Sağlık Bilimleri Fakültesi / Faculty of Health Sciences

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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.
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A novel dorsal trimline approach for passive-dynamic ankle-foot orthoses
(Assoc Mechanical Engineers Technicians Slovenia, Po Box 197-Iv, Ljubljana 61001, Slovenia, 2018) Sürmen, Hasan Kemal; Fetvacı, Mahmut Cüneyt; Arslan, Yunus Ziya; AKALAN, NAZİF EKİN; 123435; 176320; 19199; 110120
An ankle-foot orthosis (AFO) is an externally applied assistive device that encompasses the lower leg, ankle, and foot of the human body. In the current one-piece passive-dynamic AFO design, the trimming process is performed from lateral and medial parts of the ankle to ensure desired rotational displacement (hereafter referred to as Design I). In most cases, stress concentrations occurring over the trimmed regions during walking can cause permanent damage to the AFO. In this study, to reduce the stress concentration and ensure a homogeneous stress distribution, a new trimming approach is presented, in which the trim zones were transferred from lateral and medial to dorsal (hereafter referred to as Design II). Finite element analyses of the Designs I and II models were carried out. Displacement and von Mises stress values for both models under the same loading and boundary conditions were obtained. Maximum displacement values were 8.51 mm and 9.05 mm for Design I and Design II, respectively. Maximum stress values were 15.19 MPa and 6.70 MPa for Design I and Design II, respectively. For the similar range of motion of ankle joint, the novel design produced less stress and more homogeneous stress distribution than the currently used design, thus indicating that Design II would be more resistant to plastic deformation than Design I.
Open Access
Active Child, Healthy Child Project: The Effects on Dynamic Balance of an Increase in Femoral Anteversion in Healthy Developing Children
(AVES, 2024) APTİ, ADNAN; AKALAN, NAZİF EKİN; AKEL, BURCU SEMİN; EVRENDİLEK, HALENUR; ÖNERGE, KÜBRA; NAS, İMGE
Objective: Increased femoral anteversion (IFA) is defined as the anterior rotation of the femoral head in relation to the transcondylar axis of the knee. The aim of this study was to determine the frequency of IFA in healthy developing children and to investigate the effects of IFA on dynamic balance. Methods: School screening was conducted on 315 school-age children (6-14 years old, mean 9.9 ± 2 years), and IFA was determined in 26 children. From the same sample, 36 children with no IFA were selected as the control group. Data obtained from the Y balance test, handgrip strength with a digital dynamometer, IFA according to the Craig’s test, and joint hypermobility according to the Beighton score were compared between the groups. Independent sample t-test and Pearson’s correlation test were used in the statistical analysis. Results: This study was carried out on a narrow universe of children mean aged 9.9 ± 2 years, and the incidence of IFA was determined as 8.3%. The Y balance scores were found to be higher in the IFA group than in the controls (P=.049 right, P=.027 left). There was no correlation between Craig’s test and the Y balance test results (r=0.04). No difference was found between the groups for muscle strength and joint hypermobility scores associated with balance. Conclusion: Balance may not be one of the causes of frequent falls in children with IFA. Further studies are needed to further examine the biomechanical causes of falls, as studies to improve balance may not provide sufficient benefit to prevent fall-related trauma and injury in children with IFA. © 2024 AVES. All rights reserved.
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Adaptation, Reliability, and Validation of the Turkish Version of the Bad Sobernheim Stress Questionnaire-Deformity in Patients With Adolescent Idiopathic Scoliosis
(Wolters Kluwer Health, 2023) Akçay, Burçin; Kuru Çolak, Tuǧba; APTİ, ADNAN
Background:There is a limited number of disease-specific outcome measurement scales in Turkish, which can be used for individuals with adolescent idiopathic scoliosis (AIS). The aim of this study was to translate, adapt, and evaluate the validity and reliability of the Turkish version of the Bad Sobernheim Stress Questionnaire-Deformity (TRv.BSSQD) questionnaire in Turkish patients with AIS.Objective(s):After the translation and back-translation process, the TRv.BSSQD and Scoliosis Research Society-22 questionnaires were completed in face-to-face interviews with 49 patients with AIS. The TRv.BSSQD questionnaire was readministered to the same patients 2 weeks later to assess test-retest reliability.Results:The Cronbach alpha value calculated for internal reliability was 0.806. The intraclass correlation coefficient values of the items of the TRv.BSSQD ranged from 0.809 (P < 0.001) (question 8) to 0.955 (P < 0.001) (question 7). The test-retest correlation coefficient for the item-total score was 0.960 (P < 0.001). Validity analysis showed a significantly positive correlation between the TRv.BSSQD total score and pain, self-image, and mental subgroup and the total scores of the SRS-22r scale (P < 0.05).Conclusions:This patient-reported outcome instrument, the TRv.BSSQD, showed good internal consistency, good reliability with test-retest analysis, and construct validity, suggesting that it is an appropriate assessment instrument for Turkish patients with AIS.
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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Anxiolytic-Like Effects of Extremely Low Frequency Electric Field in Stressed Rats: Involvement of 5-HT2C Receptors
(Taylor & Francis Ltd., 2022) Kantar, Deniz; Acun, Alev Duygu; AFŞAR, EBRU; Yargıçoğlu, Piraye
Background Possible modulatory effects of noninvasive brain stimulation have gained interest recently. In our study, the effect of low frequency electric fields (LF-EF) on stress-induced electrophysiological, behavioral changes and the possible involvement of serotonergic 5-HT2C receptors were investigated. Materials and methods A total of eight groups including the control groups were formed by applying LF-EF with or without a 5-HT2C receptor agonist to naive or acute stress exposed rats to demonstrate the effects of LF-EF. LF-EF administration at 10 kV/m was started 30 min before acute stress application and lasted for 1 h in total. Anxiety levels and social interaction were evaluated using the elevated plus maze test and social interaction test, respectively. Auditory evoked potentials (AEP) were recorded by using ascending loudness paradigms. Loudness dependence AEP (LDAEP) was calculated by using amplitude values to analyze serotonergic transmission. Serotonin and glucocorticoid levels were measured in the frontal cortex and hippocampus. Results It was observed that the applied LF-EF reduced the anxiety behavior, and attenuated the LDAEP responses in stress and/or 5-HT2C receptor agonist applied groups. In parallel, an increase in serotonin levels and a decrease in glucocorticoid levels were observed. However, LF-EF exposure was ineffective in impaired social interaction. Conclusions Our findings show that 10 kV/m LF-EF administration may modulate the neural network and physiological responses associated with mild acute stress. 5-HT2C receptor dependent functions are thought to play a role in the anxiolytic effect of LF-EF.
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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 Nutritional Status, Body Composition and Blood Biochemical Parameters of Patients Following Sleeve Gastrectomy: 6 Months Follow Up
(Elsevier, 2021) BATAR, NAZLI; Demir, Halime Pulat; Bayram, Hatice Merve
Background and aims: Today, Sleeve gastrectomy (SG) has recently become the most common bariatric procedure among various bariatric surgical procedures due to its advantages. The aim of this study is to investigate nutritional status, body composition and biochemical parameters following SG. Methods: This was a prospective study, the subjects were patients who underwent SG at a special obesity clinic in Istanbul, Turkey, between 01.05.2017 and 01.11.2017. The mean body mass index (BMI) of the participants was 42.15 +/- 4.84 kg/m(2) for men and 41.44 +/- 4.34 kg/m(2) for women, preoperatively. Nutritional status, some anthropometric measurements and blood sampling were taken at each visit. Data were collected and analyzed for the present study at the following periods: pre-operation (pre-op), 1 month, 3 months and 6 months after surgery. Results: A total of 47 SG patients (20 men, 27 women) were evaluated. The mean BMI was 30.23 +/- 3.56 kg/m(2) for men and 30.35 +/- 4.36 kg/m(2) for women after 6 months and the amount of excess weight loss (EWL) increased in the 3 months (p <.001). Mean energy, fiber, vitamin A, vitamin C, vitamin B-1, niacin, vitamin B-12, folate, calcium, magnesium, iron, zinc, phosphorus and iodine were above the Dietary Reference Intake (DRI) recommendations. A significant association was found between protein intake and fat free mass loss in both genders after SG at 6 months (p <.05). Conclusion: Nutrition deficiencies are common for patients after SG. Therefore, it is important to routinely monitor these patients with a professional team. (C) 2021 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.
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Assessment of the Correlation Between Weight Status and the Frequency of Dietician Interviews in Sleeve Gastrectomy Patients
(Springer, 2021) BATAR, NAZLI; SEVDİN, SEZEN; Güçlü, Duygu; KERMEN, SEDA
Purpose The aim of this study was to evaluate the relationship between the weight status of sleeve gastrectomy patients during the first two postoperative years and the frequency of dietician interviews. Materials and Methods This was a retrospective cross-sectional study, and the subjects were patients who had surgery at a special obesity clinic, Bariatriklab, in Istanbul, Turkey, between February 01, 2014, and February 01, 2018.The mean age +/- standard deviation of the participants was 38.8 +/- 11.9 years. The mean body mass index (BMI) +/- standard deviation was 44.2 +/- 6.1 kg/m(2)preoperatively. The preoperative (pre-op) and 12-, 18-, and 24-month postoperative (post-op) weights and the frequency of interviews with dieticians for 2 years after the operation were collected, and statistical analysis was performed using SPSS ver. 23.0. Results A total of 247 laparoscopic sleeve gastrectomy (LSG) patients, 161 women (65.2%) and 86 men (34.8%), were evaluated in this study. As the frequency of dietician interviews increased in the first year, the amount of excess weight loss (EWL) increased in the second year (p < 0.01). In addition, as the frequency of dietician interviews increased in the second year, the amount of EWL in the second year decreased (p < 0.01). The frequency of dietician counseling among participants who did not experience weight loss between 12 and 24 months was significantly higher than that among those who experienced weight loss (p < 0.05). Conclusion It should not be forgotten that bariatric surgery requires teamwork, and patients should be cared for with an interdisciplinary approach. Dieticians play an important role in changing nutritional habits and making them sustainable.
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Assessment of the Quality and Reliability of Information on Nutrition After Bariatric Surgery on YouTube
(Springer, 2020) BATAR, NAZLI; Yıldız, Nida; Güçlü, Duygu; SEVDİN, SEZEN; KERMEN, SEDA
Background YouTube (TM) is a platform that many people, including patients, use to access health information. Recent studies have revealed that videos on YouTube (TM) are misleading or that medical videos may not contain appropriate information. This study aimed to assess the quality and reliability of videos on nutrition after bariatric surgery. Materials and Methods The keywords "after bariatric surgery diet" and "weight loss surgery postop diet" were used, and the first 100 videos for each keyword on YouTube (TM) were analyzed by considering the source, duration, content, and the number of likes of the video. The popularity of the video was calculated using the video power index (VPI) and view rate. The educational quality of the videos was evaluated using the DISCERN score, the Journal of the American Medical Association (JAMA) score, the Global Quality Score (GQS), the usefulness score, and a novel postoperation nutrition score (PONS). Results One hundred fourteen patients were included in the study. The mean duration and number of views were 12.51 min and 87,558.46, respectively. The DISCERN score, JAMA score, GQS, and usefulness score of the physicians or dietician-based videos were significantly higher than those of the patient-based videos (p < 0.001). Positive correlations were found between the VPI and view ratio, as well as between the duration and number of likes. Additionally, the DISCERN score was significant correlated with the duration and number of likes. Significantly positive correlations were found between the usefulness score and duration, usefulness score and number of likes, and PONS and duration (p < 0.01). Conclusions Informational videos on nutrition after bariatric surgery on YouTube (TM) are of low quality. Although the videos uploaded by physicians and dieticians have higher quality, only a few are available. Additionally, patients prefer to watch low-quality videos.
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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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Azaltılmış Plantar Ön-Ayak Duyusunun Taban Basıncı Üzerine Etkisinin İncelenmesi
(2018) Akalan, Ekin; Sert, Rukiye; Kuchimov, Shavkat Nadir; Leblebici, Gökçe; Ertürk, Gamze; Bilgili, Fuat; ÖNERGE, KÜBRA; 283338; 176320; 229941; 268636; 237820
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Bariatrik cerrahi planlanan obez hastalarda besin tüketimleri ile duygusal yeme davranışı arasındaki ilişki
(2019-12) Batar, Nazli
Bu çalışma, bariatrik cerrahi planlanan obez bireylerin besin tüketim sıklıkları ile bireylerin kısıtlayıcı, duygusal ve dışsal yeme davranışları arasındaki etkileri incelemek amacıyla planlanmıştır. Gereç ve Yönterm Prospektif tanımlayıcı tipteki bu araştırma, İstanbul’da özel bir obezite kliniğine bariatrik cerrahi ameliyatı olmak için başvuran ve hekim tarafından uygun görülen 86 obez birey üzerinde yürütülmüştür. Veriler araştırmacı tarafından yüz yüze görüşme yöntemi ile toplanmıştır. Bulgular:Çalışmaya katılan obez bireylerin yaş ortalaması 41,64±12,62 yıl, Beden Kütle İndeksi (BKİ) ortalaması 37,73±4,17 kg/m2’dir. Katılımcıların %65’i kadın, %35’i erkektir. Bireylerin %72’si düzenli (haftada 5-6 kez ve daha fazla) 3 ana öğün yapmakta, %48’i düzenli ara öğün yapmamaktadır. Düzenli gece ara öğün yapanlar ile gece ara öğününü atlayan obez bireylerde dışsal yeme davranışı arasında anlamlı farklılık olduğu saptanmıştır (p=0,02). BKI>45 kg/m2 olan bireylerin dışsal yeme davranış düzeyinin BKI>35-39,9 kg/m2 olanlara göre yüksek olduğu istatistiksel açıdan anlamlı bulunmuştur (p=0,029). Düzenli çikolata tüketenlerin duygusal yeme davranış düzeyinin hiç tüketmeyenlere göre daha yüksek olduğu (p=0,02), hiç beyaz ekmek tüketmeyenlerin kısıtlayıcı yeme davranış düzeylerinin düzenli tüketenlere göre daha yüksek olduğu tespit edilmiştir (p=0,01).Sonuç: Bariatrik cerrahi sonrası yeterli ağırlık kaybı ve obezite ile ilişkili komorbiditelerde iyileşmenin sağlanabilmesi için baraitrik cerrahi öncesi ve sonrası multidisipliner ekip çalışmasının önemi unutulmamalıdır.
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BMC'de Multidisipliner Ekip ve Yaşanan Etik Sorunlar ve Protein
(2019-10) BATAR, NAZLI; 256218
Multidisipliner ekip çalışmasının bariatrik cerrahide rolü büyüktür. Bariatrik cerrahi öncesi ve sonrası bir bütün olarak düşünüldüğünde, multidisipliner yaklaşımın sağlıklı beslenme alışkanlığı kazanma ve yaşam tarzı değişikliği ile optimal sonuçlara daha kolay ulaşabileceği gibi ulaşılan ağırlığın korunabilmesi açısından da önemi yapılan çalışmalarla desteklenmektedir. Kılavuzlar günümüzde dört ana uzmanlık alanını tanımlamıştır. Cerrah, hemşire, diyetisyen ve psikiyatr veya psikologlar multidisipliner ekip içinde olmalıdır. Cerrahlar, bariatrik cerrahi ekibinde cerrahi tekniği uygulayan kişiler olarak lider olarak görev alırlar. Ekip lideri hastaneye veya kliniğe bağlı olarak görev yapar, hastanın ameliyat öncesi ve sonrası değerlendirmesinden ve takibinden sorumludurlar. Psikiyatr veya psikologlar, bariatrik cerrahinin uygunluğunu belirlemek için hastanın sosyal, psikolojik ve psikiyatrik değerlendirmesini sağlarlar. Diyetisyenler ameliyat öncesi ve sonrası hastaların beslenme durumunun saptanması ve değerlendirilmesinde, antropometrik ölçümlerin alınması ve değerlendirilmesinde, sağlıklı beslenme eğitimlerinin yapılmasında görev alırlar. Ameliyat sonrası hemşireler, disiplinler arası bakım, eğitim ve ameliyat sonrası izlemenin planlanmasına yardımcı olan ekip elemanlarındandır. Obezitenin giderek evrensel bir halk sağlığı sorunu haline gelmesi, obezitenin etkili tedavi yöntemlerinden olan bariatrik cerrahi tekniklerinin uygulanma sıklığını da arttıracaktır. Bariatrik cerrahinin bir ekip çalışması olduğunun unutulmamalı ve multidisipliner yaklaşımla hastaların ele alınması gerektiği vurgulanmaktadır. Alanında uzman bir diyetisyen ekip içinde her zaman büyük bir role sahip olacaktır. Ameliyat öncesi ve sonrası beslenme durumunun saptanması, antropometrik ölçümlerin değerlendirmeleri, hasta sonuçlarının iyileştirilmesi, olası beslenme komplikasyonlarının erken tespiti ve önlenmesinde diyetisyenler hastalara yol göstermelidir. Deneyimli diyetisyen ve multidisipliner ekip yaklaşımı ile hastalar özgü sistematik bir beslenme bakım süreci ile daha başarılı sonuçlar elde edileceği unutulmamalıdır.
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Breastfeeding Practices in Medical Nutrition Treatment of Phenylketonuria
(2019-09) Çakır Biçer, Nihan; Ersoy, Melike; 25392
Objective: Phenylketonuria (PKU) is an inherited metabolic disease with the increase of phenylalanine (phe) in the blood and body fluids in the absence of phenylalanine hydroxylase enzyme. PKU was the first inborn error of metabolism treated with medical nutrition therapy (MNT). The aim o f this study was to evaluate the breastfeeding practices in the MNT of PKU patients followed up at Dr. Sadi Konuk Training and Research Hospital, metabolism reference clinic for three years. Methods: Forty-two patients were reviewed for infants diagnosed with PKU between 2016 and 2019. Eighteen PKU patients (8 mild-PKU, 10 classic-PKU) over two years old and diagnosed with National Newborn Screening Program were included the study. MNT, blood phe, tyrosine (tyr) levels and anthropometric measurements of patients were evaluated retrospectively. Results: The mean age of patients is 2,5±0,4 years and 44% were male. The patients were diagnosed at a mean age of 13,7±6,7 days with blood phe and tyr levels of the patients were 1756 pmol/dL and 65 pmol/dL. After the diagnosis, 24-hour-BH4-loading test was applied, breastfeeding was interrupted until the blood phe level was <600 pmol/dL (mean 3,7±1,6 days) and breast milk was stored for reuse. In this process, MNT was applied phe-free medical formula with an average of 2,1 g/kg/day essential amino acid (eaa), 108 kcal/kg/day energy and 150 ml/kg/day fluid. After the blood phe level was <600 pmol/dL, free breastfeeding was initiated. Mean breastfeeding duration of patients was 17,8±9,3 moths. In the first 6 moths 0.9 g/kg/day eaa, 43 kcal/kg/day and 57 ml/kg/day fluid were applied and average blood phe and tyr levels were 240 pmol/dL and 70 pmol/dL. Complementary feeding education was given to all patients at 6 months. At the age of 6-12 months the patients received MNT containing average 0,9 g/kg/day eaa, 0,54 g/kg/day natural protein, 25 mg/kg/day phe, 74 kcal/kg/day energy and average blood phe and tyr levels were 314 pmol/dL and 69 pmol/dL. At the age of 12-24 months, the MNT containing average of 1,1 g/kg/day eaa, 1 g/kg/day natural protein, 26 mg/kg/day phe, 109 kcal/kg/day was recommended to patients and average blood phe and tyr levels were 312 pmol/dL and 82 pmol/dL and phe:tyr ratio was 3,8. Anthropometric measurements of the patients were observed to be within normal range during the study. Conclusion: Free breastfeeding is a successful and reliable practice that supports the healthy growth and development of the child in the life-long MNT of PKU.
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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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