Quality of life of patients with spinal cord injury

Uvod: Okvara hrbtenjače ne pomeni samo fizičnih sprememb, ki vodijo v zmanjšano ali popolno nezmožnost opravljanja vsakodnevnih življenjskih aktivnosti, ampak so mogoči tudi številni zapleti: nevrogeni mehur in črevo, okužbe sečil, razjede zaradi pritiska, ortostatska hipotenzija, zlomi, globoka venska tromboza, spastičnost, heterotropne osifikacije, kontrakture, avtonomna disrefleksija, pulmonarni in srčno-žilni zapleti, depresivnost. Ti zapleti neposredno vplivajo na kakovost življenja pacienta z okvaro hrbtenjače in njegove družine. Namen: Namen diplomskega dela je na teoretični ravni predstaviti kakovost življenja pacienta z okvaro hrbtenjače. Cilji: Opredeliti kakovost življenja pacienta z okvaro hrbtenjače in njegove družine, opisati vlogo medicinske sestre v akutnem obdobju zdravstvene oskrbe, rehabilitacijski ustanovi in v pacientovem domačem okolju, prikazati izvajanje k pacientu in družini usmerjene zdravstvene nege s ciljem dviga kakovosti življenja pacienta z okvaro hrbtenjače. Metode dela: Diplomsko delo je teoretično z deskriptivno metodo dela. Temeljno literaturo v angleškem jeziku smo iskali po podatkovnih bazah CINAHL in PubMed ter v spletnem brskalniku Google Scholarpostavljene so bile naslednje omejitve: zadetki s polnim besedilom, znanstvene in strokovne recenzirane revije, angleški jezik, časovno obdobje med letoma 2008 in 2018. Temeljno literaturo v slovenskem jeziku smo iskali prek vzajemne bibliografsko-kataloške baze podatkov COBISS+omejitve iskanja so bile: časovno obdobje med letoma 2008 in 2018, dostopnost člankov v polnem besedilu, slovenščina. Rezultati in razprava: Primarni cilji zdravstvene oskrbe in rehabilitacije so stabilizacija zdravstvenega stanja, osamosvojitev pri opravljanju osnovnih vsakodnevnih aktivnosti, vzpostavitev ponovne hoje brez pripomočkov ali vsaj stoje s pripomočki. Globalna cilja rehabilitacije sta čim boljša vključenost v družbo in največja mogoča kakovost življenja. Pacienti z okvaro hrbtenjače kakovosti življenja ne ocenjujejo glede na obseg okvare, ampak glede na zmožnost prilagoditi se situaciji. Pomembni so: dostopnost do ustrezne zdravstvene obravnave in medicinsko-tehničnih pripomočkov, aktivno sodelovanje in učenje, finančna podpora, prilagojeno domače in širše okolje, možnost aktivnega transporta in podpora pomembnih bližnjih. Družina pacienta med zdravstveno oskrbo potrebuje predvsem natančne in poštene informacije o zdravstvenem stanju pacienta, pričakovanem napredku in o mogočih oblikah pomoči ter aktivno učenje. Zaključek: Medicinske sestre pacienta in družino z aktivnim vključevanjem v izvajanje življenjskih aktivnosti učijo obvladovati mogoče zaplete zaradi okvare hrbtenjače, da se pacient in družina lahko usmerijo k njim lastnim ciljem in h kakovosti življenja.Introduction: Spinal cord injury means not only physical changes that lead to a reduced or complete inability in performing daily life activities, but also numerous complications: neurogenic bladder and bowel, urinary tract infections, pressure ulcer, orthostatic hypotension, fractures, deep vein thrombosis, spasticity, heterotrophic oscillations, contractures, autonomic dysreflexia, pulmonary and cardiovascular complications, depression. These complications directly affect patient and his family quality of life. Purpose: in this work we would like to present the quality of life of patient with spinal cord injury at the theoretical level. The objectives are: to define the quality of life of patient with spine cord injury and family, to describe the role of nursing care in the acute period of health care, in a rehabilitation institution and in the patient\u27s home environment, and patient and family-centred nursing care with the goal to raise the quality of life of a patient with spinal cord injury. Methods: descriptive method of work was used in this diploma. The basic literature in English was searched using the CINAHL and PubMed databases and the Google Scholar web browser, the following restrictions were set: full-text, scientific and expert revised editions, English language, time period between 2008 and 2018. Basic literature in Slovenian language was searched in national bibliographic database catalog COBISS+. The search constraints were: time period between 2008 and 2018, accessibility infull text, slovene language. Results and discussion: Primary goals of health care and rehabilitation are stabilization of patient`s health, independence in basic daily activities, establishment of re-walk without aids or at least standing. Global goals of rehabilitation are the best possible integration into society and the highest possible quality of life. From patient poit of view good quality of life is assessed by the ability to adapt to the situation. Access to adequate medical treatment and medical technical devices, active participation and learning, financial support, personalized home and wider environment, the possibility of active transport and domestic support is important. Patient\u27s family needs during health care are accurate and fair information about the patient\u27s health, expected progress and possible forms of assistance and active learning. Conclusion: Nurses teach the patient and his family with active involvement in health care to cope with possible complications due to spinal cord failure, so the patient and family can focus on their own goals and quality of life