Rukuye Aylaz

Relationship between depression and loneliness in elderly and examination of influential factors

This study was planned and conducted for the purpose of examining the relationship between depression and loneliness in elderly people and the influencing factors. The study was a descriptive and correlational study and its population consisted of 17,080 older individuals aged sixty and over who were registered at six Family Healthcare Centers (FHCs) located in the provisional center of Malatya. The sample of the study comprised of 913 elderly people who were chosen from the elderly people registered at the FHCs first by cluster sampling and then by simple random sampling from the clusters in proportion to the population. The data was collected between April and June 2011 using a questionnaire developed by the investigators in line with the literature, the Geriatric Depression Scale (GDS) and the UCLA Loneliness Scale (ULS). They had a mean score of 13.83 ± 7.4 from the GDS and 40.50 ± 12.1 from the ULS. A positive correlation was found between Geriatric Depression and loneliness (r=0.608, p<0.001). It was observed that there was a significant correlation between loneliness and depression in the elderly people living in a community, presence of social security and higher income, on the other hand, led to lower mean scores. In view of these results, it can be advised that a minimum income should be secured for elderly people whether they have social security or not, their families and the society should be trained not to leave elderly people alone.

Prospective study: reducing pressure ulcers in intensive care units at a Turkish medical center.

PURPOSE The purpose of this study was to determine the impact of an educational intervention on the incidence of stage II pressure ulcers (PUs) in adult patients in intensive care units (ICUs) in a Turkish medical center. DESIGN This was a prospective study of patients admitted to ICUs. Data were collected over a 3-month period. Subjects were assessed using the Braden Scale for Predicting Pressure Sore Risk to determine the risk for developing a PU; assessment was completed within the first 24 hours of admission and each 48 hours thereafter for a maximum of 12 weeks. Educational intervention was employed: Intervention included education of ICU nurses about PU prevention and risk assessment; and following the educational intervention and implementation of the PU prevention protocol in all ICUs, data were collected for study period II. SUBJECTS AND SETTING The sample comprised 186 patients admitted to critical care units of a Turkish medical center. Ninety-three subjects participated in a preintervention comparison group, and 93 subjects participated in an intervention group. INSTRUMENTS Data were collected using a demographic and clinical data form, a nursing intervention checklist, and the Braden Scale for Predicting Pressure Sore Risk. RESULTS Stage II PUs were observed in a total of 50 patients for the overall sample. The most common site was the sacrococcygeal area, which accounted for 46% of ulcers. A statistically significant difference was observed when the rate of stage II PUs in the comparison group, 37% (34 of 93 patients), was compared to the rate in the intervention group, 17% (16 of 93 patients) (χ2 = 8.86, df = 1, P < .01). CONCLUSION Education regarding preventive care can be effective in reducing the incidence of PUs in the ICU setting. Therefore, education about risk assessment and PU prevention should be a priority for nurses in critical care settings.

The care burden and coping levels of chronic psychiatric patients’ caregivers

PURPOSE This descriptive study was conducted in order to determine care burden of caregivers of chronic psychiatric patients and their levels of coping with stress. METHODS The study was conducted with 134 caregivers of chronic psychiatric patients. The following data collection tools were used: the personal information form, the ZBI and SCI. The study participants were selected from the population by using an improbable random sampling method. RESULTS The average age of the caregivers was 49.95±13.68 and the majority were married and primary school graduates. CONCLUSION This study determined that caregivers experienced a high level of burden. However, while the deal with their difficulties of providing effective care was found to have more coping methods they use.

Relationship between social support and fatigue in patients with type 2 diabetes mellitus in the east of Turkey.

AIM This study was planned to assess the levels of fatigue and social support in patients with diabetes and to determine the relationship between fatigue and social support in these patients. METHODS A descriptive design was used in this research. The study was conducted between March and June 2013 with 300 sampled patients from 1657 studied participants with type 2 diabetes who presented to the diabetes polyclinics of Malatya State Hospital and Inonu University, Turgut Ozal Medical Center. The Multidimensional Scale of Perceived Social Support and the Fatigue Severity Scale were used in the study. RESULTS When the correlation analysis carried out between fatigue severity and social support in patients with diabetes was examined, a significant relationship was found in the negative direction between fatigue severity and family support (r = -0.145, P < 0.05) as well as overall support (r = -0.132, P < 0.05). A statistically significant difference was found between the Fatigue Severity Scale score and sex, education status, occupation, cohabitation, presence of complications, and hemoglobin A1c (P < 0.05). Family support was significant only with respect to marital status, occupation, and being employed (P < 0.05). CONCLUSION It was seen at the end of this research that social support reduced the level of fatigue in a number of patients with type 2 diabetes. Nurses of diabetes patients should carry out fatigue assessments routinely and reflect these in nursing care plans by also associating them with the social support sources of the patient.

The effect of mindfulness-based psychoeducation on insight and medication adherence of schizophrenia patients

Purpose: This research was conducted to determine the effect of mindfulness based psychoeducation program on insight and medication adherence of schizophrenia patients. Materials and methods: The study was conducted in a true experiment design with pre‐test and post‐test control groups. The study population consisted of 369 schizophrenic patients enrolled in Community Mental Health Centers located in Balıkesir and Eskişehir province centers. The sample consisted of 135 patients, 55 from experimental and 80 from control groups selected by randomized sampling. The data was collected between February and May 2016. The Descriptive Information Form, Beck Cognitive Insight Scale (BCIS) and Medication Adherence Rating Scale (MARS) were used. In the experimental group, the psychoeducation program was applied. Number, percentage, mean, standard deviation, chi‐square, t‐test in both dependent and independent groups, were used in the analysis of the data. Results: The mean post‐test score of the Beck Cognitive Insight Scale was 4.89 ± 6.05 in the experimental group, 1.68 ± 5.67 in the control group and the difference between the mean scores was statistically significant (p < 0.05). The mean post‐test score of Medication Adherence Ratıng Scale was 1.76 ± 0.42 in the experimental group, 1.50 ± 0.50 in the control group and the difference between the mean scores was statistically significant (p < 0.05). Conclusion: It was determined that psychoeducation program was effective in increasing cognitive insight level and medication adherence of patients and can be used by nurses in addition to medication.

The effect of social support to treatment adherence in psychiatric patients

Methods: This study was conducted between January and June 2017 with 250 cancer patients in the oncology and hematology clinic of a university hospital in Turkey. The data was collected by using questionnaire consisting of the information about the patient’s demographic characteristics and using state of complementary and alternative treatment. Data that was collected from the study was analyzed by using means, percentage and chi-squared test.

Intensive care nurses knowledge, attitudes, and practices for the use of physical restraints

Methods: The study adopted a two-group pretest-posttest quasi-experimental design. A convenience sample of community-dwelling older adults aged 65 and over in Beitou District of Taipei City, Taiwan was recruited. The 200 participants were assigned into the experimental and wait-list control group based on their own will. The baseline data of BMI, waistline, and body fat ratio were measured. The intervention of an elastic-band resistance training exercise was conducted at least one time per day at 60 minutes per practice session for one week. The 30-second chair stand test was evaluated at baseline and at the end of the study.T purpose of the study was to investigate the influence of symptom distress fatigue, depression, and social support on healthrelated life quality of lung cancer survivers. The study was a descriptive correlational research design. Participants were recruited from a medical center in middle Taiwan. There were 85 lung cancer survivers answered the study quessionnaire which included the basic information, the Functional Assessment of Cancer Therapy – General (FACT-G) Scale, FACT Lung Symptom Index 12 item version (FLSI-12) Scale, Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) Scale, Center for Epidemiologic Studies Depression (CES-D) Scale, Medical Outcome Study Social Support Survey (MOS-SSS), Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale, (FACIT-Sp) Scale. Data were analyzed using SPSS 19.0 software. The average age of the participants were 59.6 (SD=10.6) with a range 37~80 year old. There were 41 male and 44 female. The participants’ cancer stages were 68 (80%) in stage I, 10 in stage II (11.8%) and 7 (8.2%) in stage III. Among the 85 participants, sixty (70.6%) of them had lobectomy,, 18 (21.2%) had segmentectomy, and 7 (8.2%) had wedge resection. The results showed that the participants’ average score on health related quality of life (HRQOL) was 82.21 (SD=12.32).Person correlation coefficient analysis showed that health-related quality of life were significantly correlated with symptom distress and fatigue but were not correlated with depression or spiritual well-being. Results of stepwise linear regression analysis showed that symptom distress and social support together explained 58.3% of the variance in health-related quality of life. Lung cancer survivors who had higher symptom distress and lower social support reported lower level of health related life quality. Therefore, interventions which reliefing symptom distress and increasing social support may help to improve life quality in lung cancer survivors.Research design: This was a qualitative design. We interviewed nurses to understand their perspectives and experiences of participation in PSA. This study was conducted at a regional teaching hospital of 1,379 patient beds, located in the northern part of southern Taiwan. Because our study subjects were nurses who work in acute care units, the outpatient units, delivery rooms, operating rooms, intensive care units, and emergency departments were excluded from the study. The final number of eligible units is 12 and approximate number of registered nurses is 250. Nurses who have worked 1 year or more in these 18 units were our potential participants. Purposeful sampling will be used to identify and recruit participants from these 12 units. To aim for a focus group size of 4–8, as recommended by Kitzinger (2006), we try to recruit at least 2–3 nurses from each eligible unit. Nurses’ focus group discussions used a semi-structured interview guide and were conducted at a convenient time and place. Focus-group discussions for nurses took at least 40–50 minutes. A content-analysis approach was applied to the interview textsT nurse and physician educations took place in silos and nurses had been regarded as auxiliaries working under doctors. Studies found that skills of communicating with physicians, developing relationships with colleagues, responding appropriately to emergencies, and handling new situation are meaningful stressors for new graduate nurses. However, nurses and physicians need to work closely to enhance patient health. Thus, developing a course that provide opportunities for nursing students for not only receiving interdisciplinary knowledge, but also experiencing interaction, communication, and cooperation with clinical professionals, especially physicians, to learn each other’s professional roles and responsibilities is important. The study applied cross-disciplinary teaching to develop clinical reasoning course with nursing faculty, nurse practitioner, and medical doctors in classroom and clinical setting. After taking the course, nursing students gain interdisciplinary knowledge in patient care as well as communication skills and cooperation with physicians as a team. The course was based on Avraham’s statements about cross-discipline teaching. The course is a 3 credit elective course taught in 18 weeks including 8 units (respiratory system, cardiovascular system, endocrine system, renal system, liver, cranial neural system, sepsis and septic shock, multiple traumatic injuries, and multiple organ failure syndrome), 4 hours for each unit (2 in-class and 2 clinical) and concept mapping and evaluation. In class, students learned from lectures, case scenarios and team-based, concept mapping learning. In clinical, 4-5 students teamed up and were instructed by physicians and nursing lecturers. Each group of students observe and join assessment and management with medical colleagues interdisciplinarly. Panel discussions/ debriefing were held during clinical with physicians and with nursing lecturers after clinical when concept maps were drawn. Evaluation of student course performance included in-class observations and team-reflections as well as cocept-maps, oral presentations, and self-evaluation. Via these activities, students practiced interprofessional interaction, communications and cooperation, and finally, promoted their clinical competence. Additionally, interprofessional interactions helps to relieve tensional and uncomfortable relations between nurses and physicians and that benefs students’ successful survival in their future work. Interdiscipline learning could be the future teaching/learning model.