Effects of Active Heating Methods on Body Temperature, Shivering, Thermal Comfort, Pain, Nausea and Vomiting During General Anesthesia: A Randomized Controlled Trial.

To investigate the effect of forced-air warming and heated intravenous (IV) and irrigation fluids alone and in combination on body temperature, shivering, thermal comfort, pain, nausea and vomiting in adult patients undergoing surgery under general anesthesia in a prospective, four-group, randomized controlled trial. After induction of anesthesia, 120 patients were divided into the following groups: patients warmed with forced-air warming (n = 30), patients receiving warmed IV and irrigation fluid (n = 30), patients receiving warmed IV and irrigation fluid with forced-air warming (n = 30), and the control group without any intervention (n = 30). Body temperature, shivering, thermal comfort, pain, nausea and vomiting were monitored in the first 24 hours after surgery. The general characteristics of the groups, mean body temperature, length of stay, ambient temperature, and duration of surgery in the preoperative waiting unit were similar (p > 0.05). Compared with the other groups, patients in the control group had a significant decrease in body temperature from the 30th minute during surgery (p < 0.001), lower body temperature in the first 2 hours and thermal comfort in the first three hours after surgery (p < 0.01), and higher shivering levels in the first hour after surgery (p < 0.01). There was no significant difference between the groups in terms of postoperative pain, nausea and vomiting (p > 0.05). The study findings showed that normothermia was maintained in all three intervention groups during the surgery and in the first 24 hours after surgery. Moreover, postoperative thermal comfort increased and shivering levels decreased compared with the control group, but pain, nausea and vomiting levels were not affected. The study was registered on ClinicalTrials.gov (NCT04907617).

Pressure injuries in surgical patients: a comparison of Norton, Braden and Waterlow risk assessment scales.

OBJECTIVE: This study aims to determine the predictive power of the Norton, Braden and Waterlow scales in determining risk of pressure injury (PI) in surgical patients. METHOD: This prospective study was carried out in the surgery clinic of a training and research hospital in Istanbul, Turkey between January and April 2017. The study sample consisted of adult patients aged ≥18 years and who did not have PI on admission to the clinic, had abdominal surgery under general anaesthesia and who stayed in the clinic for at least 48 hours. The data were collected using the Turkish versions of the Norton, Braden and Waterlow risk assessment scales. The predictive validity of PI risk assessment tools was assessed based on their sensitivity, specificity, positive and negative predictive values and the area under the receiver operating characteristic (ROC) curve. Predictive capacity was measured as relative risk (RR) with 95% confidence intervals (CI). RESULTS: The study sample included 250 patients, and the incidence of PI was 12%. The sensitivity, specificity, positive predictive value and negative predictive value were: 83.3%, 45.4%, 17.2% and 95.2%, respectively, for the Norton scale (a cut-off point of 14); 100%, 40.4%, 18.6% and 100%, respectively, for the Braden scale (a cut-off point of 16); and 100%, 48.1%, 20.8% and 100%, respectively, for the Waterlow scale (a cut-off point of 10). The areas under the ROC curve were 0.749 for the Norton, 0.771 for the Braden and 0.971 for the Waterlow scales. This study's findings produced the following predictive capacity indicators: Norton (RR=3.62; 95%CI=1.43-9.14), Braden (RR=33.88; 95%CI=2.09-547.66); and Waterlow (RR=45.01; 95%CI=2.78-727.97). CONCLUSION: In this study, the Waterlow scale demonstrated the best values of predictive validity among the three scales in the assessment of PI risk. However, all three scales had low specificity despite high sensitivity in terms of a good risk prediction. No definitive decision could be reached on the predictive capacities of the scales because of wide CIs.

The effect of pedometer-supported walking and telemonitoring after disc hernia surgery on pain and disability levels and quality of life.

AIM: The aim of this study was to determine the effect of pedometer-supported walking and telemonitoring after lumbar disc hernia surgery on pain and disability levels and quality of life. METHODS: This was a randomized controlled trial with two randomly selected groups conducted between March 2018 and January 2019. Sixty-seven participants (33 in the intervention group and 34 in the control group) who had undergone lumbar microdiscectomy were allocated to receive and not to receive walking exercise. Pain and disability levels and quality of life of groups were tested with the McGill Pain Questionnaire, the Oswestry Disability Index and the 36-Item Short Form Survey. Measurements were taken 3 weeks after surgery and following completion of the first, second and third months. RESULTS: Compared with the control group, pain level at the first and second months and disability level at the second and third months in the intervention group were significantly lower (p < 0.05), and in the third month, subdimension scores of quality of life (the physical role difficulty, energy and vitality, mental health, social functionality and pain) were higher (p < 0.05). CONCLUSIONS: Walking after herniated disc surgery decreased pain and disability levels and increased the quality of life; nurses can encourage adherence to walking as an effective intervention.

Examination of Sexual Quality of Life and Dyadic Adjustment among Women with Mastectomy.

OBJECTIVE: To investigate the effect of mastectomy on sexual quality of life and dyadic adjustment among women with breast cancer. MATERIALS AND METHODS: This study was carried out in an analytical and retrospective way by comparing women with mastectomy and the control group who had similarities to this group and did not have breast cancer. The study included 88 women who underwent mastectomy surgery at least 1 year and at most 5 years ago and 88 women who did not undergo mastectomy with matching ages and levels of education. The data were collected using the "Individual Characteristics Form", "Sexual Quality of Life-Female", and the "Dyadic Adjustment Scale" for women with and without mastectomy. RESULTS: In both groups sexual quality of life and dyadic adjustment were positively correlated. Sexual quality of life and dyadic adjustment of women with mastectomy were significantly lower compared to the control group. It was found that sexual quality of life improved as the education level of women with mastectomy increased. Also, sexual quality of life and dyadic adjustment were significantly higher in women with mastectomy whose income was equal to or greater than their expenditures compared to those with income lower than expenditures. CONCLUSION: Sexual quality of life and dyadic adjustment of women with mastectomy are low than women without mastectomy. Nurses should to assess the risk of low dyadic adjustment and sexual quality of life, educate and consultant women on how they can maintain healthy sexual relationships and dyadic adjustment with their spouse after mastectomy.

Reliability and validity of Family Caregiver Quality of Life Scale in heart failure.

BACKGROUND: In this study, the Family Caregiver Quality of Life scale developed specifically for family caregivers of heart failure patients was translated into the Turkish language, and its reliability and validity was performed. METHODS: The scale was first translated into Turkish and back-translated, adapting it to the Turkish culture. The Turkish questionnaire of the scale was applied to 200 family caregivers. To evaluate the reliability of the scale and all subscales, test-retest was applied, and the Cronbach's alpha reliability coefficients were calculated. The structural validity of the scale was examined through the factor analysis. RESULTS: The internal consistency reliability (a=0.82) of the Turkish Questionnaire of the scale was proved. Two-week test-retest reliability was supported by an intraclass correlation coefficient of 0.91. The questionnaire's factor structure demonstrated acceptable fit, indicating that it could be applied to the Turkish population. The item loads found by the factor analysis ranged from 0.32 to 0.99, explaining %63 of the variance (eigenvalue=2.61-4.06). Criterion-related validity was supported by correlations with the Short Form-36 General (r=0.473, p<0.01) and Mental (r=0.406; p<0.01) Health subscales. CONCLUSION: The Turkish version of this scale can measure the quality of life of family caregivers of heart failure patients with adequate reliability and validity.

Validity and Reliability of Turkish Version of the Functional Assessment of Cancer Therapy-Brain Questionnaire.

BACKGROUND: Assessing the quality of life (QOL) of patients with brain tumors is ever more important, given increasing survivorship and the higher likelihood of developing potential morbidities associated with new therapies. OBJECTIVE: The aim of this study was to adapt the Functional Assessment of Cancer Therapy-Brain (FACT-Br) Questionnaire for Turkish populations and test its validity and reliability. METHODS: The questionnaire was first translated into Turkish and back-translated, adapting it to the Turkish culture. This Turkish version of the FACT-Br was administered to 500 patients. Confirmatory factor analysis was conducted to examine the scale's construct validity. Test-retest and Cronbach's α reliability coefficients were calculated to determine reliability of the total questionnaire and all subdimensions. RESULTS: The questionnaire's factor structure demonstrated good fit, implying that it could be applied to the Turkish population. Interclass correlation coefficients were between 0.93 and 0.99. The 5 subscales demonstrated good internal consistency, with Cronbach's α ranging from .72 to .87. Overall, the reliability estimate for the total scale was 0.93. There was no difference between a 15-day test and retest coefficients for subscale and total scores, indicating stability. CONCLUSIONS: The Turkish version of the FACT-Br is a valid and reliable instrument that can be used to measure the QOL of patients with a brain tumor in Turkey. IMPLICATIONS FOR PRACTICE: This assessment tool can be used in treatment evaluations and to evaluate other measures of QOL.

Do Turkish nursing and midwifery students teach breast self-examination to their relatives?

AIM: To describe health beliefs and breast self-examination (BSE) practice of Turkish female nursing and midwifery students and extent of teaching the screening method to their mothers, sisters and relatives. DESIGN: In this definition survey, data were obtained from 113 nursing and midwifery students (n = 113) in third and fourth class and their mothers, sisters and other relatives in Turkey. METHODS: Data were collected using a personal data form, a knowledge evaluation form for BSE (Maurer 1997) and the Champion's Health Belief Model Scale. Number percentage, Chi-square test were used in the evaluation of the data. RESULTS: Students learned breast cancer and BSE in their lessons one or two years previously. Knowledge level scores of the students were 52.3 ± 9.6 (min:25,max: 75). Rate of having regular BSE was 32.7%. When health belief scale assessed; the average of susceptibility was 7.52 ± 2.62, seriousness was 21.8 ± 5.30, benefit was 16.7±4.45, barrier was 22.3 ± 6.44, confidence was 40.3 ± 6.67 and medical motivation was 26.6 ± 4.22. The rate of having regular BSE and benefit, barrier scores were compared, they were statistically significant difference(p < 0.05). The majority (106, 91.3%) gave BSE training to their mother and sisters, and 42.6% (48) to relatives, 6.2% (7) to friends, and 5.4% (6) to patients. CONCLUSIONS: Knowledge about breast cancer and BSE repetition training programs should be planned for nursing/midwifery students, to increasae their sensitivity, beliefs and attitudes, and medical motivation for BSE.

Do Turkish nursing and midwifery students teach breast self-examination to their relatives?

AIM: To describe health beliefs and breast self-examination (BSE) practice of Turkish female nursing and midwifery students and assess teaching of BSE to their mothers, sisters, relatives. METHODS: The study was designed as a definition survey, withe data obtained from 113 participants, in third and fourth class and their mothers, sisters, relatives in Turkey. Data were collected by using a personal data form, knowledge evaluation form for BSE (Maurer 1997) and the Champion's Health Belief Model Scale. RESULTS: Students had learned about breast cancer and BSE in their lessons one or two years previous to the study. Knowledge level scores of the students were 52.3 ∓ 9.63 (min:25, max: 75). Rate of regular BSE was 32.7%. When health belief scale assessed, the average susceptibility was 7.52∓2.62, seriousness was 21.8∓5.30, benefit was 16.7∓4.45, barrier was 22.3∓6.44, confidence was 40.3∓6.67 and medical motivation was 26.6∓4.22. A statistically significant difference in the rate of having regular BSE and benefit, barrier scores was noted (p<0.05). Regarding BSE training, 91.3% (n = 106) gave assistance to their mother and sisters, 42.6% (n = 48) to relatives, 6.2% (n = 7) to friends, and 5.4% (n = 6) to patients. CONCLUSIONS: Knowledge about breast cancer and BSE repetition training programs should be planned for nursing/midwifery students. Their susceptibility, belief and attitudes, medical motivation with BSE should thereby increase.

Historical development and current status of emergency nursing in Turkey.

As the demand for high quality Accident and Emergency Departments and nursing staff increases throughout Turkey, the need for more specialized emergency nurse training has also increased. Although there have been a number of positive developments regarding emergency nursing standards, the general quality of emergency nurse training needs to be improved and job definitions amended to better reflect the specialist duties of emergency nurses.

[Pain severity and analgesia approaches in adult trauma patients]. / Yetiskin travma hastalarinda agri siddeti ve analjezi yaklasimlari.

This study was carried out descriptive for determine trauma patient's pain severity and pain relief approaches. This scope of the research covered 418 patients who were between 18-65 years and applied to emergency unit of two training hospitals because of the trauma in Istanbul. The data of the research were collected by using individual characteristics form and forth section of Mc Gill Pain Questionnaire form. It was determined that all patients had pain after trauma. Moreover, 14.6 % (n=61) of the patients defined the pain "severe", 51.7 % (n=216) that they defined the pain "much severe" and 33.7 %(n=141) that they defined the pain "unbearable". Nonsteroid Antiinflammatory Drugs (NSAID) were given only 85.9 % (n=359) that they had pain. Besides, being extra to NSAID opioid was given to 14.1% (n=59) of the patients by 95.5% (n=416) intramuscular approach and 62.9 % (n=293) of the patients, whose pains were not over in spite of the pain treatment Based on these results, trauma patients' pains still haven't been handled as a serious problem. Also, it can be said that there is hot any effective pain relief approach at emergency units yet.