Hekim davranışlarının hemşire memnuniyeti ve hemşirelerin işine devam etme durumu üzerine etkisi

This study was carried out descriptively in order to investigate the effect of physician behaviours on nurses' satisfaction and on their status to sustain their profession. This study was carried out at the clinics of Ege University Medical Faculty Hospital between the dates of April-June 2003. The sample of the research consisted of a total of 259 nurses who were selected by utilizing the formula called ;quot;If the number of individuals on the universe is known;quot;. In the research as a means of data collecting the following instruments were used; a questionnaire developed to determine socio-demographic characteristics of nurses, a survey form which was developed by Alan H. Rosenstein and having titles such as physician-nurse relationship, devastating physician behaviour and support-resolution, and which consisted of open-ended questions, which were replied on a visual analogue scale with, 10 yes-no. The data were collected from nurses working on day shift at Ege University Medical Faculty Hospital Clinics by conducting face-to-face interviews. Data collected were evaluated on SPSS program.Of the nurses participated in the study 57.1 % were in the 21-30 year age group, 40.9 % had nursing experience of 5 years and less. Most of nurses (% 84,9) witnessed or experienced a disruptive physicians' behaviour.Bu çalışma hekim davranışlarının hemşire memnuniyeti ve hemşirelerin işine devam etme durumu üzerine olan etkisini incelemek amacıyla tanımlayıcı olarak planlanmıştır. Çalışma Nisan-Haziran 2003 tarihleri arasında Ege Üniversitesi Tıp Fakültesi Hastanesi Kliniklerinde yürütülmüştür. Araştırmanın örneklemini "evreni belirli öneklem yöntemi" kullanılarak seçilen 259 hemşire oluşturmuştur. Araştırmada veri toplama aracı olarak; hemşirelerin sosyo-demografik özelliklerini belirlemek üzere geliştirilen soru formu, hekim-hemşire ilişkisi, yıkıcı hekim davranışı ve destek-çözüm başlıklarını içeren, Alan H. Rosenstein tarafından geliştirilen, evet-hayır şeklinde, 10'lu vizuel analog skala üzerinde yanıtlanan ve açık uçlu sorulardan oluşan anket formu kullanılmıştır. Veriler Ege Üniversitesi Tıp Fakültesi Hastanesi Kliniklerinde gündüz vardiyasında çalışan hemşireler ile yüz yüze görüşülerek toplanmıştır. Toplanan veriler SPSS programında değerlendirilmiştir. Araştırma sonucunda hemşirelerin % 57.1 'i 21-30 yaş grubunda yer alan % 40.9'u 5 yıl ve altında hemşirelik deneyimine sahip olan hemşirelerin % 84,9'unun yıkıcı hekim davranışına tanık olduğu veya böyle bir davranış deneyimlediği saptanmıştır

Medically inoperable early-stage lung cancer treated with stereotactic ablative radiation therapy (SABR): Multicenter study of Turkish radiation oncology group (TROG)

60th Annual Meeting of the American-Society-for-Radiation-Oncology (ASTRO) -- OCT 21-24, 2018 -- San Antonio, TXWOS: 000447811602068Purpose/Objective(s): To review treatment outcomes for SABR inmedically inoperable early stage lung cancer (NSCLC) patients treated byTurkish Radiation Oncology Group (TROG) member centers.Materials/Methods:Between 2009 and 2017, a total of 386 patients withNSCLC treated with SABR in 12 TROG centers. Patient, disease, andtreatment related prognostic factors were analyzed. Primary endpointswere, overall survival (OS), progression free survival (PFS), local control (LC) and regional control (RC) and radiation-related toxicities.Results:Median follow-up was 15 months. The median age at diagnosis was72 years (43-93) and 79% were men. Median tumor size was 30 mm (5- 78mm). Seventy-two percent of the patients have histologically confirmed diagnosiswhereas 28%of patientswere treated withclinical and radiologicalfindings only without pathological diagnosis. Staging was as follows; T1N0in 215, T2N0 in 166, T3N0 in 2 and T4N0 in 3 patients because of bilaterallytumors. Median SABR dose was 54Gy (30-70Gy), corresponding to a bio-logical equivalent dose (BED) of 112Gy (48- 180Gy) administered in me-dian5 (1-10) fractions.Responseevaluationwas made either with PET/CTorCTin median 3 months after SABR and complete response, partial response,stable disease and progression rates were 48%, 36%, 5.7% and 0.5%,respectively. The cumulative locoregional failure rate was 15%. Amongthese, 23 were local (6%) and 35 regional (9%) failures. Distant failure wasreported in 67 (17%) patients. One to 3 years LC and RC rates were 97%,91% and 93%, 86%, respectively. One and 3 years PFS and OS were 88%,72% and 90%, 65%, respectively. At their last follow up 271 patients (71%) were alive. Prognostic factors associated with LC, RC and OS were sum-marized in table 1. No severe acute side effects were observed. Overall 18patients experienced grade 3 pneumonitis, 11 patients had chest wall painand 1 patient had rib fracture.Conclusion:The results of this retrospective study have shown that SABRis a promising technique with satisfactory LC and OS rates and minimaltoxicity in patients with medically inoperabl NSCLC.American Society for Radiation Oncolog

Diagnostic delay in rare diseases

OBJECTIVE Post-operative radiotherapy (PORT) in non-small cell lung cancer (NSCLC), especially after complete resection, has long been an unresolved dilemma and debated among therapeutic disciplines. We aimed to evaluate the effects of different radiotherapy volumes and techniques on local-regional recurrence patterns and PORT results in patients with NSCLC. METHODS The results of 389 patients who underwent surgery and received PORT at 11 centers were analyzed retrospectively. The surgical margin was positive or closes in 100 (26%) patients. The PORT dose was a median of 50 Gy (36-60 Gy). Intensity-modulated RT methods were used in 68 (17.5%) patients. RESULTS The first recurrence of the patients who developed relapse, local recurrence was found in 77 (19.8%) patients, distant recurrence was found in 95 (24%) patients, and both recurrences was found in 30 (8%) patients. The median time to locoregional relapse was 14 months (1.84-59.7 months). Local-regional recurrence was not significantly higher in patients with positive surgical margins than in negative pa-tients (39% vs. 29%, p=0.1), but the dose administered to these patients was also higher. Mediastinal recurrence occurred in 28 (19%) patients who did not receive radiotherapy to the mediastinum; 25 of these recurrences (89%) were just near or outside the field. Cardiac events became 7% in all groups and did not change according to chosen mediastinal radiotherapy volume. CONCLUSION A clear description of the PORT volumes according to the localization of the primary tumor and the involved lymph nodes would be beneficial in terms of establishing the recurrence/toxicity balance better

Role of Consolidative Thoracic Radiotherapy for Extensive-stage Small Cell Lung Cancer: Trod Thoracic Oncology Study Group 08-006 Multi-institutional Study

OBJECTIV

Risk factors of radiation pneumonitis in patients with NSCLC treated with concomitant chemoradiotherapy--Are we underestimating diabetes?--Turkish oncology group (TOG)/Lung cancer study group

Introduction To evaluate the clinical and dosimetric parameters that increase the risk of radiation pneumonitis (RP) in locally advanced non-small cell lung cancer (NSCLC) patients treated with concomitant chemoradiotherapy of nationwide multicentric data analysis. Methods All data of 268 patients who underwent definitive chemoradiotherapy were retrospectively collected from eight institutes participating in this study. Patient, tumor and treatment-related factors and dosimetric parameters were analyzed for grade >= 2 RP. The toxicity scoring system of The Radiation Therapy Oncology Group used for grading the severity of pneumonitis. A relationship with the risk of RP with potential predictive factors were evaluated by univariate and multivariate analyses. A recursive partition analysis (RPA) was applied to stratify patients according to the risk of developing RP. Results There were 90 (33.6%) patients who had grade >= 2 RP. The median time to pneumonitis after treatment was 4 months (range:1-6 months). In univariate analysis, diabetes mellitus (DM), use of cisplatin/etoposide, total and daily radiotherapy (RT) fraction dose, the planning target volume (PTV) size, mean lung dose, V5, V10 and RT technique were associated with the development of pneumonitis. In multivariate analysis, only DM (P = 0.008) was found to be independent risk factors for RP. According to RPA, the risk of developing RP was highest in patients with DM. Conclusions In our study, besides the known dosimetric factors, DM was found to be the most important risk factor causing RP development in multivariate analysis and RPA. The risk is tripled compared to patients without DM

Prognostic factors in medically inoperable early stage lung cancer patients treated with stereotactic ablative radiation therapy (SABR): Turkish Radiation Oncology Society Multicentric Study

Objective We identified factors influencing outcomes in patients with medically inoperable early stage lung cancer (MIESLC) treated with stereotactic ablative radiation therapy (SABR) at 14 centers in Turkey. Materials and Methods We retrospectively analyzed 431 patients with stage I-II MIESLC treated with SABR from 2009 through 2017. Age; sex; performance score; imaging technique; tumor histology and size; disease stage radiation dose, fraction and biologically effective dose with an alpha/beta ratio of 10 (BED10); tumor location and treatment center were evaluated for associations with overall survival (OS), local control (LC) and toxicity. Results Median follow-up time was 27 months (range 1-115); median SABR dose was 54 Gy (range 30-70) given in a median three fractions (range 1-10); median BED(10)was 151 Gy (range 48-180). Tumors were peripheral in 285 patients (66.1%), central in 69 (16%) and 100 Gy (P = .011), adenocarcinoma (P = .025) and complete response on first evaluation (P = .007) predicted favorable LC. BED10> 120 Gy (hazard ratio [HR] 1.9, 95% confidence interval [CI] 1.1-3.2,P = .019) and tumor size ( 120 Gy was needed for better LC and OS for large, non-adenocarcinoma tumors