The effect of nature-based music intervention on adaptation and anxiety levels in patients with COVID-19 placed in the prone position: A randomized controlled trial

OBJECTIVE

To examine the effect of listening to nature-based music on anxiety, physiological parameters, and adjustment to the prone position in conscious and hypoxemic COVID-19 patients.

DESIGN

A single-blinded randomized control trial design.

SETTING

The study was conducted in the intensive care unit of a state hospital in Turkey. Sixty-four patients were randomized into an intervention group and a control group.

METHODS

A nature-based music intervention was applied in addition to routine care to the intervention group in the prone position, while the control group received routine care in the same position. The study outcomes included state-trait anxiety, physiological parameters, and prone time within 24 h. Measurements were performed in the supine position (Time: T0), in the 30th minute in the prone position (T1), and in the 30th minute of the supine position given following the prone position (T2). Data analysis included independent samples t-test in independent groups and repeated measures ANOVA in dependent groups.

RESULTS

State anxiety fell statistically significantly in the intervention group compared to that of the control group (39.1 ± 6.6 vs. 43.4 ± 7.9, p = 0.025). At T2, the heart rate of the intervention group did not increase, but it increased significantly in the control group compared to T0 and T1 values (87.8 ± 9.8 vs. 91.1 ± 10.8; p = 0.000). The oxygen saturation of the intervention group increased significantly compared to that of the control group (94.5 ± 2.3 vs. 93.4 ± 1.9, p = 0.035). The prone position time of the intervention group was significantly greater than that of the control group (11.5 ± 1.5 vs. 10.8 ± 1.1, p = 0.04).

CONCLUSIONS

It was found that nature-based music intervention applied to conscious and hypoxemic COVID-19 patients in the prone position improved anxiety and oxygen saturation and increased the prone position time.

IMPLICATIONS FOR CLINICAL PRACTICE

Listening to nature-based music in prone position may reduce anxiety in conscious patients with hypoxemic respiratory failure, it may increase adjustment to the prone position, and it may improve oxygenation and heart rate.

Effect of Oral Carbohydrate Solution Administered Before Hip Arthroplasty on Preoperative Anxiety and Postoperative Patient Comfort: A Randomized Controlled Trial

PURPOSE

This study aimed to determine the effect of oral carbohydrate solution (OCS) administered before hip arthroplasty (HA) on preoperative anxiety and postoperative patient comfort.

DESIGN

The study was a randomized controlled clinical trial.

METHODS

Fifty patients undergoing HA were randomized into two groups: The intervention group (n = 25) received OCS before surgery, and the control group (n = 25) fasted from midnight till surgery. The patients' preoperative anxiety was assessed using the State-Trait Anxiety Inventory (STAI), symptoms affecting postoperative patient comfort parameters using the Visual Analog Scale (VAS), and comfort levels specific to HA surgery using the Post-Hip Replacement Comfort Scale (PHRCS). Pre- and post-operative blood glucose levels of the patients were measured.

FINDINGS

In intragroup and intergroup assessments, the decrease in the preoperative and postoperative anxiety, pain, thirst, hunger, and nausea/vomiting levels were statistically significant (P < .05) in the OCS group. The OCS group's comfort levels specific to hip replacement were higher than those of the control group (P ≤ .001). In the intergroup and intragroup assessment of the patients' blood glucose levels, there was a statistically significant difference in favor of the OCS group (P < .05).

CONCLUSIONS

The results of this study provide evidence supporting OCS administration before HA surgery.

Experiences of Patients Undergoing Bypass Surgery With Health Professionals During the Perioperative Care Process: A Hermeneutic Phenomenological Study

PURPOSE

To determine the experiences and perceptions of patients who underwent Coronary Artery Bypass Graft (CABG) surgery with perioperative health care professionals.

DESIGN

The study used a qualitative research design and was conducted by interviewing eight patients who underwent CABG surgery.

METHODS

Study data were collected between April 24, 2020 and February 25, 2021 via a demographic information form and a semi-structured interview form and analyzed by using Heidegger's phenomenological approach.

FINDINGS

The participants were between the ages of 51 and 70. They were patients who had undergone CABG surgery 2 months before data collection. Two themes were elicited from the interviews: "If you are bad, I am bad, too", which indicated negative experiences of CABG, and "If you are good, I am safe", which indicated positive patient experiences. In addition, eight sub-themes were determined under these two themes.

CONCLUSIONS

In the perioperative process, patients may experience feelings of restlessness, fear, vulnerability, insecurity, and threat when ignored by health care professionals. The provision of interaction between the health professional and the patient, along with family support, changes the perceived care positively and makes patients feel cared for, well, and safe. Awareness of health care professionals about patient experiences during the CABG surgery process points to an important aspect of quality health care.

Experiences of patients and their partners with sexual problems after spinal cord injury: A phenomenological qualitative study

Objective: This study aimed to examine the experiences of patients and their partners about their sexual lives after Spinal Cord Injury (SCI).Design: This qualitative study was based on Heidegger's hermeneutic phenomenological approach.Setting: The Physical Medicine and Rehabilitation Outpatient Clinic of a city hospital in the Central Anatolia Region in Turkey.Participants: The study consisted of seven female and six male patients with spinal cord injury and their partners.Outcome measures: The textual analysis was carried out in three stages: (1) a naive reading, (2) a structural analysis, and (3) a comprehensive understanding of the text including a discussion. The sample size was calculated by using the criterion sampling technique.Results: As a result of the in-depth interviews with individuals with SCI about their sexual experiences, five themes were derived: (1) first confrontation with SCI, (2) experienced sexual problems, (3) coping, (4) partners' views on sexual problems, and (5) other people.Conclusion: It was found that the sex life of individuals with SCI was negatively affected, they were left helpless in dealing with their problems, and that some patients had difficulties in coping with this condition.

Turkish validity and reliability of coronavirus anxiety scale

The Coronavirus Anxiety Scale (CAS) was developed to differentiate individuals who were functionally impaired by anxiety about COVID-19 from those anxious, but not disabled by their emotional reactions to the disease. The aim of the present study is to validate the Turkish version of the CAS. The study was carried out in two stages. In the first phase, the validity and reliability study of the scale was conducted with 95 people. The single-factor structure of the scale was confirmed with exploratory factor analysis and confirmatory factor analysis results. Cronbach's alpha internal consistency coefficient was found to be 0.86. In the second stage; the data were collected using the Turkish version of CASand Herth Hope scale. The scales were applied to 720 people. It was determined that there was a statistically significant relationship between total CAS scores and the Herth Hope Index. These findings revealed that the CAS was a valid and reliable measurement tool for evaluating the anxiety levels of individuals.

Relationship between nursing students' perceptions of clinical instructor caring and their professional behaviors

PURPOSE

To examine the relationship between nursing students' perceptions of clinical instructor caring and their professional behaviors.

METHOD

This study used a descriptive and cross-sectional design. The data were analyzed with Pearson's correlation and Linear regression analyses.

RESULTS

The professional behaviors of nursing students were found to increase their desire to become a nurse in the future with "instills confidence through caring" and "supportive learning climate" subscales but to decrease their desire to be an academician in the future.

CONCLUSION

As students' perceptions of clinical instructor caring increased, their status of applying professional behaviors was found to increase, as well.

PRACTICAL IMPLICATION

Descriptive characteristics and clinical instructor caring are related to high professional behaviors in nursing students.

Correlation between social support and psychological resilience levels in patients undergoing colorectal cancer surgery: a descriptive study

Psychological resilience is considered to be promising especially for patients with CRC, which is among the most frequent types of cancer and is known to have serious physical and psycho-social impacts on individuals. Thus, it is stated that psychosocial interventions need to be done in order to overcome emotional stress. This study was conducted to determine the correlation between social support and resilience in patients undergoing surgical therapy due to colorectal cancer. The study is descriptive and cross sectional. A patient information form, Connor-Davidson Resilience Scale, and Multidimensional Scale of Perceived Social Support were used to interview 103 patients undergoing colorectal cancer surgery. It was determined that family support and significant other support were positively correlated with subscale and total scores of the Resilience Scale (p < 0.05). İt was determined that the model was highly significant (R² = 0.113; p < 0001). An increase of 1 unit in healthcare professionals support triggered an increase of one-unit (0.976) in psychological resilience (p:0.014). It was determined that social support provided to patients, undergoing surgical therapy due to colorectal cancer, by family and healthcare professionals, played an essential role in increasing resilience.

Mediating Role of Social Support in Resilience and Quality of Life in Patients with Breast Cancer: Structural Equation Model Analysis

Objective:

This study aimed to investigate the mediating role of social support in the relationship between resilience and quality of life (QoL) among Turkish patients with early-stage breast cancer.

Methods:

The study used a descriptive and cross-sectional design and was carried out in the oncology ward of a hospital in the Central Anatolia region of Turkey. A demographic-disease survey, the Turkish version of the Connor–Davidson Resilience Scale 25, the Multidimensional Perceived Social Support Scale, the European Organization for Research and Treatment of Cancer QoL Questionnaire Core, and the QoL Questionnaire Breast Cancer 23 were used to interview 113 patients with breast cancer.

Results:

Social support played a partial mediator role in the relationship between resilience and functional QoL. There was a negative correlation between functional QoL Questionnaire Breast Cancer 23 and psychological resilience and social support (P < 0.005). The mediation effect ratio was 10.2% (R² = 0.102). Social support was found to not have a mediating role in the relationship between psychological resilience and general QoL (P < 0.05).

Conclusions:

Patients do not want social support to end, and their weakness in the eyes of others may have a negative impact on their QoL and resilience.

Effect of Cold Application on Chest Incision Pain Due to Deep Breathing and Cough Exercises

BACKGROUND

We determined the effect of cold application after coronary artery bypass graft surgery on chest incision pain due to deep breathing and coughing exercises. Thoracotomy performed for coronary artery bypass graft surgery is one of the most painful surgical procedures. This pain prevents deep breathing and effective coughing. These problems increase the risk of morbidity in the postoperative period.

AIMS

This study aimed to determine the effect of cold application after CABG surgery on chest incision pain due to deep breathing and cough exercises.

DESIGN

Experimental study with control group and repeated measurements.

SETTINGS

Patients were selected through convenience sampling in the Cardiovascular Surgery Intensive Care Unit at a hospital.

PARTICIPANTS

The study was conducted with 57 patients who underwent open heart surgery (29 and 28 in the experimental and control groups, respectively).

METHODS

Repeated pain assessment was performed before, immediately after, and 5 min after deep breathing and coughing exercises performed in 4 periods at 2-h intervals. The first pain assessment was performed 24 h postoperatively. In the first and third assessments of the experimental group, pain was recorded before the exercise; the exercise was performed 15 min after cold gel pack application to the incision area. Pain was assessed before, immediately after, and 5 min after exercise using the Short- Form McGill Melzack Pain Questionnaire.

RESULTS

Reduction in pain severity within and between the groups was statistically significant in the first and third evaluations (p = .001).

CONCLUSIONS

The results provide evidence to support the use of cold gel pack.

Can initial lactate levels predict the severity of unintentional carbon monoxide poisoning?

Introduction:

Accidental carbon monoxide (CO) intoxication is a major cause of unintentional poisoning. This study aimed to determine the value of initial lactate levels in patients with CO poisoning and to evaluate its utilization in the emergency department (ED).

Methods:

A retrospective cross-sectional study was carried out among patients with CO intoxication, who were admitted to the ED between April 1, 2011 and April 1, 2012. The study data were extracted from a hospital database system using International Classification of Diseases-10 diagnosis codes. The patients were analyzed according to lactate levels, carboxyhemoglobin (COHb) levels, electrocardiographic manifestations, and clinical features at admission to the ED.

Results:

A total of 74 patients with CO poisoning were enrolled in this study. The average COHb value of the patients was 21.5 ± 13.9%. A total of 50 patients (67.6%) received normobaric oxygen treatment and 24 patients (32.4%) received hyperbaric oxygen (HBO) treatment. The patients who received HBO treatment had increased lactate levels compared with patients receiving normobaric oxygen treatment (2.3 mmol/L vs. 1.0 mmol/L, p < 0.001). The lactate levels were positively correlated with COHb values ( r = 0.738, p < 0.001). We determined that a lactate level of 1.85 mmol/L has a sensitivity of 70.8% and a specificity of 78.0% to predict the HBO treatment needed in CO poisoning.

Conclusion:

In evaluating patients with CO poisoning, an initial lactate level could be taken into consideration as an adjunctive parameter of severity, together with the clinical criteria and levels of COHb.