Risk Factors and Frequency of Foot Ulceration in Patients Receiving Chronic Hemodialysis Treatment.

OBJECTIVE: To determine the prevalence and risk factors of foot ulceration in patients receiving hemodialysis treatment. METHODS: A total of 180 patients who received hemodialysis treatment in two state hospitals and a private health center between April 2017 and September 2017 were included in the study. The researchers collected data using a patient information form and by conducting physical evaluation of the lower extremities. They used the diabetic foot risk assessment algorithm to classify risk according to the data obtained. RESULTS: Of the patients receiving hemodialysis treatment, 6.7% had foot ulceration, 19.4% had a history of foot ulceration, and 8.3% had a history of hospitalization associated with ulceration in a lower extremity. Infected foot ulceration was the most common (6.1%) cause of hospitalizations. In the group with current or past foot ulceration, diabetic nephropathy was the most common etiologic factor of end-stage kidney disease (48.6%); there was a significant between-group difference in diabetic nephropathy (P < .05). Etiologic factors had a significant effect on foot ulcerations: As determined by univariate logistic regression, diabetes (odds ratio [OR], 2.727; P < .05), presence of neuropathy (OR, 4.208; P < .05), low-density lipoprotein cholesterol (OR, 1.013; P < .05), and serum albumin (OR, 0.302; P < .036) all had a statistically significant effect on the presence of foot ulcerations. CONCLUSIONS: Patients receiving hemodialysis treatment are at high risk for foot ulceration. Therefore, patient awareness strategies should be expanded to include individuals with end-stage renal disease regardless of diabetes status. Clinical and dialysis nurses should educate these patients about foot ulcerations and foot health to prevent ulcer development.

Efficacy of Propolis in the Prevention of Oral Mucositis in Patients Undergoing High-Dose Chemotherapy: A Randomized Controlled Trial.

BACKGROUND: Oral mucositis is one of the most common symptoms in adults with a hematological cancer who are receiving high-dose chemotherapy. Propolis is a complementary and alternative method used to prevent oral mucositis in these patients. OBJECTIVE: The aim of this study was to determine the efficacy of propolis in the prevention of oral mucositis in patients receiving high-dose chemotherapy and/or hematopoietic stem cell transplantation. METHODS: A total of 64 patients, 32 in the propolis group and 32 in the control group, were enrolled in this prospective randomized controlled experimental study. Whereas the standard oral care treatment protocol was administered to the control group, aqueous propolis extract was applied to the propolis intervention group in addition to the standard oral care treatment protocol. Data collection forms included a Descriptive Information Form, the Karnofsky Performance Scale, the Cumulative Illness Rating Scale-Geriatric, Patient Follow-up Form, the World Health Organization Oral Toxicity Scale, and the National Cancer Institute Common Terminology Criteria for Adverse Events. RESULTS: The incidence and duration of oral mucositis were statistically significantly lower in the propolis intervention group than the control group, and the onset of oral mucositis and grade 2 to 3 oral mucositis occurred later ( P < .05). CONCLUSION: Propolis mouthwash combined with standard oral care treatment delayed the onset of oral mucositis and decreased its incidence and the number of days it lasted. IMPLICATIONS FOR PRACTICE: Mouthwash with propolis can be used as a nursing intervention to decrease oral mucositis and its symptoms in hematological cancer patients receiving high-dose chemotherapy.

The effect of web-based education delivered as part of cardiac rehabilitation on healthy lifestyle behaviors, and quality of life in patients with coronary artery disease in Turkey: A randomised controlled trial.

OBJECTIVE: This study was conducted to evaluate the effect of web-based education delivered as part of cardiac rehabilitation (CR) on healthy lifestyle behaviors, and quality of life in patients with coronary artery disease (CAD) in Turkey. METHOD: This study is a randomized controlled trial. The experimental group (n = 35) received web-based education and telephone counseling for 12 weeks after discharge, while the control group (n = 35) received standard care. RESULTS: Post-test healthy lifestyle behaviors scale total score and total scores of all sub-dimensions except nutrition were higher in the experimental group (p < 0.05). The post-test international physical activity total score, and VAS scale scores of the experimental group and were significantly higher (p < 0.05). The number of non-smoking patients in the post-test was statistically significantly higher in the experimental group (p < 0.05). CONCLUSION: The results showed that web-based education delivered as part of CR in a Turkish hospital improved healthy lifestyle behaviors, physical activity level, and quality of life in CAD. PRACTICE IMPLICATIONS: Our study proved that web-based education delivered as part of CR, nurse follow-up, and telephone counseling services may be effective tools for CAD patients to adhere to healthy lifestyle behaviors, and to promote quality of life and smoking cessation.

Evaluation of risk factors for foot ulceration in individuals with chronic kidney disease.

INTRODUCTION: CKD, like DM, is an independent risk factor for the development and course of foot ulcers. OBJECTIVE: The authors studied the incidence and risk factors of foot ulceration in patients with CKD and with or without DM and in patients receiving or not receiving HD. MATERIALS AND METHODS: Patients with or without DM and with renal failure were divided into 4 groups of 40 patients each according to whether or not they were receiving HD. Data were collected using a patient information form, physical examination of the foot, and risk assessment forms. RESULTS: Lower extremity ulceration was highest in group 3 (HD+DM+) (15% [6 of 40]), that is, in patients with CKD and DM receiving HD (P = .421). Patients in group 3 were at highest risk for foot ulcers (72.5%) compared with other groups (P = .001). Risk factors associated with foot ulceration were advanced stage (ie, stage 4 or 5) CKD, HD treatment, age, BMI, history of lower extremity ulceration and/or amputation, foot deformities, skin and nail pathology, neuropathy, and vascular insufficiency. CONCLUSIONS: Patients with CKD receiving HD are at high risk for foot ulcers, and this risk increases with the presence of DM.

The Effect of Health Literacy on Patient Outcomes in Stage 3b-4 Pre-Dialysis Patients: A Semi-Experimental Study.

This study was conducted to investigate the effect of health literacy on patient outcomes in pre-dialysis patients. A semi-experimental study. The study was conducted with 45 intervention and 45 control patients with glomerular filtration rates between 15-44ml/min/1.73m2. The adequate health literacy of the patients in the intervention group increased from 2.2% to 31.1%. Increased health literacy led to a significant decrease in systolic and diastolic blood pressure values and the severity of symptoms. The study showed that increased health literacy in pre-dialysis patients improves patient outcomes. Nursing care is needed in pre-dialysis.

Prevalence of constipation in patients undergoing chemotherapy and the effect of constipation on quality of life.

OBJECTIVE: This study was conducted as a descriptive and cross-sectional study to determine the prevalence of constipation and the impact of constipation on quality of life in patients receiving outpatient chemotherapy. MATERIALS AND METHODS: The data of the study were collected from 252 patients who applied to the outpatient chemotherapy unit of a university hospital between January 2021 and March 2021. The data were collected using the "Patient Information Form," "Eastern Cooperative Oncology Group (ECOG) Performance Status Scale," "Constipation Severity Scale (CSS)," "Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL)," and "The Bristol Stool Form Scale" through face-to-face interview technique. In the analysis of data, numbers, percentile distributions, minimum and maximum values, mean values, and standard deviations, as well as t-test, were used in the comparison of paired groups in normally distributed measurements, while the analysis of variance (ANOVA) was used in the comparison of more than two groups. RESULTS: The constipation prevalence of the patients included in the study was 31.7% and the mean constipation severity score was 30.48 ± 13.87. It was found that the quality of life of the patients due to constipation was (71.79 ± 18.74) impacted adversely on a moderate level. A significant difference was found between sex, educational status, use of antiemetic and antiulcer medication, presence of hemorrhoid disease, ECOG score, appetite, and mean CSS and PAC-QOL scores (p < 0.05). CONCLUSION: Constipation occurs in one-third of cancer patients receiving ambulatory chemotherapy. The severity of constipation in patients is at a moderate level and it impacts the quality of life moderately.

Incidence of and risk factors for development of oral mucositis in outpatients undergoing cancer chemotherapy.

AIM: The aims of the study are to determine the incidence of oral mucositis, the stage of the condition, risk factors, and other oral complications in patients receiving outpatient chemotherapy and to evaluate the factors that have an impact on these. METHODS: The study included 147 patients undergoing outpatient cancer chemotherapy at the Chemotherapy Unit of a University Hospital between February and April 2015. We used a questionnaire and the World Health Organization "Mucositis Grading Scale". Chi-squared tests were used to determine the relationships between factors, and multiple logistic regression analysis was employed to explore predictive factors. RESULTS: The frequency of oral mucositis was 51.7%. The most common oral problems were mouth dryness (55.1%), a reduced/changed sense of taste (52.4%), and a lack of appetite (47.6%). Logistic regression analysis showed that the risk factors for oral mucositis were advanced age, a lack of appetite, and the duration of chemotherapy. CONCLUSIONS: As a result, half of all patients undergoing outpatient cancer chemotherapy developed oral mucositis. Patients are unable to adequately prevent oral mucositis and carry out oral care. It is recommended that more studies be conducted in outpatient units to evaluate predictive factors for oral mucositis.

Identifying the Factors Affecting Comfort and the Comfort Levels of Patients Hospitalized in the Coronary Care Unit.

Comfort, a concept associated with the art of nursing, is important for reducing the negative impact of hospitalization in a coronary care unit (CCU). Providing nursing interventions that ensure patient comfort is important for patients to respond positively to treatment. To determine the factors affecting comfort and the comfort levels of patients hospitalized in the CCU. A descriptive study. The study was conducted between December 2015 and February 2016 in the CCU of a state hospital located in Trabzon, Turkey. The sample consisted of 119 patients who complied with the criteria of inclusion for the study. Data were collected using the "Patient Information Form" and a "General Comfort Questionnaire." The mean patient comfort score was 3.22 ± 0.33, and we found significant relationships between comfort scores and age (r = -0.19; P = .03) and communication by nurses and physicians (P < .05). Regression analysis revealed that sufficient communication by physicians, education level, age, and having a companion were related to the comfort level (P < .05). Communication by nurses and physicians and having a companion could change the comfort levels of patients hospitalized in the CCU.

Therapeutic Effects of Nurse Telephone Follow-up for Lung Cancer Patients in Turkey.

BACKGROUND: Patients with lung cancer can encounter many difficulties as they adjust to the side effects of chemotherapy treatments. OBJECTIVE: The aim of this study is to determine the therapeutic effects of nurse telephone follow-up for lung cancer patients. METHODS: In this quasi-experimental study, the sample consisted of 60 patients with lung cancer assigned to an intervention group (n = 30) and a control group (n = 30). The control group participants were sequentially enrolled first and then the intervention group participants were enrolled. The data were collected using the Patient Information Form, Eastern Cooperative Oncology Group Performance Status, the Edmonton Symptom Assessment Scale, and the Functional Living Index-Cancer. The Nursing Care Guide was created by the nurse researchers' team and given to both the intervention and control groups. Telephone follow-up calls were conducted with intervention patients within the first week after their chemotherapy session. The Kolmogorov-Smirnov, Pearson χ, Fisher exact, Mann-Whitney U, and Friedman test and descriptive statistics were used to evaluate the data. RESULTS: Patients in the intervention group demonstrated significantly better adjustment to the symptoms secondary to chemotherapy and higher social functioning quality of life scores compared with reported scores in the control group. CONCLUSION: Nurse telephone follow-up can reduce chemotherapy-related symptoms for lung cancer patients and improve participants' social functioning. IMPLICATIONS FOR PRACTICE: Nurse telephone follow-up is an acceptable and feasible form of patient contact and is a convenient and efficient way to offer patients the support and continuity of care they need.

The Effect of Empathy Training on the Empathic Skills of Nurses.

BACKGROUND: The profound impact of empathy training on quality nursing care has been recognized. Studies have shown that there has been little improvement in nurses' communication skills, and that they should work to enhance this area. Relevant training will lead to an improvement in nurses' empathic skills, which in turn, will enable them to understand their patients better, establish positive interpersonal relationships with them, and boost their professional satisfaction. OBJECTIVES: To reveal the effect of empathy training on the empathic skills of nurses. PATIENTS AND METHODS: This study was conducted as an experimental design. The research sample consisted of 48 nurses working at the pediatric clinics of Farabi hospital of Karadeniz Technical University in Turkey (N = 83). Two groups, an experimental group (group 1) and a control group (group 2) were determined after questionnaires were supplied to all nurses in the study sample. At first, it was intended to select these groups using a random method. However, since this may have meant that the experimental and control groups were formed from nurses working in the same service, the two groups were selected from different services to avoid possible interaction between them. The nurses in the Group 1 were provided with empathy training through group and creative drama techniques. Pre-tests and post-tests were conducted on both groups. Data was collected via a questionnaire designed around the topic "empathic skill scale-ESS", developed by Dokmen. The Kolmogorov Smirnov test was employed to assess whether the measurable data was suitable for normal distribution. Data was presented as numbers and percentage distributions, as mean ± standard deviation and Chi-square, and as student t tests and paired t tests. The level of significance was accepted as P < 0.05. RESULTS: The nurses in the experimental group had a mean score of 146.7 ± 38.8 and 169.5 ± 22.1 in the ESS pre-test and post-test, respectively. Although the nurses in the control group had a pre-test mean score of 133.7 ± 37.1, which increased to 135.1 ± 51.7 after the training, no statistically significant difference was found (P = 0.886). A comparison of the groups indicated that they scored similarly in the pre-test. However, the experimental group scored significantly higher than the control group in the post-test (P = 0.270 and P = 0.015, respectively). CONCLUSIONS: In the light of these findings, it is recommended that communication skills should be widely included in in-service training programs; similar studies should be conducted on broader control groups formed through randomization; and a comparison should be made between the findings.

Loneliness of oncology patients at the end of life.

BACKGROUND: Terminal stage cancer patients experience anxiety about death and pessimism about the future. They usually fear that as they approach death, their pain will increase, they will lose their reputation, and they will be alone. However, few studies have evaluated the loneliness that these cancer patients feel. This was a cross-sectional and definitive study that evaluated the feeling of loneliness in terminal cancer patients. METHODS: In total, 55 cancer patients with terminal cancer who were hospitalised for palliative therapy between 14 November 2014 and 14 January 2015 in the Okmeydani Training and Research Hospital were included in the study. The patients were given a questionnaire form that included sociodemographic properties and University of California Los Angeles Loneliness Scale to collect data. RESULTS: Loneliness was detected as 53.61 ± 9.29. There was no relationship between sociodemographic data and loneliness (p > 0.05). Regression analysis revealed that family support and sharing of emotional stress were related to the level of loneliness (p < 0.05). More than half of the patients needed psychological support because they could not handle the situation. CONCLUSIONS: Terminal stage cancer patients felt lonely in general, and patients with a lack of visitors and family support experienced a higher level of loneliness.

Nonmedical methods to relieve low back pain caused by lumbar disc herniation: a descriptive study in northeastern Turkey.

Low back pain due to the effects of lumbar disc herniation is a common complaint of patients who often subsequently seek help from medical professionals. It is also a significant health problem which is quite difficult to treat. This descriptive study was conducted to determine nonmedical methods used by patients with lumbar disc herniation to relieve low back pain; the patients' intensity of low back pain when they were admitted to the hospital was also explored. Ninety-two patients with lumbar disc herniation participated in this study, which was carried out at a university hospital in northeastern Turkey. Data were collected using a patient information form and the visual analog scale (VAS). When the patients were admitted to hospital, their mean VAS score was 6.56 ± 2.45. The study results showed that as a first choice nearly all of the patients (94.6%) with lumbar disc herniation preferred consulting with their physicians before to obtain relief for low back pain. However, in addition to seeing their physician, more than one-half of these patients (57.6%) also used nonmedical methods. The primary nonmedical methods were hot/cold compresses, wrapping various substances on the back, and herbal preparations. An increase in pain was noted by 17.0% of patients after using nonmedical methods. Findings indicated that more than two-thirds of patients experienced either no change or an increase in pain after using nonmedical methods to find relief.

Attitudes and health beliefs associated with breast cancer screening behaviors among Turkish women.

PROBLEM: This research was undertaken to determine the attitudes and health beliefs of a sample of Turkish women about breast self-examination (BSE), clinical breast examination, and mammography. DESIGN: Data were collected by means of a researcher-designed questionnaire and the Champion Health Belief Model Scale. A total of 1,342 women participated in this study. RESULTS: It was found that 10.1% of the women practiced BSE once a month, 19.8% of the women had had a clinical breast examination, and 15.0% had had a mammogram. Age and marital status were significant variables that influenced whether the women used only one or multiple methods for early detection of breast cancer. Participants who had higher levels of confidence for BSE and lower perceptions of barriers to BSE were more likely to perform BSE. Participants who perceived higher levels of confidence to perform BSE were more likely to be using all three early detection methods. IMPLICATIONS FOR PRACTICE: Interventions and strategies that help women develop confidence in their abilities to perform early breast cancer detection methods are likely to encourage them to engage in regular screening for breast cancer.

The effects of peer education on university students' knowledge of breast self-examination and health beliefs.

This study was carried out to determine the effects of peer education on breast self-examination (BSE) knowledge and health beliefs. 180 female university students were trained in BSE by the nursing students. Students instructed in groups by their peers showed a much higher degree of BSE knowledge. It was also found that perceived confidence of the students educated both individually and in groups increased afterward. Study results further revealed that the methods used for peer instruction do not affect students' sub-dimensions of health beliefs differently after the education.

The effect of home healthcare on quality of life in patients diagnosed with gastrointestinal cancer.

This study was undertaken to determine the effect of home healthcare on the quality of life (QOL) in patients diagnosed with gastrointestinal cancer. A total of 42 patients, who met eligibility criteria, were enrolled in the study and randomly assigned to either a control group or an experimental group. Control group patients received "usual care" defined as pain control and management through the pain clinic. Experimental group patients received pain control through the clinic plus three home visits. During the home visits, their nursing care was guided by an evidence-based protocol developed by the research team. Data were collected on pain, performance, symptoms, and QOL by using previously developed and validated instruments.Significant differences were found between the two groups on physiological function, psychological concerns, and total stress. In the experimental group, there was a significant decrease in pain and increase in performance from baseline to the final data collection period. For the control group, a significant decrease in QOL over the study period was observed. There were no significant differences between the two groups on pain, performance, QOL, and QOL subscales at the final visit.

A different approach to breast self-examination education: daughters educating mothers creates positive results in Turkey.

Breast cancer is a common cancer among women, and early detection is important for breast cancer mortality and morbidity. The aim of this study was to determine the effects of daughters teaching their mothers about breast self-examination (BSE) and its health beliefs. In the study's first stage, 168 university students were trained by the School of Health students about BSE through group training methods. Then, these trained university students were asked to train their mothers about BSE. Data were collected before the training and then again after the training (1 month later). The study instruments included questionnaire forms and the Champion Health Belief Model Scale. The results were analyzed using paired- and unpaired-sample t test, analysis of variance, bivariate correlation analysis, and stepwise multiple regression analysis. The results show that women's knowledge level increased 2-fold after training, and the knowledge level difference between pretraining and post-training was significant (P = .000). The mothers' background information (hear-read) and BSE practice (P = .006 and .006, respectively) before the training process were found to be significant predictors of sociodemographic and other variables influencing the mothers' knowledge levels. The training increased the perceived benefit (P = .032) and confidence (P = .000) significantly. It was found that there was a negative but significant correlation between perceived barriers and BSE knowledge after the education (P = .019). It was found that mothers' knowledge level about BSE was higher after the education. Furthermore, perceived barriers decreased while other subscales increased. Education from daughter to mother can be used as a BSE training approach to increase women's knowledge about BSE.

Comparison of three educational interventions on breast self-examination knowledge and health beliefs.

BACKGROUND: This study was designed to investigate the effectiveness of various training methods for breast self-examination (BSE) knowledge, practice, and health beliefs. METHODS: The quasi-experimental investigation was carried out in an area where two community health care centers are located, in the city of Trabzon, Turkey. Divided randomly into three groups, 1,342 women were instructed in BSE using individual or group training or by way of pamphlets. Data were gathered in four stages: during the pretraining and one month, six months and twelve months after training. RESULTS: All of the training methods used in the study produced a significant increase in the participants' BSE knowledge, but individually trained women scored higher than did the others. Regardless of the training method, BSE instruction improved the women's perceived confidence and benefits, while their perceived barriers declined. The variables influencing BSE practice were found to be BSE practice at the pretraining period, perceived confidence in and benefits from BSE six months after BSE instruction, and health motivation one year after training. No significant difference was found in women's BSE performance scores one year after training. CONCLUSION: This study in which three training methods were used enabled us to assess the effectiveness of instruction on BSE performance and competence. In addition, it provided us with valuable information on how training methods can influence health beliefs related to BSE.