Turkish Validity and Reliability Study of "Intensive Care Nurses" Attitude Scale Toward Brain Death and Organ Transplantation.

This study was carried out to analyze the validity and reliability of the Turkish adaptation of the "Intensive Care Nurses" Attitude Scale towards Brain Death and Organ Transplantation". The research was carried out as a methodological study and 256 nurses were included in the study. Language, content validity, explanatory and confirmatory factor analyzes were used to analyze data. Twenty-one point 5% of nurses stated that they had an organ donation card. It was determined that the Cronbach alpha coefficient of scale was .85, and item-total score correlations were between .143 and .700. It was established that the scale showed three-factor structure and the first factor was named as "Approving Organ Donation", the second factor as "Discomfort" and the third factor as "Improving The Quality of Life". The Turkish version of the scale was found to be an valid and reliable measurement tool.

Preoperative Anxiety Levels in Surgical Patients: A Comparison of Three Different Scale Scores.

PURPOSE: The aim of this study was to compare Anxiety Specific to Surgery Questionnaire (ASSQ) with Spielberger State-Trait Anxiety Inventory (STAI) and Amsterdam Preoperative Anxiety and Information Scale (APAIS) in the assessment of preoperative anxiety level and to evaluate the fears associated with surgery and anesthesia in surgical patients. DESIGN: This is descriptive, correlational, and cross-sectional study. METHOD: The study sample included 507 surgical patients in four surgery wards who underwent elective surgery. All the data were collected using The Descriptive Characteristics and Clinical Information Form, STAI, APAIS and ASSQ. FINDINGS: A majority (70.8%) of the participants had fears associated with surgery and anesthesia and nearly half of them had a moderate level of preoperative anxiety. Anxiety prevalence was 46.4% according to the APAIS, 44.4% according to STAI and 49.3% according to ASSQ. Women, participants with no primary school education, participants undergoing major surgery and general anesthesia who did not have knowledge about the surgical procedure, and surgical complications had higher anxiety according to three scale scores. CONCLUSION: Nearly half of the participants had moderate/high preoperative anxiety, there were consistent results among the scales and the tools were interchangeable to evaluate the preoperative anxiety level in the surgical patients.

The effectiveness of a recurrent fall prevention program applied to elderly people undergoing fracture treatment.

BACKGROUND: Worldwide 30-40% of people aged of 65 and over fall each year. It is important to develop preventive interventions for falls in the elderly to prevent injuries leading to mortality and morbidity. OBJECTIVES: This study evaluated the effectiveness of a recurrent fall prevention program in elderly individuals undergoing fracture treatment. METHODS: A pretest-posttest intervention study. A recurrent fall prevention program including assessment of fall risk factors, education on falls and home modifications was developed for elderly people undergoing fracture treatment for 52 patients. RESULTS: In the first evaluation before the delivery of the recurrent fall prevention program, the number of risk factors was 17.63 ± 3.40 as mean ± standart deviation. Following implementation of the fall prevention program, the number of risk factors decreased to 15.73 ± 3.19 in the first follow-up and decreased to 14.92 ± 3.06 in the second follow-up. Knowledge scores increased to 6.09 ± 1.65 in the first follow-up and to 6.71 ± 1.53 in the second follow-up, while it was 5.50 ± 1.54 in first evaluation. The differences between follow-ups were statistically significant. During the 3-month study period, 15.4% of participants experienced fall. CONCLUSION: The recurrent fall prevention program was effective in reducing fall-related risk factors and increase fall knowledge. Health care professionals should assess older people for fall risk factors and increase their awareness for falls.

The efficacy of integrating spirituality into undergraduate nursing curricula.

BACKGROUND: Attention to patients' spirituality, as a moral obligation of care, is now widely accepted in nursing practice. However, until recently, many nursing programs have paid little attention to spirituality. OBJECTIVE: The objective of this study was to identify the impact of two different curricula, used to teach undergraduate nursing students, on increasing nursing student awareness of spirituality in the care of patients. RESEARCH DESIGN: A quasi-experimental post-intervention two-group design was conducted in 2009-2010 and 2010-2011 academic years. PARTICIPANTS AND RESEARCH CONTEXT: The study included a total of 130 volunteer senior-year students. The students were assigned as "the intervention group/integrated system" that were informed about spirituality or as "the control group/traditional system" that received no information on spirituality. Data were collected via a personal information form and the Spirituality and Spiritual Care Rating Scale was used to assess responses. The study was conducted at the Department of Nursing of the Faculty of Health Sciences, Cumhuriyet University, in Central Anatolia/Turkey. ETHICAL CONSIDERATIONS: Permission to conduct the study at the nursing school was obtained from the schools' management teams. The rights of the participants were protected in this study by obtaining informed consent. FINDINGS: The results revealed that the intervention group had a higher mean score on the Spirituality and Spiritual Care Rating Scale than did the control group. The students in the intervention group defined the terms of spirituality and spiritual care more accurately than did the control group students. DISCUSSION: Nurses are professionally and ethically responsible for providing spiritual care. Nurses' competence in meeting the spiritual needs of their patients should be improved by undergraduate education on spiritual care. Nursing scholars reported a significant difference in the knowledge and attitudes toward spirituality of nursing students as a result of the integration of spirituality into the undergraduate nursing curriculum. CONCLUSION: Spirituality should be more widely included in nursing education.

Sleep quality of hospitalized patients in surgical units.

AIM: The aim of this study was to determine the sleep quality of the patients hospitalized in surgical units and the factors that influence it. METHOD: The research was a randomized descriptive study. It was conducted in the surgical clinics of Sivas Cumhuriyet University Health Services Research Hospital. A total of 411 patients participated in the study. The research data were gathered by means of the Pittsburgh Sleep Quality Index (PSQI) and the Questionnaire aimed at capturing personal information about the participant patients and the factors influencing their sleep. RESULTS: The sleep quality score of the patients "during the last week" (8.090 ± 3.504) was higher than their score in the "preadmission" period (4.229 ± 2.726) (p= .000). The sleep quality scores of "the patients with previous hospitalization and operation experience" (p= .000), "those who had undergone a major surgical procedure" (p= .000), "those who had been hospitalized for a week" (p= .022), and "those undergoing medical intervention during sleeping hours" (p= .000) "during the last week" were high. Patients who had a chronic illness history and whose operations were postponed had poor quality of sleep in both the hospitalization and preadmission period (p= .000). CONCLUSIONS: It could be suggested that the patients in preoperative and postoperative periods cannot get adequate rest due to low sleep-quality levels. IMPLICATIONS FOR PRACTICE: Nurses can prepare an environment aiding sleep as a way to increase surgical patients' sleep quality in hospital.

Predictors of preoperative anxiety in surgical inpatients.

AIMS AND OBJECTIVES: The aims of the present study were to identify the levels of preoperative anxiety in patients undergoing elective surgery and the relationship between preoperative anxiety and social support. In addition, predictors of preoperative anxiety were studied in surgical inpatients. BACKGROUND: Major life changes are significant factors that cause anxiety; hospitalisation and surgery are among such changes. Social support may decrease the anxiety associated with surgery. DESIGN: This is a descriptive study that included 500 patients in a surgery clinic. METHODS: The data collected included: A Patient Information Form, Multidimensional Scale of Perceived Social Support and the Surgical Anxiety Scale. The results were analysed using the Chi-square test and logistic regression analysis. RESULTS; Five hundred patients participated in this research: 59·6% were female, 54·6% were 65 years of age or older, 80·6% were married, 70·4% were literate and 62% of the patients had moderate level surgery. There was a significant relationship between the sociodemographic patient features, the level of preoperative anxiety (p < 0·05), the presence of social support and the severity of anxiety (p = 0·001). The age and level of anxiety were not significant factors. The mean anxiety score for all patients was 31·91 (SD 6·30) and the mean social support score was 66·38 (SD 13·69). CONCLUSION: The results of this study showed that the preoperative anxiety of patients awaiting surgery was associated with demographic characteristics as well as social support resources. RELEVANCE TO CLINICAL PRACTICE: Anxiety testing is feasible during the preoperative period. Such testing allows for the detection of patients with high anxiety, and for clinicians to take the appropriate steps to ameliorate this problem. Identification of patient anxiety allows for providing a focus on social support in an attempt to reduce the level of anxiety.

[Nursing approaches toward postoperative pain in patients: patients' opinions]. / Hastalarin ameliyat sonrasi yasadiklari agriya yönelik hemsirelik yaklasimlari: Hasta görüsleri.

OBJECTIVES: We aimed in this defining study to determine patients' opinions about nursing practices with respect to their postoperative pain and their satisfaction with these practices. METHODS: Data were collected by two questionnaires that were prepared by the researchers. The collected data were evaluated with chi-square and number, frequency tests. RESULTS: Of the 360 patients participating in this study, 61.4% were women, 83% were over 40 years old and 88% had low educational level. 60.4% had no previous surgery experience. It was determined that 30.6% of patients had undergone heart-lung (cardiovascular system, CVS) and 25.5% gastrointestinal system (GIS) surgery. It was found that 96.4% of patients experienced pain while coughing and 81.9% while getting out of bed. 96.4% of patients reported difficulty in coughing, 78.3% difficulty in mobilization and 46.7% difficulty in breathing because of postoperative pain. It was determined that patients who underwent CVS, TAH+BSO and GIS operations experienced more pain while coughing and trying to get out of bed, while patients who underwent discectomy experienced more pain while walking. There was a significant difference between types of operation and pain (p<0.05) and between activities in which patients experienced difficulty and types of operation (p<0.05). CONCLUSION: The patients stated that nurses did not use a pain scale, provide information about how pain could be relieved, demonstrate what they needed to do during the activities that caused pain, assist the patients to reposition to relieve the pain, or use any non-pharmacological interventions. Nevertheless, all of the patients were satisfied with the analgesics that were administered by nurses for pain relief.

Breast cancer risk factors in Turkey: a hospital-based case-control study.

BACKGROUND: Regional disparities in breast cancer (BC) outcomes have been reported in Turkey. METHODS: In a hospital-based case-control study in Sivas, Turkey, 172 patients with histologically confirmed BC were compared with 383 controls, recruited from visitors in various departments of the same hospital, who had not been previously diagnosed with BC. Information was collected from both groups using a questionnaire and logistic regression analysis was applied to assess associations between each risk factor and BC risk with adjusted odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: In multivariable models, family history of BC (OR=4.67, 95% CI: 2.23-9.76), history of smoking (OR=1.75, 95% CI: 1.08-2.84), and higher education level (OR=2.88, 95% CI: 1.64-5.07) were the strongest predictors of BC in the study population. A separate analysis studying only postmenopausal women using hormone replacement therapy (HRT) (comparing duration of use, >36 months versus ≤36 months, P<0.05) found that use of HRT was also a risk factor for BC. Duration of HRT use (P<0.05) was significantly associated with the elevated risk. On the other hand, certain factors such as first full-term pregnancy before age 30 (χ2=5.755 P<0.05) and higher parity (χ2=20.731, P<0.05) were found to be protective factors for BC. CONCLUSION: The findings of the present study indicate that family history of BC, history of smoking, education, and HRT are factors significantly associated with increased BC risk among Turkish women within the area of Central Anatolia, Turkey.