The Effect of Stoma Site Marking on Stomal Complications: A Long-term Retrospective Study.

OBJECTIVE: To identify the effect of stoma site marking on stoma-related complications. METHODS: The study sample included 639 individuals with stomas who were followed up in a stomatherapy unit in Turkey between January 1, 2017, and June 20, 2021. Researchers collected patient data from nursing records. Data were evaluated using number, percentage, χ2, and logistic regression tests. RESULTS: Of the individuals with stomas, 60.6% (n = 387) were men, and 72.6% (n = 464) had a cancer diagnosis. Their mean age was 60.16 (SD, 14.81) years. The stoma site was marked preoperatively in of 67.1% of patients (n = 429), and 17.1% (n = 109) developed stoma-related complications. The complication rate was higher in individuals with unmarked stoma sites (25.7%; P = .000), emergency surgeries (25.0%; P = .006), colostomies (23.9%; P = .042), and permanent stomas (28.3%; P = .002). The three most common complications were peristomal skin problems (56.9%), mucocutaneous separation (13.8%), and edema (9.2%). CONCLUSIONS: The incidence of stoma-related complications in the postoperative period was higher in individuals with unmarked stoma sites. The authors recommend that stoma and wound care nurses mark the stoma site in individuals for whom stoma creation is planned.

The Effect of Pelvic Floor Muscle Exercises on Bowel Evacuation and Quality of Life in Following Intestinal Ostomy Closure: Randomized Controlled Trial.

PURPOSE: This purpose of this study was to evaluate the effect of pelvic floor muscle exercises (PFMEs) on bowel evacuation problems and health-related quality of life (HRQOL) following ostomy closure. DESIGN: Randomized controlled trial. SUBJECTS AND SETTING: Forty individuals following ostomy closure consented to participate in the study; 6 participants (15%) did not complete the trial (2 died and 2 required a second ostomy) yielding a study sample of 34. Participants were randomly allocated to an Exercise Group (EG, n = 17) and Control Group (CG, n = 17). The mean age of the EG was 55.7 (SD 12.6) years, whereas the mean age of the CG was 62.0 (SD 12.1) years. The study setting was the surgery clinic of 4 hospitals in Ankara, Turkey. Data were collected between December 2018 and May 2020. METHODS: The study intervention, PFME training by a clinician, was administered to participants in the EG; CG participants received no information regarding PFME. Data were collected during face-to-face interviews on the day before discharge and by phone at the first, second, third, and sixth months after surgery. A questionnaire was used for data collection that queried a demographic and pertinent clinical questions, along with the Assessment Form for Bowel Evacuation Habits and Psychosocial Problems, Wexner Scale, and the Short Form (SF-36) Health-related Quality of Life Scale. Descriptive statistics and Mann-Whitney U test, t-test, Pearson-χ2 test, Fisher's Exact test, Friedman test, and Cochran-Q test statistical analysis according to normal distribution were used in data evaluation. RESULTS: The number of defecations in the EG was statistically significantly lower than the CG at the second, third, and sixth months (P = .002, P = .002, P = .001, respectively). In addition, the number of individuals experiencing night defecation was statistically significantly less in the EG compared to the CG at the second-, third-, and sixth-month follow-ups (P = .001, P = .001, P = .028, respectively). HRQOL scores were also significantly higher in the EG. CONCLUSION: Pelvic floor exercises applied after ostomy closure are effective in reducing bowel evacuation and increasing quality of life. Given these findings, PFMEs are recommended for patients after ostomy closure.

Developing care behaviors and ethical attitude in nursing education.

AIM: This study aims to determine the effect of education based on the Theory of Human Caring on nursing students' caring behaviors and ethical attitudes. BACKGROUND: It is crucial to plan nursing education holistically, addressing cognitive, psychomotor and affective domains for the comprehensive development of caring behaviors and ethical attitudes. DESIGN: This study employed a convergent mixed-methods approach with randomized pretest-posttest comparisons and qualitative analysis. METHODS: This study was conducted with third-year nursing students at a state university in Ankara, Turkey, in 2021. It comprised a total of 95 participants, with 47 students in the case group and 48 students in the video group. Theoretical education based on the Theory of Human Caring was simultaneously provided to both groups. Following this, one group received practical training using a video-supported teaching method, while the other group received it through a case analysis method. The research used the 'Descriptive Characteristics Form', 'Caring Nurse Patient Interaction Scale (CNPIS)', 'Scale for Attitudes of Ethical Principles (SAEP)' and 'Student Opinion Form on Care Behaviors Education' to collect data. Quantitative data were analyzed using t-tests, Mann-Whitney U tests, Wilcoxon paired two-sample tests and Linear Regression Analysis, with a significance level of p<0.05. Qualitative data were evaluated through document analysis. Permissions were obtained before the research. RESULTS: After the education provided, significant differences were found between the pre-test and post-test scores of both groups (p<0.05). It was determined that there was a statistically significant, positive and generally moderate relationship between the caring behaviors and ethical attitudes of the students. Additionally, participating students reported that they were satisfied with the education provided, stating that the teaching methods increased their motivation and positively influenced their perspectives on caring and its ethical dimensions. CONCLUSIONS: The research findings show significant improvements in nursing students' care behaviors and ethical attitudes following education based on the Human Care Theory, with both case analysis and video-supported teaching methods yielding notable results. Integration of care theories into the nursing undergraduate curriculum, alongside the use of holistic teaching methods, is recommended, along with further randomized controlled trials to assess teaching effectiveness.

The effect of simulation on auscultation skills, self-confidence and anxiety levels in nursing students: A randomized controlled trial.

AIM: This study evaluated the effect of simulation on auscultation skills, self-confidence and anxiety levels. BACKGROUND: Auscultation is an essential topic in nursing education and patient care. Simulation is efficacious in improving auscultation skills and self-confidence and reducing anxiety levels. It is a valuable educational approach whose effects should be evaluated and disseminated in the context of auscultation. DESIGN: This study had a randomised controlled trial design. METHODS: The study was conducted with second-year nursing students enrolled at a university in Turkey. One group of students studied auscultation of heart, lung and bowel sounds with a simulated patient (n = 28), the second group with a high fidelity simulator (n = 30) and the third group with traditional education (n = 28). Data were collected using a demographic information form, auscultation control list and Nursing Anxiety and Self-Confidence with Clinical Decision Making Scale. The students' psychomotor auscultation skills, self-confidence and anxiety levels were evaluated. Data on auscultation skills were assessed after the intervention, while data on self-confidence and anxiety levels were collected at baseline, after the intervention and after clinical practices throughout the academic year. RESULTS: Anxiety and self-confidence levels showed statistically significant differences in intragroup evaluation. The self-confidence levels of the groups working with simulation did not change much in the follow-up test conducted after the end of clinical practices. The mean skill scores in the auscultation control list showed a statistically significant difference between the groups. CONCLUSIONS: Simulation and traditional approaches are effective in learning auscultation skills. However, the positive effects of simulation, particularly in enhancing students' self-confidence and reducing anxiety levels, appear to be more permanent and impactful than traditional education. Therefore, it is recommended that simulation be prioritized for teaching auscultation skills.