"I Am Grateful for Every Day I Live": A Qualitative Study on the Spiritual Experiences of Women With Gynecological Cancer.

BACKGROUND: Considering the life-threatening nature of gynecological cancers, spirituality and religious beliefs may play a key role in the experiences of the patients during the disease process and their coping. OBJECTIVE: The aim of this study was to understand the spiritual experiences of Muslim women with gynecological cancer during the disease process. METHODS: A qualitative, phenomenological, and hermeneutic approach was followed in the research. Fourteen women with gynecological cancer in Turkey were interviewed individually. The thematic analysis approach of Braun and Clarke was used to evaluate the data. RESULTS: The results of the data analysis revealed 3 themes (consisting of 9 subthemes): (1) reaction to cancer: spiritual distress (fear of death, perception of punishment, fear of obscurity and uncertainty, and being a cause of spiritual distress in the family); (2) reaction to cancer: spiritual well-being (accepting whatever may come from Allah, strengthening the faith in Allah); and (3) spiritual resources for coping with cancer (religious practices, hobbies and complementary practices, and family support). CONCLUSIONS: The results of the study shed light on the cases that may cause spiritual distress and improve the spiritual well-being that is experienced by Muslim women with gynecological cancer during the disease process; they also reveal that religion has an effect on the experiences during the cancer process and the coping methods. IMPLICATIONS FOR PRACTICE: Healthcare professionals who care for Muslim women with gynecological cancer should plan spiritual care by being aware of the cultural characteristics and religious beliefs of these women and their families.

A Quality Improvement Study on Delirium Awareness Day: In Pursuit of Missed Delirium Diagnoses.

The current study aimed to screen for delirium in hospitalized older adults and assess the validity of the Turkish version of the 4A's Test (4AT-TR) as a feasible tool to integrate in routine patient care. The point prevalence of delirium according to clinical evaluation in routine practice was detected among all patients aged ≥60 years in 12 pilot wards. Delirium screening was then conducted by two arms: (a) nurses using the 4AT-TR and (b) geriatricians according to Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. Prevalence of delirium according to clinical impression was 3.3% (n = 4), whereas prevalence was 12.4% (n = 17) according to DSM-5 criteria and 13.8% (n = 17) according to the 4AT-TR. The 4AT-TR performed by nurses had a sensitivity of 66.6% and specificity of 93.5%. Area under the receiver operating characteristic curve for delirium diagnosis was 0.819 (p < 0.001). Most delirium cases remain undetected unless a routine and formal delirium assessment is integrated in hospital care of high-risk patients. The 4AT-TR performed by nurses seems to be a valid tool for determining delirium in hospitalized older adults. [Journal of Gerontological Nursing, 48(8), 43-51.].

Learning Needs of Gynecologic Cancer Survivors.

To define the learning needs of patients with gynecological oncology. The study was performed as a descriptive study. A total of 92 patients were participated. Data were collected using Patient Learning Needs Scale (PLNS). The Pearson correlation test, independent sample t test, and analysis of one-way of variance (ANOVA) followed by Tukey's-B post hoc tests were used for statistical analyses by the SPSS 15.0 software package. The mean age of women's was 50.37 ± 12.20 years. The women's diagnoses were cervical (45.7 %), ovarian (27.2 %), and endometrial (19.6 %) cancers. The most frequently stated learning needs topics were coping with pain (47.8 %), daily living activities (46.2 %), and psychological support (44.6 %). The mean PLNS score of women was 212.56 ± 35.83. The mean subscales scores of PLNS were 34.06 ± 7.29 for medicines, 38.34 ± 6.74 for daily living activities, and 24.68 ± 5.41 for community subscales. Women who graduated from elementary school needed more education than the women with higher education (p < 0.001). Learning needs level of the women are high and related to increase quality of life, medicine usage, complications of treatment, skin problems, pain management, and supportive care. As a healthcare professional, we should plan and develop educational programs in order to adequately inform patients about their learning needs.

Multimodal interventions (chewing gum, early oral hydration and early mobilisation) on the intestinal motility following abdominal gynaecologic surgery.

AIMS AND OBJECTIVES: To determine the effects of chewing gum, early oral hydration and early mobilisation on the time of first bowel sounds, first passage of flatus and first defecation following abdominal gynaecologic surgery. BACKGROUND: A major complication of abdominal surgical procedures is paralytic ileus which results in patient discomfort, prolonged length of hospital stay and increased cost of treatment. DESIGN: Prospective randomised case-control study. METHODS: Women who underwent abdominal gynaecological surgery for benign disorders under general anaesthesia were randomised into eight groups according to different combinations of interventions consisting of chewing gum, early oral hydration and early mobilisation. The effects of these interventions on the time of first bowel sounds, first passage of flatus and first defecation following abdominal gynaecologic surgery were investigated. The data were analysed using chi-square tests, t-test for independent samples, Tukey's HSD test, pairwise comparison test, one-way analysis of variance. RESULTS: It was found that the time when bowel sounds were heard was shorter, the time first passage of flatus was shorter and first defecation occurred earlier in the 1st group of women who chew gum, were hydrated orally and were mobilised early after surgery than the other groups. It was also determined that these periods were longest in the women who did not receive any intervention and received the routine hospital care when compared with other groups. Duration of hospital stay was shorter in the women who chew gum, were hydrated orally and were mobilised early than the other groups. CONCLUSIONS: Early oral feeding, early mobilisation and chewing gum are effective methods in terms of preventing paralytic ileus following abdominal gynaecological surgery, improving patient comfort and shortening the duration of hospitalisation. RELEVANCE TO CLINICAL PRACTICE: Nurses may cause early recovery, improve the patient comfort, prevent paralytic ileus and shorten the duration of hospitalisation after gynaecologic abdominal surgery by recommending gum chewing, early mobilisation and early hydration.