Effects of subcutaneous injection after coolant spray on pain, hematoma, and ecchymosis in three different regions.

AIMS: This study determined the effect of subcutaneous (SC) low molecular weight heparin (LMWH) injection in three different areas (abdomen, leg, and upper arm) after coolant spray application on pain, hematoma, and ecchymosis formation. METHODS: The sample of this randomized controlled study consisted of 50 patients that were administered SC LMWH once a day. The SC injection occurred after applying coolant spray to the arm, leg, or abdominal region. RESULTS: The study determined that there was no statistically significant difference in pain severity, hematoma, and ecchymoses between the regions of SC injection after coolant spray was applied (p > 0.05). However, the highest average pain intensity directly and 15 min after the SC injection was in the leg region. CONCLUSION: SC injection after coolant spray application in three different regions led to the biggest hematoma in the abdominal region, the biggest ecchymosis in the arm region, and the lowest pain severity in the abdominal and arm regions.

The Effects of a Walking Exercise Program on Fatigue in the Person with COPD.

PURPOSE: The aim of the study was to assess the effect of a walking exercise program, three times a week for 8 weeks, on fatigue in people with chronic obstructive pulmonary disease (COPD). DESIGN: This study was a randomized controlled trial. METHODS: Walking exercise was applied to the intervention group three times a week for 8 weeks; no exercise was applied to the control group. FINDINGS: No difference was seen between the points of pretest fatigue of the intervention and control groups (t = -0.788, p = .434). However, according to the posttest, the intervention group's point of fatigue was lower than the control groups, and this difference was statistically significant (t = -3.924, p = .001). CONCLUSION: It was found that a walking exercise program applied to patients with COPD affected the fatigue symptom positively. CLINICAL RELEVANCE: Walking exercises programme can be used by nurses as a reference to monitor chronic obstructive pulmoner disease patients' health status.

A study on the correlation between the nurses' and patients' postoperative pain assessments.

In this research, the correlation of assessment of postoperative pain between nurses and their clients is investigated. The aim of the research was to investigate whether or not the nurses can evaluate the pain that clients have in the postoperative process in the same sense as clients do and to examine personal factors that affect this evaluation. The descriptive and comparative research was undertaken between January 2008 and April 2008 in the clinics of Çukurova University Balcali Hospital. The study group consisted of 47 nurses and 94 patients aged 18-65 years evaluated in the 48 hours' postoperative period. After review of the literature regarding McGill-Melzack pain assessment, a questionnaire for patients and another for nurses were used. The data gathered from the surveys were analyzed by the SPSS program. For intermittent variables chi-square test, for denomination variables kappa, and for sequent variables congruity gamma factors were used. At the end of the research, the correlation between the patient scores and the nurse scores that were gathered from first, second, third, and fourth parts of the pain evaluation documents were observed: part 1, Γ = 290, p = .063; part 3/1-2, Γ = 380, p = .008, 3/1; part 3, Γ = 357, p = .007; part 3/2, Γ = 209, p = .031; part 4, Γ = 346, p < .001. The congruity points obtained from the statistical data contrast with the literature, showing that the nurses and the patients evaluated the postoperative pain in the same sense. Pain evaluation investigations are recommended to be done with the attendance of more nurses and patients, and their results should be shared with all nurses.

Social support and hopelessness in patients with breast cancer.

BACKGROUND: Patients with breast cancer can experience a feeling of hopelessness very deeply in the adjustment process, and the social support provided during this period can be effective in increasing the level of hope. The present study aimed to identify breast cancer patients' social support and hopelessness level. MATERIALS AND METHODS: The target population of this analytical study was all breast cancer patients (total of 85) who had treatment in the oncology department of a university hospital located in Adana/Turkey and who met the inclusion criteria. Data were collected through "Personal Information Form", "Beck Hopelessness Scale (BHS) " and "Multidimensional Scale of Perceived Social Support" (MSPSS). Analysis was performed using Shapiro Wilk, One Way ANOVA Welch, Student t-test, Mann Whitney U, and Kruskall Wallis tests. Homogeneity of variance was tested with the Levene, Bonferroni and Games Howell tests. Mean scores and standard deviation values are given as descriptive statistics. RESULTS: Average age of the participants with breast cancer is 48.6 ∓ 10.6. Of all the participants, 84.7% are married, 49.4% graduated from primary school, 81.2% are housewives, and 82.4% had children. The participants' multidimensional perceived social support total scores were found to be high (57.41 ∓ 13.97) and hopelessness scale scores low (5.49 ∓ 3.80). There was a reverse, linear relationship between hopelessness scale scores and social support total scores (r=-0.259, p=0.017). A statistically significant relationship was found between hopelessness scores and education level and having children, occupation, income status, and education level of spouses (p<0.05). CONCLUSIONS: The present study indicates that hopelessness of the patients with breast cancer decreased with the increase in their social support. Therefore, activating patient social support systems is of importance in increasing their level of hope.

Pressure ulcer prevalence in Turkey: a sample from a university hospital.

PURPOSE: The purpose of this study was to identify pressure ulcer prevalence among hospitalized patients in a university hospital setting. SETTING AND SUBJECTS: The study setting was medical and surgical inpatient wards and critical care units in a university hospital in Adana, Turkey. The sample population comprised 404 patients who were aged 18 years or older and admitted to the intensive care units and internal and surgery units at least 24 hours before data collection. METHODS: Each participating patient's skin was assessed and pressure ulcers were classified according to the National Pressure Ulcers Advisory Panel grading system. Pressure ulcer risk was assessed using the Braden Scale. Data were recorded on a patient observation form designed for this study. INSTRUMENTS: The following tools were used to collect data: (a) data collection form in identifying sociodemographic and medical characteristics of the patients, (b) the classification developed by the National Pressure Ulcers Advisory Panel in identifying the phases and localization of pressure ulcers, and (c) Braden Risk Assessment Scale in assessing risks. RESULTS: The average age of patients was 51.22 ± 0.84 years (mean ± SD); 51.7% were male. The mean hospital length of stay was 9.6 ± 0.5 days. Pressure ulcer risk assessment revealed that 34.2% of the patients were at increased risk. The prevalence of pressure ulcers was 10.4%. Pressure ulcers occurred most frequently in the sacral area (43.9%); 45.2% of them were stage (grade) II. CONCLUSIONS: The pressure ulcer prevalence identified in this study is comparable with studies conducted in other countries.

Examination of knowledge about and nursing interventions for the care of patients in pain of nurses who work at Cukurova University medical faculty Balcali hospital.

Pain is a concept that goes back into distant history and is something that is faced by every person in different degrees and at different times in their lives. A definition of pain, adopted by the International Association for the Study of Pain and the American Pain Society, is: "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage." Although pain is one of the most common reasons for needing health care, it is not well understood and continues to be one of the most important health problems today. The pain experience is dynamic, and the nurse is responsible for understanding this. Nurses need to cooperate with the patient and other members of the health care team to be able to control pain. Nurses are ethically responsible for the management and easing of pain. This study was conducted to investigate what nurses know about the care of patients in pain and what nursing actions are used. There were 198 nurses working day shift at Cukurova University Balcali Hospital who were included. The data were collected using a questionnaire that described the nurses and measured the nurses' knowledge about care. The mean age of the nurses was 30.89 years, they had a mean 12.0 years of experience in the profession, 52.0% did not have experience with chronic pain, 42.4% stated that they frequently encountered patients in pain, 70.2% had received education about pain in school, 88.4% had not received education about pain outside of school and did not read about pain in journals, 88.9% used pharmacologic management, 85.4% evaluated patients' pain based on verbal statements, 96.5% knew the important points in the use of opioid analgesics, and 3% knew pain theory. As a result of this study, it is seen that nurses have inadequate knowledge about care of patients in pain and pain control methods. After evaluation of the conclusions, they will be used in education to increase the quality of the nursing care.

Intensive care unit nurses' opinions about euthanasia.

This study was conducted to gain opinions about euthanasia from nurses who work in intensive care units. The research was planned as a descriptive study and conducted with 186 nurses who worked in intensive care units in a university hospital, a public hospital, and a private not-for-profit hospital in Adana, Turkey, and who agreed to complete a questionnaire. Euthanasia is not legal in Turkey. One third (33.9%) of the nurses supported the legalization of euthanasia, whereas 39.8% did not. In some specific circumstances, 44.1% of the nurses thought that euthanasia was being practiced in our country. The most significant finding was that these Turkish intensive care unit nurses did not overwhelmingly support the legalization of euthanasia. Those who did support it were inclined to agree with passive rather than active euthanasia (P = 0.011).

Examination of incidents of workplace verbal abuse against nurses.

The purpose of this research was to examine the incidents of verbal abuse faced by nurses in the workplace in the last year. Data were collected from 290 hospital nurses in Turkey. The study found that the majority of nurses had faced verbal abuse (n = 233, 80.3%). The findings from the research confirm the need for urgent and continuous plans for addressing verbal abuse in the workplace and for adoption of zero tolerance.