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Evaluation of goodness of fit of semiparametric and parametric models in analysis of factors associated with length of stay in neonatal intensive care unit

  • Kheiry, Fatemeh;Kargarian-Marvasti, Sadegh;Afrashteh, Sima;Mohammadbeigi, Abolfazl;Daneshi, Nima;Naderi, Salma;Saadat, Seyed Hossein
    • Clinical and Experimental Pediatrics
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    • v.63 no.9
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    • pp.361-367
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    • 2020
  • Background: Length of stay is a significant indicator of care effectiveness and hospital performance. Owing to the limited number of healthcare centers and facilities, it is important to optimize length of stay and associated factors. Purpose: The present study aimed to investigate factors associated with neonatal length of stay in the neonatal intensive care unit (NICU) using parametric and semiparametric models and compare model fitness according to Akaike information criterion (AIC) between 2016 and 2018. Methods: This retrospective cohort study reviewed 600 medical records of infants admitted to the NICU of Bandar Abbas Hospital. Samples were identified using census sampling. Factors associated with NICU length of stay were investigated based on semiparametric Cox model and 4 parametric models including Weibull, exponential, log-logistic, and log-normal to determine the best fitted model. The data analysis was conducted using R software. The significance level was set at 0.05. Results: The study findings suggest that breastfeeding, phototherapy, acute renal failure, presence of mechanical ventilation, and availability of central venous catheter were commonly identified as factors associated with NICU length of stay in all 5 models (P<0.05). Parametric models showed better fitness than the Cox model in this study. Conclusion: Breastfeeding and availability of central venous catheter had protective effects against length of stay, whereas phototherapy, acute renal failure, and mechanical ventilation increased length of stay in NICU. Therefore, the identification of factors associated with NICU length of stay can help establish effective interventions aimed at decreasing the length of stay among infants.

아동간호학 임상실습 교육의 방향

  • Park, Mun-Hui
    • The Korean Nurse
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    • v.35 no.4
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    • pp.51-56
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    • 1996
  • This research was an attempt to restructure the curriculum of pediatric clinical education on the base of the analysis of the pediatric clnical experience of nursing students acquired according to the traditional hospital-based pediatric clinical education and the evaluation of its results. As the focus of health care changes, pediatric clinical education the future necessitates changes in the traditional clinical experince at all levels. The traditional concentration of clinical experience within an acute care setting must be restructured to include the expanding future roles of the nurse and the changes in the health care structure. In order to meet the need for restructuring, it is inevitably necessary to adopt an organizational design for pediatric clinical experience that is not all traditional. The additional experiences and variety of settings will enhance the quality of pediatric clinical experience. And as a matter of course this organizational change will enhance the student learning experience by giving them the opportunity to observe normal growth and development, preventive health care measures, and the role of the nurse outside the acute care setting. As the nursing's focus changes to meet the challenges of the future the faculty must apply themselves to these changes to prepare students for the future. Students must be ready to fill the many roles that nurses will hold in the future.

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Applying Theory Informed Global Trends in a Collaborative Model for Organizational Evidence-based Healthcare

  • Lockwood, Craig
    • Journal of Korean Academy of Nursing Administration
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    • v.23 no.2
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    • pp.111-117
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    • 2017
  • Getting evidence in to practice tends to focus on strategies, theories and studies that aim to close the gap between research knowledge and clinical practice. The evidence to practice gap is more about systems than individual clinician decision making. The absence of evidence for administration and management in the organization of healthcare is persistent. Teaching nurses and providing evidence as the solution to evidence-based healthcare is no longer axiomatic. Previous studies have concluded that unit level strategies integrate multi-professional teams with organizational needs and priorities. This 'best fit' approach that characterizes how healthcare is structured and delivered. The published literature shows that increased readiness for change is aligned with integrated approaches informed by conceptual models. The Joanna Briggs Collaboration is the largest global collaboration to integrate evidence within a theory informed model that brings together academic centres, hospitals and health systems for evidence synthesis, transfer and implementation. The best approaches to implementation are tailored to local culture and context, benchmark against international evidence, combine a theory informed model and stakeholder perspectives to improve the structure and processes of health care policy and practice.

Effects of Progressive Relaxation Exercises on Anxiety and Comfort of Turkish Breast Cancer Patients Receiving Chemotherapy

  • Yilmaz, Seher Gurdil;Arslan, Sevban;Arslan, Sevban
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.217-220
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    • 2015
  • Background: Breast cancer is the second most common cancer in the world and by far the most frequent cancer among women. Objective: This study was conducted to observe the effect of progressive relaxation exercises on anxiety and comfort level of breast cancer patients receiving chemotherapy. Materials and Methods: A control group pre-test/post-test quasi-experimental model was applied with experimental (30) and control (30) groups, who agreed to participate in this study. Data collection was with the "Personnel Information Form, State-Trait Anxiety Inventory and General Comfort Scale". Results: The average age of the patients that participated in the study was $49.1{\pm}7.96$ years. Eighty-three point three percent (n=25) of the patients in the experiment group and 86.7 (n=26) percent of patients in control group were married. Patient state of anxiety post-test mean scores were $36.2{\pm}8.21$ in the experimental group and $43.4{\pm}7.96$ in the control group, the difference being statistically significant (p<0.05). The general comfort scale post-test mean scores were $149.5{\pm}13.9$ in the experimental group and $137.7{\pm}15.0$ in the control group, again statistically significant (p<0.05). Conclusions: Progressive relaxation exercises positively affect patient comfort and anxiety levels in Turkey.

Social Support and Quality of Life in Turkish Patients with Gynecologic Cancer

  • Nazik, Evsen;Nazik, Hakan;Ozdemir, Funda;Soydan, Selen
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3081-3086
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    • 2014
  • The aim of this study was to determine the level of social support and quality of life in Turkish patients with gynecologic cancer using a cross-sectional survey design. A total of 108 patients admitted to the gynecologic oncology clinic at a university hospital from September 2011 to January 2012 were included. Data were collected using patient information forms, the Multidimensional Scale of Perceived Social Support (MSPSS) and The Quality of Life-Cancer Survivors Instrument (QOL-CS). Average age was $54.5{\pm}10.8$ years and it was determined that 65.7% of patients had ovarian cancer and 19.4% had cervical cancer. The total QOL-CS mean score was $5.59{\pm}1.10$. Average score of total MSPSS was found to be $69.7{\pm}14.64$. Comparing socio-demographic and clinical characteristics of patients and average scores of QOL-CS and MSPSS, it was found that there was not a statisticaly significant corelation (p>0.05). Statistically significant relation was found between the average scores of QOL-CS and MSPSS. These results showed that quality of life was moderate and perceived social support was high in Turkish patients with gynecologic cancer.

Comfort and Anxiety Levels of Women with Early Stage Breast Cancer Who Receive Radiotherapy

  • Tuncer, Gamze;Yucel, Sebnem Cinar
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2109-2114
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    • 2014
  • Background: The aim of this planned research was to determine the comfort and anxiety levels of women with breast cancer receiving radiotherapy. Materials and Methods: This descriptive type study covered patients that applied to the radiation oncology breast polyclinic of our university hospital between January and May 2011. Patient Identification Form, Radiation Therapy Comfort Questionnaire (RTCQ), Spielberger State Trait Anxiety Inventory (STAI) were completed and analysed. Results: The mean age of the women who participated in the study was $51.6{\pm}10.4$ years. Mean scores of women were $3.73{\pm}0.31$ for RTCQ, $29.1{\pm}5.88$ for SAI and $37.8{\pm}6.91$ for TAI. While the comfort levels of the women with breast cancer receiving radiotherapy were moderate, they experienced only low levels of anxiety. Conclusions: By determining the comfort level of the patient before radiotherapy, besides providing comfort in this direction, eliminating/minimizing anxiety and stress will positively affect radiotherapy application. More attention of nurses to this issue is to be recommended.

Comparison of Quality of Life of Turkish Breast Cancer Patients Receiving Breast Conserving Surgery or Modified Radical Mastectomy

  • Acil, Hande;Cavdar, Ikbal
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.13
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    • pp.5377-5381
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    • 2014
  • Purpose: The aim of this study was to investigate the differences in quality of life in patients who received breast conserving surgery (BCS) or modified radical mastectomy (MRM) for breast cancer. Materials and Methods: A total of 100 women with breast cancer who underwent either BCS or MRM between September 2011 and April 2012 at a private health center and completed their chemotherapy and radiation therapy cycles were included in the study. To assess the quality of life, we used a demographic questionnaire, the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and the Quality of Life assessment in Breast Cancer (EORTC QLQ-BR23). Results: Using QLQ-C30, we found that patients who underwent BCS had better functional status and fewer symptoms than patients who underwent MRM. In QLQ-BR23, independent factors improving the functional scales were BCS, higher level of education and marital status (married); independent factors improving symptoms were BCS, higher level of education, younger age and low and normal body mass index (BMI). In QLQ-C30, independent factors affecting the functional and symptom scales were only BCS and higher level of education. Conclusions: We determined that patients who received BCS had better functional status and less frequent symptoms than patients who underwent MRM.

Psychoeducation Intervention to Improve Adjustment to Cancer among Turkish Stage I-II Breast Cancer Patients: A Randomized Controlled Trial

  • Dastan, Nihal Bostanci;Buzlu, Sevim
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.5313-5318
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    • 2012
  • Psycho-educational interventions are not a substitute for analgesics, but they may serve as adjuvant therapy. Nurses can provide psychoeducational programmes to cancer patients to assist them in optimizing behavior that strengthen adjustment. The aim here was to determine the effects of psychoeducation on levels of adjustment to cancer in stage I-II breast cancer patients who met the study criteria (experimental group: 38 women, control group:38 women). The psychoeducational program consisted of eight 90 minute weekly sessions and data were collected using a questionnaire and the Mental Adjustment to Cancer Scale three times: before, six weeks and six months after the intervention. Data analysis was performed using descriptive statistical methods as well as the Chi square test, the Mann Whitney U test, repeated measures analysis of variance, the matched pairs t test and the Post Hoc Bonferroni test. The results at 6 weeks and 6 months after the program revealed that the experimental group had higher levels of "fighting spirit", lower levels of "helplessness/hopelessness, anxious preoccupation and fatalism" but there was no significant change in levels of "avoidance/denial" compared to the control group with regard to adjustment to cancer. In this study, psychoeducation was shown to cause positive changes in levels of adjustment to cancer in breast cancer patients

Knowledge of Turkish Mothers with Children in the 0-13 Age Group about Cancer Symptoms

  • Demirbag, Birsel Canan;Kurtuncu, Meltem;Guven, Hadiye
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.1031-1035
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    • 2013
  • Background: There have been few studies in Turkey on the incidence of childhood cancers. A mother's knowledge about signs and symptoms of cancer is important for early diagnosis, effective treatment, and improvement of life expectancy. This study was conducted with a group of mothers of children, aged 0-13, at a Family Health Center (FHC) in Turkey's Eastern Black Sea Region, to analyze their knowledge about cancer symptoms in childhood. Materials and Methods: The study group of this descriptive/cross-sectional research comprised 2,061 mothers, ages 19-49, at an FHC in the Eastern Black Sea Region in February 1, 2011 - June 1, 2011. Before the study, permission was obtained from the local ethics board and the institutions concerned. A value of p<0.05 was accepted as statistically significant. Results: Of the mothers, 34.9% were between the ages of 40-47, 40.5% had three children, 73.8% had no experience with children with cancer, 45.9% said they learned about cancer on television, 39.7% stated that the primary reason for childhood cancer was the mother's smoking during pregnancy, 68.8% said that early diagnosis would save a child, and 98% wanted to learn about childhood cancer. Conclusion: It was determined that the mothers' knowledge of cancer was deficient.

Analysis of Health and Social Needs for the Establishment of Coordinated Health and Social Service (보건복지 통합사업을 위한 보건복지욕구 분석)

  • So, Ae-Young;Hong, Myung-Sun
    • Journal of Korean Public Health Nursing
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    • v.19 no.2
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    • pp.188-203
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    • 2005
  • The study was performed to provide basic data for developing a coordinated health and social service model. Method: The subjects consisted of 1000 residents in Wonju city. The sampling process was randomized stratified into 26 geographical areas. The data was collected from Apr. 16nd, to May. 15nd, 2002 by using a structured questionnaire that included general characteristics, the patterns of disease, the family function and the community support systems. The collected data was analyzed by the SPSS. windows program via descriptive statistics, correlation testing and t-tests. Result: 61.7% of the elderly perceived their health status as being poor. There were correlations among age, income and the way clients perceived their health status. The prevalence rate of chronic disease was 70.8% in the elderly. The prevalence rate for arthritis was the highest (33.6%). The average number of diseases in the target populations was 2.31; it was 2.65 in the deprived elderly group and 2.47 in the elderly group. 35.4% of residents did not have any family care giver. 61.2% of the clients needed support by the health and social services. Conclusions; Coordinated health and social services need to be allocated by priority to the elderly and to the socially and economic deprived clients.

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