Moral distress in Turkish intensive care nurses

Background: Moral distress is a common problem among professionals working in the field of healthcare. Moral distress is the distress experienced by a professional when he or she cannot fulfill the correct action due to several obstacles, although he or she is aware of what it is. The level of moral distress experienced by nurses working in intensive care units varies from one country/culture/institution to another. However, in Turkey, there is neither a measurement tool used to assess moral distress suffered by nurses nor a study conducted on the issue

A scale-development study: Exploration of intensive-care nurses' attitudes towards futile treatments

The study was conducted to determine the validity and reliability of the tool used to assess nurses' attitudes towards futility, and to explore intensive-care nurses' attitudes towards futility. Principal components analysis revealed that 18item scale was made up of four subdimensions that assess Identifying(beliefs), Decision-Making, Ethical Principles and Law, and Dilemma and Responsibilities related to futile treatments. The internal consistency of the scale was in the acceptable range, with a total Cronbach's alpha value of 0.72. Overall the results of study suggest that scale can be used as a valid and reliable assessment tool to assess nurses' attitudes towards futility

The Effects of Nutrition Attitude and Behaviors of the Families on Nutrition Status in Children at Different Socioeconomic Status

Amaç: Bu çalışma sosyoekonomik durumu farklı olan ebeveynlerin çocuklarının vücut ağırlığı ve yeme davranışları ile ilgili tutumlarını ve davranışlarını saptamak amacıyla yapılmıştır. Bireyler ve Yöntem: Çalışmaya farklı sosyoekonomik durumlardaki ilkokullarda eğitim gören 6-10 yaş arasındaki 632 çocuk (erkek 299, %47.3, kız333, %52.7) ve 23-56 yaş arası 441, %69.8 anne ve 191, %30.2 baba çalışmaya katılmıştır. Çocukların antropometik ölçümleri alınmış, ebeveynlere çocuk besleme anketi uygulanmıştır. Ebeveynlerin çocuklarını besleme davranışının çocukların antropometrik ölçümlerine etkisi değerlendirilmiştir. Bulgular: Yaş ortalaması ( S) annelerde 34.35.21 yıl ve babalarda 36.95.13 yıldır. Çocukların Beden Kütle İndeksi (BKİ) grupları ile ebeveynlerin çocuk besleme anketinin alt faktörleri olan "Algılanan ebeveyn vücut ağırlığı", "Algılanan çocuk vücut ağırlığı" ve "İzlem" arasında fark vardır. Farklı sosyoekonomik durumdaki ebeveynlerin BKİ'si arttıkça çocuklarında da BKİ'sinin arttığı bulunmuştur. Sonuç: Ebeveynlere belli aralıklarla sağlıklı yemek pişirme, sağlıklı besin tüketimi, çocuk beslenmesi konusunda eğitimler verilmesi gerekirAim: This study is conducted to determine the attitudes and behaviours of parents coming from different socioeconomic conditions, towards the weight of their children and nutrition. Subjects and Methods: Sample was consisted of a total of 632 (male299, 47.3%; female333, 52.7%) children, aged 6-10 years from primary schools in different socioeconomic conditions and 441, 69.8% mothers and 191, 30.2% fathers. Children’s anthropometric measurements were assessed, parents were applied child feeding questionnaire (CFQ). Child feeding behaviours of parents affecting their child’s anthropometric measurements were evaluated. Results: Mean age (SD) of male and female parents were 36.95.13 and 34.35.21 years, respectively. There are differences between children’s body mass index (BMI) groups with parents’ “Perceived parent weight”, “Perceived child weight” and “Monitoring” which are subfactors of child feeding questionnaire. As the BMI of parents in different socioeconomic status increases, BMI increases in children. Conclusion: Parents should be educated about healthy food cooking, healthy food consumption, child nutrition at certain interval

Central Diastolic Blood Pressure Is Associated With the Degree of Coronary Collateral Development

Coronary collaterals (CCs) serve as alternative conduits for blood flow in obstructive coronary artery disease. We investigated the association of various components of blood pressure (BP) parameters with the the degree of coronary collateralization. Patients (n = 245) who underwent coronary angiography were included. Intraarterial BP in the ascending aorta was determined using a standard fluid-filled system. Readings of the conventional peripheral pressure were measured using a manual sphygmomanometer. All blood samples were drawn at admission, before coronary angiography. A total of 65 patients were found to have adequate CC development. Central diastolic BP and peripheral diastolic BP were found to be lower in the group with adequate CC. In multivariate logistic regression model, central diastolic BP and Gensini score were found to be independent predictors of adequate CC. In conclusion, low central diastolic BP in the case of severe coronary stenosis may be an important stimulus for adequate CC development

Association of soluble ST2 with functional capacity in outpatients with heart failure

Background. Biomarkers play an important role in the risk stratification of patients with heart failure (HF). Recent studies have shown that soluble suppression of tumorigenicity 2 (sST2), a member of the interleukin 1 receptor family, is associated with disease prognosis in acute and chronic HE In this study we aimed to investigate the relation between sST2 level and functional capacity in outpatients with systolic HE

The relationship between D-dimer level and the development of atrial fibrillation in patients with systolic heart failure

Heart failure (HF) is one of the most common and leading cause of death worldwide. Clinical trials provide evidence that the development of atrial fibrillation (AF) is a marker of poor prognosis in patients with HF. Furthermore, elevated D-dimer level is associated with increased cardiovascular mortality independent of AF in HF patients. We investigated whether plasma D-dimer levels in patients with hospitalized systolic HF could predict development of AF. A total of 150 consecutive patients with sinus rhythm who admitted to the emergency department with hospitalized systolic HF were evaluated. All hospitalized patients were obtained D-dimer levels within the first 24 h following admission. Atrial fibrillation developed in 31 (20.7%) patients during follow-up period of 6.3 +/- A 5 months. Patients who developed atrial fibrillation had significantly increased levels of D-dimer [608 (339-1,022) ng/ml versus 1,100 (608-2,599) ng/ml, P = 0.001]. Optimal cut-off level of D-dimer to predict development of AF was found to be > 792 ng/ml. D-dimer > 792 ng/ml, right ventricular dilatation, age, systolic pulmonary pressure, left atrium size, moderate to severe tricuspid regurgitation, and beta blocker usage were found to have prognostic significance in univariate analysis. In multivariate Cox proportional-hazards model, D-dimer levels > 792 ng/ml (HR = 3.019, P = 0.006), and right ventricular dilatation (HR = 8.676, P = 0.003) were associated with an increased risk of new-onset AF. In conclusion, D-dimer could predict development of AF in patients with hospitalized systolic HF

Usefulness of Admission Red Cell Distribution Width as a Predictor of Early Mortality in Patients With Acute Pulmonary Embolism

Red cell distribution width (RDW) is strongly associated with prognosis in cardiopulmonary disorders such as coronary artery disease, acute myocardial infarction, acute and chronic heart failure, and pulmonary hypertension. However, its prognostic significance in acute pulmonary embolism (PE) is unknown. The aim of this study was to investigate the relation between admission RDW and early mortality in patients with acute PE. One hundred sixty-five patients with confirmed acute PE were included. Patients with previous treatment for anemia, malignancy, or chronic liver disease, those with dialysis treatment for chronic renal failure, and those who received erythrocyte suspension for any reason were excluded. A total of 136 consecutive patients with acute PE were evaluated prospectively. According to receiver-operating characteristic curve analysis, the optimal cut-off value of RDW to predict early mortality was >14.6%, with 95.2% sensitivity and 53% specificity. Patients were categorized prospectively as having unchanged (group 1) or increased (group 2) RDW on the basis of a cut-off value of 14.6%. The mean age of patients was 63 +/- 15 years. The mean follow-up duration was 11 +/- 7 days, and 21 patients died. Among these 21 patients, 1 (1.6%) was in group 1 and 20 (27%) were in group 2 (p 14.6% on admission, age, presence of shock, heart rate, oxygen saturation, and creatinine level were found to have prognostic significance in univariate Cox proportional-hazards analysis. Only increased RDW >14.6% on admission (hazard ratio 15.465, p.= 0.012) and the presence of shock (hazard ratio 9.354, p <0.001) remained associated with increased risk for acute PE-related early mortality in a multivariate Cox proportional-hazards model. In conclusion, high RDW was associated with worse hemodynamic parameters, and RDW seems to aid in the risk stratification of patients with acute PE. (C) 2012 Elsevier Inc. All rights reserved. (Am J Cardiol 2012;109:128-134