Nadiye Özer

Effect of Music on Postoperative Pain and Physiologic Parameters of Patients after Open Heart Surgery

The aim of this study was to investigate the effect of listening to personal choice of music on self-report of pain intensity and the physiologic parameters in patients who have undergone open heart surgery. The study design was quasiexperimental. Patients were selected through convenience sampling in the Cardiovascular Surgery Intensive Care Unit at a university hospital. The study was conducted with a total of 87 patients who underwent open heart surgery: 44 in the music group, 43 in the control group, ages between 18 and 78 years. Through pretest-posttest design, postoperative first-day data were collected. First, physiologic parameters (blood pressure, heart rate, oxygen saturation, and respiratory rate) were recorded and a unidimensional verbal pain intensity scale applied to all participants. Later, the control group had a rest in their beds while the music group listened to their choice of music for 30 minutes. Physiologic data were then collected and the pain intensity scale applied once more. In the music group, there was a statistically significant increase in oxygen saturation (p = .001) and a lower pain score (p = .001) than in the control group. There was no difference between the groups in the other physiologic parameters. Results of this research provide evidence to support the use of music. Music might be a simple, safe, and effective method of reducing potentially harmful physiologic responses arising from pain in patients after open heart surgery.

Symptom clusters and experiences of patients with cancer

AIM This study is a report of a study to characterize the prevalence and severity of symptoms in patients with cancer and describing the clustering of symptoms. BACKGROUND Patients with cancer experience multiple symptoms caused by multiple factors, including progression of the cancer, acute physiological changes associated with treatment, delayed side effects of treatment and long-term consequences of the disease. METHODS A convenience sample of 287 patients with cancer at a Turkish university hospital completed a structured questionnaire on demographical characteristics and a symptom inventory for patients with cancer. Cluster analysis, principal components and internal consistency reliability analyses were used to analyse the data. The study was conducted in 2007. FINDINGS The most common symptoms experienced were fatigue, difficulty remembering, sadness, loss of appetite, lack of enjoyment of life, pain, distress, difficulty walking and dry mouth. The least experienced symptoms were shortness of breath and vomiting. Overall, 37.5% of the patients experienced moderate symptoms and 12.5% experienced severe symptoms. Among the severe symptoms were loss of appetite, fatigue, sadness, dry mouth and distress; however, 48% rated these as moderate or severe. CONCLUSIONS Symptom cluster research is still in its early years. Further work is needed to reach a standard definition of a symptom cluster and a consensus of its criteria. Additional studies are needed to examine symptom clusters in cancer survivors. As individuals are living longer with the disease, comprehensive understanding of the symptom clusters that may be unique to cancer survivors is critical.

The quality of life of family caregivers of cancer patients in the East of Turkey

PURPOSE In this study, the aim was to examine the quality of life of family caregivers of cancer patients in the east of Turkey. METHOD The study design was descriptive. Data were collected by the researcher in Oncology-Hematology policlinic and Chemotherapy unit of Yakutiye Research Hospital of Atatürk University. Participants were 18 years old and older. The sample included 106 family caregivers who were living in the same flat with the patients during caregiving. Data were collected using a questionnaire that included sociodemographic questions for family caregivers and the World Health Organization Quality of Life-Short Form, Turkish Version (WHOQOL-BREF TR). RESULTS The mean domain scores of WHOQOL-BREF(TR) were 70.12 (SD=19.24) for social, 68.26 (SD=20.10) for physical, 59.70 (SD=18.07) for psychological, 56.32 (SD=15.12) for national environment, and 53.87 (SD=16.99) for environment domains. About 71.7% of caregivers shared the caregiving process with someone else. Environmental domain scores of those who shared the caregiving process with someone else were higher. The environment domain scores of men (49.6, SD=17.1) were lower than those of women. As the income lowers, lowered, so did the quality of life score in every domain. The quality of life scores of those feeling unhealthy during the last two weeks were low in every domain. CONCLUSION Physical and psychological health of family caregivers in assisted living facilities should be comprehensively supported by professionals.

Psychometric Evaluation of the Turkish Version of the Zarit Burden Interview in Family Caregivers of Inpatients in Medical and Surgical Clinics

The aim of this study was to adapt the Zarit Burden Interview (ZBI) to family caregivers of inpatients in medical and surgical clinics to assess the validity and reliability of the Turkish version. The study design was descriptive and methodological. A total of 223 family caregivers providing care to patients for at least 1 week in clinics were selected through convenience sampling. Data were collected using the Turkish translation of the ZBI. The psychometric testing of the adapted instrument was carried out to establish internal consistency, interitem correlation, and construct validity. The content validity procedure resulted in a final scale comprising 18 items. Cronbach’s alpha was .82. Factor analysis yielded one factor. The Turkish version of the ZBI adapted to the clinics can be used as a one-factor tool.

The effect of enhancing environmental factors on the quality of patients’ sleep in a cardiac surgical intensive care unit

Abstract The aim of this study was to investigate the effect of enhancing environmental factors on the duration and quality of sleep among patients in a cardiovascular surgery intensive care unit (CSICU). This quasi-experimental study was conducted upon 100 patients. The experimental group received nursing interventions to control the environmental factors that negatively affect nocturnal sleep. Data also were collected using a form to assess the environmental factors and the Richards–Campbell Sleep Questionnaire in the morning of the second day after the operation. The difference between the groups was statistically significant in favor of the experimental group for eight of the environmental factors. Compared with that in the control group, the duration of sleep was longer (experimental, 6.30 h; control, 3.98 h) and the quality of sleep was higher (experimental, 66.57 units; control, 44.43 units) in the experimental group. We conclude that nursing interventions should be used to control the environmental factors that negatively affect nocturnal sleep in CSICUs.

CERRAHİ KLİNİKLERDE ÇALIŞAN HEMŞİRELERİN ÇALIŞMA ORTAMLARININ, HASTA GÜVENLİĞİ KÜLTÜRÜ ALGILARININ VE TÜKENMİŞLİK DURUMLARININ İNCELENMESİ

Amac:Cerrahi kliniklerde calisan hemsirelerin calisma ortamlarinin, hasta guvenligi kulturu algilarinin ve tukenmislik durumlarinin incelenmesini belirlemekti Yontem: Tanimlayici turde olan arastirma, Agustos 2012-Ocak 2013 tarihleri arasinda cerrahi kliniklerinde calisan 308 hemsireyle yurutuldu. Veriler, tanitici ozellikler soru formu, MTO, HI-I-HCODO ve HGKO ile toplandi. Bulgular:Alt boyutlarda; MTO puan ortalamasi duygusal tukenmislikte 18.0±7.00, duyarsizlasmada 6.36±3.57, kisisel basarisizlikta 19.41±4.68 bulundu. Alt boyutlarda puan ortalamalari 4 uzerinden; HI-I- HCODO 2.55±.65 - 3.08±.53; HGKO 2.45±.61- 2.68±.54 araligindaydi. Sonuclar:Bu bulgularla, kurumlar arasinda guvenlik kulturu algisinin ve calisilan kuruma gore is ortami degerlendirmesinin farkli, cinsiyetin duygusal tukenmeyi etkiledigi; ust duzeyde guvenlik kulturu algisi olusmadigi, calisma ortamlarinin orta duzeyde iyi algilandigi soylenebilir.

SUBKUTAN HEPARİN UYGULAMASINA BAĞLI GELİŞEN EKİMOZ HEMATOM VE AĞRININ ÖNLENMESİ İÇİN HEMŞİRELERİN ALDIKLARI ÖNLEMLER / The Precautions Taken by the Nurses to Prevent the Bruise Haematoma and Pain Associated with Subcutaneous Heparin

Subkutan heparin uygulamasina bagli enjeksiyon bolgesinde gelisebilen ekimoz, hematom ve agri sonraki enjeksiyonlarda kullanilabilecek bolgelerin sinirlanmasina, hastanin endiselenmesine, tedaviyi reddetmesine, beden imajinin bozulmasina, hemsire ve hasta arasindaki guven iliskisinin azalmasina ve yol acabilmektedir Bu arastirma, subkutan yolla heparin uygulamasina bagli enjeksiyon bolgesinde gelisen ekimoz, hematom ve agri olusumunun ortadan kaldirilmasi yada azaltilmasi icin hemsirelerin aldiklari onlemleri belirlemek amaciyla yapilmistir. Tanimlayici olan arastirmaya 50 hemsire alinmistir. Hemsireler subkutan heparin uygulamasi yaparken arastirmaci tarafindan gozlenmistir. Hemsirelerin %54’unun enjeksiyon icin ust kol bolgesini, %50 sinin daha onceden kullanilan enjeksiyon alanini tercih ettigi, %36.0’inin kanama kontrolu icin aspirasyon yaptigi, %78.0’inin hava kilidi teknigi uyguladigi, %48.0’inin ilaci dokuya 2-4 saniye icinde verdigi, %6.0’inin igneyi geri cekerken dokuyu kuru pamukla destekledigi bulunmustur. Hemsirelerin hicbiri islem oncesinde ya da sonrasinda uygulama alanina soguk uygulama yapmamislardir

YOĞUN BAKIM HASTALARININ DUYUSAL GİRDİ SORUNLARINDA TAMAMLAYICI TEDAVİLER / Complementary Treatments for the Sensory Input Problems of Intensive Care Patients

OZET Yogun bakim hastalarinin, cevreden gelen uyarilari secme sanslari ve bunlari kontrol etme yetenekleri yoktur. Bu nedenle, yogun bakim hastalari, duyusal yuklenme ve duyusal yoksunluk gibi duyusal girdi sorunlariyla karsi karsiyadirlar. Duyusal girdi sorunlari yogun bakim sendromuna neden oldugu icin kontrol altina alinmasi onemlidir. Duyusal girdi sorunlarini kontrol altina almada tamamlayici tedavi yontemlerine basvurulabilir. Tamamlayici tedavi yontemleri duyusal algilari harekete gecirip gevseme etkisi olusturarak nabiz, kan basinci ve solunum gibi fizyolojik gostergeleri dusurmenin yani sira, uyku bozuklugu, agri ve anksiyeteyi iceren yogun bakimla ilgili komplikasyonlari kontrol altina alma ya da onlemede etkili olabilir. Hemsirelik bakimi icinde; ekspresif dokunma, muzik terapi ve aromaterapi gibi tamamlayici tedavi yontemleri duyusal girdi sorunlarina yonelik uygulanabilecek girisimlerdir. Anahtar Kelimeler: Yogun bakim unitesi, muzik terapi, aromaterapi, ekspresif dokunma, tamamlayici tedavi yontemleri ABSTRACT Intensive care patients can not select the signals from the environment and are incapable of controlling these signals. Therefore, these patients are likely to experience the sensory input problems such as sensory pressure and deprivation. As the sensory input problems lead to intensive care syndrome, it is important to control them. Complementary treatment methods can be resorted to control the sensory input problems. Since the complementary treatment methods trigger the sensory perceptions and create sense of relaxation, they can be effective in controlling or preventing intensive care-related problems, including sleep disorder, pain and anxiety, as well as slowing down the physiological signs like pulse, blood pressure and respiration. In nursing care, complementary treatment methods such as expressive touch, music therapy and aromatherapy are the interventions to be applied for the sensory input problems. Keywords: Intensive care unit, music therapy, aromatherapy, expressive touch, complementary treatment methods

CERRAHİ KLİNİKLERİNDE YATAN HASTALARIN ANKSİYETE VE DEPRESYON DÜZEYLERİNİN BELİRLENMESİ

Bu calisma cerrahi kliniklerinde yatan hastalarin anksiyete ve depresyon duzeylerini belirlemek amaciyla yapilmistir. Tanimlayici turde olan arastirma, Nisan- Eylul 2004 arasinda Ataturk Universitesi Aziziye Arastirma Hastanesi cerrahi kliniklerinde gerceklestirilmistir. Veriler gonullu, iletisim kurulabilen, 18 yas ve uzerinde olan, en az bir haftadir klinikte yatan 311 hastadan toplanmistir. Veri toplamada soru formu ve Hastane Anksiyete ve Depresyon (HAD) olcegi kullanilmistir. Veriler, yuzdelik, t testi, varyans analizi, Kruskal–Walles varyans analizi ve Pearson korelasyon analizleriyle degerlendirilmistir. Cinsiyet, egitim, meslek ve klinik ile HAD puan ortalamalari karsilastirildiginda aradaki fark istatistiksel olarak anlamlidir (p < 0.01). HAD – Depresyon puan ortalamasi 7.74 ± 4.9, HAD – Anksiyete puan ortalamasi 8.1±5.0 olarak bulunmustur. Hastalarin 112’si (%36) anksiyete puanina gore, 153’u (%49.2) ise depresyon puanina gore kesme noktasinin ustunde puan almislardir. Bu sonuc dogrultusunda, cerrahi kliniklerinde yatan hastalara anksiyete ve depresyonla bas etmeye yonelik egitim programlarinin hazirlanmasi ve uygulanmasi onerilebilir.