Nuran Tosun

Women's Breast Cancer Risk Perception and Attitudes Toward Screening Tests

This studys objective is to identify womens breast cancer risk perceptions and their attitudes and knowledge on screening tests. The cross-sectional research. Gulhane Military Medical Academy, Ankara, Turkey. The population of 188 females who applied for gynecological examination. The study employed a semistructured questionnaire form. Questions such as females demographic data, attitudes based on screening tests of breast cancer, family history, perceived risk breast cancer, and questions with regard to patients’ fear of breast cancer were included in the survey. In this study, it is determined that the rates of the women, who conduct breast self-examination (BSE), clinical breast examination (CBE) and mammography at least once, are very low. The reason for not performing the BSE was declared with a rate of 50.8% as “Do not know how to perform.” Of the women 20.2% were fully acknowledged about BSE. Nearly half of the women perceived 50% or more risk of developing breast cancer, and this rate increases as they get older. The risk perception and educational status increased CBE and mammography rates and BSE knowledge positively, but because of insufficient BSE application abilities BSE rate cannot increase as expected. It is recommended that nurses put forward the initiatives in training programs to increase womens BSE abilities. In planning such an education program risk perception and information of women about breast cancer should be considered.

Effectiveness of local cold application on skin burns and pain after transthoracic cardioversion

Background Transthoracic cardioversion (TTC) is widely used in emergency departments and daily clinical practice. TTC may cause skin lesions on the application of apical and sternal paddle areas. The lesions are characterised by redness, erythema and blister(s), and can be defined as first degree burns locally causing pain and increased sensitivity. Aim To evaluate the effectiveness of local cold application on reducing the incidence, severity and pain/sensitivity of skin burns in patients who underwent TTC. Methods The study was conducted in the intensive care unit of the cardiovascular surgery department. The patients were assigned to study (n=24) and control groups (n=24). Local cold application was performed for a 1 hour period on patients in the study group, whereas only clinical procedures were applied in the control group following TTC. Incidence and severity of burn was evaluated 2 h after TTC, and pain/sensitivity scores were evaluated at 2, 4 and 24 h after TTC. Results The incidence of burn was significantly lower in the study group (3/24) compared to the control group (21/24) (12.5% vs 83.3%, p<0.001). Pain/sensitivity scores were significantly lower in the study group compared to the control group (p<0.05). Conclusion Local cold application following TTC is an effective means of reducing the incidence and severity of burns and pain/sensitivity. It is cost-effective and can easily be applied by nurses in medical/surgical units and emergency departments.

Evaluation of the effect on patient parameters of not monitoring gastric residual volume in intensive care patients on a mechanical ventilator receiving enteral feeding: A randomized clinical trial

PURPOSE This study aimed to evaluate the effects of not measuring gastric residual volume (GRV) in intensive care patients on a mechanical ventilator and receiving enteral feeding on the feeding intolerance, gastroesophageal reflux (GER) risk, and nutritional adequacy. METHODS This randomized clinical study was performed in 2 medical intensive care units of 2 university hospitals in Ankara, Turkey. The patients were randomized into 2 groups. In the group with GRV monitoring, GRV was measured 3 times a day, and the GRV threshold was accepted as 250 mL. In addition, 24-hour pH monitoring was used in this group to assess the risk of GER. In the group without GRV monitoring, GRV was not measured. The patients were followed-up for 5 days. RESULTS The feeding targets were reached more quickly in the group without GRV monitoring (n = 26) with no increase in the complication rate (P < .05). No significant relationship was found between GRV and GER in the group with GRV monitoring (n = 25) (P > .05). CONCLUSION The discrepancies in GRV measurement make it unreliable for monitoring feeding intolerance and GER. The use of GRV measurements may therefore be discontinued as part of the standard care protocol in medical intensive care units.

Determination of the relationship between adequacy of dialysis and quality of life and self‐care agency

AIM AND OBJECTIVES To investigate the relationship between the dialysis adequacy and the quality of life and self-care agency. BACKGROUND Haemodialysis (HD), which is the leading treatment option for chronic renal failure (CRF), leads to significant changes in the life of the patient. These changes affecting almost all the dimensions of life also negatively affect the quality of life and self-care agency. DESIGN Descriptive study. METHODS The research was conducted with a total of 112 patients who had been admitted to two private dialysis centres between May 2009 and September 2010, who met the research criteria. The Data Collection Form for the Socio-demographic and Medical Characteristics, the Biochemical and Medical Parameters Form to determine the adequacy of dialysis, the SF-36 Quality of Life Scale and the Self-Care Agency Scale were used in the research. RESULTS A significant relationship was found between Kt/V, one of the parameters used for the assessment of dialysis adequacy, and the emotional role scores of the SF-36 Quality of Life Scale and between the URR level and physical functioning (r = +0.192, p = 0.045) and emotional role scores (r = +0.284, p = 0.003). No significant relationship could be found between the self-care agency and the evaluated parameters. CONCLUSIONS Kt/V and URR, which have an effect on dialysis adequacy, may affect the quality of life. Our results are similar to those of previous studies, which showed that Kt/V and URR affect the quality of life. RELEVANCE TO CLINICAL PRACTICE It was recommended to regularly control the parameters used for the assessment of dialysis adequacy and to evaluate their effects on the quality of life, to determine the most affected quality of life subparameters and to address these problems and solve them.

Relationship between dialysis adequacy and sleep quality in haemodialysis patients.

AIM AND OBJECTIVES The aim of this study is to examine the relationship between dialysis adequacy and sleep quality in haemodialysis patients. BACKGROUND Sleep problems are common in haemodialysis patients. Dialysis adequacy is one of the factors associated with sleep quality. Studies evaluating the association between dialysis adequacy and sleep quality in haemodialysis patients present different results. DESIGN Descriptive and cross-sectional study. METHODS This study was performed with a total of 119 patients who had applied to dialysis centres for haemodialysis treatment between January and March 2014. The data collection form consists of socio-demographic and medical characteristics as well as laboratory parameters. A modified Post-Sleep Inventory was used to examine sleep quality in the research. RESULTS There were no statistically significant relationship between sleep quality and dialysis adequacy (p > 0·05). When the Post-Sleep Inventory scores were evaluated according to sleep quality, 63·0% of patients had poor sleep quality, and 37·0% had good sleep quality. Sleep quality was worse in unemployed patients (X(2) = 4·852; p = 0·025) and patients who smoked heavily (Z = 2·289; p = 0·022). CONCLUSIONS In this study, there is no statistically significant relationship between dialysis adequacy and sleep quality. However, it was found that the majority of haemodialysis patients had poor sleep quality. RELEVANCE TO CLINICAL PRACTICE Even if the dialysis adequacy of patients is at the recommended level, their sleep qualities may be poor. Therefore, evaluations of the sleep quality of haemodialysis patients during the clinical practice must be taken into consideration.

The reliability and validity of three questionnaires: The Student Satisfaction and Self-Confidence in Learning Scale, Simulation Design Scale, and Educational Practices Questionnaire.

Purpose: The purpose of this study was to adapt the “Student Satisfaction and Self-Confidence in Learning Scale” (SCLS), “Simulation Design Scale” (SDS), and “Educational Practices Questionnaire” (EPQ) developed by Jeffries and Rizzolo into Turkish and establish the reliability and the validity of these translated scales. Methods: A sample of 87 nursing students participated in this study. These scales were cross-culturally adapted through a process including translation, comparison with original version, back translation, and pretesting. Construct validity was evaluated by factor analysis, and criterion validity was evaluated using the Perceived Learning Scale, Patient Intervention Self-confidence/Competency Scale, and Educational Belief Scale. Findings: Cronbach’s alpha values were found as 0.77–0.85 for SCLS, 0.73–0.86 for SDS, and 0.61–0.86 for EPQ. Conclusions: The results of this study show that the Turkish versions of all scales are validated and reliable measurement tools.

Investigation of the knowledge and attitudes of patients who are undergoing hemodialysis treatment regarding their arteriovenous fistula

Purpose The major cause of morbidity in hemodialysis patients is arteriovenous fistula deficiency. The patient should have adequate knowledge to ensure arteriovenous fistula patency. Our aim is to investigate the knowledge and attitude of the patients undergoing hemodialysis treatment regarding arteriovenous fistula. Methods This study was conducted on 335 patients who met the study criteria. Data collection forms evaluating the “Socio-Demographic and Medical Characteristics” and “Knowledge and Attitudes about arteriovenous fistula” of the patients were developed following a literature review by the investigators. Results The rules most known and implemented were “to not measure blood pressure” and “to not draw blood from arms with fistula”, while the least known and implemented were “to use blood vessels on the hands in arms without fistula for intravenous intervention” and “to know which situations cause hypotension”. Conclusions Hemodialysis patients with arteriovenous fistulas need to know that developing self-care behavior is a means to reconcile lifestyles with current health status. Accordingly, planned training in self-care should be provided to hemodialysis patients and their families, and nurses should repeat information to patients who demonstrate a lack of knowledge.

Integrating simulation based learning into nursing education programs: Hybrid simulation

BACKGROUND Hybrid simulation can be developed with mannequins of any fidelity and tabletop simulators with a standardized patient to create a complex, high-level learning activity. OBJECTIVE The aim of this study is to analyze the effects of a hybrid simulation technique used with nursing students in a scenario about the emergency setting. METHODS This one-group pre-test post-test model quasi-experimental study was carried out with 39 students in Ankara, Turkey, from October 2014 to July 2015. RESULTS Nearly all participants reported that the simulation improved their critical thinking, decision-making skills, and self-confidence before the clinical activity and that they felt as though they were real nurses during the activity (94.7%, 97.3%, 84.2%, and 92.1%, respectively). CONCLUSION The results of this study support the integration of hybrid simulation experiences throughout the nursing curriculum, as evidenced by positive responses from students through the simulation evaluation questionnaire.

The Evaluation of Information Requirements in End-Stage Renal Failure Patients Care of Intensive Care Nurses -

The Evaluation of Information Requirements of the Intensive Care Nurses in End-Stage Renal Failure Patients’ Care Purpose: This study was conducted to assess the information requirements of the intensive care nurses in caring of end-stage renal failure patients. Material and Method: This descriptive study was conducted in a teaching and research hospital. The practice has been completed with 133 nurses. Data collection form consists of 54 questions. Results: Twenty participants are male, mean age 28.2 ± 5.6 and 60.2% of the participants works in the surgical ICU. Average correct count is 32.7 ± 4,5 (min=11-max=40), the most correct answer count is 33 (n = 25). More than half of the nurses (55.6%) know how to control the arteriovenous fistula. However, 73.7% of the nurses do not feel competent themselves in ESRD patients care and 36.1% of the cases gave the wrong answer to the question about the need to use masks while doing hemodialysis catheter dressing. A statistically significant relationship were found between receiving training about ESRD and the count of correct answer (p=0.011). There is no statistically significant relationship between working time in intensive care unit, full operating time and the count of correct answer (p=0.45). Conclusion: Most of the participants (80%) answered at least 70% of the knowledge questions about ESRD correctly. It is suggested that standards must be created utilizing clinical practice guidelines to increase the effectiveness of nursing care. Education changes perceptions about issues especially in critical units such as intensive care units and acts by increasing the knowledge. There should be multidisciplinary training programs about ESRD and training programs should be organized related to the subject to intensive care staff.