Effects of Music and Preoperative Education on Coronary Artery Bypass Graft Surgery Patients' Anxiety.

PURPOSE: The aim of this study was to evaluate the effectiveness of music and preoperative education on anxiety, physiological responses, length of hospital stay, and quality of life in Coronary Artery Bypass Graft Surgery (CABG) patients. DESIGN: This was a non-randomized quasi-experimental study. METHODS: For this study, 214 patients were separated into an experimental and control group. A dual intervention using preoperative education and a CD with classical Turkish music was applied to the experimental group. The control group was provided with an uninterrupted rest period at the same time. The primary outcome was the difference in anxiety of the patients. Other outcomes included differences in the physiological responses, length of hospital stay, and quality of life. FINDINGS: Anxiety decreased in the preoperative and postoperative periods in both groups (P = .000), and patients' anxiety level in the experimental group was lower than the control group (P = .000). The experimental group patients had a decrease in systolic blood pressure, diastolic blood pressure, and heart rate in the preoperative period (P = .000), and all physiological responses in the postoperative period were lower than the control group (P = .000). Furthermore, the experimental group's length of hospital stay was shorter (5.8 ± 1 days), and their quality of life was better (P = .000). CONCLUSIONS: The dual integrative nursing intervention (music and preoperative education) was effective in reducing anxiety in CABG patients. The results of the study will contribute to nonpharmacological approaches in the management of anxiety in CABG patients.

Investigation of the Causes and Risk Factors of Previous End-Stage Renal Disease in Kidney Transplant Recipients.

BACKGROUND: Chronic kidney disease (CKD) is a pathophysiological process with many etiologic causes, often leading to end-stage renal disease (ESRD). The distribution of the causes that lead to ESRD varies by country, race, and sex. Renal failure may be prevented by determining these differences and reducing the risk factors. OBJECTIVE: The purpose of the study was to determine the causes and risk factors of previous ESRD in kidney transplant (KT) recipients. METHODS: In this descriptive, cross-sectional study, 393 KT recipients fitting the study criteria gave written consent to participate. Data were collected in face-to-face interviews at the Transplant Center using survey forms prepared by the researchers. RESULTS: According to a multivariate logistic regression analysis of the dependent variable of ESRD diagnosis age of KT recipients, the factors affecting ESRD diagnosis age were found to be job (Odds ratio (OD) = 5.76; 95% CI [2.291-14.481]), diabetes mellitus (DM) (OD = 2.94; 95% CI [1.143-7.571]), polycystic kidney disease (PKD) (OD = 4.55; 95% CI [1.737-11.919]), hypertension (HT) (OD = 3.53; 95% CI [2.132-5.854]), family history of ESRD (OD = 0.57; 95% CI [0.341-0.963]), surgical procedure history (OD = 1.93; 95% CI [1.150-3.230]), and stress level (OD = 5.86, 95% CI [2.212-15.528]). CONCLUSION: It is important that we determine the changeable risk factors related to ESRD development in order to prepare strategies aimed at preventing ESRD, the frequency and prevalence of which is gradually increasing. Modifiable risk factors should be identified, particularly in KT recipients, to preserve the functions of the transplanted kidney.

Evaluation of Factors Affecting the Type of Gallstone.

The aim of this study is to determine the factors affecting the formation of the gallstone types of cholesterol and pigment stones. This descriptive and retrospective study comprised 164 patients who underwent cholecystectomy. Research data were obtained using a data collection form with 34 questions developed by the researchers based on the relevant literature. Statistical analysis of the data was made on SPSS 15.0 software using the percentage assessment method and chi-square test. Advanced statistical analysis of the data was performed using multivariate logistic regression. Cholesterol stone was found to form in individuals with anemia, those going through the menopause, and those consuming liquid oil and not undertaking exercise. The risk of pigment stone formation was found to be higher in the obese and those with liver disease and who do not consume milk. From the results of the study, it was determined that the dietary habits, chronic diseases, and lifestyle behaviors of individuals could be effective factors in the formation of cholesterol and/or pigment stone.

The Impact of Facial Aesthetic and Reconstructive Surgeries on Patients' Quality of Life.

The aim of the present prospective and descriptive study was to assess the impact of facial aesthetic and reconstructive surgeries on quality of life. Ninety-one patients, of whom 43 had aesthetic surgery and 48 had reconstructive surgery, were analysed. The data were collected using the patient information form, body cathexis scale, and short form (SF)-36 quality of life scale. There were significant differences between before and after the surgery in both groups in terms of body cathexis scale and quality of life (p < 0.05 for both). It was observed that problems regarding the body image perception were encountered more, and the quality of life was poorer in both aesthetic and reconstructive surgery patients before the surgery. However, the problems were decreased, and the quality of life was enhanced after the surgery. Among the parameters of SF-36 quality of life scale, particularly the mean scores of social functioning, physical role functioning, emotional role functioning, mental health, and vitality/fatigue were found low before the surgery, whereas the mean scores were significantly improved after the surgery. The results revealed that facial aesthetic and reconstructive surgical interventions favourably affected the body image perception and self-esteem and that positive reflections in emotional, social, and mental aspects were effective in enhancing self-confidence and quality of life of the individual.

Efficiency of antibacterial suture material in cardiac surgery: a double-blind randomized prospective study.

OBJECTIVE: Postoperative surgical site infections (SSI) still greatly affect mortality and morbidity in cardiovascular surgery. SSI may be related to the suture material. In this prospective, randomized, controlled, and double-blinded study, the effect of antibacterial suture material on SSI in cardiac surgical patients was investigated. METHODS: We randomly allocated 510 patients into 2 groups. Antibacterial suture materials were used for wound closure in 170 patients (triclosan-coated suture group), and routine suture materials were used in 340 patients (noncoated suture group). All patients were evaluated for SSI on days 10, 20, and 30 following cardiac surgery. RESULTS: Preoperative risk factors and laboratory findings were comparable for the 2 groups. Sternal infection occurred in 4 (2.4%) of the patients in the triclosan-coated suture group and in 3.5% of the noncoated suture group (P > .05). Leg wound infection occurred in 5 (3.5%) of the patients in the triclosan-coated suture group and in 3.8% of the noncoated suture group (P > .05). Only diabetes mellitus was an independent predictor of SSI. CONCLUSION: Both noncoated and triclosan-coated suture materials are safe. Larger studies may be needed to show the benefit and cost-effectiveness, if any, of triclosan-coated materials over noncoated materials.

The importance of a holistic approach during the perioperative period.

Holism is the philosophy of understanding people by addressing factors that affect people in all situations. The goal of holistic nursing is to help patients integrate appropriate self-care into their lives. By providing holistic care, the perioperative nurse can help surgical patients experience fewer problems (eg, surgical trauma, pain, anesthetic complications), reach discharge more quickly, attain satisfaction with health care, and more easily resume normal activities. Holistic nursing may include the use of music, guided imagery, therapeutic massage, play therapy, touch therapy, and communication skills. Successful surgery for the patient means not only recovering but regaining physical, mental, and spiritual health as a whole.

Historical development and current status of emergency nursing in Turkey.

As the demand for high quality Accident and Emergency Departments and nursing staff increases throughout Turkey, the need for more specialized emergency nurse training has also increased. Although there have been a number of positive developments regarding emergency nursing standards, the general quality of emergency nurse training needs to be improved and job definitions amended to better reflect the specialist duties of emergency nurses.

Turkish version of the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration: a preliminary study.

BACKGROUND: The Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration is an established instrument to measure the perceived work relationship between physicians and nurses. The survey addresses areas of autonomy and decision making, interprofessional education and relations, psychosocial care, teamwork, and shared responsibility. The aim of this prelimiary study was to adapt the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration for use in Turkey and test its psychometric properties and utility in clinical and research practice. METHODS: The process of cross-cultural adaptation and validation followed the guidelines provided in the existing literature. First, three bilingual health professionals independently translated the original questionnaire into Turkish and a consensus version was generated. Then, three other translators, blind to the original questionnaire, performed a back translation into English to confirm the accuracy of the translation. This version was then compared with the original English questionnaire. Discrepancies were discussed and solved by a panel of two nurses and two physicians. The field-testing for face validity was done in a group of ten monolingual physicians and nurses. Reliability was assessed with test-retest reliability and construct validity was confirmed with factor analysis. RESULTS: The mean time of questionnaire administration was 3 minutes and 45 seconds. The test-retest reliability was 0.75, and Cronbach's coefficient alpha was 0.71 for the entire sample. The findings of the factor analysis indicated that the Turkish version of Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration was comprised of the following four factors: 'physician-nurse relationships', 'shared education', 'nursing role in patient care', and 'accountability and responsibility of nurses.' CONCLUSION: The overall findings of this study indicate that the Turkish version of the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration is a psychometrically sound tool with satisfactory measurement characteristics including construct validity and internal consistency reliability. This instrument may be useful in assessing the effectiveness of educational programs designed to enhance collaboration between physicians and nurses, whether these programs are aimed at residents and graduate nursing students or practicing physicians and nurses.

[The determination of the pain relief approaches in emergency trauma units]. / Acil travma ünitelerinde agri geçirme yaklasimlarinin belirlenmesi.

This definitive study has been performed to assess the approach to pain relief in emergency trauma units. The study population consisted of patients seen at the emergency trauma clinics of three different, state-owned, research hospitals in the city of Istanbul. A total of 375 patients with an age range of 18-65 were included. The data were obtained from an 18 question data sheet. Trauma was caused by a fall in 46.1% of the patients and 66.7% of the cases were out of building. Blunt trauma was the cause in 85.6%, 31.2% had head trauma, 38.1% extremity injuries. Of the patients enrolled in the study, only 17.1% (64 patients) had received analgesics. The most common analgesic medication group used was Nonsteroid Anti Inflammatory Drugs (NSAID). According to these results, 82.9% of patients with pain due to trauma had not received analgesics and it can be concluded that pain in trauma patients is undertreated.

Physician-nurse attitudes toward collaboration in Istanbul's public hospitals.

The need for greater collaboration between nurses and physicians in clinical practice is essential to improve patient care and worker satisfaction. This study used t-tests and logistic regression to test four research hypotheses concerning attitudes toward physician-nurse collaboration in Istanbul, Turkey. The study found that nurses express more positive attitudes toward collaboration than physicians. Noteworthy was the finding that male physicians expressed more positive attitudes toward collaboration than female physicians. Residents and those employed in secondary institutions were also more likely to express more positive attitudes toward collaboration than permanent physicians and those employed in tertiary hospitals.

Quality of life in women with breast cancer in Turkey.

PURPOSE: To determine quality of life (QoL) of Turkish women with breast cancer, and to examine whether QoL was related to sociodemographic or clinical variables. DESIGN: This descriptive study was conducted with a convenience sample of 72 Turkish women with breast cancer recruited from two hospitals in Turkey. METHODS: The data were collected using a questionnaire, the Quality of Life Scale (QoLS), and the Visual Analogue Scale (VAS), and were analyzed using descriptive statistics. FINDINGS: Two sociodemographic variables (educational background and employment status) were related to QoL of women with breast cancer. No statistically significant difference was found between patients with and without pain on scores obtained from the overall QoLS. CONCLUSIONS: The mean scores of total scale and subscales related to QoL perceived by women were considered to be moderately high. However, findings showed that educational level, employment status, and level of pain affected the level of QoL in Turkish women with breast cancer in varying degrees. Further studies are needed to determine specific effects of sociodemographic and clinical variables on QoL.

Port needles: do they need to be removed as frequently in infusional chemotherapy?

Protracted chemotherapy regimens are new treatment modalities used to treat patients with cancer. These treatments are preferred because of the ease of administration and limited side effects in the outpatient setting. Sixty patients were treated with continuous infusion chemotherapy via implanted infusion ports at Marmara University Hospital Outpatient Chemotherapy Unit in Istanbul, Turkey, from January 2000 to December 2001. Although usage of Huber needles for central venous catheters was limited to between 48 and 72 hours, needles were not removed unless there were signs of inflammatory reaction. The needles remained in place for 28 days (1-49 days) on average. No catheter infections, signs of local irritation, or thrombus formation were observed despite prolonged stay of the Huber needles. Huber needles can be left in place up to several weeks without any untoward effects as long as proper aseptic technique is used.

How do intensive care nurses assess patients' pain?

Identification and evaluation of pain in critical care patients may be difficult because of communication problems. Moreover, at present there are very few nursing studies that examine the attitudes of critical care nurses towards the assessment of patients' pain. This study was designed to determine the approach of critical care nurses towards assessing patients' pain levels, and to evaluate the problems in nursing diagnosis of those having difficulty in articulating their pain symptoms. We used a questionnaire to assess nurses attitudes to patients' pain. The study sample consisted of 91 critical care nurses who were recruited between January and February 2002. The results suggest that patient pain was considered undesirable by 44% of nurses. About 70-3% of the nurses reported resorting to administering analgesics to relieve their patients' pain. Some 57.1 % of nurses stated that they would have investigated whether the patients had really been experiencing pain, prior to administering the prescribed analgesics to patients. Some 85.7% of the sample indicated that the patients themselves would make the most accurate evaluation of their pain. The data suggested that 39.6% of nurses did not know how to evaluate pain symptoms in critical care patients suffering from complicated problems, and that 37.4% evaluated pain by monitoring the patients' behaviours. The study demonstrated that most of the critical care nurses did not know how to evaluate pain in patients having communication problems. The paper concludes by suggesting that there is a clear need to address nursing education and training with regard to evaluation and management of patients' pain whilst in critical care environment.