Incidence, severity and characteristics of medical device-related pressure injuries in adult intensive care patients: A single-centre, cross-sectional study.

AIM: This study aimed to determine the incidence, severity and characteristics of medical device-related pressure injuries in intensive care units. METHODS: This is a cross-sectional study. Data were collected from 187 patients admitted to the Anaesthesia and Reanimation intensive care unit of a university hospital between January and May 2023. The skin of the patients enrolled in the study was assessed for the presence of medical device-related pressure injuries, and all medical devices used were recorded. Data were collected using the Patient Identification Form, the Medical Device-Related Pressure Injury Follow-up Form, and the Braden Scale for Predicting Pressure Ulcer Risk. RESULTS: It was found that 30.6% of the patients developed medical device-related pressure injuries; of these, 73.7% had stage I pressure injuries. We found that 36.8% of the patients were diagnosed with medical device-related pressure injuries within 8-11 days. The results showed that endotracheal tube (61.4%), non-invasive ventilation/oxygen mask (52.6%), Foley catheter (49.1%), and nasogastric tube (36.8%) devices were the most common causes of the development of medical device-related pressure injuries. Patients' demographic characteristics were found to have a significant effect on the development of medical device-related pressure injuries (p < .05). CONCLUSION: The study found that the incidence of medical device-related pressure injuries was relatively high and that a relationship was observed between the patients' demographic characteristics and medical device-related pressure injuries. It is crucial that ICU nurses, who are more likely to encounter medical device-related pressure injuries, consider these factors when caring for their patients and take appropriate preventive measures to reduce the incidence of these injuries.

YouTube as a source of information on breast cancer-related lymphedema exercises: A content, quality, and reliability analysis.

This descriptive study aimed to determine the content, quality, and reliability of YouTube videos on breast cancer-related lymphedema exercises. A total of 127 videos were independently assessed, with 103 of them categorized as either informative or misleading content groups. The content (mean score: 4.07 ± 2.29) and quality (mean score: 3.15 ± 1.46) of videos concerning lymphedema exercises were moderate, while reliability (mean score: 2.27 ± 1.64) was low. Among the 103 videos categorized using the content checklist, Global Quality Scale, and DISCERN reliability instrument, 57.3% (n = 59) were informative, and 42.7% (n = 44) had misleading information. The mean scores of the content, quality, and reliability of the informative content videos were substantially higher than the misleading content videos, and of videos uploaded by universities/professional organizations/health care professionals/medical advertisements were higher than the videos uploaded by other sources. Through this study, the researchers have unveiled that the content and quality levels of YouTube videos in lymphedema exercises were moderate, and the reliability level was low.

Analysis of mental health symptoms and insomnia levels of intensive care nurses during the COVID-19 pandemic with a structural equation model.

BACKGROUND: Faced with this critical situation and directly involved in the treatment and care of COVID-19 patients, front-line healthcare workers are at high risk in terms of mental health symptoms. AIMS AND OBJECTIVES: To determine the stress, anxiety, depression, and insomnia levels of intensive care nurses during the pandemic with a structural equation model. DESIGN: A multi-site survey study. METHODS: The study was performed with 194 nurses working in the intensive care units of five hospitals in Istanbul in July 2020. Data were collected using the Depression Anxiety Stress-21 Scale and Insomnia Severity Index electronically. The data were evaluated with descriptive statistics in SPSS package program. In order to test the structural model and hypotheses of the research, path analysis was performed with LISREL statistical software program. A validation study for the suitability of these scales to the study sample was done by the researchers using the confirmatory factor analysis method. The study conforms to the TREND checklist. RESULTS: In this study, the majority of the intensive care nurses had moderate to extremely severe depression (65.5%), anxiety (58.3%) and stress (72.3%) scores; in addition, 39.7% of the nurses experienced moderate or severe insomnia. Within the framework of a structural model; the effects of stress, anxiety and insomnia on depression, which is the dependent variable, were found to be statistically significant (p < .001). CONCLUSIONS: It was found that the majority of the intensive care nurses fighting COVID-19 on the front-line experienced stress, anxiety, depression and insomnia at levels ranging from moderate to extremely severe; in addition, it was determined that there is a positive relationship between stress, anxiety, insomnia and depression. RELEVANCE TO CLINICAL PRACTICE: This study, in which we have determined the mental health symptoms and insomnia levels of intensive care nurses, who are in the front-line during the COVID-19 pandemic, constitutes the scientific basis for the effective coping strategies that the authorities will take in this subject.

The Effect of Gum Chewing on Abdominal Pain and Nausea Caused by Polyethylene Glycol Solution Used for Intestinal Cleansing Before Colonoscopy: An Endoscopist-Blinded, Randomized Controlled Trial.

Gum chewing is known to have a positive effect on intestinal motility. Most studies have examined its effect on ileus, but there has been no discussion of the effects of polyethylene glycol used in preparation for colonoscopy. The purpose of this study was to determine the effect of gum chewing on abdominal pain and nausea caused by polyethylene glycol solution used for intestinal cleansing before colonoscopy. The study was planned as a single-center, randomized, controlled experimental study. The research sample was determined using power analysis (n = 60). Consecutive patients undergoing colonoscopy were randomized into the experimental and control groups. Patients in the gum group chewed mint-flavored sugar-free gum for 20 minutes every 2 hours until the start of colonoscopy after consuming 2 L of polyethylene glycol solution. Patients in the control group drank only polyethylene glycol solution. Examination of precolonoscopy pain and nausea revealed a statistically significant difference in the gum chewing group (p < .05). Patients using sugar-free gum experienced statistically significant fewer problems after colonoscopy. Gum chewing had a positive effect on abdominal pain and nausea. There are no drawbacks to presolution chewing, and it may be recommended for patients.

The effect of listening to the sound of running water on pain and anxiety experienced during cannulation by hemodialysis patients: A randomized, controlled, open-label study.

INTRODUCTION: This study was conducted to determine the effect of the sound of running water, which we had not previously encountered being used in dialysis patients, on invasive pain and anxiety experienced during cannulation. METHODS: The research was conducted as a randomized, controlled study. A descriptive form, a VAS pain scale, and state-trait anxiety scales were used as a data collection form. The data were analyzed on SPSS version 22.00 for Windows software. The independent groups t-test was applied to compare descriptive statistics such as mean, standard deviation, number, and percentage in independent groups, while categorical data were compared using the chi-square test. The effect of an independent variable on a dependent variable was tested using linear regression analysis. p values < 0.05 were considered statistically significant. RESULTS: The study was completed with 32 experimental and 33 control group patients. There was no significant difference in pre-intervention pain and anxiety between the groups. The pain levels of the patients after the first and 12th cannulations were significantly lower in the experimental group (p < 0.05). State and trait anxiety levels were also significantly lower in the experimental group at the 12th session (p < 0.05). CONCLUSION: We conclude that the sound of running water has a significant positive effect on pain and anxiety experienced during cannulation by dialysis patients. We recommend that clinicians apply such a simple method as listening to the sound of running water for reducing pain and anxiety during invasive procedures.

Content and Quality of Online Videos About Ostomy Pouch Changes: A Descriptive Study.

BACKGROUND: Many health-related videos are available online. One type of health-related video is related to stoma pouch change. However, a system to evaluate the quality and content of these videos is lacking. PURPOSE: To evaluate the content and quality of YouTube videos on colostomy pouch change. METHODS: A descriptive study was carried out by searching for videos on March 15, 2021, using the key words "colostomy care," "colostomy bag/pouch change," and "ostomy bag/pouch change." A 5-point Global Quality Scale was used to evaluate the quality of the videos, and a 10-point scale was used to evaluate the content. The videos were classified as "useful" or "useless" according to their content and quality scores. RESULTS: A total of 128 videos were found; 94 videos met the criteria and were included in the study. The content of the 94 videos was examined by 2 independent researchers. The overall content score of the videos was 8.24 ± 1.56, and the overall quality score was 3.14 ± 0.97. A total of 66 (70.21%) videos were useful, and 28 (29.79%) videos were useless. The mean scores of useful videos for content (9.09 ± 0.83) and the average Global Quality Scale scores (3.53 ± 0.76) were significantly higher than those of useless videos (6.17 ± 0.90 and 2.25 ± 0.75, respectively; (P < .05). The results showed that 57.6% of the useful videos were uploaded by universities, professional organizations, and health care professionals, and 67.9% of the useless videos were uploaded by patients; the difference was statistically significant (P < .05). CONCLUSIONS: Results indicated that the majority of online videos evaluated were accurate. Most of these videos were uploaded by universities, professional organizations, health care professionals, or medical advertisers. Although there were many limitations to this study, the authors suggest that health care professionals can direct their patients to these sources after hospital discharge. However, future studies are needed..

Operating Room Nurses' Knowledge of and Attitudes About Pressure Injury Prevention: A Descriptive Cross-Sectional Study.

BACKGROUND: Understanding nurses' knowledge and attitudes might be important in influencing their behaviors of complying with pressure injury prevention measures in the operating room. PURPOSE: The aim of this descriptive and cross-sectional study was to determine operating room nurses' knowledge and attitudes about pressure injury prevention. METHODS: This study was performed with 174 nurses working in the operating rooms of 5 hospitals in Istanbul between July and October 2020. The data were collected with the Modified Pieper Pressure Ulcer Knowledge Test-MPPUKT and Attitude Towards Pressure Ulcer Prevention Instrument-APuP and analyzed with parametric and nonparametric tests using the SPSS 20.0 package program. The statistical significance level was accepted as P < .05. RESULTS: The total mean score of the MPPUKT of the operating room nurses was 32.72 ± 6.65, and the knowledge level of only 57.5% of the nurses was considered sufficient (MPPUKT score ≥ 70%); the total mean score of the APuP was 44.67 ± 3.10, and almost all (94.8%) had a satisfactory attitude (≥75%). In addition, there was a significant positive correlation between the knowledge and attitudes of the operating room nurses about pressure injury prevention (P = .000). CONCLUSION: This study has shown that the knowledge level of the operating room nurses was weak and their attitudes were satisfactory. It is recommended to improve the knowledge and attitudes of operating room nurses to prevent pressure injuries through effective in-service training programs.

Sleep Quality and Factors Affecting Sleep in Individuals With an Intestinal Ostomy: A Descriptive Cross-Sectional Study.

BACKGROUND: Multiple factors affect the sleep quality of individuals with intestinal stomas. PURPOSE: This study sought to determine sleep quality and factors affecting sleep in individuals with intestinal ostomies. METHODS: A descriptive cross-sectional design was used. This study followed 68 individuals with intestinal stomas at the stoma therapy unit of a university hospital. A form was used to gather information about patient demographic and stoma-related data (age, sex, work status, stoma duration, cause and type of stoma, stoma care provider, sleep status during the day, daily coffee consumption, and stoma-related factors affecting sleep), and the Pittsburgh Sleep Quality Index was used to score patient sleep patterns. Descriptive statistics, t-test, chi-square test, Fisher's exact test, and logistic regression analysis were used for statistical analysis. RESULTS: The patients' mean age was 53.7 ± 13.8 years; 51.5% were male, and 66.2% were married. Of the 68 patients, 41.2% had a diagnosis of rectal cancer, and 55.9% had ileostomies. Mean stoma duration was 24.1 ± 5.8 months, and 57.4% of participants performed their own stoma care. On a scale of 0 to 21, the participants' mean sleep score was 9.08 ± 5.03, and 66.2% of patients were found to have poor sleep quality. High sleep quality was significantly positively associated with colostomy (odds ratio, 1.78; 95% confidence interval [CI], 1.18-2.69; P = .006) and self-performed stoma care (odds ratio, 1.54; 95% confidence interval, 1.03-2.30; P = .036). CONCLUSION: The results of the current study can provide reference data for future studies and highlight the importance of assessing sleep quality in persons with intestinal stomas.

The effects of different degrees of head-of-bed elevation on the respiratory pattern and drainage following thyroidectomy: a randomized controlled trial.

BACKGROUND: The patient's position is important for ensuring patient comfort and preventing complications after thyroidectomy. OBJECTIVES: This study was carried out to determine the effects of different degrees of head-of-bed elevation (HOBE) on the respiratory pattern and drainage following thyroidectomy and to provide suggestions for evidence-based clinical practice. METHODS: The sample of this prospective, parallel arm, randomized controlled trial included 114 patients undergoing thyroidectomy in a university hospital in Turkey. The patients were randomly assigned (1:1:1) to supine 0° (baseline), 30° and 45° HOBE groups. Respiratory pattern including respiratory rate (RR), peripheral oxygen saturation (SpO2) and dyspnea, and drainage including amount of drainage and hematoma formation were evaluated at the 1rd, 2rd, 3rd and 4th hours following thyroidectomy. RESULTS: The majority of the patients (83.3%) were female and 84.2% had undergone total thyroidectomy. The mean RR (18.47, 95% CI=17.85-19.09) of the patients in the supine 30° HOBE group at the 1rd hour was significantly higher than that of the patients in the supine 0° group (17.32, 95% CI=16.88-17.76; p<0.05). There was no significant difference between the SpO2 values of the patients in the groups (p>0.05). The amount of drainage was significantly higher in the supine 0° group at the 2nd hour than that of the patients in the supine 45° HOBE group (5.92±5.18; 3.34±5.56 respectively; p<0.05). None of the patients in the groups had hematoma formation. While no patient in the supine 30° HOBE group had dyspnea, dyspnea occurred in 9 patients in the supine 0° group and in 3 patients in the supine 45° HOBE group. CONCLUSION: This study showed that different HOBE positions resulted in clinically insignificant changes on the RR and amount of drainage during the first 4 hours following thyroidectomy but did not affect SpO2 value.

The effects of training and the use of cranberry capsule in preventing urinary tract infections after urostomy.

PURPOSE: The study was conducted to investigate the effects of training provided by researcher and the use of cranberry capsule in preventing late term UTIs after urostomy. METHODS: The study included 60 patients who underwent ileal conduit diversion between June 2013 and November 2014. The participants were randomly divided into three groups. First group used cranberry capsule, second group received training about UTIs and the other control group. The patients were assessed for a UTI by laboratory analysis at 2, 3, and 4 months after discharge. RESULTS: When the effect of cranberry capsule use and training on the prevention of urinary tract infections were compared, we found that there was a significant difference between the group that used and didn't use cranberry capsules, favoring the cranberry capsule (log-rank test; p < 0.05). CONCLUSION: We found that the use of cranberry capsules is effective in the prevention of urinary tract infections.

Effects of Different Head-of-Bed Elevations and Body Positions on Intracranial Pressure and Cerebral Perfusion Pressure in Neurosurgical Patients.

PURPOSE: The aim of this study was to evaluate the effects of different head of bed (HOB) elevations and body positions on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) and to identify safe positions for neurosurgical patients with different Glasgow Coma Scale (GCS) scores. METHODS: This study with a quasi-experimental, prospective repeated measures is designed with control over the intervention consisted of 30 patients hospitalized in the neurocritical care units (NCU). Patients' HOB was elevated (degree of 15,30,45) and the patients were at supine, left lateral and right lateral positions. ICP and CPP were recorded for each patient. RESULTS: It was found that ICP increased and CPP decreased at supine, left and right lateral positions with different HOB elevations, which, however, did not reach statistical significance. When patients with a GCS score of 3-8 were at degree of 15 right and left lateral positions and 45 right lateral position; and when patients with a GCS score of 13-15 were positioned at degree of 15 left lateral, ICP and CPP changed significantly. CONCLUSION: The results of this study showed that different positions the patients' HOB (degree of 15,30,45) led to slight insignificant changes in ICP and CPP; and these values were maintained within the ranges established by recent guidelines.

Determination of Patient Learning Needs after Thyroidectomy.

The purpose of this study was to determine discharge learning needs of patients undergoing thyroidectomy. The population of this descriptive study consisted of patients undergoing thyroidectomy in the Endocrine Surgery Unit of a university hospital between February and December 2013. The study included 251 patients who were discharged after thyroidectomy. Data obtained using the data collection form and the Patient Leaning Needs Scale (PLNS) were analyzed by frequency, mean, standard deviation, Kruskal Wallis and student-t tests. The mean age of the patients was 47.91±13.05 and 76.1% were females. The PLNS total mean score was 208.38±34.91, with the maximum score of 39.23±6.80 on the subscale of treatment and complications and the minimum score of 19.45±4.70 on the subscale of feelings related to condition. It was found that the PLNS total score of the patients was not influenced by age, gender, marital status (p>0.05). This study demonstrated that patients had high learning needs after thyroidectomy.

Sleep and quality of life in people with ileal conduit.

OBJECTIVE: The aim of this study was to determine the sleep quality and the association between sleep quality and quality of life in people with ileal conduit. MATERIALS AND METHODS: A descriptive and cross-sectional design was adopted. The study sample comprised 111 people with ileal conduit operated on in urology clinics in a state hospital between January 2011 and May 2014. Six months after the operation, they were called by telephone to participate in the study. Data for the study were collected using a questionnaire form, the Pittsburgh Sleep Quality Index (PSQI) and the Stoma Quality of Life Scale (SQLS). RESULTS: The mean ± SD total PSQI score of the people with ileal conduit was 10.20 ± 2.95, mean total score of SQLS was 43.63 ± 7.21, mean Work/Social Function domain score was 37.27 ± 5.80 and mean Stoma Function domain score was 50.0 ± 12.56. The total sleep quality had a low degree of negative correlation with total SQLS score, a medium degree of negative correlation with Work/Social Function (r = -0.327, p < .001) and no correlation with Stoma Function (r = -0.096, p > .001). People using a night drainage system had higher sleep quality. CONCLUSIONS: This study determined that quality of life and sleep deteriorate in people with ileal conduit. The quality of life decreases when the sleep quality is poor, and decreased quality of life affects quality of sleep in people with ileal conduit.