In general in Turkey, only manual pressure is used to achieve initial hemostasis at the femoral insertion site, with a pressure dressing and sandbag added to maintain hemostasis. Arterial closure devices are rarely used. In general, after the procedure, patients are required to lie flat with, at most, a 15- to 30-degree elevation during bed rest. To prevent contrast nephropathy in patients at risk, intravenous saline solutions are started before the procedure and continued afterward. In other patients, only oral fluid replacement is used. Traditional approaches in the management of femoral artery insertion site continue, and practices used in the prevention of contrast nephropathy are similar to current practices.
Antikoagülasyon kontrolü sağlanan ve sağlanmayan hastaların tedaviye ilişkin bilgi ve uyumlarıWarfarin is widely used for the treatment of thromboembolic cases. International Normalized Ratio (INR) control should be carried regularly to adjust the dose of warfarin. This is because excessive anticoagulation increases the risk of bleeding while inadequate anticoagulation increases the risk of thromboembolism (1). For this reason, it is vital that patients taking warfarin be informed about the reasons and importance for using this drug, the control of its impact, and the drug-drug and drug-nutrient interactions.This study investigated the knowledge and adherence to treatment in patients who were given the anticoagulant drug-warfarin and who had poor or improved anticoagulation control. This cross-sectional observational study was conducted with 153 patients admitted to cardiology department of a university hospital between October 2009-March 2010. Data were collected with a "Questionnaire" and "Information Form". In statistical analysis, MannWhitney U, Kruskal Wallis, Chi-square test and descriptive statistics were used. A p≤0.05 was considered significant.Among the patients, 51% were female, the majority (86.3%) were married and the mean age was 58.5±12.5 years. Also, 54.9% of the patients reported mitral valve replacement, 31.4% used warfarin due to atrial fibrillation. The study found that 56.9% of the patients used the drug regularly, the majority (80.4%) had blood test regularly, and the INR value was within the therapeutic range for only 43.1%. The majority of the patients (68%) suffered minor problems due to warfarin use like skin bruising and bleeding in the nose and gums for no reason. Again, they significantly had major problems watery black stool / tea-colored urine (22%), temporary (27.5%) and permanent paralysis of one side (4.5%).The patients' average score for knowledge about warfarin use was moderate [6.0±2.6 (0-11)]. The patients who were over 60, female, illiterate, just started the drug, lived in village, lived alone, and reported negative perception of family relationships had lower knowledge scores than the other groups (p<0.05). The majority had insufficient knowledge about duration of drug use (84.3%), smoking (76.5%), alcohol (70.6), and drug-drug (72.5%) and drug-diet interactions (54.9%). The study found no significant difference between patients with poor or improved anticoagulation control in terms of knowledge score of warfarin, regular drug use, blood test, and having problems (p>0.05) ( Table 1). The patients had insufficient knowledge of the importance of blood tests and regular drug use, drug-drug and drug-nutrient interactions, and adherence to advice, which is compatible with other studies (2-5). However, in contrast to Rewiuk et al. (5), in our study, the knowledge and adherence of the patients with poor or improved anticoagulation control were similar.In conclusion, the study found that the patients had major problems about the use of warfarin and moderate levels of knowledge ab...
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