Ikbal Cavdar

Comparison of Intermittent Pneumatic Compression with Manual Lymphatic Drainage for Treatment of Breast Cancer-Related Lymphedema

BACKGROUND The aim of this prospective controlled study was to assess the efficacy of two different combination treatment modalities of lymphedema (LE). Manual lymphatic drainage (MLD) and compression bandage combination (complex decongestive therapy) have been compared with intermittent pneumatic compression (IPC) plus self-lymphatic drainage (SLD). METHODS AND RESULTS Both MLD with compression bandage (complex decongestive therapy) group (Group I, n=15) and IPC with SLD group (Group II, n=15) received treatment for LE 3 days in a week and every other day for 6 weeks. Arm circumferences were measured before and the 1st, 3rd, and 6th weeks of the treatment. EORTC-QLQ and ASES-tests were performed to assess the quality of life before and after 6 week-treatment. Patients in both groups had similar demographic and clinical characteristics. Even though both treatment modalities resulted in significant decrease in the total arm volume (12.2% decrease in Group II and 14.9% decrease in Group I) (p<0.001), no significant difference (p=0.582) was found between those two groups. Similarly, ASES scores were significantly (p=0.001) improved in both Group I and II without any significant difference between the groups. While emotional functioning, fatigue, and pain scores were significantly improved in both groups, global health status, functional and cognitive functioning scores appeared to be improved only in patients of group I. CONCLUSIONS Different treatment modalities consisting of MLD and compression bandage(complex decongestive therapy) or IPC and SLD appear to be effective in the treatment of LE with similar therapeutic efficacy in patients with breast cancer. However, combination modalities including IPC and SLD may be the preferred choices for their applicability at home.

Taxane-induced nail changes: Predictors and efficacy of the use of frozen gloves and socks in the prevention of nail toxicity.

PURPOSE The primary endpoint of this study was to determine predictors of taxane-related nail toxicity. The secondary endpoint was to evaluate the efficacy of the use of frozen gloves and socks in the prevention of taxane-related nail toxicity. METHODS This descriptive, interventional, cross-sectional study was conducted with 200 patients. The patients were assigned to the frozen gloves/socks intervention group or control group. Frozen gloves/socks were applied only in hourly taxane-based treatments. The Patients Record Forms of the clinic were used in data collection. Nail changes were graded using the NCI Common Toxicity Criteria for each patient and treatment. Logistic regression analysis was performed to predict the factors that affect nail changes. RESULTS The majority of the patients enrolled in the study were women diagnosed with breast cancer. The two groups were statistically similar for the cancer diagnosis, type and number of taxane cycles administered. Grade 1 nail toxicity was found in 34%, grade 2 in 11%, and grade 3 in 5.5% patients. Taxane-related nail toxicity was higher in patients who were female, had a history of diabetes, received capecitabine in conjunction with docetaxel and had breast or gynecological cancer diagnosis. Nail changes increased with an increase in the number of taxane cycles administered, BMI and severity of treatment-related neuropathy. CONCLUSIONS The multivariate analysis demonstrated that BMI, breast or ovarian cancer diagnosis and the number of taxane cycles administered were the independent factors for this toxicity. No statistically significant difference in nail toxicity incidence and time to occurrence of nail changes was found between the intervention and the control groups.

Assessment of nursing students' stress levels and coping strategies in operating room practice

The aim of this study was to evaluate the stress levels and stress coping strategies of nursing students in their first operating room experience. This descriptive study was done with 126 nursing students who were having an experience in an operating room for the first time. Data were collected by using Personal Information Form, Clinical Stress Questionnaire, and Styles of Coping Inventory. The nursing students mostly had low clinical stress levels (M = 27.56, SD = 10.76) and adopted a self-confident approach in coping with stress (M = 14.3, SD = 3.58). The nursing students generally employed a helpless/self-accusatory approach among passive patterns as their clinical stress levels increased, used a self-confident and optimistic approach among active patterns as their average age increased, and those who had never been to an operating room previously used a submissive approach among passive patterns. The results showed that low levels of stress caused the nursing students to use active patterns in coping with stress, whereas increasing levels of stress resulted in employing passive patterns in stress coping. The nursing students should be ensured to maintain low levels of stress and use active patterns in stress coping.

Comparison of quality of life of Turkish breast cancer patients receiving breast conserving surgery or modified radical mastectomy.

PURPOSE The aim of this study was to investigate the differences in quality of life in patients who received breast conserving surgery (BCS) or modified radical mastectomy (MRM) for breast cancer. MATERIALS AND METHODS A total of 100 women with breast cancer who underwent either BCS or MRM between September 2011 and April 2012 at a private health center and completed their chemotherapy and radiation therapy cycles were included in the study. To assess the quality of life, we used a demographic questionnaire, the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the Quality of Life assessment in Breast Cancer (EORTC QLQ-BR23). RESULTS Using QLQ-C30, we found that patients who underwent BCS had better functional status and fewer symptoms than patients who underwent MRM. In QLQ-BR23, independent factors improving the functional scales were BCS, higher level of education and marital status (married); independent factors improving symptoms were BCS, higher level of education, younger age and low and normal body mass index (BMI). In QLQ-C30, independent factors affecting the functional and symptom scales were only BCS and higher level of education. CONCLUSIONS We determined that patients who received BCS had better functional status and less frequent symptoms than patients who underwent MRM.

Safety of personnel working in endoscopy units.

All personnel performing or assisting with endoscopic procedures and those responsible for reprocessing the equipment should be trained in how to handle the infectious and chemical hazards associated with the endoscopic environment. Endoscopy personnel should follow a comprehensive safety program that outlines the steps individuals should take to prevent injuries from the potential hazards they may encounter in endoscopy units. Safety measures include ensuring that there is adequate lighting and ventilation in the endoscopy unit, cleaning endoscopy instruments thoroughly, and operating equipment safely.

Effects of the contact isolation application on anxiety and depression levels of the patients.

This study was aimed to assess the effects of contact isolation application on anxiety and depression levels of the patients, the effects of certain sociodemographics and patient characteristics on anxiety and depression levels, and the thoughts of the isolated patients about contact isolation. This non-randomized quasi-experimental study was carried out with 60 isolated and 57 non-isolated patients with hospital infection. The data were acquired from Hospital Anxiety and Depression Scale (HADS-A (anxiety) and HADS-D (depression)) and patient information form. There was no statistically significant difference between the anxiety and depression levels of the isolated and non-isolated patients. In the isolated patients, the depression points were higher in patients who were, women, received primary education and had lower income levels. Of the patients, 86.4% of them told that they were happy to be in the isolation room. Contact isolation application did not affect anxiety and depression levels of the patients. However, personal attributes increased the development of depression. In contact isolated patients, personal attributes should be taken into consideration in nursing care planning to prevent development of depression.

Coping and Help-Seeking Behaviors for Management of Urinary Incontinence

To describe the coping strategies and help‐seeking behaviors of women and men with urinary incontinence (UI).

Sleep and quality of life in people with ileal conduit

Abstract Objective: The aim of this study was to determine the sleep quality and the association between sleep quality and quality of life in people with ileal conduit. Materials and methods: A descriptive and cross-sectional design was adopted. The study sample comprised 111 people with ileal conduit operated on in urology clinics in a state hospital between January 2011 and May 2014. Six months after the operation, they were called by telephone to participate in the study. Data for the study were collected using a questionnaire form, the Pittsburgh Sleep Quality Index (PSQI) and the Stoma Quality of Life Scale (SQLS). Results: The mean ± SD total PSQI score of the people with ileal conduit was 10.20 ± 2.95, mean total score of SQLS was 43.63 ± 7.21, mean Work/Social Function domain score was 37.27 ± 5.80 and mean Stoma Function domain score was 50.0 ± 12.56. The total sleep quality had a low degree of negative correlation with total SQLS score, a medium degree of negative correlation with Work/Social Function (r = –0.327, p < .001) and no correlation with Stoma Function (r = –0.096, p > .001). People using a night drainage system had higher sleep quality. Conclusions: This study determined that quality of life and sleep deteriorate in people with ileal conduit. The quality of life decreases when the sleep quality is poor, and decreased quality of life affects quality of sleep in people with ileal conduit.

Approaches to Cope with Stress and Depression in Individuals with Urinary Incontinence.

Aim: The aim of study was to assess individuals with urinary incontinence (UI) with respect to depression and to determine coping mechanisms with stress. Methods: One hundred sixty female and 110 male participants that applied to Istanbul Faculty of Medicine, Urology and Urogynecology Department with UI complaints and accepted to participate in the study were included in the study. Depressive symptoms were assessed with Center for Epidemiological Studies Depression Scale (CES-D). The mechanisms of coping with stress were evaluated using Ways of Coping with Stress Inventory (WCSI). Results: Females (57.5%) scored 16 points and more from the CES-D scale, while the rate was significantly higher in males (79.1%). The scores obtained in 5 subdimensions of the WCSI showed that females utilized a desperate approach (female 1.39 ± 0.63, male 1.11 ± 0.51, p < 0.000), self-confident approach (female 1.98 ± 0.60, male 1.70 ± 0.42, p < 0.000), and social support approach (female 1.90 ± 0.57, male 1.48 ± 0.44, p < 0.000) statistically and significantly more than males in coping with stress. Conclusion: Males experienced more depression symptoms when compared to females. Females were significantly more self-confident and utilized social support mechanisms and desperate approaches more than males in order to cope with stress.

Abstract P5-15-04: A Randomized Trial Comparing Intermittent Pneumatic Compression with Manual Lymphatic Drainage for Treatment of Lymphedema in Patients with Breast Cancer

Aim: Lymphedema is a serious complication associated with axillary surgery and/or radiotherapy in patients with breast cancer. The aim of this randomized study was to assess the efficacy of two different treatment modalities of lymphedema by comparing the manual lymphatic drainage and compression bandage with intermittent pneumatic compression and self-lymphatic drainage. Material and Methods: Thirty patients diagnosed with lymphedema after treatment for breast cancer were randomized to either manual lymphatic drainage (MLD)by physicotherapists with compression bandage-group (n=15) or to the intermittent pneumatic compression (IPC)-group with self-lymphatic drainage massage (n=15). In both groups, treatment program was performed three days a week, every other day for 6 weeks. To determine the efficacy of the treatment modalities, arm circumferences were measured from wrist to shoulder girdle with 10 cm distance before and after treatment for lymphedema at the 1st, 3rd, and 6th weeks of the therapies. Tests evaluating the quality of life including EORTC-QLQ and ASES-test were also performed before and after treatment at 6th week. Results: The median age of patients was 54.5 years (31-74) and lymphedema occured after a median time of 18 months following surgery (range, 6-72 months). Patients in both groups had similar demographic and clinical characteristics. At the 6th week, even though both treatment modalities resulted in significant decreases (p Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-15-04.