Thoracic and cardiovascular surgery patients: Intensive care unit experiences.

BACKGROUND: Intensive care units are stressful places where patients experience physical and psychological discomfort. Understanding the experience of these patients regarding nursing care is very important. AIMS AND OBJECTIVES: To determine the intensive care experiences of thoracic and cardiovascular surgery patients and the factors that affect them. DESIGN: The research consists of two phases: quantitative and qualitative. METHODS: This was a descriptive and cross-sectional study. Its research sample comprised 100 patients who spent at least one night in an intensive care unit after thoracic or cardiovascular surgery. The Intensive Care Experiences Scale (ICES) and the Numeric Rating Scale were used. Two open-ended questions were asked to the patients to understand what they felt when they were attached to mechanical ventilation and to describe their intensive care experiences. RESULTS: The ICES mean score was 66.35 ± 6.88. Significant negative relationships were found between length of stay and severity of pain and ICES total scores. A significant difference was found between scale scores and being understood by health care professionals when attached to mechanical ventilation. The patients stated that, when they were attached to mechanical ventilation and during their stay in the intensive care unit, they experienced feelings of helplessness, uncertainty, and fear. They also experienced physical discomfort and reported no longer fearing death. CONCLUSION: It was determined that patients partially positively perceived their experiences. It was found that they focused on coming out of surgery alive. The physical discomfort and negative emotions reported can be reduced or relieved by competent care. RELEVANCE TO CLINICAL PRACTICE: The intensive care experiences and emotions of intensive care patients are important. Physical discomfort and negative emotions can be mitigated or alleviated by competent nursing care.

Prevalence and risk factors of venous thromboembolism in postoperative patients: A retrospective study.

OBJECTIVE: To investigate the prevalence of and risk factors for Venous Thromboembolism (VTE) in postoperative patients. METHODS: This descriptive, cross-sectional, retrospective study was conducted from August 2016 to October 2016 at two university hospitals and one public hospital. Total 217,354 patients records who underwent surgery in between 2010 and 2015 were examined. The study sample consisted of 123 patients who had postoperative venous thrombosis and pulmonary embolism, and whose discharge details, consultation data, diagnostic reports, and tests were examined in detail. RESULTS: The prevalence of VTE in postoperative patients was 5.6/10,000. The mean age of the patients was 60.22±18.56 years. Of 123 patients, 51.20% were male, 30.90% were smokers, 46.30% had a comorbid disease, and 27.60% were diagnosed with cancer. Of the patients who had postoperative VTE, 65.0% had major surgery. Pharmacologic thromboprophylaxis was used in only 24.4% of patients (n=30). CONCLUSION: The prevalence of VTE in the present study is lower than that in other studies. Because surgery is a risk factor for VTE, patients who will be operated should be assessed. Considering the present results, we can assume that patients' conditions are not being assessed appropriately. In addition, findings indicate that a standard for preventing VTE has not yet been established.

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.

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.

Experiences of family caregivers of cancer patients receiving chemotherapy.

BACKGROUND: Cancer is a disease which affects not only patients but also their families physically and emotionally. The purpose of this study was to determine the needs, challenges and ways of coping of caregivers of cancer patients. MATERIALS AND METHODS: In the study, a phenomenological approach was used. Data were collected through semi-structured individual interviews. The study sample comprised 16 family members providing care for a cancer patient. RESULTS: The study findings are grouped under four main themes: the impact of caregiving, masking feelings, experienced challenges and expectations, and coping. During the caregiving process, patient relatives are affected physiologically, psychologically and socially. It was determined that patient relatives hid their feelings and avoided talking about the disease for fear that they might upset the patient, and that they had difficulty in coping with the patient's reactions during the treatment process. Family members had difficulties arising from the health system, hospital conditions and treatment in addition to transportation and financial problems. Support is very important in coping, but it was determined that some of the relatives of patients did not receive adequate support. Patient relatives expect that health care professionals should provide them with more information about their patient's condition and the course of the disease that their patients should be dealt with by the physicians specialized in cancer, and that psychological support should be provided both for them and for their patient. CONCLUSIONS: During the caregiving process, family members are faced with many difficulties and they exhibit different coping behaviors which health care professionals should take into account.

A comparison of problem-based and traditional education on nursing students' locus of control and problem-solving skills.

PURPOSE: The purpose of this study is to compare the locus of control and problem-solving skills of nursing students studying with the problem-based learning method with those of nursing students studying with the traditional method. METHODS: This is a descriptive and comparative study. For data collection, the Problem-Solving Skills Inventory and the Locus of Control Scale were used. The study sample included 680 nursing students. CONCLUSIONS: It was determined that the problem-based learning method was more effective in the development of problem-solving skills and internal locus of control than was the traditional method.