The relationship between mental health continuum and care dependency in individuals with chronic obstructive pulmonary disease: A cross-sectional study.

AIM: To examine the relationship between mental health continuum and care dependence of hospitalized patients, who were diagnosed with chronic obstructive pulmonary disease (COPD). DESIGN: Descriptive, cross-sectional study. METHODS: The data were obtained from 448 inpatients diagnosed with COPD, who were treated in clinics, by utilizing questionnaires and face-to-face interviews between November 2021 and February 2022. The Mental Health Continuum Short Form and Care Dependency Scale were used by the researchers with the sociodemographic and clinical characteristics form created in line with the literature. The data were analysed using the SPSS 23.0 software. RESULTS: It was determined that a moderately significant positive relationship between mental health continuum and care dependency. In addition, the patient's perception of own health, disease stage and severity of dyspnoea were also found to be associated with mental health and care dependency. Gender, marital status, employment status and income level were found to be associated with mental health continuum, but not with care dependency. Advanced age, low educational level, alcohol consumption, antidepressant use and comorbidities were found to be associated with both care dependency and mental health continuum. CONCLUSION: Individuals with COPD who have low mental health, poor health perception, high disease stage and dyspnoea severity have high care dependency. IMPACT: In this study, it was revealed that the level of mental health continuum was significantly associated with care dependency in individuals with COPD; in addition, the individual's perception of poor health, disease stage and dyspnoea severity were other factors associated with care dependency. It is important for nurses working with individuals with COPD to evaluate the mental health of individuals with poor health perception, high disease stage and dyspnoea severity and to plan appropriate interventions to reduce care dependency. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution was required in the design, conduct, analysis or interpretation of this study. Patients/public members only contributed to data collection. Data were obtained from patients hospitalized in the chest diseases clinic of a training and research hospital.

Level of caregiving burden and affecting factors in family caregivers of patients with lung cancer: A cross-sectional study.

PURPOSE: To determine the caregiving burden level and affecting factors of family members caring for patients with lung cancer (LC). METHODS: This study used a cross-sectional design and a convenience sampling method. The study was conducted between April 2023 and August 2023 with the LC patients (n = 448) and their caregivers (n = 448) who met the inclusion criteria and were followed up in seven clinics of a specialized hospital for pulmonary diseases in Turkey. Data were collected by using (1) a demographic questionnaire (for patient and caregiver), (2) the Zarit Burden Interview (ZBI), (3) the Beck Depression Inventory (BDI), and (4) the Caregiver Quality of Life Index-Cancer (CQoLC). RESULTS: The study included 448 caregivers, with a mean age of 45.09 ± 13.48 years, and 71.4% were female. The mean ZBI score of 31.45 ± 16.71 indicated mild to moderate burden. Pearson correlation analysis showed that caregivers' depression levels increased and quality of life decreased significantly as the care burden increased. Multiple regression analysis indicated a significant relationship between the caregiver burden and the patient's age (p < 0.05), caregiver's chronic disease (p < 0.05), type of treatment given to the patient (p < 0.05), patient's metastasis status (p < 0.05) and caregiver's quality of life (p < 0.01). CONCLUSION: The fact that most of the risk factors identified in this study are non-modifiable highlights the necessity of identifying caregiver burden early by nurses and initiating the appropriate support processes.

Pressure Injury Prevalence and Risk Factors: A National Multicenter Analytical Study.

PURPOSE: The purpose of this study was to determine the point prevalence (PP) of general pressure injuries (PIs), hospital-acquired PIs, PI-related risk factors, and PI preventive interventions performed by nurses. DESIGN: Descriptive, multicenter, prospective, analytical study. SUBJECTS AND SETTING: The sample comprised 5088 patients cared for in 13 hospitals in 12 geographic regions of Turkey. Data were collected between November 5, 2018, and July 17, 2019. METHODS: The study was carried out in 2 stages. First, nurses who collected data were trained in the diagnosis of PI, risk assessment, staging, and prevalence studies, and informed about the purpose and methods of the study, including data collection. Second, nurses and researchers who had received training related to data collection for this study conducted a PP study for PIs in their inpatient clinics using the ASSIST II method. The PI Prevalence Study Tool and the Braden Scale for Predicting Pressure Sore Risk were also used during data collection. RESULTS: The PP of general PIs was 9.5%; the prevalence of PIs with hospitalization in intensive care units was 43.2%; medical device-related pressure injuries prevalence was 10.7%. We found that 65.1% of the PIs were acquired after hospital admission. CONCLUSIONS: Similarities exist between PI prevalence in Turkey and reported PI prevalence rates worldwide. However, the prevalence of nosocomial PIs related to intensive care units and the prevalence of all nosocomial injuries were higher than rates previously reported. Based on results, there is a need to develop strategies to reduce the prevalence of nosocomial PIs.

Effects of adherence to the Mediterranean diet on fatigue and activities of daily living in geriatric individuals with COPD.

BACKGROUND & AIMS: Fatigue is a commonly diagnosed symptom in cancers and many other chronic debilitating diseases. The second most important complaint after dyspnea in patients with Chronic Obstructive Pulmonary Disease (COPD) is the feeling of fatigue. Fatigue can have significant consequences on health status as it can limit patients' activities of daily living, lead to worsening prognosis, and is an indicator of mortality. It remains unclear how fatigue affects the daily life of COPD patients and what physical, social, and emotional challenges it brings. Some studies are showing that adhering to the Mediterranean diet significantly improves fatigue. In this study, the relationship between fatigue and adherence to a Mediterranean diet in COPD patients was investigated. METHODS: The present study is a descriptive, cross-sectional, and correlational study. The study population included ≥65-year-old patients with a diagnosis of COPD who were hospitalized in Chest Diseases Clinics of Izmir Dr. Suat Seren Chest Diseases and Surgery Training and Research Hospital and Chest Diseases Clinic of Sivas Cumhuriyet University Hospital. The Personal Information Form, Mediterranean Diet Adherence Screener (MEDAS), COPD and Asthma Fatigue Scale (CAFS), and KATZ Activities of Daily Living Scale (Katz ADL) were used as data collection tools. RESULTS: Of the total 526 participants, 58.7% were men, 52.1% were overweight, 54.3% were ex-smokers, and 65.8% were non-drinkers. In the variables related to the disease, the mean duration of having COPD was 16.41 (SD 5.26) years. According to the GOLD classification of the participants, the severity of the disease was determined as Stage III in 57.4% of them, and the severity of dyspnea was determined as "3" (moderate severity) in 54.5% of them according to the mMRC scale. According to the results of the analysis, the mean MEDAS score was 7.84 (SD: 2.76). According to the participants' levels of adherence to the MD, of them, 43.8% had high adherence to MD and 29% had low adherence to MD. The mean CAFS score indicating the level of disease-related fatigue was 69.17 (SD: 15.73), and the lowest and highest scores were 25 and 100 respectively. According to the independence in activities of daily living of the participants, 77.3% were semi-dependent and 6.4% were independent. The comparison of the level of the participant's adherence to the MD according to their mean CAFS scores demonstrated that those who had high adherence to the MD obtained significantly lower scores than the participants in the other groups (p < 0.05). The comparison of the participants' mean MEDAS scores according to their KATZ ADL independence status demonstrated that there was a significant difference (p < 0.001). CONCLUSIONS: Adherence to the MD was associated with fatigue and independence in older COPD patients. It was found that high adherence to MD is associated with decreased fatigue and increased independence in activities of daily living in older COPD patients.

Development of nursing students' attitudes scale toward pain assessment.

OBJECTIVES: This study aims to the development of nursing students' attitudes scale toward pain assessment and establish its validity and reliability. METHODS: This was a methodological study conducted in the 2017-2018 academic year. The sample consisted of 300 nursing students attending at the Department of Nursing of Gazi and Selçuk Universities. First, a 51-item draft was developed based on a literature review and interviews with 25 students. Five experts were consulted for content validity. The items were revised, and six items were removed based on their feedback. The 45-item final version was applied to participants. Afterward, exploratory and confirmatory factor analyses were performed to determine the scale structure. Test-retest reliability was determined on 190 participants selected randomly from the sample. RESULTS: A 51-item draft was developed based on a literature review and interviews. Five experts were consulted for content validity, and six items were removed based on their feedback. The rotated principal component analysis revealed 15 items loaded on two factors. The total scale had internal consistency reliability (Cronbach's alpha; α) of 0.918 and test-retest reliability of 0.738. CONCLUSION: Factor analyses showed that the scale had satisfactory construct validity and a two-factor structure. All α values were higher than 0.70, indicating that the scale had a satisfactory level of reliability. All in all, it is a valid and reliable scale that can be used to measure nursing students' attitudes toward pain assessment.

Views of students on the use of crossword and word search puzzle as a teaching technique in nursing education: A mixed-method study.

BACKGROUND: The use of puzzles in education helps to improve, consolidate and ensure the permanence of the learned information and increases the motivation of students toward the lesson. OBJECTIVES: This study was conducted to determine the views of nursing students on crossword and word search puzzles used within the scope of the course. DESIGN: A descriptive and qualitative design mixed-method study. SETTING: Department of Nursing, Faculty of Health Sciences, Ankara, Turkey. PARTICIPANTS: A total of 96 students who agreed to participate in the study and completed all the puzzles were included in the quantitative phase of the study while 21 students who were assigned to the focus groups by simple randomization method participated in the qualitative phase. METHODS: In the study, 3 different puzzle booklets (2 word search puzzles, 2 crosswords, a total of 4 puzzles) were applied to the students four weeks apart during the semester. The data of the descriptive phase of the study were collected with the personal information form. In the qualitative phase of the study, two focus group meetings were conducted and the obtained statements were evaluated using the thematic analysis method. RESULTS: The students stated that the puzzles included what they needed to learn in the lesson, that they have learned useful information and that they understood the topics they needed to learn in the lesson. Four categories were determined as a result of the qualitative phase of the study: the feelings you get while solving a puzzle, the puzzle with its advantages, the puzzle with its difficulties, and the skills I have developed. CONCLUSIONS: The students stated that they recommend the use of puzzles, that lessons become entertaining, learning becomes easier, their motivation increases and that puzzles provide the memorability of information.

The Prevalence of Pain in the First 24 Hours After Surgery: A Multicenter Study.

PURPOSE: This study was conducted to determine the prevalence and severity of postoperative pain in the first 24 hours after surgery and to emphasize the importance of postoperative pain assessment. DESIGN: A descriptive study. METHODS: This study was carried out on May 21, 2019 with 898 patients who had completed the postoperative 24th hour in the surgical clinics of 10 training and research hospitals in Istanbul, the capital of Turkey. Point prevalence was used in the study. Data were collected using a questionnaire developed by the researchers and the Revised American Pain Society Patient Outcome Questionnaire. Descriptive statistics were presented as frequency, percentage, mean, and standard deviation. Nonparametric tests were used for data without normal distribution (Kolmogorov-Smirnov Test, P < .05). Two-group comparisons were performed using the Mann-Whitney U test. The Kruskal Wallis-H test was used for the comparison of three or more groups. Statistical significance was set as P < .05. FINDINGS: The three main types of surgery were general surgery with 31.8%, gynecologic surgery with 12.9%, and orthopedic surgery with 12.7%. The mean lowest level of pain felt by the patients included in the study in the first 24 hours was 3.90 ± 2.94, and the mean highest level of pain was 6.38 ± 4.45. CONCLUSIONS: Postoperative pain is a subjective phenomenon and may be affected by factors such as type of surgery, previous experience of surgery, duration of surgery, the length of the surgical incision, the type of anesthesia, the quality of postoperative care, individual characteristics and experiences, and fear anxiety; thus, the experience of pain may vary from person to person.

Effectiveness of training in increasing awareness about managing pressure injuries in emergency departments.

INTRODUCTION: Emergency room conditions and the characteristics of the patients followed up pose a risk for pressure injury. AIM: This study was conducted as a pilot study to assess the effectiveness of a training program in increasing the awareness of healthcare professionals working in an emergency department about how to manage pressure injuries. METHODS: The study was a prospective, pre-test post-test intervention study without a control group. The study included 595 patients who were hospitalized in the emergency room for more than two hours and voluntarily agreed to participate, as well as 11 physicians and 17 nurses working in the emergency department between 15 April and 19 June 2019 2019. It was carried out in three stages. In the first stage, the 30-day pressure injury incidence rate in the emergency department was evaluated using the "Emergency Department Patients Information and Pressure Injury Assessment Form" and "The Braden Scale for Predicting Pressure Injury Risk". In the second stage, the healthcare professionals were given training about pressure injuries. The knowledge levels of healthcare professionals before and after the training were evaluated using "The Descriptive Characteristics Form for Emergency Department Personnel (doctors and nurses)" and "The Questionnaire for Identifying and Preventing Pressure Injury". In the third stage, the 30-day pressure injury incidence rate in the was re-evaluated after the training using the same two scales as before. The SPSS 25 package program was used to evaluate the data in terms of frequency, percentage, mean and standard deviation, and the Mann-Whitney U Test for independent groups, the t-test, the correlated sample t-test, the Wilcoxon Signed Rank test, Pearson Chi-square test, Yates Chi-square test and Fisher's Exact Chi-square test were also used. RESULTS: The mean knowledge test score of the healthcare professionals working in the emergency department was determined as X¯±SD = 53.71 ± 14.70 before the training and X¯±SD = 58.57 ± 11.83 after the training. The average score on the prevention dimension of the Questionnaire for Identifying and Preventing Pressure Injury was found to be statistically significantly higher than before the training (p < 0.05). The pressure injury incidence in the emergency department was 12.5% before the training and 8.8% afterwards. CONCLUSION: It was observed that the knowledge of healthcare professionals about pressure injury was insufficient and that training given on this topic both increased their knowledge and decreased the incidence of pressure injury. However, the difference was not statistically significant. Training about pressure injuries is important for preventing pressure injury, identifying the injury early, treating the injury appropriately and increasing the awareness of healthcare professionals.

Impact of tailored training about pressure injuries on nurses' knowledge levels and pressure injury point prevalence: The case of Turkey.

AIM: This study was conducted to determine the impact of tailored training provided to nurses for preventing pressure injuries (PIs) on nurses' knowledge levels and the PI point prevalence (PP). MATERIALS AND METHODS: This interventional study was carried out in a university hospital with a bed capacity of 1114 in an urban center in Turkey. Ethics committee approval (28.06.2018/31) and institutional permission were obtained for the study, in addition to the nurses' written, informed consent. The study was completed in three stages. In the first stage an initial PP study was conducted in the clinics with the participation of the nurses and the members of the research team (n = 422 patients). In the second stage the knowledge levels of 194 nurses were measured before training was given on following-up and preventing PIs. The nurses then participated in the tailored training and their knowledge levels were re-measured afterwards. All the nurses were given individual advice related to the prevention of PIs for 30 days after they had completed the training. In the third stage a second PP study was conducted four months after the first PP study (n = 454 patients). The data were collected using the Pressure Injury Prevalence Form, the Braden Pressure Ulcer Risk Assessment Tool and the Knowledge Level Measurement Form. Descriptive values, the paired samples t-test, Pearson's chi-squared test and Fisher's Exact test were used to evaluate the data. RESULTS: The nurses' pretest mean knowledge score was 55.36% ± 14.40 and their posttest mean score was 69.92% ± 9.73. The difference between these scores was statistically significant (p < 0.05). The study found no significant difference between the first PP ratio and the second PP ratio (p > 0.05), and the nurses were better able to evaluate skin and PIs after the training. CONCLUSION: The study determined that the tailored training given to the nurses increased their knowledge; however, it had no impact on the PP after four months. It is recommended that any training programs using this model be continued and that PP studies of institutions be conducted annually.

Prevalence of Nausea-Vomiting and Coping Strategies in Patients Undergoing Outpatient Surgery.

PURPOSE: The present study aimed to determine the prevalence and coping strategies for postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) in patients undergoing outpatient surgery. DESIGN: A descriptive research design was used. METHODS: This descriptive study was carried out with 350 patients who were admitted within the scope of outpatient surgery of the ear, nose, and throat; orthopaedics, urology, and general surgery departments of a university hospital between July 3, 2017 and March 6, 2018. A patient diagnosis form consisting of 34 items developed by the researcher and nausea-vomiting diary were used to collect data. FINDINGS: The results showed that 30.6% of the patients had PONV and 26.3% had PDNV. Of the 92 patients with postdischarge nausea, 26.1% experienced mild, 44.6% moderate, 20.7% high, and 8.7% severe nausea. Among the strategies for coping with PDNV, the patients preferred resting (49%), going outdoors (23.4%), eating something (17%), and drinking something (10.6%). A statistically significant difference was found between postdischarge nausea and risk factors for nausea-vomiting, such as female gender, history of nausea-vomiting, nausea in the postanesthesia care unit, and opioid use in the postanesthesia care unit (P < .05). CONCLUSIONS: This study shows that approximately a quarter of patients who undergo outpatient surgery will experience nausea and vomiting immediately after surgery as well as at home after discharge. Assessment of risk factors for PONV/PDNV was discovered to be an important factor in the care of perioperative patients. Therefore, the risk scoring system is expected to contribute to reducing PONV/PDNV incidence and improving patient coping strategies and satisfaction.

Investigating the Effect of a Structured Discharge Training Program on Patient Outcomes Following Gynecologic Oncology Surgery.

This study aimed to investigate the effect of a discharge training program structured according to the Roy adaptation model (RAM) on patient outcomes (quality of life, coping-adaptation, self-esteem) following gynecologic oncology surgery. This nonrandomized intervention studies consisted of two stages. In the first stage, patients were interviewed, patient needs after discharges were determined. Interview data were analyzed, and RAM-based training booklet was prepared. This booklet was prepared in line with a number of themes. In the second stage, the study was conducted with a sample of 36 control and 36 intervention patients, who were included in the discharge training program. Data was collected preoperatively, at 9th and 13th weeks after discharge. The mean quality of life and coping/adaptation scores of the intervention group at 13th weeks were significantly higher than those of the control group, however, no significant difference was found between the groups in terms of mean self-esteem scores.

Effectiveness of Computer Assisted Training of Patients Undergoing Lumbar Disc Herniation Surgery.

AIM: To identify the effects of computer assisted training schemes provided to patients who have undergone surgical intervention for lumbar disc herniation on their level of knowledge, level of anxiety, problems experienced after discharge, and level of functional incapacity. MATERIAL AND METHODS: The study was performed as a randomized controlled invasive study with a pre-testâ€'post-test design. The study was conducted with 62 patients, 31 of which were included in the intervention group and 31 in the control group. Training and counselling were provided to the patients included in the intervention group via a training web-site, while a training guidebook with the same content as the website for patients was given to the patients included in the control group. RESULTS: The patients who have undergone a surgical intervention for lumbar disc herniation, those who were provided computer assisted training were better informed, had better functional capacity, and experienced less anxiety after discharge than those who were only informed through the training guidebook. CONCLUSION: Computer-assisted training was efficient educational tool for patients undergoing lumbar disc herniation surgery.

Evaluating the Effects of a Pressure Injury Prevention Algorithm.

OBJECTIVE: To evaluate the effect of a pressure injury prevention algorithm on pressure injury prevention. DESIGN, SETTING, AND PARTICIPANTS: This intervention study was conducted in the anesthesiology and reanimation ICU (ARICU) of a university hospital. The study included two sample groups (nurses and patients). All patients older than 18 years (prealgorithm, n = 80; postalgorithm, n = 74) in the ARICU who verbally consented were included in the study. All 15 nurses who worked in the ARICU during the postalgorithm period agreed to participate in the study. INTERVENTIONS: The study was performed in four phases. In the first phase, pressure injury incidence was evaluated in the ARICU (prealgorithm period; April 1 to September 30, 2016). At the same time, a pressure injury prevention algorithm was developed. In the second phase, ARICU nurses were provided education on how to prevent pressure injury and use the pressure injury prevention algorithm. In the third phase, the nurses provided care based on the pressure injury prevention algorithm (postalgorithm period; November 1, 2016, to April 30, 2017). In the fourth phase, the incidence of pressure injury in the pre- and postalgorithm periods was compared, and the effectiveness of the algorithm was evaluated. MAIN RESULTS: The pressure injury incidence was 46.10 per 1,000 patient-days in the prealgorithm period and 9.21 per 1,000 patient-days in the postalgorithm period. The decline was statistically significant (z = 9.590, P < .001). CONCLUSIONS: Nursing education and the evidence-based pressure injury prevention algorithm reduced pressure injury rates. Further study of this algorithm in other ICUs and among various care populations is recommended to fully establish its efficacy.

The Use of Complementary and Alternative Medicines Among Surgical Patients: A Survey Study.

PURPOSE: The use of complementary and alternative medicine (CAM) has increased around the world. This study evaluates CAM use in surgery patients. DESIGN: Cross-sectional and descriptive study. METHODS: This study was conducted in a university hospital in Turkey between January 1 and June 30, 2016, on volunteer inpatients who were scheduled for surgery because of various complaints. FINDINGS: In this study, 65.9% of the patients used CAMs, 87.4% of the patients used herbal methods, and 63.7% of the patients used cognitive-behavioral methods. CONCLUSIONS: Health care providers, and nursing staff, in particular, should have adequate knowledge of societal approaches to CAMs, as well as the possible benefits and harms CAM may cause.

Surgical nurses' knowledge and practices about informed consent.

BACKGROUND: Informed consent involves patients being informed, in detail, of information relating to diagnosis, treatment, care and prognosis that relates to him or her. It also involves the patient explicitly demonstrating an understanding of the information and a decision to accept or decline the intervention. Nurses in particular experience problems regarding informed consent. RESEARCH QUESTION AND DESIGN: This descriptive study was designed to determine nurse knowledge and practices regarding their roles and responsibilities for informed consent in Turkey. The research was performed using 92 nurses who work at the surgical clinics. Data collection form was prepared by the researchers with assistance from the literature, and the data were evaluated by the SPSS 12.0 data analysis program. ETHICAL CONSIDERATION: This study was approved by the Medicine and Health Sciences Research and Ethics Committee of the university. Written consent was received from the nurses. FINDINGS: Among the nurses who participated in this study, 39.1% indicated that they were responsible for obtaining informed consent. It was also found that 90.2% of the nurses informed patients before providing nursing interventions and 32.6% of the nurses obtained consent from patients, and 90.0% of the nurses who indicated that they obtain patient consent only obtain verbal consent. Among all of the nurses, 21.7% agreed that informed consent needs to be obtained in order to protect the medical staff legally. DISCUSSION: It is argued that a lack of official procedures at hospitals regarding informed consent and insufficient information being provided to healthcare providers has caused problems regarding informed consent. CONCLUSION: The nurses in this study lacked information regarding their role in obtaining informed consent from patients and they often performed incomplete and/or incorrect practices within the framework of their required role. It is believed that an increased level of education along with the creation of official policies and procedures would contribute towards solving these problems.

Efficacy of a care bundle to prevent multiple infections in the intensive care unit: A quasi-experimental pretest-posttest design study.

BACKGROUND: Healthcare-associated infections extend hospitalization time, increase treatment costs and increase morbidity-mortality rates. OBJECTIVES: To evaluate the efficacy of a care bundle aimed at preventing three most frequent intensive care unit-acquired infections. MATERIALS AND METHOD: This quasi-experimental study occurred in an 18-bed tertiary care intensive care unit at a university hospital in Turkey. The sample consisted of 120 patients older than 18years and receiving invasive mechanical ventilation therapy, or had a central venous catheter or urinary catheter. The study comprised three stages. In stage one, the intensive care unit nurses were trained in infection measures, VAP, CA-UTIs and CLABSIs sections of the care bundle. In stage two, the trained nurses applied the care bundle and received feedback on any problematic issues. In stage three, the nurses' compatibility and efficacy of the infection prevention care bundle on the infection rates of VAP, CA-UTIs and CLABSIs were evaluated over three 3-month periods. RESULTS: Over 1000 ventilation days, ventilator-associated pneumonia infection rates were 23.4, 12.6, and 11.5, during January-March, April-June and July-September, respectively, with January-March and April-June showing a significant decrease (χ2=6.934, p=0.031). The central line-associated bloodstream infection rates were 8.9, 4.2, and 9.9 per 1000 catheter days, during January-March, April-June and July-September, respectively, but were not significantly different based on pair-wise comparisons (p>0.05). The catheter-associated urinary tract infection rates were higher during July-September (6.7/1000 catheter days) compared to January-March (5.7/1000 catheter days) and April-June (10.4/1000 catheter days) but the differences were not significant (p>0.05). CONCLUSIONS: The infection rates decreased with increased compatibility of the care bundle prepared from evidence-based guidelines.

Nursing Students' Perspectives on Assisting Cancer Patients.

OBJECTIVE: The objective of this study was to examine the experiences of student nurses who have provided care to cancer patients. METHODS: A mixed method approach consisting of semistructured focus groups (n = 61) and a survey questionnaire (n = 129) was used in the study. Student nurses were first interviewed, and then, a questionnaire was developed for them to answer. Following the content analysis, three themes and 19 subthemes were identified. Frequency and percent were used for qualitative data. RESULTS: Among the student nurses, 80.6% reported that working with cancer patients was "difficult." Difficulties experienced by the student nurses included patients rejecting their care, a large number of problems cases encountered when providing care to cancer patients, communication problems (38.0%), working with patients and attendants who fear death, and problems arising from family attendants who obstruct care. The majority of students experienced patients fearing death (28.7%) and felt feelings such as pity (71.1%), sadness (50.0%), and fear of cancer (41.9%) during their internships in oncology clinics. CONCLUSIONS: Students should be supported by instructors and oncology nurses, and nursing curricula should contain topics on how to best approach cancer patients.

The Effect of Warm Water Intake on Bowel Movements in the Early Postoperative Stage of Patients Having Undergone Laparoscopic Cholecystectomy: A Randomized Controlled Trial.

This study was aimed at determining the effect of oral administration of warm water during the postoperative initial stage on the time of first flatus in patients who had undergone laparoscopic cholecystectomy. In the literature, it is emphasized that warm water has favorable effects on intestinal movements such as "reliving gastrointestinal spasms and helping peristalsis return." This randomized controlled trial and experimental study was conducted in a university hospital between May and December 2011. In the study sample, we included a total of 60 patients; 30 were in the experimental group (drank warm water), while the other 30 composed the control group. Patients were randomized through a simple random sampling method. The experimental group was provided with 200 ml of warm water at 98.6°F (37°C) in the fourth postoperative hour and were made to drink it within 15 minutes. Patients received no oral intake other than warm water until the eighth postoperative hour. The oral feeding of both groups started in the eighth postoperative hour with fluids and soft food. They shifted to the normal diet as tolerated. In the analysis of the data and percentage numbers, chi-square test and Fisher's exact test, Student's t test, Mann-Whitney U test, Kruskal-Wallis variance, and correlation analysis were used. The results of the data were considered reliable and statistically significant when they were in the reliability interval of 95% and p < .05. No significant differences were found between the patients in the experimental and control groups in terms of demographic features, bowel habits, surgery durations, postoperative applications, nausea/vomiting conditions, and initial mobilization times (p > .05). Groups were homogeneously distributed. Flatus expulsion in the experimental group was 11 ± 4.2 hours and was determined to be 18.6 ± 6 hours for patients in the control group (p < .05); in contrast, no significant difference was detected in terms of the times of stool defecation (p > .05). It was determined that warm water intake in the fourth postoperative hour significantly decreased the first flatus expulsion period and had a favorable impact on intestinal movements.

The Effect of Cold Vapor Applied for Sore Throat in the Early Postoperative Period.

PURPOSE: This study was conducted for the purpose of determining the effect of cold vapor applied for sore throat in the early postoperative stage. DESIGN: A quasi-experimental design was used. METHODS: The study sample consisted of 60 patients who underwent lumbar disc herniation surgery in the Neurosurgery Clinic of Gazi University Health Research and Practice Center in Ankara, Turkey. The study involved two intervention groups and one control group. The study data were collected through questionnaire and observation forms. FINDINGS: 65% (n = 39) of patients experienced sore throat. There were no statistical differences between the groups in terms of sore throat and hoarseness (P > .05); however, a significant difference was determined in the group to whom oxygen together with cold vapor was applied for dry throat (4th and 8th hours) and swallowing difficulties(8th and 12th hours) (P < .05). CONCLUSIONS: Cold vapor did not have an effect on sore throat on its own; however, it decreased hoarseness and swallowing difficulties when applied together with oxygen.

The Problems Experienced by Parents Providing Postoperative Home Care Following Their Child's Surgery for Developmental Dysplasia of the Hip.

BACKGROUND: Families, especially mothers, experience problems providing home care after their child's surgery for developmental dysplasia of the hip (DDH). PURPOSE: To assess the problems experienced by parents providing postoperative home care to their child after DDH surgery. METHODS: This was a descriptive cross-sectional study. The sample consisted of 33 parents. Data were collected through a survey conducted at the hospital following the child's surgery and by telephone 4-6 weeks after surgery. Frequencies, means, percentages, and chi-square tests were used to analyze the data. RESULTS: The parents (93.9% women) provided postoperative care for approximately 3 months. Nearly all of the parents (97%) had physical (96.9%), psychological (65.6%), and social (75.0%) problems in addition to child care problems. CONCLUSIONS: We recommend preparing a comprehensive discharge-training package for parents after their child's DDH surgery, supplementing home care instructions with visual training materials, and providing telephone counseling to parents after discharge.