Effects of using a stress ball on anxiety and depression in patients undergoing hemodialysis: A prospective, balanced, single-blind, crossover study

IntroductionUse of a stress ball is a known t non-pharmacological method to distract attention and to relieve stress and anxiety. The goal of our study was to evaluate the effect of stress ball use on anxiety and depression in hemodialysis patients. MethodsThe study utilized a single-blind, balanced crossover design. There were two sequential 4-week intervention periods separated by a 4-day washout period. During one intervention period stress ball use at home was encouraged while the other 4-week "intervention" period served as a control. The order in which the two evaluation periods were applied was randomized for a given patient. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale before and after each 4-week intervention period. FindingsA total of 65 patients participated in this study. There were statistically significant reductions in both anxiety (p < 0.001) and depression (p < 0.001) during the stress ball intervention periods vs. no change during the control interventions. A delayed follow-up evaluation showed that the anxiety level of patients remained reduced after 1 month of no longer using a stress ball. DiscussionThe use of a stress ball at home for 4 weeks significantly decreased anxiety and depression levels in our group of hemodialysis patients

Comparison of Dosage Loss Between Medications Crushed with Two Different Methods by Two Nurses: An In Vitro Study

Objective: Administration of crushed medications can lead to various problems associated with use of inappropriate crushing method, such as administration of an incorrect dosage, alterations in drug bioavailability, and reduction in the effectiveness of the treatment. This experimental study aimed to compare the dosage loss of crushed metoclopramide hydrochloride (MT-HCI) 10-mg tablet using two crushing methods. Methods: MT-HCI 10 mg tablets (n=80) were crushed by two nurses, and each nurse used a pill crusher and a pestle and plastic bag to crush the tablet. Dosage loss was calculated by a specialist pharmacist in a laboratory environment. Results: The dosage loss was 0.515 +/- 0.299 mg (5.16%) with the pestle and self-sealing plastic bag and 0.415 +/- 0.359 mg (4.16%) with the pill crusher. No statistically significant difference was found between the two methods (p>0.05). The mean dosage loss was 0.482 +/- 0.367 mg for the first nurse and 0.449 +/- 0.298 mg for the second nurse. No statistically significant difference was noted in the mean dose between the two nurses (p>0.05). Conclusion: This study found no significant difference between the nurses and die crushing methods, but the mean dosage loss with both methods was not within the limits recommended by the United States Food and Drug Administration

Investigation of the Psychological Resilience of Health Sciences Students in Terms of Some Variables in the COVID-19 Pandemic

Psychological resilience is defined as the ability to recover from difficult life experiences or the ability to effectively deal with changes or disasters. The unexpectedly high rate of COVID-19 disease spread and quarantine policies can escalate stress levels and lead to emotional problems. It is crucial to equip health sciences students with proper knowledge, attitudes and behaviors on COVID-19, as they will serve in the frontlines of the campaign against the pandemic and proper training comes with resilience. This research, which aims to examine the psychological resilience of health sciences faculty students in the Covid-19 pandemic in terms of some variables, was carried out with 426 students studying at the Faculty of Health Sciences of a university located in the southeast region of Turkey. Personal Information Form, Coronavirus Information Form and the Adult Psychological Resilience Scale were used as data collection tools. After the analysis of normality, Student t Test, One way ANOVA ve Multiple Lineer Regresyon analyses were used, the means were given with standard deviations, and p<0.05 was accepted as statistically significant. More than half of the students (55.6%) were female, 93.9% were single and their mean age was 20.65 +/- 2.25 years. The nursing students got the lowest scale score, nutrition and dietetics students; the psychological endurance of singles, unemployed people, and those who constantly wash their hands and clean their surroundings were higher. It was concluded that the pandemic affected the resilience of health sciences faculty students in different ways, and that the resilience of students was above the average

Investigating the Effect of a Structured Intervention on the Development of Self-Care Behaviors With Arteriovenous Fistula in Hemodialysis Patients

This study aimed to assess the effectiveness of a structured intervention on the frequency of self-care behaviors with arteriovenous fistula (AVF) by patients on hemodialysis. This is a quasi-experimental study with pre- and post-measurements. Participants were assigned to an intervention group (IG) (n=48) or to a control group (CG) (n=41). IG patients were subject to a structured intervention on self-care with AVF (SISC-AVF) consisting of both a theoretical and a practical part. After SISC-AVF application, patients in the IG showed better overall self-care behaviors with AVF than patients in the CG (79.2% and 91.4%, respectively, p<.001) as well as better self-care concerning both the management of signs and symptoms (90.1% and 94.4% respectively, p=.004) and the prevention of complications (72.7% and 89.5%, respectively, p<.001). The study results suggest that the SISC-AVF had positive effects on patients in the IG.info:eu-repo/semantics/publishedVersio

Do patients with diabetes use the insulin pen properly?

Aim: This study was conducted to evaluate the insulin pen application knowledge and skills of patients with diabetes. Methods: In our descriptive study, 200 patients with diabetes were asked to present the insulin pen injection technique on a mannequin and the steps of the pen injection implementation were noted on the data collection form as correct/incorrect by researchers. Results: More than 3 out of 4 (79.5%) of the participants were using the insulin pen or the cartridge after the expiry date, 70.5% were not rotating the injection site, and 63.0% were massaging the skin after injection. Injection sites complications were significantly more in those who were using the insulin pen or the cartridge after the expiry date, those who don\u2019t know the proper length of the needle and the possible body injection sites, those who don\u2019t rotate the injection sites, those who massage after injection, and those who don\u2019t use a new needle at each injection (p&lt;0.05). Conclusion: This study put into light some failures in the knowledge and skills of patients with diabetes regarding insulin pen use. Nurses should provide patients with diabetes an effective and repetitive training concerning insulin pen use. DOI: https://dx.doi.org/10.4314/ahs.v19i1.38 Cite as: Tosun B, Cinar FI, Topcu Z, Masatoglu B, Ozen N, Bagcivan G, et al. Do patients with diabetes use the insulin pen properly? Afri Health Sci. 2019;19(1). 1628-1637. https://dx.doi.org/10.4314/ahs.v19i1.3

Hemodialysis vascular access coordinator: Three‐level model for access management

Management of vascular access is a challenge for the dialysis team, particularly tokeep the arteriovenous access working. The vascular access coordinator can posi-tively contribute to increase the number of arteriovenous fistulas and reduce centralvenous catheters. In this article, we introduce a new approach to vascular accessmanagement centered on (the results of setting up) the role of vascular access coor-dinator. We described the three-level model (3Level_M) for vascular access manage-ment organized in three levels: vascular access nurse manager, vascular accesscoordinator, and vascular access consultant. We defined the instrumental skills andtraining required to be developed by each element and clarify the articulationbetween the model and all members of the dialysis team related to vascular access.1|INTRODUCTIONThe implementation and effectiveness of renal replacement therapy(RRT) depend directly on appropriate vascular access, such as arterio-venous fistula (AVF) (best choice), or alternatively a graft or a centralvenous catheter (CVC).1Nowadays, chronic kidney disease (CKD) patients are older, sufferfrom a larger number of comorbidities, and have more complex vascu-lar accesses. Therefore, the dialysis team and patients face new chal-lenges. The complications of the arteriovenous accesses are alreadydocumented and require supervision (monitoring and surveillance) inorder to decide the appropriate time to intervene.1,2Literature shows that the vascular access coordinator canhave an important contribution in the identification ofthese situations and in the implementation of a new approachleading to the best results in clinical care.3–8The vascularaccess coordinator's role can be crucial to improve the planning oftimely interventions free of thrombosis,7,6improve vascular accessoutcomes,3,7decrease the number of grafts and CVCs,5and applya quality policy with the vascular access.6The purpose of thisarticle is to analyze the vascular access coordinator's contribution(to) in the vascular access outcomes and introduce a newapproach on vascular access management, the three-level model(3Level_M).Received: 12 February 2023 Revised: 22 March 2023 Accepted: 26 March 2023DOI: 10.1111/sdi.13153Semin Dial.2023;1–6.wileyonlinelibrary.com/journal/sdi© 2023 Wiley Periodicals LLC.1info:eu-repo/semantics/publishedVersio

The Effect of Aromatherapy with Lavender on Pain of Needle Insertion and Severity of Restless Legs Syndrome in Hemodialysis Patients; a Systematic Review and Meta-analysis

Introduction: Pain experienced during the insertion of a catheter into the arteriovenous fistula (AVF) and restless legs syndrome (RLS) are prevalent issues among Hemodialysis (HD) patients. The primary objective of this systematic review and meta-analysis was to consolidate the findings from randomized clinical trial (RCT) studies examining the impact of aromatherapy with lavender on the pain associated with AVF catheter insertion and RLS in HD patients. Methods: A systematic search was conducted on PubMed, Web of Science, Scopus, Cochrane, Embase, ClinicalTrials.gov, and Google Scholar search engine from inception to August 1, 2022, using keywords extracted from Medical Subject Headings, such as “Aromatherapy”, “Lavender”, “Arteriovenous fistula”, “Pain”, “Restless legs syndrome”, and “Hemodialysis”. Results: Finally, eleven articles were included in this systematic review and meta-analysis. The results showed that aromatherapy reduced the average pain of catheter insertion in AVF compared to the control group (Standard Mean Difference: -1.60, 95% Confidence Interval: -2.32 to -0.87, Z=4.32, I2:90.3%, P<0.001). Also, aromatherapy massage reduced the average severity of RLS compared to the control group, which was statistically significant (Weighted Mean Difference: -13.21, 95% Confidence Interval: -17.50 to -8.91, Z=6.03, I2:93.0%, P<0.001). Also, the subgroup analysis showed that lavender in the intervention group significantly decreased the pain intensity compared to the "no intervention" group (P<0.001), yet it was not significant compared to the placebo group (P=0.12). Conclusion: In summary, the findings indicate a notable reduction in catheter insertion pain in AVF and relief from RLS among HD patients through the use of lavender essential oil. As a result, future research is encouraged to include a comparison of lavender's effects with those of a placebo group

Hematopoietic Cell Transplantation Cures Adenosine Deaminase 2 Deficiency: Report on 30 Patients

PURPOSE: Deficiency of adenosine deaminase 2 (DADA2) is an inherited inborn error of immunity, characterized by autoinflammation (recurrent fever), vasculopathy (livedo racemosa, polyarteritis nodosa, lacunar ischemic strokes, and intracranial hemorrhages), immunodeficiency, lymphoproliferation, immune cytopenias, and bone marrow failure (BMF). Tumor necrosis factor (TNF-α) blockade is the treatment of choice for the vasculopathy, but often fails to reverse refractory cytopenia. We aimed to study the outcome of hematopoietic cell transplantation (HCT) in patients with DADA2. METHODS: We conducted a retrospective study on the outcome of HCT in patients with DADA2. The primary outcome was overall survival (OS). RESULTS: Thirty DADA2 patients from 12 countries received a total of 38 HCTs. The indications for HCT were BMF, immune cytopenia, malignancy, or immunodeficiency. Median age at HCT was 9 years (range: 2-28 years). The conditioning regimens for the final transplants were myeloablative (n = 20), reduced intensity (n = 8), or non-myeloablative (n = 2). Donors were HLA-matched related (n = 4), HLA-matched unrelated (n = 16), HLA-haploidentical (n = 2), or HLA-mismatched unrelated (n = 8). After a median follow-up of 2 years (range: 0.5-16 years), 2-year OS was 97%, and 2-year GvHD-free relapse-free survival was 73%. The hematological and immunological phenotypes resolved, and there were no new vascular events. Plasma ADA2 enzyme activity normalized in 16/17 patients tested. Six patients required more than one HCT. CONCLUSION: HCT was an effective treatment for DADA2, successfully reversing the refractory cytopenia, as well as the vasculopathy and immunodeficiency. CLINICAL IMPLICATIONS: HCT is a definitive cure for DADA2 with > 95% survival

Hematopoietic Cell Transplantation Cures Adenosine Deaminase 2 Deficiency : Report on 30 Patients

Correction; Early Access: ' DOI: 10.1007/s10875-022-01280-y Early Access: APR 2022Purpose Deficiency of adenosine deaminase 2 (DADA2) is an inherited inborn error of immunity, characterized by autoinflammation (recurrent fever), vasculopathy (livedo racemosa, polyarteritis nodosa, lacunar ischemic strokes, and intracranial hemorrhages), immunodeficiency, lymphoproliferation, immune cytopenias, and bone marrow failure (BMF). Tumor necrosis factor (TNF-alpha) blockade is the treatment of choice for the vasculopathy, but often fails to reverse refractory cytopenia. We aimed to study the outcome of hematopoietic cell transplantation (HCT) in patients with DADA2. Methods We conducted a retrospective study on the outcome of HCT in patients with DADA2. The primary outcome was overall survival (OS). Results Thirty DADA2 patients from 12 countries received a total of 38 HCTs. The indications for HCT were BMF, immune cytopenia, malignancy, or immunodeficiency. Median age at HCT was 9 years (range: 2-28 years). The conditioning regimens for the final transplants were myeloablative (n = 20), reduced intensity (n = 8), or non-myeloablative (n = 2). Donors were HLA-matched related (n = 4), HLA-matched unrelated (n = 16), HLA-haploidentical (n = 2), or HLA-mismatched unrelated (n = 8). After a median follow-up of 2 years (range: 0.5-16 years), 2-year OS was 97%, and 2-year GvHD-free relapse-free survival was 73%. The hematological and immunological phenotypes resolved, and there were no new vascular events. Plasma ADA2 enzyme activity normalized in 16/17 patients tested. Six patients required more than one HCT. Conclusion HCT was an effective treatment for DADA2, successfully reversing the refractory cytopenia, as well as the vasculopathy and immunodeficiency. Clinical Implications HCT is a definitive cure for DADA2 with > 95% survival.Peer reviewe

Correction to: Hematopoietic cell transplantation cures adenosine deaminase 2 deficiency: report on 30 patients

Correction to: Journal of Clinical Immunology (2021) 41:1633–164