Kars Merkez

Researchers are evaluating a method called peripheral venous pressure (PVP) measurement to better guide diuretic therapy and predict long-term outcomes such as death, hospital readmission, and emergency visits in patients hospitalized with heart failure. This Phase 4 study aims to improve management of congestion in heart failure patients, who often leave the hospital with persistent fluid buildup, increasing the risk of complications. The trial includes adults aged 18 to 99 with new or worsening chronic heart failure, regardless of heart function or cause. Participants will be randomly assigned to receive diuretic treatment guided either by standard clinical evaluation or by PVP measurements taken through a peripheral intravenous line placed in the arm. The PVP group will target a pressure below 9 mmHg before discharge to guide fluid removal. Blood samples, heart tests including ECG and echocardiogram, and fluid balance assessments will be performed. Those who cannot have PVP measured or need advanced support like dialysis during hospital stay will be excluded from certain parts of the study. During the one-year follow-up, researchers will track major adverse events including death, hospitalizations, and emergency visits. They will also analyze correlations between PVP readings and outcomes, kidney function changes, length of hospital stay, and repeat admissions. Data will be collected electronically and analyzed to compare the effectiveness of PVP-guided therapy versus standard care in managing heart failure congestion.

Researchers are evaluating the effects of structured breastfeeding education on infants experiencing nipple refusal and their mothers. This study focuses on mothers with infants aged 1 to 6 months who have had nipple refusal for 3 to 30 days. The goal is to see if this education can improve infants' sucking skills, increase maternal breastfeeding motivation, and strengthen the bond between mother and infant. Mothers in the intervention group will participate in a one-week structured breastfeeding education program led by midwives. This program includes daily one-hour sessions covering breastfeeding techniques, managing nipple refusal, increasing milk production, skin-to-skin contact, mother-infant bonding, and motivation strategies. After the education week, online support will continue for 15 days, and breastfeeding will be monitored daily. The control group will receive standard medical care and an educational brochure after the study. Participants will be assessed at the start and after the intervention period on infants' sucking skills, mother-infant bonding, and maternal breastfeeding motivation using questionnaires and observations. The main outcome measure is the Breastfeeding Motivation Scale for first-time mothers, evaluated from the beginning of the intervention to day 16. The study includes monitoring and follow-up over the 16-day period to compare results between groups.

Researchers are evaluating the effects of a nurse consultancy program called EMÖZGEDAP, based on Dennis's Breastfeeding Self-Efficacy Theory and hypnobreastfeeding philosophy, on how mothers and their family members perceive social support, their confidence in breastfeeding, and breastfeeding outcomes. The study involves pregnant women and their close relatives in Turkey and aims to improve breastfeeding self-efficacy through targeted counseling. Breastfeeding self-efficacy is an important factor influencing a mother's ability to breastfeed successfully, and social support from family members plays a key role in this process. The intervention group will receive individual counseling through the EMÖZGEDAP program, which consists of five sessions totaling 7.5 hours. These include two sessions with the mother and her family relatives, two sessions with the mother alone, and one session with the family relatives alone. The program incorporates techniques such as affirmations, breathing exercises, relaxation, and hormone-enhancing practices combined with educational methods like presentations, videos, role-play, and discussions. The control group will not receive this counseling. Participants will be assessed using various forms and scales before and after birth. The Antenatal Breastfeeding Self-Efficacy Scale is completed at 28 weeks of pregnancy before the counseling begins. Following delivery, breastfeeding and nutrition results as well as several breastfeeding self-efficacy and social support scales for both mothers and fathers will be evaluated at 1, 3, and 6 months postpartum. These assessments help measure how well the program supports breastfeeding confidence and outcomes over time.

This research aims to evaluate how colostomy care training based on Jeffries' Simulation Theory influences nursing students' knowledge, skills, stress, self-efficacy, readiness, state anxiety, satisfaction, and self-confidence. The study tests several hypotheses about the impact of this training on various aspects of student learning and emotional responses related to colostomy care. Participants are fourth-year nursing students enrolled in a specific course, and the study compares two groups to assess the effectiveness of the training approach. The intervention group receives colostomy care training individually in a simulation laboratory using mannequins designed as standard patients, where they practice applying the skills they learn. The control group uses a low-fidelity patient model to perform colostomy bag changes and care skills. Both groups follow a structured training booklet prepared by the researchers to ensure consistent instruction across participants. During the study, nursing students' knowledge, skill levels, stress, self-efficacy, readiness, state anxiety, and satisfaction with learning are assessed within one week after the simulation exercise. Researchers measure changes in these areas to evaluate the training's impact. The study monitors participation closely, comparing outcomes between the simulation and control groups to understand the effect of the simulation-based training on nursing education related to colostomy care.