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    Evaluation of Pain as a Fifth Vital Sign: Nurses' Opinions and Beliefs

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    Objective: After the American Pain Society recognized pain as a fifth vital sign, many countries adopted similar pain screening approaches. The routine evaluation of pain has recently come to the agenda in Turkey, along with the important role played by nurses in pain evaluation, and hence, this study focuses on the opinions of nurses on the evaluation of pain as a fifth vital sign, their pain beliefs, and how their pain beliefs influence their opinions. Methods: This descriptive study was conducted in a City Hospital with the involvement of 223 nurses. A questionnaire and a Pain Beliefs Questionnaire were used for the collection of data, and the data were analyzed using descriptive statistics, and Mann-Whitney U-test, analysis of variance, and Kruskal-Wallis tests. Results: Of the respondent nurses, 31.8\% of the nurses were working in medical inpatient clinics, and 56.5\% stated that pain should not be evaluated as a fifth vital sign, giving the following reasons: if patients are in pain, they already report it (40.5\%), and overwork and the lack of sufficient nurses (34.9\%). There was no difference in the pain beliefs scores of the nurses who stated that pain should not be evaluated as a fifth vital sign (56.5\%) and the scores of those who stated the opposite (43.5\%) (P > 0.05). Conclusions: Most of the nurses do not think that pain should be evaluated as a fifth vital sign. Furthermore, the pain beliefs of nurses do not influence their opinions regarding the assessment of pain as a fifth vital sign

    Efficacy of manual lymph drainage plus exercise on range of motion and flexibility in refractory chronic cutaneous graft-versus-host disease: A case report

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    Graft-versus-host disease (GvHD) is a common complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT) with high morbidity and mortality rates. The purpose of this study was to demonstrate the efficacy of Manual Lymph Drainage (MLD) and a home-based exercise programme on range of motion (ROM) and flexibility in a patient diagnosed with chronic cutaneous GvHD. A 29-year-old male who was diagnosed as acute lymphoblastic leukemia underwent allo-HSCT after induction chemotherapy. He developed extended chronic cutaneous skin GvHD. He received systemic immunosuppressive treatment and Psoralen and ultraviolet radiation (PUVA) for 20 sessions. He was then consulted to physiotherapy department for the limitation of multiple ROM due to severe GvHD. The range of motions of shoulder, elbow, hip, knee and ankle joints were evaluated with universal goniometer. The chair sit, reach and back scratch tests were performed. MLD was applied for 2 weeks. Additionally, exercise recommendations were maintained as a home-programme. After the therapy, ROM values were better in wrist extension and hip abduction/adduction and the back scratch test result improved. According to chair sit and reach tests, the results decreased from 25 to 22 cm distance after 2 weeks. With MLD treatment with exercise, ROM has been preserved and even improved in this refractory case. In addition, the flexibility test results were found to be increased. The efficacy of MLD and exercise in chronic cutaneous GvHD should be investigated in further studies. (C) 2019 Elsevier Masson SAS. All rights reserved

    Süleyman Saim Tekcan’ın Hayatı, Sanatı ve Riva Atları

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