ZDRAVSTVENA NEGA PACIENTA PO OPERACIJI KRONIČNE ANALNE FISURE ; NURSING THE PATIENT AFTER SURGERY OF CHRONIC ANAL FISSURE

Teoretična izhodišča: V diplomskem delu je predstavljena zdravstvena nega pacienta po operaciji kronične analne fisure. Opisani so dejavniki tveganja za nastanek kronične analne fisure, predstavljene pa so tudi posebnosti zdravstvene nege po operaciji. Metodologija: V diplomskem delu smo uporabili deskriptivno metodo dela, raziskovalni del pa je temeljil na kvalitativni metodi dela. Za izdelavo teoretičnega dela smo uporabljali elektronske vire ter domačo in tujo literaturo, katero smo preučili, analizirali in uredili. Literaturo smo iskali v obliki knjig v knjižnicah in s pomočjo spletne strani COBISS in SpringerLink. S pomočjo intervjuja smo obravnavali enega pacienta. Intervju se je nanašal na ugotavljanje anamneze in potreb po zdravstveni negi glede na 14 osnovnih življenjskih aktivnosti konceptualnega modela Virginie Henderson. Razprava: Ugotovili smo, da se pacient s kronično analno fisuro pred operacijo srečuje predvsem s težavami pri odvajanju. Odvaja trdo, zasušeno blato, ki ga spremljata krvavitev in močna bolečina. Po operaciji je bila največji problem boleča rana, zaradi katere je bila otežena tudi prva defekacija. Spopadal pa se je tudi s strahom, kakšno bo stanje po operativnem posegu in ali je bila operacija uspešna. Poleg teh negovalnih diagnoz smo izpostavili še naslednje negovalne diagnoze: nepopolna sposobnost hoje, nevarnost infekcije in obnašanje v podporo zdravju. Pacient potrebuje veliko pogovora o svoji bolezni in zdravstveno vzgojnih informacij glede načina življenja ob prihodu v domače okolje. Sklep: Medicinska sestra mora dobro poznati postopke obravnave pacienta po operaciji analne fisure. Tak pacient potrebuje namreč veliko zdravstveno vzgojnih informacij glede načina življenja (prehrana, odvajanje blata, gibanje, higiena,…) po operativnem posegu, s katerimi ga seznanimo že na samem začetku obravnave. ; Theoretical background: The diploma presented the health care of the patient after surgery of chronic anal fissure. We described the risk factors for chronic anal fissure and explain the specifics of nursing care after surgery. Methodology: In diploma we used the descriptive method, part of the research is based on qualitative methods. For the theoretical part we use electronic resources, as well as home and foreign literature, which we have studied, analyzed and edited. The literature was obtained from books and websites, like COBISS and SpringerLink. Through the interview we discussed about one patient. The interview concerned the determination of anamnesis and the need for nursing care in relation to the 14 basic life activities of the conceptual model of Virginia Henderson. Discussion: We found, that patients with chronic anal fissure have many defecation problems before surgery. Patients indicate a problem with the hard and dried mud, accompanied by bleeding and intense pain. After the surgery the biggest problem was the painful wound, there has also been a difficulty with the first defecation. The patient is suffering from a fear of what will be after the surgery and if the operation was successful. Apart from these nursing diagnoses, there were also exposed these nursing diagnoses: incomplete walking ability, the risk of infection and behavior in support of health. The patient needs a lot of talk about their illness and health educational information about the way of life in home environment. Conclusion: The nurse must be familiar with procedures for the treatment of a patient after surgery of anal fissure. Patient needs health educational information about lifestyle (diet, defecation, exercise, hygiene.) after surgery. With that patient shall be informed at the beginning of treatment.