The Effect of Virtual Reality Application on Pain During Wound Care Dressing Change: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

OBJECTIVE: To evaluate the effect of virtual reality application on pain during a wound care dressing change. DESIGN: Systematic review and meta-analysis DATA SOURCES: PubMed, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL (EBSCOhost), and YÖKTEZ REVIEW/ANALYSIS METHODS: The last screening of all databases was performed on 20.07.2022. Parallel-group RCTs suitable for the research subject were included in the study. The "Cochrane risk-of-bias tool" was used to measure the risk of bias. A heterogeneity test was done with the I2 value and the p value for the Q statistics. Five methods were employed to assess publication bias. Sensitivity analysis was performed for studies with a high risk of bias. RESULTS: As a result of the screening, 13 RCTs involving 882 wound care patients were included in the study. It was determined that the virtual reality application reduced pain moderately during a wound care dressing change (SMD= -0.60; 95% CI= -0.73 and -0.46; p < .001). The fixed effect model was used because the value of heterogeneity (I2 = 0%, p = 0.796) was low in the analysis. No significant results were obtained in the moderator analysis. CONCLUSION: It was found that the virtual reality application moderately reduced pain during a wound dressing change and was a reliable application. However, it was suggested that the virtual reality application alone was insufficient to reduce pain during wound care and should be applied together with analgesic or anesthetic drugs included in the standard wound care procedure.

The Effect of Abdominal Massage on Discharge and Ventilator-Associated Pneumonia in Enterally Fed Patients Connected to Mechanical Ventilation: A Randomized Controlled Study.

PURPOSE: The present research was conducted to reveal the impact of abdominal massage on enteral nutrition-induced ventilator-associated pneumonia and the gastrointestinal system in mechanically ventilated patients. MATERIALS AND METHODS: The present research is a prospective, randomized, controlled clinical trial. This study was completed with 63 patients (31 in the experimental group and 32 in the control group). Data collection was performed using a patient information form, a patient follow-up form, and the Bristol Stool Scale. After patients were under mechanical ventilation for 48 hours, the data collection tools were filled out twice a day for 3 days by visiting the mechanical ventilation patients. The experimental group received 15 minutes of abdominal massage twice a day before nursing care was delivered in the morning and the evening. RESULTS: According to the intergroup evaluations, the experimental group had lower gastric residual volume and abdominal distension, types of stool closer to normal, and higher defecation frequency. Differences between the groups were statistically significant (P < .05). In accordance with the intragroup evaluations, the experimental group had lower gastric residual volume, abdominal distension, and ventilator-associated pneumonia. The difference between the groups was revealed to be statistically significant (P < .05). CONCLUSION: Abdominal massage reduces ventilator-associated pneumonia development to a statistically significant degree. Furthermore, it decreases gastric residual volume and abdominal distension, causes stools to be closer to the normal/ideal stool, increases defecation frequency, and regulates bowel movements and excretion (P < .05).

Body Image Perception and the Effect of Different Educational Programs on Embarrassment in Patients Undergoing Colonoscopy.

PURPOSE: Colonoscopy is recognized as a safe and effective tool for detecting colorectal cancer. However, patients may experience discomfort and embarrassment arising from their body image, with the prejudice that health care professionals will have negative thoughts about their bodies. This study was carried out to determine the effect of the perception of body image and education given with different educational programs on the feeling of embarrassment in patients who were scheduled to undergo colonoscopy. DESIGN: Quasi-experimental study with pre-test, post-test. METHODS: The population of this quasi -experimental study with pre-test, post-test, and experimental groups consisted of 184 patients who underwent colonoscopy for the first time at the endoscopy department of a university hospital. FINDINGS: No statistically significant difference in the mean Colonoscopy Embarrassment Scale (CES) pre-test scores was found between the groups (P > .05). The mean CES post-test scores of the video group were lower than those of the other groups, with a statistically significant difference (P < .05). Comparing the intragroup CES pre-test and post-test mean scores, the mean CES post-test scores were found to be lower in all three groups, with a statistically significant difference between the groups (P < .05). Although a statistically weak negative correlation was found between the body image mean scores and the pre-test CES mean scores of the booklet and video groups, no correlation was observed in the control group. CONCLUSIONS: The body image perception was found to affect the sense of embarrassment in patients undergoing colonoscopy, and the mean embarrassment scores decreased with planned training programs.

Effect of Cold Application on Chest Incision Pain Due to Deep Breathing and Cough Exercises.

BACKGROUND: We determined the effect of cold application after coronary artery bypass graft surgery on chest incision pain due to deep breathing and coughing exercises. Thoracotomy performed for coronary artery bypass graft surgery is one of the most painful surgical procedures. This pain prevents deep breathing and effective coughing. These problems increase the risk of morbidity in the postoperative period. AIMS: This study aimed to determine the effect of cold application after CABG surgery on chest incision pain due to deep breathing and cough exercises. DESIGN: Experimental study with control group and repeated measurements. SETTINGS: Patients were selected through convenience sampling in the Cardiovascular Surgery Intensive Care Unit at a hospital. PARTICIPANTS: The study was conducted with 57 patients who underwent open heart surgery (29 and 28 in the experimental and control groups, respectively). METHODS: Repeated pain assessment was performed before, immediately after, and 5 min after deep breathing and coughing exercises performed in 4 periods at 2-h intervals. The first pain assessment was performed 24 h postoperatively. In the first and third assessments of the experimental group, pain was recorded before the exercise; the exercise was performed 15 min after cold gel pack application to the incision area. Pain was assessed before, immediately after, and 5 min after exercise using the Short- Form McGill Melzack Pain Questionnaire. RESULTS: Reduction in pain severity within and between the groups was statistically significant in the first and third evaluations (p = .001). CONCLUSIONS: The results provide evidence to support the use of cold gel pack.

Effects of early mobilization protocol performed after cardiac surgery on patient care outcomes.

AIM: This study aimed to determine the effects of an early mobilization protocol performed in patients who underwent cardiac surgery on post-operative outcomes. BACKGROUND: Post-operative complications are common in patients undergoing cardiac surgery. Early mobilization is recommended for patients who undergo cardiac surgery to prevent complications and achieve successful outcomes in post-operative care. DESIGN: The study design was quasi-experimental with a control group. METHODS: Participants were patients who underwent cardiac surgery between January and October 2015. The study included 102 patients (51 patients each in the experimental and control groups). The introductory characteristics form, the Richards-Campbell Sleep Questionnaire (RCSQ), duration of hospital stay (post-operatively), and development of a post-operative late complications form were used to collect data. RESULTS: The study results revealed that patients in the experimental group had better improvement in RCSQ scores, shorter duration of hospitalization, and fewer late complications after surgery than patients in the control group. CONCLUSION: Early mobilization is feasible in adult cardiac surgery patients and has significant benefits. More research is recommended into the effectiveness of early mobilization in different patient groups.

Patients' Opinions of OR Nurses and Environments in the Postoperative Period.

PURPOSE: To determine patients' opinions of operating room (OR) nurses and environments in the postoperative period. DESIGN: A descriptive study. METHODS: The data were collected by using researcher developed forms that defined patients' opinions of OR nurses and environments and were given to the patients on the first postoperative day. FINDING: The final sample consisted of a total of 208 patients who underwent surgery with regional anesthesia. Percentage measurements were used in the assessment of data. The majority (69.3%) of nurses did not introduce themselves to their patients and 61.3% failed to introduce the OR environments to their patients. Patients explored their (ORs) in the range of 62% and 90% and considered these locations to be calm and reliable environments where their needs were met and their communications with the staff were positive. The rate of patients who felt that their ORs were not cold was 35.3%. CONCLUSIONS: In this study, most patients were not aware that OR nursing played an important role in a postive patient perception of the OR. Most OR nurses did not introduce themselves to patients while providing nursing care, and patients were not aware of who provided this service to them. In light of these findings, it is recommended that nurses introduce themselves to patients in the OR when beginning care of the patient. Moreover, special effort should be made regarding maintenance of normal body temperature of patients in the OR.

Effect of music on postoperative pain and physiologic parameters of patients after open heart surgery.

The aim of this study was to investigate the effect of listening to personal choice of music on self-report of pain intensity and the physiologic parameters in patients who have undergone open heart surgery. The study design was quasiexperimental. Patients were selected through convenience sampling in the Cardiovascular Surgery Intensive Care Unit at a university hospital. The study was conducted with a total of 87 patients who underwent open heart surgery: 44 in the music group, 43 in the control group, ages between 18 and 78 years. Through pretest-posttest design, postoperative first-day data were collected. First, physiologic parameters (blood pressure, heart rate, oxygen saturation, and respiratory rate) were recorded and a unidimensional verbal pain intensity scale applied to all participants. Later, the control group had a rest in their beds while the music group listened to their choice of music for 30 minutes. Physiologic data were then collected and the pain intensity scale applied once more. In the music group, there was a statistically significant increase in oxygen saturation (p = .001) and a lower pain score (p = .001) than in the control group. There was no difference between the groups in the other physiologic parameters. Results of this research provide evidence to support the use of music. Music might be a simple, safe, and effective method of reducing potentially harmful physiologic responses arising from pain in patients after open heart surgery.

Psychometric evaluation of the Turkish version of the Zarit Burden Interview in family caregivers of inpatients in medical and surgical clinics.

The aim of this study was to adapt the Zarit Burden Interview (ZBI) to family caregivers of inpatients in medical and surgical clinics to assess the validity and reliability of the Turkish version. The study design was descriptive and methodological. A total of 223 family caregivers providing care to patients for at least 1 week in clinics were selected through convenience sampling. Data were collected using the Turkish translation of the ZBI. The psychometric testing of the adapted instrument was carried out to establish internal consistency, interitem correlation, and construct validity. The content validity procedure resulted in a final scale comprising 18 items. Cronbach's alpha was .82. Factor analysis yielded one factor. The Turkish version of the ZBI adapted to the clinics can be used as a one-factor tool.

Symptom clusters and experiences of patients with cancer.

AIM: This study is a report of a study to characterize the prevalence and severity of symptoms in patients with cancer and describing the clustering of symptoms. BACKGROUND: Patients with cancer experience multiple symptoms caused by multiple factors, including progression of the cancer, acute physiological changes associated with treatment, delayed side effects of treatment and long-term consequences of the disease. METHODS: A convenience sample of 287 patients with cancer at a Turkish university hospital completed a structured questionnaire on demographical characteristics and a symptom inventory for patients with cancer. Cluster analysis, principal components and internal consistency reliability analyses were used to analyse the data. The study was conducted in 2007. FINDINGS: The most common symptoms experienced were fatigue, difficulty remembering, sadness, loss of appetite, lack of enjoyment of life, pain, distress, difficulty walking and dry mouth. The least experienced symptoms were shortness of breath and vomiting. Overall, 37.5% of the patients experienced moderate symptoms and 12.5% experienced severe symptoms. Among the severe symptoms were loss of appetite, fatigue, sadness, dry mouth and distress; however, 48% rated these as moderate or severe. CONCLUSIONS: Symptom cluster research is still in its early years. Further work is needed to reach a standard definition of a symptom cluster and a consensus of its criteria. Additional studies are needed to examine symptom clusters in cancer survivors. As individuals are living longer with the disease, comprehensive understanding of the symptom clusters that may be unique to cancer survivors is critical.

The quality of life of family caregivers of cancer patients in the east of Turkey.

PURPOSE: In this study, the aim was to examine the quality of life of family caregivers of cancer patients in the east of Turkey. METHOD: The study design was descriptive. Data were collected by the researcher in Oncology-Hematology policlinic and Chemotherapy unit of Yakutiye Research Hospital of Atatürk University. Participants were 18 years old and older. The sample included 106 family caregivers who were living in the same flat with the patients during caregiving. Data were collected using a questionnaire that included sociodemographic questions for family caregivers and the World Health Organization Quality of Life-Short Form, Turkish Version (WHOQOL-BREF TR). RESULTS: The mean domain scores of WHOQOL-BREF(TR) were 70.12 (SD=19.24) for social, 68.26 (SD=20.10) for physical, 59.70 (SD=18.07) for psychological, 56.32 (SD=15.12) for national environment, and 53.87 (SD=16.99) for environment domains. About 71.7% of caregivers shared the caregiving process with someone else. Environmental domain scores of those who shared the caregiving process with someone else were higher. The environment domain scores of men (49.6, SD=17.1) were lower than those of women. As the income lowers, lowered, so did the quality of life score in every domain. The quality of life scores of those feeling unhealthy during the last two weeks were low in every domain. CONCLUSION: Physical and psychological health of family caregivers in assisted living facilities should be comprehensively supported by professionals.