Palliative Care and Death Anxiety

Diminishing treatment alternatives, losing hope for a possible recovery, insufficient control of pain and inability to provide the necessary technical support lead palliative care to bring multiple problems with itself. Along with technical and professional challenges, palliative care can put a humanitarian strain on the nurse. Caring for a dying patient is a worrisome experience which causes spiritual pain. An increase in nurses’ death anxiety may cause unwillingness to be together with a dying patient. In terms of the end of life, it is expected that the nurse stands by patient’s family to help them in sustaining their psychosocial wellness. In order to meet this expectation, nurses should get a qualitative training for end of life care along with good interpersonal communication skills and coping strategies

Posttraumatski rast kod majki novorođenčadi primljene u neonatalnu jedinicu intenzivnog liječenja

This descriptive and cross-sectional study investigated social support and posttraumatic growth in 210 mothers whose newborns were hospitalized at neonatal intensive care unit. The study population consisted of all mothers living in the Niğde provincial center whose babies were admitted to the Level 1 Neonatal Intensive Care Unit between December 2007 and November 2008. The Posttraumatic Growth Inventory, the Impact of Event Scale and the Multidimensional Scale of Perceived Social Support were administered in the mothers’ homes. Posttraumatic growth was reported in 75.70% (n=210) mothers. The impact of event and perceived social support were highly (97.40%) predictive of posttraumatic growth. Traumatic events are frequently experienced within the healthcare system. Current research fi ndings are therefore extremely valuable for preventing the negative impact of traumatic events on individuals and for transforming the experience into an opportunity for growth.Ova deskriptivna poprečna studija ispitivala je društvenu potporu i posttraumatski rast u 210 majki čija je novorođenčad hospitalizirana u neonatalnoj jedinici intenzivnog liječenja. Ispitivana populacija obuhvatila je sve majke koje žive u pokrajini Niğde, a čija je novorođenčad primljena na 1. razinu neonatalne jedinice intenzivnog liječenja u razdoblju od prosinca 2007. do studenoga 2008. godine. Majkama su kući dostavljeni upitnici Posttraumatic Growth Inventory, Impact of Event Scale i Multidimensional Scale of Perceived Social Support. Posttraumatski rast je opisalo 75,70% od 210 majki. Utjecaj događaja i doživljena društvena potpora u visokoj su mjeri (97,40%) pretkazivali posttraumatski rast. Kako se traumatski događaji često doživljavaju unutar zdravstvenog sustava, nalazi dobiveni ovim istraživanjem veoma su vrijedni za sprječavanje negativnog utjecaja traumatskih događaja na pojedinca te za pretvaranje takvog iskustva u priliku za rast

The Effect of High Dose Melatonin on Cardiac Ischemia-reperfusion Injury

Purpose: Melatonin, the most potent scavenger of toxic free radicals, has been found to be effective in protecting against pathological states due to the release of reactive oxygen species. This study was performed to establish the effect of high dose melatonin on protection against ischemia-reperfusion (I/R) injury in rat hearts. Materials and Methods: Forty male Sprague-Dawley rats were used in this study. They were separated into four groups of ten rats each. A left coronary artery occlusion was induced in the rats by ligating the artery for 20 minutes and then releasing the ligation (reperfusion) afterwards. The control group was Group A. Group B was subjected to myocardial ischemia-reperfusion without any treatment, while Group C underwent myocardial ischemia-reperfusion with a melatonin treatment before the ischemia. Group D was subjected to myocardial ischemia-reperfusion with a melatonin treatment before the reperfusion. After 20 minutes of reperfusion, blood samples were obtained from each group for biochemical studies, and the animals were sacrificed for histological and, immunohistochemical examinations of the myocardial tissue. Results: We found that the cardiac troponin T(cTn-T) levels were significantly increased in Group B when all groups were compared. In the Group C rats treated with melatonin, the cTn-T values were significantly lower than those in Groups B and D. In addition, malondialdehyde (MDA) and antioxidant enzymes including, superoxide dismutase (SOD) and myeloperoxidase (MPO) were lower than those in Group B in the melatonin treated groups. The differences were statistically significant (p < 0.05). Histopathologic and immunohistopathologic studies also supported the effectiveness of melatonin. Conclusion: Our study suggests that high dose melatonin, appears to offer protection against cardiac ischemia-reperfusion injuries in rats by scavenging the free radicals and could have a potential clinical use in the management of myocardial ischemia.PURPOSE:Melatonin, the most potent scavenger of toxic free radicals, has been found to be effective in protecting against pathological states due to the release of reactive oxygen species. This study was performed to establish the effect of high dose melatonin on protection against ischemia- reperfusion (I/R) injury in rat hearts.MATERIALS AND METHODS:Forty male Sprague-Dawley rats were used in this study. They were separated into four groups of ten rats each. A left coronary artery occlusion was induced in the rats by ligating the artery for 20 minutes and then releasing the ligation (reperfusion) afterwards. The control group was Group A. Group B was subjected to myocardial ischemia-reperfusion without any treatment, while Group C underwent myocardial ischemia-reperfusion with a melatonin treatment before the ischemia. Group D was subjected to myocardial ischemia-reperfusion with a melatonin treatment before the reperfusion. After 20 minutes of reperfusion, blood samples were obtained from each group for biochemical studies, and the animals were sacrificed for histological and, immunohistochemical examinations of the myocardial tissue.RESULTS:We found that the cardiac troponin T(cTn-T) levels were significantly increased in Group B when all groups were compared. In the Group C rats treated with melatonin, the cTn-T values were significantly lower than those in Groups B and D. In addition, malondialdehyde (MDA) and antioxidant enzymes including, superoxide dismutase (SOD) and myeloperoxidase (MPO) were lower than those in Group B in the melatonin treated groups. The differences were statistically significant (p < 0.05). Histopathologic and immunohistopathologic studies also supported the effectiveness of melatonin.CONCLUSION:Our study suggests that high dose melatonin, appears to offer protection against cardiac ischemia-reperfusion injuries in rats by scavenging the free radicals and could have a potential clinical use in the management of myocardial ischemia

The Effect of High Dose Melatonin on Cardiac Ischemia-reperfusion Injury

Purpose: Melatonin, the most potent scavenger of toxic free radicals, has been found to be effective in protecting against pathological states due to the release of reactive oxygen species. This study was performed to establish the effect of high dose melatonin on protection against ischemia-reperfusion (I/R) injury in rat hearts. Materials and Methods: Forty male Sprague-Dawley rats were used in this study. They were separated into four groups of ten rats each. A left coronary artery occlusion was induced in the rats by ligating the artery for 20 minutes and then releasing the ligation (reperfusion) afterwards. The control group was Group A. Group B was subjected to myocardial ischemia-reperfusion without any treatment, while Group C underwent myocardial ischemia-reperfusion with a melatonin treatment before the ischemia. Group D was subjected to myocardial ischemia-reperfusion with a melatonin treatment before the reperfusion. After 20 minutes of reperfusion, blood samples were obtained from each group for biochemical studies, and the animals were sacrificed for histological and, immunohistochemical examinations of the myocardial tissue. Results: We found that the cardiac troponin T(cTn-T) levels were significantly increased in Group B when all groups were compared. In the Group C rats treated with melatonin, the cTn-T values were significantly lower than those in Groups B and D. In addition, malondialdehyde (MDA) and antioxidant enzymes including, superoxide dismutase (SOD) and myeloperoxidase (MPO) were lower than those in Group B in the melatonin treated groups. The differences were statistically significant (p < 0.05). Histopathologic and immunohistopathologic studies also supported the effectiveness of melatonin. Conclusion: Our study suggests that high dose melatonin, appears to offer protection against cardiac ischemia-reperfusion injuries in rats by scavenging the free radicals and could have a potential clinical use in the management of myocardial ischemia.PURPOSE:Melatonin, the most potent scavenger of toxic free radicals, has been found to be effective in protecting against pathological states due to the release of reactive oxygen species. This study was performed to establish the effect of high dose melatonin on protection against ischemia- reperfusion (I/R) injury in rat hearts.MATERIALS AND METHODS:Forty male Sprague-Dawley rats were used in this study. They were separated into four groups of ten rats each. A left coronary artery occlusion was induced in the rats by ligating the artery for 20 minutes and then releasing the ligation (reperfusion) afterwards. The control group was Group A. Group B was subjected to myocardial ischemia-reperfusion without any treatment, while Group C underwent myocardial ischemia-reperfusion with a melatonin treatment before the ischemia. Group D was subjected to myocardial ischemia-reperfusion with a melatonin treatment before the reperfusion. After 20 minutes of reperfusion, blood samples were obtained from each group for biochemical studies, and the animals were sacrificed for histological and, immunohistochemical examinations of the myocardial tissue.RESULTS:We found that the cardiac troponin T(cTn-T) levels were significantly increased in Group B when all groups were compared. In the Group C rats treated with melatonin, the cTn-T values were significantly lower than those in Groups B and D. In addition, malondialdehyde (MDA) and antioxidant enzymes including, superoxide dismutase (SOD) and myeloperoxidase (MPO) were lower than those in Group B in the melatonin treated groups. The differences were statistically significant (p < 0.05). Histopathologic and immunohistopathologic studies also supported the effectiveness of melatonin.CONCLUSION:Our study suggests that high dose melatonin, appears to offer protection against cardiac ischemia-reperfusion injuries in rats by scavenging the free radicals and could have a potential clinical use in the management of myocardial ischemia

Sex estimation in a contemporary Turkish population based on CT scans of the calcaneus

Building a reliable biological profile from decomposed remains depends heavily on the accurate estimation of sex. A variety of methods based on every single skeletal element have been developed over the years for different populations employing both osteological and virtual methods. The latter seem to be a reasonable alternative in countries lacking osteological reference collections. The current study used 3D virtual models of calcanei from CT scans of living adults to develop a sex estimation method for contemporary Turkish. Four hundred and twenty eight calcanei CT scans were analysed. The sample was divided in two subsamples: an original (N = 348) and a validation sample (N = 80) with similar distribution of males and females. Nine classical measurements were taken using the 3D models of the calcanei and two different statistical methods (Discriminant function analysis and Binary logistic regression) were used. Classification accuracy ranged from 82% to 98% for the validation sample and it was consistently high using any of the two methods. Sex bias seems to be lower for most of the logistic regression equations compared to the discriminant functions. These results, however, need further testing to be verified. Based on the results of this study we recommend the use of both methods for sex estimation from the measurements of the calcaneus bone in a Turkish population. (C) 2017 Elsevier B.V. All rights reserved

Posttraumatic growth in women after a childbirth experience: The influence of individual characteristics and intrusive and deliberate rumination.

Objective: This study targets women who had a self-defined traumatic childbirth experience to (a) explore the differences between sociodemographic-, obstetric-, and trauma-related variables in relation to the rumination style; (b) determine differences between intrusive and deliberate rumination in relation to posttraumatic growth (PTG) dimensions, and (c) test whether intrusive rumination is associated with deliberate rumination, which in turn is associated with PTG dimensions. Method: A cross-sectional study design was employed using a web-based survey method for data collection. In total, 202 women who identified their childbirth experience as traumatic participated in this study. Results: Intrusive rumination and deliberate rumination were positively associated with all dimensions of PTG in women following the traumatic childbirth event. Deliberate rumination fully explained the relationship between intrusive rumination and PTG aspects of relating to others, new opportunities, and personal strength, and partially explained the relationship between intrusive rumination and PTG aspects of spiritual changes and appreciation of life. Conclusions: The results suggest that deliberate rumination can contribute to explain the occurrence of PTG. These findings could help develop psychosocial interventions to maximize opportunities for deliberate rumination for women with traumatic childbirth experiences

Policy, service, and training provision for women following a traumatic birth: an international knowledge mapping exercise

Background: High numbers of women experience a traumatic birth, which can lead to childbirth-related post-traumatic stress disorder (CB-PTSD) onset, and negative and pervasive impacts for women, infants, and families. Policies, suitable service provision, and training are needed to identify and treat psychological morbidity following a traumatic birth experience, but currently there is little insight into whether and what is provided in different contexts. The aim of this knowledge mapping exercise was to map policy, service and training provision for women following a traumatic birth experience in different European countries. Methods: A survey was distributed as part of the COST Action "Perinatal mental health and birth-related trauma: Maximizing best practice and optimal outcomes". Questions were designed to capture country level data; care provision (i.e., national policies or guidelines for the screening, treatment and/or prevention of a traumatic birth, service provision), and nationally mandated pre-registration and post-registration training for maternity professionals

The Burden of Care and Quality of Life of Caregivers of Leukemia and Lymphoma Patients Following Peripheric Stem Cell Transplantation

WOS: 000354877000003PubMed ID: 25758128This study was conducted to identify the burden of care and quality of life of caregivers of leukemia and lymphoma patients who had undergone peripheric stem cell transplantation. The sample consisted of 123 patient caregivers, all of whom were relatives. Data were collected using a survey, the Burden Interview, and the Caregiver Quality of Life Index Cancer Scale. Data evaluation was done using correlation analysis, Kruskall Wallis, and Mann-Whitney U tests. Factors that were significantly associated with quality of life and care burden perception included caring for an older patient, patient dependence for daily activities, and having low economic status

The attitudes of cancer and job satisfaction physicians and nurses working with oncology patients and determination the variables effecting them

Tüm dünyada olduğu gibi ülkemizde de ölüm nedenleri arasında ilk sıralarda yer alan kanser, fiziksel olmanın yanında ruhsal ve psikososyal bileşenleri olan önemli bir hastalık grubudur. Yapılan araştırmalar bu alanda çalışan hekim ve hemşirelerin kansere yönelik tutumlarının, hastalığın süreci ve seyri üzerinde etkili olduğunu göstermektedir. Bu araştırma onkoloji hastalarıyla çalışan hekim ve hemşirelerin kansere yönelik tutumu, iş doyumu ve bunları etkileyen değişkenlerin belirlenmesi amacıyla tanımlayıcı türde yapılmıştır. Araştırmanın evrenini, Kayseri İl Merkezinde bulunan Erciyes Üniversitesi Tıp Fakültesine bağlı Onkoloji-Hematoloji Klinikleri ile Kayseri Şehir Hastanesi Onkoloji-Hematoloji Kliniklerinde çalışan hekim ve hemşireler oluşturmuştur. Ayrıca bir örneklem seçimine gidilmeyip, araştırma hakkında bilgi verildikten sonra katılmak isteyen 150 hekim ve hemşire örnekleme dahil edilmiştir. Araştırmada veri toplama aracı olarak; araştırmacılar tarafından ilgili literatür taranarak hazırlanan Anket Formu, Kansere Yönelik Tutum Ölçeği ve Minnosota İş Doyumu Ölçeği kullanılmıştır.Araştırmaya katılan hekim ve hemşirelerin Kansere Yönelik Tutum Ölçeği (KYTÖ) toplam puan ortalaması 91.62±14.80 (27.00-132.00) olarak belirlenmiştir. Katılımcıların Minnesota İş Doyum Ölçeği (MİDÖ) genel doyum puan ortalaması 3.34±0.55 (2.05-5.35), içsel doyum alt boyutu puan ortalaması 3.60±0.56 (2.08-6.17) ve dışsal doyum alt boyutu puan ortalaması ise 2.94±0.77 (1.38-6.75) olarak saptanmıştır. Bu sonuçlar çalışmaya katılan sağlık profesyonellerinin kansere yönelik tutumlarının orta düzeyde, genel ve içsel iş doyumlarının yüksek, dışsal iş doyumlarının ise düşük olduğunu göstermektedir. Ölçek puanları arasındaki ilişki incelendiğinde; MİDÖ toplam, MİDÖ içsel ve MİDÖ dışsal alt boyutları ile KYTÖ toplam puanı arasında pozitif yönde istatistiksel olarak anlamlı düzeyde ilişki saptanmıştır (p<0.05). MİDÖ toplam puanı (r=.296, p<0.05) ve MİDÖ dışsal puanı ile KYTÖ toplam puanı arasında pozitif yönde düşük düzeyde (r=.187, p<0.05), MİDÖ içsel puanı ile KYTÖ puanı arasında ise pozitif yönde orta düzeyde istatistiksel olarak anlamlı ilişki belirlenmiştir (r=.309, p<0.05). Araştırmaya katılan bireylerin sosyo-demografik özelliklerine göre yapılan karşılaştırmalarda erkeklerin MİDÖ toplam (3.47±0.46) puanının kadınlardan, bekar olanların MİDÖ dışsal alt boyut ölçek puanın evli olanlardan, hekimlerin MİDÖ toplam, içsel ve dışsal doyum puanlarının hemşirelerden yüksek olduğu belirlenmişitir. Araştırmaya katılan bireylerin çalıştığı kurum özelliklerine göre yapılan karşılaştırmada üniversite hastanelerinde çalışan hekim ve hemşirelerin KYTÖ toplam puanının şehir hastanesinde çalışan hekim ve hemşireden anlamlı düzeyde yüksek olduğu görülmüştür (p<0.05). Araştırmaya katılan sağlık çalışanlarının çalıştığı alana göre yapılan karşılaştırmada, onkolojide çalışmayı kendi isteğiyle seçenlerin MİDÖ dışsal alt boyut puan ortalamalarının daha yüksek olduğu belirlenmiştir. Bu bulgular doğrultusunda onkoloji alanında çalışan sağlık profesyonellerinin dışsal iş doyumlarını artırmak için gerekli kurumsal düzenlemelerin yapılması, kansere yönelik olumlu tutumları artırmak için konuya ilişkin eğitim programları ve psikososyal destek sistemlerinin geliştirmesi, onkoloji alanına ilgili ve çalışma isteği olan personelin istihdamının sağlanması önerilmektedir. Ayrıca alanda çalışanların memnuniyet anketleri ile düzenli olarak izlenmesi, memnuniyetsizliğin erken belirlenmesi ve müdahale edilebilmesi açısından önemlidir.Cancer, which is one of the leading causes of death in our country as well as all over the world, is an important disease group with mental and psychosocial components besides being a physical disease. Studies show that the attitudes of physicians and nurses working in this field towards cancer are effective on the process and course of the disease. This descriptive study was conducted to determine the attitudes of physicians and nurses working with oncology patients towards cancer, their job satisfaction, and the variables affecting them. The population of the study consisted of the physicians and nurses working in the Oncology-Hematology clinics of Erciyes University Faculty of Medicine in Kayseri City Center and the Oncology-Hematology Clinics of Kayseri City Hospital. In addition, a sample selection was not made and 150 physicians and nurses who wanted to participate after giving information about the research formed the sample of the research. As a data collection tool in the research; Questionnaire Form, Turkish Version of the Attitudes Towards Cancer Scale and Minnesota Job Satisfaction Scale, which were prepared by researchers by scanning the relevant literature, were used. The data obtained in the study were evaluated using the SPSS program in computer environment.The total mean score of the Attitudes Towards Cancer Scale (ATC) of the physicians and nurses participating in the study was determined as 91.62±14.80. Participants' Minnesota Job Satisfaction Scale (MJSS) General Satisfaction score average was 3.34±0.55, Intrinsic Satisfaction sub-dimension mean score was 3.60±0.56, and External Satisfaction sub-dimension mean score was 2.94±0.77. These results show that the general and internal satisfaction of the researchers participating in our study is high and the external satisfaction is low. In the comparisons made according to the socio-demographic characteristics of the individuals participating in the study, it was determined that the MIDOSA Total score of men was higher than that of women, the MIDOSA Extrinsic Subdimension scale score of singles was higher than those of married people, and the MIDOSA Total, Intrinsic and Extrinsic Satisfaction scores of physicians were higher than that of nurses. In the comparison made according to the characteristics of the institution where the individuals participating in the research work, it was seen that the KYTO Total score of the physicians and nurses working in university hospitals was significantly higher than the physicians and nurses working in the city hospital. In the comparison made according to the field of study of the individuals participating in the research, it was determined that those who voluntarily chose to work in oncology had higher MIDOSA external sub-dimension score averages. In line with these findings, in order to increase job satisfaction in oncology and reduce negative attitudes towards cancer, equalizing the conditions of the institutions as much as possible, and solving the problems in line with their ideas and opinions by applying satisfaction surveys to the personnel in the institution can increase the satisfaction received from the job. It can also positively affect the quality of life and the attitude towards cancer