stomatologickeho osetřeni efektivně zvladat, bez zohledněni individuality ditěte a zohledněni konkretni situace neni vhodne.

Predictors of Change in Quality of Life in Patients With End-Stage Disease During Hospitalization

Background: Currently, there are no studies aimed at evaluating the quality of life (QoL) of patients with end-stage disease during hospitalization and the factors that influence it. Aim: The aim of the research was to identify predictors of change in the QoL of patients hospitalized due to advanced stage of disease. Methods: The sample consisted of 140 patients with end-stage disease who were hospitalized on this account. For evaluation of QoL, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was used. The Hospital Anxiety and Depression Scale and Karnofsky Performance Status questionnaires were used for the assessment of mental and functional status. For the evaluation of predictors of negative change in QoL, a logistic regression analysis was used. Results: During hospitalization, there was a significant deterioration in the scores given for all domains of the functional QLQ-C30 scale, but not the symptomatic scale. Predictors of change in overall QoL detected were marital status, improved functional status, and depression detected on admission to hospital. Gender and age were found to be protective factors against deterioration in overall QoL. Conclusion: Sociodemographic characteristics and mental and functional status may be associated with change in QoL of patients with end-stage disease during hospitalization.

Measuring quality of life of cognitively impaired elderly inpatients in palliative care: psychometric properties of the QUALID and CILQ scales

ABSTRACT Objectives: The study aimed to assess the psychometric properties of the Czech versions of the Quality of Life in Late-Stage Dementia (QUALID) and the Cognitively Impaired Life Quality (CILQ) scales for use in the palliative care setting in terminally ill patients with cognitive impairment. Methods: The sample comprised 306 cognitively impaired inpatients with advanced cancer and non-cancer conditions. In this cross-sectional study, two Quality of Life (QoL) measurements were performed at baseline and after five days. The dimensionality of the QUALID and CILQ scales was evaluated using a principal component analysis with Varimax rotation. Reliability was assessed using Cronbachs alpha; inter-rater reliability was evaluated with Kappa index. Test–retest stability was calculated using the intraclass correlation coefficients (ICCs) comparing scores from baseline and 3–5 days post-baseline. The construct validity of the QUALID and CILQ scale was established by Spearmans correlation coefficients with the Symptom Management at the End-of-Life in Dementia (SM-EOLD). Results: Both scales were shown to have adequate validity and reliability (Cronbachs α = 0.812 for QUALID, and α = 0.73 for CILQ), good inter-rater agreement (QUALID: κ = 0.760; CILQ: κ = 0.801) as well as test–retest reliability (QUALID: ICC = 0.847; CILQ: ICC = 0.925). Conclusion: The Czech versions of the QUALID and CILQ scales may be recommended for use in the Czech Republic in the area of palliative care.

Association Between Quality of Life, Demographic Characteristics, Physical Symptoms, and Unmet Needs in Inpatients Receiving End-of-Life Care: A Cross-sectional Study

Quality-of-life assessment is an important component of end-of-life care. The objective of this study was to evaluate the quality of life of patients in the final stage of their illness and its association with their demographic characteristics, physical symptoms, and unmet needs during their care. For data collection, the European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire tool for quality of life measurements and the Patient Needs Assessment in Palliative Care questionnaire for determination of unmet needs were used. The study comprised 349 inpatients in the final stage of their illness. Differences were found in quality-of-life assessment with respect to the type of illness, gender, and age of the patients. There was an association between lower quality of life, symptom burden (pain), worse functional status, and unmet needs in the physical and psychosocial areas. Therefore, quality of life of terminal patients is tightly associated with good symptom management and high-quality nursing care.

EVALUATING THE NEEDS OF CHILDREN WITH CANCER

Aim: The aim of the survey study was to analyze published studies assessing the needs of children with cancer. Design: Literature review. Methods: Freely available and licensed databases (MEDLINE, ProQuest, ScienceDirect, Scopus, EBSCO, Google Scholar, Web of Science, Wiley and CINAHL) were searched for necessary data. Results: The literature analysis revealed that needs assessment of children with cancer was described by several authors. Specifically, eight studies were found that were published between 1993 and 2011. The needs of children with cancer diagnosis were evaluated by both qualitative and quantitative research methods. Individual areas of bio-psycho-socio-spiritual needs of the study were investigated separately by the authors. None of the studies evaluated children’s needs comprehensively in all the areas. Conclusion: The issue of assessing the needs of children with cancer is often discussed and examined. Studies cover different needs, from biological to spiritual needs. The greatest emphasis should be placed on biological needs due to many side effects of cancer treatment. In the future, it would be appropriate to develop and validate an evaluation tool that would map biological needs of children with cancer. The most effective way would be an assessment tool which would map the needs of children in a comprehensive way.