Ethical dilemmas in perinatology: Perinatolojide etik ikilemler

The development of science and technology and in parallel with this, advancements in new applications in health area, confront nurses with ethical problems. It is considerably important that nurses decide based on the ethical problems and ethical principles they face and the effective professional care. Perinatology nursing   are the area, in which the ethical dilemmas are most experienced.  Due  to the fact that  nurses  do not mostly  have   freedom of choice  and the environmental factors,  they are obliged to make a choice  between professional obligation and ethical responsibility  Approach  in obstetric care has to be conducted by considering   the health of  both mother  and baby.  Although the legal regulations, policies, and cooperation with women organizations concerning women enhance quality of care, they influence nursing applications. While the nurses working in the area of perinatology realize the consultancy, educator, and care roles in their every sorts of intervention and decisions in presenting health service, it is highly important for them to behave in the framework of ethical principles. Due to the fact that nurses are the closest health profession members to the patient, have the changing roles and responsibilities in their working areas, and sometimes make decisions and applications on the name of patients, they face to the ethical problems and experience confliction. Therefore, nurses need guidance and support about solution of ethical problems. In this study; ethical dilemmas the nurses working on the perinatology area face and how to be acted in the face of these dilemmas were discussed.  ​Extended English summary is in the end of Full Text PDF (TURKISH) file. Özet Bilim ve teknolojinin gelişmesi, buna paralel olarak sağlık alanında yeni uygulamalarda ilerlemeler hemşireleri etik sorunlarla karşı karşıya bırakmaktadır. Hemşirelerin, karşılaştıkları etik sorunlara etik ilkelere dayanarak karar vermesi ve etkili profesyonel bakım oldukça önemlidir. Perinatoloji hemşireliği etik ikilemlerin en çok yaşandığı alandır. Hemşirelerin çoğu kez seçme hakkının olmaması ve çevresel faktörler nedeniyle kendilerini mesleki yükümlülük ve ahlaki sorumluluk arasında ikilemde bulmalarına neden olmaktadır. Obstetrik bakımda yaklaşım hem annenin hem de bebeğin yararı düşünülerek yapılmalıdır. Kadınları ilgilendiren yasal düzenlemeler, politikalar, kadın kuruluşlarıyla işbirliği yapılması bakım kalitesini artırmakla birlikte hemşirelik uygulamalarını etkilemektedir. Perinatoloji alanında çalışan hemşireler sağlık hizmeti sunmadaki her türlü müdahale ve kararlarında, aynı zamanda danışmanlık, eğitici ve bakım rollerini gerçekleştirirken etik ilkeler çerçevesinde davranış göstermeleri oldukça önemlidir. Hemşireler hastaya en yakın sağlık meslek üyeleri olmaları, çalışma alanlarında değişen rol ve sorumlulukları, kimi zaman hastalar adına karar verme ve uygulamalarda bulunmalarından dolayı etik sorunlarla karşı karşıya kalmakta ve çatışma yaşamaktadır. Bu nedenle etik sorunların çözümü konusunda hemşirelerin rehberliğe ve desteğe gereksinimleri vardır. Bu derlemede perinatoloji alanında çalışan hemşirelerin karşılaştıkları etik ikilemeler ve bu ikilemler karşısında nasıl hareket edilmesi gerektiği amacıyla gerçekleştirilmiştir

Determination of science teachers’ perceptions of competence and use of teaching methods

Araştırma, ortaokullarda görev yapan Fen Bilimleri Öğretmenlerinin yetkinlik algıları ve öğretim metodu kullanma durumlarının belirlenmesi, öğretim metodu kullanma durumları ile yetkinlik algıları arasında fark olup olmadığının değerlendirilmesi amacıyla kesitsel ve tanımlayıcı tipte planlanmıştır. Çalışma, Karaman İl Merkezi devlet ortaokullarında görev yapan toplam 52 Fen Bilimleri Öğretmeni ile yürütülmüştür. Veriler Mart-Mayıs 2018 tarihleri arasında, Kişisel Bilgi Formu, Öğretmen Yetkinlik Ölçeği ve Öğretim Programına Göre Öğretim Yöntemi Kullanma Formu kullanılarak toplanmıştır. Toplanan veriler SPSS21.0 paket programı ile ortalama, yüzde gibi tanımlayıcı istatistikler, Shapiro-Wilk, Skewnes, Kurtosis, t testi, Kruskal Wallis ve Mann Whitney U testleri ile değerlendirilmiştir. Araştırma kapsamına alınan öğretmenlerin yetkinlik algılarının “çevresel etkiler” alt boyutunun cinsiyetten etkilendiği görülmüştür. Öğretmen Yetkinlik Ölçeği toplam ve alt boyut puan ortalamalarının, yaş, eğitim durumu ve mesleki çalışma yılından etkilenmediği belirlenmiştir.The research was planned in a cross-sectional and descriptive type in order to determine the competence perceptions and teaching method usage status of the Science Teachers working in secondary schools, and to evaluate whether there is a difference between their teaching method usage status and their competence perceptions. The study was carried out with a total of 52 Science Teachers working in Karaman City Center state secondary schools. The data were collected using the Personal Information Form, the Teacher Competency Scale and the Use of Instructional Methods According to the Curriculum Form between March-May 2018. The collected data were evaluated with SPSS 21.0 package program and descriptive statistics such as mean, percentage, Shapiro-Wilk, Skewnes, Kurtosis, t test, Kruskal Wallis and Mann Whitney U tests. It was observed that the "environmental effects" sub-dimension of the teachers' perceptions of competence included in the study was affected by gender. It was determined that the total and sub-dimension mean scores of the Teacher Competency Scale were not affected by age, education level and professional working year

The effects of virtual reality glasses and external cold and vibration on procedural pain and anxiety in children during venous phlebotomy: randomized controlled trial

WOS:000879127900001Needle-related procedures are among the most feared and painful experiences reported by children and their parent. For this reason, use of effective methods of pain relief is very important during phlebotomy procedures in children. The aim of this study is to research two different distraction methods (external cold and vibration-Buzzy + virtual reality) on relief of procedural pain and anxiety in children during phlebotomy. This study is a prospective, randomized and controlled trial. Sample of the study consisted of a total of 119 children who met the sample selection criteria. Children aged 7 to 12 years who required phlebotomy were divided into three groups: buzzy (n = 40), virtual reality (n = 40), and control (n = 39). Data were collected using the information form, Wong-Baker FACES Pain Rating Scale, and Children's Fear Scale. In the study, 119 children [girls n = 59 (49.6%), boys n = 60 (50.4%)] were included. The children's pain levels were assessed and reported by the parents and observers and the children themselves who self-reported using Wong-Baker FACES. The children's anxiety levels were also assessed using the Children's Fear Scale. A significant difference was found between the groups in terms of the parent-reported and observer-reported assessments (p 0.05). According to the parent-reported and observer-reported assessments, a significant difference was found between procedural anxiety levels. VR is more effective than external cold and vibration-Buzzy in reducing pain during phlebotomy and should be preferred as the first choice

Effects of music therapy and distraction cards on pain relief during phlebotomy in children

WOS:000392894000029PubMed:28096012Aim: To investigate three different distraction methods (distraction cards, listening to music, and distraction cards + music) on pain and anxiety relief in children during phlebotomy. Methods: This study was a prospective, randomized, controlled trial. The sample consisted of children aged 7 to 12 years who required blood tests. The children were randomized into four groups, distraction cards, music, distraction cards + music, and controls. Data were obtained through face-to-face interviews with the children, their parents, and the observer before and after the procedure. The children's pain levels were assessed and reported by the parents and observers, and the children themselves who self-reported using Wong-Baker FACES. The children's anxiety levels were also assessed using the Children's Fear Scale. Results: Two hundred children (mean age: 9.01 +/- 2.35 years) were included. No difference was found between the groups in the self, parent, and observer reported procedural pain levels (p = 0.72, p = 0.23, p = 0.15, respectively). Furthermore, no significant differences were observed between groups in procedural child anxiety levels according to the parents and observer (p = 0.092, p = 0.096, respectively). Conclusions: Pain and anxiety relief was seen in all three methods during phlebotomy; however, no statistically significant difference was observed. (C) 2016 Elsevier Inc. All rights reserved

Çocuklarda prosedürel ağrı yönetiminde dikkati başka yöne çekme yöntemlerinin kullanımı

WOS:000422265800007Medical procedures such as phlebotomy and injections are the most important sources of pain for children. Pain causes children to be frightened of needles and this leads to unwillingness to medical procedures such as vaccine administration, injections and phlebotomy, even may result in neglect or delay in treatment and care. Thus, the nurse should be able to manage painful procedures to reduce emotional and physical effects of painful procedures and to avoid long-term results of pain in children. There are many different approaches to the treatment of procedural pain and anxiety of children during medical procedures, including pharmacological and non-pharmacological methods. In recent years research focusing on nurses' use of non-pharmacological methods for pain relief of children's has increased. Present widely used non-pharmacological method for pain relief of children during painful medical procedures is distraction methods. Distraction is a nursing attempt focusing patient's attention to any other stimulants to control and reduce pain better. The rationale for the pain-reducing effects of distraction hypothesized that the brain has a limited capacity of focusing attention on stimulation. In this article frequently used ditraction method will be discussed.Kan alma, enjeksiyon uygulama gibi medikal prosedürler çocukların en büyük ağrı kaynaklarından biridir. Ağrı çocukların aşı, enjeksiyon ve kan alma uygulaması gibi medikal prosedürlerden korkmasına, bazı medikal prosedürlere karşı gönülsüzlüğü hatta tedavinin ihmal edilmesine yada gecikmesine neden olabilmektedir. Bu nedenle hemşire, çocuklarda ağrının uzun dönem olumsuz etkilerini azaltmak ve ağrılı prosedürlerin fiziksel ve emosyonel etkilerini gidermek için ağrılı prosedürleri yönetmelidir. Çocuklarda medikal prosedürler sırasında oluşabilecek ağrı ve anksiyeteyi azaltmaya yönelik farmakolojik ve non-farmakolojik yöntemleri kapsayan pek çok yaklaşım vardır. Son yıllarda, hemşirelerin ağrılı prosedürlerde ağrıyı gidermeye yönelik non-farmakolojik yöntemlerin kullanımı ile ilgili araştırmalar artmıştır. Medikal prosedürler sırasında oluşan ağrıyı gidermede en sık kullanılan yöntemlerden biri dikkati başka yöne çekmedir. Dikkati başka yöne çekme yöntemi, ağrıyı azaltmak için hastanın dikkatini başka bir uyarana yoğunlaştırma girişimidir ve beynin stimulasyona dikkatini yoğunlaştırma ile ilgili kapasitesinin sınırlı olduğu hipotezine dayanmaktadır. Bu makalede sıklıkla kullanılan dikkati başka yöne çekme yöntemleri tartışılacaktır

The experiences of women who have babies in risk of congenital anomaly: qualitative research

24th Annual Meeting of the European-Society-of-Paediatric-and-Neonatal-Intensive-Care -- JUN 12-15, 2013 -- Rotterdam, NETHERLANDSWOS:000342430900536The Experiences Of Women Who Have Babies In Risk Of Congenital Anomaly: Qualitative ResearchEuropean Soc Paediat & Neonatal Intens Car

Results of umbilical cord care in the last 10 years: Systematic review

WOS:000297503200272

The effect of regional massage performed before blood collection on pain and vital signs in newborns

Aim: This randomised-controlled trial aims to examine the effect of regional massage performed before blood collection on pain and vital signs in term newborns. Methods: The study sample consisted of a total of 96 term newborns, 49 in the experimental group and 47 in the control group, in the neonatal intensive care unit (NICU). Before the blood collection process, those in the experimental group received two (2) minutes of massage on their blood collection region, and their pain levels and vital signs were observed. Data were collected using a newborn information form, an intervention follow-up form, and the Neonatal Infant Pain Scale (NIPS). Statistical analyses of the collected data included descriptive statistics, Chi-squared test, independent-samples t test, paired-samples t test and Cohen's kappa statistic. A value of P 0.05). The mean crying time in the control group (56.9 ± 25.4 s) was significantly longer than that in the experimental group (30.6 ± 29.3 s) (P < 0.05). The newborns in the experimental group had shorter crying times, lower pain levels and heart rate, and higher oxygen saturation than those in the control group. Conclusion: The regional massage intervention reduced pain in term newborns. Therefore, neonatal nurses can be trained to use massage as an alternative infant care practice

The effects of three different distraction methods on pain and anxiety in children

WOS:000382967700003PubMed:26040282This study aims to investigate of three different distraction methods (distraction cards, listening to the music of cartoon and balloon inflation) on pain and anxiety relief of children during phlebotomy. This study is a prospective, randomized, and controlled trial. The sample consisted of 6 to 12 years old children who require blood tests. Children were randomized into four groups as the distraction cards, the music, the balloon inflation, and the control. Data were obtained by conducting interviews with the children, their parents, and the observer before and after the procedure. The pain levels of the children were assessed by the parent and observer reports as well as self-report using the Wong-Baker FACES. The anxiety levels of children were assessed by parent and observer reports using Children Fear Scale. One hundred and twenty children (mean age: 9.1 +/- 1.6 years) were included. The self-reported procedural pain levels showed significant differences among the study groups (p = .040). The distraction card group (2.33 +/- 3.24) had significantly lower pain levels (p = .057) than the control group (4.53 +/- 3.23). The procedural child anxiety levels reported by the observer showed a significant difference among the study groups (p = .032). All the forms of distraction significantly reduced pain and anxiety perception

Adolesan dönem cinselliğiyle öne çıkan serviks kanseri ve risk faktörleri]

Recently, the importance of cervical cancer one of the women's most important health problems has increased. One of the important causes of cervical cancer is the HPV (Human Papilloma Virus). Cervical cancer has high level of severity and it is difficult to diagnose because it is difficult detect its symptoms in earlier period. Therefore, in order to reduce the negative effects of cervical cancer and to take appropriate measures, its' risk factors should be known. This study is designed to review studies to determine risk factors of cervical cancer. In reviewed studies, the clear and exact factors are given; however, common risk factors that were stated in the studies are listed as adolescent sexuality in the period (age at first intercourse at a young age or pregnancy in young), multiple sexual partner, smoking and oral contraceptive. As it is believed by the researchers that some precautions could be taken, informing of the community in this regard is of great importance.Günümüzde kadınların en önemli sağlık sorunlarından olan serviks kanserinin önemi giderek artmaktadır. Serviks kanserinin önemli nedenlerinden biri HPV (Human Papilloma Virüs)’dir. Serviks kanseri erken dönemde belirti göstermediğinden tanılanması zor ve ciddiyeti yüksek bir kanser türüdür. Bu nedenle serviks kanserinin olumsuz etkilerini azaltmak için risk faktörlerinin bilinmesi ve ona uygun önlemler alınması gerekmektedir. Bu çalışma serviks kanserinin risk faktörlerini belirlemeye yönelik yapılan çalışmaları incelemek amacı ile yapıldı. İncelenen çalışmalarda kesin bir neden belirtilmemekle birlikte en sık vurgulanan risk faktörlerinin; adolesan dönem cinselliği (ilk ilişki yaşının küçük olması ya da küçük yaşta yaşanan gebelik), cinsel partner sayısının fazla olması, sigara kullanımı ve oral kontraseptifler olabileceği vurgulanmaktadır. Belirtilen bu nedenler önlem alınabilecek unsurlar olduğundan toplumun bu konuda bilgilendirilmesi büyük önem taşımaktadır