District nurses' duties in the care of chronic patients

Patronažna djelatnost je važan dio primarne zdravstvene zaštite. Dio je sestrinstva u zajednici čije je djelovanje usmjereno na skrb korisnika izvan zdravstvenih ustanova. Cilj rada je bio prikazati sve značajke patronažne sestre u skrbi za kronične bolesnike. Djelatnost patronažne službe je primarno preventivna, edukativna i informativna s obilježjima medicinsko-socijalnog djelovanja. Sastavni je dio Doma zdravlja. Financira je Hrvatski zavod za zdravstveno osiguranje te je za cjelokupno stanovništvo Hrvatske besplatna. Patronažna djelatnost surađuje u svakodnevnom radu s drugim djelatnostima: liječnikom obiteljske medicine, zdravstvenom njegom u kući bolesnika, s ustanovama na ostalim razinama zdravstvene zaštite, socijalnom službom, udrugama/ klubovima oboljelih. Najužu suradnju ostvaruje s liječnikom obiteljske medicine i zdravstvenom njegom u kući bolesnika. Patronažna sestra u svojoj skrbi, između ostalih, ima oboljele od različitih kroničnih bolesti. Najčešći kronični bolesnici u skrbi patronažne sestre su oboljeli od dijabetesa, hipertenzije, oboljeli nakon infarkta miokarda, oboljeli od cerebrovaskularnih bolesti, oboljeli od alkoholizma. Patronažna sestra u skrbi ima i djecu oboljelu od kroničnih bolesti, najčešće oboljelu od dijabetesa, astme te celijakije. Skrb patronažne sestre za kronične bolesnike je zahtjevan rad koji obuhvaća sve domene bolesnikovog zdravlja i života. Osim provjeravanja bolesnikovog zdravstvenog statusa, patronažna sestra mora procijeniti bolesnikovo znanje o bolesti, o uzimanju terapije, o preporučenom načinu života vezano za njegovu kroničnu bolest. Procjenjuje bolesnikovo nošenje s bolešću, prilagodbu, suradnju s liječnikom te podršku obitelji. Patronažna sestra pomaže oboljelom u prilagodbi na život s bolešću te da postigne što kvalitetniju razinu života. Rad patronažne sestre u skrbi za kronične bolesnike je vrijedan jer ona ulazi izravno u dom bolesnika i ima uvid u njegove socijalne uvjete i uvjete za unapređenje zdravlja i kontrolu bolesti. Patronažna sestra je poveznica između bolesnika i zdravstvenog sustava.What district nurses do is of great importance when speaking of primary health care nowadays. The goal of this paper was to point out why district nurses play a big role in lives of people with chronic diseases. This profession is a part of nursing and it deals with taking care of people outside health care facilities. What is more, it is primarily preventive, educational , informative and has a medical and social character. It is a part of medical centre and is financed by the Croatian Institute for Health Insurance. It is completely free of charge for all the people in Croatia. When working as a district nurse, one has to cooperate with general practicioners and home care practicioners to a great extent. Cooperation also includes working with social services, other health care facilities and finally, associations and clubs for people who suffer from various diseases. People who need help from a district nurse suffer from various chronic diseases. The majority of these people suffer from diabetes, hypertension, cerebrovascular diseases. People who had mycardium infarct and alcoholics also need help from a district nurse. Being a district nurse also involves taking care of children who suffer from chronical diseases, mostly diabetes, asthma and celiac disease. Their job includes taking care of a patients' health as well as their lives. Not only do they have to check on a patient's health condition; they also have to estimate how much a patient knows about the disease, their therapy and the life they have to lead. Moreover, they estimate how well patients deal with their disease and adjust to it. They also observe if patients cooperate with their doctor and have support from their families. A district nurse helps patients to sadjust to living with a disease and have a normal life as much as possible. Working as a district nurse is priceless because it enables one to get a deep insight into a patient's home, social status and life conditions