Ayla Gürsoy

Attitudes and Health Beliefs Associated With Breast Cancer Screening Behaviors Among Turkish Women

Problem: This research was undertaken to determine the attitudes and health beliefs of a sample of Turkish women about breast self-examination (BSE), clinical breast examination, and mammography. Design: Data were collected by means of a researcher-designed questionnaire and the Champion Health Belief Model Scale. A total of 1,342 women participated in this study. Results: It was found that 10.1% of the women practiced BSE once a month, 19.8% of the women had had a clinical breast examination, and 15.0% had had a mammogram. Age and marital status were significant variables that influenced whether the women used only one or multiple methods for early detection of breast cancer. Participants who had higher levels of confidence for BSE and lower perceptions of barriers to BSE were more likely to perform BSE. Participants who perceived higher levels of confidence to perform BSE were more likely to be using all three early detection methods. Implications for Practice: Interventions and strategies that help women develop confidence in their abilities to perform early breast cancer detection methods are likely to encourage them to engage in regular screening for breast cancer.

Body Image of Women with Breast Cancer After Mastectomy: A Qualitative Research

OBJECTIVE To gain a holistic and deep understanding about how mastectomy effects the body image of women who have breast cancer. MATERIALS AND METHODS The sample of this qualitative descriptive study consisted of twenty patients who underwent mastectomy procedures. Semi-structured interviews were conducted during the second week after mastectomy. Each interview was transcribed verbatim, and a thematic analysis was performed. RESULTS After the mastectomy, the findings related to the womens body image and their experiences were specified as four main themes and seven sub-themes. The main themes were: meaning of the breast, mastectomy and me, my body image and body image changes, and social life. Most of the participants in this study stated that the breast meant femininity, beauty, and motherhood. It was found that the meaning of mastectomy varied according to individuals. Women used quite negative statements about their appearances. The participants also said that they felt that half themselves was missing, as individuals and women. The women stated that they preferred clothes that hid their lack of breast. Some of the participants mentioned that relations with their husbands were not like before, and they abstained from social interaction. CONCLUSION Our findings suggest that mastectomy as a surgical treatment for breast cancer may negatively affect a womans body image and her self-image.

The Effect of Home Healthcare on Quality of Life in Patients Diagnosed With Gastrointestinal Cancer

This study was undertaken to determine the effect of home healthcare on the quality of life (QOL) in patients diagnosed with gastrointestinal cancer. A total of 42 patients, who met eligibility criteria, were enrolled in the study and randomly assigned to either a control group or an experimental group. Control group patients received “usual care” defined as pain control and management through the pain clinic. Experimental group patients received pain control through the clinic plus three home visits. During the home visits, their nursing care was guided by an evidence-based protocol developed by the research team. Data were collected on pain, performance, symptoms, and QOL by using previously developed and validated instruments. Significant differences were found between the two groups on physiological function, psychological concerns, and total stress. In the experimental group, there was a significant decrease in pain and increase in performance from baseline to the final data collection period. For the control group, a significant decrease in QOL over the study period was observed. There were no significant differences between the two groups on pain, performance, QOL, and QOL subscales at the final visit.

Evaluation of the Breast Cancer Train the Trainer Program for Nurses in Turkey

The Breast Cancer Train the Trainer (TTT) program was designed to increase breast cancer awareness, improve knowledge about breast cancer among nurses, and provide quality care for breast cancer patients by trained nurses. A total of three programs were held and 82 nurses from different regions of Turkey attended this training. The educational activities employed several teaching and learning strategies. After completion, we determined that the participating nurses’ knowledge on breast cancer had increased significantly, and they were satisfied with the training received. The Breast Cancer TTT program is a unique educational endeavor for nurses in Turkey, and our results showed that the training achieved its goal. Trained nurses in Breast Cancer TTT programs can help educate women about the importance of breast health and the measures they need to take to protect themselves against breast cancer. At the same time, nurses can also increase and enhance the quality of life in patients with breast cancer. This is an example of a program that can easily be spread throughout the world as it was done from England and Australia to Turkey.

Therapeutic Effects of Nurse Telephone Follow-up for Lung Cancer Patients in Turkey.

Background: Patients with lung cancer can encounter many difficulties as they adjust to the side effects of chemotherapy treatments. Objective: The aim of this study is to determine the therapeutic effects of nurse telephone follow-up for lung cancer patients. Methods: In this quasi-experimental study, the sample consisted of 60 patients with lung cancer assigned to an intervention group (n = 30) and a control group (n = 30). The control group participants were sequentially enrolled first and then the intervention group participants were enrolled. The data were collected using the Patient Information Form, Eastern Cooperative Oncology Group Performance Status, the Edmonton Symptom Assessment Scale, and the Functional Living Index–Cancer. The Nursing Care Guide was created by the nurse researchers’ team and given to both the intervention and control groups. Telephone follow-up calls were conducted with intervention patients within the first week after their chemotherapy session. The Kolmogorov-Smirnov, Pearson &khgr;2, Fisher exact, Mann-Whitney U, and Friedman test and descriptive statistics were used to evaluate the data. Results: Patients in the intervention group demonstrated significantly better adjustment to the symptoms secondary to chemotherapy and higher social functioning quality of life scores compared with reported scores in the control group. Conclusion: Nurse telephone follow-up can reduce chemotherapy-related symptoms for lung cancer patients and improve participants’ social functioning. Implications for Practice: Nurse telephone follow-up is an acceptable and feasible form of patient contact and is a convenient and efficient way to offer patients the support and continuity of care they need.

Turkish health care providers' views on inappropriate use of emergency department: Who, when and why?

OBJECTIVE Inappropriate use of emergency departments is recognized globally as a widespread problem. The study was undertaken to determine the perceptions of emergency department personnel regarding inappropriate use of this department. METHODS The study was undertaken with 124 emergency department employees from six emergency departments in a province of the Eastern Black Sea region of Turkey. Using a questionnaire form designed by the researcher, the data were gathered and analyzed with the chi-square test, numerical and percentage calculations. RESULTS According to the emergency department employees, more than half of emergency department visits were inappropriate with most visits occurring between the hours of 19:01 and 01:00. In order of occurrence, employees also indicated that most inappropriate use concerned requests for prescription renewals, treatment for pain, and upper respiratory tract infections (URTI). According to the employees, patients made inappropriate use of emergency departments in the belief that these provide services for every kind of health problem. Unfortunately, according to the health care workers this misperception of emergency services results in less effective patient care and a decrease in employee motivation. CONCLUSION Health team members thought that inappropriate use of emergency services led to negative outcomes in the quality of care and motivation of the workers. Solutions to minimize inappropriate use of emergency departments need to be developed and put into place.

Surgical Count Implementations in the Operating Rooms: An Examplefrom Turkey

Aim: Although retained foreign bodies are a rare and preventable problem, it is one of the medical errors in surgery can have heavy medico-legal consequences. Retained sponges can cause significant morbidity, prolonged hospital stay, postoperative complications, pain and disabilities. Also the costs associated with treatment of retained surgical items can be considerable. The study was undertaken to determine the current implementations related to instruments and sponges counts in the operating rooms in Turkey. Method: This descriptive study was carried out with 261 operating room nurses. The data collection tool was a questionnaire which was designed on the Google Drive application using the internet. Thereafter its internet link was distributed throughout Turkey using nursing, surgical nursing and operating room nursing social media websites; the answers were gathered in the same way. Results: Ninety-five percent of participants stated that instruments and sponges were usually counted by the scrub nurses (88.5%). Sponges (97.7%), pads (95.4%), tampons (89.2%), surgical instruments (88.1%) and needles (70.4%) were the items which were usually counted. According to 81.6% of the nurses, a written count protocol exists for their hospitals, however, they noted there was a significant difference in implementation among the various institutions (p=0.026). While 49.8% of participants stated that the count before surgery was done by nurses, 23.7% reported that the count was performed by operating room employees. Furthermore, 81.2% of the nurses noted that if the scrub nurses were replaced during surgery, the surgical count would be repeated. Nurses stated that last count was usually done just before applying skin sutures (72.7%), and if there were a problem with the count, radiological imaging would be done (73.5%) and the count irregularity would be signed by staff (31.0%). Conclusion: Our results demonstrated that because surgical counts were generally done by the scrub nurses, changing of scrub nurse have high risk for surgical count error. In addition, although most of the hospitals have a count protocol, a serious issue concerns the use of unprofessional hospital employees who carry out this task, thus jeopardizing patient safety to be operating room employess join the count are other problems related to surgical count. There is not any comprehensive research related to surgical instrument and material count in Turkey. The current study enables us to obtain information concerning surgical count protocol in the operating rooms in Turkey.

Time for Nurses to Make the Move: From Evidence Based Practice to Care Bundle

* B Candaş, Araş. Gör. Karadeniz Teknik Üniversitesi Sağlık Bilimleri Fakültesi Cerrahi Hastalıkları Hemşireliği Anabilim Dalı, Trabzon Yazışma Adresi / Address for Correspondence: Bahar Candaş, Araş. Gör., Karadeniz Teknik Üniversitesi Sağlık Bilimleri Fakültesi Üniversite Mah. Farabi Cad. No:88, 61080, Trabzon Tel.: 0 462 377 88 62 Faks: 0 462 230 04 75 e-posta: candasbahar@hotmail.com ** A Gürsoy, Prof. Dr. Uluslararası Kıbrıs Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Bölümü, Kuzey Kıbrıs Türk Cumhuriyeti ÖZ

Nurses and Women With Breast Cancer: No Time to Lose.

B reast cancer continues to threaten women_s health all over the world despite the many advances in treatments in recent years. Nurses need to actively use their health training and counselor roles to educate women about risk factors for breast cancer and ways to reduce them. Even with our best efforts, we may not be able to protect all women against developing breast cancer. Nevertheless, we can provide women with the tools to understand the importance of early diagnosis and how to effectively and regularly utilize breast cancer screening methods. After a breast cancer diagnosis, the long, exhausting, and complicated treatments create challenges for both patients and families. The treatments have adverse effects that may result in physical, emotional, and psychological ramifications. Patients and families may find that the issues of life and death often dominate their thoughts. For all these reasons, many kinds of support from the clinical care team are critically important. In most cultures, the breast carries a special significance. Breasts signify womanhood and femininity, the feeding of babies, and sexuality. The importance of women_s breasts and a diagnosis of breast cancer can render the journey through diagnosis and treatment especially difficult. Therefore, women who received a diagnosis of breast cancer should receive the highest level of holistic nursing care for as long as they need this support. In order to make progress in the fight against breast cancer, what difference can one nurse make? The answer may vary depending on the characteristics of the nurse and the environment. However, without a doubt, many individuals, who are united around the same objective, can achieve many things. Between 2000 and 2004, the BInternational Breast Health and Breast Cancer Education[ project was conducted in cooperation with the International Society of Nurses in Cancer Care and the Susan G. Komen Foundation. During the 2-day program, 32 nurses from 20 countries were trained. One of my colleagues represented our country of Turkey and participated in the program in 2002; it was exciting for me to participate in the same pioneering program in 2004 in Sydney. The 2 of us began working in our country in 2005 with the Turkish Oncology Nursing Association to offer breast cancer nursing training workshops. To date, we have trained 227 nurses and 28 breast cancer nursing trainers who educate and guide nurses in all geographical regions of our country. Within Turkish Oncology Nursing Association, we formed a breast cancer nursing subgroup in 2007 that expanded its efforts into creating community training, nursing training, and research groups. The community training group organizes community training workshops, awareness walks, and radio-television programs in the month of breast cancer awareness. The nursing training group conducts breast cancer nursing courses. The training groups are preparing educational materials for healthy women, patients, and nurses about breast cancer. The research group determines the research priorities of our country and plans and undertakes studies. At the end of the year, as a subgroup of the association, we prepared the annual activity report to see what we had achieved and what more we could achieve. It was then that I understood that the real excitement had just started. Women_s accessibility to healthcare services varies depending on the country where they live. However, wherever they live, they are scared. They want to be informed and to be guided in learning about surgical and reconstruction options. They want to be supported when they grieve for their removed breasts and hair loss. They do not want to have pain, vomiting, and hot flashes. When the treatment process ends, they want to ask questions and get answers that will help them begin their lives again. All women, no matter where they live, deserve information and support as they navigate the journey of breast cancer diagnosis and treatment. Yet, the reality is many countries do not have the same treatment infrastructure as other more developed countries. Turkey currently is experiencing a nursing shortage, and those presently employed do not always have enough knowledge or interest in working with breast cancer patients Therefore, we as nurses of different countries should share our knowledge with other colleagues around the world to unite and strengthen our resolve to eradicate breast cancer through education and research. We can provide the nurses of the countries in need with the training, training materials,

P8 Evaluation of the breast cancer train-the-trainer programme for nurses in Turkey

The Breast Cancer Train the Trainer (TTT) program was designed to increase breast cancer awareness, improve knowledge about breast cancer among nurses, and provide quality care for breast cancer patients by trained nurses. A total of three programs were held and 82 nurses from different regions of Turkey attended this training. The educational activities employed several teaching and learning strategies. After completion, we determined that the participating nurses’ knowledge on breast cancer had increased significantly, and they were satisfied with the training received. The Breast Cancer TTT program is a unique educational endeavor for nurses in Turkey, and our results showed that the training achieved its goal. Trained nurses in Breast Cancer TTT programs can help educate women about the importance of breast health and the measures they need to take to protect themselves against breast cancer. At the same time, nurses can also increase and enhance the quality of life in patients with breast cancer. This is an example of a program that can easily be spread throughout the world as it was done from England and Australia to Turkey.