Effects of Sleeve Gastrectomy on Pelvic Floor Disorders in Female Patients with Severe Obesity: a Prospective Study.

INTRODUCTION: Obesity is associated with pelvic floor disorders (PFD). Sleeve gastrectomy (SG) is one of the most effective weight loss methods. Although SG has been found to improve urinary incontinence (UI) and overactive bladder (OAB), its impact on fecal incontinence (FI) remains controversial. MATERIALS AND METHODS: This prospective, randomized study involved 60 female patients with severe obesity who were randomly assigned to two groups: the SG group and the diet group. The SG group underwent SG, while the diet group received a low-calorie, low-lipid diet for 6 months. The patients' condition was assessed before and after the study using three questionnaires: the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS), the Overactive Bladder 8-Question Awareness Tool (OAB-V8), and the Wexner Score (CCIS). RESULTS: After 6 months, the SG group had a significantly higher percentage of total weight loss (%TWL) compared to the diet group (p<0.01). Both groups showed a decrease in the ICIQ-FLUTS, OAB-V8, and CCIS scores (p<0.05). UI, OAB, and FI improved significantly in the SG group (p<0.05), but no improvement was observed in the diet group (p>0.05). The correlation between %TWL and PFD was statistically significant but weak, with the strongest correlation between %TWL and ICIQ-FLUTS score and the weakest correlation between %TWL and CCIS score (p<0.05). CONCLUSIONS: We recommend bariatric surgery for the treatment of PFD. However, given the weak correlation between %TWL and PFD after SG, further research should explore factors other than %TWL that are effective in recovery, particularly in relation to FI.

The Effect of Using a Stress Ball During Endoscopy on Pain, Anxiety, and Satisfaction: A Randomized Controlled Trial.

A stress ball is a simple and effective distraction method during painful procedures. The aim of this study was to evaluate the effect of using a stress ball during endoscopy on patients' pain, anxiety, and satisfaction levels. The randomized controlled study included 60 patients who underwent endoscopy in a training and research hospital in Istanbul. Patients were randomly assigned to the stress ball group or the control group. Patients in the stress ball group ( n = 30) squeezed a stress ball during endoscopy, whereas the control group ( n = 30) received no intervention during endoscopy. Data were collected using a sociodemographic form, a postendoscopy questionnaire, the Visual Analog Scale to assess pain and satisfaction, and the State-Trait Anxiety Inventory. Pain scores did not differ significantly between the groups before ( p = .925) or during ( p = .149) the endoscopy procedure but were significantly lower in the stress ball group after the procedure ( p = .008). Similarly, preprocedure anxiety scores were comparable ( p = .743), whereas postprocedure anxiety scores were significantly lower in the stress ball group ( p < .001). The satisfaction score after endoscopy was higher in the stress ball group, but the difference was not statistically significant ( p = .166). This study suggests that use of a stress ball during endoscopy reduces patients' pain and anxiety levels.

Fear, Anxiety, and Coping Self-efficacy of Individuals With Cancer During COVID-19 and Predictive Risk Factors: A Descriptive and Correlational Study.

OBJECTIVES: In this study, we determined COVID-19-related fear, anxiety, and coping self-efficacy in individuals with cancer and predicted the risk factors of these parameters. DATA SOURCES: A descriptive and correlational study was conducted in a single cancer center with 396 individuals. The data were collected using the Participant Information Form, the Fear of Coronavirus Scale, the Coronavirus Anxiety Scale, and the Cancer Behavior Inventory Short Form. Approximately 94% of individuals had received the COVID-19 vaccine. The boosting effect of the vaccination on self-confidence (ß = 0.209), duration of diagnosis (ß = 0.219), and perception of mental health (ß = 0.284) was associated with fear of COVID-19. Smoking (ß = 0.116), vaccination dose (ß = 0.139), disease stage (ß = 0.101), perception of physical health (ß = -0.262), and perception of mental health (ß = -0.112) were associated with coping self-efficacy. CONCLUSION: We found that most individuals did not have anxiety, had a moderate level of fear, and their coping self-efficacy was satisfactory. IMPLICATIONS FOR NURSING PRACTICE: The perception of mental health was the common risk factor for fear and coping self-efficacy. Health professionals should be aware of the psychological problems experienced by individuals with cancer, and they should adopt strategies that can increase self-efficacy in coping.

Perceived social support, mental health, and marital satisfaction in multiple sclerosis patients.

PURPOSE: This study aimed to examine the patients' perceived social support, mental health, and marital satisfaction. DESIGN AND METHODS: Data were collected via Patient Information Form, Barthel Index of Activities of Daily Living, Marital Life Scale, Multidimensional Scale of Perceived Social Support, and General Health Questionnaire for 72 patients. FINDINGS: Multiple sclerosis (MS) patients had a moderate level of marital satisfaction. The perceived social support showed positive correlation with marital satisfaction and negative correlation with mental health disorders in MS. PRACTICE IMPLICATIONS: These results will facilitate the perception of mental problems, marital satisfaction, and social support in MS patients by the nurses.

Effect of nurse-led program on the exercise behavior of coronary artery patients: Pender's Health Promotion Model.

OBJECTIVE: To determine the effect of nurse-led program based on Pender's Health Promotion Model on the exercise behaviors of coronary artery patients. METHODS: The two-arm parallel, single-blind, randomized controlled trial was conducted with a total of 62 patients, intervention (n = 32) and control group (n = 30). Intervention group received a nurse-led program based on Pender's Health Promotion Model and routine follow-ups of control group continued. The health perception, perceived exercise self efficacy, perceived exercise benefits/barriers, exercise-related effect, exercise frequency and time were assessed at baseline, 4th, 8th and 12th weeks. The data were evaluated by frequency, percentage, median, mean and standard deviation, chi-square, Friedman and Mann Whitney U tests. RESULTS: Health perception (62.6 ± 9.5; median:67.0; p < 0.001), perceived exercise benefit (105.8 ± 7.4; median:107.0; p < 0.001), perceived exercise self efficacy (71.2 ± 5.4; median: 71.5; p < 0.05), exercise-related effect (31.6 ± 6.0; median:34.0; p < 0.05), exercise frequency (4.8 ± 2.2; median:6.0 days/week; p < 0.05) and time (105.9 ± 53.6; median:130.0 min/week; p < 0.05) were higher and perceived barriers (43.1 ± 3.9; median: 42.0; p < 0.001) were lower in the intervention group at 12th week. CONCLUSIONS: The nurse-led program has been shown to increase the exercise behavior in the intervention group. PRACTICE IMPLICATIONS: Since it enables patients to gain and maintain exercise, it is highlighted the model to be integrated into clinical practice.

Behaviours of healthcare professionals towards difficult patients: A structural equation modelling study.

BACKGROUND: Some patients are stigmatised as difficult patients by healthcare professionals. This phenomenon has great many negative consequences. The behaviours of healthcare professionals towards difficult patients are important. OBJECTIVE: To explore the behaviours of all healthcare professionals towards difficult patients. RESEARCH DESIGN: This study was based on a cross-sectional research design using structural equation modelling. PARTICIPANTS AND RESEARCH CONTEXT: Two hundred and fifty-four healthcare professionals were involved in the study in Turkey. 'Participant Information Form' and the 'Healthcare Professionals Behaviour Assessment Questionnaire For Difficult Patient' were used to collect data from participants. ETHICAL CONSIDERATION: Ethical approval was obtained from Gazi University Ethics Committee for the study. Informed consent of the participants in the study was taken and the confidentiality of the participants was ensured. FINDINGS: It was explored that the behaviours of healthcare professionals towards difficult patients were categorised into ethical, supportive and negative. The highest mean score was supportive behaviour and the least mean score was negative. According to structural equation modelling, the most important predictor of difficult encounters was an ethical dimension. One-unit increase in ethical behaviour contributed to 0.92 unit increase in positive patient behaviour. DISCUSSION: Patients generally are perceived as 'difficult patient' by the healthcare professionals, so the patients' treatment and care services are affected negatively due to healthcare professionals' negative beliefs and attitudes. The healthcare professionals should behave supportively towards difficult patients. CONCLUSION: Healthcare professionals should be aware of management strategies in dealing with difficult encounters. The behaviours of healthcare professionals should be improved in a positive way and awareness of ethical dimension of difficult encounters should be increased.

Nursing Students' Knowledge of Palliative Care at a University in Turkey.

BACKGROUND AND PURPOSE: Nursing students must acquire knowledge and skills sufficient to deliver high-quality services. Previous studies indicated that students' palliative care knowledge was insufficient. Few studies evaluating nursing students' palliative care opinions and skills are available in Turkey. This study aimed to determine student nurses' knowledge of palliative care. METHODS: This descriptive survey study included 658 students. Researchers collected the data via a 19-item questionnaire. Frequency, percentage, and mean values were used in analysis of the data. RESULTS: Only 5.3% of participants correctly answered all items, while 26.3% gave correct answers in line with palliative care theoretical framework, and 5.3% gave correct responses for symptom management. Students were found to be quite lacking in palliative care knowledge. IMPLICATIONS FOR PRACTICE: A content increase in the curriculum could improve students' theoretical knowledge. In addition, students can be incorporated, as team members, into the palliative care process beginning at patient diagnosis.

Perceived social support and psychosocial adjustment in patients with coronary heart disease.

AIM: This study was performed to assess perceived social support and psychosocial adjustment in patients with coronary heart disease. METHODS: Participants were 250 patients referred to the cardiology outpatient clinic of a university hospital in Ankara, Turkey, between December 2013 and March 2014. Data were collected using a participant information form, the Multidimensional Scale of Perceived Social Support, and the Psychosocial Adjustment to Illness Scale-Self-Report. Data were analysed using frequencies, percentages, mean scores, and Pearson's correlation coefficient. RESULTS: Patients' mean perceived social support scores were relatively low and patients' mean scores for psychosocial adjustment considered to be poor. Subgroups in the psychosocial adjustment and social support scales were significantly associated. CONCLUSION: This study's results indicate that patients' social support is linked to their psychosocial adjustment to coronary heart disease. As psychosocial adjustment is inhibited in patients who lack sufficient social support, sources of social support of patients should be identified and facilitated.

Factor Structure and Psychometric Properties of the Brief Illness Perception Questionnaire in Turkish Cancer Patients.

OBJECTIVE: The main aim of this study was to investigate the factor structure and psychometric properties of the Brief Illness Perception Questionnaire (BIPQ) in Turkish cancer patients. METHODS: This methodological study involved 135 cancer patients. Statistical methods included confirmatory or exploratory factor analysis and Cronbach alpha coefficients for internal consistency. RESULTS: The values of fit indices are within the acceptable range. The alpha coefficients for emotional illness representations, cognitive illness representations, and total scale are 0.83, 0.80, and 0.85, respectively. CONCLUSIONS: The results confirm the two-factor structure of the Turkish BIPQ and demonstrate its reliability and validity.