The Effect of Using a Stress Ball During Endoscopy on Pain, Anxiety, and Satisfaction: A Randomized Controlled Trial.

A stress ball is a simple and effective distraction method during painful procedures. The aim of this study was to evaluate the effect of using a stress ball during endoscopy on patients' pain, anxiety, and satisfaction levels. The randomized controlled study included 60 patients who underwent endoscopy in a training and research hospital in Istanbul. Patients were randomly assigned to the stress ball group or the control group. Patients in the stress ball group ( n = 30) squeezed a stress ball during endoscopy, whereas the control group ( n = 30) received no intervention during endoscopy. Data were collected using a sociodemographic form, a postendoscopy questionnaire, the Visual Analog Scale to assess pain and satisfaction, and the State-Trait Anxiety Inventory. Pain scores did not differ significantly between the groups before ( p = .925) or during ( p = .149) the endoscopy procedure but were significantly lower in the stress ball group after the procedure ( p = .008). Similarly, preprocedure anxiety scores were comparable ( p = .743), whereas postprocedure anxiety scores were significantly lower in the stress ball group ( p < .001). The satisfaction score after endoscopy was higher in the stress ball group, but the difference was not statistically significant ( p = .166). This study suggests that use of a stress ball during endoscopy reduces patients' pain and anxiety levels.

Effect of menthol lozenges after extubation on thirst, nausea, physiological parameters, and comfort in cardiovascular surgery patients: A randomized controlled trial.

OBJECTIVES: To determine the effect of post-extubation oral menthol lozenges on thirst, nausea, physiological parameters, and comfort level in patients undergoing cardiovascular surgery. RESEARCH METHODOLOGY/DESIGN: The study was a single-centre, randomized controlled trial. SETTING: This study included 119 patients undergoing coronary artery bypass graft surgery in a training and research hospital. Patients in the intervention group (n = 59) received menthol lozenges at 30, 60, and 90 min after extubation. Patients in the control group (n = 60) received standard care and treatment. MAIN OUTCOME MEASURES: The primary outcome of the study was the change in post-extubation thirst assessed by Visual Analogue Scale after using menthol lozenges compared to baseline. Secondary outcomes were changes in post-extubation physiological parameters and nausea severity assessed by Visual Analogue Scale compared to baseline, and comfort level assessed with Shortened General Comfort Questionnaire. RESULTS: Between-group comparisons showed that the intervention group had significantly lower thirst scores at all time points and nausea at the first assessment (p < 0.05) and significantly higher comfort scores (p < 0.05) than the control group. There were no significant differences between the groups in physiological parameters at baseline or any of the postoperative assessments (p > 0.05). CONCLUSION: In patients undergoing coronary artery bypass graft surgery, the use of menthol lozenges effectively increased comfort level by reducing post-extubation thirst and nausea, but had no effect on physiological parameters. IMPLICATIONS FOR CLINICAL PRACTICE: Nurses should be vigilant for complaints such as thirst, nausea, and discomfort in patients after extubation. Nurses' administration of menthol lozenges to patients may help reduce post-extubation thirst, nausea, and discomfort.

Effect of perioperative pelvic floor muscle training program on incontinence and quality of life after radical prostatectomy: A randomized controlled trial.

OBJECTIVE: The aim of this study was to evaluate the effect of a perioperative pelvic floor muscle training program on urinary incontinence symptoms and the quality of life of patients after radical prostatectomy. METHODS: This single-center, parallel-group, randomized, controlled study was conducted with a total of 60 patients undergoing open radical prostatectomy in a training and research hospital in Turkey. Patients were randomly assigned to the pelvic floor muscle training group (n = 30) and the control group (n = 30). The data were collected by face-to-face and phone interviews following surgery at seven days after removal of the urethral catheter (baseline) and 3 months using the Patient Information Form, the International Consultation on Incontinence Questionnaire Short Form and the International Consultation on Incontinence Questionnaire for Male Lower Urinary Tract Symptoms. Descriptive statistics, Chi-square test, Independent-samples t-test, and paired-samples test were used to analyze the data. Primary and secondary endpoints were the differences between groups in terms of both scale scores after 3 months. FINDINGS: After 3 months, Incontinence Questionnaire Short Form scores (P < 0.001) and "voiding, incontinence, frequency, nocturia" symptoms scores (P < 0.001) were significantly lower in the pelvic floor muscle training group, and quality of life scores were higher than in the control group (P < 0.001). CONCLUSION: According to this study, the perioperative pelvic floor muscle training program was effective on patients' urinary incontinence symptoms and quality of life 3 months after radical prostatectomy. Evidence-based practices should be used for patients to alleviate common urinary symptoms and to accelerate the recovery of urinary continence.

Evaluation of moral sensitivity and moral courage in intensive care nurses in Turkey during the COVID-19 pandemic.

BACKGROUND: During the COVID-19 pandemic, intensive care nurses may experience ethical issues related to fear of transmission, limited resources, and increased workload. Nurses' moral sensitivity and courage may have a role in dealing with these problems. AIM: The purpose of this study was to assess intensive care nurses' moral sensitivity and moral courage during the COVID-19 pandemic. DESIGN: Descriptive cross-sectional survey. METHODS: A total of 362 nurses working in the intensive care units of pandemic hospitals in Turkey participated in the study between January and March 2021. Data were obtained using a personal information form, the Moral Sensitivity Questionnaire, and the Nurses' Moral Courage Scale. A link to the online data collection tools was sent to the management of participating institutions, who forwarded it to nurses. Reporting followed the CHERRIES guidelines. RESULTS: In this study, the response rate of nurses was 89%. The nurses' total mean moral sensitivity score was 90.70 ± 28.89 and their mean moral courage score was 82.08 ± 13.51. A weak inverse correlation was found between the nurses' moral sensitivity and moral courage scores (r = -.176, p = .001). Total moral sensitivity score differed significantly according to years of Intensive care unit (ICU) experience (p = .007). Total moral courage scores increased significantly with education level (p = .012), years of nursing experience (p = .016), and willingness to work in the ICU (p < .001). CONCLUSION: The study suggests that nurses working in the intensive care unit during the pandemic had moderate moral sensitivity and high levels of moral courage. Nurses' sociodemographic characteristics and ICU work conditions may affect their moral sensitivity and moral courage. RELEVANCE TO CLINICAL PRACTICE: The results of this study can help guide efforts to improve moral courage and sensitivity and address ethical issues among ICU nurses.

The Effects of Motivational Messages Sent to Emergency Nurses During the COVID-19 Pandemic on Job Satisfaction, Compassion Fatigue, and Communication Skills: A Randomized Controlled Trial.

INTRODUCTION: During the COVID-19 pandemic, emergency nurses have been adversely affected physically, socially, and psychologically by factors such as increased workload, longer working hours, isolation from family, and limited resources. This study aimed to investigate the effect of motivational messages sent to emergency nurses during the COVID-19 pandemic on their job satisfaction, compassion fatigue, and communication skills. METHODS: This was a randomized controlled experimental study. The study was conducted with 60 emergency nurses in 2 training and research hospitals in Istanbul between July 31 and August 31, 2021. The participants were randomly assigned to the intervention and control groups. Participants in the intervention group (n = 30) received daily motivational messages to their mobile phones by short message service for 21 days; those in the control group (n = 30) received no motivational messages. The Job Satisfaction Scale, Compassion Fatigue Scale, and Communication Skills Scale were administered before and after the intervention. RESULTS: The mean age was 29.8 (SD = 7.5) and 28.7 years (SD = 6.9) in the intervention and control groups, respectively. Before the intervention, there were no significant differences in the groups' scores for job satisfaction (P = .561), compassion fatigue (P = .687), or communication skills (P = .355). After the intervention, the intervention group had significantly higher scores for job satisfaction (P < .001) and communication skills (P < .001) and significantly lower compassion fatigue scores than the control group (P < .001). DISCUSSION: Our results suggest that motivational messages sent to emergency nurses during the COVID-19 pandemic increase job satisfaction and improve communication skills while reducing compassion fatigue.

Effects of Information, Motivation, Behavioral Skills Model on Urinary Incontinence in Men With Overactive Bladder and Urge Incontinence: A Randomized Controlled Trial.

PURPOSE: The aim of this study was to evaluate the effect of an intervention based on and information, motivation, behavioral skills (IMB) model on urinary incontinence symptoms, impact on daily activities, and incontinence-specific quality of life in men with overactive bladder dysfunction (OAB) and urge incontinence. DESIGN: Parallel-group, open-label, randomized-controlled clinical trial. SUBJECTS AND SETTING: The sample comprised 60 male patients admitted to the urology clinic of a training and research hospital in Ankara, Turkey. Inclusion criteria were adult men older than 18 years and diagnosed with OAB and urge incontinence. METHODS: Data were collected from February 2018 to February 2019. Participants were randomized into 2 equal groups. The intervention group (n = 30) received a structured intervention based on the IMB model, and a control group (n = 30) received standard OAB management. The primary outcome was severity of urge incontinence measured by the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Secondary outcomes were mean scores on the Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire-7 (IIQ-7), and Urinary Incontinence Information Rating. All outcome measures were evaluated before and 6 months after the training. RESULTS: Following the intervention, mean ICIQ-SF scores were significantly lower in the IMB model group as compared to the control group. Analysis revealed a significant increase in knowledge scores in both groups when baseline scores were compared to postintervention scores (P = .000 for the intervention group and P = .004 for the control group). The intervention group participants also had a higher postintervention scores when compared to control group subjects (P = .000). CONCLUSIONS: A structured behavioral intervention based on the IMB model significantly alleviated the severity of bothersome lower urinary tract symptoms in adult males with OAB and urge incontinence when compared to standard care.

Adaptation of the Person-Centered Perioperative Nursing Scale to Turkish: A Validity and Reliability Analysis.

PURPOSE: This study aims to perform a detailed analysis of the validity and reliability of the Turkish version of the Person-Centered Perioperative Nursing Scale (PCPON). DESIGN: Methodological and descriptive study. METHOD: This study was conducted online between December 2020 and February 2021, with 240 nurses working in the surgical wards of private hospitals in Istanbul, Turkey. Individual Characteristics Questionnaire and PCPON were used to collect data. Cronbach Alpha reliability analysis and Confirmatory Factor Analysis (CFA) were applied using R Project software to the data. FINDINGS: As a result of the analysis, all corrected item correlation values for compassionate interaction, respect, comfort, sharing information, and expertise were found to be positive following the original factors structure of the scale. According to reliability analysis statistics, Cronbach's Alpha coefficients were calculated as 0.781, 0.758, 0.780, 0.750 and 0.808 for compassionate interaction, respect, comfort, sharing information, and expertise sub-dimensions, respectively. According to these findings, all five sub-dimensions had high reliability levels. As a result of CFA, the items in all sub-dimensions were statistically significant. Standardized factor loads were also positive in the five sub-dimensions of the scale. Based on these results, all PCPON items were under appropriate sub-dimensions. CONCLUSIONS: PCPON as adapted from English to Turkish had high levels of validity and reliability. It was concluded to be a valid and reliable scale, which we believe will be useful for our country in the fields of education, practice, and research to evaluate the attitudes and behaviors of surgical nurses towards the care-oriented nurse-patient relationship.

The effects of environmental stressors in intensive care unit on anxiety and depression.

BACKGROUND: Physical and emotional conditions of patients treated in an intensive care unit (ICU) may be adversely affected by environmental stressors. AIMS AND OBJECTIVES: The aim of this study was to investigate the relationship between patients' anxiety and depression levels and environmental stressors in the ICU. DESIGN: This was a descriptive cross-sectional study. METHODS: The study was conducted between June 2018 and April 2019 with 150 patients treated in the ICUs of a training and research hospital. Patient information form and ICU environmental stressors and hospital anxiety and depression scales were used for data collection. Descriptive statistics, t-test, one-way analysis of variance, and Pearson's correlation coefficient were used to evaluate the data. RESULTS: The mean hospital anxiety score of the patients in ICUs was 11.1 ± 2.7, and 77.3% of patients were at risk for anxiety (10-point cut-off). The mean hospital depression score was 10.6 ± 3.3, and 94% of patients were at risk for depression (7-point cut-off). The mean score of environmental stressors was 123.9 ± 13.1. A moderate positive correlation between hospital anxiety and hospital depression (r = .63, P < .001) and a weak negative correlation between environmental stressors and hospital anxiety (r = -.24, P = .003) were found. However, no significant correlation between environmental stressors and hospital depression was found (r = -.13, P = .12). CONCLUSION: According to this study, the environmental stressors in the ICU were high, and the patients were at risk of anxiety and depression. The depression levels of the patients increased along with their anxiety levels. As environmental stressors increased, hospital anxiety levels of the patients decreased. However, there was no significant relationship between environmental stressors and patients' hospital depression levels. RELEVANCE TO CLINICAL PRACTICE: Environmental stressors in ICUs are high, and the patients in the ICUs are at risk of anxiety and depression.

The effectiveness of motivational messages to intensive care unit nurses during the COVID-19 pandemic.

OBJECTIVES: To examine the effect of motivational messages on optimism, hopelessness, and life satisfaction of intensive care nurses during the COVID-19 pandemic. STUDY DESIGN: This is a multicentre, randomized controlled, open-label study. RESEARCH METHODOLOGY/DESIGN: The study was conducted with a total of 87 nurses working in the COVID-19 intensive care units of three hospitals in Istanbul. Motivational messages were sent via SMS to the participants in the motivational group (n = 41) for 21 days. The data were obtained using a Personal Information Form, the Life Orientation Test, Beck Hopelessness Scale and the Satisfaction with Life Scale. RESULTS: The nurses' mean age in the motivational and control groups was 28.4 ± 7.6 and 26.9 ± 3.7 years, respectively. Before the messages, no statistically significant difference was found between the two groups in terms of life orientation (p = 0.059), hopelessness (p = 0.214), and satisfaction with life (p = 0.898) scores. After the messages, life orientation (p = 0.042) and life satisfaction (p = 0.040) scores were significantly higher in the motivational group compared with the control group, and the hopelessness score was significantly lower (p = 0.005). CONCLUSION: According to our study, motivational messages sent to intensive care nurses during the pandemic increased their level of optimism and life satisfaction and decreased their level of hopelessness. TRIAL REGISTRATION: NCT04751474.

Is tablet-based interactive distraction effective on pain and anxiety during circumcision in children? A randomized controlled trial.

OBJECTIVE: Distraction is a nonpharmacological method commonly used during painful procedures in children. However, there are a few studies investigating the effectiveness of active distraction on pain and anxiety in children during circumcision. The purpose of this study was to evaluate the effectiveness of tablet-based interactive distraction on pain and anxiety in children during circumcision. MATERIAL AND METHODS: To evaluate how tablet distraction could improve children's outcomes during circumcision, a single-center, nonblinded, randomized controlled, parallel group trial research design was employed. In this study, 35 children were included in tablet distraction group, which have a control group (n » 35). The primary outcome measure was the Numeric Rating Scale for pain. Secondary outcome measure was the State- Trait Anxiety Scale for Children, and other outcome variables were physiological parameters and satisfaction levels. RESULTS: During and after the surgical procedure, pain scores (P < .001, P < .001, respectively) and pulse rates (P < .001, P < .001, respectively) were significantly lower in the tablet distraction group, whereas O2 saturation was higher than the control group (P < .001, P < .001, respectively). After the procedure, the anxiety scores were significantly lower in the tablet distraction group (P < .001), whereas the satisfaction scores were higher than control group (P < .001). CONCLUSION: This study concluded that the use of tablet distraction during circumcision has a positive effect on children's pain, anxiety, satisfaction levels, and physiological parameters.

Does Watching a Relaxing Video During Cystoscopy Affect Pain and Anxiety Levels of Female Patients? A Randomized Controlled Trial.

BACKGROUND: Cystoscopy is noted to be more painful in men. Research has been done to support the use of video in men to reduce pain; it would follow that video would be useful in reducing pain in women as well. AIMS: The aim of this study was to evaluate the effect of watching a relaxing video during cystoscopy on the pain and anxiety levels of female patients. DESIGN: The study was a single-center, parallel, randomized, controlled, nonblinded trial. SETTING: This study was carried out in the cystoscopy unit of a training and research hospital in Turkey. PARTICIPANTS: Sixty female patients aged 18 years and older undergoing rigid cystoscopy for the first time and under local anesthesia. METHODS: The participants were randomized into two equal groups: video and control. Data were collected with Visual Analog Scale, State-Trait Anxiety Scale, and hemodynamic parameters. RESULTS: A statistically significant difference was found between the two groups in terms of pain levels during and after cystoscopy (p < .001). Pain levels were significantly lower in the video group during and after the procedure. A statistically significant difference was also found between the groups in terms of anxiety levels before and after cystoscopy (p < .05). Anxiety levels were significantly lower in the video group after the procedure. Satisfaction levels were higher in the video group (p < .001). CONCLUSION: According to this study, watching a relaxing video during cystoscopy had a positive effect on pain, anxiety, satisfaction levels, and hemodynamic parameters of the patients.

Ethical and Cultural Issues in Transplantation: The Views and Attitudes of Nurses.

Organ transplantation is lifesaving for individuals with end-stage organ failure. However, many people are still waiting for organ transplantation due to religious beliefs and the perspectives of society. Many studies on organ donation have shown that the knowledge levels and attitudes of nurses have an important effect on organ donation rates. The aim of this study was to evaluate the views and attitudes of nurses about ethical and cultural issues related to transplantation. This descriptive study was conducted on 220 nurses who worked in a university hospital in Istanbul, Turkey. Data were collected using a questionnaire form included sociodemographic characteristics, ethical-cultural values, and knowledge levels about transplantation of the participants. Descriptive statistics and Chi-square test were used for the analysis of data. The mean age of the participants was 24.8 ± 6.04 years. Sixty percent of the participants reported that a person with brain-death was the most ideal candidate for organ donation. Seventy-seven percent of them suggested that organ sale was the most common ethical problem in organ transplantation. Sixty-three percent reported that the patient awaiting transplantation for a long time had priority order for organ transplantation. Most of the nurses (91.0%) believed that organ transplantation was religiously and culturally appropriate; however, 67.7% of them reported that it was not considered appropriate by the society due to religious and cultural beliefs. Sixty-two percent of them suggested that the society believed that organ transplantation was unlawful (haram) religiously. Nurses generally had positive views and attitudes about organ transplantation.

Social Support Perceptions and Hope Levels of Patients Waiting for Organ Transplantation.

BACKGROUND: The aim of this study was to determine the social support perceptions and hope levels of patients waiting for organ transplantation. METHOD: A sample of the descriptive study consisted of a total of 136 patients who attended to the dialysis unit of a university hospital in Istanbul between January and May 2017. Data were collected using the Patient Information Form, the Multidimensional Scale of Perceived Social Support, and the Herth Hope Scale. RESULTS: The mean age of the participants was 49.0 ± 1.15; 55.9% were male, 67.6% were married, and 41.2% were primary school graduates. A statistically significant difference was found between total perceived social support scores and age ratios. There was a statistically significant difference between participants' marital status and income level with total hope scores. There was a statistically significant difference between total hope scores and having chronic illness. There was a statistically significant difference between total perceived social support scores and having organ transplantation in the family or relatives. A statistically significant difference was found between total perceived social support and total hope scores with feelings perceived by family or relatives. A significant weak positive correlation between total perceived social support scores and total hope scores was found. CONCLUSION: According to this study, the sociodemographic characteristics of individuals waiting for transplantation affected their social support perceptions and hope levels. It seems that hope levels increased as family or relatives social support increased.

Relationship Between Depression and Healthy Lifestyle Behaviors of Patients With History of Transplant.

BACKGROUND: The aim of this study was to investigate the relationship between depression and healthy lifestyle behaviors of patients with a history of transplant. METHODS: This was a descriptive study. The study was conducted on 110 patients who received organ transplant and attended a university hospital in Istanbul, Turkey. Data were collected using a patient information form, the Beck Depression Inventory, and the Healthy Lifestyle Behaviors Scale-II. RESULTS: The mean age of the patients in years ± SD was 45.8 ± 12.35; 60.9% of them were men; and the mean body mass index (kg/m2) was 26.9 ± 4.84. There was a statistically significant difference between nutrition subscale and body mass index. A statistically significant difference was found between the total score of healthy lifestyle behaviors, nutrition, and interpersonal relationships subdimension with education status. There was a statistically significant difference between health responsibility, nutrition, and interpersonal relationships subdimension with marital status. There was a statistically significant difference between health responsibility subdimension and income status. A statistically significant difference was found between nutrition, spiritual growth, interpersonal relationships, stress management subdimension with living alone or living with someone. There was a statistically significant difference between depression scores and elapsed time after transplantation. There was a significant moderate negative correlation between depression and healthy lifestyle behaviors scores. CONCLUSION: According to results of this study, healthy lifestyle behaviors of patients with a history of organ transplant were affected by factors such as body mass index, education status, income status, and marital status. Depression levels decreased as healthy lifestyle behaviors improved for the patients of organ of the transplant.

Three Distraction Methods for Pain Reduction During Cystoscopy: A Randomized Controlled Trial Evaluating the Effects on Pain, Anxiety, and Satisfaction.

BACKGROUND: Cystoscopy is a safe diagnostic procedure commonly used to evaluate lower urinary tract symptoms. This can cause pain, anxiety, and dissatisfaction in patients undergoing cystoscopy. OBJECTIVES: The aim of this study was to compare the effects on pain, anxiety, and satisfaction of distraction methods used during cystoscopy. DESIGN: Single-center, open-label, randomized, parallel-group trial. SETTING: Cystoscopy unit of a training and research hospital in Turkey. PARTICIPANTS: Male patients ≥18 years of age who underwent rigid cystoscopy for the first time. METHODS: A total of 120 male patients were recruited and randomized into four groups as music, stress ball, video, and control group. Data were collected using visual analog scale for pain and satisfaction, State-Trait Anxiety Inventory for anxiety, and hemodynamic parameters. The primary outcome was the difference with respect to pain scores among intervention groups. Other outcome measures were anxiety and satisfaction scores. RESULTS: Pain severity during cystoscopy was found to be significantly lower in the intervention groups than the control group. In the video group, the severity of pain during cystoscopy was also found to be significantly lower than music and stress ball groups (p = 0.006, p < 0.001). After cystoscopy, anxiety levels were significantly lower and satisfaction levels were significantly higher in the intervention groups than in the control group. Anxiety levels were significantly lower in the video group than music and stress ball groups (p < 0.001, p < 0.001). Satisfaction levels were also significantly higher after cystoscopy in the video group than in the music and stress ball groups (p = 0.018, p = 0.018). CONCLUSIONS: According to this study, distraction methods used during rigid cystoscopy were found to have a reducing effect on pain, anxiety, and dissatisfaction. As the results of the study are evaluated, video should be recommended to be the first preferred distraction method during rigid cystoscopy.

In Vivo Comparison of "V-Loc 90 Wound Closure Device" With "Vicryl" and "Monocryl" in Regard to Tissue Reaction in a Rabbit Bladder Model.

OBJECTIVE: To compare the barbed polyglyconate suture (BPS) with 2 commonly used conventional sutures, this prospective randomized trial was designed. The sutures applied in the urinary collecting system, in terms of long-term histopathologic and macroscopic suture material features. MATERIALS AND METHODS: Eight female and 6 male New Zealand rabbits were included in the study. Each animal served as its own control and was subjected to cystotomy. Watertight running cystorrhaphies were performed using 3 different sutures in a randomized fashion, namely Monocryl, Vicryl, and V-Loc 90. Seven animals were sacrificed after the third and 7 after the sixth week. Macroscopic and histopathologic examinations were performed. Tissue reaction, like inflammation and fibrosis, around the sutures were evaluated. Friedman and Wilcoxon signed ranks test was used for the statistical analysis. RESULTS: The BPS demonstrated no adhesion. However, in the six-week group, stone formation was recorded on 4 BPS and 1 Vicryl thread, a difference being statistically significant (P = .039). Additionally, in the third- and in the sixth-week group, 1 (P = .368) and 3 (P = .050) BPS threads migrated, respectively. The histopathologic analysis revealed less inflammation and fibrosis associated with the BPS thread in both the third and the sixth-week groups (P = .010 and P = .002, respectively). CONCLUSION: The BPS appears to be superior to conventional sutures in terms of local inflammation and fibrosis. However, suture migration and stone formation following collecting system closure could be potential predicaments.

Comparison of 3 Different Teaching Methods for a Behavioral Therapy Program for Female Overactive Bladder: A Randomized Controlled Trial.

PURPOSE: The purpose of this study was to compare the effect of 3 instructional methods for behavioral therapy on lower urinary tract symptom (LUTS) severity and health-related quality of life (HRQOL) in women with overactive bladder. DESIGN: Single-center, parallel-group, randomized, clinical trial. SUBJECTS AND SETTING: The sample comprised 60 women diagnosed with overactive bladder. The study setting was a university-based female urology clinic in Ankara, Turkey; data were collected from November 2012 to May 2013. Eligible participants were ambulatory women 18 years or older with predominant overactive bladder and urge urinary incontinence (UI) symptoms, with or without stress UI symptoms. METHODS: Subjects were randomized into 4 groups based on educational intervention; group 1 received structured verbal instruction plus a leaflet, group 2 received structured verbal instruction, group 3 received a leaflet alone, and group 4 received usual care that included unstructured verbal counseling about continence care. The primary outcome measures were Incontinence Impact Questionnaire-7 (IIQ-7) and Urinary Distress Inventory-6 (UDI-6) scores. We also measured changes in UI-specific HRQOL scores via the Urinary Incontinence Quality of Life Instrument (I-QOL). All outcomes were measured before and 6 to 8 weeks after the interventions. The Wilcoxon test was used to identify differences in LUTS severity and HRQOL before and after the educational intervention. The Kruskall-Wallis test was used to compare differences among the groups. RESULTS: The severity of LUTS and UI-specific quality of life assessed by the IIQ-7, UDI-6, and I-QOL scores significantly improved after training in all 4 groups (P < .05). The group that received structured verbal instruction plus an educational leaflet achieved significantly lower LUTS scores and significantly higher UI-specific HRQOL when compared to the other groups (P < .05). CONCLUSIONS: Findings suggest that structured verbal instruction plus educational leaflet is the most effective method of bladder training in women with overactive bladder and urge UI.

Comparison of Two Different Distraction Methods Affecting the Level of Pain and Anxiety during Extracorporeal Shock Wave Lithotripsy: A Randomized Controlled Trial.

BACKGROUND: Extracorporeal shock wave lithotripsy can cause pain and anxiety for patients. Despite the use of many distraction methods to reduce pain and anxiety, there is no study on the use of stress balls during lithotripsy. AIM: The aim of the study was to investigate the efficacy of use of stress balls and music therapy to reduce pain and anxiety during lithotripsy. DESIGN: This was a single-center, parallel randomized controlled trial. SETTINGS: The study involved the lithotripsy unit in a training and research hospital in Turkey. PARTICIPANTS: The study included 120 patients who had kidney or ureter stones. METHODS: The patients were randomly divided into three groups. The control group (group 1) received no interference, whereas experimental groups received stress ball (group 2) and music (group 3) interventions during lithotripsy, respectively. Data were collected using the Patient Information Form, visual analog scale, and State-Trait Anxiety Inventory. RESULTS: There was no statistically significant difference among the three groups in regard to anxiety and pain mean scores (p > .05). No statistically significant difference was found between anxiety scores before and after lithotripsy in each group (p > .05), whereas there was a statistically significant difference between pain scores during and after lithotripsy (p < .05). CONCLUSION: Based on the present study, no statistically significant difference was found between the use of stress balls and music in reducing pain and anxiety during lithotripsy. Further studies are needed to evaluate the effectiveness of stress balls used during lithotripsy.

Symptoms Control for Patients with Superficial Bladder Cancers Before and After TURBT and Intravesical Epirubicin Instillation.

Bladder cancer is one of the most common cancers among urologic cancers. Intravesical instillation following transurethral resection of bladder tumor (TURBT) is used as a treatment of bladder cancer. According to results of this study, before and after intravesical instillations following TURBT have no effect on symptom outcomes of patients with superficial bladder cancer.

Cross-Cultural Adaptation and Psychometric Evaluation of the Turkish Version of the Cancer Behavior Inventory-Brief Version.

CONTEXT: Cancer Behavior Inventory-Brief Version (CBI-B) is a simple and non-burdensome tool used to evaluate the self-efficacy of the cancer patients. OBJECTIVES: The aim of this study was to examine the psychometric properties of the Turkish version of the CBI-B. METHODS: This methodologic study was conducted on 143 cancer patients who received radiotherapy at the Department of Radiation Oncology at a Training and Research Hospital in Turkey. Data were collected using Medical and Demographic Information Form, CBI-B, Satisfaction With Life Scale, and European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30). Descriptive statistics, exploratory factor analysis, and correlation coefficients were used for the analysis of data. RESULTS: Exploratory factor analysis confirmed four-factor structure explaining 74.7% of the total variance: 1) Maintaining Independence and Positive Attitude, 2) Participating in Medical Care, 3) Coping and Stress Management, and 4) Managing Affect. The CBI-B had acceptable internal consistency (Cronbach α = 0.87) and test-retest reliability (intraclass correlation coefficient = 0.961) and concurrent validity with Satisfaction With Life Scale and EORTC QLQ-C30 scores. The measures of life satisfaction and quality of life were positively correlated with CBI-B, whereas the symptom levels and the functions (with the exception of the role function) were negatively correlated. CONCLUSION: The CBI-B was found to be a valid and reliable inventory for assessing the self-efficacy of Turkish cancer patients. The CBI-B, is a simple and brief measure of self-efficacy for coping with cancer, could be easily used in clinical and research settings.