Investigation of usage, attitudes toward complementary and alternative medicine among cancer patients in Turkey during the COVID-19 pandemic1.

BACKGROUND: Complementary and alternative medicines (CAM) are being uses more often with cancer patients. OBJECTIVE: This study aimed to investigate attitudes, use and influencing factors of CAM among cancer patients during the COVID-19 pandemic. METHODS: This descriptive, cross-sectional study was conducted on 407 cancer patients in Turkey. The study was conducted during July-September 2021 using a Questionnaire that included a Complementary, Alternative and Conventional Medicine Attitude Scale (CACMAS). Pearson's Chi-Squared Test, Mann-Whitney U, Kruskal Wallis, and logistic regression were all utilized. RESULTS: The findings revealed that 76.2% of the participants stated that they used CAM methods while undergoing cancer treatment, and 65.2% of those who did so kept from sharing this information to medical professionals. Phytotherapy was the most common CAM method used by patients. The use of CAM was found to be significantly higher among those who were 55-64 years of age, married, secondary school graduates, non-smokers, CAM users before their cancer diagnosis, and who had a family history of cancer (p <  0.05). The participants' average CACMAS scores were 112.20±16.53. Among those who used CAM during treatment, non-smoking, overweight-obese participants had higher CACMAS scores (p <  0.05). CONCLUSION: Due to the high prevalence of CAM usage among cancer patients and possible interaction effects with chemotherapy medications, it is important for healthcare professionals to assess and educate cancer patients regarding CAM use. Additional research is needed to determine potential interactions, as well as pros and cons of CAM use during cancer treatment.

An intervention study through education: The change in attitudes and knowledge of educators about the COVID-19 vaccine.

BACKGROUND: Reliable and culturally informed health communication is vital in developing positive health behaviors. OBJECTIVE: The aim of this study was to investigate the change in knowledge and attitudes about COVID-19 vaccines by providing training to educators in a province in the east of Turkey. METHODS: A questionnaire developed by the researchers on the basis of the literature was used in this intervention study. It consisted of three parts: socio-demographic information, before education knowledge (BEK) and Attitudes Towards the COVID-19 Vaccine (BEATV), and after education knowledge (AEK) and Attitudes Towards the COVID-19 Vaccine (AEATV). There were 99 teachers, 32 public education teachers, and 144 religious officials who participated in the study. The data were analyzed using SPSS Statistics Pack version 22.0 (IBM, Armonk, NY, USA). Statistical significance value was accepted as p < 0.05. RESULTS: Among the participants, the number of correct answers to all questions increased as a result of the study. There was a positive increase in most of the ATV items after the training. CONCLUSION: Education on COVID-19 vaccines increased awareness as shown by the total number of correct answers and the improved attitude of educators.

Effects of tracheostomy on mothers of children with cerebral palsy.

OBJECTIVE: We aimed to investigate psychosocial changes such as burnout, caregiver burden, depression, and coping in mothers of children with cerebral palsy (CP) after tracheostomy placement. DESIGN: A total of 48 children with CP and chronic respiratory insufficiency and their mothers participated in the study. The children with tracheostomy were classified as T (+) (n = 26) and those who did not have tracheostomy were classified as T (-) (n = 22). The patients with tracheostomy through invasive mechanical ventilation were classified as TIV (+). The data about the clinical conditions of the patients and the sociodemographic characteristics of the mothers were recorded. Zarit caregiver burden, Maslach burnout, Beck depression, and Coping Orientation to Problems Experienced (COPE) questionnaires were applied to all mothers. FINDINGS: Beck depression score was 14 ± 8.24 in T (+) group and 16.09 ± 9.65 in T (-) group (p = .576). There was no significant difference between the T (+) and T (-) groups in the Maslach burnout inventory, Zarit caregiver burden scale, and their subgroups. The first two methods from the COPE scales were identical. In the T (+) group, the third coping method was found as "planning" and in the T (-) group as "active coping". Maslach burnout inventory, Zarit 1, and Zarit 2 scores were higher in patients with only tracheostomy compared to those with TIV (p = .002, p = .018, p = .021). CONCLUSION: In the study presented, the placement of tracheostomy in children with CP does not increase mother's depression tendencies and mood changes.

Internal carotid artery dissection following blunt head trauma: a pediatric case report and review of the literature.

BACKGROUND: Internal carotid artery dissection (ICAD) is a rare but potentially devastating complication after trauma in the pediatric age group. The diagnosis of traumatic dissection is difficult and is usually recognized only when ischemic symptoms appear. We report a pediatric patient with ICAD due to blunt cerebrovascular injury (BCVI). CASE: A 14-year-old boy suffered major trauma due to a motor vehicle accident. When the first aid team reached the accident site, he was intubated because of his low Glasgow Coma Score (GCS) and then transported to the nearest emergency department. Cranial computed tomography (CT) showed multiple fractures at the skull base and independent bone fragments in both carotid canals. On the 6th day; a brain magnetic resonance imaging (MRI) was performed to detect diffuse axonal injury. There was a loss of signal in the left internal carotid artery (LICA) tract but the limitation of diffusion was not associated with the same side, conversely there was a limitation of diffusion on the other side, affecting a very large area. CT angiography was performed in order to detect a filling defect and showed dissection in the LICA. The patient did not have any specific neurological symptoms associated with ICAD. Low-dose aspirin was utilized as anticoagulant therapy. On the 25th day of admission, the patient`s GCS was 14, neurologic examination showed no difference between the right and left sides. He was discharged on the 55th day of the accident and was walking without support. CONCLUSION: Our patient was a rare case in pediatrics due to having a clinically silent form of ICAD. It is very difficult to diagnose ICAD dissection during the early phase in cases with BCVI accompanied by multiple trauma. Even in the absence of typical neurological deficit, the possible presence of ICAD should be explored in patients with cranial fractures encompassing the skull base.

Impact of treatment satisfaction on quality of life of patients with acromegaly.

PURPOSE: To evaluate satisfaction of acromegalic subjects with their medical treatment and its contribution to their quality of life. METHODS: This cross-sectional study included a total of 159 medications used in 133 subjects with acromegaly (controlled n = 84 and uncontrolled n = 49, female/male: 81/52). Subjects were asked to complete questionnaires on symptoms of depression (BDI) and satisfaction with the medical therapy they received for acromegaly (TSQM). Acromegaly cases also completed Acromegaly Quality of Life Questionnaire (AcroQoL). RESULTS: Subjects on pegvisomant therapy scored lower on convenience (p = 0.007). Cases on combination therapy had lower domain scores for effectiveness, convenience and global satisfaction in comparison to the cases on monotherapy (p = 0.01, p = 0.01 and p = 0.01, respectively). The time elapsed since diagnosis and the duration of medical therapy were positively correlated with effectiveness score (r = 0.2, p = 0.007 and r = 0.2, p = 0.04, respectively). The AcroQoL score was positively correlated with all domains of TSQM (for effectiveness r = 0.2, p = 0.01; for side effects r = 0.3, p = 0.001; for convenience r = 0.3, p = 0.004 and for global satisfaction r = 0.2, p = 0.01). In contrast, the BDI score was inversely correlated with all domains of TSQM (for effectiveness r = -0.3, p = 0.001; for side effects r = -0.2, p = 0.006; for convenience r = -0.3, p < 0.001 and for global satisfaction r = -0.3, p = 0.001). CONCLUSION: In acromegaly, quality of life, status of depression and satisfaction of the subjects with their treatment are intercorrelated.