Relationship between altered taste and smell with malnutrition among hemodialysis patients

INTRODUCTION

Alterations in taste and smell are among the most distressing symptoms experienced by haemodialysis patients. There is limited research on the relationship between these two symptoms and malnutrition in haemodialysis patients. This study aimed to investigate alterations in taste and smell in hemodialysis patients and their relationship with malnutrition.

METHODS

This cross-sectional study was carried out with 149 hemodialysis patients at the dialysis centers of three state hospitals. The Taste and Smell Dysfunction Questionnaire was used to assess the changes in patients' taste and smell, and the Prognostic Nutritional Index (PNI), as well as the Controlling Nutritional Status (CONUT) tool, were utilized to evaluate their nutritional status.

FINDINGS

A substantial percentage (45.6%) of patients reported an altered sense of smell, and 40.2% reported an altered sense of taste. The aspect of taste that was most abnormal was bitterness (46.7%); 53.0% of the patients were at moderate risk of malnutrition by PNI score, and 14.8% were categorized as malnourished by CONUT score. Malnutrition was related to dialysis vintage: a 1-year increase in vintage was associated with an increased risk of malnutrition (OR: 1.17, 95% CI 1.02-1.32, p < 0.001). Altered taste was associated with malnutrition: one-unit increase in the standard deviation of the taste subdimension score was associated with a relative risk of malnutrition (OR: 6.89, 95% CI 1.67-28.39, p < 0.001). A one-unit increase in the standard deviation of the smell subdimension was associated with relative risk of malnutrition (OR: 1.35, 95% CI 1.10-1.64, p < 0.001).

DISCUSSION

Malnutrition was found in a significantpercentage of hemodialysis patients. Altered taste and smell and the durationof dialysis treatment were significantly associated with malnutrition scores It isrecommended that healthcare professionals regularly assess alterations in tasteand smell in hemodialysis patients, as these alterations may be associated withmalnutrition, and manage these alterations accordingly.

Nursing Students' Operating Room Experiences: A Qualitative Meta-Synthesis

PURPOSE

Missed nursing care is a condition that is likely to be encountered frequently in the surgical care process and is generally related to the educational and emotional needs of the patients. Perception of and witnessing missed care can affect nursing images, expectations, and experiences by causing nursing students to experience professional disappointment. The purpose of the study was to explore nursing students' perception of missed perioperative nursing care according to "role theory" and Benner's "novice to expert" theories.

METHODS

The study used a qualitative design based on Heidegger's hermeneutical phenomenological approach. Study data were collected using a semistructured interview form prepared by the researchers through face-to-face interviews lasting approximately 50 minutes. The analysis of the data was conducted using van Manen's thematic analysis. The Standards for Reporting Qualitative Research (SRQR) checklist was used in reporting the study.

RESULTS

This study, which was conducted to explore awareness of perioperative missed nursing care (PMNC), consisted of 12 students, including five males and seven females. Nursing students who noticed PMNC in clinical practice experienced internal conflict about the issue, were concerned about the image of nursing, and experienced role and professional identity confusion. The themes of the study were formed in light of these experiences of nursing students. Three themes and 11 subthemes emerged in the study. The themes of the study were (1) perceived PMNC applications-behavior patterns (2) internal reflections of PMNC-its impact on professional identity development and (3) perceptions of professionalism in perioperative nursing CONCLUSIONS: This study provided important data about the awareness of PMNC in the surgical clinical practice of nursing students in Turkey and the effects of this awareness on the professional roles and professional identity process. Students were aware of the behavioral patterns of PMNC and experienced internal conflict, anxiety about the nursing image, role confusion, and professional identity confusion due to this awareness. Some students justified the PMNC behaviors of the nurses and others saw themselves as the power to change the PMNC behaviors.

Nursing Students' Perception of Missed Perioperative Nursing Care: Hermeneutic Phenomenology

PURPOSE

Missed nursing care is a condition that is likely to be encountered frequently in the surgical care process and is generally related to the educational and emotional needs of the patients. Perception of and witnessing missed care can affect nursing images, expectations, and experiences by causing nursing students to experience professional disappointment. The purpose of the study was to explore nursing students' perception of perioperative missed nursing care (PMNC) according to "role theory" and Benner's "novice to expert" theories.

DESIGN

The study used a qualitative design based on Heidegger's hermeneutical phenomenological approach.

METHODS

Study data were collected using a semistructured interview form prepared by the researchers through face-to-face interviews lasting approximately 50 minutes. The analysis of the data was conducted using van Manen's thematic analysis. The Standards for Reporting Qualitative Research checklist was used in reporting the study.

FINDINGS

This study, which was conducted to explore awareness of PMNC, consisted of 12 students, including five males and seven females. It was understood that nursing students noticed PMNC in clinical practice, experienced internal conflict about the issue, were concerned about the image of nursing, and experienced role and professional identity confusion. The themes of the study were formed in light of these experiences of nursing students. Three themes and 11 subthemes emerged in the study. The themes of the study were (1) perceived PMNC application-behavior patterns, (2) internal reflections of PMNC-its impact on professional identity development, and (3) perceptions of professionalism in perioperative nursing.

CONCLUSIONS

This study provided important data about the awareness of PMNC in the surgical clinical practice of nursing students in Turkey and the effects of this awareness on the professional roles and professional identity process. Students were aware of the behavioral patterns of PMNC and that they experienced internal conflict, anxiety about the nursing image, role confusion, and professional identity confusion due to this awareness. Some students justified the PMNC behaviors of the nurses and others saw themselves as the power to change the PMNC behaviors.

Dyadic adjustment and the relationship between sexual self-consciousness and sexual dysfunction in individuals with spinal cord injuries: A descriptive study

PURPOSE

This study was conducted to determine the dyadic adjustment between individuals with SCI and their spouses and the relationship between their sexual self-consciousness and sexual life and to evaluate it according to the objectification theory.

METHOD

This descriptive and cross-sectional study was conducted with 131 married individuals with SCI registered in the physical therapy and rehabilitation outpatient clinic of a university hospital between February 2020 and April 2021. The data of the study were collected using a Descriptive Information Form, the American Spinal Injury Association Impairment Scale (ASIA), the Dyadic Adjustment Scale (DAS), the Sexual Self-Consciousness Scale (SSCS), and the Arizona Sexual Experiences Scale (ASEX). In the study, the predictors of the sexual life of individuals with SCI were evaluated with the Stepwise Multiple Linear Regression analysis. In addition, predictors of sexual dysfunction in individuals with SCI were evaluated by the logistic regression analysis. The results were discussed within the framework of objectification theory.

RESULTS

According to the results of the study, .67.2% of the individuals with spinal cord injuries experienced sexual functionality problems; increased age, falling injuries, and being in ASIA grade A increased sexual self-awareness and sexual dysfunction; and being a male with SCI increased sexual focus. It was found that the adjustment between individuals with SCI and their spouses was a predictor that significantly reduced sexual embarrassment, sexual self-consciousness, and sexual dysfunction and that the strong adjustment between couples was an important factor for the prevention of sexual dysfunction development.

CONCLUSION

It was found that most individuals with spinal cord injuries experienced sexual dysfunction. The importance of dyadic adjustment and sexual self-consciousness has come to the fore in the sexual life of these individuals.

Experiences of nurses providing care for patients with COVID-19 in acute care settings in the early stages of the pandemic: A thematic meta-synthesis study

AIM

The aim of this work is to synthesize and interpret qualitative research examining the experiences of nurses providing care for patients with COVID-19 in acute care settings in the early stages of the pandemic in different countries.

BACKGROUND

The prevalence of disasters, including the pandemic, is increasing globally. It is important to understand nurses' experiences in depth to effectively manage extraordinary events that may occur in the future.

DESIGN

This is a thematic meta-synthesis study.

METHODS

Electronic databases, including CINAHL, MEDLINE, PubMed, Web of Science, OVID, and Scopus, were searched for publications from December 2019 to October 2020. The search was updated for publications to 30 May 2022. The thematic synthesis method was used to analyse and interpret the data.

FINDINGS

The experiences of the nurses giving care to patients with COVID-19 were grouped under four themes: (1) Difficulties encountered in the care of patients with COVID-19; (2) mixed emotions experienced in the care of patients with COVID-19; (3) coping strategies that nurses used in the management of the pandemic; (4) the benefits of the COVID-19 to nurses.

CONCLUSION

Nurses faced many difficulties and experienced mixed emotions while providing care for patients with coronavirus disease. Perceived social support was seen as the most important strategy for coping with these difficult situations. It is important to be aware of the difficulties and emotions experienced by nurses and support them during the COVID-19 pandemic for the management of future pandemics.

The Effect of Modified Epley Maneuver Implementation on the Anxiety and Comfort Levels of Patients with Posterior Canal Bening Paroxysmal Positional Vertigo: A Prospective Study

To evaluate the effects of the modified Epley maneuver during Posterior Canal Benign Paroxysmal Positional Vertigo (BPPV) on patients' anxiety and comfort levels. The study, organized as a prospective, worked with 72 patients who were diagnosed with Posterior Canal BPPV through Dix-Hallpike maneuver. The data for the study was collected through Descriptive Characteristics Form, General Comfort Questionnaire Short Form, and Beck Anxiety Inventory. It was found that that 63.9% of the patients experienced average-level anxiety before the implementation of the Epley maneuver and received a total of 3.07 ± .37 (1-6) from the General Comfort Questionnaire. Before applying the modified Epley maneuver and I and IV When the score changes after the week were examined, it was determined that there was a statistically significant difference in all scale scores, as comfort levels increased, anxiety levels decreased. Anxiety was identified as the most important predictor of patients' comfort level before and after the implementation of the modified Epley maneuver. In light of these findings, it can be said that modified Epley maneuver can safely be used to increase the comfort of patients with Posterior Canal BPPV. Considering that patients with BPPV can consult to emergency rooms, family clinics along with polyclinics, it is recommended to organize regular trainings on BPPV and the implementation of the Epley maneuver. It is believed that evaluation of BPPV patients for their anxiety and offer support when needed is important for the prognosis and patients' comfort.

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.

The effect of inadequately conducted compulsory distance education on the professional identity development process from nursing students' perspective: A phenomenological qualitative study

PURPOSE

This study was conducted to explore the effect of inadequately conducted compulsory distance education on the professional identity (PI) development process from nursing students' perspective.

DESIGN AND METHODS

The study used a qualitative design based on Heidegger's hermeneutic phenomenological approach. The data were analyzed by using Van Manen's thematic analysis.

RESULTS

The themes of the study were: (1) an inadequate, compulsory, uncertain, and difficult experience, (2) negative impact on PI development.

PRACTICE IMPLICATIONS

It is important for educators to realize that the PI development of nursing students is affected during the distance education process. In this context, students can be included in clinical practice in small groups before graduation in addition to online learning in terms of PI development.

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.

"I Felt Alienated in the Operating Room": A Phenomenological Qualitative Study

PURPOSE

To investigate the clinical practice experiences of nursing students in the operating room and to evaluate these experiences in terms of professional socialization.

DESIGN

This study was designed as a qualitative study based on Heidegger's hermeneutic phenomenological approach.

METHODS

The study was conducted with second-year nursing students who attended the operating room (OR) as an observer for 10 hours as part of the Surgical Nursing course. The study data were collected with a semistructured interview form on the day following this restricted and limited experience. This form included items that questioned the students' experiences of how they perceived the clinical experience and how they were ultimately affected. The data were analyzed using van Manen's thematic analysis.

FINDINGS

The study was conducted with nine students, including four males and five females. The ages of the students ranged between 19 and 21 years. Two themes and seven subthemes were determined as a result of the data analysis. The themes of the study were (1) short and difficult experience and (2) very important for professional socialization.

CONCLUSIONS

The study provided important information about nursing students' experiences regarding the effect of OR practice on their professional socialization. It was understood that the students perceived OR practice as a short and difficult experience, felt worthless and alienated, and realized that there was no empathy in the OR. Additionally, they stated that the team members did their job very well and that they felt the importance of being the best. Moreover, they found OR practice important for guiding one's career goals, professional socialization, and gaining a professional identity.

The relationship between the fear of breast cancer, risk factors, and early diagnosis behaviors of women by age groups

PURPOSE

This study investigates the relationship between fear of breast cancer, risk factors, and early diagnosis behavior of women aged 20 or above.

METHOD

It is a descriptive cross-sectional study.

FINDINGS

It was found that 17.3% of the women conducted breast self-examination, 14.0% underwent clinical breast examination, and that 9.3% of them underwent mammography. The predictors regularly affecting early diagnosis behaviors were identified through logistic regression. Different predictors for breast cancer diagnostic behaviors were found in each age group.

PRACTICE IMPLICATIONS

This study is important in terms of taking into account the age factor in the practices aiming to increase the diagnostic behavior of healthcare personnel, especially nurses.

CONCLUSION

It was concluded that there were different predictors of breast cancer diagnostic behaviors in both age groups of the women in the study.

The Relationship between Malnutrition and Subjective Taste Change Experienced by Patients with Cancer Receiving Outpatient Chemotherapy Treatment

Taste changes and malnutrition are two important problems in patients with different types of cancer. This study was conducted to evaluate the relationship between malnutrition and subjective taste changes experienced by cancer patients receiving outpatient chemotherapy. The study used a cross-sectional design and was carried out with 1382 patients with cancer receiving outpatient chemotherapy. Of the patients, 63.1% experienced taste changes. It was determined that 8.8% of patients had malnutrition according to the Mini Nutritional Assessment. The mean scores of patients experiencing malnutrition and being at risk for malnutrition from all sub-dimensions of The Chemotherapy-induced Taste Alteration Scale (CiTAS) were found to be higher than the patient group evaluated to have normal nutrition. It was determined that a unit increase in the scores of the parageusia and phantogeusia subscales of the CiTAS increased the risk of malnutrition by 3.36 times (%95 CI= 2.68-4.02). In line with these results, we recommend that patients with cancer receiving chemotherapy should be routinely evaluated in terms of taste changes in clinical practice and that they should be followed up in terms of malnutrition in the presence of taste changes.

An evaluation of the factors that affect the sexual satisfaction of people with spinal cord injuries

Objective: To evaluate the relationships between the variables that affect the sexual satisfaction of patients with spinal cord injuries.Design: Descriptive and cross-sectional survey.Setting: The physical medicine and rehabilitation outpatient clinic of a university hospital in Turkey.Participants: This study was performed from July to December2018. It included 103 patients with spinal cord injuries.Outcome Measures: The data were collected using an introductory information form, the American Spinal Injury Association Impairment Scale and the Golombok Rust Inventory of Sexual Satisfaction. Data were evaluated using the chi-square test, the Mann-Whitney U test, the Kruskal-Wallis test and linear regression.Results: The total mean scores on the Golombok Rust Inventory of Sexual Satisfaction were 40.2 ± 21.6 for males and 44.9 ± 18.1 for females. According to the linear regression analysis, model VII presented the best results of the relationship between physiological and psychological determinants that affect the sexual satisfaction of patients with spinal cord injuries. Model VII consisted of the variables of ASIA A and B scores, age, injury due to falling from height, being a housewife, and thinking of being unable to reach future goals. These explained 75.4% of the variation in sexual satisfaction scores.Conclusion: The participants' mean scores on the Golombok Rust Inventory of Sexual Satisfaction were found to be affected by various variables. A significant relationship between their mean scores on the American Spinal Injury Association (ASIA) Impairment Scale and the Golombok Rust Inventory of Sexual Satisfaction was determined.

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.

Caring behaviors, moral sensitivity, and emotional intelligence in intensive care nurses: A descriptive study

PURPOSE

To evaluate the relationship of caring behaviors with moral sensitivity, emotional intelligence and descriptive characteristics in intensive care nurses.

METHOD

Descriptive study. The sample of this study consisted of 156 nurses. The data were collected using introductory information form, caring behaviors inventory, moral sensitivity questionnaire, and emotional intelligence scale. The factors affecting caring behavior were determined using stepwise multiple linear regression.

FINDING

It was determined that high education level, working in shifts, as well as appraisal of emotion subscale of emotional intelligence scale and also autonomy, expressing benevolence, and following praxis subscales of moral sensitivity questionnaire were high predictors for caring behaviors.

PRACTICE IMPLICATIONS

Descriptive characteristics, moral sensitivity, and emotional intelligence are related to high caring behavior in intensive care nurses.

The effect of instructors' clinical experience on professional socialization from the perspective of nursing students: A phenomenological qualitative study

Nursing students spend efforts to be familiar with their professional roles and professional values and to understand professional behaviors, functions, and values correctly in clinical practices. First and second-year nursing students are in the early stages of professional socialization in clinical practice. In the third year, students start to reach a level at which they are aware of the professional behaviors of instructors in clinical practice in terms of professional socialization. This study aimed to determine how the effect of instructors on the professional socialization of students in clinical practice was perceived by the students. The study used a qualitative design based on Heidegger's hermeneutic phenomenological approach. First, the content of the questions in the interview form and the aim of the study were explained to the students, and then the interviews were conducted with 10 students who agreed to participate in face-to-face in-depth interviews. The data were analyzed using van Manen's thematic analysis and three themes and seven sub-themes were determined. The themes of the study were as follows: (1) It may make professional socialization easier or difficult (subthemes: "It is important to be aware of my presence"; "Unfair practices related to marks and threat with marks"), (2) Instructors' communication with nurses affects us (subthemes: "Positive atmosphere of care", "Acceptance in the clinic"), (3) I am aware of our instructors with clinical experience (subthemes: "Like someone in the clinic", "Role model with care behaviors", "Like carrying water in your palms"). In light of the results of this study, it has been understood that the clinical experience of the instructors is important. In addition, the importance of clinical experience in the employment of instructors has emerged.

Breast Cancer Perception Scale: Psychometric Development Study

Objective

The Breast Cancer Perception Scale was developed using a well-supported theory, thought to be associated with breast cancer prevention behaviors. The aim of this study is to develop the Breast Cancer Perception Scale based on the Health Belief Model and conduct psychometric analysis.

Materials and Methods

The study was conducted with women aged 20 or above with a methodological design. The scale study was conducted with 572 women who were not diagnosed with breast cancer and willing to participate in the study.

Results

The results of the exploratory factor analysis revealed that the scale is made up of six sub-dimensions (perceived knowledge, perceived treatment belief, the perceived need for a health check, perceived stigma, perceived fear, perceived risk) and 24 items, which explain the 74.36% of the total variance. The model obtained from the confirmatory factor analysis was within the limits of the acceptable fit index and factor loads between 0.655 and 0.998. Cronbach's alpha reliability coefficient of the scale sub-dimensions was determined as 0.815-0.950.

Conclusion

The overall psychometric evaluation results of the Breast Cancer Perception Scale found it to be a valid and reliable instrument that can be associated with multi-dimensional cases, such as healthy life behaviors in women, breast cancer diagnostic behaviors, family history, traumatic experiences regarding breast cancer, and the level of breast cancer knowledge.

The Effect of Postoperative Telephone Counseling on the Sexual Life of Patients With a Bowel Stoma: A Randomized Controlled Trial

Sexual problems following ileostomy or colostomy surgery are common.

PURPOSE

The purpose of this study was to determine the effect of telephone counseling on the sexual lives of individuals with a bowel stoma.

METHOD

Using a randomized, controlled, quasi-experimental study design, patients who were between 18 and 70 years old, had a sexual partner, and had undergone ileostomy or colostomy surgery were eligible to participate. Patients were randomized to telephone counseling as needed (intervention) or regular outpatient follow-up care only (control) for 12 weeks following surgery. Sociodemographic data were collected, and the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) was completed on admission for surgery and 6 and 12 weeks postoperatively. Data were analyzed using descriptive statistics and the Mann-Whitney U, Kruskal-Wallis, Friedman, Wilcoxon signed ranks, and chi-squared tests and Yates's correction for continuity.

RESULTS

Of the 70 participants (35 in each group), the average age of intervention group participants was 53.00 ± 11.18 years, and the average age of the control group was 50.74 ± 13.72 years; 19 (54.3%) in the intervention group and 18 (51.4%) in the control group were male. Neither the demographic data nor the GRISS scale scores were significantly different between groups at baseline. After discharge, patients in the intervention group called to receive counseling for their concerns regarding sexual life and challenges they experienced with their stoma an average of 3.57 ± 0.86 (range 2-5) times during the first 6 weeks and 6.52 ±.77 (range 5-8) times between weeks 6 and 12. Mean total and subscale GRISS scores improved significantly from 5.89 ± 1.33 to 7.33 ± 1.24 (P <.01).

CONCLUSION

In this study, telephone counseling was effective in improving the sexual lives of patients with a colon- or ileostoma 12 weeks after surgery.