Background: There are many factors, which affect the bowel evacuation of neurosurgical intensive care unit (NICU) patients, resulting in constipation. Aim and objectives:The aim of this study was to investigate effect of abdominal massage on bowel evacuation and the risk of constipation in NICU patients.Design: A prospective, randomized-controlled clinical trial. Methods:The sample of this study included 80 NICU patients. The patients were randomly assigned to abdominal massage and control groups. The constipation risk of all the patients was assessed with Constipation Risk Assessment Scale (CRAS). The patients in the abdominal massage group received a total of 30 minutes of massage, 15 minutes every morning and evening, until the first defecation. The bowel sounds of all patients in the abdominal massage and control groups were assessed on a daily basis. The days when bowel sounds were heard and the first defecation took place were recorded in a Bowel Evacuation Form.Results: The risk of constipation was higher in the patients in the abdominal massage (CRAS score 19.02 ± 1.81) and control groups (CRAS score 20.45 ± 2.61). The time of return of bowel sounds and the time of the first defecation were earlier in the abdominal massage group, compared to the control group (P < .05). In the control group, there was a weak correlation (P = .004) between the CRAS score and the time of return of bowel sounds, while there was a moderate correlation between the CRAS score and the time of the first defecation (P < .001). Conclusion:Our study results show that the risk of constipation is high in NICU patients, and abdominal massage is an effective nursing intervention to shorten the time of return of bowel sounds and the time of the first defecation.Relevance to clinical practice: Nurses can safely apply abdominal massage to improve bowel evacuation in NICU patients.
Hemşirelik öğrencilerinin COVID-19 korunmak için uyguladığı koruyucu yöntemler ile geleneksel ve tamamlayıcı tıp uygulamalarını belirlemektir.Yöntem: Tanımlayıcı olan bu çalışmanın evrenini, 2019-2020 eğitim öğretim yılı bahar döneminde hemşirelik bölümünde öğrenim gören ve "Tamamlayıcı Tıp ve Hemşirelik" dersini alan 70 hemşirelik öğrencisi oluşturmuştur. Araştırmada örneklem seçimine gidilmemiş, evrenin tümü örnekleme alınmış olup araştırma çalışmaya katılmayı kabul eden 64 hemşirelik öğrencisi (katılım oranı %91,4) ile tamamlanmıştır. Araştırma evreninin %91,4'ine ulaşıldı. Veriler, araştırmacılar tarafından literatür taranarak 5 açık uçlu sorudan ve koruyucu önlemleri içeren 14 ifadeden oluşturulmuş anket formu ile toplandı. Verilerin değerlendirilmesinde frekans, yüzde, ortalama ve standart sapma kullanıldı.Bulgular: Öğrencilerin tamamının COVID-19'dan korunmak için belirlenen 14 kuraldan en çok "ellerinizi sık sık su ve sabun ile en az 20 saniye boyunca ovalayarak yıkayın"ı uyguladıkları belirlendi. Katılımcıların COVID-19'e karşı uyguladıkları geleneksel ve tamamlayıcı tıp uygulamaları sırasıyla; biyolojik uygulamalar, yağlar ile masaj uygulama, rahatlatıcı müzik dinlemektir. Temizlik konusunda en çok sebze ve meyvelerin yıkanmasında sirkeli suyun kullanıldığı belirlendi.Sonuç: COVID-19 sürecinde katılımcıların tamamının en az bir bitkiyle birlikte doğal beslenme yöntemini tercih ettikleri, öncelikle de bitki çayları ile bağışıklık sistemini destekleyici uygulamalar yapmaya çaba sarf ettikleri söylenebilir.
Background: Intensive care settings are characterized by their structure, which constantly changes in parallel with scientific and technological developments, the uncertainty of the lifeline between birth and death, the challenges in the fair distribution of limited resources, the participation of individuals in medical decisions, and witnessing the pain experienced by individuals. These characteristics also affect the level of moral distress, which can make it difficult for ICU nurses to provide the most appropriate individualized care for their patients. Aims:The purpose of this study was to determine the moral distress levels and individualized care perceptions of intensive care nurses.Study design: This study employed a cross-sectional descriptive survey design.Methods: This descriptive study was conducted with 128 nurses working in the intensive care units of a university hospital in Turkey. Data were collected using an 'Information Form', 'the Moral Distress Scale', and 'the Individualized Care Scale-Nurse Version'.Results: 78.9% of the nurses stated that there was staff shortage, and 36.0% stated that the physical conditions were not suitable for care in the intensive care units in which they worked. The mean score on the Moral Distress Scale was 79.2 ± 46.4.The mean total score on the Individualized Care Scale-Nurse Version was 3.5 ± 0.8. Conclusion:This study revealed that the intensive care nurses had moderate levels of moral distress and good levels of individualized care perceptions although there was no significant relationship between their moral distress levels and individualized care perceptions. Also, the nurses adopted care behaviours supporting patients' feelings and autonomy.Relevance to clinical practice: In our study, the intensive care nurses did not reflect their moderate-level moral distress in the individualized care provided. It could be beneficial to measure intensive care nurses' moral distress and care levels at frequent intervals so that early precautions could be taken to prevent the accumulation of moral distress and care difficulties among intensive care nurses.
Abstract:Background: Heparin and low molecular weight heparin are the most frequently used antithromboembolic drugs in fractures. Objectives: We aimed to compare the effects of heparin and enoxaparin, which are used as standard treatment, on viability in degloving injuries. Methods: Thirty rats were used in the study. Three groups were composed including 10 rats in each group. Degloving injuries were formed in the tails of the rats. Enoxaparin was injected subcutaneously to the rats in group 1. Standard heparin was injected subcutaneously to the rats in group 2. Serum physiologic solution was injected subcutaneously to the rats in group 3. The experiment was ended on day 15. The tails of the rats were evaluated clinically and histopathologically.Results: There was a statistically signifi cant difference in the clinical results (p < 0.05). There was a statistically signifi cant difference in the histopathological results (p < 0.05). Conclusions:We encountered positive effects of both heparin and enoxaparin on the treatment of degloving injuries in this experimental study. However, the fi ndings of this study should be supported and improved by new experimental and especially clinical studies (Fig. 3 "Degloving" is a soft tissue injury defi ned as traumatic avulsion of the skin and subcutaneous tissue, together with the underlying deep fascia. Skin includes a dermal vascular plexus. A break in the dermal vascular plexus is formed due to the separation of vessels from the skin in degloving type of injury. Skin necrosis can be seen as a result.De-gloving occurs frequently due to shear forces as a result of contact of the extremity with circling objects forming a high speed of friction, such as car wheels or motorcycle accidents. Degloving injuries are divided into two groups as open and closed injuries (1). Skin is generally open in degloving injury due to shear forces.Open de-gloving injury was fi rst defi ned by Slack (2) in 1952. Slack evaluated the association of these injuries with wheel injuries and defi ned these injuries as friction injuries.Slack, in addition, proved in his study that the skin necrosis was due to loss of muscle support of subcutaneous tissue in secondary sepsis, and delayed skin gangrene. Closed degloving injury may occur when the underlying deep fascia raises the subcutaneous tissue without superfi cial tears (1). Most frequently seen degloving injuries are reported to be in the leg in 31.6 %, in femur in 21.1 %, in pelvis in 21.1 %, and in the feet in 13.2 % of cases (3).Data related to the results of treatment of degloving injuries are scarce. Two points have to be taken into account for the results: these are cosmetic results and extremity function.Standard heparin acts by binding to an inhibitor enzyme, antithrombin III. Lower molecular heparin compounds are obtained by chemical and enzymatic depolimerization of heparin (4). LMWH lowers the risk of bleeding by minimally effecting on aPTT; while, heparin increases the bleeding risk by lengthening the coagulation time (aPTT, TT). We eval...
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