Esra Akin Korhan

The effect of music therapy on physiological signs of anxiety in patients receiving mechanical ventilatory support

AIMS The aim of this study was to investigate if relaxing music is an effective method of reducing the physiological signs of anxiety in patients receiving mechanical ventilatory support. BACKGROUND Few studies have focused on the effect of music on physiological signs of anxiety in patients receiving mechanical ventilatory support. DESIGN A study-case-control, experimental repeated measures design was used. METHOD Sixty patients aged 18-70 years, receiving mechanical ventilatory support and hospitalised in the intensive care unit, were taken as a convenience sample. Participants were randomised to a control group or intervention group, who received 60 minutes of music therapy. Classical music was played to patients using media player (MP3) and headphones. Subjects had physiological signs taken immediately before the intervention and at the 30th, 60th and 90th minutes of the intervention. Physiological signs of anxiety assessed in this study were mean systolic and diastolic blood pressure, pulse rate, respiratory rate and oxygen saturation in blood measured by pulse oxymetry. Data were collected over eight months in 2006-2007. RESULTS The music group had significantly lower respiratory rates, and systolic and diastolic blood pressure, than the control group. This decrease improved progressively in the 30th, 60th and 90th minutes of the intervention, indicating a cumulative dose effect. CONCLUSION Music can provide an effective method of reducing potentially harmful physiological responses arising from anxiety. RELEVANCE TO CLINICAL PRACTICE As indicated by the results of this study, music therapy can be supplied to allay anxiety in patients receiving mechanical ventilation. Nurses may include music therapy in the routine care of patients receiving mechanical ventilation.

The effect of music therapy on pain and anxiety in intensive care patients

In recent years, intensive care units have been using advanced technology that provides significantly improved results in clinical treatment and care practices. However, this results in intensive care patients experiencing pain and anxiety. This pain and anxiety is generally brought under control with various pharmacological preparations. When a pharmacological approach is not used or is ineffective, doctors and nurses also use non-pharmacological approaches such as music to control pain and anxiety. Research has found music therapy to be an effective method of reducing pain intensity and anxiety levels in intensive care patients. Therefore, the use of music therapy is important for intensive care patients. This article will deal with the effects of music therapy on pain and anxiety management in intensive care patients.

Reflexology: its effects on physiological anxiety signs and sedation needs.

To investigate whether reflexology has an effect on the physiological signs of anxiety and level of sedation in patients receiving mechanically ventilated support, a single blinded, randomized controlled design with repeated measures was used in the intensive care unit of a university hospital in Turkey. Patients (n = 60) aged between 18 and 70 years and were hospitalized in the intensive care unit and receiving mechanically ventilated support. Participants were randomized to a control group or an intervention group. The latter received 30 minutes of reflexology therapy on their feet, hands, and ears for 5 days. Subjects had vital signs taken immediately before the intervention and at the 10th, 20th, and 30th minutes of the intervention. In the collection of the data, “American Association of Critical-Care Nurses Sedation Assessment Scale” was used. The reflexology therapy group had a significantly lower heart rate, systolic blood pressure, diastolic blood pressure, and respiratory rate than the control group. A statistically significant difference was found between the averages of the scores that the patients included in the experimental and control groups received from the agitation, anxiety, sleep, and patient-ventilator synchrony subscales of the American Association of Critical-Care Nurses Sedation Assessment Scale. Reflexology can serve as an effective method of decreasing the physiological signs of anxiety and the required level of sedation in patients receiving mechanically ventilated support. Nurses who have appropriate training and certification may include reflexology in routine care to reduce the physiological signs of anxiety of patients receiving mechanical ventilation.

Nursing diagnoses determined by first year students: a vignette study.

Purpose The study aimed to determine the ability of first year students in identifying nursing diagnoses. Methods In a descriptive evaluation study, an expert-validated vignette containing 18 nursing diagnoses was used. Results The students determined 15 nursing diagnoses. The highest percentages of diagnoses identified were disturbed sleep pattern and nutrition imbalance. Students also considered medical diagnoses as nursing diagnoses: hypertension and tachycardia. Conclusions Despite the fact that students were only at the end of their first semester and had limited clinical experience, they successfully identified the majority of nursing diagnoses. Implications for Nursing Practice Patient case study vignettes are recommended for education. To foster students’ knowledge and experience, it is also suggested that evaluating nursing diagnoses in clinical practicals becomes a requirement. Amac Bu calismada birinci sinif ogrencilerinin hemsirelik tanilarini belirleyebilme durumlarinin saptanmasi amacladi. Yontem Uzmanlar tarafindan belirlenmis 18 hemsirelik tanisini iceren bir vaka kullanilarak yapilan tanimlayici bir calismadir. Bulgular Ogrenciler 15 hemsirelik tanisi belirlemistir. En cok belirlenen hemsirelik tanilari uyku oruntusunde rahatsizlik ve beslenmede dengesizlik tanisidir. Ogrenciler ayrica hipertansiyon ve tasikardi gibi tibbi tanilari da hemsirelik tanisi olarak dusunmuslerdir. Sonuclar Ogrenciler sadece birinci donemin sonunda ve sinirli klinik deneyimlere sahip olmasina ragmen, hemsirelik tanilarinin buyuk bir cogunlugunu tanimlamada basarili olmuslardir. Hemsirelik Uygulamalari Icin Oneriler Egitim icin hasta vaka calismalarinin kullanilmasi onerilmektedir. Ogrencilerin bilgi ve deneyimlerini gelistirmek icin ayrica klinik uygulamalarda hemsirelik tanilarinin degerlendirilmesi gerektigi onerilmektedir.

The effect of nail polish on pulse oximetry readings

INTRODUCTION Pulse oximeters utilise the pulsatile nature of arterial blood flow to distinguish it from venous flow and estimate oxygen saturation in arterial blood. Pulse oximetry is primarily used in hospital wards, emergency rooms, intensive care units, operating rooms and home care. AIM The objective of this study is to determine whether the use of nail polish of various colours have an effect on oximeter readings of oxygen saturation value. METHOD The sample group of this study is comprised of 40 healthy women. In the first phase of the study, readings were taken on left and right hand fingers, with no nail polish, to determine any differences in oxygen saturation value. In the second phase of the study, 10 different colours of nail polish, namely dark red, yellow, dark blue, green, purple, brown, white, metallic, black and pink, of the same brand were applied. Readings were recorded once oxygen saturation values on the screen became stable. Number and percentage distributions along with Wilcoxon signed ranks and Friedman test were used in the analysis of data. CONCLUSION Only red nail polish did not yield statistically significant reading results. We conclude that different nail polish colours cause a clinically significant change in pulse oximeter readings in healthy volunteers.

Health Related Quality of Life and Care Dependency among Elderly Hospital Patients: An International Comparison

Many countries in Europe and the world have to cope with an aging population. Although health policy in many countries aims at increasing disability-free life expectancy, elderly patients represent a significant proportion of all patients admitted to different hospital departments. The aim of the research was to investigate the relationship between health-related quality of life (HRQOL) and the care dependency status among elderly hospital patients. In 2012, a descriptive survey was administered to a convenience sample of 325 elderly hospital patients (> 60 years) from The Netherlands (N = 125), from Poland (N = 100), and from Turkey (N = 100). We employed the Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System and the Care Dependency Scale. FACIT is a collection of HRQOL questionnaires that assess multidimensional health status in people with various chronic illnesses. From demographic variables, gender (female) (r = -0.13, p < 0.05), age and informal care given by family members (r = -0.27 to 0.27, p < 0.01) were significantly correlated with the care dependency status for the whole samples. All HRQOL variables, hearing aid and duration of illness correlated with care dependency status (r = -0.20 to 0.50, p < 0.01). Moreover, the FACIT sum score (Poland and Turkey) and functional wellbeing (The Netherlands) are significantly associated with the decrease in care dependency status. Thus, the FACIT variables are the most powerful indicators for care dependency. The study provides healthcare professionals insight into improvement of quality of care in all three countries.

Examination of ethical dilemmas experienced by adult intensive care unit nurses in physical restraint practices.

Nurses are more likely to face the dilemma of whether to resort to physical restraints or not and have a hard time making that decision. This is a descriptive study. A total of 55 nurses participated in the research. For data collection, a question form developed by researchers to determine perceptions of ethical dilemmas by nurses in the application of physical restraint was used. A descriptive analysis was made by calculating the mean, standard deviation, and maximum and minimum values. The nurses expressed (36.4%) having difficulty in deciding to use physical restraint. Nurses reported that they experience ethical dilemmas mainly in relation to the ethic principles of nonmaleficence, beneficence, and convenience. We have concluded that majority of nurses working in critical care units apply physical restraint to patients, although they are facing ethical dilemmas concerning harm and benefit principles during the application.

Comparison of Oxygen Saturation Values Obtained From Fingers on Physically Restrained or Unrestrained Sides of the Body

Objective: The aim of this study was to compare semiexperimentally the pulse oximetry values obtained from a finger on restrained or unrestrained sides of the body. Background: The pulse oximeter provides a noninvasive measurement of the oxygen saturation of hemoglobin in arterial blood. One of the procedures most frequently applied to patients in intensive care units is the application of physical restraint. Circulation problems are the most important complication in patients who are physically restrained. Evaluation of oxygen saturation from body parts in which circulation is impeded or has deteriorated can cause false results. Methods: The research sample consisted of 30 hospitalized patients who participated in the study voluntarily and who were concordant with the inclusion criteria of the study. Patient information and patient follow-up forms were used for data collection. Pulse oximetry values were measured simultaneously using OxiMax Nellcor finger sensors from fingers on the restrained and unrestrained sides of the body. Numeric and percentile distributions were used in evaluating the sociodemographic properties of patients. Results: A significant difference was found between the oxygen saturation values obtained from a finger of an arm that had been physically restrained and a finger of an arm that had not been physically restrained. The mean oxygen saturation value measured from a finger of an arm that had been physically restrained was found to be 93.40 (SD, 2.97), and the mean oxygen saturation value measured from a finger of an arm that had not been physically restrained was found to be 95.53 (SD, 2.38). Conclusions: The results of this study indicate that nurses should use a finger of an arm that is not physically restrained when evaluating oxygen saturation values to evaluate them correctly.

The Effects of Simulation on Nursing Students Psychomotor Skills

Background: Simulation-based education has positive contributions in nursing education. Using different methods of simulation has effectiveness in clinical education and also effectiveness of simulation was stated verbally by the students and the researchers. Objective: The aim of this research was to examine the effect of simulation training on psychomotor skills of nursing students. Design: The research sample was determined by a simple random sampling. Setting: Research was carried out with students of a Nursing School in Turkey, between February and June 2016. Participants: Participants of the research 82 first-grade students of this research, 65 (81.7 %) of them were female and 15 (18.3 %) were male. Methods: Assessment was performed with a single-blind method using with the “Skills Checklists” that include the steps of “Performing Nasotracheal Aspiration”, “Measuring Blood Pressure”, “Measuring Pulse and Respiration Rate” and “Administration of Intramuscular Injection”. Results: According to findings of the research, there was a statistically significant difference between the experimental and control groups mean total score of skills and there was a significant relationship between total score skills and the having simulation training of students. Conclusion: As a result of the research, the students nursing skills with simulation education have higher psychomotor skill scores. In addition to the traditional education methods, use of simulation tools is thought to boost skill levels.

Validity and Reliability of the Turkish Chronic Pain Acceptance Questionnaire

Background: Pain acceptance is the process of giving up the struggle with pain and learning to live a worthwhile life despite it. In assessing patients with chronic pain in Turkey, making a diagnosis and tracking the effectiveness of treatment is done with scales that have been translated into Turkish. However, there is as yet no valid and reliable scale in Turkish to assess the acceptance of pain. Aims: To validate a Turkish version of the Chronic Pain Acceptance Questionnaire developed by McCracken and colleagues. Study Design: Methodological and cross sectional study. Methods: A simple randomized sampling method was used in selecting the study sample. The sample was composed of 201 patients, more than 10 times the number of items examined for validity and reliability in the study, which totaled 20. A patient identification form, the Chronic Pain Acceptance Questionnaire, and the Brief Pain Inventory were used to collect data. Data were collected by face-to-face interviews. In the validity testing, the content validity index was used to evaluate linguistic equivalence, content validity, construct validity, and expert views. In reliability testing of the scale, Cronbach’s α coefficient was calculated, and item analysis and split-test reliability methods were used. Principal component analysis and varimax rotation were used in factor analysis and to examine factor structure for construct concept validity. Results: The item analysis established that the scale, all items, and item-total correlations were satisfactory. The mean total score of the scale was 21.78. The internal consistency coefficient was 0.94, and the correlation between the two halves of the scale was 0.89. Conclusion: The Chronic Pain Acceptance Questionnaire, which is intended to be used in Turkey upon confirmation of its validity and reliability, is an evaluation instrument with sufficient validity and reliability, and it can be reliably used to examine patients’ acceptance of chronic pain.