Predictors of frailty after cardiovascular surgery and the relationship between frailty and postoperative recovery: A cross-sectional study.

AIM: To investigate the factors affecting postoperative frailty and the relationship between frailty and postoperative recovery in patients undergoing cardiovascular surgery. DESIGN: The study was descriptive, cross-sectional, and predictive. METHODS: Data were collected by researchers in a university research and application hospital cardiovascular surgery inpatient clinic between March 2022 and March 2023. Sociodemographic-Clinical Characteristics Form, Comorbidity Index, Edmonton Frail Scale, Postoperative Recovery, and Nutritional Risk Screening were used to collect the data. RESULTS: Of the 145 patients included in the study, 65.51% (n = 95) were male and the mean age was 62.02 ± 10.16 years. While frailty was not found to be significant by age group, it was found that women had more comorbidities and were more frail than men. It was found that 17.2% (n = 25) of patients had a history of falls before surgery, 26.2% (n = 38) had a fear of falling after surgery and 17.24% (n = 25) had rehospitalisations. While postoperative recovery index predicted fraility by 34% in patients undergoing cardiovascular surgery; general symptoms and psychological symptoms, which are the sub-dimensions of the postoperative recovery index and comorbidity and, fear of falling after surgery predicted frailty by 61%. The order of importance of variables on fraility: general symptoms (ß = 0.297), fear of falling (ß = 0.222), psychological symptoms (ß = 0.218), Charlson Comorbidity Index (ß = 0.183). PATIENT OR PUBLIC CONTRIBUTION: This study clarifies the role of frailty as an important factor influencing the recovery process in patients undergoing cardiovascular surgery. The findings show that frailty has a determining effect on postoperative recovery in these patients. Among the factors affecting frailty status, comorbidities, fear of postoperative falls, and postoperative general and psychological symptoms were found to contribute. These findings emphasise that these factors should be taken into account when assessing and managing the postoperative recovery process. Understanding these factors that influence postoperative frailty is crucial for patient care. Recognising the multifaceted nature of frailty, personalised interventions are needed to improve patient care and postoperative outcomes. Personalised interventions are particularly important for older women with multiple comorbidities, as they are more likely to be frail.

Investigation of the Effect of Nurse Counseling With Mechanical Valve Replacement Patients.

Background and Purpose: Mechanical valve surgery encompasses the management of complications related to antithrombotic therapy, as well as the complications arising from open-heart surgery. The objective of this study is to investigate the impact of personalized counseling on the adherence to anticoagulant treatment, self-efficacy levels, and quality of life (QOL) among patients undergoing mechanical valve replacement surgery. Methods: This study followed an interventional design with both intervention (n = 30) and control (n = 30) groups. Patients in the intervention group received individualized nurse counseling prior to the surgery and for 3 months following the surgery. Patients in the control group received routine care. Data collection involved the utilization of the Sociodemographic and Clinical Characteristics Form, the Short Form Quality of Life Scale, the Barnason Efficacy Expectancy Scale, and the Anticoagulant Treatment Adherence Scale (ATAS). Results: After 3 months of surgery, patients who received counseling had statistically higher average scores in the Efficacy Expectancy Scale and the ATAS (p < .05). Additionally, providing continuous counseling to postoperative patients for 3 months elevated their self-efficacy levels and increased adherence to the recommended treatment. There were no between-group differences in the subdimensions of the QOL scale before and after discharge. Implications for Practice: It is recommended to provide personalized and individualized counseling covering the preoperative and postoperative processes for patients. Trainings should be repeated, and the contents should be differentiated by considering patient characteristics.

Investigating compassion fatigue and predictive factors in paediatric surgery nurses.

BACKGROUND: Nurses provide care to meet the complex needs of patients in the increasing workload in the health system and are at risk of compassion fatigue. The concept of compassion fatigue has begun drawing attention in the last decade, as it negatively affects nurses' physical and mental health, job performance and satisfaction, and therefore patient care quality. OBJECTIVES: This study was to examine compassion fatigue and predictive factors in paediatric surgery nurses. PARTICIPANTS AND RESEARCH CONTEXT: The study was cross-sectional, predictive and quantitative. It was conducted with the 135 paediatric surgery nurses. The data were sent to the email addresses of the members via Google Survey. Research data were collected with the Nurse Information Form, Compassion Fatigue Scale, Life Satisfaction Scale and Multidimensional Perceived Social Support Scale. ETHICAL CONSIDERATIONS: After obtaining the approval of the University's ethics committee, the study was carried out after obtaining participants' informed written and verbal consent. RESULTS: There was a difference between the level of compassion fatigue according to the paediatric surgery unit that worked the longest and the thought of changing their profession. Burn unit nurses and nurses who were considering changing professions have higher compassion fatigue scores. When the predictors of compassion fatigue were examined, the thought of changing the nursing profession and life satisfaction were significant predictors of compassion fatigue. The thought of changing the nursing profession and life satisfaction explained 22% of compassion fatigue. The same variables and the longest working period of the paediatric surgery unit were the estimators of the level of occupational burnout; explaining 29% of occupational burnout. CONCLUSIONS: Compassion fatigue, life satisfaction and perceived social support of paediatric surgery nurses are moderate. Compassion fatigue is affected by working time, the thought of changing the profession, life satisfaction and perceived social support.

Factors Affecting Knowledge Levels and Protective Behaviors to Prevent the Development of Skin Cancer in Organ Transplant Recipients as a High-Risk Group.

OBJECTIVES: Organ transplantrecipients are at high risk of skin cancer due to immunosuppressant therapy. This study investigated the factors affecting organ transplant recipients' knowledge and protective behaviors to prevent the development of skin cancer. MATERIALS AND METHODS: This was a cross-sectional descriptive study of kidney (n = 82) and liver (n = 31) transplant recipients seen at our hospitals in Turkey from June 2019 to February 2020. A sociodemographic and clinical characteristics form, the Skin Cancer and Sun Knowledge scale, the Sun Protection Behavior questionnaire, and the General Self-Efficacy scale were used to collect data. RESULTS: The mean age of organ transplant recipients was 46.63 ± 13.24 years. Self-efficacy and awareness that transplant increases the risk of skin cancer are 2 characteristics that affected the participants' knowledge level. The type of graft (kidney) affected participants' behavior in avoiding outdoor exposure between the hours of 10 am and 4 pm. Green/blue eye color and self-efficacy affected the participants' hatwearing behavior. These details showed that, as the patients' sensitivity and self-efficacy increased, their levels of knowledge and sun protection behaviors were positively affected. CONCLUSIONS: The knowledge level of patients was affected by (1) awareness that transplant is associated with an increased risk of skin cancer and (2) high levels of self-efficacy. We observed that (1) organ transplant recipients with high self-efficacy and kidney transplant recipients were more likely to avoid outdoor exposure between 10 am and 4 pm and that (2) organ transplant recipients with green/blue eyes and high levels of selfefficacy were more likely to wear a hat when outdoors. Organ transplant teams should provide education and counseling about skin cancer and sun protection in the follow-up care of transplant recipients.

Effects of web-based concept mapping education on students' concept mapping and critical thinking skills: A double blind, randomized, controlled study.

BACKGROUND: Using concept maps in nurse education improves students' critical thinking skills. Offering web-based concept mapping education can increase motivation for learning in students actively using the Internet. OBJECTIVES: To examine the effects of web-based concept mapping education on nursing students' concept mapping and critical thinking skills. DESIGN: This is a double-blind, randomized, controlled, experimental study. SETTINGS: A nursing faculty at a state university in Turkey. PARTICIPANTS: Second-year nursing students taking the course surgical nursing in the spring term of the academic year of 2018/2019. METHODS: The experimental group (n = 201) was offered web-based concept mapping education before starting practicums. Data were collected using a students' information form, concept map evaluation keys, and the Critical Thinking Motivational Scale at the end of the practicums. A structured questionnaire was used to reveal opinions of the students about concept mapping. RESULTS: There was a significant difference in concept mapping scores between the students offered web-based concept mapping education (16.45 ± 10.91) and those not receiving this education (12.70 ± 9.31) (p= .000). Also, there was a significant difference in students' scores for the subscales of Critical Thinking Motivational Scale expectancy, attainment and utility between the groups. The students reported that concept maps facilitated their learning and management of nursing processes but that they occasionally experienced difficulty. CONCLUSION: It can be concluded that web-based concept mapping education improves concept mapping skills and motivation for critical thinking skills. Web-based education could be utilized as a tool to enhance nursing students' concept mapping and critical thinking skills.