Meeting the Needs of Family Members of Trauma Patients in the Emergency Department.

BACKGROUND: While the needs of family members have previously been studied, the needs of families of trauma patients have received less attention. OBJECTIVE: This study aims to assess the needs of family members of trauma patients in the emergency department. METHODS: This cross-sectional survey study was conducted over 4 months (February-May 2022) with family members of trauma patients admitted to the emergency department of a state hospital in Istanbul, Turkey. The validated Critical Care Family Needs Inventory - Emergency Department survey was administered face-to-face to a convenience sample of consenting family members. RESULTS: A total of 248 family members participated, representing 84 patients. The mean age of the participants was 33 (8.18) years, with a gender distribution of 50% women. On average, 76.5% of the family members' needs were met. The most important needs reported as mean (SD) were as follows: communication, 3.52 (0.68); participation in care, 3.52 (0.68); comfort, 3.36 (0.65); and support needs, 3.21 (0.72). These needs were met to varying degrees: communication 85%, participation in care 81.2%, comfort 75.4%, and support needs 65.2%. CONCLUSION: The study findings indicate that the needs of family members of emergency department trauma patients are not fully met. Families report needing communication the most and comfort the least.

Evaluation of Pain During Endotracheal Aspiration in Intensive Care Patients Diagnosed with COVID-19.

BACKGROUND: Endotracheal aspiration, a procedure that is particularly painful for intensive care patients, has received little attention in terms of pain evaluation specifically among intubated patients with COVID-19 in intensive care. AIM: The study aims to assess the level of pain experienced by intubated intensive care patients diagnosed with COVID-19 during an endotracheal aspiration procedure. METHOD: The study population was composed of patients admitted to the COVID-19 intensive care unit of the specified hospital between February and March 2021. Of the 56 patients admitted during that period, 47 were contacted and participated in the study. These 47 intubated and sedated patients were evaluated for 94 different expressions of pain during endotracheal aspiration twice a day before and during the procedure. Data were collected using the patient descriptive information form, the Non-Verbal Pain Scale for adults and data observation record form. RESULTS: In the study, pain behavior was observed in 54.2% (n = 51) of the 94 observations. The patients were found to experience mild pain with an average score of 3.6 ± 1.07 on the Non-Verbal Pain Scale. The mean pain score before the procedure was found to be significantly different from the mean pain score during the procedure (p < .05), with an increase in pain during the procedure. During the procedure, 33.3% (n = 17) of the patients had a 10% decreased SpO2, and 29.4% (n = 15) had an increase in systolic blood pressure (>20), pulse (>20), and respiration (>10). Additionally, 21.5% (n = 11) of the patients experienced severe incompatibility with the ventilator, and 15.68% had muscle tension. CONCLUSIONS: The study findings showed that nonverbal pain scores of sedated and intubated intensive care patients diagnosed with COVID-19 increased during endotracheal aspiration, accompanied by physiologic pain indicators. Effective pain management should be a priority for nurses. It is important to remember that patients with COVID-19 in the intensive care unit may experience pain while sedated and intubated. A holistic approach should be adopted for the evaluation and relief of pain in these patients. Intensive care nurses should consider physiologic and nonverbal behavioral pain indicators when evaluating pain in patients diagnosed with COVID-19.

Investigation of Effects of Preoperative Readiness on Symptom Management in Patients with Intestinal Stoma: A Systematic Review and Meta-Analysis Study.

OBJECTIVE: This study aims to examine the effect of preoperative readiness on postoperative symptom management in patients with intestinal stoma through systematic review and meta-analysis. METHODS: "Intestinal stoma", "complications" and other related terms were searched regardless of the language of publication in the publications published in the databases until December 29, 2021. RESULT: As a result, 30 studies were found. Two independent reviewers reviewed the studies, and the methodological quality of the included studies was assessed using the Health Evidence™ Quality Assessment Tool. The Comprehensive Meta-Analysis 3 was used to analyze the data. Publication bias, funnel plot, and the effect size were calculated using Cohen's kappa. Preparation for intestinal stoma surgery consisted of two main themes, and postoperative complications/problems consisted of nine sub-themes. The meta-analysis results showed that preoperative readiness had a moderate effect size on postoperative complications (d=0.498, d=0.457). CONCLUSION: It was thus concluded that preoperative practices were significant and effective in postoperative symptom management.

Relationship between the insulin use and stigma in type 2 diabetes mellitus.

AIMS: This study aimed to investigate the relationship between insulin use and stigma in Type 2 Diabetes Mellitus (T2DM). METHODS: The study was carried out in the endocrinology and metabolic disorders outpatient clinic of a state hospital between February and October 2022. The study was carried out with 154 patients, 77 of them were treated with insulin while 77 were treated with peroral antidiabetic drugs (PAD). The patient identification form and Type 2 Diabetes Stigma Assessment Scale (DSAS-2) were used for data collection. The data were analyzed by using IBM SPSS 26.0 software. RESULTS: DSAS-2 total score, treated differently, blame and judgment, and self-stigma subscales were higher in insulin-treated T2DM patients compared to the patients treated with PAD. There was a positive relationship between the number of daily injections and the DSAS-2 total score (r = 0.554). Multiple linear regression showed that type of the treatment, treatment duration, number of daily injections and perceived level of health were the determinants of the DSAS-2 score. CONCLUSIONS: Stigma was high in insulin-treated T2DM patients and as the number of daily injections increased, the level of the perceived stigma increased. We recommend considering the high level of perceived stigma in insulin-treated T2DM patients while preparing nursing investigations.

Effect of the Educational Intervention on the Balance of Diabetic Foot Amputees: A Randomized Controlled Study.

This study aimed to evaluate the effect of educational intervention on the balance of diabetic foot amputees. There were 2 groups and 60 patients (30 in each group) in the study. The patients were divided into 2 groups using block randomization to provide equal distribution of the minor and major amputations in groups. An education program was prepared in line with Bandura's Social Cognitive Learning theory. Education was administered to the intervention group before the amputation. Three days after the education, the patients' balance was examined using Berg Balance Scale (BBS). There were not any statistically significant differences between the groups regarding the sociodemographic and disease-related characteristics except for marital status (P = .038). The mean BBS scores were 31.4 ± 17.6 for the intervention group and 20.3 ± 17.8 for the control group. We demonstrated that the intervention lowered fall risk after minor (P = .045) but not major amputation (P = .067). We recommend using education for the patients who will undergo amputation and further studies in larger and different populations.

Prevalence of pain in adult population in Türkiye.

vObjectives: The aim of this study is to determine the incidence and characteristics of pain in adults in Türkiye. METHODS: This cross-sectional study was carried out with 1391 participants in 28 provinces spread across seven demographic regions of Türkiye, between February 1 and March 31, 2021. The data were collected through the introductory and pain assessment information form prepared by the researchers and the online Google forms. SPSS 25.0 statistical program was used for data analysis. RESULTS: As a result of the analysis of the data obtained, it was found that the average age of the participants included in the study was 40.83±7.78 years, education level was 70.4% at most, and 80.9% was female at most. It was determined that 58.1% lived in the Marmara region and 41.8% lived in Istanbul, and 41.2% were private sector employees. It was determined that the pain prevalence of adults in Türkiye was 80.84% and 79.07% of them had pain in the last year. It was determined that the region with the most pain was the head and neck region with 37.88%. CONCLUSION: According to the results of the research, the prevalence of adult pain is quite high in Türkiye. Despite the high prevalence of pain, the rate of preference for drug therapy to relieve pain is low and the preference for non-drug treatment methods is high.

The Relationship of Evidence-Based Nursing Attitudes of Nurses Working in Surgical Wards With Patient-Centered Care Competencies.

PURPOSE: The aim of this study was to determine the relationship between the evidence-based nursing attitudes of nurses working in surgical wards and their patient-centered care competencies. DESIGN: This was a prospective, correlational, and cross-sectional study. METHODS: The sample for this study included 209 surgical nurses working in the surgical clinics of a research hospital. Data were collected between March and July 2020 using the Nurses' Descriptive Characteristics form, Evidence-Based Attitude Toward Nursing Scale (EATNS) and the patient-centered care competency of the nurses, Patient-Centered Care Competency Scale (PCCS). Descriptive statistics and correlation analysis were conducted to analyze the data. FINDINGS: The mean total EATNS was moderate (53.93 ± 7.18, out of 75), and their approach to patient-centered care behaviors was high (69.46 ± 8.64, out of 85). CONCLUSIONS: We found a medium level of positive correlation and a significant relationship between the attitudes toward evidence-based nursing and patient-centered care competencies of the nurses participating in the study (r = 0.507, P < .05).

Pandemic journey to prestige at nursing.

Respect, which is human virtue by its very nature, is a universal feeling and action. Prestige; it is expressed as being respected, valuable, and reliable. These intertwined concepts draw attention basically for nursing, in which interpersonal interactions stand out compared to other professions. Moreover, while continuing the services in a kind of mobilization environment during the pandemic process that we have been faced with since 11 March 2020 and will obviously be affected for a long time in our country, the most common sense and respectful perspectives and approaches are needed. Respectful actions and respectful practices which are also included in the scope of professional ethics are more strategically important as we experience such a mass and historical human experience in which each of us is responsible for each other's health. The reputation of nursing continues to be formed and differentiated with how this profession is perceived by members of the profession and society, influenced by various processes from past to present. In this article, the change/development of the reputation of the nursing profession during the COVID-19 pandemic period was discussed.

Validity and Reliability Study of the Turkish Form of Post-Discharge Surgical Recovery Scale.

AIM: This study was carried out to adapt the "Post-Discharge Surgical Recovery Scale " developed by Kleinbeck into Turkish and analyze the scale's validity and reliability. METHODS: The study sample consisted of 343 patients who underwent surgery in a state hospital operating in the province of Diyarbakir, in the province of Istanbul. The sample consisted of 271 people due to voluntary participation and reasons for not being able to reach. This research, which is of methodological type, was carried out between April and July 2019. The Individual Information Form and the Post-Discharge Surgical Recovery Scale, which the researchers developed by scanning the literature, were used to collect the data. In the validity and reliability study of the scale; Linguistic equivalence, content validity for expert assessment, the correlation between items for internal consistency/reliability, and calculating Cronbach alpha values and confirmatory and exploratory factor analyzes were performed for construct validity. IBM SPSS Statistics 25 and IBM SPSS Amos 21 programs were used for statistical evaluation of the data. RESULTS: It was determined that the content validity index of the scale was 0.96, the correlation values between the items were r=0.47-0.97, the explained variance was 75.238%, and it was gathered under a single factor. The general reliability of the scale is very high as alpha=0.975. In the confirmatory factor analysis for the scale, the fit indices of the scale were CFI = 0.76; NNFI = 0.93; It was determined that RMR =0.11 and RMSEA = 0.13, AGFI=0.69, GFI=0.77. CONCLUSION: The research results suggest that the Turkish version of the "Post-Discharge Surgical Scale" is a valid and reliable measurement tool and can be used in scientific research and health care institutions to measure recovery post discharge.

Elderly patients and falls: a systematic review and meta-analysis.

OBJECTIVE: The predetermination of the risk for falls in elderly patients, who will have or had a surgery, enables one to carry out the protective/preventive interventions on this matter. The aim of this review was to provide an up-to-date meta-analysis with regard to falls in elderly surgical patients. MATERIALS AND METHODS: The studies, which were carried out on elderly patients between January 2009 and November 2019 and which investigated the risk factors for falls in elderly surgical patients, were screened on the databases of Google Scholar, Pubmed, Ovid, Cinahl through various combinations of keywords, such as "geriatrics", "aged", "surgery", "accidental falls" in English or Turkish, to determine the risk factors for the falls in elderly surgical patients. RESULTS: Meeting the study inclusion criteria, 18 studies were analyzed. Of these studies, three were retrospective, seven descriptive, two case-control, four cross-sectional, and two prospective. The kappa value of the general rate of agreement was found as 0.84. No publication bias found in the studies included (Kendall's tau b = 0.31; p = 0.07) in the meta-analysis based on the values calculated. CONCLUSION: In this meta-analysis, it was determined that the falls in elderly surgical patients were quite a prevalent public health problem, that the presence of chronic diseases and previous history of falls constituted an extremely high risk for the falls in elderly patients, and that the age or the presence of a gait-inhibiting condition did not constitute any risk for the falls in elderly patients.

The effect of comorbidity on mortality in elderly patients undergoing emergency abdominal surgery: a systematic review and metaanalysis

Background/aim: With the increase in the elderly population, the elderly proportion needing emergency surgery is also increasing. Despite medical advances in surgery and anesthesia, negative postoperative outcomes and high mortality rates are still present in elderly patients undergoing emergency surgery. Comorbidities are described as the main determining factors in poor outcomes. In this metaanalysis, it was aimed to investigate the effect of comorbidity on mortality in elderly patients undergoing emergency abdominal surgery. Materials and methods: The studies published between 2010-2019 were scanned from databases of Google Scholar, Cinahl, Pub Med, Medline and Web of Science. Quality criteria proposed by Polit and Beck were used in the evaluation of the included studies. Interrater agreement was calculated by using the Kappa statistic, effect size by using the odds ratio, and heterogeneity among studies by using the Cochran's Q statistics. Kendall's Tau-b coefficient and funnel plot were used to determine publication bias. Results: A total of 9 studies were included in the research. There was a total of 1330 cases in the studies. The total mortality rate was 21% (n = 279), the total rate of having a comorbid factor was 83.6% (n = 1112), and the rate of having a comorbid factor in mortality was 89.2% (n = 249). According to the fixed effects model, the total effect size of comorbid factors on causing mortality was not statistically significant with a value of 1.296 (C.I; 0.84-1.97; P > 0.05). Conclusion: Our study revealed that comorbidity had no significant effect on causing mortality in geriatric patients undergoing emergency abdominal surgery. There are controversial results in the literature, and in order to reach more precise results, studies involving wider groups of patients and further studies examining the specific effect of certain comorbid conditions are needed.

Evaluation of Postoperative Delirium: Validity and Reliability of the Nursing Delirium Screening Scale in the Turkish Language.

PURPOSE: Postoperative delirium is the most well-known form of postoperative cognitive impairment in all patient groups, especially in the elderly. Delirium is a syndrome that causes serious consequences, increasing mortality and morbidity rates and extending the length of hospital stay. The aim of this study was to evaluate the validity and reliability of the Turkish version of the Nursing Delirium Screening Scale (Nu-DESC). METHOD: One hundred twelve patients who were hospitalized for a surgical operation in the orthopedics, neurosurgery, and general surgery clinic of a state hospital for 3 months were evaluated concurrently (and independently for delirium). Patients were observed by clinical nurses 3 times over a 24-h period. The presence of delirium was diagnosed by 2 neurologists according to DSM-IV criteria. Student's t test, the χ2 test, and the Mann-Whitney U test were used, and construct validity, intrascale factor analysis, interrater reliability, and specificity and sensitivity (ROC) analyses were performed for descriptive analysis. SPSS 25.0 and MedCalc18.6 were used for statistical analysis. RESULTS: Delirium was detected in 28 patients according to the Nu-DESC. The ICC (intraclass correlation) is 0.97 in the 95% confidence interval from 0.96 to 0.98 for agreement between nurses and neurologists for the total Nu-DESC score. Weighted κ rates were between 0.78 and 0.92. In the ROC analysis of the Nu-DESC scale, the optimum cutoff value calculated for the 1,344 observations and 112 patients was determined as >1 according to the maximum sensitivity and the specific situation. Sensitivity at the cut-off point was 92.27; specificity was determined as 92.72. The Youden index was found to be J = 0.845 (0 < J = 0.845 < 1). CONCLUSION: We believe that Turkish translation of Nu-DESC is valid and reliable for clinicians, nurses, and researchers and will contribute to delirium studies.

[Patient satisfaction with nursing practices about postoperative pain management: A systematic review]. / Hastalarin, ameliyat sonrasi agri yönetimine iliskin hemsirelik uygulamalarindan memnuniyet düzeyleri: Bir sistematik derleme.

OBJECTIVES: The aim of this study was to investigate patient satisfaction with nursing practices regarding postoperative pain management. METHODS: A systematic review of the literature published between 2005 and 2015 was conducted, comprising a search of 7 databases: ScienceDirect, Turkish Medline, PsycINFO, Ovid, Prequest, Google Scholar, and the ULAKBIM Turkish Medical Database. Five articles were identified as eligible for review. The methodological quality of the studies was assessed using the Turkish version of the Joanna Briggs Institute-Meta Analysis of Statistics Assessment and Review Instrument (JBI -MAStARI) Critical Appraisal Checklist. The data were extracted using a standard data extraction form developed for this study, and subsequently evaluated. RESULTS: In the articles eligible for this review, the study samples comprised patients with blunt or penetrating trauma sent to the emergency room (n=418) and those who underwent total knee replacement (n=120); heart, lung, or gastrointestinal system surgery (n=559); or open heart surgery (n=52). The maximum pain score was 7.20±1.95 (min-max: 0-10) and the maximum satisfaction score was 100%. The findings revealed that pharmacological methods were most frequently used for postoperative pain management and non-pharmacological methods were not used sufficiently by nurses. Nevertheless, the patients were satisfied with the postoperative pain relief nursing care. CONCLUSION: In this systematic review, scientific evidence indicated that patient satisfaction with nursing practices related to postoperative pain management was high; however, non-pharmacological methods were used insufficiently in the last decade.

Determination of food intake and the factors affecting food intake in perioperative period in patients who undergo open heart surgery.

BACKGROUND: This study aims to investigate the factors affecting food intake in perioperative period of patients who undergo open heart surgery and the effects of body weight, albumin and hemoglobin values, nausea, vomiting and constipation on food intake. METHODS: This cross-sectional study was conducted between 4 February 2015 and 4 May 2015 in a cardiovascular surgery clinic. A questionnaire including 25 questions was applied to a total of 86 volunteer participants (62 males, 24 females; mean age 61.3±10.8 years; range 38 to 82 years). RESULTS: Patients consumed 38% of the food one day before the surgery and 51% one day after, 47% three days after, and 52% five days after the surgery. Factors affecting food intake were the procedure of discontinuing food intake for pre-surgery anesthesia preparation (84.9%), nausea (31.4%) one day after surgery, and constipation three (26.5%) and five (33.7%) days after surgery. Albumin levels decreased significantly in days after surgery compared to the day before surgery (p<0.05). There was a significant positive correlation between food intake rates and albumin levels on the first, third and fifth days after surgery (r=0.354, r=0.353, and r=0.521, respectively; p<0.05). CONCLUSION: Patients' body weight and albumin levels decreased in accordance with their nourishment status after surgery. Food intake was insufficient in the perioperative period.

Relationship between student nurses' self-efficacy and psychomotor skills competence.

This study aimed to determine the general self efficacy levels of students studying for undergraduate degree in nursing and to examine the relationship between skills development and self efficacy. The research was conducted in a descriptive way. The sample consisted of 100 students. Data were collected via the use of a student introduction form, Self-Efficacy Scale (SES) and an intramuscular (i.m.) injection procedure checklist; the forms were filled in by 100% of the nursing students. The mean general self-efficacy score of the students in the study was high. the self-efficacy levels of our students were high, and no correlation was observed between personal characteristics and self-efficacy; therefore, education in injection technique had the same influence on all students' self-efficacy.

[The impact of visits on vital signs of the patients in surgical intensive care unit: a pilot study]. / Cerrahi yogun bakim hastalarinda ziyaretin yasam bulgulari üzerine etkisi: Pilot çalisma.

BACKGROUND: This research was conducted to analyze the impact of visiting patients in the intensive care unit on the vital signs of the patients. METHODS: This descriptive study was conducted at the emergency surgical intensive care unit of a university hospital in Istanbul. The sample consisted of 43 patients aged 18 and above, who stayed at the unit for more than 24 hours. Data collection included the demographic features of the patients as well as the information and evaluation form including the vital signs of patients before, during and after visits. Data were measured before, during and after visits. RESULTS: 39.5% (n=17) of the patients were female and 60.5% (n=26) were male. Values before and after visits, respectively, were as follows: Mean fever 36.7±0.81 and 36.8±.94; pulse 97.3±26.4 and 98.4±26.1; mean respiration 23.76±4.55 and 24.30±4.53; systolic pressure 113.4±25.86 and 120.4±21.15; and diastolic pressure 64.81±8 and 67.30±3. CONCLUSION: This study, carried out as a pilot study, found that visiting patients in intensive care units affects the patients; however, this effect does not cause a serious physiological change in the vital signs of the patient.

[Reality about pain control: the knowledge and beliefs of nurses on the nature, assessment and management of pain]. / Agri kontrol gerçegi: Hemsirelerin agrinin dogasi, degerlendirilmesi ve geçirilmesine iliskin bilgi ve inançlari.

The present research was conducted descriptively to define the approaches of nurses to the nature of pain, its assessment, and management. The research was carried out in October 2001 in Antalya with a scope of 227 nurses attending to the Second National Clinician Nurses' Congress. Initial aim was to include all 286 nurses attending the congress, however, because 59 nurses refused to participate, the number of the participants finalized as 227. A data gathering form of 20 questions was used. Results were presented in percentages. At the end of the research, though the knowledge the nurses had on the nature of pain was satisfactory, their attitudes related with pain assessment and management were noted to be below expectations. These results point out a void in the nurses' knowledge pertaining to pain management. As a result, we consider imperative that the nurses should acknowledge the significance of pain and should improve their professional attitudes and knowledge in order to gain control over pain through a multidisciplinary approach and to prove the crucial and inevitable role of nurses in such a team.