Prehranska podpora bolnika po transplantaciji pljuč : diplomsko delo

Vehar, Aleš (avtor), Pandel Mikuš, Ruža (mentor), Mihelič Zajec, Andreja (recenzent)

Uvod: Transplantacija pljuč je končna oblika zdravljenja v zadnji fazi nekaterih pulmonalnih bolezni, ko so izčrpani vsi drugi načini zdravljenja. Presaditev pljuč izboljša kakovost življenja bolnikov in podaljša pričakovano življenjsko dobo. Optimalni prehranski status je neposredno povezan z boljšimi posttransplantacijskimi izidi in s preživetjem. Prehrana po transplantaciji je ključnega pomena za preprečevanje zapletov in optimalno okrevanje. Namen: Namen diplomskega dela je poudariti prehransko podporo po transplantaciji pljuč in njeno pomembnost, največji poudarek pa je na zgodnjem in poznem posttransplantacijskem obdobju. Metode dela: Uporabili smo kvalitativni raziskovalni pristop. Obravnavani raziskovalni problem smo obravnavali z dveh različnih vidikov. Prvi je bil analiza znanstvenih študij raziskovalnega problema, drugi pa je predstavljal intervju bolnika po transplantaciji pljuč. Način zbiranja podatkov je potekal z izvajanjem polstrukturiranega intervjuja, v katerem smo se osredinili na sedem večjih sklopov. Izbrali smo moškega, ki je uspešno prestal poseg transplantacije pljuč. Pridobljene podatke smo obdelali v programu ATLAS.ti. Rezultati: Rezultate smo prikazali grafično in opisno. Pridobljene podatke iz intervjuja smo uredili v tematske sklope in jih organizirali glede na izbrane kategorije. Intervjuvanec je opisal simptome KOPB s poudarkom na težkem dihanju ob naporu in fizični nemoči. Izrazil je občutke ob prejemu novice, da potrebuje zdravljenje s transplantacijo pljuč. Opisal je zdravstveno obravnavo v vseh sedmih izbranih obdobjih in izpostavil pomanjkanje zdravstvene vzgoje ter predvsem prehranske podpore. Opisal je zaplete, ki so nastali kot posledica jemanja imunosupresivne terapije. Povedal je, da so se pri njem pojavile hiperglikemija, hipertenzija in hiperlipidemija. Za vse naštete zaplete je prejel samo medikamentozno terapijo. Nasvetov glede življenjskega sloga in prehranskih prilagoditev ni prejel. Razprava in zaključek: Ugotovili smo, da obstajajo velike razlike med zdravstveno obravnavo v kliničnem okolju v slovenskem prostoru in tujini. V primerjavi s tujimi priporočili in smernicami je bila zdravstvena obravnava bolnika pomanjkljiva. Predvsem je bila razvidna odsotnost ustrezne prehranske podpore, rehabilitacije in zdravstvene vzgoje.

• Jezik: Slovenski jezik
• Ključne besede: diplomska dela, zdravstvena nega, transplantacija pljuč, prehranska podpora, prehransko svetovanje, bolniki
• Vrsta gradiva: Diplomsko delo/naloga
• Organizacija: ZF - Zdravstvena fakulteta
• Kraj izida: Ljubljana
• Založnik: [A. Vehar]
• Leto izida: 2020
• Št. strani: 55 str., [50] str. pril
• PID: 20.500.12556/RUL-124234
• COBISS.SI-ID: 25692675
• Datum objave v RUL: 11.01.2021

Sekundarni jezik

• Jezik: Angleški jezik
• Naslov: Nutritional support of the patient after lung transplantation : diploma work

Izvleček

Introduction: Lung transplantation is the final treatment option in the end stage of certain lung diseases, once all possible conservative treatments have been exhausted. Lung transplantation can improve the patient’s quality of life and prolong life expectancy. An optimal nutritional status is associated with better post-transplant outcomes and survival. Nutrition after transplantation is the key for reducing the risk of complications and optimal recovery. Purpose: The purpose of this diploma work is to highlight the nutritional support after lung transplantation and its importance. The greatest emphasis is on the early and late post-transplant period. Methods: We used a qualitative research approach. The research problem was considered from two different aspects. The first aspect was the analysis of scientific studies of the research problem and the second aspect was the interview of the patient after lung transplantation. The data collection method was conducted by conducting a semi-structured interview where we focused on 7 major thematic sets. We selected a man who successfully underwent a lung transplant procedure. We processed the obtained data in the ATLAS.ti program. Results: The results were presented graphically and descriptively. The data obtained from the interview were arranged into thematic sections and organized according to the selected codes. The interviewee described the symptoms of COPD, with an emphasis on shortness of breath on exertion and physical impotence. He also described feelings that he experienced when he found out that his lungs will be transplanted. He described the medical treatment in all 7 selected periods and pointed out the lack of health education and especially nutritional support. The interviewee described the complications that arose because of taking immunosuppressive therapy. He said he developed hyperglycaemia, hypertension and hyperlipidaemia. For all the listed complications, he received only drug therapy. He did not receive any lifestyle advice or dietary adjustments. Discussion and conclusion: We found that there are large differences between medical treatment in the clinical environment in Slovenia and abroad. Compared to foreign recommendations and guidelines, the patient's medical treatment was deficient. Above all, the lack of adequate nutritional support, rehabilitation and health education was evident.

• Ključne besede: diploma theses, nursing care, lung transplant, nutritional support, nutrition counselling, patients