Hospital In Istanbul Research Articles

A Single-Center Evaluation of Pediatric Measles Cases in Istanbul, Türkiye, in 2019.

Although measles can be prevented and eliminated by vaccination, it is a highly contagious viral disease that can lead to serious complications, disability, and death. The aim of this retrospective study was to evaluate the characteristics of measles cases in a single center. All children with clinically suspected measles who attended the Pediatric Clinic at Esenler Maternity and Child Health Hospital in Istanbul, Türkiye, between January 1 and June 30, 2019 were included in the analysis. None of the children with measles were fully vaccinated. The incidence and duration of conjunctivitis were significantly higher in the unvaccinated group than in the partially vaccinated group (P = 0.027 and P = 0.019, respectively). Unvaccinated patients had a significantly lower median leukocyte count (P = 0.019) and significantly higher median C-reactive protein level (P = 0.021). The vitamin A level and leukocyte count were moderately positively correlated (r = 0.698; P = 0.008). Children should be fully vaccinated in order to prevent measles.

The Effect of Perceived Social Support by Nurses on Their Fear of Death Post–COVID-19 Pandemic Period

IntroductionThe COVID-19 pandemic covers a period of quite challenging and various problems for nurses. During the pandemic, most nurses could not spend enough time with their families and social circles and faced death. It is not known whether nurses received adequate social support and the level of fear of death after the COVID-19 pandemic. ObjectiveIn this study, we aimed to examine the perceived social support and fear of death felt by nurses after the COVID-19 pandemic. MethodThis study is descriptive and correlational. We conducted this study with the participation of n = 411 nurses working in a city hospital in Istanbul. We used the personal information form, Multidimensional Perceived Social Support Scale and The Turkish Death Anxiety Scale for data collection. We used descriptive statistical methods, Paired sample t test, one way analysis of variance (ANOVA), PostHoc and Pearson correlation tests for data analysis. ResultsIn this study, 52.1% of the nurses were male, 39.2% lived alone with their children, and 75.5% had cared for COVID-19 patients for more than 2 years in the hospital. Among the nurses, 75.9% worked only during the day. In this study, the perception of social support was higher in nurses who were male, married and chose their profession voluntarily (p < .05). In our study, nurses who had a master's degree or higher level of education, lived with family members, worked with mixed day and night work, and had received COVID-19 vaccine had a higher fear of death. In our study, we found a correlation between perception of social support and fear of death. ConclusionFear of death should be reduced to protect psychological and mental health among nurses after the COVID-19 pandemic. For this, improving social support may be appropriate. Various psychotherapeutic interventions are needed to decrease the fear of death.

Renal implications of off-pump coronary artery bypass grafting: A retrospective cohort study analyzing postoperative creatinine levels

Background/Aim: Coronary artery disease is a significant health concern worldwide. While coronary artery bypass grafting is a gold standard of treatment, acute kidney injury (AKI) is a possible postoperative complication of concern. Off-pump coronary artery bypass grafting (OPCABG) aims to curtail perioperative complications; however, its impact on postoperative AKI is debated. This retrospective study aims to inform patient care by identifying potential effects of OPCABG on AKI utilizing postoperative creatinine alterations. Methods: This retrospective study was conducted at Koç University Hospital in Istanbul, Turkey. We reviewed the records of patients who underwent OPCABG between June 2018 and June 2019. Patients with incomplete records or individuals who had undergone renal replacement therapy prior to surgery were excluded. The primary metric was serum creatinine levels, which were assessed preoperatively and up to 7 days postoperatively. Preoperative creatinine levels were compared with postoperative levels using the Wilcoxon signed-rank test. Acute kidney injury was defined using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Results: Seventy-two patients satisfied the inclusionary criteria. A significant increase in creatinine was observed on postoperative Day 1 (P&lt;0.001); creatinine levels fell below baseline by postoperative Day 4 and 5. We note that the incidence of AKI was low; there were no instances of Stage 2 or higher AKI during the observation period. Conclusion: Our data suggest that OPCABG may result in a transient increase in creatinine post-surgery. Creatinine levels normalize over time, implicating the renal safety of OPCABG. Despite these promising findings, additional comprehensive studies are essential to validate these observations and assess long-term renal outcomes after OPCABG.

A qualitative study: Patients’ operating room experiences

PurposeThe aim of this study was to understand the operating room experiences of patients operated under regional anaesthesia. DesignInterpretive phenomenology design was used in this study. MethodsThe universe and sample of the study consisted of 11 patients who were operated under regional anaesthesia in a training and research hospital in Istanbul. The study was conducted using the criterion sampling method and the individual in-depth face-to-face interview method. The data were collected with a patient information form and a semi-structured interview form. In the analysis of the data, the answers given by the patients to the semi-structured interview form were brought together under the themes determined in accordance with the purpose and grouped and evaluated using the content analysis method. FindingsNine themes and 16 sub-themes specific to the study subject were determined under four main categories. The patients described the operating room as a cold and scary place, told that they did not get enough information about the operating room and anaesthesia before the operation, complained that the clothes they wore while going to the operating room were uncomfortable. ConclusionsPatients who underwent surgery experienced widespread anxiety and fear due to a lack of knowledge about the surgical process and the operating room environment. Due to the limited number of studies in the literature on patients' operating room experiences, we believe that the results of this study will be valuable in planning patient management in the operating room and understanding the experiences of patients undergoing surgery.

Changing the Surgical Approach to Breast Diseases During the COVID-19 Pandemic Period.

Background Postponing elective surgeries during the COVID-19 pandemic has also affected the approach to both malignant and benign breast diseases. This paper aims to share how the COVID-19 pandemic affects our approach to breast cancer, benign breast cases, and the procedures' results. Methodology A cross-sectional study was conducted in a tertiary-level public hospital in Istanbul, Turkey. We retrospectively analyzed our treatment options for patients diagnosed with breast cancer and benign breast disease in the general surgery clinic of a tertiary hospital that declared a pandemic status between March 11, 2020, and June 1, 2020. Results The number of patients who visited the breast outpatient clinic and received a diagnosis of breast cancer was 23. Among the benign diseases, no intervention was made except for abscess (eight patients, 40%) and mastitis (12 patients, 60%). Conclusions Patients with acute abscesses and mastitis were treated for both diagnostic and therapeutic purposes. Chemotherapy and hormone therapy were chosen for those diagnosed with cancer. Priority was given to oncology protocols rather than surgical approaches during the pandemic. We think that different approaches will be defined as the pandemic continues.

: Evaluation of the knowledge and attitudes about hypospadias of the parents of children diagnosed with hypospadias: A qualitative study

Purpose: The purpose of the study to determine the knowledge and attitudes of the parents of children diagnosed with hypospadias.&#x0D; Methods: This descriptive study conducted on the families of children diagnosed with hypospadias and discharged from a pediatric surgery clinic in a state hospital in Istanbul between April 2018 and December 2018. Data collected with parent information form, type recorder, semi-structured interview. Content analysis was used to evaluate the qualitative data. Research results are reported according to the COREQ Checklist.&#x0D; Results: After analyzing the interviews of the participants, eight themes have been created: “Inaccuracy of information about hypospadias”, “The fact that the information is not clear and understandable by the family”, “Anxiety about the surgery and the prognosis of the disease in the pre-operative period”, “Fears about the process and after the surgery”, “Positive emotions after surgery", "Negative emotions after surgery", "Supporting post-operative care", "Importance of cosmetic appearance",&#x0D; Conclusion: It was found that the parents did not have enough information about hypospadias and the postoperative process adversely affected the attitudes of the parents towards the disease.

The effect of auditory stimuli on the pain and physiological parameters of children on mechanical ventilation during aspiration procedure: A randomized controlled trial.

The study was conducted to determine the effect of mother's voice and music sound on pain and physiological parameters during aspiration procedure in children with mechanical ventilation support in the pediatric intensive care unit. This study was a randomized controlled type experimental study. According to the power analysis result of the sample of the study, 84 children who were treated in the pediatric intensive care unit of two university hospitals in Istanbul were formed. Introductory Information Form, Ramsey Sedation Scale, Physiological Parameter Form and Face, Legs, Activity, Cry, Consolability (FLACC) Pain Scale were used to collect data. When the pain results of the children were evaluated, the mean FLACC Pain Scale value of the children in the control group was found to be significantly higher than children in the mother's voice and music voice group (p < 0.05). It was determined that the lowest FLACC Pain Scale value was in the mother's voice group (p < 0.05). When the physical parameter results were evaluated, it was determined that the physiological measurement values of the children in the experimental group were positively affected (p < 0.05), there was a significant difference between the control group (p < 0.05) and the most effective result was in the mother's voice group (p < 0.05). Allowing children to listen mother's voice and music during aspiration procedure reduces pain of the children, positively affects their physical parameter values and enhances quality of nursing care. The results of this study create a scientific basis for nursing practices in the clinical settings and contribute to the clinical practices by shedding a light on future evidence-based studies.

Turkish Adaptation of Patient Nurse Trust Scale: A Validity and Reliability Study

Objective: This study aims to adapt the Patient-Nurse Trust Scale to Turkish and perform validity and reliability analyses.&#x0D; Methods: This study has been conducted as methodological. It was conducted between February 2021 and June 2021 in a training and research hospital in Istanbul, Turkey. The study was completed with 311 participants. Introductory Information Form, Patient-Nurse Trust Scale, and Trust in Nurses Scale were used for data collection. In addition to descriptive statistics, language validity, content validity, construct validity, criterionrelated validity, discrimination, internal consistency reliability, two-half test reliability, and item analysis methods were used to determine the scale’s psychometric properties.&#x0D; Results: As a result of factor analysis, it was determined that the scale showed a single factor structure, and explained 66.63% of the total variance. Item factor load values were found to vary between .74 and .88. The ratio of the chi-square value to the degrees of freedom (397.496/112) was found to be 3.549. It was found that RMSEA= .09, GFI= .86, IFI= .93, NFI= .91, CFI= .93, and RFI= .87. It was found that the correlations of all items varied between .71 and .87. The Chronbach’s alpha value for the whole scale was calculated as .97. As a result of parallel test analysis, it was determined that there was a significant positive correlation between both scales (r= .301; p= .000).&#x0D; Conclusion: The exploratory factor analysis and confirmatory factor analysis results of the Turkish version of the scale are acceptable, and their reliability indexes are high.

Factors linked to Kawasaki disease and MIS-C in children with prolonged fever: A retrospective cohort study

Background/Aim: Prolonged fever in children presents a diagnostic challenge due to its diverse underlying causes. While infectious diseases historically played a primary role, recent shifts in disease patterns and the emergence of conditions such as multisystem inflammatory syndrome in children (MIS-C) have added complexity. Understanding factors contributing to prolonged fever, particularly the rise in MIS-C and Kawasaki Disease (KD), is vital for accurate diagnosis and timely intervention. This study aimed to identify the etiologies causing prolonged fever in children with temperatures exceeding 38°C for a minimum of 5 days and to examine its relationship with conditions like MIS-C and KD following the coronavirus disease 2019 (COVID-19) pandemic. Methods: We conducted a retrospective cohort study at a pediatric hospital in Istanbul, Turkey, involving 243 children aged 3 months to 17 years with prolonged fever (&gt;38°C for ≥5 days) between April 2020 and October 2022. We collected data on patient demographics, clinical characteristics, laboratory results, and final diagnoses. The study categorized patients into Group 1 (KD and MIS-C) and Group 2 (other causes). We performed logistic regression analysis to identify factors associated with KD and MIS-C, using hospitalization days and levels of C-reactive protein (CRP), ferritin, and D-dimer. We calculated sensitivity, specificity, and likelihood ratio values and generated ROC (Receiver operating characteristic) curves. The threshold for statistical significance was set at P&lt;0.05. Results: This study encompassed 243 patients with prolonged fever. The primary causes of admission included infection-related illnesses (60.91%, n=148), MIS-C (18.52%, n=45), and KD (10.70%, n=26). Significant differences were observed in lymphocyte count (P&lt;0.001), CRP level (P&lt;0.001), ferritin level (P&lt;0.001), D-dimer level (P&lt;0.001), hospitalization days (P&lt;0.001), and echocardiographic findings (P&lt;0.001) between the groups. Logistic regression analysis revealed noteworthy associations between the presence of KD and MIS-C and hospitalization days (P=0.001), elevated CRP levels (P=0.018), elevated ferritin levels (P=0.009), and elevated D-dimer levels (P=0.001). Ferritin exhibited an AUC (Area under curve) of 0.737 (P&lt;0.001), and D-dimer demonstrated an AUC of 0.782 (P&lt;0.001) in differentiating between the presence of KD and MIS-C. Conclusion: The prevalence of infectious and inflammatory conditions remains high in cases of prolonged fever, with a noticeable increase in the occurrence of KD and MIS-C since the onset of the COVID-19 pandemic. Notably, ferritin, CRP, and D-dimer levels are valuable indicators for identifying children at elevated risk of developing KD and MIS-C. While data were collected during the epidemic, additional data collection beyond this period would be necessary.

The relationship between diabetes burden and health-related quality of life in elderly people with diabetes

BackgroundOne of the most common chronic diseases in the elderly is diabetes. When diabetes is not well controlled, it can cause complications and affect health-related quality of life. Determining the burden of diabetes in elderly patients can provide a good health-related quality of life. AimThe study was conducted to examine the relationship between diabetes burden and health-related quality of life in elderly patients with diabetes. MethodsThis is a descriptive and correlational study of 207 patients who applied to the diabetes outpatient clinics of a private and a public hospital in Istanbul. Respondents were completed with “Personal Information Form for Elderly People”, “Elderly Diabetes Burden Scale” and the “Quality of Life in the Elderly Scale”. Data were analyzed by SPSS. The tests used are Kolmogorov-Smirnov, Mann-Whitney U, Kruskal Wallis and Spearman Correlation tests. ResultsThe mean total score from the Elderly Diabetes Burden Scale was 47.13 ± 11.95 (18−88), and the mean score from the Quality of Life in the Elderly Scale was 19.36 ± 7.00. In the study, as the total diabetes burden score of the elderly patients increased, the Quality of Life in the Elderly Scale score decreased. There was a difference between the mean total score of the Elderly Diabetes Burden Scale and gender, education, living alone and using oral antidiabetic (p < 0.05). ConclusionsAs a result it was determined, a negative correlation was found between the diabetes CASP-19 scale total score and the total EDBS. Determining the burden of diabetes and affecting factors in elderly is important in terms of increasing the health-related quality of life. It may be recommended to plan diabetes education programs that will reduce the burden of diabetes and increase the health-related quality of life in elderly patients.

Cancer patients’ attitudes towards holistic complementary and alternative medicine in the management of sleep problems

Introduction and aim. Sleep problems are frequently experienced in cancer patients and complementary and alternative medicine (CAM) is solve the problem. However, patients’ attitudes towards this practice are crucial. This study was purpose to investigate the attitudes of cancer patients towards CAM practices in the management of sleep problems. Material and methods. This cross-sectional. and descriptive study was conducted between February-June 2020, on 140 cancer patients in oncology/haematology clinics, three different hospitals in Istanbul. Data were collected by using the Information Form, “Richard Campbell Sleep Questionnaire and The Attitudes towards Holistic Complementary and Alternative Medicine scale”. Results. It was found that the patients had problems with sleep in general 42.74±21.31, mostly in the aspect of the quality of sleep 36.28±26.1. It was determined that stage IV cancer, education and income level of patients affect sleep problems. While female holistic health attitudes were more negative and, their attitudes towards CAM were positive. It was found in the analysis of variance that was performed to determine the difference between the mean scores towards sleep problems of patients in different stages (F=3.062; p&lt;0.05). Conclusion. It was found that cancer patients usually had sleep problems, and their attitudes towards CAM practices were positive.

INNOVATIVE BUSINESS BEHAVIOUR AND PERSONAL FEATURES: AN APPLICATION IN THE HEALTH SECTOR

Purpose- Creativity and innovation in the workplace have been recognized as important determinants of organizational performance and success. In order to fully understand the effect of personality traits of healthcare professionals on job performance, this study aimed to determine the relationship between innovative work behavior and personality traits. Methodology- In this study, it was aimed to evaluate the relationship between innovative work behavior and personality traits. The research was conducted with 120 health managers working in three public hospitals in Istanbul. In the study, data were collected with the Personality Traits Scale developed by Raad et al. (2008) and the Innovative Behavior Scale developed by Scott and Bruce (1994) and adapted into Turkish by Çalışkan et al. (2019). In the study, NCSS (Number Cruncher Statistical System) 2007 (Kaysville, Utah, USA) program was used for statistical analysis. While evaluating the study data, the distribution of the data as well as descriptive statistical methods (Mean, Standard Deviation, Median, Frequency, Ratio, Minimum, Maximum) Shapiro -Assessed with the Wilk Test. Kruskall-Wallis test for comparison of quantitative data of three or more groups; Mann-Whitney U Test was used for comparison of two groups. Spearman's correlation analysis was used to determine the relationship between quantitative data. Simple linear regression analysis was used to determine the factors affecting the dependent variable. Cronbach's Alpha values were found to be at a high level of reliability. Findings- Of the participants, 70.3% (n=64) were male, 39.6% (n=36) were 25-29 years old, 73.6% (n=67) were university graduates. When the work experiences of the participants are examined; It was determined that 38.5% (n=35) of them had 10 years or more experience. When examining the differences between personality traits and innovative work behavior; Compatibility personality traits of male participants were found to be higher than female participants (p=0.001;p&lt;0.05). There is a statistically significant difference in extraversion personality traits according to the experience period of the employees (p=0.013;p&lt;0.05). The extraversion personality trait value of employees aged 1-5 years was found to be statistically significant compared to those working between 5-10 years (p=0.001;p&lt;0.05). It was found statistically significant that the value of the extraversion personality trait of employees aged 1-5 years was higher than those of 10 years or more (p=0.001;p&lt;0.05). The fact that the extraversion value of the manager group was higher than that of the department managers was found to be statistically significant (p=0.001;p&lt;0.05). It was found that the extraversion value of department managers was higher than those in charge of clinics (p=0.001;p&lt;0.05). There was no statistically significant relationship between personality traits of agreeableness, honesty, emotional stability and gender, work experience, age, education level, and duration of experience (p&gt;0.05). There is a positive and weakly significant relationship between extraversion and innovative behavior (r=.247, p&lt;0.05). There was no statistically significant relationship between personality traits of adaptability, honesty, emotional stability and innovative behavior (p&gt;0.05). Conclusion- As a result of the findings obtained based on the analysis in this study; It has been evaluated that innovative behavior is not associated with personality traits of agreeableness, honesty, and emotional stability, but only extroversion personality trait and innovative work behavior. According to the task status, the value of extraversion shows a statistically significant difference. It can be said that the value of extraversion increases as the status of individuals in their duties increases, due to the increase in the quality and quantity of the people they communicate with due to their duties. According to the duration of experience, the value of extraversion shows a statistically significant difference, and as the duration of experience increases, the value of extraversion decreases. In this situation; It can be said that the value of extraversion decreases as the duration of experience increases due to the fact that people have experienced business life more socially and technically. A positive and significant relationship was found between the personality trait of extroversion and innovative work behavior. Keywords: Innovative Behavior, Personality, Personality, Manager, Health Professional JEL Kodlar: J20, M10, L20

The relationship between environmental turbulence and organizational improvisation in hospitals: The moderator role of organizational culture

Aim: In today's business environment, dynamism, uncertainty, and environmental turbulence are quite high. Organizational improvisation is seen as an effective mechanism for organizations operating in these environments to respond to demands from the environment. This study aims to examine the relationship between environmental turbulence and organizational improvisation, and also the moderator role of organizational culture (adhocracy, clan, hierarchy, and market culture). &#x0D; Methods: The study used a descriptive cross-sectional design. The data were collected from 487 lower, middle, and upper-level managers working in private hospitals in Istanbul. The disproportionate stratification method was used since hospitals are not homogeneous regarding technological and financial structure, size, and human resource quality. The data was analyzed using Statistical Package for the Social Sciences 23 program through PROCESS macro. &#x0D; Results: The results show a positive relationship between environmental turbulence and organizational improvisation. Also, adhocracy, clan, and market cultures moderate the environmental turbulence and organizational improvisation relationship. As these three organizational cultures increase, the effect of environmental turbulence on organizational improvisation weakens. &#x0D; Conclusion: This study indicates that environmental turbulence is an effective factor in hospitals' organizational improvisation capability. Furthermore, the moderation analysis suggests that organizational culture may be an important mechanism underlying environmental turbulence and organizational improvisation relationship.

“The biggest disappointment”: women’s expectations from sex are ignored, from the perspective of infertile women

ABSTRACT Objective The aim of this study is to determine the attitudes, behaviours and experiences of infertile women towards sexuality. Methods This study was carried out in the infertility outpatient clinic of a state hospital in Istanbul of Turkey. Fifteen infertile women who had been receiving primary infertility treatment for at least two years and were actively continuing infertility treatment were included in the study. Data were collected by means of an detailed information form and a semi-structured interview. Content analysis was applied to the data obtained from semi-structured interviews. Consistency percentage calculation was made between the codes and themes determined by 4 researchers who are experts in their fields. Results Results based on the interviews with the participants, 2 main themes, 6 sub-themes and 27 codes related to sub-themes were determined as ‘Factors Affecting Sexual Life’ and ‘Overview of Sexual Health and Sexuality’. ‘Disappointment’ was determined as the most commonly defined code in the determined main theme and sub-themes. Conclusion It was determined that the majority of infertile women base their sexual lives on reproductive functions, experience serious sexual health problems, feel worthless, and describe their sexual life as a great disappointment.

The Impact of the Active Stage of Labor on Estimate Fetal Weight: A Prospective Cohort Study

Objective: In the literature, there have been few data on ultrasound measurements during the active phase of labor. In this study, it was aimed to compare the accuracy of fetal weight estimation by ultrasound in terms of active phase of labor. Methods: This was a prospective cohort study at the obstetrics clinic of Esenler Gynecology and Children's Hospital in Istanbul. A total of 85 patients in active labor were included in the study. All pregnant women were evaluated for estimated fetal weight (EFW) by ultrasound evaluation, and cervical dilation and effacement measurements by pelvic examination, at most 24 hours before labor. Hadlock-4 formula was used for EFW. EFW and actual birth weight (ABW) and absolute errors of pregnant women in active labor were compared. Results: The mean EFW and ABW of the patients were 3161±482 and 3150±476 g, respectively. In terms of EFW and ABW, a finding in favor of the ultrasound was found. The error and error rates between EFW and ABW were found to be 234±191 g and 7.6±6.2, respectively. No significant difference was found in terms of these parameters (p&amp;gt;0.05). A significant and strong (0.80) correlation was found with estimated fetal weights and actual birth weights. Conclusion: Ultrasound can be used as a safe method to measure estimated fetal weight in the active phase of labor.

Evaluation of education and counseling using social media tools after discharge in women who underwent episiotomy

In this study, it was aimed to evaluate the effects of post-discharge education and counseling using social media tools on wound healing, pain status, and care and practices for women with episiotomy. The study was conducted experimentally with 60 women (30 experimental, 30 control) who had vaginal delivery with episiotomy in a public hospital in Istanbul. Data were collected using a data entry form and evaluations on the REEDA (Redness, Edema, Ecchymosis, Discharge, Approximation) scale, VAS (Visual Analogue Scale), and Diagnostic Form for Episiotomy Care and challenges. In our study, training and counseling were given to the experimental group by making video calls via social media on the 3rd, 5th, 7th, and 14th postnatal days (PP), and the results were evaluated without any training to the control group. SPSS program was used for data analysis. There was no difference between the experimental and control groups in terms of demographic and obstetric data. It was determined that the total scores of the experimental group on the REEDA scale on the 7th postnatal day (x¯ =2.167 ± 0.747) were statistically significantly lower than the total scores of the control group on the REEDA scale on 7th postnatal day (x¯ =3.100 ± 0.923) (p = 0.000 > 0.05). It was determined that the total scores of the experimental group on REEDA scale on the 14th postnatal day (x¯ =0.200 ± 0.407) were also statistically significantly lower than the total scores of the control group on REEDA scale on the 14th postnatal day. (x¯ =1.333 ± 0.844) (p = 0.000 > 0.05). The VAS DS scores of the experimental group on 3rd (x¯ =4.733 ± 0.907) and the 5th (x¯ =3.267 ± 0.691) postnatal day were statistically significantly lower than the VAS DS scores of the control group on 3rd (x¯ =5.267 ± 0.944) and 5th (x¯ =3.933 ± 0.944) (p = 0.003 > 0.05) postnatal day. In the light of this information, it was found that scores on REEDA scale were lower and pain experiences were significantly less in the group that received education and counseling with social media tools after discharge in women who underwent episiotomy.

Relationship Between Style of Coping With Stress and Level of Transition Shock Among New Graduate Nurses: A Cross-Sectional Study.

Transition shock is prevalent among new graduate nurses. Coping effectively with stress may be essential for a successful transition into practice. The relationship between transition shock and style of coping with stress remains unexplored. The goal of this study was to determine the relationship between style of coping with stress and level of transition shock among new graduate nurses. This descriptive, cross-sectional study was carried out with 252 new graduate nurses in two public hospitals in Istanbul, Turkey. Data were collected with a personal information form, the Coping Styles with Stress Scale, and the Nursing Transition Shock Scale. Seeking social support, self-confidence, and optimism were the most commonly used styles of coping with stress, with median scores of 7 (range, 6-9), 12 (range, 10-14), and 8 (range, 7-10), respectively. Levels of transition shock for new graduate nurses were moderate, with a median score of 2.61 (range, 2.05-3.33). The helpless (rs = .34, p = .000) and submissive (rs = .23, p = .000) styles were correlated with higher levels of transition shock. The level of transition shock increases with the helpless style and decreases with the use of the social support-seeking style. New graduates can cope with transition shock with simulation-based learning, effective orientation programs, a supportive working environment, and flexibility in the work shift. [J Contin Educ Nurs. 2023;54(8):350-359.].

Pressure injuries in the operating room: who are at risk?

Objective: Operating room (OR)-related pressure injuries (PIs) constitute the majority of all hospital-acquired PIs. The aim of this study is to reveal the prevalence and risk factors of OR-related PIs. Method: This study used a cohort design. The data were collected at Acıbadem Maslak Hospital in Istanbul between November 2018 and May 2019. The study population consisted of all patients undergoing surgery between these dates (n=612). The haphazard sampling method was used following application of the inclusion criteria. A patient identification form, the 3S intraoperative pressure ulcer risk assesment scale and the Braden Scale were used to collect data. Results: Within the scope of the study, data were collected from 403 patients, of which 57.1% (n=230) were female and 42.9% (n=173) were male; mean age was 47.90±18.15 years. During surgery, PIs were detected in 8.4% of patients. In total, 42 PIs were detected in patients in the study; 92.8% were stage 1 and 7.2% were stage 2. It was determined that the PIs observed in 11.8% (n=4) of the patients were related to device/instrument use and 23.5% (n=8) were related to the positioning device. Risk factors found to be significant in the development of PIs were sex (male) (p=0.049), large amount of bleeding during surgery (p=0.001), dry (p=0.020) and lighter skin (p=0.012), duration of surgery (p=0.001), type of anaesthesia (p=0.015), and medical devices used (p=0.001). Conclusion: Early identification of risk factors may reduce OR-related PIs. Guidelines and procedures that focus on preoperative, intraoperative and postoperative evaluation can be developed to reduce and prevent surgery-related PIs and to standardise care.

The Relationship between Mothers' Breastfeeding Anxiety and Fear of COVID-19

The research was designed as a descriptive study. This research was conducted in a maternity hospital in Istanbul between 03 May and 31 August 2021. The study sample consisted of 348 primiparous and multiparous volunteer mothers who had vaginal and cesarean section delivery methods.

Factors Associated with 28-day Critical Illness Development During the First Wave of COVID-19.

This study aimed to define the predictors of critical illness development within 28 days postadmission during the first wave of the COVID-19 pandemic. We conducted a prospective cohort study including 477 PCR-positive COVID-19 patients admitted to a tertiary care hospital in Istanbul from March 12 to May 12, 2020. The most common presenting symptoms were cough, dyspnea, and fatigue. Critical illness developed in 45 (9.4%; 95% CI=7.0%-12.4%) patients. In the multivariable analysis, age (hazard ratio (HR)=1.05, p<0.001), number of comorbidities (HR=1.33, p=0.02), procalcitonin ≥0.25 µg/L (HR=2.12, p=0.03) and lactate dehydrogenase (LDH) ≥350 U/L (HR=2.04, p=0.03) were independently associated with critical illness development. The World Health Organization (WHO) ordinal scale for clinical improvement on admission was the strongest predictor of critical illness (HR=4.15, p<0.001). The patients hospitalized at the end of the study period had a much better prognosis compared to the patients hospitalized at the beginning (HR=0.14; p=0.02). The C-index of the model was 0.92. Age, comorbidity number, the WHO scale, LDH, and procalcitonin were independently associated with critical illness development. Mortality from COVID-19 seemed to be decreasing as the first wave of the pandemic advanced. Graphic Abstract.