The current status of palliative care in Turkey: a nurse's perspective.

There has been a growing awareness for the need to develop a palliative care service in Turkey. But a significant proportion of the Turkey population still does not have access to palliative care. The majority of cancer patients are treated in university hospitals that have support units with pain specialists and medical oncologists. Some significant barriers to the development of palliative care nursing were identified: 1) Lack of palliative care education and training programs 2) Lack of certification for Palliative Care Nursing 3) There is very limited research about palliative care nursing 4) lack of public awareness and 4) shortage of nursing staff 5) the limited availability of/knowledge about opioid analgesics. Nurses have a unique and primary responsibility for advocating for the right of patients to maintain their quality of life for as long as possible and to experience a dignified and peaceful death. Continued efforts are needed to overcome these barriers to successful implementation of palliative and end-of-life care for patients with cancer.

Nurses' perceived barriers to assessment and management of pain in a university hospital.

A self-report questionnaire was answered by 114 nurses working at the internal medicine, oncology, and surgery clinics. The most commonly perceived barriers to pain management were system-related barriers. Lack of psychosocial support services and patient-to-nurse ratio received the highest ratings. Institutional and governmental attempts are needed to increase the number of nurses in the clinics and to establish support services. Nurse-related barriers were less perceived as an obstacle when compared with the other barriers. A small percentage of the nurses agreed that nurses' inadequate knowledge of pain management (10%) and nurses' indifference (8%) were barriers to pain management. Inadequate time for health teaching with patients was agreed on by 65% of the nurses. Most commonly rated physician-related barriers were inadequate assessment of pain and pain relief by doctors (63%) and physicians' indifference (47%). Patients' difficulty with completing pain scales (56%) and consumers not demanding results (53%) were the most commonly reported patient-related barriers. A significant percentage of the participating nurses indicated that they have no idea about patient-related barriers. Regular and continuous pain education programs may help to establish a supportive team spirit between doctors and nurses.

Health screening: a survey of children's growth and development in Turkey.

AIM: To determine the status of children's growth and development, visual acuity and blood pressure at four to six years of age. METHODS: This descriptive study included 447 children enrolled in kindergartens in Turkey. Height, weight, developmental level, visual acuity and blood pressure of each child were assessed. RESULTS: Most children were in the normal ranges for height and weight. Application of the Denver II Developmental Test revealed no children in the abnormal category. The authors identified 66 children (14.8 per cent) with visual acuity problems. Five children (1.1 per cent) had systolic blood pressures above the recommended value for their age. CONCLUSION: A preschool screening programme is needed when children begin education, either kindergarten or primary school.

Students' opinions about and expectations of effective nursing clinical mentors.

Nursing practice is an integral part of nursing education in which clinical mentors play an important role. Mentors' attitudes, experience, and knowledge influence nursing students and help them to complete their nursing practice with success. The purpose of this qualitative study was to determine nursing students' opinions about and expectations of effective nursing clinical mentors. Focus group interviews were used to obtain data from 24 students after completion of their third year of nursing school. The students, who had nursing practice experience in internal diseases, surgery, gynecology, pediatrics, psychiatry, and public health, were divided into three groups of 8 students. The students noted that effective clinical mentors should be able to communicate without prejudice, give positive feedback, have empathy, require students to do their own research, and offer the students information.

Determining problems experienced by student nurses in their work with clinical educators in Turkey.

Clinical education is considered an indispensable and vital part of nursing education. Educators have an important role in the successful completion of a student's clinical education. The clinical educator's approach, experience and knowledge have an influence on the students. Students encounter certain problems during their clinical practice under the supervision of educators. This study was conducted to determine the nature of the problems student nurses encounter during clinical training in Turkey. The focus-group interviews were used for this study. Three groups of 8, a total group of 24, composed of students completing their third year were included in the interviews. The students in this study had completed their practical training in the departments of internal medicine, surgery, pediatrics, psychiatry and public health. Among the problems mostly encountered by students, as established by the study, were inadequate assessment by the clinical educator, judgment, negative feedback, communication problems, inadequate guidance and overload. At the end of the research, recommendations were that educators should offer information in the direction of student expectations, increase their positive feedback and lighten the academic workload of these students.

Responsibilities and difficulties of caregivers of cancer patients in home care.

BACKGROUND: From having been known as a virulent disease in 1970s, cancer is now considered a chronic disease and about two thirds of cancer patients live for five years after diagnosis. Home care has gradually gained more importance and it is a great burden on the shoulders of caregivers. Caregivers have to undertake the responsibility of the cancer patient's home management, and organize care and arrange health care services according to the ever-changing condition of patients. Caregivers should be prepared for home care so they can provide accurate and complete care. This descriptive study aimed to investigate challenges that caregivers encounter in the home care of patients and the reasons for these challenges. MATERIALS AND METHODS: The research group consisted of caregivers of outpatients in a daily treatment center in a university hospital. The research sample consisted of 137 voluntary caregivers of patients who attended the Daily Treatment Center for control, chemotherapy or other supportive cares services between January-June, 2011. Data were collected with face-to-face interviews in the Daily Treatment Center. Ethics Committee approval was taken from the university hospital; caregivers and their patients were informed about the research and their approval was obtained as well. RESULTS: It was found that 54.0% of caregivers helped with patient's nutrition, 50.4% with medicine use, 26.3% with oral hygiene, 26.3% with meeting urinary needs and 51.8% with changing clothes. In addition, 69.3% of caregivers helped to change bed sheets, 38.7% assisted patients to communicate with their environment and 71.5% to bring the patient to hospital or outside. CONCLUSIONS: In this study, it was found that Turkish caregivers experience challenges due to following factors: patient nutrition, medicine use, oral and body hygiene, colostomy maintenance and stomach tube feeding, concern of dropping the patient, feeling incompetence in body temperature and fever control, fatigue, and lack of personal time.

Sleep quality in lung cancer patients.

BACKGROUND: The aim of this study was to determine factors affecting sleep quality of 100 patients with advanced stage lung cancer. METHODS AND RESULTS: it was a descriptive study. A variety of assessment tools were used to provide sleep scores to examine the relation between adverse effects caused by the treatment (nausea, vomiting, fatigue) and sleep quality. As a result, no statistically significant relation between coughing and respiratory problems of patients, or existing depression, and average sleep quality score was found (KW:0.872, p=0.646, KW: 3.174, p=0.205, u: 441.000 p=0.916). It was revealed that nausea and loss of appetite experienced also did not affect the sleep quality score (p>0.05), whereas problems such as vomiting and fatigue did exert effects (p<0.01). CONCLUSIONS: Patients with advanced stage lung cancer suffer from sleep problems and cancer related symptoms also affect their sleep quality negatively. Nurses should plan interventions that can control symptoms such as pain, vomiting and fatigue, which affect the sleep of patients.