GEVHER NESIBE JOURNAL OF MEDICAL AND HEALTH SCIENCES

Clinical Picture of The Breast Cancer-Related Lymphedema and Parkinson Disease in A Male Patient: A Case Report

Alper TUĞRAL — 2024-11-29

Objective: Breast cancer (BC) is the most common type of cancer seen in women globally. However, BC can also be seen in males. On the other hand, the possible link between cancer and Parkinson's Disease (PD) has been debated regarding the significant association between specific types of cancer and PD yet reports still need to be updated. Breast cancer-related lymphedema (BCRL) is one of the most common and fearsome chronic complications after BC treatment. Not only in the perspective of BCRL but also in PD, exercise and ongoing conservative physiotherapy are prerequisites for improving clinical outcomes. Therefore, we aimed to present a compact clinical picture of a male patient with BCRL and PD.

Case Description: The 67-year-old male patient was referred due to having BCRL in his left upper extremity in August 2018. He was diagnosed with BC and a modified radical mastectomy was performed in March 2015. BCRL has been evident after 21 sessions of chemotherapy and 16 sessions of radiotherapy in June 2016.

Conclusion: Results showed that kinesiophobia and affected functionality of upper extremities along with affected balance ability were evident. Due to exercise acting as a milestone in lymphedema treatment, potential barriers should be carefully evaluated to manage symptoms not only for BCRL but also for PD

Prediction of Pulmonary Function Test Values in COPD Patients Using Artificial Intelligence Architecture- Clinical Decision Support System

Filiz ÖZDEMİR — 2024-11-29

Objective: To develop a model that can predict pulmonary function test (PFT) values in individuals with chronic obstructive pulmonary disease (COPD) using an artificial neural network (ANN).

Method: Levenberg-Marquardt algorithm was used. For performance testing, the ANN was trained using the Mean Sequential Error (MSE) method. While age, sex etc. of the individual were input data, PFT value was output data. The data required to test this model were 29 patients diagnosed with COPD, aged between 40 and 70 years, who were referred to Malatya Training and Research Hospital Chest Diseases Polyclinic. A triple cross validation test was used to calculate the performance of the system. The performance parameter was determined using the accuracy parameter.

Results: A triple cross validation test was used to calculate performance of system. Accuracy parameter was used as performance parameter. In designed model, average success rates were determined for each PFT value and total average success rate was evaluated as 97.40%.

Conclusion: With this system PFT values can be easily determined. It is believed that the system will help in the management of dyspnoea, planning, creating an exercise treatment programme and maintaining quality of life.

Investigation of The Effect of Education Given to University Students Studying in The Field of Health and Taking Sign Language Courses on Their Attitudes Towards Hearing-Impaired Individuals

Nurten ALAN — 2024-11-29

Objective: This study was planned to determine the attitudes of the health students (n=30), who take sign language courses in the 2022-2023 Fall Semester, towards hearing-impaired individuals.

Materials and Methods: taking the Sign Language elective course at the Faculty of Nursing. Ethics committee and institution permission was obtained for the study. Data were collected using the Personal Introduction Form, the Attitude Scale Towards the Disabled, and the Emotional Self-Efficacy Scale.

Results: 90% of the participants are in the 20-22 age range, 67% are women, 93% are satisfied with their profession, very satisfied, and 30% have relatives with disabilities. Emotional Self-Efficacy Scale and Multidimensional Attitude towards Disabled Scale mean scores of the students after the education were at a better level than before the education (Emotional Self-Efficacy Scale=109.46, Disabled Attitude Scale=88.03) and statistically significant (Emotional Self-Efficacy Scale p= 0.009, Attitudes towards the Disabled Scale p= 0.001).

Conclusion: It is thought that sign language course increases positive attitudes and emotional self-efficacy in students towards disabled people. In our country, it is recommended to make arrangements to increase the awareness of students receiving health education in terms of knowledge, skills and competence, with practices that encourage academic and social participation in the use of sign language in universities.

Clinical Characteristics of Patients With Pressure Ulcers: A Cross-Sectional Analysis

Seda HAKYEMEZ — 2024-11-29

Objective: Pressure sores cause patients to lose their independence, social isolation, pain, decreased quality of life, prolonged hospitalization, increased health care costs, morbidity and mortality rates. Therefore, pressure ulcer rate is one of the important indicators of health care quality in health care institutions. The aim of this study was to evaluate the clinical characteristics of patients who were followed up for pressure sores in a training and research hospital between 2021 and 2022.

Materials and Methods: The study was designed as a retrospective cross-sectional study. Data were obtained from Clinical Pressure Ulcer Rate Data Collection forms. SPSS IBM Statistics 25 Program was used to analyze the patient data. Descriptive statistical methods (frequency, percentage, mean, median, minimum-maximum values) and Spearman correlation nonparametric analysis methods were used to analyze the data.

Results: The data of 264 patients were evaluated within the scope of the study. The majority of the patients (52,3%) were female, and the mean age of these patients was 70,78 years. The mean duration of hospitalization was 34,7 days, and 11,6% of these patients were diagnosed with Covid-19 and 10.2% with CVD (cerebrovascular diseases). The mean score of the Braden Risk Assessment Scale was 10,6, 16,3% of the patients recovered partially or completely, and 25,6% of the patients were exited.

Conclusion: Pressure sores occur mostly in the sacrum, shoulder, heel, auricle, gluteal region, trochanteric region, lower extremities and ischial region of inpatients. The most important care in the prevention of these wounds is frequent position changes and holistic care of the patient. The rate of pressure sores in hospitals is an indicator of nursing care quality and it is considered important to increase the quality of care.

Blood Transfusion Knowledge Levels of Emergency Department Workers and The Effect of Training

Uğur TAKTUK — 2024-11-29

Objective: This research was conducted to evaluate the knowledge level of emergency service personnel about blood transfusion and to determine the effect of the training given on this subject on their knowledge level.

Method: It was conducted as a planned quasi-experimental study to investigate the blood transfusion knowledge levels of non-physician health professionals working in the adult emergency department and the effect of the training provided on this situation. It was conducted with a total of 87 volunteers. Two surveys were used to collect data: "Individual Identity Form" and "Blood Transfusion Practices Survey”. The surveys used to collect data were collected online before and after the training.

Results: The average age of the participants was 27.87±3.87, 76.7% were women, 79.1% were university graduates, and 55.8% had professional experience between 1-3 years. The rate of blood transfusion practice in the emergency department was 76.7%, and 90.7% had blood transfusion training. The pretest knowledge average of the emergency service personnel was 53.31±17.73, and the posttest knowledge average was 84.59±12.35, and this difference was found to be statistically significant (p< 0.05).

Conclusion: It was determined that the knowledge of emergency medical personnel on blood and blood product transfusion increased after their training. This result shows the effectiveness of the planned blood transfusion training.

The Effect of Social Media Addiction on Depression Level in University Students

Hatice PEKİNCE — 2024-11-29

Objective: This study was conducted to determine the effect of social media addiction on the level of depression in university students

Method: A cross-sectional design was used to this study. The research was conducted between February and August 2020 with 824 university students. Data were collected by an information form, the Social Media Addiction Scale - Student Form and Beck Depression Scale in the study.

Results: It was determined that the students got 87.2±21.98 points from Social Media Addiction Scale and their addiction level was moderate, and they got 17.5±8.87 points from Beck Depression Scale and they were moderately depressed. It was determined that social media addiction is an important variable predicting the level of depression (R2: 35.5, p<0.001).

Conclusion: It has been determined that as students' social media addictions increase, their depression levels increase.

Bibliometric Analysis of Rheumatoid Arthritis Research Published in The Field of Nursing

Ayşenur ÇETİN ÜÇERİZ — 2024-11-29

Objective: This study aims to identify key trends and focal points in rheumatoid arthritis-related nursing research to enhance the quality of nursing care by informing future study planning in this area.
Materials and Methods: The data for the study were obtained from studies published between July 13, 2024, and July 16, 2024, in the Web of Science Core Collection database using the keywords "rheumatoid arthritis" and "nursing," and from studies with "research" and "review article" in the "nursing" category published between 2004-2024. The content analysis of 275 publications obtained in this context was performed with the VOSviewer program 1.6.19.
Results: Within the scope of the study, 2,376 publications in the Web of Science category constituted the universe of the study, and the study, which included 275 studies featuring the keywords "rheumatoid arthritis" and "nursing," constituted the sample of the study. Chen SH, Pietilä AM, Salt E, Shao JH, and Yu KH (n=5) found that the number of studies on the subject was the highest. When examined in terms of document type, the distribution was mostly "research" (n=239). In terms of publication years, the highest number of publications was in 2019 (n=21) and the least in 2017 (n=7). The publication language was mostly English (n=264). When evaluated in terms of countries, the United States of America (n=112) ranked first, while the number of publications was low in England (n=22) and Turkey (n=20). Considering the journals in which the studies were published, the "Journal of Clinical Nursing" (n=27) was found to be the journal with the most publications in this field. The most frequently used and linked keyword was "rheumatoid arthritis," and "Fatigue as experienced by patients with rheumatoid arthritis: A qualitative study" was part of the general survey on the subject. "The Effects of Aromatherapy Massage and Reflexology on Pain and Fatigue in Patients with Rheumatoid Arthritis: A Randomized Controlled Trial" was the most cited article in our country.
Conclusion: It has been determined that the studies on rheumatoid arthritis published in the field of nursing have not yet reached a sufficient level. It has been concluded that nurses should take an active role in order to carry out more evidence-based studies on the subject and to integrate the studies into the clinic.

Evaluation of Body-Body-Based Reconnect Integrative Trauma Therapy Model (RITTM®): Pilot Study

Yaşar Kubilay TANER — 2024-11-29

Objective: This study aimed to examine the meaning, experience and effects of Karol Darsa's Reconnect® Integrative Trauma Therapy Model (RITTM®) on individuals exposed to relational trauma through a pilot study.

Methods: The case study population consisted of 56 trainees who had recently started Integrative Psychotherapy Training. The data were obtained using the Adverse Childhood Events Turkish Form (ACE-TR) and Semi-structured Interview Form. The sample consisted of 3 participitant (2 female and 1 male) who gor high score from the ACE-TR and volunteer. These participants had the highest score on the ESRQ and were volunteers. The model was evaluated by applying a five-session RITTM® pilot application to the participants. The analytical pluralism approach was adopted in qualitative data analysis by using thematic and phenomenological analysis together.

Results: One of the participants was 34 years old, and the other two were 24 years old. The participants had a history of neglect (n=2), abuse (n=1), harassment (n=1) and domestic violence (n=2). As a result of the 5-week RITTM® implementation, two themes, five sub-themes and 32 codes related to these sub-themes were determined. (1) The theme of Overview of the RITTM® Model: Awareness, arousing curiosity and coping mechanisms. (2) Experiences Related to RITTM® Practices theme: Methods with positive and mixed results.

Conclusion: The RITTM® was differentiated from classical methods as a body-oriented therapy and provided safe access to trauma by direct contact with the body. It had positive effects on individuals experiencing relational trauma; participants gained awareness, learnt to calm their nervous systems and developed new coping strategies. Thus, they were able to control the problems that occupied their lives.

CD21 Ligands Provide Better Antibody Specific Response Than The Polyclonal Stimulation in mBCs Activation

Hande AKALAN — 2024-11-29

Objective: In this study, we evaluated if the CD21 activation through its free ligands can improve the in vitro assessment of antigen specific antibody response of mBCs.

Methods: Amongst five healthy voluenteer, a volunteer with the highest level of anti-tetanus toxoid IgG (anti TT-IgG) antibody was detected by Enzyme-Linked Immunosorbent Assay (ELISA). The volunteer’s peripheral blood mononuclear cells (PBMNCs) obtained by ficoll method were treated following conditions in vitro; in the group 1) the polyclonal stimulation and CD21 soluble ligands were applied, in the group 2) antigen-specific stimulation by tetanus toxoid (TT) and CD21 soluble ligands were applied, in the group 3) the CD21 soluble ligands C3d, iC3b and IFNα in addition to the polyclonal stimulation and antigen-specific stimulation by TT were applied. Anti-TT-IgG and total IgG antibody quantities were determined in culture supernatants at the end of the day-12 by ELISA.

Results: We found that total IgG antibody levels were higher in the 3th group where the soluble CD21 ligands added to the polyclonal stimulation and TT antigen. CD21 free ligand C3d was observed to increase specific antibody response together with TT antigen-specific stimulation. In addition, antigen-specific antibody responses were different depending on the CD21 free ligands.

Conclusion: Antigen specific stimulation in combination with C3d provided stronger specific antibody responses than polyclonal stimulation. Our data indicate that CD21 free ligands may have a potential in determining specific antibody responses.

Surgical Intervention and Management of Nursing Care in Paediatric Patients with DiGeorge Syndrome

Aydın NART — 2024-11-29

DiGeorge Syndrome (22q11.2 deletion syndrome) is a genetic disorder affecting multiple organ systems including cardiovascular anomalies, immune deficiencies and developmental delays. Surgical interventions, especially cardiac surgeries, are frequently required in paediatric patients with this syndrome and the importance of a multidisciplinary approach in these processes emerges. In this article, the management of surgical processes in children with DiGeorge Syndrome and the role of nursing care in these processes were examined. The article focuses on critical care areas such as nutrition, immune prophylaxis and infection risk management, as well as the roles of nurses before and after surgery. In addition, the monitoring of complications that may develop due to the characteristics of the syndrome and proactive nursing interventions for these complications are detailed. It is emphasised that nurses, as part of the multidisciplinary team, have a critical role to improve the quality of life of patients and their families, prevent complications and optimise the treatment process. In conclusion, adopting a multidisciplinary approach in the surgical interventions and care processes of paediatric patients with DiGeorge Syndrome is vital in improving patient outcomes and reducing the risk of complications.

Ethical Issues Encountered By Nurses and Their Relationship With Stress: A Systematic Review

Şeyma DİLMEN — 2024-11-29

Objective: The main purpose of this study is to highlight the ethical problems faced by nurses in health services without any time constraints and to inform clinical nurses and researchers, especially manager nurses, administrative units, by examining their relationship with stress and to contribute to the literature.

Methods: The systematic review method was used in the study. There was no time restriction when scanning the literature, and it was searched in Web of Science, Scopus and Pubmed databases within the abstract, keyword and study name ("ethic^* issues" OR "ethic^* problems" OR "ethic^* distress" OR "moral problems". The search was carried out with the keywords "OR "moral distress") AND ("stress") AND ("nurs*") between 9-31 July 2024. Screening and selection of articles PRISMA (Preferred Reporting Items for Systematic review and Meta-Analysis Protocols 10 articles were included in the review. Article selection and quality assessment processes were carried out independently by two authors, and it was determined that there was a statistically significant and significant level of agreement between the authors.

Results: A total of 10 articles were reviewed in accordance with the inclusion and exclusion criteria. In the studies examined, it was determined that the ethical problems that most increased the stress level of nurses were "lack of personnel and resources", "workload", "working with unethical and incompetent colleagues" and "patient density". Among the results is that the "social stigma" problem has been added to the ethical problems affecting the stress level with the COVID-19 pandemic.

Conclusion: According to the results of the study; ethical problems encountered by nurses negatively affect their stress levels. Providing nurses with the opportunity to express their ethical problems openly, especially eliminating personnel and resource deficiencies, establishing ethics committees, organizing training programs, providing support from the management especially on ethical issues and providing psychological support are important for controlling stress levels.

The Relationship Between Insomnia and Hypertension

Hasan EKİM — 2024-11-29

Objective: Sleep, which accounts for approximately one-third of our lives, is an important part of our daily lives. Sleep disorders are associated with a variety of mental and physical health problems. Common sleep disorders include insomnia, obstructive sleep apnea syndrome, and narcolepsy. Insomnia is the most common among these, and its main symptoms are difficulty falling asleep, difficulty maintaining sleep, early awakening, decrease in sleep quality, decrease in total sleep time and accompanied by daytime dysfunction. Insomnia generally has a negative effect on blood pressure through psychogenic, neurogenic and humoral pathways. The aim of our study is to investigate the frequency of insomnia, which we consider to be an important problem in hypertensive patients, and to comprehensively discuss its relationship with vitamin B12 and vitamin D in the light of the relevant literature.

Materials and Methods: In our study, the frequency of insomnia was investigated in 108 adult patients with hypertension between March 2020 and November 2023. In addition to the routine laboratory and radiological examinations of the patients, vitamin D, vitamin B12, magnesium and folate levels were also investigated.

Results: Of the 108 patients accepted to our study, 48 were men and 60 were women. Their ages ranged from 36 to 81 years, with a median age of 61.14±10.32 years. A total of 24 patients (22.2%), 14 of whom were women, had insomnia. The average age of patients with insomnia was significantly higher. The mean vitamin D and vitamin B12 levels were significantly lower in those with insomnia (p<0.05).

Conclusion: Since insomnia is common in hypertensive patients, it is important to investigate sleep status by taking a detailed anamnesis in each hypertensive patient. Insomnia in hypertension patients should be identified early and managed. Likewise, the diagnosis and treatment of hypertension should not be delayed in those with insomnia. Further studies are needed to elucidate the exact mechanisms between insomnia and hypertension.

Examination of the Relationship Between the Quality of Life and Comfort Levels of Caregivers of Home-Care Patients

Muhammed Burak BİLGİN — 2024-11-29

Objective: This research aimed to investigate the association between the quality of life and the comfort levels of caregivers providing home care to patients.

Method: This descriptive and correlational study was conducted with 341 caregivers caring for home health patients affiliated to the health directorate of a province. Data were collected using the "Caregiver Recognition Form", "General Comfort Questionnaire" and "SF-36 Quality of Life Scale". SPSS 23.0 statistical software programme was used to evaluate the data.

Results: In the research, it was observed that 73.3% of the caregivers were of the female gender, 78.9% were in a married status, 28.7% were spouses of the patients, 81.5% were not employed, 26.7% had no formal education, 28.2% had completed primary school, and 89.7% primarily provided physical support. A significant relationship was found between gender, marital status, education level, degree of relationship with patients and employment status and quality of life (p<0.05). İn addition, a significant relationship was found between gender, marital status, education level, type of relationship with patients and the presence of social security and comfort level (p<0.05).

Conclusion: A significant and moderately positive relationship was found between the quality of life and comfort levels of caregivers (p<0.05).