Investigation of Post-Transplant Mental Well-Being in Liver Transplant Recipients with Hepatic Encephalopathy.

Objective: In this study, we aimed to examine the healing trend of hepatic encephalopathy after transplantation surgery in patients with liver failure. Method: We conducted this descriptive and cross-sectional study with the participation of liver transplant recipients. A personal information form, the West Haven Criteria (WHC), the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS), and the Richmond Agitation Sedation Scale (RASS) were used for data collection. The data were analyzed using Chi-squared tests, ANOVA, and paired-samples t-tests. Results: As time progressed after liver transplantation, hepatic encephalopathy stages regressed (p < 0.01). We found that liver transplant recipients with end-stage hepatic encephalopathy were mostly within the first 6 months after transplantation, while patients with first-stage hepatic encephalopathy had received liver transplants more than 2 years ago (p < 0.01). Conclusions: The results of our study revealed that hepatic encephalopathy stages regressed after transplantation, but there was no complete recovery. This highlights the need to develop new treatment strategies other than liver transplantation for the treatment of hepatic encephalopathy.

Evaluation of Nipple-Areola Circulation in Central Pedicle Mastopexy Patients with Subpectoral Implant Placement: A Quasi-Experimental Study.

OBJECTIVE: Mastopexy is a procedure which is used in breast lift and reconstruction surgery and requires a small amount of parenchymal resection. In this procedure, the preservation of nipple-areola circulation is vital. The purpose of this study is to evaluate nipple-areola circulation in patients undergoing central pedicle mastopexy with subpectoral implant placement. MATERIAL AND METHOD: In this observational quasi-experimental study, data were collected retrospectively from electronic medical records. The perioperative nipple-areola circulation of patients undergoing central pedicle mastopexy with subpectoral implant placement was evaluated by integrated laser Doppler flowmetry. Descriptive statistics, one-way analysis of variance, and Tukey's range tests were used to analyze the data. RESULTS: The preoperative, skin dissection, pectoral elevation, implant placement, 24th hour, and 2nd week nipple-areola circulation statuses of each patient who underwent central pedicle mastopexy with subpectoral implant placement were examined using an integrated laser Doppler flowmeter, and the results were compared. At each stage, all measurements were in the range of 1.8-3.6 ml/min/100g. There was no statistically significant difference between the measurement results. CONCLUSION: Central pedicle mastopexy with subpectoral implant placement seems highly advantageous in terms of better functionality and aesthetics in the reconstruction of heavy and sagging breasts. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/0026.

Mindfulness-based cognitive therapy for adherence of immunosuppressive treatment in liver transplant recipients: A randomized controlled trial.

OBJECTIVE: The aim of this study was to analyze the effects of mindfulness-based cognitive therapy on the adherence of liver transplant recipients to immunosuppressive therapy with a randomized controlled design. METHOD: This randomized controlled trial was performed with 120 liver transplant recipients hospitalized at the liver transplant department of a research and practice hospital (n = 120). While we administered no intervention to the patients in the control group (n = 60), we provided Mindfulness-Based Cognitive Therapy to those in the experimental group (n = 60). We used the Mindful Attention Awareness Scale and the Immunosuppressant Therapy Adherence Scale to collect data. We utilized descriptive statistics, paired-samples t-tests, independent-samples t-tests, one-way analysis of variance, and chi-squared tests to analyze the data. RESULTS: After the intervention, the immunosuppressive therapy adherence levels of the experimental group increased significantly (p < 0.01). On the other hand, the control group had significantly higher adherence to immunosuppressive therapy and significantly higher levels of mindfulness in the pretest phase than it did in the posttest phase (p < 0.01). CONCLUSIONS: Complete adherence to immunosuppressive therapy is imperative for the prevention of graft rejection in liver transplant recipients. In our study, the experimental group equipped with enhanced mindfulness had higher adherence to immunosuppressive therapy. Therefore, the use of Mindfulness-Based Cognitive Therapy in the promotion of adherence to immunosuppressive therapy is recommended.

Comparison of case and control groups in terms of postoperative complications, outcomes, and survival in total hip arthroplasty patients with and without COVID-19.

Introduction: Total hip aarthroplasty (THA) is not performed worldwide as an emergency surgical procedure and has often been postponed during the COVID-19 pandemic. The hypothesis of this study was that COVID-19 caused the extra burden and mortality of THA patients. This study aimed to investigate the problems caused by comorbid COVID-19 in addition to the current clinical status in patients who had undergone THA. Materials and methods: A case-control group study was conducted with the participation of patients with COVID-19 and without COVID-19 who had undergone THA and were hospitalized in an orthopedic clinic and intensive care unit at a research and training hospital. IBM Statistical Package for Social Sciences 25.0 was used for data analysis. Results: A total of 291 patients who had undergone THA were included in the study: 161 patients with COVID-19 constituted the control group and 130 patients without COVID-19 constituted the case group. In this study, the authors found that THA patients with COVID-19 had higher rates of nausea, vomiting, diarrhea, musculo-articular pain, and headache compared to those without COVID-19, and the difference was statistically significant (p < 0.01); 17.7% of the patients with COVID-19 died, and delirium developed in 35.4%. The difference between the case and the control groups was statistically significant in terms of delirium and death (p < 0.01). Discussion: COVID-19 increases the risk of delirium and death in THA patients, as well as extending the hospital stay. The fact that the pandemic is not over yet and that despite vaccination, COVID-19 continues to have its devastating effects experienced, especially by individuals in their advanced age.

The effect of bed exercises following major abdominal surgery on early ambulation, mobilization, pain and anxiety: A randomized-controlled trial.

This randomized-controlled trial aimed to investigate the effect of bed exercises on postoperative anxiety, pain, early ambulation and mobilization. This study was conducted with a randomized-controlled trial design and in the general surgical clinic of a research and training hospital. A total of 120 patients (60 in the experimental group and 60 in the control group) scheduled for major abdominal surgery took part in the study. The data were collected using a patient information form, the Anxiety Specific to Surgery Questionnaire and the Visual Analog Scale through face-to-face interviews. The patients in the experimental group performed 15-min bed exercises on the day of their operation, as well as on the postoperative first and second days, and the control group underwent only the routinely performed procedures in the clinic. The data were analysed using descriptive statistics, analysis of variance and t-tests. The sample of our study included major abdominal surgery patients. Ambulation was achieved at a mean time of 4 h earlier in the experimental group. On the postoperative first and second days, the patients in the experimental group had mean mobilization durations that were approximately 2 h longer compared with the patients in the control group. Moreover, the postoperative pain and anxiety levels of the patients in the experimental group were significantly lower than those of the patients in the control group (p < 0.05). We recommend that bed exercises be performed to lower anxiety and pain severity, achieve early ambulation and increase the duration of mobilization among patients following major abdominal surgery.

The effect of post-traumatic growth on recovery in liver transplant recipients.

Aim: In our study, we examined the effect of post-traumatic growth on recovery in liver transplant recipients in the post-transplant period. Method: This research was performed as a descriptive and cross-sectional study with the participation of 218 patients who had liver transplantation at the liver transplant institute of a research and training hospital. The personal information form, the Post-Traumatic Growth Inventory, and the Recovery Assessment Scale were used in the data collection process. The Statistical Package for Social Science 25.0 was utilized in the data analysis process. Findings: In the research, of all participant liver transplant recipients, 67.8% were aged 45-64 years, 34.4% had incomes below expenses, and 91.7% had living donor liver transplantation. Besides, it was found that participants who had living donor liver transplantation obtained higher mean scores from both the Post-Traumatic Growth Inventory and the Recovery Assessment Scale than participants who had cadaveric donor liver transplantation, and likewise, participants who had past surgery experiences obtained higher mean scores from both the Post-Traumatic Growth Inventory and the Recovery Assessment Scale than participants who had no past surgery experience (p < 0.05). Moreover, there was a statistically significant positive linear relationship between participant liver transplant recipients' Post-Traumatic Growth Inventory and Recovery Assessment Scale scores. Conclusion: Post-traumatic growth supports recovery. Also, social support and a good economic situation are other parameters that promote recovery. In the two-year process during which the treatment is intensively applied to liver transplant recipients following the transplantation surgery, it is important to enable patients to find more meaning in life and to find solutions that facilitate recovery.

Nursing Image From the Perspective of Healthcare Professionals During the Post-COVID-19 Pandemic Period: A Cross-Sectional Study.

In this study, the goal was achieved to examine the nursing image from the perspective of healthcare professionals in the post-COVID-19 period. This descriptive study was conducted with the participation of n = 264 healthcare professionals working in a training and research hospital. A personal Information Form and Nursing Image Scale were used to collect data. Descriptive methods, the Kruskal-Wallis test, and the Mann-Whitney U test were used in data analysis. Sixty-three point three percent of the healthcare professionals were women and 76.9% were nurses. Sixty-three point six percent of healthcare professionals had COVID-19 and 84.8% had worked without leave during the pandemic. In the post-COVID-19 period, 39% of the healthcare professionals were in partial anxiety and 36.7% were in constant anxiety. Personal characteristics of healthcare professionals did not have a statistical impact on nursing image scale scores. From the perspective of healthcare professionals, the total score of the nursing image scale was moderate. The lack of a strong nursing image may trigger poor care practices.

The Effects of the Spiritual Well-Being Levels of Surgical Nurses on Care Satisfaction in Liver Transplant Recipients After Transplantation: The Case of a Turkish Sample.

This study examined the effects of the spiritual well-being levels of surgical nurses on care satisfaction in liver transplant recipients after transplantation. The sample in this cross-sectional study consisted of 69 surgical nurses working in the organ transplant centre of a research and training hospital in Turkey and 79 liver transplant recipients. The data of this study were collected between 1 August 2020 and 30 August 2021. The "Three-Factor Spiritual Well-being Scale" and the "Newcastle Satisfaction with Nursing Scale" were used for data collection. A statistically significant relationship was found between the spiritual well-being levels of the surgical nurses and the care satisfaction levels of the transplant recipients. Surgical nurses should be capable of treating patients holistically and be knowledgeable enough to support the mental health of patients. High levels of spiritual well-being in surgical nurses contribute to increased satisfaction with care among organ transplant recipients.

Investigation of the monocyte/high-density lipoprotein ratio as a prognostic criterion in burn patients.

In this study, it was aimed to investigate the monocyte/high-density lipoprotein ratio as a prognostic criterion in adult burn patients. A descriptive and cross-sectional method was adopted in this study. The sample included 177 patients with burn injuries. This study was conducted in a research and training hospital in Turkey. Data were collected by the researchers in the burn unit. Descriptive methods, Kruskal-Wallis, Mann-Whitney U, ROC curve, and correlation analyses were used for the statistical analyses of the data. While 66.1% of the patients were second-degree burn patients, 96.6% of all patients recovered and were discharged from the hospital, and the rest died. In this study, the monocyte/high-density lipoprotein ratios of the patients decreased as their clinical condition worsened. The mean C-reactive protein value of the patients was 8.52 ± 5.02 on the 7th day. A statistically significant correlation was found between an increase in monocyte counts and a decrease in high-density lipoprotein concentrations at the 24th hour, 3rd day and 7th day after the burn (p < 0.01). The monocyte/high-density lipoprotein ratio can be considered a biomarker in the identification and follow-up of sepsis and morbidity durations in burn patients. A low monocyte/high-density lipoprotein ratio in burn patients can provide an insight into the severity of sepsis.

The Effect of Attitude to Death on Self-Management in Patients With Type 2 Diabetes Mellitus During the COVID-19 Pandemic.

This study was conducted to examine the effect of attitude to death on self-management in patients with Type 2 Diabetes Mellitus during the COVID-19 pandemic. This study was carried out in a descriptive and correlational type with the participation of n = 103 type 2 diabetes mellitus patients registered in the Internal Medicine Unit at a University Hospital. Personal Information Form, Death Attitude Profile-Revised (DAP-R), Diabetes Self-Management Questionnaire and Fear of COVID-19 Scale were used in data collection. According to the results of the study, it was determined that diabetes patients' fear of COVID-19 increased their fear of death and self-management. Similarly, neuropathy and nephropathy developed in these patients. In addition, it was determined that the diabetic patients who worked 6-7 days a week outside the home had higher levels of fear. It was found that those with high fear were more attentive to social distancing, wearing masks and hand sanitizer use. Staying at home is also not always possible for patients with chronic diseases, and people struggle with COVID-19 by working in crowded workspaces. It is necessary to recognize the struggle of patients with chronic diseases and provide social, economic and psychological support.

Effect of Perceived Dyspnea on Attitude Toward Death From the Perspective of COPD Patients.

In this study, it was aimed to examine attitudes toward dyspnea and death from the perspective of Chronic Obstructive Pulmonary Disease (COPD) patients and to determine the relationship between them. This descriptive research was carried out in the chest diseases clinic of a public hospital and with the participation of COPD patients (n = 124). The data were obtained from the Personal Information Form, Death Attitude Profile-Revised, and Medical Research Council Scale. The neutral acceptance and approach acceptance subscale is explained as believing that death is an inevitable part of life and a transition to life after death. The escape acceptance subscale is explained as believing that life will save from physical or psychological harms. It was determined that the Neutral Acceptance and Approach Acceptance sub-dimension of the predictors of dyspnea, comorbid diseases, and COPD had a significant effect at a rate of 33% (p = 0.000). Dyspnea, Comorbid diseases, and the predictors of the severity of COPD affect the Escape Acceptance sub-dimension by 57% (p = 0.000). This research has shown that fear of death is high in COPD patients with high perceived dyspnea. The psychological support provided to patients with COPD should be considered to relieve the fear of death. New studies are needed in which these should be reevaluated in the same context.

Effect of meditation music and comedy movie interventions on postoperative kinesiophobia and pain in patients undergoing total knee arthroplasty.

BACKGROUND: This study aimed to investigate the effects of music and comedy movie interventions on postoperative pain and kinesiophobia in patients who underwent total knee arthroplasty. METHODS: This randomized-controlled study was carried out with the participation of patients who underwent total knee arthroplasty. The patients were divided into three groups. To reduce surgical pain and kinesiophobia, the patients in group 1 watched a comedy movie, those in group 2 listened to music, and those in group 3 did not participate in any intervention other than the routine practices of the clinic. RESULTS: The personal and medical characteristics of the patients in all groups were similar. The patients in all three groups were kinesiophobic, and their surgical pain levels were moderate despite pharmaceutical interventions. Groups 1 and 2 had a statistically significant decrease in kinesiophobia and pain scores after the interventions. The effects of having patients watch a comedy movie and having them listen to meditation music were not significantly different. CONCLUSIONS: The results of the study showed that listening to meditation music or watching comedy movie scenes had significant positive effects in alleviating postoperative pain and kinesiophobia after TKA. Based on the results of this study, it is recommended that patients watch comedy movies and listen to meditation music to alleviate their postoperative pain and kinesiophobia. TRIAL REGISTRATION: NCT, NCT05471778. The study was registered at ClinicalTrials.gov.

Examining the perceived stress and body image in burn patients: A cross-sectional study.

This study aimed to examine the perceived stress and body image in burn patients and the relationship between these two variables. This is a descriptive and cross-sectional study. The study included total of 144 patients who had burn injuries, received treatment in a research and training hospital and were scheduled to be discharged. The data were collected prospectively by the researchers, using descriptive methods, Kruskal Wallis test, paired samples t test, and Pearson's correlation analysis. Of the patients, 59% were between the ages of 18 and 35 years, 68.1% were male, 65.3% had second-degree burns, 77.1% had burn surfaces ranging between 10% and 20% of their body, and 54.9% had autograft surgery. The burn patients aged 51 years and over had higher perceived stress than younger patients, and the difference between them was statistically significant (P < 0.05). As the percentage of burn surface increased, the perceived stress increased, and the perceived body image weakened (P < 0.05). The burn patients with autograft surgery had lower perceived stress and higher perceived body image than those without autograft surgery, and the difference between them was statistically significant (P < 0.01). This study found an inverse relationship between perceived stress and body image in burn patients, which was affected by the percentage of burn surface and autograft surgery. Relevant interventions are suggested to increase perceived body image in burn patients and reduce their perceived stress.

A randomized controlled trial of reflexology effect after abdominal surgery on patient satisfaction, pain and vital signs.

OBJECTIVE: In our study, we investigated the effect of reflexology on patient satisfaction, pain and vital signs after abdominal surgery. METHOD: This study was conducted as a randomized controlled trial with the participation of 156 abdominal surgery patients hospitalized in the general surgery unit of a training and research hospital. Personal Information Form, Visual Analogue Scale and Newcastle Nursing Care Satisfaction Scale were used in data collection. We performed the data analysis with One-way analysis of variance, Chi-squared test, paired samples t-test, and independent samples t-test. RESULTS: When the pain, vital signs and satisfaction levels of the experimental and control groups were compared, the pain intensity of the experimental group was found to be lower and the level of satisfaction was higher after reflexology (p<0.01). After reflexology, the blood pressure was closer to 120/80 in the experimental group, the respiratory rate was between 16-22 (number/minute), the difference between the experimental and control groups were statistically significant (p<0.01). There was no statistically significant difference between the pulce oximetry values between the experimental and control groups. CONCLUSION: Surgical pain and non-optimal vital signs that are not well managed after surgery causes various complications and decrease patient satisfaction. The results of our study emphasize the power of reflexology in effective surgical pain management and normalizing vital signs and increasing patient satisfaction. We suggest that reflexology be performed to patients following abdominal surgery.

The Treatment Perspective of Pediatric Condyle Fractures and Long-Term Outcomes.

PURPOSE: In our study, the characteristics, treatment approach and long-term outcomes of condyle fractures treated in the pediatric plastic surgery and reconstruction unit in the last 10 years were evaluated. MATERIALS AND METHODS: This study consisted of two retrospective and prospective sections with the participation of pediatric patients with condylar fractures who were treated in the Plastic, Reconstructive and Aesthetic Surgery clinic of a university hospital in the last 10 years. In the retrospective section, data were obtained from the electronic patient records and patient files regarding the treatment applied, as well as the characteristics of the patient and condyle fractures. In the perspective section, patients were invited to the clinic and the effectiveness of the treatment was evaluated. Statistical analyses were performed with SPSS (Statistical Package for Social Sciences) for IBM 25 package program. RESULTS: It was determined that 55.8% of the pediatric patients had accompanying facial fractures, and 72.4% had unilateral condyle fractures. It was determined that 59.5% of the pediatric patients underwent intermaxillary fixation (IMF). Physical complications were seen in 6.75% in the long term after treatment. CONCLUSION: Falling from height and traffic accidents, which are the most important factors in the occurrence of condyle fractures, should be eliminated by increasing parental attention and awareness. Surgical treatment should be considered in the treatment of pediatric condyle fractures, especially if there are accompanying facial and mandible bone fractures.

Investigation of Neurological Symptoms Caused by COVID-19 in Intensive Care Unit.

We examined the neurological symptoms of patients treated in intensive care for COVID-19 in this study. We obtained the study data retrospectively from data records of 1,699 patients treated in the COVID-19 clinics of a training and research hospital. The study is a descriptive and cross-sectional study. Sociodemographic and Disease Information Form were used for data collection. Statistical Packed for the Social Sciences 25.0 IBM was used in Data analysis. It was observed that 37% of the COVID-19 patients were between the ages of 66-80 years and 55.6% of the COVID-19 patients were male. The most common neurological symptoms in the disease process and their rates were as follows: insomnia 74.6%, taste loss 74%, smell loss 75.6%, muscle pain 83.2%, headache 45.1%, dizziness 32.2%, weakness 20.2%, and agitation 34.7%. Assessment of neurological symptoms of patients followed up for COVID-19 is of great importance. We suggest that neurological problems should be tried to be cured with appropriate treatment protocols and therapy support before they progress further and the neurological prognosis progresses.

Examining the perspectives of textile workers on organ donation and related factors.

OBJECTIVE: In this study, we aimed to examine the perspectives of textile workers on organ donation and related factors. METHOD: The sample of this descriptive and cross-sectional study consisted of employees of a textile factory located in eastern Turkey (n = 166). The data were collected using the forms Personal Information and determining Knowledge, Awareness, and Willingness regarding Organ Donation and Transplantation. Data collection forms were prepared by researchers based on the literature and taking expert opinion. In the analysis of the study data, number-percentage, chi-square test and Cramér's phi correlation analysis were used. RESULTS: The mean age of the participants was 21.10 ± 2.53, and the numbers of men and women were equal. It was determined that 63.3% of the participants needed education related to organ donation, and 57.8% were willing to donate their organs. There is a correlation the high levels of knowledge, awareness, and willingness regarding organ donation and transplantation with the participant's levels of thinking about donating their organs. CONCLUSION: Our results supported the view that high levels of knowledge and awareness increased willingness about organ donation. In increasing the number of organ donors, high levels of knowledge and awareness are highly important, all parts of society should be provided with education on this issue, and it should be considered that workers of all sectors, especially textile workers, constitute a significant proportion of most societies in terms of numbers.

The Effect of Environmental Stressors on Patient Experience in Medical, Surgical, and COVID-19 Intensive Care Unit.

This study was conducted to evaluate the effects of environmental stressors on patients' intensive care experiences in medical, surgical, and COVID-19 intensive care units (ICUs). The sample group consisted of 231 patients hospitalized in medical and surgical ICUs and agreed to participate in the study. The data analysis was performed with IBM SPSS Statistics 25. The average age of the patients was 53.67 ± 13.3, 55.4% were male, 47.6% were high school graduates, and 45.5% were followed up in the COVID-19 ICU. It was also found that there was a negative and moderate degree of correlation between the Intensive Care Experience Scale (ICES) and the Intensive Care Unit Environmental Stressors Scale (ICUESS). Environmental stressors in ICUs are associated with patient experiences. It is clear that ICU stressors create a negative perception in the patient and this situation is emotionally exhausting.

The Effect of Spiritual Well-Being of Perioperative Nurses on Compassion.

PURPOSE: This study aimed to determine the effects of spiritual well-being of perioperative nurses on their compassion. DESIGN: This was a prospective and cross-sectional study. METHODS: The sample for this study included 168 perioperative nurses working in the surgical clinics of a research hospital. Data was collected between August and October 2020 using "Nurses' Descriptive Characteristics, Compassion and Three-factor Spiritual Well-Being Scales". Descriptive statistics, correlation and simple regression analysis were used to analyze the data. FINDINGS: Our sample included 51% between the ages of 22 and 30, 85.7% women, 73.8% undergraduates, 33.3% general surgery clinicians, and 41.7% with a work experience of 5 to 9 years. Perioperative nurses were found to have moderate compassion and close to a good level spiritual well-being. Although all the descriptive features of the nurses contributed to their spiritual well-being, it was determined that the education level, the clinics they worked in and their working years in the profession were important factors in determining their compassion. Positive correlation was found between the Compassion and Spiritual Well-Being Scales (r = 1.000; P < .05). CONCLUSIONS: We found that the spiritual well-being of perioperative nurses had an effect on compassion. Every patient deserves compassionate care. If spirituality increases compassion, it is acceptable for nurses to increase their awareness and knowledge of spiritual values.

Investigation of adherence to immunosuppressive therapy and spiritual well-being in liver recipients.

OBJECTIVE: In our study, we investigated the relationship between spiritual well-being and adherence to immunosuppressive therapy after liver transplantation. METHOD: We conducted this descriptive and cross-sectional study with the participation of 131 liver transplant recipients after they had received their transplants. Data collection was carried out using a Personal Information Form, the Spiritual Well-Being Scale and the Immunosuppressant Therapy Adherence Scale. The IBM Statistical Package for the Social Sciences 25.0 was used for the statistical analyses. RESULTS: While 73.3% of the patients were at the ages of 45-64, 72.5% were male, and 39.7% had been using immunosuppressive medication for a period between 6 months and 1 year. The rate of corticosteroid use among the patients was 30.5%, and the rate of antimetabolite use was 21.4%. A positive and significant relationship was found between adherence to immunosuppressive treatment and spiritual well-being (B = 0.425, p = 0.017). CONCLUSION: Spiritual well-being is an inexpensive, effective and easy strategy to increase adherence to immunosuppressive treatment. Awareness should be raised in physicians and nurses about the importance of spiritual well-being, and they should be encouraged to support spiritual well-being.