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Öğe Assessment of Patient Safety Attitude Levels Among Healthcare Professionals Working in the Operating Room(Erciyes Univ Sch Medicine, 2023) Tamer, Murat; Akbulut, Sami; Cicek, Ipek Balikci; Saritas, Hasan; Akbulut, Mehmet Serdar; Ozer, Ali; Colak, CemilObjective: This study aims to determine the factors affecting the perception levels of operating room (OR) nurses and nurse anesthetists working in the OR regarding patient safety attitudes. Materials and Methods: This study was conducted using face-to-face interviews with 117 healthcare professionals working as OR nurses (n=60) and nurse anesthetists (n=57). The patient safety attitude questionnaire (SAQ), where the reliability analysis was also performed for the SAQ scale. and sociodemographic characteristics were used for this study. Qualitative variables were given as numbers and percentages (%), and the dataset belonging to quantitative variables that met the normal distribution criteria was given as mean (standard deviation), and data of quantitative variables that did not comply with nor-mality were given as median, IQR, and 95% CI of the median.Results: There were significant differences between OR nurses and nurse anesthetists regarding job satisfaction (p=0.015) and total SAQ score (p=0.040). Significant differences were detected between men and women participants regarding smoking (p=0.020) and stress recognition (p=0.040). The reliability analysis of the scale was as follows: total (alpha: 0.791), job satisfaction (alpha: 0.883), teamwork climate (alpha: 0.856), safety climate (alpha: 0.864), perceptions of management (alpha: 0.881), stress recognition (alpha: 0.791), and working conditions (alpha: 0.530).Conclusion: It was shown that the patient safety attitudes of the healthcare professionals participating in this study are above average, although it is still insufficient, where the stress identification score of the female participant was higher, and it was also found that the nurses' job satisfaction and SAQ score were higher.Öğe Effect of COVID-19 Pandemic on Patients Who Have Undergone Liver Transplantation Because of Hepatocellular Carcinoma(Elsevier Science Inc, 2023) Akbulut, Sami; Bagci, Nazlican; Akyuz, Musap; Garzali, Ibrahim Umar; Saritas, Hasan; Tamer, Murat; Ince, VolkanBackground and Aim. Many clinical studies have shown that the COVID-19 case fatality rate is higher in older patients, those with comorbidities, those with immunosuppressive conditions, and those who stay in the intensive care unit. This study aims to evaluate the clinical outcomes of 66 liver transplant (LT) patients with primary liver cancer who were exposed to COVID-19 infection.Methods. Demographic and clinical data of 66 patients with primary liver cancer (hepatocellu-lar carcinoma = 64, hepatoblastoma = 1, cholangiocarcinoma = 1) who underwent LT in our institute and were exposed to COVID-19 infection between March 2020 and November 2021 were analyzed in this cross-sectional study. The following data of the patients were recorded: age, sex, body mass index (kg/m2), blood group, underlying primary liver disease, smoking, tumor characteristics, post-transplant immunosuppressive agents, COVID-19 symptoms, hospi-talization, intensive care unit stay, intubation, and other clinical features. Results. There were 55 (83.3%) male and 11 (16.7%) female patients, with a median age of 58 years. Sixty-four patients were exposed to COVID-19 only once, whereas the remaining 2 patients were exposed 2 and 4 times, respectively. After exposure to COVID-19, it was deter-mined that 37 patients used antiviral drugs, 25 were hospitalized, 9 were followed in the inten-sive care unit, and 3 were intubated. One intubated patient was under hospital follow-up because of biliary complications before exposure to COVID-19, and this patient died from sepsis. Conclusion. The low mortality rate of LT patients with primary liver cancer exposed to COVID-19 infection can be attributed to background immunosuppression that prevents cytokine storm. However, it is appropriate to support this study with multicenter studies to make strong comments on this issue.Öğe Effect of Pre-Transplant Covid-19 Exposure on Post-Liver Transplant Clinical Outcomes(Elsevier Science Inc, 2023) Akbulut, Sami; Barut, Bora; Garzali, Ibrahim Umar; Sarici, Kemal Baris; Tamer, Murat; Unsal, Selver; Karabulut, ErtugrulBackground. COVID-19 has led to an unprecedented global health crisis. This situation caused an immediate reduction in solid organ transplantation activity. This study aimed to present the follow-up results of patients with chronic liver disease who underwent liver transplantation (LT) after a history of COVID-19 infection. Methods. Sociodemographic characteristics and clinicopathological data of 474 patients who underwent LT at Inonu University Liver Transplant Institute between March 11, 2020 and March 17, 2022 were prospectively recorded and analyzed retrospectively. Among these, the data of 35 patients with chronic liver disease who were found to be exposed to COVID-19 infection in the pre-LT period were analyzed for this study. Results. The median body mass index, Child score, and Model for end-stage liver disease/ Pediatric end-stage liver disease scores of the 35 patients were calculated as 25.1 kg/m2 (IQR: 7.4), 9 points (IQR: 4), and 16 points (IQR: 10), respectively. Graft rejection occurred in 4 patients at a median of 25 days post-transplant. Five patients underwent retransplantation at a median of 25 days post-transplant. The most common cause of retransplantation is early hepatic artery thrombosis. There were 5 deaths during postoperative follow-up. Mortality developed in 5 (14.3%) patients exposed to COVID-19 infection in the pretransplant period, whereas mortality occurred in 56 (12.8%) patients not exposed to COVID-19 infection. There was no statistically significant difference in mortality between the groups (P = .79). Conclusions. The results of this study showed that exposure to COVID-19 before LT does not affect post-transplant patients and graft survival.Öğe Effect of the COVID-19 Pandemic on the Psychological Health of Patients Who Underwent Liver Transplantation Due to Hepatocellular Carcinoma(Mdpi, 2023) Akbulut, Sami; Kucukakcali, Zeynep; Saritas, Hasan; Bozkir, Cigdem; Tamer, Murat; Akyuz, Musap; Bagci, NazlicanBackground: The primary aim of this study was to compare liver transplant (LT) recipients with and without hepatocellular carcinoma (HCC) in terms of COVID-19-related depression, anxiety, and stress. Method: A total of 504 LT recipients with (HCC group; n = 252) and without HCC (non-HCC group; n = 252) were included in the present case-control study. Depression Anxiety Stress Scales (DASS-21) and Coronavirus Anxiety Scale (CAS) were used to evaluate the depression, stress, and anxiety levels of LT patients. DASS-21 total and CAS-SF scores were determined as the primary outcomes of the study. Poisson regression and negative binomial regression models were used to predict the DASS and CAS scores. The incidence rate ratio (IRR) was used as a coefficient. Both groups were also compared in terms of awareness of the COVID-19 vaccine. Results: Poisson regression and negative binomial regression analyses for DASS-21 total and CAS-SF scales showed that the negative binomial regression method was the appropriate model for both scales. According to this model, it was determined that the following independent variables increased the DASS-21 total score: non-HCC (IRR: 1.26; p = 0.031), female gender (IRR: 1.29; p = 0.036), presence of chronic disease (IRR: 1.65; p < 0.001), exposure to COVID-19 (IRR: 1.63; p < 0.001), and nonvaccination (IRR: 1.50; p = 0.002). On the other hand, it was determined that the following independent variables increased the CAS score: female gender (IRR:1.75; p = 0.014) and exposure to COVID-19 (IRR: 1.51; p = 0.048). Significant differences were found between the HCC and non-HCC groups in terms of median DASS-21 total (p < 0.001) and CAS-SF (p = 0.002) scores. Cronbach's alpha internal consistency coefficients of DASS-21 total and CAS-SF scales were calculated to be 0.823 and 0.783, respectively. Conclusion: This study showed that the variables including patients without HCC, female gender, having a chronic disease, being exposed to COVID-19, and not being vaccinated against COVID-19 increased anxiety, depression, and stress. High internal consistency coefficients obtained from both scales indicate that these results are reliable.Öğe Immunosuppressive Medication Adherence in Patients With Hepatocellular Cancer Who Have Undergo Liver Transplantation: A Case Control Study(Elsevier Science Inc, 2023) Akbulut, Sami; Tamer, Murat; Saritas, Serdar; Unal, Ozlem; Akyuz, Musap; Unsal, Selver; Kucukakcali, ZeynepBackground. We aimed to compare the adherence to immunosuppressive medication use in patients who underwent liver transplantation (LT) due to hepatocellular carcinoma (HCC) and non-HCC reasons.Methods. The study population was determined as 242 patients with HCC and 1290 patients with non-HCC who had LT performed in our institute between March 2002 and November 2021; all these patients were contacted by phone in March 2022. The sample size was calculated using the MedCalc software program, and the number of patients required in each group was determined as 111 patients. Furthermore, we used the sample.int function, a random integer generator in the R (version 4.1.2) software program. Whereas demographic and clinical parameters were determined as independent variables, the immunosuppressive medication adherence scale (IMAS) score was determined as a dependent variable. Patients were evaluated by the IMAS. This 11-item IMAS scale evaluates the lowest compliance score as 11 and the highest as 55.Results. Out of a total number of 221 patients, 161 (72%) were men and 60 (27.1%) were women, with a median age of 58 years (IQR: 14); one patient in the non-HCC group was excluded due to lack of data. Among the HCC and non-HCC groups, significant differences were found in terms of the variables of age (P = .003), IMAS score (P < .001), sex (P = .001), working status (P = .004), chronic diseases (P = .008), tacrolimus alone (P < .001), tacrolimus plus everolimus (P < .001), and often medication changes (P < .001). A statistically significant correlation was found between the IMAS score and whether the patients had HCC (P < .001) and frequently changing immunosuppressive drugs (P = .023).Conclusion. This study showed that patients with frequent drug changes or non-HCC etiology had better adherence to immunosuppressive drug use.Öğe Knowledge levels, attitudes, and awareness of nurses toward organ donation(Kare Publ, 2022) Akbulut, Sami; Demyati, Khaled; Tamer, Murat; Unsal, Selver; Beyoglu, Sakine; Saritas, HasanOBJECTIVE: The aim of this study was to assess the knowledge, attitudes, and practices of nurses in Turkiye concerning organ donation.METHODS: This survey-based, descriptive cross-sectional study was conducted from January 2020 to March 2020, recruiting 560 of 850 nurses currently working in a tertiary university hospital with a face-to-face interview technique. The question-naire consisted of 35 questions evaluating sociodemographic features, organ donation knowledge level, attitude, and nurses' awareness.RESULTS: This study showed that only 6.5% of the nurses donated their organs. While 31.9% stated that they are willing to consider organ donation in the future, 41.3% were not decided about organ donation yet, and 27% rejected organ donation in any condition. Among the nurses who refused organ donation, 69.6% had no specific reason and 10.6% worried that their organs might be taken without proper diagnosis of brain death. About 10% denied organ donation for religious beliefs, and 5% were because of concerns about body integrity. Hesitation about procuring organs for commercial purposes was present in 7.2% of the nurses. Following a possible diagnosis of brain death of a relative, 33.8% of the nurses said that they would consent for organ donation to him/her, whereas 47.1% were not sure about this issue. Among the nurses, 76.6% agreed on a possible living-related organ donor for a close relative, 53.3% accepted receiving an organ from a close relative if required. Furthermore, this investigation showed that nurses who reported attending previous seminars, conferences, or training pro-grams about organ donation have significantly better donation rates and stronger attitudes toward organ donation. Nurses who donated their organs are found to know better about brain death irreversibility, understand better the related national legal regulations for organ donation, and are more informed about the compatibility of organ donation with religious beliefs.CONCLUSION: This study showed that nurses have a relatively positive attitude toward donation and transplantation but are unwilling to bequeath their organs. This study underlines the indispensable contribution of nurses promoting organ donation and highlights the need for well-structured educational programs to enhance their role in organ donation and transplantation.Öğe Nöroşirurji yoğun bakım hastalarında elma sirkesi, klorheksidin glukonat ve sodyum bikarbonat kullanılarak yapılan ağız bakımının oral mikrobiyal kolonizasyon üzerine etkisi(İnönü Üniversitesi, 2023) Tamer, Murat; Özkan, MeralAmaç: Nöroşirurji yoğun bakımda mekanik ventilatöre bağlı hastalarda elma sirkesi, klorheksidin glukonat ve sodyum bikarbonat kullanılarak yapılan ağız bakımının oral mikrobiyal kolonizasyon üzerine etkisini incelemektir. Materyal ve Metot: Araştırma, deneysel çalışma olarak yapıldı. Evrenini İnönü Üniversitesi Turgut Özal Tıp Merkezi Nöroşirürji Yoğun Bakımdaki entübe hastalar; örneklemini ise 90 hasta (elma sirkesi, klorheksidin glukonat ve sodyum bikarbonat grubu) oluşturdu. Veriler Ocak 2021-Ocak 2022 tarihleri arasında Hasta Tanıtım Formu, Ağız Değerlendirme Ölçeği ve Mikrobiyoloji İzlem Formu kullanılarak toplandı. Ağız bakımı verilmeden önce ve 5 gün boyunca 6 saatte bir ağız bakımı verildikten sonra hastaların ağız içi değerlendirilip, kültür alınarak mikrobiyoloji laboratuvarında analiz edildi. Verilerin değerlendirilmesinde frekans, yüzde, ortalama, standart sapma, ki-kare, One-way ANOVA ve Paired Sample Test kullanıldı. Bulgular: Ağız bakımı öncesi ve sonrasındaki mikroorganizma koloni sayılarındaki ve Ağız Değerlendirme Ölçeği puan ortalamalarındaki değişim incelendiğinde, gruplar arasında istatistiksel olarak önemli bir farklılık bulunmadı (p>0.05). Ancak grup içi karşılaştırmalarda; sodyum bikarbonat ve elma sirkesi ile verilen bakımın, hastaların ağız değerlendirme ölçeği puan ortalamasını düşürmede etkili olduğu belirlendi (p<0.05). Ağız bakımı öncesi ve sonrası oral mukoz membran bütünlüğünün gruplar arasında istatistiksel açıdan önemli bir farklılık göstermediği (p?0.05), grup içi karşılaştırıldığında ise; sodyum bikarbonat ve elma sirkesi ile yapılan ağız bakımının, oral mukoz membran bütünlüğünü sürdürmede etkili olduğu bulundu (p<0.05). Sonuç: Hastaların oral mikroorganizma koloni sayıları ve ağız değerlendirme ölçeği puan ortalamaları ağız bakımı öncesine göre düşüş göstermekle birlikte gruplardan birinin diğerine üstünlüğünün olmadığı, sodyum bikarbonat ve elma sirkesinin, ağız sağlığının iyileştirilmesinde etkili solüsyonlar olduğu bulundu. Anahtar Kelimeler: Hemşirelik, Klorheksidin Glukonat, Nöroşirürji, Sodyum BikarbonatÖğe The quality of life of patients after liver transplantation(2022) Tamer, Murat; Yava, AylaAim: With increased survival rates after liver transplantation (LT), studies have focused on improving the quality of life in these patients. The purpose of this study is to assess the quality of life levels of recipients after LT. Materials and Methods: This descriptive study was conducted with 103 voluntary patients between January 01-May 15, 2015. The sample of the study consisted of the patients who had liver transplantation and met the inclusion criteria. The data were collected using personal and disease information form and SF-36 health survey. Results: It was found in the study that the mean score of the Physical Component Summary (PCS) was 39.90±8.53 and the mean score of the Mental Component Summary (MCS) was 43.93±9.86. The patients who underwent LT had a moderate quality of life. The MCS score enhanced with increasing level of education. The PCS score is higher in those with men, single patients, cadavers as the source of transplantation, and those without a prolonging post-operative hospitalisation. Another finding of the study indicated that PCS score enhanced as the time elapsed after transplantation increased. In addition, patients with chronic diseases had lower physical health quality of life. Conclusion: Although many complications develop in most of the patients, LT can make the patient more functional in many areas of life compared to their pre-transplantation life. The patients should be referred to other departments regularly to keep chronic diseases under control.
