Person: GÖKDEMİR, YASEMİN
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GÖKDEMİR
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YASEMİN
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Publication Metadata only Sleep disordered breathing and sleep quality in children with bronchiolitis obliterans(WILEY, 2016) KARADAĞ, BÜLENT TANER; Uyan, Zeynep S.; Turan, Ihsan; Ay, Pinar; Cakir, Erkan; Ozturk, Ersin; Gedik, Ahmet H.; Gokdemir, Yasemin; Erdem, Ela; Sen, Velat; Karadag, Bulent; Karakoc, Fazilet; Ersu, RefikaThe incidence of sleep-disordered breathing (SDB) increases in chronic lung diseases. Our aim was to evaluate SDB and sleep quality in children with postinfectious bronchiolitis obliterans (BO) and assess associated risk factors. We hypothesized that children with BO are at increased risk for SDB and have impaired sleep quality. We also hypothesized that severity of SDB and impairment of sleep quality is related to the severity of lung disease. Sleep Related Breathing Disorder (SRBD) subscale of the Pediatric Sleep Questionnaire (PSQ) and Pittsburgh Sleep Quality Index (PSQI) questionnaires; spirometry, impulse oscillometry (IOS), and overnight polysomnography (PSG) were performed. Twenty-one patients (14 male, median age: 8.3 years) were enrolled. Five patients (25%) had a PSQ score of >0.33, predictive of a SDB. Ten patients (48%) had poor sleep quality. Four patients (19%) had an OAHI of >1/hr. Nineteen patients (90%) had a high desaturation index. Four patients (19%) had a mean oxygen saturation of <93%. Median central apnea time was 7.5 (IQR: 6.9-9.1) seconds. Central apnea index of the patients correlated positively with R5, R10, R15, R20, Z5, and negatively with X10 and X15 at IOS. There was a positive correlation between the lowest oxygen saturation and FVC, FEV1, X5, X10, X15, X20 while there was a negative correlation between lowest saturation and the central apnea index at PSG, R5, R10, and Z5 at IOS. Mean oxygen saturation during PSG correlated positively with FVC, FEV1, FEF25-75, X5, X10, X15, X20 results. The risk of nocturnal hypoxia is increased in patients with BO and correlated to the severity of lung disease determined by pulmonary function tests. Although BO patients have a shorter duration of central apneas, they are more prone to desaturate. Pediatr Pulmonol. 2016;51:308-315. (c) 2015 Wiley Periodicals, Inc.Publication Metadata only Efficacy of standardized tracheostomy training with a simulation model for healthcare providers: A study by ISPAT team(WILEY) ERDEM ERALP, ELA; Uyan, Zeynep S.; Atag, Emine; Ergenekon, Almala P.; Gokdemir, Yasemin; Gokler, Ozan; Ay, Pinar; Ikizoglu, Nilay Bas; Cenk, Muruvvet; Eralp, Ela Erdem; Sivrikaya, Ulufer; Girit, Saniye; Cakir, Erkan; Kilic, Ayse A.; Yazan, Hakan; Oksay, Sinem Can; Hepkaya, Evrim; Kiyan, Gursu; Karadag, Bulent; Karakoc, Fazilet; Oktem, SedatIntroduction Tracheostomy care in children may be challenging, due to lack of knowledge of healthcare providers (HCPs). The aim of this study was to determine the level of knowledge of HCP who follow patients with tracheostomy and to increase this level with theoretical training and training in a simulation laboratory. Materials and Methods ISPAT (IStanbul PAediatric Tracheostomy), a multidisciplinary team for tracheostomy care was established and a training program was prepared. Participants were subjected to theoretical and practical pretests which evaluated their knowledge levels and skills for care, follow-up, and treatment of a patient with tracheostomy. After the theoretical and practical training given to the participants with a simulation model, theoretical and practical posttests were applied. Results Fifty-one HCP from nine tertiary pediatric clinics in Istanbul were enrolled in the training program. Only six (11.8%) of them had received standardized training programs previously. Regarding the theoretical tests, seven of the 33 questions were indicated as essential. The knowledge level of the participants based on the essential questions significantly increased after the training (p < 0.05 for all of the essential questions). The total number of correct answers and correct answers of three subheadings also significantly increased after the practical training (p < 0.001 for all). Ninety-five percent of the participants assessed the course as good or excellent in general. Conclusion Training in a simulation laboratory in combination with theoretical education can improve the knowledge and skills of the HCP enabling improved care of children with a tracheostomy.Publication Metadata only Effect of standardized hands-on-training in caregivers of children with tracheostomy(2021-09-01) AY, NADİYE PINAR; GÖKDEMİR, YASEMİN; Yegit C. Y., Kilinc A. A., Gulieva A., Atag E., Yazan H., Oksay S. C., Kostereli E., UZUNER S., Onay Z. R., Hepkaya E., et al.Publication Metadata only The ISPAT project: Implementation of a standardized training program for caregivers of children with tracheostomy(WILEY, 2022) ERDEM ERALP, ELA; Yegit, Cansu Yilmaz; Kilinc, Ayse Ayzit; Oksay, Sinem Can; Unal, Fusun; Yazan, Hakan; Kostereli, Ebru; Gulieva, Aynur; Arslan, Huseyin; Uzuner, Selcuk; Onay, Zeynep Reyhan; Baskan, Azer Kilic; Collak, Abdulhamit; Atag, Emine; Ergenekon, Almala Pinar; Ikizoglu, Nilay Bas; Ay, Pinar; Oktem, Sedat; Gokdemir, Yasemin; Girit, Saniye; Cakir, Erkan; Uyan, Zeynep Seda; Cokugras, Haluk; Karadag, Bulent; Karakoc, Fazilet; Eralp, Ela ErdemBackground Tracheostomy-related morbidity and mortality mainly occur due to decannulation, misplacement, or obstruction of the tube. A standardized training can improve the skills and confidence of the caregivers in tracheostomy care (TC). Objective Our primary aim was to evaluate the efficiency of standardized training program on the knowledge and skills (changing-suctioning the tracheostomy tube) of the participants regarding TC. Materials and Methods Sixty-five caregivers of children with tracheostomy were included. First, participants were evaluated with written test about TC and participated in the practical tests. Then, they were asked to participate in a standardized training session, including theoretical and practical parts. Baseline and postintervention assessments were compared through written and practical tests conducted on the same day. Results A significant improvement was observed in the written test score after the training. The median number of correct answers of the written test including 23 questions increased 26%, from 12 to 18 (p < .001). The median number of correct steps in tracheostomy tube change (from 9 to 16 correct steps out of 16 steps, 44% increase) and suctioning the tracheostomy tube (from 9 to 17 correct steps out of 18 steps, 44% increase) also improved significantly after the training (p < .001, for both). Conclusion Theoretical courses and practical hands-on-training (HOT) courses are highly effective in improving the practices in TC. A standardized training program including HOT should be implemented before discharge from the hospital. Still there is a need to assess the impact of the program on tracheostomy-related complications, morbidity, and mortality in the long term.Publication Metadata only Geographical barriers to timely diagnosis of cystic fibrosis and anxiety level of parents during newborn screening in Turkey(WILEY, 2021) AY, NADİYE PINAR; Gokdemir, Yasemin; Eyuboglu, Tugba Sismanlar; Emiralioglu, Nagehan; Er, Berrin; Sen, Velat; Pekcan, Sevgi; Ergenekon, Almala Pinar; Hizal, Mina Gharibzadeh; Eryilmaz, Sanem; Kose, Mehmet; Hangul, Melih; Cakir, Erkan; Cokugras, Haluk; Kilinc, Ayse Ayzit; Sasihuseyinoglu, Ayse Senay; Altintas, Derya Ufuk; Gulen, Figen; Eski, Aykut; Bingol, Aysen; Ozdemir, Ali; Topal, Erdem; Gursoy, Tugba Ramasli; Girit, Saniye; Ay, Pinar; Yilmaz, OzgeBackground Despite the availability of cystic fibrosis (CF) screening countrywide, diagnostic delay is still a crucial issue. The objectives of this study were to explore the stages of the NBS process, determine the risk factors associated with diagnostic delay and evaluate parent anxiety and experience throughout the process. Methods This is a multicenter cross-sectional study. A questionnaire was completed by parents of newborns diagnosed with CF via NBS in 17 centers. Socio-demographic characteristics, parent knowledge and experiences related to NBS, sweat test availability in the region of residence, and time to the definitive CF diagnosis were assessed through this questionnaire. Parents' anxiety levels were evaluated through the State-Trait Anxiety Inventory scales 1 and 2. Delayed diagnosis (DD) was defined as a definite CF diagnosis beyond the 8th week of life. Predictors of delayed CF diagnosis were evaluated by univariate and multivariate analysis. Results A total of 220 CF patients diagnosed via NBS were enrolled; 82 (37.3%) babies had DD. Multivariable analysis indicated that residence in the Southeast Anatolia region of Turkey (OR = 10.79, 95% CI = 2.37-49.2) was associated with a higher incidence of DD compared with other regions in Turkey. Of the total, 216 (98.1%) of the caregivers regarded the NBS program as useful and 180 (82%) reported high anxiety levels. Conclusion The organization of newborn screening should take into account regional and socio-cultural characteristics to improve the early diagnosis of CF and also reduce the anxiety level of parents.Publication Metadata only Effect of Night Symptoms and Disease Severity on Subjective Sleep Quality in Children With Non-Cystic-Fibrosis Bronchiectasis(WILEY, 2011) KARADAĞ, BÜLENT TANER; Erdem, Ela; Ersu, Refika; Karadag, Bulent; Karakoc, Fazilet; Gokdemir, Yasemin; Ay, Pinar; Akpinar, Ihsan Nuri; Dagli, ElifBackground: Night-time symptoms and hypoxemia during sleep may affect sleep quality in children with chronic lung disease such as bronchiectasis. Poor sleep quality may impair growth, learning, and emotional development of children. Our aim was to assess the sleep quality and associated factors in children with non-cystic fibrosis bronchiectasis. Methods: Fifty-four patients with bronchiectasis and age-matched controls were included to the study. Pittsburgh Sleep Quality Index (PSQI) and Pediatric Sleep Questionnaire (PSQ) were used to evaluate sleep quality and presence of sleep disordered breathing. A global sum of 5 or more according to PSQI indicated a poor sleep quality. A cut-off value of 0.33 in PSQ was used to identify pediatric sleep disordered breathing. Association between PSQI, pulmonary function tests, symptoms and HRCT scores were evaluated. Results: Thirty-seven percent of patients with bronchiectasis and 17% of patients in the control group had poor sleep quality (P < 0.05). Patients with sputum and wheezing had poorer sleep scores (P = 0.003 and P = 0.005). The association of wheezing and breathlessness during night time with sleep quality tended to be significant (P = 0.05). Twenty-two percent of patients with bronchiectasis and 9% of controls had sleep disordered breathing (P = 0.003). Bronchiectasis patients who snored had poorer sleep quality (P < 0.001) and patients with wheezing had significantly higher rate of snoring (P = 0.04). Children with worse HRCT scores also had worse sleep quality (r = 0.28, P = 0.04). Conclusions: Patients with bronchiectasis have disturbed sleep associated with severity of disease. Night symptoms increase the risk of poor sleep quality. Sleep disordered breathing and sleep quality should be assessed in these patients. Pediatr Pulmonol. 2011; 46:919-926. (C) 2011 Wiley-Liss, Inc.Publication Metadata only The effect of training the health care providers with simulation model on the care of patients with chronic tracheostomy(2021-09-01) ERGENEKON, ALMALA PINAR; GÖKDEMİR, YASEMİN; AY, NADİYE PINAR; ERDEM ERALP, ELA; Uyan Z. S., Atag E., Ergenekon A. P., GÖKDEMİR Y., Gokler O., AY N. P., Ikizoglu N. B., Cenk M., ERDEM ERALP E., Sivrikaya U., et al.Introduction: Tracheostomy care in children may be challenging, due to lack of knowledge of health care providers. The aim of this study was to determine the level of knowledge of health care providers who follow patients with tracheostomy and to increase this level with theoretical education and training in a simulation laboratory. Materials and Methods: Volunteer participants were subjected to a theoretical pretest which evaluated their knowledge level for the care, follow-up and treatment of patients with tracheostomy. Then, practical testing with three subheadings evaluating the change of the tracheostomy cannula was applied. After theoretical training and one-on-one practical training given to the participants with a simulation model, theoretical and practical posttests were applied. Results: Fifty-one health care providers from six tertiary pediatric clinics in Istanbul were enrolled in the educational course. Only 6 (11.8%) of them received standardised training programme previously. Regarding the theoretical tests, seven of the 33 questions were indicated as crucial. The knowledge level of the participants based on the crucial questions significantly increased after the training (p value <0.05 for all of the crucial questions). Total number of correct answers and correct answers of 3 subheadings also significantly increased after the practical training (p value <0.001 for all). Ninety-five percent of the participants assessed the course as good or excellent. Conclusion: Training in simulation laboratory together with theoratical education can improve the knowledge and skills of the health care providers enabling improved care of children with tracheostomy.