The Effects of Preoperative Video-Assisted Education on Anxiety and Comfort After Breast Cancer Surgery: Nonrandomized Controlled Study.

PURPOSE: This study aimed to determine the effects of video-assisted education given before breast cancer surgery on patients' anxiety and comfort. DESIGN: A nonrandomized, controlled, quasi-experimental model was used. METHODS: The study was conducted in the general surgery clinic of a public hospital. Seventy patients voluntarily participated in the study, 35 of them were in the Control (CG) and 35 of them were in the Experimental Group (EG). While routine treatment and care were given to CG, a video-assisted education was also provided to EG. The data were collected using the Personal Information Form, State-Trait Anxiety Inventory (STAI), and General Comfort Questionnaire (GCQ). The patients in both groups filled in the STAI and GCQ on the first day preoperatively, STAI-S and GCS on the second postoperative day and STAI-S on the tenth day after surgery. P < .05 was accepted as a statistical significance value. FINDINGS: The groups were similar in terms of descriptive features and preoperative anxiety scores (P > .05). Postoperative second and tenth-day anxiety scores were significantly higher in CG (43.97 ± 9.42 and 39.45 ± 3.88) compared to EG (33.29 ± 4.94 and 33.31 ± 3.01) (P < .05). In terms of the mean scores of the GCQ and its subscales of comfort, preoperative comfort was found to be lower than postoperative comfort level (P < .05). CONCLUSIONS: Preoperative video-assisted education decreased the anxiety level and increased the comfort level in EG. We conclude that the use of video-assisted education in reducing anxiety and increasing the perception of comfort in breast cancer surgery patients would be beneficial.

The importance of cancer prevention policies to inform and guide preventative and screening measures for people with intellectual disabilities: The COST project "Cancer- Understanding Prevention in Intellectual Disabilities".

Cancer is a global public health problem, but its exact prevalence in people with intellectual disabilities is still uncertain. This population, with limited health skills and complex health needs, faces many challenges in cancer prevention, screening, timely diagnosis and treatment. Furthermore, they are often underrepresented in general cancer prevention and screening policies across Europe, leading to widened disparities in health outcomes and premature mortality. Thus, unified national and local policies are needed to reduce inequalities and promoting a pan-European inclusion of people with intellectual disabilities. Our goal is to raise public awareness of this issue, including the involvement of people with intellectual disabilities, and promote engagement from relevant stakeholders. The COST Action 'Cancer- Understanding Prevention in Intellectual Disabilities' (CUPID) project will address health inequalities faced by people with intellectual disabilities in relation to cancer, and support the development of policy recommendations specifically tailored to their unique cognitive and healthcare needs, having a positive long-term impact on quality of life.

Effect of family presence on stress response after bypass surgery.

BACKGROUND: Coronary artery bypass grafting (CABG) is a major surgery that may cause severe surgical stress response (SR). Although the presence of family members in intensive care unit (ICU) is known to benefit intensive care patients socially and emotionally, its effects on surgical SR are unknown. OBJECTIVES: To investigate the effect of an informed family member (IFM)'s presence in the awakening process in ICU on patients' SR after CABG. METHODS: A nonrandomized controlled clinical study was completed with a total of 73 patients: 37 patients in the control (CG) and 36 in the intervention group (IG) underwent CABG surgery. In the CG patients, no family members were taken into the ICU during the awakening process and routine care and treatment practices were continued. In the IG patients, besides routine care and treatment practices, an IFM was taken into the ICU during the awakening process in accordance with the research method. Groups were statistically compared in terms of serum cortisol level which is the one of the main indicators of surgical SR, state anxiety, sedative drug requirements, and duration of intubation, sedation, and ICU stay. A p value <0.05 was accepted as statistically significant. RESULTS: Presence of an IFM in the ICU was found to be effective in decreasing serum cortisol level, state anxiety, sedative drug requirements, and the duration of intubation, sedation, and ICU stay (p<0.05). CONCLUSIONS: In CABG, the presence of IFM in ICU is effective in reducing SR.

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.

Health-related quality of life in persons living with a urostomy.

PURPOSE: The purpose of the study was to determine the life experiences and health-related quality of life (HRQOL) of patients living with a urostomy. DESIGN: Cross-sectional descriptive study. SUBJECTS AND SETTING: This prospective and descriptive study was carried out in a research and training hospital in Gaziantep, Turkey; data were collected from May 2009 to September 2011. Twenty-four participants had undergone a urostomy operation at least 4 months before study participation. METHODS: A form querying pertinent demographic and clinical information, combined with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QoL Q-C30) was used for data collection. Data collection forms were sent to the patients via mail in closed envelopes. The Mann-Whitney U, the Kruskal Wallis, and Wilcoxon signed rank tests were used for the comparative statistics; statistical significance was accepted when P values were <.05. RESULTS: The mean age of the 24 participants was 63.45 ± 6.33 years (mean ± SD; range, 49-72 years). The average time since surgery was 9.83 ± 2.34 months (range, 4-18 months). Most respondents stated that their urostomy affected their dressing habits (83.4%), sleep patterns (91.7%), family life (91.7%), participation in social activities (91.7%), and occupation (75.0%). All participants reported problems with psychological health and sexual activity following urostomy surgery. Analysis of EORTC QoLQ-C3 scores revealed that general wellness, functional condition, and symptomatic condition mean scores were lower than population-based norms associated with this instrument (54.16 ± 15.29, 44.07 ± 9.62, and 64.31 ± 12.56, respectively). CONCLUSIONS: Creation of a urostomy affected the patients' lifestyle and HRQOL negatively. Determining the patients' experiences, problems, and the change in HRQOL may provide assistance in designing appropriate nursing approaches to alleviate problems adapting to a urostomy.

Evaluation of Early Warning Scoring System and Nursing Guide Application in Post-Anaesthesia Care Unit.

OBJECTIVE: To determine the effect of nursing guide application developed for the present study and to evaluate the Early Warning Scoring System (EWSS) in post-anaesthesia care unit (PACU). METHODS: The study was carried out as a randomised-controlled experimental study. The study sample comprised of 123 adult patients having thoracic and abdominal surgery between January 2011 and April 2011 in the Anaesthesiology and Reanimation Department of a training and research hospital. Patients were randomised during the pre-operative period; the patients who were followed-up according to the EWSS and a nursing guide constituted the study group (SG=63) and the patients whose EWSS score was calculated but routine follow-up in PACU was not intervened constituted the control group (CG=60). RESULTS: During the PACU, complications developed in in 34.92% of SG patients and in 30.00% of CG patients. Of the SG patients, 95.45% developing complications and of the CG patients, 22.22% developing complications were treated in the first 10 minutes, and it was determined that in 61.12% of CG patients, complications were not treated. There was a significant difference between the SG and CG patients in terms of treatment duration against complications (p<0.05). CONCLUSION: The EWSS and nurse's guide provides early determination and treatment of patients developing complications. Thus, it is recommended to use the EWSS and a nursing guide in PACU.

Effectiveness of local cold application on skin burns and pain after transthoracic cardioversion.

BACKGROUND: Transthoracic cardioversion (TTC) is widely used in emergency departments and daily clinical practice. TTC may cause skin lesions on the application of apical and sternal paddle areas. The lesions are characterised by redness, erythema and blister(s), and can be defined as first degree burns locally causing pain and increased sensitivity. AIM: To evaluate the effectiveness of local cold application on reducing the incidence, severity and pain/sensitivity of skin burns in patients who underwent TTC. METHODS: The study was conducted in the intensive care unit of the cardiovascular surgery department. The patients were assigned to study (n=24) and control groups (n=24). Local cold application was performed for a 1 hour period on patients in the study group, whereas only clinical procedures were applied in the control group following TTC. Incidence and severity of burn was evaluated 2 h after TTC, and pain/sensitivity scores were evaluated at 2, 4 and 24 h after TTC. Results The incidence of burn was significantly lower in the study group (3/24) compared to the control group (21/24) (12.5% vs 83.3%, p<0.001). Pain/sensitivity scores were significantly lower in the study group compared to the control group (p<0.05). CONCLUSION: Local cold application following TTC is an effective means of reducing the incidence and severity of burns and pain/sensitivity. It is cost-effective and can easily be applied by nurses in medical/surgical units and emergency departments.

The effect of nurse-performed preoperative skin preparation on postoperative surgical site infections in abdominal surgery.

AIM: To determine the effect of preoperative skin preparation procedures performed by nurses on postoperative surgical site infection in abdominal surgery. BACKGROUND: Despite all interventions, postoperative SSIs still greatly affect mortality and morbidity. DESIGN: This is an experimental study. METHODS: Procedures developed for nurse application of preoperative skin preparations were tested on a control group (n = 39) and study group (n = 43). RESULTS: Only clinical routines for preoperative skin preparation were performed on the control group patients. Control group members' skins were mostly prepared by shaving with a razor blade (41%). For the study group members, the researchers used the preoperative skin preparation procedure. Clippers were used to prepare 55.8% of study group members while 44.2% of them were not treated with the clipper because their wounds were clean. As a requirement of the procedure, all members of the study group had a chlorhexidine bath at least twice after being hospitalised and at least once a night before the operation under controlled conditions. In the group where chlorhexidine bath was not applied, the infection risk was found to be 4.76 times (95%CI = 1.20-18.83) greater even after corrections for age and gender had been made. The difference between control group and study group with respect to surgical site infections was also statistically significant (p < 0.05). CONCLUSION: Preoperative skin preparation using clipper on the nights before an operation and a 50 ml chlorhexidine bath excluding head area taken twice in the pre-operative period are useful to reduce SSI during postoperative period. RELEVANCE TO CLINICAL PRACTICE: We find that preoperative skin preparation using the procedures developed as a result of findings of this study is useful in reducing surgical site infection during the postoperative period.