The evaluation of the effectiveness of a health promotion training on breast cancer survivors.

BACKGROUND: Increased early diagnosis and improved treatment options have decreased the mortality rate of breast cancer and increased the survival rate. Healthy lifestyle behaviors are very important in breast cancer survivors as they reduce mortality and morbidity rates, cancer recurrence frequency, and side effects of treatment and improve health. This study was conducted to evaluate the effectiveness of a health promotion training intervention in breast cancer survival. MATERIALS AND METHODS: The study is a quasi-experimental, pre-test-post-test and single-group study. It was conducted with 43 women breast cancer survivors. The "Healthy Lifestyle Behaviors Scale II" was used to collect the data. Four sessions of training were given to the women once a week, and a 3-month post-training follow-up was performed. The t-test, Wilcoxon analysis, and Spearmen correlation analysis were used to evaluate the data. RESULTS: Pre-training and post-training scores in the sub-dimensions and total scores of the healthy lifestyle behavior scale showed that the training was highly effective. There was a significant increase in all sub-dimensions and total scale post-training scores (P < 0.05). In the correlation analysis, a negative correlation was found between age and physical activity, between elapsed time after diagnosis and nutrition, and between elapsed time after diagnosis and spiritual development (P < 0,05). However, there was a positive correlation between educational status and nutrition (P < 0.05). CONCLUSIONS: The results show that a health promotion training program covering physical activity/exercise, healthy nutrition, effective communication, coping with stress, and increasing health responsibility had positive effects on healthy lifestyle behaviors in this population, and age, educational status, and elapsed time after diagnosis influence healthy lifestyle behaviors in survival.

The effect of mindfulness-based compassionate living training for informal caregivers of palliative inpatients on burnout and caregiving burden: a randomized controlled trial.

This study was conducted to determine the effect of Mindfulness-Based Compassionate Living (MBCL) training given to the informal caregivers of palliative patients on burnout and caregiving burden. A single-blind, randomized, controlled, experimental study was conducted with 54 caregivers of patients admitted to a hospital palliative care unit. The participants were randomly allocated to the experimental group (n = 26) and control group (n = 28). The experimental group received MBCL training twice a week for 4 weeks. Data were collected before and after the intervention using the Maslach Burnout Inventory, Caregiver Burden Scale and Self-Compassion Scale-Short Form. The data were analyzed using kurtosis and skewness coefficients, number, percentage, mean, standard deviation, chi-square test, independent samples t test, Wilcoxon signed ranks test and Mann-Whitney U test in SPSS version 22.0. The informal caregivers in the experimental group demonstrated a significant decrease in emotional exhaustion and depersonalization scores and an increase in personal accomplishment and self-compassion scores in posttest assessments after the MBCL intervention (P < 0.05). All of these parameters differed significantly between the experimental and control groups after the intervention (P < 0.05). MBCL training seems to be effective in reducing emotional exhaustion and depersonalization and increasing personal accomplishment and self-compassion among informal caregivers of palliative inpatients. The results of this study can be generalized to the caretakers of patients receiving palliative care in university hospitals.

Effect of home care after cardiac surgery.

OBJECTIVES: Home care that maintains continuity of health care services after cardiac surgery is considered a complementary component of clinical care. We estimated that effective home care given with a multidisciplinary approach would contribute to decreasing symptoms and readmissions to the hospital after cardiac surgery. STUDY DESIGN: This experimental study with a 6-week follow-up period and a 2-group repeated measures design with pretest, posttest, and interval tests was conducted in a public hospital in Turkey in 2016. METHODS: We identified the self-efficacy levels, symptoms, and readmissions to the hospital of 60 patients (30 in the experimental group and 30 in the control group) throughout the data collection process, and we estimated the effect of home care on self-efficacy, symptom management, and hospital readmissions by comparing the data of patients in the experimental and control groups. Each patient in the experimental group received 7 home visits along with 24/7 telephone counseling services throughout the first 6 weeks after discharge, and patients were provided physical care, training, and counseling services during these home visits with the collaboration of their physician. RESULTS: Home care resulted in better self-efficacy and fewer symptoms in the experimental group (P < .05), and it also reduced readmissions to the hospital in the experimental group (23.3%) compared with the control group (46.7%). CONCLUSIONS: This study's findings suggest that home care, with a focus on continuity of care, decreases symptoms and readmissions to the hospital and improves the self-efficacy of patients after cardiac surgery.

Prevention of microbial colonization of feeding tubes in the intensive care unit.

BACKGROUND: Various microorganisms which increase the mortality rate in the intensive care unit (ICU) cause microbial colonization of the nasogastric tube (NGT) and use the NGT as a reservoir. AIM: To detect the colonization on the NGT and to determine the effect that training regarding hand hygiene, NGT management, and enteral feeding (EF) provided to ICU nurses and auxiliary service staff (ASS) has on the level of NGT colonization. STUDY DESIGN: A quasi-experimental pre-test and post-test control design was used in this study. Microbial samples were taken from the outer and inner parts of NGT. The microorganisms were categorized as: group 1, no risk; group 2, low risk pathogenic; group 3, high-risk pathogenic group. The training was given to nurses (n = 15) and ASS (n = 7). Hand hygiene, NGT, and EF care training are provided to nurses and ASS by researchers. A total of three training sessions were scheduled to be held in 3 weeks so that all health care staff members were trained. Each session lasted 2 h in total. Patients were assigned to a group if one of the microorganisms presented on the outer surface of the patient's feeding tube and/or on the hub. The hand hygiene compliance was evaluated by direct observation according to the World Health Organization hand hygiene indications. RESULTS: The study was conducted with 46 patients. Evaluating the patients for the presence of microorganisms before education revealed that 4.3% were in group 1, 21.8% were in group 2, and 73.9% were in group 3. After the education, evaluating the samples for the presence of microorganisms revealed that 39.1% were in group 1, 13% were in group 2, and 47.8% were in group 3. A statistically significant difference was found between the number of samples included in the groups after the participants had received training (H = 8.186; p = .017). CONCLUSIONS: An NGT could act as a reservoir of microbial colonization and high-risk microorganisms could be on the tube. Providing training not only to nurses but also to ASS will help reduce the risk of colonization. RELEVANCE TO CLINICAL PRACTICE: Eliminating such colonization with effective hand hygiene during NGT feeding is a cost-effective method. Providing training not only to nurses but also to ASS will help obtain the optimum benefit from patient care.

Relationship between the fear of COVID-19 and social isolation and depression in elderly individuals.

BACKGROUND: The COVID-19 pandemic has seriously affected elderly individuals and it has been associated with high morbidity and mortality rates. This study was conducted to examine the relationship between fear of COVID-19, social isolation and depression in elderly individuals. METHODS: The study is a descriptive type. The sample consisted of 362 elderly people. The study data were collected using the Introductory Information Form, the Fear of COVID-19 Scale, the Nottingham Health Profile Social Isolation Scale and the Geriatric Depression Scale-Short Form. RESULTS: It was determined there was a positive and moderate relationship between fear of COVID-19 and depression and social isolation, and a positive and high relationship between social isolation and depression, and the results were statistically significant (P < 0.001). CONCLUSIONS: Public health nurses, during epidemic periods, should help elderly individuals manage their fears about the disease. In addition, they should lead the practices that can sustain social participation and prevent depression in the elderly.

The Profile of Caring: An Internationally Tested Model to Assess and Support Nurses During Pandemic.

The psychological impact of the COVID-19 pandemic on nurses, and subsequent increases in turnover, have been extensively documented. This article examines a profile of nurses which included (1) the degree to which direct-care nurses are caring for themselves, (2) the degree to which their manager acts in a caring way, (3) the degree to which nurses have clarity about their professional role and about how the system works, and (4) the degree to which nurses are satisfied with essential social and technical dimensions of their jobs, to help understand how some of the critical internal states and working relationships of nurses fit together as a model. To test the model, authors used structural equation modeling with a 35-item measurement tool in three countries (Russia, Serbia, and Turkey; n = 984), replicating a recent 8-country study. Results revealed a good model fit, similar to the original study, despite statistically significant differences in mean scores between the countries studied. Good model fit with a second group of countries, despite differences in mean scores, suggests that results from both studies can be used for a global conversation about how caring, clarity, and job satisfaction in nursing relate to one another. These results provide evidence that health facilities should study variables such as caring for self, caring by the unit or department manager, clarity of role and system, and job satisfaction to learn about, recover, and monitor nurses' health and experience of work as they emerge from the pandemic.

Correlation of spiritual well-being with hope and depression in oncology patients: The case of Turkey.

PURPOSE: This study was conducted to determine the correlation between spiritual well-being and hope and depression in oncology patients. DESIGN AND METHODS: The sample of the study consisted of 210 cancer patients. For data collection, a Patient Information Form, the FACIT-Sp-12 Scale, the Beck Hopelessness Scale, and the Beck Depression Inventory were used. FINDINGS: The patients had mean scores of 32.02 ± 5.14 for spiritual well-being, 4.15 ± 4.17 for hopelessness, and 16.05 ± 8.29 for depression. A negative relationship was determined between spiritual well-being and hopelessness and depression, and a positive and significant relationship was found between depression and hopelessness. PRACTICE IMPLICATIONS: Oncology patients should be given psychosocial care that supports their spiritual well-being and hope, and depression symptoms should be well known and given importance.

An investigation of the relationship between religious coping and life satisfaction in oncology patients aged 65 and over.

BACKGROUND: Religious coping refers to the use of religion or spirituality to cope with stressful situations. Religious coping is a concept which involves both positive and negative cases. Studies on oncology patients, who encounter various physical and psychological difficulties, report that religious coping beliefs and practices are of great importance in helping patients to face the disease, adapt to this crisis period and accept their disease, and maintain their hope. The purpose of the present study is to investigate the relationship between religious coping and life satisfaction in oncology patients aged 65 and over. METHODS: This descriptive study was conducted at a university hospital in a city located in eastern Turkey between March and July 2020 with the voluntary participation of 125 patients with cancer. Data collection was performed via the Demographic Characteristics Form, Life Satisfaction Scale, and Religious Coping Scale. RESULTS: Mean score of the Life Satisfaction Scale was significantly higher among the participants with a monthly income of 2000 tl and over, who lived with their spouse and children, who adapted to the diseases, and who perceived their health status as 'good'. The mean score of the Religious Coping Scale was significantly higher in the participants with metastasis. There was a negative, statistically significant relationship between the Life Satisfaction Scale total mean score and the Negative Religious Coping sub-scale mean score (P < 0.05). CONCLUSION: This study found that negative religious coping negatively affected life satisfaction. Further, patients with cancer should be provided with psychosocial support programs that enable them to express the cases causing them to think what they experience is a divine punishment, encourage them in this way, and help them feel relieved.

The Effects of the Training Program and Counseling Program Given to Women Who Underwent a Mastectomy and Spouses.

Following breast cancer treatment, many families are negatively affected following the treatment for breast cancer of their women members. This study focused on assessing the effects of the training program and counseling program given to women who underwent a mastectomy and their spouses. Sixty women and 60 spouses were recruited for this study. The women in the experimental group and their spouses were provided with a four-session training program, once a week. Following this training, a 3-month follow-up and counseling were given and an assessment made. There was significant difference between average post-test scores of spouses in the experimental and control groups, in terms of problem solving (p = .003), communication (p = .033), and roles (p = .000) dimensions of family assessment device (FAD). Noting that women in the experimental and control groups demonstrated significant differences among average post-test scores in terms of role emotional (p = .045) and mental health (p = .017) dimensions of Quality of Life Scale (SF-36), a significant difference existed among average post-test scores of spouses in the experimental and control groups in terms of general health (p = .017), role physical (p = .011), role emotional (p = .003), and mental health (p = .005) dimensions of Quality of Life Scale. These results indicated that training and counseling program provided to this population produced positive effects upon family functioning and quality of life.

Gender perspective on the factors predicting recycling behavior: Implications from the theory of planned behavior.

This study aimed to assess the role of some socio-psychological attributes in explaining recycling behavior of Turkish university community from a gender perspective within the context of the theory of planned behavior with an additional variable (past experience). The recycling behavior of whole sample, females and males, has been examined in 3 sessions -depending on the arguments that explain gendered pattern of private and public environmental behavior and sticking to the fact why females' stronger environmental values, beliefs, and attitudes do not translate consistently into greater engagement in public behavior. As a result of model runs, different variables shaping intention for behavior have been found, namely perceived behavior control for females and past behavior for males. Due to the low percent of the variance in explaining recycling behavior of females, they have been identified as the ones who do not carry out intentions (non-recyclers). Since intentions alone are capable of identifying recyclers accurately but not non-recyclers, there may be other factors to be considered to understand the reason for females not carrying out the intentions. The results of descriptive statistics supported the identification by attitudes toward recycling. Female attitudes were innate (recycling is good, necessary, useful and sensitive), whereas those of males were learnt (recycling is healthy, valuable and correct). Thus, it has been concluded that males' intention for recycling is shaped by their past behavior and the conclusion is supported by males having learnt attitude toward recycling whereas females' lack of intention for recycling is shaped by their perceived behavior control and is supported by their innate attitude for recycling. All in all, the results of the present study provide further support for the utility of the TPB as a model of behavioral prediction and concur with other studies examining the utility of the TPB in the context of recycling.

The dynamic relationship between health expenditure and economic growth: is the health-led growth hypothesis valid for Turkey?

The well-known health-led growth hypothesis claims a positive correlation between health expenditure and economic growth. The aim of this paper is to empirically investigate the health-led growth hypothesis for the Turkish economy. The bound test approach, autoregressive-distributed lag approach (ARDL) and Kalman filter modeling are employed for the 1975-2013 period to examine the co-integration relationship between economic growth and health expenditure. The ARDL model is employed in order to investigate the long-term and short-term static relationship between health expenditure and economic growth. The results show that a 1 % increase in per-capita health expenditure will lead to a 0.434 % increase in per-capita gross domestic product. These findings are also supported by the Kalman filter model's results. Our findings show that the health-led growth hypothesis is supported for Turkey.

Equity in maternal health care service utilization: a systematic review for developing countries.

OBJECTIVES: The objective was to explore progress of equity in the utilization of maternal health care services in developing countries since maternal care is a crucial factor in reducing maternal mortality, which is targeted by the Millennium Development Goal 5. METHODS: A systematic review of quantitative studies was done. PubMed Central, Web of Science, and Science Direct databases were searched for peer-reviewed and English-language articles published between 2005 and 2015. RESULTS: Thirty-six articles were included in the review. The results reveal the lack of equity in the utilization of maternal health care in developing countries. Thirty-three out of 36 studies found evidence supporting severe inequities while three studies found evidence of equity or at least improvement in terms of equity. CONCLUSIONS: Most of the literature devoted to utilization of maternal health care generally provides information on the level of maternal care used and ignore the equity problem. Research in this area should focus not only on the level of maternal care used but also on the most disadvantaged segments of the population in terms of utilization of maternal care in order to reach the set targets.

Prevalence of urinary incontinence in older Turkish women, risk factors, and effect on activities of daily living.

PURPOSE: The study was conducted to determine the prevalence of urinary incontinence (UI) among older women, risk factors, and the effect on activities of daily living (ADLs). METHOD: The study was conducted in family health centers located in a city in eastern Turkey. The study population consisted of 1094 women age 65 and older chosen with a simple random sampling method. The inclusion criteria were 65 years and older, female, and not diagnosed with mental or emotional diseases or conditions that obstruct communication. Data were collected in face-to-face interviews with the Questionnaire and Daily Life Activities Data Form created by the researchers based on the Roper, Logan, and Tierney model. RESULTS: The prevalence of UI in women age 65 and older was 51.6%, and the most common type was urge incontinence. The number of births, number of abortions, age at last birth, and home births affected the development of UI (p<0.001). In addition, body mass index, constipation, urinary tract infection, cough, hormone replacement therapy, genital prolapse, cystocele, urogenital surgery, nocturia, and daily urine output were determined to be risk factors (p<0.001). Among the ADLs, 13.7% with UI reported that they had fallen when getting up from the toilet, 34.3% had experienced a sense of shame, 45.8% avoided coughing, and 46.5% restricted fluid intake. CONCLUSION: Prevalence of UI in women age 65 and older was high, and the most common was urge incontinence. UI has many risk factors and affects many ADLs.

Gender differences in cigarette consumption in Turkey: evidence from the Global Adult Tobacco Survey.

OBJECTIVE: The aim of this study is to examine the potential factors associated with both smoking participation and the level of cigarette consumption in Turkey from a gender perspective, the understanding of which are crucial to the formulation and implementation of anti-smoking policies. METHODS: The Global Adult Tobacco Survey for 2008 is used in the analysis. Since the dependent variable, the number of cigarettes smoked per day, consists of nonnegative integer values, Negative Binomial and Zero-inflated Negative Binomial models are used as an estimation methodology. The zero-inflated model allows the interpretation of smoking propensity and smoking intensity behaviours separately. RESULTS: The main findings of this study are twofold. First, the factors affecting the smoking behaviour of males and females are different. Second, there are also differences between the factors affecting the decisions of whether to smoke and how much to smoke for both genders. Cigarette prices, for example, affect the level of cigarette consumption of females but not of males whereas pro-cigarette marketing affects the decision of how much to smoke for males with no effect on female smoking. CONCLUSIONS: The findings highlight the importance of gender differences in cigarette consumption. Overall, education programs, cigarette taxation and tobacco advertising bans have different effects on each gender whereas social interaction is important for cigarette smoking behaviour of both genders. The anti-smoking policies can be more effective if policy makers take into account gender differences in both smoking propensity and intensity.

What is the economic burden of sports injuries?

Despite the health benefits of sports activities, sports injury and fear of injury are important barriers to participation in sport. The incidence, prevalence and type of sports injuries vary among men and women as well as age groups. It is usually difficult to examine these different aspects of sports injuries due to insufficient data. This study argues that sport injuries can be considered as an important economic burden in terms of the direct and indirect costs it bears. As a result, strong and effective strategies are needed to prevent sports injuries. Sports medicine has also been attracted increasing attention in recent years, particularly. In this article, the importance of sports injuries and their economic costs as well as the role of sport medicine as a prevention method for sports injuries were discussed.

Difficulties experienced by nurses in older patient care and their attitudes toward the older patients.

BACKGROUND: There is little known about nurses' attitudes toward older people in Turkish society, particularly within centers providing care to older patients. OBJECTIVE: This research was conducted to determine nurses' attitudes toward older patient care and the difficulties they experience. DESIGN: A descriptive research design was used. SETTINGS: The research population comprised 282 nurses working in the clinics of public hospitals in central Erzurum that mostly accommodate older patients. METHODS: Participants completed questionnaires regarding descriptive characteristics, the type of difficulties they experienced in older patient care, and the Turkish version of Kogan's Attitudes Toward Old People Scale. Data were evaluated by using percentage, Kruskal-Wallis variance analysis, t test and Mann-Whitney U test. RESULTS: The study revealed that nurses experienced difficulties due to the inadequacy of physical conditions and technical equipment in hospitals; administrative problems; communication problems; and insufficient knowledge, skills and experience in older patient care. The nurses' overall attitude toward the older people was found to be positive (98.83 ± 11.19). CONCLUSIONS: The difficulties experienced by nurses in this sample resulted from the lack of technically equipped hospitals or clinics for older patients and the inadequacy of nurses' gerontology education. Despite these factors, the nurses' attitude toward older people was positive.

Effects of care burdens of caregivers of cancer patients on their quality of life.

In this study, the aim was to examine the effects of caring burdens of family caregivers of cancer patients on their quality of life in the east of Turkey. Data were collected at the Chemotherapy unit of Yakutiye Research Hospital of Ataturk University. Participants were 18 years old and older. The sample included 190 family caregivers who were living in the same flats with the patients during caregiving. Data were collected using a questionnaire that included socio-demographic questions for family caregivers and the Burden Interview, and the Caregiver Quality of Life Index-Cancer (CQOLC) Scale. SPSS version 14.0 was used to analyse the data. Descriptive statistics were computed for demographic variables of family caregivers. Pearson correlation analysis was used to analyze the relationship between the care burden and quality of life, linear logistic regression analysis was applied to determine the effect care burdens have on the quality of life, and logistic regression analysis was employed to determine the effect descriptive characteristics and care-related properties have on the quality of life. The score mean of the burden interview of caregivers was 36.6 ± 11.2; and their score mean of CQOLC was 81.4 ± 17.3. This study concluded that there was a negative relationship between caring burdens and the quality of life (p<0.001); descriptive characteristics, caring-related properties, and caring burden variables were all significant predictors of the quality of life. It is recommended that caregivers are given support by being offered training about providing care.

Knowledge, attitude and beliefs women attending mammography units have regarding breast cancer and early diagnosis.

OBJECTIVE: Breast cancer is an extremely important issue that threats women's health; it is the most common illness that leads to death in women, worldwide. The purpose of this descriptive-comparative study was to determine the knowledge, attitude, and beliefs women attending mammography units have regarding breast cancer and early diagnosis. METHODS: The study population comprised 333 women visiting second and third stage mammography units for a mammography, and 1018 women visiting first stage mammography units at Cancer Surveying and Training Centres. Questionnaires determining the descriptive characteristics of women, and their attitudes towards breast cancer and early diagnosis, a knowledge evaluation form, and the Turkish version of the Champion's Health Belief Model Scale was used to gather data. RESULTS: The rate of obtaining information about early diagnosis in breast cancer (88.6%), information about breast self-examination (87.6%), conducting breast self-examination (61.8%), and undergoing a clinical breast examination (99.6%) were higher in the group of women attending first stage mammography units in comparison to women attending other mammography units. The knowledge score (71.8+18.8) of women attending first stage mammography units regarding breast cancer and early diagnosis was also higher in comparison to women attending other mammography units (p=.00). Sub-scales of the breast cancer health belief model scale were high for women attending Cancer Surveying and Training Centres, while their perception of self breast examination limitations and mammography limitations were low. CONCLUSION: Based on the effect of peer education, this study proves that women attending first stage mammography unit have a higher level of knowledge about breast cancer and early diagnosis, and more positive health beliefs regarding breast cancer and screenings in comparison to women attending other mammography units.