The İnfluence Of Abdominal Massage Administered To İntubated And Enterally-Fed Patients İn İntensive Care Units On The Development Of Ventilator-Associated Pneumonia

This study was conducted as an intervention study to identify the effect of abdominal massage applied to intubated and enterally-fed patients in intensive care units on the development of ventilator-associated pneumonia. This study was carried out in the Internal Medicine Intensive Care Unit of Gazi University Research and Application Hospital between the dates of February 2013 and February 2014. The sample of the study consisted of totally 32 patients, distributed to 16 patients in intervention and 16 in control group. The intubated patients in the intervention group were administered abdominal massage for 15 minutes after the commencement of enteral feeding during day and night. Abdominal massage was not administered to patients in the control group. The gastric residual volume amounts, abdominal circumference measurements, oral care, aspiration counts and development of ventilator-associated pneumonia in both group patients were recorded day and night. The data was evaluated by using Ki-square, Mann-Whitney U tests, number, average, and percentage methods. According to the findings of the study, at the end of monitoring days, a reduction has been identified in the amount of gastric residual volume and abdominal circumference measurement of the patients in the intervention group compared to the patients in the control group. This reduction is found significant in the statistical analysis (p<0.005). Moreover, although not reached statistically significance level, ventilator-associated pneumonia was observed in 31.3% of the patients in the control group and 6.3% of the patients in the intervention group. In conclusion, abdominal massage administered to intubated and enterally-fed patients reduced gastric residual volume amount and abdominal distention. Due to take effect on abdominal distension and gastric residual volume, application of abdominal massage to intubated and enterally-fed patients was recommended.Bu araştırma, yoğun bakım ünitelerinde sürekli enteral beslenen, entübe hastalara uygulanan abdominal masajın ventilatör ilişkili pnömoni gelişimine etkisini belirlemek amacıyla bir müdahale çalışması olarak yapılmıştır. Araştırma, Şubat 2013–Şubat 2014 tarihleri arasında Gazi Üniversitesi Sağlık Araştırma ve Uygulama Hastanesi İç Hastalıkları Yoğun Bakım Ünitesinde gerçekleştirilmiştir. Çalışmanın örneklemini müdahale grubunda 16 hasta, kontrol grubunda 16 hasta olmak üzere toplam 32 hasta oluşturmuştur. Müdahale grubunda yer alan entübe hastalara enteral beslenme başladıktan sonra sabah ve akşam olmak üzere 15 dakika abdominal masaj uygulanmıştır. Kontrol grubundaki hastalara ise abdominal masaj uygulanmamıştır. Her iki grubun da gastrik rezidüel volüm miktarları, karın çevresi ölçümleri, ağız bakımı, aspirasyon sayıları ve ventilatör ilişkili pnömoni gelişme durumları sabah ve akşam kayıt edilmiştir. Veriler ki-kare, Fisher kesin ki-kare, Mann-Whitney U testleri, sayı, ortalama ve yüzde ile değerlendirilmiştir. Araştırmadan elde edilen bulgulara göre, müdahale grubunda yer alan hastaların izlem günleri sonunda gastrik rezidüel volüm miktarlarında ve karın çevresi ölçümlerinde, kontrol grubunda yer alan hastalara göre azalma olduğu saptanmıştır. Yapılan istatistiksel analizde bu azalmanın anlamlı olduğu belirlenmiştir (p<0.05). Ayrıca istatistiksel olarak anlamlı olmamasına rağmen, kontrol grubunda yer alan hastaların % 31.3'ünde, müdahale grubunda yer alan hastaların ise yalnızca %6.3'ünde ventilatör ilişkili pnömoni geliştiği saptanmıştır. Sonuç olarak, sürekli enteral beslenen entübe hastalara uygulanan abdominal masajın gastrik rezidüel volüm miktarını ve abdominal distansiyonu azalttığı belirlenmiştir. Abdominal distasiyon ve gastrik rezidüel volüm üzerine etkili olması nedeniyle abdominal masajın sürekli enteral beslenen entübe hastalara uygulanması önerilmiştir

Health-Related Adverse Events and Associated Factors in Recreational Divers With Different Certification Levels

Background. There is a paucity of research on diving-related health issues and associated factors. This study aimed to examine the health problems encountered during diving and to ascertain the factors associated with adverse events. Methods. The sample of this descriptive study consisted of 132 recreational divers from diving schools in Ankara. The researchers collected the data using a questionnaire developed according to the relevant literature. Results. Diving-related health issues including barotraumas, nitrogen narcosis, and decompression sickness were mostly dependent on depth. The divers with higher certification levels witnessed diving-related adverse events more frequently and a significant increase in health problems with greater depth attained (p0.05). Conclusions. The finding implies the importance of adherence to the depth limit of 40m for recreational divers, being a slow ascend diver, and utilization of a buddy system in order to prevent diving-related adverse events. A data recording system related to diving and regulations particularly for tourist divers in the countries attracting tourists is required.WoSScopu

Opinions of family caregivers on the use of physical restraints in Intensive care unit

*Aşiret, Güler Duru ( Aksaray, Yazar )Objective: This study aimed to determine the opinions of family caregivers on the use of physical restraints in patients admitted to intensive care units. Material and Methods: This descriptive study included the caregivers of 42 restrained patients admitted in Medical and Surgical Intensive Care Units of the Hacettepe University Adult Hospital between August 2012 and August 2013. Data was collected using a data collection form developed by researchers based on the literature. Descriptive statistical analyses and chi-square tests were used for data analysis. Results: The mean age of patients was 41.2 +/- 11.2; 52.4% of the patients were females. Among the caregivers, 61.9% were the patients' children. In this study, physical restraints were applied to the upper extremity alone and to both wrists and ankles in 90.5% and 9.5% of the patients, respectively. Among the relatives, 78.6% stated that they were informed of the physical restraining; 90.9% stated that the information provided was adequate. In addition, 85.7% of the relatives reported that physical restraint on the patient was necessary, 9.5% of the relatives stated that it was unnecessary, and 4.8% of the caregivers were ambivalent regarding the requirement of physical restraining. Only 8.6% of the patients suggested that their presence next to the patient in the intensive care unit may be a substitution for physical restraint. Informed consent for physical restraining was obtained from only 9.8% of the caregivers. Conclusion: Most of the caregivers were informed about physical restraining, and they thought that it was necessary; however, it was determined that informed consent was obtained from only a small percentage of caregivers...