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Early and balanced replacement of blood products appears to be the key factor in improving outcomes of major bleeding patients including acute trauma, cardiac, obstetric and transplant surgery patients. Definitive clinical guidance regarding the optimal ratio of blood products, including those containing fibrinogen, is still lacking. Therefore, we tested the hypothesis that increasing the fibrinogen content to erythrocyte suspension ratio improves the mortality and functional outcomes of patients undergoing surgeries with expected major bleeding.
The Approximate Dose-Equivalent of Fibrinogen-to-Erythrocyte Suspension (ADEFES) ratio is a multicentre, prospective, observational, cohort study of patients undergoing major surgical procedures with expected major perioperative bleeding (ie, requiring packed red blood cells (PRBC)>4U/24 hours). For 5U of cryoprecipitate and 1.5 U of fresh frozen plasma (FFP), the approximate dose-equivalent for fibrinogen is considered as 1 gram of fibrinogen. Association of the ADEFES ratio at 24 hours will be assessed on the primary objective, which will consist of the composite of 30-day all-cause mortality, 30-day bleeding-specific mortality and the ‘highly-dependent scores’ of Katz index of independence in activities of daily living.
The study protocol was approved by the Ethics Committee of Ankara Bilkent City Hospital (approval no. E2-23-4265, dated 07 June 2023; Chair: Prof. Dr. F.E. Canpolat) and by the institutional review boards of all participating centres. The study will be conducted in accordance with the principles of the Declaration of Helsinki and the Strengthening the Reporting of Observational Studies in Epidemiology guidelines, as well as in compliance with national regulations on data protection and Good Clinical Practice standards. Written informed consent will be obtained from all participants prior to inclusion in the study.
The results of this study will be disseminated through peer-reviewed scientific journals, presentations at national and international conferences, and communication with relevant stakeholders including clinical practitioners and healthcare institutions. If applicable, study outcomes will also be shared via institutional newsletters and digital platforms to reach a broader audience in the medical community.
The aim of this study was to investigate the effect of postoperative thirst on patient comfort and quality of recovery in patients undergoing colorectal surgery.
This study is an analytical cross-sectional study.
This study was conducted between July 2022 and January 2023 in the general surgery clinics of a university hospital in Ankara, Türkiye. The study sample consisted of 110 patients. Patient Identification Form, Thirst Symptom Assessment Scale (TSAS), Numeric Rating Scale (NRS), Perianesthesia Comfort Scale (PCS) and Quality of Recovery-40 questionnaire (QoR-40) were used for data collection. The severity of thirst was assessed three times: at the time of arrival to the postoperative clinic, at the 8th hour, and at the 24th hour, and the PCS and QoR-40 scales were administered at the 24th hour.
In this study, more than half of the patients were male (62.7%) and the mean age was 61.35 ± 13.79 years. The mean thirst severity of the patients was 12.25 ± 4.65, 12.36 ± 4.49 and 11.27 ± 4.76 according to the TSAS, 7.27 ± 2.39, 7.27 ± 2.01 and 6.17 ± 2.89 according to the NRS, respectively. The mean total score of PCS was 5.12 ± 0.43 and the mean total score of QoR-40 was 171.58 ± 10.33. Postoperative 8th hour thirst severity according to NRS, PCS total score level and postoperative thirst severity measured by TSAS at three times were found to have a significant effect on QoR-40 total score level in a decreasing direction. PCS total score was found to have a significant effect on QoR-40 total score level in an increasing direction.
The results obtained in this study showed that the thirst symptom experienced by the patients was moderate. It was determined that an increase in the severity of thirst decreased patients' comfort and quality of recovery levels, whereas an increase in comfort level increased the level of quality of recovery.
It is recommended that the severity of thirst should be assessed frequently with appropriate scales and appropriate nursing care should be provided for thirst management in order to increase the postoperative comfort of patients and to improve their recovery more positively.
No study has been found to describe and compare the effect of postoperative thirst on comfort and quality of recovery in patients undergoing colorectal surgery. In this study, it was found that an increase in the severity of postoperative thirst decreased the level of postoperative comfort and quality of recovery, whereas an increase in the level of postoperative comfort increased the level of quality of recovery. This information can be used to optimally manage the symptom of thirst after colorectal surgery, develop evidence-based nursing interventions, and improve the quality of care.
This study was reported according to the STROBE checklist.
Patients answered the scales with their voluntary consent. There is no public contribution.
The aim of this study is to explore patterns of the lived experiences of first-generation Turkish immigrants (≥ 60 years) living and ageing in Norway regarding their experiences with healthcare services and ageing.
This study used a qualitative study.
The sample consisted of 17 individuals aged 60 and above who were of Turkish origin, and immigrated to and living in Norway. All participants resided in the same city in the middle part of Norway. Individual face-to-face interviews were conducted between February and June 2023. All transcripts were examined using reflexive thematic analysis.
Two main themes and five subthemes were identified. The first theme was ‘Utilization of the healthcare service to their best’, with the subthemes: (a) ‘Communication through a translator: Expressing health problems’ and (b) ‘From physician to physician: Seeking a second opinion in health’. The second theme was ‘Being born in Türkiye: Aging in Norway’, with the subthemes: (a) ‘Between two worlds: Efforts to establish balance’, (b) ‘Family ties and care preferences: Understanding the care preferences’ and (c) ‘Two cultures, one life: Lifestyles’.
This study reveals the experiences Turkish immigrants have with the healthcare service and ageing while living in Norway and balancing between two cultures. These findings offer a valuable perspective for healthcare providers and social workers and offer insight relevant to developing a cross-cultural healthcare service programme.
This study could provide a fundamental step towards understanding older Turkish immigrants and how healthcare services fit their needs. The results revealed Turkish individuals' experiences with ageing and healthcare services, including the use of translator services and general care preferences. The development of more inclusive support programmes for ageing immigrant populations may have far-reaching impacts on individuals' ability to live healthy and meaningful lives.
Diabetes is a global problem. Diabetes nurses, in particular, take great responsibility in reducing and controlling the fears of individuals using insulin and increasing their capacity to tolerate discomfort.
This study was conducted to examine the effects of the capacity to tolerate discomfort on the fear of self-injection and the status of testing blood glucose levels in patients with type 1 and type 2 diabetes using insulin.
This cross-sectional study was conducted between December 2022 and February 2023 with 320 adult patients with type 1 and type 2 diabetes using insulin who were followed up in the Endocrinology and Internal Medicine Clinics of a university hospital in Turkey. The data analysis process included analyses of the frequency, independent-samples t-tests, one-way ANOVA, the Kruskal–Wallis H test, and Pearson's correlation analysis. Data were analysed using the IBM SPSS v27.0 software, considering alpha as 0.05.
The mean total Discomfort Intolerance Scale score of the patients was 22.78 ± 6.74, and the mean Fear of Self-Injecting and self-testing was 21.1 ± 6.7. A negative significant correlation was found between the discomfort intolerance levels of the patients and their levels of fear of self-injection and self-testing (p < 0.05).
Individuals with a higher capacity to tolerate discomfort have lower levels of fear of self-testing and self-injection. Therefore, the fear of self-testing and self-injection in patients using insulin injections may affect diabetes self-management.
Individuals with low tolerance for discomfort should be identified, interventions to increase tolerance in individuals at risk should be planned, and diabetes self-management should be better supported.
The reporting of the results of the study adhered to the STROBE guidelines.
Today, with the enhancement in the usage of smartphones, the concepts of nomophobia and phubbing have emerged. Nomophobia refers to the fear of being deprived of smartphones/smart devices. Phubbing is the use of a person's smartphone in situations that are not appropriate for the situation, time, and place. Therefore, the study purposed to evaluate nursing students' nomophobia and phubbing scores in Turkey, Portugal, and the United States. The data were collected with the Personal Information Questionnaire, Nomophobia Scale, and Phubbing Scale from N = 446 nursing students. The mean age of the students was 22.04 ± 4.08 years, and 86.5% were women. It was found that the total nomophobia scores of the nursing students were 80.15 ± 21.96, 72.29 ± 28.09, and 99.65 ± 6.11, respectively in Turkey, Portugal, and the United States. When the countries' Nomophobia Scale total scores, “giving up convenience,” “not being able to communicate,” and “losing connectedness” scores were compared with each other, they were found to be statistically significant (P
The study was carried out to investigate the effect of motivational interviewing on peer bullying and cyberbullying among adolescents.
A parallel-group randomized controlled trial.
The study population consisted of ninth-grade (aged 14 years) high school students (n = 200). The study was completed with 48 participants (intervention: 24; control: 24). The data were collected using the Participant Information Form, the Stages of Change Questionnaire, the Peer Bullying Scale, and the Cyberbullying Scale. The intervention group received a preparatory session and five weekly motivational interviewing sessions. Instruments were administered to both groups before the intervention, at the end of the last motivational interviewing session (post-test), and at 3rd- and 6th-month follow-ups. The data were analyzed using chi-square test, independent sample t-test, and two-way mixed-design ANOVA with Bonferroni's test.
In the pre-test, no statistically significant difference was observed between the intervention and control groups regarding mean scores for peer bullying and cyberbullying (p > 0.05). Following the motivational interviewing sessions, adolescents in the intervention group had a significantly lower mean score for peer bullying and cyberbullying than the control group at the post-test and follow-up tests (p < 0.001).
The present study concluded that motivational interviewing effectively reduced peer bullying and cyberbullying behaviors among adolescents.
Nurses would implement motivational interviewing to prevent bullying behaviors in schools.
This randomized-controlled trial aimed to investigate the effect of bed exercises on postoperative anxiety, pain, early ambulation and mobilization. This study was conducted with a randomized-controlled trial design and in the general surgical clinic of a research and training hospital. A total of 120 patients (60 in the experimental group and 60 in the control group) scheduled for major abdominal surgery took part in the study. The data were collected using a patient information form, the Anxiety Specific to Surgery Questionnaire and the Visual Analog Scale through face-to-face interviews. The patients in the experimental group performed 15-min bed exercises on the day of their operation, as well as on the postoperative first and second days, and the control group underwent only the routinely performed procedures in the clinic. The data were analysed using descriptive statistics, analysis of variance and t-tests. The sample of our study included major abdominal surgery patients. Ambulation was achieved at a mean time of 4 h earlier in the experimental group. On the postoperative first and second days, the patients in the experimental group had mean mobilization durations that were approximately 2 h longer compared with the patients in the control group. Moreover, the postoperative pain and anxiety levels of the patients in the experimental group were significantly lower than those of the patients in the control group (p < 0.05). We recommend that bed exercises be performed to lower anxiety and pain severity, achieve early ambulation and increase the duration of mobilization among patients following major abdominal surgery.
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