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Mid-term clinical outcomes of new generation drug-eluting stents for treatment of diffuse coronary artery disease
No full textObjective: Diffuse coronary artery disease (CAD) is a challenging issue in clinical cardiology practice. There are limited data about percutaneous revascularization in these patients.
Methods: This study was an observational clinical evaluation. The records of patients with diffuse CAD revascularized with new-generation drug-eluting stents (DES) were researched retrospectively. Patients treated with multiple, overlapping new-generation DES (at least 60mm in length per vessel) were included. The incidence of major adverse cardiac events (MACE), defined as cardiac death, stent thrombosis, non-fatal myocardial infarction, and target lesion revascularization (TLR), at the end of the first year following the index procedure was recorded.
Results: A total of 71 patients (with 75 coronary vessels) treated with new-generation DES for diffuse CAD were enrolled in the study. Zotarolimus-eluting stents were used in 48 vessels and biolimus A9-eluting stents were used in 27 vessels. The median total stent length per vessel was 75.0 mm (60.0-106.0) and the median number of stents implanted was 3 (2-4) for each vessel. The cumulative incidence of MACE at the end of the first year was 11.2% (8 patients). The presence of diabetes mellitus (DM) and ST-segment elevated myocardial infarction (STEMI) were defined as independent clinical risk factors related to MACE development.
Conclusion: Coronary artery revascularization with new-generation drug-eluting stents can be a good choice in the treatment of selected patients with diffuse CAD. DM and STEMI were found to be related to poorer clinical outcomes with this treatment option in our study
Factors associated with social anxiety disorder in a group of obese Turkish female patients
No full textBackground/aim: Mental disorders may accompany obesity. This study aims to evaluate the association between social anxiety disorder (SAD) and obesity and the risk factors for SAD in obese female patients.
Materials and methods: A total of 114 obese patients and 110 healthy controls were included. The Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), State and Trait Anxiety Inventory (STAI I-II), and Liebowitz Social Anxiety Scale (LSAS) were administered to assess anxiety, depression, and social anxiety levels. Scale scores were analyzed statistically.
Results: The rate of SAD in obese female patients was found to be 8.8%. Anxiety, depression, and social anxiety levels were significantly higher in the obesity group compared to the control group (P < 0.05). According to linear regression analyses, a significant association between LSAS anxiety level and age, prior surgery, social support, history of being teased, BDI, and BAI was found.
Conclusion: The present study shows that many factors are related to obesity and SAD in obese female patients. The clinical implications of these findings should be considered. Interventions for these factors may help prevent SAD in obese female patients
Effect of PLIF and TLIF on sagittal spinopelvic balance of patients with degenerative spondylolisthesis
No full textObjective: The aim of this study was to evaluate the effects of PLIF and TLIF on sagittal spinopelvic balance and to compare radiological results of two surgical procedures with regard to spinopelvic parameters.
Methods: Thirty-five patients (34 female and 1 male; mean age: 52.29 +/- 13.08 (range: 35-75)) with degenerative spondylolisthesis cases were included in the study. Patients were divided into two groups according to surgical technique: PLIF and TLIF. The level and the severity of listhesis according to Meyerding classification were assessed and spinopelvic parameters including sacral slope, pelvic tilt, pelvic incidence (PI), lumbar lordosis, and segmental lumbar lordosis were measured on digital X-rays. All preoperative and postoperative parameters and the results were compared between two groups.
Results: The age distribution was similar in both groups (p = 0.825) and there was no difference between the mean PI of the groups (p = 0.616). In 15 patients, spondylolisthesis level were at the L5-S1 level (PLIF: 8, TLIF: 7), in 16 patients at the L4-L5 level (PLIF: 6, TLIF: 10) and in 4 patients at the L3-L4 level (PLIF: 2, TLIF: 2). According to Meyerding classification, before the operation, the sliding grades were 0 in 4 patients, 1 in 21 patients, 2 in 7 patients, and 3 in 3 patients. The grades changed into 0 in 28 patients, 1 in 5 patients, and 2 in 2 patients after surgery. There were no differences in the grade of listhesis between PLIF and TLIF groups preoperatively (p = 0.190) and postoperatively (p = 0.208). In both groups, the spondylolisthesis-related deformities of patients were significantly corrected after surgery (p < 0.001).
Conclusion: PLIF and TLIF techniques have similar radiological results in restoring the sagittal spinopelvic balance in patients with degenerative spondylolisthesis. Both techniques are good options to achieve reduction and fusion in patients with degenerative spondylolisthesis, but have no advantage over each other for restoring spinopelvic balance. (C) 2018 Turkish Association of Orthopaedics and Traumatology. Publishing services by Elsevier B.V
Value of shear wave elastography by virtual touch tissue imaging quantification in patients with diffuse thyroid gland pathology
No full textBackground/aim: This study was performed to assess the diagnostic accuracy of shear wave elastography by virtual touch tissue imaging quantification in patients with diffuse thyroid gland pathology and to differentiate Graves' disease from Hashimoto's thyroiditis.
Materials and methods: Thirty patients with Hashimoto's thyroiditis and 22 patients with Graves' disease were evaluated with conventional ultrasonography and shear wave elastography by virtual touch tissue imaging quantification. Thirty healthy participants formed the control group. Ten elastographic measurements of each thyroid lobe were performed in all three study groups. The mean shear wave velocity was calculated and compared between the patients and controls.
Results: The mean shear wave velocity of the controls (1.92 +/- 0.14 m/s) was significantly lower than that of the patients with Graves' disease (2.71 +/- 0.22 m/s) and Hashimoto's thyroiditis (2.50 +/- 0.20 m/s). Patients with Graves' disease had significantly higher shear wave velocities than those with Hashimoto's thyroiditis (P < 0.001).
Conclusion: Shear wave elastography by virtual touch tissue imaging quantification can be used to discriminate a normal thyroid gland from diffuse thyroid gland pathology after conventional sonography and may assist in the diagnosis of Graves' disease and Hashimoto's thyroiditis
Comparison between corneal cross-linking, topical antibiotic and combined therapy in experimental bacterial keratitis model
No full textPurpose: This study was conducted to investigate the effects of an experimental bacterial keratitis model on the corneal collagen cross-linking treatment (CXL), and also to compare topical antibiotic treatment with the combined treatment.
Methods: The study involved 40 young adult female Sprague Dawley rats, which had a 2 mm scraped defect of the central corneal epithelium in both eyes. The rats were divided into two equal groups. The first group was inoculated in both eyes with standard Pseudomonas Aeruginosa (PA) from a strain suspension prepared from 0.05 ml (Group 1), and the second group was inoculated with standard Methicillin Resistance Staphylococcus Aureus (MRSA) strains from a suspension prepared from 0.05 ml (Group 2). Group 1 was divided into four sub-groups: Group 1A was treated by collagen cross-linking (CXL), Group 1C was treated with topical tobramycin drops CXL and also treated by collagen cross-linking (CXL), Group 1D was treated with topical tobramycin drops, and Group 1B was left untreated in order to create a control group. Similarly, Group 2 was also divided into four sub-groups: Group 2A was treated by CXL, Group 2C was treated with topical 5% fortified vancomycin drops CXL and also treated by CXL, Group 2D was treated with topical 5% fortified vancomycin drops, and Group 2B was left untreated in order to create a control group. CXL was performed on the third day following the inoculation and topical drop therapy. Biomicroscopy and microbiologic assessments were performed on the third and seventh days following the inoculation of microorganisms.
Results: In the treatment, which compared baselines in all groups before treatment, the diameter of keratitis infiltrations, corneal clouding, and corneal swab samples were obtained from the reduction in reproduction. The results were statistically significant (p < 0.01). Keratitis infiltration groups were conducted on the seventh day for Groups 1C and 1D according to Group 1B, whilst Groups 2A, 2C and 2D were conducted according to Group 2B, which showed a significant statistical reduction (p < 0.01). On the seventh day, focal groups were conducted in corneal clouding Group 1D according to Group 1B and in Groups 2A, 2C and 2D according to Group 2B, which revealed a significant statistical reduction (p < 0.01). On the seventh day, reproduction in culture was obtained from corneal swab samples in Groups 1C and 1D according to Group 1B; in Groups 1C and 1D according to Group 1A; in Groups 2A, 2C and 2D according to Group 2B; and in Group 2C according to Group 2A, where a significant statistical reduction was observed (p < 0.01).
Conclusions: The clinical and microbiological efficacy of the CXL treatment is evaluated in our study. In accordance with the conclusion reached an effective reduction in the density and severity of (infection), occurred as a result of CXL treatment, CXL treatment combined with topical antibiotic treatment and topical antibiotic treatment of Pseudomonas Aeruginosa (PA) and Metisilin Rezistant Staphylococcus Aureus (MRSA) keratitis infections. From these results, it is shown that topical antibiotics and CXL potentiate each other's effects in the treatment of resistant bacterial keratitis
Comparable survival using a CMV-matched or a mismatched donor for CMV+ patients undergoing T-replete haplo-HSCT with PT-Cy for acute leukemia: A study of behalf of the infectious diseases and acute leukemia working parties of the EBMT
No full textThe role of donor CMV serostatus in the setting of non T-cell depleted haplo-HSCT with post-transplant cyclophosphamide (PT-Cy) has not been specifically addressed so far. Here we analyzed the impact of the donor CMV serological status on the outcome of 983 CMV seropositive (CMV+), acute leukemia patients receiving a first, non T-cell depleted haplo-HSCT registered in the EBMT database. The 1-year NRM was 21.3% (95% CI: 18.4-24.8) and 18.8% (95% CI: 13.8-25.5) in the CMV D+/R+ and D-/R+ pairs, respectively (p = 0.40). Similarly, 1-year OS was 55.1% (95% CI: 50.1-58.0) and 55.7% (95% CI: 48.0-62.8) in the same groups (p = 0.50). The other main outcomes were comparable. No difference in NRM nor OS was observed after stratification for the intensity of conditioning and multivariate anaysis confirmed the lack of significant association with NRM or OS. In conclusion, the choice of a CMV-seronegative donor did not impair early survival of CMV-seropositive patients with acute leukemia after a first, non T-cell depleted haploidentical HSCT and PT-Cy among this series of 983 consecutive patients. Future research may focus on the assessment of the hierarchy of all the donor variables. © 2017 Macmillan Publishers Ltd., part of Springer Nature
Sağlıklı erişkin bireylerde yapılan işitsel beyin sapı cevapları ölçümlerinde LS CE-Chirp uyaran ve CE-Chirp uyaran cevaplarının karşılaştırılması
No full textGiriş
Chirp uyaranlar, daha fazla nöral senkronizasyon sağlayarak işitsel beyinsapı cevap
amplitütlerinin arttırılması hedeflenerek oluşturulmuş akustik ses uyaranlarıdır. Cevap
amplitütlerinin artması işitsel beyin sapı cevaplarında özellikle V. dalganın kolay ve
hızlı bir şekilde tespitinin yapılmasını sağlamakta ve buna bağlı olarak test hızı
artmaktadır. Son yıllarda geliştirilen CE-Chirp ve LS CE-Chirp uyaranlar buna
örnektir. Bu çalışmada sağlıklı bireylerden CE–Chirp ve LS CE-Chirp uyaranlara karşı
elde edilen işitsel beyin sapı cevaplarının karşılaştırması amaçlanmıştır.
Materyal ve Metod
Bu çalışma, Başkent Üniversitesi Hastanesi KBB Kliniğinde (KA17/164 proje nolu,
26/07/2017 tarih ve 17/160 sayılı karar ile) etik kurul onayı alınarak yapılmıştır.
Çalışma grubuna 18 – 40 yaş arasında normal işitmeye sahip, 14 kadın (28 kulak) ve
9 erkek (18 kulak), toplam 23 kişi (46 kulak) dahil edilmiştir. Çalışmaya dahil edilen
gönüllü bireylerin ayrıntılı bir anamnezi alınmış, kulak burun boğaz muayenesi
yapılarak herhnagi bir patoloji saptanmamış, odyometri testi ve akustik immitansmetri
ölçümleri yapılıp işitmesinin normal olduğu görülmüş ve gönüllülerin test kriterlerine
uygun olduğu ispatlandıktan sonra ABR testleri yapılmıştır. ABR testi CE-Chirp ve
LS CE-Chirp uyaranlar verilerek 80,60,40 ve 20 dB nHL şiddetlerinde yapılmıştır.
Elde edilen veriler, verilerin dağılımına uygun olarak istatistiksel yöntemler ile
değerlendirilmiştir.Bulgular
80 dB nHL’de CE Chirp ve LS CE-Chirp uyaranların I., III. ve V. dalga latansları ve
I. ve III. dalgaların amplitütlerinde istatistiksel farklılıklar izlenirken, V. dalganın
amplitütünde istatistiksel bir farklılık izlenmemiştir. 80 dB nHL şiddetinde interpik
latansları (I-III,III-V ve IV) farkı karşılaştırıldığında I-III arasında istatistiksel anlamlı
farklılık izlenmezken, III-V ve I-V arasında istatistiksel anlamlı fark tespit edilmiştir.
60, 40 ve 20 dB nHL şiddetinde yapılan ölçümlerde tüm dalga latansları ve amplitütleri
arasında istatistiksel olarak anlamlı bir farklılık izlenmemiştir.
Sonuç
LS CE-Chirp uyaranlar işitme eşiğinin değerlendirilmesinde etkilidir. Çalışmamızda
LS CE CHRIP latans ve amplitüt değerlerinin yüksek şiddetlerde CE-CHIRP e göre
daha yüksek olduğu gösterilmiştir. Düşük şiddetlerde her iki uyaran arasında herhangi
bir üstünlük izlenmemiş ve literatürle uyumlu sonuçlar elde edilmiştir.
Introduction
Chirps are acoustic stimuluses generated to increase the amplitudes arising from brain
stem responses by increasing the neural syncronization. With the increase of response
amplitudes, V. wave can be detected faster and easier and the duration of testing is
shortened. CE-Chirp and LS CE-Chirp are stimuluses which are developed for this
purpose. In this study, CE-Chirp and LS CE-Chirp stimulus responses are compared
in ABR’s.
Material&Method
This study is done by the confirmation of ethical committee approval in Baskent
University hospital ENT clinic (Project no: KA17/164, Date of issue 26.07.2017,
Decision no: 17/160). Work group was consist of 14 Woman (28 ears) and 9 Man (18
ears), with the age range of 18-40, normal hearing total of 23 subjects. All the subjects
detailed anemnesis were taken, examined by ENT, audiometry and tympanometry
testings were done showing no pathologies and then subjects were tested with ABR.
ABR testing was performed with 80, 60, 40 and 20 dB nHL levels using CE-Chirp and
LS CE-Chirp stimuluses. The results acquired were evaluated by statistical methods
according to the distribution of the data.
Results
There were statistically significant differences with 80dB nHL CE-Chirp & LS CEChirp
stimulus responses for I., III. & V. latencies and I. & III. amplitudes, but no
statistically significance was observed for V. wave amplitude. At 80 dB nHL interpeak
latency (I-III, III-V & I-V) differences were evaluated and there was no statistically significant difference for I-III, but for III-V & I-V statistically significance was
observed. For the rest 60, 40 and 20 dB nHL levels, there were no statistically
significant values for the all response latencies and amplitudes.
Conclusion
LS CE-Chirp stimulus is valuable for hearing threshold examination. Within this
study, latency and amplitude responses were higher for LS CE-Chirp with high
stimulus levels compared to CE-Chirp. For lower stimulus levels there was no
significant supremecy in between two stimuluses and results acquired were complying
with the literatüre
Basel düzenlemeleri ve Türk bankacılık sektöründe sermaye yeterliliği rasyosuna etkisi üzerine bir çalışma
No full textKüreselleşen ve sürekli değişip gelişen dünya düzeninde yaşanılan krizler ve şoklar
sonucunda ayakta kalmaya çalışan bir finans sitemi söz konusudur. Bu finans sisteminin en
önemli unsurlarından olan bankaların krizleri nasıl atlattığı finans sistemi açısından oldukça
önemlidir. Bankaların yaşamış oldukları zararları minimuma indirmek finans sektörünüde
korumak anlamına gelmektedir.
İşte bu sebeplerle G10 ülkeleri tarafından kurulan BASEL Komitesi ve bu komitenin
geliştirip sunduğu BASEL Düzenlemeleri bankaların güçlü bir özkaynak ve risk yönetimi
açısından güçlenerek yaşanılan krizlerden etkilenmemeleri için öneri niteliğinde
düzenlemeler sunmuştur.
BASEL düzenlemeleri ilk olarak 1988 yılında hazırlanmış ve kamuoyuna
sunulmuştur. Günümüzde hala sürekli olarak değişim ve gelişim göstererek güvenilirliğini
ve uygulanabilirliğini korumaktadır.
Tez çalışmamızda BASEL I, BASEL II ve BASEL III düzenlemeleri üzerinde
ayrıntılarıyla durulmuş BASEL IV düzenlemeleri ile ilgili sınırlı kaynak bulunduğundan
dolayı yeni düzenlemenin ana hatlarından bir özet oluşturulmuştur. Ayrıca BASEL
düzenlemelerinin esasını teşkil eden sermaye yeterlilik rasyosunun Türk bankacılık
sektöründeki seyri incelenmiş, seçilen 18 bankalar için ayrıntılı durum analizi yapılmıştır.
Bu çalışma BASEL düzenlemelerinin ve Türk bankacılık sektöründe sermaye
yeterliliği üzerindeki etkilerinin ayrıntılarıyla ele alındığı bir tez çalışmasıdır.
It is a financial system that is trying to survive as a result of crises and shocks
experienced in a globalized and continuously evolving world order. It is very important in
terms of the financial system that the banks, which are the most important elements of this
financial system, survive the crises. The minimizing the damages that banks have
experienced, means protecting them in the financial sector.
Thereby, BASEL Committee which established by G10 countries and BASEL
Regulatory which developed and prepared by this Committee have submitted regulations as
a recommendation to getting strong with regards to shareholder’s equity and risk
management of the banks.
BASEL Regulatory has prepared and released to the public on 1988 firstly. And
today it still maintains its reliability and applicability by constantly changing and developing.
In our thesis, we have elaborated on BASEL I, BASEL II and BASEL III regulations
with their details; but, due to there is limited resources with regard to BASEL IV regulations,
a summary of the new regulation could not established.
Furthermore, the course of the Capital Adequacy Ratios, the basis of the BASEL
regulations, was examined in the Turkish banking sector and a detailed situation analysis
was conducted for the 18 selected banks.
The aim of this study is to provide a guideline for elaboration of the BASEL
regulations and the effects on the capital adequacy of the Turkish banking sector
Endüstri mirasının sergilenmesi ve motosiklet müzeciliği
No full textSon yıllarda dünya genelinde müzeler toplumlar üzerinde sağladıkları farkındalık
sebebiyle oldukça dikkat çekmeye başlamıştır. Gün geçtikçe müzelerin ziyaretçi sayısı
artmakta olup, farklı ilgi alanlarına göre müzeler çeşitlenmektedir. Taşımacılık müzeciliği
de bunlardan biridir. Taşımacılık insanların varlığından beri hayatın kaçınılmaz bir parçası
olmuştur. Taşımacılık alanındaki her gelişme insanların ilgisini çekmektedir. İnsanların bu
ilgisi otomobil ve motosiklet müzeciliğine olan ilgiyi de arttırmaktadır. Günümüzde
taşımacılık müzeciliği alanında yayınlar oldukça kısıtlıdır.
Bu çalışmanın amacı; taşımacılık, özellikle de motosiklet müzeciliğine bir ışık
tutmaktadır. Çalışmamızda nitel veriler kullanılarak otomobil müzeleri incelenmiş;
yönlendirme elemanları, aydınlatma elemanları, iç mekanda kullanılan renkler, sergileme
yöntemleri değerlendirilmiştir. Yine çalışmamızda motosiklet müzeleri ve atölyeleri
(Orange County Choppers, Harley-Davidson Museum, Piaggio Museum) incelenip
değerlendirilmiştir. Aynı zamanda Türkiye’de bir motosiklet müzesinin sağlıklı bir şekilde
oluşturulması için tavsiyelerde bulunulmuştur.
Çalışmanın gerçekleşmesinde büyük emeği bulunan kıymetli hocam Prof. Dr.
Adnan Tepecik, İnsan Kaynakları Yöneticisi Sn. Michael Louis Wheeler, Araç Tasarımcısı
ve Restorasyoncusu Sn. Mehmet Taşanyürek ve Harley-Davidson firması çalışanı Sn.
Gürol Narin başta olmak üzere kıymetli aileme, hocalarıma ve dostlarıma teşekkür ederim.
recent years, museums have begun to draw considerable attention due to the
awareness they raised on societies. Day by day, the number of visitors to the museums has
increased and also the museums have diversified according to different interests of these
visitors. Transport museum has been one of these diversified museums. Transportation has
been an inevitable part of life since people's existence, and each development increased the
interest in automobile and motorcycle museums in the transport sector attracts people's
attention. Nowadays, publications written in the area of transport museum are very limited.
The purpose of this study is to find out the ideal conditions for transport museums
especially motorcycle museums. In this study, orientation and lighting elements, colors and
exhibition methods which have been used in interior design of car museums have been
analyzed by using qualitative data. Also, motorcycle museums such as Orange County
Choppers, Harley-Davidson Museum and Piaggio Museum were examined and evaluated.
Meanwhile, this study includes important recommendations for building motorcycle
museum in Turkey.
Special thanks to Prof. Dr. Adnan Tepecik, Human Resources Manager: Michael
Louis Wheeler, Vehicle Designer and Restorer: Mehmet Taşanyürek, Harley-Davidson
Company employee: Gürol Narin , my family , instructors and friends for their help and
support
Palyatif bakım hastalarının ve hemşirelerinin itibarlı bakıma ilişkin görüşleri
No full textBu çalışma palyatif bakım hastalarının ve bu alanda çalışan hemşirelerin itibarlı bakım konusundaki görüşlerinin incelenmesi ve Hasta İtibar Envanteri’nin Türkçe geçerlilik ve güvenilirliğinin değerlendirilmesi amacıyla gerçekleştirilmiştir. Tanımlayıcı ve metodolojik tipteki bu araştırma iki aşamadan oluşmaktadır. İlk aşama Chochinov ve arkadaşları tarafından Kanada’da geliştirilen “Hasta İtibar Envanteri’nin” Türk toplumunda geçerlilik ve güvenilirlik çalışması olup örneklemini Ankara’da iki üniversite hastanesinin kliniklerinde yatan 127 ileri evre kanser hastası oluşturmuştur. Çalışmada demografik form, Palyatif Performans Skoru, Hasta İtibar Envanteri ve Hastane Anksiyete ve Depresyon Ölçeği kullanılmıştır. Hasta İtibar Envanteri ilk uygulamadan en az bir hafta sonra 32 hastaya tekrar uygulanmıştır. İkinci aşamada ise 10 palyatif bakım hastası ve bu hastalarla çalışan 10 hemşirenin itibarlı bakıma ilişkin görüşleri birebir yarı yapılandırılmış görüşme tekniğiyle incelenmiştir. Çalışma Şubat-Temmuz 2018 tarihleri arasında yapılmıştır.
Hasta İtibar Envanteri dil geçerliliği sağlandıktan sonra uzman görüşüne sunulmuş ve uygun bulunmuştur. Cronbach alfa değeri ilk uygulamada 0.94, ikinci uygulamada 0.90 olarak elde edilmiştir. Ölçeğin toplam puanı ilk uygulamada 46.85±18.49 (min:25- max:125), ikinci uygulanmasında ise 40.78±13.96 (min:25-max: 70) olarak bulunmuştur. Ölçeğin yapı geçerliliğini incelemek için açımlayıcı faktör analizi ve doğrulayıcı faktör analizi yapılmıştır. Açımlayıcı faktör analizinde Kaiser-Meyer- Olkin örneklem yeterliği ölçütü değeri 0.89; faktör analizi yeterliği ölçütü Bartlett Küresellik Testi p<0.000 olarak bulunmuştur. Hasta İtibar Envanterinin Türkçe versiyonunun yapı geçerliliği analizleri sonucunda 5 faktör elde edilmiş olup madde dağılımlarında orijinal ölçekle farklılıklar olduğu belirlenmiştir. Elde edilen 5 faktörün varyansın % 68.7’sini açıkladığı saptanmıştır.
Hastalarla yapılan görüşmelerin çözümlemesi sonucunda saygınlık, bakım uygulamaları ve yararlılık şeklinde 3 ana tema elde edilmiştir. Hemşirelerle yapılan görüşmelerde ise veriler saygınlığın sürdürülmesi; engeller ve öneriler ile bakımın sonuçları olarak üç ana başlık altında toplanmıştır.
Sonuç olarak Hasta İtibar Envanterinin Türk toplumu için geçerli ve güvenilir bir ölçek olduğu belirlenmiştir. Hasta ve hemşirelerle yapılan görüşmelerde itibarlı bakımın hastanın saygınlığını koruyan; sağlık çalışanları ile hasta arasında sağlıklı iletişim kurulmasına ve bireyin kendini değerli ve güvende hissetmesine yol açan olumlu etkilere sahip, hastanın bütüncül bakım almasını sağlayan bir süreç olduğu ve buna bağlı olarak da hemşirenin iş doyumunu artırdığı belirtilmiştir. İtibarlı bakım kültürünü oluşturmak ve sürdürmek için kurumsal politikalar geliştirilmesi; bu politikaların da konuya ilişkin farkındalığı artıracak ve personelin yeterliliklerine göre görevlendirilmelerini sağlayacak; tükenmişliği önleyecek düzenlemeler içermesi önerilmiştir.
This study was conducted to investigate the views of the palliative care patients and the nurses working in this field about dignified care and to evaluate Turkish validity and reliability of the Patient Dignity Inventory. This descriptive and methodological study comprise of two phases. The first stage is validity and reliability study of "Patient Dignity Inventory" developed in Canada by Chochinov et al. within the Turkish society with a sample consisted of 127 advanced cancer patients who were hospitalized in the clinics of two university hospitals in Ankara. Demographic form, Palliative Performance Scale, Patient Dignity Inventory and Hospital Anxiety and Depression Scale were used to collect data in the study. Patient Dignity Inventory was reapplied to 32 patients at least one week after the first application. In the second stage, opinions of 10 palliative care patients and 10 nurses working with those patients were investigated relating to dignified care via one-to-one semi-structured interview technique. The study was conducted between February-July 2018.
Patient Dignity Inventory was presented to expert opinion after the language validity was provided and, approved by experts. The Cronbach alpha value was calculated as 0.94 for the first application and 0.90 for the second application. The total score of the inventory was 46.85±18.49 (min: 25- max: 125) for the first application and 40.78 ± 13.96 (min: 25-max: 70) for the second application. Explanatory factor analysis and confirmatory factor analysis were performed to examine construct validity of the scale. The Kaiser-Meyer-Olkin sampling adequacy criterion value was found as 0.89 and factor analysis adequacy criterion The Bartlett’s Test of Sphericity was found as p <0.000. Five factors were obtained as result of construct validity analysis of the Turkish version of Patient Dignity Inventory, differing from the original scale in terms of item distribution. It was found that 5 factors obtained by analysis explained 68.7 of total variances.
Analysis of the interview data performed with the patients resulted in three themes as respectability, caring practices and usefulness. Three major themes were detected through data of interviews held with nurses such as maintaining respectability; barriers and facilitators and benefits. As a result, it was determined that the Patient Dignity Inventory is a valid and reliable scale for Turkish society. Dignified care is specified through interviews held with patients and nurses as a process that protects patient’s dignity and provides holistic care for the patient resulting in positive effects by establishing healthy communication between healthcare team and patient, and making the patient feel valuable and safe, and therefore enhances job satisfaction of a nurse. Developing institutional policies to build up and maintain a dignified care culture including raising awareness of the issue, assigning staff according to their qualifications and making arrangements to prevent burnout is recommended