Research Outputs
Permanent URI for this communityhttps://hdl.handle.net/20.500.14288/2
Browse
88 results
Search Results
Publication Open Access “Noise Factory”: a qualitative study exploring healthcare providers’ perceptions of noise in the intensive care unit(Elsevier, 2020) Güner, Perihan; Kebapçı, Ayda; Faculty Member; School of Nursing; 203808Objectives: this study aimed to explore healthcare providers’ perceptions of noise in the intensive care unit. Design: a qualitative exploratory study was conducted using group interviews. Setting: the setting comprised a total of 15 participants (five physicians and ten registered nurses) working in an 18-bed medical surgical intensive care unit at a teaching hospital in Istanbul, Turkey. Semi-structured questions were formulated and used in focus group interviews, after which the recorded interviews were transcribed by the researchers. Thematic analysis was used to identify significant statements and initial codes. Findings: four themes were identified: the meaning of noise, sources of noise, effects of noise and prevention and management of noise. It was found that noise was an inevitable feature of the intensive care unit. The most common sources of noise were human-induced. It was also determined that device-induced noise, such as alarms, did not produce a lot of noise; however, when staff were late in responding, the sound transformed into noise. Furthermore, it was observed that efforts to decrease noise levels taken by staff had only a momentary effect, changing nothing in the long term because the entire team failed to implement any initiatives consistently. The majority of nurses stated that they were now becoming insensitive to the noise due to the constant exposure to device-induced noise. Conclusion: the data obtained from this study showed that especially human-induced noise threatened healthcare providers’ cognitive task functions, concentration and job performance, impaired communication and negatively affected patient safety. In addition, it was determined that any precautions taken to reduce noise were not fully effective. A team approach should be used in managing noise in intensive care units with better awareness.
Publication Metadata only Advanced practice pediatric oncology nursing as imagined or in place in four lower- and upper-middle-income countries(Elsevier Science Inc, 2024) Samba, Vera Larfi; Diaz, Dorian René Navarro; Punjwani, Rehana; Challinor, Julia; Semerci, Remziye; School of NursingObjectives: The implementation of pediatric oncology advanced practice nurse (s) roles in low- and middleincome countries (LMICs) presents opportunities and challenges. The authors explore the implications of pediatric oncology advanced practice nursing roles in Pakistan, Cameroon, Turkey, and Mexico. Potential bene fits and drawbacks of advanced practice nursing roles, impacts on nursing care, and strategies for advanced practice nursing role development in LMIC settings are considered. Methods: Information from scholarly articles, policy documents, and four LMIC pediatric oncology nurse expert perspectives on existing and imagined advanced practice nursing roles in pediatric oncology in LMIC were synthesized. Results: Current literature and policies point to efforts across LMICs to establish a wide variety of advanced nursing practices, not necessarily aligned with internationally accepted advanced practice nursing standards of practice or education. The LMIC nurses describe a wide range of national general nurse education and government advanced practice nurse recognition/licensing. Challenges to achieving or strengthening advanced practice nursing roles include, for example, healthcare professional resistance, government unwillingness to recognize/license advanced practice nurses, and lack of advanced practice nursing faculty. To promote a pediatric oncology advanced practice nursing role in LMICs requires navigating the national nursing scope of practice and nursing culture. Conclusion: The strategic introduction of pediatric oncology advanced practice nursing roles in LMICs has the potential to signi ficantly enhance patient care by, for example, addressing healthcare workforce shortages and facilitating timely care delivery. However, challenges related to role complexity, resistance from traditional healthcare structures, and role overlap must be considered. Tailoring these roles to local contexts and fostering stakeholder collaboration are essential for successful implementation. Implications for Nursing Practice: The adoption of advanced practice nursing roles can lead to improved quality of care for pediatric oncology patients and their families in LMICs, where cancer care is challenging. The positive impact of pediatric oncology advanced practice nurses on patient outcomes and healthcare delivery cannot be discounted but must align with local nursing and healthcare culture and expectations. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.Publication Metadata only Ambivalent sexism of nursing students in Turkey and South Korea: a cross-cultural comparison study(Wiley, 2020) Park, Sihyun; Kerman, Kader Tekkaş; Beşer, Ayşe; Faculty Member; Faculty Member; School of Nursing; School of Nursing; 34111; 143490Culture has become increasingly important concepts in nursing in the era of globalization. Nurses' cultural biases and prejudices are huge obstacles to their caring for patients from diverse cultural backgrounds. Therefore, this study examined sexism among nursing students from two patriarchal societies: Turkey influenced by Islam, and South Korea influenced by Confucianism. For this comparative study, we used the survey data from the sample of 560 nursing students, 309 from Turkey and 251 from South Korea. The findings showed that both samples showed high levels of sexism, both hostile and benevolent. When comparing the two samples, Turkish nursing students showed significantly higher sexism than did Korean students. Additionally, in both countries, male participants showed higher scores on sexism, especially hostile sexism. In terms of age, older students in Turkey showed lower levels of benevolent sexism. We hope the findings of this study can provide evidence to develop customized transcultural nursing education content in the context of different ethnicities and to help nurses and nursing students from specific cultural backgrounds in becoming aware of their own cultures.Publication Metadata only An exploratory study of positive life changes in Turkish women diagnosed with breast cancer(Elsevier Sci Ltd, 2010) N/A; N/A; Güner, Perihan; Faculty Member; School of Nursing; 101859Purpose: The present study explored the prevalence of positive changes in Turkish women with breast cancer and the possible relationships between these changes and patient variables such as socio-demographic and illness-related information. It also explored the nature of positive life changes reported by Turkish women with breast cancer. Methods and sample: The study was conducted at Hacettepe University Oncology Hospital in Ankara. Participants were 84 women with breast cancer and open-ended questionnaires eliciting patient narratives were primarily used to collect the data. Socio-demographic and illness characteristics, as well as any positive changes in the participants' life after the breast cancer diagnosis was also collected. For the participants who indicated positive changes a further open-ended question was asked: "Could you write down the positive changes that occurred in your life after being diagnosed with breast cancer?". Content analysis was used to analyze the qualitative data gathered from the participants who mentioned a positive change in their life following the breast cancer diagnosis. Results: Positive life changes were reported by 50% (n = 42) of the women and these changes were found to increase only with an increase in the patients' educational level. Qualitative analysis of the data indicated four main themes of positive changes: self-perception, empowerment, greater appreciation of life, and changes in interpersonal relations. Conclusion: If nurses are aware of positive changes following the illness, they can help their patients to understand, adapt better and cope with their illness.Publication Metadata only Analysis of the prevalence and risk factors of pressure injuries in the hospitalized pediatric population: a retrospective study(Elsevier Sci Ltd, 2023) Yilmaz, Dilek; Semerci, Remziye; Umaç, Eyşan Hanzade; Karadağ, Ayişe; School of Nursing; Graduate School of Health SciencesBackground: Pressure injury (PI) is an essential indicator of the quality of nursing care and affects hospitalized newborns and children. However, studies on the prevalence of PI and associated risk factors in children are limited. Aims: This study aimed to analyze the prevalence of PI and risk factors affecting the development of PI in the hospitalized pediatric population. Methods: This was a descriptive, retrospective study. Data were obtained via electronic medical records of 6350 pediatric patients admitted to a university hospital between January 2019 and April 2022. Ethics committee approval was obtained. Patient medical records and data associated with PI and medical treatment were collected through the 'Information Form,' 'Braden Scale,' 'Braden Q Scale,' 'Pressure Ulcer Staging Form,' and 'Pediatric Nutrition Risk Score (PNRS).' Data were analyzed using descriptive statistics, correlation analysis, Mann-Whitney U test, Kruskal Wallis test, and Multilinear Regression analysis. Results: More patients (66.2%) were males, and 49.2% of the children were 0-12 months old. 2368 out of 6350 pediatric patients were treated in the PICU. It was determined that a total of 143 PI occurred in 59 patients from PICU. The PI prevalence was 2.25% for all patients and 6.04% for PICU patients. Twenty-one percent of the patients had medical device-related PI (MDRPIs), 35.7% of PI occurred in the occiput, 13.3% in the coccyx/ sacrum, and 67.1% of PI was Deep Tissue Injury. In the multiple regression model, children's albumin level, hemoglobin level, PNRS scores, Body Mass Index, and length of hospital stay significantly affected BRADEN scores. They were explained 30.3% of their scores of Braden. Conclusion: Despite the limitations of the retrospective study, the prevalence of PI in the pediatric population in this study was lower than that reported in previous studies, but the prevalence of MDRPIs was higher. Based on the study results, it is recommended to implement preventive interventions for MDRPIs and plan prospective studies.Publication Metadata only Antecedents and outcomes of nurses' subjective career success: a path analysis(Wiley, 2021) Sönmez, Betül; Gül, Duygu; İspir Demir, Öznur; Erkmen, Tuna; Yıldırım, Aytolan; N/A; Emiralioğlu, Ramazan; Nurse; N/A; Koç University Hospital; N/APurpose This study aimed to test the hypothesis model showing the relationship between nurses' individual and working characteristics, nursing work environment, subjective career success, job satisfaction, intent to leave, and professional commitment. Design and Methods A cross-sectional and correlational design was utilized for the study. The study sample consisted of 604 nurses working in four hospitals in Istanbul, Turkey. Data were collected using the Nurse Information Form, Subjective Career Success Inventory, Practice Work Environment Scale of the Nursing Work Index, Job Satisfaction Global Item, Intent to Leave Subscale, and Professional Commitment Scale. Data were analyzed using descriptive and correlation analysis, and the hypothesis model was tested using structural equation modeling. Findings The hypothesis model that was established to test the antecedents and outcomes of subjective career success in nurses was acceptable and had a good fit. Having a master's degree, work schedule with rotating shifts (negative), good individual income, participation in hospital affairs, staffing and resource adequacy, and nurse-physician relations were significantly associated with the subjective career success of nurses. Subjective career success had a positive effect on job satisfaction and professional commitment and a negative significant effect on intent to leave in nurses. Conclusions This study revealed that human capital, objective career success, and some characteristics of the nursing work environment were significantly associated with nurses' subjective career success, and that increased subjective career success produced positive professional and organizational outcomes. Clinical Relevance The results of this study, which revealed the antecedents and outcomes of nurses' career success, should be taken into consideration by managers who wish to retain a qualified nursing workforce.Publication Metadata only Association of norepinephrine with pressure ulcer development in critically ill patients with Covid-19-related acute respiratory distress syndrome: a dose–response analysis(Churchill Livingstone, 2024) Mahmoodpoor, Ata; Chalkias, Athanasios; Izadi, Morteza; Gohari-Moghadam, Kievan; Rahimi-Bashar, Farshid; Khosh-Fetrat, Masoum; Vahedian-Azimi, Amir; Karadağ, Ayişe; School of NursingObjectives: To investigate the correlation between varying doses of norepinephrine (NE) and the incidence of pressure injuries (PIs) in COVID-19 patients in intensive care units (ICUs). Design: A retrospective multicenter study was conducted on 1,078 COVID-19 patients admitted to ICUs with acute respiratory distress syndrome (ARDS) requiring mechanical ventilation. The research spanned from March 2020 to April 2021 across five university-affiliated hospitals in Iran. Univariate and multivariate binary logistic regression analyses, along with linear and non-linear dose–response assessments, were utilized to evaluate the relationship between NE dosages and the probability of PI development. Findings: The multivariate analysis revealed a significant association between higher doses of NE administered over 24 h (OR: 1.832, 95 % CI: 1.218–2.754, P=0.004) and cumulative doses (OR: 1.408, 95 % CI: 1.204–1.975, P=0.048) with the occurrence of PIs. Moreover, patients receiving high NE doses had a nearly fourfold increased risk of developing PIs, regardless of PIs stage, compared to those on low or moderate doses (>15 µg/min vs. ≤ 15 µg/min; OR: 4.401, 95 % CI: 3.339–5.801, P=0.001). Although the linear dose–response analysis did not show a significant correlation between NE doses (µg/min) and PI development (P>0.05), the non-linear analysis indicated that NE doses ≤ 9 µg/min were associated with a reduced risk of PI development. Conclusion: Maintaining NE infusion within the range of 1–9 µg/min appears to be most effective in reducing the likelihood of PIs in ICU patients with COVID-19. Lower NE doses (≤9 µg/min) were associated with a lower risk of PI development, suggesting that factors beyond NE dosage or the use of other vasopressors may play a crucial role in PI formation in this patient cohort. Implications for Clinical Practice: Rather than suggesting a specific threshold, clinicians should consider further studies to determine the optimal dose that balances microvascular perfusion and patient outcomes. It is crucial to comprehensively evaluate additional factors and selectively use vasopressors. Individualized care, including regular monitoring and personalized treatment plans, is essential for achieving the best outcomes in this patient population.Publication Metadata only Attitudes towards futile treatments, moral distress and intention to leave job in nurses(Cambridge Univ Press, 2023) Kasim, D. S.; Oflaz, Fahriye; School of NursingPublication Metadata only Cancer nursing research priorities: a rapid review(Elsevier, 2023) Dowling, Maura; Efstathiou, Nikolaos; Drury, Amanda; Semple, Cherith; Fernandez-Ortega, Paz; Dieperink, Karin Brochstedt; Pape, Eva; Kotronoulas, Grigorios; Miguel, Susana; Colomer-Lahiguera, Sara; N/A; Bağçivan, Gülcan; Faculty Member; School of Nursing; 261422Purpose: Identifying cancer nursing research priorities is central to influencing the direction of cancer care research. The aim of this rapid review was to explore research priorities identified by oncology nurses for cancer care delivery between 2019 and 2022. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis informed the design of the rapid review. MEDLINE, CINAHL, PUBMED, Web of Science, and Cochrane databases were searched for studies published between December 1st, 2018, and September 30th, 2022. This timeframe was chosen to account for the latest relevant evidence synthesis, as well as changes in cancer care necessitated by the COVID-19 pandemic. The Quality Assessment of Diverse Studies tool was used to appraise quality. Results: Four studies met the inclusion criteria. Many of the research priorities identified were influenced by the COVID-19 pandemic. The top cancer nursing research priority identified was the role of technology in improving patient and caregiver symptoms and health outcomes. Other most prevalent research priorities were focused on symptom management, culturally sensitive palliative and psychosocial care, early/integrated palliative care, financial toxicity, modifiable risk factors related to social determinants of health, public and patient involvement in research, and oncology nurses' well-being and scope of practice.Conclusion: The findings indicate a need to steer a strategic programme of cancer nursing research towards digitalisation in cancer care to meet the current needs of people living with cancer and their caregivers. However, cancer nurses' burnout, staff shortages and disparities in specialist education will hinder the implementation of certain models of care.Publication Open Access Case study: an older COVID-19 patient in a Turkish intensive care unit with prolonged stay(Wiley, 2021) Kebapçı, Ayda; Kütük, Kübra; Eker, Emine; Faculty Member; School of Nursing; Koç University Hospital; 203808; N/A; N/AThis paper reports the presentation and management of an older female patient who was diagnosed with Coronavirus disease (COVID-19) and discharged from an intensive care unit (ICU) after prolonged hospitalization. The patient's COVID-19 test was negative; therefore, she was monitored in the COVID-19 general clinic with normal levels of oxygen saturation (SpO(2)). The patient had been taking Plaquenil for rheumatoid arthritis for a long time. Azithromycin was administered first, and then, the treatment continued with favipiravir according to the national treatment protocol in Turkey. On the third day in the COVID-19 general clinic, she was transferred to the ICU because of decreased saturation levels. Owing to worsening respiratory status and SpO(2) <70%, the patient was intubated on the sixth day in the ICU, and every day, she was nursed in a prone position for >16 hours. We believe that the treatment and care activities under qualified and effective nursing care, such as providing appropriate respiratory support at the right time, early initiation and maintenance of anticoagulant therapy, long-term prone positioning, maintaining sufficient fluid resuscitation, and early commencement of balanced enteral nutrition, contributed to the successful discharge of the patient from the ICU. The patient was finally extubated on the 23rd day. Respiratory support was continued with oxygen administered at 2 lt/min through a nasal canula with SpO(2) at 94%. We believe that by combining all these factors, the patient's results improved. She was discharged from the ICU after 25 days without any organ dysfunction. During the 25 days of care in the ICU, infectious disease protection and isolation rules were strictly adhered to, and personal protective equipment was worn.