Fusun Terzioglu

Investigation into effectiveness of counseling on assisted reproductive techniques in Turkey.

This experimental study was conducted to determine the specific problems experienced by couples participating in assisted reproductive techniques (ART) and to assess couples’ counseling needs. It was also intended to determine the effects of the counseling service model, developed and implemented by the researcher, on the success rate of ART, and to assess the couples’ anxiety, depression and life satisfaction levels. Thirty couples for the experimental group and 30 couples for the control group were included in the study. The couples in the control group experienced the routine procedures that the treatment currently includes. Couples in the experimental group took part in the counseling service model, and were informed and supported throughout the steps of the ART. A guide developed for the couples and education material developed for the counseling service model were used during the study. Three psychological tests were given to the couples before (pretest) and after (post-test) each procedure. These tests included anxiety, depression and life satisfaction inventories. The difference means test and Students t test were used for statistical analysis. The results of the study showed that couples in the experimental group had lower anxiety and depression scores than the couples in the control group. Life satisfaction scores and pregnancy rates were higher for couples in the experimental group than for the couples in the control group. Statistical evaluation showed that the difference between the experimental group and the control group was significant (p < 0. 05). This study demonstrates the importance of the counseling role of the nurse, and the development and application of counseling services in ART centers, in lowering the anxiety and depression levels of couples and ensuring success of the treatment

Assessment of genotoxic damage in nurses occupationally exposed to antineoplastics by the analysis of chromosomal aberrations

To estimate the genotoxic risk of occupational exposure to antineoplastic drugs, chromosomal aberration (CAs) frequencies in peripheral lymphocytes were determined for 20 nurses handling antineoplastics and 18 referents matched for age and sex. Urinary cyclophosphamide (CP) excretion rates, which are used as a marker for drug handling, were also measured on these nurses. We have observed significant frequencies of CAs (about 2.5-fold increase) including chromatid breaks, gaps, and acentric fragments for nurses handling antineoplastics as compared to control subjects (p<0.05, p<0.01, excluding and including gaps, respectively). The mean value of CP excretion rate for 12 nurses was 1.63 μg/24 h, suggesting that when the nurses handled CP (and other antineoplastic drugs) this particular compound was absorbed. Our study has shown that increased genetic damage was evident in nurses, at population level, due to occupational exposure to antineoplastics. Until the effects of handling antineoplastics from low-level exposure are known, it will be important to keep the exposure to a minimum.

Does cigarette smoking really have detrimental effects on outcomes of IVF

OBJECTIVE Cigarette smoke contains many toxic chemicals associated with poor reproductive outcome and reduced fertility. It also has a negative effect on sperm motility and morphology. The aim of this study was to analyze the effects of male and female cigarette smoking on the outcomes of in vitro fertilization (IVF). STUDY DESIGN In this comparative prospective analysis, the effects of smoking on outcomes of IVF including semen parameters, oocyte quality, fertilization rate, transfer day embryo scores and pregnancy rates were analyzed. For this purpose, patients were grouped based on their follicular or seminal fluid cotinine (a nicotine metabolite) levels as smokers and non-smokers (non-smokers: female (n=171), male (n=118), smokers: female (n=43), male (n=96)). RESULTS The mean age and baseline hormonal levels of all groups were found to be comparable. While the numbers of total and mature oocytes collected were higher in the smoker group (p=0.005 and p=0.006, respectively), oocyte quality index, fertilization rate, embryo development rate and pregnancy rate were not significantly different between the groups (p>0.05). Analysis based on the type of ovarian hyperstimulation protocol (GnRH agonist, antagonist and others) showed that within the antagonist group the mean age of smokers was significantly lower and the total number of collected oocytes was significantly higher compared with non-smokers. Cigarette smoking among men did not have a significant negative effect on outcomes of IVF whether their partners were smokers or nonsmokers. Regression analysis did not give any significant difference when male and/or female smoking status was analyzed for fertilization rates, transferred embryo qualities and clinical pregnancy rates. CONCLUSION Cigarette smoking does not have detrimental effects on outcomes of IVF.

Multimodal interventions (chewing gum, early oral hydration and early mobilisation) on the intestinal motility following abdominal gynaecologic surgery

AIMS AND OBJECTIVES To determine the effects of chewing gum, early oral hydration and early mobilisation on the time of first bowel sounds, first passage of flatus and first defecation following abdominal gynaecologic surgery. BACKGROUND A major complication of abdominal surgical procedures is paralytic ileus which results in patient discomfort, prolonged length of hospital stay and increased cost of treatment. DESIGN Prospective randomised case-control study. METHODS Women who underwent abdominal gynaecological surgery for benign disorders under general anaesthesia were randomised into eight groups according to different combinations of interventions consisting of chewing gum, early oral hydration and early mobilisation. The effects of these interventions on the time of first bowel sounds, first passage of flatus and first defecation following abdominal gynaecologic surgery were investigated. The data were analysed using chi-square tests, t-test for independent samples, Tukeys HSD test, pairwise comparison test, one-way analysis of variance. RESULTS It was found that the time when bowel sounds were heard was shorter, the time first passage of flatus was shorter and first defecation occurred earlier in the 1st group of women who chew gum, were hydrated orally and were mobilised early after surgery than the other groups. It was also determined that these periods were longest in the women who did not receive any intervention and received the routine hospital care when compared with other groups. Duration of hospital stay was shorter in the women who chew gum, were hydrated orally and were mobilised early than the other groups. CONCLUSIONS Early oral feeding, early mobilisation and chewing gum are effective methods in terms of preventing paralytic ileus following abdominal gynaecological surgery, improving patient comfort and shortening the duration of hospitalisation. RELEVANCE TO CLINICAL PRACTICE Nurses may cause early recovery, improve the patient comfort, prevent paralytic ileus and shorten the duration of hospitalisation after gynaecologic abdominal surgery by recommending gum chewing, early mobilisation and early hydration.

The Use of Lactational Amenorrhea as A Method of Family Planning in Eastern Turkey and Influential Factors

Although the lactational amenorrhea method (LAM) is commonly used for contraception, it frequently fails and pregnancy ensues. This descriptive study was conducted to determine the status of the use of breastfeeding as a method of family planning and the influential factors that may have contributed to the success or failure of LAM. The research sample was comprised of 188 women with 6-month-old infants in eastern Turkey. A semistructured interview form was used for data collection in face-to-face meetings with the women during visits in their homes. In this study, 34% of the women used LAM to prevent pregnancy after childbirth. However, it was observed that only 17.2% of women using LAM fulfilled the LAM criteria with success, and 82.8% did not fulfill one or more of the LAM criteria. The pregnancy rate of women using this method was 32.8%. Two of the three basic criteria necessary for LAM to be effective were not met by the women: having menses (43.8%) and starting supplemental feeding (70.3%). Prenatal and postnatal counseling services need to be integrated and include information and education about the criteria that are necessary for LAM to be used effectively. These services should be given to women who choose to use LAM for contraception.

Anxiety of infertile men who undergo genetic testing for assisted reproductive treatment

In this paper we implement a bio-behavioral macrosimulation model of the spread of HIV to first assess the extent of the oversupply of males in the partnership market and then to examine potential consequences of these sex ratio imbalances for the adoption of high risk behaviors. We simulate a range of possible HIV prevalence outcomes consistent with behavioral adaptations to changes in the availability of partners associated with both imbalances in the sex ratio at birth and rural-to-urban migration flows. Baseline behavioral inputs are drawn primarily from the Chinese Health and Family Life Survey (CHFLS) while potential behavioral adaptations to these demographic shifts are informed by hypotheses elaborated in the literature. (excerpt)Purpose. This descriptive study was conducted with the aim to determine the anxiety level of infertile men who undergo genetic testing for assisted reproductive treatment. Method. Sample of the study included 60 individuals. Data was collected by interview through a data collection form and Spielbergers STAI Inventory. Results. It was identified that participants experienced psychological distress and anxiety before and after genetic testing. State anxiety scores of infertile men were found to be significantly higher than their trait anxiety scores (p < 0.001). About 98.3% of the participants had normal genetic test results, with only one person with Klinefelters syndrome (XXY). Conclusion. Anxiety due to genetic testing in infertile men who seek assisted reproductive treatment indicated the need for informative and psychologically supportive counseling.

The Effect of Gum Chewing, Early Oral Hydration, and Early Mobilization on Intestinal Motility After Cesarean Birth

AIM The aim of the study was to investigate the effect of gum chewing, early oral hydration, and early mobilization after cesarean birth on intestinal sounds, passing gas, and intestinal evacuation. DESIGN Randomized controlled study. SETTING This study was conducted at the Obstetrics Service of the one Obstetrics and Child Diseases Hospital. PARTICIPANTS A total of 240 females divided into 8 groups of 30 subjects each were included within the scope of the sample. METHODS The women who underwent cesarean birth were divided into eight groups by using 2(3) factorial test levels, depending on the use of three different methods of gum chewing, early oral hydration, and early mobilization. No intervention was applied to the women in the control group. For the other seven groups, the intestinal sounds were checked every 30 minutes with a stethoscope over the abdomen and the first time of passing gas and the first evacuation time were recorded by asking the mother. The data were evaluated with numbers, mean, and percentage calculations, Students t test, one-way variance analysis, correlation, and Tukey HSD test. RESULTS The intestinal sounds were heard earlier, gas was passed earlier, and bowel movements were earlier in the first group that received all interventions compared to the other groups (p < .05). The patient could not be discharged before 48 hours had passed after the cesarean birth according to the hospital protocol and the time of discharge was therefore not affected by interventions. LINKING EVIDENCE TO ACTION All of the three different interventions, such as gum chewing, early oral hydration, and early mobilization after cesarean birth, increase intestinal motility. The interventions are recommended during postoperative routine care to shorten hospital stay and prevent postoperative ileus.

A Multicenter Pilot Study of Burden Among Caregivers of Geriatric Rehabilitation Patients with Neuromusculoskeletal Diseases

Purpose: In this study, we aimed to describe the sociodemographic characteristics of caregivers of patients in a geriatric unit and to clarify the relationship between caregiver burden and specific clinical variables in the patients and the characteristics of the caregivers. Design: Cross-sectional multicenter study. Methods: One hundred twenty-three patients and 123 caregiver dyads, with mean ages of 72.5 ± 7.7 years and 51 ± 14.7 years, respectively, were included. The functional, psychological, and cognitive statuses of the patients were determined, and the sociodemographic characteristics of the caregivers as well as the type and duration of caregiving were recorded. Caregivers completed the Caregiver Burden Inventory (CBI) to measure the perceived burden of care. Most patients were female and generally lived with their family. Findings: Most of the caregivers were family members (90%), female (73.2%), primary school graduates (52.8%), and first-degree relatives (73.1%). The average CBI score was 33, and the highest CBI subscores were for time, developmental, and physical burdens. Caregiver burden correlated with the patient’s ambulatory, psychological, and cognitive status and with the caregiver’s age, gender, income level, and duration of caregiving. Conclusions: We have highlighted the relationship between caregiver and patient characteristics in a cohort of elderly Turkish patients with neurological and musculoskeletal disorders. In particular, we have highlighted the heavy caregiver burden in a developing country. Clinical Relevance: Our results may guide the nurses to understand the requirements of caregivers and to help them find suitable resources that would meet their needs to cope with their burden.

Premenstrual syndrome in university students: its correlation with their attitudes toward gender roles

Abstract Introduction: Psychosocial factors causing premenstrual syndrome (PMS) are closely correlated with gender. Thus, this study’s aim was to identify correlations between gender role attitudes (GRA) and PMS status of university students. Methods: The participants of this descriptive study were 1515 female students from 13 departments of Hacettepe University using stratified sampling method. Data were collected between February and May 2014 using a semi-structured questionnaire, the Premenstrual Syndrome Scale (PMSS), and the Gender Roles Attitude Scale (GRAS). Correlations between PMSS and GRAS scores were analyzed using the Spearman correlation coefficient. The difference between PMSS and GRAS scores in terms of sociodemographic characteristics was analyzed using the t-test and one-way analysis of variance. Results: The mean total PMSS score was 117.96 ± 34.41, indicating moderate PMS levels. The total mean GRAS score was 162.71 ± 17.50, indicating an egalitarian GRA. As the gender roles in marriage of the participants became traditional, depressive thoughts and swelling became more common (rs= −0.620, p < .05; rs= −0.560, p < .05). The educational level of the mothers and perceived economic status were sociodemographic factors affecting both GRA and PMS. Discussion: GRA and sociodemographic characteristics should be considered in healthcare services for PMS.

Palliative Care in Gynecologic Cancers

Gynecologic cancers constitute a significant part of cancer load, especially in developing countries, and may be an important reason for mortality and morbidity for women in these countries. Procedures in diagnosis and treatment for gynecologic cancers might remain insufficient, and disorders related to symptoms may negatively influence the quality of life of women and their families. In this respect, interest on palliative care in gynecologic cancer cases has increased. The literature demonstrates that palliative care allows women to remain active as much as possible in the period between diagnosis and death, aids in management of pain and discomfort during the terminal stage, and ensures a comfortable death process. Palliative care has been shown to improve quality of life, mood, symptom control, satisfaction, survival duration, and caregiver satisfaction, depression, and stress burden. Palliative care improves healthcare utilization outcomes such as decreased hospital costs. Therefore, healthcare provider training and palliative care for patients need to be integrated into standard oncology care.