Challenges experienced by cardiac intensive care nurses during first out-of-bed patient mobilization after open-heart surgery: A descriptive phenomenological qualitative study.

AIM: To investigate the potential challenges experienced by cardiac intensive care unit (ICU) nurses in the first out-of-bed patient mobilization after open-heart surgery and propose solutions. DESIGN: A qualitative study design using the descriptive phenomenological approach. METHODS: Individual face-to-face interviews were conducted via a widely used videoconferencing program between 28 July and 22 October 2022, in the tertiary cardiac ICU of a university hospital. Nurses who had at least 1 year of cardiac ICU experience and actively participating in patient care were included. The COREQ criteria and checklist were followed in this investigation and the data were analysed by using the ATLAS.ti 8.0. FINDINGS: Nurses reported that they experience challenges when mobilizing patients, such as patients' fear, reluctance or resistance; nurses having insufficient experience, strength or lack of team members. Despite these challenges, they highlighted some positive outcomes of mobilization, such as feeling happy, reinforced team communication and nurse-patient relationship. The nurses also suggested some facilitators, such as patient motivation and an explanation of the process. CONCLUSION: Nurses experience various patient-related and nurse-related challenges during the first out-of-bed mobilization of the patient after open-heart surgery. It is recommended that healthcare institutions should implement effective strategies to address the staffing shortages and to support nurse motivation to ensure adequate nursing care. IMPACT: This study provides valuable insights into the existing literature by examining the potential challenges and strategies of the first out-of-bed patient mobilization in the cardiac ICU. It shows that patient education and organizational adaptations are effective ways to overcome the challenges. It also suggests that motivating and informing patients before the mobilization can make the process easier. Moreover, it reveals that successful patient mobilization makes nurses happy, improves team communication and strengthens nurse-patient relationship. PATIENT AND PUBLIC INVOLVEMENT AND ENGAGEMENT: No patient or public contribution.

The Relationship Between Emotional Intelligence and Fear of Pain in Patients Undergoing Elective Surgery.

PURPOSE: This study aimed to investigate the effect of emotional intelligence levels on the fear of pain for patients undergoing surgical intervention. DESIGN: This descriptive and cross-sectional study consisted of 254 patients. METHODS: Data were collected using the Personal Characteristics Information Form, Modified Schutte Emotional Intelligence Scale, Fear of Pain Questionnaire-III, and Numerical Pain Form. A correlational analysis was performed. FINDINGS: The mean age of patients was 47.33 ± 17.70 years, and 57.9% (n = 147) were female. More than half of the patients (n = 174) were experiencing a certain degree of preoperative pain. A positive and statistically significant correlation was observed between the mean scores of the Fear of Pain Questionnaire-III and the Emotional Intelligence Scale. Female patients had significantly more fear of pain and higher scores in the Fear of Pain Questionnaire-III (optimism/mood regulation, utilization of emotions) and the Emotional Intelligence Scale. CONCLUSIONS: The patients who manage "optimism/mood regulation" and have increasing levels of Emotional Intelligence could have a relatively higher fear of experiencing severe pain in the preoperative period. Despite the fear of experiencing severe pain, the patients tried to turn this negative situation into a positive one, as the dimensions of their emotional intelligence that provide and manage optimism/mood regulation were at a high level. The increasing level of Emotional Intelligence and "appraisal of emotions" might result in a decrease in the levels of fear of "minor pain" and "medical pain".

Pain-related fear among adult patients undergoing open-heart surgery: an interpretative phenomenological analysis.

BACKGROUND: One of the sources of anxiety and fear among patients undergoing open-heart surgery is the possibility of experiencing pain, such as sternotomy-related chest pain. Giving them the chance to express their feelings about the potential pain may be effective in reducing their anxiety and may support their coping strategies. OBJECTIVES: To examine pain-related fear among patients undergoing open-heart surgery and to understand the underlying reasons of their fears. METHODS: A qualitative interview based on Heidegger's interpretative phenomenological approach was conducted adhering to the COREQ guidelines. Sixteen patients who were undergoing open-heart surgery in the following day were interviewed at the cardiovascular surgery ward of a university hospital. The organization and mapping of the qualitative data was done by using ATLAS.ti 8.0. RESULTS: The patients who were afraid of experiencing pain after surgery seemed to be more concerned about open-heart surgery itself (such as pain from sternotomy and chest tubes) and the possibility of prolongation of postoperative pain. To cope with these fears, the patients employed a variety of social and self-coping strategies. Trusting the healthcare team, having a high pain tolerance, and having personal thoughts that take precedence over pain-related fear were the key factors explaining not being afraid of experiencing pain. CONCLUSIONS: This study provides a deeper understanding of the underlying reasons and the needs of patients in controlling their pain-related fears before open-heart surgery. Trusting the healthcare professionals is one of the main factors for patients to control their pain-related fears. To develop a supportive sense of trust and to help patients in controlling their pain-related fears, surgical nurses must dedicate enough time for understanding patients' concerns while planning their nursing care plans. Future studies may focus on exploring the role of nursing interventions and multidisciplinary team approaches on the management of preoperative pain-related fear.

Effects of Footbath on Postoperative Pain and Sleep Quality in Patients With Lumbar Degenerative Disc Disease: A Randomized Controlled Study.

ABSTRACT: BACKGROUND: Pain management and good sleep are essential for patients after surgical procedures. This study aimed to evaluate the effects of footbath on postoperative pain severity and sleep quality levels of patients who have undergone degenerative lumbar spine surgery. METHODS: Sixty patients were randomly assigned to the footbath intervention group or the control group. The intervention was a 20-minute footbath in 42°C water before patients fell asleep on the evening of the surgery day. On the morning of the surgery day and the morning of postoperative day, the patient's pain severity and sleep quality scores were obtained using the visual analog scale and the Visual Analog Sleep Scale. RESULTS: There was no significant difference between the pain severity scores of the study groups ( P > .05). The sleep quality level of the intervention group was statistically significantly higher than that of the control group ( P < .05). CONCLUSION: Consequently, a footbath is effective in increasing sleep quality levels of patients who have undergone degenerative lumbar spine surgery. It may be used as a simple and practical nonpharmacological nursing strategy for improving patients' sleep quality.

The effect of anti-fatigue floor mat on pain and fatigue levels of surgical team members: A crossover study.

As ergonomics is important to maintain comfort, this study aimed to examine the effect of anti-fatigue floor mats on pain and fatigue levels of surgical team members. Thirty-eight members participated in this crossover-designed study with no-mat and with-mat conditions, separated by a one-week washout period. They stood on the 15 mm thick rubber anti-fatigue floor mat and on the standard antistatic polyvinyl chloride flooring surface during the surgical procedures. Subjective ratings of pain and fatigue levels were measured pre and after-surgery for each experimental condition using the Visual Analogue Scale and Fatigue-Visual Analogue Scale scales. The after-surgery pain and fatigue levels for the with-mat condition were significantly lower than the no mat condition (p < .05). Consequently, anti-fatigue floor mats are effective in decreasing pain and fatigue levels of surgical team members during surgical procedures. Using anti-fatigue mats may be a practical and easy way to prevent discomfort that is often experienced by surgical teams.

Turkish Validity and Reliability Study of the Surgical Anxiety Questionnaire for Adult Patients.

PURPOSE: This research aims to adapt the Surgical Anxiety Questionnaire (SAQ) to Turkish culture and conduct validity and reliability studies. DESIGN: This research is a methodological study. METHODS: The sample of the research consisted of 311 patients and research data were collected between April 2019 and May 2021. FINDINGS: The scale content validity index was 0.931. As a result of the factor analysis, the items were distributed in four subdimensions and explained 58.745% of the variance, and the model had good fit values. The Cronbach's α coefficient of the scale was 0.890. CONCLUSIONS: The Turkish version of SAQ is a valid and reliable measurement tool and can be used for adult patients.

Adaptation of Parental Self-Efficacy Scale for Child Autonomy Toward Minor Surgery to Turkish.

PURPOSE: The purpose of the study was to conduct validity and reliability testing of the Turkish version of the Parent Self-Efficacy Scale for Child Autonomy toward Minor Surgery (PSESCAMS). DESIGN: The research is a methodological study. METHODS: Data were collected using an Introductory Form and the PSESCAMS. Factor analysis, Cronbach's alpha, and item-total score analysis were used for the data analysis. FINDINGS: The scale consisted of 18 items and four subscales. The Cronbach's alpha coefficient for the overall scale was 0.95, and the Cronbach's alpha values for the subscales were 0.64-0.92. The total factor loading was > 0.45 for both exploratory and confirmatory factor analyses. GFI, AGFI, and CFI were > 0.90, RMSEA was 0.06. CONCLUSION: PSESCAMS was found to be a valid and reliable measurement tool for Turkish culture.

Personal protective equipment related skin changes among nurses working in pandemic intensive care unit: A qualitative study.

AIM: The respiratory tract is the main transmission way of the SARS-CoV-2 virus and nurses who care for COVID-19 patients in intensive care units (ICUs) are required to constantly use personal protective equipment (PPE) during their daily work. This study aimed to examine the PPE-related skin changes experienced by the nurses working in pandemic ICU during the COVID-19 pandemic. METHODS: Using a descriptive phenomenological approach, semi-structured interviews were conducted between November 1st and December 25th, 2020, in the pandemic ICU of a training and research hospital in Usak, Turkey. The nurses who worked in the pandemic ICU for at least one week and experienced skin changes due to PPE use were included. Individual interviews were carried out online through video conferencing. Colaizzi's method was used in data analysis by using the ATLAS.ti 8.0. RESULTS: The main themes were main causes of PPE-related skin changes, its location along with secondary adverse effects, symptomatology, prevention, and therapeutic interventions used for curing PPE-related skin changes. Nurses mostly reported PPE-related skin changes behind their ears, over their nose, cheeks and jaw due to wearing N95 masks and on the forehead due to wearing face shields. Wearing PPE at least 2 h, the type/quality of PPE, and being dehydrated were identified as the common causes. CONCLUSION: This study provides a deeper understanding into the PPE-related skin change experiences of pandemic ICU nurses and the importance of the quality of the PPE used. It is recommended to enable shortened working shifts and ergonomic PPE materials for ICU nurses.

COVID-19 Fear Level of Surgical Nurses Working in Pandemic and Surgical Units.

PURPOSE: Nurses who care for COVID-19 patients are more likely to be affected psychologically than nurses who do not, and reactions such as increased fear may lead to psychological problems among nurses. The aim of this study was to determine the COVID-19 fear level of surgical nurses by using the Fear of COVID-19 Scale. DESIGN: A descriptive and cross-sectional study. METHODS: Totally, 202 surgical nurses who take care of suspected or infected COVID-19 patients working in pandemic and surgical units of a university hospital were included in the study. For data collection, "Nurse Characteristics Form" and "Fear of COVID-19 Scale" were used. Study data was analyzed with the descriptive statistics, Mann-Whitney U test, Spearman Correlation test. FINDINGS: The mean total COVID-19 fear score of the nurses was 25.09 ± 7.29 (min: 7, max: 35) and nurses who received training related to COVID-19 had statistically lower fear than those who did not (U = 3773.500; P= .027). Losing a patient because of COVID-19, being older and experienced in nursing significantly affected the total fear score of nurses (respectively, U = 3899.000; P= .004; rs = 0.152; P = .031, rs = 0.205; P = .003). CONCLUSIONS: Surgical nurses have a moderate level of COVID-19 fear and it is recommended to conduct appropriate on-line training programs to develop psychological support strategies.

The Effect of Balloon-Blowing Exercise on Postoperative Pulmonary Functions in Patients Undergoing Total Hip Arthroplasty.

General anesthesia, prolonged immobilization, and pain may adversely affect pulmonary function in patients undergoing prosthetic surgery. The aim of this study was to evaluate the effect of balloon-blowing exercises on pulmonary functions in patients undergoing total hip arthroplasty. The patients in the experimental group performed three sets of balloon-blowing exercises in the morning, at noon, and in the evening on the first to third days postoperatively. The increase in forced vital capacity (FVC) values between the control and experimental groups in the postoperative period was statistically significant (p < .001), in favor of the experimental group. The increase in forced expiratory volume during the first second (FEV1)/FVC ratio was found to be significantly higher in the experimental group than in the control group (p < .001). Patients who performed balloon-blowing exercises increased their FVC and FEV1/FVC ratio.

The palliative care difficulty levels of the nursing students during clinical practices.

PURPOSE: This study aimed to determine the palliative care difficulties experienced by nursing students during their clinical practice. DESIGN AND METHODS: This descriptive and cross-sectional study was conducted with 305 nursing students at a university in Turkey. Data were collected using a student identification form and the palliative care difficulties scale. FINDINGS: Nursing students experience a moderate level of difficulty in providing care for palliative care patients and receiving expert support facilitates their care initiatives. PRACTICE IMPLICATIONS: It is important to support nursing students during their nursing education courses and clinical training, along with psychiatric nursing skills.

Patient Safety Attitude of Nurses Working in Surgical Units: A Cross-Sectional Study in Turkey.

PURPOSE: To determine the attitudes of nurses working in surgical units toward patient safety. DESIGN: A descriptive and cross-sectional study. METHODS: The sample in this study was 207 nurses (92% of all the nurses) working in surgical units in a training and research hospital in Turkey, all of whom agreed to participate in this study between April 30 and June 25, 2019. Study data were collected using a demographic characteristics form and the Patient Safety Attitude Questionnaire. Number, mean, SD, percentage calculations, Kruskal-Wallis test, Mann-Whitney U test, and the Spearman correlation test were used to analyze the study data. FINDINGS: The mean total attitude score of the nurses was 176.30 ± 26.92. Nurses who previously received training on patient safety had statistically higher attitude scores than those who did not (U = 3883.000; P = .01). CONCLUSIONS: Nurses working in surgical units had a positive attitude toward patient safety, and previous training on patient safety significantly improved their attitude scores. A recommendation is to conduct effective in-service training programs for patient safety in hospitals and to encourage participation by nurses in training programs such as courses and conferences that will result in attitude improvement.

Effectiveness of a Group Game Intervention in Reducing Preoperative Anxiety Levels of Children and Parents: A Randomized Controlled Trial.

Surgical experiences are often stressful for children and their parents. This study aimed to determine the effect of a group game intervention on the preoperative anxiety levels of 94 parent-child dyads who were awaiting elective minor surgery at a pediatric surgery clinic. The experimental group intervention included routine preoperative preparation and a group (ie, child, parent, and researcher) game. After the parent dressed the child for surgery, a research team member assessed the child's and parent's anxiety levels using the Facial Affective Scale and Visual Facial Anxiety Scale, respectively. Before the child was transferred to the OR, the research team member reassessed both anxiety levels. When compared to the control group, the results showed that children and parents involved in facilitated group play experienced significantly decreased anxiety levels (P < .001).

Effect of Short Message Service Use on Bowel Preparation Quality in Patients Undergoing Colonoscopy.

This study aimed to determine the effect of SMS use on the bowel preparation quality and satisfaction in patients who underwent colonoscopy. This study was conducted as an experimental-control study with 200 patients who had received colonoscopy in the endoscopy unit of a university hospital in Eastern Thrace of Turkey between December 1, 2016, and June 30, 2017. All patients received a standard bowel preparation. The SMS was sent in addition to the standard bowel preparation to patients in an SMS group. In the SMS group, patients were informed about the standard bowel preparation practices via SMS 3 days before colonoscopy. "Patient identification," "bowel preparation quality," and "patient satisfaction" forms were used for data collection. Chi-square and independent sample t tests were used in data analysis. The average age of the participants was 57.57 ± 12.37 years, and it was determined that most of the participants were male (64.5%) and had colonoscopy experience (55%). The bowel preparation quality was significantly higher in the SMS group than in the no-SMS group (p = .044), and most patients (91%) were "very satisfied" with being informed via SMS. Sending SMS about bowel preparation practices to colonoscopy patients improves bowel preparation quality and patient satisfaction. Integrating SMS into standard care may help patients manage the bowel preparation process.

Effect of stoma model based education on knowledge and skill levels of student nurses: a quasi-experimental study from Turkey.

OBJECTIVE: To determine the effect of education with a stoma model on knowledge and skill levels of student nurses. METHODS: The quasi-experimental study was conducted at a professional education and skills laboratory of the Nursing Department within a health sciences faculty in Turkey between March 2015 and November 2016. The sample comprised an experimental group that had students who took a surgical diseases nursing course during the spring, and a control group that had students who took the same course during the autumn. A student information form, a knowledge level evaluation form, and a skill level evaluation form were used data collection. SPSS 20 was used for data analysis. . RESULTS: Of the 133 students, 69(52%) were in the experimental group and 64(48%) in the control group. It was determined that the skill level of the experimental group was higher than the control group (p<0.05) and there was a positive correlation between knowledge and skill levels of student nurses in both groups (p<0.05). CONCLUSIONS: Education with a stoma model increased student nurses' skills and promotes their knowledge.

A Descriptive, Qualitative Study to Explore the Pain Experience During Negative Pressure Wound Therapy for Postsurgical Abdominal Wounds.

Pain during negative pressure wound therapy (NPWT) has been reported in the literature. PURPOSE: The study was conducted to describe patients' pain experience, pain-coping skills, and the effect of NPWT-related pain on daily life activities following abdominal surgery. METHOD: Using a descriptive, qualitative design, semi-structured face-to-face interviews were conducted between April 3, 2016 and December 26, 2016, in the surgical ward of a university hospital in Edirne, Turkey. Patients aged ≥18, receiving NPWT, who had at least 1 dressing change, and with no diagnosis of diabetes mellitus or neurological disease were included. Interviews were conducted at the patients' bedside 1 day after wound debridement. All wounds were covered with the NPWT black foam dressing, and NPWT settings were -50 mm Hg to -125 mm Hg. One (1) researcher led the interviews using a voice-recorder while 2 researchers observed and took notes. Data were analyzed using Colaizzi's phenomenological method. RESULTS: The themes identified were: 1) pain experience, 2) pain coping, 3) pain prevention, and 4) affects daily life activity. Patients mostly reported pain during foam dressing changes and wrap removal unless the dressing change occurred while receiving anesthesia. Self-applied pain-coping strategies between dressing changes included limiting mobility, trying not to cough, applying pressure, or walking; these strategies were mostly ineffective. The results are supported by many findings from other studies investigating the effects of NPWT on patient pain. CONCLUSION: This study provides further insight into the patients' wound pain experiences during NPWT and its effect on daily activities. Increased awareness about NPWT-associated pain and pain control measures as well as qualitative and controlled quantitative studies are needed. Inservice training and educational meetings should be conducted at surgical clinics to expand surgical nurse and physician knowledge and awareness of how to efficiently manage pain during NPWT treatment and related procedures.

Deep breathing exercise education receiving and performing status of patients undergoing abdominal surgery.

OBJECTIVES: This study aimed to explore deep breathing exercise education receiving and performing status of patients undergoing abdominal surgery and the relation between them. METHODOLOGY: This descriptive and cross-sectional study was conducted at the surgical ward of a university hospital with 130 patients between August 17 and October 15, 2015. A patient information form and a deep breathing exercise questionnaire were used for data collection. The patients were visited in their rooms after their surgeries and were asked to answer these questions through face-to-face interviews. Descriptive statistics, the Mann-Whitney U test, Spearman's correlation, and Pearson's Chi-squared test were used for analyzing the data. RESULTS: Of the patients, 56.2% of the patients received education about deep breathing exercises, and 51.5% of them performed it. A total of 60.3% of the patients received their education from nursing students. Furthermore, 54.8% of them received this education after surgery. A strong correlation was found between the status of receiving education and performing statuses of patients (P < 0.001). CONCLUSION: The study results indicated that the surgical patients did not receive adequate education about deep breathing exercises and most of them received this education after their surgeries. As a good finding, receiving education affected patients' exercise performing statuses positively. It is advised from this study that clinical nurses should receive in-service education on the importance of pre-operative deep breathing exercise education to improve the exercise application rate among surgical patients.

The Effect of Hand Exercise on Reducing the Symptoms in Hemodialysis Patients with Carpal Tunnel Syndrome.

CONTEXT: Carpal tunnel syndrome (CTS) is one of the most common peripheral neuropathies, and there is no consensus on the preferred method of treatment. AIMS: The aim of this study is to determine the effects of hand exercise performed with a ball on symptoms and to evaluate the results in hemodialysis (HD) patients with CTS. SETTINGS AND DESIGN: This study was conducted in patients with HD who were treated in dialysis centers and state hospitals in Turkey between 2011 and 2012. SUBJECTS AND METHODS: This study included 19 patients (28 hands) that were diagnosed as CTS. For exercise treatment, a hand and finger exercise ball that consists of two parts: a foam body and flexible rubber cords was used. Patients placed their fingers through each cord, squeezed it for 1 s, and then opened their fingers against the cord for 1 s. Patients repeated this exercise for 30 s to 1 min/day. STATISTICAL ANALYSIS USED: The McNemar, Friedman ANOVA, and the Wilcoxon test with a Bonferroni correction were used on SPSS 20.0 software package program. P < 0.05 was considered statistically significant. RESULTS: Results showed that recovery was performed from physical examination results, grip strength, and Boston questionnaire scores. About 21.4% of patients' electrophysiological results were negative at the end of the 1st month and 32.1% of them at the end of the 3rd month. CONCLUSION: Due to the slowed progress of CTS and detection of slight improvement in evaluation parameters, this self-applicable and practical exercise can be used as an alternative treatment of mild CTS in patients with HD.

[Turkish validity and reliability study of fear of pain questionnaire-III]. / Agri korkusu ölçegi-III'ün Türkçe geçerlilik ve güvenilirlik çalismasi.

OBJECTIVES: This study aimed to develop a Turkish version of the Fear of Pain Questionnaire-III developed by McNeil and Rainwater (1998) and examine its validity and reliability indicators. METHODS: The study was conducted with 459 university students studying in the nursing department. The Turkish translation of the scale was conducted by language experts and the original scale owner. Expert opinions were taken for language validity, and the Lawshe's content validity ratio formula was used to calculate the content validity. Exploratory factor analysis was used to assess the construct validity. The factors were rotated using the Varimax rotation (orthogonal) method. For reliability indicators of the questionnaire, the internal consistency coefficient and test re-test reliability were utilized. RESULTS: Explanatory factor analyses using the three-factor model (explaining 50.5% of the total variance) revealed that the item factor loads varied were above the limit value of 0.30 which indicated that the questionnaire had good construct validity. The Cronbach's alpha value for the total questionnaire was 0.938, and test re-test value was 0.846 for the total scale. CONCLUSION: The Turkish version of the Fear of Pain Questionnaire-III had sufficiently high reliability and validity to be used as a tool in evaluating the fear of pain among the young Turkish population.

Attitude of Nursing Students Toward Scientific Research: A Cross-Sectional Study in Turkey.

BACKGROUND: Nursing, a social applied science, is a dynamic profession. Professional nurses must be curious, investigative, and open to learning as well as practice critical and analytic thinking to sustain their professionalism. PURPOSE: The aim of this study was to determine the attitudes of nursing students toward scientific research. METHODS: A descriptive and cross-sectional study design was used. This study was conducted at a nursing department of a university in Turkey. A sample of 375 nursing students participated. Data were collected using the "Personal Information Form" and "Attitude Scale towards Scientific Studies." Standard descriptive statistical methods, correlation, Mann-Whitney U, Kruskal-Wallis, and post hoc Bonferroni were used in data analysis. RESULTS: Nearly all (90.1%) of the participants were female, and 33.9% were sophomore (second-year) students. Junior (third-year) students held the most positive attitudes toward research, as compared with the participants in other academic years. Participants who had participated in scientific activities held more positive attitudes toward research than those who had not. Participants who had prior experience doing scientific research showed more positive attitudes toward research and researchers than those without this experience. Being older, having scientific research experience, following the continuous broadcasts related to nursing, and participating in scientific activities all significantly influenced attitude toward research (p < .05). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: Although nursing students who participated in this study exhibited generally positive attitudes toward scientific research, they had relatively little experience participating in scientific activities. Therefore, to foster a positive scientific research culture among undergraduate students, grants should be provided that encourage wider participation in scientific activities and offer opportunities for undergraduate students to do scientific research.