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Publication Open Access The effect of comorbidity on mortality in elderly patients undergoing emergency abdominal surgery: A systematic review and metaanalysis(Turkiye Klinikleri, 2021) Cinar, F.; Parlak, Göknur; Eti Aslan, Fatma; Cinar, F., Department of Management, İstanbul Sabahattin Zaim University, Kucukcekmece, Turkey; Parlak, Göknur, Department of Nursing, Bahçeşehir Üniversitesi, Istanbul, Turkey; Eti Aslan, Fatma, Department of Nursing, Bahçeşehir Üniversitesi, Istanbul, TurkeyBackground/aim: With the increase in the elderly population, the elderly proportion needing emergency surgery is also increasing. Despite medical advances in surgery and anesthesia, negative postoperative outcomes and high mortality rates are still present in elderly patients undergoing emergency surgery. Comorbidities are described as the main determining factors in poor outcomes. In this metaanalysis, it was aimed to investigate the effect of comorbidity on mortality in elderly patients undergoing emergency abdominal surgery. Materials and methods: The studies published between 2010-2019 were scanned from databases of Google Scholar, Cinahl, Pub Med, Medline and Web of Science. Quality criteria proposed by Polit and Beck were used in the evaluation of the included studies. Interrater agreement was calculated by using the Kappa statistic, effect size by using the odds ratio, and heterogeneity among studies by using the Cochran’s Q statistics. Kendall’s Tau-b coefficient and funnel plot were used to determine publication bias. Results: A total of 9 studies were included in the research. There was a total of 1330 cases in the studies. The total mortality rate was 21% (n = 279), the total rate of having a comorbid factor was 83.6% (n = 1112), and the rate of having a comorbid factor in mortality was 89.2% (n = 249). According to the fixed effects model, the total effect size of comorbid factors on causing mortality was not statistically significant with a value of 1.296 (C.I, 0.84-1.97, P > 0.05). Conclusion: Our study revealed that comorbidity had no significant effect on causing mortality in geriatric patients undergoing emergency abdominal surgery. There are controversial results in the literature, and in order to reach more precise results, studies involving wider groups of patients and further studies examining the specific effect of certain comorbid conditions are needed. © 2021 Elsevier B.V., All rights reserved.Publication Open Access Adherence to Anti-hypertensive Treatment in Geriatric Patients: A Systematic Review and Meta-analysis, Geriatrik Hastaların Anti-hipertansif Tedaviye Uyumu: Sistematik Derleme ve Metaanaliz(Ortadog u Reklam Tanitim Yayincilik Turizm Egitim Insaat Sanayi ve Ticaret A.S., 2021) Özdemir Aslan, Emine Özdemir; Cinar, F.; Eti Aslan, Fatma; Özdemir Aslan, Emine Özdemir, Department of Nursing, Bahçeşehir Üniversitesi, Istanbul, Turkey; Cinar, F., Department of Health Management, Sebahattin Zaim University Faculty of Health Sciences, Istanbul, Turkey; Eti Aslan, Fatma, Department of Nursing, Bahçeşehir Üniversitesi, Istanbul, TurkeyObjective: This study was planned for the systematic review and meta-analysis of the studies evaluating adherence to antihypertensive treatment in geriatric patients. Material and Methods: Google Scholar, Web of Science, PubMed, CINAHL, MEDLINE and Scopus databases were searched using the keywords Geriatric, Geriatric patients, Elderly, Elderly patients, Hypertension, Anti-hypertensive agents, Drug compliance. A total of 13 studies were included in the meta-analysis. The included studies were evaluated with the quality evaluation criteria proposed by Polit and Beck. The agreement between the researchers was measured by the kappa test for agreement. The odds ratio was used for effect sizes, Cochran's Q test was used for heterogeneity, the funnel plot and Kendall's tau coefficient were used for publication bias. Results: Age, gender, educational status, income level, place of residence and presence of comorbid diseases that affect adherence to anti-hypertensive treatment in geriatric patients were examined. The fact that age and presence of comorbid diseases decreased adherence to anti-hypertensive treatment (OR <1) while being a resident of the city, high educational status, and income level increased adherence to anti-hypertensive treatment (OR >1) in geriatric patients was confirmed by the meta-analysis. Conclusion: The factors affecting adherence to anti-hypertensive treatment in geriatric patients were found to be similar to the literature. In contrast to the literature, it was found that gender did not affect adherence to anti-hypertensive treatment in any way. This difference was thought to be due to the lack of homogeneity in the samples of the studies. © 2022 Elsevier B.V., All rights reserved.Publication Open Access Post-operative Analgesic Use and Analysis of Related Factors(AMG Transcend Association, 2022) Hayat, Deniz; Cinar, F.; Eti Aslan, Fatma; Hayat, Deniz, Department of Intensive Care Unit, Kocaeli Üniversitesi, İzmit, Turkey; Cinar, F., Department of Nursing, Nişantaşı Üniversitesi, Istanbul, Turkey; Eti Aslan, Fatma, Department of Nursing, Bahçeşehir Üniversitesi, Istanbul, TurkeyPain is a problem that humanity has experienced since its existence and is still seeking a solution. Despite all the advances in pharmacology and technology in recent years, surgical pain remains a serious problem. This study was carried out to determine the analgesic use status and related factors according to the patients' pain levels after surgery. The study consisted of 188 patients hospitalized for surgical intervention in a private hospital operating in the province of Istanbul between 01.01.2019 and 31.12.2019 and followed up on analgesic use in the clinic for 3 days after the surgical intervention. Surgical pain averages of the patients who underwent surgery were compared according to the patient’s descriptive characteristics regarding the day of the surgery. According to this comparison, it was found that the type of surgical intervention and the character of the pain affects the incidence of pain score on the first day of surgery. It was determined that on the 1st day after surgery, gender, age, alcohol use affected the incidence of pain, and on the 2nd day, there was a significant difference between the pain averages of alcohol substance use and anesthesia type. It was determined that the rate of patient-controlled analgesia use was 42% on the day of surgery, 14.4% on the 1st day, and 7.4% on the 2nd day. It was determined that the mean pain score did not differ between patients who received and did not receive patient-controlled analgesia on the 1st and 2nd days after surgery. As a result, it was determined that the frequency of experiencing surgical pain was high despite the development in pharmacological treatments and evidence-based non-pharmacological methods. Nurses play a very important role in providing painlessness and comfort with the adequate use of analgesic drugs. It is thought that nurses and doctors must plan pain before surgery, taking into account the individual characteristics of the patients, for the adequate use of analgesics after surgery. For these plans, it is recommended to increase awareness by following up-to-date information on pain treatment. © 2023 Elsevier B.V., All rights reserved.Publication Open Access Investigation of Education Requirements of Individuals Using Warfarin and Achievement of Target INR Value(AMG Transcend Association, 2022) Cinar, F.; Yalin, Hayat; Eti Aslan, Fatma; Cinar, F., Department of Nursing, Nişantaşı Üniversitesi, Istanbul, Turkey; Yalin, Hayat, Nursing Department, Bahçeşehir Üniversitesi, Istanbul, Turkey; Eti Aslan, Fatma, Nursing Department, Bahçeşehir Üniversitesi, Istanbul, TurkeyThromboembolic diseases are important causes of morbidity and mortality. Oral anticoagulants for preventing or treating thromboembolic diseases reduce blood clotting and prevent fibrin deposition, thrombus development, and growth. This study aimed to investigate the educational needs and the rate of reaching the target INR level of individuals using warfarin for heart diseases. The population of this cross-sectional study was attempted to reach the entire population by not choosing a sample due to heart diseases between August –September 2019 in the cardiology outpatient clinic of a public hospital operating in Istanbul. However, due to the voluntary basis and incorrect registration of the questionnaires, 157 participants formed the sample. Data were analyzed using the SPSS 25.0 program. 75.1% of the individuals stated that they were informed about the use of warfarin, and 66.8% of those who received the information stated that they received the information from their physician. In addition, 75.7% stated that they took warfarin regularly, 81.7% had regular INR control, 52.1% knew the target INR value, 68.9% knew the complications. It was found to be 47.6. A statistically significant difference was found between individuals who reached the target INR level and those who did not, according to their information acquisition status (p <0.05). The low rate of individuals reaching the target INR level draws attention. For this reason, it is thought that the knowledge level of patients who are starting treatment with warfarin should be increased, and new generation oral anticoagulant drugs can be used as an anticoagulant treatment instead of warfarin in patients whose target INR cannot be achieved despite sufficient training. © 2023 Elsevier B.V., All rights reserved.Publication Open Access Evaluation of Pain During Endotracheal Aspiration in Intensive Care Patients Diagnosed with COVID-19(W.B. Saunders, 2024) Eti Aslan, Fatma; Cinar, F.; Hayat, Deniz; Eti Aslan, Fatma, Bahçeşehir Üniversitesi, Istanbul, Turkey; Cinar, F., Faculty of Health Sciences, Nişantaşı Üniversitesi, Istanbul, Turkey; Hayat, Deniz, Kocaeli Üniversitesi, İzmit, TurkeyBackground: Endotracheal aspiration, a procedure that is particularly painful for intensive care patients, has received little attention in terms of pain evaluation specifically among intubated patients with COVID-19 in intensive care. Aim: The study aims to assess the level of pain experienced by intubated intensive care patients diagnosed with COVID-19 during an endotracheal aspiration procedure. Method: The study population was composed of patients admitted to the COVID-19 intensive care unit of the specified hospital between February and March 2021. Of the 56 patients admitted during that period, 47 were contacted and participated in the study. These 47 intubated and sedated patients were evaluated for 94 different expressions of pain during endotracheal aspiration twice a day before and during the procedure. Data were collected using the patient descriptive information form, the Non-Verbal Pain Scale for adults and data observation record form. Results: In the study, pain behavior was observed in 54.2% (n = 51) of the 94 observations. The patients were found to experience mild pain with an average score of 3.6 ± 1.07 on the Non-Verbal Pain Scale. The mean pain score before the procedure was found to be significantly different from the mean pain score during the procedure (p < .05), with an increase in pain during the procedure. During the procedure, 33.3% (n = 17) of the patients had a 10% decreased SpO2, and 29.4% (n = 15) had an increase in systolic blood pressure (>20), pulse (>20), and respiration (>10). Additionally, 21.5% (n = 11) of the patients experienced severe incompatibility with the ventilator, and 15.68% had muscle tension. Conclusions: The study findings showed that nonverbal pain scores of sedated and intubated intensive care patients diagnosed with COVID-19 increased during endotracheal aspiration, accompanied by physiologic pain indicators. Effective pain management should be a priority for nurses. It is important to remember that patients with COVID-19 in the intensive care unit may experience pain while sedated and intubated. A holistic approach should be adopted for the evaluation and relief of pain in these patients. Intensive care nurses should consider physiologic and nonverbal behavioral pain indicators when evaluating pain in patients diagnosed with COVID-19. © 2024 Elsevier B.V., All rights reserved.Publication Open Access Validity and Reliability Study of the Turkish Form of Post-Discharge Surgical Recovery Scale(2021) Çınar, Fadime; Eti Aslan, Fatma; Korkmaz Turkurka, Evin; Azizoğlu, Hatice; İstanbul Sabahattin Zaim Üniversitesi; Bahçeşehir Üniversitesi; Bahçeşehir Üniversitesi; Van Yüzüncü Yıl ÜniversitesiAIM: This study was carried out to adapt the “Post-Discharge Surgical Recovery Scale “ developed by Kleinbeck into Turkish and analyze the scale’s validity and reliability.METHODS:The study sample consisted of 343 patients who underwent surgery in a state hospital operating in the province of Diyarbakır, in the province of Istanbul. The sample consisted of 271 people due to voluntary participation and reasons for not being able to reach. This research, which is of methodological type, was carried out between April and July 2019. The Individual Information Form and the Post-Discharge Surgical Recovery Scale, which the researchers developed by scanning the literature, were used to collect the data. In the validity and reliability study of the scale, Linguistic equivalence, content validity for expert assessment, the correlation between items for internal consistency/reliability, and calculating Cronbach alpha values and confirmatory and exploratory factor analyzes were performed for construct validity. IBM SPSS Statistics 25 and IBM SPSS Amos 21 programs were used for statistical evaluation of the data. RESULTS:It was determined that the content validity index of the scale was 0.96, the correlation values between the items were r=0.47-0.97, the explained variance was 75.238%, and it was gathered under a single factor. The general reliability of the scale is very high as alpha=0.975. In the confirmatory factor analysis for the scale, the fit indices of the scale were CFI = 0.76, NNFI = 0.93, It was determined that RMR =0.11 and RMSEA = 0.13, AGFI=0.69, GFI=0.77. CONCLUSION: The research results suggest that the Turkish version of the “Post-Discharge Surgical Scale” is a valid and reliable measurement tool and can be used in scientific research and health care institutions to measure recovery post dischange.Publication Open Access The effect of comorbidity on mortality in elderly patients undergoing emergency abdominal surgery: a systematic review and metaanalysis(2021) Çınar, Fadime; Eti Aslan, Fatma; Parlak, Göknur; İstanbul Sabahattin Zaim Üniversitesi; Bahçeşehir Üniversitesi; Bahçeşehir ÜniversitesiBackground/aim: With the increase in the elderly population, the elderly proportion needing emergency surgery is also increasing. Despite medical advances in surgery and anesthesia, negative postoperative outcomes and high mortality rates are still present in elderly patients undergoing emergency surgery. Comorbidities are described as the main determining factors in poor outcomes. In this metaanalysis, it was aimed to investigate the effect of comorbidity on mortality in elderly patients undergoing emergency abdominal surgery. Materials and methods: The studies published between 2010-2019 were scanned from databases of Google Scholar, Cinahl, Pub Med, Medline and Web of Science. Quality criteria proposed by Polit and Beck were used in the evaluation of the included studies. Interrater agreement was calculated by using the Kappa statistic, effect size by using the odds ratio, and heterogeneity among studies by using the Cochran’s Q statistics. Kendall’s Tau-b coefficient and funnel plot were used to determine publication bias. Results: A total of 9 studies were included in the research. There was a total of 1330 cases in the studies. The total mortality rate was 21% (n = 279), the total rate of having a comorbid factor was 83.6% (n = 1112), and the rate of having a comorbid factor in mortality was 89.2% (n = 249). According to the fixed effects model, the total effect size of comorbid factors on causing mortality was not statistically significant with a value of 1.296 (C.I, 0.84-1.97, P > 0.05). Conclusion: Our study revealed that comorbidity had no significant effect on causing mortality in geriatric patients undergoing emergency abdominal surgery. There are controversial results in the literature, and in order to reach more precise results, studies involving wider groups of patients and further studies examining the specific effect of certain comorbid conditions are needed.Key words: Emergency, abdominal surgery, elderly, mortality, comorbidPublication Open Access Geriatrik Hastaların Anti-hipertansif Tedaviye Uyumu: Sistematik Derleme ve Metaanaliz(2021) Çınar, Fadime; Eti Aslan, Fatma; Özdemir Aslan, Emine; İSTANBUL SABAHATTİN ZAİM ÜNİVERSİTESİ; BAHÇEŞEHİR ÜNİVERSİTESİ; BAHÇEŞEHİR ÜNİVERSİTESİAmaç: Bu çalışma, geriatrik hastalarda anti-hipertansif tedaviye uyumu değerlendiren araştırmaların sistematik derlemesi ve metaanalizi amacıyla planlandı. Gereç ve Yöntemler: Google Scholar, Web of Science, PubMed, CINAHL, MEDLINE ve Scopus veri tabanlarında “Geriatria, Geriatric patients, Elderly, Elderly patients, Hypertension, Anti-hypertensive agents, Drug compliance” ile tarama yapıldı. Toplam 13 araştırma, meta-analiz kapsamına alındı. Dâhil edilen araştırmalar, Polit ve Beck tarafından önerilen kalite değerlendirme ölçütleri ile değerlendirildi. Araştırmacılar arası uyum, kappa uyum analizi ile ölçüldü. Etki büyüklükleri için olasılık oranı [odds ratio (OR)], heterojenlik için Cochran Q testi, yayın yanlılığı için huni saçılım grafiği ve Kendall tau katsayısı kullanıldı. Bulgular: Geriatrik hastalarda, anti-hipertansif tedaviye uyumu etkileyen yaş, cinsiyet, eğitim durumu, gelir düzeyi, yaşanılan yer ve komorbid hastalığa sahip olma durumları incelendi. Geriatrik hastalarda, yaş ve komorbid hastalığa sahip olma durumunun, anti-hipertansif tedaviye uyumu azaltırken (OR <1), yaşanılan yerin şehir olması, eğitim ve gelir düzeyinin yüksek olmasının anti-hipertansif tedaviye uyumu artırdığı (OR >1) meta-analiz sonucu doğrulandı. Sonuç: Geriatrik hastalarda, anti-hipertansif tedaviye uyumu etkileyen faktörlerin, literatür ile benzer olduğu tespit edildi. Literatürün aksine cinsiyetin, anti-hipertansif tedaviye uyumu herhangi bir şekilde etkilemediği tespit edildi. Bu farkın, çalışmaların örneklemlerinde homojenliğin olmamasından kaynaklanacağı düşünüldü.Publication Open Access Sadness in nurses during the COVID-19 pandemic(2022) Eti Aslan, Fatma; Uyar, Serpil; Bahçeşehir Üniversitesi; Afyonkarahisar Sağlık Bilimleri FakültesiThis study aimed to draw attention to sadness and ensure that the sense of sadness experienced by nurses during the COVID-19 pandemic is noticed. During the pandemic, the sadness of nurses who have the most and close contact with patients should be evaluated. Support programs that would increase psychological resilience should be implemented for them to experience sadness at the lowest levels possible. If healthcare system managers improve the conditions that lead to nurses experiencing sadness and provide the necessary support to them, nurses will feel safe and perform their jobs willingly and enthusiastically.Publication Open Access Investigating Post-Discharge Experiences in Ileostomy: Systematic Review and Meta-analysis(2022) Eti Aslan, Fatma; Korkmaz, Evin; Bahçeşehir Üniversitesi; Bahçeşehir ÜniversitesiIn case of diseases such as cancers of the gastrointestinal system, traumas, and inflammatory bowel diseases, there is a need for an opening, called a stoma, that changes the excretory pathway for patients. Stoma, a word of Greek origin, means “mouthing, opening, mouth”. The type of stoma that causes the greatest metabolic changes is called an ileostomy. These changes may negatively affect the recipient's adjustment to ileostomy and coping with this new circumstance. This systematic review and meta-analysis aimed to investigate post-discharge experiences of individuals who have undergone ileostomy. Cross-sectional, cohort, and qualitative studies, which were published between January 2010-September 2020, were assessed. Suitable studies were identified from Medline, CINAHL, PsycINFO, Ovid, and PubMed databases on 21.09.2020. Results from a total of 20 studies (11 cross-sectional, 5 cohort, and 4 qualitative) were combined. Analysis of the combined reports showed: 29% had wound complication, 26% had wound dehiscence, 29% had skin complications, 7% had stomal complications, 11% had an anastomosis, 7% had ileus, and 10% had infection. It was concluded that individuals with ileostomy had problems with their social environment and healthcare team, as well as with communication, role change, adjustment, and psychological and ileostomy-related complications. It was concluded that individuals with ileostomy had problems with their social environment and healthcare team as well as on communication, role change, adjustment, and psychological and ileostomy-related complications.