Vascular complications in extremities of physically restrained intensive care unit patients: A prospective, observational study.

BACKGROUND: Physical restraint is used to prevent agitation, to continue treatments and to ensure safety in intensive care patients. Physical restraint has negative effects on physical and psychological health, and physical restraint should not be used unless necessary. AIMS: The purpose of this study was to evaluate the development of vascular complications in extremities of physically restrained patients hospitalized in the intensive care unit (ICU) and the associated factors. STUDY DESIGN: A prospective, observational study. The study was conducted between September 1, 2022, and March 31, 2023 in eight ICUs of a hospital located in the inner regions of Türkiye. The development of vascular complications (discolouration, distemperature, variations in capillary refill time, fluctuations in peripheral pulse, skin ulceration and oedema in the area of physical restraint) rate in patients hospitalized in the ICUs who were physically restrained. Independent sample t test, Mann-Whitney U test and Pearson-χ2 test were used to analyse the data. RESULTS: During the study, 2409 patients were admitted to ICUs. Physical restraint was applied to 209 of these patients. Of the 209 patients, 112 patients who met the inclusion criteria were included in the study. The physical restraint site of the patients was evaluated an average of 230.12 times and physical restraint was terminated in 9.8% of the patients (n = 112) because of vascular complications that developed in the physical restraint site. The rate of vascular complications at the site of physical restraint was higher in patients with endotracheal tubes (p < .05), lower GCS scores (p < .05) and higher INR values (p < .05). Patients with skin ulceration at the restraint site received more massages and cream applications (%95CL = 1. 1.692-34.734, OR = 7.667, p = .032). It was determined that more massage was applied to patients with changes in skin temperature at the restraint site (%95Cl = 1.062-11.599, OR = 3.510, p = .032). CONCLUSIONS: Vascular complications may develop at the restraint site in patients hospitalized in the ICU. This may be more common in ICU patients with endotracheal tube, lower GCS score and higher INR values. RELEVANCE TO CLINICAL PRACTICE: Nurses should closely monitor ICUs patients with endotracheal tube, lower GCS score and higher INR values, and implement care interventions to prevent the development of vascular complications.

The Effect of Cold Sand Pack on Percutaneous Coronary Intervention-Induced Vascular Complications and Pain: A Randomized Controlled Trial.

AIM: The aim of this study was to evaluate the effect of cold sand pack on vascular complications and pain in patients who undergoing percutaneous coronary intervention. METHODS: This randomized controlled interventional trial was conducted in a hospital between November 30, 2021 and April 3, 2022. The patients were randomly assigned to CSP and NSP. A 5 kg sand pack was applied on the femoral area of the patients in the CSP group at an average temperature of 18.9°C for the first 20 minutes. A 5 kg sand pack was applied at an average temperature of 24.1°C after the procedure on the femoral region of the patients in the NSP group. RESULTS: After percutaneous coronary intervention, less bleeding developed in the CSP group at hours 2, 3, and 12 when compared to the NSP group, and the ecchymosis diameters measured at hours 1, 2, 3, 4, 5, 6, 12, and 24 were higher than those of the NSP patients (p < 0.05). It was detected that the pain score of the NSP group was higher at hours 1, 2, 3, 4, 5, 6, 12, and 24 on the femoral region when compared to the CSP group. CONCLUSION: It was detected that the cold sand pack applied for the first 20 minutes prevented bleeding and reduced ecchymosis diameter and pain intensity.

The Effect of Bright White Light on Fatigue Levels in Patients with Gynecological Cancer: A Randomized Control Trial.

Objectives: Bright white light (BWL) therapy is one of the non-pharmacological methods in the management of fatigue. The aim of the study was to evaluate the effect of BWL on fatigue levels in patients with gynecological cancer who were receiving chemotherapy. Methods: This randomized controlled study were made with 72 women (intervention (n:36) and control (n:36) groups) at gynecologic oncology clinic. Standard BWL at the intensity of 10,000lux was applied to the patients in the intervention group at the same time every day between the second and the eighth days of the chemotherapy cycle. Fatigue levels of all patients (n: 72) were evaluated on the first,ninth and 21st days. Results: The first, ninth, and 21st days general fatigue scores of intervention and control groups was 4.876 ± 0.000;4.384 ± 0.270;4.387 ± 0.258 and 4.876 ± 0.000;5.033 ± 0.270;4.984 ± 0.258, respectively (p = 0.100). Interference of fatigue with daily life scores was found statistically different between the intervention and control groups in the first, ninth, and 21st day, respectively 4.55 ± 0.26; 3.53 ± 0.23; 3.57 ± 0.22 and 4.95 ± 0.26;4.79 ± 0.23;4.82 ± 0.22 (p = 0.029). Conclusions: BWL therapy was effective in reducing interference of fatigue with daily life in patients receiving chemotherapy, but did not affect the general fatigue level of the patients. Based on the available data, it is possible that the application of BWL may have a positive effect on general fatigue when the number of samples and the application time are increased. Trial Registration: ClinicalTrials.gov Identifier: NCT05009693.

The effect of a combined treatment of foot soak and lavender oil inhalation therapy on the severity of insomnia of patients with cancer: Randomized interventional study.

OBJECTIVES: This three-arm randomized intervention study was carried out with the aim to evaluate the effects of a combined foot soak and lavender oil inhalation therapy on the severity of insomnia of patients with cancer. METHOD: This research was carried out in oncology and palliative services. Forty-five patients were randomly assigned to three groups. Throughout a 14-day period, 20 min of foot soak treatment was applied to the patients in the F group, patients in the L group were applied lavender oil inhalation therapy for 5 min and a combined treatment of foot soak and lavender oil inhalation therapy were applied to the patients in the FL group. Insomnia severity of the patients in all groups were evaluated twice using the Insomnia Severity Index at the baseline and on the fifteenth day. RESULTS: The severity of the insomnia of the patients in all groups was found to be moderate. The severity of the insomnia in the second evaluation was found to be statistically significantly lower in the L and FL groups (p<0.05) compared to the baseline evaluation within the group, however no significant difference was found in the F group (p>0.05). The effect size of a combined treatment of foot soak and lavender oil inhalation therapy on the severity of insomnia of patients in the FL group was higher and moderate (d = 0.684) compared to merely foot soak and merely lavender oil inhalation therapy. CONCLUSION: A combined treatment of foot soak and lavender oil inhalation therapy shall mitigate the severity of a moderate level of insomnia of patients with cancer.

The effect of local cold application on intradialytic cramp: A quasi-experimental study.

AIMS: An intradialytic cramp, which frequently occurs in hemodialysis patients, is a disturbing condition. This study was conducted to evaluate the effect of local cold applications on the severity and duration of intradialytic cramps in patients with chronic kidney disease. MATERIALS AND METHODS: This quasi-experimental study sample comprised of 74 patients who were aged >18 years, conscious, and reported experiencing intradialytic cramps in a dialysis center. In this study, the application group had the local cold treatment as well as the treatment recommended by the physician whereas the control group was only given the treatment recommended by the physician. The cramp severity was assessed using a visual analog scale as soon as the cramp started (T1) and 10 min after the onset of the cramp (T2). The cramp duration was determined by a chronometer. The Independent Sample T-test, One-Way ANOVA test, Paired Samples T-test and the Two-Way ANOVA test were used to analyze the data. RESULTS: In the study, the duration of the cramp (sd) was 9.49 (0.86) minutes in the application group and 7.51 (0.69) minutes in the control group (t = 1791, p = 0.078). It was determined that the pain severity scores of the application and control group patients were significantly decreased at the T2 time point compared to T1 (p = 0.001), and the effect of the group and evaluation time points on the cramp severity score was not statistically different (p = 0.548). CONCLUSION: In this study, the mean duration of the intradialytic cramp was below 10 min for both groups. The local cold application had no effect on cramp severity or duration.

Evaluation of the Effect of Self-Efficacy on Symptoms in Gastrointestinal Cancer Patients.

Objective: The incidence of gastrointestinal cancer is increasing day by day and is among the highest 10 cancer types in the world. This study was conducted to evaluate the effects of self-efficacy of patients with gastrointestinal system cancer on symptom clusters. Methods: This cross-sectional study was conducted with 105 patients treated for gastrointestinal system cancer in a hospital located in the south of Turkey. In the study, patients over 18 years of age without hearing or speech impairment were included. To determine symptom clusters, Latent Profile Analysis and comparison of self-efficacy scale items by symptom clusters were performed with Chi-square, ANOVA, and Kruskal Wallis test. Results: The mean age of the patients was 58.83 ± 13.1 years; of the patients, 37.1% had colon ca, 21.9% had rectum ca. The patients had higher mean scores of fatigue, pain, feeling distressed, feeling sad, dry mouth, sleep disturbance, loss of appetite and nausea in the last week. The patients had higher mean scores of fatigue, pain, feeling distressed, feeling sad, dry mouth, sleep disturbance, loss of appetite and nausea in the last week. Three symptom clusters were determined by latent profile analysis; high, moderate, mild. It was determined that the level of self-efficacy was high in the symptom cluster which is low symptom severity and number of symptoms (p < .05). Conclusion: The number and the severity of symptoms are lower in patients with high self-efficacy perceptions.

Evaluation of the relationship between health literacy and self-efficacy: A sample of hemodialysis patients.

PURPOSE: The aim of this study was to evaluate self-efficacy and health literacy of patients undergoing hemodialysis, to investigate the relationship between health literacy and self-efficacy, and to determine the factors affecting self-efficacy. METHODS: The study was conducted in Eskisehir and Gumushane state hospitals affiliated to the Public Hospitals Association with the participation of 198 patients receiving hemodialysis treatment for chronic renal failure. The inclusion criteria were as follows: being ⩾18 years old, receiving hemodialysis, and agreeing to participate in the study. The study data were collected using face-to-face interview technique, and they were analyzed using descriptive statistics, correlation, and regression analysis. RESULTS: The mean age of the patients was 59.73 ± 16.32 years. Of the patients, 46% were primary school graduates, and 63.6% reported having other chronic diseases. The mean health literacy and self-efficacy scores were found to be 79.43 ± 26.09 and 23.98 ± 7.42, respectively. The results showed that the self-efficacy scores of the patients increased as the general health literacy scores increased, with a strong linear correlation between these variables (r = 0.712; p ˂ 0.001). Patients with advanced age, low educational level, and widowed patients had lower self-efficacy and health literacy scores than others (respectively eta2 = 0.263, 0.116, 0.268, 0.141). CONCLUSION: High score of health literacy positively affects the self-efficacy score of hemodialysis patients.

Empowering caregivers in the radiotherapy process: the results of a randomized controlled trial.

PURPOSE: The present study aims to evaluate the effectiveness of a mobile-assisted empowerment program developed specifically for caregivers of cancer patients undergoing radiotherapy. METHODS: In this study, seventy-four individuals who gave care for cancer patients that received radiotherapy between September 2019 and May 2020 were randomized to receive a mobile-assisted empowerment program or standard care. The mobile-assisted empowerment program comprised of education and information related to the radiotherapy process, videos, activities, and question-and-answer modules to support caregivers during the radiotherapy process. Outcome measures were collected at baseline (day 1 of radiotherapy) and on day 21 and included caregiver demographics, distress, quality of life, and coping style using validated questionnaires. RESULTS: Compared with baseline, individuals' mean scores of distress were lower in the empowerment group than the control group (p < 0.001). General quality of life and sub-dimension mean scores were higher in the empowerment group than the control group (p ≤ 0.05). There was no difference in the coping style average scores (p ≥ 0.05) between the two groups. CONCLUSIONS: This study supports the findings that a mobile-supported empowerment program reduced the level of caregiver distress and increased quality of life during their loved one's treatment with radiotherapy.

The Effect of Progressive Muscle Relaxation Exercises on Pain on Patients with Sickle Cell Disease: Randomized Controlled Study.

PURPOSE: The study aimed to evaluate the effect of progressive muscle relaxation exercises on pain in patients with sickle cell disease. MATERIALS-METHOD: This randomized controlled interventional study was conducted in a hospital in Mersin, Turkey between October 2017 and July 2018. The study sample comprised 58 patients who were aged >18 years, conscious, had sickle cell disease, reported pain, and were treated with non-opioid or weak opioid analgesic based on the physician's recommendation (treatment group = 29, control group = 29). Data were collected by the individual presentation form and visual analog scale. During the study, both groups were treated with analgesics prescribed by the physician for three days. In addition to the analgesics, the treatment group was performed progressive muscle relaxation exercises for 30 minutes whereas the control group was rested. Pain level of both groups was evaluated at three time points every day for three days. In the study, frequency distributions and descriptive statistics were presented for categorical and numerical variables, respectively. Chi-square analysis, independent samples t-test, Mann-Whitney U test, three-way ANOVA, and Sidak test were used to analyze the difference between the variables. RESULTS: The mean age of the patients was 29.59 ± 6.94 years, and 53.4% of the patients were female and 69% were single. The mean pain score of the treatment group at the third time point on days 1, 2, and 3 was significantly lower than the control group (p < .05). There was no statistically significant difference between the two groups in terms of coping methods for pain, pain location, and complaints accompanying pain (p > .05). CONCLUSION: Progressive muscle relaxation exercises were found to be effective in the pain management of patients with sickle cell anemia.

Comparing the symptoms experience of cancer and non-cancer older adult patients in Turkish cancer patients: A cross-sectional study.

This cross-sectional study was conducted with 160 older people to compare the symptoms experience of cancer and with non-cancer older adult patients. A patient information form and The Rotterdam Symptom Checklist (RSCL) were used to gain information on the experience of their symptoms. The most prevelant symptoms of older cancer patients were tiredness (53.8%), decreased sexual interest (51.2%) and lack of energy (41.2%), for non-cancer older adult patients was a decreased sexual interest (75.0%). Cancer patients proportionately reported more symptoms than non-cancer patients which was reflected in their higher RSCL score. These findings reflect that a greater number of cancer patients report a higher average of symptoms, especially those that are physical in nature: tiredness, lack of energy, head ache, acid ingestion, loss of hair, burning eyes and sore mouth. Oncology nurses, who are an important part of the health care team should be able to assess the symptom burden of older patients during their treatment before, during and after chemotherapy.

The Effect of Health Literacy on Self-Efficacy and Quality of Life among Turkish Cancer Patients.

OBJECTIVE: To assess the effect of health literacy on cancer patients' self-efficacy and quality of life. METHODS: The cross-sectional, descriptive study was conducted from June 15 to November 15, 2017, at the Private Unit Hospital in Eskisehir, Turkey, and comprised cancer patients aged 18 years or above who were treated in the Medical Oncology clinics and who had received less than four points on the Eastern Cooperative Oncology Group performance scale. Data were collected using the European Health Literacy Survey, the Self-Efficacy to Manage Chronic Disease Scale and the European Organisation for Research and Treatment of Cancer Quality of Life - C 30 scale . RESULTS: Of the 111 patients, 83(74.8%) were females. The overall mean age was 55.62±12.75 years. With a mean score of 36.09±6.42, the sample had 'sufficient health literacy'. There was a positive and significant relationship between the European Health Literacy Survey score and the general health subscale score (p=0.036), and a negative and significant relationship with the symptom subscale score (p<0.01). A statistically significant positive relationship was found between the Self-Efficacy to Manage Chronic Disease Scale and the functional (p<0.001) and general health (p<0.001) subscales while a statistically significant negative relationship (p<0.001) was found between the Self-Efficacy to Manage Chronic Disease Scale and the symptom subscale. CONCLUSIONS: Increased literacy levels were found in cancer patients and it helped in improving in their self-efficacy, general health and functional status.

Investigation of the effect of black cumin oil on pain in osteoarthritis geriatric individuals.

PURPOSE: This study has been carried out to investigate the analgesic effect of black cumin oil on individuals with knee pain. METHOD: The experimental group (n = 30) and control group (n = 30) have been randomly selected. The control group patients have continued their routine prescription. For the experimental group, black cumin oil has been applied by rubbing to their knees 3 times a week for 1 month. FINDINGS: As a result of the study, the mean VAS values of the patients in the experimental group has changed to 7.50 ±â€¯0.97 on the 1st day and 6.30 ±â€¯1.14 on the 30th day and there has been a significant decrease in pain severity in this group (p < 0.001). RESULTS: This study has shown that the pain relieving properties of black cumin oil is effective on geriatric individuals living with knee pain.

Aromatherapy: The Effect of Lavender on Anxiety and Sleep Quality in Patients Treated With Chemotherapy

BACKGROUND: A cancer diagnosis is a serious stressor that is associated with anxiety, depression, sleep disorders, and inability to fulfill daily routines. Many pharmacologic and nonpharmacologic options are available to help patients with cancer manage anxiety. OBJECTIVES: This randomized, controlled trial examined the effects of lavender oil aromatherapy on anxiety and sleep quality in patients undergoing chemotherapy. METHODS: 70 patients were randomly assigned to a lavender oil group, a tea tree oil group, and a control group with no oil. A patient identification form, the State-Trait Anxiety Inventory, and the Pittsburgh Quality Sleep Index (PSQI) were used to measure anxiety and sleep quality before and after chemotherapy. FINDINGS: State anxiety before and after chemotherapy did not vary among groups. The authors compared trait anxiety values before and after chemotherapy and found a significant difference in the lavender group. In addition, a significant change in PSQI measurements before and after chemotherapy was observed.

Effect of education and telephone counseling on adherence to treatment and challenges experienced in anti-TNF-α treatment: a pilot study.

BACKGROUND: Anti-tumor necrosis factor-α (anti-TNF-α) drugs used in the treatment of rheumatologic diseases. OBJECTIVE: This study was conducted to examine the effects of education about the drug use and consultation by telephone calls on treatment adherence and drug-induced challenges in patients under 'the first anti-TNF-α treatment'. METHODS: The research instruments were used Morisky's Questions-Self Report Measure of Adherence, drug-induced problems determination form. RESULTS: In the Morisky Drug Adherence Scale, the answers to the questions 'Do you forget to use your drugs?' and 'Are you sometimes careless when you use your drug?' changed from 'yes' to 'no', and the difference was statistically significant (p < .001, p < .001). 21.9% of the intervention group and 34.4% of the control patients reported they experienced some problems (χ2 = 3.244, p = .087). CONCLUSION: Education is effective on adherence to drug treatment in patients on anti-TNF-α treatment however telephone counselling had no effect on challenges experienced.

Educational Study to Increase Breast Cancer Knowledge Level and Scanning Participation among Women Working at a University.

OBJECTIVE: The aim of the study is to increase the participation level of women in screening programs by increasing the level of knowledge about early diagnosis and screening methods for breast cancer (BC). MATERIALS AND METHODS: This was a pretest-posttest one group design study held in Eskisehir Osmangazi University, Turkey. The sample consisted of 405 women in all departments of the University. Data were collected using socio-demographic forms and questionnaires. Training about BC was provided for participants. The questionnaire used prior to the training to measure levels of knowledge about BC was re-administered 3 weeks after the training. RESULTS: The women were most commonly aware of the breast self-examination (68.1%). The ratio of women who had had mammography in the previous year was 11.4%. The BC knowledge level significantly increased after the training (p=0.001). CONCLUSION: This study determined that the level of knowledge about BC in terms of early detection and screening was low and that the percentage of participation in screening was also low.

Knowledge Level on Administration of Chemotherapy through Peripheral and Central Venous Catheter among Oncology Nurses.

OBJECTIVE: The aim of this study is to determine the knowledge levels of oncology nurses about peripheral and central venous catheter during their chemotherapy administration. METHODS: Data collection of this descriptive study was started on April 15, 2015-July 15, 2015. The data presented in this summary belong to 165 nurses. Data were collected with data collection form including questions related to sociodemographic qualifications and knowledge levels of nurses. Data collection forms were E-mailed to the members of Turkish Oncology Nursing Society. Data presented with numbers, percentages, and mean ± standard deviation. RESULTS: The mean age of nurses was 33.60 ± 7.34 years and mean duration for oncology nursing experience was 2.65 ± 0.91 years. Nurses had correct information about the importance of selecting peripheral venous catheter and choosing the placement area for chemotherapy administration (63.6%), control of catheter before the administration (93.9%), influence of chemotherapeutic agent on length of catheter (40.6%), and management of extravasation (75.7%). Nurses also had correct information about the first use of port catheter (67.3%) and checking the catheter whether it is working properly or not (75.8%). CONCLUSIONS: In General, nurses' level of knowledge related to catheter is 50% and higher. It is recommended to increase the knowledge of nurses about evidence-based information for catheter care as a step to safe chemotherapy practice.

Effect of Isometric Hand Grip Exercises on Blood Flow and Placement of IV Catheters for Administration of Chemotherapy.

BACKGROUND: Complications may occur in the subcutaneous or subdermal tissues during IV administration of chemotherapy related to blood flow and catheter placement. OBJECTIVES: Daily isometric hand grip exercises were evaluated for their effect on blood flow in the vessels of the nondominant arm before placement of IV catheters and the success rate of IV catheter placement on the first attempt. METHODS: The study focused on patients with non-Hodgkin lymphoma receiving the first and second cycles of chemotherapy. The intervention group performed daily isometric hand grip exercises before chemotherapy with peripheral catheter insertion. The control group performed routine activities only. Blood flow was measured by ultrasound in the brachial artery (BA) and brachial vein (BV) of the nondominant arm before the first (T1) and second (T2) cycles of chemotherapy. FINDINGS: Blood flow slightly increased in the intervention group at T2 compared to T1. In the control group, blood flow decreased in the BA and did not change in the BV at T2 compared to T1. The success rate for first-attempt placement of a peripheral IV catheter was the same for the intervention and control groups.

Effects of music on pain in patients with fibromyalgia.

Fibromyalgia syndrome (FMS) is a chronic syndrome characterized by diffuse musculoskeletal system pain and painful tender points in certain areas of the body. The aim of the investigation was to determine the effects of music on pain in fibromyalgia patients. This randomized clinical trial was carried out with 37 fibromyalgia outpatients as an experimental group (n = 21) and control group (n = 16) at a University Hospital Internal Medicine and Rheumatology Clinic between 1 June and 1 December 2014. The research instruments used were descriptive characteristics questionnaire, Visual Analogue Scale (VAS), music CD which includes water and wave sounds recommended by the Turkish Psychological Association for psychological relaxation, and pain evaluation form. According to the findings, the average age of patients was 43.59 years ± 10.30, 94.6 % were women and 81.1 % were married. The fibromyalgia patients had the disease ranged from 1 month to 20 years, the average of disease duration was 23.6 ± 45.5 months, and the average of pain intensity was 6.89 ± 1.64 on the VAS. Average pain was reported in the experimental group in VAS on day 1 (5.45 ± 2.73), day 7 (4.57 ± 2.71), and day 14 (4.14 ± 2.45), and significant reduction in pain in the listening music group was seen (p = 0.026). A repeated measure analysis of variance controlling for differences between days demonstrated a significant decrease in pain between day 1 and day 14 (p = 0.022). There was no significant decrease in pain among control group participants. The effect of music has been found to control pain in fibromyalgia patients. Music therapy should be suggested in pain management for fibromyalgia patients as an non-pharmacologic nursing intervention.

Relationships between social support and social image concerns in Turkish women with breast cancer.

BACKGROUND: Breast cancer is one of the most common cancer types in women and is amongst the most devastating and stressful events in the life of women. The external appearance of breast cancer patients usually changes due to the surgical and/or medical therapies used. An association may be found between social support perception and social appearance anxiety in patients with breast cancer in the period after mastectomy. Therefore, this study investigated the social appearance anxiety and social support status in women with breast cancer in our country. MATERIALS AND METHODS: A descriptive cross-sectional study was conducted in breast cancer patients undergoing treatment or follow-up in Medical Oncology and General Surgery departments. RESULTS: The mean age of the participants was 51.13 ± 8.48 years (range, 24-74 years) with nearly half of the patients (40.6%) aged 40-50 years. Of the patients, 39.1% had stage 3 breast cancer. The mean score on Cancer Patient's Social Support Scale (CPSSS) was 134.85 ± 9.35, and there was a significant difference in CPSSS total scores between the age groups, educational levels, self-reported income levels and stage of disease (p<0.05). The mean Social Image Anxiety Scale (SIAS) score was found to be 34.30 ± 9.35 (min:16, max:66) in women participating in this study. The CPSSS and SIAS scores of the participants were inversely correlated, and the SIAS score was found to decrease with the increasing CPSSS score but with no statistically significant difference (r=-0.110, p=0.217). CONCLUSIONS: Social appearance anxiety is higher in the patients with poor social support.

The effect of relaxation exercises on quality of sleep among the elderly: holistic nursing practice review copy.

The aim of this study was to determine the effect of relaxation exercises on quality of sleep of the elderly people staying in a nursing home. Control group had 44 elderly persons and the intervention group had 20 elderly persons in a nursing home. Quality of sleep in the intervention group increased statistically (P = .000). The elderly people should be encouraged to perform relaxation exercises.