Emotions reflected in colours: experiences of nursing students during the COVID-19 period.

BACKGROUND: The aim of this study was to identify nursing students' fears and emotions and to concretise the metaphors they used to describe their feelings towards the COVID-19 pandemic. METHODS: This study was conducted with nursing students at a foundation university between December 2021 and February 2022 using a sequential mixed methods research design. In the quantitative part of the study, 323 nursing students answered the 'Positive and Negative Emotion Scale' and the 'COVID-19 Fear Scale'. In the qualitative part, students were asked to metaphorise COVID-19 with a colour and 21 in-depth interviews were conducted on the reasons for choosing this colour. RESULTS: The average age of the students participating in the study was 21.41 ± 1.97 years and 78% of them were female. It was observed that 15.8 of the students had previously tested positive for COVID-19. Most of the participants (98.5%) were vaccinated against COVID-19 and 31.9% had a relative who died due to COVID-19. When the participants were asked which colour they compared COVID-19 to, it was observed that more than half of them chose red (51.4%) among bright colours and 13% chose black among dark colours. In this study, it was determined that students who chose dark colours to describe COVID-19 had higher COVID-19 Fear and Negative Emotion Scale scores. In in-depth interviews, it was observed that students who chose dark colours were more deeply affected by the COVID-19 process, while students who chose light colours associated this period with negative emotions. CONCLUSION: In this study, it was observed that nursing students' feelings and thoughts about the COVID-19 period in line with their experiences affect the choice of colour in metaphorisation.

New method for autonomous learning of BLS psychomotor skills: Pillow mannequin: Randomized controlled study.

BACKGROUND: Evidence supporting the benefits of autonomous learning of basic life support, such as rapid outcomes and cost-effectiveness, is increasing. Reports supporting the autonomous learning of cognitive skills in basic life support exist. However, there is currently no report supporting the autonomous learning of psychomotor skills in basic life support. AIM: This study aimed to assess how using a research-developed pillow-made mannequin affects autonomous learning of psychomotor skills in basic life support training. DESIGN: Randomized controlled trial. SETTING: This study was conducted in a nursing school in Turkey. PARTICIPANTS: Sixty-one (n = 61) third-year formal science undergraduate students. METHODS: At XXX University, 61 nursing students were divided into Intervention (n = 31) and Control Groups (n = 30). Students in both groups received basic life support training, including live demonstrations. Intervention Group students practiced with the mannequin for 15 days. Skill assessments were conducted by two independent evaluators using a real mannequin 15 days later and six months later. Researchers used a checklist to assess psychomotor skills. RESULTS: The sociodemographic characteristics of both student groups were similar. There was no significant difference in cognitive knowledge levels after the blended training (p > 0.05). However, at both post-intervention assessments, after 15 days and after 6 months, significant skill differences emerged in "placing the index finger on the ends of the sternum," "combining the thumbs in the middle," "defining the lower sternum as a massage point," "placing the base of the chest" "placing the weaker hand at the massage point," "placing the body perpendicular to the ribcage," and "performing 30 compressions." Cohen's kappa value was calculated as 0.932. CONCLUSION: Use of the mannequin facilitates autonomous learning of psychomotor skills and promotes accurate application. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT05346003, 08/02/2022.

Designing and implementing a training program on surgical hand scrubbing, wearing surgical cap and surgical mask, gowning, and gloving using HMD-based virtual reality technologies for nursing students: an exploration of student perceptions.

Objective: The aim of this study is to determine the steps of a training program utilizing Head-Mounted Display (HMD) based Virtual Reality Technology to enhance nursing students' skills in surgical hand scrubbing, wearing surgical cap and surgical mask, gowning and gloving, and to evaluate students' perceptions toward the program. Methods: The study aimed to investigate the potential applications of HMD-Based Virtual Reality Technology in Surgical Hand Scrubbing, Wearing Surgical Cap and Surgical Mask, Gowning and Gloving Program for nursing students, as well as students' perceptions toward this technology. The research was conducted with a focus group consisting of second-year nursing students in Osmaniye/Turkey, between January and June 2022, and the training program was implemented in five stages: Analysis, Design, Development, Implementation, and Evaluation. The program was evaluated with a focus group of nursing students. Focus group discussions were conducted to provide insights into students' experiences, feedback, and perceptions of the program. Results: A vast majority of participants (92.5%) reported feeling fully immersed in the operating room environment during the virtual reality (VR) experience. Notably, all students acknowledged the potential of HMD-Based Virtual Reality Technology to enrich their understanding of surgical hand scrubbing, wearing surgical cap and surgical mask, gowning and gloving procedures, surpassing conventional instructional models. While many participants found the experience exhilarating (85.1%), a considerable portion reported a decline in engagement after repeated exposures (88.8%). Overall, participants welcomed the integration of VR technology into education, expressing optimism about its capacity to facilitate additional instructional modules (74.4%). Moreover, they conveyed satisfaction with the opportunity to engage with the VR application, emphasizing its significant educational value (81.4%). Conclusion: Based on these findings, we can suggest that virtual reality technology has the potential to have an impact on nursing students' education. The majority of students expressing a sense of presence in the operating room highlights the value of this method in education. However, the reported boredom after repeated experiences by most participants underscores the importance of diversifying the program and introducing innovative approaches to keep students engaged.

The Effects of Preoperative Video-Assisted Education on Anxiety and Comfort After Breast Cancer Surgery: Nonrandomized Controlled Study.

PURPOSE: This study aimed to determine the effects of video-assisted education given before breast cancer surgery on patients' anxiety and comfort. DESIGN: A nonrandomized, controlled, quasi-experimental model was used. METHODS: The study was conducted in the general surgery clinic of a public hospital. Seventy patients voluntarily participated in the study, 35 of them were in the Control (CG) and 35 of them were in the Experimental Group (EG). While routine treatment and care were given to CG, a video-assisted education was also provided to EG. The data were collected using the Personal Information Form, State-Trait Anxiety Inventory (STAI), and General Comfort Questionnaire (GCQ). The patients in both groups filled in the STAI and GCQ on the first day preoperatively, STAI-S and GCS on the second postoperative day and STAI-S on the tenth day after surgery. P < .05 was accepted as a statistical significance value. FINDINGS: The groups were similar in terms of descriptive features and preoperative anxiety scores (P > .05). Postoperative second and tenth-day anxiety scores were significantly higher in CG (43.97 ± 9.42 and 39.45 ± 3.88) compared to EG (33.29 ± 4.94 and 33.31 ± 3.01) (P < .05). In terms of the mean scores of the GCQ and its subscales of comfort, preoperative comfort was found to be lower than postoperative comfort level (P < .05). CONCLUSIONS: Preoperative video-assisted education decreased the anxiety level and increased the comfort level in EG. We conclude that the use of video-assisted education in reducing anxiety and increasing the perception of comfort in breast cancer surgery patients would be beneficial.

Assessing the impact of the COVID-19 pandemic on latex glove usage and latex allergy complaints among nurses: A descriptive study.

BACKGROUND: The coronavirus 2019 (COVID-19) pandemic has led to a significant increase in the use of latex gloves among nurses. However, concerns about the rise in latex allergies and related complaints due to this increase remain uncertain. OBJECTIVE: This study aims to assess the rates of latex glove usage and allergy-related complaints among nurses working in hospitals during the COVID-19 pandemic. METHODS: Between May 15 and June 15, 2021, ethical approvals were obtained for a cross-sectional study involving 448 volunteer nurses. Descriptive statistics were used to represent categorical values as counts (n) and percentages (%), while continuous values were represented as mean±standard deviation. The normal distribution of the data was assessed using the Kolmogorov-Smirnov and Shapiro-Wilk tests. Comparative analyses were conducted using paired sample t-test, Pearson's chi-squared (x2) test, McNemar's chi-squared (x2) test, and Spearman correlation analysis. RESULTS: Before the pandemic, the average number of invasive procedures was 45.13±26.48, whereas during the pandemic, this rate increased to 50.23±29.14. The average glove usage duration went from 7.69±3.13 hours to 14.73±3.68 hours during the pandemic. Among nurses, the rate of allergic symptoms, which was previously at 31.5%, rose to 33.3% during the pandemic. CONCLUSION: This study revealed a significant increase in daily invasive procedures and the use of latex gloves among nurses during the pandemic period. Simultaneously, the frequency of allergic symptoms also rose. These findings underscore the importance of awareness and preventive measures, particularly regarding latex allergies, in the healthcare field.

The importance of cancer prevention policies to inform and guide preventative and screening measures for people with intellectual disabilities: The COST project "Cancer- Understanding Prevention in Intellectual Disabilities".

Cancer is a global public health problem, but its exact prevalence in people with intellectual disabilities is still uncertain. This population, with limited health skills and complex health needs, faces many challenges in cancer prevention, screening, timely diagnosis and treatment. Furthermore, they are often underrepresented in general cancer prevention and screening policies across Europe, leading to widened disparities in health outcomes and premature mortality. Thus, unified national and local policies are needed to reduce inequalities and promoting a pan-European inclusion of people with intellectual disabilities. Our goal is to raise public awareness of this issue, including the involvement of people with intellectual disabilities, and promote engagement from relevant stakeholders. The COST Action 'Cancer- Understanding Prevention in Intellectual Disabilities' (CUPID) project will address health inequalities faced by people with intellectual disabilities in relation to cancer, and support the development of policy recommendations specifically tailored to their unique cognitive and healthcare needs, having a positive long-term impact on quality of life.

From a learning opportunity to a conscious multidimensional change: a metasynthesis of transcultural learning experiences among nursing students.

BACKGROUND: Several educational activities in nursing schools worldwide have been implemented to promote transcultural nursing and cultural competence. Despite the diversity of their experiences and outcomes, the available evidence has not been systematically reviewed and reinterpreted. This study aimed to review and reinterpret all rigorous qualitative evidence available, providing an opportunity to understand how students learn transcultural nursing and assisting faculties, researchers, managers, and practitioners in designing new interventions to improve transcultural training. METHODS: A meta-synthesis was conducted to review and integrate qualitative studies of these phenomena. English, Spanish and Portuguese articles were searched in Pubmed and Scopus databases. Only peer-reviewed journals in which qualitative approaches were used were included. Quality was assessed using the CASP qualitative version checklist. The metasynthesis technique proposed by Noblit and Hare was used to analyse the data. RESULTS: Twenty-nine studies were included in the analysis. Most studies used phenomenological approaches that were conducted in Australia and the United States of America, with international internships being the most popular learning method. The data revealed one central theme, "From learning opportunity to conscious multidimensional change," and six subthemes. The transcultural nursing learning experience is not a simple or linear process. Instead, it appears to be a complex process formed by the interaction between a) self-awareness, b) reflective thinking, c) Cultural Encounters, d) cultural skills, e) Cultural Desire, and f) Cultural Knowledge. CONCLUSIONS: Transcultural nursing learning is a multifaceted process that arises from specific learning opportunities. This process is still to evolving. Therefore, specific educational strategies should be implemented to encourage attitudinal change and promote reflective thinking.

Developing the better and effective nursing education for improving transcultural nursing skills cultural competence and cultural sensitivity assessment tool (BENEFITS-CCCSAT).

BACKGROUND: A clear need for the development of new comprehensive, reliable, sensitive and valid measurement tools to adequately asses the cultural competence and cultural sensitivity of nursing students exists. This study aimed to develop a new measurement tool to assess the nursing students' cultural competence and sensitivity. METHODS: This cross-sectional, instrument development study's first phase included postgraduate nursing students (n = 60) for the piloting study, and the second one included undergraduate nursing students (n = 459) for the main survey. This study used two data collection forms: The Student Descriptive Information Form and the Better and Effective Nursing Education for Improving Transcultural Nursing Skills Cultural Competence and Cultural Sensitivity Assessment Tool (BENEFITS-CCCSAT) draft. The content validity index was calculated using the Davis method. Cronbach's α coefficient and the item total correlation were calculated during the reliability analysis. The Kaiser-Meyer-Olkin (KMO) coefficient test, Bartlett significance test, and explanatory factor analysis (EFA) were used to evaluate the validity of the assessment tool. RESULTS: Scale validity and reliability analyses showed that the BENEFITS-CCCSAT included 26 items and five sub-dimensions: respect for cultural diversity; culturally sensitive communication; achieving cultural competence; challenges and barriers in providing culturally competent care; and perceived meaning of cultural care. CONCLUSION: The BENEFITS-CCCSAT appears to be a valid and reliable instrument for measuring the cultural sensitivity and cultural competence of nursing students. This can be of great use, especially before attending clinical areas, and can offer both students and faculty reliable information to promote reflective and critical thinking, especially in areas where improvement is needed.

Examination of individualised care behaviours and ethnocentrism of nurses caring for refugees: A descriptive and exploratory study.

BACKGROUND: Qualified individualised nursing care should be provided to all communities and ethnic groups with free of ethnocentrism. AIMS: To evaluate nurses' individualised care behaviours and ethnocentric attitudes and predict the relationship between their individualised care behaviours and ethnocentric attitudes. DESIGN: A descriptive and exploratory study. METHODS: This study was conducted with 250 nurses working in a public and two private hospitals in a city, an area with many refugees. Data were collected using the Ethnocentrism Scale and Individualised Care Behaviours Scale. Structural equation model analysis to test hypothetical model and descriptive statistics were used. RESULTS: Nurses working in the private hospitals had a higher individualised care decision control mean score. Those nurses who enjoyed spending time with people from different cultures had lower mean ethnocentrism scale scores, higher individualised care clinical status, personal life and decision control status subscales mean scores compared to other nurses. Mean scores of the individualised care personal life and decision control status subscales of the nurses who followed the literature on transcultural nursing was higher. A significant relationship between the ethnocentrism levels and individualised care behaviours was identified. Accordingly, the ethnocentric attitudes of the nurses negatively affected their individualised care behaviours, and the model established between the two concepts is statistically appropriate. CONCLUSIONS: Nurses who work in private hospitals, receive intercultural nursing education and enjoy spending time with different cultures have higher individualised care behaviours and lower ethnocentrism levels. Ethnocentric attitudes of the nurses negatively affected their individualised care behaviours. Care strategies should be developed that consider the factors that will maximize individualised care practices that minimize ethnocentric behaviours among nurses. IMPLICATIONS FOR THE PROFESSION: Increasing awareness on individualised care behaviours, ethnocentric attitudes and effected factors will contribute to improve of nursing care quality of nurses while giving care to individuals from different cultures.

Knowledge and Practices of Surgical Nurses on Inadvertent Perioperative Hypothermia.

AIM: This study aimed to determine surgical nurses' knowledge of the risk factors and complications of inadvertent perioperative hypothermia and the practices preferred to prevent inadvertent perioperative hypothermia and to provide normothermia. METHODS: This descriptive study was conducted on 122 volunteer nurses working in the surgical clinics of a state and a private hospital between August 1 and September 15, 2019. The data collection form included questions to determine the characteristics of nurses and the risk factors, complications, and preventive practices of inadvertent perioperative hypothermia. The data forms were distributed by visiting the nurses one by one and were retrieved after an appropriate time. For statistical analyses, Statistical Package for the Social Sciences 22.0 software was used. RESULTS: The most known risk factors for IPH were "excessive blood loss" (75.4%), "anemia" (73.0%), and "inadequate covering of the patient/ not enough clothing" (72.9%). The most known complications of inadvertent perioperative hypothermia were "increased oxygen consumption and need" (65.6%), "hypoxemia" (61.5%), and "hypoxia" (49.4%). The most preferred method to provide normothermia in the perioperative period was "covering the patient with a blanket" (80.3%). CONCLUSION: In this study, nurses did not have enough information about the risk factors and complications of Inadvertent perioperative hypothermia. In addition, it was determined that most of the nurses did not use the methods in the guidelines to prevent inadvertend perioperative hypothermia.

Evaluation of the relationship between individual workload perception and compliance with isolation measures of emergency and critical care nurses.

BACKGROUND: As a result of the coronavirus 2019 (COVID-19) pandemic, compliance with isolation measures has become challenging. OBJECTIVE: To evaluate the individual workload perception and compliance with isolation measures of nurses working in the emergency service and critical care unit during the COVID-19 outbreak. METHODS: This descriptive correlational study was carried out in the emergency service and critical care unit of a public hospital between April 20 and May 20, 2021. A total of 153 nurses working in the emergency service and critical care unit who agreed to participate in the study were included in the study. RESULTS: Nurses from a state hospital's emergency department and critical care unit (n = 153) were included in the study sample. The impression of overall individual workload by nurses and compliance with isolation (r = 0.153; p < 0.05) had a positive, weak, and significant relationship. The Isolation Measures Compliance Scale resulted in a mean score of 70.70±5.35. The mean score on the Individual Workload Scale for nurses was moderate (3.22±0.54). CONCLUSION: The low perception of individual workload of nurses working in the emergency service and critical care unit during the COVID-19 pandemic increased the compliance with isolation measures.

Exposure of Emergency Nurses to Workplace Violence and Their Coping Strategies: A Cross-Sectional Design.

INTRODUCTION: Violence against nurses working in the emergency department is a serious problem worldwide. METHODS: This descriptive study used a participant questionnaire and was conducted in-person, using semi-structured interviews with 120 emergency nurses (69 female, 51 male) working in the emergency department between September 1 and November 30, 2017. RESULTS: Overall, 90% of the study participants were exposed to workplace violence at least once while working in the emergency department, and 94.4% experienced verbal abuse, including insults, shouting, threats, and swearing. Most of such workplace violence came from the patients relatives. Most workplace violence incidents occurred during the 4 pm to midnight time slot and in the triage area. The most important perceived reasons for workplace violence were the long waiting period for treatment and care (79.6%) and not being prioritized for treatment (68.5%). The top 3 coping methods used were reporting to the nurse in charge (78.1%), followed by reaching out to the security personnel (72.8%) and filing lawsuits if exposed to physical violence (65.8%). CONCLUSIONS: Most emergency nurses had experienced workplace violence. Hospital administration should take more effective security measures, hospitals should provide education and training programs for dealing with workplace violence, and programs to support staff members on encountering workplace violence should be implemented.

Effect of family presence on stress response after bypass surgery.

BACKGROUND: Coronary artery bypass grafting (CABG) is a major surgery that may cause severe surgical stress response (SR). Although the presence of family members in intensive care unit (ICU) is known to benefit intensive care patients socially and emotionally, its effects on surgical SR are unknown. OBJECTIVES: To investigate the effect of an informed family member (IFM)'s presence in the awakening process in ICU on patients' SR after CABG. METHODS: A nonrandomized controlled clinical study was completed with a total of 73 patients: 37 patients in the control (CG) and 36 in the intervention group (IG) underwent CABG surgery. In the CG patients, no family members were taken into the ICU during the awakening process and routine care and treatment practices were continued. In the IG patients, besides routine care and treatment practices, an IFM was taken into the ICU during the awakening process in accordance with the research method. Groups were statistically compared in terms of serum cortisol level which is the one of the main indicators of surgical SR, state anxiety, sedative drug requirements, and duration of intubation, sedation, and ICU stay. A p value <0.05 was accepted as statistically significant. RESULTS: Presence of an IFM in the ICU was found to be effective in decreasing serum cortisol level, state anxiety, sedative drug requirements, and the duration of intubation, sedation, and ICU stay (p<0.05). CONCLUSIONS: In CABG, the presence of IFM in ICU is effective in reducing SR.

Validity and reliability of functional assessment of chronic illness treatment-fatigue scale in Turkish patients with type 2 diabetes / Validez y fiabilidad de la escala de fatiga de la valoración funcional del tratamiento de enfermedades crónicas en pacientes turcos con diabetes tipo 2

Background: A long-term diabetic complication, fatigue, which is a direct result of treatment and psychological processes, is a common symptom in diabetic individuals. Aims: To determine the reliability and validity of Functional Assessment of Chronic Illness Treatment-Fatigue Scale in Turkish patients with type 2 diabetes. Study design: A methodological study. Methods: The sample consisted of 133 patients with type 2 diabetes who agreed to participate in the study and met the criteria for the study. Data were collected using the descriptive information form prepared by the researcher and the Scale obtained from FACIT System. The research data were collected by face-to-face interviews with the patients. Language and content validity of the Turkish version of the Scale was provided, Cronbach's Alpha coefficient, test-retest analysis and item analysis methods were used as reliability analysis. Results: The total Cronbach Alpha coefficient of the scale was found to be 0.92. According to the results of factor analysis, unlike the original scale, two sub-dimensions emerged in the Turkish version of the scale. Conclusions: As a result of the validity and reliability analysis of the FACIT-Fatigue Scale, it can be said that it provides psychometric measures that can be used to determine the level of fatigue of type 2 diabetes patients in Turkish society

Antecedentes: La fatiga, una complicación a largo plazo de la diabetes que es consecuencia directa del tratamiento y de procesos psicológicos, es un síntoma frecuente en los diabéticos. Objetivos: Determinar la fiabilidad y la validez de la escala de fatiga de la valoración funcional del tratamiento de enfermedades crónicas (FACIT) en pacientes turcos con diabetes tipo 2. Diseño del estudio: Estudio metodológico. Métodos: La muestra constaba de 133 pacientes con diabetes tipo 2 que aceptaron participar y cumplían los criterios del estudio. Se recogieron datos mediante el impreso informativo descriptivo preparado por el investigador y la escala obtenida del sistema FACIT. Los datos se recogieron en entrevistas personales con los pacientes. Se informa de la validez del idioma y el contenido de la versión turca de la escala, y se utilizaron el coeficiente alfa de Cronbach, el análisis prueba-reprueba y métodos de análisis de ítems para analizar la fiabilidad. Resultados: El coeficiente alfa total de Cronbach de la escala era 0,92. Según los resultados del análisis de factores, a diferencia de la escala original, en la versión turca de la escala surgieron 2 subdimensiones. Conclusiones: Basándose en el resultado de los análisis de validez y fiabilidad de la escala de fatiga de la FACIT, puede afirmarse que proporciona medidas psicométricas que pueden emplearse para determinar el grado de fatiga de los pacientes con diabetes tipo 2 en la sociedad turca

Validity and reliability of functional assessment of chronic illness treatment-fatigue scale in Turkish patients with type 2 diabetes.

BACKGROUND: A long-term diabetic complication, fatigue, which is a direct result of treatment and psychological processes, is a common symptom in diabetic individuals. AIMS: To determine the reliability and validity of Functional Assessment of Chronic Illness Treatment-Fatigue Scale in Turkish patients with type 2 diabetes. STUDY DESIGN: A methodological study. METHODS: The sample consisted of 133 patients with type 2 diabetes who agreed to participate in the study and met the criteria for the study. Data were collected using the descriptive information form prepared by the researcher and the Scale obtained from FACIT System. The research data were collected by face-to-face interviews with the patients. Language and content validity of the Turkish version of the Scale was provided, Cronbach's Alpha coefficient, test-retest analysis and item analysis methods were used as reliability analysis. RESULTS: The total Cronbach Alpha coefficient of the scale was found to be 0.92. According to the results of factor analysis, unlike the original scale, two sub-dimensions emerged in the Turkish version of the scale. CONCLUSIONS: As a result of the validity and reliability analysis of the FACIT-Fatigue Scale, it can be said that it provides psychometric measures that can be used to determine the level of fatigue of type 2 diabetes patients in Turkish society.

Determination of food intake and the factors affecting food intake in perioperative period in patients who undergo open heart surgery.

BACKGROUND: This study aims to investigate the factors affecting food intake in perioperative period of patients who undergo open heart surgery and the effects of body weight, albumin and hemoglobin values, nausea, vomiting and constipation on food intake. METHODS: This cross-sectional study was conducted between 4 February 2015 and 4 May 2015 in a cardiovascular surgery clinic. A questionnaire including 25 questions was applied to a total of 86 volunteer participants (62 males, 24 females; mean age 61.3±10.8 years; range 38 to 82 years). RESULTS: Patients consumed 38% of the food one day before the surgery and 51% one day after, 47% three days after, and 52% five days after the surgery. Factors affecting food intake were the procedure of discontinuing food intake for pre-surgery anesthesia preparation (84.9%), nausea (31.4%) one day after surgery, and constipation three (26.5%) and five (33.7%) days after surgery. Albumin levels decreased significantly in days after surgery compared to the day before surgery (p<0.05). There was a significant positive correlation between food intake rates and albumin levels on the first, third and fifth days after surgery (r=0.354, r=0.353, and r=0.521, respectively; p<0.05). CONCLUSION: Patients' body weight and albumin levels decreased in accordance with their nourishment status after surgery. Food intake was insufficient in the perioperative period.

Health-related quality of life in persons living with a urostomy.

PURPOSE: The purpose of the study was to determine the life experiences and health-related quality of life (HRQOL) of patients living with a urostomy. DESIGN: Cross-sectional descriptive study. SUBJECTS AND SETTING: This prospective and descriptive study was carried out in a research and training hospital in Gaziantep, Turkey; data were collected from May 2009 to September 2011. Twenty-four participants had undergone a urostomy operation at least 4 months before study participation. METHODS: A form querying pertinent demographic and clinical information, combined with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QoL Q-C30) was used for data collection. Data collection forms were sent to the patients via mail in closed envelopes. The Mann-Whitney U, the Kruskal Wallis, and Wilcoxon signed rank tests were used for the comparative statistics; statistical significance was accepted when P values were <.05. RESULTS: The mean age of the 24 participants was 63.45 ± 6.33 years (mean ± SD; range, 49-72 years). The average time since surgery was 9.83 ± 2.34 months (range, 4-18 months). Most respondents stated that their urostomy affected their dressing habits (83.4%), sleep patterns (91.7%), family life (91.7%), participation in social activities (91.7%), and occupation (75.0%). All participants reported problems with psychological health and sexual activity following urostomy surgery. Analysis of EORTC QoLQ-C3 scores revealed that general wellness, functional condition, and symptomatic condition mean scores were lower than population-based norms associated with this instrument (54.16 ± 15.29, 44.07 ± 9.62, and 64.31 ± 12.56, respectively). CONCLUSIONS: Creation of a urostomy affected the patients' lifestyle and HRQOL negatively. Determining the patients' experiences, problems, and the change in HRQOL may provide assistance in designing appropriate nursing approaches to alleviate problems adapting to a urostomy.

Evaluating the effects of preoperative fasting and fluid limitation.

The aim of the study was to evaluate the effects of preoperative fasting and fluid limitation in patients undergoing laparoscopic cholecystectomy. Although traditional long-term fasting is not recommended in current preoperative guidelines, this is still a common intervention. Visual analogue scale was used to assess hunger, thirst, sleepiness, exhaustion, nausea and pain; State and Trait Anxiety Inventory was used to assess the preoperative anxiety of 99 patients undergoing elective laparoscopic cholecystectomy. Mean time of preoperative fasting and fluid limitation were, respectively, 14.70 ± 3.14 and 11.25 ± 3.74 h. Preoperatively, 58.60% of the patients experienced moderate anxiety. Patients fasting 12 h or longer had higher hunger, thirst, nausea and pain scores. The mean trait anxiety score of patients fasting 12 h or longer was statistically significantly higher. Receiving nothing by mouth after midnight preoperatively is a persisted intervention and results in discomfort of patients. Clinical protocols should be revised and nurses should be trained in current fasting protocols.

Evaluation of Early Warning Scoring System and Nursing Guide Application in Post-Anaesthesia Care Unit.

OBJECTIVE: To determine the effect of nursing guide application developed for the present study and to evaluate the Early Warning Scoring System (EWSS) in post-anaesthesia care unit (PACU). METHODS: The study was carried out as a randomised-controlled experimental study. The study sample comprised of 123 adult patients having thoracic and abdominal surgery between January 2011 and April 2011 in the Anaesthesiology and Reanimation Department of a training and research hospital. Patients were randomised during the pre-operative period; the patients who were followed-up according to the EWSS and a nursing guide constituted the study group (SG=63) and the patients whose EWSS score was calculated but routine follow-up in PACU was not intervened constituted the control group (CG=60). RESULTS: During the PACU, complications developed in in 34.92% of SG patients and in 30.00% of CG patients. Of the SG patients, 95.45% developing complications and of the CG patients, 22.22% developing complications were treated in the first 10 minutes, and it was determined that in 61.12% of CG patients, complications were not treated. There was a significant difference between the SG and CG patients in terms of treatment duration against complications (p<0.05). CONCLUSION: The EWSS and nurse's guide provides early determination and treatment of patients developing complications. Thus, it is recommended to use the EWSS and a nursing guide in PACU.

Effectiveness of local cold application on skin burns and pain after transthoracic cardioversion.

BACKGROUND: Transthoracic cardioversion (TTC) is widely used in emergency departments and daily clinical practice. TTC may cause skin lesions on the application of apical and sternal paddle areas. The lesions are characterised by redness, erythema and blister(s), and can be defined as first degree burns locally causing pain and increased sensitivity. AIM: To evaluate the effectiveness of local cold application on reducing the incidence, severity and pain/sensitivity of skin burns in patients who underwent TTC. METHODS: The study was conducted in the intensive care unit of the cardiovascular surgery department. The patients were assigned to study (n=24) and control groups (n=24). Local cold application was performed for a 1 hour period on patients in the study group, whereas only clinical procedures were applied in the control group following TTC. Incidence and severity of burn was evaluated 2 h after TTC, and pain/sensitivity scores were evaluated at 2, 4 and 24 h after TTC. Results The incidence of burn was significantly lower in the study group (3/24) compared to the control group (21/24) (12.5% vs 83.3%, p<0.001). Pain/sensitivity scores were significantly lower in the study group compared to the control group (p<0.05). CONCLUSION: Local cold application following TTC is an effective means of reducing the incidence and severity of burns and pain/sensitivity. It is cost-effective and can easily be applied by nurses in medical/surgical units and emergency departments.