Validity and Reliability of the Pieper-Zulkowski Pressure Ulcer Knowledge Test for Use in Turkey.

OBJECTIVE: To assess the validity and reliability of the Pieper-Zulkowski Pressure Ulcer Knowledge Test (PZ-PUKT) for use in Turkey. METHODS: This methodological study was carried out at a state hospital from June to November 2022. The authors used the PZ-PUKT and nurse identification form for data collection. They assessed the validity and reliability of the PZ-PUKT for Turkish society by evaluating language validity, content validity index, exploratory factor analysis, confirmatory factor analysis, Cronbach α, Spearman-Brown Split-Half analysis, item-scale correlations, and test-retest correlations. RESULTS: Item-level content validity indices ranged from .778 to 1.000 and the scale-level content validity index was .960. Factor loadings of the Turkish version of the PZ-PUKT ranged between .297 and .671. Cronbach α coefficients for the scale subsections were .838 for wounds, .851 for prevention, and .844 for staging; the Cronbach α coefficient was .936 for the total scale score. CONCLUSIONS: The PZ-PUKT is valid and reliable for use with nurses in Turkey. The authors recommend using the Turkish version of the tool in education and research to assess nurses' pressure injury knowledge.

The Effect of Exaggerated Lithotomy Position on Shoulder Pain after Laparoscopic Cholecystectomy.

BACKGROUND: The exaggerated lithotomy position with the expertise of nurses can be successful solution for the patients who have the postoperative shoulder pain after laparoscopic cholecystectomy. AIMS: This study aimed to determine the effect of applying an exaggerated lithotomy positions to patients who had laparoscopic cholecystectomy to relieve shoulder pain. The study was conducted on nonrandomized groups and made as a semiexperimental study with a pretest/post-test control group design. Design, Settings, and Subjects/Participants: The study was conducted on 102 patients who had elective laparoscopic cholecystectomy and agreed to participate in this study after they met the inclusion-exclusion criteria in the general surgery clinic of a training and research hospital in Istanbul between December 12, 2012, and June 30, 2013. METHODS: The pain levels (10 minutes before and after positioning) and peripheral oxygen saturation (SPO2) levels (1 minute, 5 minutes, and 10 minutes before and after positioning-total 6 times) of the patients were measured using a visual analog scale and pulse oximetry, respectively. The pain levels and the analgesic (pethidine hydrochloride and diclofenac sodium) usage of the patients in both the experimental and the control group were compared. RESULTS: The exaggerated lithotomy position appreciably lowered the shoulder pain of the patients in the experimental group (t = 12.663; p = .000 < .001). It also increased peripheral saturation levels of the patients more rapidly compared with those in the control group receiving analgesics (t = 17.693; p = .000 < .005). In addition, it decreased the need to use additional analgesics and opioids (t = 2.14; p = .037). CONCLUSIONS: In this study the exaggerated lithotomy position was found to be fast and effective for relieving shoulder pain after laparoscopic cholecystectomy, decreased the need to use additional analgesics and opioids, and, in conjunction with pain control, also contributed to improvements in respiratory functions.

Patients' experience of pain after cardiac surgery.

Pain after Cardiac Surgery (CS) is the most common patient complaint. However the first 48 h after surgery, when patients' pain is the most severe, is generally spent in the Intensive Care Unit (ICU). It is almost impossible for patients to report their pain because of their inadequate level of consciousness in the ICU. Many factors alter verbal communication with patients, such as administration of sedative medications, mechanical ventilation, and patients' changed level of consciousness. This descriptive study was conducted for the purpose of describing the experience of pain in CS patients in the ICU and determining situations that affect their pain. This research was conducted with 300 adult patients at a Ministry of Health Hospital who stayed in a cardiac surgery ICU post-operatively for a minimum of 48 h, had a sternal incision, chest tube, and required mechanical ventilation. The data were collected from the patients in face-to-face interviews by the researchers following transfer from the ICU to the surgical ward within 48 h of transfer. Most patients described their pain as aching (n = 177) and throbbing (n = 154). The presence of chest tubes (n = 95), endotracheal tube suctioning (n = 47), change of dressings (n = 27) and the use of air mattresses (n = 20) were also identified as painful experiences for patients. Based on these results it can be said that CS patients experience pain in the ICU, however they verbalized it with different words and identified different situations that decreased or increased their pain, which shows the subjective and complex nature of pain.

[The determination of the pain relief approaches in emergency trauma units]. / Acil travma ünitelerinde agri geçirme yaklasimlarinin belirlenmesi.

This definitive study has been performed to assess the approach to pain relief in emergency trauma units. The study population consisted of patients seen at the emergency trauma clinics of three different, state-owned, research hospitals in the city of Istanbul. A total of 375 patients with an age range of 18-65 were included. The data were obtained from an 18 question data sheet. Trauma was caused by a fall in 46.1% of the patients and 66.7% of the cases were out of building. Blunt trauma was the cause in 85.6%, 31.2% had head trauma, 38.1% extremity injuries. Of the patients enrolled in the study, only 17.1% (64 patients) had received analgesics. The most common analgesic medication group used was Nonsteroid Anti Inflammatory Drugs (NSAID). According to these results, 82.9% of patients with pain due to trauma had not received analgesics and it can be concluded that pain in trauma patients is undertreated.

[The reasons for postponement of scheduled orthopedic surgical operations and its effect on the patients' anxiety and pain levels]. / Ortopedik cerrahi girisimlerin ertelenme nedenleri ve ertelemenin hastalarin anksiyete ve agri düzeylerine etkisi.

OBJECTIVES: This comparative-descriptive study was planned to evaluate the reasons for postponement of scheduled orthopedic surgical operations and its effect on anxiety and pain levels of patients. METHODS: The study included 100 patients (age range 21 to 56 years) who were admitted to the orthopedics department for a scheduled surgical operation in the lower extremity. Fifty patients who were subject to postponement of the operation on the scheduled day comprised the study group, and 50 patients who underwent surgery on the intended day comprised the controls. Data were collected by means of a patient questionnaire, the Spielberger State and Trait Anxiety scale, and a pain assessment scale. Evaluation of pain was made six times at regular intervals within 48 hours postoperatively. The results were compared. RESULTS: The most common reason (28%) for postponement was the presence of medical diseases on the part of the patient. Most frequently, the decision for postponement came from anesthesiologists (42%). Compared to the preoperative level, the mean state anxiety score showed a significant increase following the notification of the patients concerning the postponement (p=0.001). The number of patients who reported "disturbing pain" was at all times high in the study group, being significantly more in the second, third, and sixth evaluations. CONCLUSION: Postponed surgical operations result in an increased degree of emotional trauma and pain in patients assigned to have orthopedic surgical interventions.

Prevalence of cancer pain in outpatients registered to a cancer therapy center in Turkey.

INTRODUCTION: Although the World Health Organization (WHO) has stated that cancer pain can be controlled in 85-97% of cases with knowledge and technology available today, effective pain control is about 40%. This situation emphasizes the necessity of discussing cancer pain again. OBJECTIVE: This descriptive study was conducted with the aim of determining prevalence, severity, region and frequency of cancer pain in patients registered to a cancer treatment center. MATERIALS AND METHODS: A total of 256 patients who were treated in the outpatient clinic of a cancer center in Istanbul in 2010 constituted the study population and 99 cancer patients who agreed to participate in the study and could be reached constituted study sample. The study was completed with 49 (49.5%) patients as 50 (50.5%) out of 99 patients who were reached did not report pain. RESULTS: Of the patients with cancer pain, 30.6% (n=15) had colon/rectum cancer, 24.5% (n=12) had lung cancer and 51% (n=25) had metastasis. Pain was in lower extremities in 34.3% (n=35), 57.1% (n=28) had moderate pain, 24.5% (n=12) had severe pain and pain was constant in 28.6% (n=19). Additionally, 20.4% (n=10) were not receiving pain treatment. Usually opioids, nonsteroidal anti-inflammatory drugs (NSAIDs) and adjuvant analgesics were being used in combination for pain treatment. CONCLUSION: The fact that 20.4% (n=10) of 49 patients were not receiving pain treatment and half of the cancer patients under control are experiencing pain is bothersome and thought provoking.

[Pain severity and analgesia approaches in adult trauma patients]. / Yetiskin travma hastalarinda agri siddeti ve analjezi yaklasimlari.

This study was carried out descriptive for determine trauma patient's pain severity and pain relief approaches. This scope of the research covered 418 patients who were between 18-65 years and applied to emergency unit of two training hospitals because of the trauma in Istanbul. The data of the research were collected by using individual characteristics form and forth section of Mc Gill Pain Questionnaire form. It was determined that all patients had pain after trauma. Moreover, 14.6 % (n=61) of the patients defined the pain "severe", 51.7 % (n=216) that they defined the pain "much severe" and 33.7 %(n=141) that they defined the pain "unbearable". Nonsteroid Antiinflammatory Drugs (NSAID) were given only 85.9 % (n=359) that they had pain. Besides, being extra to NSAID opioid was given to 14.1% (n=59) of the patients by 95.5% (n=416) intramuscular approach and 62.9 % (n=293) of the patients, whose pains were not over in spite of the pain treatment Based on these results, trauma patients' pains still haven't been handled as a serious problem. Also, it can be said that there is hot any effective pain relief approach at emergency units yet.

Are patients in Western Turkey contented with healthcare services?: a quality assessment study.

The purpose of this study was to describe service quality as perceived by 1200 patients who had inpatient treatment at 3 hospitals in Istanbul: university, social security administration, and government. Patients were most satisfied with the helpful attitudes of personnel during check-in procedures, promptness and skill of nurses, overall service provided by physicians, speedy and skilled work of personnel in laboratories and X-ray rooms, and hospitals in general.

Quality of life in women with breast cancer in Turkey.

PURPOSE: To determine quality of life (QoL) of Turkish women with breast cancer, and to examine whether QoL was related to sociodemographic or clinical variables. DESIGN: This descriptive study was conducted with a convenience sample of 72 Turkish women with breast cancer recruited from two hospitals in Turkey. METHODS: The data were collected using a questionnaire, the Quality of Life Scale (QoLS), and the Visual Analogue Scale (VAS), and were analyzed using descriptive statistics. FINDINGS: Two sociodemographic variables (educational background and employment status) were related to QoL of women with breast cancer. No statistically significant difference was found between patients with and without pain on scores obtained from the overall QoLS. CONCLUSIONS: The mean scores of total scale and subscales related to QoL perceived by women were considered to be moderately high. However, findings showed that educational level, employment status, and level of pain affected the level of QoL in Turkish women with breast cancer in varying degrees. Further studies are needed to determine specific effects of sociodemographic and clinical variables on QoL.

How do intensive care nurses assess patients' pain?

Identification and evaluation of pain in critical care patients may be difficult because of communication problems. Moreover, at present there are very few nursing studies that examine the attitudes of critical care nurses towards the assessment of patients' pain. This study was designed to determine the approach of critical care nurses towards assessing patients' pain levels, and to evaluate the problems in nursing diagnosis of those having difficulty in articulating their pain symptoms. We used a questionnaire to assess nurses attitudes to patients' pain. The study sample consisted of 91 critical care nurses who were recruited between January and February 2002. The results suggest that patient pain was considered undesirable by 44% of nurses. About 70-3% of the nurses reported resorting to administering analgesics to relieve their patients' pain. Some 57.1 % of nurses stated that they would have investigated whether the patients had really been experiencing pain, prior to administering the prescribed analgesics to patients. Some 85.7% of the sample indicated that the patients themselves would make the most accurate evaluation of their pain. The data suggested that 39.6% of nurses did not know how to evaluate pain symptoms in critical care patients suffering from complicated problems, and that 37.4% evaluated pain by monitoring the patients' behaviours. The study demonstrated that most of the critical care nurses did not know how to evaluate pain in patients having communication problems. The paper concludes by suggesting that there is a clear need to address nursing education and training with regard to evaluation and management of patients' pain whilst in critical care environment.