Background: Vitamin D deficiency is a potentially modifiable risk factor that may be targeted for breast cancer (BC) prevention. It may also be related to prognosis after diagnosis and treatment. The aim of our study was to determine the prevalence of vitamin D deficiency as measured by serum 25-hydroxy vitamin D (25-OHD) levels in patients with BC and to evaluate its correlations with life-style and treatments. Materials and Methods: This study included 186 patients with stage 0-III BC treated in our breast center between 2010-2013. The correlation between serum baseline 25-OHD levels and supplement usage, age, menopausal status, diabetes mellitus, usage of bisphosphonates, body-mass index (BMI), season, dressing style, administration of systemic treatments and radiotherapy were investigated. The distribution of serum 25-OHD levels was categorized as deficient (<10ng/ml), insufficient (10-24 ng/ml), and sufficient (25-80 ng/ml). Results: The median age of the patients was 51 years (range: 27-79 years) and 70% of them had deficient/insufficient 25-OHD levels. On univariate analysis, vitamin D deficiency/insufficiency was more common in patients with none or low dose vitamin D supplementation at the baseline, high BMI (${\geq}25$), no bisphosphonate usage, and a conservative dressing style. On multivariate analysis, none or low dose vitamin D supplementation, and decreased sun-exposure due to a conservative dressing style were found as independent factors increasing risk of vitamin D deficiency/insufficiency 28.7 (p=0.002) and 13.4 (p=0.003) fold, respectively. Conclusions: The prevalence of serum 25-OHD deficiency/insufficiency is high in our BC survivors. Vitamin D status should be routinely evaluated for all women, especially those with a conservative dressing style, as part of regular preventive care, and they should take supplemental vitamin D.
The study was designed to identify the attitude of nursing students to clinical education through Q-methodology. A C sample was developed through a review of the literature and interviews. Twenty - seven statements made up the finalized Q- sample. This was out of an initial 143 statements developed through consultation with eight professors. The P sample consisted of 25 nursing students in S Health Junior College.0 statements were written on seperate cards and were given to the 25 subjects to sort according to degree of agreement or disagreement. The Q-sorts by each subject were coded and analyzed with QUANL PC Program. The analysis discovered three major attitudes, namely “amicable adaptation” 〈type 1), “Nightingale social service” (type 2), and “realistic occupation pursuit” (type 3). The correlation was .465 between type 1 and type 2, .293 between type 1 and type 3, and .273 between type 2 and type 3. The characteristics of each type were as follows ; Type 1 (amicable adaptation) They satisfied in interpersonal relationships in the clinical setting. They would not dream of becoming Nightingale, but thought of nursing care affirmatively and performed their works faithfully and adapted themselves to the new circumstances easily, Fourteen subjects were classified as type 1. Type 2 (Nightingale: social service) They often dreamed as a child that they would be Nightingale with a white uniform and think that nursing is a gift from heaven. They have an aptitude for nursing care by nature and selected nursing science them-selves. They give care to the sick with pleasure. Seven subjects were classified as type 2. Type 3 (realistic occupation pursuit) They were not satisfied with their nursing practice. First of all they want a stable job, therefore they selected nursing science. They had conflicts in clinical practice, but were responsible for nursing and studied hard. Four subjects were classified as type 3. Through the results of this study, the attitude of nursing students to clinical education could be classified into three types. Therefore it is suggested that clinical education would be more valuable, if it was planned according to an understanding of the attitudes of nursing students to clinical education.
The purpose of this study was to determine discharge learning needs of patients undergoing thyroidectomy. The population of this descriptive study consisted of patients undergoing thyroidectomy in the Endocrine Surgery Unit of a university hospital between February and December 2013. The study included 251 patients who were discharged after thyroidectomy. Data obtained using the data collection form and the Patient Leaning Needs Scale (PLNS) were analyzed by frequency, mean, standard deviation, Kruskal Wallis and student-t tests. The mean age of the patients was $47.91{\pm}13.05$ and 76.1% were females. The PLNS total mean score was $208.38{\pm}34.91$, with the maximum score of $39.23{\pm}6.80$ on the subscale of treatment and complications and the minimum score of $19.45{\pm}4.70$ on the subscale of feelings related to condition. It was found that the PLNS total score of the patients was not influenced by age, gender, marital status (p>0.05). This study demonstrated that patients had high learning needs after thyroidectomy.
The limiting equivalent conductances of LiCl, NaCl, KCl and KBr have been obtained in water using conductometric method from 1 to 2000 bars at $25^{\circ}C$. From the limiting equivalent ionic conductances (obtained using TATB[Tetraphenyl Arsonium Tetraphenyl Borate]method) of $Li^+$, $Na^+$, $K^+$, $Cl^-$, and $Br^-$ ions and viscosity of water at given pressure, their Stokes radii have been calculated. From the corrected radii caliberated by Nightingale method and the crystallographic radii at a given pressure, the volume of hydration-shell surrounding ion was calculated and hydration numbers of $Li^+$, $Na^+$, $K^+$, $Cl^-$, and $Br^-$ ions were obtained. From the experimental results, it was found that the hydration number of $Li^+$, $Na^+$, $K^+$, $Cl^-$, and $Br^-$ ions slightly decreased with increasing pressure. This trend may be explained by Horne's suggestion[Advances in High Pressure Research]. Comparing results of this study with those of Nakahara's, the hydration numbers of $K^+$ and $Cl^-$ ions were almost twice as large as those of Nakahara's[Rev. Phys. Chem. Japan, 42, 12 (1972)]. By comparing the present results with those of Kollman's [J. Am. Chem. Soc., 113, 2481 (1991)], the hydration number obtained by applying TATB method and Nightingale method may be inferred to be reasonable.
Aims: To identify the psychosocial adjustment of Turkish patients with breast cancer and the effects of perceived social support on their adjustment. Materials and Methods: The sample comprised 100 volunteering patients diagnosed with breast cancer in the last six months reporting to the Outpatient Chemotherapy Unit at the Medical Faculty Hospital in northern Turkey. The data for the study were collected through the Descriptive Information Form, the Psychosocial Adjustment to Illness Scale-Self-reflection (PAIS-SR) and the Cancer-Specific Social Support Scale and analyzed via SPSS 16.0 for Windows. Descriptive statistics, Chi square test, ANOVA and correlation were used to evaluate data. Results: There was a negative significant correlation between mean scores in the sub-scales of the social support scale and the ones in the sub-scales of the psychosocial adjustment to illness scale (p<0.05). Similarly, there was a negative significant correlation between confidence support and health care orientation as well as adjustment to social environment. Likewise, emotional support was in a negative significant correlation with health care orientation, adjustment to domestic environment, extended family relationships and adjustment to social environment. Conclusions: It was concluded that social support for patients with breast cancer had an influence on their psychosocial adjustment to illness. Holistic care should be given to breast cancer patients by oncology nurses especially in the first six months of treatment. It could be concluded that patients should be accompanied by their family/relatives in treatment and care following their diagnosis with breast cancer, that their family should be made more aware of the fact that the patient should be physically and psychologically supported, that patients with breast cancer should be provided with domiciliary care, and that they should be encouraged to participate in social support groups.
Ford Madox Ford, the early twentieth-century writer most famous for his novel The Good Soldier, perceived his "business in life [as an] ... attempt to discover and to try to let you see where you stand." With this grand purpose in mind, Ford disregarded distinctions of genre in his prolific output of what we would consider novels, memoirs, literary criticism, travel writing, and history. Claiming that "the Novelist ... [is a] historian of his own time," Ford sought his own version of the "truth," a truth that was more faithful to his own subjective impressions than to verifiable "fact." Among these works that depict his age are a series of "memoirs" or "reminiscences," works published from the 1910s to the 1930s which carry out his Impressionistic purpose. What lies behind these memoirs is Ford′s view that his own individual history can be understood as his contemporary society′s collective history. This article explores Ford′s experimentation with boundaries of fact and fiction, and history and narrative, as he employs and expands the memoir form. In particular, 1 focus on two works, Memories and Impressions (1911) and It Was the Nightingale (1933), and Ford′s techniques in these memoirs, such as 1) the adoption of fictional personae from which to comment on his society at large and 2) the use of emblematic "parables" to encapsulate larger lessons of life within the minutiae of existence. Current theorists on the memoir form share interests in these questions of genre and of the social role of the memoir Nancy Miller, for instance, terms the memoir "the record of an experience in search of a community." This article engages these current discussions of the memoir genre by examining Ford′s early twentieth-century examples as innovative experiments that play with the boundaries between fiction and history, and personal impressions and collective truth.
A review of this literature and discussions reveal a development of ideas concerning the elements of nursing models. The elements of a nursing model are the nurses view of the human being, nursing's goal, and nursing activities. It has long been recognized that human beings, at one time or another, require nursing care. Varieties of literature were reviewed in regard to the human being as recipient of nursing care through the theory development in nursing. Florence Nightingale initiated the modern era of nursing and described more clearly man as the recipient of nursing care. She looked at man as responding to the laws of nature whether the person was healthy or sick. Henderson added to Nightingale's concept of man , the recipient of nursing care by emphasizing that man is a whole, complete, and independent being. Her view is further specified by her enumeration of the activities the human being must perform. Johnson has developed a very comprehensive view of man as the recipient of nursing care. Man is a behavioral system which has a tendency to achieve and maintain stability in patterns of functioning. Like Nightingale, Johnson sees that similar patterns occur in both health and illness. Johnson postulates that the whole behavioral system of the human is composed of eight sub-systems: affiliative, achievement, aggressive, dependency, eliminative, ingestive, restorative, sexual. Roger's main contribution to the development of nursing models was her emphasis upon unitary man. She pointed out that man is a unified whole, possessing his own integrity and manifesting characteristics that“are more than and different from the sum of his parts.”Rogers focuses on the life processes of the human and points out that these processes have the following characteristics. Wholeness, openness, unidirectionality, pattern and organization, sentence, and thought. According to Roy, man is a biopsychosocial being in constant interaction with a changing environment. To cope with this changing environment, man has certain innate and acquired mechanisms. Man's ability to respond positively or to adapt, depends upon the degree of the change taking place and the state of the person coping with the change. When she analyzes man as an adaptive organism she further describes man as being composed of four adaptive modes: physiological needs, self-concept, role function, and interdependence. Based on the literary review through the theory development in nursing, general approach by a unified nursing model to a view of the recipient of nursing care may be stated as follows: Man is a unified whole composed of subsystems with a flexible and normal line of defense; his internal regulating mechanisms help him to cope with a changing environment; he functions by the principles of homeodynamics.
Background: Breast cancer is the leading cause of cancer-related deaths in women. Despite being associated with high morbidity and mortality, breast cancer is a disease that can be diagnosed and treated early. Materials and Methods: In this cross-sectional study of 321 women, data were collected by Questionnaire, Breast Cancer Risk Assessment Form and Champion's Health Belief Model Scale. Mann-Whitney U, Kruskal-Wallis, Chisquared tests and logistic regression were used in the statistical analysis. Results: It was found that only 2.2% of women have high and very high risk levels of breast cancer risk. There is a positive correlation between early diagnosis techniques and Health Belief Model Sub-Dimension scores which are sensibility, health motivation, BSE (Breast self-examination) self-efficient perception and negative correlation between mammography barrier score and BSE barrier score (p 0.05). When factors for not having BSE were examined, it was determined that the women who do not have information about breast cancer and the women who smoke have a higher risk of not having BSE. Conclusions: It is important to determine health beliefs and breast cancer risk levels of women to increase the frequency of early diagnosis. Women's health beliefs are thought to be a good guide for planning health education programs for nurses working in this area.
Jo, Hyun Sook;Park, Jeong Mo;Park, Jeong Hee;Yi, Sung Eun
The Journal of Korean Academic Society of Nursing Education
/
v.21
no.4
/
pp.540-549
/
2015
Purpose: To identify current status of university health care program. Methods: Data and information from homepages of 309 colleges or universities in South Korea were collected. The data was analyzed by frequencies, t-test, ${\chi}^2$ test with SPSS Ver. 18.0. Results: 117(37.9%) universities had organization of health care. Whether university had health care program or not had shown significantly depended on number of students, types of school (university or college), region, and existence of medical and nursing course. Medical course was shown as a strong predictor for facilitating university health care program limitedly focusing on diseases treatment. Health promotion programs have been operated in 15 universities, vaccination programs in 10 universities, and health screening in 20 universities. Conclusion: It is strongly recommended to revise the School Health Law for constructing a comprehensive university health care program consolidating health counseling and physical training.
Background: Work and work environment have a critical influence on adolescent workers' health. They are subjected to more risks than adults. The aim of this study is to examine psychological health outcomes in adolescent workers in the areas of depression, somatization, anxiety, hostility, and negative self-concept, and to investigate any related factors. Methods: This is a descriptive and cross-sectional study. Research samples were collected from adolescent workers between 15 and 18 years old attending a 1-day mandatory education course at vocational training centers, working 5 days per week in small enterprises. Data were collected using the following instruments: Brief Symptom Inventory, Multidimensional Scale of Perceived Social Support, and Descriptive Characteristics of Children's Assessment Form. Results: The investigation covers 837 young workers, of whom 675 were males and 162 were females. The majority of the families had low incomes (68.1%). Overall, 33.5% of the adolescents had been hospitalized because of health problems. Their average weekly working hours were $78.1{\pm}10.7$. Almost 50% of adolescent workers scored above the mean average in the Brief Symptom Inventory, indicating serious pschological health symptoms. Those who scored high for hostility, depression, negative self-concept, anxiety, and somatization were between 45.4% and 48.9% of the sample. Logistic regression analysis was conducted to determine the underlying factors: a perception of "feeling very bad" health conditions was 2.07-fold whereas the rate of "no annual leave" was 0.73-fold, and both were found to be effective on psychological problems. Conclusion: In this study, it seems likely that psychological health problems are the result of multiple adverse factors including working conditions, annual leave, and health considerations.
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