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Teoretična izhodišča: V diplomskem delu je predstavljena človekova telesna drža, ki je lahko nepravilna in pravilna. Na kratko smo opisali boleznsko ukrivljenost hrbtenice, kot so kifoza, lordoza, skoliotična drža, ploski in okrogel hrbet. Ustavili smo se tudi pri teži šolske torbe, poiskali vzroke in opisali pravilno sedenje. Ugotavljali smo vlogo medicinske sestre in zdravstveno vzgojno delo osnovnošolskih otrok in staršev. Metodologija raziskovanja: V empiričnem delu smo izvedli anonimno raziskavo med starši osnovnošolskih otrok v 3. in 5. razredu, ki je temeljila na kvantitativni metodologiji. Vprašalnik je zajemal 20 vprašanj zaprtega in odprtega tipa. Rezultate smo analizirali in sistematično uredili s pomočjo računalniških programov Microsoft Word in Microsoft Excel. Rezultati: Iz rezultatov raziskave smo ugotovili, da je večini staršev pomembna telesna drža otroka tako v 3. kot 5. razredu osnovne šole. Rezultati ankete so pokazali, da je teža šolske torbice absolutno pretežka glede na težo otroka tako v 3., kot v 5. razredu. Sklep: Starši so tisti, ki skrbijo in so odgovorni za zdravje svojih otrok. Žal je slovenski šolski sistem naravnan tako, da imajo šolarji dejansko pretežke šolske torbe, katere teža vpliva na njihovo ukrivljenost hrbtenice. Starši lahko vplivajo na zmanjšanje teže šolske torbe le s tem, da otroka opozorijo, da ne nosi v šolo stvari, ki jih tisti dan ne potrebuje in niso na urniku. Theoretical frame of reference: This diploma thesis deals with the human body posture, which can be either correct or incorrect. We briefly describe the different types of spine curvature disorders, such as kyphosis, lordosis, scoliosis, as well as the flat back and round back syndrome. An additional reference is made to the weight of the school bag, whereby we researched its causes and described the correct sitting position. We established the role of medical nurses as well as the importance of medical education of primary school children and their parents. Research methodology: In the empirical part an anonymous survey among parents of primary school children, attending the 3rd and 5th grade, was conducted, which was based on the quantitative methodology. The questionnaire consisted of 20 questions of open and closed type. The results were analysed and systematically categorised with the help of Microsoft Word in Microsoft Excel computer software programmes. Study results: The obtained results showed that most of the surveyed parents put great emphasis on their children’s posture (i.e. reference to 3rd and 5th grade). The results illustrate that the weight of the school bag is unquestionably too heavy for the weight of the children attending the 3rd and 5th grade. Conclusion: It is the responsibility of the parents to take full responsibility for the health of their children. Unfortunately, the school system is structured in a way which requires school children to carry schoolbags that are too heavy, which inevitably affects the curvedness of the spine. Parents can have a positive influence on reducing the weight of the school bag by reminding their children to only carry school requisites that they need that day in school

V diplomskem delu bomo predstavili hernijo diska, vzroke za nastanek, zdravljenje ter vlogo medicinske sestre. Bolečine v hrbtenici so v današnjih časih zelo pogost problem, celotne populacije. Način življenja in starost sta glavni vzrok za degenerativne spremembe hrbtenice, predvsem medvretenčne ploščice. Hernija diska pomeni zdrs medvretenčne ploščice iz vretenca in sicer kot posledica degenerativnih sprememb. Hernija najpogosteje nastane v ledvenem segmentu hrbtenice. Pojavijo se bolečine, ki predstavljajo veliko breme za pacienta in ga omejujejo pri vsakodnevnih aktivnostih. Pacienta je potrebno zdraviti. Medicinska sestra je tista, ki ima pomembno vlogo pri negovanju pacienta, saj sodeluje od začetka zdravljenja pa do popolne ozdravitve pacienta. Skrbi za pacientove aktivnosti, mu nudi podporo, sodeluje pri rehabilitaciji in deluje zdravstveno vzgojno. Uporabili bomo deskriptivno metodo dela. Podatke za izdelavo empiričnega dela bomo pridobili na osnovi študije primera pacienta po operaciji discus hernie. Podatke bomo zbirali s pomočjo intervjuja o pacientu, ki smo ga oblikovali po funkcionalnih vzorcih zdravega obnašanja Marjory Gordon, ter pacientove medicinske dokumentacije. In my thesis I will describe the herniated disc, reasons for its occurrence, treatment and the role of a nurse. Pain in the back is today a common issue of the population. The modern way of life and high age are the most often cause for degenerative changes of the spine, especially the intervertebral disc. Herniated disc is the slipping of the intervertebral disc from the vertebra as a result of degenerative changes. Usually, hernia occurs in the lumbar area of the spine. Pain arises, what is a heavy burden and limits the patients in carrying out their daily activities. A nurse has an important role in patient treatment, since he or she is involved in the process from the beginning of the treatment until the successful recovery. The nurse takes care for patient's activities, offers support, aids with rehabilitation and acts in a healthy and educational manner. We will use the descriptive method of work. Data for the empirical part will be gained on a role example of a patient after a herniated disc surgery. Data will be also acquired in form of an interview with the patient in line with the functional health patterns provided by Marjory Gordon and the patient's medical documentation.

Namen diplomskega dela je opisati obravnavo pacienta s spondilolistezo pred in po operativnem posegu ter opisati vlogo medicinske sestre. Spondilolisteza je posledičen zdrs vretenca naprej ali nazaj, kjer lahko privede do močnih bolečin in omejitev pri vsakodnevnem gibanju. V teoretičnem delu je predstavljena spondilolisteza in vzroki za njen nastanek, vrste spondilolistez, klinični pregledi in diagnostične preiskave ter celostna obravnava pacienta pred operacijo in po njej. V raziskovalnem delu smo obravnavali pacienta s spondilolistezo pred in po operacijskem posegu. Obravnava je potekala po enajstih funkcionalnih vzorcih Marjory Gordon. Obravnavali smo pacienta v Ortopedski bolnišnici Valdoltra. Podatke smo zbrali s pomočjo intervjuja s pacientom, merjenjem vitalnih funkcij, opazovanjem in ocenjevanjem pacientovega stanja, s preučevanjem medicinske in negovalne dokumentacije pacienta in pogovorom s člani zdravstvenega in negovalnega tima. Z analizo pridobljenih podatkov smo oblikovali negovalne diagnoze, si postavili negovalne cilje in načrtovane aktivnosti zdravstvene nege ter vrednotili zdravstveno nego in počutje bolnika. Ugotovili smo, da so najpogostejše negovalne diagnoze pri pacientu s spondilolistezo: Nevarnost infekcije Mobilnost, nepopolna telesna mobilnost (I. stopnja) Samonega, zmanjšana zmožnost za samostojno osebno higieno (I. stopnja) Samonega, zmanjšana zmožnost samostojnega oblačenja in osebnega urejanja (I. stopnja) ter bolečina (v spodnjem delu hrbtenice). The purpose of this study is to describe the treatment of a patient with spondylolisthesis before and after the surgery as well as describe the role of a nurse in the treatment. Spondylolisthesis is a displacement of a vertebra either forward or backward, which can lead to severe pain and restraint at everyday movement. The theoretical part presents the causes of spondylolisthesis and its origin, types of spondylolisthesis, clinical examinations and diagnostic tests as well as a comprehensive care for the patient before and after the surgery. In our research work we treated a patient with spondylolisthesis before and after the surgery. The treatment was done in accordance with Gordon’s eleven functional health patterns. We treated a patient in the OB Valdoltra hospital. We gathered information through interviews with a patient, measuring vital functions, monitoring and evaluating patient’s condition, by examining medical and nursing documentation of the patient and by talking to members of the medical and nursing team. With the analysis of the acquired data we made a nursing diagnosis, we set nursing objectives and planned activities of nursing care. We also evaluated the nursing care and welfare of the patient. We found that the most frequent nursing diagnoses for a patient with spondylolisthesis is: Risk for infection Impaired physical mobility (Level I) Self-Bathing-Hygiene Deficit (Level I) Self-Dressing-Grooming Deficit (Level I) Pain (in low back).

Teoretična izhodišča: Hernija diska pomeni zdrk medvretenčne ploščice, ki najpogosteje nastane v ledvenem delu hrbtenice, predvsem zaradi degenerativnih sprememb. Najpogosteje se kaže z bolečino v križu, ki je še vedno eden najpogostejših vzrokov za obisk zdravnika in predstavlja velik zdravstveni in ekonomski problem. Bolnike omejuje pri vsakodnevnih aktivnostih in s tem vpliva na kakovost življenja. Le ti morajo spremeniti način življenja omenjeni bolezni in svojo hrbtenico neprestano varovati. Namen: Predstaviti obravnavo bolnikov s hernijo diska v ledvenem delu hrbtenice. Z raziskavo smo želeli ugotoviti, ali bolniki s hernijo diska varujejo svojo hrbtenico, kako jo varujejo in s katerimi težavami se srečujejo ti bolniki. Metode: V diplomskem delu smo uporabili deskriptivno metodo dela. Teoretična izhodišča smo predstavili s pomočjo analize literature. Za zbiranje podatkov smo kot raziskovalni inštrument uporabili anketni vprašalnik. V raziskavi je sodelovalo 30 bolnikov s hernijo diska obravnavanih v Zdravilišču Laško. Rezultati in diskusije: Podatki, ki smo jih pridobili z raziskavo, kažejo, da vsi bolniki varujejo svojo hrbtenico, vendar večji del bolnikov le ob prisotni bolečini. Srečujejo se z različnimi težavami, med katerimi prevladuje bolečina v križu, kar nas ne preseneča, saj je le-ta ena glavnih znakov hernije diska. Theoretical bases: A Spinal Disc Herniation is a medical condition affecting the spine, in which a tear in the outer, fibrous ring of an intervertebral disc allows the soft, central portion to bulge out. This tear in the disc ring is mostly caused by degenerative modifications. The most common form is Lumbar Disc Herniation, causing lower back pain and it is the most frequent reason to visit a doctor. It represents profound medical and economic problem. Patients with Lumbar Dics Herniation are limited in daily activities and this affects their quality of life. They need to change their way of life due to the condition and protect their spines constantly. Aim: To introduce treatment of patients with herniated disc. In research we wanted to determine if Lumbar Dics Herniation patients are protecting their spine, how they are protecting it and what difficulties they are confronting. Methods: Descriptive work method was used. Theoretical bases were presented with literature analysis. Data was collected by personal interviews. 30 patients with Lumbar Disc Herniation from Laško Health Resort participated in the research. Results and discussions: Data gained show that all patients protect their spine but most of them only when the pain is present. They are facing many different difficulties, lower back pain is prevailing. Lower back pain is anticipated for it is one of the most common symptoms of Lumbar Disc Herniation.

V diplomskem delu smo prikazali anatomijo, fiziologijo, patologijo, diagnostične metode in načine zdravljenja s poudarkom na zdravstveni negi bolnika s poškodbo hrbtenjače v ledvenem delu hrbtenice. Bolnik, ki je utrpel takšno poškodbo, potrebuje ob sebi negovalni in zdravstveni tim, ki mu bo stal ob strani, ko se bo soočal s svojo spremenjeno telesno podobo. Negovalni problemi so na področju vseh življenjskih aktivnosti, vendar jih zaradi možnosti zgodnje mobilizacije, kjer ima rehabilitacija pomembno vlogo, sodobnega znanja in pripomočkov lažje obvladamo. Tukaj se zdravstvena nega in rehabilitacija močno prepletata. Predstavili smo tudi komunikacijo z bolniki in njihovimi svojci. Medicinska sestra potrebuje zelo razširjeno in poglobljeno strokovno znanje, izkušnje in osebnostne lastnosti, ki omogočajo dobro komunikacijo in empatijo. Zdravstveno vzgojno delo se prične že v bolnišnici in je eden najpomembnejših poslanstev medicinske sestre. Z njo želi bolnike usposobiti za sodelovanje pri zdravljenju njihove bolezni in nadaljnje življenje. V diplomskem delu smo s pomočjo anketnega vprašalnika, ki smo ga razdelili 40 medicinskim sestram in zdravstvenim tehnikom v Enoti intenzivne medicine operativnih strok in na Travmatološkem oddelku Splošne bolnišnice Celje, ugotavljali pomen vključevanja zdravstvene nege v rehabilitacijo, komunikacije z bolnikom in svojci ter zdravstvene vzgoje. Pokazati smo želeli tudi, ali delo z bolniki, ki so utrpeli poškodbo hrbtenjače v ledvenem delu hrbtenice, stresno in fizično vpliva na medicinske sestre in zdravstvene tehnike. The subsequent work comprehends anatomical, physiological, diagnostic and therapeutic aspects of spinal cord trauma with special emphasis on nursing care for patients after lumbar spinal cord injury. Patients suffering this trauma need health and nursing care teams that would help them to overcome the healing process and to face themselves with their altering physical image. Nursing problems with theses patients are numerous, concerning many of patients vital activities. Using modern rehabilitation approaches, skills, techniques and devices, therapeutic goals become more efficently achieved. Therefore nursing care and rehabilitation activities applied on spinal patients should be strongly interconnected. Another important issue is communication with patients and with their relatives. Nurses are expected to have knowledge, experience and personal characteristics that are required for appropriate communication and empathy with these patients. Health care education and preparation for their future life should be stared during in-hospital stay and is one of the most important tasks carried out by the nurses. A questionnaire was distributed among 40 nurses working in surgical ICU and traumatological department of Celje General Hospital in order to investigate their vision on importance of incorporation of their nursing care activities in rehabilitation processes, on communication with patients and their relatives, and on health care education as part of an integral treatment of patients after lumbar spinal cord injuries. Questions about physical and psychological stress that nurses are exposed to when nursing these patients were also included in the study.

V diplomskem delu smo predstavili pomen, kompleksnost in specifičnost zdravstveno-vzgojnega dela medicinske sestre pri bolniku s poškodbo hrbtenice ter pomebno vlogo tega v procesu zdravljenja in rehabilitacije. In the first part of a diploma we have presented significance, complexity and specification of a nurse health- education work, when patients with spine injuries are concerned, and the importance of that task in a process of rehabilitation and medical treatment.