Nomophobia and Phubbing Levels of Nursing Students: A Multicenter Study.

Today, with the enhancement in the usage of smartphones, the concepts of nomophobia and phubbing have emerged. Nomophobia refers to the fear of being deprived of smartphones/smart devices. Phubbing is the use of a person's smartphone in situations that are not appropriate for the situation, time, and place. Therefore, the study purposed to evaluate nursing students' nomophobia and phubbing scores in Turkey, Portugal, and the United States. The data were collected with the Personal Information Questionnaire, Nomophobia Scale, and Phubbing Scale from N = 446 nursing students. The mean age of the students was 22.04 ± 4.08 years, and 86.5% were women. It was found that the total nomophobia scores of the nursing students were 80.15 ± 21.96, 72.29 ± 28.09, and 99.65 ± 6.11, respectively in Turkey, Portugal, and the United States. When the countries' Nomophobia Scale total scores, "giving up convenience," "not being able to communicate," and "losing connectedness" scores were compared with each other, they were found to be statistically significant (P < .05). When the countries' Phubbing Scale total scores and all subscale scores were compared with each other were found to be statistically significant (P < .05). It is seen that nomophobia scores were moderate (60 ≤ NMP-Q nomophobia ≤ 99) and phubbing scores (<40) were below the level indicating addiction in all countries.

Cross-cultural adaptation, reliability, and validity study of the Turkish version of the "Spinal Cord Injury-Falls Concern Scale".

PURPOSE: This study aims to conduct a Turkish validity and reliability study of the Spinal Cord Injury-Falls Concern Scale (SCI-FCS). METHODS: The study involved 134 volunteer patients with spinal cord injury. Various validity analyses, including content validity analysis, Confirmatory Factor Analysis (CFA), Pearson product-moment correlation coefficient, and Cronbach's alpha value based on a single application for reliability, were employed. The Falls Efficacy Scale-International (FES-I) was used for criterion validity. RESULTS: All the standardized regression coefficients for the single factor measurement model established with 16 items in the scale are above 0.84. The CFA model, also with a single factor and 16 items, yields the following fit indices: Root-Mean-Square Error of Approximation value of 0.15, Standardized Root Mean Residual Squares value of 0.06, Chi-square value of 2.20, and Comparative Fit Index and Non-Normed Fit Index values of 0.98. The scores they received from the SCI-FCS and the scores they received from the FES-I scale have a statistically significant positive correlation (p < 0.01). The test-retest reliability coefficient value is 0.81, and the Cronbach Alpha value is 0.97. CONCLUSION: The Turkish version of the SCI-FCS is a valid and reliable tool for determining fall concerns for patients with spinal cord injury.

The Spinal Cord Injury- Falls Concern Scale (SCI-FCS) is a tool for assessing concerns about falling in people with spinal cord injuries.The Turkish version of the SCI-FCS is a valid and reliable tool.The Turkish version of SCI-FCS can be a useful tool in clinical and research settings for determining fall concerns for patients with spinal cord injury.

The effect of cold gel pack application in the prevention of amiodarone-related phlebitis.

The purpose of this study was to evaluate the effect of cold application on amiodarone-related vein phlebitis. A quasi-experimental design was used. The study sample consisted of 79 patients who received an amiodarone infusion. The control group of the study consisted of patients receiving amiodarone treatment, while the intervention group consisted of patients receiving cold application during the amiodarone infusion. In the intervention group, after the start of amiodarone treatment, cold gel packs were applied a total of 12 times for 15 min at 2-h intervals. The rate of phlebitis development was 59% in the intervention group and 95% in the control group (p < .001). It was found that 52.2% of the patients in the intervention group had first grade phlebitis and 84.4% of the patients in the control group who developed phlebitis had second grade phlebitis (p < .001). The 15-min cold application was found to be effective in terms of the rate of phlebitis development, phlebitis grade and time of phlebitis development. (ClinicalTrials.gov NCT05058053).

The effect of rose oil aromatherapy and hand-holding on pain due to peripheral intravenous catheter insertion.

INTRODUCTION: The study aimed to evaluate the effectiveness of rose oil (Rosa Damascene Mill.) aromatherapy and hand-holding in reducing pain associated with peripheral intravenous catheter insertion. METHODS: A comparative mixed-method design. A total of 126 patients were included in the study. For the study's quantitative data, sociodemographic characteristics of the patients and the Patient Interview Form for the qualitative data of the Numeric Rating Scale were used. In all patients included in the study, PIVC insertion was performed a single time by the same nurse using a standard procedure. Chi-square and Bonferroni tests were used for comparative statistics. RESULTS: No statistically significant difference between the groups regarding age, gender, marital status, BMI, and education level (p>0.05). Pain scores: it was 2.40±1.78 in the rose oil group, 3.53±1.98 in the hand-holding group, and 4.88±1.56 in the control group. The difference between the groups regarding pain scores is statistically significant (p=0.001). CONCLUSIONS: The study determined that rose oil aromatherapy and hand-holding interventions reduce pain during PIVC. However, rose oil aromatherapy was more effective on pain than the hand-holding intervention. (Clinical Trial ID: NCT05425849).

Is Virtual Patient Simulation Superior to Human Patient Simulation: A Randomized Controlled Study.

Virtual and human patient simulation methods offer an effective way to increase patient safety, reduce the incidence of errors, and improve clinical decision-making skills. The study was conducted to compare the effects of virtual and human patient simulation methods on performance, simulation-based learning, anxiety, and self-confidence with clinical decision-making scores of nursing students. A quasi-experimental, stratified, randomized controlled study was conducted with third-year nursing students. The students (n = 166) were divided into experimental and control groups. The difference between the pretest-posttest scores of intragroup nursing anxiety and self-confidence with clinical decision-making and total and sub-scale scores of in-group simulation-based learning were statistically significant ( P < .05). Performance scores were found to be statistically significantly high in the virtual patient simulation group ( P < .001). It was determined that virtual patient simulation was superior to other methods in terms of nursing anxiety and self-confidence with clinical decision-making, simulation-based learning, and performance scores.

Coronavirus and Health Anxiety of Nursing Students in Two Different Countries.

INTRODUCTION: Even under normal circumstances, anxiety is quite common among nursing students. Therefore, this study compared nursing students' health and coronavirus anxiety in two European countries. METHOD: The sample of the descriptive, cross-sectional study consisted of 685 undergraduate students studying at two different nursing schools in Turkey and Portugal. The study data were collected with the Personnel Data Collection Form, Coronavirus Anxiety Scale, and Short Health Anxiety Inventory. RESULTS: While there was no difference between the Coronavirus Anxiety Scale scores of Turkish and Portuguese nursing students (p > .05), a statistically significant difference was found between the Short Health Anxiety Inventory total scores and negative consequences scores (p < .05). DISCUSSION: Against the pandemic that the whole world is experiencing, it is recommended to compare nursing students in a cultural context and take precautions.

Nursing students' perceptions on clinical learning environment and mental health: a multicenter study. / Percepções de estudantes de enfermagem sobre o ambiente de aprendizagem clínica e saúde mental: um estudo multicêntrico.

OBJECTIVE: this study aimed at evaluating the perceptions of Nursing students from public universities in three European Union countries on mental health and clinical learning environments, a topic that has been rarely investigated in the literature. METHOD: data collection took place using a demographic data form, the Clinical Learning Environment, Supervision and Nurse Teacher Scale, and the Mental Health Continuum Short Form. A total of 571 participants from Turkey, Lithuania and Portugal were included in the study. RESULTS: there was a significant difference among the three groups regarding clinical learning environment and mental health status (p<.001). Supervision was the most valued element. The Portuguese students presented the highest mean in the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores (p<.001). Age, gender and mental health were effective in the Clinical Learning Environment, Supervision and Nurse Teacher Scale scores. CONCLUSION: the results indicated that the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores obtained by the Portuguese Nursing students were higher. It was also revealed that the students' perceptions on the clinical learning environment were affected by age and gender, and that their perceptions on mental health were influenced by the Clinical Learning Environment, Supervision and Nurse Teacher scale scores.

Comparison of surgical gloves: perforation, satisfaction and manual dexterity.

The purpose of this study was to assess the effectiveness of two different surgical gloves (powdered latex and powder and latex free) for glove perforation frequency, problems and satisfaction with glove usage and manual dexterity levels during surgical operations that include scrub nurses. Scrub nurses wore antiallergenic gloves (powder and latex free) gloves during three operations, double latex and powdered gloves during three operations and single latex and powdered gloves during three operations. The gloves were checked for punctures after each surgery with a water-inflation test. In our study, 19% of single gloves and 18.1 % of double gloves and 4.8% of powder and latex free worn by scrub nurses were punctured during surgery. None of the inner gloves in double gloves were punctured. Although wearing double gloves restricts manual dexterity, results in discomfort problems such as perspiration and fetor and results in a low satisfaction rate among scrub nurses, double gloves are protective against injuries and punctures.

Percepções de estudantes de enfermagem sobre o ambiente de aprendizagem clínica e saúde mental: um estudo multicêntrico / Nursing students' perceptions on clinical learning environment and mental health: a multicenter study / Percepciones de estudiantes de enfermería sobre el Ambiente de Aprendizaje Clínico y la salud mental: estudio multicéntrico

Resumo Objetivo: este estudo teve como objetivo avaliar as percepções dos estudantes de Enfermagem das universidades públicas de três países da União Europeia sobre saúde mental e ambientes de aprendizagem clínica, tema pouco investigado na literatura. Método: a coleta de dados ocorreu por meio de um formulário de dados demográficos, a Escala Ambiente de Aprendizagem Clínica, Supervisão e Professor de Enfermagem e o Mental Health Continuum Short Form. Um total de 571 participantes da Turquia, Lituânia e Portugal foram incluídos no estudo. Resultados: houve uma diferença significativa entre os três grupos em relação ao ambiente de aprendizagem clínica e estado de saúde mental (p <0,001). A supervisão foi o elemento mais valorizado. Os estudantes portugueses apresentaram a média mais elevada nos escores do Mental Health Continuum Short Form e Ambiente de Aprendizagem Clínica, Supervisão e Professor de Enfermagem (p<0,001). Idade, sexo e saúde mental influíram nos escores do Ambiente de Aprendizagem Clínico, Supervisão e Professor de Enfermagem. Conclusão: os resultados indicaram que os escores do Mental Health Continuum Short Form e Ambiente de Aprendizagem Clínica, Supervisão e Professor de Enfermagem obtidos pelos estudantes de Enfermagem portugueses foram mais elevados. Revelou-se também que as percepções dos alunos sobre o ambiente de aprendizagem clínica foram afetadas pela idade e sexo, e que suas percepções sobre saúde mental foram influenciadas pelos escores da escala Ambiente de Aprendizagem Clínica, Supervisão e Professor de Enfermagem.

Abstract Objective: this study aimed at evaluating the perceptions of Nursing students from public universities in three European Union countries on mental health and clinical learning environments, a topic that has been rarely investigated in the literature. Method: data collection took place using a demographic data form, the Clinical Learning Environment, Supervision and Nurse Teacher Scale, and the Mental Health Continuum Short Form. A total of 571 participants from Turkey, Lithuania and Portugal were included in the study. Results: there was a significant difference among the three groups regarding clinical learning environment and mental health status (p<.001). Supervision was the most valued element. The Portuguese students presented the highest mean in the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores (p<.001). Age, gender and mental health were effective in the Clinical Learning Environment, Supervision and Nurse Teacher Scale scores. Conclusion: the results indicated that the Mental Health Continuum Short Form and Clinical Learning Environment, Supervision and Nurse Teacher Scale scores obtained by the Portuguese Nursing students were higher. It was also revealed that the students' perceptions on the clinical learning environment were affected by age and gender, and that their perceptions on mental health were influenced by the Clinical Learning Environment, Supervision and Nurse Teacher scale scores.

Resumen Objetivo: este estudio tuvo como objetivo evaluar las percepciones de estudiantes de enfermería de universidades públicas de tres países de la Unión Europea sobre la salud mental y los Ambientes de Aprendizaje Clínico, tema poco estudiado en la literatura. Método: la recolección de datos se realizó mediante un formulario de datos demográficos, la Escala de Evaluación de Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería y el Mental Health Continuum Short Form. Se incluyeron en el estudio un total de 571 participantes de Turquía, Lituania y Portugal. Resultados: hubo una diferencia significativa entre los tres grupos con respecto al Ambiente de Aprendizaje Clínico y al estado de salud mental (p < 0,001). La supervisión fue el elemento más valorado. Los estudiantes portugueses obtuvieron los puntajes promedio más altos en el Mental Health Continuum Short Form y Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería (p<0,001). La edad, el sexo y la salud mental influyeron en los puntajes de Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería. Conclusión: los resultados indicaron que los estudiantes de Enfermería portugueses obtuvieron los puntajes más altos en el Mental Health Continuum Short Form y Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería. También se reveló que las percepciones de los estudiantes sobre el Ambiente de Aprendizaje Clínico se vieron afectadas por la edad y el género, y que sus percepciones sobre la salud mental fueron influenciadas por los puntajes de la escala de evaluación de Ambiente de Aprendizaje Clínico, Supervisión y Profesor de Enfermería.

Effectiveness of Vapocoolant Spray on Venipuncture Pain in Young Male Donors: A Randomized Controlled Trial.

The aim of this single-blinded, randomized controlled study was to determine the effectiveness of vapocoolant spray in reducing pain related to venipuncture in young, healthy male blood donors. The participants were separated into 2 groups by randomization. The donors in the control group (n = 44) were not given any intervention during the blood collection process. Vapocoolant spray was applied to the donors in the vapocoolant spray group (n = 44). The pain score was 1.90 ± 1.47 for the vapocoolant spray group and 3.23 ± 2.21 for the control group, and the difference between the groups was found to be statistically significant (P = .02). The study result showed that the use of vapocoolant spray for pain management is an effective method of reducing pain related to venipuncture during the process of blood donation in young male donors.

Virtual reality and distraction cards to reduce pain during intramuscular benzathine penicillin injection procedure in adults: A randomized controlled trial.

AIM: The aim of this study was to determine the effect of using three-dimensional videos with virtual reality glasses and distraction cards including optical illusion pictures on patients' pain and satisfaction levels during intramuscular benzathine penicillin injection. DESIGN: A randomized controlled trial. METHOD: The study population consisted of 91 patients who were prescribed intramuscular benzathine penicillin medication. The participants were stratified by gender and assigned to three groups (control, virtual reality and distraction cards groups). The visual analogue scale was used to assess pain and patient satisfaction. A one-way analysis of variance and Dunnett's post hoc tests were used to compare the pain and satisfaction levels by group. RESULTS: The mean pain was 6.67 (2.17) in the control group, 4.4 (2.71) in the distraction cards group and 4.93 (3.07) in the virtual reality group and the difference was statistically significant (F = 5.84, p Ë‚ .01). The average of the satisfaction levels in the groups was 3.57 (2.23) in the control group, 7.13 (2.86) in the distraction cards group and 8.07 (2.55) in the virtual reality group. The difference between the satisfaction levels was statistically significant (F = 25.77, p Ë‚ .01). CONCLUSION: The three-dimensional videos with virtual reality glasses and distraction cards including optical illusion pictures were effective in reducing pain associated with intramuscular benzathine penicillin injection and increasing patient satisfaction. IMPACT: The results of this study will contribute to evidence-based nursing practices for the pain associated with intramuscular benzathine penicillin injection. CLINICAL TRIAL REGISTRY: NCT04420559.

Effectiveness of simulation-based cardiopulmonary resuscitation training programs on fourth-year nursing students.

BACKGROUND: Cardiopulmonary resuscitation (CPR) training for nursing students is important. The aim of study is to examine the effectiveness of a simulation-based CPR training program on the knowledge, practices, satisfaction, and self-confidence of nursing students. METHODS: The study was conducted with a mixed-method design. The quantitative data were obtained by using the "CPR Knowledge Questionnaire," the "Students' Satisfaction and Self-Confidence Scale," and the "CPR Skills Observation Checklist", and the qualitative data were collected by using the "Semistructured Interview Form" in four focus group sessions, each consisting of six participants. RESULTS: The mean pretest CPR knowledge score of the students before the simulation-based CPR training was 5.66 ± 1.97 out of 10.0. The mean posttest CPR knowledge score (8.38 ± 1.30) increased significantly after the simulation (p < 0.001). In addition, the mean posttest CPR skills score was significantly higher than the mean pretest CPR skills score (p < 0.001). Themes from the qualitative data revealed that the students considered the simulation to be an interesting and useful teaching method. These themes were "worries before simulation" and "satisfaction following simulation". CONCLUSION: Simulation-based CPR training improved the levels of knowledge and skills of nursing students. In addition, after the simulation training, satisfaction and self-confidence scores were found to be high.

Daily life activities simulation: Improving nursing students' attitudes toward older patients.

AIM: This study aims to evaluate the effects of daily life activities simulation on the attitudes of first-year nursing students toward older adults within the scope of geriatric nursing. METHODS: The study was carried out using a pretest-posttest, quasi-experimental design. First-year undergraduate students (N = 119) of a nursing faculty constituted the study sample. The students were divided into two groups as intervention and control groups. The intervention group performed the daily life activities simulation. Data were collected by using Kogan's Attitudes Towards old People Scale (KAOP) and Positive and Negative Ageism Scale (PNAS). SPSS Ver. 22.00 software was used for statistical analysis. Chi-square test, and t test were used for comparative statistics. RESULTS: Most of the participants were female, and mean age was 20.96 ± 3.24. Intergroup comparison of the KAOP and PNAS scores reveals a statistically significant difference between the pretest and posttest scores for the simulation group (p ˂ .05). The posttest KOAP and PNAS scores of the simulation and control groups were statistically significantly different (p ˂ .05). CONCLUSION: Daily life activities simulation is an effective method to improve nursing students' positive attitudes toward older adults. Participant feedback from our study shows that the simulation increased empathy and awareness of geriatric nursing.

Is Moulage effective in improving clinical skills of nursing students for the assessment of pressure injury?

BACKGROUND: In wound care simulations, the practice can be performed on 3D-wounds formed by moulage. Moulage helps the student to perceive the etiology, physiology, and healing processes of the wound, and it can also be used to improve the students' wound assessment skills. OBJECTIVE: The aim of this study is to investigate the effectiveness of moulage in the improvement of pressure injury assessment skills of nursing students. DESIGN: A quasi-experimental study. SETTINGS: A nursing faculty at a public university. PARTICIPANTS: All fourth-year students (n = 73) who take the simulation elective course were invited to participate. METHODS: Fall semester students (n = 38) constituted the control group and spring semester students (n = 35) formed the intervention group. The coin-flipping method was used to match the education period and student groups. The intervention group simulation was performed using moulage, and the control group simulation was performed using a pressure ulcer visuals. The same simulation scenarios were used for both groups. The data were collected using the Simulation Design Scale, Student Satisfaction and Self-Confidence Scale, and student identification form, knowledge test, performance checklist and feedback form developed by the researchers. RESULTS: Students' knowledge scores for pressure injury assessment have improved significantly in both the intervention group (pre-test:61.71 ± 9.77 and post-test 70.57 ± 12.53, t = -4.27, p < 0.001) and the control group (pre-test: 66.81 ± 13.47 and post-test 73.06 ± 15.50, t = -2.34, p = 0.02). Laboratory and clinical pressure injury assessment skill scores of the intervention group students were significantly higher than the control group. Besides, the correct staging percentages of the intervention group students are higher than the control group students during the clinical practice (χ2 = 5.05, p = 0.02). CONCLUSIONS: It can be concluded that the simulation with moulage was effective in improving the skills of nursing students who received training for pressure injury assessment and in transferring what they learned to the clinical setting.

The Effects of Intraoperative Progressive Muscle Relaxation and Virtual Reality Application on Anxiety, Vital Signs, and Satisfaction: A Randomized Controlled Trial.

PURPOSE: This study aimed to determine the effects of intraoperative progressive muscle relaxation (PMR) and the application of virtual reality (VR) on anxiety, vital signs, and satisfaction levels during a knee arthroscopy operation. DESIGN: The study was a three-group randomized controlled trial. METHODS: This study was conducted with 93 patients who consented to participate in the study. FINDINGS: The State-Trait Anxiety Inventory-S anxiety scale (STAI-S) scores were increased in all the three groups after the surgery. When the preoperative and postoperative STAI-S scores in the group were examined; intragroup STAI-S scores in the PMR and VR groups were statistically significant (P < .05). There was a significant difference between the control group and the PMR and VR groups in mean satisfaction scores (P < .05). The differences between blood pressure and pulse rate were statistically significant in the PMR and VR groups (P < .05). CONCLUSIONS: Intraoperative PMR and VR can be used as nursing interventions to increase satisfaction and positively affect vital signs in patients who undergo surgery with spinal anesthesia.

Distraction-based relief of pain associated with peripheral intravenous catheterisation in adults: a randomised controlled trial.

AIMS AND OBJECTIVES: This study aimed to determine the effect of methods of distraction to relieve pain associated with the peripheral intravenous catheter (PIC) insertion procedure, thus improving patient satisfaction. Specifically, we examined such effect by playing 3D videos with virtual reality goggles and showing pictures to the patient containing distractive optical illusions. BACKGROUND: In the literature, although the efficacy of various pharmacological methods for reducing pain associated with the insertion of PIC has been evaluated in adults, studies on nonpharmacological methods are limited. METHODS: The research was conducted with a randomised controlled single-blind experimental study. The sample consisted of 120 patients. While nothing is applied to the control group, cards containing distractive optical illusion pictures and playing 3D videos with VR goggles during PIC insertion is applied for distraction groups. The data collection form consisted of items that measured the sociodemographic characteristics of the patients and a visual analog scale. The CONSORT checklist was followed in reporting this study. This study is registered with ClinicalTrials.gov. No. NCT03945929. RESULTS: The mean pain level was 4.72 ± 3.15 in the control group and 3.41 ± 2.81 in the distraction groups and the difference was found to be statistically significant (p = .02). When the mean satisfaction level between the groups was compared, it was found to be 5.12 ± 3.41 in the control group and 8.07 ± 2.67 in the groups undergoing distraction methods. The difference between them was statistically significant (p = .01). CONCLUSIONS: This study found that the use of cards containing distractive optical illusion pictures and playing 3D videos with VR goggles during PIC insertion in adult patients were both effective. RELEVANCE TO CLINICAL PRACTICE: These distraction methods may be used to reduce pain due to PIC insertion in nonurgent and less urgent adult patients in the emergency department.

The effect of simulation based education on patient teaching skills of nursing students: A randomized controlled study.

According to the literature, main problem in the education of nursing students in patient teaching about application of inhaler medication is ineffective and inadequate class and cannot be applied to the live patients. Also the literature shows that the main obstacle for teaching nursing students to provide inhaler instruction is inadequate in-class practice. In this study, comparison of the effectiveness between standard patients (SPs) usage and theoretical lecture on improving the patient teaching skills of nursing students for inhaler drug use for live patient is aimed. This study was conducted as a randomized controlled and single-blind trial. Total patient teaching skill score for control group was 26.73 ±â€¯5.63 and 39.08 ±â€¯5.49 for SP group which causes a statistically significant difference (p ≤ 0.01). The students' self-confidence mean score was 8.48 ±â€¯0.88 for SPs group and 7.07 ±â€¯1.33 in the control group for a statistically significant difference (p ≤ 0.01). The patient teaching skill scores of the students included in the group receiving simulation teaching with the SPs were found to be higher than the control group. The students included in SPs group were found to feel more confident while teaching a live patient on inhaler drug use.

Analysis of the effects of high-fidelity simulation on nursing students' perceptions of their preparedness for disasters.

INTRODUCTION: As disasters may occur any time, health care staff and institutions should be prepared to manage these events. The aim of study is to analyze the effects of high-fidelity simulation on the perceptions of senior nursing students regarding their preparedness for disasters. METHODS: This study used a pretest-posttest design and was conducted as a quasi-experimental investigation. RESULTS: Slightly less than the half of the students (42.5%) expressed that they were prepared to face a disaster. There was a statistically significant difference in their scores on the Scale of Perception of Disaster Preparedness among Nurses between the pre-intervention and postdisaster stage (p < 0.05). CONCLUSION: Supporting simulation activities with drills positively affected nurses' perceptions of disasters.

Does CT help in predicting preepiglottic space invasion in laryngeal carcinoma?

OBJECTIVE: Evaluating preepiglottic space involvement in laryngeal cancer by CT may lead misinterpretation. We sought to understand the causes of misinterpretation in evaluating the preepiglottic space by CT and assessed the effects of misinterpretation in treatment plans of patients with laryngeal squamous cell carcinomas. METHODS: Specimen histopathology reports of 102 (99 male, 3 female) patients who underwent total or partial laryngectomy due to supraglottic and/or transglottic laryngeal carcinoma were reviewed. Neck CTs were also re-assessed for preepiglottic space involvement by three radiologists. The initial surgical treatment choices were re-examined according to the current radiological evaluation in combination with pathological results of the specimens and physical examination findings in the patients. Interobserver agreement regarding image interpretation was based on a kappa analysis. RESULTS: The interclass correlation coefficient in predicting preepiglottic space invasion was 0.74; this was considered 'good.' Among the three radiologists, sensitivity, specificity, accuracy of CT in detecting preepiglottic space involvement were 86-93%, 75-93%, and 77-93%, respectively, while the negative and positive predictive values were 97-98% and 38-50%, respectively. Given the previous treatments applied, false-positive diagnoses for PES involvement resulted in overtreatment in 2.9% of cases. False-negative diagnoses of PES involvement (1.9% of cases) did not result in any undertreatment. CONCLUSIONS: Although CT is a practical and inexpensive imaging tool for evaluating laryngeal carcinomas, the PPV of CT in assessing preepiglottic space invasion, especially in advanced tumors, is low and may lead to overtreatment.

Integrating simulation based learning into nursing education programs: Hybrid simulation.

BACKGROUND: Hybrid simulation can be developed with mannequins of any fidelity and tabletop simulators with a standardized patient to create a complex, high-level learning activity. OBJECTIVE: The aim of this study is to analyze the effects of a hybrid simulation technique used with nursing students in a scenario about the emergency setting. METHODS: This one-group pre-test post-test model quasi-experimental study was carried out with 39 students in Ankara, Turkey, from October 2014 to July 2015. RESULTS: Nearly all participants reported that the simulation improved their critical thinking, decision-making skills, and self-confidence before the clinical activity and that they felt as though they were real nurses during the activity (94.7%, 97.3%, 84.2%, and 92.1%, respectively). CONCLUSION: The results of this study support the integration of hybrid simulation experiences throughout the nursing curriculum, as evidenced by positive responses from students through the simulation evaluation questionnaire.