Awareness of breast cancer risk factors and practice of breast self examination among high school students in Turkey

Background: Young breast cancer patients have a lower rate of survival than old breast cancer patients due to being diagnosed at advanced stages. Breast self-examination makes women more breast aware, which in turn may lead to an earlier diagnosis of breast cancer. The purpose of this study was to investigate knowledge and practice of breast self-examination and to determine knowledge of risk factors for breast cancer among high school students. Methods: This is a descriptive and cross-sectional study. It was conducted in a high school in Manisa, Turkey. The study sample included 718 female high school students. A socio-demographic characteristics data form, knowledge of breast self examination and risk factors for breast cancer form and breast self examination practice form were used to collect data. Results: The female high school students had insufficient knowledge about breast self-examination and a low percentage of students reported that they had performed breast self examination monthly. The most common reason for not doing breast self-examination was not knowing how to perform breast self-examination (98.5%). Most of the students had little knowledge of the risk factors for breast cancer. The most widely known risk factor by the students was personal history of breast cancer (68.7%). There was a significant relation between breast self-examination practice and age, school grade, knowledge about breast cancer and knowledge about breast self-examination. Conclusion: There is a need to increase knowledge of adolescent females about the risks of breast cancer and benefits of early detection. In fact, health care professionals can develop effective breast health care programs and help young women to acquire good health habits

Investigation of adaptation after liver transplantation using Roy's Adaptation Model

In this study we explored the adaptation of transplant recipients in Turkey using the Roy Adaptation Model. A descriptive qualitative design was used with data collected from liver transplant recipients in either individual or group interviews between May 2009 and February 2010. Using deductive content analysis, four themes were identified in the data: physiological mode, self-concept mode, role function mode, and interdependence mode. Each theme included both adaptive and ineffective behaviors of liver transplant recipients. The findings of this study indicate that liver transplant recipients need information and support about their ineffective behaviors in all modes of the Roy Adaptation Model. The findings also support the use of a nursing model in the delivery of nursing care for liver transplantation recipients. © 2012 Wiley Publishing Asia Pty Ltd

Examination Of Pain And Quality Of Life in Patients With Chronic Pain Before And After TENS and Their Satisfaction Levels Regarding Nurses

Giriş: Transkutanöz Elektriksel Sinir Uyarımı sağlıkla ilgili yaşam kalitesini bozan kronik ağrının tedavisinde yaygın olarak kullanılmaktadır. Hemşireler, multidisipliner ekibin bir üyesi olarak kronik ağrılı hastaların ağrılarını azaltmada ve yaşam kalitelerini iyileştirmede rol oynayan sağlık profesyonelleridir. Amaç: Kronik ağrı nedeniyle ağrı ünitesine başvuran hastaların TENS uygulaması öncesi ve sonrası yaşam kalitesi, ağrı ve hemşirelerden memnuniyet düzeylerinin incelenmesidir. Yöntem: Tanımlayıcı ve kesitsel araştırmanın yapılabilmesi için etik kurul izni ve hastalardan yazılı aydınlatılmış onam alınmıştır. Veriler hemşireler tarafından 22 Nisan 2012- 20 Şubat 2013 tarihlerinde bir üniversite hastanesinin ağrı ünitesinde TENS uygulaması öncesi ve sonrası Hasta Tanıtım Formu, SF-36 Yaşam Kalitesi Ölçeği, Sayısal Ağrı Ölçeği, Hemşire Memnuniyet Formu kullanılarak toplanmıştır. Bulgular: Ortalama yaşı 53.50±16.60 olan hastaların %85.2'si kadın, %63.0'ü kronik hastalığa sahip, %90.7'si analjezik kullanmakta ve %27.8'i lumbar disk hernisi nedeniyle ağrı yaşamaktadır. Kronik ağrısı olan hastaların TENS uygulaması sonrası öncesine göre istatistiksel olarak anlamlı bir şekilde yaşam kalitesinin mental işlev alt boyutu hariç diğer yedi alt boyut puan ortalamalarının arttığı, ağrı puan ortalamalarının azaldığı ve hemşirelerden memnuniyet puan ortalamalarının yüksek olduğu saptanmıştır. Sonuç: Sonuçlar, TENS uygulaması sonrası ağrı ile yaşam kalitesinin birçok boyutunun iyileştiğini ve bu süreçte hemşireden memnuniyetin yüksek olduğunu göstermektedir. TENS uygulamasının hastaların kronik ağrılarını azaltmada ve yaşam kalitelerini iyileştirmede kullanılması önerilmektedir. Introduction: Transcutaneous Electrical Nerve Stimulation (TENS) is widely used for the treatment of chronic pain causes the impairment of health-related quality of life (QoL). Nurses, as a membe rof multidisciplinary team, are a health professional that play a role to reducing pain in patients with chronic pain and develop the life qualities of patients by approaching them. Aim: The aim of this study was to investigated quality of life, pain, and patients' satisfaction levels from nurses of patients that was applicated to pain unit before and after TENS application.Methods: Informed consent and ethical permission were obtained for performed to descriptive and cross-sectional study. Data was collected obtained by nurses using Patients Identification Form, Numerical Rating Pain Scale (NPRS), Short Form 36 (SF 36), and Nurse Saticfaction Form between 22th April 2012-20th February 2013 in a university hospital pain unit before and after TENS. Results: The patients' mean age was 53.50±16.60, 85.2% of the patients were female, 63.0% has chronical disease. 90.7% was used analgesic drugs. 27.8% of the pain etiology was lumbar disc hernia. It is found that significantly increased to seven subsclaes means of quality of life, expect mental health, decreased to pain mean and increased to satisfaction from nurses mean of the patients with chronic pain after TENS application compared to before. Conclusion: The results showed that improvements in pain and QoL after TENS, and satisfaction from nurses during the process. As a result, it is suggested that TENS can use to reduce for chronic pain and improve for QO

Using theatre in education in a traditional lecture oriented medical curriculum

<p>Abstract</p> <p>Background</p> <p>Lectures supported by theatrical performance may enhance learning and be an attractive alternative to traditional lectures. This study describes our experience with using theatre in education for medical students since 2001.</p> <p>Methods</p> <p>The volunteer students, coached by experienced students, were given a two-week preparation period to write and prepare different dramatized headache scenarios during three supervised meetings. A theatrical performance was followed by a student presentation about history taking and clinical findings in diagnosing headache. Finally, a group discussion led by students dealt with issues raised in the performance. The evaluation of the theatre in education lecture "A Primary Care Approach to Headache" was based on feedback from students.</p> <p>Results</p> <p>More than 90% of 43 responding students fully agreed with the statement "Theatrical performance made it easier to understand the topic". More than 90% disagreed with the statements "Lecture halls were not appropriate for this kind of interaction" and "Students as teachers were not appropriate". Open-ended questions showed that the lesson was thought of as fun, good and useful by most students. The headache questions in the final exam showed results that were similar to average exam results for other questions.</p> <p>Conclusion</p> <p>Using theatrical performance in medical education was appreciated by most students and may facilitate learning and enhance empathy and team work communication skills.</p

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

HALT (Hernia Active Living Trial): protocol for a feasibility study of a randomised controlled trial of a physical activity intervention to improve quality of life in people with bowel stoma with a bulge/parastomal hernia

Background Parastomal hernia (PSH) can be repaired surgically, but results to date have been disappointing, with reported recurrence rates of 30 to 76%. Other types of intervention are therefore needed to improve the quality of life of people with PSH. One potential intervention is physical activity. We hypothesise that the intervention will increase core activation and control across the abdominal wall at a site of potential weakness and thus reduce the risk of PSH progression. Increases in physical activity will improve body image and quality of life (QoL). Methods Subjects and sample There were approximately 20 adults with a bowel stoma and PSH. People with previous PSH repair will be excluded as well as people who already do core training. Study design This is a feasibility study of a randomised controlled trial with 2 months follow-up, in 2 sites using mixed methods. Stage 1 involves intervention development and in stage 2, intervention and trial parameters will be assessed. Intervention A theoretically informed physical activity intervention was done, targeting people with PSH. Main outcome of feasibility study The main outcome is the decision by an independent Study Steering Committee whether to proceed to a full randomised controlled trial of the intervention. Other outcomes We will evaluate 4 intervention parameters—fidelity, adherence, acceptability and safety and 3 trial parameters (eligible patients’ consent rate, acceptability of study design and data availability rates for following endpoints): I. Diagnosis and classification of PSH II. Muscle activation III. Body composition (BMI, waist circumference) IV. Patient reported outcomes: QoL, body image and physical functioning V. Physical activity; VI. Psychological determinants of physical activity Other data Included are other data such as interviews with all participants about the intervention and trial procedures. Data analysis and statistical power As this is a feasibility study, the quantitative data will be analysed using descriptive statistics. Audio-recorded qualitative data from interviews will be transcribed verbatim and analysed thematically. Discussion The feasibility and acceptability of key intervention and trial parameters will be used to decide whether to proceed to a full trial of the intervention, which aims to improve body image, quality of life and PSH progression. Trial registration ISRCTN1520759

Hepatitis B screening in the Turkish-Dutch population in Rotterdam, the Netherlands; qualitative assessment of socio-cultural determinants

Background. Hepatitis B is an important health problem in the Turkish community in the Netherlands. Increased voluntary screening is necessary in this community, to detect individuals eligible for treatment and to prevent further transmission of the disease. Methods. We investigated socio-cultural determinants associated with hepatitis B screening in male and female, first and second generation Turkish migrants, by means of Focus Group Discussions. Results. Socio-cultural themes related to hepatitis B screening were identified; these were social norm, social support, sensitivity regarding sexuality, reputation, responsiveness to authority, religious responsibility, cleanliness and religious doctrine regarding health and disease, and the perceived efficacy of Dutch health care services. Motivating factors were the (religious) responsibility for one's health, the perceived obligation when being invited for screening, and social support to get tested for hepatitis B. Perceived barriers were the association of hepatitis B screening with STDs or sexual activity, the perception of low control over one's health, and the perceived low efficacy of the Dutch health care services. Reputation could act as either a motivator or barrier. Conclusion. This study identified relevant socio-cultural themes related to hepatitis B screening, which may serve to customize interventions aimed at the promotion of voluntary hepatitis B screening in the Turkish-Dutch population in the Netherlands

Champion Sağlık İnanç Modeli Ölçeği'nin Türkiye için uyarlanması ve kendi kendine meme muayenesi uygulama sıklığını etkileyen faktörlerin incelenmesi

Bu araştırma, “ Champion Sağlık İnanç Modeli Ölçeginin” (C.S.İ.M.Ö.) Türk kadınlarında güvenirlik ve geçerliliğini test etmek için metodolojik ve tanımlayıcı araştırma türüne uygun olarak yapılmıştır. Araştırma, İzmir ilinin Güzelbahçe ilçesinde Güzelbahçe sağlık ocağı bölgesinde yürütülmüştür. Güzelbahçe sağlık ocağına kayıtlı 20-60 yaş arasında, en az ilkokul mezunu olan, gebe olmayan ve emzirmeyen 430 kadın araştırmanın örneklemini oluşturmuştur. Ölçek Champion V. (1984) tarafından geliştirilmiş, sonraki çalışmalarında (1993,1997, 1999) yeniden düzenlenmiştir. C.S.İ.M.Ö., Sağlık İnanç Modelinin altı kavramını içeren, altı boyuttan oluşan 43 maddelik bir araçtır. C.S.İ.M.Öʼde alt boyutlar için iç tutarlılık Cronbach Alpha güvenirlik katsayısı 0.69 ile 0.90 arasında, test-tekrartest güvenirlik katsayısıları 0.45 ile 0.70 arasında değişmektedir. Ölçeğin içerik ve yapı geçerliği mevcuttur. Türkçe ölçek örneklem grubu ile benzer özellikleri taşıyan 30 kadına ön uygulamadan sonra örneklem grubuna (n=430) ve dört hafta sonra örneklemde bulunan 96 kadına tekrar uygulanmıştır. Champion Sağlık İnanç Modeli ölçeğinin dil geçerliği için Türkçeye çevirisi ve geri çevirisi yapılmış, içerik geçerliği için uzman görüşü alınmıştır. Türkçeleştirilen ölçeğin yapı geçerliğini değerlendirmek için yapılan faktör analizi sonucunda orjinal ölçek ile benzeyen altı faktörlü bir yapıya sahip olduğu ve benzer maddelerin aynı faktörler altında toplandığı bulunmuştuır. Türkçeleştirilen Ölçeğin Zamana karşı değişmezliği, Pearson Momentler Çarpımı Korelasyonu Tekniği ile incelenmiş alt boyutlar için r= 0.89 ile 0.99 arasında oldukça yüksek düzeyde bulunmuştur. Ölçeğin iç tutarlığı için cronbach alfa çözümlemesi ve madde toplam puan korelesyon tekniği ile gerçekleştirilmiş, cronbach alfa güvenirlik katsayısı alt boyutları için 0.58 ile 0.89 arasında değişen değerlerde bulunmuştur. Madde Toplam Puan Tekniği sonucunda hiç bir maddenin ölçekten çıkarılmamasına karar verilmiştir. Ölçek Türk kadınlarının meme kanseri ve KKMM uygulaması ile ilgili inanç ve tutumları ölçmek için geçerli ve güvenilir bir araçtır. Ölçeğin alt boyut puanları ile KKMM uygulama sıklığı arasındaki ilişki, çok basamaklı regresyon analizi kullanılarak incelenmiş, çoklu korelasyon katsayısı R= 0.42, (p<0.001) olarak saptanmıştır. Güven, sağlık motivasyon, duyarlılık algı, ciddiyet algı, yarar algı puanları yüksek olan kadınların son bir yılda KKMM uygulama sıklığının arttığı, engel puanı yüksek olan kadınların KKMM uygulama sıklığının azaldığı saptanmıştır. Kadınların sadece %6.2ʼsinin önerilen sıklıkta ayda bir yaptığı, %50.5ʼnin KKMMʼsini hiç yapmadığı bulunmuştur. Kadınların KKMM uygulama sıklığını etkileyebilecek faktörler ki-kare analizi ile incelenmiş, eğitim düzeyi yüksek, emekli, aile öyküsünde meme kanseri bulunan, meme kanseri ve KKMM eğitimi alan, son bir yılda klinik muayene yaptıran ve mammografi çektiren kadınların KKMMʼsini daha sık uyguladıkları saptanmıştır. Sonuç olarak bu ölçeğin farklı gruplara uygulanması ve bu gruplarda ki geçerlik ve güvenirliğin incelenmesi önerilmiştir