Browsing by Author "Yildirim, Dilek"

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    Article
    Effectiveness of Vibration in Reducing Pain and Improving Satisfaction During Subcutaneous Injections: A Randomized Crossover Clinical Trial
    (Taylor & Francis Ltd, 2025) Yildirim, Dilek; Kugu, Emre
    AimThe pain experienced during and after the injection may cause discomfort and lead individuals to develop a negative perception toward future injections. This study aimed to evaluate the impact of vibration stimulation on pain induced by subcutaneous injections and patient satisfaction.MethodsThis was a prospective, randomized, single-blind, crossover study design. Data were collected from 85 patients. Vibration and non-vibration subcutaneous anticoagulant injections were administered randomly by the same investigator following a standardized procedure. Pain and satisfaction were evaluated by a study-blind investigator using the Visual Analogue Scale immediately after the injection. Data were analyzed using descriptive statistics, the Student's t-test, paired sample test, and a generalized linear mixed model.ResultsA total of 175 injections were analyzed. It was found that the pain level of patients was lower when vibration was applied (4.06 +/- 1.68 vs. 5.32 +/- 2.19, p = 0.004). Additionally, patient satisfaction was higher when vibration was used (7.17 +/- 1.71vs. 5.97 +/- 2.46, p = 0.011).ConclusionThe results of this study demonstrated that vibration was effective in reducing the pain associated with subcutaneous anticoagulant injections and in increasing patient satisfaction. Vibration can be used as a method to alleviate pain from subcutaneous anticoagulant injections and enhance patient satisfaction. Clinically, this suggests that incorporating vibration during subcutaneous injections can be a simple, non-pharmacological strategy to improve patient comfort and adherence to therapy.
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    Inter-Rater Reliability in the Assessment of Consciousness in Patients Receiving Palliative Care in Intensive Care: A Prospective Cross Sectional Observational Study
    (Wiley, 2025) Yildirim, Dilek; Kavala, Arzu; Oz, Seda Degirmenci; Sezer, Esra; Kugu, Emre; Coskun, Zeynep; Tıbbi Hizmetler ve Teknikler Bölümü
    BackgroundThe Glasgow Coma Scale (GCS) is one of the methods that has validity for evaluating the consciousness levels of patients in the literature and is accepted by health authorities.AimThe purpose of this study was to evaluate the inter-rater reliability of GCS in intensive care patients receiving palliative care.Study DesignA prospective cross sectional observational study. The study was conducted in a general intensive care unit with 20 beds with patients receiving palliative care. In the unit, 18 nurses worked in two shifts, day and night. Each patient's primary palliative care nurse and two additional researchers were given one minute to independently record the patient's GCS total and subscale scores. All observations were completed within 5 min as there could be significant changes in the patient's GCS score during observations.ResultsA total of 258 assessments were completed. For the GCS total scoring, a moderate agreement was found between palliative care nurses and the first researcher-observer (49.0%) and also between palliative care nurses and the second researcher-observer (47.7%). In addition, there was a substantial agreement between the first and second researchers (78.9%) and also between all observers (61.5%) (all p = .001).ConclusionsAlthough there was a near-perfect agreement between the two researcher-observers, we found only moderate agreement among all observers (palliative care nurses and two researcher-observers) in the evaluation of GCS total and subscale scores.Relevance to Clinical PracticeWe found that lack of knowledge and training on the standardized use of GCS is still a problem for palliative and intensive care units. Because of the diversity of patients requiring GCS assessment in palliative care units, refresher training programs and hands-on workshops on consciousness assessment should be organized regularly for more experienced nurses.