Eastern Michigan University, USA
Breast Cancer-Related Lymphedema (BCRLE) is an incurable condition that causes varied degrees of chest, arm and/or hand swelling, pain, limb deformity, and physical immobility and patients are at risk for the development of this dreaded condition for their lifetime. Studies embracing these topics in the healthcare literature are scant. This study is to describe and understand the differences and similarities between races and among members of the same race living with the experience of BCRLE. A mixed-method utilizing both qualitative and quantitative methodologies were used. Over a ten-month period, a total 14 out of 25 participants completed both the interview and questionnaire sections of the study. Descriptive analysis of data involved participant responses to the following surveys: Patient-Doctor-Relationship Questionnaire (PDRQ-9) (Farin, Gramm, & Schmidt 2013), Group-Based Medical Mistrust Scale (GBMMS) (Thompson et al, 2004), and The Patient Perceptions of Integrated Care Survey (PPICS) (Singer, Friedberg, Klang, Dunn, & Kuhn, 2013). The study findings concurred with the argument that patients have significant global factors that contribute to distrust of physicians and other health care providers. These concerns should be considered in clinical practice to facilitate trust and improve the provision of health care to patients. In general, study participants proposed that healthcare providers were unconcerned and/or uniformed about BCRLE. Those perceived behaviors also seemed to contribute to feelings of distrust and amplify perceptions of feelings of rejection, unconcern, uncompassionate and unsupportive attitudes on the part of some healthcare providers. In-depth interviews were completed, audio taped, and transcribed. Five themes were intuited: (a) unconcerned/ uninformed healthcare providers; (b) mistrust of physicians; (c) communication barriers; (d) educational preparedness, and (e) use of support groups. The findings from this study may be used to help healthcare providers examine the long-term psychological and psychosocial effects of BCRLE on the survivorship of women.
Dr. Deborah Collins-Bohler, Assistant Professor at Eastern Michigan University, graduated from Wayne State Universityand holds a Post-Masterʼs Graduate Certificate in Gerontology. Bohlerʼs extensive clinical background includes: Community/Public Health program planning and design, healthcare administration in Hospice and Home Health Care, Geriatric Rehabilitation, Retirement Disability, Workers Compensation; Auto/No Fault; Catastrophic Case Management, and Occupational Health Nursing. Bohler has taught undergraduate and graduate nursing courses at several universities.
Karabuk University, Turkey
This research was conducted in order to evaluate the pain in the abdomen and arm region and hematoma and discoloration differences in patients to whom applied heparin.
This study was carried out on Chest Diseases clinic. The number of samples was determined as 60 people at a confidence interval of 92% with random tables. The data was collected by “Patient Identification Form”, “Visual Pain Scale”, “Patient Monitoring and Pain Assessment Form”. In the evaluation of the data numbers, percentages, and averages were calculated for descriptive analyses. In comparative analyses, Chi-square, Kruskal Wallis, Friedman, and Mann Whitney tests were used. The results were evaluated at the 0.05 significance level.
Subjects were divided into equal groups according to gender and body weight. Of those who were surveyed; their average age is 70.3, 66.7% of them were married, 60% of them were primary school graduates, 55% of them in the first 4 days of heparin usage, it was found that from previous applications 76.7% of them had local complications in the right and left arm. In the first 48 hours and first 72 hours hematoma development in arm region was found to be % 87,82 and colour change was found to be %51,67, hematoma development in the abdominal region was found to be %33,35 and colour change was found to be %15,8.
Hematoma development in normal weight according to body mass index in first 48 hours right arm (Chi-square=11,882;p=0,001) and left arm (Chi-square=8,523;p=0,004) It was found a significant difference in all regions in the first 72 hours (p=0,000). A significant correlation was found between the pain levels in all regions after the first and second injections (F=193,058;p=0,000). No pain was observed in both areas before injection.
In the study it was found that complications were encountered more frequently in the arm region than in the abdominal region and according to the body mass index it showed a significant difference. As a result, it was concluded that the abdominal region should be preferred in the first place.
Keywords: Pain, Hematoma, Colour Change, Subkutan Heparin Application
Yadigar ORDU was born in Giresun in 1991 and she completed her primary and secondary education in the same city. After graduating from Giresun High School, she entered ÇankırıKaratekin University School of Health Nursing Department in 2009. After graduating with a “honour” degree in 2013, he started to work as a nurse at Çankırı State Hospital Surgical Service. Currently; she continues her graduate program study at Karabük University Institute of Health Sciences, Nursing Science Department from the year 2015.
Koç University, Turkey
The aim of this study was to evaluate the perception of patient safety culture among nurses working in public versus private hospitals.
This descriptive and comparative research study was conducted among nurses working in public and private hospitals which are related to Health Ministry in Istanbul between March and May 2016. A total of 274 volunteer nurses who had worked at least 1 year and having completed orientation training participated in this study. The research data were collected with using a questionnaire containing demographic characteristics prepared by researchers and “Patient Safety Culture Scale” which is prepared by Turkmen et al. in 2011. The data has been analysed at 95% confidence intervals and 5% significance level in SPSS-22 software programme. Descriptive statistics was done while evaluating data variables using frequency, percentage, t-test, Mann Whitney U test, One Way ANOVA and Kruskal Wallis tests.
As a result of findings related to patient safety, it has found that 95.6% of nurses had completed their training. The highest mean score obtained from the scale as lower size “Training of employees” was been found to be 3.00 ± 0.44. According to the results of our study, the number of patients seen in daily and weekly working hours increase represents that the negative impact on patient safety. It is determinated that the nurses who are satisfied with their professions and sections have higher points than the nurses who had average score of patient safety. A significant difference was found between hospitals in terms of patient safety culture. It is recommended that making more comparisons between institutions for patient safety culture, lacking or need of improvement areas should be done in the field of study.
Keywords: Patient Safety, Patient Safety Culture, Nurse, Nursing Services
Jordanian Expert Team for Training & Consultation, Jordon
Nursing is considered as one of the most stressful professions, due to work in a fast-paced work environment. Literature was reviewed for the related keywords from 2008 to 2015. Most of the studies in the nursing literature focused on stress response, work-related stressors, and the effects of stress. Lesser studies discussed stress management and stress reduction techniques. Stress response mechanism was explained by Hans Selye through “GAS Model”. It was clear that stress has negative consequences on physical, behavioral, psychological and emotional aspects of nursesʼ health. As a result, nurses with chronic stress have had more sick leaves, absenteeism, lower job satisfaction, lower productivity, and higher turnover. Therefore, patientsʼ safety and quality of care will be threatened. Preventive measures included managing staffing ratios, modification of workload, clear job descriptions, open-communication channels, involving nurses in decision-making, high-performance rewards, balancing break times with working hours. Providing relaxation, massage and music therapy was suggested as well. In times when work-related stressors are inevitable, coping strategies are recommended. Time management skills, early preparation and checking prior to procedures and operations, improving staff own knowledge and brain-storming skills have formed literature-supported strategies. As proved in the Noble Qurʼan, Spiritual practices and religiousness such as prayer provide an invaluable, great support to believers. Physical exercise, Meditation, Yoga, Aromatherapy, Massage Therapy and other relaxation techniques were suggested with suitable Gyms and Spa. In conclusion, organizations and institutions need to involve nurses in stress prevention and management programs and initiatives. Nursing managers and leaders are responsible of insuring the application of a holistic workplace improvement. Nurses are advised to balance their work-related demands with their personal and home issues. Therefore, a state of equilibrium to maintain nursesʼ physical and psychological well-being is realistically attainable.
Shahrazad Ghuzlaan is a Nurse Trainerat JET. Prior to working at JET, Ghuzlaan worked as a CRNatSFH-Saudi Arabia, and as an RN atKHCCJordan. Ghuzlaan graduated in 2008 from JUST, honored by the president of JNCfor being the first among her batch. Ghuzlaan achieved her Masterʼs degree in Critical Care Nursing in 2012, and worked for a total of 7 years in Nursing Education and Clinical Nursing, has one published article in SFH Nursing Magazine in 2015, has become a certifiedAHA-ACLS Instructor in 2016, and recently submitted a paper for publication.
Karabük University Turkey
It is stated that mobbing behaviors are encountered more common in health sector which is one of the service sectors where people have intensive relationship. It is reported that the professions of nursing and midwifery constitute group of employee that are riskier in comparison with other professions.
The study was carried out as a descriptive study to examine the psychological mobbing behaviors and their dimensions that nurses and midwives experience. The population which consists of 432 contributors (327 nurses, 105 midwives) who have been working as nurse and midwife at a state hospital for at least 6 months. The sample consisted of 235 contributors who have filled in the questionnaire in full. The data in the study was collected by “Information Form” and The Scale of Mobbing Behaviors”. The data were collected the contributors who received informed consent following ethics committee and institutional permission. Number, percent values, point averagesof the scales, ANOVA, Kruskal Wallis and Mann Whitney-U tests were used in order to evaluate of the data.
It was appointed that 10,2% of the contributors, that is only 24 contributors, exposed to mobbing behaviors at least once a week within last 6 months. The point average of the study group was determined as low with 1,53±0,43 (min=1; max=3,79)and it was seen that mobbing behaviors were not encountered much among this study group. Points in the sub dimensions were found low, too. No significant difference was found after comparing point averages of the scale and sub groups and the features of study group(p>0.05).
The ratio of the contributors who were stated that they were exposed to mobbing behaviors and scale point averages in the study was found low both for nurses and midwives.
Keywords: Nursing, midwifery, mobbing.