The effect of hand fine motor skills on peritoneal dialysis-related peritonitis.

INTRODUCTION: We aimed to evaluate the relationship between the hand fine motor skills of peritoneal dialysis (PD) practitioners and PD-related peritonitis. METHODS: This multicenter prospective observational study was conducted with 120 incident PD patients. Patients were divided into two groups who had PD-related peritonitis within the first year as Group 1, and those who did not as Group 2. Hand fine motor skills were evaluated by Nine-Hole Peg Test (NHPT) and Nut Screwing Test (NST). RESULTS: Initial NHPT (28.5 ± 6.0 s vs. 25.8 ± 5.0 s, p = 0.011) and NST (82.3 (61.5-102.8) s versus 65.3 (52.3-88.5) s p = 0.023) scores were significantly higher in Group 1 than Group 2. In multivariate logistic regression analysis, NHPT, Body Mass Index, Mini-Mental Test, self PD practitioner, and catheter complications were found to be independent variables in predicting PD-related peritonitis. CONCLUSION: Decreased hand fine motor skills of PD patients is a risk factor for peritonitis.

The effect of nature-based music intervention on adaptation and anxiety levels in patients with COVID-19 placed in the prone position: A randomized controlled trial.

OBJECTIVE: To examine the effect of listening to nature-based music on anxiety, physiological parameters, and adjustment to the prone position in conscious and hypoxemic COVID-19 patients. DESIGN: A single-blinded randomized control trial design. SETTING: The study was conducted in the intensive care unit of a state hospital in Turkey. Sixty-four patients were randomized into an intervention group and a control group. METHODS: A nature-based music intervention was applied in addition to routine care to the intervention group in the prone position, while the control group received routine care in the same position. The study outcomes included state-trait anxiety, physiological parameters, and prone time within 24 h. Measurements were performed in the supine position (Time: T0), in the 30th minute in the prone position (T1), and in the 30th minute of the supine position given following the prone position (T2). Data analysis included independent samples t-test in independent groups and repeated measures ANOVA in dependent groups. RESULTS: State anxiety fell statistically significantly in the intervention group compared to that of the control group (39.1 ± 6.6 vs. 43.4 ± 7.9, p = 0.025). At T2, the heart rate of the intervention group did not increase, but it increased significantly in the control group compared to T0 and T1 values (87.8 ± 9.8 vs. 91.1 ± 10.8; p = 0.000). The oxygen saturation of the intervention group increased significantly compared to that of the control group (94.5 ± 2.3 vs. 93.4 ± 1.9, p = 0.035). The prone position time of the intervention group was significantly greater than that of the control group (11.5 ± 1.5 vs. 10.8 ± 1.1, p = 0.04). CONCLUSIONS: It was found that nature-based music intervention applied to conscious and hypoxemic COVID-19 patients in the prone position improved anxiety and oxygen saturation and increased the prone position time. IMPLICATIONS FOR CLINICAL PRACTICE: Listening to nature-based music in prone position may reduce anxiety in conscious patients with hypoxemic respiratory failure, it may increase adjustment to the prone position, and it may improve oxygenation and heart rate.

Colostomy may offer hope in improving quality of life: a phenomenological qualitative study with patients dependent on a wheelchair.

PURPOSE: This study aimed to evaluate the perspectives of patients who had spinal cord injuries and were wheelchair-dependent on colostomy surgery, which is among the bowel movement methods. METHODS: In this qualitative study, which was based on Heidegger's hermeneutical phenomenological approach, the Van Manen method was used to reveal how patients were affected by their experiences. The data of the study were collected by directly interviewing the patients and using a semi-structured interview guide. The interviews were recorded with a voice recorder device with the permission of the participants. Nine patients who were leading a life dependent on a wheelchair as a result of spinal cord injury made up the sample of the study. RESULTS: Six of the participants were female. The ages of participants ranged between 32 and 52, and all of them were married. The results of the interviews indicated that the experiences of participants who were dependent on a wheelchair about bowel movement management consisted of three main themes: (a) difficult experiences; (b) coping with difficulties; and (c) colostomy awareness experience. CONCLUSIONS: Results showed that knowledge of a stoma obtained from different sources was a glimmer of hope for patients but that healthcare professionals did not exhibit a supportive attitude toward this hope.

One-Year Post-Vaccination Longitudinal Follow-Up of Quantitative SARS-CoV-2 Anti-Spike Total Antibodies in Health Care Professionals and Evaluation of Correlation with Surrogate Neutralization Test.

Numerous vaccines have been generated to decrease the morbidity and mortality of COVID-19. This study aims to evaluate the immunogenicity of the heterologous boosts by BioNTech against homologous boosts by CoronaVac at three-month intervals in two health care worker (HCW) cohorts, with or without prior COVID-19, for one year post-vaccination. This is a prospective cohort study in which the humoral responses of 386 HCWs were followed-up longitudinally in six main groups according to their previous COVID-19 exposure and vaccination status. Anti-SARS-CoV-2 spike-RBD total antibody levels were measured and SARS-CoV-2 neutralization antibody (NAbs) responses against the ancestral Wuhan and the Omicron variant were evaluated comparatively using international standard serum for Wuhan and Omicron, as well as with the aid of a conversion tool. The anti-SARS-CoV-2 spike-RBD total Ab and Nab difference between with and without prior COVID-19, three months after two-dose primary vaccination with CoronaVac, was statistically significant (p = 0.001). In the subsequent follow-ups, this difference was not observed between the groups. Those previously infected (PI) and non-previously infected (NPI) groups receiving BioNTech as the third dose had higher anti-SARS-CoV-2 spike total Ab levels (14.2-fold and 17.4-fold, respectively, p = 0.001) and Nab responses (against Wuhan and Omicron) than those receiving CoronaVac. Ab responses after booster vaccination decreased significantly in all groups at the ninth-month follow-up (p < 0.05); however, Abs were still higher in all booster received groups than that in the primary vaccination. Abs were above the protective level at the twelfth-month measurement in the entire of the second BioNTech received group as the fourth dose of vaccination. In the one-year follow-up period, the increased incidence of COVID-19 in the groups vaccinated with two or three doses of CoronaVac compared with the groups vaccinated with BioNTech as a booster suggested that continuing the heterologous CoronaVac/BioNTech vaccination, revised according to current SARS-CoV-2 variants and with at least a six-month interval booster would be an effective and safe strategy for protection against COVID-19, particularly in health care workers.

Effect of Oral Carbohydrate Solution Administered Before Hip Arthroplasty on Preoperative Anxiety and Postoperative Patient Comfort: A Randomized Controlled Trial.

PURPOSE: This study aimed to determine the effect of oral carbohydrate solution (OCS) administered before hip arthroplasty (HA) on preoperative anxiety and postoperative patient comfort. DESIGN: The study was a randomized controlled clinical trial. METHODS: Fifty patients undergoing HA were randomized into two groups: The intervention group (n = 25) received OCS before surgery, and the control group (n = 25) fasted from midnight till surgery. The patients' preoperative anxiety was assessed using the State-Trait Anxiety Inventory (STAI), symptoms affecting postoperative patient comfort parameters using the Visual Analog Scale (VAS), and comfort levels specific to HA surgery using the Post-Hip Replacement Comfort Scale (PHRCS). Pre- and post-operative blood glucose levels of the patients were measured. FINDINGS: In intragroup and intergroup assessments, the decrease in the preoperative and postoperative anxiety, pain, thirst, hunger, and nausea/vomiting levels were statistically significant (P < .05) in the OCS group. The OCS group's comfort levels specific to hip replacement were higher than those of the control group (P ≤ .001). In the intergroup and intragroup assessment of the patients' blood glucose levels, there was a statistically significant difference in favor of the OCS group (P < .05). CONCLUSIONS: The results of this study provide evidence supporting OCS administration before HA surgery.

Experiences of Patients Undergoing Bypass Surgery With Health Professionals During the Perioperative Care Process: A Hermeneutic Phenomenological Study.

PURPOSE: To determine the experiences and perceptions of patients who underwent Coronary Artery Bypass Graft (CABG) surgery with perioperative health care professionals. DESIGN: The study used a qualitative research design and was conducted by interviewing eight patients who underwent CABG surgery. METHODS: Study data were collected between April 24, 2020 and February 25, 2021 via a demographic information form and a semi-structured interview form and analyzed by using Heidegger's phenomenological approach. FINDINGS: The participants were between the ages of 51 and 70. They were patients who had undergone CABG surgery 2 months before data collection. Two themes were elicited from the interviews: "If you are bad, I am bad, too", which indicated negative experiences of CABG, and "If you are good, I am safe", which indicated positive patient experiences. In addition, eight sub-themes were determined under these two themes. CONCLUSIONS: In the perioperative process, patients may experience feelings of restlessness, fear, vulnerability, insecurity, and threat when ignored by health care professionals. The provision of interaction between the health professional and the patient, along with family support, changes the perceived care positively and makes patients feel cared for, well, and safe. Awareness of health care professionals about patient experiences during the CABG surgery process points to an important aspect of quality health care.

The Effect of Preoperative Fear and Related Factors on Patients' Postcataract Surgery Comfort Level: A Regression Study.

PURPOSE: This study was conducted to evaluate the impact of precataract surgery fear levels on postoperative patient comfort. DESIGN: A descriptive study was conducted with 236 patients undergoing cataract surgery. METHODS: Study data were collected using the Introductory Information Form, Surgical Fear Scale, and Short General Comfort Questionnaire. The extent of the relationship between predictors affecting patient comfort in cataract surgery was evaluated using linear regression analysis. FINDINGS: A statistically significant negative correlation was found between preoperative fear and postoperative patient comfort. Surgical Fear Scale sub-dimensions, patients' inadequate information perception, gender, and previous cataract surgery experience were identified as predictors of comfort level. CONCLUSIONS: Patients' surgical fear and being inadequately informed decreased postoperative patient comfort. Patient characteristics of male gender and prior cataract surgery were associated with increased postoperative comfort levels. This study revealed the importance of fear management and individualized care in cataract surgery.

Turkish validity and reliability of coronavirus anxiety scale.

The Coronavirus Anxiety Scale (CAS) was developed to differentiate individuals who were functionally impaired by anxiety about COVID-19 from those anxious, but not disabled by their emotional reactions to the disease. The aim of the present study is to validate the Turkish version of the CAS. The study was carried out in two stages. In the first phase, the validity and reliability study of the scale was conducted with 95 people. The single-factor structure of the scale was confirmed with exploratory factor analysis and confirmatory factor analysis results. Cronbach's alpha internal consistency coefficient was found to be 0.86. In the second stage; the data were collected using the Turkish version of CASand Herth Hope scale. The scales were applied to 720 people. It was determined that there was a statistically significant relationship between total CAS scores and the Herth Hope Index. These findings revealed that the CAS was a valid and reliable measurement tool for evaluating the anxiety levels of individuals.

Experiences of patients and their partners with sexual problems after spinal cord injury: A phenomenological qualitative study.

Objective: This study aimed to examine the experiences of patients and their partners about their sexual lives after Spinal Cord Injury (SCI).Design: This qualitative study was based on Heidegger's hermeneutic phenomenological approach.Setting: The Physical Medicine and Rehabilitation Outpatient Clinic of a city hospital in the Central Anatolia Region in Turkey.Participants: The study consisted of seven female and six male patients with spinal cord injury and their partners.Outcome measures: The textual analysis was carried out in three stages: (1) a naive reading, (2) a structural analysis, and (3) a comprehensive understanding of the text including a discussion. The sample size was calculated by using the criterion sampling technique.Results: As a result of the in-depth interviews with individuals with SCI about their sexual experiences, five themes were derived: (1) first confrontation with SCI, (2) experienced sexual problems, (3) coping, (4) partners' views on sexual problems, and (5) other people.Conclusion: It was found that the sex life of individuals with SCI was negatively affected, they were left helpless in dealing with their problems, and that some patients had difficulties in coping with this condition.

Mediating Role of Social Support in Resilience and Quality of Life in Patients with Breast Cancer: Structural Equation Model Analysis.

OBJECTIVE: This study aimed to investigate the mediating role of social support in the relationship between resilience and quality of life (QoL) among Turkish patients with early-stage breast cancer. METHODS: The study used a descriptive and cross-sectional design and was carried out in the oncology ward of a hospital in the Central Anatolia region of Turkey. A demographic-disease survey, the Turkish version of the Connor-Davidson Resilience Scale 25, the Multidimensional Perceived Social Support Scale, the European Organization for Research and Treatment of Cancer QoL Questionnaire Core, and the QoL Questionnaire Breast Cancer 23 were used to interview 113 patients with breast cancer. RESULTS: Social support played a partial mediator role in the relationship between resilience and functional QoL. There was a negative correlation between functional QoL Questionnaire Breast Cancer 23 and psychological resilience and social support (P < 0.005). The mediation effect ratio was 10.2% (R 2 = 0.102). Social support was found to not have a mediating role in the relationship between psychological resilience and general QoL (P < 0.05). CONCLUSIONS: Patients do not want social support to end, and their weakness in the eyes of others may have a negative impact on their QoL and resilience.

Correlation between social support and psychological resilience levels in patients undergoing colorectal cancer surgery: a descriptive study.

Psychological resilience is considered to be promising especially for patients with CRC, which is among the most frequent types of cancer and is known to have serious physical and psycho-social impacts on individuals. Thus, it is stated that psychosocial interventions need to be done in order to overcome emotional stress. This study was conducted to determine the correlation between social support and resilience in patients undergoing surgical therapy due to colorectal cancer. The study is descriptive and cross sectional. A patient information form, Connor-Davidson Resilience Scale, and Multidimensional Scale of Perceived Social Support were used to interview 103 patients undergoing colorectal cancer surgery. It was determined that family support and significant other support were positively correlated with subscale and total scores of the Resilience Scale (p < 0.05). It was determined that the model was highly significant (R2 = 0.113; p < 0001). An increase of 1 unit in healthcare professionals support triggered an increase of one-unit (0.976) in psychological resilience (p:0.014). It was determined that social support provided to patients, undergoing surgical therapy due to colorectal cancer, by family and healthcare professionals, played an essential role in increasing resilience.

Relationship between nursing students' perceptions of clinical instructor caring and their professional behaviors.

PURPOSE: To examine the relationship between nursing students' perceptions of clinical instructor caring and their professional behaviors. METHOD: This study used a descriptive and cross-sectional design. The data were analyzed with Pearson's correlation and Linear regression analyses. RESULTS: The professional behaviors of nursing students were found to increase their desire to become a nurse in the future with "instills confidence through caring" and "supportive learning climate" subscales but to decrease their desire to be an academician in the future. CONCLUSION: As students' perceptions of clinical instructor caring increased, their status of applying professional behaviors was found to increase, as well. PRACTICAL IMPLICATION: Descriptive characteristics and clinical instructor caring are related to high professional behaviors in nursing students.

Effect of Cold Application on Chest Incision Pain Due to Deep Breathing and Cough Exercises.

BACKGROUND: We determined the effect of cold application after coronary artery bypass graft surgery on chest incision pain due to deep breathing and coughing exercises. Thoracotomy performed for coronary artery bypass graft surgery is one of the most painful surgical procedures. This pain prevents deep breathing and effective coughing. These problems increase the risk of morbidity in the postoperative period. AIMS: This study aimed to determine the effect of cold application after CABG surgery on chest incision pain due to deep breathing and cough exercises. DESIGN: Experimental study with control group and repeated measurements. SETTINGS: Patients were selected through convenience sampling in the Cardiovascular Surgery Intensive Care Unit at a hospital. PARTICIPANTS: The study was conducted with 57 patients who underwent open heart surgery (29 and 28 in the experimental and control groups, respectively). METHODS: Repeated pain assessment was performed before, immediately after, and 5 min after deep breathing and coughing exercises performed in 4 periods at 2-h intervals. The first pain assessment was performed 24 h postoperatively. In the first and third assessments of the experimental group, pain was recorded before the exercise; the exercise was performed 15 min after cold gel pack application to the incision area. Pain was assessed before, immediately after, and 5 min after exercise using the Short- Form McGill Melzack Pain Questionnaire. RESULTS: Reduction in pain severity within and between the groups was statistically significant in the first and third evaluations (p = .001). CONCLUSIONS: The results provide evidence to support the use of cold gel pack.

A public awareness study about antibiotic consumption habits and antibacterial resistance in north-eastern region of Cyprus.

INTRODUCTION: Antibiotic resistance is a current global issue. Investigation of the level of knowledge of the public about antibiotics and antibiotic resistance is necessary to combat the antibiotic resistance problem. The aim of the present study was to evaluate the level of knowledge of the citizens of the north-eastern part of Cyprus on antibiotics and antibiotic resistance problem. METHODOLOGY: Randomly selected 701 adults were included in the study. A modified version of World Health Organization's public awareness survey was used to assess the knowledge on antibiotics and the resistance. Logistic regression was used to find out the relationship between knowledge and education level. Spearman's correlation analysis was carried out to determine the association between the education level and the awareness of antibiotic resistance. RESULTS: Overall, 47.9% (336/701) of the respondents had used antibiotics in the last 6 months. Approximately 70% of respondents were determined to have intermediate/high knowledge on antibiotic consumption. In total, 66% of the population heard about antibiotic resistance and of these, 64% had intermediate knowledge on the resistance concept. University graduates were more likely to hear the term antibiotic resistance than primary school graduates. CONCLUSIONS: In the north-eastern region of Cyprus, the public is moderately knowledgeable about antibiotics and resistance. The study is the first large scale study in the northern part of Cyprus and is thought to improve the national health policies related with antibiotic consumption in Cyprus and other developing countries.

Antibiotic Resistance Results of Helicobacter pylori in a University Hospital: Comparison of the Hybridization Test and Real-Time Polymerase Chain Reaction.

AIM: H. pylori is a bacterial pathogen in the human stomach which infects about 50% of the world population. Untreated infection can lead to various diseases leading to cancer. Some of the H. pylori strains are asymptomatic, but some of them cause more severe diseases. Standard treatment protocol used for the treatment of H. pylori infection is triple therapy, which includes omeprazole as a proton pump inhibitor (PPI) and two antibiotics usually consist of amoxicillin and clarithromycin or metronidazole. In the recent years, because of the increase in the rate of antibiotic resistance, the eradication rate has decreased. MATERIALS AND METHODS: We evaluated 140 patients who applied to a university hospital gastroenterology department and underwent biopsy during endoscopy. In these patients, we analysed floroquinolone and clarithromycin resistance using the GenoType® HelicoDR (Hain Life Science, Germany). We also used the real-time method for clarithromycin resistance. RESULTS: We found the number and rate of floroquinolone resistance as 20 (25.6%) and clarithromycine resistance as 31 (39.7%). With the real-time PCR method, we detected clarithromycine resistance in 26 (33.3%) patients. These results were not statistically significant. Discussion and Conclusion. Our results show similarity to the other studies held in our country. There should be more studies for the policy of eradication through our country.

[Saccharomyces cerevisiae fungemia in an elderly patient following probiotic treatment]. / Probiyotik tedavisinden sonra yasli bir hastada gelisen Saccharomyces cerevisiae fungemisi.

Saccharomyces cerevisiae, known as baker's yeast, is also used as a probiotic agent to treat gastroenteritis by modulating the endogenous flora and immune system. However, since there have been increasing reports of fungemia due to S.cerevisiae and its subspecies S.boulardii, it is recommended that probiotics should be cautiously used in immunosuppressed patients, people with underlying diseases and low-birth weight babies. To emphasize this phenomenon, in this report, a case of S.cerevisiae fungemia developed in a patient given probiotic treatment for antibiotic-associated diarrhea, was presented. An 88-year-old female patient was admitted to our hospital with left hip pain, hypotension, and confusion. Her medical history included hypertension, chronic renal failure, left knee replacement surgery, and recurrent urinary tract infections due to neurogenic bladder. She was transferred to the intensive care unit with the diagnosis of urosepsis. After obtaining blood and urine samples for culture, empirical meropenem (2 x 500 mg) and linezolid (1 x 600 mg) treatment were administered. A central venous catheter (CVC) was inserted and after one day of inotropic support, her hemodynamic parameters were stabilized. The urine culture obtained on admission yielded extended-spectrum beta-lactamase-producing Klebsiella pneumoniae and Escherichia coli. Urine culture was repeated after three days and no bacteria were isolated. On the 4th day of admission she developed diarrhea. Toxin A/B tests for Clostridium difficile were negative. To relieve diarrhea, S.boulardii (Reflor 250 mg capsules, Sanofi Aventis, Turkey) was administered twice a day, without opening capsules. Two days later, her C-reactive protein (CRP) level increased from 23.2 mg/L to 100 mg/L without fever. Her blood culture taken from the CVC yielded S.cerevisiae. Linezolid and meropenem therapies were stopped on the 13th and 14th days, respectively, while prophylactic fluconazole therapy was replaced with caspofungin 1 x 50 mg on the fifth day. After seven days of therapy CRP and serum creatinine levels decreased to 9.1 mg/L and 1.2 mg/dl, respectively; and she was discharged from the hospital with improvement. The probiotic capsules were used unopen, thus, it was proposed that S.cerevisiae fungemia originated from translocation from the intestinal mucosa. Since it was not possible to investigate the molecular genetics of the strain isolated from the blood culture and the strain present in the probiotic, a definite conclusion about the origin of the strain could not be reached. It was thought that old age and underlying disease of the patient were the related predisposing factors for S.cerevisiae fungemia. This case emphasized that clinicians should be cautious in case of probiotic application even though in encapsulated form, even in immunocompetent patients with a history of long-term hospital stay and use of broad-spectrum antimicrobials since there may be a risk of S.cerevisiae fungemia development.

Virological and clinical characterizations of respiratory infections in hospitalized children.

BACKGROUND: The purpose of this study was to determine the incidence and seasonal distribution of viral etiological agents and to compare their clinical manifestations and disease severity, including single and co infections. METHODS: Multiplex reverse-transcription PCR was performed for the detection of viruses in nasopharyngeal aspirat. Disease severity was grouped using a categorization index as very mild/mild, and moderate/severe. Clinical and laboratory characteristics of hospitalized children with viral respiratory tract infection were analyzed. RESULTS: Viral pathogens were detected in 103/155 (66.5%) of patients. In order of frequency, identified pathogens were respiratory syncytial virus (32.0%), adenovirus (26.2%), parainfluenza viruses type 1-4 (19.4%), rhinovirus (18.4%), influenza A and B (12.6%), human metapneumovirus (12.6%), coronavirus (2.9%), and bocavirus (0.9%). Coinfections were present in 21 samples. Most of the children had very mild (38.8%) and mild disease (37.9%). Severity of illness was not worse with coinfections. The most common discharge diagnoses were "URTI" with or without LRTI/asthma (n=58). Most viruses exhibited strong seasonal patterns. Leukocytosis (22.2%) and neutrophilia (36.6%) were most commonly detected in patients with adenovirus and rhinovirus (p<0.05). Monocytosis was the most remarkable finding in the patients (n=48, 53.3%), especially in patients with adenovirus (p<0.05). CONCLUSIONS: RSV and RhV were associated with higher severity of illness in hospitalized children. RSV found to account for half of LRTI hospitalizations. In AdV and FluA and B infections, fever lasted longer than in other viruses. Coinfections were detected in 21 of the patients. The presence of coinfections was not associated with increased disease severity.