Comparison of the Predictive Validity of Norton and Braden Scales in Determining the Risk of Pressure Injury in Elderly Patients

AIM

To compare the reliability and predictive validity of Norton and Braden scales in determining the risk of pressure injury in elderly patients.

DESIGN

This research used a comparative design. One hundred thirty elderly patients participated in the study.

METHODS

The daily pressure injury risk of participants was evaluated by a researcher using both the Norton and Braden scales in a consecutive manner.

RESULTS

The mean age of patients was 75.1 ± 8.5 years, and that for those without and with pressure injury development was 75.0 ± 8.3 years and 76.1 ± 9.7 years (P < .001), respectively. The reliability coefficients of the Norton and Braden scales were .82 and .89, respectively. The sensitivity, specificity, and positive and negative predictive values of the Norton Scale were 100%, 40.7%, 20.2%, and 100%, and those of the Braden Scale were 100%, 32.7%, 18.3%, and 100%, respectively.

CONCLUSIONS

The reliability of both scales for elderly patients was found to be high, and their ability to differentiate patients at risk was comparable. However, both scales had low specificity. Further research is needed to develop scales that have higher predictive validity for the elderly population, taking into account other risk factors that influence total scale scores.

Sleep Quality and Factors Affecting Sleep in Individuals With an Intestinal Ostomy: A Descriptive Cross-Sectional Study

BACKGROUND: Multiple factors affect the sleep quality of individuals with intestinal stomas. PURPOSE: This study sought to determine sleep quality and factors affecting sleep in individuals with intestinal ostomies. METHODS: A descriptive cross-sectional design was used. This study followed 68 individuals with intestinal stomas at the stoma therapy unit of a university hospital. A form was used to gather information about patient demographic and stoma-related data (age, sex, work status, stoma duration, cause and type of stoma, stoma care provider, sleep status during the day, daily coffee consumption, and stoma-related factors affecting sleep), and the Pittsburgh Sleep Quality Index was used to score patient sleep patterns. Descriptive statistics, t-test, chi-square test, Fisher’s exact test, and logistic regression analysis were used for statistical analysis. RESULTS: The patients’ mean age was 53.7 ± 13.8 years; 51.5% were male, and 66.2% were married. Of the 68 patients, 41.2% had a diagnosis of rectal cancer, and 55.9% had ileostomies. Mean stoma duration was 24.1 ± 5.8 months, and 57.4% of participants performed their own stoma care. On a scale of 0 to 21, the participants’ mean sleep score was 9.08 ± 5.03, and 66.2% of patients were found to have poor sleep quality. High sleep quality was significantly positively associated with colostomy (odds ratio, 1.78; 95% confidence interval [CI], 1.18–2.69; P = .006) and self-performed stoma care (odds ratio, 1.54; 95% confidence interval, 1.03–2.30; P = .036). CONCLUSION: The results of the current study can provide reference data for future studies and highlight the importance of assessing sleep quality in persons with intestinal stomas.

The Effect on Pain and Anxiety of Hot Pad Applied to Patients During Transrectal Prostate Biopsy

AIM

The aim of the study was to evaluate the effect of the application of a heating pad on the sacral region on pain and anxiety during a transrectal prostate biopsy.

DESIGN

This was a quasi-experimental study.

METHODS

The quasi-experimental study was conducted in the Urology Outpatient Clinic of a Training and Research Hospital in Istanbul. A total of 40 males were nonrandomly divided into two groups: experimental group (n = 20) and control group (n = 20). A heating pad (40-45°C) was applied to the sacral region of the patients in the experimental group during transrectal prostate biopsy. Data were collected using the Beck Anxiety Inventory (BAI) and visual analogue scale (VAS).

RESULTS

It was detected that the mean scores of the BAI were significantly lower in the experimental group compared with the control group (p < .001). The scores of the VAS were significantly lower in the experimental group compared with the control (p = .016).

CONCLUSION

Applying a heating pad to the sacral region during a transrectal prostate biopsy is an effective non-pharmacologic method to increase patient comfort and reduce pain and anxiety.

Low Back Pain in Operating Room Nurses and Its Associated Factors

Objective:

To determine the presence of low back pain and the associated factors in operating room nurses.

Methods:

The population of the descriptive study consists of 133 operating room nurses working in the operating rooms of five major hospitals located in Istanbul, and the study sample consists of 96 operating room nurses who are not on leave or sick leave between July-2016 to February 2017. Data were collected via a question form prepared by the researchers.

Results:

It was determined that more than half of the operating room nurses forming the sample group had low back pain and that it is affected from the practices of operating room nurses during a shift, which may cause physical strain such as year of working as an operating room nurse, bending and staying in the same position for a long time, holding an instrument for a long time, rotational movement inadequate to body mechanics, lifting/carrying heavy medical items and pushing/pulling heavy medical equipment.

Conclusion:

Majority of operating room nurses had low back pain and it was associated with coercive movements during surgery.

Determining the incidence of postoperative delirium in elderly patients who undergo orthopaedic surgical interventions in Turkey

OBJECTIVE

To determine the incidence of postoperative delirium in elderly patients having undergone orthopaedic surgical interventions.

METHODS

The cross-sectional study was conducted at the traumatology clinic of GATA Haydarpasa Training and Research Hospital in Istanbul, Turkey, from April 2014 to April 2015 and comprised patients who underwent orthopaedic surgical interventions. The subjects included were aged >65 years, had no mental disorders, no acute cerebrovascular disease, no known history of delirium and/or dementia. Data was collected using a self-generated questionnaire, mini mental state examination and delirium rating scale. SPSS 18 was used for data analysis.

RESULTS

Of the 60 participants, 39(65%) were female and 21(35%) were male. The overall mean age was 77.07±8.66 years. Besides, 22(36.7%) patients hadmoderate cognitive impairment preoperatively, and 51(85%) had no delirium postoperatively while 9(15%) had delirium.

CONCLUSIONS

Degree of cognitive impairment,advanced age and type of surgery were determined to be risk factors for delirium.

Effect of perceived social support on psychosocial adjustment of Turkish patients with breast cancer

AIMS

To identify the psychosocial adjustment of Turkish patients with breast cancer and the effects of perceived social support on their adjustment.

MATERIALS AND METHODS

The sample comprised 100 volunteering patients diagnosed with breast cancer in the last six months reporting to the Outpatient Chemotherapy Unit at the Medical Faculty Hospital in northern Turkey. The data for the study were collected through the Descriptive Information Form, the Psychosocial Adjustment to Illness Scale-Self-reflection (PAIS-SR) and the Cancer-Specific Social Support Scale and analyzed via SPSS 16.0 for Windows. Descriptive statistics, Chi square test, ANOVA and correlation were used to evaluate data.

RESULTS

There was a negative significant correlation between mean scores in the sub-scales of the social support scale and the ones in the sub-scales of the psychosocial adjustment to illness scale (p<0.05). Similarly, there was a negative significant correlation between confidence support and health care orientation as well as adjustment to social environment. Likewise, emotional support was in a negative significant correlation with health care orientation, adjustment to domestic environment, extended family relationships and adjustment to social environment.

CONCLUSIONS

It was concluded that social support for patients with breast cancer had an influence on their psychosocial adjustment to illness. Holistic care should be given to breast cancer patients by oncology nurses especially in the first six months of treatment. It could be concluded that patients should be accompanied by their family/relatives in treatment and care following their diagnosis with breast cancer, that their family should be made more aware of the fact that the patient should be physically and psychologically supported, that patients with breast cancer should be provided with domiciliary care, and that they should be encouraged to participate in social support groups.

Overview of the social impact of urinary incontinence with a focus on Turkish women

Although urinary incontinence is a common problem among women and can seriously affect their quality of life, more than half of women report no discomfort with the disorder, and most do not seek medical help. In Turkey, women traditionally prefer not to seek medical advice for a urinary incontinence problem. Except for treatment-seeking behaviors, women practice coping methods for the management of urinary incontinence. The problem of urinary incontinence has been gaining more importance in recent years, and nurses' roles and responsibilities have been increased in this area. Consequently, there have been developments in Turkey related to the education of nurses.

Safety of Personnel Working in Endoscopy Units

All personnel performing or assisting with endoscopic procedures and those responsible for reprocessing the equipment should be trained in how to handle the infectious and chemical hazards associated with the endoscopic environment. Endoscopy personnel should follow a comprehensive safety program that outlines the steps individuals should take to prevent injuries from the potential hazards they may encounter in endoscopy units. Safety measures include ensuring that there is adequate lighting and ventilation in the endoscopy unit, cleaning endoscopy instruments thoroughly, and operating equipment safely.