Işıl Maral

Burnout and its correlates among nursing staff: questionnaire survey.

AIM This paper is a report of a study to determine the burnout level and its correlates in nurses. BACKGROUND Healthcare providers and especially nurses are generally considered a high risk group regarding work stress and burnout and this syndrome has been a major concern in the field of occupational health. METHOD The study was carried out at a university hospital in Turkey during May-June 2005. A total of 418 nurses from the 474 working at the hospital at the time (88.2%) answered a self-administered questionnaire including the Maslach Burnout Inventory. FINDINGS All the nurses were female, with a mean age of 30.6 (5.4) and a median age of 29 years. The mean score was 17.99(6.35) for the Emotional Exhaustion subscale, 5.72 (3.87) for the Depersonalization subscale and 19.83 (4.66) for the Personal Accomplishment subscale. Emotional Exhaustion decreased with increasing age (P < 0.05). Total time in the job, weekly working hours, shift-working and the unit where employed influenced burnout scores (P < 0.05). Not being happy with relations with superiors, not finding the job suitable, feeling anxious about the future, perceived poor health, problems with personal life and financial difficulties were also factors influencing burnout scale scores (P < 0.05). CONCLUSION It is necessary to consider nurses having the characteristics shown as the correlates of burnout in this study as a target group, to screen periodically the burnout status and improve their working conditions, especially relationships with colleagues.

Effectiveness of Inactivated Influenza Vaccine for Prevention of Otitis Media in Children

Objective: The objective of this study was to evaluate the effectiveness of inactivated influenza vaccine in preventing acute otitis media (AOM) and otitis media with effusion (OME) in children aged 6 to 60 months who attend day care. Study Design: This prospective, single-blind study was conducted in 8 day care centers in Ankara, Turkey. One hundred nineteen (61 vaccinated and 58 unvaccinated against influenza) healthy children were examined at study entry and at 6-week intervals for 6 months by the same 2 otorhinolaryngologists who were blinded about the vaccination status of the children. The frequency of AOM and OME is compared between the 2 groups and the effect of influenza season on frequency of episodes was evaluated. Based on national influenza laboratory data, the influenza season was determined to be the period between December 15, 2003, and January 31, 2004. Result: The frequencies of AOM, OME and total otitis media episodes in vaccinated children were 2.3%, 22.8% and 25.2%, respectively, and these frequencies were 5.2%, 31.1% and 36.3% in the unvaccinated group. The difference was statistically significant (P < 0.01). This difference was especially prominent in the influenza season (P < 0.05). Conclusion: Influenza vaccine is effective in reducing AOM and OME episodes in 6- to 60-month-old day care children, especially during influenza season.

Differential diagnosis of solid breast lesions: contribution of Doppler studies to mammography and gray scale imaging.

To assess the role of Doppler sonography when used in conjunction with mammography and gray scale sonography in differentiating solid breast lesions and to find out whether lesion size is a limiting factor for Doppler evaluation.

Prevalence and risk factors of monosymptomatic nocturnal enuresis in Turkish children.

Objectives To determine the prevalence of primary monosymptomatic nocturnal enuresis (PMNE) and assess risk factors that can cause this disease. Methods After the determination of 15 primary schools in the provincial center of Ankara, questionnaires were given to 15,150 students to be answered by their parents. Detailed urologic history was obtained and physical examination applied to the students whose parents answered the questionnaire. After excluding children with polysymptomatic NE, 14060 questionnaires of MNE patients were evaluated. Demographic features with social and medical history of students and their parents, general approach of family to the children, school success of the students and general behavioral attitudes, method of toilet training and the presence of nocturnal enuresis were questioned. Results MNE was determined in 9.0% (n: 1266) of the students and nocturnal enuresis frequency was higher in boys than girls (P<0.05). Univariate analysis revealed gender, method of toilet training, sleep problems, school success, and general approach of the family to children and general behavioral attitudes of the children as significant factors. In logistic regression analysis; age, male gender, toilette training with threatening method, deep sleeper, sleep walking, being introverted and shy, significantly increases the risk of nocturnal enuresis. Conclusions The current study suggests that the methods of toilet training are extremely important to prevent bedwetting and behavioral disorders due to enuresis. Parents should be well-informed about the appropriate toilet training method.

The effectiveness of training for breast cancer and breast self-examination in women aged 40 and over.

Background. Training on breast health is required to increase awareness of early detection of breast cancer, especially in countries with limited resources.Methods. Of the 784 invited women, 462 participated in the study (58.9%). The training included both theoretical and breast self-examination (BSE) training between preeducation and posteducation tests. Following the theoretical presentation, breast examination training was performed using a breast simulator. The competency of the participants on breast examination was assessed by an evaluation guide.Results. All breast cancer symptoms were stated at significantly higher rates compared to those before education (P<.05). The most commonly stated risk factor in both preeducation and posteducation tests was “no breast-feeding,” with ratios of 15.2% and 56.3%, respectively. Early detection modalities for breast cancer were also stated more often in the posteducation test compared to the preeducation (P<.05). In the preeducation test, only 4.3% to 18.7% of the participants women could state most of the BSE steps. After BSE training, 85% to 92% of the participants were competent in BSE steps.Conclusions. Theoretical education on breast cancer and BSE training in low-educated women, even illiterate, is highly effective.

A study on the prevalence of accessory auricle anomaly in Turkey

OBJECTIVE Accessory auricular anomaly is a small elevation of skin containing a bar of elastic cartilage localized most commonly just anterior to the tragus or ascending crus of the helix. The anomaly may exist isolated or may be associated with other congenital anomalies of the first arch. The purpose in this study is to detect prevalence of accessory auricle in Turkey and find out whether it is associated with other craniofacial anomalies or hearing loss. METHODS The study was performed on 850 children from the age of 7 to 9 during a screening program in primary schools. Complete otolaryngologic examination and acoustic reflectometry measurements were performed on all the children. Full physical examination, tympanometric and audiometric evaluation and EEG measurements were added to the cases with accessory auricle anomaly. RESULTS Among 850 children examined, four had accessory auricle anomaly and prevalence of the anomaly was calculated as 0.47% (95% confidence interval (CI), 0.13-1.20%). Children were developmentally normal, and no other congenital craniofacial or systemic anomaly was detected in any of the cases. Further, tympanometric, audiometric evaluations and EEG tests were in normal limits. CONCLUSIONS In this study, the prevalence rate of the condition was calculated as 0.47%. Although one study from China reported this prevalence as 0.22%, the difference between the reported prevalances was not statistically significant. Further, although external ear anomalies may present together with cranifacial anomalies and neurologic disorders like epilepsy, neuromotor retardation and EEG disorders, in our cases, mental and motor development was normal and epilepsy history or abnormal EEG patterns do not exist. On the other hand, no hearing loss was found to be associated with accessory auricles.

Induced abortion frequency in Ankara, Turkey, before and after the legal regulation of induced abortion.

Objective To determine the effects of the 1983 law that legalized induced abortion on the number and place of abortions, and on the use of family planning (FP) methods before and after abortion, and to determine the demographic characteristics and reproductive health features according to the order of abortion. Method This study included 2455 married, widowed or divorced women presenting at Mother and Child Health-Family Planning Centres in Ankara. A questionnaire was used for data collection. Result Nearly three out of 10 (28.7%) of the women had undergone at least one induced abortion. In the age groups 45–54 and 55–64, 49 and 37.3%, respectively, had had one or more terminations of pregnancy (TOPs). The induced abortion rate increased following the enacting of the law. In the 15–24 and in the 55–64 age group, 55.6 and 89%, respectively, of the women had been aborted by a private physician. Before the index pregnancy, 63.1% were not using contraception compared with 37.3% thereafter. The rate of use of FP increased after the law was passed. Conclusion Although the most common reason for having an abortion was unwanted pregnancy in all age groups and nearly 60.0% of the women aged less than 55 reported that they were not using any FP method at the time of the TOP, the proportion of women having undergone at least one of these procedures increased after the law was passed, indicating that abortion is used as a FP method.

Prevalence of insomnia symptoms: results from an urban district in Ankara, Turkey

Objective. Characteristics of insomnia symptoms in Turkey are not well established. The goal of this study was to determine the prevalence of insomnia and related symptoms in an urban district of Turkey. Method. The study was carried out in Ankara, in an urban district with a population of 2665. Out of the 1332 people in the sample, 1034 in the 15–65 age range were included in the study. Interviews were conducted according to the “Sleep Disorders Assessment Questionnaire” developed by the researchers. The Insomnia Severity Index (ISI) was also given to the subjects with a sleep problem to measure the subjective quality and quantity of insomnia symptoms. Results and conclusion. A total of 29.4% of all participants reported a sleep problem, out of which 23.7% defined one or more of the insomnia symptoms which included difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), early morning awakening (EMA), non-restorative sleep (NRS) and sleep deprivation (SD). Insomnia risk was found to be significantly increased with age, female sex, smoking and chronic medical illness. A total of 75.9% of participants who reported insomnia symptoms did not seek medical help for their complaint. According to the ISI, among the subjects with insomnia symptoms, 79 (32.2%) had subthreshold insomnia, 43 (17.6%) had clinical insomnia, 12 (4.9%) had severe clinical insomnia, while 88 (35.9%) did not score in the range indicating insomnia. The findings are discussed in the light of previous research and in relation to sociocultural factors emphasizing the need for public education on sleep disorders as medical conditions.

Tetanus immunization in pregnant women. Serum levels of antitetanus antibodies at time of delivery

The objective of this study was to determine the tetanus immunity status of pregnant women at the time of delivery according to tetanus toxoid (TT) vaccination coverage during their most pregnancy. The serum anti-tetanus antibody levels of 493 mothers who had live births at a hospital in Ankara were determined by enzyme-linked immunosorbent assay (ELISA). Protected women were defined as those with serum antibody levels ≥ 0.6 IU/ml. Overall, 69.0% of mothers had protective tetanus antibody titers at the time of delivery. The rates of protection for mothers who had received no vaccination, one TT dose, or two TT doses during pregnancy were 46.4, 93.5, and 95.6%, respectively. Vaccinating every pregnant woman with at least one dose of TT would be an affordable and effective way to protect against neonatal tetanus, and would be a step toward eliminating the deaths that continue to occur due to this preventable disease in Turkey.

Hepatitis B Virus and Hepatitis C Virus Seroprevalence in the Elderly Living in Nursing Homes

Background Communal living situations such as nursing homes create a risk for the spread of hepatitis B virus and hepatitis C virus (HCV). The aim of this study was to determine the seroprevalence of hepatitis B virus and HCV in the elderly living in 2 nursing homes in Ankara, Turkey. Methods A total of 227 persons (mean age, 76.11 ± 8.55 years) participated in this cross-sectional study. All individuals were investigated seroprevalence for hepatitis B surface antigen (HBsAg), anti-HBs immunoglobulin G (IgG), anti-hepatitis B core IgG, and anti-HCV IgG. Results Positive seroprevalence was 11.9% for HBsAg, 48.0% for anti-HBs IgG, 25.1% for anti-hepatitis B core IgG, and 2.5% for anti-HCV IgG. Hepatitis B surface antigen positivity was 12.4% in males and 11.5% in females (P > 0.05); and the seroprevalence was 10.4% for those living in nursing homes for 1 year or less and 13.0% for those living in nursing homes for more than 1 year (P > 0.05). Conclusions The fact that nearly half of those living in nursing homes had not encountered hepatitis B infection or had not received hepatitis B vaccination indicates the need for administering hepatitis B vaccines in this group.