Investigation of the relationship between cultural sensitivity and effectiveness levels among nursing students.

AIM: The aim of this study is to investigate the relationship between cultural sensitivity and effectiveness levels among nursing students. BACKGROUND: The world is changing and globalizing, and societies are becoming increasingly multicultural. Therefore, nurses, who play an important role in health service delivery, are expected to be competent in interacting with patients from different cultures and to develop cultural sensitivity during their education. DESIGN: The design of this study is a prospective descriptive study. METHODS: The research was conducted with 284 nursing students in the faculty of nursing at a university in Ankara. The data collection process of this study was conducted at the end of the spring semester of the 2019-2020 academic year between 20 and 30 June 2020. The Sociodemographic Characteristics Form, Intercultural Sensitivity Scale, and Intercultural Effectiveness Scale were used to collect data. Descriptive statistics, parametric and nonparametric tests were used for data analysis. RESULTS: The mean age of the students was 20.80 ± 1.64, and 82% of the students were female. The mean scores on the Intercultural Sensitivity and Intercultural Effectiveness Scales were 92.56 ± 11.98 and 53.87 ± 6.28, respectively. A positive, moderate, and statistically significant correlation was found between the scores on the two scales. In the study, it was determined that females have higher cultural sensitivity and cultural effectiveness level than males, and students who could not understand and speak English have lower cultural sensitivity and cultural effectiveness level than students who could understand and speak English. CONCLUSION: In this study, it was evaluated that the nursing students had high cultural sensitivity and moderate cultural effectiveness levels, and cultural sensitivity levels were found to increase in line with cultural effectiveness levels. It is recommended to review the educational curricula to improve cultural communication competence and organize programs to improve English speaking and conduct more studies examining the cultural effectiveness of students.

Immunogenicity, safety and clinical outcomes of the SARS-CoV-2 BNT162b2 vaccine in adolescents with type 1 diabetes.

Introduction: The mRNA-based BNT162b2 (Pfizer-BioNTech) vaccine has been shown to elicit robust systemic immune response and confer substantial protection against the severe coronavirus disease (COVID-19), with a favorable safety profile in adolescents. However, no data exist regarding immunogenicity, reactogenicity and clinical outcomes of COVID-19 vaccines in adolescents with type 1 diabetes (T1D). In this prospective observational cohort study, we examined the humoral immune responses and side effects induced by the BNT162b2 vaccine, as well as, the rate and symptomatology of laboratory-confirmed COVID-19 vaccine breakthrough infections after completion of dual-dose BNT162b2 vaccination in adolescents with T1D and compared their data with those of healthy control adolescents. The new data obtained after the vaccination of adolescents with T1D could guide their further COVID-19 vaccination schedule. Methods: A total of 132 adolescents with T1D and 71 controls were enrolled in the study, of whom 81 COVID-19 infection-naive adolescents with T1D (patient group) and 40 COVID-19 infection-naive controls (control group) were eligible for the final analysis. The response of participants to the BNT162b2 vaccine was assessed by measuring their serum IgG antibodies to the spike protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 4-6 weeks after the receipt of first and second vaccine doses. Data about the adverse events of the vaccine was collected after the receipt of each vaccine dose. The rate of COVID-19 vaccine breakthrough infections was evaluated in the 6-month period following second vaccination. Results: After vaccinations, adolescents with T1D and controls exhibited similar, highly robust increments in anti-SARS-CoV-2 IgG titers. All the participants in the patient and control groups developed anti-SARS-CoV-2 IgG titers over 1,050 AU/ml after the second vaccine dose which is associated with a neutralizing effect. None of the participants experienced severe adverse events. The rate of breakthrough infections in the patient group was similar to that in the control group. Clinical symptomatology was mild in all cases. Conclusion: Our findings suggest that two-dose BNT162b2 vaccine administered to adolescents with T1D elicits robust humoral immune response, with a favorable safety profile and can provide protection against severe SARS-CoV-2 infection similar to that in healthy adolescents.

Influence of burn specific pain anxiety on pain experienced during wound care in adult outpatients with burns.

Burn pain is known as the most difficult type of pain to manage. In order to improve patient outcomes, nurses must be aware of burn pain and the conditions that affect it. This study aimed to evaluate the influence of burn-specific pain anxiety on pain experienced by adult outpatients with burns during burn wound care. This was a single-center, prospective, and descriptive study. The study was conducted with 60 adult outpatients with burns between March 2021 and April 2021 in a burn centers' outpatient service in Ankara. Personal information form, burn-specific pain anxiety scale, numerical rating scale, and verbal category scale were used for data collection. The mean age of the patients was 38.50 ± 14.27 years, and 53.33% patients were females. The primary cause of burns was home accidents (80%), and patients generally suffered from scalding-type burns (73.33%). This study demonstrated that the patients reported high pain anxiety associated with burns (59.85 ± 15.71), the mean pain score experienced during wound care was 6.33 ± 2.14 and the pain was primarily classified as disturbing (35%) based on the verbal category scale. In this study, it was found that burn-specific pain anxiety affects the pain experienced during burn wound care in adults receiving outpatient treatment. Hence, nurses should provide effective pain management to patients with burn injuries. In addition, the inclusion of anxiety-reducing practices in the care plans of such patients is recommended, and further studies are needed to identify and meet the care needs of patients with severe burns.

Caring for Patients With Electrical Burns Using the Holistic Neuman Systems Model: A Case Study.

Patients with burns should be provided with holistic nursing care that considers all systems of the body. The Neuman Systems Model (NSM) is especially suited to holistic care as it proposes an open system approach and addresses five major interacting variables. This study aimed to investigate the applicability of the NSM when caring for a patient with electrical burns. In this case study, we planned and applied nursing care for a 20-year-old man with electrical burns based on the NSM. The study was conducted between November 25, 2018, and January 10, 2019. We used the six-item Neuman Diagnostic Tool (NDT) developed by Neuman in our interviews with the patient. We found that the electrical burns had caused multiple physiological, psychological, and sociocultural problems for our patient, most of which were physical problems, including the burn injury and subsequent limb amputation. The NDT guided our data collection and aided in our ability to determine stressors and formulate appropriate nursing diagnoses. The NSM strengthened the patient's flexible line of defense for coping individually and facilitated the identification of deficiencies in the normal and resistance lines of defense. The NSM provides a theoretical framework for nurses caring for patients with burns where entire systems are affected.

Investigation of the relationship between social appearance anxiety and perceived social support in patients with burns.

INTRODUCTION: Since burns affect body image, they cause appearance anxiety. Interventions designed to reduce appearance anxiety that can cause psychological problems such as depression are important. This study aimed to determine the social appearance anxiety of individuals following burns and the factors affecting it and to examine the relationship between social appearance anxiety and perceived social support. METHODS: This descriptive study was conducted between November 2018 and November 2019 with 106 adult patients with burns. Data were collected using a Personal Information Form, the Social Appearance Anxiety Scale, and the Multidimensional Scale of Perceived Social Support. Shapiro-Wilk test, Independent Two Samples T-Test, One Way Analysis of Variance, Duncan's test, Pearson's correlation analysis, multiple linear regression analysis, the Q-Q plot, and the Durbin-Watson statistics were used in data analysis. RESULTS: The social appearance anxiety scores were moderate (39.38 ± 17.71). Being single; having a high level of education; burns on the face, head, or neck; burn-related amputation; and passing the one-week after injury period were found to significantly increase social appearance anxiety (p < 0.05). Although the perceived social support scores of the individuals with burns were high (68.34 ± 18.08), they were found to have no correlation with social appearance anxiety (p > 0.05). CONCLUSIONS: The results of this study show that social support does not affect social appearance anxiety. In this respect, we recommend that interventions such as reconstruction and professional psychological support initiatives be prioritized for individuals with burn trauma who are evaluated to have high social appearance anxiety by the appearance anxiety scales.

Effect of acupressure application to the P6 acupoint before laparoscopic cholecystectomy on postoperative nausea-vomiting: A randomized controlled clinical study.

BACKGROUND: Nausea and vomiting are common postoperative complications that occur within the first 24 h in adults. Clinical practice guidelines and a Cochrane review recommend stimulating the P6 acupoint to prevent or reduce postoperative nausea and vomiting. However, there are currently no standards and optimal timing is not known. OBJECTIVES: The purpose of this study was to evaluate the effect of acupressure application on the P6 acupoint, using acupressure wristbands, in the prevention of postoperative nausea and vomiting and the antiemetic drug requirement in patients who had high postoperative nausea and vomiting risk related to laparoscopic cholecystectomy. DESIGN: This was a longitudinal, randomized controlled clinical study. SETTINGS: The study was conducted in the general surgery department of a training and research hospital (105 beds), from March 2015 to March 2016. PARTICIPANTS: A total of 111 female patients who underwent laparoscopic surgery were divided into three groups of 37, using a block randomization method. METHODS: Training on acupressure wristband use was provided to the intervention group and an acupressure wristband with a plastic cap was placed at the P6 acupoint. A wristband with the same appearance as the acupressure wristband, but without a cap, was used in the placebo group. No intervention was used in the control group. The wristband was placed approximately one hour before the surgery and removed six hours after the surgery in both the intervention and placebo groups. The data were collected at the 2nd, 6th, and 24th postoperative hours. RESULTS: The application of the acupressure wristband to the P6 acupoint in patients who underwent laparoscopic cholecystectomy was found to be more effective in decreasing the severity of nausea at the 2nd postoperative hour and the nausea incidence at 2-6 h, postoperatively, when compared to the placebo group (p < 0.05). However, there was no statistically significant difference between the intervention group and the control group. Therefore, acupressure application to the P6 acupoint was not found to be clinically effective in decreasing postoperative vomiting, antiemetic drug requirement, and in decreasing pain, anxiety, or the need for analgesic drugs (p > 0.05). CONCLUSIONS: We did not find the stimulation of the P6 acupoint with an acupressure wristband to be clinically effective in reducing postoperative nausea and vomiting or antiemetic drug requirement in patients who underwent laparoscopic cholecystectomy.

Rabies Suspected Animal Contact Cases in a City with Animal Husbandry and the Appropriateness of Prophylactic Procedures.

OBJECTIVES: This study aims to evaluate the features of rabies suspected animal contact cases in the emergency department and the appropriateness of administering post-exposure prophylaxis procedures according to World Health Organization (WHO) instructions. METHODS: Rabies suspected animal contact cases that applied to the emergency department between August 2012 and December 2013 were included in the study. Patients' data were obtained retrospectively from patient files, records of hospital automation system, and the "Rabies Suspected Animal Contact Cases Examination Form". The post-exposure prophylaxis recommended by the WHO were compared to the prophylactic applications administered by the emergency department. RESULTS: A total of 515 cases were included in the study. According to WHO classification, cases involving category 3 injuries (n=378, 73.4%) were more common than the others (p>0.0001). Compared to post-exposure prophylaxis recommendations by the WHO, 44.7% of all cases (n=230) were administered inappropriate prophylaxis. Thirty-seven percent of cases received less rabies Ig than recommended, despite category 3 contact. Six percent of cases with category 2 contact were given unnecessary rabies Ig and all cases with category 1 contact (1.5% of all cases) were given unnecessary rabies vaccine. CONCLUSIONS: We observed that in 44.7% of cases, post-exposure prophylaxis was applied inappropriately according to WHO instructions. Not only were there unnecessary vaccine and Ig applications, there were also missing prophylaxis procedures. Updating the current "Rabies Prevention and Control Directive" plus educating and controlling healthcare personnel on a regular schedule may help prevent inadequacies in prophylactic application.

Emergency Department During Long Public Holidays.

OBJECTIVES: The purpose of this study is to determine the impact of the expected increase in the volume of patient visits in the emergency department during holiday periods on physicians' tendencies regarding test and consultation requests as well as on the length of time patients stay in the emergency department. METHODS: The study groups included all of the patients who visited the emergency department during the nine-day public holiday (Eid al-Adha, a religious festival of sacrifice) celebrations and a nine-day non-holiday "normal" period. The patients' demographic information, reasons for their visits, comorbid diseases, whether or not they had undergone laboratory and screening tests, consultations, length of stay, and the way their visits ended were compared statistically. RESULTS: Of the 6353 patients enrolled in the study, 3523 (55.5%) were seen in the emergency department during the holiday period, while 2830 (45.5%) were seen during the non-holiday period (p≤0.001). During the holiday period, there was a 1.9% decrease in laboratory test requests (p=0.108), a 7.7% increase in radiology examination requests (p≤0.001), and a 1.2% increase in consultation requests (p=0.063). The patients' length of stay during the holiday period was 55.9±75.3 minutes and was 56.3±71.9 minutes during the non-holiday period (p=0.819). The length of time for the patients who underwent tests or consultations was 88.6±92.8 minutes during the holiday period and 92.6±87.5 minutes during the non-holiday period (p=0.224). CONCLUSIONS: As expected, the number of patient visits to the emergency department increased during the holiday period, but this increase did not lead to a similar increase in test and consultation requests by the physicians, except for radiology examination requests. In addition, the length of time that patients stayed in the emergency department was not affected by the increase in the volume of patient visits during the holiday period.

The relationship between socio-demographic characteristics of patients and diagnostic delay in acute pulmonary thromboembolism.

BACKGROUND: In pulmonary thromboembolism (PE), delay to diagnosis is very common. In this study, we examined the role of patients and the socio-demographic characteristics in delayed diagnosis of PE. PATIENTS AND METHODS: We evaluated 156 PE patients for the dates of symptom onset, the dates of first visit to a health institution and diagnosis, signs and symptoms, and the socio-demographic characteristics. Delays were analyzed using the Mann-Whitney U test, and the predictors were analyzed using logistic regression analysis. RESULTS: Of the patients, 60.3% visited a health institution within the first day of the symptoms. Mean time from symptoms to the first admission to a health institution (patient delay) was 2.04 ± 3.89 days (median 0 day, range 0-30). Current smoking, a high level of education, and co-morbidity were associated with longer patient delays. The time interval from first symptom to the diagnosis (total delay) was 7.93 ± 10.05 (median 4 days, range 0-45) days. While hypotension, syncope, and previous surgery/trauma were significantly associated with a shorter total delay, a previous visit to any health institution was associated with longer total delay. CONCLUSION: In conclusion, although some socio-demographic characteristics of patients such as smoking, educational status, and co-morbid diseases were found to be associated with delayed visit to any health institution, our results showed that physician or health system delays were more prominent in delayed diagnosis of PE.