Effects of selfcare and selected factors on the quality of life in women with breast cancer-related lymphedema.

BACKGROUND: This study was performed to examine the effects of selfcare and selected factors on the quality of life in women with breast cancer-related lymphedema (BCRL). METHODS: The study was descriptive and cross-sectional and included 101 women with BCRL. Data were gathered with a descriptive characteristics questionnaire, the Lymphedema Quality of Life Scale-Arm and the Breast Cancer-Related Lymphedema Selfcare Scale. Obtained data were analyzed with numbers, percentages, mean, and multiple regression analysis. RESULTS: The lowest and the highest scores of the women with lymphedema (LE) on the Lymphedema Quality of Life Scale-Arm were 35 and 71 respectively with a mean of 52.63 ± 11.81. The lowest and the highest scores to be obtained from this scale are 20 and 80 respectively. The quality of life was predicted significantly and positively by time elapsing after the diagnosis of breast cancer and significantly and negatively by time elapsing after the diagnosis of LE and selfcare (p < 0.05). Other variables did not individually affect the quality of life (p > 0.05). CONCLUSION: Since selfcare influences the quality of life, patients with BCRL should be given education and support for selfcare, the quality of their lives should be regularly evaluated, and interventions that enhance the quality of their lives should be conducted.

Factors related to older patients' fear of falling during the first mobilization after total knee replacement and total hip replacement.

The aim of this study was to determine fear of falling in the first mobilization and affecting factors in older patients. The study had a descriptive and cross-sectional design. Data were collected in Izmir, Turkey between February 2014 and March 2016. The sample included 204 older patients undergoing joint replacement surgery. Fifty-seven-point four percent and 42.6% of the patients had total hip and knee replacement respectively. 42.2% of the patients had a severe fear of falling when they were first mobilized. There was a statistically significant difference between fear of falling in the first mobilization and the mean pain severity. In addition, the difference between fear of falling and the mean anxiety level was statistically significant. Pain and anxiety are important factors contributing to fear of falling in mobilization. The results of the study can help develop multidimensional strategies for reducing fear of falling in older people after joint replacement.

Pediatric liver transplant patients' transition to adulthood: Patient and parent experiences.

This qualitative research study describes the experiences of child and adolescent liver transplant recipients and their parents during the patients' transition to adulthood. Data were collected from pediatric liver transplant recipients and their parents during individual interviews, and these were later analyzed using conventional content analysis. Seven main themes emerged: coping, self-management, body image, social relationships, academic life, work life, and live donors. Study results revealed that the patients who received liver transplants during their childhood and adolescence used both effective and ineffective strategies to cope with the difficulties they faced during the transition period into adulthood. The parents experienced many problems: on learning of their child's need for a transplant, parents were advised that they should consider becoming a live donor. This very difficult decision was a source of great stress and required serious consideration. After transplantation the parents wanted their children to have autonomy but could not encourage them because of concerns for their health.

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.

Validation and adaptation of the Modified Transplant Symptom Occurrence and Symptom Distress Scale-59 Items Revised into Turkish.

CONTEXT: The Modified Transplant Symptom Occurrence and Symptom Distress Scale-59 Items Revised (MTSOSD-59R) is a validated self-reported scale assessing patients' subjective experiences of adverse effects of immunosuppressants. It has been reported that the scale should be adapted and validated before it is used in patients of a different cultural (Brazilian, Dutch, German, French, Hindi, Italian, Spanish, and Swedish) background. OBJECTIVE: To validate and adapt the MTSOSD-59R for use in Turkish transplant recipients. MATERIALS AND METHODS: This cross-sectional study was performed between March 2010 and February 2011, and included 180 liver and kidney transplant recipients treated in 2 university hospitals in western Turkey. In addition, 180 healthy control participants were recruited from a community health service. Data were collected by using a demographic and clinical characteristics scale (MTSOSD-59R) and the Beck Depression Inventory. Items were translated in a culturally sensitive way by using forward-backward translation. Content validity was evaluated by using the content validity index. Ridit analysis and descriptive statistics helped to describe symptom experience in our population, and Mann Whitney U testing was used to compare patients versus healthy controls, depressed versus nondepressed patients, and male versus female patients for validity purposes. Split-half reliability analysis was used. RESULTS: The content validity index was perfect (ie, value 1.0); the Turkish translation of the MTSOSD-59R had excellent known group validity. Split-half Spearman Brown corrected reliability coefficient was 0.991 for symptom occurrence and 0.992 for symptom distress. CONCLUSION: The results suggest that the Turkish scale has appropriate language, content, and construct validity. This scale can now be used to assess the symptom experience related to immunosuppressive therapy in Turkish organ transplant recipients.

Investigation of adaptation after liver transplantation using Roy's Adaptation Model.

In this study we explored the adaptation of transplant recipients in Turkey using the Roy Adaptation Model. A descriptive qualitative design was used with data collected from liver transplant recipients in either individual or group interviews between May 2009 and February 2010. Using deductive content analysis, four themes were identified in the data: physiological mode, self-concept mode, role function mode, and interdependence mode. Each theme included both adaptive and ineffective behaviors of liver transplant recipients. The findings of this study indicate that liver transplant recipients need information and support about their ineffective behaviors in all modes of the Roy Adaptation Model. The findings also support the use of a nursing model in the delivery of nursing care for liver transplantation recipients.

Factors Affecting COVID-19-Related Fear and Burnout in Surgical Nurses.

BACKGROUND: Surgical nurses face the risk of psychological problems while trying to cope with the challenges arising from the COVID-19 pandemic. AIM: This study aimed to determine levels of COVID-19-related fear and burnout and affecting factors in surgical nurses. DESIGN: The study has a descriptive, cross-sectional design. METHODS: The study sample included 321 nurses working in surgical units and operation rooms in Turkey. Data were gathered with a sociodemographic and occupational characteristics form, the Fear of COVID-19 Scale and the COVID-19 Burnout Scale through a Google form between 1 August and 15 October in 2021. Obtained data were analyzed with independent groups t-test, One-Way ANOVA and simple and multiple linear regression analyses. RESULTS: The nurses had moderate levels of fear (20.00 ± 6.77; Min-Max: 7-35) and burnout (29.52 ± 10.03; Min-Max:10-50) due to COVID-19. The female gender and belief in health staff shortage were predictive of fear and burnout related to COVID-19. Age was not predictive of COVID-19 fear and receiving education about COVID-19, exposure to violence, having adequate supplies of goggles/face shields and having a limited number of aprons/work wear were not predictive of COVID-19-related burnout. Fear of COVID-19 was predictive of COVID-19 burnout. CONCLUSIONS: Female nurses and nurses believing in health staff shortage had higher levels of fear and burnout due to COVID-19. As COVID-19 fear increased, so did COVID-19 burnout. Nurses working in surgical units should be provided with education about coping strategies taking account of the factors affecting COVID-19-related fear and burnout.

Development of the Breast Cancer Related Lymphedema Self-Care Scale.

The purpose of study was to develop the Breast Cancer Related Lymphedema Self-Care Scale to evaluate the self-care practices of women with breast cancer-related lymphedema (BRCL); and to examine the psycholinguistic and psychometric characteristics of this scale. The item pool of the scale was created based on the literature in this descriptive study. Content validity, explanatory and confirmatory factor analyses used in evaluation of the validity; and item analyzes, the Cronbach's Alpha and Split Half analyzes were made for reliability in the study. The content validity index was found to be above 0.80. In the Explanatory Factor Analysis, a four-factor structure was obtained. In Confirmatory Factor Analysis, fit indices were found to be acceptable. Cronbach's Alpha coefficients of the sub-dimensions of the scale varied between 0.62 and 0.86. It was determined the Breast Cancer Related Lymphedema Self-Care Scale was a valid and reliable scale for women with BRCL.

Quality of work life and working conditions among oncology nurses: A national online descriptive cross-sectional study.

The aim of this study was to examine the quality of work life (QoWL) and working conditions of oncology nurses in Turkey. The study utilized a descriptive cross-sectional design. The data were collected via the introductory information form and Brooks' Quality of Nursing Work Life Survey. The study was completed with 138 nurses. The factors affecting QoWL were determined using stepwise multiple linear regression. Nurses had a moderate QoWL, and age, duration of working in nursing, the number of nurses, and the working style were significantly associated with QoWL. To improve the QoWL, the nurses' socio-demographic factors should be considered and working conditions should be improved. Furthermore, well-designed institutional policies should be developed to improve the patient-nurse ratio and provide a quality healthcare.What this paper adds?In the current study, Turkish oncology nurses had a moderate quality of work life.Age, duration of working in the nursing, the number of nurses in the unit and the working style were linked to work-related quality of life in oncology nurses.Well-designed institutional policies should be developed to improve the working conditions and to increase work-related quality of life in oncology nurses.

Evaluation of Psychosocial Outcomes of Living Liver Donors in Liver Transplantation.

BACKGROUND: The purpose of this study was to evaluate the risk factors affecting psychosocial outcomes of living liver donors after liver transplantations. METHODS: This was a descriptive, cross-sectional study. The sample consisted of living liver donors followed by 2 liver transplantation centers in 2 private hospitals in 2 different provinces, between August 2017 and October 2019. All the living liver donors were contacted without a time frame after donation and all the participants were evaluated once. The Beck Depression Scale, SF-36, General Self- Efficacy Scale, and Perceived Available Support Scale were used to collect data. The t-test, Kruskal-Wallis test, Mann-Whitney U-test, and Pearson correlation analysis were used for data analysis. RESULTS: The mean age of the patients was 34.31 ± 8.22 years. There was a positive, weak correlation between age and physical func- tion. Gender, marital status, financial status, and education levels significantly affected physical components, social function, vitality, depression, and self-efficacy scores. High depression levels negatively affected the physical component, self-efficacy, and social sup- port scores of the living liver donors. High self-efficacy positively affected social support. CONCLUSION: The study revealed that gender, marital status, employment status, and education levels were associated with psychosocial outcomes. The financial status was the main factor affecting each psychosocial variable. Financial status needs to be assessed in detail before and after the operation.

Effects of a Roy's Adaptation Model-Guided Support Group Intervention on Sexual Adjustment, Body Image, and Perceived Social Support in Women With Breast Cancer.

BACKGROUND: The side effects of local and systemic treatments for breast cancer negatively impact the body image, sexual functioning, and social life of women on treatment for breast cancer. One of the ways to help these women adapt to their disease and cope with the effects of the disease and the side effects of its treatment is through support groups. OBJECTIVE: The aim of this study was to investigate the effect of a support group intervention, guided by Roy's Adaptation Model, on sexual adaptation, body image, and perceived social support in women on treatment for cancer. METHODS: The study had a quasi-experimental design with pretests and posttests and a control group. The sample included 79 women, 42 in the control group and 37 in the intervention group. Data were gathered with demographic and clinical forms, the Sexual Adjustment and Body Image Scale, and the Multidimensional Scale of Perceived Social Support. The intervention group received a support group intervention guided by Roy's Adaptation Model. RESULTS: The intervention group had significantly higher scores for perceived social support, post body image, impact on sexual functioning, and friendly and significant others than the control group did. CONCLUSION: The Roy's Adaptation Model-based support group intervention contributes positively to physiologic, self-concept, role-function, and interdependence modes by creating a positive effect on body image, improving sexual functions, and increasing social support for women on treatment for breast cancer. IMPLICATIONS FOR PRACTICE: This support group intervention may enhance care outcomes in women on treatment for cancer and could thus be incorporated into standard care for this patient group.

The effects of pain management education on knowledge, attitudes, and beliefs in nursing students in Turkey: A quasi-experimental study.

PURPOSE: The aim of this study is to examine the effects of pain management education on nursing students' knowledge, attitudes, and beliefs concerning pain management in Turkey. DESIGN AND METHODS: A quasi-experimental design with pretest/posttest measures was used. The study sample included 79 students. FINDINGS: The nursing students were found to have enhanced knowledge, attitudes following the initial education, and at the 3-month evaluation, compared to their knowledge and attitudes about pain before the education. However, education had no influence on their organic and psychological beliefs as they did not change across time. PRACTICE IMPLICATIONS: Pain management education improved the knowledge and attitudes of nursing students. Nurse educators could revise their teaching methods and adopt interactive education methods.

Validity and reliability of the Turkish version of the lymphedema symptom intensity and distress survey.

OBJECTIVES: This study aims to adapt the Lymphedema Symptom Intensity and Distress Survey- Arm (LSIDS-Arm) into Turkish and to test its validity and reliability. PATIENTS AND METHODS: Between September 2017 and July 2018, this descriptive, methodological study included a total of 186 women (mean age: 55.4±10.2 years; range, 20 to 80 years) who were diagnosed with breast cancer-related lymphedema (BCRL) and followed in the lymphedema outpatient clinic. Data were collected using sociodemographic and clinical features form, LSIDS-Arm, and Functional Assessment of Cancer Treatment-Breast Cancer Scale+4 (FACT-B+4). After the linguistic and content validity of the scale was achieved, confirmatory factor analysis and known-groups validation were utilized to test the construct validity. Reliability of the survey was tested using the Cronbach alpha and Spearman Brown coefficient, item analysis, and parallel forms reliability. RESULTS: All patients completed the questionnaire. After achievement of linguistic and content validity, confirmatory factor analysis results were found to be higher than the accepted value. Known-groups validation revealed a significant difference in the mean scores for the intensity and distress scales between the patients with and without lymphedema. Cronbach alpha for the subscales ranged from 0.61 to 0.86. Parallel forms reliability showed a moderate, significant correlation between subscales of the intensity and distress scales of the survey and the subscales of FACT-B+4. CONCLUSION: The Turkish version of the survey is valid and reliable and can be used to evaluate symptoms, severity of symptoms, and distress caused by BCRL symptoms in the Turkish women.

Self-care practices, patient education in women with breast cancer-related lymphedema.

OBJECTIVES: This study aims to evaluate self-care practices, sociodemographic and clinical factors that affect self-care and patient education among women with breast cancer-related lymphedema (BCRL). PATIENTS AND METHODS: This descriptive, cross-sectional study included a total of 102 women with BCRL (median age: 59 years; range, 35 to 80 years) who received lymphedema (LE) treatment at least once between July 2014 and May 2016. A Sociodemographic and Clinical Characteristics Form and the Lymphedema Self-care Survey were used to collect data via face-to-face interviews. RESULTS: The median LE self-care practices score for women was 10 (range, 5 to 14). A total of 39.1% of the women implemented regular self-care. A statistically significant relationship was found between the score for perceived benefit of LE self-care and the score for self-care practice. No statistically significant difference was found among the self-care scores of the women with LE in terms of sociodemographic and clinical factors, except for education status. A total of 90.2% of the women with LE received self-care education, mostly from a physical therapy specialist and a physiotherapist. There was a statistically significant difference among self-care scores between patients who were educated and uneducated about LE. CONCLUSION: It is recommended that healthcare professionals should educate patients diagnosed with breast cancer to reduce LE risk and promote the implementation of self-care practices following the breast cancer surgery. Interventions should be made to increase the perceived benefits and reduce the perceived barriers and burden towards self-care behaviors to prevent and manage LE.

Adaptation of Quality of Life Measure for Limb Lymphedema-Arm in Turkish Women With Breast Cancer-Related Lymphedema.

BACKGROUND: Quality-of-life measures are needed for clinicians and researchers to identify quality of women's life with breast cancer-related lymphedema (BCRL). OBJECTIVE: To adapt Quality of Life Measure for Limb Lymphedema-Arm into Turkish (TR) and to test its validity and reliability. METHODS: This is a methodological and cross-sectional study and was conducted in the lymphedema outpatient clinic of a university hospital. The study included 109 women with BCRL. After linguistic validity of the scale was achieved, confirmatory factor analyses and known group validity were used to test its construct validity. Reliability of the scale was tested with Cronbach's α, item-total correlations, and Spearman-Brown coefficient. RESULTS: After linguistic validity was achieved, opinions requested from 5 experts specializing in lymphedema showed that item and content validity indexes of the scale were 1. Fit indexes of confirmatory factor analysis were as follows: χ/df = 1.86, root mean square error of approximation = 0.089, standardized root mean square residual = 0.09, and comparative fit index = 0.81. Known group validity analysis showed a significant difference in the mean scores for the subscales of Quality of Life Measure for Limb Lymphedema-Arm-TR, symptom, function, and body image/appearance in terms of lymphedema stages (P < .05). The internal reliability coefficients for the subscales ranged from 0.78 and 0.86. The item-total correlation coefficients ranged between 0.36 and 0.73. CONCLUSION: Quality of Life Measure for Limb Lymphedema-Arm-TR was found to be valid and reliable in the TR population. It could be used in research to evaluate the quality of life in patients with BCRL. IMPLICATIONS FOR PRACTICE: The scale can be used to evaluate effectiveness of nursing interventions directed toward patients developing breast cancer-related lymphedema in clinical settings and studies.

Exploration Into Donor-Recipient Relationship After Living-Donor Liver Transplantation Using Gift-Exchange Theory.

AIM: This qualitative study aimed to explore the donor-recipient relationships following living-donor liver transplantation. METHOD: A 1-time cross-sectional qualitative interview was conducted with liver transplant recipients (n = 17) and living liver donors (n = 11) post-transplant. The interviews were transcribed verbatim and analyzed manually by using thematic content analysis. RESULTS: The mean age of the recipients and the donors was 54.41 ± 8.0 (range 39-71) and 36.6 ± 7.69 (range 28-57) years, respectively. Following the interviews, 2 overarching themes emerged: (1) Became care providers, and (2) differentiation in relationships after transplantation. A total of 3 sub-themes were explained under "differentiation in relationships after transplantation;" feeling guilty, becoming closer and more intense owing to a feeling of indebtedness, and putting some distance owing to a feeling of indebtedness. CONCLUSION: The study focused on the reciprocation stage according to gift-exchange theory. During reciprocation, although recipients expressed positive feelings such as gratitude, closer relationships, and special bonds; they also reported negative feelings like guilt and indebtedness resulting in a purposeful distancing from their donors. Most donors understood what the recipients felt, but they wanted their relationship to return to normal. Married female donors had worse experiences, such as divorce or a weakened marital relationship after donation.

Evaluation of the breast cancer train the trainer program for nurses in Turkey.

The Breast Cancer Train the Trainer (TTT) program was designed to increase breast cancer awareness, improve knowledge about breast cancer among nurses, and provide quality care for breast cancer patients by trained nurses. A total of three programs were held and 82 nurses from different regions of Turkey attended this training. The educational activities employed several teaching and learning strategies. After completion, we determined that the participating nurses' knowledge on breast cancer had increased significantly, and they were satisfied with the training received. The Breast Cancer TTT program is a unique educational endeavor for nurses in Turkey, and our results showed that the training achieved its goal. Trained nurses in Breast Cancer TTT programs can help educate women about the importance of breast health and the measures they need to take to protect themselves against breast cancer. At the same time, nurses can also increase and enhance the quality of life in patients with breast cancer. This is an example of a program that can easily be spread throughout the world as it was done from England and Australia to Turkey.

The effect of web-based training on life quality and spousal adjustment for women with breast cancer and their spouses.

PURPOSE: The aim of the study was to examine the effects of web-based training that was structured in line with Roy's Adaptation Model on the "life quality" of women with breast cancer, and on the "spousal adjustment" of women and their spouses. METHOD: The study used a pretest-posttest, quasi-experimental controlled group design and 83 women with breast cancer and their spouses were enrolled. The data were collected at baseline and again three months later using the Functional Assessment of Cancer Therapy-breast cancer scale and the Dyadic Adjustment Scale as data collection tools. RESULTS: The average scores of life quality and agreement between spouses in the web-based training group were higher than in the control group. More specifically, the physical well-being (p=0.002), emotional well-being (p<0.001), functional well-being (p=0.001), breast cancer module scores (p<0.001) and dyadic cohesion (p=0.003) and dyadic consensus (p<0.001) sub-dimension scores of the women in the intervention group were higher than those in the control group in the third month. Similarly, the third month mean score of dyadic consensus (p<0.001) and affectional expression (p=0.023) of the spouses in the intervention group were higher than those in the control group. CONCLUSIONS: The web-based training programme that was prepared by nurses in line with Roy's Adaptation Model improved the life quality and couples' adjustment in women with breast cancer. Web-based training can be used to improve patient care outcomes because of the continuity of training for women and their spouses.

Validation of the Turkish version of the Brief Pain Inventory in surgery patients.

The Brief Pain Inventory (BPI) is a comprehensive instrument for pain assessment and has been validated in several languages. A validated Turkish version has not been available until now. The purpose of this study was to determine the reliability and validity of the BPI for assessing pain in patients undergoing abdominal surgery in Turkey. The sample consisted of 178 patients who underwent abdominal surgery in general surgery and in obstetrics and gynecology clinics of a university hospital in Zmir, Turkey. A demographic questionnaire and the BPI were used to collect data. The content validity was tested by requesting opinions of experts. The structure validity of the scale was evaluated with factor analyses and reliability of the scale with Cronbach alpha and with item-to-total correlations. Two factors with an eigenvalue greater than one were extracted, supporting the validity of two-factor structure of the original BPI. Factor loads of these two factors ranged from 0.55 to 0.91. The Cronbach alpha reliability coefficient was 0.79 for the severity scale and 0.80 for the interference scale. The item-to-total correlations of the scale ranged between 0.42 and 0.69. The Turkish version of the BPI (BPI-Tr) is a reliable and valid instrument for assessing postsurgical pain severity and its interference. The BPI-Tr will be useful for clinical assessment of postsurgical pain in Turkey.

A study on development of a scale to assess nursing students' performance in clinical settings.

AIMS: To develop a valid and reliable scale to assess nursing student performance in clinical settings. BACKGROUND: In nursing education, clinical evaluation is important for students, teachers and patients and there is a need to evaluate with valid and reliable scales. DESIGN: Instrument development. METHODS: Data were collected at 2002-2003 and 2003-2004 academic years and 350 evaluations of third and fourth year students formed the study population. In the light of the literature and our experiences, we determined clinical responsibilities of nursing students and wrote 77 items accordingly. These items were discussed twice by 17 teachers at a University School of Nursing and then the items were decreased to 28. Each item was scored between 1 and 10. The structure validity of the scale was evaluated with factor analyses and reliability of the scale with Cronbach's alpha and item-to-total correlation. RESULTS: The item-to-total correlation coefficient was 0.40 and items were excluded with item-to-total correlation coefficient of lower than 0.40. Cronbach's alpha was 0.97. Three factors with an eigenvalue greater than one were extracted. These factors were 'nursing process', 'professionalism' and 'ethical principles' and their Cronbach's alpha values were 0.97, 0.94 and 0.87, respectively. CONCLUSION: This scale can be used to evaluate nursing students' performance in clinical settings. RELEVANCE TO CLINICAL PRACTICE: A valid and reliable tool may allow an objective evaluation of nursing students' performance in clinical settings.