Derya Gezer

Background/Objectives: Sexual dysfunction is a common and persistent concern among women with breast cancer. Although various interventions have been developed to address sexual health, evidence regarding counseling interventions structured around theoretical models remains limited. This systematic review and meta-analysis aimed to evaluate the effects of model-based sexual counseling on overall sexual life and sexual function in women with breast cancer. Methods: The review was conducted in accordance with the Cochrane Handbook and PRISMA guidelines and was prospectively registered in PROSPERO (CRD420251004532). Five electronic databases were searched for controlled intervention studies published up to February 2025. Risk of bias was assessed using the Cochrane Risk of Bias tool (RoB 1) for randomized controlled trials and ROBINS-I for nonrandomized studies. Random-effects meta-analyses were performed using Comprehensive Meta-Analysis version 3, with effect sizes expressed as Hedges’ g and 95% confidence intervals (CIs). Results: Ten controlled intervention studies involving 779 participants were included, comprising seven randomized controlled trials and three nonrandomized controlled intervention studies. Model-based counseling was associated with statistically significant pooled effects on overall sexual life (g = 1.86, 95% CI 0.94–2.77; p < 0.001; I² = 95.93%) and sexual function (g = 2.11, 95% CI 0.94–3.28; p < 0.001; I² = 97.08%). PLISSIT-based counseling showed no statistically significant pooled effects. Time-based analyses showed the largest effects at 6–8 weeks, with statistically significant effects persisting at 12 weeks. Substantial heterogeneity was observed across analyses. Conclusions: Model-based sexual counseling may have beneficial effects on overall sexual life and sexual function in women with breast cancer; however, the very low certainty of evidence and substantial heterogeneity limit confidence in these findings. Further well-designed randomized controlled trials using standardized interventions and longer follow-up are needed.

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Background: Vascular access devices (VADs) are essential for delivering systemic anticancer therapies, yet device-related complications remain a major challenge in oncology care. Objectives: To analyze global research trends and the knowledge structure of vascular access-related complications in oncology using bibliometric methods. Research design: Bibliometric analysis. Subjects: A total of 3072 articles and reviews published between 1977 and 2026 and indexed in the Web of Science Core Collection. Measures: Bibliometric analyses were performed using Biblioshiny and VOSviewer to evaluate publication trends, journal productivity, authorship, citation structure, collaboration networks, and thematic development. Results: Publication output increased markedly after 2020. The Journal of Vascular Access ( n = 79) and Supportive Care in Cancer ( n = 67) were the most productive journals. Raad I ( n = 29), Hachem R ( n = 23), and Jiang Y ( n = 20) were the leading authors. The literature primarily focused on complication prevention, thrombosis, and catheter-related infections. Conclusions: Research on vascular access-related complications in oncology has expanded substantially, while patient-centered topics and standardized vascular access management remain underrepresented. These findings provide a comprehensive overview of the field and may help guide future research priorities.

In this study the authors aimed to examine quality of life (QoL), sexual function (SF), and associated factors among 136 women with anal incontinence (AI). Data were collected using the Fecal Incontinence Quality of Life Scale (FIQLS), the Index of Female Sexual Function (IFSF), and the Wexner incontinence score. The mean Wexner score was 12.97 ± 4.47, indicating severe incontinence. Mean IFSF scores (17.09 ± 7.76) indicated a high risk of sexual dysfunction, while the mean total FIQLS score was 58.94 ± 20.34. Significant negative correlations were identified between age, symptom duration, incontinence severity, and both QoL and SF scores (p < 0.05). Women with greater symptom severity and longer symptom duration reported poorer QoL and SF. Our findings suggest that AI is a multidimensional and stigmatized women's health condition affecting intimacy, emotional wellbeing, and everyday life. Culturally sensitive and holistic care may improve recognition and support for affected women.

Background: This meta-analysis aimed to determine the effect of intraoperative intravenous methylene blue administration on the incidence of postoperative delirium in adult surgical patients. Methods: This systematic review and meta-analysis was reported in accordance with PRISMA guidelines and registered in PROSPERO. A comprehensive search of seven electronic databases was performed from inception to January 2026 to identify randomized controlled trials evaluating intraoperative intravenous methylene blue administration and postoperative delirium in adult surgical populations. Study selection, data extraction, and methodological quality assessment were independently conducted by two reviewers using predefined eligibility criteria. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool. Pooled odds ratios with 95% confidence intervals were calculated using a fixed-effect model due to the absence of between-study heterogeneity. Publication bias was evaluated using funnel plot inspection, Egger’s regression test, and Kendall’s tau test. Results: Three randomized controlled trials involving 779 patients were included. Intraoperative methylene blue administration was associated with a statistically significant reduction in postoperative delirium (OR = 0.35; 95% CI: 0.23–0.53; I ² = 0%). Conclusions: Intraoperative methylene blue administration was associated with a reduction in postoperative delirium in surgical patients. However, given the limited number of included studies, further large-scale randomized controlled trials are required.

Background: Preoperative surgical fear and anxiety, is known to influence postoperative pain perception. The aim of this study is to evaluate the relationship between preoperative surgical fear, surgical anxiety, and postoperative pain severity. Methods: This descriptive and correlational study included 138 adult patients undergoing elective general surgery at a tertiary care hospital. Preoperative surgical fear and anxiety were assessed one day before surgery using the Surgical Fear Questionnaire (SFQ) and the Surgical Anxiety Questionnaire (SAQ). Postoperative pain intensity was measured using the Visual Analog Scale (VAS) at predefined intervals during the first 24 postoperative hours. Correlation analyses were performed to examine associations between psychological variables and pain intensity. Results: Patients had mean SFQ and SAQ scores of 34.6±18.1 and 40.4±12.6, respectively. SFQ was weakly but significantly correlated with postoperative pain intensity across all time intervals during the first 24 hours (r = 0.186–0.257, p< 0.05). Similarly, SAQ showed significant positive correlations with postoperative pain at all time points, with slightly stronger associations observed in the early postoperative period (r = 0.232–0.326, p < 0.01). A strong positive correlation was identified between SFQ and SAQ (r = 0.733, p< 0.001). No significant association was found between psychological variables and total analgesic consumption (p > 0.05). Conclusion: Preoperative surgical fear and anxiety were significantly associated with postoperative pain in general surgery patients, particularly in the early postoperative period. Routine psychological assessment may contribute to improved pain management and perioperative care outcomes.

Purpose This study examined the prevalence and systemic causes of missed nursing care (MNC) in surgical units and investigated the relationship between missed care and nurses’ professional satisfaction to support global patient safety strategies. Methods This descriptive, cross-sectional study included 107 registered surgical nurses at a university hospital in 2024. The validated MISSCARE Questionnaire was utilized, demonstrating high reliability (Cronbach’s alpha = 0.915). Data were analyzed using descriptive and inferential statistics. Results Primary causes of MNC were insufficient workforce (87.9%) and equipment shortages (75.7%). Critical safety omissions were prevalent; 60.7% of nurses reported that timely medication administration and 57.9% reported that regular vital sign monitoring were rarely achieved. Notably, 57.9% of nurses liked their profession only at a “moderate” level, a sentiment linked to the 87.9% staffing shortage preventing quality care. Nurses who "did not like their job at all" had significantly higher MNC scores (p = 0.001), establishing that understaffed environments impair both professional satisfaction and patient safety. Conclusions MNC in surgical units is a systemic problem caused by workforce and logistical inadequacies, threatening patient safety. Job satisfaction is a direct organizational predictor of MNC (p < 0.001), suggesting that investing in positive work environments is crucial for clinical quality. We advocate for the global implementation of surgery-specific nurse-patient ratios.

Aim: This study was conducted to examine postoperative pain severity and the time-dependent pattern of rescue analgesic administration, and to identify factors associated with this pattern in elective general surgery patients. Materials and Methods: This prospective descriptive cohort study included a total of 369 elective general surgery patients evaluated between February 2022 and January 2023 in a tertiary university hospital. Pain severity (Visual Analogue Scale) and rescue (additional) analgesic administration were recorded at postoperative 0-2, 3-4, 5-8, 9-12, and 13-24 hours. Demographic and clinical factors associated with pain intensity and opioid use were analyzed. Results: Mean pain severity significantly decreased from 0-2 hours to 13-24 hours (2.39 ± 1.75 vs. 1.69 ± 2.17, p<0.001). Pain was lower among women at 0-2 hours and among older adults (≥65 years) and those with chronic disease at 3-4 hours. Male patients were more likely to receive opioids across the early postoperative period, and opioid use at 3-4 hours was higher in patients without chronic disease. Conclusions: During the first 24 postoperative hours, pain severity decreased while rescue analgesic administration increased over time. Rescue analgesic patterns were influenced by age, sex, and chronic disease status. Although low pain scores suggest generally adequate pain management, the increasing need for rescue analgesia indicates that routine practice is open to improvement. These findings support structured pain assessment, reassessment and individualized, multimodal postoperative pain management in surgical nursing practice.

Aim: This study aimed to examine breast cancer fear (BCF), associated risk factors, and early screening behaviors among women undergoing breast surgery.Materials and Methods: This descriptive cross-sectional study was conducted in the general surgery clinic of a university hospital between September 2021 and January 2022. The study included 136 women aged 20 years or older who underwent breast surgery for malignant or benign conditions, were able to communicate, and voluntarily agreed to participate. Data were collected in the preoperative period through face-to-face interviews using a demographic information form and the Breast Cancer Fear Scale (BCFS). Descriptive statistics and chi-square tests were used to analyze the relationship between BCF level and screening behaviors.Results: The mean age of the participants was 50.03±14.11 years. The mean BCFS score was 30.11±8.08, indicating that most participants experienced a high level of fear. Participation in early screening behaviors was low; only one-third of the women regularly performed breast self-examination (BSE). Women with lower levels of fear were significantly more likely to perform regular BSE (p < 0.05).Conclusions: High breast cancer fear and low screening participation were identified among women undergoing breast surgery. The findings suggest that fear may have a dual effect on early detection behaviors, and excessive fear may trigger avoidance, reducing adherence to screening. In this context, perioperative nursing practices should go beyond information provision and incorporate fear management, emotional regulation strategies, risk-based counseling, and culturally sensitive psychosocial support.