Effects of Transcutaneous Electrical Nerve Stimulation on Mastectomy Pain, Patient Satisfaction, and Patient Outcomes.

PURPOSE: Mastectomy is one of the most painful surgical procedures. Postoperative pain guidelines recommend transcutaneous electrical nerve stimulation (TENS) as a reliable non-pharmacological analgesic method. The aim of this study was to investigate the effects of TENS on postoperative pain and outcomes in patients undergoing modified radical mastectomy (MRM). DESIGN: A single-center, single-blind, prospective, randomized-controlled study. METHODS: This single-center, single-blind, randomized-controlled study included a total of 80 patients who underwent MRM at general surgery clinic of a tertiary center were included. The pain management of the patient outcomes were evaluated using the Turkish Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R-TR). FINDINGS: The pain levels of the intervention group were lower than the control group. There were significant improvements in the patient outcomes such as mobilization, position, sleep, anxiety, and fear in the intervention group. CONCLUSIONS: Our study results suggest that TENS reduces MRM pain. Thus, TENS can be recommended as a useful analgesic method in MRM.

The effect of standard pain assessment on pain and analgesic consumption amount in patients undergoing arthroscopic shoulder surgery.

Pain assessment has a key role in relief of the postoperative pain. In this study, we aimed to examine the effect of the Standard Pain Assessment Protocol (SPAP), which we developed based on acute pain guidelines, on pain level, and analgesic consumption. The study population consisted of a total of 101 patients who had arthroscopic shoulder surgery. The routine pain assessment was administered to the control group, while the SPAP was administered to the study group. The routine pain therapy of the clinic was administered to the subjects from both groups based on the pain assessment. Throughout the study, pain was assessed nearly two times more in the study group (p<0.001) and the mean pain levels were lower at 8th-11th hours in the study group (p<0.001). Pain assessment was not performed after 12th hour despite the severe pain in the control group, and, therefore, analgesia was administered at irregular intervals or was not administered at all. However, the hours of analgesic administration were found to be more regular according to the pain levels of the patients in the study group. In conclusion, the SPAP reduced the pain level by providing regular analgesia when used in combination with regular pain assessment. PERSPECTIVE: This article highlights the appropriate assessment for patients with surgical pain. In majority of literature on the subject, the authors emphasize the importance of Standard Pain Assessment Protocol to provide adequate pain relief.

The Effect of Cold Vapor Applied for Sore Throat in the Early Postoperative Period.

PURPOSE: This study was conducted for the purpose of determining the effect of cold vapor applied for sore throat in the early postoperative stage. DESIGN: A quasi-experimental design was used. METHODS: The study sample consisted of 60 patients who underwent lumbar disc herniation surgery in the Neurosurgery Clinic of Gazi University Health Research and Practice Center in Ankara, Turkey. The study involved two intervention groups and one control group. The study data were collected through questionnaire and observation forms. FINDINGS: 65% (n = 39) of patients experienced sore throat. There were no statistical differences between the groups in terms of sore throat and hoarseness (P > .05); however, a significant difference was determined in the group to whom oxygen together with cold vapor was applied for dry throat (4th and 8th hours) and swallowing difficulties(8th and 12th hours) (P < .05). CONCLUSIONS: Cold vapor did not have an effect on sore throat on its own; however, it decreased hoarseness and swallowing difficulties when applied together with oxygen.

The effect of ethics training on students recognizing ethical violations and developing moral sensitivity.

BACKGROUND: Moral sensitivity is a life-long cognitive ability. It is expected that nurses who work in a professional purpose at "curing human beings" should have a highly developed moral sensitivity. The general opinion is that ethics education plays a significant role in this sense to enhance the moral sensitivity in terms of nurses' professional behaviors and distinguish ethical violations. AIM: This study was conducted as intervention research for the purpose of determining the effect of the ethics training on fourth-year students of the nursing department recognizing ethical violations experienced in the hospital and developing ethical sensitivity. METHODS: The study was conducted with 50 students, with 25 students each in the experiment and control groups. Students in the experiment group were provided ethics training and consultancy services. The data were collected through the data collection form, which consists of questions on the socio-demographic characteristics and ethical sensitivity of the students, Moral Sensitivity Questionnaire, and the observation form on ethical principle violations/protection in the clinic environment. The data were digitized on the computer with the SPSS for Windows 13.0 program. The data were evaluated utilizing number, percentile calculation, paired samples t-test, Wilcoxon test, and the McNemar test. RESULTS: The total Moral Sensitivity Questionnaire pre-test score averages of students in the experiment group were determined to be 93.88 ± 13.57, and their total post-test score averages were determined to be 89.24 ± 15.90. The total pre-test score averages of students in the control group were determined to be 91.48 ± 17.59, and their total post-test score averages were determined to be 97.72 ± 19.91. In the study, it was determined that the post-training ethical sensitivity of students in the experiment group increased; however, this was statistically not significant. Furthermore, it was determined that the number of ethical principle protection/violation observations and correct examples provided by students in the experiment group were higher than the control group and the difference was statistically significant. ETHICAL CONSIDERATIONS: Written permission and ethical approval were obtained from the university where the study was conducted. Written consent was received from students accepting to participate in the study. CONCLUSION: As a result, ethics education given to students enables them to distinguish ethical violations in a hospital and make a proper observation in this issue.

Effectiveness of home monitoring according to the Model of Living in hip replacement surgery patients.

AIMS AND OBJECTIVES: To evaluate the effectiveness of home monitoring according to the Model of Living in hip replacement surgery patients. BACKGROUND: Hip replacement surgery is important for increasing the quality of life of patients. After these operations, patients may encounter many problems having an impact on their activities of daily living. DESIGN: Quasi-experimental. METHODS: Sixty patients were included in the study: 30 in the experimental group and 30 in the control group. Patients in the control group received the existing care provided in the hospital. In addition to existing care, patients in the experimental group received training and counselling according to the Model of Living from the time of admission to the clinic. After discharge, home monitoring was performed in the 1st and 6th weeks for control group patients and in the 1st, 3rd and 6th weeks for experimental group patients. Statistical analysis was carried out using percentage calculations, mean, median, chi-square test, Fisher's exact test, likelihood ratio test, Mann-Whitney U-test, Kruskal-Wallis test, anova for repeated measures, independent-sample t-test, Friedman test, McNemar test and McNemar-Bowker tests. RESULTS: It was found that the experimental group patients' knowledge scores increased, they were more independent in performing activities of daily living, and they encountered less problems in the 1st and 6th week after discharge. CONCLUSION: As a result, it can be claimed that by means of providing training, counselling and home monitoring hip replacement surgery patients according to the Model of Living, the level of knowledge of patients on activities of daily living increased, they were more independent in daily living activities, and they experienced less problems. RELEVANCE TO CLINICAL PRACTICE: The use of the Model of Living in the home monitoring of patients who have undergone hip replacement surgery could assist in focusing on the problems most frequently experienced by patients in postoperative care and achieving effective solutions.

The Problems Experienced by Parents Providing Postoperative Home Care Following Their Child's Surgery for Developmental Dysplasia of the Hip.

BACKGROUND: Families, especially mothers, experience problems providing home care after their child's surgery for developmental dysplasia of the hip (DDH). PURPOSE: To assess the problems experienced by parents providing postoperative home care to their child after DDH surgery. METHODS: This was a descriptive cross-sectional study. The sample consisted of 33 parents. Data were collected through a survey conducted at the hospital following the child's surgery and by telephone 4-6 weeks after surgery. Frequencies, means, percentages, and chi-square tests were used to analyze the data. RESULTS: The parents (93.9% women) provided postoperative care for approximately 3 months. Nearly all of the parents (97%) had physical (96.9%), psychological (65.6%), and social (75.0%) problems in addition to child care problems. CONCLUSIONS: We recommend preparing a comprehensive discharge-training package for parents after their child's DDH surgery, supplementing home care instructions with visual training materials, and providing telephone counseling to parents after discharge.

Effect of mentoring program on ways of coping with stress and locus of control for nursing students.

PURPOSE: This study evaluated the effectiveness of a 14-week mentoring program for first year nursing students and their ways of coping with stress and locus of control. METHODS: The study was designed as a quasi-experimental study. Sixty-six first year students (mentees) and 66 fourth year students (mentors) were eligible to be in the mentoring program. Mentors and mentees contacted each other weekly, as required, to provide information and support. In order to determine the efficiency of the mentoring program, a Locus of Control Scale, the Ways of Coping Inventory and Mentoring Assessment Form were filled out by mentees. RESULTS: In this study the mentoring program increased students' internal locus of control and active coping with stress. The increase in internal locus of control showed parallelism with students' behaviors of seeking social support. CONCLUSION: It is recommended that in nursing schools, the mentoring program be used as an additional program.

A multicenter, retrospective study to evaluate the effect of preoperative stoma site marking on stomal and peristomal complications.

Even though preoperative marking of the stoma area is considered important for the prevention of postoperative complications, not all healthcare institutions have universally adopted this practice. A multicenter, retrospective, descriptive study was conducted to determine the effect of stoma site marking on stomal and peristomal complications. The 1-year study included 748 patients (408 [54.5%] male, mean age 56.60 ± 16.73 years) from eight stomatherapy units in Turkey. Patient data, including age, gender, diagnosis, type of surgery, history of preoperative stoma site marking, person performing the marking, and postoperative complications, were obtained from patient records, abstracted, and analyzed. Cancer was the reason for the operation in 545 (72.9%) of the cases. In 287 patients (38.4%), the stoma and wound care nurse and/or surgeon marked the stoma area; this occurred 1 day before or on the day of surgery according to Wound Ostomy Continence Nurses Society and American Society of Colon and Rectal Surgeons recommendations. Stomal/ peristomal complications developed in 248 (33.2%) persons; the most frequently observed complications in patients were parastomal skin problems (136, 48.7%), mucocutaneous separation (52, 18.6%), and retraction (31, 11.1%). The rate of complications was higher among patients whose stoma site was not marked than among those whose stoma site was marked (22.9% and 46%, respectively; P <0.001). The results of this study confirm the stoma area should be marked preoperatively in all planned surgical interventions in order to reduce the risk of postoperative complications. Additional prospective and experimental studies on effectiveness of preoperative stoma site marking should be conducted with larger sample groups.

Evaluation of mentorship programme in nursing education: a pilot study in Turkey.

Mentorships increase the students' confidence, help ease the difficulties associated with their new environment and reality, increase self-esteem and help socialize students into the nursing role. The main objective of the programme was to support mentee students in facilitating their transition to the university and nursing. This descriptive, exploratory study was designed using Maslow's hierarchy of needs and a pre/post test Rotter's locus of control. Sixty-two (62) first-year students and fifty-eight (58) fourth-year students were eligible to be in the mentoring programme. Mentors and mentees contacted each other weekly as required to provide information and support. Nursing lecturers were available to support the mentors for regular contact over the 13 weeks of the programme. The data were collected by questionnaire for the first-year and fourth-year students. In addition, in order to determine the efficacy of the mentoring programme, Rotter's Locus of Control Scale was administered to first-year students both at the beginning and the end of the study. The majority of first-year students stated that they benefited from the programme. It was established that the mentoring programme influenced the locus of control positively. The mentoring programme may be used to improve the adaptation of nursing students to both the university and nursing profession.