Fatma Eti Aslan

Patients' experience of pain after cardiac surgery

Abstract Pain after Cardiac Surgery (CS) is the most common patient complaint. However the first 48 h after surgery, when patients’ pain is the most severe, is generally spent in the Intensive Care Unit (ICU). It is almost impossible for patients to report their pain because of their inadequate level of consciousness in the ICU. Many factors alter verbal communication with patients, such as administration of sedative medications, mechanical ventilation, and patients’ changed level of consciousness. This descriptive study was conducted for the purpose of describing the experience of pain in CS patients in the ICU and determining situations that affect their pain. This research was conducted with 300 adult patients at a Ministry of Health Hospital who stayed in a cardiac surgery ICU post-operatively for a minimum of 48 h, had a sternal incision, chest tube, and required mechanical ventilation. The data were collected from the patients in face-to-face interviews by the researchers following transfer from the ICU to the surgical ward within 48 h of transfer. Most patients described their pain as aching (n = 177) and throbbing (n = 154). The presence of chest tubes (n = 95), endotracheal tube suctioning (n = 47), change of dressings (n = 27) and the use of air mattresses (n = 20) were also identified as painful experiences for patients. Based on these results it can be said that CS patients experience pain in the ICU, however they verbalized it with different words and identified different situations that decreased or increased their pain, which shows the subjective and complex nature of pain.

WITHDRAWN: Patient Complaints in the Emergency Department.

Methods: This study, designed as a descriptive and analytic type of research, was conducted between December 9, 2006, and June 30, 2007, with 1514 patients in the emergency department of a private hospital in Istanbul. Data collected consisted of 3 measures: (1) a 13-question “Individual Characteristics Form”; (2) a 35-item “Evaluation of Patient Complaints Form,” which utilized a face-to-face interview method; and (3) a “Triage Categories Form,” a 5-tier triage tool used by the emergency department where this study took place.

The Effect of Exaggerated Lithotomy Position on Shoulder Pain After Laparoscopic Cholecystectomy

Abstract: Background: The exaggerated lithotomy position with the expertise of nurses can be successful solution for the patients who have the postoperative shoulder pain after laparoscopic cholecystectomy. Aims: This study aimed to determine the effect of applying an exaggerated lithotomy positions to patients who had laparoscopic cholecystectomy to relieve shoulder pain. The study was conducted on nonrandomized groups and made as a semiexperimental study with a pretest/post‐test control group design. Design, Settings, and Subjects/Participants: The study was conducted on 102 patients who had elective laparoscopic cholecystectomy and agreed to participate in this study after they met the inclusion‐exclusion criteria in the general surgery clinic of a training and research hospital in Istanbul between December 12, 2012, and June 30, 2013. Methods: The pain levels (10 minutes before and after positioning) and peripheral oxygen saturation (SPO2) levels (1 minute, 5 minutes, and 10 minutes before and after positioning—total 6 times) of the patients were measured using a visual analog scale and pulse oximetry, respectively. The pain levels and the analgesic (pethidine hydrochloride and diclofenac sodium) usage of the patients in both the experimental and the control group were compared. Results: The exaggerated lithotomy position appreciably lowered the shoulder pain of the patients in the experimental group (t = 12.663; p = .000 < .001). It also increased peripheral saturation levels of the patients more rapidly compared with those in the control group receiving analgesics (t = 17.693; p = .000 < .005). In addition, it decreased the need to use additional analgesics and opioids (t = 2.14; p = .037). Conclusions: In this study the exaggerated lithotomy position was found to be fast and effective for relieving shoulder pain after laparoscopic cholecystectomy, decreased the need to use additional analgesics and opioids, and, in conjunction with pain control, also contributed to improvements in respiratory functions.

The Human Papilloma Virus Vaccination: Turkish Mothers’ Views

Objectives: This study was conducted in order to analyze the knowledge and opinions of mothers of daughters in Turkey regarding the human papilloma virus (HPV) vaccine. Methods: This descriptive study was conducted at 8 public family health centers at primary health care institutions affiliated with the Ministry of Health located in Ataşehir, in Istanbul province. A total of 252 mothers of daughters participated. A sociodemographic characteristics form and an HPV vaccine evaluation questionnaire were used to collect the data. The data were analyzed using percentage, frequency distribution, a chi-square test, and Fisher’s exact test. Results: Most of the participating mothers were between the ages of 28 and 47 years (68.7%), had a high school graduate education or less (82.5%), were not employed (67.9%), and had a low family income (57.6%). The majority (95.6%) had no experience with cervical cancer in their family, 60.7% had never heard of HPV infection, 72.2% did not know that HPV infection is related to cervical cancer, 54.8% had never heard of the HPV vaccine, 89.7% had not been advised to have their daughters vaccinated, and 98.8% had not yet had their daughters vaccinated. Among the factors influencing the mothers’ information about HPV infection were age (p=0.021), education level (p<0.001), work status (p<0.001), mothers’ marriage age (p<0.001) and family income level (p=0.009). It was determined that a greater education level positively influenced the mothers’ intention to get the HPV vaccine for their daughter (p=0.044). Conclusion: This study revealed that the mothers had very limited knowledge of the HPV vaccine and that health professionals do not sufficiently inform parents on this subject. It was also found that the high cost of the vaccine and other influences had a negative impact on intention to pursue obtaining the vaccine.