The effect of bed exercises following major abdominal surgery on early ambulation, mobilization, pain and anxiety: A randomized-controlled trial.

This randomized-controlled trial aimed to investigate the effect of bed exercises on postoperative anxiety, pain, early ambulation and mobilization. This study was conducted with a randomized-controlled trial design and in the general surgical clinic of a research and training hospital. A total of 120 patients (60 in the experimental group and 60 in the control group) scheduled for major abdominal surgery took part in the study. The data were collected using a patient information form, the Anxiety Specific to Surgery Questionnaire and the Visual Analog Scale through face-to-face interviews. The patients in the experimental group performed 15-min bed exercises on the day of their operation, as well as on the postoperative first and second days, and the control group underwent only the routinely performed procedures in the clinic. The data were analysed using descriptive statistics, analysis of variance and t-tests. The sample of our study included major abdominal surgery patients. Ambulation was achieved at a mean time of 4 h earlier in the experimental group. On the postoperative first and second days, the patients in the experimental group had mean mobilization durations that were approximately 2 h longer compared with the patients in the control group. Moreover, the postoperative pain and anxiety levels of the patients in the experimental group were significantly lower than those of the patients in the control group (p < 0.05). We recommend that bed exercises be performed to lower anxiety and pain severity, achieve early ambulation and increase the duration of mobilization among patients following major abdominal surgery.

Opinions of nursing and theology faculty students on Xenotransplantation.

BACKGROUND: It is mentioned that students' opinions about xenotransplantation (XTx) have been explored in a limited manner. In particular, there is no literature in Turkey on Nursing and Theology students' perspectives on XTx. This research aimed to find out what Nursing and Theology students thought about XTx. METHODS: This descriptive and cross-sectional study was conducted on students studying at the Theology and Nursing faculties. The study population consisted of 2.581 students educated in these faculties. Without using any sampling method, it was aimed to reach all students, and 1.780 (70%) students were reached. Data were collected using a participant identification form and questionnaire form, which the researchers developed. RESULTS: The difference between the answers given by the Nursing and Theology students to the information statements about XTx was statistically significant (p < .001). Nursing and Theology students' attitudes to organ or tissue Tx from halal animals in case of necessity were positive (p < .001). While the nursing students' attitude toward organ or tissue Tx from non-helal animals in case of necessity was negative, Theology students had no idea (p < .001). In other attitude statements, while nursing students responded positively, Theology students responded as "I have no idea" (p ≤ .001). CONCLUSION: Theology students tended to have the question about XTx and only positive attitude towards XTx from halal animals. Nursing students mostly had positive attitude, but negative when XTx is practiced out of necessity.

Evaluation of the effects of ketogenic diet therapy on sleep quality in children with drug-resistant epilepsy and their mothers.

BACKGROUND: Sleep disorders are common in drug-resistant children with epilepsy and their mothers. Ketogenic diet therapy (KDT) may have positive effects on sleep quality. The aim of this study was to evaluate the sleep quality of children with epilepsy and their mothers after starting KDT. METHODS: Using a prospective cross-sectional model, pre- and post-KDT questionnaires were given to the study subjects. A children's sleep habits questionnaire was administered to children with epilepsy, and the Pittsburgh sleep questionnaire was administered to their mothers. Sociodemographic and some clinical categorical variables of the patient group were evaluated using descriptive statistics. Evaluation of the data was conducted using the Wilcoxon and paired t-tests as parametric and non-parametric tests. RESULTS: Of 24 patients scheduled to begin KDT between January 2019 and January 2020, 14 were included in the study. Regarding sleep quality, improvement was reported in 7 (50%) of 14 patients, deterioration in 5 (35.7%) patients, and no change was seen in 2 (14.3%) patients. Sleep quality was reported to improve in all working mothers. Seven (50%) patients reported no seizures and 6 (42.9%) patients reported more than 50% seizure reduction. Although there were improvements in sleep scores in both groups, these improvements were not statistically significant. A significant decrease in sleep anxiety was reported in children after the third month of the KDT (p = 0.09). CONCLUSIONS: The results of this study determined that three months of KDT offered significant improvement on the sleep anxiety of children with epilepsy. It was thought that paying attention to patient selection may lead to better sleep quality by increasing compliance to KDT. However, a larger scale study and longer term follow-up should be done.

The effects of neuro-linguistic programming and guided imagery on the pain and comfort after open-heart surgery.

OBJECTIVE: The present study aims to evaluate the effects of neuro-linguistic programming (NLP) and guided imagery on postoperative pain and comfort after open-heart surgery. METHODS: In the current, prospective, randomized, single-blind clinical study, the participants received NLP with a new behavior formation technique or the guided imagery relaxation technique using an audio compact disc for a duration of 30 min. RESULTS: The patients in the NLP group had significantly lower posttest pain levels, compared to the patients in the guided imagery and control groups. Moreover, the patients in the guided imagery group had significantly higher posttest comfort levels, compared to the patients in the NLP and control groups. CONCLUSION: The application of both NLP and guided imagery interventions resulted in reduced postoperative pain and increased postoperative comfort levels after open-heart surgery.

The Effect of Immunosuppressant Therapy Adherence on the Comfort of Liver Transplant Recipients.

Inadequate immunosuppressive therapy causes rejection, whereas an overdose may lead to infections or malignancy to affect a patient's life and comfort. This study used a descriptive correlational design to determine how compliance with immunosuppressive therapy affected the well-being of liver transplant patients. The study was conducted in the liver transplant unit of a university hospital with 103 patients who underwent liver transplant surgery. The target population included patients who received treatment in liver transplant clinics between July 2016 and August 2017. Mean age of the patients in the study was 44.66 ± 14.86 years and the time after transplant was 15.48 ± 16.90 months on the average. A significant difference was found between mean General Comfort Scale scores according to the variable of adherence status (t = 6.898, p < .05). Simple linear regression analysis showed a positive moderate, significant correlation between the adherence variable and mean General Comfort Scale scores (R = 0.543, p < .001). It was found that the patients who adhered to immunosuppressive therapy experienced higher levels of comfort. Therefore, arrangements to improve patient adherence to therapy, hence comfort, are recommended, as well as periodic evaluations of patient comfort levels.

Pediatric emergency department visit characteristics of the patients on the ketogenic diet.

BACKGROUND: The ketogenic diet (KD) has been frequently used for the patients with drug-resistant epilepsy in recent years. The management of these patients in emergency departments (EDs) has some difficulties due to the special needs of KD. We aimed to determine the characteristics and the management of the patients on the KD in the pediatric ED setting. METHODS: Patients who were on the KD and admitted to the ED were included in the study. Demographic, clinical, and laboratory data of all patients were retrospectively reviewed and recorded. RESULTS: There were 105 emergency admissions of 27 patients. The median age of all patients was 55.0 (IQR: 29.0-91.0) months. The most common symptom was vomiting (43.8%). Four patients had upper gastrointestinal bleeding, and one patient had hyperammonemic acute hepatic failure while receiving KD. Of the patients, 41.9% had seizure-related ED admission. Infections were present in 41.9% of the ED visits. The frequency of status epilepticus was significantly lower in the patients who were on the KD for more than 6 months (p < 0.01). In 42.9% of all ED admissions, dextrose containing maintenance fluids was administered mistakenly; although ketosis rate was lower, no seizure was observed in this group. CONCLUSION: The patients on the KD can be admitted to EDs with intercurrent illnesses or adverse effects of the KD. For accurate management, emergency physicians must be aware of the common reasons for ED admission of these patients and the effects of the KD.

The Effects of Music on the Life Signs of Patients in the Reanimation Unit/Recovery Room After Laparoscopic Cholecystectomy.

The purpose of the study is to determine the effects of music on the life signs of patients in the postanesthesia care unit after laparoscopic surgery. The study was carried out as a quasi-experimental model with pretest-posttest and control group in the postanesthesia care unit of a training and education hospital from March 2017 to May 2018. The sample consisted of 148 patients (74 experiment and 74 control) who were selected by the method of nonprobability sampling determined on the basis of power analysis who met the inclusion criteria. When the change in the life signs between the groups was examined, after music treatment (second measurement), there was a significant difference only in the respiratory rates (P < .05). There was a significant difference in terms of diastolic blood pressures and respiratory rates in the first admission to the clinic from the postanesthesia care unit (third measurement) (P < .05).

The importance of ultrasonographic measurement of peritoneal wall thickness in pediatric chronic peritoneal dialysis patients.

Loss of peritoneal function due to peritoneal fibrosing syndrome (PFS) is a major factor leading to treatment failure in chronic peritoneal dialysis (PD) patients. Although the precise biologic mechanisms responsible for these changes have not been defined, the general assumption is that alterations in peritoneal function are related to structural changes in the peritoneal membrane. Studies of the peritoneal membrane by non-invasive ultrasonography (US) in chronic PD patients are limited. The aim of the present study is to assess the relationship between functional parameters of peritoneum and peritoneal thickness measured by US in children treated by chronic PD. We recruited two groups of patients: 23 subjects (13 females, 10 males) on chronic PD (patient group) and 26 (7 females, 19 males) on predialysis out-patient follow-up (creatinine clearance: 20-60 mL/min/1.73 m(2)) (control group). Age, sex, weight, height, body mass index (BMI), chronic PD duration, episodes of peritonitis and the results of peritoneal equilibration test (PET) were recorded. Hemoglobin (Hb), blood pressure (BP), left ventricular mass index (LVMI) and renal osteodystrophy (ROD) parameters were also obtained. The thickness of the parietal peritoneum was measured by trans-abdominal US in all children. Statistical analyses were performed by using Student's t and Pearson's correlation tests. Mean peritoneal thickness in chronic PD patients (1028.26 ± 157.26 µm) was significantly higher than control patients (786.52 ± 132.33). Mean peritoneal thickness was significantly correlated with mean body height (R(2) = 0.93, p < 0.05), BMI (R(2) = 0.25, p < 0.05), chronic PD duration (R(2) = 0.64, p < 0.05), episodes of peritonitis (R(2) = 0.93, p < 0.05), D/Pcreatinine (R(2) = 0.76, p < 0.05) and D4/D0glucose (R(2) = 0.81, p < 0.05). No correlation was found between peritoneal thickness and Hb, BP, LVMI and ROD parameters. In conclusion, ultrasonographic measurement of peritoneal membrane thickness is a simple and non-invasive method in chronic PD children. This diagnostic tool likely enables to assess peritoneal structure and function in these patients.

A single-center experience on percutaneously performed partial omentectomy in pediatric peritoneal dialysis patients.

OBJECTIVE: This study describes a single-center experience on percutaneously performed partial omentectomy procedure in pediatric peritoneal dialysis (PD) patients who showed early catheter dysfunction and required catheter replacement due to catheter flow obstruction. MATERIALS AND METHODS: We performed a retrospective review of clinical outcomes from pediatric PD patients who underwent percutaneous catheter replacement by pediatric nephrologists between November 1995 and December 2012. Partial omentectomy was performed in those patients in whom omental or adhesion trapping to the catheter tip was seen. RESULTS: During the study period, catheter dysfunction that eventually required percutaneous catheter replacement occurred in 32 (23.7%) children. Of these, 9 patients were performed partial omentectomy. Mean age at initiation of PD and time of omentectomy was 97.48 ± 46.06 and 98.53 ± 45.55 months, respectively. Catheter dysfunction appeared after a mean 1.20 ± 1.0 months. The causes of catheter dysfunction were omental wrapping and malposition. No peritonitis occurred before omentectomy. Mean total operation time was 60 ± 8.83 min. No complications were encountered during the procedure. After omentectomy, mean catheter survival period was 5.92 ± 6.88 months. A total of five peritonitis episodes occurred. Three patients were transferred to hemodialysis. Six patients were on PD treatment without any problem at the end of the first year of their follow-up. Two patients underwent kidney transplantation. Four patients were still on chronic PD treatment at the end of the study period. CONCLUSION: When performed by an experienced nephrologist, the performance of partial omentectomy by percutaneous route, when required, is an easy, safe and efficient therapeutic procedure in children on chronic PD treatment.

The Effect of Virtual Reality Practice and Music on Patients' Pain, Comfort, and Vital Signs After Laparoscopic Abdominal Surgery.

AIM: This research was conducted to identify the effect of virtual reality and music on patients' pain, comfort, and vital signs after laparoscopic abdominal surgery. METHODS: This study was designed as a prospective randomized controlled single-blind clinical trial. The research population consisted of adult patients who underwent laparoscopic abdominal surgery in surgery clinics. The research sample comprised 225 patients who had laparoscopic abdominal surgery. Experimental groups watched virtual reality videos and listened to music, whereas no intervention was administered to the control group. The research data were evaluated with descriptive statistics, the χ 2 test, the Friedman test, the one-way analysis of variance, the Kruskal-Wallis test, and Tukey's and Dunn's post hoc tests. FINDINGS: In the post-test phase after the 2 interventions, the virtual reality and music groups had lower pain and comfort levels than the control group, and this intergroup difference was statistically significant ( P <0.05). Results for vital signs in successively repeated post-test measurements after interventions were in general different, and these differences were statistically significant. Patients in the virtual reality group generally had higher pulse rate, diastolic blood pressure, respiratory rate, and body temperature values in successively repeated post-test measurements than patients in other groups ( P <0.05). Patients in the control group generally had higher systolic blood pressure and saturation values in successively repeated post-test measurements than patients in other groups ( P <0.05). CONCLUSION: It was discerned that music and the virtual reality practice reduced patients' pain and comfort levels and had positive effects on their vital signs after laparoscopic abdominal surgery.

Pain Beliefs, Coping Approaches, and Related Factors in Nursing Students.

Objectives Pain, a common human experience, is also experienced by nursing students, and pain beliefs, thoughts, and behaviors toward pain play an important role in coping with pain. There is insufficient data about the relationship between pain beliefs and pain coping strategies. Thus, this study aims to reveal the relationship between pain beliefs and pain coping approaches of nursing students and affecting factors. Methods A descriptive, cross-sectional, and correlational design was used, and the data were collected with respondent characteristics form, the Numerical Rating Scale (NRS) and the Pain Beliefs Questionnaire (PBQ), by researchers from 380 nursing students in the nursing department. Results Nursing students who used non-pharmacological interventions to cope with pain had higher levels of psychological belief (PBQ-P) scores (4.97±0.86) than organic belief (PBQ-O) scores (3.90±0.71) and the difference was statistically significant (p<0.001). According to the multivariate linear regression analysis results, nursing students' gender, utilizing non-pharmacological interventions, and NRS scores affected PBQ-P scores by 87.1% (R2=0.871) and PBQ-O scores by 81.0% (R2=0.810). Conclusions As can be seen from the results of this study, the higher psychological beliefs of nursing students who use non-pharmacological interventions to cope with pain are an example of this situation. In light of the information in this study, it should be taken into consideration that both psychological and organic beliefs have a strong relationship with pain intensity and pain coping approaches. Nursing students, the nurses of tomorrow, should be aware of the impact of psychological and organic beliefs on individuals' pain experiences and coping approaches and should take this into account when planning nursing care.

Investigation of Post-Transplant Mental Well-Being in Liver Transplant Recipients with Hepatic Encephalopathy.

Objective: In this study, we aimed to examine the healing trend of hepatic encephalopathy after transplantation surgery in patients with liver failure. Method: We conducted this descriptive and cross-sectional study with the participation of liver transplant recipients. A personal information form, the West Haven Criteria (WHC), the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS), and the Richmond Agitation Sedation Scale (RASS) were used for data collection. The data were analyzed using Chi-squared tests, ANOVA, and paired-samples t-tests. Results: As time progressed after liver transplantation, hepatic encephalopathy stages regressed (p < 0.01). We found that liver transplant recipients with end-stage hepatic encephalopathy were mostly within the first 6 months after transplantation, while patients with first-stage hepatic encephalopathy had received liver transplants more than 2 years ago (p < 0.01). Conclusions: The results of our study revealed that hepatic encephalopathy stages regressed after transplantation, but there was no complete recovery. This highlights the need to develop new treatment strategies other than liver transplantation for the treatment of hepatic encephalopathy.

Effects of inhalation of peppermint oil after lumbar discectomy surgery on pain and anxiety levels of patients: A randomized controlled study.

AIM: This study was conducted to analyze the effects of the inhalation of peppermint oil after lumbar discectomy surgery on the pain and anxiety levels of patients. MATERIALS AND METHOD: This study was performed as a randomized controlled trial from September 2022 to June 2023 with 68 patients (34 patients in the experimental group and 34 patients in the control group). A Patient Information Form, the Numerical Pain Rating Scale, and the State Anxiety Inventory were used in the data collection process. The researcher administered the Patient Information Form to the patients before they underwent surgery. The State Anxiety Inventory and the Numerical Pain Rating Scale were administered to the patients after the second hour in the postoperative period. Next, for 10 minutes, only the patients in the experimental group inhaled five drops of peppermint oil dripped on a sterile gauze pad whereas no intervention was administered to the patients in the control group. Then, the State Anxiety Inventory and the Numerical Pain Rating Scale were administered again to the patients in both groups successively after the third and fourth hours in the postoperative period. RESULTS: After the second hour in the postoperative period, the difference between the mean pain or state anxiety levels of the two groups were not statistically significant (p > 0.05). On the other hand, after the third and fourth hours in the postoperative period, the differences between the two groups were statistically significant (p < 0.05). CONCLUSION: It was concluded that the inhalation of peppermint oil after lumbar discectomy surgery reduced pain and anxiety levels.

The effect of guided imagery on postoperative pain and comfort of geriatric orthopaedic patients: a randomized controlled trial.

BACKGROUND: The purpose of this study is to investigate the effects of guided imagery on postoperative pain and comfort in geriatric orthopedics patients. METHODS: This study was carried out with a randomized-controlled true experimental design. The population of the study included geriatric patients receiving treatment at the orthopedics and traumatology inpatient clinic of a university hospital. Based on random selection, the sample consisted of total of 102 patients, including 40 patients in the experimental group and 40 in the control group. The data were collected using a Personal Information Form, the Visual Analog Scale, and the General Comfort Questionnaire. RESULTS: After the guided imagery intervention, the pain levels of the experimental group significantly decreased compared to their baseline pain levels (t = 4.002, P = 0.00). Their perceived comfort was also significantly improved (t = -5.428, P = 0.00). Although the perceived comfort of the control group decreased, this decrease was not statistically significant (t = 0.698, P = 0.489). CONCLUSION: It is recommended that guided imagery, which is an inexpensive and accessible method, be integrated into the nursing care process to reduce the pain and increase the comfort of geriatric orthopedics patients.

The effect of guided imagery applied on geriatric orthopaedic patients on preoperative anxiety and comfort.

BACKGROUND: This study was designed to examine the effect of guided imagery applied to geriatric orthopaedic patients on preoperative anxiety and comfort. METHODS: This study was conducted as a randomized controlled trial. The population of the study consisted of geriatric patients treated in the orthopaedics and traumatology clinic of a university hospital. The sample consisted of 80 patients, including the experimental group (n = 40) and the control group (n = 40). Personal Descriptive Form, The State-Trait Anxiety Inventory (STAI) and General Comfort Scale were used as data collection tools. RESULTS: After the guided imagery application, it was determined that the anxiety of the experimental group decreased statistically significantly, and their comfort improved (P < 0.05). CONCLUSION: After the imagery, it was determined that the patients in the experimental group had a decrease in their anxiety level and an improvement in their comfort. Since it is a low-cost and easily accessible method, applying imagery in the preoperative period is recommended.

Turkish Validity and Reliability Study of the Scale of Psychosocial Assessment of Candidates for Transplantation (PACT).

BACKGROUND: The Psychosocial Assessment of Candidates for Transplantation (PACT) scale shows a statistically acceptable level of reliability and validity and can guide clinicians in managing transplant candidates. This study aims to adapt PACT scale to Turkish and evaluate its validity and reliability for Turkish transplant candidates. METHODS: This was a psychometric study of a sample of 162 patients in the organ transplant services of 2 hospitals in Turkey. The number of patients enrolled in the study was 20 times the number of items on the scale. The research data were collected using PACT. Descriptive statistics, Cronbach's alpha reliability coefficient, Pearson correlation, and factor analysis were used to evaluate the data. RESULTS: The data were analyzed using varimax rotation in principal component analysis. The factor loadings of the items ranged from 0.56 to 0.79. The internal reliability coefficient of the scale is 0.87. It was also found that the scale accounted for the 52.82% of the total variance. CONCLUSION: According to the results of this study, evidence of the validity and reliability of the PACT was obtained.

A randomized controlled trial of reflexology effect after abdominal surgery on patient satisfaction, pain and vital signs.

OBJECTIVE: In our study, we investigated the effect of reflexology on patient satisfaction, pain and vital signs after abdominal surgery. METHOD: This study was conducted as a randomized controlled trial with the participation of 156 abdominal surgery patients hospitalized in the general surgery unit of a training and research hospital. Personal Information Form, Visual Analogue Scale and Newcastle Nursing Care Satisfaction Scale were used in data collection. We performed the data analysis with One-way analysis of variance, Chi-squared test, paired samples t-test, and independent samples t-test. RESULTS: When the pain, vital signs and satisfaction levels of the experimental and control groups were compared, the pain intensity of the experimental group was found to be lower and the level of satisfaction was higher after reflexology (p<0.01). After reflexology, the blood pressure was closer to 120/80 in the experimental group, the respiratory rate was between 16-22 (number/minute), the difference between the experimental and control groups were statistically significant (p<0.01). There was no statistically significant difference between the pulce oximetry values between the experimental and control groups. CONCLUSION: Surgical pain and non-optimal vital signs that are not well managed after surgery causes various complications and decrease patient satisfaction. The results of our study emphasize the power of reflexology in effective surgical pain management and normalizing vital signs and increasing patient satisfaction. We suggest that reflexology be performed to patients following abdominal surgery.

Immunosuppressive Medication Adherence in Patients With Hepatocellular Cancer Who Have Undergo Liver Transplantation: A Case Control Study.

BACKGROUND: We aimed to compare the adherence to immunosuppressive medication use in patients who underwent liver transplantation (LT) due to hepatocellular carcinoma (HCC) and non-HCC reasons. METHODS: The study population was determined as 242 patients with HCC and 1290 patients with non-HCC who had LT performed in our institute between March 2002 and November 2021; all these patients were contacted by phone in March 2022. The sample size was calculated using the MedCalc software program, and the number of patients required in each group was determined as 111 patients. Furthermore, we used the sample.int function, a random integer generator in the R (version 4.1.2) software program. Whereas demographic and clinical parameters were determined as independent variables, the immunosuppressive medication adherence scale (IMAS) score was determined as a dependent variable. Patients were evaluated by the IMAS. This 11-item IMAS scale evaluates the lowest compliance score as 11 and the highest as 55. RESULTS: Out of a total number of 221 patients, 161 (72%) were men and 60 (27.1%) were women, with a median age of 58 years (IQR: 14); one patient in the non-HCC group was excluded due to lack of data. Among the HCC and non-HCC groups, significant differences were found in terms of the variables of age (P = .003), IMAS score (P < .001), sex (P = .001), working status (P = .004), chronic diseases (P = .008), tacrolimus alone (P < .001), tacrolimus plus everolimus (P < .001), and often medication changes (P < .001). A statistically significant correlation was found between the IMAS score and whether the patients had HCC (P < .001) and frequently changing immunosuppressive drugs (P = .023). CONCLUSION: This study showed that patients with frequent drug changes or non-HCC etiology had better adherence to immunosuppressive drug use.

Effect of COVID-19 Pandemic on Patients Who Have Undergone Liver Transplantation: Retrospective Cohort Study.

BACKGROUND: In liver transplant (LT) recipients, immunosuppressive therapy may potentially increase the risk of severe COVID-19 and may increase the mortality in patients. However, studies have shown conflicting results, with various studies reporting poor outcomes while the others show no difference between the LT recipients and healthy population. The aim of this study is to determine the impact of the COVID-19 pandemic on survival of LT recipients. METHODS: This is a retrospective cohort study analyzing the data from 387 LT recipients diagnosed with COVID-19. LT recipients were divided into two groups: survival (n = 359) and non-survival (n = 28) groups. A logistic regression model was used to determine the independent risk factors for mortality. Machine learning models were used to analyze the contribution of independent variables to the mortality in LT recipients. RESULTS: The COVID-19-related mortality rate in LT recipients was 7.2%. Multivariate analysis showed that everolimus use (p = 0.012; OR = 6.2), need for intubation (p = 0.001; OR = 38.4) and discontinuation of immunosuppressive therapy (p = 0.047; OR = 7.3) were independent risk factors for mortality. Furthermore, COVID-19 vaccination reduced the risk of mortality by 100 fold and was the single independent factor determining the survival of the LT recipients. CONCLUSION: The effect of COVID-19 infection on LT recipients is slightly different from the effect of the disease on the general population. The COVID-19-related mortality is lower than the general population and vaccination for COVID-19 significantly reduces the risk of mortality.

The relationship between anxiety and stress levels with quality of sleep in patients after living donor liver transplantation.

OBJECTIVE: This research study was carried out as a descriptive and cross-sectional study to determine the relationship between anxiety and stress levels with quality of sleep in patients after living donor liver transplantation (LDLT). METHODS: The research population was composed of all of the adult patients who underwent surgery in these clinics. The sample of the study consisted of 98 patients who were selected from among these patients by using the non-random sampling method, who were able to communicate and volunteered to participate in the study. Personal Information Form, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale (ESS), Beck Anxiety Inventory (BAI) and Perceived Stress Scale (PSS) were used in data collection. The data analysis was performed with IBM SPSS (Statistical Package for the Social Sciences) Statistics 16. RESULTS: It was determined that 34.7% of the patients were 55 years old and over, and 79.6% of them were male and 92.9% were married. It was found that patients were a poor quality of sleep. Patients' perceived stress and anxiety levels after liver transplantation were found to be moderate. It was determined that as the patients were increased anxiety level, their sleep quality decreased. CONCLUSIONS: Training programs should be planned to strengthen communication in order to increase the sleep quality of the patients and to reduce their anxiety levels.