The effect of abdominal massage and in-bed ROM exercise on gastrointestinal complications and comfort in intensive care unit patients receiving enteral nutrition: A randomized controlled trial.

AIM: Abdominal massage facilitates gastric and colonic motility, reduces intra-abdominal distension and increases circulation. In-bed range of motion (ROM) exercise has effects on muscle strength, cardiac parameters and excretion. The aim of this study was to assess the effects of abdominal massage and in-bed ROM exercise on gastrointestinal complications and patient comfort in intensive care patients receiving enteral nutrition. METHODS: This randomized controlled trial was conducted in the internal intensive care units of two tertiary public hospitals. The sample consisted of 130 patients randomly assigned to three groups (abdominal massage = 44, in-bed ROM exercise = 43, control = 43). The individuals received abdominal massage and in-bed ROM exercises every morning before enteral feeding for 3 days. We assessed gastrointestinal complications and comfort levels of the patients 24 h after each intervention. RESULTS: While the differences in abdominal distention, defecation status, constipation, and gastric residual volume complications were significant (p < .05), there was no significant difference in diarrhea and vomiting (p > .05). Comfort level showed a statistically significant change in the experimental groups in the in-group comparison (p < .05). CONCLUSION: Abdominal massage and in-bed ROM exercise reduce abdominal distention, constipation and gastric residual volume. Abdominal massage affects the frequency of defecation; and, both interventions increase the comfort while reducing the pain level over time.

Evidence-Based Investigation of Nurses' Nutrition Interventions in Intensive Care Patients Regarding Enteral Nutrition.

AIM: The aim of this study was to examine the practices and knowledge levels of nurses regarding enteral nutrition interventions in intensive care unit patients in terms of evidence. METHOD: This cross-sectional study was conducted in 2 hospitals between May and August 2021. A total of 136 nurses working in the intensive care units of the hospitals completed online questionnaires including demographic characteristics and questions about enteral nutrition. RESULTS: According to the nurses' knowledge level about the indication of enteral nutrition formulas, the following were incorrect or incomplete: their knowledge about transition to parenteral nutrition in case of nutritional contraindications, what to do when the amount of gastric residual volume in tolerance is >500 mL every 6 hours, the conditions for starting enteral nutrition, and which formulas are appropriate to use. Regarding their knowledge about enteral feeding tubes/sets, their knowledge about radiologic imaging after tube placement, measurement of gastric pH level, and marking the tube location was insufficient. Differently, the correct answer percentages of the nurses in 11 of the 13 questions regarding the principles of enteral nutrition practice were above 70%. CONCLUSION: Nurses had adequate knowledge of the principles of enteral nutrition practice, but their knowledge of the indication of enteral nutrition formulas and the evidence for enteral feeding tubes/sets varied. The results showed that nurses need to gain information about the indication of enteral nutrition formulas and evidence related to enteral feeding tubes/sets.

The effect of frailty levels of older individuals on their mental well-being and depression levels.

BACKGROUND: Frailty has become an important public health issue. This study was conducted to determine the effect of frailty levels of older individuals on their mental well-being and depression levels. METHODS: This descriptive cross-sectional study was conducted with a total of 325 older individuals aged 60 years and over. A demographic questionnaire form, the FRAIL Frailty Scale, the Warwick-Edinburgh Mental Well-Being Scale, and the Geriatric Depression Scale-Short Form were used to collect data. Data were evaluated using the SPSS 25.0 package program. Number, percentage, mean, standard deviation, Chi-square, correlation, and multiple regression analyses were used. RESULTS: The mean age of the older individuals was 69.56 ± 7.75 years, and the variables of age, education level, income status, the person they were living with, regular medication use, forgetting to take medication, urinary incontinence, hospitalisation, and accidents were found to affect both frailty and depression (P < 0.05). There was a positive correlation between frailty and depression (r: 0.460, P < 0.001) and a negative correlation between mental frailty and well-being (r: -0.391, P < 0.001). Socio-demographic variables, depression, and mental well-being had a 40% effect on frailty (P < 0.001). CONCLUSION: Depression status and mental well-being level are related to frailty, so negativity in one of them negatively affects the other. In line with these results, it is recommended to determine the level of depression and mental well-being of older individuals with high risk of frailty, and according to the results of the research, to provide care and support regarding the predictors affecting frailty.

The effects of aromatherapy with thyme oil on disease symptoms, vital findings, and hemodynamic parameters in COVID-19 patients.

OBJECTIVE: To determine the effect of aromatherapy with thyme oil on disease symptoms, vital signs, and hemodynamic parameters in COVID-19 patients. METHODS: We conducted the randomized controlled trial with 140 (experimental group=70, control group=70) COVID-19 patients. Patients admitted to the COVID-19 service of the Batman Training and Research Hospital were included in the sample between 31.01 - 31.08 2022. Patients in the experimental group inhaled thyme oil 3 times a day during 5 days. At the end of day 5, symptoms and hemodynamic parameters were measured as posttest. Vital signs were measured 3 times a day during 5 days. The control group only received routine treatment. RESULTS: Thyme oil was found to be effective in relieving symptoms of shortness of breath, dizziness, secretion, diarrhea, weakness, loss of appetite, cough, headache and muscle joint pain. Although there was improvement in the symptoms of nausea-vomiting, runny nose and loss of taste-smell, the effect was not statistically significant. Thyme oil significantly decreased body temperature, pulse rate and respiratory rate (p<0.05), increased SPO 2 (p<0.05), and did not affect systolic and diastolic blood pressure (p>0.05). It had a significant effect on the regulation of pH, decreased CO2 and increased O2 significantly (p<0.05). CONCLUSION: Thyme oil aromatherapy was effective in reducing symptoms, regulating vital signs and hemodynamic parameters. Accordingly, thyme oil is recommended as non-pharmacological treatment method in COVID-19 patients.

Compassion Fatigue and Ethical Attitudes in Nursing Care in Intensive Care Nurses During the COVID-19 Pandemic: A Cross-sectional Study.

BACKGROUND: Intensive care unit (ICU) nurses faced an increased risk of compassion fatigue and ethical concerns during the COVID-19 pandemic. PURPOSE: To evaluate compassion fatigue of ICU nurses and their ethical attitudes in care during the COVID-19 pandemic and analyze contributing factors. METHODS: An exploratory cross-sectional research design was used. RESULTS: A total of 103 ICU nurses participated. The nurses' compassion fatigue and ethical attitude scores were high. Compassion fatigue was explained by the following variables: considering resigning, receiving support for ethical decisions, willingness to work in the ICU, duration of providing activities of daily living in a shift, and number of patients per nurse. CONCLUSIONS: Compassion fatigue was high in nurses working in the ICU during COVID-19. The high level of ethical attitudes shows commitment to professional ethics and reflects the development of the nurses' professional identity. Implementation of interventions that help improve compassion fatigue among nurses is needed.

Comparison of cold spray and shotblocker to reduce intramuscular injection pain: A randomized controlled trial.

WHAT IS KNOWN AND OBJECTIVE: It is important to identify effective, easy-to-use and cost-effective non-pharmacological methods in the management of pain caused by medical interventions. The purpose of this study is to compare the effects of cold spray and ShotBlocker on pain in adults in reducing pain caused by intramuscular injection in the adult emergency department. METHODS: This is a randomized controlled trial with two experimental groups, two placebo groups and a control group. The study was conducted on 195 adults who received diclofenac sodium injections. In the study, the injection procedure was performed by following the same injection protocol in all five groups. In the injection process, cold spray or ShotBlocker was used in the intervention groups based on the group, and cold spray with distilled water or the smooth surface of the ShotBlocker was used in the placebo groups. Following the injection, the pain caused by the injection was evaluated using the Visual Analog Scale. RESULTS AND DISCUSSION: The study was completed with the remaining 195 patients. In the study, the average pain scores due to injection of the individuals in the cold spray group were lower than those of the control group (p < 0.05). There was no statistically significant difference between the pain score averages due to injection of the individuals in the ShotBlocker group and cold spray, control, ShotBlocker placebo and cold spray placebo groups. WHAT IS NEW AND CONCLUSION: The routine use of a fast-acting, cost-effective and easy-to-use method, cold spray, to reduce pain in the intramuscular injection will be beneficial in increasing patient satisfaction and quality of care.

Effects of Progressive Relaxation Exercises on Vital Signs and Fatigue in Liver Transplant Patients: A Randomized Controlled Trial.

This randomized controlled study was conducted to evaluate the effects of progressive relaxation exercises on vital signs and fatigue level. Ninety patients with liver transplantation (experimental group = 45, control group = 45) were included in the study. The patients in the experimental group performed progressive relaxation exercises for 25 to 30 minutes every day for 4 weeks. Before the progressive relaxation exercises, the vital signs and fatigue level of the patients were recorded. Vital signs were recorded again immediately after the progressive relaxation exercises and at the end of the second week. At the end of the fourth week, the final measurement of vital signs was performed along with the second fatigue level assessment. In the experimental group, pulse and respiratory rates, systolic and diastolic blood pressure values, and fatigue severity mean scores were found to be lower and oxygen saturation level was higher than those of the control group. The improvement in vital signs in the experimental group was evident at week 3 (p < .05).

Challenges experienced by nursing students during the COVID-19 pandemic.

PURPOSE: This study was conducted to assess the challenges faced by nursing students during the pandemic and to examine the factors affecting these challenges. DESIGN AND METHODS: This qualitative study involved 344 nursing students at a university in eastern Turkey. FINDINGS: Five main themes, each with its own subthemes, indicated the psychological difficulties experienced by students, insufficiencies and uncertainties regarding education, restrictions regarding social life, family conflicts, and the possibility to turn crises into opportunities. PRACTICE IMPLICATIONS: The themes emphasizing the lives of nursing students showed that there was a need for important measures, such as psychosocial support, determination of best practices for online education, supporting students with telemental applications by university counseling centres, and organization of action courses.

Applying the health belief model to the rational use of drugs for hemodialysis patients: A randomized controlled trial.

BACKGROUND: Non-rational use of drugs is a common problem among people with chronic disease. The Health Belief Model (HBM) can develop beliefs and behaviors related to rational drug use. OBJECTIVES: To investigate the effect of HBM-based training on the rational use of drugs in hemodialysis patients. METHODS: This randomized controlled trial was conducted in 132 people receiving hemodialysis treatment. The data were collected using a Demographic Survey and the Rational Use of Drugs Scale (RUDS). Patients in the study groups were provided with HBM-based rational use of drugs training. The first training session took an average of 30-35 min for each patient, and the second (summary) took an average of 15-20 min RESULTS: The mean RUDS pretest score was 60.29 ± 10.17 in the intervention group and 62.85 ± 9.94 in the control group. The mean RUDS posttest scores were 78.80 ± 8.16 in the intervention group and 63.48 ± 9.77 in the control group. The difference between the pretest scores in these groups was not statistically significant (p > 0.05), whereas the difference between the posttest scores was found to be significant (p < 0.001). CONCLUSION: It was observed that training based on the HBM increased the RUD scores. Thus, HBM may be recommended for use as a guide for rational drug use training, especially for patients undergoing hemodialysis. PRACTICE IMPLICATIONS: The HBM can be an effective and cost-efficient strategy for standardized rational drug use training and supporting hemodialysis patients.

Behaviours and experiences of nurses during the COVID-19 pandemic in Turkey: A mixed methods study.

AIM: The aim of this work is to present behaviours and experiences of nurses in Turkey during the current coronavirus pandemic. BACKGROUND: The coronavirus pandemic leads to difficulties for most health care workers, especially for nurses who mostly accompany patients and are on the front line. METHODS: In the study, a parallel mixed pattern converging quantitative and qualitative research methods was used. RESULTS: The model revealed that 41 years old or older, diabetic, female, single professionals, working in the pandemic department took more personal measures. Five main themes appeared regarding the experiences of the nurses during the pandemic period: (1) psychological and mental strain; (2) personal protective equipment; (3) organizational, physical, and social strains; (4) change in professional values; (5) turning the crisis into an opportunity. CONCLUSIONS: Personal measures are associated with the risk status. There is a need to protect nurses with significant measures by providing psychosocial support, meeting their basic needs, and preventing all complications likely to occur due to increasing workload. IMPLICATIONS FOR NURSING MANAGEMENT: More efforts should be made to ensure good work, fair treatment, no tolerance for discrimination, and equal compensation conditions.

Perception of spiritual care among palliative care nurses: cross-sectional study in eastern Turkey.

BACKGROUND: Spiritual care is an integral part of palliative care. A nurse's perception of spiritual care is an effective factor for giving spiritual care. AIM: To determine the perception of spiritual care and the variables that might affect the perception of spiritual care among palliative care nurses. METHODS: This cross-sectional study included 51 nurses working in the palliative care units. Perceptions of spiritual care was measured with the Spiritual Support Perception Scale. FINDINGS: The mean score of the perception of the spiritual care of the nurses was found to be 64.22±9.25. A negative correlation was found between the nurses' mean score of the perception of spiritual care and the number of patients to whom those nurses provided daily care. CONCLUSION: This study has found that palliative care nurses had a high level of perception of spiritual care. Based on the study results, it was determined that the number of patients receiving daily care was a predictor for the perception of spiritual care.

Care Burden and Quality of Life in Family Caregivers of Palliative Care Patients.

This research was conducted for the purpose of examining the care burden and quality of life in family caregivers of palliative care patients. The research design was a descriptive correlational study conducted with the caregivers of 163 patients residing in palliative care units. Data were collected via a demographic survey, The Zarit Burden Interview (ZBI) and the World Health Organization Quality of Life Assessment (WHOQOL). The results showed that there was a negative correlation between ZBI and WHOQOL scores. Further, there was a significant negative correlation between many subdimensions of the ZBI (general quality of life, general perception of health, being satisfied with daily life skills, home conditions, energy and self-satisfaction) and the WHOQOL. Quality of life thus appeared to be reduced in family members with a high level of care burden and that the quality of life of caregivers depends on the individual characteristics of the caregiver. Social workers, nurses and physicians should regularly assess the burden and quality of life of caregivers.

The Relationship Between Self-Care Agency and Depression in Older Adults and Influencing Factors.

Depression is a significant mental health problem in older adults. There is a decrease in self-care agency and an increase in the prevalence of depression with aging. The current study was conducted to determine the relationship between self-care agency and depression in Turkish older adults aged ≥65 years (N = 473) and the influencing factors. Data were collected using a demographics questionnaire, the Self-Care Agency Scale, and the Geriatric Depression Scale. Self-care agency was related to age, marital status, level of education, economic status, and persons lived with, and depression was related to gender, marital status, level of education, economic status, chronic disease, and persons lived with. A negative correlation was found between the scales. As the score of self-care agency increased, depression decreased. [Journal of Psychosocial Nursing and Mental Health Services, 58(10), 39-47.].

Use of complementary medicine among people with diabetes in eastern Turkey: A descriptive study.

PURPOSE: To measure the frequency, type, purpose of complementary medicine (CM) use among people with diabetes mellitus. MATERIALS AND METHODS: The population of this descriptive study consisted of the patients hospitalized in the endocrine clinic of a university hospital in Eastern Turkey who were diagnosed with diabetes. Data were collected from 316 patients. RESULTS: 43.0% of the patients were using CM, and 97.0% of those using CM tried herbal methods. The patients who had variable glycated haemoglobin values (60.3%) and those who had DM-related complications (60.3%) used CM more. CONCLUSION: It was determined that CM usage was prevalent among the patients. The most frequently used CM method was herbal therapy. We found that the use of CM was more common in patients with poor metabolic control. Therefore, healthcare professionals must be assess use of CM and provide suitable counseling.

Comparison of abdominal and arm areas in patients receiving subcutaneous heparin in terms of development of pain, hematoma, and ecchymosis.

The purpose of this study was to compare the abdominal and arm areas in the patients using subcutaneous heparin in terms of pain, hematoma, and ecchymosis development. As a result of subcutaneous heparin injections, complications such as pain, ecchymosis, and hematoma may develop in the injection site. The injection site chosen for injection is one of the factors that are effective on complications. This quasi-experimental study was conducted with 54 patients at orthopedics-traumatology and cardiothoracic surgery clinics of a university hospital. The data were collected using a patient description and follow-up form, visual analog scale, transparent film, and a chronometer. Ecchymosis and hematoma were evaluated at the 48th hour after injection, whereas the pain level was evaluated right after the injection, and the pain duration was evaluated during the injection. The rate of pain in the arm area was statistically higher. Differences between the areas in terms of level and duration of pain and development and size of ecchymosis and hematoma were not significant. More pain developed due to heparin injection in the arm area than in the abdominal area. No differences were observed between the areas in terms of level and duration of pain, development and size of ecchymosis, or development and size of hematoma.