Effect of Oral Carbohydrate Solution Administered Before Hip Arthroplasty on Preoperative Anxiety and Postoperative Patient Comfort: A Randomized Controlled Trial.

PURPOSE: This study aimed to determine the effect of oral carbohydrate solution (OCS) administered before hip arthroplasty (HA) on preoperative anxiety and postoperative patient comfort. DESIGN: The study was a randomized controlled clinical trial. METHODS: Fifty patients undergoing HA were randomized into two groups: The intervention group (n = 25) received OCS before surgery, and the control group (n = 25) fasted from midnight till surgery. The patients' preoperative anxiety was assessed using the State-Trait Anxiety Inventory (STAI), symptoms affecting postoperative patient comfort parameters using the Visual Analog Scale (VAS), and comfort levels specific to HA surgery using the Post-Hip Replacement Comfort Scale (PHRCS). Pre- and post-operative blood glucose levels of the patients were measured. FINDINGS: In intragroup and intergroup assessments, the decrease in the preoperative and postoperative anxiety, pain, thirst, hunger, and nausea/vomiting levels were statistically significant (P < .05) in the OCS group. The OCS group's comfort levels specific to hip replacement were higher than those of the control group (P ≤ .001). In the intergroup and intragroup assessment of the patients' blood glucose levels, there was a statistically significant difference in favor of the OCS group (P < .05). CONCLUSIONS: The results of this study provide evidence supporting OCS administration before HA surgery.

The Effect on the Care Behaviors of Nurses Working in Intensive Care Clinics of Moral Distress Experienced During End of Life Patient Care.

This research was conducted as a descriptive study in order to examine the effects of the moral problems experienced by nurses working in intensive care clinics on their end of life care behaviors. The data were collected using the Moral Distress Scale and Caring Behaviors Inventory. It was found that 74.5% of the nurses were women and their mean age was 32.60 ± 6.6 years. The frequency of moral distress in the nurses was 44.27 ± 16.25 and total score was 111.02 ± 63.85. There were significant differences in the scores of the concept the use of futile treatment by nurses, the decision not to begin life-support treatment being made only by physicians, and moral distress and discomfort felt by pediatric intensive care nurses (p < .05). A statistically significant relationship was found between total scores of discomfort on moral distress and assurance, knowledge and skills, connectedness, and being respectful on the end of life care behaviors (p < .05).

Determine the Symptom Intensities, Performance and Hopelessness Levels of Advanced Lung Cancer Patients for the Palliative Care Approach.

This research was conducted descriptively to determine the symptom intensities, performance and hopelessness levels of advanced lung cancer patients for the palliative care approach. The research sample consisted of 130 patients with advanced lung cancer, who were selected from 600 lung cancer populations in thoracic surgery and intensive care, outpatient chemotherapy, oncology in a university hospital in Turkey. Ethics Committee permission and the patients' written consent was obtained. Study data were collected face to face between January 2020 and July 2020 using the Edmonton Symptom Assessment System, Karnofsky Performance and Beck Hopelessness Scale. The mean age of the patients was 62.68 ± 8.867, 72.3% were males, and 89.2% were not currently working. The most common symptom in the patients was found to be fatigue 5.46 ± 2.12, worsening in general health and well-being 5.69 ± 1.87, loss of appetite 5.40 ± 2.59, and total symptom score 47.17 ± 19.03. Feelings and expectations about the future 1.40 ± 1.66, loss of motivation 3.43 ± 2.41, hope 2.05 ± 1.75, and total score of hopelessness 7.41 ± 6.01. There was a positive correlation between the patients' hopelessness level and their symptom burden, and a negative correlation was found with Karnofsky performance (P < .05). A significant difference was found between the patients' age, months since diagnosis, gender, education and employment status, stage of the disease, presence of metastases and analgesic use, and hopelessness scores (P < .05). It was determined that the symptom burden of patients with advanced lung cancer increased and as their Karnofsky performance decreased, their hopelessness level further increased. Hopelessness scores are affected by the socio-demographic and disease variables of the patients.

Relationship Between the Needs of Turkish Relatives of Patients Admitted to an Intensive Care Unit and Their Coping Styles.

Admission to an intensive care unit is a traumatic event for many patients' relatives. Also, the relatives may be subject to many requirements to during this process. Therefore, it is very important to determine their requirements and coping styles. This study used a descriptive, relational design. The sample of the research consisted of 247 relatives of patients staying in six intensive care units. It was found that, 65.2% of the patients' relatives were women, and their mean age was 37.25 ± 12.7 years. What they mostly needed was support, proximity, information, assurance and comfort. In that order; among the coping styles it was found that they usually used the following approaches: self-confident approach, an problem-focused coping method; was found to be used by relatives most frequently, followed by helpless approach, an emotion-focused coping style. Requirements: Assurance, information, support and comfort sub-dimension scores and problem-focused coping style; self-confident approach and social support search approach sub-dimension scores between statistically positive, significant relationship was found. Information, proximity, support and comfort sub-dimension scores and emotion-focused coping style; helpless approach and submissive sub-dimension scores between statistically positive, significant relationship was found (p<0.05). It was found that patients' relatives used the helpless approach and submissive approach to cope with stres: during this process their information needs increased and upon fulfillment of requirements, they started using self-confident approach and the social support approach, which are problem-focused coping styles.

The Effect of Education on the Early Diagnosis of Breast and Cervix Cancer on the Women's Attitudes and Behaviors Regarding Participating in Screening Programs.

The objective of this paper was to define the effect of education on the early diagnosis of breast and cervix cancer on the women's attitudes and behaviors regarding participating in Cancer Early Diagnosis, Screening and Training Centers-CEDSTC screening programs. This semi-experimental study was completed with 342 women. The data were collected with forms "Champion's Health Belief Model Scale Breast Cancer-HBMSBC" and "Health Belief Model Scale for Cervical Cancer and the Pap Smear Test-HBMSCCPST." When the women's health beliefs before and after 6 months of the education about the early diagnosis of breast and cervical cancers are considered, it is seen that the HBMSBC subscales health motivation, breast self-examination (BSE), and evasion to mammography (MMG) decreased and BSE self-efficacy and MMG benefit attitudes increased and HBMSCCPST subscales pap smear benefit attitudes increased and evasion to pap smear attitude decreased (p < 0.05). Six months after the education, 28.4% of the women had undergone MMG, 69.9% had performed BSE, and 33.6% had undergone a pap smear test. Education regarding early diagnosis of breast and cervix cancer was found to have positive effects on the health behaviors of the women related to BSE, MMG, and pap smear tests. The women require professional education program for increasing their attitudes and behaviors for CEDSTC screening programs. We suggest regularly providing education to increase participation in early screening programs.

Reliability and validity of the Turkish version of the EORTC QLQ-C15-PAL for patients with advanced cancer.

OBJECTIVE: Assessing quality of life, which is the main focus of palliative care, is highly important. The number of available, specific, simple, and valid assessment instruments for patients with advanced cancer in Turkey is limited. The aim of our study was to perform a psychometric evaluation of the Turkish version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-PAL (EORTC QLQ-C15-PAL). METHOD: The study was conducted in Izmir with patients who had received treatment in the palliative care unit of a university hospital between November of 2011 and December of 2013. Sociodemographic and disease characteristics forms, the Karnofsky Performance Status (KPS) Scale, and the EORTC QLQ-C15-PAL Scale were employed in order to gather data. RESULTS: A total of 150 patients completed the study: 55.3% of participants were female, 80.7% were married, and the average age was 52.76 ± 14.55. The value of Cronbach's α in the analyses ranged from 0.93 to 0.98. Most questionnaire areas had low to moderate correlations with the others. The moderate correlations were between fatigue and physical function (-0.41) and between insomnia and emotional function (-0.53). Conversely, weak correlations were found between nausea/vomiting and appetite loss (0.31) and between insomnia and pain (0.22). KPS scores decreased, patient physical and emotional function were diminished, global QoL declined, and patients' symptoms became more frank. SIGNIFICANCE OF RESULTS: We concluded that the EORTC QLQ-C15-PAL is a valid and reliable tool to determine the quality of life of advanced cancer patients who are undergoing palliative treatment in Turkey.

Use of Complementary and Alternative Medicine and Quality of Life of Cancer Patients: Turkish Samples.

A large proportion of cancer patients use complementary and alternative medicine (CAM) to extend their quality of life. The purpose of this study was to determine the level of CAM use by patients undergoing cancer treatment. The study was conducted in Turkey at a large state university hospital and a government hospital between March and December 2013. The research sample consisted of a total of 147 cancer patients undergoing either chemotherapy or radiotherapy. Data collection was performed using a Patient Description Form and the EUROHIS (WHOQOL-8.Tr) quality-of-life scale through face-to-face interviews. The use of CAM, green tea (28.00 ± 4.24), and garlic (29.00 ± 0.00), as well as the use of a combination of plant products such as pomegranate juice, pollen, and herbal tea (31.25 ± 5.96), not feeling the need to inform the physician of the use of CAM, regular use of CAM, finding CAM use effective, and suggesting CAM use to others were found to have a statistically significant relationship to average quality-of-life scores (P < 0.05). This study could be used to develop holistic nursing interventions and CAM use by patients undergoing cancer treatment.

Determining the satisfaction levels of the family members of patients with advanced-stage cancer.

OBJECTIVE: The objective of our study was to determine the satisfaction levels of family members of patients with advanced-stage cancer. METHOD: This descriptive study was conducted in the palliative care and medical oncology clinics of a university hospital in the province of Izmir between April of 2011 and January of 2012. The study sample consisted of a total of 145 family members, who were selected from among the family members of patients with advanced-stage cancer receiving palliative treatment. The study data were obtained using the Patient Description Form and Family Satisfaction Scale during face-to-face interviews with patients. RESULTS: Some 67% of patients were female and 33% male, 70% were married, 35% were high school graduates, and 34.5% were housewives. The average total family satisfaction score was 76.87 ± 1.14, and the average scores for the component variables were as follows: information giving 74.37 ± 1.28, availability of care 78.40 ± 1.17, physical care 78.99 ± 1.09, and psychosocial care 74.52 ± 1.30. We found a relationship between the level of satisfaction of family members and (1) gender, (2) occupation, (3) presence of someone supporting the care, and (4) possession of sufficient information about the patient (p < 0.05). SIGNIFICANCE OF RESULTS: Satisfaction levels of participants were determined to be high. We found that family member satisfaction levels were affected by gender and occupation, the existence of someone supporting the care, and possession of sufficient information about the patient.

Examination of the Relationship Between Hopelessness Levels and Coping Strategies Among the Family Caregivers of Patients With Cancer.

BACKGROUND: Family caregivers who provide care for cancer patients may have to cope with a variety of physical, social, and economic problems during the caregiving process. A sense of hopelessness seems to lead to increasingly negative evaluations of new situations and less effective coping strategies. OBJECTIVE: The objective of the study was to examine the relationship between hopelessness and the coping strategies of the family caregivers of oncology patients. METHODS: This cross-sectional, descriptive correlational design study was carried out in the adult oncology unit and outpatient radiation oncology units of a university hospital in Turkey. The research sample was composed of 110 family caregivers. A sociodemographic data form, the Coping Stress Strategies Scale, and the Beck Hopelessness Scale were used in face-to-face interviews. RESULTS: Significant correlations were found between hopelessness and coping strategies. There was a positive correlation between hopelessness and the helpless approaches, which constitute a part of the emotion-focused coping strategies (r = 0.254, P < .01). There was a negative correlation between hopelessness and problem-focused coping strategies (optimistic approach and seeking social support) (r = -0.484, P < .01; r = -0.190, P < .05). CONCLUSION: In our study, we found that when the hopes of family caregivers are raised, they may adopt a more optimistic approach, and seek more social support, and display more effective coping strategies. IMPLICATIONS FOR PRACTICE: This study could be used to help develop nursing interventions and efficient coping strategies. It suggests how oncology nurses may support family caregivers to increase their level of hope.

Nursing students' approaches toward euthanasia.

BACKGROUND: In Turkey, which is a secular, democratic nation with a majority Muslim population, euthanasia is illegal and regarded as murder. Nurses and students can be faced with ethical dilemmas and a lack of a legal basis, with a conflict of religious beliefs and social and cultural values concerning euthanasia. The aim of this study was to investigate undergraduate nursing students' attitudes towards euthanasia. METHOD: The study, which had a descriptive design, was conducted with 600 students. The 1st, 2nd, 3rd, and 4th year nursing students at a school of nursing were contacted in May 2009, and 383 students (63.8% of the study population of a total of 600 students) gave informed consent. Two tools were used in accordance with questionnaire preparation rules. RESULTS: The majority of students were female and single (96.9%), and their mean age was 21.3 ± 1.5 years. A majority (78.9%) stated they had received no training course/education on the concept of euthanasia. Nearly one-third (32.4%) of the students were against euthanasia; 14.3% of the students in the study agreed that if their relatives had an irreversible, lethal condition, passive euthanasia could be performed. In addition, 24.8% of the students agreed that if they themselves had an irreversible, lethal condition, passive euthanasia could be performed. Less than half (42.5%) of the students thought that discussions about euthanasia could be useful. There was a significant relation between the study year and being against euthanasia (p < 0.05), the idea that euthanasia could be abused (p < 0.05), and the idea that euthanasia was unethical (p < 0.05). CONCLUSION: It was concluded that the lack of legal regulations, ethical considerations, religious beliefs, and work experience with dying patients affect nursing students' attitudes towards euthanasia.

[Case management based multidisciplinary care protocol in the palliative care of cancer patients]. / Kanser hastasinin palyatif bakiminda vaka yönetimine dayali multidispliner bakim protokolü.

Today, multifaceted approach is needed for the palliative care of advanced stage cancer patients. The main objective for these patients, elimination of pain and other symptoms, psychosocial and spiritual needs are met and to increase the quality of life. We are also faced with the challenge of meeting the physical and psychosocial needs of family members. The purpose of a holistic approach to patient and family who provide effective and quality care, care coordination and case management of a multidisciplinary team approach is based on cooperation. Care protocols specified patient care activities to be carried by the related disciplines to achieve results on a timeline that shows a certain, a multidisciplinary clinical management tool. A lot of care guidelines and protocols developed by a team of experts to contribute to the palliative care activities, and this is thought to be a guiding team members, working with patients.

Examining the effect of the case management model on patient results in the palliative care of patients with cancer.

PURPOSE: We aimed to investigate the improvement in symptoms, quality of life, patient and family satisfaction with care, and direct costs resulting from a palliative care program based case management model. METHODS: The research was implemented at the Medical Oncology Clinic hospital of a University between September 2009 and September 2011. The research sample consisted of a total of 44 patients (22 control and 22 intervention group). The research tools were the Edmonton Symptom Diagnosis System, the Karnofsky Performance Scale, the EORTCQLQ-C30 Quality of Life Scale, a patient and family satisfaction form, and a patient cost record form. RESULTS: The difference between total symptom mean scores and the sub-dimension symptoms of pain, fatigue, nausea, depression, anxiety, lack of appetite, lethargy, well-being, dyspnea, and constipation post-hospitalization and post-discharge of patients in the control and experimental groups were found to be statistically significant (p < 0.05). The level of decrease in symptom severity in the experimental group patients was more than in the control group (p < 0.000). The satisfaction level of patients and family in the palliative care based case management service was higher than that for conventional service in the control group (p < 0.05). No statistical difference was detected between the experimental and control groups regarding health costs and duration of hospitalization (p > 0.05). CONCLUSION: We provided a better symptom control, improved the patient s quality of life (excluding physical and congnitive functions), and patient and family satisfaction levels were higher in the palliative care based case management intervention group, but direct health costs were not affected.