Changes in the Lives of Individuals with a Stoma and Their Spouses: A Qualitative Study.

OBJECTIVE: Individuals with a stoma and their spouses experience various changes with regard to their new life situation. The authors aimed to determine the changes caused by stoma creation in the lives of individuals with a stoma and their spouses. METHODS: This study was carried out with individuals with a stoma (n = 15) and their spouses (n = 15) in a stoma therapy unit. Semistructured interviews were digitally audio recorded and transcribed. Inductive reasoning was used in the analysis of the qualitative data. RESULTS: As a result of the data obtained from in-depth interviews, the authors identified three contexts, nine themes, and many subthemes (49 subthemes for individuals with a stoma and 30 subthemes for spouses). Most subthemes were expressed by both the individual with a stoma and his/her partner, showing that the feelings, thoughts, and difficulties experienced were often shared between spouses. CONCLUSIONS: Ostomies change the lives of individuals and their spouses. These changes have mostly negative biopsychosocial effects. However, after stoma surgery, spouses strengthen their commitment to each other and better understand the value of being healthy.

Development, reliability and validity of the Nurses' Ethical Behaviours for Protecting Patient Rights Scale.

AIM: The aim of this study was to develop a self-assessment scale for nurses' ethical behaviours for protecting patients' rights and to determine its reliability and validity. METHODS: This was a methodological study. This study was conducted in public, private and university hospitals in Turkey between August 2018 and May 2019. The sample group consisted of 450 nurses. The item pool was formed with 44 items. After five experts' assessment for content validity, the draft scale was formed with 37 items with a 5-point Likert-type scale. The item-total score correlation and exploratory factor analysis were used. RESULTS: The scale included 28 items and five subscales (respect for right to information and decision making, providing fair care, providing benefit-not harming, respect for patient values and choices, attention to privacy). Cronbach's alpha was 0.84 for the whole scale. CONCLUSION: Validity and reliability have been demonstrated for a newly developed scale to measure nurses' ethical behaviours to protect patients' rights.

Effect of music therapy on nursing students' first objective structured clinical exams, anxiety levels and vital signs: A randomized controlled study.

BACKGROUND: Music is a tool that can be used to reduce stress and anxiety, maintain vital signs at normal levels, and increase exam success. OBJECTIVES: This study aimed to determine the effect of music therapy on nursing students' first objective structured clinical exam success, anxiety levels, and vital signs, and to reveal their views about music therapy in the context of an exam. DESIGN: Mixed-pattern single-blind randomized controlled qualitative study. SETTING: Department of Nursing, Faculty of Health Sciences, Ankara, Turkey. PARTICIPANTS: First-year students enrolled in the Fundamentals of Nursing II course were randomly assigned to an experimental (n = 61) or control group (n = 64). Twenty-two (22) experimental group students provided the sample for the qualitative stage. METHODS: Data were collected between February and June 2018 using the Informative Features Form, State-trait Anxiety Inventory, Vital Signs Assessment Form, Skill Checklists, and Focus-group Interview Form. All students completed the theoretical classes, laboratory classes, and small-group studies. The experimental group participated in five music therapy sessions two weeks before the exam. All students' vital signs were measured before and after the exam. Three focus group interviews were conducted with the 22 experimental group students in the week after the exam. RESULTS: The blood pressure values of the experimental group before and after the exam were significantly lower than those of the control group (p < 0.05). No significant difference was observed between exam success and anxiety levels between the two groups. In the focus group interviews, students said they found music therapy suitable for reducing anxiety in their daily lives, but not before the exam. CONCLUSIONS: Music therapy had positive effects on the students' blood pressure but had no effect on exam success or anxiety levels. This study suggests that more music therapy sessions be conducted with different groups of students in greater numbers before different exams.

Effect of simulation on the ability of first year nursing students to learn vital signs.

BACKGROUND: The acquisition of cognitive, affective and psychomotor knowledge and skills are required in nursing, made possible via an interactive teaching method, such as simulation. OBJECTIVE AND DESIGN: This study conducted to identify the impact of simulation on first-year nursing students' ability to learn vital signs. SETTING AND PARTICIPANTS: A convenience sample of 90 first-year nursing students enrolled at a University, Ankara, in 2014-2015. METHOD: Ninety students enrolled for lessons on the "Fundamentals of Nursing" were identified using a simple random sampling method. The students were taught vital signs theory via traditional methods. They were grouped into experimental 1, experimental 2 and control group, of 30 students each. Students in the experimental 1 group attended sessions on simulation and those in the experimental 2 group sessions on laboratory work, followed by simulation. The control group were taught via traditional methods and only attended the laboratory work sessions. The students' cognitive knowledge acquisition was evaluated using a knowledge test before and after the lessons. The ability to measure vital signs in adults (healthy ones and patients) was evaluated using a skill control list. RESULTS: A statistically significant difference was not observed between the groups in terms of the average pre-test scores on knowledge (p>0.050). Groups exposed to simulation obtained statistically significantly higher scores than the control group in post-test knowledge (p<0.050). The ability of the groups exposed to simulation to measure vital signs in healthy adults and patients was more successful than that the control group (p<0.050). This was statistically significant. CONCLUSION: Simulation had a positive effect on the ability of nursing students to measure vital signs. Thus, simulation should be included in the mainstream curriculum in order to effectively impart nursing knowledge and skills.

A Prospective, Descriptive Study to Assess Nursing Staff Perceptions of and Interventions to Prevent Medical Device-related Pressure Injury.

Nurses play an important role in identifying patients at risk for medical device-related (MDR) pressure injuries and preventing their occurrence. A prospective, descriptive study was conducted across 6 hospitals in Ankara, Turkey between December 2014 and June 2015 to assess nursing perceptions about and interventions used for the pre- vention of MDR pressure ulcers. A questionnaire was used to collect demographic information and data on experience with MDR pressure ulcers; in addition, participants completed a Nursing Interventions Form that included 10 statements regarding basic nursing interventions to prevent MDR pressure ulcers; answer options were I perform, I partly perform, I do not perform. Of the 1555 nurses invited, 606 (38%) participated. Nurses who chose to volunteer completed the study instruments independently at their convenience; their responses were entered directly into the statistical analysis system by the researchers. Demographic and interventions data were analyzed using frequency and percentage distributions. Participant mean age was 30.0 ± 6.83 years, most were women (86.9%), with a mean of 8.47 ± 6.70 years of experience. Most had a bachelor's degree (55.1%), 38.2% worked in intensive care units, 50.2% participated in a scienti c program regarding the prevention/treatment of pressure ulcers after their gradu- ation, and 87.9% provided care to patients with pressure ulcers. A great majority (80.1%) of the nurses believed the use of medical devices can lead to pressure ulcers and 59.2% had experience with MDR pressure ulcers, but almost 20% did not believe medical devices can cause a pressure ulcer. The nurses identi ed 18 medical devices that posed the highest risk of causing MDR pressure ulcers; the 3 most commonly identi ed devices were endotracheal tubes (59.7%), tracheostomy ties (58.9%), and blood pressure cuffs (58.4%). The most common interventions used by these nurses included ensuring correct device positioning (87.9%) and loosening devices at least once every shift (80%) when medical conditions allowed. These ndings suggest nurses may not be aware of the risk for pressure ul- cers associated with a number of medical devices, indicating a need for comprehensive inservice training programs and research to identify optimal measures and methods to prevent MDR pressure ulcers.

The effect of the application of manual pressure before the administration of intramuscular injections on students' perceptions of postinjection pain: a semi-experimental study.

AIMS AND OBJECTIVES: To evaluate the efficacy of applying manual pressure before intramuscular injection and compare it with the standard injection technique in terms of reducing the young adult student's postinjection pain. BACKGROUND: The administration of intramuscular injections is a procedure performed by nurses and one that causes anxiety and pain for the patient. Nurses have ethical and legal obligations to mitigate injection-related pain and the nurses' use of effective pain management not only provides physical comfort to the patients, but also improves the patients' experience. DESIGN: Comparative experimental study. METHODS: This study was conducted with first-year university students (n = 123) who were scheduled for hepatitis A and hepatitis B vaccination via deltoid muscle injection. Students were randomly assigned to the groups. Comparison group students (n = 60) were given an injection using the conventional method, that is without manual pressure being applied prior to the injection. The experimental group students (n = 63) received manual pressure at the vaccination site immediately before injection for a period of 10 seconds. The two techniques were used randomly. The subjects were given pressure to the injection site, and perceived pain intensity was measured using Numerical Rating Scale. RESULTS: Findings demonstrate that students experienced significantly less pain when they received injections with manual pressure compared with the standard injection technique. The postinjection average pain score in the comparison group was higher than that in the experimental group (p < 0·05). CONCLUSIONS: This study's results show that the application of manual pressure to the injection site before intramuscular injections reduces postinjection pain intensity in young adult students (p < 0·05). Based on these results before the injection, applying manual pressure to the adult's intramuscular injection site is recommended. RELEVANCE TO CLINICAL PRACTICE: Applying pressure to the injection area is a simple and cost-effective method to reduce the pain associated with injection.