"I don't Want to Die Alone" Nurses' Perception of Ageism: A Qualitative Study.

The aim of the study was to learn the perceptions and thoughts of nurses with whom older patients interact constantly. In this research, semi-structured interview was used. In a research hospital in Istanbul between March-June 2019, 16 volunteers were included in the study. Researchers led individual semi-structured interviews regarding nurses' perceptions, how they overcame those challenges, and need and expectations aging care (dying patients). All interviews were analysed using thematic analysis methods and synthesized into major themes. The research was planned based on the 32-item checklist (COREQ) guideline. Nurses (N = 16) reported three themes: (i) ageing perceptions (ii) care for dying patients, (iii) expectations and five subthemes emerged in this study. It is understood that nurses have a positive perception of ageing. In addition, nurses have expectations from the state (financial support, gerontology service etc.) and society (respectful, understanding etc.) to reduce the difficulties they experience while caring for dying patient.

Determining the symptoms and coping methods of patients at home after hematopoietic stem cell transplantation.

AIM: This descriptive study was conducted to determine symptoms experienced at home in the early period by patients who received hematopoietic stem cell transplantation (HSCT), identify coping behaviors used by the patients in the management of symptoms and assess the quality of life of these patients. METHOD: The study included 200 patients who had received HSCT at a private hospital in Kocaeli in Turkey between October 2017 and November 2018 and been discharged. The data of the study were collected by using a patient information and interview form developed by the researcher, the Memorial Symptom Assessment Scale and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30. RESULTS: The mean age of the patients was approximately 51, 39% (n = 78) of the patients were female, 61% (n = 122) were male, and the vast majority (82%) were married. The three most frequently experienced symptoms among the patients after being discharged were identified as pain (63%), weakness (48%), and loss of appetite (43%). It was found that the vast majority of the patients complied with coping behaviors reported in the literature, but these behaviors were partially effective. Clinical diagnosis, type of transplant, status of re-hospitalization of the being discharged, and number of problems experienced were identified as variables that were significantly effective on the treatment-related symptom experiences and many dimensions of the quality of life of the patients (p < 0.05). CONCLUSION: It was determined that the patients who were included in this study experienced various symptoms on different levels and at different frequencies. Regarding the effectiveness of the approaches used by the patients in coping with the symptoms they experienced, it was determined that the approaches they used to cope with nausea-vomiting, fever and insomnia were effective, and those they used for weight loss and anxiety were ineffective.

A valid and reliable tool in assessing patient education: the Patient Education Implementation Scale.

AIM: This study aimed to develop a valid and reliable tool for assessing the frequency of nurses' implementation of patient education in line with the stages of determining needs, assessment and planning, implementation, and evaluation and documentation. BACKGROUND: Patient education is important in terms of the patient's completion of a reliable and effective treatment process. Patient education is one of the main responsibilities of a nurse. No valid and reliable study that assessed nurses' patient education process implementation was found in the literature. METHODS: This instrument development study was conducted with 583 nurses working at university, private, and research and training hospitals located in the province of Istanbul in Turkey. The items of the Patient Education Implementation Scale were developed in line with the literature and expert opinions. The analyses involved descriptive statistics and psychometric analyses. The level of statistical significance was accepted as P < .05. RESULTS: The content validity index was calculated as 0.96 for the 42-item Patient Education Implementation Scale, which explained 63.37% of the total variance. The scale items whose factor loads were 0.45 or higher were divided into four factors as (a) determining education needs, (b) assessment and planning, (c) implementation, and (d) evaluation and documentation. The Cronbach's alpha coefficients were 0.78-0.95 for the subdimensions and 0.97 for the general scale. CONCLUSION: It was determined that the Patient Education Implementation Scale is a valid and reliable tool.

The Effect of Lotus Position on Dyspnoea Management in Intensive Care Unit.

OBJECTIVE: To determine the effect of lotus position on dyspnea management. METHODS: The case-control study was conducted from June to November 2016 at a training and research hospital in Istanbul, Turkey, and comprised patients with lung disease in an intensive care unit. The patients were divided into an experimental group who were exposed to lotus position for dyspnoea management, while the control group was subjected to Orthopnoeic position. Data was collected using a patient description form, and the Medical Research Council Scale. Respiratory rate, oxygen saturation, heart rate and blood pressure for all subjects were noted. SPSS 22 was used for data analysis. RESULTS: Of the 35 subjects, 17(48.5%) were cases and 18(51.4%) were controls. The overall mean age was 61.48±15.51 years. There was a significant improvement in the intra-group respiratory rate, oxygen saturation, heart rate and systolic blood pressure in both groups (p<0.05). Patients in both groups were similar in their vital signs both before and after the intervention (p>0.05). CONCLUSIONS: Both lotus and Orthopnoeic positions significantly improved dyspnoea-related variables, and lotus position was as effective as Orthopnoeic position.

Correction to: Human Development Index and its association with staff spiritual care provision: a Middle Eastern oncology study.

Incorrect family name of Layth Mula-Hussain.

Human Development Index and its association with staff spiritual care provision: a Middle Eastern oncology study.

BACKGROUND: Although staff spiritual care provision plays a key role in patient-centered care, there is insufficient information on international variance in attitudes toward spiritual care and its actual provision. METHODS: A cross-sectional survey of the attitudes of Middle Eastern oncology physicians and nurses toward eight examples of staff provision of spiritual care: two questionnaire items concerned prayer, while six items related to applied information gathering, such as spiritual history taking, referrals, and encouraging patients in their spirituality. In addition, respondents reported on spiritual care provision for their last three advanced cancer patients. RESULTS: Seven hundred seventy responses were received from 14 countries (25% from countries with very high Human Development Index (HDI), 41% high, 29% medium, 5% low). Over 63% of respondents positively viewed the six applied information gathering items, while significantly more, over 76%, did so among respondents from very high HDI countries (p value range, p < 0.001 to p = 0.01). Even though only 42-45% overall were positively inclined toward praying with patients, respondents in lower HDI countries expressed more positive views (p < 0.001). In interaction analysis, HDI proved to be the single strongest factor associated with five of eight spiritual care examples (p < 0.001 for all). Significantly, the Middle Eastern respondents in our study actually provided actual spiritual care to 47% of their most recent advanced cancer patients, compared to only 27% in a parallel American study, with the key difference identified being HDI. CONCLUSIONS: A country's development level is a key factor influencing attitudes toward spiritual care and its actual provision. Respondents from lower ranking HDI countries proved relatively more likely to provide spiritual care and to have positive attitudes toward praying with patients. In contrast, respondents from countries with higher HDI levels had relatively more positive attitudes toward spiritual care interventions that involved gathering information applicable to patient care.

Training for awareness of one's own spirituality: A key factor in overcoming barriers to the provision of spiritual care to advanced cancer patients by doctors and nurses.

OBJECTIVE: When patients feel spiritually supported by staff, we find increased use of hospice and reduced use of aggressive treatments at end of life, yet substantial barriers to staff spiritual care provision still exist. We aimed to study these barriers in a new cultural context and analyzed a new subgroup with "unrealized potential" for improved spiritual care provision: those who are positively inclined toward spiritual care yet do not themselves provide it. METHOD: We distributed the Religion and Spirituality in Cancer Care Study via the Middle East Cancer Consortium to physicians and nurses caring for advanced cancer patients. Survey items included how often spiritual care should be provided, how often respondents themselves provide it, and perceived barriers to spiritual care provision.ResultWe had 770 respondents (40% physicians, 60% nurses) from 14 Middle Eastern countries. The results showed that 82% of respondents think staff should provide spiritual care at least occasionally, but 44% provide spiritual care less often than they think they should. In multivariable analysis of respondents who valued spiritual care yet did not themselves provide it to their most recent patients, predictors included low personal sense of being spiritual (p < 0.001) and not having received training (p = 0.02; only 22% received training). How "developed" a country is negatively predicted spiritual care provision (p < 0.001). Self-perceived barriers were quite similar across cultures.Significance of resultsDespite relatively high levels of spiritual care provision, we see a gap between desirability and actual provision. Seeing oneself as not spiritual or only slightly spiritual is a key factor demonstrably associated with not providing spiritual care. Efforts to increase spiritual care provision should target those in favor of spiritual care provision, promoting training that helps participants consider their own spirituality and the role that it plays in their personal and professional lives.

Effect of myocardial infarction on female sexual function in women.

PURPOSE: The aim of this study was to assess sexual function in female patients with myocardial infarction (MI). METHODS: As research instruments, an interview form of 20 questions that questioned personal characteristics was developed by researchers, Female Sexual Function Index (FSFI) that evaluated sexual dysfunction was used. The Beck Depression Inventory was used to evaluate depression. RESULTS: In the course of this study, 45 female patients (62.73 ± 8.55 years) with MI and 50 control women were interviewed. The total FSFI score was 16.41 ± 8.04 in the MI group versus 23.13 ± 3.95 (P < 0.001) in the control group. The prevalence of sexual dysfunction is significantly higher and the mean FSFI score was significantly lower in MI group women in comparison with the control group. Subscale scores of desire, arousal, lubrication and orgasm domains were lower than the other subscale scores in the MI group. Besides, 75.6% of the women in the MI group and 48.2% of women in the control group had a female sexual dysfunction. The frequency of intercourse was significantly lower in women with MI (1.55 ± 0.50 times last month) compared to the control group (2.14 ± 1.04 times last month). No significant differences were detected between the mean total BDI scores. But the correlation between FSFI and BDI total scores indicates that the increasing BDI scores in MI and control groups affected the total FSFI scores negatively. CONCLUSION: Sexual problems are frequent in women with MI. Sexuality should be evaluated after MI and patients' education and counseling may contribute to a better sexual function.

The effect of breathing exercises on chemotherapy-induced nausea and vomiting in autologous hematopoietic stem cell transplantation patients: A randomized controlled trial.

PURPOSE: This research was conducted as a randomized controlled study to examine the effect of breathing exercises on managing chemotherapy-related nausea and vomiting in patients who underwent autologous hematopoietic stem cell transplantation. METHODS: A randomized controlled trial design was used, including an intervention group doing breathing exercises and a control group receiving standard care for chemotherapy-induced nausea and vomiting. The sample was selected from patients hospitalized in the bone marrow transplantation unit. A total of 70 autologous hematopoietic stem cell transplantation patients (35 intervention and 35 control participants). Several variables were evaluated, including the frequence and degree of nausea and vomiting, the patient's nutritional status, and the need for antiemetics. Data were analyzed and interpreted using Mann Whitney U, Pearson chi-square test, Independent t-test, Mann Whitney U, and multiple linear regression. RESULTS: It was found that there was a negative relationship between the number of breathing exercises, the number of nausea and vomiting and the severity of nausea. As the number of breathing exercises increased, the number nausea and vomiting, and severity of nausea decreased significantly (p < 0.05). It was found that the use of antiemetics decreased in the intervention group. Furthermore, it was found that the intervention group had higher daily food consumption on the 3rd, 7th, and 9th days (p < 0.05). CONCLUSION: Breathing exercises were a practical approach to managing chemotherapy-related nausea and vomiting.

The efficiency of the acupressure in prevention of the chemotherapy-induced nausea and vomiting.

PURPOSE: This experimental study was planned to assess the efficiency of the acupressure in prevention of the chemotherapy-induced nausea and vomiting (CINV). METHODS: This single-blinded randomized trial was performed at Istanbul University Institute of Oncology between October 2010 and January 2011. The patients, diagnosed with breast, gynecological, or lung cancer treated by doxorubicin-based- or cisplatin-based treatment were included in the study. Taking the consent of the patients, they were divided into experimental (n = 67) and control groups (n = 53) in line with the randomization list prepared before. The patient description form, Rhodes Index of Nausea, Vomiting, and Retching (INVR), and Functional Assessment of Cancer Therapy-General were used in data collection. Non-parametric tests were applied. RESULTS: The patients in the experimental and control groups were identical in terms of sociodemographic features and their conditions. Most of the patients were married (84 %), and some were primary school graduates (41.7 %) and had mid-level income (54.2 %). In nausea-vomiting-retching, experiences of the patients before using a placebo and a real acupressure were identical and similar changes had been observed during 5 days after the treatment. It has been determined that there was no difference between the groups statistically. A similar result has been observed when the impact of acupressure on the subgroups of sociodemographic features and condition were examined, and it has been concluded that real acupressure application cannot increase the quality of life. CONCLUSION: It has been determined that CINV is directly related to the treatment, and acupressure wristband was not an effective approach in preventing CINV.

Development of Cancer Palliative Care in Turkey.

Palliative care is an important component of integrated, person-centered health care. It can be provided alone or in combination with the patient's medical treatment, not only by the palliative care team but also by the healthcare team caring for the patient. The concept of palliative care was developed in 2010 along with the establishment of the National Cancer Control Program in Turkey, and today there are many palliative care units, especially in metropolitan hospitals, that provide comprehensive palliative care. One-third of patients who come to the palliative care unit for treatment of pain, malnutrition, and respiratory problems are cancer patients. The care needs of all patients presenting to the palliative care unit are assessed, and a multidisciplinary team plans comprehensive palliative care for patients. Theoretical and practical patient care training is provided by palliative care nurses for family members or caregivers. Considering the burden of cancer as well as the increasing life expectancy at birth, it can be stated that the actual need for palliative care in Turkey will be much greater in the near future.

Effectiveness of mandala coloring in reducing anxiety in women with early-stage breast cancer receiving chemotherapy for the first time.

CONTEXT: Many people with cancer experience fear or anxiety when starting chemotherapy for the first time. Mandala coloring is an art therapy approach commonly used for anti-stress therapy. OBJECTIVE: To assess whether mandala coloring reduces the anxiety experienced by women with early-stage breast cancer during their first chemotherapy session. DESIGN: A quasi-experimental controlled study with pretest/posttest design. SETTING: The study was conducted in the outpatient chemotherapy unit of the Istanbul University Institute of Oncology between March 2017 and May 2018. PARTICIPANTS: Eight-four women with early-stage breast cancer who presented for their first session of chemotherapy were included, 41 in the intervention group and 43 in the control group. INTERVENTION: Patients in the intervention group were asked to color a mandala for 30 min while receiving premedication prior to chemotherapy. No intervention was applied to the control group. MAIN OUTCOME MEASURES: Levels of distress and anxiety were assessed before and after premedication using the distress thermometer and State-Trait Anxiety Inventory. RESULTS: The sample group consisted primarily of women who had primary school education, were married, and were homemakers. Average distress levels were low in both the intervention and control group before premedication, and state anxiety scores did not differ statistically between the groups before or after premedication. However, patients in the intervention group who had high distress levels before premedication showed a significant decrease in state anxiety score after premedication, while patients in the control group showed no decrease.

Effect of Auricular Acupressure in Management of Constipation in Palliative Care Patients.

Objectives: This experimental randomized-controlled study was performed to define the efficacy of auricular acupressure (AA) in the management of constipation developing in palliative care patients. Methods: According to the pre-prepared randomization list, 44 patients were included in the experimental group and 46 patients were included in the control group. Routine clinical treatment and care implementation were maintained in the patients in both groups. AA was performed for 4 weeks in patients in the experimental group. During the study, to determine the complaints of the patients regarding constipation, the information in the daily patient chart was examined at least 5 times by interviewing with the patient/patient's relative in the clinic and/or via phone call, and the results were recorded in the patient chart and data collection forms. The independent variable of the study is AA application, and the dependent variables are constipation and quality of life. Results: It was determined that there was no statistically significant difference between the daily defecation frequency of the 2 groups during the first 11 days. However, after the 12th day, the daily stool frequency of the experimental group was higher compared to the control group and this difference obtained between the 2 groups was statistically significantly different. AA was effective in decreasing laxative use. Conclusion: This intervention increased stool frequency, reduced physical and psychosocial symptoms, anxieties, and improved stool satisfaction and it was an effective approach to improving the quality of life. It is recommended that the daily use of AA should be evaluated. The healthcare providers including nurses, patients, and patient relatives should be trained regarding AA.

Evaluation of job stress and quality of life in individuals returning to work after cancer treatment.

PURPOSE: The aim of this study was to investigate the impact of work life on work stress and quality of life in cancer patients returning to work after treatment. METHODS: This descriptive cross-sectional study was conducted between January 2021 and June 2021 with 302 cancer patients who ad registered at the oncology outpatient clinic of a university hospital and had started or continued work after treatment. Data were collected using a personal information questionnaire, the Perceived Work Stress Scale, and the EORTC QLQ-C30. Results with p < 0.05 were considered statistically significant. RESULTS: The mean age of the patients was 44.97 ± 10.08 years. They were predominantly women, had a diagnosis of breast cancer, and had received chemotherapy. The patients' perceived work stress score was 2.10 ± 0.68 (level D) and the EORTC QLQ-C30 score was 65.95 ± 20.11. Women, participants who were worried about their jobs, those who worked >36 months after cancer treatment, public and private sector workers, those who considered leaving their jobs after cancer treatment, and those who considered changing jobs had higher work stress scores. CONCLUSIONS: The results of this study suggest that perceived work stress negatively affects the quality of life in individuals returning to work after cancer treatment. Therefore, individuals should be supported in returning to work and subsequent phases, and future should focus on the concepts of rehabilitation and return to work.

The Effect of Coffee in the Prevention of Oral Mucositis Associated with Head and Neck Radiotherapy.

AIM: This study investigates the effect of coffee on the management of oral mucositis associated with head and neck radiotherapy. METHOD: Twenty-nine patients who underwent radiotherapy for the first time due to head and neck cancer between March 2019 and February 2020 were included in the experimental study. One cup/day of Turkish coffee (6 mg) was given to the patients in the intervention group every day for 3 weeks from the first day of radiotherapy. Data monitoring of both groups was performed once a week for 3 weeks. RESULTS: Most of the patients participating in the study were at local stage (65.2%), and 72.4% underwent head and neck radiotherapy with the diagnosis of nasopharynx and larynx cancer. Although the development rate of oral mucositis was lower in the intervention group, no statistically significant difference was determined (p > 0.05). In the repeated follow-up, the quality of life scores was found to be similar in both groups. CONCLUSION: We concluded that coffee application is not an effective approach in the prevention of oral mucositis associated with head and neck radiotherapy. Further studies with larger sample sizes are needed to determine the prophylactic effect of coffee in the management of oral mucositis.

Effects of alopecia on body image and quality of life of Turkish cancer women with or without headscarf.

PURPOSE: The aim of this study was to find out the effects of chemotherapy-related alopecia on body image and quality of life of Turkish women who have cancer with or without headscarves and factors affecting them. METHODS: This descriptive study was conducted with 204 women who received chemotherapy at the Istanbul University Institute of Oncology, Turkey. The Patient Description Form, Body Image Scale and Nightingale Symptom Assessment Scale were used in data collection. Statistical analyses were performed using descriptive statistics and non-parametric tests. Logistic regression analysis was done to predict the factors affecting body image and quality of life of the patients. RESULTS: No difference was found between women wearing headscarves and those who did not in respect of their body image. However, women who wore headscarves who had no alopecia felt less dissatisfied with their scars, and women not wearing headscarves who had no alopecia have been feeling less self-conscious, less dissatisfied with their appearance. There was difference in terms of quality of life: women wearing headscarves had worse physical, psychological and general well-being than others. CONCLUSION: Although there were many important factors, multivariate analysis showed that for body image, having alopecia and wearing headscarves; and for quality of life, having alopecia were the variables that had considerable effects.

Nursing students' perceptions about nursing care plans: a Turkish perspective.

This descriptive study was planned in order to assess self-perceived sufficiency levels of nursing students at preparing nursing care plans and also determine the effect of these plans on students' occupational development. Sample of the study was consisted of 55 nursing students who were taking oncological training. Data were collected by using Personal Information Form and Student Care Plan Evaluation Form. Non-parametric tests were used in data analysis. Students perceived themselves 'insufficient' although assessing reproductive neurological and cardiovascular systems, respectively, and also interpreting results of hemogram and urine tests. No significant difference was found between the initial and last nursing care plans prepared by the students during clinical training. Sixty % of students reported that preparing and implementing nursing care plans had favourable effects on their occupational development. Results suggest that students should be well prepared before clinical training programmes and also nursing care plans should be revised and used in more proper and practical ways in order to enhance students' occupational development.

Evaluation of the caregiving roles and attitudes of nurses during the COVID-19 pandemic.

BACKGROUND: Nurses play a critical role in providing care to patients, in particular, they work in the frontlines in caring for patients with complicated COVID-19 requiring hospitalization. Evaluation of the caregiving roles and attitudes of nurses is critical in the current crisis. Therefore, this study aimed to determine the caregiving roles and attitudes of nurses during the COVID-19 pandemic. METHODS: A quantitative descriptive study was performed with 130 nurses in Turkey. The attitude scale for the caregiving roles of nurses (ASCRNs) was used to collect data. We conducted an online survey between May and November 2020. RESULTS: The mean total score of the participants on the ASCRN was 62.20 ± 18.42. All nurses stated that they were affected by the COVID-19 pandemic. The ASCRN scores of nurses who received training about the COVID-19 pandemic and who thought that the personal protective equipment they used was sufficient had statistically higher scores on the ASCRN (p < .05). CONCLUSION: The results of this study suggested that the COVID-19 pandemic had a negative effect on the caregiving roles and attitudes of the nurses.

Evaluation of Factors That Affect COVID-19 Infection in Turkish Society.

AIM: The study aims to determine the risk factors that affect coronavirus-2019 infection in Turkey. METHOD: This descriptive study was performed between October 18, 2020, and November 18, 2020. The online link of the form created on Google forms was sent to the participants' phones. Totally 1104 individuals from different regions of Turkey participated. Logistic regression analysis was performed to detect risk factors of coronavirus-2019 infection. RESULTS: Most of the participants were women and university graduates. All participants except one wore masks, 96.8% paid attention to social distance, and 57.8% did not use public transportation. Of the participants, 9.8% (n = 108) were diagnosed with coronavirus-2019 and 41.5% (n = 458) had a coronavirus-2019-positive relative. The infection risk was higher for those who lived in the Marmara region, who went to work daily (odds ratio = 2.18; 95% CI: 1.18-4.04), who had a coronavirus-2019-positive patient where they lived (odds ratio = 3.44; 95% CI: 1.95-6.05), and who shared items with a coronavirus-2019-positive patient (odds ratio = 4.76; 95% CI: 2.64-8.58). CONCLUSION: Sharing items with a coronavirus-2019-positive patient, living in crowded regions, and going to work daily were the main risk factors of coronavirus-2019 infection in Turkish society.

Effects of a Mindfulness-Based Stress Reduction Program on Stress, Depression, and Psychological Well-being in Patients With Cancer: A Single-Blinded Randomized Controlled Trial.

BACKGROUND: A mindfulness-based stress reduction program combined with music therapy is one of the interventions designed to help patients cope with stress and depression. OBJECTIVE: The aim of this study was to examine the effects of an online mindfulness-based stress reduction program combined with music therapy on stress, depression, and psychological well-being in adult patients with cancer. METHODS: This study was a single-blinded, prospective, randomized-controlled experimental design. One hundred twenty cancer patients were recruited (60 each in the intervention and control groups). Patients in the intervention group received a 10-day mindfulness-based stress reduction program combined with music therapy. Stress was measured with the State Trait Anxiety Inventory-State, psychological well-being was measured with the Psychological Well-being Scale, and depression was measured with the Beck Depression Inventory at baseline and the end of the study. RESULTS: The intervention group showed significantly lower stress and depression scores than the control group in the total scores at 10 days ( P < .05). The intervention group had significantly higher scores in the psychological well-being ( P < .001) than the control group at 10 days. Intragroup comparison of the stress and depression scores showed that posttest score of the intervention group was significantly lower than its pretest score ( P < .05). CONCLUSION: Mindfulness-based stress reduction program combined with music therapy reduced the levels of stress and depressive symptoms and improved psychological well-being in cancer patients. IMPLICATIONS FOR PRACTICE: A nurse-led mindfulness-based stress reduction program combined with music therapy is an innovative and effective psychological intervention that may be integrated with regular patient care for adults receiving treatment of cancer.