Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 37
Filtrar
1.
J Tissue Viability ; 2021 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-34511325

RESUMO

AIM: This study aimed to determine the problems faced by physicians and nurses dealing with chronic wound care during the COVID-19 pandemic and their views on telehealth. MATERIALS AND METHODS: A descriptive and cross-sectional design was used in this study. The sample comprised physicians (n = 74) and nurses (n = 271) interested in chronic wound care. Data were collected through a questionnaire form consisting of open- and closed-ended questions. RESULTS: Of the participants, 21.4% (n = 74) were physicians and 78.6% (n = 271) were nurses. Of the physicians, 45.9% (n = 34) were obliged to work in another unit during the COVID-19 period, while 43.2% continued their service related to chronic wound care, and only 17.0% (n = 18) in the wound care service before the pandemic. These rates are 51.3% (n = 139), 51.6% (n = 157) and 36.8% (n = 128) for nurses, respectively. 40.7% of the physicians (n = 33) and 34.9% of the nurses (n = 106) stated that their time had been reduced for chronic wound care. When the telehealth experiences were examined, 32.4% (n = 24) of the physicians utilized telehealth, 29.7% (n = 22) used e-visit, 77.0% (n = 57) stated that they thought telehealth was a good option, 47.3% (n = 35) utilized it for wound evaluation and treatment, and 31.9% (n = 59) used smart phones. These rates for nurses were 16.6% (n = 45), 14.0% (n = 38), 72.7% (n = 197), 33.9% (n = 92), and 27.0% (n = 182), respectively. CONCLUSIONS: The COVID-19 pandemic negatively affected the manner of delivery, duration, and quality of service regarding wound management. During this period, face-to-face contact times with patients were reduced, some diagnosis and treatment attempts were not performed, and wound care services were suspended temporarily or permanently. On the other hand, a positive result was achieved in that the physicians and nurses gave positive feedback for the telehealth experience.

2.
Nurs Open ; 8(3): 1005-1022, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34482649

RESUMO

AIM: To provide a systematic review of the literature from 1997 to 2017 on nursing-sensitive indicators. DESIGN: A qualitative design with a deductive approach was used. DATA SOURCES: Original and Grey Literature references from Cochrane Library, Medline/PubMed, Embase, and CINAHL, Google Scholar Original and Grey Literature. REVIEW METHODS: Quality assessment was performed using the NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. RESULTS: A total of 3,633 articles were identified, and thirty-nine studies met the inclusion criteria. The quantitative assessment of investigated relationships in these studies suggests that nursing staffing, mortality, and nosocomial infections were the most frequently reported nursing-sensitive indicators. CONCLUSION: This review provides a comprehensive list of nursing-sensitive indicators, their frequency of use, and the associations between these indicators and various outcome variables. Stakeholders of nursing research may use the findings to streamline the indicator development efforts and standardization of nursing-sensitive indicators. IMPACT: This review provides evidence-based results that health organizations can benefit from nursing care quality.


Assuntos
Cuidados de Enfermagem , Pesquisa em Enfermagem , Recursos Humanos de Enfermagem , Estudos Transversais , Humanos , MEDLINE
3.
Geriatr Nurs ; 42(4): 816-824, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34090225

RESUMO

OBJECTIVE: The aim of this study is to report the findings of meta-synthesis of the experiences and perceptions of person-centered care among nurses and nurse aides in long term care facilities to help managers and policy makers in providing and improving health services. METHODS: This is a meta-synthesis of qualitative studies guided by seven steps process of meta-ethnography developed by Noblit and Hare. Systematic literature searching was conducted in CINAHL, MEDLINE, Web of Science, PubMed, PsycINFO, Scopus, Cochrane library and ProQuest dissertations databases. We assessed quality of the studies using Critical Appraisal Skills Program tool. RESULTS: Eleven studies and one dissertation were identified as relevant for the review. The analysis of this systematic review was resulted in three categories: Recognizing resident's emotional needs and preferences under the task-based workload; holistic understanding to build relationship and participation; teamwork, being recognized and ongoing training to overcome the challenges. CONCLUSION: The concept of PCC in direct care level is perceived well with majority of the study participants but the reality between perceived and practicing PCC is different which indicates mostly lack of organizational rearrangements and support.

4.
J Tissue Viability ; 30(1): 21-27, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33187790

RESUMO

AIM: The present study was carried out as a comparative observational study in order to determine the effect of prophylactic dressing on the prevention of skin injuries due to the use of personal protective equipment (PPE) in health care workers (HCWs) working with COVID-19 patients. In addition, the effect of nasal strip on the prevention of discomfort in breathing with mask was also investigated. MATERIALS AND METHODS: The present study was carried out with 48 HCWs (Control Group-CG, n = 20; Experimental Group 1-EG1, n = 20; Experimental Group 2-EG2, n = 8) who use PPE on the face region and work with COVID-19 patients. Data was collected with Data Collection Form developed by researchers. In participants in CG, normal procedures of the institution in using PPE were followed. In EG1, prophylactic dressing was used on risky areas on the face. In EG2, nasal strip sticky on one side was used in addition to prophylactic dressing. The evaluation of the facial skin was made once a day by a researcher with expertise in wound management. RESULTS: Groups were similar in terms of demographic characteristics of participants. Overall rate of skin injuries associated with PPE use was 47.9%. Skin injuries developed in all participants in CG (n = 20), and in two and one participants in EG1 and EG2 respectively, with significant difference between groups. The most common skin injuries were Stage 1 pressure injury (29.2%), blanchable erythema of intact skin (27.1%) and itching (18.8%). No participant in EG2 reported discomfort in breathing (n = 8). Significant difference was found between groups in favor of EG2 in terms of experiencing discomfort in breathing (p < 0.001). CONCLUSIONS: In the present study, it was established that using prophylactic dressing under PPE prevents skin injuries on the facial skin and using nasal strip prevents discomfort in breathing with mask. In view of these results, it was recommended that prophylactic dressing should be used under PPE.


Assuntos
COVID-19/prevenção & controle , Equipamento de Proteção Individual/efeitos adversos , Pele/lesões , Adulto , Bandagens , Traumatismos Faciais/prevenção & controle , Feminino , Pessoal de Saúde , Humanos , Masculino , Máscaras/efeitos adversos
5.
J Adv Nurs ; 77(3): 1609-1623, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33305504

RESUMO

AIM: To develop and psychometrically evaluate a skin tear knowledge assessment instrument (OASES). DESIGN: Prospective psychometric instrument validation study. METHOD: The skin tear knowledge assessment instrument was developed based on a literature review and expert input (N = 19). Face and content validity were assessed in a two-round Delphi procedure by 10 international experts affiliated with the International Skin Tear Advisory Panel (ISTAP). The instrument was psychometrically tested in a convenience sample of 387 nurses in 37 countries (April-May 2020). Validity of the multiple-choice test items (item difficulty, discriminating index, quality of the response alternatives), construct validity, and test-retest reliability (stability) were analysed and evaluated in light of international reference standards. RESULTS: A 20-item instrument, covering six knowledge domains most relevant to skin tears, was designed. Content validity was established (CVI = 0.90-1.00). Item difficulty varied between 0.24 and 0.94 and the quality of the response alternatives between 0.01-0.52. The discriminating index was acceptable (0.19-0.77). Participants with a theoretically expected higher knowledge level had a significantly higher total score than participants with theoretically expected lower knowledge (p < .001). The 1-week test-retest intraclass correlation coefficient (ICC) was 0.83 (95% CI = 0.78-0.86) for the full instrument and varied between 0.72 (95% CI = 0.64-0.79) and 0.85 (95% CI = 0.81-0.89) for the domains. Cohen's Kappa coefficients of the individual items ranged between 0.21 and 0.74. CONCLUSION: The skin tear knowledge assessment instrument is supported by acceptable psychometric properties and can be applied in nursing education, research, and practice to assess knowledge of healthcare professionals about skin tears. IMPACT: Prevention and treatment of skin tears are a challenge for healthcare professionals. The provision of adequate care is based on profound and up-to-date knowledge. None of the existing instruments to assess skin tear knowledge is psychometrically tested, nor up-to-date. OASES can be used worldwide to identify education, practice, and research needs and priorities related to skin tears in clinical practice.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Humanos , Estudos Prospectivos , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários
6.
Wound Manag Prev ; 66(10): 29-40, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33048829

RESUMO

Ulceration of the foot is a major complication of diabetes mellitus, and optimal self-care may help prevent its development. Research suggests that mobile applications (apps) may affect behavioral change. OBJECTIVE: The purpose of this study was to develop the Mobile Diabetic Foot Personal Care System (m-DAKBAS) and evaluate its effectiveness for patients with diabetes. METHOD: During Phase 1, a mobile app that included communication features, remote patient monitoring, and information was developed and pilot-tested among 10 patients. The Phase 2 study, conducted from June 2017 to April 2018, used a 2-group, pre-test/post-test design to evaluate the effect of the app on patients' knowledge, behavior, and self-efficacy scores when used for 6 months. Both the experimental (app) and control groups participated in 1 education session at the start of the study. RESULTS: Of 106 patients who enrolled, 88 completed the study (44 in the experimental group and 44 in the control group). Only 6 patients had received education about foot care previously. The average age of all participants was 51.63 years (SD = 8.08). There were significantly more women in the experimental group than in the control group (65% vs. 45.5%; P = 0.5). Each participant used the app for 24 weeks, and the data entry rate was 72.9%. Throughout the study, participants had 1977 data entries (blood glucose and foot observation) in total. Differences between pre- and post-intervention test scores were significantly higher for knowledge, behavior, and self-efficacy in both groups, but the difference was greater in the experimental group (P < .05). Only post-test knowledge scores were significantly higher in the experimental compared with the control group (P < .05). Compared to the start of the study, the proportion of participants with cracked/dry skin and inappropriate footwear was significantly lower in the experimental group but not in the control group. CONCLUSION: In this study, education and follow-up via the mobile app and verbal-only instruction increased the knowledge, behavior, and self-efficacy scores of patients in both groups. Post-study knowledge scores were significantly higher in the experimental group than in the control group. Patient education remains a crucial component of optimal care, and further development, refinement, and testing of mobile applications to improve self-efficacy and reduce the risk of diabetic foot are warranted.

7.
J Tissue Viability ; 29(4): 337-341, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32800627

RESUMO

AIM OF THE STUDY: Pressure ulcers (PUs) constitute a health issue that has a high prevalence and incidence rate in acute and long-term care, requiring long-term nursing care for treatment and prevention. Therefore, nurses should have adequate knowledge of the interventions and practices used to prevent PUs. MATERIALS AND METHODS: This study employed a descriptive and cross-sectional design to assess the level of nurses' knowledge concerning preventive interventions for PUs. Based on data found in the literature, researchers developed a 16-question Participant Information Form (including age, gender, level of education, employed ward, and training on PUs) and used this form, along with the Turkish version of the Pressure Ulcer Prevention Knowledge Assessment Instrument (PUPKAI-T), to collect data. RESULTS: A group of 471 nurses working in two foundation hospitals in 2018 participated in the study by completing a questionnaire. Among the participants, 44.2% worked in surgery, 21.2% in internal medicine, and 34.6% in other wards (such as intensive care, pediatrics, and the operating theater). Most of the nurses(73.5%) held a bachelor's degree, and their average work experience was 7.27 ± 7.00 years. It was determined that 69.4% of the nurses had not received in-service training relating to PUs, 55.6% did not attend lectures/conferences or read articles on the prevention of PUs, and 59.7% rated themselves as "adequate" in interventions used to prevent PUs. Based on the use of PUPKAI-T, 17 individuals (3.6%) scored equal to or more than the 60% cut-off value, and 454 individuals (96.4%) scored less than 60%. The mean level of knowledge on PUs was calculated as 11.1 ± 2.659 (range: 1-18) out of 26 questions. CONCLUSIONS: Results of the study showed that the general level of knowledge of nurses in preventing PUs are extremely insufficient. Therefore, various strategies should be developed to increase nurses' level of knowledge on the etiology and development, classification and observation, and risk assessment of PUs, as well as on nutrition plans and preventive interventions.

8.
Wound Manag Prev ; 66(1): 30-38, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-32459659

RESUMO

The creation of a stoma is a life-saving surgical procedure that requires major adjustments. PURPOSE: The aim of this study was to examine the relationships among family functioning, perceived social support, and adaptation to living with a stoma. METHOD: A descriptive, cross-sectional survey was conducted between October 2013 and June 2015 among consecutive patients who visited the stomatherapy unit of a university hospital in Ankara, Turkey, for regular follow-up visits. Eligibility criteria stipulated participants must be at least 18 years of age, literate, live with family, have their stoma for at least 2 months, and be willing to participate. Instruments included a demographic and stoma-related information form, the Multidimensional Scale of Perceived Social Support (MSPSS; subscale range 4-28, total score range 12-84; higher scores indicate better perceived support), the McMaster Family Assessment Scale (FAS; range 1.32-3.15; higher scores indicate deteriorating family function), and the Ostomy Adjustment Inventory Scale-23 (OAI-23; range 19-85; higher scores indicate increasing adaptation). Data were entered into statistical software for analysis that included descriptive statistics and Mann-Whitney U and Spearman correlation tests. RESULTS: Among the 75 participants (mean age 55.4 ± 12.96 years; average stoma duration 3.77 ± 4.97 years), 41 (54.7%) were male, 59 (78.7%) were married, and mean duration of living with a stoma was 3.77 ± 4.97 years. The average MSPSS score was 61.0 5 ± 15.00, the average FAS score was 1.98 ± 0.38, and the average OAI-23 score was 49.39 ± 14.62, all within the "moderate" range for their measures. Stoma complications, time since surgery, stoma self-care, marital status, whether the surgery was planned or an emergency, and employment status significantly affected MSPSS, FAS, and OAI-23 scores. As the FAS scores increased, the MSPSS (r = -.399; P = .001), and OAI-23 (r = -.300; P = .009) scores decreased. CONCLUSION: The results suggest wound, ostomy, continence nurses should assess and encourage familial and social support. Prospective studies examining the effect of familial and social support on stoma adjustment are warranted.


Assuntos
Percepção , Apoio Social , Estomas Cirúrgicos/normas , Adaptação Psicológica , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Estatísticas não Paramétricas , Estomas Cirúrgicos/efeitos adversos , Inquéritos e Questionários , Turquia
9.
Int J Nurs Pract ; 26(6): e12840, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32301580

RESUMO

AIMS: To assess the validity and reliability of the stoma self-efficacy scale for Turkish-speaking individuals with stoma. BACKGROUND: Self-efficacy in stoma care is one of the most important variables requiring compliance for an increase in the quality of life and well-being of individuals with stoma. DESIGN: A methodological study. METHODS: This study used translation and back translation for the scale's language equivalence and expert opinion for the content validity. An expert panel and 10 individuals with stoma evaluated the scale for face validity. The scale's reliability was assessed by internal consistency, Pearson correlation, and test-retest reliability in a sample of 174 individuals with stomas. The scale's construct validity was tested with confirmatory factor analysis and exploratory factor analysis. RESULTS: The content validity index was .96, and Cronbach's alpha was .95. In the test-retest analysis, the intraclass correlation coefficients were high. In the factor analysis, two factors emerged from the scale, and after the confirmatory factor analysis and scale modification, the fit indices of the model were found to provide a good level of validity. CONCLUSION: The Turkish version of the stoma self-efficacy scale is a valid and reliable tool to determine the levels of self-efficacy in individuals with stoma.


Assuntos
Colostomia/psicologia , Ileostomia/psicologia , Autoeficácia , Estomas Cirúrgicos , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Qualidade de Vida , Reprodutibilidade dos Testes , Inquéritos e Questionários , Traduções , Turquia , Adulto Jovem
10.
Wound Manag Prev ; 65(11): 33-41, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31702993

RESUMO

The spouses of persons with an ostomy can experience various problems with regard to their new life situation. PURPOSE: A study was conducted to determine the problems encountered by spouses of people with an intestinal stoma and examine practices used to address these problems. METHODS: The descriptive, cross-sectional study was conducted between November 2, 2015, and February 29, 2016, at 3 university hospitals in Istanbul, Turkey. Eligible participants were spouses of patients who were 18 years of age or older and who had a stoma for at least 3 months. During separate interviews with researchers, patients answered 15 open- and closed-ended demographic and clinical background questions, and spouses answered 10- open- and closed-ended questions regarding their demographic characteristics and 40 open- and closed-ended questions addressing the physiological, work/life, psychological, and economic problems they experienced as the spouse of a person with a stoma and how they handled these issues. Data were entered into statistical software for analysis; frequency and percentage distributions were reported. RESULTS: Participants included 80 patients and their spouses; 50 (62.5%) patients were male (average age 56.53 ±14.57 years), 55 (68.8%) did not work after the operation, 58 (72.5%) had an ileostomy, and 62 (77.5%) were cared for by their spouse. Spouses included 50 women (62.5%), average age 54.14 ± 13.63 years. Couples had been married an average of 29.87 ± 14.52 years. The most common problems reported by partners were odor (51, 63.7%), housework (27, 33.7%), anxiety (26, 32.5%), loud gas (25, 31.2%), cutting the adapter to the size of the ostomy (25, 31.2%), desperation/pessimism (24, 30.0%), and stoma appearance (23, 28.7%). Spouses cited a variety of coping mechanisms, including sleeping in different bedrooms and attributing the health problem to god's will, which sometimes added to the psychological issues they experienced. CONCLUSION: Spouses of stoma patients experience psychological and social issues and could benefit from attention to their concerns and demonstrations of how to provide care for their partners. .


Assuntos
Cônjuges/psicologia , Estomas Cirúrgicos/efeitos adversos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cônjuges/estatística & dados numéricos , Inquéritos e Questionários , Turquia
11.
J Wound Ostomy Continence Nurs ; 46(5): 434-440, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31513132

RESUMO

PURPOSE: The purpose of this study was to determine the knowledge of incontinence-associated dermatitis (IAD) among nurses working in intensive care units. DESIGN: Descriptive study. SUBJECTS AND SETTING: The study was conducted in 6 intensive care units of a 550-bed academic research hospital in Turkey. Licensed practical and registered nurses with a minimum of a Bachelor of Science in Nursing degree employed full-time on these units were invited to participate. METHODS: The survey consisted of statements that examined the demographic characteristics (14 questions) and knowledge levels (59 statements) of the nurses. For each statement, nurses were required to mark only one of the following options: "correct," "incorrect," or "no knowledge." Data were collected from July to September 2016. The Shapiro-Wilk test, Mann-Whitney U test, Kruskal-Wallis H test, post hoc multiple comparison test, and Spearman's correlation coefficient were used to analyze the data. RESULTS: Of the 126 RNs who participated in the study, 46.83% (n = 59) had an undergraduate degree in nursing. The majority (29.37%) practiced in gastroenterology surgery and urology intensive care units. The mean knowledge score was 33.05 ± 10.16 (min = 0, max = 59). The most correctly answered statement (94.44%; n = 119) was "The pH of the skin plays a role in skin barrier function." The statement with the most incorrect or "no knowledge" answers (96.03%; n = 120) was "The natural moisturizing factor found in the structure of corneocytes helps the skin to maintain its oil levels." Based on correctly answered statements, we found knowledge levels of the prevention and treatment of IAD were higher among nurses with a master of science degree in nursing (40.67 ± 4.32) and lower among licensed practical nursing (29.12 ± 10.08) (P < .05). CONCLUSION: In this study, knowledge of the nurses on identification, prevention, and treatment of IAD was low. Comprehensive basic nursing education and in-service training programs on IAD are recommended.


Assuntos
Competência Clínica/normas , Dermatite/enfermagem , Enfermeiras e Enfermeiros/normas , Adulto , Competência Clínica/estatística & dados numéricos , Incontinência Fecal/enfermagem , Feminino , Humanos , Unidades de Terapia Intensiva/organização & administração , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/estatística & dados numéricos , Higiene da Pele/enfermagem , Inquéritos e Questionários , Turquia , Incontinência Urinária/enfermagem
12.
J Wound Ostomy Continence Nurs ; 46(2): 117-123, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30844868

RESUMO

PURPOSE: The purpose of this study was to determine nurses' knowledge and practices regarding pressure injury and identify relationships between these factors and professional nurse characteristics. DESIGN: Cross-sectional, descriptive study. SETTING AND SUBJECTS: The sample comprised 347 nurses attending the 2013 and 2015 Wound Management Congresses. The meetings were organized by the Wound Management Association located in Antalya, Turkey. METHODS: A 35-item data collection form was designed for purposes of this study. It divided into 2 parts: 8 items queried demographic and professional characteristics of nurse respondents. The second part comprised 9 cases describing patients with pressure injury; these cases were associated with 27 items querying pressure injury-related knowledge and practices. Demographic and professional characteristics of nurse respondents were summarized via descriptive statistics. The Kruskal-Wallis H and Mann-Whitney U tests were used to identify relationships between nurse characteristics and pressure injury knowledge and practices. RESULTS: The mean score for the 27 items related to pressure injury knowledge and practices was 57.37 ± 14.26 out of 100 points. Pressure injury knowledge and practices were positively associated with nurses having a bachelor's and/or postgraduate degree (P = .012), nurses caring for a higher number of patients with pressure injuries per week (P = .042), nurses practicing in intensive care units and wound care clinics (P = .011), nurses with specific education in pressure injury (P = .000), and those indicating adequate skills and knowledge in pressure injury (P = .005). CONCLUSIONS: Nurses' knowledge and practices regarding pressure injuries were lower than anticipated in this sample. We recommend additional education and training activities to increase nurses' knowledge and practices related to pressure injury.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Enfermeiras e Enfermeiros/normas , Lesão por Pressão/diagnóstico , Adulto , Competência Clínica/normas , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras e Enfermeiros/psicologia , Lesão por Pressão/fisiopatologia , Estatísticas não Paramétricas , Inquéritos e Questionários , Turquia
13.
Worldviews Evid Based Nurs ; 15(1): 54-61, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29210516

RESUMO

BACKGROUND: A reduction in tissue tolerance promotes the development of pressure ulcers (PUs) and incontinence-associated dermatitis (IAD). AIMS: To determine the cost-effectiveness and efficacy of evidence-based (EB) nursing interventions on increasing tissue tolerance by maintaining tissue integrity. METHODS: The study involved 154 patients in two intensive care units (77 patients, control group; 77 patients, intervention group). Data were collected using the following: patient characteristics form, Braden PU risk assessment scale, tissue integrity monitoring form, PU identification form, IAD and severity scale, and a cost table of the interventions. Patients in the intervention group were cared for by nurses trained in the use of the data collection tools and in EB practices to improve tissue tolerance. Routine nursing care was given to the patients in the control group. The researcher observed all patients in terms of tissue integrity and recorded the care-related costs. RESULTS: Deterioration of tissue integrity was observed in 18.2% patients in the intervention group compared to 54.5% in the control group (p < .05). The average cost to increase tissue tolerance prevention in the intervention and control groups was X¯ = $204.34 ± 41.07 and X¯ = $138.90 ± 1.70, respectively. LINKING EVIDENCE TO ACTION: It is recommended that EB policies and procedures are developed to improve tissue tolerance by maintaining tissue integrity. CONCLUSIONS: Although the cost of EB preventive initiatives is relatively high compared to those that are not EB, the former provide a significant reduction in the prevalence of tissue integrity deterioration.


Assuntos
Dermatite/etiologia , Lesão por Pressão/prevenção & controle , Análise Custo-Benefício , Enfermagem Baseada em Evidências/métodos , Incontinência Fecal/complicações , Humanos , Unidades de Terapia Intensiva/organização & administração , Turquia , Incontinência Urinária/complicações
14.
Ostomy Wound Manage ; 63(10): 34-41, 2017 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29091036

RESUMO

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.


Assuntos
Equipamentos e Provisões/efeitos adversos , Enfermeiras e Enfermeiros/psicologia , Percepção , Lesão por Pressão/prevenção & controle , Adulto , Atenção à Saúde/métodos , Feminino , Humanos , Unidades de Terapia Intensiva/organização & administração , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Enfermeiras e Enfermeiros/estatística & dados numéricos , Lesão por Pressão/etiologia , Estudos Prospectivos , Inquéritos e Questionários , Turquia , Recursos Humanos
15.
J Clin Nurs ; 26(11-12): 1632-1638, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27535654

RESUMO

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.


Assuntos
Injeções Intramusculares/métodos , Manejo da Dor/métodos , Medição da Dor , Dor/prevenção & controle , Percepção , Pressão , Adolescente , Adulto , Ansiedade , Feminino , Humanos , Injeções Intramusculares/efeitos adversos , Masculino , Dor/fisiopatologia , Manejo da Dor/enfermagem , Distribuição Aleatória , Estudantes , Adulto Jovem
16.
J Wound Ostomy Continence Nurs ; 43(4): 392-7, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27196688

RESUMO

PURPOSE: The aim of this study was to determine the impact of colostomy and ileostomy on Muslim patients' acts of worship. DESIGN: This was a cross-sectional, descriptive study. SUBJECTS AND SETTING: The research setting was a stoma therapy unit of a 500-bed capacity training and research hospital in Ankara, Turkey. The study sample comprised 150 patients with colostomies (40.7%) or ileostomies (59.3%); their mean age was 51.6 ± 12.9 (mean ± standard deviation), more than half (60.7%) were men, and 84.7% were married. METHODS: Participants were queried about specific religious practices following ostomy surgery including those related to salat, fasting, and pilgrimage. Data were collected using forms specifically designed for this study; respondents were interviewed either face-to-face or via telephone. Descriptive statistics were used to characterize the influence of a fecal ostomy on specific religious activities. RESULTS: Participants reported decreasing the frequency of daily and Friday prayers (25.2% and 22.7%, respectively) or stopped practicing these activities all together (12.0% and 14.0%, respectively). Respondents tended to increase the frequency of acts of absolution while reducing acts of fasting. Perceptions of cleanliness, central to performance of salat within the Islamic faith, emerged as a central concern. CONCLUSIONS: Ostomy surgery influences multiple religious acts practiced by Muslims. Awareness of the potential impact of a fecal ostomy on religious acts within the Islamic faith, combined with specialized education about spiritual practices delivered by the WOC nurse or a knowledgeable resource person, is strongly recommended for all persons following ostomy surgery.


Assuntos
Colostomia/psicologia , Ileostomia/psicologia , Islamismo/psicologia , Qualidade de Vida/psicologia , Espiritualidade , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estomas Cirúrgicos/normas , Turquia
17.
Ostomy Wound Manage ; 62(2): 12-22, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26901386

RESUMO

Pressure ulcers do not develop only in areas with bony prominences; they can develop in any tissue under pressure, including pressure exerted by medical devices. A prospective, descriptive study was conducted from December 15, 2013 to March 25, 2014 to determine the prevalence, risk factors, and characteristics of medical device-related hospitalacquired pressure ulcers (MDR HAPUs) among all patients (N = 175) in 5 adult intensive care units (ICUs) in a university hospital in Turkey. The previously established point prevalence of hospital-acquired pressure ulcers (HAPUs) in these ICUs was 15%. Patients were evaluated in the first 24 hours after admission and observed 6 times thereafter in intervals of 48 hours. Demographic (eg, age, gender, body mass index) and medical device-related pressure ulcer data (eg, location, device type, stage), and Braden Scale scores were collected and analyzed; frequencies and percentages were calculated and Mann-Whitney U Test, t-test, and odds ratios were applied. Twenty-seven (27) patients (15.4%) developed nonMDR HAPUs and 70 (40.0%) developed MDR HAPUs. MDR HAPUs occurred most frequently (45.0%) in patients with an endotracheal tube. The most frequent type (42.6%) was Stage II. The highest rates of MDR HAPUs were observed among internal medicine ICU patients (OR 7.041), patients who also had a nonMDR HAPU (OR 6.6), patients in the high Braden risk score group (OR 1.8), or patients who received enteral feeding (OR 2.12). Because of the high rate of MDR HAPUs noted, policies and procedures aimed at preventing medical device-related pressure ulcers are needed.


Assuntos
Cuidados Críticos , Equipamentos e Provisões/efeitos adversos , Lesão por Pressão/epidemiologia , Adulto , Idoso , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco , Turquia
18.
Ostomy Wound Manage ; 62(2): 34-40, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26901388

RESUMO

Risk evaluation scales are used as part of prevention strategies for pressure ulcers (PUs). Two of the more used scales, the Braden and Waterlow Pressure Ulcer Risk Assessment Scales (B-PURAS and W-PURAS, respectively) are used in Turkey and worldwide, and their validity in terms of sensitivity, specificity, and predictive validity have been examined in various studies. To determine nurses' opinions of B-PURAS and W-PURAS in terms of administration time, practicality, clarity, and perceived ability to encompass PU risks and accurately predict PUs, a descriptive study was conducted from October 15, 2011 to November 20, 2011 at a university hospital among nurses who volunteered to participate. Demographic information collected and assessed included age, highest degree of education completed, and practice area. Participants were trained to use both scales by researchers during a 1-hour session and asked to use them for 2 weeks in their daily practice. The nurses then completed a paper-and-pencil, 12-item questionnaire measuring agreement with general questions about PURAS with options to provide comments. In addition, the questionnaire contained 3 openended questions on scale preference, 1 question to rate perceived scale accuracy in predicting PUs, and the opportunity to recommend changes to the scales. Data were analyzed using SPSS 20.0. Frequencies, percentages, and Spearman's rank correlations were calculated. Eighty-three (83) registered nurses (mean age 27.46 ± 3.73, mean nursing experience 6.53 ± 3.25 [range 0.5-16] years) participated; 18.1% of the nurses had prior experience using such scales, and none of the clinics in the study facility had used PU risk scales previously. Most participants (71, 85.5%) had a bachelor's degree, 62 (74.7%) worked in a facility that admitted patients at high risk for developing PU, but 66 (almost 80%) saw fewer than 4 ulcers per week. Each nurse performed an average of 22 assessments during the study for a total of 1,826 assessments. Participants generally found both scales practical and appropriate; almost 75% thought the B-PURAS was acceptable for use in all clinics, compared to 51% for the W-PURAS; only 20 participants questioned the scales' accuracy in predicting PUs. While 43% preferred the B-PURAS for precision, clarity, and practicability, 25% preferred the W-PURAS because it was more comprehensive. Also, the older the nurse, the more likely the preference for the B-PURAS (P less than 0.019). Some nurses (13%) suggested adding different risk factors such as serum albumin. Overall, 61.4% stated they would prefer to use the B-PURAS over the W-PURAS. Nurses' recommendations should be considered for practice and new scale development and testing, ideally in different patient populations.


Assuntos
Atitude do Pessoal de Saúde , Avaliação em Enfermagem , Lesão por Pressão/diagnóstico , Lesão por Pressão/etiologia , Adulto , Feminino , Humanos , Masculino , Recursos Humanos de Enfermagem , Projetos Piloto , Lesão por Pressão/enfermagem , Medição de Risco , Turquia , Adulto Jovem
19.
Ostomy Wound Manage ; 61(10): 16-29, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26479123

RESUMO

Patients with a stoma undergo physiological, psychological, and social adjustment to their new life situation. A descriptive, prospective study was conducted to assess adaptation among patients >18 years of age with a new temporary or permanent colostomy or ileostomy living in Turkey and receiving care at a participating stomatherapy unit. The study took place between September 1, 2011, and September 1, 2012. During hospitalization and following discharge, patients with a stoma received training and counseling according to their individual characteristics and their physiological, psychological, and social needs. Each participant completed the 19-item "Identification Form for Patients with a Stoma" at the beginning of the study to document sociodemographic and stoma characteristics. To assess adjustment to the stoma, The Ostomy Assessment Inventory (OAI-23) was administered 2 times - the first within 1 month and the second within 6 months after surgery or when a temporary stoma was closed (whichever came first). This instrument comprised 23 items regarding adaptation to the stoma using Likert-type response options (0-4 range). Total scores ranged from 10 to 92, with higher scores indicating better adjustment. The instruments were completed by stoma and wound care nurses during face-to-face interviews. Data were analyzed using the Kruskal-Wallis, Mann-Whitney, and Wilcoxon tests. Of the 135 participants, the majority (77, 57.0%) were male; 73 (54.1%) had a colostomy, and 106 (78.5%) had a temporary stoma. The primary reason for stoma creation was cancer (89, 65.9%). Mean total OAI-23 scores were 48.63 ± 13.75 at the first administration and 50.59 ± 13.89 for the second. In terms of sociodemographic factors, significant increases in mean scores from the first to the second survey time were noted among patients in the 50-69 age group, women, married persons, and unemployed persons (P less than 0.05). With regard to stoma characteristics, the OAI-23 scores of patients with planned stoma operations and persons with permanent stomas increased significantly (P less than 0.05) between assessments. Significant increases in OAI-23 scores also were noted among persons who did not receive information before the operation, patients whose stoma site was not marked, and patients who had experienced a complication (P less than 0.05). Postoperatively, it is important to consider sociodemographic and stoma characteristics as well as preoperative variables that may influence adaptation to stoma. Additional larger, multicentered studies with extended patient follow-up are warranted.


Assuntos
Ajustamento Emocional , Autocuidado/psicologia , Ajustamento Social , Estomas Cirúrgicos/efeitos adversos , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Autocuidado/métodos , Inquéritos e Questionários , Turquia
20.
J Prof Nurs ; 31(3): 262-70, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25999200

RESUMO

The development of professional attitudes in nursing students is influenced by their learning experiences (knowledge, skills, and attitudes) and instructors' professional behaviors. Instructors can enhance students' professional attitude by organizing the training environment, being a role model, and providing counseling. This study was conducted as a tailoring intervention study over 4 years (2010-2013) examining 73 nursing students (34 intervention, 39 control) to determine the effect of training and counseling on nursing students' professional attitudes. Data were collected utilizing the Introductory Characteristics Form and the Instrument of Professional Attitude for Student Nurses. Intervention group students were provided training and counseling complementing their current education to develop their professional attitudes. Controls proceeded with their current education. Instrument for Professional Attitude for Student Nurses posttest scores of the intervention group were significantly higher than those of control group students. Furthermore, intervention group scores on all subscales other than "competence and continuous education" significantly increased after training. Controls showed no growth in professional attitudes, other than in "contribution to scientific knowledge." The training and counseling program had a positive influence on the professional attitudes of nursing students. Thus, providing tailored training and counseling associated to professionalism throughout the educational process at schools providing nursing training is recommended.


Assuntos
Atitude , Aconselhamento , Estudantes de Enfermagem/psicologia , Humanos , Estudos Longitudinais
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...