Observational Retrospective Cohort Two Centred Study on External Ventricular Drain-Related Infections in US and Turkey.

AIM: To compare external ventricular drain-related infection (EVD-RI) rates of two Academic Medical Centers in Turkey and the US in order to determine the key factors. MATERIAL AND METHODS: We performed an observational retrospective cohort study to compare the EVD-RI rates between two hospitals (Hospital T in Turkey; Hospital A in US). We analyzed data gathered from 736 patients (Hospital T, n=237; Hospital A, n=499), in a total of 736 EVD cases which occurred between January 1, 2013 and December 31, 2018. Electronic records of hospitals were searched according to the procedure code ?external ventricular drain?. The study protocol was approved by the audit and clinical governance committees of both participating hospitals. RESULTS: EVD-RI rates were 18.3 per 1000 days for a total of 3227 catheter days in Hospital T, whereas 4.0 per 1000 cases for a total of 7010 catheter days in Hospital A. The prolonged use of EVD catheter, length of stay, and frequency of number of cerebrospinal fluid sampling were associated with EVD-RI in both hospitals. Cerebrospinal fluid culture of Hospital A was dominant for gram positive 32.6% and gram negative 46.1% rods, whereas for Hospital T, gram positive 39.0% and gram negative 33.9% rods were the main microorganisms for the EVD-RI. There was a correlation, between the duration of antibiotic use and EVD-RI in Hospital T. The nursing care facilities of the hospitals were significantly different. All-cause mortality found to be 12.0% versus 3.7% in Hospital A and Hospital T respectively (p < 0.05). CONCLUSION: In both institutions, the EVD-RI was associated with EVD characteristics rather than patients? personal characteristics. Early drain removal and patient discharge should be goals whenever medically appropriate. The wide range infection and mortality rates between Hospital A and T is most likely attributable to many factors, including the variety of populations evaluated and the use of dissimilar methodologies in the management of EDVs.

The Effects of Training on Knowledge and Beliefs About Breast Cancer and Early Diagnosis Methods Among Women.

OBJECTIVE: Breast cancer (BC) is the most common female malignancy in the world and Turkey. Its prevalence and mortality are surprisingly increasing at a rapid rate. The objective of this study was to determine the effectiveness of training sessions on women's knowledge of relevant risk factors of BC and screening methods, screening behaviors and health beliefs among of healthy women in Turkey. MATERIALS AND METHODS: In this study, in order to establish the efficiency of BC training, a semi-empirical single group pre-test & post-test research model was used. The data were collected by using a self-administered questionnaire and by using the Turkish version of Champion's health belief model scale (CHBMS). The pre-test was performed before the training and after one week of the training, post-test was performed with a questionnaire having the same content. RESULTS: In total, 244 women participated in the study. The average age of the women was 39.44 (SD=1.06) years. The mean total knowledge score increased significantly (p<.001) from 9.05 in the pre-test to 16.53 in the post-test. The results showed that both mean knowledge scores and CHBMS subscales scores of the women were increased significantly (p<.001) from the pre-test to the post-test. In multiple linear regression analysis, BC screening knowledge of women with susceptibility, benefit, self-efficacy and health motivation subscales of CHBMS, breast self-examination (BSE) practice and self-efficacy were also significant in the post-test; in the pre- and post-tests, a significant relationship among the level of education of women, susceptibility and seriousness was found (p<.001). CONCLUSION: The study showed that the training program had profound effects on BC knowledge, screening behaviors and health beliefs of women.

Turkish validity and reliability of Organ Donation Attitude Scale.

AIMS AND OBJECTIVES: To report the translation and adaptation process from English to Turkish and the psychometric estimates of the validity and reliability of The Organ Donation Attitude Scale Turkish. Its aim (1) is to provide data about and (2) to assess Turkish people's attitudes and volunteerism towards organ donation. BACKGROUND: Lack of donors is a significant problem for organ transplantation worldwide. Attitudes about organ donation and volunteerism are important factors in the lack of donors. DESIGN: To collect survey data from Turkish participants, a cross-sectional design was used: the classical measurement method. METHODS: The Organ Donation Attitude Scale was translated from English to Turkish and back-translated into English. The analysis included a total of 892 Turkish participants. The validity of the scale was confirmed by exploratory factor analysis and criterion-relation validity testing. A test-retest procedure was implemented for the reliability of the scale over time. RESULTS: The Organ Donation Attitude Scale consists of three relatively independent components: humanity and moral conviction, fears of medical neglect and fears of bodily mutilation. Internal consistency of these three components resulted in acceptable Cronbach's α levels. Positive correlation occurred between the volunteerism score and positive attitude about organ donation. The correlation between volunteerism score and negative attitude about organ donation was negative. Fears of bodily mutilation were most significantly related to unwillingness to commit to organ donation. The test-retest correlation coefficients proves that the Organ Donation Attitude Scale were reliable over time. CONCLUSION: The Organ Donation Attitude Scale Turkish version is both a reliable and valid instrument that can be useful in measuring positive and negative attitudes of Turkish people about organ donation. RELEVANCE TO CLINICAL PRACTICE: With the Organ Donation Attitude Scale, researchers in Turkey will be able to ascertain important data on volunteerism and attitudes towards organ donation. Thus, positive attitudes towards cadaver organ donations will be able to encourage organ donation in Turkey.

Comparison of pain scale preferences and pain intensity according to pain scales among Turkish Patients: a descriptive study.

Pain scale preferences may vary among patients. Providing a choice of which pain scale to use might be helpful for patients. The aim of this study was to determine patient pain scale preferences and compare the level of agreement among pain scales commonly used during postoperative pain assessment. A total of 621 patients during the early postoperative period were enrolled in this descriptive study. A questionnaire form, the faces pain scale (FPS), visual analog scale (VAS), numeric rating scale (NRS), verbal descriptor scale (VDS), thermometer pain scale (TPS), McGill Pain Questionnaire (MPQ), Short-form McGill Pain Questionnaire (SFMPQ), and Brief Pain Inventory (BPI) were used to collect data. Most patients reported that their pain was not measured with any of the pain scales. Patient preference for pain scales were as follows: 97.4% FPS, 88.6% NRS, 84.1% VDS, 78.1% TPS, 60.1% SFMPQ, 37.0% BPI, 11.4% VAS, and 10.5% MPQ. Education was an important factor in the preferences for all scales (p < .000). The level of pain determined by the VAS did not correlate with the level of pain identified by the NRS, TPS, FPS, and VDS (p < .05). There was no difference among the levels of pain for the NRS, TPS, FPS and VDS (p > .05), but there was for the VAS (p < .05). The pain scales chosen should be reliable, valid, and able to evaluate the effects of treatment. The results suggest that the NRS, TPS, FPS, and VDS were appropriate pain rating scales for the participants in this study, and that the VAS should be used in combination with one of these scales.

Turkish translation and adaptation of Champion's Health Belief Model Scales for breast cancer mammography screening.

AIMS AND OBJECTIVES: To examine the translation and adaptation process from English to Turkish and the validity and reliability of the Champion's Health Belief Model Scales for Mammography Screening. Its aim (1) is to provide data about and (2) to assess Turkish women's attitudes and behaviours towards mammography. BACKGROUND: The proportion of women who have mammography is lower in Turkey. The Champion's Health Belief Model Scales for Mammography Screening-Turkish version can be helpful to determine Turkish women's health beliefs, particularly about mammography. DESIGN: Cross-sectional design was used to collect survey data from Turkish women: classical measurement method. METHODS: The Champion's Health Belief Model Scales for Mammography Screening was translated from English to Turkish. Again, it was back translated into English. Later, the meaning and clarity of the scale items were evaluated by a bilingual group representing the culture of the target population. Finally, the tool was evaluated by two bilingual professional researchers in terms of content validity, translation validity and psychometric estimates of the validity and reliability. The analysis included a total of 209 Turkish women. The validity of the scale was confirmed by confirmatory factor analysis and criterion-related validity testing. RESULTS: The Champion's Health Belief Model Scales for Mammography Screening aligned to four factors that were coherent and relatively independent of each other. There was a statistically significant relationship among all of the subscale items: the positive and high correlation of the total item test score and high Cronbach's α. The scale has a strong stability over time: the Champion's Health Belief Model Scales for Mammography Screening demonstrated acceptable preliminary values of reliability and validity. CONCLUSION: The Champion's Health Belief Model Scales for Mammography Screening is both a reliable and valid instrument that can be useful in measuring the health beliefs of Turkish women. RELEVANCE TO CLINICAL PRACTICE: It can be used to provide data about healthcare practices required for mammography screening and breast cancer prevention. This scale will show nurses that nursing intervention planning is essential for increasing Turkish women's participation in mammography screening.

Sleep quality of hospitalized patients in surgical units.

AIM: The aim of this study was to determine the sleep quality of the patients hospitalized in surgical units and the factors that influence it. METHOD: The research was a randomized descriptive study. It was conducted in the surgical clinics of Sivas Cumhuriyet University Health Services Research Hospital. A total of 411 patients participated in the study. The research data were gathered by means of the Pittsburgh Sleep Quality Index (PSQI) and the Questionnaire aimed at capturing personal information about the participant patients and the factors influencing their sleep. RESULTS: The sleep quality score of the patients "during the last week" (8.090 ± 3.504) was higher than their score in the "preadmission" period (4.229 ± 2.726) (p= .000). The sleep quality scores of "the patients with previous hospitalization and operation experience" (p= .000), "those who had undergone a major surgical procedure" (p= .000), "those who had been hospitalized for a week" (p= .022), and "those undergoing medical intervention during sleeping hours" (p= .000) "during the last week" were high. Patients who had a chronic illness history and whose operations were postponed had poor quality of sleep in both the hospitalization and preadmission period (p= .000). CONCLUSIONS: It could be suggested that the patients in preoperative and postoperative periods cannot get adequate rest due to low sleep-quality levels. IMPLICATIONS FOR PRACTICE: Nurses can prepare an environment aiding sleep as a way to increase surgical patients' sleep quality in hospital.

The nurse's role in providing information to surgical patients and family members in Turkey: a descriptive study.

In 2008, we conducted a nonexperimental, cross-sectional, descriptive study in the surgical services department of a hospital in Istanbul, Turkey, with the aim of determining how much information was required by perioperative patients and their family members, the extent to which this information was provided, and the role that nurses play in this process. We included a total of 394 outpatients and inpatients and their family members (ie, 197 patients, 197 family members) and 30 nurses in the study. We collected the research data by using one questionnaire for patients, a second for family members of patients, and a third for nurses. We discovered that the patients and their family members wanted to be given more information about the surgical process than they had received. Patients wanted more information about the intraoperative period, whereas their family members wanted more information about the postoperative period. We also found that nurses were aware that they did not play an effective role in providing information to patients and their family members because of a lack of knowledge about what information they were responsible for providing and insufficient staffing. We concluded that nurses should know what education they are responsible for providing, put more effort into understanding patient and family member information needs, and plan a better means of providing information to meet those needs.

The effect of analgesic education on pain in patients undergoing breast surgery: within 24 hours after the operation.

AIM: The goal of this study was to assess the effect of patient information about the analgesics used after breast surgery, on patient's level of pain and mobilisation ability. BACKGROUND: Pain needs to be managed efficiently; in particular, for surgical cases, postoperative pain must be effectively controlled. Information about analgesic helped reduce the severity of pain. DESIGN: This study was a clinical trial comparing a test group that received information about the analgesic to be used and a control group that received information as usual. METHODS: Eighty-four patients who had a modified radical mastectomy or breast-conserving surgery were included in the study. Data were collected in a breast surgery clinic with a questionnaire, with the use of Short-form McGill-Melzack Pain Questionnaire and the Visual Analogue Scale. The test group received information about the surgical pain and the analgesics that would be used during the postoperative period. RESULTS: The results showed that the level of pain reported by patients was similar in the test and control groups. However, the average level of postoperative pain in the test group was lower than that in the control group. The total pain reduction score for the test group, after surgery, was greater than for the control group. Following surgery, 73·8% of the test group and 50·0% of the control group achieved mobilisation within the first six hours. CONCLUSION: Informing patients about the analgesics to be used for their care reduced pain and provided earlier mobilisation. RELEVANCE TO CLINICAL PRACTICE: The findings of this study can provide guidance to nurses and improve analgesic control of pain management.

Reasons for nursing telephone counseling from individuals discharged in the early postoperative period after breast surgery.

UNLABELLED: The aim of this study was to determine the rate of and causes of asking for telephone counseling in patients undergoing modified radical mastectomy (MRM) and breast-conserving surgery (BCS), and discharged one night after surgery. METHOD: This is a randomized descriptive study. This study was conducted on surgery service of a university hospital in Istanbul, Turkey, with MRM and BCS patients. This study sample included 174 patients. Inclusion criteria were staying in hospital for one night and being discharged, ability to talk on the phone, and being a candidate for MRM or BCS. Data were collected on a form that was developed by the researcher after consultation with experts, reviewing THE related literature, and clinical observations. The patients were given two mobile telephone (for two of the researchers) and home telephone number (for two of the researchers) that had an answering machine and were encouraged to call or leave a message for health problems they experienced at home. RESULTS: A higher rate of the patients undergoing mastectomy asked for telephone counseling. The rate of the women asking for telephone counseling was very high within the first 6 weeks of discharge. The leading causes of asking for telephone counseling were wound problems, arm exercises, and difficulties in adapting to daily living activities. The women also had a psychological problem: fear of inability to recover. CONCLUSIONS: The study found that home follow-up of patients undergoing mastectomy was particularly important.