Únava u pacientů po cévní mozkové příhodě

• Název práce v češtině: Únava u pacientů po cévní mozkové příhodě
• Název v anglickém jazyce: Fatigue in post-stroke patients
• Klíčová slova: Únava, cévní mozková příhoda, únava po mrtvici, management, ergoterapie
• Klíčová slova anglicky: Fatigue, stroke, post-stroke fatigue, management, occupational therapy
• Akademický rok vypsání: 2022/2023
• Typ práce: diplomová práce
• Jazyk práce: čeština
• Ústav: Klinika rehabilitačního lékařství 1. LF UK a VFN (11-00640)
• Vedoucí / školitel: Bc. Mária Krivošíková, M.Sc.
• Řešitel: skrytý - zadáno vedoucím/školitelem
• Datum přihlášení: 01.02.2023
• Datum zadání: 28.04.2025
• Datum a čas obhajoby: 16.06.2025 08:30
• Datum odevzdání elektronické podoby: 02.05.2025
• Datum proběhlé obhajoby: 16.06.2025
• Předmět: Obhajoba diplomové práce (B02662)
• Oponenti: MUDr. Sylva Klimošová

Seznam odborné literatury

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Předběžná náplň práce

Pozadí: Únava po cévní mozkové příhodě je multifaktoriální a multidimenzionální
následek cévní mozkové příhody a potýká se s ní zhruba polovina pacientů. Je velmi často
opomíjena, těžko diagnostikovatelná a možnosti jejího zvládání jsou stále otázkou výzkumu.
Mechanismus vzniku je diskutován napříč studiemi a jednotlivé mechanismy jsou vysvětleny
pomocí tzv. modelů únavy. Cílem této práce je zmapovat tuto problematiku a zároveň
představit možnosti zvládání únavy na základě systematické rešerše.
Metody: Práce byla zpracována jako analyticko-deskriptivní rešerše a má charakter
rešerše systematické. Literatura pro zpracování výsledků práce byla hledána v databázích
PubMed, Academic Search Ultimate, Evidence-Based Medicine Reviews a Science Direct.
Kritéria pro zařazení byla publikování v letech 2019-2024, anglický nebo český jazyk,
dostupnost plného textu a obsahová relevance. Finální studie byly zpracovány pomocí
otevřeného a axiálního kódování. Studie také byly kriticky zhodnoceny pomocí CASP
checklistu.
Výsledky: Z celkem nalazených 1766 studií bylo po čištění dat zařazeno 28 studií, ze
kterých bylo vytvořeno 17 skupin různých přístupů pro zvládání únavy. Takovými jsou např.
fyzická aktivita, kognitivně-behaviorální terapie, edukace, self-management nebo nácvik
strategií pro šetření energie či expresivní techniky.
Závěr: Z výsledků práce vyplývá, že nejsou k dispozici studie zabývající se výlučně
ergoterapeutickou intervencí pro zvládání únavy, ale dohledané přístupy se překrývají s
kompetencemi ergoterapeutů a jejich postavení v této problematice tak má své místo. Přístupy
využívané pro zvládání únavy jsou ve studiích kombinovány v rámci komplexních programů.
Autoři nejčastěji kombinují prvky kognitivně-behaviorální terapie, fyzickou aktivitu a edukaci,
dále také podporu self-management strategií a strategie pro šetření energie. Některé zařazené
studie se zabývali také subjektivními potřebami pacientů s únavou. Neexistuje tedy jeden
přístup, který by měl dostatečně silnou evidenci sám o sobě, ale kombinací klíčových přístupů
lze zajistit dostatečný efekt pro ovlivnění únavy.

Předběžná náplň práce v anglickém jazyce

Background: Post-stroke fatigue is a multifactorial and multidimensional consequence
of stroke and affects approximately half of patients. It is very often neglected, difficult to
diagnose, and management options are still a matter of research. The mechanism of occurrence
is debated across studies and the different mechanisms are explained using so-called fatigue
models. The aim of this paper is to map and present this complex issue and to present research-
based options for fatigue management.
Methods: The thesis was conducted as an analytical-descriptive research and has the
character of a systematic review. PubMed, Academic Search Ultimate, Evidence-Based
Medicine Reviews and Science Direct databases were searched for the literature for processing
the results. Inclusion criteria were publication in 2019–2024, English or Czech language,
availabilit of full text and ontent relevance. Final studies were then processed using open and
axial coding strategies. Studies were also critically appraised using the CASP checklist.
Results: Of the 1766 studies retrieved, the total of 28 studies were included after data
cleaning to form 17 groups of different approaches for managing post-stroke fatigue. These
included e.g. physical activity, cognitive-behavioural therapy, education, self-management or
training in energy conservation strategies or expressive techniques.
Conclusion: The results of this study suggest that there are no studies that deal
exclusively with occupational therapy intervention for fatigue management, but the approaches
traced overlap with the competencies of occupational therapists and thus have a place in this
issue. The approaches used for fatigue management in the studies are combined within
comprehensive programs. The authors most commonly combine elements of cognitive-
behavioural therapy, physical activity and education, as well as promoting self-management
strategies and energy conservation strategies. Some included studies also addressed the
subjective needs of patients with fatigue. Thus, there is no one approach that has a strong
enough evidence base on its own, but by combining key approaches, a sufficient effect or
influencing fatigue can be ensured.