Mobile care app development process: using the ADDIE model to manage symptoms after breast cancer surgery (step 1).

The use of mobile applications is widespread in patient monitoring or education today. This study aims to describe the design and development process of a mobile app that supports patient self-care after breast cancer surgery. We used the ADDIE model to develop and test the mobile app. ADDIE (Analysis, Design, Development, Implementation, Evaluation) is a systematic approach based on a standard instructional design model for creating training materials. The model consists of five phases, each with its own set of steps. Once the steps within each phase are completed, the model progresses to the next phase, ultimately resulting in a "usable" product. Different team collaborations were established within each phase, and support was obtained from multiple experts during the design process. Thanks to this model, the information that patients need was transformed into a technological product. This article, which explains the stages of the product design process for mobile applications, provides information that may be helpful to researchers working on similar products.

"Who am I?" A qualitative meta-synthesis of Chemotherapy-induced alopecia and body image perception in breast cancer patients.

BACKGROUND: Since alopecia may be the first physical evidence and sign of cancer diagnosis and treatment, it may have a more serious and challenging effect on a woman than the loss of breast tissue. OBJECTIVE: The purpose of this study was to summarize the current qualitative research which explores the body image perceptions of breast cancer patients with chemotherapy-induced alopecia. MATERIAL AND METHODS: We searched three electronic databases and reviewed studies from December 2011 to December 2021 for qualitative results analysing the experiences of women with breast cancer and chemotherapy-induced alopecia. The Joanna Briggs Institute critical (JBI) appraisal tool was used to assess the quality of the targeted studies. The Meta-synthesis process developed by Sandelowski and Barroso was used to collect and analyse the data. RESULTS: We discovered two main and five sub-themes from the meta-synthesis findings of 11 qualitative studies involving 225 women. The main themes were "I am not comfortable in this body" and "Who am I?". The first main theme revealed patients' intense reactions to their hair loss: "I'm in emotional chaos", "I am looking for a place to hide" and "I knew it and now I'm experiencing it".The second main theme of "Who am I?" contained two sub-themes: "What did my hair take from my femininity when it was gone?" and "Will I lose my partner after my hair?". CONCLUSION: Meta-synthesis provided an up-to-date and integrated interpretation of scientific results about the experiences of women with breast cancer, alopecia, and their body image perceptions. This interpretation will facilitate a more comprehensive understanding of the alopecia-body image relationship. Thus, the aim of the meta-synthesis results is that these will contribute to nurses' understanding of how alopecia, although a temporary symptom, affects women's perceptions of body image.

Nurse-led web-based patient education reduces anxiety in thyroidectomy patients: A randomized controlled study.

AIM: The aim of this study was to determine the effect of web-based patient education on anxiety in patients scheduled for thyroid surgery. A secondary aim was to evaluate the patients' postoperative recovery outcomes. DESIGN: This study is a randomized controlled trial. METHOD: The study was conducted at a university hospital in Turkey between September 2018 and May 2019 with 76 patients scheduled for thyroidectomy surgery and randomly assigned into two groups. Patients in the intervention group received web-based education, while those in the control group were given only routine care. Measurements were performed before surgery, on the day of surgery, and 1 week after discharge. RESULTS: On the day of surgery, intervention group anxiety levels were lower than those of the control group, and the majority of early recovery parameters were significantly better in the intervention group than in the control group. One week after discharge, the intervention group patients' anxiety levels were significantly lower. Web-based education had no impact on pain, time in the operating room, readmission to the hospital after discharge, or length of hospitalization. CONCLUSIONS: Nurse-led web-based education reduced patients' anxiety regarding surgery. The results also show that it may improve postoperative early recovery.

Breast cancer-related apps in Google Play and App store: evaluate their functionality and quality.

AIM: This study aimed to evaluate the functionality and quality of breast cancer apps that can be accessed from Turkey. METHODS: In this study, a systematic search strategy was used to identify free mobile apps on breast cancer available in the App and Google Play stores. According to the study's PRISMA flowchart, 707 apps met the inclusion criteria. The Mobile App Rating Scale (MARS) assessed the quality of the apps. RESULTS: Mobile apps focused on the categories of communication, education, and treatment order/plan. The mean MARS quality score for all apps was 3.4, and according to the mean score of the subscales, they were categorized as functionality, aesthetics, information quality, and participation. In addition, the mean scores of the subscales were listed on MARS as functionality, aesthetics, knowledge quality, and participation. CONCLUSION: Nowadays, "e-health" apps are attracting attention in the treatment of health problems. While the apps in download stores appear to provide basic information about breast cancer, they offer limited and personalized problem management related to prevention, early detection, and screening. Support from healthcare professionals and further efforts can be made to develop innovative technologies and apps that include evidence-based informational content about breast cancer. IMPLICATIONS FOR CANCER SURVIVORS: In the process of breast cancer information, survivors can be encouraged to manage this process using e-health services.

Computer-Based Communication Tool Provides Effective Communication for Non-speaking Patients: A Quasi-experimental Study.

Even though they are conscious, patients who are unable to speak while connected to a mechanical ventilator have serious difficulties in communicating with healthcare staff. This research aimed to determine the effectiveness for patients of a computer-based communication tool (CBCT) and to compare these results with patients using a routine method. This quasi-experimental study was conducted with 90 intubated patients. It was found that 20.0% of the patients using CBCT stated that they had difficulties in communicating, while this rate was 82.2% among patients not using CBCT. Compared with participants in the control group, experimental group patients reported a lower median score for the anxiety levels (23.0 [20.0-39.0], 29.0 [20.0-57.00], p < .001) and higher mean comfort levels (130.2 ± 9.0, 109.6 ± 13.3, p < .001). Positive impacts of the CBCT are its suitability for patients who are dependent upon ventilation for different reasons and their improved ability to communicate effectively.

Lymphedema Information and Prevention Practices of Women After Breast Cancer Surgery.

AIM: This study was carried out to determine women's knowledge about lymphedema precautions and their practice status. The sample of this descriptive and correlationally designed study included 107 women who underwent surgery. METHOD: This descriptive study's data were collected using a questionnaire form developed by the researcher. The data were structured on a 3-point Likert-type scale. The one-way analysis of variance, correlations, and the Kolmogorov-Smirnov test were used in the statistical analysis. RESULTS: Three-quarters of the women knew that they should do arm exercises, keep the arm above the heart level while resting, and that blood pressure should not be measured, and jewelry not be worn. However, it was found that the percentage of women who did not know that the arm circumference should be measured at regular intervals or how to evaluate the arm circumference measurements and what to do in case of an injury was the same. It was determined that the precautions that the majority of women took in measuring lymphedema consisted of not measuring blood pressure, not wearing tight jewelry, and wearing an appropriate bra. CONCLUSION: It is thought that patients should be informed about the development of lymphedema after breast cancer surgery because their compliance with taking the precautions will be important in reducing the incidence, degree, and effects of lymphedema.

Evaluation of Illness Perception of Women with Breast Cancer in Turkey.

OBJECTIVE: The aim of this study is to examine the illness perceptions of women with breast cancer and possible relationships between these perceptions and descriptive characteristics such as sociodemographic and clinical characteristics in Turkey. MATERIALS AND METHODS: The study was conducted in compliance with correlational, descriptive research principles. Three hundred eighty women with breast cancer who were treated in various hospitals in seven regions of the country were included in the study. A sociodemographic and clinical characteristics form, and The Illness Perception Questionnaire were used for data collection. RESULTS: The mean age of the patients with breast cancer was 49.8±11.5, among them, 83.95% were married, 37.37% were at stage 2 breast cancer, and 67.11% experienced mastectomy. It was found that the patients perceived higher personal control over illness (20.88±4.76). The patients perceived most common risk factors as the cause of the illness (19.42±6.38). This study show that variety sociodemographic and clinical characteristics of the patients affected their perceptions of illness. CONCLUSION: The meaning of illness from the perspective of patient with breast cancer should be assessed. The care, education and counselling programs should be planned according to the patient's illness perceptions.

Nurse-led patient training improves deep vein thrombosis knowledge and self-care practices.

The study focused on assessing the effect of nurse-led deep vein thrombosis prevention training on patients' knowledge and self-care practices. Forty patients participated in this quasi-experimental study. Participants were trained by the guidebook prepared by the researchers before the surgery. Data were collected with Autar Deep Vein Thrombosis Risk Assessment Scale and questionnaires before and after the training. The questionnaires were prepared by the researcher. Data were evaluated with Mann-Whitney U, Wilcoxon, Kruskal-Wallis variance analysis, significance of difference test between two means, and one-way variance analysis tests. The average deep vein thrombosis knowledge score was 0.1 ± 0.5 over 54 before the training, whereas it was 20.2 ± 5.7 after the training, and there was a statistically significant difference in patients' deep vein thrombosis knowledge scores after training period (P = .000). Patients performed an average of 8.8 out of 13 protective self-care practices during the postsurgery period. The majority of the patients were satisfied with the training. The training provided by the nurse contributed to the fact that the patients had knowledge about their own health problems and took responsibility for self-care. We have not been able to increase the awareness we want on some groups such as those older than 52 years. Other studies should be carried out, especially in these groups, with different training methods.

Nothing is more important than my partner's health: Turkish men's perspectives on partner's appearance after mastectomy and alopecia.

PURPOSES: The aim of this study was to acquire a deeper understanding of male experiences on the emotional and social impact of their partners' mastectomy and chemotherapy-induced alopecia. METHODS: A purposive sample of 16 males whose partners had undergone mastectomy and alopecia due to chemotherapy was chosen. The data were collected through a semi-structured interview method. Interpretative Phenomenological Analysis of tape-recorded interviews was employed. RESULTS: Two main themes emerged from the data: facing the changes and my wife and I at present. Male partners were affected differently by the change in the physical appearance of their female partners. Our study participants said it was a difficult experience to see their partners for the first time after the surgery, but they emphasized that it was more important that their partners were healthy than the fact that they did not have a breast and hair. They also said they did not know how to behave towards their partners after surgery and/or chemotherapy. Nevertheless, they felt that the disease process of their partners had strengthened their bond and had not negatively influenced their relationship with others. CONCLUSIONS: The changes in the partners' physical appearance after mastectomy and chemotherapy affected males differently in psychological, emotional and social terms. Since nurses working in this field are in contact with patients during all phases of treatment and care, it would be positive and beneficial to plan nursing interventions that give emotional support for male partners of patients with breast cancer.

Therapeutic Effects of Nurse Telephone Follow-up for Lung Cancer Patients in Turkey.

BACKGROUND: Patients with lung cancer can encounter many difficulties as they adjust to the side effects of chemotherapy treatments. OBJECTIVE: The aim of this study is to determine the therapeutic effects of nurse telephone follow-up for lung cancer patients. METHODS: In this quasi-experimental study, the sample consisted of 60 patients with lung cancer assigned to an intervention group (n = 30) and a control group (n = 30). The control group participants were sequentially enrolled first and then the intervention group participants were enrolled. The data were collected using the Patient Information Form, Eastern Cooperative Oncology Group Performance Status, the Edmonton Symptom Assessment Scale, and the Functional Living Index-Cancer. The Nursing Care Guide was created by the nurse researchers' team and given to both the intervention and control groups. Telephone follow-up calls were conducted with intervention patients within the first week after their chemotherapy session. The Kolmogorov-Smirnov, Pearson χ, Fisher exact, Mann-Whitney U, and Friedman test and descriptive statistics were used to evaluate the data. RESULTS: Patients in the intervention group demonstrated significantly better adjustment to the symptoms secondary to chemotherapy and higher social functioning quality of life scores compared with reported scores in the control group. CONCLUSION: Nurse telephone follow-up can reduce chemotherapy-related symptoms for lung cancer patients and improve participants' social functioning. IMPLICATIONS FOR PRACTICE: Nurse telephone follow-up is an acceptable and feasible form of patient contact and is a convenient and efficient way to offer patients the support and continuity of care they need.

Preoperative Stress: An Operating Room Nurse Intervention Assessment.

PURPOSE: The purpose of this research study was to determine the effect of preoperative visits by the operating room (OR) nurse on patient stress levels before undergoing surgery. DESIGN: This research was a quasi-experimental study. METHODS: The research sample included patients (N = 179) who were hospitalized for surgery during 6 months in the general surgery department of a public hospital in the Eastern Black Sea Region. The OR nurse, part of the medical staff for surgery, visited patients in the experimental group 1 day before surgery. The OR nurse collected information that was consistent with the requirements of the patients. Patients in the control group were provided with preoperative care that was consistent with hospital procedure. Research data were collected using question forms, patient satisfaction scores, and Burford Distress Thermometer scale. Statistical evaluations included t tests and receiver operating characteristic analysis for independent groups. FINDING: Most patients stated that they felt stressed because of the impending surgery. Patients made the following most common statements of the factors that caused stress; fear of unknown, anesthesia phobia, and fear of OR environment and complications that may occur during surgery. Patients in both groups experienced a significant decrease in postoperative stress levels. The perceived distress in the experimental group was significantly lower than the control group during the postoperative period. Patients in the experimental group reported that the OR nurse's visit effectively minimized their stress levels. CONCLUSIONS: OR nurse visits to patients before surgery contributed to decreased preoperative stress levels.

Turkish health care providers' views on inappropriate use of emergency department: Who, when and why?

OBJECTIVE: Inappropriate use of emergency departments is recognized globally as a widespread problem. The study was undertaken to determine the perceptions of emergency department personnel regarding inappropriate use of this department. METHODS: The study was undertaken with 124 emergency department employees from six emergency departments in a province of the Eastern Black Sea region of Turkey. Using a questionnaire form designed by the researcher, the data were gathered and analyzed with the chi-square test, numerical and percentage calculations. RESULTS: According to the emergency department employees, more than half of emergency department visits were inappropriate with most visits occurring between the hours of 19:01 and 01:00. In order of occurrence, employees also indicated that most inappropriate use concerned requests for prescription renewals, treatment for pain, and upper respiratory tract infections (URTI). According to the employees, patients made inappropriate use of emergency departments in the belief that these provide services for every kind of health problem. Unfortunately, according to the health care workers this misperception of emergency services results in less effective patient care and a decrease in employee motivation. CONCLUSION: Health team members thought that inappropriate use of emergency services led to negative outcomes in the quality of care and motivation of the workers. Solutions to minimize inappropriate use of emergency departments need to be developed and put into place.

Body Image of Women with Breast Cancer After Mastectomy: A Qualitative Research.

OBJECTIVE: To gain a holistic and deep understanding about how mastectomy effects the body image of women who have breast cancer. MATERIALS AND METHODS: The sample of this qualitative descriptive study consisted of twenty patients who underwent mastectomy procedures. Semi-structured interviews were conducted during the second week after mastectomy. Each interview was transcribed verbatim, and a thematic analysis was performed. RESULTS: After the mastectomy, the findings related to the women's body image and their experiences were specified as four main themes and seven sub-themes. The main themes were: meaning of the breast, mastectomy and me, my body image and body image changes, and social life. Most of the participants in this study stated that the breast meant femininity, beauty, and motherhood. It was found that the meaning of mastectomy varied according to individuals. Women used quite negative statements about their appearances. The participants also said that they felt that half themselves was missing, as individuals and women. The women stated that they preferred clothes that hid their lack of breast. Some of the participants mentioned that relations with their husbands were not like before, and they abstained from social interaction. CONCLUSION: Our findings suggest that mastectomy as a surgical treatment for breast cancer may negatively affect a woman's body image and her self-image.

Nursing and midwifery college students' expectations of their educators and perceived stressors during their education: a pilot study in Turkey.

Nursing and midwifery education is known to be negatively affected by several factors. Nevertheless, the present learning environments for students can be effectively altered to optimize their learning and practical training and decrease their stress levels. In order to minimize the stressors and to encourage the qualities needed of a competent educator, it would be important to first determine students' perceived stressors and the expectations they have of their educators. The main purpose of the study was to define the expectations that nursing and midwifery college students have of their educators as well as the stressors they perceive during their education. The present descriptive study was carried out with 474 students; there were 345 nursing students and 129 midwifery students at a college in northeastern Turkey. Data were obtained with a questionnaire and assessed with X(2) analyses. The findings of the study demonstrated that a majority of the students had some expectations of the educators and perceived stressors during their education. The students' most common expectations of the educators included their desire to be understood during their clinical education. In addition, students wanted the educators to make more use of visual materials during the theoretical part of their courses. The study also determined that the students felt very stressed when they were questioned by the educator on both clinical and theoretical aspects of their coursework.

Attitudes and health beliefs associated with breast cancer screening behaviors among Turkish women.

PROBLEM: This research was undertaken to determine the attitudes and health beliefs of a sample of Turkish women about breast self-examination (BSE), clinical breast examination, and mammography. DESIGN: Data were collected by means of a researcher-designed questionnaire and the Champion Health Belief Model Scale. A total of 1,342 women participated in this study. RESULTS: It was found that 10.1% of the women practiced BSE once a month, 19.8% of the women had had a clinical breast examination, and 15.0% had had a mammogram. Age and marital status were significant variables that influenced whether the women used only one or multiple methods for early detection of breast cancer. Participants who had higher levels of confidence for BSE and lower perceptions of barriers to BSE were more likely to perform BSE. Participants who perceived higher levels of confidence to perform BSE were more likely to be using all three early detection methods. IMPLICATIONS FOR PRACTICE: Interventions and strategies that help women develop confidence in their abilities to perform early breast cancer detection methods are likely to encourage them to engage in regular screening for breast cancer.

Evaluation of the breast cancer train the trainer program for nurses in Turkey.

The Breast Cancer Train the Trainer (TTT) program was designed to increase breast cancer awareness, improve knowledge about breast cancer among nurses, and provide quality care for breast cancer patients by trained nurses. A total of three programs were held and 82 nurses from different regions of Turkey attended this training. The educational activities employed several teaching and learning strategies. After completion, we determined that the participating nurses' knowledge on breast cancer had increased significantly, and they were satisfied with the training received. The Breast Cancer TTT program is a unique educational endeavor for nurses in Turkey, and our results showed that the training achieved its goal. Trained nurses in Breast Cancer TTT programs can help educate women about the importance of breast health and the measures they need to take to protect themselves against breast cancer. At the same time, nurses can also increase and enhance the quality of life in patients with breast cancer. This is an example of a program that can easily be spread throughout the world as it was done from England and Australia to Turkey.

The effects of peer education on university students' knowledge of breast self-examination and health beliefs.

This study was carried out to determine the effects of peer education on breast self-examination (BSE) knowledge and health beliefs. 180 female university students were trained in BSE by the nursing students. Students instructed in groups by their peers showed a much higher degree of BSE knowledge. It was also found that perceived confidence of the students educated both individually and in groups increased afterward. Study results further revealed that the methods used for peer instruction do not affect students' sub-dimensions of health beliefs differently after the education.

The effect of home healthcare on quality of life in patients diagnosed with gastrointestinal cancer.

This study was undertaken to determine the effect of home healthcare on the quality of life (QOL) in patients diagnosed with gastrointestinal cancer. A total of 42 patients, who met eligibility criteria, were enrolled in the study and randomly assigned to either a control group or an experimental group. Control group patients received "usual care" defined as pain control and management through the pain clinic. Experimental group patients received pain control through the clinic plus three home visits. During the home visits, their nursing care was guided by an evidence-based protocol developed by the research team. Data were collected on pain, performance, symptoms, and QOL by using previously developed and validated instruments.Significant differences were found between the two groups on physiological function, psychological concerns, and total stress. In the experimental group, there was a significant decrease in pain and increase in performance from baseline to the final data collection period. For the control group, a significant decrease in QOL over the study period was observed. There were no significant differences between the two groups on pain, performance, QOL, and QOL subscales at the final visit.