Theses supervised by Dr. Öğr. Üyesi Müjgan Onarıcı
13 theses · Çankırı Karatekin Üniversitesi
İntramüsküler enjeksiyonda soğuk sprey uygulamasının ağrı düzeyi ve ağrı korkusuna etkisi
Bu çalışma soğuk sprey uygulamasının enjeksiyon ağrısı ve ağrı korkusuna etkisini araştırmak amacıyla yarı deneysel olarak yapılmıştır. Soğuk sprey uçucu sıvının hızlı buharlaşmasıyla cilt sıcaklığını düşürerek ağrı reseptörlerinin duyarsızlaştırır ve ağrı duyusunun geçici olarak kesilmesini sağlar. Etkisinin hızlı başlaması, maliyeti uygun ve kullanımı kolay bir ağrı önleme yöntemidir. Bu çalışma bir devlet hastanesindeki enjeksiyon polikliniğine başvuran ve siyanokobalamin etken maddesini içeren reçeteli ilacı olan hastalara uygulanmıştır. Çalışma, haziran- ağustos 2022 tarihlerinde 48 müdahale, 48 kontrol grubu toplam 96 katılımcıyla yapılmıştır. Enjeksiyon işlemi araştırmacı tarafından ventrogluteal bölgeden, belirlenen işlem basamaklarına uyularak gerçekleştirilmiş ve gerekli tüm etik izinler alınmıştır. Müdahale grubuna enjeksiyon öncesi soğuk sprey uygulanmış kontrol grubuna herhangi bir girişim uygulanmamıştır. Veri toplama araçları olarak ise Kişisel Tanılama Anket Formu, Visüel Analog Skala ve Ağrı Korkusu Ölçeği-III kullanılmıştır. Verilerin değerlendirilmesi normal dağılmayan, ikili gruplar arasındaki karşılaştırmalarda Mann-Whitney U testi, ölçümler arasındaki farklılık için Wilcoxon İşaret Testi kullanılmıştır. Müdahale grubunun tamamının, kontrol grubunun %68,8'inin daha önce enjeksiyon tecrübesi yaşadığı görülmüş ve enjeksiyon sırasında müdahale grubunun %39,6'sı kontrol grubunun ise %30,3'ü ağrı yaşadığını bildirmiştir. Müdahale grubunun visüel analog skala son test değerleri ön test değerlerinden anlamlı derecede daha düşüktür. Ağrı korkusu ölçeğinde ise her iki grupta "Tıbbi Ağrı Korkusu ve Toplam Ağrı Korkusu Ölçek Puanı" ön test- son test değerleri arasında anlamlı bir farklılık görülmektedir. Gruplar arasına bakıldığında ise "Şiddetli Ağrı Korkusu Ölçek Puanları" ön test değerleri son test değerlerinden anlamlı derecede daha yüksektir. Sonuç olarak; soğuk sprey uygulamasının intramüsküler enjeksiyona bağlı ağrı ve ağrı korkusunu azalttığı görülmüştür. Bu nedenle intramüsküler enjeksiyonlarda konfor sağladığı ve hemşireler tarafından kullanımı önerilmektedir.
Irak'taki Al-Nasseriya şehrindeki hemşirelerin kronik böbrek hastalıkları hakkındaki bilgilerinin değerlendirilmesi
Background: Many types of kidney disease may cause a gradual loss of kidney functions over time. Diabetic kidney disease is a progressive disorder that may lead to renal failure. The kidneys remove waste materials and extra fluid from the circulation and excrete it as urine. A buildup of potentially harmful fluids, electrolytes, and waste products may occur in people with severe chronic renal disease. The most common causes of chronic kidney disease include diabetes mellitus, high blood pressure, obesity, certain hereditary illnesses, tobacco use, and excessive alcohol consumption. There may be no outward signs at first, but as the illness progresses, problems like leg swelling, fatigue, vomiting, lack of appetite, and disorientation may appear. Increased risk of cardiovascular disease, renal failure, hypertension, osteoporosis, anemia, blood creatinine levels, urine results, and a thorough medical history are the primary diagnostic tools for chronic kidney disease. The health of patients with chronic kidney disease must be monitored regularly, with clinical and laboratory examinations as well as educational seminars on the risks and treatments for chronic kidney diseases, according to numerous scientific studies and reports from organizations like the World Health Organization and the Centers for Disease Control. Objective: The aim of the study is to assess nurses' knowledge about chronic kidney diseases in Al-Nasseriya City/Iraq. Materials and Method: To achieve the study's aims, descriptive cross-sectional design was used. Between March 2022 and May 2022, non-probability sampling (purposive sampling) was used to conduct this study in the kidney diseases, hemodialysis, and emergency departments at Al-Hussein teaching hospital in Nasiriyah, Iraq. The sample included 100 nurses, including 20 from the Kidney Diseases Unit, 31 from the Hemodialysis Unit, and 56 from the Emergency Room of Al-Hussein Teaching Hospital. A two-part questionnaire was prepared as a data collection tool. The socio-demographic profile of the nursing staff is questioned in the first part (age, gender, educational level, marital status, clinical nursing experience, place of the unit, duration of working in the unit, status of following updated information, information sources, status of receiving training on chronic kidney diseases or course of chronic kidney diseases). The second part consists of 33 questions and their responses (sure, not sure, and I don't know). Each nurse's level of knowledge was evaluated based on the percentage of correct responses. The data was analyzed using both descriptive and inferential statistics. Results: The majority of the participants were female, aged 20–29, and had completed secondary school in nursing or a nursing training program. They were married and had a high experience (49%) of six to ten years in clinical nursing work, a great majority of the participants worked in emergency departments (49%), and the vast majority of them had worked in those units for one to five years (56%). 55% of the participants did not want to get scientific information about kidney disease. The majority of people with chronic kidney disease learned about such information from books and the Internet. The vast majority of them did not receive any kind of training on chronic kidney disease. Even though 68% of the nursing staff held degrees from secondary schools and institutes, their knowledge of chronic kidney disease was low based on their responses to the questionnaire items and since they did not follow recent scientific developments. Conclusion: The results of the study revealed that most of the participants had moderate knowledge of chronic kidney disease because of their low levels of education, the absence of training courses specialized in kidney disease, and the lack of educational programs and protocols to train those staff.
Evaluation of nurses' practices for trauma patients during the golden hours of care in the emergency department in Al-Najaf city hospitals
Background: Trauma injuries cause millions of deaths worldwide, and for every fatal accident, several thousand injury survivors are left with permanent disabilities. While most injuries are currently thought to be preventable, unlike other disease processes such chronic disease, osteoarthritis, and neoplasms, injuries are typically instantaneous as a result of a quick, unexpected incident. Objective: The aim of the study is to evaluate nurses' practices for trauma patients during the golden hours of care in the emergency department in Al-Najaf city hospitals. Methods: In the study, the descriptive cross-sectional design was used. A total of 201 nurses were randomly selected among nurses who work in the emergency department in the Al-Sader Medical Hospital Al-Hakem General Hospital and Imam Al-Sajjad Hospital, in Al-Najaf Governorate (n = 420) according to calculating the number of nurses for each hospital. The study of Krejcie and Morgan was used to determine the sample size based on an equation. This procedure included selecting (201) nurses from the Al-Sader Medical Hospital Al-Hakem General Hospital and Imam Al-Sajjad Hospital, where the proportional stratified sampling procedure was employed for calculating the number of nurses for each hospital. Data are collected by using two tools. The first tool was a questionnaire designed to collect the demographic characteristics of nurses. The second tool was an observational checklist to evaluate nurses' practices towards trauma patients during the golden hours of care and it consisted of two domains; a primary survey and a secondary survey. Data were collected from April to September 2022 through interviews with nurses and data were analyzed by applying descriptive statistical analysis that included percentages, numbers, standard deviation values, mean scores, and p-value. Results: It was found that most of the participants 71.14% were less than 30 years old, 50.75% were female, 50.25% were single, 49.75% were bachelor graduates and 36.82% had been working for 3-6 years. 57.71% of the nurses did not participate in the training courses, and 56.72% did not participate in the training courses. They did not attend these courses and 45.77% work the morning shift. Among the other hospitals in the primary and secondary surveys, 88.56% of the nurses had unsatisfactory practices for trauma patients and only 11.44% of the nurses' practices were satisfactory. In addition, there was a statistically significant correlation between nurses' practices and gender (p=0.038), beneficiaries of training courses (p=0.024) and shift work (p=0.025) and no statistically significant correlation was found between other demographic characteristics and nurses. Conclusions: As a result of this study, it was concluded that nurses did not have adequate practices in the care of trauma patients. It is recommended that nurses be frequently included in training courses and training programs frequently in order to increase nurses' knowledge and improve care practices for trauma patients.
Assessment of nurses` knowledge about diabetic foot care management in iraq
Background: Diabetic foot is a significant concern for diabetics, and it is one of the biggest challenges facing health care providers, particularly nurses. It is widely acknowledged that nurses play a crucial role in the care and treatment of diabetic feet, as well as in informinging patients about diabetic foot concerns, preventative foot care, and foot wounds. Nurses are constantly interacting with patients at risk of developing diabetes complications, and education is the most important factor in controlling diabetic foot complications, so they must have the skills and expertise to effectively address this issue. Objective: The aim of the study is to evaluate nurses' knowledge needed to manage diabetic foot care at Al-Diwaniyah Teaching Hospital in Al-Diwaniyah city / Iraq. Method: A descriptive, cross-sectional study was carried out in order to achieve the study's objectives. The current study was conducted on the nurses who were working at Al-Diwaniya Teaching Hospital in Iraq. Thev sample size was 298 (n = 298), which represents the representative sample of all nurses at AL-Diwaniya Teaching Hospital after some inclusion and exclusion considerations. Data collection form consisted of four domains, demographic characteristics, professional characteristics, risk factor, and foot examination. Data collection took place between April 2022 and July 2022. The data were analyzed using the statistical software. Frequencies, percentages, maximums, and minimums were used to describe the data Results: The study found that 44,3% of the nurses were young (18–25 years old). Concerning gender, the greater number of them were females and accounted for 54,4%. In relation to social status, the most were married, accounting for 65,8% of all nurses. While the level of education, 44,3 % of the nurses had diplomas while only 2% had postgraduate degree. Regarding the shift work, most (59.1%) of the nurses were working during the day. 69,1% of the nurses were educating patients about diabetic foot, and 57% of them did not perform diabetic foot exams for the patients. 83,2% of the nurses expressed a desire to be trained on diabetic foot care, particularly on foot examination. Regarding the knowledge assessment of the nurses about risk factors, the rate of nurses who answered the questions correctly was 63,8 %. Regarding the assessment of knowledge about foot examination, about 53 % of the total respondents were correct. Conclusions: This study's findings suggest that nurses lack essential knowledge for effectively managing diabetic foot care, which is also affected by substantial effects. It is recommended for nurses to regularly participate in training courses and educational programs in order to better care for diabetic patients
Evaluation of nurses' knowledge about patient safety after diagnostic cardiac catheterization in Iraq
Background: There will be 17.9 million deaths worldwide due to cardiovascular disease in 2022, and the death rate by age in Iraq is two hundred twenty-seven and twenty-six per hundred thousand inhabitants, and it ranks 23rd in the world. Cardiac catheterization is the most common type of heart procedure. There is a possibility that the surgery may be accompanied by some complications related to the patient. These problems have been dramatically reduced due to significant technological advances in cardiac catheterization, improvements in operator proficiency levels, and the implementation of new methods. In some cases, cardiac catheterization applies to either right or left heart catheterization or both. Nurses caring for cardiac catheterization patients must also be aware of vascular problems such as hematomas, retroperitoneal bleeding, pseudoaneurysm, arteriovenous fistula, compression, and embolism. Atherosclerosis, after the procedure, nurses must design a standard and safe protocol for patient care or care, and coronary connective tissue intervention can be enhanced as a result of patient outcomes if more or better medical assistance is available. Objectives: This study evaluated nurses' patient safety knowledge after diagnostic catheterization. Methodology: A descriptive cross-sectional study was conducted between May-August 2022 at the Nasiriyah Heart Center in Nasiriyah, Iraq. The study population consisted of nurses100 in the cardiac catheterization department, 50 in the cardiac care unit, 50 in the intensive care unit, 34 in the operating department, and 50 in cardiology. Clinics, 50 in the department of Men's surgery and 50 in the department of women's surgery. Inclusion criteria were determined as follows; being 18 or over in these specific units, nurses and night shift workers are included during the morning and evening shifts. As nurses who did not work in these units are excluded, inpatients and patients outside these hospitals are also included. Face-to-face data were collected using a questionnaire to identify nurses' sociodemographic factors and a questionnaire of nurses' knowledge regarding patient safety after diagnostic cardiac catheterization to collect data. The data were analyzed using SPSS version 26 (Statistical Package for Social Sciences) through statistical data analysis methods to determine whether the study's objectives were achieved. Descriptive statistics were used: frequencies, percentages, mean, standard deviation, one-way analysis of variance (ANOVA), two-sample t-test, and the significance level to be determined in data evaluation is P≤0.05. Result: The study showed that the majority of the study sample was female at a rate of 53.4% and that 45.3% were between the ages of 26-35 years, 57.0% were married, 50.8% were nursing diplomas, and 51.3% were male. It was determined that the total knowledge scores of the participants showed a statistically significant difference according to the nurse's education (p < 0.05). Accordingly, the sum of knowledge scores for the undergraduate group is higher than the other groups, and it was also determined that the sum of knowledge scores showed a statistically significant difference according to the participants' experience (p < 0.05). According to the results, it was observed that the group with one year of age or less had a total knowledge score of 6 to 10, higher than the groups with 11 or more years of age. The 3-year-olds had higher total knowledge scores than the 4- to 7-year-old group. In addition, it was determined that the total knowledge scores of the participants showed a statistically significant difference according to the training date (p < 0.05). Accordingly, the total knowledge scores for the group that did not take a particular education course were higher than for the other groups. Multiple comparison tests were performed to determine which group the difference arose from. According to the results, it was observed that the total cognitive scores of the group that did not take a unique course were higher than those obtained by the groups that received it six months ago and one year ago. Conclusions: As a result of the study, nurses' knowledge level about patient safety after cardiac catheterization was found to be moderate.
Assessment of the quality of life for elderly people with acute myocardial infarction living in al-najaf
Background: Having heart diseases or coronary artery disease is the leading cause of heart disease deaths. Its syndrome includes myocardial infarction syndrome, sudden cardiac death, and stable angina. Moreover, it causes myocardial ischemia and massive necrosis, so acute myocardial infarction occurs due to sudden blockage of a coronary artery. Acute myocardial infarction has increased in younger age groups, with mortality rates as well as progressive arrhythmias, cardiogenic shock, and persistent retrosternal pain, putting patients at risk of death. Emergency percutaneous coronary intervention opens and dredges blood vessels to restore blood flow and reduce the determined myocardial area, thus resulting in improved patient prognosis. Patients with myocardial infarction may develop coronary artery stenosis and ischemia after this intervention. Perioperative nursing care for acute myocardial infarction patients undergoing interventional therapy has been shown to directly influence surgical success, reduce complications and improve rescue success rates, which has significant clinical implications for finding a safe and effective mode of care to improve outcomes of patient with acute myocardial infarction and therapeutic effects. Health-related quality of life, a new term developed in the past 30 years, encompasses the physical and emotional factors. Health-related quality of life takes into account expectations of an individual's physical and mental health, like energy level and mood, as well as the relationships between these two aspects of health, health risks and disorders, employment status, welfare, and socioeconomic status. Acute myocardial infarction survivors are characterized and subjective health-related quality of life pathway differences are not noted. It would be easy to determine whether integrated care therapies would enhance valetudinarians' long-term quality of life; therefore, quality of life measurements may improve physical functioning, relieve pain, and predict treatment efficacy or mortality rate. Objectives: This study aimed to assess the quality of life in old age patients with acute myocardial infarction. Methodology: A descriptive cross-sectional study was conducted between February and May 2022 in three hospitals (Al-Hakim General Hospital, Al-Furat Al-Awsat Hospital, and Al-Najaf Center for Cardiac Surgery and Catheterization) in Al-Najaf City, Iraq. The population consisted of old age patients with acute myocardial infarction in these hospitals. The sample consisted of 197 old age male and female patients in the related hospitals: 48 in Al-Hakim General Hospital, 39 in Al-Furat Al-Awsat Hospital, and 110 in Al-Najaf Center for Cardiac Surgery and Catheterization who agreed to participate during the data collection time. Inclusion criteria were determined as being 60 years or older in these hospitals, being hospitalized patients. Patients in the hospital other than these hospitals were also excluded. Data were collected using a personal information form and the MacNew heart disease health-related quality of life questionnaire and analyzed using frequency, percentage, mean, standard deviation, and ANOVA and t-test in SPSS 26 software. p≤0.05 was accepted as the level of significance. Result: 51.3% of the participants were female and 71.6% were older than 65 years of age. 55.8% were married, 81.2% were unemployed, 48.7% were hospitalized in the cardiac care unit for the first time, 45.2% were secondary graduates, and 42.1% stayed in hospital for 3 days. The score of MacNew heart disease health-related quality of life questionnaire was 67.78 ± 8.71, the mean score of global subscale was 0.86 ± 2.71 and the lowest mean score was obtained from social subscale (2.11 ± 0.74). The score of MacNew heart disease health-related quality of life questionnaire was higher in those who were from the age group of 60-64 years, were working couples, were staying in critical care units for the first time, were college/university graduates, had no comorbidity, and were staying in the hospital for one day compared to the other groups, and there was a statistically significant difference between them (p≤0.05). Conclusion: Consequently, it was found that old age patients with myocardial infarction were affected by variables such as age, marital status, work, and education.
Koroner anjiyografi uygulanan hastaların kaygı düzeyleri ile hemşirelik bakımını algılayış durumlarının değerlendirilmesi
Bu araştırma, koroner anjiyografi işlemi uygulanacak hastaların işlem öncesi ve sonrası dönemlerde kaygıları ile hemşirelik bakımını algılayış durumlarının belirlenmesi amacıyla tanımlayıcı olarak gerçekleştirilmiştir. Veriler, İç Anadolu Bölgesi'nde yer alan bir şehir hastanesinin kalp damar hastanesi anjiyografi ünitesinde Nisan-Temmuz 2022 tarihleri arasında toplanmıştır. Araştırmanın örneklemini araştırmaya katılmayı kabul eden, 18 yaşından büyük, Türkçe okuma yazma bilen, herhangi bir psikiyatrik veya mental hastalığı olmayan, herhangi bir iletişim sorunu olmayan, ilk defa koroner anjiyografi yapılan ve sağlık profesyoneli olmayan 58 hasta oluşturmaktadır. Verilerin toplanmasında "Hasta Tanıtım Formu", "Durumluk-Sürekli Kaygı Envanteri" ve "Hastanın Hemşirelik Bakımını Algılayışı Ölçeği" kullanılmıştır. Durumluk-Sürekli Kaygı Envanteri ve Hastanın Hemşirelik Bakımını Algılayışı Ölçeği hem işlem öncesi hem de sonrası tekrarlanarak uygulanmıştır. Veriler SPSS 21 paket programı aracılığıyla analiz edilmiştir. Katılımcıların %62,1'i erkek, %43,1'i 60 yaş ve üzeri, %55,2'si ilköğretim mezunu, %34,5'i emekli, %84,5'i evlidir. Durumluk-Sürekli Kaygı Ölçek puan ortalamaları sırasıyla işlem öncesi 42,26±5,38, 49,16±6,78; işlem sonrası 41,69±5,15, 48,03±7,24'tür. İşlem öncesi Hastanın Hemşirelik Bakımını Algılayışı Ölçeği puan ortalaması 71,22±6,11, işlem sonrası puan ortalaması ise 71,97±4,76'dır. Sonuç olarak hastaların işlem öncesi ve sonrası durumluk ve sürekli kaygı puan ortalamaları açısından orta düzey kaygı yaşadıkları görülmektedir. Araştırmada hastaların hemşirelik bakımını algılamalarının hem işlem öncesi hem de işlem sonrası dönemde yüksek olduğu söylenebilir. Bu sonuçlar doğrultusunda bireylere hemşirelik süreci yaklaşımıyla bakım verilerek sağlık durumlarının sürekli izlenmesi ve değişen ihtiyaçlarına göre bakımlarının yeniden planlanması, bu konuda kanıta dayalı çalışmaların arttırılması, hastaların kaygı düzeylerinin ve memnuniyetlerinin uygun ölçeklerle değerlendirilmesi, sonuçlara göre uygun planlamalar yapılması önerilir.
Yoğun bakım hemşı̇relerine verilen ı̇zolasyon önlemlerı̇ eğitiminin bı̇lgı̇ ve uyum düzeylerı̇ne etkisinin değerlendirilmesi
Bu araştırma yoğun bakım ünitelerinde çalışan hemşirelere izolasyon önlemlerine yönelik verilen eğitimin bilgi ve uyum düzeylerine olan etkisini değerlendirmek amacıyla ön test-son test kontrol gruplu yarı deneysel bir araştırma olarak yapılmıştır. Araştırma İç Anadolu Bölgesi'nde yer alan bir şehir hastanesinin iki farklı kulesinde, 3. basamak erişkin yoğun bakım ünitelerinde çalışan hemşireler ile gerçekleştirilmiştir. Araştırmanın örneklem hesaplanmasında güç analizi kullanılarak 30 kontrol ve 30 müdahale olarak iki gruba ayrılmıştır. Veriler "Kişisel Bilgiler Formu", "İzolasyon Önlemleri Bilgi Testi" ve "İzolasyon Önlemlerine Uyum Ölçeği" ile toplanmıştır. Araştırmada kontrol ve müdahale gruplarına ön test olarak bilgi testleri; müdahale grubuna ise ön test sonrası "Enfeksiyon Kontrol ve İzolasyon Önlemleri" içerikli eğitim verilmiş ve eğitim sonrasında eş zamanlı ikinci test uygulanmıştır. Veri toplama sürecinin en son aşaması olarak 2 hafta sonrasında kontrol ve müdahale gruplarına son test kapsamında bilgi testleri uygulanmıştır. Verilerin analizinde SPSS 22 paket programı, gruplar arası karşılaştırmalarda Mann-Whitney U testi, grup içi karşılaştırmalarda ise Wilcoxen işaret testi kullanılmıştır. Araştırma sonucunda, müdahale grubunun izolasyon önlemleri bilgi testi puanlarında, ikinci testte ön testte göre anlamlı bir artış olduğu (p = 0,0001), son testte ise ön testte kıyasla anlamlı bir fark olduğu, eğitimin katılımcıların bilgi seviyelerini arttırdığı tespit edilmiştir (p < 0,001). Müdahale grubunun "İzolasyon Önlemlerine Uyum Ölçeği"ndeki ikinci test puan ortalamasında ön testte göre anlamlı bir artış olduğu gözlemlenmiştir (p = 0,011). Sonuç olarak, verilen eğitimin hemşirelerin bilgi düzeylerini arttırmada etkili olduğu, diğer alanlarda uyum ve bilgi artışının sınırlı kaldığı tespit edilmiş olup, davranışsal değişiklikler için farklı müdahalelerin (uygulamalı eğitim, simülasyon vs.) uygulanması önerilmektedir. Anahtar Kelimeler: Bilgi, Hemşire, İzolasyon, İzolasyon Önlemlerine Uyum, Yoğun Bakım Üniteleri.
İlçe devlet hastanesine başvuran kronik obstrüktif akciğer hastalığı olan bireylerin hastalığa uyum durumlarının incelenmesi
Kronik obstrüktif akciğer hastalığı, dünya genelinde prevalansı, mortalitesi ve morbiditesi yüksek, ilerleyici, önlenebilir ve tedavi edilebilir bir hastalıktır. KOAH ile ilgili çalışmalar yapılmasına rağmen halen görülme sıklığı fazladır. KOAH sadece bireysel bir sorun değil toplumsal düzeyde tüm insanlığı etkileyen bir sorundur. Bu çalışmada ilçede yaşayan ve acil servise başvuran KOAH'lı bireylerin hastalığa uyum düzeyinin incelenmesi amaçlanmaktadır. Veriler, çalışma kriterlerini karşılayan ve 2024 yılının Mart ve Temmuz ayları arasında İç Anadolu Bölgesi'nde bulunan bir ilin ilçesinde yer alan ilçe devlet hastanesi acil servisine başvuran 44 KOAH'lı bireyden elde edilmiştir. Veriler, yüz yüze görüşme yöntemiyle bireylerin onayı alındıktan sonra Kişisel Bilgi Formu ve Kronik Hastalık Uyum Değerlendirme Ölçeği kullanılarak toplanmıştır. Çalışmanın sonucunu etkileyen önemli faktörler ilçe devlet hastanesi acil servisini kapasitesi ve yataklı servisinin bulunmamasıdır. Tanımlayıcı bulgular için sayı, yüzde, minimum, maksimum, ortalama ve standart sapma değerleri belirlenmiştir. Bulgular için anlamlılık düzeyi p <0,05 olarak kabul edilmiştir. Bireylerin ölçekten elde ettikleri toplam puan ortalaması 59,90±3,85'tir. İlköğretim ve üzeri eğitim almış olan bireylerin Kronik Hastalıklara Uyumu Değerlendirme Ölçeği sosyal alt boyutundan aldıkları puan ortalaması eğitimi daha düşük seviyede olanlardan anlamlı ölçüde yüksektir (p=0,04). Kronik obstrüktif akciğer hastalığı dışı solunum yolu enfeksiyonu olan bireylerin spiritüel alt boyut puan ortalamaları anlamlı oranda yüksektir (p=0,03). Sonuç olarak, KOAH'lı bireylerin hastalığa uyum düzeyleri orta düzeyde olup, eğitim, yaş, psikososyal destek gibi faktörler bu uyumu etkilemektedir. Hastalığa uyumu etkileyen etmenler hemşirelik bakım planına entegre edilmelidir. KOAH'lı bireylere hastalığa uyum düzeylerinin arttıracak eğitim vermek hastalığın seyrini olumlu yönde etkileyebilir. Gelecekte KOAH için yeni tedavi yöntemlerinin geliştirilmesi bireylerin hastalığa uyumunu arttırabilir.
The determination of nurses views of knowing the myocardial infarction
Background: Myocardial infarction is when cardiac muscle cells die from a lack of oxygen. In acute coronary syndrome, blood vessels harden, and arteries become clogged by thrombuses, restricting blood flow. Many people who have chest pain, shortness of breath, and profuse sweating have an acute myocardial infarction, these symptoms may be possible for other diseases. Also, not all people who feel pain in their chest have an acute myocardial infarction. A 12-lead electrocardiogram and cardiac enzymes should be obtained as soon as possible when a patient presents symptoms and a full clinical evaluation. Doctors and nurses have an important role in identifying heart attacks and advising patients on how to avoid it through early diagnosis and suggesting preventative measures. Objectives: The aim of this study is to determine the views of nurses about knowing myocardial infarction. Methods: A descriptive study was conducted in Al-Sader Teaching Hospital in Basra City in the coronary care wards, the emergency, intensive care unit, and the internal medicine unit, in addition to the catheterization unit. The study included a non-probability sample of 100 nurses working in the units above. The study data were collected from February to March 2022. The researcher created a questionnaire designed for data collection forms after reviewing the literature and relevant sources. The first part includes demographic information for the nursing staff generally, including their ages, sexes, years of clinical experience, level of education, marital statuses, places of employment, and whether or not they have worked in the cardiac unit before. In regards the second part comprehensive general information about the topic of Myocardial infarction consisted of 29 items. And statistical analysis was performed on the collected data using descriptive statistics, such as percentages and frequencies, were used in the analysis of the results. Results: The study showed that 56% of the sample females, with an average age of 19–28 years accounted for 63%, and the level of education, with the majority in secondary school nursing 42%. And the years of nursing experience were less than a year 37%. The majority did not participate in a training course 87%. And 34 % of the participating nursing employees work in the internal medicine unit, and 47% of the nurses participating in the research did not follow up or update their information, Also, only 16% of the nursing staff worked in coronary care units previously. 57% of respondents do not know that myocardial infarction causes heart failure and cardiogenic shock, in addition to cardiac arrest. 15% of the participants knew that chest pain was one of the most common symptoms of myocardial infarction. 16% of nurses know that patients' health becomes better when they receive high-quality nursing care for patients with myocardial infarction. And 60% of the participants did not know that myocardial infarction can be reduced by taking lipid-lowering drugs, 46% of the staff knew that monitoring vital activities, conducting an electrocardiogram, oxygen saturation, and others are important for a patient with a myocardial infarction. 38% of nurses do not know that the most common cause of myocardial infarction is plaque rupture from atherosclerosis. 38% of nurses were know that body mass index can be assessed to determine whether or not a patient is obese and therefore at risk for a myocardial infarction. About half of the respondents 57% were did not know that myocardial infarctions typically cause a diffuse, constant discomfort that lasts longer than 20 minutes regardless of body position. Conclusion: Findings from the study indicated that nurses' knowledge fell short of expectations or did not reach the required level because of insufficient training and experience among nursing staff. The study recommended allowing nursing staff to complete their studies in nursing colleges and activating training courses and educational programs for nurses.
Factors affecting the quality of life of patients with diabetes mellitus: A descriptive cross-sectional study
Background: Diabetes mellitus is now one of the most difficult public health issues of the 21st century. It is a metabolic disease that causes high levels of glucose (hyperglycemia) in the blood and stems from problems in insulin production, insulin action, or both. Diabetic patients have a lower quality of life in both rural and urban areas. Objective: The aim of the study is to assess the factors affecting the quality of life of diabetics Method: This is a descriptive cross-sectional study. 200 adults with diabetes, including 110 females and 90 males, were randomly selected from patients receiving treatment in Sharqat General Hospital in Salah al-Din Governorate. The participants answered a three-part questionnaire including demographic characteristics, medical characteristics, and quality of life domains prepared based on the World Health Organization Quality of Life Questionnaire. Five-point scales were used to classify items. Data collection took place between January 1th, 2022 and February 5th, 2022 through the use of an interview. The data was analyzed by applying descriptive statistical analysis that included number, percentage, mean, standard deviation, p-value and anova. Results: When it comes to age groups, the participants were mostly from the age group of 57 years and older (40,5%). The results showed that diabetes was more prevalent in females than in males (55%). The sample comprised almost all married patients (97,5%). As for the education level, a great majority of the participants were primary school graduates (43,5%). About 44% of the samples were housewives. The results also showed that monthly income of the participants was barely sufficient, which was approximately 54% or more than half. In terms of residence place, most of the patients were living in rural areas (61%). The number of family members in the house ranged between 6-10 members (49%). The number of children was mostly 1-2 (46%). The results showed that number of the patients with diabetes of the second type was higher than number of the patients with diabetes of the first type (61%), and the percentage of diabetes diagnosed for a year or more was 90%. While patients who used oral hypoglycemic drugs was 59,5%, those who used insulin was 29,5%. In terms of the presence of chronic diseases, some patients had mostly heart diseases and hypertension, which accounted for 55% of the diseases and more than half of the patients with diabetes had genetic diseases (53%). About 47% of the participants gave the answer "no," that is, there was no genetic disease. When it comes to smoking, the majority of the participants (83,5%) were non-smokers, while 16,5% of them were smokers. All the participants did not consume alcohol (100%). The rate of patients who had a device for measuring blood glucose was 40,5%. The rates of patients who measured their blood glucose daily, weekly, and monthly were 21,5%, 42,5%, and 36%. The results showed that the body mass index of 25-29,9 had the highest percentage (50%). Upon examination, it was determined that the quality of life was at a high level in social relations, (72,86 ± 14,08), while the lowest mean of score was seen in physical domain (4,95 ±12,67). quality of life had a strong correlation with some socio-demographic characteristics (gender, educational level, occupation, monthly income, residence, number of children, type of medication, and presence of chronic diseases). Middle-aged and elderly people were more likely to be obese, the information obtained about the disease was acceptable, but the safety precautions against the disease were poor. At the level of P < 0,05 there was a significant difference between gender, educational level, occupation, monthly income, residence place, and number of children (P = 0,003, 0,019, 0,009, <0,0001, <0,0001, and 0,031). There were a significant difference between type of drug, do you have chronic diseases, If yes, who with P = 0,012, 0,025, and 0,009. Conclusions: This study supported the effect of diabetes on the quality of life of patients in our country. It was also observed that the information obtained about the disease was acceptable, but the safety precautions against the disease were weak.
Factors affecting the quality of life of patients with HEART failure in irak
Background: Heart failure, whose frequency is increasing every other day and which can sometimes be diagnosed incorrectly, is a general and serious condition of health that can lead to a serious influence on the quality of life and life expectancy of patients. Because of changing population dynamics, the prevalence of hypertension and coronary heart disease will increase modestly assuming constant incidence rates specific to age, race and gender. The incidence of diabetes and obesity is expected to rise by age, ethnicity and gender, resulting in a higher prevalence of these risk factors and possibly a higher prevalence of heart failure than that caused by alteration population dynamics. Heart failure will remain a growing health problem. Objective: The aim of the study is to evalyuate the levels of factors affecting the quality of life of patients with heart failure. Methods: In the study, adescriptive cross-sectional design was used. A total of 150 adults with heart failure were randomly selected among patients in the Al-Hakeim, Al-Sadir, and Al-Furat hospitals, which provides health care for patients with heart failure, in Nejef Governorate (n = 246) according to the hospitals' monthly target for intensive care units. The study relied on the study of Krejcie and Morgan to determine the sample size based on an equation. This procedure included selecting (150) patients from the Al-Hakeim, Al-Sadir, and Al-Furat hospitals, where the total number of patients was 246. Al-Sadir hospital included 199 patients, Al-Hakeim hospital had 35 patients, and Al-Furat hospital had 12 patients. The proportional stratified sampling procedure was employed for calculating the number of patients for each hospital. So, the number of patients selected from each hospital was found as follows: 122 from Al-Sadr Hospital, 21 from Al Hakim Hospital, and 7 from Al Furat Hospital. Participants answered a three-part questionnaire. These parts included demographic characteristics, medical characteristics, and quality of life domains from the World Health Organization Quality of Life Scale. A five-point likert-type scale was used to evaluate the items. Data were collected from January 1, 2022 to March 1, 2022 through interviews and were analyzed by applying descriptive statistical analysis that included percentages, numbers, standard deviation values, mean scores, and p-value. Results: It was found that the majority of the patients with heart failure were aged 65 and above, the disorder was more prevalent among females, the majority of the patients had not received higher education, most patients were housewives and unemployed, and that the majority of patients with heart failure were urban residents. According to the findings, most patients with heart failure had a considerable limitation in physical activity, the majority of them had high blood pressure and diabetes, and most of them were smokers. The study indicated that the majority of patients controlled their weight, a high percentage of patients had been readmitted to hospital due to heart failure, and that most of the patients could not do their personal hygiene. The majority of patients had a higher level of social support than the rest of the psychological, environmental, and physical domains. The information obtained about the disease was acceptable, but the safety precautions against the disease were poor. Statistically significant differences were found between quality of life and occupation, monthly income, and stage of heart failure and hospital readmission. Conclusions: We concluded that the quality of life had a substantial effect on patients with heart failure, as the quality of life of the majority of patients in Najaf governorate was poor.
Assessments of knowledge of nurses working in hemodialysis units in Al-najaf on toward infection control measures
Background: Renal failure patients undergoing hemodialysis treatment and nursing staff working in hemodialysis units are at a significantly increased risk of healthcare-acquired infections, for example, blood-borne infections such as hepatitis B virus, hepatitis C virus, human immunodeficiency virus, and bacterial and fungal infections due to repeated and prolonged exposure to many potential pollutants in the hemodialysis setting. Healthcare-acquired infections are the most common reason for hospitalization and mortality rates among hemodialysis patients after cardiovascular disease. Nursing staff's compliance with infection control and prevention measures reduces transmission, therefore standard precautions must be adhered to in hemodialysis units. Objective: The aims of the study is to assess knowledge of nurses working in hemodialysis units towards infection control measures. Materials and Method: Quantitative design (the descriptive cross-sectional study) was used to achieve the objectives of this study. This study was conducted in the hemodialysis units at Al-Najaf city hospitals in Iraq between March 2022 and April 2022 based on a non-probability sampling (purposive sampling). The sample consisted of 100 nurses including 59 nurses working in Al-Sadr Medical City Hospital and 41 nurses working in Al-Hakim General Hospital. A questionnaire was prepared as a data collection tool and consists of two parts. The first part includes the socio-demographic information of the nursing staff (age, gender, level of education, residence, marital status, workplace, years of experience in hospitals, years of experience in hemodialysis unit, participation in training courses related to hemodialysis units, participation in training courses related to infection control measures, and doses of the hepatitis vaccine they got). The second part includes 39 multiple-choice questions aiming to assess knowledge of nurses working in hemodialysis units about infection control measures. The number of correct answers was used to measure each nurse's knowledge level. They were rated as two points for correct answer and one point for incorrect answer. Descriptive and inferential statistics were used to analyze the results. Results: The findings of the study showed that the majority of the participants were female and aged between 25 and 29 years, had a bachelor of nursing, lived in urban cities, were married and were well-experienced in working in hospitals and hemodialysis units, and a great majority of them got the hepatitis vaccine, most of them also received training courses on hemodialysis and infection control measures. The results revealed that the nurses' knowledge of the infection control measures was average (moderate). 74,95% had a statistical mean score of 1,499. The findings also showed a high level of statistical significant correlation between nurses' knowledge of working in hemodialysis units and socio-demographic information in line with the critical and unique nature of hemodialysis units, such as the educational level of socio-demographic information, participation in training courses on hemodialysis units inside and outside Iraq, and participation in training courses on infection control measures training inside and outside Iraq, the number of infection control training courses, and duration of infection control training courses. The probability value were (p < = 0,05). Conclusions: The study concluded that most of the participants had knowledge about infection control measures and there was a highly statistically significant correlation between nurses' knowledge levels and their socio-demographic information, but because of the critical and unique nature of hemodialysis units, very strict procedures must be imposed in those units and nursing staff must be trained on infection control measures for hemodialysis units.