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Öğe Are Nurses Willing to Provide Care to Obese Surgical Patients?(Mary Ann Liebert, Inc, 2017) Ugras, Gulay Altun; Yuksel, Serpil; Erer, Meryem Turkan Isik; Kettas, Elife; Randa, SerapObjectives: The aim of this study was to identify the willingness of nurses working in surgical units to provide care to obese surgical patients and related factors. Methods: This descriptive study was conducted with 250 nurses from surgical units of the 3 hospitals. Data analysis was performed by using frequency, percentage, mean, standard deviation, and chi-square test. Results: It was found that 85.6% of nurses were unwilling to provide care to obese surgical patients. The reasons of nurses' unwillingness to provide care included back/low-back pain, fears of dropping the patient, and inability to meet patients' care needs. It was determined that the intensive care nurses, who provided care to one to three patients a month, who were untrained in obese patient care, who worked with inadequate staff during nursing care procedures, and those who experienced emotional problems during care delivery were unwilling to provide caring. It was also found that most of the equipment required for obese patient care was unsuitable for caring. Conclusion: The findings of this study demonstrated that nurses were unwilling to provide care to obese surgical patients. The unwillingness was mostly caused by certain clinical features, nurses' emotional problems during care delivery, lack of necessary equipment, and inadequate staffing.Öğe Effect of abdominal massage on bowel evacuation in neurosurgical intensive care patients(Wiley, 2022) Ugras, Gulay Altun; Yuksel, Serpil; Isik, Meryem Turkan; Tasdelen, Bahar; Dogan, Havva; Mutluay, OzumBackground: There are many factors, which affect the bowel evacuation of neurosurgical intensive care unit (NICU) patients, resulting in constipation. Aim and objectives: The aim of this study was to investigate effect of abdominal massage on bowel evacuation and the risk of constipation in NICU patients. Design: A prospective, randomized-controlled clinical trial. Methods: The sample of this study included 80 NICU patients. The patients were randomly assigned to abdominal massage and control groups. The constipation risk of all the patients was assessed with Constipation Risk Assessment Scale (CRAS). The patients in the abdominal massage group received a total of 30 minutes of massage, 15 minutes every morning and evening, until the first defecation. The bowel sounds of all patients in the abdominal massage and control groups were assessed on a daily basis. The days when bowel sounds were heard and the first defecation took place were recorded in a Bowel Evacuation Form. Results: The risk of constipation was higher in the patients in the abdominal massage (CRAS score 19.02 +/- 1.81) and control groups (CRAS score 20.45 +/- 2.61). The time of return of bowel sounds and the time of the first defecation were earlier in the abdominal massage group, compared to the control group (P <.05). In the control group, there was a weak correlation (P =.004) between the CRAS score and the time of return of bowel sounds, while there was a moderate correlation between the CRAS score and the time of the first defecation (P <.001). Conclusion: Our study results show that the risk of constipation is high in NICU patients, and abdominal massage is an effective nursing intervention to shorten the time of return of bowel sounds and the time of the first defecation. Relevance to clinical practice: Nurses can safely apply abdominal massage to improve bowel evacuation in NICU patients.Öğe The Effect of Cuff Size on Blood Pressure Measurement in Obese Surgical Patients: A Prospective Crossover Clinical Trial(Istanbul Univ-Cerrahpasa, 2020) Yuksel, Serpil; Ugras, Gulay Altun; Altinok, Nurhan; Demir, NeclaAim:This study aimed to determine the effect of a cuff properly sized for mid-upperarm circumference on blood pressure measurement in obese surgical patients. Method: This prospective crossover clinical trial was conducted with 100 patients who had body mass index >= 30 kg/m(2) and mid-upper arm circumference >= 27 cm and were admitted to the general surgery unit of a medical faculty hospital in Istanbul, Turkey between January 1, 2015, and December 31, 2015. Blood pressure of the patients was measured using a small-sized adult cuff and a cuff properly sized for mid-upper arm circumference. Results: Among the patients, 39% were morbidly obese and 67% had mid-upper arm circumference between 35 and 44 cm. Systolic blood pressure of the patients with a small adult cuff was 20.78 mmHg higher than that obtained with a cuff properly sized for mid-upper arm circumference, and their diastolic blood pressure was 10.15 mmHg higher on average (p<0.001). Only 6% of those with systolic hypertension according to the small adult cuff readings were found to have hypertension according to the cuff properly sized for mid-upper arm circumference (p<0.001). Conclusion: The results showed that, in obese surgical patients, blood pressure is measured inaccurately and found to be falsely high when measurements are not performed using a cuff properly sized for mid-upper arm circumference.Öğe The effect of different types of music on patients' preoperative anxiety: A randomized controlled trial(Elsevier Sci Ltd, 2018) Ugras, Gulay Altun; Yildirim, Guven; Yuksel, Serpil; Ozturkcu, Yusuf; Kuzdere, Mustafa; Oztekin, Seher DenizObjective: The purpose of this study was to determine effect of three different types of music on patients' preoperative anxiety. Method: This randomized controlled trial included 180 patients who were randomly divided into four groups. While the control group didn't listen to music, the experimental groups respectively listened to natural sounds, Classical Turkish or Western Music for 30 min. The State Anxiety Inventory (STAI-S), systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR) and cortisol levels were checked. Findings: The post-music STAI-S, SBP, DBP, HR and cortisol levels of the patients in music groups were significantly lower than pre-music time. All types of music decreased STAI-S, SBP, and cortisol levels; additionally natural sounds reduced DBP; Classical Turkish Music also decreased DBP, and HR. Conclusions: All types of music had an effect on reducing patients' preoperative anxiety, and listening to Classical Turkish Music was particularly the most effective one. (C) 2018 Elsevier Ltd. All rights reserved.Öğe The effects of different degrees of head-of-bed elevation on the respiratory pattern and drainage following thyroidectomy: a randomized controlled trial(Makerere Univ, Fac Med, 2020) Yuksel, Serpil; Oztekin, Seher Deniz; Temiz, Zeynep; Ugras, Gulay Altun; Sengul, Emel; Teksoz, Serkan; Sunal, NihalBackground: The patient's position is important for ensuring patient comfort and preventing complications after thyroidectomy. Objectives: This study was carried out to determine the effects of different degrees of head-of-bed elevation (HOBE) on the respiratory pattern and drainage following thyroidectomy and to provide suggestions for evidence-based clinical practice. Methods: The sample of this prospective, parallel arm, randomized controlled trial included 114 patients undergoing thyroidectomy in a university hospital in Turkey. The patients were randomly assigned (1:1:1) to supine 0 degrees (baseline), 30 degrees and 45 degrees HOBE groups. Respiratory pattern including respiratory rate (RR), peripheral oxygen saturation (SpO(2)) and dyspnea, and drainage including amount of drainage and hematoma formation were evaluated at the 1st, 2nd, 3rd and 4th hours following thyroidectomy. Results: The majority of the patients (83.3%) were female and 84.2% had undergone total thyroidectomy. The mean RR (18.47, 95% CI=17.85-19.09) of the patients in the supine 30 degrees HOBE group at the 1st hour was significantly higher than that of the patients in the supine 0 degrees group (17.32, 95% CI=16.88-17.76; p<0.05). There was no significant difference between the SpO 2 values of the patients in the groups (p>0.05). The amount of drainage was significantly higher in the supine 0 degrees group at the 2nd hour than that of the patients in the supine 45 degrees HOBE group (5.92 +/- 5.18; 3.34 +/- 5.56 respectively; p <0.05). None of the patients in the groups had hematoma formation. While no patient in the supine 30 degrees HOBE group had dyspnea, dyspnea occurred in 9 patients in the supine 0 degrees group and in 3 patients in the supine 45 degrees HOBE group. Conclusion: This study showed that different HOBE positions resulted in clinically insignificant changes on the RR and amount of drainage during the first 4 hours following thyroidectomy but did not affect SpO(2) value.Öğe Effects of Different Head-of-Bed Elevations and Body Positions on Intracranial Pressure and Cerebral Perfusion Pressure in Neurosurgical Patients(Lippincott Williams & Wilkins, 2018) Ugras, Gulay Altun; Yuksel, Serpil; Temiz, Zeynep; Eroglu, Selin; Sirin, Keziban; Turan, YukselPurpose: The aim of this study was to evaluate the effects of different head of bed (HOB) elevations and body positions on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) and to identify safe positions for neurosurgical patients with different Glasgow Coma Scale (GCS) scores. Methods: This study with a quasi-experimental, prospective repeated measures is designed with control over the intervention consisted of 30 patients hospitalized in the neurocritical care units (NCU). Patients' HOB was elevated (degree of 15,30,45) and the patients were at supine, left lateral and right lateral positions. ICP and CPP were recorded for each patient. Results: It was found that ICP increased and CPP decreased at supine, left and right lateral positions with different HOB elevations, which, however, did not reach statistical significance. When patients with a GCS score of 3-8 were at degree of 15 right and left lateral positions and 45 right lateral position; and when patients with a GCS score of 13-15 were positioned at degree of 15 left lateral, ICP and CPP changed significantly. Conclusion: The results of this study showed that different positions the patients' HOB (degree of 15,30,45) led to slight insignificant changes in ICP and CPP; and these values were maintained within the ranges established by recent guidelines.Öğe Health Problems and Reasons for Stress of Intensive Care Nurses During COVID-19(Aves, 2022) Ugras, Gulay Altun; Yuksel, Serpil; Dolek, Elife Kettas; Erden, Sevilay; Sirin, KezibanAIM: This study aimed to examine health problems and related reasons for stress including physiological, psychological, and patient-care-related stressors among intensive care unit (ICU) nurses during COVID-19 in Turkey. METHOD: This study was designed as a cross-sectional study. Data were collected between June and July 2020 and from 1140 ICU nurses who were actively working in the pandemic process from 65 provinces in Turkey. An online questionnaire was used consisting of questions regarding nurses' health problems, reasons for psychological, physiological, and patient care-related stress during the pandemic. Descriptive data were presented in mean, median, or number and percentage. RESULTS: Only 15.6% of ICU nurses experienced health problems. Nurses had psychological symptoms such as anxiety, insomnia, and physiological symptoms such as respiratory, musculoskeletal symptoms. The majority of nurses experienced the following psychological stressors: fear of being a COVID-19 carrier and infecting loved ones, and getting sick with COVID-19. Reasons for physiological stress were mostly due to working with personal protective equipment (PPE), skipping toilet breaks, and inadequate hydration. Reasons for patient care-related stress included excessive sweating in PPE, fogging of goggles, and inability to select a venipuncture site with double gloves. CONCLUSION: The findings of this study indicate that almost one-fifth of ICU nurses experience various health problems although most of them experience intense psychological, physiological, and patient care-related stress.Öğe A Risk Assessment Comparison of Breast Cancer and Factors Affected to Risk Perception of Women in Turkey: A Cross-sectional Study(Iranian Scientific Society Medical Entomology, 2017) Yuksel, Serpil; Altun Ugras, Gulay; Cavdar, Ikbal; Bozdogan, Atilla; Ozkan Gurdal, Sibel; Akyolcu, Neriman; Esencan, EcemBackground: The increase in breast cancer incidence has enhanced attention towards breast cancer risk. The aim of this study was to determine the risk of breast cancer and risk perception of women, factors that affect risk perception, and to determine differences between absolute risk and the perception of risk. Methods: This cross-sectional study was carried out among 346 women whose score in the Gail Risk Model (GRM) was >= 1.67% and/or had a 1(st) degree relative with breast cancer in Bahcesehir town in Istanbul, Turkey between Jul 2012 and Dec 2012. Data were collected through face-to-face interviews. The level of risk for breast cancer has been calculated using GRM and the Breast Cancer Risk Assessment Form (BCRAF). Breast cancer risk perception (BCRP), has been evaluated by visual analogue 100-cm-long scale. Results: Even though 39.6% of the women considered themselves as high-risk carriers, according to the GRM and the BCRAF, only 11.6% and 9.8% of women were in the high risk category, respectively. There was a positive significant correlation between the GRM and the BCRAF scores (P<0.001), and the BCRAF and BCRP scores (P<0.001). Factors related to high-risk perception were age (40-59 yr), post-menopausal phase, high-very high economic income level, existence of breast cancer in the family, having regular breast self-examination and clinical breast examination (P<0.05). Conclusion: In women with high risk of breast, cancer there is a significant difference between the women's risk perception and their absolute risk level.
