Turkish Validation and Reliability of the EORTC QLQ-CR29 Quality of Life Scale for Colorectal Cancer

BACKGROUND

This study aims to test the validity and reliability of the Turkish version of the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire-Colorectal Cancer Scale, and to evaluate the relationship between the factors affecting the quality of life in patients with colorectal cancer (CRC).

METHODS

117 patients diagnosed with CRC and treated at the Training and Research Hospital were included. A Personal Information Form, questionnaires on the Quality of Life in Cancer Patients, Quality of Life in Patients with CRC, and the Adaptation Scale for Individuals with Ostomy were used.

RESULTS

The validity and reliability of the KKHYK scale were found significant (P < .05). From the demographic data of the patients, the differences between 3 sub-dimensions, grouping according to gender, and 2 sub-dimensions were statistically significant. In the characteristics related to the disease, the differences between the groups were significant; for one for the diagnosis time of the disease, 2 dimensions in the adaptation parameter (P < .05).

CONCLUSION

The Turkish version of the scale is a measurement tool with validity and reliability indicators to measure the quality of life of patients with CRC. It was concluded that patients did not have sufficient knowledge about their disease, and that this increased the burden of nursing care.

Evaluation of Quality of Life and Health Care Needs in Cancer Patients Receiving Chemotherapy

Symptoms are decisive in the quality of life of patients. Progression of the underlying disease leads to many physical and psychological symptoms in patients. Increases in these symptoms often prevent patients from complying with treatment. Therefore, the symptoms must be recognized, evaluated, and controlled for the treatment to be effective. This study determined the unmet needs of patients undergoing chemotherapy treatment and the effects of these needs on the patients' quality of life. Four hundred fifty patients were studied. Data were collected using the Patient Information Form, the Nightingale Symptom Assessment Scale (N-HAQ), the Supportive Care Requirements Questionnaire (DBGÖ), and the FACT-G (v4) Quality of Life Scale. The areas in which patients needed the most support were pain, weakness/fatigue, bad feelings, sadness, mood swings, difficulty in doing home-related tasks, fear of the cancer spreading, inability to control the situation, worries about the future, fear of death, worries about upsetting relatives, and being in need of information regarding their sexual lives. The results showed that for patients who had higher support requirements, higher incidences of symptoms led to a reduced quality of life. Consequently, frequently evaluating these symptoms to meet the needs identified, frequently measuring the quality and efficiency of care and advising these patients on their needs is recommended.

Patient satisfaction with the quality of nursing care

AIM

To evaluate patients' satisfaction with the quality of nursing care and examine associated factors.

DESIGN

A cross-sectional, descriptive survey study.

METHODS

The sample was composed of 635 patients discharged from a private hospital. Data were collected using "Patient Satisfaction with Nursing Care Quality Questionnaire" with a total of 19 items, and a questionnaire designed to record socio-demographic characteristics and medical histories between January 1-May 31, 2015.

RESULTS

Patients were more satisfied with the "Concern and Caring by Nurses" and less satisfied with the "Information You Were Given." Patients (63.9%) described nursing care offered during hospitalization as excellent. Patients who were 18-35 years old, married, college or university graduates, treated at the surgery and obstetrics-gynaecology units, and patients who stated their health as excellent and hospitalized once or at least five times were more satisfied with the nursing care. According to this study, the nurses needed to show greater amount of interest to the information-giving process.

Interpretation of symptoms as a cause of delays in patients with acute myocardial infarction, Istanbul, Turkey

This cross-sectional study aimed to assess interpretation of symptoms as a cause of delays in patients with acute myocardial infarction (AMI). It was conducted at a university hospital in Istanbul, Turkey. The sample included 93 patients: 73 male, mean age 57.89 (12.13) years. Prehospital delay time ranged from 15 minutes to 10 days, with a median of 2 hours (interquartile range: 9.50). Patients waited for pain to go away (48.4%) and tried to calm down (39.8%). Most patients attributed AMI-related symptoms to a reason other than heart disease. In a multivariate logistic regression analysis, the type of AMI was classified based on electrocardiography findings (odds ratio 5.18, 95% confidence interval: 1.69-15.91, P=0.004) and was independently associated with a long prehospital delay time, indicating that patients with ST segment elevation MI would seek early medical care. Misinterpretation of symptoms and misconceptions about emergency treatment during AMI cause delays in admission and may affect treatment.

Validity and Reliability of the Quality of Life in Epilepsy Inventory (QOLIE-10) For Turkey

INTRODUCTION

The purpose of this study was to test as a shortened form of the health-related quality of life for patients with epilepsy inventory (QOLIE).

METHODS

A study of 148 adult epileptic patients admitted to the Neurology Outpatient Clinic at Cumhuriyet University Hospital in Sivas was used to derive a brief screening tool from a longer instrument (QOLIE-31).

RESULTS

The 10-item questionnaire (QOLIE-10) contains general and epilepsy-specific dimensions grouped into three domains: Epilepsy Effects (memory, physical effects, and mental effects of medication), Mental Health (energy, depression, overall quality of life), and Role Functioning (seizure worry, work, driving, social limits). Cronbach's alpha (measure of internal consistency) was high, as were the associations between QOLIE-10 and the Nottingham Health Profile (NHP). High correlations between QOLIE-10 and NHP domains (emotional reactions, energy, physical mobility, and social isolation) were found.

CONCLUSION

The QOLIE-10 questionnaire is considered to be a valid and reliable tool for use in Turkey. Health professionals are encouraged to use this questionnaire to routinely examine the influences of the disease process in epilepsy patients.

Validity and Reliability of the Quality of Life in Epilepsy Inventory (QOLIE-31) for Turkey

INTRODUCTION

The purpose of this study was to evaluate reliability and validity of the 31-item Quality of Life in Epilepsy Inventory (QOLIE-31) in Turkish epileptic patients.

METHODS

This study was performed methodologically. To standardize the inventory, using a standard "forward-backward" translation and cultural adaptation procedure the English version of the QOLIE-31 was translated to Turkish. Language equivalence of the scale was provided. The opinions of experts were considered regarding the content validity of the scale. Reliability of the scale was determined with the test-retest reliability, item-total correlation and internal consistency analysis. For the construct validity, QOLIE-31 was compared with Nottingham Health Profile (NHP) scale and pre validity was determined.

RESULTS

One hundred and forty-eight epileptic patients (62 females, 86 males), with a mean age of 32.5 (SD: 10.71) years were enrolled in the study. Content Validity Index of instrument was .85. Alpha reliability was .91. Item-total correlations were between .46 and .74 (p=.001). The mean score for the quality of life of epileptic patients was found to be moderate level (56.4; SD: 17.3). The mean score of Seizure Worry subscale was the lowest (48.9, SD: 29.82), while social function subscale (60.1, SD: 20.12) was found to be highest. As expected, correlations between QOLIE-31 and NHP subscales were fairly strong, particularly between those subscales with close or interdependent content. Thus, Emotional Well-Being correlated with NHP Emotional Reactions, Social Isolation and Pain; Social Function with NHP Social Isolation and Physical Mobility; Seizure Worry with NHP Social Isolation and Emotional Reactions; and Cognitive Function with NHP Energy, Emotional Reactions and Pain.

CONCLUSION

The Turkish version of the QOLIE-31 questionnaire has good structural characteristics, is a reliable and valid instrument and can be used for measuring the effect of epilepsy on the quality of life.

Symptoms after hospital discharge following hematopoietic stem cell transplantation

Aims:

The purposes of this study were to assess the symptoms of hematopoietic stem cell transplant patients after hospital discharge, and to determine the needs of transplant patients for symptom management.

Materials and Methods:

The study adopted a descriptive design. The study sample comprised of 66 hematopoietic stem cell transplant patients. The study was conducted in Istanbul. Data were collected using Patient Information Form and Memorial Symptom Assessment Scale (MSAS).

Results:

The frequency of psychological symptoms in hematopoietic stem cell transplant patients after discharge period (PSYCH subscale score 2.11 (standard deviation (SD) = 0.69, range: 0.93-3.80)) was higher in hematopoietic stem cell transplant patients than frequency of physical symptoms (PHYS subscale score: 1.59 (SD = 0.49, range: 1.00-3.38)). Symptom distress caused by psychological and physical symptoms were at moderate level (mean = 1.91, SD = 0.60, range: 0.95-3.63) and most distressing symptoms were problems with sexual interest or activity, difficulty sleeping, and diarrhea. Patients who did not have an additional chronic disease obtained higher MSAS scores. University graduates obtained higher Global Distress Index (GDI) subscale and total MSAS scores with comparison to primary school graduates. Total MSAS, MSAS-PHYS subscale, and MSAS-PSYCH subscale scores were higher in patients with low level of income (P < 0.05). The patients (98.5%) reported to receive education about symptom management after hospital discharge.

Conclusions:

Hematopoietic stem cell transplant patients continue to experience many distressing physical or psychological symptoms after discharge and need to be supported and educated for the symptom management.

Quality of life during chemotherapy and satisfaction with nursing care in Turkish breast cancer patients

This descriptive cross-sectional study aimed to evaluate quality of life for breast cancer patients (n = 105) undergoing chemotherapy, and to assess their satisfaction with nursing care. It also explored relationships between quality of life, satisfaction with nursing care, and demographic and disease-related characteristics. Ethics approval for this study was provided. The research was carried out between October 2011 and June 2012. Quality of life and satisfaction with nursing care were assessed using the Functional Assessment of Cancer Therapy-General Scale, the Memorial Symptom Assessment Scale and the Newcastle Satisfaction with Nursing Scale. We found that emotional well-being was the area most negatively affected, with patients reporting being afraid of death, feeling sad and being worried about their health. Patients were overall quite satisfied with the nursing care they received at the hospital. We found a positive correlation between total scores on the Newcastle Satisfaction with Nursing Scale and social and family well-being scores. Breast cancer patients have fears and concerns about their health and need support during chemotherapy for coping with negative changes in their emotional well-being, physical and functional well-being.

Turkish nursing students' knowledge of and attitudes towards patients with HIV/AIDS

AIMS AND OBJECTIVES

To assess nursing students' knowledge of and attitudes towards such patients and to determine the variables associated with students' knowledge and attitudes towards them.

BACKGROUND

Improving nurses' and nursing students' knowledge and attitudes towards patients with HIV/AIDS is vital for providing quality care for such patients.

DESIGN

This descriptive, cross-sectional study was conducted at three nursing schools located in two different cities in Turkey. The inclusion criteria for the nursing students were as follows: being at least 18 years old; being a first-, second-, third- or fourth-year nursing student; and giving consent to participate in the research.

METHODS

The sample comprised 580 nursing students. The study used three data collection tools: (1) the Student Socio-Demographic Questionnaire, (2) the HIV/AIDS Knowledge Questionnaire and (3) the HIV/AIDS Attitude Questionnaire.

RESULTS

Participants' knowledge was found to be insufficient, particularly with regard to HIV transmission routes. They generally had positive attitudes towards patients with HIV/AIDS. However, they expressed some concerns and were hesitant about working with AIDS and HIV-positive patients.

CONCLUSIONS

The current results reveal that nursing students still have misconceptions and a lack of knowledge of HIV/AIDS and that their attitudes need to be improved.

RELEVANCE TO CLINICAL PRACTICE

Improving education programmes about HIV/AIDS and using information sources effectively may contribute to better knowledge and more desirable attitudes towards HIV/AIDS.

Assessment of relationship between self-care and fatigue and loneliness in haemodialysis patients

AIMS AND OBJECTIVES

To assess the level of fatigue, self-care abilities and level of loneliness in Turkish haemodialysis patients and to determine the relationship between the level of fatigue, self-care and loneliness.

BACKGROUND

Dialysis patients experience difficulties such as deterioration in physical performance and self-care abilities, fatigue and social isolation due to the disease and the treatment.

DESIGN

This is a descriptive study and was conducted at two dialysis treatment centres.

METHODS

The sample included 325 haemodialysis patients. Patients were selected via convenience sampling. Criteria for inclusion of patients undergoing haemodialysis treatment were those who volunteered to take part in the study, who were literate and who were over 18 years of age. Data were gathered using Patient Information Form, Visual Analog Fatigue Scale, UCLA Loneliness Scale and Self-Care Ability Scale.

RESULTS

Haemodialysis patients reported high level of fatigue, low level of self-care and moderate level of loneliness. The correlation values indicated that as the levels of loneliness and fatigue increased, the self-care abilities decreased. The self-care abilities of the female patients were worse. Patients over the age of 60 years, those with low education level or patients on a low income and those with other chronic diseases had higher levels of loneliness and fatigue, and lower level of self-care.

CONCLUSIONS

In this study, the level of fatigue of haemodialysis patients was high, their self-care ability was very low and their level of perceived loneliness was moderate. Furthermore, fatigue negatively affects patients' self-care; the higher the patients' level of fatigue was, the lower their level of self-care.

RELEVANCE TO CLINICAL PRACTICE

In order for haemodialysis patients to manage their fatigue successfully, to improve their self-care abilities and to decrease their levels of loneliness and social isolation, nurses should provide physical, social and emotional support.

Assessment of oral care needs of patients treated at the intensive care unit

AIMS AND OBJECTIVES

To assess the oral hygiene needs and the status of the oral mucus membranes of patients being treated in an intensive care unit and to determine the personal- or treatment-related variables associated with oral hygiene and the status of the oral mucus membranes of patients.

BACKGROUND

Oral hygiene has an impact on the clinical outcomes and well-being of critically ill patients.

DESIGN

A descriptive, cross-sectional design was used.

METHOD

The study was conducted in the intensive care unit of a private hospital located in Istanbul. The study sample consisted of 60 patients treated in the intensive care unit for five consecutive days. Oral assessments were conducted once per day every morning for five days. The oral assessments were performed using the Oral Assessment Tool and Oral Assessment Checklist.

RESULTS

The oral hygiene status and the health of the oral mucus membranes improved over the consecutive five-day assessments, and the routine oral care provided by nurses in the intensive care unit was effective in preventing oral mucus membrane-related complications.

CONCLUSIONS

The frequency of oral care and oral moistening should be determined according to the patient's condition and the presence of risk factors for oral complications. Oral mucus membranes should be assessed closely and systematically in all critically ill patients who are mechanically ventilated, are receiving oxygen therapy, are undergoing invasive procedures, have a history of chronic health problems or are receiving enteral or parenteral nutrition.

RELEVANCE TO CLINICAL PRACTICE

To prevent infections or complications during intensive care treatment, it is important for nurses working in critical care units to develop and implement oral care assessments and evidence-based oral care protocols.

Prenatal distress in Turkish pregnant women and factors associated with maternal prenatal distress

AIMS AND OBJECTIVES

To assess: (1) the prenatal distress level in Turkish pregnant women and (2) to examine the association between prenatal maternal distress and personal and pregnancy-specific factors.

BACKGROUND

Pregnant women experience stress originating from a variety of pregnancy-specific issues, including physical symptoms and changes, changes in body image, physiological, social and emotional changes, parenting concerns, changes in relationships with significant others, medical problems, anxiety about labour and delivery, concerns about birth and the baby's health.

DESIGN

A descriptive cross-sectional study.

METHODS

This study was conducted at a gynaecology clinic of a private hospital in Istanbul, Turkey within a 12-month period. The study sample comprised 522 pregnant women continuing their regular visits for prenatal care. Pregnancy Description Form and Turkish Version of Revised Version of Prenatal Distress Questionnaire [(NUPDQ)-17 Item Version] were used for data collection.

RESULTS

Study sample was moderately distressed. Turkish pregnant women were mostly distressed and concerned about premature delivery, having an unhealthy baby, labour and delivery, feeling tired and having low energy during pregnancy. Prenatal distress in Turkish pregnant women was associated with personal and pregnancy-related characteristics.

CONCLUSIONS

This study found that pregnant women need to be supported emotionally, physically and socially. A better understanding of prenatal maternal distress could assist in informing healthcare professionals about the provision of physically, emotionally, socially and behaviourally appropriate support for achieving a healthy pregnancy.

RELEVANCE TO CLINICAL PRACTICE

It is crucial for pregnant women to be regularly assessed and educated for dealing successfully with concerns and fears about prenatal period, birth and postnatal period and about difficulties that women may encounter during their pregnancy.

Knowledge of and attitudes toward tuberculosis of Turkish nursing and midwifery students

AIM

The aim of the study was to describe the level of knowledge and the attitudes of Turkish nursing and midwifery students toward tuberculosis in an attempt to understand and determine whether there is a need for improvement in nursing and midwifery education regarding tuberculosis.

METHOD

The research is a descriptive study conducted at four nursing or midwifery schools in Turkey. The sample was composed of 615 students who were first-, second-, third-, or fourth-year nursing and midwifery students. Data were collected using the Knowledge and Attitudes toward Treatment and Control of Tuberculosis Questionnaire.

RESULTS

The level of tuberculosis knowledge was poor [7.22±1.92 (range: 2-9)]. The attitudes of nursing and midwifery students toward tuberculosis were generally negative. Only 5.9% of the sample would prefer to care for patients with tuberculosis. Students who received tuberculosis lectures/education had higher levels of knowledge and more positive attitudes toward tuberculosis than their peers who did not receive such education.

CONCLUSION

In order to fight effectively against tuberculosis, positive attitudes toward tuberculosis must be developed among health care teams, and awareness of tuberculosis via theoretical and practical education, starting from the initial semesters of the professional education, must be increased.

Effect of kefir on the quality of life of patients being treated for colorectal cancer

PURPOSE/OBJECTIVES

To determine kefir's effect on the prevention of gastrointestinal complaints and quality of life (QOL) in patients being treated for colorectal cancer.

DESIGN

Randomized, controlled, prospective, interventional study.

SETTING

Istanbul University Oncology Institute in Turkey.

SAMPLE

40 patients, 20 of whom were randomized to the experimental (kefir) arm and 20 who were randomized to the control arm.

METHODS

Informed consent to participate in the study was obtained. Before treatment began, demographics, illness-related characteristics, complaints, and QOL of participants were evaluated. During treatment, side effects were evaluated one week after every cycle of therapy. QOL was evaluated after the third and sixth cycles of treatment.

MAIN RESEARCH VARIABLES

The effect of kefir on the prevention of gastrointestinal complaints and QOL in patients being treated for colorectal cancer.

FINDINGS

Following chemotherapy, the experimental (kefir) group had more treatment-related gastrointestinal complaints but a decrease in sleep disturbance. No difference was found between the two groups for QOL.

CONCLUSIONS

Kefir does not prevent or decrease gastrointestinal complaints in patients undergoing chemotherapy for colorectal cancer. Kefir did decrease sleep disturbances in the experimental group.

IMPLICATIONS FOR NURSING

Many patients use complementary and alternative medicine during cancer therapy. This study may provide information about the effectiveness of kefir in patients with cancer.

Effect of oral administration of kefir on serum proinflammatory cytokines on 5-FU induced oral mucositis in patients with colorectal cancer

In order to investigate the effect of kefir consumption on mucositis induced by 5-FU based chemotherapy (CT), we monitored the systemic immune response by measurement of the serum proinflammatory cytokine levels and we evaluated the anti-microbial effect of kefir with an agar diffusion method. Forty patients with colorectal cancer were included in this randomized prospective study. On the first 5 days of each CT cycle, the study group received oral lavage with kefir and then swallowed 250 ml of kefir while control group received oral lavage with 0.09% NaCl twice a day. Before and after every cycle of CT, the oral mucosa was assessed. Serum proinflammatory cytokine levels were evaluated before the initiation and after the third and the sixth cycle. Kefir was administered in 99 out of 205 courses. Mucositis developed in 27.3% of the courses given with kefir administration and in 21.7% of the courses given with 0.9% NaCl oral rinses. The difference between the two groups was not statistically significant (p > 0.05). When we compared the serum proinflammatory cytokine levels of the two groups at the baseline and following the third and the sixth cycles, we again found no statistically significant difference (p > 0.05). Kefir consumption at the mentioned doses made no statistically significant effect on serum proinflammatory cytokine levels and on the incidence of mucositis development in cancer patients. Under in vitro conditions, kefir inhibits only Staphylococcus epidermidis.

The quality of life and self-efficacy of Turkish breast cancer patients undergoing chemotherapy

Self-efficacy has a positive effect on health behaviors, symptom control, compliance with cancer treatment, and quality of life. This study aims to describe the quality of life and self-efficacy of Turkish breast cancer patients undergoing chemotherapy. The sample consisted of 141 patients. Data was gathered using a Patient Information Form, the Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B), a scale about Strategies Used by Patients to Promote Health and the Rotterdam Symptom Checklist. All quality of life dimensions were negatively affected at a significant level. Following commencement of chemotherapy, there was an increase in the negative effect on physical well-being, emotional well-being and additional concerns subscales and total FACT-B and their self-efficacy was negatively affected to a moderate degree. However, a significant degree of change did not occur in the self-efficacy. During treatment the physical symptoms and psychological distress increased and the activity level was negatively affected. The quality of life and self-efficacy were influenced by personal and medical characteristics, showing consistency with similar studies. Because there are negative effects of cancer and chemotherapy on patients' quality of life and self-efficacy, nurses need to focus on designing psychosocial interventions to improve their self-efficacy and quality of life.

Assessment of Fatigue in and Care Needs of Turkish Women With Breast Cancer

Using Piper's Integrated Fatigue Model, this research project was planned to determine the level of fatigue experienced by Turkish women with breast cancer undergoing adjuvant chemotherapy, to discover the factors affecting fatigue, and to provide a reference by means of which an effective nursing care for such patients could be planned. In assessing the level of fatigue and factors affecting it, a patient information form, the Piper Fatigue Scale, and the Rotterdam Symptom Checklist were used. The reliability tests performed afterwards showed that the scales are appropriate tools for use in Turkish women with breast cancer. Before treatment, psychological symptoms' distress was higher than physical symptoms' distress. However, following treatment, the latter was found to be closer to the former. When pretreatment and posttreatment physical and psychological symptoms were compared, it was noticed that fatigue, nausea, anorexia, vomiting, constipation, depression, and loss of hope for the future were among the symptoms observed to increase the most in the posttreatment period. Different from the other studies, we determined that all of the patients experienced fatigue 7 to 10 days after the chemotherapy cycle and the sensory/affective fatigue scores were high. Breast cancer patients undergoing chemotherapy experienced a moderate level of fatigue, which was influenced by level of income, stage of disease, and symptoms related to chemotherapy, showing compliance with similar studies. Following up patients individually and keeping the treatment-related symptoms under control were noticed to help prevent fatigue.

Evaluation of self-management education for asthmatic patients

Self-management of asthma, achieved through an effective educational program for asthmatic patients, is very important in facilitating adaptation to illness and positive response to treatment. An effective self-management plan helps patients to gain information about and skills in life style modifications, self-monitoring, and environmental control. The study, both descriptive and analytic, was planned as a means to evaluate the need of asthmatic patients for self-management education and to design supportive educational programs. The study group consisted of 42 adult patients who were chosen randomly from among patients treated in the Chest Diseases Department of the Medical Faculty of Istanbul University. The following evaluation tools were used: St. George Respiratory Questionnaire, a questionnaire designed by the research team, and patients' asthma diaries. The survey form designed by the research team included questions about demographic characteristics, asthma triggering factors, and morbidity factors. An asthma educational program, consisting of one session that lasted for 120 minutes, was implemented by doctors and nurses in cooperation and, 2 months later, patients were followed up. After completion of the educational program, it was found that patients related their health during the last month and the extent to which they drew benefits from their treatment with higher scores, the result clearly stating that the impact of asthma on their lives has experienced a decrease. The educational program was thus implemental in improving the quality of patients' lives. Results have finally shown that our educational program can be used as a model by other health care centers in our country.