İkiz bebek bekleyen gebelere verilen emzirme eğitiminin emzirme niyetlerine etkisi

06.03.2018 tarihli ve 30352 sayılı Resmi Gazetede yayımlanan “Yükseköğretim Kanunu İle Bazı Kanun Ve Kanun Hükmünde Kararnamelerde Değişiklik Yapılması Hakkında Kanun” ile 18.06.2018 tarihli “Lisansüstü Tezlerin Elektronik Ortamda Toplanması, Düzenlenmesi ve Erişime Açılmasına İlişkin Yönerge” gereğince tam metin erişime açılmıştır.GİRİŞ VE AMAÇ: İkiz bebeklerde başarılı bir şekilde emzirmenin gerçekleştirilmesini sağlayan en önemli faktörlerden biri de annenin emzirme niyetidir. Bu çalışma "İkiz Bebek Bekleyen Gebelerde Emzirme Niyet Ölçeği"nin geliştirilmesi, geçerlik güvenirliğinin test edilmesi ve antenatal dönemde verilen emzirme eğitiminin ikiz bebek bekleyen gebelerin emzirme niyeti üzerine etkisinin belirlenmesi amacıyla yapılmıştır. GEREÇ VE YÖNTEM: Metodolojik ve deneysel olarak planlanan araştırma, Sakarya ilinde bir eğitim ve araştırma hastanesinde Haziran 2016-Aralık 2017 tarihleri arasında yapılmıştır. Çalışmanın örneklemini ölçek geliştirme aşamasında 105, çalışma grubunda 38 ikiz bebek bekleyen gebe oluşturmuştur. Ölçek geliştirme aşamasında veriler Tanıtıcı Bilgi Formu-I ve geliştirilen ölçek taslağı, çalışma grubunda Tanıtıcı Bilgi Formu-II ve "İkiz Bebek Bekleyen Gebelerde Emzirme Niyet Ölçeği" kullanılarak toplanmıştır. Çalışma grubundaki gebelere görsel eğitim araçları kullanılarak birebir emzirme eğitimi verilmiştir. Veriler IBM SPSS Statistics 23 ve IBM SPSS AMOS 23 programına aktarılarak açımlayıcı ve doğrulayıcı faktör analizi, iç tutarlılık katsayısı, test-tekrar test yöntemi, yüzdelik, ortalama, bağımsız t testi, bağımlı örneklem t testi, ANOVA analizleri kullanılarak değerlendirilmiştir. BULGULAR: Gebelerin yaş ortalaması 29,84±5,63 (min:20 max:42)'tür. Ölçeğin yapı geçerliliğinde; Kaiser-Meyer-Olkin değerinin 0,817 ve ölçeğin faktör analizi için uygunluğunu gösteren Barlett's Testinin anlamlı olduğu bulunmuştur (p<0.01). Ölçeğin 7 madde ve tek faktörden oluştuğu belirlenmiştir. Ölçeğin doğrulayıcı faktör analizi modeline ilişkin uyum indeks değerleri χ2/df=2,153, GFI=0,927, IFI=0,927, CFI=0,925, SRMR=0,058 ve Cronbach alfa katsayısı 0,82 olarak saptanmıştır. Antenatal dönemde verilen emzirme eğitimin ikiz bebek bekleyen gebelerin emzirme niyeti üzerine etkili olduğu belirlenmiştir (p<0,05). SONUÇ: Çalışma, geliştirilen ölçeğin geçerli ve güvenilir bir ölçüm aracı olduğunu göstermiştir. İkiz bebek bekleyen gebelere verilen emzirme eğitiminin emzirme niyetlerine etkili olduğu bulunmuştur.INTRODUCTION AND AIM: Breastfeeding intent of mother is one of the most important factors which ensure a successful breastfeeding for twin babies. This study was performed to develop and test the validity and reliability of ''Breastfeeding Intent Scale in Twin Expecting Pregnancy'' and to determine the effect of breastfeeding education provided at the antenatal period on breastfeeding intent of pregnant women who expect twins. MATERIAL AND METHOD: The research which was planned methodologically and experimentally was carried out at a training and research hospital in Sakarya Province of Turkey between June 2016 and December 2017. 105 pregnant women who expect twins constituted the sample of research at the scale-developing stage and 38 pregnant women who expect twins constituted the sample of research for the working group. At the scale-developing stage, data was collected by using Introductory Information Form-I and developed scale draft and in the working group, by using Introductory Information Form-II and ''Breastfeeding Intent Scale in Twin Expecting Pregnancy''. Pregnant women in the working group received one-to-one breastfeeding training by using visual teaching materials. Data was evaluated via IBM SPSS Statistics 23 and IBM SPSS AMOS 23 programs by using exploratory and confirmatory factor analyses, internal consistency coefficient, test- retest method, percentile method, average method, unpaired t test, paired sample t test and ANOVA analyses. RESULTS: The average age of the pregnant women is 29,84±5,63 (min:20 max:42). It is found that Kaiser-Meyer-Olkin value for the construct validity of scale is 0,817 and Barlett's Test which demonstrates the suitability of the scale for factor analysis is meaningful (p<0.01). It is determined that scale consists of 7 clauses and sole factor. Fit index values of scale concerning confirmatory factor analysis model are detected as χ2/df=2,153, GFI=0,927, IFI=0,927, CFI=0,925 and SRMR=0,058 and Cronbach alpha internal consistency reliability coefficient is detected as 0.82. It is determined that breastfeeding education provided at the antenatal period has an effect upon breastfeeding intent of pregnant women who expect twins (p<0,05). CONCLUSION: This study demonstrates that the scale developed for this study is a valid and reliable measurement instrument. In addition to this, it is determined that breastfeeding education provided to pregnant women who expect twins affects their breastfeeding intents

Impact of training giving to peadiatric nurses by interactive workshops against to problems during lactation period

Aim:  The study has been conducted in order to determine the impact of training which giving to peadiatric nurses by interactive workshops against to problems during lactation period.Methods:  This study, which is an experimental type in which pre-test/ post-test measurements were taken, was carried out in a state hospital in Samsun in October 2014. Before the training, the nurses accepted the presentation invitation. Evaluation of participants’ knowledge on the subject was performed via a Multiple Choice Questionnaire (MCQ) prepared by the researchers in relation with the literature. The study was conducted by 33 volunteer nurses working in the pediatric departments of a state hospital in the conference hall. MCQ, consisting of 24 questions, was answered by the participants before and after the interactive workshop. Analyses were performed using commercial software (IBM SPSS Statistics 20, SPSS Inc. An IBM Corp., Armonk, NY)Findings:  Nurses (n= 33) who work in pediatric units participated in the study. The  average age of nurses who participated to study is  36.30 ± 6.47 (min=21 max=48).  There was a significant improvement in mean test score after the lecture when compared with pre-lecture score (Mean =23.66, SD=0.54 vs. Mean=12.24, SD=4.11, z= -5.021 p = 0.000)Conclusions: Lecture based interactive workshop on the problems faced during lactation period helps to improve nurses’ knowledge. It also helps in overcoming deficiencies in nurses training

First-line treatment of patients with HER2-positive metastatic gastric and gastroesophageal junction cancer

Fluoropyrimidine+cisplatin/oxaliplatin+trastuzumab therapy is recommended for the first-line treatment of HER2-positive metastatic gastric adenocarcinoma. However, there is no comprehensive study on which platinum-based treatment should be preferred. This study aimed to compare the treatment response and survival characteristics of patients with HER2-positive metastatic gastric or gastroesophageal junction (GEJ) cancer who received fluorouracil, oxaliplatin, and leucovorin (mFOLFOX)+trastuzumab or cisplatin and fluorouracil (CF)+trastuzumab as first-line therapy. It was a multicenter, retrospective study of the Turkish Oncology Group, which included 243 patients from 21 oncology centers. There were 113 patients in the mFOLFOX+trastuzumab arm and 130 patients in the CF+trastuzumab arm. The median age was 62 years in the mFOLFOX+trastuzumab arm and 61 years in the CF+trastuzumab arm (P = 0.495). 81.4% of patients in the mFOLFOX+trastuzumab arm and 83.1% in the CF+trastuzumab arm had gastric tumor localization (P = 0.735). The median progression-free survival (PFS) was significantly higher in the mFOLFOX+trastuzumab arm (9.4 months vs. 7.3 months, P = 0.024). The median overall survival (OS) was similar in both groups (18.4 months vs. 15.1 months, P = 0.640). Maintenance trastuzumab was continued after chemotherapy in 101 patients. In this subgroup, the median OS was 23.3 months and the median PFS was 13.3 months. In conclusion, mFOLFOX+trastuzumab is similar to CF+trastuzumab in terms of the median OS, but it is more effective in terms of the median PFS in the first-line treatment of HER2-positive metastatic gastric and GEJ cancer. The choice of treatment should be made by considering the prominent toxicity findings of the chemotherapy regimens

Relación entre la adicción a los videojuegos y la disfunción vesical o intestinal en niños

Introduction. Video games have a strong influence on children and adolescents. Video game addiction has negative effects on children’s health.Objective. To determine the relationship between video game addiction and bladder/bowel dysfunction in children.Materials and methods. Three hundred sixty-three children and their mothers who met the inclusion criteria constituted the sample of this correlational study. The data were collected using a descriptive information form, the Video Game Addiction Scale for Children, and the Childhood Bladder and Bowel Dysfunction Questionnaire.Results. We found that 72.5% of the children were nine years old and 27.5% were ten years old; 50.4% were males and 49.6% were female. While 4.7% of the children whoparticipated in the study were underweight, 19.6% were overweight, and 17.9% were obese. The mean Video Game Addiction Scale for Children score was 50.77 ± 16.17,whereas the mean Childhood Bladder and Bowel Dysfunction Questionnaire score was 29.98 ± 8.90. The ratio of children with a mean Video Game Addiction Scale for Children scores equal to or greater than 90 was 0.8% (n = 3). We found that 3.6% (n = 13) of the children had urinary/fecal incontinence while playing video games. There was a weak positive relationship between the dimensions of the Video Game Addiction Scale for Children scores, the Childhood Bladder and Bowel Dysfunction Questionnaire scores, and children’s bladder and bowel function (r = 0.220; p ˂ 0.05).Conclusions. There is a correlation between children’s video game addiction level and their bladder and bowel dysfunction grade. Higher video game addiction levels correspond to higher bladder and bowel dysfunction.Introducción. Los videojuegos tienen una fuerte influencia en los niños y adolescentes. La adicción a ellos tiene efectos perjudiciales para la salud de los niños.Objetivo. Determinar la relación entre la adicción a los videojuegos y la disfunción vesical o intestinal en niños.Materiales y métodos. Los 373 niños y sus madres que cumplieron con los criterios de inclusión constituyeron la muestra de este estudio descriptivo y correlacional. Los datos se recopilaron mediante un formulario de información descriptiva, la Video Game Addiction Scale for Children y el Childhood Bladder and Bowel Dysfunction Questionnaire.Resultados. El 72,5 % de los niños tenía nueve años y, el 27,5 %, diez; el 50,4 % eran hombres y el 49,6 %, mujeres. El 4,7 % de los estudiantes que participaron en el estudio tenían bajo peso, el 19,6 % presentaba sobrepeso y el 17,9 % tenía obesidad. Se constató que las puntuaciones medias de las escalas fueron 50,77 ± 16,17 para la Video Game Addiction Scale for Children y 29,98 ± 8,90 para el Childhood Bladder and Bowel Dysfunction Questionnaire. La proporción de niños con una puntuación de 90 o superior en la dicha escala fue del 0,8 % (n = 3). Se encontró que el 3,6 % (n = 13) de los niños tenía incontinencia urinario-fecal mientras jugaba videojuegos. Se reveló que había una correlación positiva débil entre las dimensiones de las dos escalas evaluadas, y la función de la vejiga y el intestino (p ˂ 0,05).Conclusiones. El grado de adicción a los videojuegos de los niños está correlacionado con su grado de disfunción vesical o intestinal: entre mayor sea la adicción, mayor es la disfunción

Mothers' Attitudes Toward Feeding Twin Babies in the First Six Months of Life: A Sample From Sakarya, Turkey

Conclusions: It was found that the number of twin babies who were only breastfed in the first six months of life was low. According to the literature, a mother's breast milk is sufficient for multiple babies. Mothers expecting twin babies should be informed about the benefits of breastfeeding and be encouraged to breastfeed. They should also receive training on this subject

Efecto de las preocupaciones maternas sobre el parto y el puerperio en las conductas obsesivas y compulsivas relacionadas con el cuidado del bebé

Introduction. Postpartum anxiety after childbirth is a common condition among pregnant women due to reasons such as the uncertainty of experiencing pregnancy and childbirth for the first time, or previous negative experiences. Fear of childbirth can affect the mother’s baby care process.Objective. This study was conducted analytically with a single-subject design to determine the effects of maternal concerns about childbirth and the postpartum period on obsessive and compulsive behaviors related to baby care.Materials and methods. The study was conducted with 260 mothers. Data were collected using a descriptive information form, and the scales ‘Fear of Childbirth and Postpartum Period’, and ‘Obsessive and Compulsive Behaviors of Mothers in the Postpartum Period Related to Baby Care’. The data were analyzed using the SPSS™ software to calculate percentages, mean values, t tests, ANOVA, Pearson’s correlation, and simple linear regression analysis.Results. A statistically significant and positive correlation was found between participant scores of the ‘Fear of Childbirth and Postpartum Period’ and the ‘Obsessive and Compulsive Behaviors of Mothers in the Postpartum Period Related to Baby Care’ scales (p &lt; 0.01). The regression model showed that 18.0% of the total variance in the obsessive and compulsive behaviors of mothers in the postpartum was explained by the fear of childbirth and the postpartum period (corrected R2 = 0.180).Conclusions. Fear of childbirth and the postpartum period were moderate. However, as the fear of women regarding childbirth and the postpartum period increased, theirpostpartum obsessive and compulsive behaviors about baby care also increased.Introducción. La ansiedad del parto y el posparto es una condición común entre las mujeres embarazadas por la incertidumbre de vivir el embarazo y el parto por primera vez o por previas experiencias negativas. El miedo al parto puede afectar el proceso del cuidado del bebé de la madre.Objetivo. Determinar el efecto de las preocupaciones maternas sobre el parto y el puerperio y su efecto sobre las conductas obsesivas y compulsivas relacionadas con el cuidado del bebé. Materiales y métodos. El estudio se realizó con 260 madres. Los datos fueron recolectados en el formulario de información descriptiva y se usaron la “Escala de miedo al parto y al período posparto” y la de “Comportamientos obsesivos y compulsivos de las madres en el período posparto relacionados con el cuidado del bebé”. Los datos fueron evaluados mediante el software SPSS™ mediante el cálculo de porcentajes, promedio, prueba t, ANOVA, correlación de Pearson y análisis de regresión múltiple.Resultados. Se encontró una correlación positiva y estadísticamente significativa entre la “Escala de miedo al parto y del período posparto” y la de “Comportamientos obsesivos y compulsivos de las madres en el período posparto relacionadas con el cuidado del bebé” (p &lt; 0.01). En el modelo creado por análisis de regresión se observó que el 18,0% del cambio en la escala de comportamientos obsesivos-compulsivos estaba explicado por el miedo al parto y al puerperio (R2 corregido = 0,180).Conclusiones. En el estudio se determinó que el miedo al parto y al puerperio era moderado. Sin embargo, a medida que aumentaba el puntaje de miedo al parto y al período posparto, también aumentaban los comportamientos obsesivos y compulsivos de las madres en el puerperio relacionados con el cuidado del bebé

Mothers' Knowledge and Attitudes about HPV Vaccination to Prevent Cervical Cancers

Background: Cervical cancer which is one of the most preventable cancers is an important public health problem worldwide, and especially in developing countries. The aim of this study was to determine knowledge and attitudes about the HPV vaccination of mothers with 0- to 18-year old children. Materials and Methods: Written approval was taken from the local authorities. The study subjects consisted of 799 mothers who agreed to participate. The data were collected via a " Personal Information Form" which included 30 questions that were prepared by the researchers themselves in line with the literature. The data were collected by face to face interviews with the mothers. Analyses were performed using commercial software. Results: The mean age of the mothers who participated in the study was 32.0 +/- 6.52, and 88.1% reported no information about HPV, and 83.5% no information about HPV vaccination. Only 0.7% of the mothers had daughters who had HPV vaccination, and 44.3% of the mothers who had sons were found out to be indecisive about having HPV vaccination. There was a significant corelation between the educational status of the mothers and their knowledge about HPV vaccination (p0.05). Conclusions: This study suggested that mothers had very little information on HPV and HPV vaccination. Knowledge of the disease and its vaccination is an essential factor for the success of the vaccination program. It is of great importance that mothers are trained in this subject by health professionals

Predictive Value of Obstetrical Doppler Parameters to Predict Oxidative Stress and Cord Blood PH in Newborn Infants

OBJECTIVE: We sought to determine the clinical value of obstetrical Doppler performed at early stages of active labor in predicting oxidative stress and cord blood pH in neonates. STUDY DESIGN: A total of 54 pregnant women with oligohydramnios who were in active labor were enrolled for the study. Active labor was confirmed for each woman according to uterine contraction frequency, cervical dilatation and effacement. Subjects with amniotic fluid index (AFI) lower than 80 mm were included in the study. Doppler assessment included uterine artery (UtA), umbilical artery (UmA) and middle cerebral artery (MCA) measurements. Umbilical cord lengths were measured after delivery. Cord blood gamma glutamyl transferase (GGT) levels and umbilical arterial blood pH were analyzed. RESULTS: Umbilical artery PI significantly predicted cord blood GGT levels >101 ıu/L (area under curve=0.690, P=0.018). Umbilical artery PI significantly predicted cord blood pH<7.21 (area under curve (AUC) =0.870, P=0.015). None of the MCA Doppler parameters were significantly correlated with cord blood pH or cord blood GGT (P>0.05). Also, MCA Doppler studies could not significantly predict cord blood pH<7.21 OR GGT>101(P>0.05). CONCLUSION: This data led us to conclude that UmA Doppler parameters at early periods of active labor in high-risk population may be predictive for newborn well-being

Obstetrik Doppler parametlerinin yenidoğanda oksidatif stres ve Kord pHsını öngörmedeki değeri

AMAÇ: Aktif doğum eyleminin erken döneminde obsterik Dopplerin oksidatif stres ve yenidoğan kord kanı pH sını öngörmedeki değerini tanımlamayı amaçladık. GEREÇ VE YÖNTEM: Çalışmaya aktif doğum eyleminde oligohidramniozu olan 54 hasta dahil edildi. Aktif doğum eylemi her hasta için uterin kontraksiyon, servikal dilatasyon ve efasman ile doğrulandı. Amniotik sıvı indeksi (AFİ) 80 mm altında olan hastalar dahil edildi. Doppler değerlendirmesi umbilikal arter, uterin arter ve orta serebral arter parametrelerini içermekteydi. Umbilikal kord uzunluğu doğumdan sonra ölçüldü. Kord kanı gama glutamil transferaz (GGT) düzeyi ve umbilikal arter PH düzeyi ölçüldü. BULGULAR: Umbilikal arter PI değeri, kord kanı GGT 101ıu/L düzeyini anlamlı olarak öngörmekteydi (AUC0,690, p0,018). Umbilikal arter PI değeri, kord kanı pH7,21 değerini anlamlı olarak öngörmekteydi (AUC0,870, p0,015). MCA doppler parametrelerinden hiçbiri ne kord kanı ne de pH değeri ile anlamlı korele idi (p0,05). Ayrıca MCA Doppler çalımaları kord kanı pH7,21 veya GGT101 değerini öngörmüyordu (p0,05). SONUÇ: Bu veriler aktif doğum eyleminin erken dönemindeki yüksek riskli hastalarda umbilikal arter Doppler parametrelerinin yenidoğan iyilik halini değerlendirmede öngörücü olabileceğini göstermektedir.OBJECTIVE: We sought to determine the clinical value of obstetrical Doppler performed at early stages of active labor in predicting oxidative stress and cord blood pH in neonates. STUDY DESIGN: A total of 54 pregnant women with oligohydramnios who were in active labor were en- rolled for the study. Active labor was confirmed for each woman according to uterine contraction fre- quency, cervical dilatation and effacement. Subjects with amniotic fluid index (AFI) lower than 80 mm were included in the study. Doppler assessment included uterine artery (UtA), umbilical artery (UmA) and middle cerebral artery (MCA) measurements. Umbilical cord lengths were measured after delivery. Cord blood gamma glutamyl transferase (GGT) levels and umbilical arterial blood pH were analyzed. RESULTS: Umbilical artery PI significantly predicted cord blood GGT levels >101 ıu/L (area under curve0.690, P0.018). Umbilical artery PI significantly predicted cord blood pH0.05). Also, MCA Doppler studies could not significantly predict cord blood pH101(P>0.05). CONCLUSION: This data led us to conclude that UmA Doppler parameters at early periods of active labor in high-risk population may be predictive for newborn well-being