Validade e confiabilidade da versão turca da escala de avaliação do Ambiente de Aprendizagem Clínica, Supervisão e Professor de Enfermagem (CLES+T)

Aim: A methodological type of study was conducted for the purpose of investigating the validity and reliability of the Turkish version of the Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) evaluation scale of the clinical learning environment of students, clinical nurses, and educators. Methods: Sample was comprised of 602 Turkish nursing students with clinical practice experience at the hospital. The CLES+T, developed by Saarikoski, was used for data collection. Language equivalency, internal consistency, item-total correlation, and structure validity were conducted within the scope of the validity and reliability study on the CLES +T scale. Results: It was determined that item-total correlations of four items were lower than 0.30, and those items were removed from the scale as a result of item analysis. The Cronbach’s alpha value of the scale was 0.93-0.99; item total point correlations of the scale varied between 0.45 and 0.66; six factors were identified in the CLES+T factor analysis study, with a total variance explained by these six factors of 64%. Conclusion: According to the findings of the research, the CLES+T Turkish version was found to be a valid and reliable scale, which can be used to evaluate satisfaction of nursing students with their clinical education in TurkeyObjetivo: Um estudo do tipo metodológico foi desenvolvido com o propósito de investigar a validade e a confiabilidade da versão turca da escala de avaliação do Ambiente de Aprendizagem Clínica, Supervisão e Professor de Enfermagem (CLES + T) no ambiente de aprendizagem clínica de estudantes, enfermeiros clínicos e educadores. Métodos: A amostra foi composta por 602 estudantes de enfermagem turcos com experiência na prática clínica hospitalar. O CLES + T, desenvolvido por Saarikoski, foi utilizado para coleta de dados. Equivalência de linguagem, consistência interna, correlação item-total e validade de estrutura foram avaliados no escopo do estudo de validade e confiabilidade na escala CLES + T. Resultados: As correlações item-total de quatro itens foram inferiores a 0,30, e tais itens foram removidos da escala como resultado da análise de itens. O valor alfa de Cronbach da escala foi de 0,93-0,99; as correlações itemtotal da escala variaram entre 0,45 e 0,66; seis fatores foram identificados na análise fatorial da escala, com uma variância total explicada por esses seis fatores de 64%. Conclusão: De acordo com os resultados da pesquisa, a versão turca do escala CLES+T foi considerada válida e confiável, a qual pode ser usada para avaliar a satisfação de estudantes de enfermagem com sua educação clínica na Turquia.Objetivo: Se realizó un estudio de tipo metodológico con el fin de investigar la validez y la fiabilidad de la versión turca de la escala de evaluación del entorno de aprendizaje clínico, la supervisión y la enfermera docente (CLES + T) del entorno clínico de aprendizaje de estudiantes, enfermeras clínicas, y docentes. Métodos: La muestra estuvo compuesta por 602 estudiantes de enfermería turcos con experiencia en práctica clínica en el hospital. Se utilizó el CLES + T, desarrollado por Saarikoski, para la recopilación de datos. Se realizaron la equivalencia idiomática, la consistencia interna, la correlación ítem-total y la validez de la estructura dentro del alcance del estudio de validez y confiabilidad en la escala CLES + T. Resultados: se determinó que las correlaciones ítem-total de cuatro ítems eran inferiores a 0.30, y se eliminaron de la escala como resultado del análisis. El valor alfa de Cronbach de la escala fue 0.93-0.99; las correlaciones de puntos totales de los ítems de la escala variaron entre 0.45 y 0.66; se identificaron seis factores en el estudio de análisis del factor CLES + T, con una varianza total explicada por estos seis factores del 64%. Conclusión: según los resultados de la investigación, se encontró que la versión turca de CLES + T era una escala válida y confiable, que se puede utilizar para evaluar la satisfacción de los estudiantes de enfermería con su educación clínica en Turquí

Evaluation of patients with fibrotic interstitial lung disease: Preliminary results from the Turk-UIP study

OBJECTIVE: Differential diagnosis of idiopathic pulmonary fibrosis (IPF) is important among fibrotic interstitial lung diseases (ILD). This study aimed to evaluate the rate of IPF in patients with fibrotic ILD and to determine the clinical-laboratory features of patients with and without IPF that would provide the differential diagnosis of IPF. MATERIAL AND METHODS: The study included the patients with the usual interstitial pneumonia (UIP) pattern or possible UIP pattern on thorax high-resolution computed tomography, and/or UIP pattern, probable UIP or possible UIP pattern at lung biopsy according to the 2011 ATS/ERSARS/ALAT guidelines. Demographics and clinical and radiological data of the patients were recorded. All data recorded by researchers was evaluated by radiology and the clinical decision board. RESULTS: A total of 336 patients (253 men, 83 women, age 65.8 +/- 9.0 years) were evaluated. Of the patients with sufficient data for diag-nosis (n=300), the diagnosis was IPF in 121 (40.3%), unclassified idiopathic interstitial pneumonia in 50 (16.7%), combined pulmonary fibrosis and emphysema (CPFE) in 40 (13.3%), and lung involvement of connective tissue disease (CTD) in 16 (5.3%). When 29 patients with definite IPF features were added to the patients with CPFE, the total number of IPF patients reached 150 (50%). Rate of male sex (p<0.001), smoking history (p<0.001), and the presence of clubbing (p=0.001) were significantly high in patients with IPE None of the women <50 years and none of the men <50 years of age without a smoking history were diagnosed with IPE Presence of at least 1 of the symptoms suggestive of CTD, erythrocyte sedimentation rate (ESR), and antinuclear antibody (FANA) positivity rates were significantly higher in the non-IPF group (p<0.001, p=0.029, p=0.009, respectively). CONCLUSION: The rate of IPF among patients with fibrotic ILD was 50%. In the differential diagnosis of IPF, sex, smoking habits, and the presence of clubbing are important. The presence of symptoms related to CTD, ESR elevation, and EANA positivity reduce the likelihood of IPF

Validity and reliability of the Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T), Turkish version

ABSTRACT Aim: A methodological type of study was conducted for the purpose of investigating the validity and reliability of the Turkish version of the Clinical Learning Environment, Supervision and Nurse Teacher (CLES+T) evaluation scale of the clinical learning environment of students, clinical nurses, and educators. Methods: Sample was comprised of 602 Turkish nursing students with clinical practice experience at the hospital. The CLES+T, developed by Saarikoski, was used for data collection. Language equivalency, internal consistency, item-total correlation, and structure validity were conducted within the scope of the validity and reliability study on the CLES +T scale. Results: It was determined that item-total correlations of four items were lower than 0.30, and those items were removed from the scale as a result of item analysis. The Cronbach’s alpha value of the scale was 0.93-0.99; item total point correlations of the scale varied between 0.45 and 0.66; six factors were identified in the CLES+T factor analysis study, with a total variance explained by these six factors of 64%. Conclusion: According to the findings of the research, the CLES+T Turkish version was found to be a valid and reliable scale, which can be used to evaluate satisfaction of nursing students with their clinical education in Turkey

Çocuklarda Yüksek Akım Nazal Kanül Oksijen Tedavisine Yanıtsızlığı Belirleyen Faktörler: Prospektif Çok Merkezli Çalışma

Giriş : Yüksek akım nazal kanül (YANK) oksijen tedavisi, akut solunum sıkıntısı olan çocuklarda kolay uygulanabilir bir tedavi seçeneğidir. Literatürde YANK oksijen tedavisinin entübasyon oranını, solunum sayısı, kalp tepe atım sayısını azalttığını ve klinik skorlarda iyileşme sağladığını gösteren çok sayıda çalışma mevcuttur. YANK oksijen tedavisine %6-19 oranında tedavi başarısızlığı bildirilmektedir. Bu çalışmada YANK oksijen tedavisine yanıtsızlığı öngören faktörlerin belirlenmesi amaçlanmaktadır.Gereç-Yöntem : Bu çalışmaya Eylül 2017- Eylül 2018 tarihleri arasında Türkiye’nin 7 farklı ilinden 9 çocuk acil ve 7 çocuk yoğun bakım ünitesi katılmıştır. YANK oksijen tedavisi uygulanan hastalara ait demografik bilgiler, başvuru anında ve YANK oksijen tedavisi sırasında vital bulgular, oksijen saturasyonu, S/F oranı, klinik skor (modified respiratory distress score ve pediatric respiratory severity score), laboratuvar ve görüntüleme sonuçları, uygulanan medikal tedaviler ve YANK oksijen tedavisine yanıt durumu değerlendirilmiştir. Veriler prospektif olarak toplanmıştır. Başka bir solunum destek tedavisine geçiş yanıtsızlık olarak değerlendirilmiştir.Bulgular : Toplam 475 veri kayıt formu değerlendirilmiştir. Doksan dokuz form veri eksikliği nedeniyle değerlendirme dışında bırakılmıştır. Kalan 356 hastaya ait veri kayıt formları incelenmiştir. Ekstübasyon sonrası YANK oksijen tedavisi uygulanan 20 hasta çalışmaya dahil edilmemiştir. Çalışmaya dahil edilen 356 hastanın 216’sı (%60.7) erkek ve ortanca yaş 9 aydır (ÇAA=4-27ay). Hastaların %39.0’ına akut bronşiolit (n=139), %36.2’sine atipik/viral pnömoni (n=129), %26.8’ine bakteriyel pnömoni (n=88) tanısıyla YANK oksijen tedavisi uygulanmıştır. Kırk altı (%12.9) hastada prematür doğum ve 143 (%40.2) hastada tekrarlayan hışıltı atağı öyküsü saptanmıştır. Hastaların %62.9’undan (n=224) solunum virüs PCR paneli çalışılmıştır. Bu hastaların 101’inde (%45.1) tek etken pozitifliği saptanırken 36 hastada ko-enfeksiyon gösterilmiştir. En sık görülen etkenler RSV ve rhinovirüstür. Başvurudan sonra ortanca YANK oksijen başlama süresi 2 saat (ÇAA= 30dk-6 sa) ve median tedavi uygulama süresi 48 saattir (ÇAA=24-96 sa). Tedavi sonrasında hastaların solunum sayısında (SS) belirgin azalma, oksijen saturasyonu (SpO₂) ve SF oranında istatistiksel anlamlı artış saptanmıştır (p&lt;0.001). Otuzyedi (%9.9) hastada tedaviye yanıt alınamamıştır. Median yanıtsızlık süresi 6.5 saattir (ÇAA=3.0-19.5sa). Tedaviye yanıt alınamayan hastalarda, başvuruda SpO₂, S/F oranı ve kan gazında pH daha düşük ve pCO₂’nin daha yüksek olduğu saptanmıştır (p=0.005, p=0.008, p=0.012 ve p=0.039 sırayla). Tedavi komplikasyonu olarak 2 hastada lokal cilt lezyonu ve 2 hastada pnömotoraks izlenmiştir. Yanıtsız hastaların 5’i mortalite ile sonuçlanmıştır. Sonuç : Çalışmamızda YANK oksijen tedavisine yanıtsızlık oranı %9.9 olarak saptanmıştır. Tedaviye yanıt alınamayan hastalarda, başvuruda SpO₂ ve SF oranının, kan gazında pH’nın daha düşük, pCO₂’nin ise yüksek olduğu bulunmuştur. Tedavi başlangıcında bu bulguları olan hastalar daha yakın takip edilmeli ve bir üst tedavi basamağına geçiş acısından dikkatli olunmalıdır.</p

Prevalence and clinical profile of patients with myocardial infarction with non-obstructive coronary arteries in Turkey (MINOCA-TR): A national multi-center, observational study

CETIN, NURULLAH/0000-0002-4158-5469; Tascanov, Mustafa Begenc/0000-0002-9008-6631; Yenercag, Mustafa/0000-0002-0933-7852; OZYASAR, MEHMET/0000-0001-5227-1716WOS:000522763500010PubMed: 32120362Objective: Myocardial infarction (MI) with non-obstructive coronary arteries (MINOCA) is a relatively new term that is characterized by clinical evidence of MI with normal or near-normal coronary arteries on coronary angiography (QCA). To date, there have been no population-based studies on the prevalence of MINOCA in Turkey. The aim of this nationwide study was to document the prevalence and demographics of MINOCA in a Turkish population. Methods: MINOCA-TR is national, multi-center, prospective, all-comer study that was conducted in 32 hospitals. All consecutive patients who were >= 18 years old, diagnosed with MI according to the Third Universal Definition of Myocardial Infarction, and had undergone DCA were included in the study. Patients with stable coronary artery disease, unstable angina pectoris, a history of revascularization, and type 4/5 MI were excluded. Results: A total of 1793 patients who were diagnosed with MI and had undergone QCA were screened between March 2018 and October 2018, of whom 1626 (mean age: 61.5 +/- 12.5 years, 70.7% male) were enrolled from 32 centers. The prevalence of MINOCA was 6.7% (n=109) in the overall study population. Compared with non-MINOCA patients, those with MINOCA were younger, had a higher prevalence of the female gender, and had a history of flu. The percentages of current smokers, ST-segment elevated myocardial infarction patients, and those with a history of hypertension, diabetes mellitus, and hyperlipidemia were significantly lower in MINOCA patients (p<0.05, for all). Also, the median left ventricular ejection fraction as seen on echocardiography and the ratio of Killip Class I status at presentation was significantly higher in MINOCA patients than in non-MINOCA patients (p<0.001). Patients with MINOCA received a preload dose of P2Y12 antagonist before QCA less often than non-MINOCA patients (p<0.001). Conclusion: The prevalence of MINOCA in Turkey is 6.7% in patients who were admitted with MI. Also, as compared to non-MINOCA patients, the MINOCA patients were exposed to fewer traditional risk factors of coronary artery disease