The level of collaboration amongst nurses in Turkey.

AIM: This study was conducted to determine the level of collaboration amongst nurses in Turkey. BACKGROUND: Collaboration amongst nurses is thought to increase nurse-physician collaboration and decrease medical mistakes. It has been connected with positive patient outcomes and increased job satisfaction for nurses. There are some studies on nurse-physician collaboration in Turkey, but nurse-nurse collaboration has not been measured before in this context. There are limited studies in the literature on nurse-nurse collaboration. METHODS: The sample of this study consisted of 859 nurses who work at one public hospital, one university hospital and four private hospitals in Turkey. The study was designed as descriptive and cross-sectional research. The data were collected using the nurse-nurse collaboration scale and a socio-demographic questionnaire. The nurse-nurse collaboration scale comprises five subdimensions: problem-solving, shared process, communication, coordination and professionalism. The cut-off value of the scale for minimum expected collaboration degree was determined as 2.5. RESULTS: It was found that the total nurse-nurse collaboration level in the sample was 3.09, which is above minimum expected degree of collaboration (2.5). In regard to the subdimensions of the scale, the lowest mean score (2.97) was for problem-solving and the highest (3.20) was for professionalism. Graduate nurses' problem-solving, coordination, professionalism and cooperation skills were found to be higher than those of undergraduate nurses. Nurses employed under continuous employment contracts presented higher collaboration scores than those employed with annual, temporary contracts. CONCLUSIONS: Regarding the results obtained in the study, although the Turkish nurses were collaborating at the minimum expected level, they can collaborate more. Improved collaboration between nurses will increase patient satisfaction and thus will have a favourable impact on patient safety. IMPLICATIONS FOR NURSING POLICY AND HEALTH POLICY: Nurses who have a bachelor's or higher level degree should be hired, and nurses should be provided with job security in the form of a continuous employment contract to enhance nurse-nurse collaboration.

The role of VEGF and other parameters in tracking the clinical course in metronomic chemotherapy.

PURPOSE: The purpose of this study was to investigate the effect of metronomic chemotherapy on serum vascular endothelial growth factor (VEGF) levels in cancer patients. METHODS: The study included 11 metastatic cancer patients who received daily 50 mg cyclophosphamide and biweekly 5 mg methotrexate per os as metronomic chemotherapy. Bevacizumab together with FOLFIRI chemotherapy was administered as anti-angiogenic treatment in another group of 16 metastatic colorectal carcinoma patients. Furthermore, VEGF levels of 10 healthy individuals and 5 cord blood samples served for comparisons. VEGF levels of patients before therapy and 3 months after treatment were analyzed and compared. RESULTS: Serum VEGF levels prior to metronomic chemotherapy were higher compared with the healthy controls (p=0.0001). Similarly, serum VEGF levels prior to the bevacizumab-based chemoimmunotherapy were significantly higher compared with the healthy controls (p=0.005). In patients on metronomic chemotherapy VEGF levels showed non significant decrease (p=0.075). On the contary, VEGF levels decreased significantly (p=0.002) with bevacizumab treatment. CONCLUSION: Serum VEGF levels may be used for assessing of the efficacy of anti-angiogenic therapies.