Determination of Compassion and Compassion Fatigue in Intensive Care Nurses.

Introduction: Compassion is defined as the sadness felt by a living thing or a person due to a negative situation. Compassion fatigue describes emotional, physical, social and spiritual exhaustion or a decrease in these feelings. The concept of compassion, which is at the center of nursing, may be related to compassion fatigue in nurses. Objective: The aims of the study were to determine the level of compassion fatigue and compassion among intensive care nurses and to examine the relationship between them. Methods: This study was conducted through descriptive research and cross-sectional survey. The population of the research consisted of intensive care nurses from two hospitals in Turkey. Since the universe is accessible, the sample selection method was not used (n = 182). Demographic data form, Compassion Fatigue sub-dimension of the Professional Quality of Life Scale and Compassion Scale were used in the study. Results: The mean score of the nurses' compassion fatigue was 15.86 ± 7.22, and compassion was 72.21 ± 7.28. There was a moderate negative relationship between compassion and compassion fatigue (r = -.405). It was determined that the nurses' compassion was at a moderate level and their compassion fatigue was at a low level. Conclusion: It can be assumed that ICU nurses' compassion is at a medium level and their compassion fatigue is at a low level. It was established that as the compassion level of the nurses increased, the level of compassion fatigue decreased. Developing a sense of compassion in nurses working in intensive care units can reduce compassion fatigue.

Alexithymia and Forgiveness Levels of Forensic Psychiatric Patients.

The current cross-sectional study was performed to examine levels of alexithymia and forgiveness in forensic psychiatric patients. Data were collected between March 2022 and August 2022 at a high-security forensic psychiatric hospital affiliated with a city hospital in Turkey. A personal information form prepared by the researchers, the Toronto Alexithymia Scale, and the Heartland Forgiveness Scale were used to obtain data. Participants comprised 132 forensic psychiatric patients who agreed to participate in the study. A significant negative correlation was found between alexithymia and forgiveness levels of participants (p < 0.01, r = -0.259). In other words, as alexithymia levels increased, participants were found to be less forgiving. In addition, results suggest that forensic psychiatric patients are susceptible to alexithymia and higher levels of forgiveness. Determining forgiveness and alexithymia levels of forensic psychiatric patients will contribute to the structuring of care to be offered to these patients. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

Could the Cerebral Involvement of COVID-19 Disease be Related to Microstructural Changes that are not Reflected in Conventional MRI Images?

In patients with COVID-19, neurodegeneration may develop before clinical symptoms appear. Diffusion-weighted (DW) MRI is an important technique for analyzing microstructural changes such as gliosis. In this study, a quantitative evaluation of microstructural changes in the brain with apparent diffusion coefficient (ADC) values in patients presenting with a headache after the COVID-19 disease was analyzed and compared. DW MR images of patients of 20 COVID-19 patients (13 females, 7 males) who required imaging due to headache; 20 controls (16 females, 4 males) were retrospectively reevaluated. ADC measurements were taken from 16 regions of the brain, including right and left symmetrical in patients with COVID-19 infections and control groups. All regions of interest (ROIs) were taken from the hypothalamus, parahippocampus, thalamus, corpus striatum, cingulate gyrus, occipital gyrus, dentate nucleus, and medulla oblongata posterior. ADC values in the dentate nucleus right (784.6 ± 75.7 vs. 717.25 ± 50.75), dentate nucleus left (768.05 ± 69.76 vs. 711.40 ± 52.99), right thalamus (731.15 ± 38.14 vs. 701.60 ± 43.65), left thalamus (744.05 ± 39.00 vs. 702.85 ± 28.88), right parahippocampus (789.10 ± 56.35 vs. 754.75 ± 33.78), right corpus striatum (710.00 ± 39.81 vs. 681.55 ± 39.84) were significantly higher than those in the control group. No significant changes were observed in other areas. A significant increase in ADC values at many levels in the brain in patients with COVID-19 disease and headache was observed. Thus, this study indicates that cerebral involvement in COVID-19 disease may be related to microstructural changes that are not reflected in conventional MRI images.

The effect of functional remission and cognitive insight on criminal behavior in patients with schizophrenia.

OBJECTiVE: This study was planned to determine the relationship of functional remission with a criminal history and determine its effect on criminal behavior in patients with schizophrenia. METHODS: This cross-sectional study was conducted with 132 patients with schizophrenia (66 with and 66 without a criminal history). Data were collected between November 2020 and April 2021 using a personal information form, the Functional Remission of General Schizophrenia (FROGS), the Taylor Crime Violence Rating Scale, the Beck Cognitive Insight Scale, and the Positive and Negative Syndrome Scale (PANSS) was used to collect data. RESULTS: In terms of all scale variables, there were significant differences between the groups with and without a criminal history (p < 0.05). These differences were mostly clearly observed in the FROGS-social functionality (effect size: 16.79), PANSS-positive (effect size: 2.62) and FROGS-health and treatment (effect size: 2) subscales. CONCLUSIONS: In this study, it was determined that as the symptoms of the illness increased in schizophrenia, the patients' functional remission and insight decreased, and their tendency to commit crimes increased. Psychiatric nurses can plan therapeutic interventions to increase the functionality and insight levels of patients with schizophrenia.

The effects of long-term doppler ultrasound exposure in the prenatal period on renal tissue physiology in rats.

Doppler ultrasonography (DUSG) is widely used for fetal evaluations. This study investigated the effects of new generation Doppler ultrasound application at different frequencies during pregnancy on postnatal renal development. Six pregnant female rats were divided into three groups. No procedure was performed on the first (control) group. In the second group, transabdominal DUSG was performed continuously for 15 min every day from the first day of gestation until birth. In the third group, DUSG was applied for 15 min every two days. Twenty-four male pups were sacrificed after 60 days. Renal tissues were then collected and subjected to biochemical, histopathological, and immunohistochemical evaluation. Malondialdehyde, glutathione, urea, Ca, K, and Cl levels increased in the DUSG groups compared to the control group (p < .05). Histopathologically, tubular damage increased in the DUSG groups compared to the control group (p < .05). Immunohistochemically, an increase was determined in Caspase-3 expression in the DUSG groups compared to the control group (p > .05). The DUSG groups also exhibited an increase in the superficial areas of the proximal and distal tubules, although the difference compared to the control group was not significant (p > .05). Multiple administrations of new generation DUSG to pregnant rats resulted in deleterious effects on the development of postnatal renal tissue. This shows that DUSG should be applied for as short a time as possible and that re-exposure should be avoided.

An analysis of the relationship between social support levels and treatment compliance of individuals diagnosed with schizophrenia.

PURPOSE: The aim of this study was to determine the relationship between social support levels and treatment compliance of individuals with schizophrenia. DESIGN AND METHODS: A descriptive and correlational research design was used in the study. The sample was not selected from the universe and the study was completed with 110 patients. FINDINGS: There was a significant positive correlation between the total score of family subscale and total score of the Morisky compliance scale (p < 0.05). Morisky adherence scale (p < 0.05), suggesting that family support can favor the treatment adherence of patients. PRACTICE IMPLICATIONS: Psychiatric professionals should carefully evaluate the family support perceived from the patients with schizophrenia to improve their adherence to treatment.

The relationship of suicidal ideation with psychological pain and anger rumination in patients with major depressive disorder.

OBJECTiVE: The study was conducted to determine the association between ruminating anger and mental pain with suicidal ideation in patients diagnosed with major depression disorder. METHODS: The study with 156 patients diagnosed with major depressive disorder was carried out in a cross-sectional study design. Personal Information Form, Reflection on Anger Scale, Psychological Pain Scale and Beck Depression Scale were used. RESULTS: It was concluded that there was a statistically equal directional and linear relationship between the Meebunney and Beck depression scores of all patients diagnosed with a major depressive disorder and the total reflective anger score and its sub-dimensions. Suicidal attempts and psychological pain and depression levels were found to be effective in the increase in suicidal ideation in the patients with major depressive disorder. CONCLUSIONS: Studies with larger samples are recommended to determine the factors that may pose a risk of suicidal ideation in patients diagnosed with majör depressive disorder.

The effect of acceptance and commitment therapy orientated anger management training on anger ruminations and impulsivity levels in forensic psychiatric patients: A randomized controlled trial.

PURPOSE: This study aimed at determining the effect of acceptance and commitment therapy (ACT) orientated anger management training on levels of anger rumination and impulsivity in people receiving forensic mental healthcare. DESIGN AND METHODS: This was a randomized controlled study. The research data were collected between July 2018 and February 2019. The personal information form, Anger Rumination Scale, and Barratt Impulsiveness Scale were used for data collection. FINDINGS: Total scores on the Barratt Impulsiveness and Anger Rumination Scales were significantly lower in the experimental group than in the control group (p < 0.001). PRACTICE IMPLICATIONS: This study adds to existing evidence on the provision of anger management training, offering an evidence-based solution along with necessary knowledge and skills for use by forensic psychiatric nurses.

Examination of evidence-based nursing attitudes and the relationship with professional self-concept in nurses working in a psychiatric hospital.

PURPOSE: The study was carried out with nurses working in a psychiatric clinic to examine their attitudes toward evidence-based practices and levels of professional self-concept. DESIGN AND METHODS: This study was carried out using a descriptive and correlational search design. We used a Personal Information Form developed by the authors and Evidence-Based Nursing Attitude Scale (EBNAS) and Professional Self-Concept Scale for Clinical Nurses (PSCSCN) to obtain data. Percentages and averages, and the Pearson correlation coefficient was used for data analysis. FINDINGS: The mean scores of the total and subdimensions of EBNAS and PSCSCN were high for the participating nurses. A positive relationship was found between EBNAS and PSCSCN. PRACTICE IMPLICATIONS: The positive attitude of the nurses toward evidence-based nursing is related to their high professional self-concept.

Determination of the relationship of the spiritual orientation of nurses with compassion fatigue, burnout, and compassion satisfaction.

PURPOSE: This study aimed to determine the relationship of the spiritual orientation of nurses with compassion fatigue, burnout, and compassion satisfaction of nurses working in two large hospitals. DESIGN AND METHODS: This was a descriptive relational study conducted in Atatürk University Research Hospital between April and September 2016. Data were collected from 379 volunteer nurses using the convenience sampling method. A questionnaire, Professional Quality of Life Scale (ProQOL) R-IV and Spiritual Orientation Inventory (SOI) were used to collect the research data. FINDINGS: It was found that 55.7% of nurses were aged 18 to 27 years, 74.1% of nurses were females. The professional satisfaction of the nurses was high, with low rates of burnout and compassion fatigue. The spiritual orientation of the nurses was high according to the average SOI total score (98.83 ± 15.04). The mean score for compassion fatigue was 21.50 ± 8.69, and the mean score for compassion satisfaction was 34.10 ± 9.91. The mean score for burnout was 19.83 ± 6.39. PRACTICE IMPLICATIONS: Nurses' compassion fatigue, burnout and compassion satisfaction should be evaluated regularly. The results revealed no correlation between spiritual orientation and these parameters. Studies investigating compassion fatigue among nurses should question the time nurses spend on themselves and leisure time.

Rationalization of Using the MR Diffusion Imaging in B12 Deficiency.

CONTEXT: The structural imaging of brain does not demonstrate any changes in the vast majority of patients with vitamin B12 deficiency, even in the advanced stages. AIMS: We investigated the microstructural changes in the brain with diffusion imaging among patients with biochemical evidence of B12 deficiency. PATIENTS AND METHODS: We retrospectively analyzed all diffusion-weighted MRI images between the periods 2014-2016 who had biochemical evidence of B12. The age-sex matched controls were chosen from the group with normal B12 levels. Patients with pathological findings in conventional MRI images were excluded from the study. RESULTS: About 37 patients were recruited (22 women, 15 men; mean age, 34.1 ± 9.9 years; age range). They were about thirty-four age-and sex-matched controls (with normal B12 levels), which were also included in the study. The mean apparent diffusion coefficient (ADC) value of amygdala (773.8 ± 49.9 vs. 742.2 ± 24.2, P = 0.01), hypothalamus (721.3 ± 39.2 vs. 700.2 ± 38.2, P = 0.02), striate cortex (737.6 ± 77.6 vs. 704.3 ± 58.2, P = 0.04), suprafrontal gyrus (740.7 ± 46.9 vs. 711.6 ± 40.7, P = 0.007) and medulla oblongata-olivary nucleus (787.3 ± 56.4 vs. 759.7 ± 46.2, P = 0.02) were significantly higher in B12 deficiency group compared to controls, whereas ADC values were similar at hippocampus, thalamus, insula, corpus striatum, cingulate gyrus, occipital gyrus, dentate nucleus, cerebral pedicle, tegmentum, pons, and posterior medulla oblongata. CONCLUSIONS: Our study indicates that a significant increase in ADC values occurs in multiple brain regions in patients with vitamin B12.

Noninvasive Assessment of Liver Parenchyma Using Gray-Scale Ultrasound-Based Histogram Analysis in Patients With Chronic Hepatitis B Infection.

The aims of this study were to examine the alterations of liver echo-intensity histogram parameters in chronic hepatitis B (CHB) patients and to assess the potential role of histogram parameters in the evaluation of hepatic fibrosis. A total of 52 patients with CHB who underwent liver biopsies were included in the study. The control group consisted of 30 healthy individuals. Histogram parameters were obtained from histogram analysis of gray-scale ultrasound images of both groups. The histogram parameters of the groups were compared. The association of histogram parameters with the grading and staging of histological activity index (HAI) in patients with CHB were evaluated. The patient group had statistically significant lower skewness, kurtosis, and higher variance, mean, 50th, and 90th percentile values compared with control group. When patients with CHB were divided into subgroups according to HAI stage, there was the increasing trend in skewness values and decreasing trend in kurtosis values across subgroups. The first percentile values showed negative correlation with HAI staging in patients with CHB. Ultrasound is a fast, inexpensive, and reproducible imaging method; histogram analysis of gray-scale ultrasound images may provide useful information for evaluation of hepatic fibrosis in CHB patients.

Effects of Gadodiamide and Gadoteric Acid on Rat Kidneys: A Comparative Study.

BACKGROUND: Gadolinium-based contrast agents are complex chelates to provide contrast in NRI. However, recent studies have highlighted the deposition of free Gd+3 ion in various tissues. PURPOSE: To evaluate the histopathological and immunohistochemical changes on rat kidney tissue following both macrocyclic (gadoteric acid) and linear (gadodiamide) agents under the hypothesis that gadolinium-based contrast agents (GBCA) lead to toxic, free Gd+3 accumulation in tissues. STUDY TYPE: The local Animal Care Committee approved the prospective animal study. ANIMAL MODEL: Thirty-two healthy Sprague-Dawley male rats were administered 2 mmol/kg gadodiamide and gadoteric acid for the first 4 days for 5 weeks. Group 1 received no drug (control, n = 8) and Group 2 (n = 8) was administered 0.1 ml/kg saline. Group 3 was administered 0.1 mmol/kg gadodiamide and Group 4 (n = 8) was administered 2 mmol/kg gadoteric acid. ASSESSMENT: Biochemical, histopathological, and immunohistochemical changes in testis kidney tissue were evaluated at the end of 10 weeks. STATISTICAL TESTS: Differences between groups were analyzed using the nonparametric Kruskal-Wallis test followed by one-way analysis of variance and the Tamhane test, also followed by Turkey's HSD test. RESULTS: Gadolinium increased serum urea, Ca+2 , and Caspase-3 positive tubular cell number. Larger Bowman capsules shrank proximal and distal tubules were revealed in the gadodiamide and gadoteric acid groups compared to the control group (P < 0.05). Histopathologic examination showed significantly more interstitial fibrosis, amyloid deposits, and vasocongestion in the gadodiamide group than the gadoteric acid and control groups, while the gadoteric acid group demonstrated significantly more leukocytic infiltration with atrophied proximal and distal tubules than the gadodiamide and control groups (P < 0.05). DATA CONCLUSION: GBCA administration causes significant histopathologic changes in kidney tissue. This study advocates additional investigation to assess the in vivo safety of GBCAs. LEVEL OF EVIDENCE: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:382-389.

The effect of cholecystectomy on 25-hydroxyvitamin D levels and bone mineral density in postmenopausal women.

Vitamin D deficiency has been reported in patients with gastrointestinal disorders. Little is known on the potentially deleterious effect of cholecystectomy on vitamin D levels and osteoporosis. We found that 25-hydroxyvitamin D levels and bone mineral density were lower in patients with prior cholecystectomy. PURPOSE: The influence of bile salts on vitamin D absorption is well-known, and increased incidence of vitamin D deficiency has been reported in patients with gastrointestinal disorders. Little is known on the potentially deleterious effect of cholecystectomy on vitamin D levels and osteoporosis. Herein, we aimed to investigate the effects of cholecystectomy on vitamin D levels and osteoporosis in postmenopausal women. METHODS: The study group comprised 50 postmenopausal women who had previously undergone cholecystectomy; the control group comprised 50 age-matched postmenopausal women. Serum vitamin D, calcium, and phosphorus levels were determined. Bone mineral density (BMD) was determined using dual-energy X-ray absorptiometry. RESULTS: The study group had significantly higher parathyroid hormone levels (94.4 ± 45.1 vs. 69.2 ± 37.5, p < 0.001) but significantly lower 25-hydroxyvitamin D levels (16.3 ± 7.6 vs. 19.8 ± 8.7, p = 0.03). Compared with the control group, the BMDs of both the lumbar spine (- 1.5 ± 1.0 vs. - 0.9 ± 1.0, p = 0.004) and femur (- 0.5 ± 0.8 vs. 0.19 ± 1.1, p = 0.001) were significantly lower in the study group. Body mass index [B = 0.81 (CI 0.67-0.98), p = 0.03] and prior cholecystectomy [B = 7.9 (CI 1.0-71.7), p = 0.04] were independent predictors of osteoporosis. CONCLUSION: In postmenopausal women, prior cholecystectomy is associated with lower serum 25-hydroxyvitamin D levels and BMD.

Renal Artery Dissection in a Patient With Degenerative Scoliosis: A Rare Complication Caused by Lumbar Vertebra Osteophyte.

Isolated spontaneous renal artery dissection (RAD) without known trauma is rare, and its etiology has not been determined. However, notable risk factors including hypertension, strenuous exercise, connective tissue disorders, atherosclerosis, extracorporeal shock wave lithotripsy, and cocaine abuse have been reported. To the best of our knowledge, isolated RAD caused by lumbar vertebra osteophytes in patients with degenerative lumbar scoliosis has not been reported in the literature. In this article, we present a case of RAD caused by lumbar vertebra osteophyte in a patient with degenerative scoliosis and discuss the management of the disease.

Effect of Septoplasty on the Heart Rate Variability in Patients With Nasal Septum Deviation.

BACKGROUND: Nasal septum deformities (NSD) are one of the most common causes of upper airway obstruction. Heart rate variability (HRV) is a physiologic parameter that is affected by the balance between the sympathetic and parasympathetic tonus. OBJECTIVE: The aim of this study was to evaluate the effects of a septoplasty operation on HRV parameters as assessed by 24 hours ambulatory Holter recordings in patients with NSD. METHODS: The prospective study involved 54 consecutive patients (16 women and 38 men) who underwent septoplasty due to a marked C- or S-shaped NSD. Twenty-four-hour Holter monitoring was performed to all patients pre- and 2 months postseptoplasty operation. For the HRV analyses, the definitions of evaluated parameters were made according to the Task Force of European Society of Cardiology and the North American Society of Pacing and Electrophysiology on HRV. RESULTS: Low-frequency norm () (73 [68-86] versus 78 [70-81], P = 0.039) values were significantly increased after septoplasty whereas changes in other parameters were not statistically significant. CONCLUSION: The authors' study showed that low-frequency norm values were significantly increased after septoplasty operation in patients with NSD which may be interpreted as a decreased sympathetic tone.

The Effect of Reflexology Applied to Patients with Chronic Obstructive Pulmonary Disease on Dyspnea and Fatigue.

PURPOSE: The purpose of this study was to determine the effect of reflexology on reducing dyspnea and fatigue in patients with chronic obstructive pulmonary disease (COPD). DESIGN/METHODS: The study was conducted as a pretest-posttest experimental design. The population of the study consisted of 60 patients (30 in experimental group and 30 in control group). Patient Description Form, Baseline Dyspnea Index (BDI) and Visual Analogue Scale-Fatigue (VAS-F) were used to collect the data. RESULTS: The difference between pretest-posttest dyspnea and fatigue mean scores of patients in the experimental group was statistically significant (p < .01). The difference between pretest-posttest dyspnea and fatigue mean scores of patients in the control group was statistically insignificant (p > .05). CONCLUSION: It was determined that the reflexology reduced dyspnea and fatigue in patients with COPD. CLINICAL RELEVANCE: Complementary methods such as reflexology should be used with pharmacological methods to reduce dyspnea and fatigue of COPD patients.

Association of Reactive-Proactive Aggression and Anxiety Sensitivity with Internalizing and Externalizing Symptoms in Children with Attention-Deficit/Hyperactivity Disorder.

This study evaluates the associations among the symptoms of anxiety, depression, and disruptive behavioral disorders (DBD) in the context of their relationships with reactive-proactive aggression and anxiety sensitivity in children with attention-deficit/hyperactivity disorder (ADHD). The sample consisted of 342 treatment-naive children with ADHD. The severity of ADHD and DBD symptoms were assessed via parent- and teacher-rated inventories. Anxiety sensitivity, reactive-proactive aggression and severity of anxiety and depression symptoms of children were evaluated by self-report inventories. According to structural equation modeling, depression and anxiety scores had a relation with the DBD scores through reactive-proactive aggression. Results also showed a negative relation of the total scores of anxiety sensitivity on DBD scores, while conduct disorder scores had a positive relation with anxiety scores. This study suggests that examining the relations of reactive-proactive aggression and anxiety sensitivity with internalizing and externalizing disorders could be useful for understanding the link among these disorders in ADHD.