Older people living in a residential setting have the right to respectful care based on professional ethics. The aim of this study was to describe employees' and clients' lived experiences of elder abuse. A qualitative phenomenological method was used with 26 employees and 20 residents from four homes for elderly people in the town of Ostrava, Czech Republic, and two managers from outside these institutions. All complaints about elder abuse (n 5 11) received by Ostrava Municipal Authority during the period 2003 to 2007 were examined. Two main dimensions of the examined phenomenon were identified: forms of elder abuse and causes of elder abuse. Established forms of elder abuse were summarized as rights violation, financial abuse, psychological abuse, physical abuse and neglect. Causes of elder abuse included institution, employee and client characteristics. It is necessary in residential settings to create preventive policies that will focus on supervision regarding elderly people's rights violation and psychological and physical abuse, as well as on building organizational cultures that will respect ethical principles.

This study focuses on issues of elder abuse in residential settings. Violation of ethical principles is shown in the results of this quantitative study aimed at defining the extent, nature and causes of such abuse by employees' unethical conduct towards clients in senior homes (i.e. residential nursing homes) in the Moravian-Silesian region of the Czech Republic. The research sample comprised 454 employees and 488 clients from 12 residential homes for older people. The data were collected from interviews with clients, who also received a questionnaire concerning their satisfaction with the institution. Two questionnaires were administered to the employees, one based on a pilot qualitative study and a second to investigate burnout. Outcomes were assessed according to the extent and form of elder abuse, the causes of elder abuse and the violation of basic ethical principles. The responses, in particular those of employees, revealed both psychological and physical abuse of older clients, and thus violation of two basic principles: respect for the person and non-maleficence. The group at risk of elder abuse comprised aggressive and dissatisfied clients, as well as those with mental problems and dementia. The employees most at risk of being abusers were those who had been employed in institutional care for more than five years, had inadequate knowledge about social services and suffered from burnout. The prevention of elder abuse is recommended to be through education focused on ethical principles, increasing employees' satisfaction by promoting a friendly and safe organizational culture, and providing adequate working conditions.

Aim: The aim of this survey was to determine the degree of burnout among healthcare workers caring for patients in hospices, sources of occupational stress and ways of coping with stress. Also to determine the associations between burnout and demographic characteristics of workers, type of hospice care and length of experience in hospice care. Design: A cross-sectional, observational study. Methods: The sample consisted of 241 healthcare professionals working in twenty hospices with a minimum length of experience in hospice care of 6 months. The Burnout Measure, a standardized questionnaire for the assessment of burnout, and our own questionnaire for determination of demographic data, sources of occupational stress and ways of coping with stress were used. Results: The survey found that the degree of burnout among healthcare workers in hospices was low and did not depend on demographic factors, length of experience or the type of hospice care. Burnout was found in 6% of workers and alarming levels in 28%. The main source of stress identified by the workers were administrative work and being confronted with suffering. The most common ways of coping with stress were spending time with their families; as the best prevention of burnout, they wished to meet their colleagues outside working hours. Conclusion: Burnout among workers in hospice care should be monitored in order to identify individuals requiring greater care and support.

The results of tests on the psychometric properties of the PNAP questionnaire showed at least satisfactory validity and reliability, and it can be employed to assess the needs of palliative care patients in Central European countries.

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Assessing the quality of life and unmet needs of cancer patients is an integral part of palliative care. This cross-sectional study sought to determine whether there is an association between quality of life and unmet needs, anxiety and depression in cancer patients who are no longer receiving anti-cancer treatment. The sample consisted of 93 patients from the oncology department at the University Hospital in Ostrava for whom further cancer treatment had been terminated as ineffective in halting the progression of their cancer. The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Patient Needs Assessment in Palliative Care (PNAP) questionnaire, and the Hospital Anxiety and Depression Scale (HADS) were used to collect data. The overall quality of life score was quite low at 46. Most unmet needs were defined in terms of physical, psychological or spiritual needs. Correlations were found between impaired quality of life and lower Karnofsky scores (r = 0.50); increased physical (r = 0.52), psychological (r = 0.44) and spiritual (r = 0.36) needs; and higher levels of anxiety (r = -0.30) and depression (r = -0.68). Effective management of patients' physical (pain, fatigue and depression), psychological and spiritual needs may improve their quality of life.

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The quality of life of patients with diabetic foot ulcer reflects the conditions and healthcare system in each of the Visegrad countries. We have to respect socio-demographic factors and clinical characteristics in nursing care. This could have an impact on managing patient care not only with regard to their diabetic foot ulcer but also with regard to the patient as a personality with their own problems in relation to physical, psychosocial and environmental conditions.