Hemşirelik Bölümü / Department of Nursing

Permanent URI for this collectionhttps://hdl.handle.net/11413/6829

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A comparison of Gordon's functional health patterns model and standard nursing care in symptomatic heart failure patients: A randomized controlled trial
(W.B. Saunders, 2020-06) Türen, Sevda; Enç, Nuray
Background Heart failure (HF) is associated with poor quality of life and increased morbidity and mortality. Aim This study aimed to investigate effect of application of Gordon's functional health pattern (FHP) model in nursing care of symptomatic HF patients on quality of life, morbidity and mortality in the post-discharge 30-day. Methods This is a prospective randomized controlled study conducted in a single center. Experimental group received nursing care planned in accordance with Gordon's FHP model. 60 control and 60 experimental HF patients were included in the study. In the control group nursing care was given according to the standard protocol of the hospital whereas in the experimental group nursing care was given in accordance with Gordon's FHP model. Patients in both groups were followed up after discharge at 30th day. Results Mean Minnesota Living with Heart Failure Questionnaire score improved significantly in the experimental group compared to the control group at 30th day (40.2 ± 23.5 vs 62.3 ± 22.9 respectively, p = 0.001). Seven patients (11.7%) in the experimental group and 17 patients (28.3%) in the control group were readmitted in the post discharge 30-day (p = 0.02). Kaplan-Meier survival curve analysis revealed significant difference in 30-day event free survival rates between groups (log-rank p = 0.31). Conclusion Application of Gordon's FHP model in the nursing care of HF patients was associated with significantly improved quality of life, and reduced hospital readmission rates at 30th day. This was the only independent predictor of 30-day event free survival.
Open Access
Ameliyat Sonrası Akut Ağrı Yoğunluğunun Değerlendirilmesinde Dört Farklı Ağrı Ölçeğinin Karşılaştırılması
(Çukurova Üniversitesi, 2020) Gürkan, Aysel; Aldemir, Kadriye; Andsoy, Işıl Işık; GÜL, ASİYE
Amaç: Bu çalışmada yaşlılar da dahil yetişkinlerde yaygınkullanılan Görsel Analog, Numerik Orantılama, Sözel Tanımlayıcı ve Yüz Ağrı ölçekleri arasındaki uyum düzeyinive hasta tercihlerini karşılaştırmak amacıyla yapılmıştır. Gereç ve Yöntem: Çalışma 17 Mart - 17 Haziran 2016tarihleri arasında bir üniversite hastanesinin cerrahikliniklerinde tanımlayıcı araştırma modeli kullanılarak yapıldı. Bu çalışmaya her grupta 40 kişi olmak üzere toplam 120 yetişkin hasta çalışmaya alındı. Verilerin toplanmasında bireysel özellikler formu, Görsel Analog Ölçeği, Numerik Orantılama Ölçeği, Sözel Tanımlayıcı Ölçek ve Yüz Ağrı Ölçekleri kullanıldı. Bulgular: Bu çalışmada 0,71 – 0,83 arasında değişen korelasyon katsayıları ile dört ağrı ölçeğinin birbirleriyle iyi bir uyum içinde olduğu bulundu. Numerik Orantılama Ölçeği, tüm hastalar tarafından kullanılması en basit ve gelecekte kullanılması en fazla tercih edilen ve en az hata oranına sahip ölçek olurken Görsel Analog Ölçeği hastalar tarafından en az basit bulunan ve en az tercih edilen, en fazla hata oranına sahip ölçek olduğu saptandı. Genç ve orta yaş grubu hastalar tarafından kullanılması en basit ve fazla tercih edilen ölçek Numerik Orantılama Ölçeği seçilirken, yaşlılar tarafından Sözel Tanımlayıcı Ölçek seçildi. Sonuç: Postoperatif akut ağrı yoğunluğunun değerlendirilmesinde dört ölçeğin birbirleri ile iyi bir uyum içinde olduğu, Numerik Orantılama Ölçeği’nin ilk, Sözel Tanımlayıcı Ölçeğin ikinci tercih olarak seçilmesi ve Görsel Analog Ölçeği’nin ise son seçenek olduğu sonucu çıkarılabilir.
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Arteriovenous Fistula Self-Care Behaviors in Patients Receiving Hemodialysis Treatment: Association With Health Literacy and Self-Care Agency
(Sage Publications Ltd., 2022) Bülbül, Elif; Ayvaz, Meryem Yıldız; Yeni, Tuğba; TÜREN, SEVDA; Efil, Sevda
Background: Arteriovenous fistula-related self-care behaviors, self-care agency and health literacy are important for vascular access patency, which is vital in the continuation of hemodialysis treatment. The purpose of this study was to determine the arteriovenous fistula-related self-care behaviors of patients receiving chronic hemodialysis treatment and the relationship between these behaviors and their health literacy and self-care agency levels. Methods: In this descriptive correlational study, the data were collected from 216 chronic hemodialysis patients. Results: The rate of the patients who had good self-care behaviors levels was 83.96%. The sociodemographic variables that were significantly related to AVF-related self-care behaviors were education, employment status and age. It was found that the patients who had had AVF for a longer time had better self-care behaviors regarding their management of symptoms and findings (p < 0.05). As the self-care agency of the patients (r = 0.612, p < 0.001) and their health literacy (r = 0.421, p < 0.001) increased, their AVF-related self-care behaviors also increased. Conclusion: Age, education status, health literacy and self-care agency were identified to affect AVF-related self-care behaviors.
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Assessment of the Risk of Pressure Ulcer During the Perioperative Period: Adaptation of the Munro Scale to Turkish
(Elsevier Science Ltd., 2021) GÜL, ASİYE; Şengül, Tuba; Yavuz, Hafize Özge
Aim of the study: This study was conducted to adapt the Munro Pressure Ulcer Risk Assessment Scale (Munro Scale) to Turkish and to test its validity and reliability. Materials and methods: In the methodological study, the data were collected using the patient identification form, the Braden Scale, and the Munro Scale. A total of 188 patients were diagnosed for the risk of preoperative and intraoperative pressure ulcer, and then re-evaluated in the recovery room and in their bed. Results: The study group consisted of 81 (43.1%) males and 107 (56.9%) females with a mean age of 51.98 ± 16.87. The Kaiser-Meyer-Olkin sampling adequacy test was 0.588 and the Bartlett's test was 430.471. The results of goodness of fit indices were not as expected value in the confirmatory factor analysis. In the exploratory factor analysis, it was determined that the factor loadings of the Munro Scale varied between 0.336 and 0.873 and explained 62% of the total variance. In the parallel-form method performed for the reliability of the scale, it was observed that there was a weak and negative correlation between the total scores of the Munro Scale and Braden Scales before the surgery and a negative and moderate correlation between the total scores after the surgery. The total Cronbach's alpha value was found to be 0.504. In the reliability analysis of the scale, interrater correlation coefficients were found to be 0.865-0.998.
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Awareness of health sciences students about colorectal cancer risk factors
(2019-05) Üstündağ, Hülya; Zengin, Neriman; Andsoy, Işıl Işık; GÜL, ASİYE
Objective This descriptive study was conducted in order to determine the risk factors, symptoms and awareness of health sciences students with regards to colorectal cancer (CRC). Methods This study included 1,028 health science students from two different universities. Data for this study were collected via a questionnaire form that included questions about CRC risk factors, protective approaches and symptoms. Frequencies, percentages and averages of the data were assessed with Kruskal-Wallis and Mann-Whitney U tests. Results The most frequent risk factors of the students (mean age: 21.25 years) were smoking (90.5%), excessive alcohol consumption (87.4%), family history of cancer (84.2%) and obesity (82.6%), while the most common protective approaches were smoking cessation, avoiding alcohol, regular physical activity and a low-fat diet. There was a significant difference in the CRC awareness of students in terms of gender, the department and grade level at which they were studying, and having a family history of cancer. Conclusion Results of this study revealed that students had a sufficient awareness about risk factors and what they could do to diminish their risk, but their knowledge about CRC symptoms was less than expected. We believe that health sciences students should be given more education on CRC symptoms.
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Burnout Levels and Care Behaviours in Intensive Care Nurses: A Cross-Sectional, Multicentre Study
(Elsevier Sci Ltd., 2022) Efil, Sevda; TÜREN, SEVDA; Ayvaz, Meryem Yıldız; Bülbül, Elif; Yeni, Tuğba
Objective: To examine the relation between burnout levels and caring behaviours in intensive care nurses in Turkey, and the affecting factors. Research methodology/design: The research was conducted as a descriptive, cross-sectional and multi-centred study. Setting: In this study, an online questionnaire was applied in April and May 2021, using Google Form. A total of 460 intensive vare nurses responded to the questionnaire. Main outcome measures: Burnout was assessed with the Maslach Burnout Inventory, and care behaviours with the Caring Behaviours Inventory-24. Results: The nurses reported a high level of emotional exhaustion (73.9%) and depersonalization (52.2%), and a medium level of personal accomplishment (40%). The nurses' levels of perception of care quality were high (5.4 +/- 0.6). It was found that their highest score on the subdimensions was on knowledge and skills (5.6 +/- 0.5), and the lowest was on connectedness (5.2 +/- 0.7). There was a very weak, respectively weak correlation, between nurses' emotional exhaustion (r = -0.1), respectively depersonalization (r = -0.2), and poor care behaviours. There was a strong correlation between low personal accomplishment scores and poor care behaviours (r = 0.8). It was found that the mean scores of the nurses' exhaustion and care behaviours varied according to many descriptive characteristics, such as education, age, professional experience, the unit where they worked, communication difficulties, living conditions and whether they had chosen nursing willingly. Conclusions: It appears that the level of personal accomplishment, is the only subscale reflecting risk of burnout, that strongly correlates with care behaviour.
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Case report: Necrotising fasciitis after removing the intrauterine device
(2018-12) Özkaya, B.; Küçük, A.; Tosun, H.; GÜL, ASİYE
Necrotising fasciitis is a rapidly progressive, destructive soft tissue infection that mainly involves fascia and subcutaneous tissues. Rapidly spread necrosis in tissues is often caused by systemic sepsis, toxic shock syndrome, multiorgan failure and thrombosis in the subcutaneous vasculature. Necrotising fasciitis can be seen in all the anatomical regions of the body; the extremities and perineum are frequently affected. In this case report, we emphasised the importance of nursing care of a necrotising fasciitis patient who has been treated for a long time with aggressive surgical treatment. Vacuum-assisted closure application is a non-invasive method with controlled and localised negative pressure on the wound to accelerate healing in acute/chronic wounds. Necrotising fasciitis can be successfully treated with early diagnosis, adequate debridement, and appropriate antibiotic therapy. A multidisciplinary approach is necessary for the comprehensive care of these patients.
Open Access
Cerrahi Girişim Uygulanan Hastalarda Ağrı ve Konfor İlişkisi
(Oğuz KARABAY, 2022) Tosun, Hale; Özkaya, Birgül Ödül; Uz, Ferişte; GÜL, ASİYE
Amaç: Çalışma cerrahi girişim uygulanan hastalarda ağrı ve konfor ilişkisini değerlendirmek amacıyla yapıldı. Materyal ve Metot: Bir eğitim ve araştırma hastanesinde cerrahi girişim uygulanan hastalar araştırma evrenini oluşturdu. Tanımlayıcı olan çalışmada örnekleme cerrahi girişim uygulanmış ve çalışmaya katılmayı kabul eden 132 hasta alındı. Veriler hasta tanım formu, Sayısal Derecelendirme Ölçeği ve Genel Konfor Ölçeği kullanılarak elde edildi. Bulgular: Örnekleme alınan hastaların yaş ortalamaları 42,64±17,27, %53’ü erkek, %58,3’ü evlidir. Katılımcıların %72’sinin herhangi bir kronik hastalığı bulunmamaktadır. Daha önce cerrahi bir girişim uygulananların oranı %16,7’dir. Çalışmada en fazla uygulanan cerrahi işlemin laparoskopik kolesistektomi (%19,7) ve laparoskopik apendektomi (%16,7) olduğu belirlendi. Genel anestezi %80,3’üne uygulandı. Hastaların ağrı puan ortalaması 3,68±1,37, Genel Konfor Ölçeği toplam puanı 136,46±11,20 olarak belirlendi. Ameliyat sonrası hastaların %59,1’inin orta derecede ağrısı bulunmaktaydı. Ağrı ile Genel Konfor Ölçeği toplam puan ortalaması arasında negatif yönlü çok zayıf bir ilişki belirlendi (r=-0,175; p=0,045). Sonuç: Ameliyat sonrası ağrı rahatsızlık yaratan bir durumdur. Ağrı ve konfor düzeyinin belirlenmesi, bakımın kalitesini ve hasta memnuniyetini arttırmak için önemlidir.
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Chemotherapy and radiation induced pulmonary dysfunction in hodgkin lymphoma patients
(2016-12) İzmir Güner, Şebnem; Teoman Yanmaz, Mustafa; Selvi, Ahmet; Usul, Çiğdem
Although the deterioration in pulmonary functions is a well-known important problem due to the treatment of the Hodgkin's lymphoma patients, the immediate and long term effects of the therapy and its distinctive components were not shown clearly yet. We planned to investigate effects of multiple agent chemotherapy and/or radiotherapy to pulmonary functions immediately and thereafter and the possible effects of the managing this situation. 34 patients were included the study. The patients were evaluated for peak expiratory flow (PEF), forced expiratory volume in 1 s (FEV1), forced expiratory vital capacity (FVC), mean total lung capacity (TLC) values, FEV1/FVC ratio, diffusing capacity for carbonmonoxide (DLco), diffusing capacity for carbonmonoxide corrected for hemoglobin concentration (DLCO) before and at 1, 6 and 12 months after the initiation of the treatment. Demographic characteristics; disease stages; chemotherapy protocols; whether radiotherapy is received; if yes, the region and the dose received were recorded. The tests were finally analysed in two separated groups; group A treated with only chemotherapy and group B; treated with combination therapy, chemotherapy and radiotherapy. In group A, FVC and FEV1 is similar before and after treatment. FEV1/FVC ratio was increased (P = 0.0001) in this group despite increasing in mean TLC values (P = 0.001). No meaningful changes were observed in PEF and DLCO values in group A. In group B, FVC, FEV1 and PEF were decreased after treatment (for FVC P = 0.028, for FEV1 P = 0.04). Despite a decrease in first month of the treatment in FEV1/FVC ratio and DLco these two parameters were recovered at the end of the first year in group B patients. TLC values were increased after treatment in group B as in group A (P = 0.035). We believe that, if these patients are managed well in 1 year; necessary precautions are provided; and patients are well-informed, then there wouldn't be too much risk and mortality rate for long-term side effects of ABVD and mediastinal RT.
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COVID-19 Fear, Vaccination Hesitancy, and Vaccination Status in Pregnant and Breastfeeding Women in Turkey
(Afr J Reprod Health, 2023) MİRAL, MUKADDES TURAN; Turgut, Nurgül; Güldür, Ayşe; Güloğlu, Zübeyde E.; Mamuk, Rojjin
This study aimed to determine the level of COVID-19 fear, vaccination, and vaccination hesitancy as well as the affecting factors in pregnant and breastfeeding women who participated in an online prenatal education in Turkey. The study, which was designed as descriptive cross-sectional, was conducted online with 360 pregnant and breastfeeding women from Istanbul. Data were collected through the Participant Information Form, Fear of COVID-19 Scale and Vaccine Hesitancy Scale in Pandemics. The rate of accepting the COVID-19 vaccine is 65.6%. The Fear of COVID-19 Scale was 16.215.54, and the Vaccine Hesitancy Scale in Pandemics mean score was 29.294.54. The COVID-19 fear of the women participating in this study was moderate, the level of vaccination hesitancy was low, and two-thirds of them were vaccinated. There is a need to organize special counseling and vaccination campaigns for pregnant and lactating women.
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Cultural Beliefs of Turkish Women for Breast Cancer and Screening
(SAGE Publications Inc., 2021) Tosun, Hale; Andsoy, Işıl Işık; GÜL, ASİYE
Introduction: Breast cancer is an important health problem and early diagnosis is important in its treatment. Women's approach and cultural beliefs are effective in ensuring early diagnosis. This study examined psychometric properties of the Ferrans Cultural Beliefs Scale and assessed cultural beliefs on breast cancer and screening programs among Turkish women. Method: The study was performed in a descriptive and cross-sectional design with 420 women using the Ferrans Cultural Beliefs Scale that is considered reliable and valid in Turkey. Results: The mean total score of the Ferrans Cultural Beliefs Scale was 3.24 +/- 3.16. The highest "yes" responses were for the statement "If breast cancer is treated correctly, it can be cured" (n = 387, 92.1%). Discussion: This study, which is the first in Turkey, highlights the importance of measuring the effects of Turkish healthy women's cultural beliefs in breast cancer and screening for early diagnosis. Determining women's cultural beliefs will make known the attitudes and behaviors toward breast cancer, so that the nurse will provide sensitive and effective nursing care, develop nursing knowledge, and integrate this knowledge with clinical practice.
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Determination of Factors Affecting Time in Therapeutic Range in Patients on Warfarin Therapy
(Sage Publications Inc., 2023) TÜREN, SEVDA; Türen, Selahattin
Background The effectiveness and safety of warfarin depend on maintaining an international normalized ratio (INR) within the therapeutic range. Time in Therapeutic Range (TTR) is defined as the percentage of time a patient's INR is within the therapeutic range. Objective We sought to determine the factors affecting good TTR in patients on warfarin therapy. Methods This was a descriptive cross-sectional study conducted in a single tertiary care center. Good anticoagulation control was defined as TTR >= 65%. Results The study population consisted of 518 patients. The mean age was 57.6 +/- 12.3 (19-87) and 54.4% of the patients were female. 47.5% patients achieved good anticoagulation control (TTR >= 65%). The mean Medication Adherence Report Scale (MARS) score was significantly higher in patients with good TTR (23.5 +/- 1.9 vs. 22.8 +/- 2.1, p = .002). Only 40.2% of the patients received education on warfarin. In multivariable analyses, the duration of warfarin therapy >10 years (OR: 2.27, 95% CI: 1.34-3.84, p = .002) and MARS score (OR: 1.22, 95% CI: 1.09-1.35, p < .001) were found to be the independent predictors of the good anticoagulation control. Conclusion Duration of warfarin therapy >10 years and MARS score were the independent predictors of good anticoagulation control.
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The Determination of Patient Learning Needs After Day Surgery: A Cross-Sectional Study
(Elsevier, 2022) Üstündağ, Hülya; GÜL, ASİYE; Özkaya, Birgül
Purpose: This study was conducted to investigate the care perception and learning needs of patients undergoing day surgery. Design: A descriptive and cross-sectional model was used. Methods: The study was conducted with 234 patients who underwent day surgery in a general surgery clinic of a university hospital. Data were collected using a sociodemographic characteristics form, the Patient Perception of Hospital Experience with Nursing Scale (PPHEN) and the Patient Learning Needs Scale (PLNS). Findings: The PPHEN mean score was 67.99 ± 11.98 and the PLNS total score was 211.15 ± 38.49. The subscales showed that the highest scores were 38.47 ± 6.93 for activities of life, while the lowest score was 20.60 ± 4.23 for feelings related to condition. There was a statistically significant negative correlation in the PPHEN and PLNS subscales in terms of medications, activities of living, treatment, and complications. There was no statistically significant relationship between the demographic data of the patients (age, gender, and educational status). Conclusions: This study demonstrated that patients had high information needs and greater concerns, particularly about "activities of life." Nurses should be aware of the importance of identifying high learning needs to increase the level of satisfaction with nursing care in day surgery patients.
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Development of Fistula in a Patient With Crohn's Disease: a case report
(2019-06) GÜL, ASİYE; 112620
INTRODUCTION: A fistula is an abnormal connection between two epithelized surfaces. 15- 25% of the fistulas develop spontaneously and 75-85% develop after surgery. Spontaneous fistulas develop after radiotherapy, diverticulitis, appendicitis, peptic ulcer perforation, pancreatitis, intestinal tuberculosis, inflammatory bowel disease. Malnutrition, sepsis, shock, circulatory failure, corticosteroid treatment, difficulties in surgical anastomosis cause fistula formation. Fistula develops 20% -40% with Crohn's disease. 75% of intestinal fistulas open to the skin. It has psychological, physiological, sociological and economic effects in patients with fistula. Objective: In this study, it was emphasized the importance of nursing care of a patient with Crohn's disease, difficult management, and long-standing fistula. Case: Mr. ET who has Crohn's disease, is 27 years old, married, graduated from primary school, lived in the village outside of Istanbul. The patient admitted to the emergency department with severe abdominal pain at the time of his visit to his brother. The emergency operation performed due to Ileus and common small intestinal dilatation. Segmenter small intestine resection and ileostomy performed and the patient followed up in the intensive care unit. Because of intraabdominal abscess, a vacuum system is applied. Afterward, two fistulas developed in the abdominal region. The total parenteral and enteral food is used for weight loss. Antibiotic therapy initiated for infection. Three months later, the fistula healed and the patient discharged on his own request. Conclusion: Complicated nursing care and multidisciplinary care must be provide for the problems that may occur in the patient who is hospitalize for a long time after the fistula.
Open Access
The Effect of Position on Feeding Performance in Infants With Cleft Lip and Palate: Quasiexperimental Study
(Wiley, 2024) ERDOST, ŞERİFE KARTAL; Gözen, Duygu
Purpose: This single-group, quasiexperimental study was conducted to determine the effect of feeding position on the physiological parameters and feeding performance of term-born infants with cleft lip and palate (CLP) in the preoperative period. Methods: The study sample consisted of 45 infants aged 0-6 months with CLP followed up preoperatively in our outpatient clinic between January 2021 and 2022. Infants who were being fed with a specialty bottle for babies with CLP and whose families consented to participate in the study were included. After 2 h of fasting, the infants were fed in the elevated supine (ESU) position for the first meal, then in the elevated side-lying (ESL) position for the second meal after another 2 h of fasting. The infants' heart rate and oxygen saturation values before, during, and after each feed and indicators of feeding performance were compared between the positions. Results: There was no significant difference between the positions in terms of heart rate and oxygen saturation before, during, or after feeding (p > .05). There was no statistically significant difference in measures of feeding performance according to the infants' feeding position (p > .05). Conclusion: According to the findings obtained in this study, infants with CLP showed no statistically significant differences in heart rate, oxygen saturation, or feeding performance when fed in the ESL and ESU positions. Practice Implications: However, despite the lack of statistical significance, both physiological values and feeding performance tended to be better when the infants were fed in the ESL position, nurses can practice ESL position according to the infant's opposite direction of the side of the cleft lip or palate.
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Effect of the Head of Bed Elevation on Back Pain After Elective Coronary Angiography: A Randomized Controlled Trial
(W.B. Saunders, 2022) TÜREN, SEVDA; YILMAZ, RAHİME ATAKOĞLU; Yeşiltepe, Nezahat; Bektaş, İbrahim
Background: Patients are restricted to bed and required to lie flat after coronary angiography (CAG) due to potential risk of vascular complications. This often cause back pain. Aim: We aimed to investigate effect of the head of bed (HOB) elevation on back pain and vascular complications after elective CAG. Methods: Three hundred and seven consecutive patients who underwent elective CAG were randomized into three groups. One control (HOB: 0 degree-flat position) and two experimental (HOB: 15 and 30°) groups were compared. Back pain level was assessed by using visual analogue scale. Results: Mean age was 58.1 ± 10.7 and 59.9% (n = 184) of patients were male. Pain level at the 3rd hour and at the 6th hour was significantly higher in control group compared to experimental groups. In the post-hoc analysis, pain level was significantly higher in HOB 15 compared to 30°. In multivariate analysis, HOB elevation to 30° was the only independent predictor of the pain level at 3rd hour and 6th hour. Only one patient in the HOB 0 degree group had a minor bleeding at the access site. Conclusions: Elevation of the HOB to 30° was associated with decreased back pain level without increased risk of vascular complications. © 2022 Elsevier Inc.
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Evde Bakım ve Palyatif Bakımın Entegrasyonunda Etik İklimler
(2019-12) Atakoğlu, Rahime; Türen, Sevda; Gül, Asiye; Madenoğlu Kıvanç, Meral; 301959; 269959; 112620; 100855
Yaşlı nüfusun hızla artması, kronik hastalıklara sahip bakım ihtiyacı olan hastaların artışını gündeme getirmektedir. Gelişmiş teknolojik aletlerin evde kullanılabilirliğinin yaygınlaşması ve maliyet etkili bir model olması nitelikli uzun dönemli bakım hizmetleri olan evde bakımın gerekliliğini doğurmuştur. Evde sağlık hizmetleri hastaların kendi yaşam alanı içerisinde kişiselleştirilmiş hizmet almalarını sağlarken, aynı zamanda bakımın sürekliliğinin sağlanmasında da önemli bir role sahiptir (1,2,3,5). Kronik, tedavisi mümkün olmayan ve yaşamı tehdit edici hastalığı bulunan hastaların nitelikli bakımlarına yönelik gereksinimin artması, palyatif bakımın bir disiplin olarak ortaya çıkmasına neden olmuştur. Dünya Sağlık Örgütünün (DSÖ) tanımına göre; palyatif bakım yetişkin/pediatrik hastaların ve ailelerinin hayatını tehdit eden hastalıklarla ilgili fiziksel, sosyal, psikolojik ve spritüel sorunlarla karşı karşıya kalmalarını önleyen ve yaşam kalitesini yükseltmeyi hedefleyen bir yaklaşımdır (6,7). Terminal dönemdeki birçok kanser hastası gibi yaşamlarının son dönemlerinde hastalar son zamanlarını kendi güven ortamları olan evlerinde geçirmek ister. Evde sağlık hizmetlerinin koordinasyonu da hastalara bu olanağı sunar. Hastanın eve gelmesiyle birlikte evde sağlık ekibi (hekim, hemşire) palyatif bakım yaklaşımının gerektirdiği tüm girişimleri yerine getirmelidir. Evde sağlık hekiminden ağrı yönetimini ve bu tür hastalar için semptom kontrollerini iyi bilmesi, evde bakım hemşiresinden de palyatif bakımın temel prensiplerini bilmesi ve uygulaması beklenmektedir. Palyatif bakım yaşamı tehdit eden her türlü hastalığın teşhisiyle başlamakta, ölüm sonrası hasta yakınının desteklenmesiyle ya da yaşamı devam eden hastanın rehabilitasyon süreciyle devam etmektedir. Bu süreç tıbbi, psikososyal ve kültürel değerler, din ve maneviyat, ekonomi gibi birçok gereksinimi kapsamaktadır. Sürecin devam etmesiyle birlikte bakımdaki hizmet sınırlılıkları etik ikilemleri de beraberinde getirmektedir. Yaşam sonu kararları, gerçeğin söylenmesinde etkili kültürel ve ekonomik faktörler, evde bakım hizmeti sunan sağlık ekibinin özellikle hemşirenin niteliği ve eğitim durumu, hemşirelerin bağımsız karar verebilme durumu, işte yaşanılan güçlükler, şağlık çalışanlarının psikososyal yönden desteklenme durumu, yaşanılan sorunlar ve ikilemlerde etik danışmanlık hizmetlerine duyulan ihtiyaç başlıca etik ikilemleri oluşturmaktadır (7,8,9,10). Sonuç olarak; hasta ve hasta yakınlarına evde sunulan palyatif bakımın hangi hizmetleri kapsadığının detaylı bir şekilde anlatılması, hizmet sunan sağlık profesyonellerinin bakım etiği hakkında eğitim alması, çalışanların gerekli motivasyonun sağlanması açısından psikososyal yönden desteklenmesi ve bir etik danışmanın tüm tarafları kapsayacak çözüm yolları ve sağlıklı iletişimin sağlanması adına danışmanlık hizmeti vermesi etik ikilemlerin ortadan kaldırılmasında faydalı olacaktır.
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Febrile Convulsion Knowledge Scale for Parents/Caregivers: A Validity and Reliability Study
(W.B. Saunders, 2023) TOKSÖZ, FATMA; Açıkgöz, Ayfer; Mutlu, Fezan Şahin; Sayık, Dilek
Background The primary worry of parents/caregivers in relation to fever is the potential for their child to experience a seizure as a result. The literature suggests that parents/caregivers need to be informed about febrile convulsion. Thus, this study sought to develop the ‘Febrile Convulsion Knowledge Scale for Parents/Caregivers’. Design and methods It is a methodological study comprising 984 parents/caregivers who were accessible online between 07/04/2021 and 30/06/2022. After creating the scale item pool's construction, expert opinions were sought to evaluate the scale, and a content validity analysis was conducted. Subsequent analysis included exploratory and confirmatory factor analyses, Cronbach's Alpha, and a test-retest reliability assessment of the scale data. Results The scale was found to consist of 8 items and 3 factors according to the factor analyses. Exploratory factor analysis indicated that the scale explained 72.783% of the variance. The scale's reliability analysis produced a Cronbach's Alpha score of 0.679, indicating good internal consistency, and it was consistent with test-retest measures (t = −0.660, p = 0.514). Conclusions It has been determined that the scale is a valid and reliable scale for evaluating the knowledge of parents/caregivers regarding febrile convulsions. Practice implications It is advisable for pediatric nurses to routinely use the devised scale with families of children who are vulnerable to febrile convulsion and impart instruction based on the findings derived from the scale.
Open Access
Gebe Okulu Eğitimcilerinin Gözüyle Endokrin Bozucular: Nitel Bir Çalışma
(Atatürk Üniversitesi, 2024) MİRAL, MUKADDES TURAN; Siyahtaş, Gamze Fışkın
Amaç: Bu araştırmanın amacı gebe okulu programlarında eğitimci olarak görev alan ebe ve hemşirelerin endokrin bozucular konusundaki bilgi ve tutumlarını incelemektir. Yöntem: Fenomenolojik tipte tasarlanan araştırmanın evreni, İstanbul ilindeki gebe okulu programlarında eğitimci olarak görev yapan 44 ebe/hemşireden oluşmuştur (N=44). Ölçüt örnekleme yöntemi kullanılarak örneklem veri doygunluğu takip edilmiş ve doygunluk sağlandığında veri toplama işlemi tamamlanmıştır (n=7). 13 Eylül 2021 tarihinde yapılan araştırmada, veriler odak grup yöntemi ile araştırmacılar tarafından oluşturulan yarı yapılandırılmış görüşme formuyla toplanmıştır. Nicel veriler, tanımlayıcı istatistiksel analizler kullanılarak, nitel veriler ise içerik analiziyle değerlendirilmiştir. Bulgular: Ebe ve hemşirelerin görüşme formuna verdikleri cevaplar doğrultusunda; endokrin bozucuların önemi, endokrin bozucular bilgisi, endokrin bozucular farkındalığı oluşturma ve gebe eğitimine entegrasyon şeklinde dört adet tema oluşturulmuştur. Prenatal dönem eğiticilerinin endokrin bozucuların öneminin farkında olmalarına rağmen konu hakkındaki bilgilerinin yetersiz olduğu belirlenmiştir. Ayrıca katılımcıların konunun prenatal eğitimlerde yer alması ve farkındalık geliştirilebilmesi için çeşitli önerilerinin bulunduğu saptanmıştır. Sonuç: Ebe ve hemşirelerin endokrin bozuculara yönelik çok fazla bilgilerinin olmadığı hatta kısmen yanlış bilgilere sahip oldukları görülmüştür. Eğitici eğitimlerinin içeriğine endokrin bozucularla ilgili konuların eklenerek bilinçlendirme çalışmalarının arttırılması gerektiği sonucuna varılmıştır.
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Gelecek Kuşak: Alfa Kuşağı ve Hemşirelik
(2019-11) Madenoğlu Kıvanç, Meral; 100855

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