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  • Publication
    Open Access
    Pediatri yoğun bakım ünitesindeki entübe olan çocuk hastaların endotrakeal aspirasyon'a gösterdikleri ağrı davranışları ve ağrının değerlendirilmesi
    TUNALI, İpek; AŞTI, Türkinaz; ERDOĞAN, Özcan
    This research was planned and carried out in order to measure and evaluate the pain behaviors of intubated pediatric patients hospitalized in the pediatric intensive care unit due to the endotracheal aspiration process and to determine the role of the nurse in controlling the pain that occurs. The universe of the research was composed of patients admitted to the Pediatric Intensive Care unit of Bezmialem Vakıf University Faculty of Medicine Hospital. All patients (60 patients) who were admitted to the Pediatric Intensive Care Unit and met the inclusion criteria of the study were included in the sample of the study. The data of this research, which determines the literature by the researcher obtained by the demographic characteristics of the patient and the patient taranila question 9 which consists of 7 questions that are evaluated during the treatment by 'Data evaluation form', FLACC Pain scale, the behavioral pain scale and the Wong-Baker face scale were collected using a. In the analysis of the data obtained from the study, the SPSS 24 program was used. Frequency and percentage analysis were used from descriptive analyses to evaluate the distribution of the study according to demographic characteristics. The mean and standard deviation were used to obtain descriptive analyses of the pain scales used in the study. An independent sample t-test was used to decipher the differences in the scores obtained from the pain scales according to the 2 groups, and a one-way anova analysis was performed to determine the differences between more than 2 groups. The study examined the demographic characteristics of the patients of pediatric patients in pediatric intensive care unit %36,7% girl %63.3% of male he is a child, %58,3% of complaints in addition to hospitalization, is a hereditary disease, %41,7% in the absence of another underlying disease, %60,0% is a medicine that is used during the normal life of, %40,0% if they were taking any medicine. Of the patients who underwent endotracheal intubation in the pediatric intensive care unit, 26.7% were diagnosed with respiratory distress, 13.3% were diagnosed with epilepsy, and 60% had other (heart disease, diabetic ketoacidosis, trauma, etc.) it has been determined that the diagnosis lies with the. It was found that pediatric patients included in the study expressed pain in different ways depending on the application of endotracheal aspiration. Looking at the way child patients describe pain; It was found that 17.0% vomited, 22.6% squeezed their eyes, 11.9% cried, 20.0% had a tense body posture, 19.6% grimaced, and 8.9% expressed it in other ways. Endotracheal suctioning of intubated pediatric patients on mechanical ventilation in the Pediatric Intensive Care Unit support related to changes in vital signs pediatric patients prior to aspiration of the process when looking at heart rate levels (X =113,18) aspiration after the procedure, the level of the heart while (X =120,12) is aspiration from the application of the pre-oxygen saturation levels (X =96,68) aspiration after the process of oxygen saturation level (X =96,32) it is revealed that. It was found that there was a positive increase between the results obtained from the pain scales used to measure and evaluate the pain levels of children with endotracheal aspiration prior to the aspiration procedure dec the results obtained from the evaluation after the procedure. Pediatric patients sedated and intubated in the Pediatric Intensive Care Unit followed flacc pain scale used in the evaluation of the level of pain measured Behavioral pain scale and Wong-Baker face scale their relationship with each other when looking at the process in line with the results obtained before and after endotracheal suctioning, it was determined that there is a correlation between low positive pain scales.
  • Publication
    Open Access
    Deneysel migren modeli oluşturulan sıçanlarda timokinon'un analjezik etkisi ve nöroglial aktivite ve öğrenme-bellek ile ilişkisinin değerlendirilmesi
    BÜYÜKDEMİRTAŞ, Tuğba; MERAL, İsmail
    Migraine is a neurovascular disorder characterized by unilateral and throbbing headache with recurrent attacks. Headache can be accompanied by cognitive impairments such as attention deficit along with many symptoms. Thymoquinone is the main bioactive ingredient of black cumin and has been used as an herbal remedy for centuries. Recent studies have shown that thymoquinone is a compound with anticancer, antimicrobial, anti-inflammatory, antihistamine, antidiabetic, gastroprotective, hepatoprotective, cardioprotective, and nephroprotective effects. In addition to all these effects, it is also reported to have antinociceptive, neuroprotective and antioxidant activities. In our study, we aimed to investigate the effects of thymoquinone on pain, learning-memory and neuroglial activation in rat model of migraine. In the study, 27 adults male Wistar albino type rats aged 3 months, weighing between 250-350 gram, were used. The migraine model was induced using nitroglycerin (NTG). NTG was prepared by diluting with isotonic saline to be 10 mg/kg/1 ml for each animal. There were 4 groups as; control (K) group (n=6), nitroglycerin (NTG) group (n=7), thymoquinone (TQ) group (n=7) and nitroglycerin and thymoquinone (NTG+TQ) applied group (n=7). The K group and the NTG group were administered 1 ml of corn oil with gastric gavage for 15 days. TQ and NTG+TQ groups were treated with gastric gavage of 10 mg/kg/1 ml of TQ dissolved in corn oil for 15 days. NTG and NTG+TQ groups were administered 10 mg/kg NTG intraperitoneal (i.p.) on days 1, 5, 10 and 15th . K and TQ groups were administered with 0.3 ml saline i.p. on the same days. To determine the pain threshold of the animals, tail flick test was performed just before gastric gavage and 2 hours after i.p. injection administration. On the 16th day of the experiment, the Morris water maze test was administered to assess learning-memory functions. On the 22nd day of the experiment, the animals were decapitated under general anesthesia with 10 mg/kg xylazine i.p. and 100 mg/kg ketamine i.p. and their brains were removed. The hippocampal region of a hemisphere of the brain was used in biochemical analyses to evaluate markers of learning-memory and oxidative stress. The hippocampal region of the other hemisphere of the brain was used in immunohistochemical studies to evaluate neuroglial activation. The data were evaluated by Benforroni's multiple comparison test by applying one-way analysis of variance and the values were given as standard deviation ±. P<0.05 value was considered statistically significant. In the Morris water maze test, thymoquinone significantly reduced the animals' latency to find the hidden platform in the TQ (***p<0.001) and NTG+TQ (*p<0.05) groups. There was a significant increase (**p<0.01) in the latency of the NTG group to find the platform. When BDNF levels in hippocampus tissue were compared to the K group, it was determined that it was lower in the NTG group. When BDNF levels were compared according to the NTG group, it was found that both TQ and NTG+TQ groups increased, but this increment was only significant in the TQ group (**p<0.01). CREB1 levels were found decreased in the NTG and NTG+TQ groups compared to the K group. But it was statistically significant (*p<0.05) only in the NTG group. When the groups were compared to the NTG group, there was a significant increase in both the TQ (***p<0.001) and NTG+TQ (**p<0.01) groups. SOD levels were evaluated in hippocampus tissue, and it was determined that there was a statistically significant increase (***p<0.001) in the TQ group compared to all other groups. CAT levels similarly increased significantly in the TQ group compared to all other groups (*p<0.05, ***p<0.001). When immunohistochemical staining was evaluated, it was seen that the number of GFAP positive cells increased statistically significantly in all three of the NTG, TQ and NTG+TQ groups compared to the K group (***p<0.001, **p<0.01, *p<0.05, respectively). In the tail flick test, it was found that there was no statistically significant difference within the group and between the groups. When the results of our study were evaluated, it was seen that the application of thymoquinone in the experimental migraine model; It has been concluded that it does not have an analgesic effect on migraine pain, contributes to the spatial learning and memory mechanism by increasing BDNF and CREB1 levels, has a positive effect on migraine-related oxidative stress by increasing SOD and CAT levels, may have a positive effect on migraine and oxidative stress associated with learning-memory deficit with astrocyte activation, and may have a protective effect on migrainerelated astroglial activation.
  • Publication
    Open Access
    Yatarak tedavi bakım alan yaşlılarda basınç yaralanması prevelansı, nedenleri ve ilişkili risk faktörleri
    Kartal, Neslihan; SAYIN, Yazile
    Aim: The aim of this study was to investigate the prevalence and risk factors of pressure ulcers in hospitalized patients at the a private university hospital in Turkey,. Methods: It is a descriptive prospective cross-sectional design. The population was calculated by G power analysis according to the number of elderly patients hospitalized in a year (N=594). The sample of the study consisted of 382 elderly patients hospitalized in a private university hospital. Ethics committee approval was obtained. Study data were evaluated using the sociodemographic diagnosis and health diagnosis form, the Braden scale, and the The National Pressure Injury Advisory Panel pressure sore staging system. Analysis of risk factors was performed using SPSS IBM version software. Results: The mean age was 76.20±8.36 (with pressure injury: 79.34±8.38, without pressure injury: 74.81±7.98) years. The prevalence of patients with pressure injury was 30.6% with a prevalence of 14.1% of hospitalize-acquired pressure injury. The most frequent sites were sacrum/coaxes and Trochanter / ischium. Stages II ((%31.6) and III and IV (%24.7) were the mainly stages described. Statistical analysis showed significant correlation with long-term hospitalization, chronic disease recurrence, oral feeding difficulty, high number of invasive procedures, history of pressure sores, dependency incontinence in mobilization and position change, age ≥ 75 years. These variables were defined as risk factors. Conclusion: Pressure injury for elderly patients remains a major problem in the hospital. Age, inactivity due to the disease process, number of invasive procedures, past health history, incontinence in hospitalized elderly are important pressure injury factors for hospitalized elderly. Identifying risks specific to the elderly can be an important step in preventing this problem.
  • Publication
    Open Access
    Covid-19 pandemisi sürecinde Sakarya Eğitim ve Araştırma Hastanesi'nde görev yapan doktor ve hemşirelerin öz yeterlilik ve anksiyete bozukluğunun değerlendirilmesi
    EKİN ÇELİK, Çağla; YILDIRIM, Nuran
    In this study; The anxiety and self-efficacy levels of the doctors and nurses working in Sakarya Training and Research Hospital during the COVID-19 pandemic period, working in areas with risk of contamination and continuing the examination and treatment of the patients, were investigated, and the relationship between the anxiety and self-efficacy levels of the employees due to the COVID-19 pandemic was examined. Our descriptive and cross-sectional research, permission was obtained from the Sakarya Provincial Health Department and Sakarya Training and Research Hospital's Chief Physician, within the framework of expert opinions and literature knowledge, to 252 people working at Sakarya Training and Research Hospital between August 2021 and January 2022; Questionnaire forms were created by the researcher and data were collected by using the socio-demographic information form, the General Self-Efficacy Scale and the Coronavirus Anxiety Scale (CAS). IBM SPSS Statistics 21.0 program was used for statistical analysis and calculations. Statistical significance level was accepted as p<0.05. The number and percentage values of the questions in the demographic information questionnaire of the individuals included in the study were calculated. In the research; 25,8% of the 252 participants were in the 18-25 age range, 55,6% were in the 26-35 age range, 15,5% were in the 36-45 age range, and 3,2% were in the 46-55 age range, 39,3% are male, 60,7% are female, marital status is married 42,1%, single employees 57,9%, having children 37,3%, childless personnel 62,7% is. 38,1% of the participants work as doctors and 55,6% as nurses. 17.,9% of the employees are on duty 0-3, 32,9%4-7, 35,7% 8-10, 13,5% 11 and over. 25,4% of the individuals thought of resigning, 74,6% did not. In the research, 79,8% of the employees did not receive psychological support, 8,3% received support and 11,9% wanted to receive support. 79,8% of the participants live with their family members, and 20,2% live alone. 45,2% of them got COVID-19 disease, 54,8% of them did not get the disease. 80,6% of the employees are self-confident while practicing their profession. The coronavirus anxiety level averaged 3,26 in women and 2,01 in men; 3,47 for married individuals, 2,26 for singles; 3,24 for nurses, 1,98 for doctors; 3,31 for people without children, 1,87 for those with children; The highest level of anxiety was calculated with the rate of 4,44 in the workers with 11 or more shifts, and a statistically significant result was obtained in these variables. Coronavirus Anxiety Scale; Statistically significant results were seen in those working in the pandemic service or intensive care unit, those who were considering resigning from their duties due to the pandemic, and those who received or wanted to receive psychological support during the pandemic process. Considering the self-efficacy levels; 61,75 for married people, 65,02 for single people; It was calculated 65,01 for people who believed in themselves while practicing the profession, 58,30 for those who did not, and 57,87 for those who partially trusted, and when these results were evaluated statistically, significant differences were found. In questions about COVID-19, the level of self-efficacy was calculated as 64,43 for those who did not think to resign due to the pandemic, and 57,00 for those who thought to resign, and these results were statistically compared, and significant results were found. As a result, it has been seen that the COVID-19 pandemic, which affects the whole world and has high mortality and morbidity of the disease, negatively affects health workers mentally. This situation of health workers who are actively working during the pandemic should be taken into account by health managers.
  • Publication
    Open Access
    6-paradol molekülünün amiloid beta enjeksiyonu ile oluşturulmuş alzheimer hastalığı modelindeki nöroinflamatuvar ve nöroprotektif etkilerinin araştırılması
    KİNSİZ, Beyza; ELİBOL, Birsen
    Alzheimer's disease (AD) is a progressive type of age related dementia in humans. It is considered that increase in oxidative stress due to microglia activation may cause progression of the disease. Studies have shown that 6-Paradol, one of the ginger metabolites, has positive effects on memory and reduces microglia activated-neuroinflammation. Therefore, the aim of the present study is to investigate the neuroprotective and anti-neuroinflammatory effects of 6-Paradol in amyloid beta (Aβ1-42)-injected AD model in rats. In this study, 33 adult rats (12-month-old) were divided into 5 groups; healthy control (n=6, no treatment), Sham control (n=6, Aβ1-42 solvent (5 µL) injected by intracerebral injection (i.c.v)), Aβ1-42 (n=9, 5 µL Aβ1-42 (i.c.v.) to the hippocampus), Positive control (n=6, 5 µL Aβ1-42 (i.c.v.) and 21 days of donepezil (2mg/kg) treatment), 6-Paradol (n=6, 5 µL Aβ1-42 (i.c.v.) and 2 weeks of 6-Paradol (5 mg/kg) treatment). Behavioral tests were performed after two weeks of treatment. Then, the rats were sacrificed and histological and molecular studies were performed. As a result, compared to the control group, it was observed that the rats in the Aβ1-42-injected AD group had delay in learning and deficiency in memory performance which measured by Morris Water Maze and passive avoidance test. 6-Paradol had no effect on learning and memory performance of rats. According to the resuls obtained by hematoxylin and eosin, the histological structures of brain tissues of the control groups and pozitive drug group were similar each other which were healthy appearance. However, in sections belonging to Aβ1-42 and 6-Paradol groups, it was observed that the nuclei of some neuronal cells were irregular and pycnotic. Also, there was vacuolization in brain tissue of the 6-Paradol group. According to Nissl staining, there was a significant decrease in the number of CA1 pyrimidal cells in the Aβ1-42 group of hippocampus (p<0.05). An increase in cell count was observed in the treatment groups given Donepezil and 6-Paradol. In Congo-red staining, which shows the presence of amyloid plaques, there was no change in the groups with treatment. Protein expression studies performed with Western blotting showed that apoptosis increased in the Aβ1-42 group and decreased significantly in the treatment groups. Also the expressions of fractalkine and fractalkine receptors, which are associated with microglia activation, were examined, and there was no significant change in the amount of fractalkine ligand among groups, there was a significant increase in its receptor in the Aβ1-42 group and this increase was improved by 6-Paradol treatment. While the amount of AD indicator proteins (pTau and PSEN1) increased with Aβ1-42, the concentrations of these proteins decreased to control levels by 6-Paradol treatment. No significant difference was observed among groups in the expression of BACE and Reelin proteins. In summary, the 6-Paradol teratment in AD model of rats shows an anti-inflammatory effect as it causes an improvement in microglia-related proteins.