Stoma Perceptions of Adults with an Ostomy: A Metaphor Analysis in a Single Center.

OBJECTIVE: To use metaphor to evaluate stoma perceptions among adults with ostomies to conceptualize and portray their lived experiences using a figurative approach. METHODS: A qualitative research design was used. Participants were 27 adults with an ostomy who were followed up in the stoma therapy unit. Individuals were included in the study if they had had a temporary or permanent ostomy for at least 2 months and spoke Turkish. Participants were asked to complete the sentence: "Stoma is like…/similar to… because…." The researchers used content analysis to evaluate participants' responses. Interpretation of the metaphors developed by participants was carried out in five phases: coding, example metaphor compilation, theme development, ensuring trustworthiness, and transferring. RESULTS: Participants expressed a total of 17 unique and 10 repeated metaphors for the concept of "stoma." These metaphors were grouped under three different themes: positive (lifesaving), negative (punishment/enemy), and neutral (temporary/necessity for life). The most commonly used metaphors were life, savior, comfort, difficulty, fear, punishment, and necessity. CONCLUSIONS: Individuals with an ostomy mostly had negative metaphorical associations with stomas. The authors recommend that hospitals implement multifaceted interventions to bring positive metaphors to individuals with ostomies.

Investigating compassion fatigue and predictive factors in paediatric surgery nurses.

BACKGROUND: Nurses provide care to meet the complex needs of patients in the increasing workload in the health system and are at risk of compassion fatigue. The concept of compassion fatigue has begun drawing attention in the last decade, as it negatively affects nurses' physical and mental health, job performance and satisfaction, and therefore patient care quality. OBJECTIVES: This study was to examine compassion fatigue and predictive factors in paediatric surgery nurses. PARTICIPANTS AND RESEARCH CONTEXT: The study was cross-sectional, predictive and quantitative. It was conducted with the 135 paediatric surgery nurses. The data were sent to the email addresses of the members via Google Survey. Research data were collected with the Nurse Information Form, Compassion Fatigue Scale, Life Satisfaction Scale and Multidimensional Perceived Social Support Scale. ETHICAL CONSIDERATIONS: After obtaining the approval of the University's ethics committee, the study was carried out after obtaining participants' informed written and verbal consent. RESULTS: There was a difference between the level of compassion fatigue according to the paediatric surgery unit that worked the longest and the thought of changing their profession. Burn unit nurses and nurses who were considering changing professions have higher compassion fatigue scores. When the predictors of compassion fatigue were examined, the thought of changing the nursing profession and life satisfaction were significant predictors of compassion fatigue. The thought of changing the nursing profession and life satisfaction explained 22% of compassion fatigue. The same variables and the longest working period of the paediatric surgery unit were the estimators of the level of occupational burnout; explaining 29% of occupational burnout. CONCLUSIONS: Compassion fatigue, life satisfaction and perceived social support of paediatric surgery nurses are moderate. Compassion fatigue is affected by working time, the thought of changing the profession, life satisfaction and perceived social support.

Psychometric Properties of the Turkish version of The Preparedness for Colorectal Cancer Surgery Questionnaire (PCSQ-TR).

PURPOSE: Preparing a patient cognitively, psychosocially and emotionally for an operation is important for the healing process. The purpose of this study is to investigate the psycholinguistic and psychometric properties of the Turkish version of The Preparedness for Colorectal Cancer Surgery Questionnaire (PCSQ-TR). DESIGN: Methodological study. METHODS: The sample consisted of 220 patients. Patients who underwent operation or reoperation for colorectal cancer were included. The language validity, content validity, discriminant validity and construct validity (confirmatory factor analysis) analyses were performed. The item analysis and internal consistency were examined. FINDINGS: Item total score correlations were between 0.38 and 0.85. The Cronbach's alpha was 0.97 for the overall PCSQ-TR and ranged between 0.85 and 0.91 for its domains. Discriminant validity revealed a statistically significant moderate positive correlation between the patients' mean score for the overall PCSQ-TR and their subjective preparedness for surgery score (r = 0.64, P = .000). In the confirmatory factor analysis, the fit indexes were χ2/df = 2.5; P = .00, RMSEA = 0.08, CFI = 0.92, IFI = 0.92, RMR = 0.18, GFI = 0.79. CONCLUSIONS: PCSQ-TR is a valid and reliable scale that can be used to determine colorectal cancer patients' preparedness for surgery and recovery. PCSQ-TR can be administered in writing or online and can help identify patients who do not feel ready for the surgical recovery process and need advanced nursing care support.

Validation and Clinical Experience With a Turkish Language Version of the Pittman Ostomy Complication and Severity Index.

PURPOSE: The purpose of this study was to evaluate the content validity and interrater reliability of a Turkish language version of the Pittman Ostomy Complication and Severity Index (OCSI). DESIGN: Psychometric evaluation of instrument. SUBJECTS AND SETTING: The sample comprised 90 individuals living with an ostomy for 2 to 6 months. Their mean age was 59.48 years (SD 13.292); 52.2% were female. Almost two-thirds (73.3%, n = 66) had experienced at least 1 ostomy complication. The study was conducted in the Wound and Stoma Therapy Unit of the Dokuz Eylül University Hospital General Surgery Clinic and Polyclinic in Izmir, Turkey. METHODS: A Turkish language version of the OCSI was created using a translation, back-translation technique. The instrument's content validity was analyzed by 26 experts. Interrater reliability test was evaluated using Cohen's κ and intraclass correlation coefficients. Data were collected between January 15, 2017 and July 30, 2017 through face-to-face interviews conducted in our Wound and Stoma Therapy Unit. RESULTS: The overall content validity index was 0.95. Cohen's κ coefficient varied from 0.70 and 1.0 for all items. The Pearson correlation coefficient and intraclass correlation coefficient were 0.982 (P = .000) and 0.986 (P = .000), respectively, indicating good internal consistency. The most prevalent complications were leakage (41.1%), peristomal moisture-associated skin damage (42.2%), and stomal retraction (27.7%). CONCLUSIONS: Findings indicate that the Turkish language version of the Pittman OCSI is a reliable and valid instrument for assessment of presence and severity of early postoperative complications in individuals with an ostomy. We found the instrument parsimonious, easy-to-use, and clinically practical. It can be used to determine appropriate interventions to prevent or treat complications and evaluate the effects of nursing interventions designed to improve outcomes for patients with ostomies.

The Effect of Web-Based Preoperative and Postoperative Patient Care Education on Nursing Students: A Randomized Controlled Study.

This study examined the effect of Web-based preoperative and postoperative patient care education among undergraduate nursing students. This was an experimental, randomized controlled study. The study included 305 nursing students (experimental group: n = 155, control group: n = 150), who were assessed with the following instruments: the Preoperative and Postoperative Care Knowledge Test, Preoperative and Postoperative Care Skill Control List, Clinical Decision Making in Nursing Scale, and Nursing Student Clinical Performance Evaluation Scale. t Tests and χ tests were used to evaluate the data. There was no statistically significant difference between the students' posttest knowledge levels, clinical performance assessment, or clinical decision-making scores. The experimental group was found to perform the skills of "check patient's documents and prophylactic antibiotics when going to surgery" (χ = 4.88; P = .02), "controls the surgical safety checklist (before surgery) before going to surgery" (χ = 10.41; P = .00), and "observes surgical site/dressing (χ = 7.77; P = .00)" at a statistically significantly higher level. The education provided in the Web-based education was equivalent to that provided in traditional education. Thus, Web-based education appears to be a useful tool to educate student nurses in preoperative and postoperative patient care.

The Impact of an Ostomy on the Sexual Lives of Persons With Stomas: A Phenomenological Study.

PURPOSE: The purpose of this study was to describe the lived experiences of persons with stomas related to sexual function and perceptions and their expectations of the ostomy nurses who care for them. DESIGN: Qualitative, phenomenological study. SUBJECTS AND SETTING: Fourteen persons living with an ostomy for least 2 months participated in the study. Data collection occurred at the ostomy and wound care unit at Dokuz Eylul University Hospital in Izmir, Turkey. METHODS: Data were collected using an in-depth interview method. Interviews lasted from 20 to 60 minutes and were audiotaped. These recordings were transcribed and subjected to content analysis. RESULTS: Five themes emerged from the unstructured interviews: (1) changes in sexual life; (2) changes in body image; (3) fear and anxiety experienced during sexual intercourse; (4) psychological impact of sexual problems; and (5) expectations concerning sexual counseling from ostomy nurses. CONCLUSIONS: Study findings suggest that persons with ostomies experience changes in their body image, along with a decrease in sexual desire. Respondents described avoiding sexual intercourse, and abstained from sleeping with their partners. Male respondents described erectile dysfunction, and female respondents reported pain during sexual intercourse (dyspareunia). Participants stated that they did not feel adequately informed about these problems and desired to receive more information and support from ostomy nurses regarding sexual issues. Based on these findings, we recommend that ostomy nurses provide more counseling concerning sexual function and challenges following ostomy surgery.

Effect of a telephone-based perioperative nurse-led counselling programme on unmet needs, quality of life and sexual function in colorectal cancer patients: A non-randomised quasi-experimental study.

PURPOSE: To investigate the effect of perioperative nurse-led counselling intervention on unmet needs, sexual function and quality of life in colorectal cancer patients. METHOD: This quasi-experimental study included 82 patients who underwent colorectal cancer surgery (control n = 45, intervention n = 37). The telephone-based perioperative nurse-led counselling intervention, which contained implementation, follow-up, and assessment, was applied to start from pre-surgery to post-surgery 3rd month. Data were collected with the Unmet Needs of Cancer Survivors Scale, European Organisation for Treatment and Research of Cancer Quality of Life Scale-30, Colorectal-29, Female Sexual Function Index, and International Index of Erectile Function pre- and post-surgery 3rd-6th months. The control data was collected before the pandemic, and the intervention group throughout the pandemic. The Mann-Whitney-U, Wilcoxon rank test was used. RESULTS: Compared to the control group, intervention group patients reported lower unmet and total needs scores (p = 0.000); higher quality of life (p = 0.000), physical, emotional (p = 0.000), role (p = 0.001), and social functioning scores (p = 0.002); lower fatigue (p = 0.000), constipation (p = 0.034), pain (p = 0.018), nausea-vomiting (p = 0.004), and insomnia scores (p = 0.003); and higher body image, anxiety (p = 0.000) and weight scores (p = 0.003), lower urinary frequency buttock pain (p = 0.000), dysuria (p = 0.001), abdominal pain (p = 0.001), fluctuance (p = 0.000), stool frequency (p = 0.002), and faecal incontinence (p = 0.006) scores at the sixth month (p < 0.05). There were no statistically significant differences between male and female sexual function scores (p > 0.05). CONCLUSIONS: Perioperative nurse-led counselling reduced unmet needs and increased the overall quality of life by decreasing symptom levels but did not affect sexual health outcomes in patients with colorectal cancer surgery.

Experiences of parents of children with corrosive esophageal ingestion: a qualitative study.

PURPOSE: To describe the experiences of parents of children treated for corrosive esophageal ingestion. METHODS: In-depth interviews were conducted with 17 parents (nine mothers and eight fathers) of children who had suffered a corrosive esophageal ingestion requiring hospitalization. Online interviews were also conducted with parents of children who were still undergoing treatment for corrosive esophageal ingestion. The interview guide explored the parents' overall experiences and included research questions that explored the participants' perceptions, thoughts, feelings and problems. The interviews were digitally recorded and transcribed verbatim. Inductive reflective thematic analysis was performed using MAXQDA. RESULTS: Analysis of the interview transcripts generated three themes and nine sub-themes describing parents' experiences: emotional consequences, social consequences and facilitators. The results reveal that caregivers experienced anxiety and difficulties, prompting them to seek support from their family and social environment. CONCLUSION: These findings highlight the importance of identifying and understanding parental experiences. This understanding will also enable healthcare professionals to optimize the parental experience in caring for children with corrosive esophageal ingestion within a holistic clinical service. Understanding the experiences of children with corrosive esophageal ingestion from the parents' perspective identifies opportunities for systematic treatment and care.

Corrosive esophageal ingestion in children is an injury that restricts and damages the quality of life for both children and their families.Due to the negative experiences of parents resulting from the gaps in treatment and care of corrosive esophageal ingestion, health professionals require training to deliver a holistic clinical service.The implementation of support group interventions is needed to address changes in the social and emotional consequences experienced by parents.

Caregiver burden of families of children with corrosive esophageal injuries.

This cross-sectional and descriptive study aimed to determine care burden of families of children with corrosive esophageal injuries. The study involved 112 parents who had children with corrosive esophageal injury. Caregiver's Stress Scale and Reactions to Helping Family Members Scale were used to assess care burden of families. Caregiver's Stress Scale median score was 7.0 [interquartile range 5.0], and Reactions to Helping Family Members Scale median score was 45.0 [interquartile range 14.0]. The burden of family caregivers was thus found to be high. Factors affecting the care burden were found to be child's age, parents' age, child's weight, substance type and pH, surgery status, and number of surgeries. Nurses should consider these factors when advising and educating these families. Additionally, initiatives including support groups should be planned with regard to the needs of these families with a high care burden.

Nutritional Experiences of Parents of Children Who Had Gastric Transposition Surgery.

This study aimed to understand the postoperative nutritional experiences of parents of children who had undergone gastric transposition surgery after corrosive esophageal injury. The study had a descriptive qualitative research design, and used a structured interview form as a result of the COVID-19 pandemic. The population of the study consisted of the parents of 12 children who had undergone gastric transposition surgery at the pediatric surgery clinic of a university hospital in an urban area in Turkey. Thematic analysis was conducted on the transcripts using the MAXQDA program. Four main themes emerged and five supporting sub-themes were identified. The main themes were what we experienced in the postoperative nutrition process, coping with how we live, what we want to know, and our recommendations to healthcare professionals. Family-centered care should be a main focus when caring children who have had gastric transposition surgery, and children and their parents should be supported by a multidisciplinary team.

Living With My Baby With Congenital Anomaly: A Qualitative Case Report.

This case report was made to understand the emotions, thoughts, and experiences of the mother, who was lying in the long-term neonatal intensive care unit. An individual in-depth interview was conducted once with the mother of the infant with the diaphragm hernia. The interview recorded and lasted approximately 30 min. The data were analyzed by inductive method and themes and codes were created. The mother of the infant with a diaphragmatic hernia was 31 years old, married with 2 children, and employed full-time. The infant was diagnosed antenatally at 37 weeks old, weighed 3.000 g, and was male. As a result of the interview, 3 main themes were identified: "Facing the disease," "Experiences in intensive care," and "Change in family life." The results show that having an infant with congenital anomaly affects the life of all family members and shows the problems experienced strikingly.

Assessment of the Environmental and Physical Ergonomic Conditions of ORs in Turkey.

This descriptive, cross-sectional study in hospital ORs in Izmir, Turkey, assessed the environmental and physical ergonomic conditions that may place perioperative personnel at risk for injury or illness. We used an ergonomic conditions and risk factor description form to collect data in 58 ORs in nine different hospitals. We identified that the noise level and general air quality in the ORs were within recommended levels. However, none of the ORs had a surgical smoke evacuation system, pressure-absorbing mats, or special equipment to facilitate patient moving and lifting. Approximately 70% of the ORs had high stools to provide short periods of rest for the surgical personnel. In addition, perioperative personnel did not wear protection to prevent intraoperative radiation exposure. These results indicate that although some environmental factors were within acceptable limits, other physical ergonomic risks were not adequately addressed, thereby placing perioperative staff members at risk for health concerns.

Investigation of inadvertent hypothermia incidence and risk factors.

OBJECTIVE: This study was conducted to determine the incidence of inadvertent hypothermia in operative patients and the risk factors that are involved in the development of hypothermia. MATERIAL AND METHODS: This prospective, descriptive, cross-sectional study was conducted from January 2016to August 2016 with 144 patients who over the age of 18 years, underwent general surgery, orthopedic surgery, urologic surgery, neurosurgery, and plastic and reconstructive surgery. Data was collected with the "Hypothermia Data Collection Form." Body temperature was measured by the tympanic membrane in the waiting room, operating room, and PACU. RESULTS: Overall, 89% of the patients (n=129) were normothermic in the preoperative phase; 74.30% of the patients (n=107) in intraoperative phase and 75.70% of the patients (n=109) in postoperative phase were hypothermic. American Society of Anesthesiologist (ASA) score, preoperative body temperature, operating room temperature, and using heating method at operation were found to be effective in the development of inadvertent hypothermia during the operating period. It was determined that premedication, preoperative and postoperative body temperature, and the operating room temperature were effective for inadvertent hypothermia in the postoperative period. CONCLUSION: As a result of the study, it was determined the rate of inadvertent hypothermia was high during and after surgery. Preoperative and intraoperative patient body temperature and operating room temperature were found to be effective in preventing inadvertent hypothermia.

Ergonomics: an important factor in the operating room.

There is a mutual interaction between health and the workplace. Health affects the capacity to work and working conditions affect a worker's health. Operating rooms (ORs) are stressful, complex settings in which there are ergonomic risk factors, such as lifting/moving heavy equipment. Work-related musculoskeletal disorders (WRMSDs) can arise due to unhealthy ergonomic conditions. Our study showed that nurses had been absent from work and/or retired early due to WRMSDs. Good ergonomic conditions in ORs increase nurses' occupational health and safety, their job satisfaction and performance. These factors contribute to patient care outcomes in a positive way.

Psychometric Properties of the Body Image Scale in Turkish Ostomy Patients.

PURPOSE: To investigate the validity and reliability of the Body Image Scale in Turkish ostomy patients. METHODS: This study has a methodological and cross-sectional design. A hundred patients with ostomy lasting for at least 2 months were recruited from an ostomy and wound care unit. FINDINGS: Confirmatory factor analyses showed that goodness-of-fit indexes were acceptable. Exploratory factor analyses showed that factor loadings of the scale items varied between 0.74 and 0.91, and a single factor was determined. The Cronbach's alpha value of the scale was 0.94. Item-to-total correlation coefficients ranged from 0.75 to 0.91. CONCLUSION: The Turkish version of the Body Image Scale is a valid and reliable tool for evaluating body image in Turkish ostomy patients.