Experiences of Patients Undergoing Robot-assisted Cardiac Surgery: A Qualitative Study.

PURPOSE: Over the last two decades, the use of robotic surgery in cardiac procedures has become increasingly prevalent. Typically, assessments of patient outcomes for robot-assisted surgery concentrate on patient morbidity and mortality, surgical complications, and length of hospital stay. However, there is limited research on patients' perceptions of robot-assisted surgery. Therefore, this study aims to determine the experiences of patients undergoing robot-assisted cardiac surgery. DESIGN: The study used a qualitative design. METHODS: The study was conducted with 12 patients who underwent robot-assisted heart surgery at an educational and research hospital. Ethical approval and written informed consent were obtained before the study. FINDINGS: 66.7% of the participants were male with an average age of 38.25 ± 16.06 years. The analysis of qualitative data identified three themes: Robotic surgery, Post-Surgical Experience, and Homecoming. CONCLUSIONS: Patients expressed satisfaction with robotic surgery and recommended it to others undergoing surgery. Based on the findings, we may suggest that nurses may conduct personalized education programs about robotic surgery and develop programs to follow up with patients at home.

Implementation and Evaluation of the SBAR Communication Model in Nursing Handover by Pediatric Surgery Nurses.

PURPOSE: Situation, Background, Assessment, Recommendations (SBAR) is recommended as a standardized model to improve communication between health professionals and increase patient safety. Correct use of the SBAR model reduces communication errors, facilitates rapid decision-making, and increases patient safety. Therefore, effective use of the SBAR model among health care professionals contributes to safer patients. This study examines the implementation and evaluation of the SBAR communication model in nursing handover by pediatric surgical nurses. DESIGN: The study had a pretest-post-test semi-experimental design. METHODS: Data were collected between April 1 and June 30, 2022 from 24 nurses, who worked at two pediatric surgery units of a training research hospital in Turkey. Ethical approval and written informed consent were obtained prior to the study. FINDINGS: The mean age of the nurses was 26.00 ± 3.43 years and 75% were female. The mean score obtained from the handover rating scale was 60.33 ± 11.11 (18 to 70). The pretest and post-test scores obtained from the SBAR communication model questionnaire were 60.00 ± 20.64 (20 to 90) and 92.50 ± 9.89 (60 to 100), respectively. 66.7% of the nurses answered no to the statement "Using the SBAR communication model did not contribute positively to the handover." The majority answered yes to the items other than this statement, the ratio of those who answered yes and no to the statement "The SBAR communication model caused me to waste time during the handover" was equal, and the majority completed the SBAR handover form. CONCLUSIONS: Some of the nurses felt that the SBAR communication model made a positive contribution to shift performance, while others felt that it did not. Although half of the nurses considered the SBAR communication model to be a waste of time, it was observed that no negative events occurred during the use of the model and that the nurses were willing to use the SBAR communication model. Therefore, it is recommended that in-service training programs be organized to increase the use of the SBAR communication model and that the use of SBAR should be continuously reviewed and improved.

Development of the compliance with mechanical ventilator scale in: A validity and reliability study.

BACKGROUND: Mechanical ventilation is a widely used treatment modality in cardiac surgery intensive care units (ICUs), especially for patients requiring respiratory support during postoperative management. AIM: The aim of this study was to define the process of developing a scale to assess adherence to mechanical ventilation in cardiac surgery patients and to assess the validity and reliability of the scale. STUDY DESIGN: This is a scale development and scale validation study. The study was conducted with 222 patients between April and September 2023. In the first stage, face-to-face interviews were conducted with seven nurses. Based on the literature review and content analysis of the interviews, the researchers created an item pool. In the second stage, the validity and reliability of the Mechanical Ventilator Compliance Scale in cardiac surgery patients were assessed. The scale was developed to be used by nurses working in cardiac surgery ICUs. RESULTS: The first 36-item scale was subjected to content validity assessment by 14 experts. It was revised according to the experts' feedback and a content validity criterion of 0.83 was obtained. Confirmatory factor analysis showed good fit values for the scale (χ2/SD = 3.09, GFI = 0.90, AGFI = 0.90, CFI = 0.91, RMSEA = 0.06, and RMR = 0.07). Test-retest analysis to assess the reliability of the scale showed good agreement between responses over time (ICC: 0.932; p < .001). Cronbach's alpha values for the scale and its subscales, behavioural and physical responses were 0.956, 0.949 and 0.912, respectively. CONCLUSIONS: The study findings indicate that the scale is a reliable and valid tool for assessing mechanical ventilator compliance in cardiac surgery patients. RELEVANCE FOR CLINICAL PRACTICE: This study provides nurses in cardiac surgery intensive care units with a measurement tool to objectively assess patients' compliance with mechanical ventilation therapy. The scale provides more reliable results by preventing subjective judgement and estimation in patient assessment.

The Clinical Learning Environment, Supervision and the Nurse Teacher Evaluation Scale: Turkish Version.

AIM: The aim of this study is to adapt the Clinical Learning Environment, Supervision and Nurse Teacher Evaluation Scale to the Turkish language and culture. METHODS: This psychometric test was conducted in a nursing school in Ankara, Turkey, from April to June 2014. Convenience sampling was used. The sample of this study was 190 third- and fourth-year nursing students. The items of the scale were evaluated by Pearson correlation coefficient for correlation-based item analysis. Cronbach's alpha, test and retest analysis were used to measure reliability. Exploratory factor analysis and correlation analysis were performed to determine validity. Principal component analysis was used to analyze factor. RESULTS: The subscales' Cronbach's alpha values were varied between .760 and .933. A positive relationship was found between tests and retests points of the subscales (P < .05). Five factors were identified in the exploratory factor analysis. There was a meaningful correlation between subscale points of the Clinical Learning Environment, Supervision and Nurse Teacher Evaluation Scale and the Clinical Learning Environment Scale (P < .05). CONCLUSION: The Turkish version of the Clinical Learning Environment, Supervision and Nurse Teacher Evaluation Scale was validated and a reliable measurement tool. It can be used to evaluate clinical nursing education in Turkey.

Health-related quality of life in persons living with a urostomy.

PURPOSE: The purpose of the study was to determine the life experiences and health-related quality of life (HRQOL) of patients living with a urostomy. DESIGN: Cross-sectional descriptive study. SUBJECTS AND SETTING: This prospective and descriptive study was carried out in a research and training hospital in Gaziantep, Turkey; data were collected from May 2009 to September 2011. Twenty-four participants had undergone a urostomy operation at least 4 months before study participation. METHODS: A form querying pertinent demographic and clinical information, combined with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QoL Q-C30) was used for data collection. Data collection forms were sent to the patients via mail in closed envelopes. The Mann-Whitney U, the Kruskal Wallis, and Wilcoxon signed rank tests were used for the comparative statistics; statistical significance was accepted when P values were <.05. RESULTS: The mean age of the 24 participants was 63.45 ± 6.33 years (mean ± SD; range, 49-72 years). The average time since surgery was 9.83 ± 2.34 months (range, 4-18 months). Most respondents stated that their urostomy affected their dressing habits (83.4%), sleep patterns (91.7%), family life (91.7%), participation in social activities (91.7%), and occupation (75.0%). All participants reported problems with psychological health and sexual activity following urostomy surgery. Analysis of EORTC QoLQ-C3 scores revealed that general wellness, functional condition, and symptomatic condition mean scores were lower than population-based norms associated with this instrument (54.16 ± 15.29, 44.07 ± 9.62, and 64.31 ± 12.56, respectively). CONCLUSIONS: Creation of a urostomy affected the patients' lifestyle and HRQOL negatively. Determining the patients' experiences, problems, and the change in HRQOL may provide assistance in designing appropriate nursing approaches to alleviate problems adapting to a urostomy.

Quality of care perceived by patients during cystoscopy and affecting factors.

It is necessary and important for quality of care to ensure the comfort of patients during the procedure, as well as before and after surgery. According to literature, it is necessary to know what patients experience and how they perceive the care they receive. This study aimed to investigate the quality of care perceived by patients during cystoscopy and the factors affecting it. This descriptive study was conducted in the surgical clinic of a teaching and research hospital, with 105 patients who underwent cystoscopy in 2022. Data collection forms consisting of a Sociodemographic and Disease Characteristics Questionnaire and the Good Perioperative Nursing Care Scale (for Patients) (GPNCS) were used for data collection, with face-to-face interviews on the first day after the procedure. This study was conducted in accordance with the principles of the Declaration of Helsinki. The study included patients with urinary tract stones, transurethral prostatectomy, and transurethral bladder resection. Of the participants, 72.4% were male, and 81.9% were married. The mean age of the patients was 50.09 ± 16.79 years. The mean total score was 143.56 ± 16.62. It was higher in single patients and those who had not previously undergone surgery. It was found that the mean of the environment sub-dimension was the highest at 18.57 ± 2.51 and the mean of the support sub-dimension was the lowest at 16.01 ± 3.44. The results of this study showed that patients undergoing cystoscopy have a good perception of the quality of their peri-operative nursing care.

The effects of preoperative education of cardiac patients on haemodynamic parameters, comfort, anxiety and patient-ventilator synchrony: A randomised, controlled trial.

BACKGROUND: Patients on mechanical ventilation are likely to suffer stress, which may lead to problems of patient-ventilator synchrony, anxiety, haemodynamic instability and decrease in comfort levels. OBJECTIVES: The aim of this study is to evaluate the effects of preoperative education regarding haemodynamic parameters, patient comfort and anxiety, and patient-ventilator synchrony provided to patients before they undergo cardiac surgery. METHODS: The study is a randomised, controlled clinical study, it was conducted at the cardiovascular surgery clinic of a teaching hospital in Turkey. The study was conducted on 200 patients who underwent cardiac surgery and received mechanical ventilation. Using the block randomisation method, the patients were grouped into intervention and control groups, with 100 patients in each group. The patients in the intervention group received preoperative education on mechanical ventilation and the usage of the communication panel that patients under mechanical ventilation use to communicate with health personnel, the control group received no education. Data was collected while the patients were on mechanical ventilation support in the intensive care unit on their second postoperative day. RESULTS: The difference between the patient-ventilator synchrony levels of the patients to the mechanical ventilation treatment in the intervention and control groups was found statistically significant (p < 0.05). The differences between the haemodynamic measurements of the patients in both groups, which were measured after the patients woke up and before extubation, were also statistically significant (p < 0.05). Median scores obtained by the patients in the intervention group on the Perianaesthesia Comfort Questionnaire and the Tension-Anxiety subscale of the Profile of Mood Scale were 5.7 and 2.0, respectively. The median scores obtained by the patients in the control group on the same scales were 4.1 and 24.0, respectively. CONCLUSIONS: Compared to the participants in the control group, the participants in the intervention group who received education had higher patient-ventilator synchrony, comfort and haemodynamic stability levels, as well as lower anxiety levels when they were under mechanical ventilation, showing that results were better in the intervention group than the control group.

The communication skills and the empathic tendency levels of nursing students: a cross-sectional study.

BACKGROUND: The most basic component of communication skills is the complex and multidimensional skill of empathy. AIM: This study was conducted to assess the communication skills and empathic tendency levels of female nursing students Turkish university. METHODS: This cross-sectional study sample consisted of 342 nurse student. RESULTS: There was a significant difference between the classes in terms of communication skills (0.021, p < .05) but no significant difference in terms of the empathic tendency levels (0.712, p > .05). The mean communication skills score increased in the final year but empathic tendency levels did not increase with increasing school years. CONCLUSION: This result suggests that the empathic tendency level could not be increased with the courses in the curriculum in our study. The results suggest that empathic tendency levels were not increased with subsequent nursing coursework. Determining empathic predisposition levels prior to entry into nursing programs should therefore be considered.

Turkish Version of the Student Nurse Stress Index: Validity and Reliability.

PURPOSE: This study aimed to adapt the Student Nurse Stress Index (SNSI) for the Turkish nursing students and investigate its psychometric properties. METHODS: Research was conducted with 152 volunteer female students who attended a university college in Ankara, Turkey. Test-retest reliability was investigated for the scale internal consistency (Cronbach α) and stability. Also, content validity and construct validity of the SNSI were assessed. In order to determine the construct validity of SNSI, Uygulamali Çok Degiskenli Istatistiksel Yöntemler and confirmatory factor analysis was conducted. RESULTS: The Turkish version of SNSI with 15 items comprised four factors (academic load, clinical concerns, personal problems, interface worries). The content validity index (CVI) score was .97. Factor loadings of Turkish version of SNSI varied between .532 and .868. The "personal problems" subscale explained 19.01% of the variance; "clinical concerns" explained 18.51%; "interface worries" explained 15.32%; "academic load" explained 14.14%. The total variance explained was 66.99%. CFA results (χ2/SD, GFI, CFI, TLI, IFI, RMSEA and SRMR) were acceptable and in good agreement. The internal consistency coefficient of the SNSI was .86. CONCLUSION: Results showed that the SNSI had a satisfactory level of reliability and validity in nursing students in Turkey. Multicenter studies including nursing students from different nursing schools are recommended for the SNSI to be generalized.

[Determination of subacute and chronic period sleep quality in burn patients]. / Yanik hastasinda sub akut ve kronik dönemde uyku kalitesinin belirlenmesi.

BACKGROUND: The aim of this study was to determine the sleep quality of patients treated at burn center. METHODS: The present study is descriptive research conducted between January 2014 and July 2015 at a university hospital. The study included 36 patients (32 male, 4 female; mean age 26.69±9.63; range 19 to 60 years). Patient information form and Pittsburgh Sleep Quality Index (PSQI) were used to collect data. SPSS software (version 22.0; SPSS Inc., Chicago, IL, USA) was used for the analysis of the data, and statistical significance was regarded as p<0.05 in all analyses. RESULTS: Burn injuries of 50% of the patients were due to flash burn that occurred in the house. Complications developed in 52.8% of the patients. PSQI score average of the patients was 9.30±4.03 and 86.5% of them suffer from poor sleep quality. It was found that there was a statistically significant correlation (p<0.05) between Pittsburgh Sleep Quality averages and patient being in the intensive care unit (ICU), education level, percentage of area burned, length of time that had passed since the burn, and medication (antidepressant or antipsychotic). DISCUSSION: The sleep quality of patients in the study was found to be of poor degree. It is known that after burn injury, sufficient sleep enhances the function of natural defense cells, protein synthesis, and release of growth hormones, thereby healing the burn injuries. Information about patient sleep quality and sleep problems can lead to the development of nursing care for patients suffering from burns.

A study on reliability and validity of the Turkish version of the Face Anxiety Scale on mechanically-ventilated patients.

Mechanical ventilation treatment causes patient anxiety, such that for those people dependent on mechanical ventilation, it was suggested to self-evaluate anxiety levels using a scale. The aim of this study was to assess the reliability and validity of the Turkish version of the Face Anxiety Scale in order to evaluate general patient anxiety levels for those receiving mechanical ventilation in a cardiovascular surgery (CVS) intensive care unit (ICU). A survey was conducted between April and December 2015 with 99 patients in receipt of mechanical ventilation at the CVS-ICU of a military training hospital in Turkey. Patients' average age was 59.31±16.47 years (range 18-83 years), with 73.7% for males and 73.7% for those undergoing coronary artery bypass graft surgery. The average scores from the Face Anxiety Scale were 2.8±1.3. A statistically significant (positive) correlation was found between scores from the test and retest (r=0.87, p<0.001), which indicated that the scale was reliable. The relationship between the Face Anxiety Scale and Profile of the Mood States (POMS) of participants scored 0.89, corroborating the validity of the former (p<0.001). This study found that it was valuable for evaluating patient anxiety in those receiving mechanical ventilation.

Evaluation of Early Warning Scoring System and Nursing Guide Application in Post-Anaesthesia Care Unit.

OBJECTIVE: To determine the effect of nursing guide application developed for the present study and to evaluate the Early Warning Scoring System (EWSS) in post-anaesthesia care unit (PACU). METHODS: The study was carried out as a randomised-controlled experimental study. The study sample comprised of 123 adult patients having thoracic and abdominal surgery between January 2011 and April 2011 in the Anaesthesiology and Reanimation Department of a training and research hospital. Patients were randomised during the pre-operative period; the patients who were followed-up according to the EWSS and a nursing guide constituted the study group (SG=63) and the patients whose EWSS score was calculated but routine follow-up in PACU was not intervened constituted the control group (CG=60). RESULTS: During the PACU, complications developed in in 34.92% of SG patients and in 30.00% of CG patients. Of the SG patients, 95.45% developing complications and of the CG patients, 22.22% developing complications were treated in the first 10 minutes, and it was determined that in 61.12% of CG patients, complications were not treated. There was a significant difference between the SG and CG patients in terms of treatment duration against complications (p<0.05). CONCLUSION: The EWSS and nurse's guide provides early determination and treatment of patients developing complications. Thus, it is recommended to use the EWSS and a nursing guide in PACU.