Nuran Kömürcü

Bladder Training and Kegel Exercises for Women with Urinary Complaints Living in a Rest Home

Background: Urinary incontinence is an annoying, uncomfortable and unpleasant condition affecting the elderly. The problem of bedwetting and other urinary complaints are common in rest homes. Objective: Our study aimed to determine the efficiency of bladder training and Kegel exercises for older women living in a rest home. Methods: This is an experimental prospective research study. Through a randomization process, 25 women were included in the treatment group, and another 25 were included in the control group. Participants were living in a rest home for women aged older than 65 years with urinary complaints. The pretreatment interview form, Quality of Life Scale, Mini-Mental Test, Rankin Scale, daily urinary forms and pad tests were administered to the treatment and control groups. Bladder training and Kegel exercises were given to the treatment group for 6–8 weeks. The second evaluation was performed 8 weeks after treatment, and the last evaluation was carried out 6 months after treatment. Results: The average age of the treatment group was 78.88 ± 4.80 years, and the average age of the control group 79.44 ± 5.32 years. Urgency, frequency and nocturia were common complaints. Pretreatment, 8-week and 6-month evaluations revealed that the amount of urinary incontinence with urgency, frequency and nocturia complaints statistically and significantly decreased in the treatment group compared to the control group. In the pad test results, a statistically significant decrease was observed in the treatment group compared to the control group. A significant increase in pelvic floor strength was observed in the treatment group compared to the control group upon all evaluations. Conclusion: Behavioral therapy can be used easily as an effective treatment for urinary incontinence in elderly women living at a rest home.

The Effects of Local Low-Dose Heat Application on Dysmenorrhea

OBJECTIVES This is a controlled, prospective study which compares the effects of a low-dose heat patch for self-medication on the reduction of pain symptoms in dysmenorrhea. METHODS The sample group included female sophomore students studying at a university in Istanbul, Turkey, between 2007 and 2008. These female participants completed the Dysmenorrhea Identification Form to determine the sample group, and a total of 193 female students possessed the eligible criteria. The research control group consisted of 66 patients, the analgesia group consisted of 61, and the heat patch group consisted of 66. The control group did not use any treatments, while the self-medication group used analgesic medication (single dose), and the heat patch group applied a heat patch on the lower abdomen, against the skin, for an application period of 2 menstrual cycles. Using a visual analog scale (VAS), the pain severity was recorded at the baseline, after 4 hours of intervention, and after 8 hours of intervention. The data were examined using ANOVA. RESULTS There were significant differences between the groups in terms of pain severity after 8 hours of application (P < .001). All groups had similar pain levels at baseline and during the fourth and eighth hours, with no significant differences between the groups during the first and the second menstrual cycles (P > .05). CONCLUSION The authors conclude that the heat patch is an effective method for reducing dysmenorrhea.

Premenstrual Sendromlu Kadınlarda Uyku Hijyen Girişimlerinin Etkisi

Amac: Calisma premenstrual sendromda uyku hijyen egitimlerinin etkisini degerlendirmeyi amaclamistir. Gerec ve Yontem: Calismada, pre-test post-test, non-randomize, control grup tasarim kullanildi. Calisma, premenstrual sendromlu 88 kadinile gerceklestirildi (Girisim grubu= 47; Kontrol Grubu n=41). Girisim grubunda yer alan katilimcilar uyku hijyen girisimlerini kullandi. Calismanin birinci adiminda, girisim grubunda yer alan katilimcilara uyku hijyen egitimi yapildi. Ikinci adimda, girisim grubundaki katilimcilar iki menstrual siklus boyunca uyku hijyen girisimlerini uyguladilar. Veriler, girisim oncesi ve girisim sonrasi (1.menstruasyon ve 2.menstruasyon) Premenstrual Sendrom Olcegi (PMSO), Pittsburgh Uyku Kalitesi Olcegi (PUKO) kullanilarak elde edildi. Bulgular: Calismadan elde edilen bulgular sonucunda, girisim grubunun ve control grubunun hem PMSO puanlari hem de PUKO puanlarinin takip surecinde benzer oldugu, gruplar arasinda istatistiksel olarak anlamli duzeyde fark olmadigi belirlendi (p>0.05). Bununla birlikte, 1.menstruasyon ve 2.menstruasyon PMSO puan farklari gruplar arasinda karsilastirildiginda, gruplar arasinda istatistiksel olarak anlamli fark bulundugu belirlendi. Deney grubunun PMSO puanlari, takip surecinde, kontrol grubuna gore istatistiksel olarak anlamli duzeyde azalmisti (p<0.001). Tartisma: Premenstrual semptom yasayan kadinlarin, uyku hijyen girisimlerini kullanmasi, premenstrual semptomlarinin azaltilmasinda yardimci olabilir.

Relationship Between Maternal Characteristics and Postpartum Hemorrhage: A Meta-Analysis Study

Background: Postpartum hemorrhage (PPH) is a leading cause of maternal death in low-income countries and the primary cause of approximately one of every four maternal deaths worldwide. Purpose: The aim of this study was to determine the antenatal risk factors of PPH and its effects. Methods: The literature from nine databases was reviewed, and studies published between 2000 and 2012 were analyzed using terms such as “postpartum hemorrhage,” “prevention of postpartum hemorrhage,” and “management of postpartum hemorrhage.” The full text of 1,061 articles was reviewed, and 29 studies were selected according to the inclusion criteria. Studies that determined bias using the funnel plot test were excluded, and 20 studies were included in the meta-analysis. The data were analyzed using Microsoft Office Excel 2010 and comprehensive meta-analysis. Results: The meta-analysis included five studies and 1,286,752 women for maternal age, six studies and 607,822 women for body mass index, and six studies and 1,118,490 women for parity. The results of the analysis showed that body mass index ≥ 25.00 kg/m2 (OR = 1.43, 95% CI [1.40, 1.47]), primiparity of mothers (OR = 1.37, 95% CI [1.35, 1.40]), and hypertensive disorder in mothers (OR = 1.52, 95% CI [1.43, 1.61]) are risk factors for the development of PPH. No rela-tionship was found between maternal age ≥ 35 years and PPH (OR = 1.02, 95% CI [0.99, 1.04]). Conclusions: Midwives, obstetric nurses, and obstetricians should carefully evaluate mothers for the risk factors of PPH during the antepartum, intrapartum, and postpartum periods. Moreover, at-risk pregnant women should give birth in a unit with emergency initiative options. Future studies should examine relevant personal characteristics of mothers, as familiarity with the risk factors facilitates the management and treatment of PPH. Finally, meta-analyses should review more studies to detect risk factors more comprehensively.