The Effectiveness of Discharge Training for Patients After Cardiac Surgery.

PURPOSE: The aim of this study was to evaluate the effectiveness of written and verbal discharge training given to patients who underwent cardiac surgery. DESIGN AND METHODS: It was conducted on 180 patients between November 2011 and June 2012. The patients were divided into two groups. The first 90 patients were given verbal discharge training, whereas the others were provided with both written and verbal trainings. Using pretest and posttest questionnaires, knowledge levels of the patients were evaluated before training and 1 month after discharge. Patients given verbal discharge training had a success rate of 10.2% pretest, 48.1% posttest, whereas the success rate of patients who received both written and verbal discharge training was 6.35% pretest, 90.7% posttest. FINDINGS: The findings show that both written and verbal discharge training increased the knowledge levels. CONCLUSION AND CLINICAL RELEVANCE: The findings imply that written-verbal discharge training may help patients to solve the problems after discharge, which may reduce the number of patients presenting at hospital and, in turn, related healthcare costs.

Determination of vaccination status of pregnant women during pregnancy and the affecting factors.

AIMS AND OBJECTIVES: To determine the vaccination status of pregnant women during pregnancy and factors affecting their vaccination. BACKGROUND: Immunisation provided through vaccination is one of the most effective ways to reduce or prevent the risks of disease, disability and death. Maternal and newborn health may be protected and morbidity may be decreased through vaccinating pregnant women when necessary. DESIGN: This was a descriptive and cross-sectional survey. METHODS: This study was conducted in a university hospital in Ankara, Turkey, between 01 March and 31 May 2010. The study was carried out with 198 healthy pregnant women who had completed the 26th week of gestation. Data were collected using the data collection form composed of questions enquiring about the demographic and obstetric features of pregnant women and whether or not they knew that vaccinations could be given during pregnancy, and which vaccines could be used during pregnancy, which vaccine/vaccines they had previously received and the reasons for having been vaccinated or not. RESULTS: Approximately half of the participants had received at least one of the vaccines that may be used in pregnancy (52·0%). The pregnant women received vaccinations for tetanus (47·0%), H1N1 (9·1%), seasonal influenza (3·0%) and hepatitis B (0·5%), respectively. The pregnant women who had been educated about vaccinations had been vaccinated at a statistically significantly higher rate compared with those who had not. CONCLUSION: This study revealed that pregnant women's knowledge about the required vaccines during pregnancy affected their behaviour towards vaccination. Acquiring knowledge about vaccines that may be used during pregnancy from health personnel is effective to increase vaccination. This result may be interpreted as 'acquired information affects behaviour towards vaccination'. RELEVANCE TO CLINICAL PRACTICE: Providing information about immunisation to pregnant women at the antenatal clinic is important in terms of maternal and newborn health. Nurses and midwives working in the antenatal field should be sufficiently educated about immunisation.

Premenstrual syndrome and attitudes toward menstruation in a sample of nursing students.

OBJECTIVE: The aim of this study was to evaluate baccalaureate nursing students' attitudes toward menstruation, and to analyze the frequency of premenstrual syndrome (PMS) symptoms, as well as the relationship between attitudes toward menstruation and PMS symptoms. METHODS: This cross-sectional study was carried out between February 15 and March 10, 2009, in Ankara Turkey. The study participants were 250 undergraduate nursing student volunteers. Data were collected using a demographic questionnaire, the validated Turkish version of the Menstrual Attitude Questionnaire (MAQ), and the validated Turkish Premenstrual Syndrome (PMS) Scale. Obtained data were analyzed using SPSS version 15.0. FINDINGS: The average age of participants was 19.89 ± 1.43. The MAQ's five subscales' mean scores ranged from 2.67 ± 0.58 to 3.37 ± 0.52, indicating natural to moderate attitudes toward menstruation. The mean PMS score was 114.86 ± 35.15, indicating moderate PMS symptoms. PMS symptoms were detected in 36.4% of the nursing students. Thirty one percent of the students reported having dysmenorrhoea during every menstrual cycle. Students who had PMS symptoms scored significantly higher on the debilitation subscale and scored significantly lower on the denial subscale of the MAQ (p < 0.05). CONCLUSIONS: The findings of this research showed that menstruation was considered to be a natural event by most of the nursing students. In addition, dysmenorrhea was found to be the most common menstrual problem and the rate of PMS was found lower than that found in previous researches conducted in Turkey.

Comparison of prenatal education delivered by nurses in Ankara (Turkey) and New Orleans (USA).

AIM: This research was planned to compare prenatal education delivered by nurses in Ankara (Turkey) and New Orleans (USA). BACKGROUND: Prenatal education can increase awareness and improve the knowledge about risks factors and complications of pregnant women. Therefore, prenatal education is an important determinant of improved health outcomes of infants and of reduced maternal mortality. DESIGN: A descriptive survey. METHODS: This descriptive study was performed in various obstetrics clinics and antenatal outpatient clinics between April 2002-April 2003. The sample included all graduate nurses in prenatal units who gave their informed consent to participate. A demographic data form to collect data and a prenatal education checklist were prepared by the investigator. RESULTS: There was a significant difference in the educational levels of the nurses both in nursing education and in special courses as preparation to present prenatal education. The topics addressed during the prenatal education also differ significantly. The nurses in the USA mostly had a master's degree, while the nurses in Turkey mostly had two years of education after college. There was a significant difference between the two countries related to the qualification for giving prenatal education and having a certificate. CONCLUSION: There was a significant difference between the educational preparation of presenting nurses as well as the content of prenatal education in Ankara, Turkey and New Orleans, USA. Turkish nurses may benefit from an educational programme to prepare them to present prenatal education that may improve the knowledge of pregnant women and eventually lead to reduced maternal and infant mortality. RELEVANCE TO CLINICAL PRACTICE: The quality of the care provided by the nurses and midwives working in the prenatal area will increase following specific standardised training for becoming proficient.

A survey of emotional difficulties of nurses who care for oncology patients.

Nurses who care for dying patients are under pressure emotionally because of their beliefs and values about death as well as the emotions and reactions of the patients and their families. This study examines the emotional difficulties of nurses caring for oncology patients in Turkey. The study used a descriptive survey design. The participants were 157 nurses from three medical oncology units in Ankara. Results showed that nurses had difficulty in talking to oncology patients about end-of-life issues and found that caring for dying patients affected their personal lives. This study also showed that the length of nurses' work experience had no effect on their feelings and perceptions toward terminally ill patients. However, the nurses who had more work experience were more likely to report difficulty in talking to patients. Most of the nurses expressed feelings of inadequacy and hopelessness about pain management and treatments.

Living with gynecologic cancer: experience of women and their partners.

PURPOSE: To describe the experiences of Turkish women with gynecologic cancer and their partners. DESIGN AND METHODS: Qualitative research using a descriptive phenomenological approach. SETTING: Gynecologic oncology outpatient clinic of the Gulhane Military Medical Academy in Ankara, Turkey. Nineteen women with gynecologic cancer aged 43-70 years and 12 partners aged 46-73 years were recruited. Data were obtained through open-ended and in-depth, audio-taped interviews which lasted approximately 35-45 minutes each. FINDINGS: Seven themes emerged from the participants' description of their experience: (a) experiences during the diagnosis period; (b) experiences during the treatment period; (c) the effect of cancer on family life; (d) changes in daily life; (e) coping methods and support sources; (f) the meaning of illness; and (g) experiencing the illness as a woman. CONCLUSIONS: Receiving the diagnosis of gynecologic cancer was remembered as a very dramatic experience. The women and partners reported many physical and psychosocial difficulties relating to the treatment period. Healthcare professionals must understand and recognize cancer patients' and their partners' experiences to provide appropriate holistic care. CLINICAL RELEVANCE: Nurses can only provide effective and comprehensive nursing care to gynecologic cancer patients and their families if they fully understand the physical, emotional, social, and spiritual experiences in their lives.

Percutaneous management of ureteral injuries that are diagnosed late after cesarean section.

OBJECTIVE: We wanted to present the results of percutaneous management of ureteral injuries that were diagnosed late after cesarean sections (CS). MATERIALS AND METHODS: Twenty-two cases with 24 ureteral injuries that were diagnosed late after CS underwent percutaneous nephrostomy (PN), antegrade double J (DJ) catheter placement and balloon dilatation or a combination of these. The time for making the diagnosis was 21 +/- 50.1 days. The injury site was the distal ureter in all cases (the left ureter: 13, the right ureter: 7 and bilateral: 2). Fifteen complete ureteral obstructions were detected in 13 cases. Ureteral leakage due to partial (n = 4) or complete (n = 3) rupture was noted in seven cases. Two cases had ureterovaginal fistula. All the cases were initially confirmed with antegrade pyelography and afterwards they underwent percutaneous nephrostomy. Balloon dilatation was needed in three cases. Antegrade DJ stents were placed in 10 cases, including the three cases with balloon dilatation. Repetition of percutaneous nephrostomy with balloon dilatation and DJ stent placement was needed in one case with complete obstruction. All the cases were followed-up with US in their first week and then monthly thereafter for up to two years. RESULTS: Eighteen ureters (75%) were managed by percutaneous procedures alone. A total of six ureter injuries had to undergo surgery (25%). CONCLUSION: Percutaneous management is a good alternative for the treatment of post-CS ureteral injuries that are diagnosed late after CS. Percutaneous management is at least preparatory for a quarter of the cases where surgery is unavoidable.

Is uterine artery embolization prior to myomectomy for giant fibroids helpful?

PURPOSE: To determine whether uterine artery embolization (UAE) prior to myomectomy is more effective than myomectomy alone. MATERIALS AND METHODS: The study included 15 consecutive infertile women with uterine fibroids > 10 cm (Group I) that underwent UAE with spherical particles using a microcatheter technique and a unilateral femoral approach between March 2005 and January 2007. The day after embolization all cases underwent myomectomy since the protocol for large fibroids in our hospital is myomectomy only. The control group was composed of 15 patients who underwent myomectomy only (Group II). Group II was established based on fibroid size (14 +/- 3 cm). Operating time, estimated blood loss and transfusion, complications, and hospital stay were calculated by retrospective chart reviews, and comparisons were made between the groups with Student's t-test. RESULTS: Mean operating time was 138 min in Group I and 240 minutes in Group II (P < 0.01). Mean estimated blood loss was 250 ml in Group I and 690 ml in Group II (P < 0.01). There was no need for transfusion in Group I, while transfusion was needed in 2 cases (13%) in Group II. Mean hospital stay in Group I was 5 days versus 8 days in Group II. Complications, including subsequent hysterectomy, were seen in 2 cases and bowel-bladder injuries in 1 case in Group II (a total of 20%), while no complications were observed in Group I. One of the cases in Group I later conceived and gave birth to a healthy child. CONCLUSION: UAE prior to myomectomy is more effective than myomectomy alone.