Funda Büyükyilmaz

Evaluation of Night-Time Pain Characteristics and Quality of Sleep in Postoperative Turkish Orthopedic Patients

This descriptive, correlational study was conducted to determine orthopedic patients’ night-time pain characteristics, their quality of sleep and the contributing factors to poor sleep experiences, and the relationship between pain and sleep. Data were collected by using the McGill Pain Questionnaire-SF (MPQ-SF) and Pittsburgh Sleep Quality Index (PSQI) on the second postoperative day. Data were analyzed using the SPSS version 10.0 for Windows. Mean age of the 75 patients was 49.55 ± 21.10 years and were hospitalized in the orthopedic wards for 10.56 ± 14.74 days. Of the sample, 65.3% were female and 36% had hip/knee arthroplasty surgery. Pain (45%) and noise (23%) were found to be the most cited factors affecting the sleep of patients in postoperative periods. They experienced “external” pain at the surgical site and verbalized their pain as “stabbing” and “tiring-exhausting.” Patients’ night-time pain was determined to be severe (6.59 ± 1.62); their quality of sleep was also poor (9.24 ± 3.53). A statistically significant correlation was found between patients’ pain intensity and quality of sleep (p≤.05).

Comparison of 3 methods to prevent pain and bruising after subcutaneous heparin administration.

Purpose: The purpose of this study was to assess the effects of the injection duration (30 seconds) and local dry cold application (5 minutes before and after injection) on pain intensity and bruising at the injection site in subcutaneous heparin injections. Design This was a randomized controlled, prospective, experimental study. Setting: This study was performed between February 2011 and February 2012 in the orthopedic wards of 1 university hospital. Sample: The sample consisted of 60 patients receiving subcutaneous injections of heparin once a day and hospitalized in the orthopedic and trauma wards. Methods: A computerized randomization program was used to allocate the patients to 3 experimental groups: group A (30-second injection duration), group B (30-second injection duration and 5-minute dry cold application applied locally), and group C (injection administered for 10 seconds and no dry cold application applied locally). Results: This study observed statistically significant differences in pain intensity and bruising occurrence and formation measured over time among groups A and B (30-second injection duration or 30-second injection duration and 5-minute local dry cold application) and group C (10-second injection duration). Conclusion: It was determined that a subcutaneous injection duration of 30 seconds and 5-minute local dry cold application (before and after injection) can be effective in decreasing the intensity of pain and in reducing the occurrence of bruising.

Evaluation of body image and self-esteem in patients with external fixation devices: a Turkish perspective.

PURPOSE This descriptive study aimed to describe the body image and self-esteem of patients with external fixation devices. SAMPLE Fifty patients with external fixation devices who came for follow-up to the Ilizarov Outpatient Clinic of a university hospital in Turkey were included in this study. INSTRUMENTS Data were collected by using a Demographic Questionnaire Form, Multidimensional Body-Self Relations Questionnaire (MBSRQ), and Coppersmith Self-Esteem Inventory. RESULTS The perceived body image (197.58 ± 25.14) and self-esteem (65.28 ± 17.97) of the patients with external fixation devices were in the moderate range. There was no significant correlation between body image and self-esteem. Self-esteem was correlated with ones perception of whether external fixation impacted ones appearance and whether one wanted to avoid being seen by certain individuals because of the appearance of the external fixator. CONCLUSION The study highlighted that body image disturbance and threats to self-esteem are not universal with the use of external fixation and need to be assessed individually.

Risk level analysis for deep vein thrombosis (DVT): A study of Turkish patients undergoing major orthopedic surgery.

Deep vein thrombosis (DVT) is a prevalent problem for orthopedic patients, particularly owing to the nature of operative interventions and treatment procedures, predisposing to an high risk of DVT. This descriptive study was conducted to determine the levels of risk, the risk factors, and their odds ratio for DVT in patients undergoing major orthopedic surgery. Data were collected using a Patient Information Form and the Autar DVT Risk Assessment Scale (DVTRAS) in orthopedic wards of a university hospital on postoperative day 2. Data were analyzed using descriptive, comparative analysis, and binary logistic regression. The 102 patients (mean age, 52.58 ± 21.58 years) were hospitalized for a mean of 14.35 ± 14.56. Of the sample, 53.9% were female, 65.7% had a history of previous surgery, and 54.9% had undergone total hip/knee arthroplastic surgery, 67.6% of patients wore graduated compression stockings, and 62.7% were administered liquid infusion. Those patients had moderate risk score (12.77 ± 5.66) in the Autar DVTRAS. According to binary logistic regression analysis, aging, obesity, immobility, and acute and chronic diseases were significant risk factors for postoperative DVT (p ≤ .05). This study highlights evidence on the degree of DVT risk, risk factors, and impact of venous thromboembolism in patients undergoing major orthopedic operations. For evidence-based clinical practice, these high-level risk factors should be taken into account in the prevention of DVT in orthopedic patients.

Opinions of Intensive Care Nurses: Traditional or Disposable Wipes Bed Bath? A Quasi-Qualitative and Cost Analysis Study

Background: This study is to compare the traditional basin with the disposable washcloths bed bath in terms of two outcomes: ICU nurses’ satisfaction/preference and cost analysis. Methods: This is a quasi-qualitative and descriptive study was performed in three ICUs (orthopaedic, neurosurgery, and general surgical) at a university hospital. The sample consisted of 41 ICU nurses agreed to participate in the study. The ICU nurses used a visual analogue scale to respond to the questions about the two types of bed-baths. The researchers conducted interviews with ICU nurses about the two bedbath practices based on open-ended questions. The interview, lasting for 20-30 minutes, was administered during a rest period. A cost analysis was calculated by researchers based on equipment and workload. Results: The application time, workload of nurses, and cost analysis scores favoured the disposable bedbath method (p≤0.05). The traditional bed-bath application scored higher than the disposable washcloth application in parameters (performing, providing communication to the patient, patient feedback, cleanliness, integrity, and softness of skin) (p≤0.01). ICU nurses reported that the three most important parameters that affect the preference for the traditional bed-bath application are communication with patients, patient satisfaction feedback, and the cleanness and integrity of skin. Conclusion: Disposable bed-bath method was performed less time, less workload of nurses, and cost effective than traditional method. Furthermore the ICU nurses preferred the traditional bed bath application. Researchers determined that a bridge between cultural habits and nursing science should be established.