Publication: Jinekolojik onkoloji hemşirelik uygulamalarına ilişkin akış şemalarının geliştirilmesi ve alana uyarlanması
Abstract
JİNEKOLOJİK ONKOLOJİ HEMŞİRELİK UYGULAMALARINA İLİŞKİN AKIŞ ŞEMALARININ GELİŞTİRİLMESİ VE ALANA UYARLANMASI ÖZET Kanser, hastalığın kendisi ve tedavinin istenmeyen etkileri nedeniyle hastalar ve bu hastalarına bakım veren sağlık çalışanları için uzun ve zorlu bir dönemdir. Bu süreçte ortaya çıkan semptomların tam ve zamanında değerlendirilmesinde ihtiyaçları karşılayan, etkin, hedeflere ulaşmayı sağlayan uygun hemşirelik bakımının verilmesinde sistematik yaklaşım önemlidir. Bu çalışma, jinekolojik onkoloji hastalarına verilen hemşirelik uygulamalarına ilişkin akış şemalarını geliştirmek ve alana uyarlamak amacıyla tek gruplu yarı deneysel bir çalışma olarak planlanmıştır. Araştırma İstanbul ilinde hemşirelik hizmetleri etkin olarak verilen 6 hastanede (3 sağlık bakanlığı hastanesi, 2 özel hastane, 1 üniversite hastanesi), Ekim 2008- Mart 2009 tarihleri arasında yapılmıştır. Çalışmanın evrenini, jinekolojik onkoloji hastalarına bakım veren, birimde en az 6 aydır çalışan ve çalışmaya gönüllü katılan 97 ebe/ hemşire oluşturmuş; verilerin toplandığı tarihlerde raporlu/ izinli olan ve çalışmaya katılmak istemeyen hemşirelerin olması nedeniyle 87 kişi örneklemi oluşturmuştur. Veriler, tanımlayıcı bilgi formu ve araştırmacılar tarafından oluşturulmuş olan “Akış Şemalarının Etkinliğini Belirleme Formları” ile toplanmıştır. Veri toplama işlemi öncesinde, jinekolojik onkoloji problemlerine ait riskler belirlenmiş, literatür taraması yapılarak uygulamalara yönelik akış şemalarının olup olmadığı araştırılmış ve bulunan şemalar gözden geçirilerek akış şeması oluşturma çalışmaları başlatılmıştır. Yapılan değerlendirmeler sonucunda risklere, semptomlara ve operasyon süreci ve taburculuğa yönelik 15 akış şemasının oluşturulmasına karar verilmiştir. Katılımcılara uygulama öncesinde ve sonrasında etkinliği belirleme anketleri uygulanmıştır. Çalışma sonucunda katılımcıların uygulama sonrasında akış şemalarının etkinliğinin anlamlı düzeyde arttığı (p<0.01), yaş grubu, eğitim durumu, meslekte çalışma süresi ve jinekolojik onkoloji alanında çalışma yılı ile uygulama öncesi ve sonrasında değerlendirmeleri ile anlamlı ilişki olmadığı (p>0.01) saptanmıştır. Çalışma sonucunda, katılımcılardan hemşire kadrosunda olanların; üniversite hastanesi ve özel hastanede çalışanların, standart bakımın gerekli olduğunu düşünen ve alanda akış şeması olmasını isteyen katılımcıların akış şemalarına yönelik değerlendirmeleri daha olumlu bulunmuştur. Akış şeması, jinekolojik onkoloji, bakım standardı, hemşirelik yaklaşımı. DEVELOPMENT AND AREA ADAPTATION OF FLOW CHARTS RELATED TO GYNECOLOGIC ONCOLOGY NURSING PRACTICES
Cancer is a long and difficult period for patients and caregivers in health sector because of both the disease itself and the treatment due to its adverse effects. In this process, a systematic approach in appropriate nursing care is important to provide a complementary patient-employee satisfaction that meets the needs of on time, certain and target-oriented evaluation of the symptoms appearing in this period. This study is planned to be a one grouped semi-experimental research to develop and adapt the flow charts of the nursing practices applied to gynecologic oncology patients to the field. The research was conducted between October 2008 and March 2009 in 6 hospitals in Istanbul (3 health ministry hospitals, 2 private hospitals and 1 university hospital) where their effective programs they practice. The scope of the study included 97 midwives/ nurses who had been working as caregivers of gynecologic oncology patients in this unit at least for 6 months and who participated in this study voluntarily; 87 people composed the sampling because of the absence of nurses who were on vacation or on sick leave when the data were collected and who didn’t want to participate in the study. The data were formed by descriptive information form and by the researchers and then collected via “Forms to Determine the Efficiency of Flow Charts”. Before data collection process, the risks related to gynecologic oncology problems were identified, the literature scanning was made to search the existence of flow charts based on the practices and the discovered charts were reviewed so the efforts to create a flow chart began. As a result of the evaluations, it was decided to create 15 flow charts intended for risks, symptoms, operation processes and discharge. Questionnaires to determine the activity were applied to participants before and after the practice. As a result of the study, it was determined that the efficiency of the flow charts increased significantly (p <0.01) after the practice of the participants and there wasn’t a significant relationship (p>0.01) between the age group, education level, occupational period in this job and in the gynecologic oncology field and their evaluations of the practice before and after it was applied. The results of the study revealed that participants who worked in the nursing staff; who worked in university and private hospitals and who supported the existence of a flow chart in the field evaluated the flow charts positively. Key words: Flow chart, gynecologic oncology, care standards, nursing approach
Cancer is a long and difficult period for patients and caregivers in health sector because of both the disease itself and the treatment due to its adverse effects. In this process, a systematic approach in appropriate nursing care is important to provide a complementary patient-employee satisfaction that meets the needs of on time, certain and target-oriented evaluation of the symptoms appearing in this period. This study is planned to be a one grouped semi-experimental research to develop and adapt the flow charts of the nursing practices applied to gynecologic oncology patients to the field. The research was conducted between October 2008 and March 2009 in 6 hospitals in Istanbul (3 health ministry hospitals, 2 private hospitals and 1 university hospital) where their effective programs they practice. The scope of the study included 97 midwives/ nurses who had been working as caregivers of gynecologic oncology patients in this unit at least for 6 months and who participated in this study voluntarily; 87 people composed the sampling because of the absence of nurses who were on vacation or on sick leave when the data were collected and who didn’t want to participate in the study. The data were formed by descriptive information form and by the researchers and then collected via “Forms to Determine the Efficiency of Flow Charts”. Before data collection process, the risks related to gynecologic oncology problems were identified, the literature scanning was made to search the existence of flow charts based on the practices and the discovered charts were reviewed so the efforts to create a flow chart began. As a result of the evaluations, it was decided to create 15 flow charts intended for risks, symptoms, operation processes and discharge. Questionnaires to determine the activity were applied to participants before and after the practice. As a result of the study, it was determined that the efficiency of the flow charts increased significantly (p <0.01) after the practice of the participants and there wasn’t a significant relationship (p>0.01) between the age group, education level, occupational period in this job and in the gynecologic oncology field and their evaluations of the practice before and after it was applied. The results of the study revealed that participants who worked in the nursing staff; who worked in university and private hospitals and who supported the existence of a flow chart in the field evaluated the flow charts positively. Key words: Flow chart, gynecologic oncology, care standards, nursing approach