Psychometric Properties of a Turkish Version of The Psychosocial Needs Inventory; Sampling from Oncology Patients.

OBJECTIVES: This study aimed to assess the reliability and validity of the Psychosocial Needs Inventory (PNI) among Turkish oncology patients. METHODS: A methodological study was conducted with 1,547 oncology patients. This validation study was divided into two phases. Phase 1 included translation of the PNI according to World Health Organization recommendations, investigation of content validity by experts, and a pilot study involving 136 participants. Phase 2 included a validity and reliability analysis of the PNI. Data analysis comprised exploratory (EFA) and confirmatory factor analyses (CFA), Cronbach's alpha, test-retest reliability, Hotelling's T2 test and item-total score correlation, and the Content Validity Index (CVI). RESULTS: For the phase 1, the CVI for items and scale were >.75 and .883, respectively. Cronbach's alpha values of the subdimensions ranged between 0.84 and 0.94. The test-retest analyses of the subdimensions showed correlation coefficients based on the pilot test (p < .001). For the phase 2, based on the fit indices in confirmatory factor analysis, the structures of the dimensions "Importance" and "Satisfaction" were acceptable. Cronbach's alpha values of the subdimensions ranged between 0.84 to 0.94 in the "Importance" dimension and 0.86 to 0.94 in the "Satisfaction" dimension. As a result of EFA, the Kaiser-Meyer-Olkin, Bartlett's test (p < 0.001) and PNI Importance explained at 68.46% and PNI Satisfaction at 70.15% of the total variance by the six-factor structure. CFA showed that the indices and validity, including content validity, convergent validity were satisfactory. CONCLUSION: The PNI, which was found to be a valid and reliable measurement tool, can be used to determine the psychosocial needs of cancer patients. IMPLICATIONS FOR NURSING PRACTICE: Health professionals need to use the PNI to measure their importance to cancer patients' psychosocial needs and assess their satisfaction with meeting them to improve holistic care and support.

Caregiver support and burden drive intention to engage in a peer-to-peer exchange of services among caregivers of dementia patients.

Introduction: The number of people diagnosed with dementia is increasing, creating significant economic burden globally. With the progression of the disease, patients need a caregiver whose wellbeing is important for continuous care. Providing respite as a service, through sharing the responsibility of caregiving or support for the caregiver, is a costly initiative. A peer-to-peer online support platform for dementia caregivers, motivated by the sharing economy, putting exchange of knowhow, resources, and services at its center, has the potential to balance cost concerns with a search for respite. The aim of this research is to assess caregivers' intention to engage in peer-to-peer exchange. Methods: A survey including sociodemographic, technology use, and caregiving variables, structured questionnaires (Zarit caregiver burden, WHO brief quality of life scale, ADCS-ADL and chronic stress scale) were administered, January 2018-May 2019, in the dementia outpatient clinic of a university hospital, to a convenience sample of n = 203 individuals identifying themselves as primary caregivers. A path analysis exploring the drivers of an intention to engage in peer-to-peer service exchange was conducted. Results: In the path model, caregivers experiencing higher caregiver burden showed higher intention to engage (0.079, p < 0.001). Disease stage had no effect while patient activities of daily living, chronic social role related stressors of the caregiver and general quality of life were significant for the effect on the caregiver burden. Existing household support decreased the caregiver burden, affecting the intention to engage. Caregivers who can share more know-how demonstrate a higher intention to engage (0.579, p = 0.021). Caregiver technology affinity (0.458, p = 0.004) and ability and openness to seek professional help for psychological diagnoses (1.595, p = 0.012) also increased intention to engage. Conclusion: The model shows caregiver burden to be a major driver, along with caregiver characteristics that reflect their technology affinity and openness to the idea of general reciprocity. Existing support for obtaining knowhow and exchanging empathy have a direct effect on the intention to engage. Given the scarcity of caregiver support in the formal care channels, the identified potential of enlarging informal support via a peer-to-peer exchange mechanism holds promise.

Effect of a Compassion Fatigue Resiliency Program on Nurse Managers' Professional Quality of Life, Stress, and Resilience: A Mixed-Methods Study.

BACKGROUND: Compassion fatigue, stress, and burnout have an adverse impact on nurse managers. PURPOSE: To evaluate the impact of a compassion fatigue resiliency program on nurse managers and to obtain their views of the program. METHODS: This mixed-methods study was conducted with 16 nurse managers. The compassion fatigue resiliency program was implemented; compassion fatigue, compassion satisfaction, burnout, perceived stress, and resilience were assessed before and after implementation of the program. RESULTS: The mean compassion fatigue and perceived stress scores of nurses decreased significantly after the intervention. Four themes were identified from qualitative analysis, including awareness, coping with stress, effective communication skills in team management, and recommendations. CONCLUSIONS: The current study shows the training program reduced nurse managers' compassion fatigue and stress and enabled nurse managers to improve their coping skills and awareness.

Oncology-Hematology Nurses' Perspectives on the Compassion Fatigue Resiliency Program: A Qualitative Study.

Background Oncology-hematology nurses are at increased risk for compassion fatigue. It remains unclear whether the Compassion Fatigue Resiliency program is effective, and qualitative evidence from participant feedback is limited. This was a follow-up study to a quantitative study of the Compassion Fatigue Resiliency program. The aims of this study were to evaluate how the content of the program affects nurses' compassion fatigue and coping abilities and to obtain their views. Method This qualitative study was performed with 24 oncology-hematology nurses at two hospitals. Three focus groups were conducted using a semi-structured questionnaire. The data were analyzed using conventional content analysis. Results Four themes emerged: awareness; coping; not for others, for me; and training design. Nurses stated they had only just learned what compassion fatigue and its impact were and had gained more awareness. Conclusion The content of the Compassion Fatigue Resiliency program helped nurses learn effective coping skills; however, the program's design is important to its effectiveness. [J Contin Educ Nurs. 2022;53(7):329-336.].

Psychometric Features of the Turkish Version of the Cancer Rehabilitation Evaluation System-Short Form for Patients With Cancer.

Background and Purpose: The Cancer Rehabilitation Evaluation System-Short Form (CARES-SF) is one of the first self-report measurement tools that addresses problems and rehabilitation needs of patients with cancer. This study aimed to examine the validity and reliability of the CARES-SF for Turkish-speaking patients with cancer. Methods: The Turkish version of the CARES-SF was administered to 300 patients with colorectal, lung, or breast cancer. Results: While the first six factors of the Turkish CARES-SF covered the same spectrum as the original scale's subscales, the present study suggests dividing the original psychosocial factors into two subscales: psychological and social (relatives and friends). Conclusions: This preliminary inquiry on the Turkish CARES-SF confirmed the validity and reliability of the original scale except for the shifting of a few items between subsections.

Women's reproductive behaviour and perspectives on fertility, and their modifying factors, in a Turkish province with a high fertility rate.

OBJECTIVES: Population growth is an important public health problem with economic, social, cultural and political consequences. The aim of the study was to determine the reproductive behaviour and perspectives on fertility of women in Sanliurfa, the city with the highest fertility rate in Turkey. METHODS: The quantitative dimension of the study was carried out using a mixed methods approach in which 300 women were interviewed and a questionnaire was completed; the qualitative dimension was carried out through in-depth individual interviews with 14 women, using a semi-structured interview form. Analysis of the qualitative data was done using a content analysis technique. RESULTS: The median number of children was three (range 0-10). Women with no or a low level of education tended to have a greater number of children. Preference for a particular sex of child was one reason behind the higher number of children. These two factors were main causes of an increased number of children. Women with no or a low level of education (odds ratio [OR] 9.1) and women who expressed a preference for a male child (OR 5.9) had more children compared with other women. Participants regarded a male child as more valuable than a female child and that having many children strengthened the family. Parents regarded their sons as insurance for their old age. Having an induced abortion was perceived as a sin. CONCLUSION: The results showed that cultural norms and values significantly affected fertility rates.

"Noise Factory": A qualitative study exploring healthcare providers' perceptions of noise in the intensive care unit.

OBJECTIVES: This study aimed to explore healthcare providers' perceptions of noise in the intensive care unit. DESIGN: A qualitative exploratory study was conducted using group interviews. SETTING: The setting comprised a total of 15 participants (five physicians and ten registered nurses) working in an 18-bed medical surgical intensive care unit at a teaching hospital in Istanbul, Turkey. Semi-structured questions were formulated and used in focus group interviews, after which the recorded interviews were transcribed by the researchers. Thematic analysis was used to identify significant statements and initial codes. FINDINGS: Four themes were identified: the meaning of noise, sources of noise, effects of noise and prevention and management of noise. It was found that noise was an inevitable feature of the intensive care unit. The most common sources of noise were human-induced. It was also determined that device-induced noise, such as alarms, did not produce a lot of noise; however, when staff were late in responding, the sound transformed into noise. Furthermore, it was observed that efforts to decrease noise levels taken by staff had only a momentary effect, changing nothing in the long term because the entire team failed to implement any initiatives consistently. The majority of nurses stated that they were now becoming insensitive to the noise due to the constant exposure to device-induced noise. CONCLUSION: The data obtained from this study showed that especially human-induced noise threatened healthcare providers' cognitive task functions, concentration and job performance, impaired communication and negatively affected patient safety. In addition, it was determined that any precautions taken to reduce noise were not fully effective. A team approach should be used in managing noise in intensive care units with better awareness.

Effect of a compassion fatigue resiliency program on nurses' professional quality of life, perceived stress, resilience: A randomized controlled trial.

AIMS: This study aimed to conduct a short- and long-term Compassion Fatigue Resiliency Program and compare its impact on nurses' professional quality of life, perceived stress, and resilience. DESIGN: The research was conducted between January 2017 January 2019 as a randomized controlled trial. METHODS: The sample comprised 125 oncology-haematology nurses randomly assigned to a Experimental I, Experimental II, or control group. The Compassion Fatigue Resiliency Program was conducted with the nurses as an intervention. Experimental I received a short-term program (5 hr per day for 2 days, 10 hr in total) while Experimental II received a long-term one (5 weeks, 2 hr per week, 10 hr in total). Measurements were obtained during pre- and post-test and at 3-, 6-, and 12-month follow-ups. Research hypotheses were analysed using multilevel models. RESULTS: The results of multilevel model analyses showed there was no statistically significant difference between mean scores for compassion fatigue, burnout, perceived stress, and resilience of nurses in the short- or long-term groups or of those in the control group. Mean compassion satisfaction scores of nurses in the short- or long-term groups were significantly higher than those in the control group. Mean compassion satisfaction scores of nurses in the short- or long-term groups were significantly higher than the control group's pre-test mean after 6 and 12 months. CONCLUSION: This study concluded that short- or long-term programs had no influence on compassion fatigue, burnout, perceived stress, and resilience; however, both programs positively affected compassion satisfaction. We recommend that further studies be conducted, which will help determine the effectiveness of new programs. IMPACT: Caring for patients with cancer can generate work-related stress that can negatively affect oncology nurses' physical and emotional health, which could lead to compassion fatigue. The program provided nurses with an opportunity to improve their compassion satisfaction. Because there was no difference between both programs regarding mean compassion satisfaction scores, a short-term program may be preferred to encourage more participation among nurses. We also recommend further studies should be conducted that include environmental improvements along with the training programs. Trial registered at ClinicalTrials.gov (The name of the trial register: Effect of a Compassion Fatigue Resiliency Program; the clinical trial registration number: NCT04372303).

Psychosocial care from the perspective of nurses working in oncology: A qualitative study.

PURPOSE: In cancer patients, unmet psychosocial needs are a common occurrence. The purpose of this study was to determine the views, obstacles, and needs of the nurses working with adult oncology patients with regards to psychosocial care. METHODS: A qualitative descriptive research design conducted through focus group interviews was adopted for the study. Thirty nurses providing care for cancer patients in adult oncology departments of three hospitals in Turkey with comprehensive oncology centers were involved in the interviews. The interviews were conducted via a semi-structured interview form. In analyzing the data, content analysis technique was utilized. RESULTS: In the study, three main themes and seven sub-themes were determined. These were as follows: "Challenge" (Sub-themes: The nature of the disease: A thin line between life and death; Lack of team/institutional support; Lack of time, staff, and knowledge; Vulnerability of the patient and their family), "reward and cost" (Sub-themes: Satisfaction; Personal growth; Exhaustion), and "essential but hard to define". CONCLUSIONS: This study reveal that nurses have difficulty delivering psychosocial care, which they perceive in abstract terms, in an environment where the disease is still considered fatal, the conditions of the patients change constantly, and they cannot receive the necessary support. It can be important that, as well as supportive institutional regulations, the nurses are in need of necessary assistance to help them change their own perceptions on cancer, to become emotionally stronger, and to acquire necessary knowledge and skills to give psychosocial care.

Perceptions of final-year nursing students on the facilities, resources and quality of education provided by schools in Turkey.

The purpose of this study is to determine the perceptions of final-year nursing students regarding the adequacy of education, resources and internships in preparation for graduation. The study design was a descriptive cross-sectional study of nursing students (n: 1804) in their final year of education and questionnaires were used to collect data. Information related to student-to-instructor ratios and internships was obtained from each institution. Most students reported receiving instruction or supervision by lecturers and clinicians who did not specialise in the field. Overall, students did not find the facilities, educational or technological resources and the quality of education offered by their respective schools adequate. The proportion of students who found the level of theoretical education, clinical practice and instructor support adequate was higher in state university colleges of nursing/faculties of health sciences than in state university schools of health sciences.

Preparedness of final-year Turkish nursing students for work as a professional nurse.

AIMS AND OBJECTIVES: To determine the preparedness levels of final-year Turkish nursing students starting their careers as professional nurses. BACKGROUND: The transition from nursing student to professional nurse is challenging. One of the ways to help facilitate this transition is to determine how well students are prepared to start work. There are limited, but conflicting, results on this topic. DESIGN: Mixed-methods study. METHODS: Undergraduate nursing students (n = 4490) in their final year of study from 74 Turkish universities were eligible to participate in this study. Of these, 1804 total students participated from 38 randomly selected universities. Data were collected through an investigator-developed questionnaire (n = 1804) and focus group interviews (n = 57). RESULTS: Students felt highly prepared to start work (57·6%). Those who were older, male, graduates of a vocational high school or already working as a nurse felt most prepared. Students who felt that their education preparation and resources were adequate felt more prepared. Focus group interviews revealed that students felt confident in their knowledge of educational theory, but not in clinical skills. CONCLUSIONS: Students may have felt prepared to start work, but insufficient clinical experience probably contributed to a lack of confidence in their skills. The resources of the school, the quality of the education, and the clinical practice environments were considered most important for the students' perceived preparedness levels. RELEVANCE TO CLINICAL PRACTICE: An undergraduate education provides the foundation for successful nurse preparation. A good clinical environment along with a high-quality education programme can help give students more confidence in their skills when they join the nursing workforce. Internship or residency programmes may also facilitate this learning. This is extremely important for safe, high-quality patient care.

Illness perception in Turkish schizophrenia patients: a qualitative explorative study.

BACKGROUND: Schizophrenia is a serious mental illness that is highly complex and not fully understood. Individuals with serious mental illnesses like schizophrenia experience difficulty trying to access mental health services. Few have the opportunity to receive the most optimal evidence-based treatment and only half of those who do actually adhere to the recommended treatment. Understanding what it is like to have this illness would help in our approaches to treatment. METHODS: In-depth interviews were conducted on nine Turkish patients with schizophrenia in order to explore the illness from the perspective of patients in remission. RESULTS: Five themes emerged from the patients' descriptions of schizophrenia: schizophrenia is a complicated illness, a mystery, a lost life, a dynamic journey towards recovery, and a developmental process of recovery. CONCLUSION: This study has identified areas of concern about reflecting the patients' perspectives on their experiences thoroughly, which should help improve healthcare provision and guide future research.

Identifying an optimal treatment for schizophrenia: a 2-year randomized controlled trial comparing integrated care to a high-quality routine treatment.

OBJECTIVE: This study used repeated outcome measures over a 2-year period to compare the clinical and social benefits of routine schizophrenia treatment with those of evidence-based pharmacological and psychosocial treatment strategies. METHOD: One hundred patients who were diagnosed with schizophrenia according to DSM-IV criteria were randomly assigned to 24 months of either optimal case management (OCM) or routine case management (RCM). OCM involved minimally effective doses of antipsychotic medication with compliance training, an identical treatment programme with the addition of manual-based communication and problem solving training to help patients and caregivers manage stress, social skills training, supported employment, cognitive-behavioural strategies for residual psychotic and non-psychotic symptoms, as well as anger management and substance use counselling. RCM involved minimally effective doses of antipsychotic medication with compliance training, the monitoring of side effects, education about schizophrenia and its optimal treatment, detection of early warning signs and supportive psychotherapy to address practical problems. The symptoms, impairment, disability, unmet needs, quality of life of the patients were examined by blinded researchers every 6 months. RESULTS: Statistically and clinically significant advantages were observed for OCM versus RCM on all measures. Most of these advantages increased throughout the 24-month period. CONCLUSIONS: This study helps demonstrate the importance of psychosocial interventions in the treatment of schizophrenia. Recent advances in evidence-based psychosocial strategies can be implemented into routine clinical practice with additional clinical and social benefits.

Quality of life and sociodemographic characteristics of patients with cancer in Turkey.

PURPOSE/OBJECTIVES: To determine whether a relationship exists between quality of life (QOL) and the sociodemographic characteristics of gender, age, marital status, educational level, occupation, and level of income in patients with cancer in Turkey. DESIGN: Exploratory study using a convenience sample. SETTING: Five hospitals in the capital city of Turkey. SAMPLE: 620 patients with cancer (44 inpatients and 576 outpatients). METHODS: The study was carried out using face-to-face interviews. A questionnaire was used as a tool for collecting data on the sociodemographic characteristics of patients, and the Rolls-Royce Quality-of-Life Scale was employed to measure QOL. MAIN RESEARCH VARIABLES: Gender, age, marital status, educational level, occupation, level of income, and QOL. FINDINGS: Men, older adults, widowed spouses, patients with lower levels of education, housewives, and those with lower income had lower QOL scores. CONCLUSIONS: Considering the results and giving the groups referred to in the study priority in the planning of patient care would be useful. IMPLICATIONS FOR NURSING: In the field of nursing in Turkey, a limited number of studies have examined the relationship between the sociodemographic characteristics of patients with cancer and QOL. The results will help nurses assess patient needs and engage in nursing interventions that are appropriate to the needs.

The status of alternative treatment in cancer patients in Turkey.

This study was designed to measure the frequency at which Turkish patients with cancer resort to complementary and alternative medicine (CAM). A total of 704 patients referred to the Gülhane Military Medical Academy and Ankara Numune Training Hospital between September 2002 and January 2003 were asked about the CAM therapies they used. Of these, 276 patients (39.2%) had used CAM. Gender, marital status, educational status, age, financial status, severity of pain, history of cancer in the family, and their own ideas concerning CAM therapies were found to be correlated with the frequency of resorting to CAM. Resorting to CAM may lead to delayed diagnosis and treatment, adverse drug interactions, treatment withdrawal, and disease progression. Therefore, it is very important to inform patients about these potential dangers. Further studies are needed to clarify the reasons that lead patients to resort to CAM.

Optimal treatment project for schizophrenia: results from a randomized, controlled, longitudinal study.

This study aimed to compare the clinical and social benefits associated with Optimal Case Management (OCM) treatment that employ cognitive-behavioural strategies to those associated with Routine Case Management (RCM) that is widely used in community health services. Hundred patients with schizophrenia were randomly allocated to OCM and RCM treatment conditions. Patients in the OCM condition showed significantly more improvement on all measures compared to patients in RCM condition. Improvement on clinical symptoms and social functioning achieved by OCM tended to show a regular and continuous pattern throughout the course of the study. The results of this study suggest that every optimal treatment should aim improvement in social functioning and therefore quality of life of the patients.