Cerrahi hastalarında perioperatif basınç yaralanması insidansının ve risk faktörlerinin belirlenmesi: tanımlayıcı, ileriye yönelik ve karşılaştırmalı bir çalışma

Objective: This study aimed to determine the incidence and risk factors of perioperative pressure injury (PI) in surgical patients. Material and Methods: This descriptive, prospective, and comparative study was conducted with 101 patients who underwent general surgery in a training and research hospital in İstanbul between September 2018 and June 2019. Data were collected using the “Patient Data Form,” the “Braden Scale,” and the “International Pressure Injury Classification System.” Data were analyzed with parametric and nonparametric tests using the SPSS package program. The statistical significance level was taken as p<0.05. The necessary institutional and ethics committee permission was obtained to conduct the study. Results: In this study, it was observed that the incidence of perioperative PI was 12.9% (13/101) in surgical patients, and most developed after pancreaticoduodenectomy (38.5%). Preoperative hemoglobin and serum albumin levels, surgical time longer than 185 minutes, and intraoperative hypotensive episodes were found to be determinant risk factors in the development of PI (p<0.01). Conclusion: Surgical nurses should carefully evaluate individual and surgery-related risk factors and implement evidence-based interventions in the prevention of pressure injuries.Amaç: Bu çalışmanın amacı, cerrahi hastalarında perioperatif basınç yaralanması insidansını ve risk faktörlerini belirlemektir. Gereç ve Yöntemler: Bu tanımlayıcı prospektif ve karşılaştırmalı çalışma, Eylül 2018-Haziran 2019 tarihleri arasında İstanbul’da bir eğitim ve araştırma hastanesinde genel cerrahi uygulanan 101 hasta ile gerçekleştirildi. Veriler “Hasta Veri Formu,” “Braden Ölçeği” ve “Uluslararası Basınç Yaralanması Sınıflandırma Sistemi” kullanılarak toplandı. Veriler, SPSS paket programı kullanılarak parametrik ve parametrik olmayan testler ile değerlendirildi. İstatistiksel anlamlılık düzeyi p<0,05 olarak alındı. Araştırmanın gerçekleştirilebilmesi için gerekli kurum ve etik kurul izinleri alındı. Bulgular: Bu çalışmada, cerrahi hastalarında perioperatif basınç yaralanması insidansının %12,9 (13/101) olduğu ve en çok pankreatikoduodenektomi sonrası (%38,5) geliştiği görüldü. Perioperatif basınç yaralanması gelişiminde belirleyici risk faktörlerinin; ameliyat öncesi hemoglobin ve serum albumin düzeyleri, ameliyat süresi (≥185 dk) ve intraoperatif hipotansif atakların olduğu belirlendi (p<0,01). Sonuç: Cerrahi hemşireleri, perioperatif basınç yaralanmalarının önlenmesinde bireysel ve cerrahi ile ilişkili risk faktörleri dikkatli bir şekilde değerlendirmeli ve kanıta dayalı girişimleri uygulamalıdır

Analysis of mental health symptoms and insomnia levels of intensive care nurses during the COVID-19 pandemic with a structural equation model

Background: Faced with this critical situation and directly involved in the treatment and care of COVID-19 patients, front-line healthcare workers are at high risk in terms of mental health symptoms. Aims and Objectives: To determine the stress, anxiety, depression, and insomnia levels of intensive care nurses during the pandemic with a structural equation model. Design: A multi-site survey study. Methods: The study was performed with 194 nurses working in the intensive care units of five hospitals in Istanbul in July 2020. Data were collected using the Depression Anxiety Stress-21 Scale and Insomnia Severity Index electronically. The data were evaluated with descriptive statistics in SPSS package program. In order to test the structural model and hypotheses of the research, path analysis was performed with LISREL statistical software program. A validation study for the suitability of these scales to the study sample was done by the researchers using the confirmatory factor analysis method. The study conforms to the TREND checklist. Results: In this study, the majority of the intensive care nurses had moderate to extremely severe depression (65.5%), anxiety (58.3%) and stress (72.3%) scores; in addition, 39.7% of the nurses experienced moderate or severe insomnia. Within the framework of a structural model; the effects of stress, anxiety and insomnia on depression, which is the dependent variable, were found to be statistically significant (p <.001). Conclusions: It was found that the majority of the intensive care nurses fighting COVID-19 on the front-line experienced stress, anxiety, depression and insomnia at levels ranging from moderate to extremely severe; in addition, it was determined that there is a positive relationship between stress, anxiety, insomnia and depression. Relevance to clinical practice: This study, in which we have determined the mental health symptoms and insomnia levels of intensive care nurses, who are in the front-line during the COVID-19 pandemic, constitutes the scientific basis for the effective coping strategies that the authorities will take in this subject