Development And Psychometric Testing Of The Turkish Immunosuppressive Medication Adherence Scale

Objective: The monitoring of immunosuppressive medication adherence is an important issue for solid organ transplant patients. In Turkey, there has been no valid and reliable measurement tool specific to transplantation for evaluation of medication adherence. The aim of this methodological study was to develop and psychometrically test Immunosuppressive Medication Adherence Scale. Materials and Methods: The Immunosuppressive Medication Adherence Scale was developed, and its validity and reliability were examined using data from 200 solid organ transplant patients. An expert panel evaluated the content validity, and factor analysis was used to evaluate the construct validity. Internal consistency analysis was performed to evaluate the reliability of the scale, and item-total correlations were evaluated. Results: As a result of exploratory factor analysis, all 11 items were found to be collected in a single dimension, and factor loadings varied between 0.32 and 0.87. All scale items had a good positive significant correlation with the total scale score. Content validity was evidenced by obtaining the views of 13 experts (0.80 content validity index). Cronbach's a was 0.61. Conclusion: The Immunosuppressive Medication Adherence Scale has acceptable internal consistency, good content, and construct validity. The scale is appropriate for use in clinical practice settings and research to evaluate immunosuppressive medication adherence of solid organ transplant patients.Wo

Experiences of adult extracorporeal membrane oxygenation patients following discharge: A mixed methods study.

Background: Survival and discharge rates after extracorporeal membrane oxygenation are gradually increasing. More research is warranted to investigate extracorporeal membrane oxygenation patients' post-discharge experiences, problems and quality of life. Objective: The aim of this study was to determine adult extracorporeal membrane oxygenation patients' experiences, problems and quality of life following discharge. Methods: A mixed methods research was used. Study sample consisted of 11 adult extracorporeal membrane oxygenation patients discharged at least one month prior to study entry. In-depth interviews were conducted. Participants' quality of life was assessed using the EuroQol 5 Dimension 5 Level questionnaire. Results: Two categories (pre- and post-discharge), 7 themes and 16 sub-themes were developed based on in-depth interviews. According to the EuroQol 5 Dimension 5 Level, participants had high perceptions of health. Conclusion: Extracorporeal membrane oxygenation patients should be provided with comprehensive post-discharge education, exercise programs, social support and regular home visits for post-discharge assessment and follow-up care

Nursing Care Of The Patient With Neurogenic Bladder After Kidney Transplantation: A Case Report

Objective. Urologic complications are among the most common complications after kidney transplantation. These complications are urinary retention, hematuria, hemorrhage, urinary leakage, vesicoureteral reflux, pyelonephritis, and nephrolithiasis. Although neurogenic bladder is one of the indications for kidney transplantation, it is not considered in the literature to be an expected complication after transplantation. In this case, we discuss the nursing care of a patient who underwent kidney transplantation from a living donor and developed neurogenic bladder. Case report. A 60-year-old woman underwent kidney transplantation from a living donor, and neurogenic bladder developed in the patient 1 year after kidney transplantation. Clear intermittent catheterization treatment was administered for the kidney transplant recipient with neurogenic bladder. Clear intermittent catheterization treatment was stopped in the patient who had frequent urinary tract infections and, alternatively, sacral neuromodulation treatment was administered to the patient. Conclusions. The nursing care of a patient with neurogenic bladder after kidney transplantation aims to prevent excessive bladder distension, infection, stone formation, vesicoureteral reflux, renal failure, urinary tract damage, and incontinence, and to ensure regular and complete discharge of the bladder. The most common treatment modalities for these objectives are permanent or intermittent catheterization, sacral neuromodulation, and medical therapy. In the care of the patient with neurogenic bladder after kidney transplantation, nurses should provide appropriate care related to treatment options and bladder training, plan urination schedules of the patient, and monitor for possible complications.WoSScopu