The efficacy of preopoerative instruction in reducing anxiety following gyneoncological surgery: a case control study

<p>Abstract</p> <p>Background</p> <p>This is a quasi-experimental case control research focusing on the impact of systematic preoperative instruction on the level of postoperative anxiety in gyneoncologic patients. The population studied consists of the gyneoncologic surgery patients admitted to the Gynecologic Oncology Service at Zekai Tahir Burak Gynecology Training and Research Hospital from May to September 2010.</p> <p>Patients and methods</p> <p>Through a random sampling, 60 patients were recruited in each group. The study group was given a systematic preoperative instruction while the control group was given routine nursing care. Patients were interviewed in the postoperative period and anxiety was measured. The data-collecting tool consisted of the Individual Information Form and the State-Trait Anxiety Inventory. The collected data were analyzed by using the SPSS Program to find the frequency, the percentage, the mean and the standard variables, and the hypothesis was tested with Chi-square, variance, and t-independent test.</p> <p>Results</p> <p>It was found that the incidence rates from the post-operative anxiety score of the study group were lower than those of the control group (p < .05). The results of this research demonstrated that gyneoncologic surgery patients who were given systematic preoperative instruction felt less anxious than the ones who were given merely a routine nursing care.</p> <p>Conclusions</p> <p>Results of this study suggest that preoperative instruction programs aiming at informing gyneoncologic surgery patients at the preoperative stage should be organized in hospitals and have an essential role.</p

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Pain Behavior Experienced During Nursing Interventions by Patients on Mechanical Ventilation: A Cross-Sectional Study

AIM: The study aimed to examine pain behavior during nursing interventions in patients who were on mechanical ventilation. METHOD: The study was carried out in patients who were under treatment at a university hospital during the 2017-2018 period and who were connected to a mechanical ventilator and were unable to communicate verbally. In two intensive cares (n = 165), 568 pain assessments were made before and during nursing interventions (aspirating the respiratory tract, wound care, injection applications, bed bath, perineal care, mouth care, etc.). Patients' sedation levels were determined according to the Ramsay Sedation Scale and their pain and physiological parameter were determined according to the Behavioral Pain Scale. The Wilcoxon-signed rank test was used to evaluate the difference between the pain scores and physiological parameters before and during the procedure. A p-value of <.05 was accepted as statistically significant. RESULTS: Totally 45.4% of the patients are over age 65, 59.4% were males and 66.1% had chronic diseases. The interventions causing pain score difference was nasogastric intubation, tracheal expiration, nasotracheal expiratory, oropharyngeal expiration, dressing change, perineum care, position change, bed bath, oral care, intravenous catheter application, tracheostomy cannula care, urethral catheter application, and eye care while a significant increase was seen in all physiological parameters during bed bath, perineal care, and nasogastric intubation. CONCLUSION: It is concluded that nurses should take some precautions before painful procedures

An Investigation of Nursing Students’ Awareness of Evidence-Based Nursing Practices

Amaç: Bu çalışma hemşirelik son sınıf öğrencilerinin kanıta dayalı uygulama ile ilgili farkındalıklarını değerlendirmek amacıyla yapılmıştır. Yöntem: Araştırmanın örneklemini İzmir ilinde bulunan bir hemşirelik fakültesinde Kasım 2017 – Mart 2018 tarihleri arasında entegre sistem ile öğretim gören 188 4.sınıf öğrencisi oluşturmuştur. Veriler, öğrencilerin kanıta dayalı hemşirelik uygulamalarına ilişkin bilgi düzeylerini ölçen 20 soruluk bir anket formu aracılığıyla toplanmıştır. Verilerin analizi için sayı ve yüzdelik dağılımlar ortalama ve standart sapma kullanılmıştır. Bulgular: Çalışmadaki öğrencilerin %53.7’sinin KDU hakkında eğitim aldığı, %86.2’sinin KDU hakkında eğitime ihtiyacı olduğu saptanmıştır. Öğrencilerin %67’sinin lisans eğitimleri süresince derslerde KDU hakkında bilgi sahibi olduğu ve hemşirelikte kullanılan Joanna Briggs Enstitüsü kanıt düzeyi sınıflamasını örneklemin yalnızca %1.2’sinin doğru sıralandırdığı tespit edilmiştir. Sonuç: Hasta bakım sonuçlarında hemşirelik bakımının kalitesini artırmak, bakımı standardize etmek ve hasta memnuniyetini arttırmak; lisans müfredatlarında KDU’ya daha fazla yer verildiğinde, eğitim bu uygulamalarla paralel yürütüldüğünde mümkün olacaktırAim: This study was carried out to evaluate the senior nursing students’ awareness of evidence-based nursing practices. Method: the sample of the research comprised 188 senior students who were educated in an integrated system between November 2017 and March 2018 in a nursing faculty located in the İzmir province. Data were collected by a twenty-item questionnaire that measures students’ knowledge of evidence-based nursing practices. Number and percentage distributions and mean and standard deviation were used to analyze the data. Findings: of the students in the study, 53.7% were trained in evidence-based practice (EBP) and 86.2% were in need of training in EBP. It was determined that 67% of the students had knowledge of EBP during their undergraduate training and that only 1.2% of the sample ranked the Joanna Briggs Institute as evidence level classification. Results: EBP training should be included in the undergraduate curriculum in parallel with the practices of increasing the quality of nursing care in patient care outcomes, standardizing care, and increasing patient satisfaction

Undergraduate nursing students' experiences of distance education during the COVID-19 pandemic

Background: The COVID-19 pandemic has led to significant changes in the field of education, including not least of all the adoption of distance education, which nursing students have had limited experience with in Turkey. Purpose: This study aimed to determine the factors affecting nursing students' success in distance education and to evaluate their experiences during this process. Methods: The study was designed as a descriptive, cross-sectional study and involved the participation of 454 nursing who were members of the Student Nurses Association in Turkey. An evaluation form for assessing students' sociodemographic and distance education-related characteristics and the Distance Education Assessment Questionnaire for Nursing Students (DEAQNS) were used for data collection. Results: The students further reported that the main factors affecting the success of distance education were provision of preliminary information, proficiency level of technological software use, economic status, proficiency level of use of technological devices, and asynchronous learning. Conclusions: In order to increase the success of distance education, students need information on the protection of personal data and use of technological software and devices in the nursing curriculum

WEB DESTEKLİ EĞİTİMİN HEMŞİRELİK ÖĞRENCİLERİNİN HEMŞİRELİK SÜRECİ ÖĞRENMELERİNE ETKİSİ, PİLOT ÇALIŞMA

Amaç: Hemşirelik bilgisini uygulamaya aktarmada en önemli araçlardan biri hemşirelik sürecidir. Hemşirelik sürecinin, bireye özgü ve bütüncül bakım verilmesini sağlama, bakım kalitesini ve hasta memnuniyetini arttırma, hemşirelerin otonomisi ve bilgisinin gelişmesine katkı sağlama ve kayıtları geliştirme gibi pek çok yararı bulunmaktadır. Bununla beraber çalışmalarda; öğrencilerin hemşirelik sürecine ilişkin bilgi ve uygulamalarında sorun yaşadıkları ve hemşirelik süreci eğitimi alan öğrencilerin bakım planını hazırlamakta güçlük çektikleri, planı uygulama aşamasına getiremedikleri bildirilmektedir. Hemşirelik eğitiminde klasik yöntemler kullanılarak öğretimi yapılan hemşirelik süreci eğitiminin yetersiz kalması, geleneksel öğretimin yanında başka yöntemlerinde kullanımını gündeme getirmektedir. Bu noktada, web destekli eğitim hemşirelik sürecinin öğretiminde kullanılabilecek alternatif bir yöntem olarak karşımıza çıkmaktadır. Bu çalışma, Web destekli eğitimin hemşirelik öğrencilerinin hemşirelik süreci öğrenmelerine etkisini incelemek amacıyla yapılmıştır. Yöntem: Araştırma 2017-2018 öğretim yılında Ege Üniversitesi Hemşirelik Fakültesi’nde yapılmıştır. Araştırmanın evrenini 2. sınıf öğrencileri oluşturmuştur. Araştırmanın örneklemini araştırmaya katılmayı kabul eden, kontrol grubunda 46 ve uygulama grubunda 44 olmak üzere toplam 90 öğrenci oluşturmuştur. Verilerin toplanmasında, “Birey Tanıtım Formu”, öğrencilerin hazırladıkları hemşirelik süreçlerinin değerlendirildiği “Hemşirelik Süreci Değerlendirme Formu” kullanılmıştır. Öğrencilerin öğretimden memnuniyet ve hemşirelik süreci uygulama konusundaki özgüvenlerinin belirlenmesinde “Görsel Kıyaslama Ölçeği” kullanılmıştır. Araştırmada, her iki gruba sınıf ortamında hemşirelik süreci teorik olarak anlatılmış ve arkasından vaka örneği sunulmuştur. Hastane uygulaması esnasında kontrol grubundaki öğrencilere mevcut programda uygulamakta olan ve hemşirelik sürecinin öğretiminde kullanılan geleneksel yöntem uygulanmıştır. Uygulama grubundaki öğrencilere ise ilave olarak hemşirelik sürecinin basamakları doğrultusunda hazırlanan ve internet ortamından ulaşılabilen bir program geliştirilmiş ve bu web sayfasına erişimleri sağlanmıştır. Araştırma verilerinin analizinde sayı ve yüzdelik dağılımları, ki-kare testi, Mann- Whitney testi kullanılmıştır. Bulgular: Araştırmaya katılan öğrencilin yaş ortalaması, uygulama grubunda 20,7±2,25, kontrol grubunda 20,7±1,35 olduğu; kadın cinsiyetin uygulama grubunda %77, kontrol grubunda %89,1 olduğu tespit edilmiştir. Öğrencilerden uygulama grubunun %70,5’i, kontrol grubunun %56,5’i hemşirelik süreci ile ilgili verilen eğitimi yeterli görmüş; hemşirelik bakım planı hazırlarken uygulama grubunun % 95,5’i, kontrol grubunun %84,8’inin hemşirelik sürecinin gerekli olduğunu düşündüğü tespit edilmiştir. Yapılan analiz sonucunda, uygulama grubundaki öğrencilerin hemşirelik sürecinin öğretiminde kullanılan eğitim metodundan memnun olma (p = 0,005) ve hemşirelik süreci uygulama becerisi puanlarının kontrol grubuna göre daha yüksek olduğu bulunmuştur. Bunun yanında, uygulama ve kontrol grubundaki öğrencilerin hemşirelik sürecini uygulama özgüven puanları arasında anlamlı bir fark saptanmamıştır (p = 0,441). Sonuç: Bu araştırma sonucunda, Web destekli eğitimin hemşirelik öğrencilerinin hemşirelik süreci öğrenmelerine olumlu yönde katkı sağladığı, web destekli eğitim alan öğrencilerin almayanlara göre eğitim metodundan memnuniyetleri ile hemşirelik süreci hazırlama ve uygulama düzeylerini arttırdığı belirlenmiştir

Growth of Cu2ZnSnS4 absorber layer on flexible metallic substrates for thin film solar cell applications

In this work, Cu2ZnSnS4 (CZTS) absorber layers were fabricated using a two-stage process. Sequentially deposited Cu-Zn-Sn thin film layers on metallic foils were annealed in an Ar + S2(g) atmosphere. We aimed to investigate the role of flexible titanium and molybdenum foil substrates in the growth mechanism of CZTS thin films. The Raman spectra and X-ray photoelectron spectroscopy analyses of the sulfurized thin films revealed that, except for the presence of Sn-based secondary phases, nearly pure CZTS thin films were obtained. Additionally, the intense and sharp X-ray diffraction peak from the (112) plane provided evidence of good crystallinity. Electron dispersive spectroscopy analysis indicated sufficient sulfur content but poor Zn atomic weight percentage in the films. Absorption and band-gap energy analyses were carried out to confirm the suitability of CZTS thin films as the absorber layer in solar cell applications. Hall effect measurements showed the p-type semiconductor behavior of the CZTS samples. Moreover, the back contact behavior of these metallic flexible substrates was investigated and compared. We detected formation of cracks in the CZTS layer on the molybdenum foils, which indicates the incompatibility of molybdenum's thermal expansion coefficient with the CZTS structure. We demonstrated the application of the magnetron sputtering technique for the fabrication of CZTS thin films on titanium foils having lightweight, flexible properties and suitable for roll-to-roll manufacturing for high throughput fabrication. Titanium foils are also cost competitive compared to molybdenum foils. © 2015 Elsevier B.V.Scientific and Technological Research Council of Turkey (112T068--114F341); University Research Foundation (2014-IYTE-21

The Effects of Antimicrobial Resistance and the Compatibility of Initial Antibiotic Treatment on Clinical Outcomes in Patients With Diabetic Foot Infection

We aimed to determine pathogen microorganisms, their antimicrobial resistance patterns, and the effect of initial treatment on clinical outcomes in patients with diabetic foot infection (DFI). Patients with DFI from 5 centers were included in this multicenter observational prospective study between June 2018 and June 2019. Multivariate analysis was performed for the predictors of reinfection/death and major amputation. A total of 284 patients were recorded. Of whom, 193 (68%) were male and the median age was 59.9 +/- 11.3 years. One hundred nineteen (41.9%) patients had amputations, as the minor (n = 83, 29.2%) or major (n = 36, 12.7%). The mortality rate was 1.7% with 4 deaths. A total of 247 microorganisms were isolated from 200 patients. The most common microorganisms were Staphylococcus aureus (n = 36, 14.6%) and Escherichia coli (n = 32, 13.0%). Methicillin resistance rates were 19.4% and 69.6% in S aureus and coagulase-negative Staphylococcus spp., respectively. Multidrug-resistant Pseudomonas aeruginosa was detected in 4 of 22 (18.2%) isolates. Extended-spectrum beta-lactamase-producing Gram-negative bacteria were detected in 20 (38.5%) isolates of E coli (14 of 32) and Klebsiella spp. (6 of 20). When the initial treatment was inappropriate, Klebsiella spp. related reinfection within 1 to 3 months was observed more frequently. Polymicrobial infection (p = .043) and vancomycin treatment (p = .007) were independent predictors of reinfection/death. Multivariate analysis revealed vascular insufficiency (p = .004), hospital readmission (p = .009), C-reactive protein > 130 mg/dL (p = .007), and receiving carbapenems (p = .005) as independent predictors of major amputation. Our results justify the importance of using appropriate narrow-spectrum empirical antimicrobials because higher rates of reinfection and major amputation were found even in the use of broad-spectrum antimicrobials