Relationship between the insulin use and stigma in type 2 diabetes mellitus.

AIMS: This study aimed to investigate the relationship between insulin use and stigma in Type 2 Diabetes Mellitus (T2DM). METHODS: The study was carried out in the endocrinology and metabolic disorders outpatient clinic of a state hospital between February and October 2022. The study was carried out with 154 patients, 77 of them were treated with insulin while 77 were treated with peroral antidiabetic drugs (PAD). The patient identification form and Type 2 Diabetes Stigma Assessment Scale (DSAS-2) were used for data collection. The data were analyzed by using IBM SPSS 26.0 software. RESULTS: DSAS-2 total score, treated differently, blame and judgment, and self-stigma subscales were higher in insulin-treated T2DM patients compared to the patients treated with PAD. There was a positive relationship between the number of daily injections and the DSAS-2 total score (r = 0.554). Multiple linear regression showed that type of the treatment, treatment duration, number of daily injections and perceived level of health were the determinants of the DSAS-2 score. CONCLUSIONS: Stigma was high in insulin-treated T2DM patients and as the number of daily injections increased, the level of the perceived stigma increased. We recommend considering the high level of perceived stigma in insulin-treated T2DM patients while preparing nursing investigations.

Psychometric properties of the Turkish version of the therapeutic relationship assessment scale for nurses.

Background: It is essential for nurses who care for individuals diagnosed with mental illness to establish a therapeutic relationship. There is no measurement tool available in Türkiye to assess the therapeutic relationship between patient and nurse. Aim: The objective of this study is to perform a validity and reliability study of the Turkish version of a scale that enables the evaluation of the quality of the therapeutic relationship established between nurses and patients. Methods: 140 nurses were included in this study. The data were analysed using the exploratory and confirmatory analyses. Results: The scale consists of 25 items and four sub-dimensions. In confirmatory factor analysis (CFA), all factor loads were >0.30. As a result of CFA, all fit indices were >0.85 and the root mean square approximation was <0.080. Cronbach alpha was 0.93 for the whole scale. Conclusion: The Turkish version of the TRAS-Nurse scale and its original version were compatible with each other and gave similar results. This scale can be used to determine the therapeutic relationship of nurses who care for psychiatric patients in Türkiye and can be a useful measurement tool when evaluating the factors that may be effective in improving the therapeutic relationship.

Nurses' Attitudes Towards Death and Its Relationship With Anxiety Levels.

This study examined nurses' attitudes towards death, anxiety levels, and socio-demographic characteristics affecting their attitudes towards death. Three hundred and eighty-four nurses participated in the study. A questionnaire form, the Death Attitude Profile-Revised (DAP-R), and the Penn State Worry Questionnaire were applied to the nurses. Nurses' attitudes towards death were positive and their level of fear of death was low. Approach acceptance was high in younger ones; the escape acceptance score was higher in single ones. The neutral acceptance score was higher in those who received training on death. A statistically significant positive correlation was found between nurses' anxiety level and escape acceptance score. There was a statistically significant positive correlation between the length of working years of nurses and the escape acceptance and approach acceptance. Nurses should be prepared for and supported on death with in-service training. It will be useful to provide these training programs to nursing students during their education process.

Turkish adaptation of Wilson-Sims psychiatric fall risk assessment scale.

PURPOSE: This study aimed to adapt the Wilson-Sims Fall Scale to Turkish and assess the levels of sensitivity and selectivity. DESIGN AND METHODS: The scale consisting of two sections and 15 items including age, gender, mental and physical status, elimination, impairments, gait/balance, falls' history, medications, and detox protocol was administered to 750 patients in psychiatric clinic. FINDINGS: The kappa coefficient of the study (K: 0.44, p < .000) showed a moderate agreement. The sensitivity and selectivity rates of the scale were 78.5% and 77.6%, respectively. Positive and negative predictive values were 6.25% and 99.4%. PRACTICE IMPLICATIONS: The scale has acceptable sensitivity and selectivity values. It is best practice to use both Wilson-Sims and Itaki Scale simultaneously for identification of patients at risk of falling.

The effectiveness of illness management and recovery program in patients with schizophrenia.

AIM: This study was conducted to determine the effect of the illness management and recovery program in patients with schizophrenia. METHODS: This study was conducted using a pretest, posttest and follow up experimental design with randomized controlled. The sample of this study consisted of patients with schizophrenia (n = 50). The patients were assigned to intervention (n = 25) and control (n = 25) groups using the randomisation method. The intervention group consisted of 10 modules and 20 sessions of Illness Management and Recovery Program, while in the control group, a face-to-face interview. Data were collected by the Illness Management and Recovery Scale-Patient Form (IMRS-P) and Social Functioning Scale-Patient Form (SFS-P). RESULTS: There were significant differences in posttest and 1-month follow-up IMRS-P points between the intervention and control groups. There was no significant difference in post-test and 1-month follow-up SFS-P total points between the intervention and control groups. There were only significant differences for the pro-social activities' subscale of SFS-P. CONCLUSION: The Illness Management and Recovery Program have a positive effect on illness management and social functionality in patients with schizophrenia. In the light of this study, it was suggested that this structured program should be used by mental health and psychiatric nurses.

Psychometric properties of the Turkish version of Illness Management and Recovery Scale-Patient form.

PURPOSE: The aim of this study was to provide the Turkish version of the Illness Management and Recovery Scale-Patient (IMRS-P) form and to determine its psychometric properties. DESIGN AND METHODS: This is a descriptive and correlation study. The sample of this study consisted of 75 people with schizophrenia. Translation and content validity, confirmatory factor analyses were used to test the validity and reliability of the scales. RESULTS: The content validity index was found to be 0.93. The scale had a three-factor structure, which subscales were 0.69 for recovery, 0.69 for management, and 0.35 for substance. The Cronbach's alpha was determined as 0.76. PRACTICE IMPLICATIONS: The Turkish version of the IMRS-P form is a valid and reliable scale for Turkish patients.

Long-term outcomes of the shaken baby syndrome prevention program: Turkey's experience.

AIM: Shaken baby syndrome (SBS) is a condition which may cause to serious health problems in the baby. SBS may be prevented by increasing awareness with giving education to parents especially in the early postnatal period. In shaken baby prevention programs, education is recommended to be given before the 2-4(th) month during which the frequency of crying is increased. It is important that education given in the early period is permanent until the period during which the frequency of crying is increased. The aim of this study was to evaluate the persistency of the benefit of the SBS prevention program until the 2-4(th) month during which crying is intensified. MATERIAL AND METHODS: This study is an interventional study. When the babies became 2-4 months old, a questionnaire which questioned the usefulness of education and the experiences with babies was applied to a group selected randomly among the mothers who received SBS prevention education during pregnancy or in the first 7 postnatal days (group A). The same questionnaire was applied to 143 mothers whose babies completed their first 2 months, who presented to the hospital for vaccination and who did not receive education about SBS as the control group (group B). The data were evaluated using the Statistical Program for Social Sciences (SPSS) 15.0 statistical analysis package program. Ethical approval was obtained from the local ethics committee (30.12.2009, 2785). RESULTS: The rate of the mothers who stated "yes" to the sentence "babies occasionally cry" which was one of the main messages of the education was statistically significantly higher in group A compared to group B (p=0.001). The rate of the mothers who stated "I agree" to the sentence "battering is harmful for babies" was statistically significantly higher in group A compared to group B (p=0.001). CONCLUSIONS: Conclusively, it was found that SBS prevention program education was permanent until the 2-4(th) month.

Minor anomalies in childhood lymphomas and solid tumors.

BACKGROUND: Despite the presence of reports on correlation between major congenital defects and cancer, very few studies have investigated the frequency of minor anomalies in childhood malignancy. The aim of this study was to determine the prevalence of minor anomalies in children with lymphoma and solid tumors. PROCEDURE: A total of 281 well-defined minor anomalies were determined in 116 patients. The patients were compared with age-matched and sex-matched healthy control subjects. RESULTS: Concerning the cumulative data, 87.9% (102/116) of the patients and 37.9% (44/116) of the controls had at least 1 minor anomaly (P < 0.05). A total of 281 minor anomalies (2.42 per subject) were noted in the patient group, whereas 41 (0.35 per subject) were noted in the control group (P < 0.05). The eye, ear, mouth, hand, and feet anomalies were statistically higher in the patient group than the control group (P < 0.05). CONCLUSIONS: Our results contribute to the understanding of the role of genetic factors in childhood cancer. Future studies might be directed toward identifying the developmental pathways and the relevant genes that are involved in relation to childhood cancer and minor anomalies.

Peer training increases the level of knowledge on sexual and reproductive health in adolescents.

To reach 'youth' and equip them with accurate information on sexual and reproductive health (SRH) is a very important issue. Forty one volunteer students from Mersin University School of Medicine were trained as peer trainers on SRH in Mersin, Turkey. Every peer trainer then trained 100 peers aged between 15 and 20 years about SRH. A total of 3941 students participated and answered a questionnaire consisting of 20 questions about SRH before and after the training sessions. The mean score before the training session was 13.6 ± 3.2 and after the training session was 17.0 ± 2.8. The posttraining test results were found to be significantly higher (p < 0.001). Having previous SRH information from any kind of source also was found to be effective on pretraining test results positively (p = 0.002). As adolescence is the most vulnerable period to sexual health problems, increasing the awareness of sexual health is very important.

New opportunity for vaccinating older people: well-child clinic visits.

BACKGROUND: Streptococcus pneumoniae causes considerable morbidity and mortality in the elderly. As aging of the population is making the health of the elderly a universal priority, preventive measures, such as vaccination, will become increasingly important. METHODS: We designed a prospective interventional study to determine whether recommendations to vaccinate grandparents of children attending well-child clinics would increase the pneumococcal vaccination rate in the elderly. Children younger than 5 years of age, attending a university well-child clinic from 1 May to 31 September 2008 who had grandparents over 65 years of age were eligible. A survey including the questions about the demographic characteristics of children, their parents and grandparents over 65 was carried out by face-to-face interview with the parents. High-risk medical conditions and vaccination history of grandparents was also noted and the benefits and necessity of pneumococcal vaccination (23vPPV) for the elderly was emphasized. Four months later these families were contacted to determine whether this intervention had increased the pneumococcal vaccination rates of the elderly. RESULTS: Information was obtained from 938 grandparents of 545 children. Before the interview, among all grandparents, only 0.9% were vaccinated with 23vPPV. Four months after this intervention, immunization coverage increased to 19.1%. The sex of the grandchild (OR: 1.99) and previous hepatitis B or influenza immunization of the grandparents (OR: 2.73) were the significant parameters accounting for higher immunization rates. CONCLUSION: Reminding elderly grandparents about vaccines in well-child clinics could be an opportunity in this field.

Growth patterns of large, small, and appropriate for gestational age infants: impacts of long-term breastfeeding: a retrospective cohort study.

BACKGROUND: In several studies, since high and low birth weights are demonstrated as associated with obesity in childhood, these values should be followed up and documented carefully. OBJECTIVE: The aim of this retrospective cohort study is to demonstrate the variation on body mass index outcomes of large (LGA), small (SGA), appropriate (AGA) for gestational age infants from birth to the end of fourth year of age and the effects of breastfeeding duration on these outcomes. METHODS AND RESULTS: Four hundred and seven infants were recruited in the study (304AGA, 85 LGA, 18 SGA infants). LGA was frequent in boys and SGA in girls (p = 0.001). The mothers with gestational diabetes mellitus did have LGA infants (10.0% vs. 3.3%) (p = 0.022). The SGA infants performed rapid catch-up growth in the second month while the LGA infants performed catch-down growth in the ninth month. After the first 4 months, there was no difference on the values of BMI depending on breastfeeding time, less or more than 4 months, on the basis of the AGA and LGA infants. However, the body mass index (BMI) of LGA infants breastfed more than 12 months were not different from the AGA; unless the breastfeeding ceased earlier, the means of BMI remained significantly higher until 3 years. CONCLUSION: Consequently, long duration of breastfeeding might protect LGA infants from childhood obesity risk.

Evaluation of growth and neurodevelopment in children with congenital heart disease.

BACKGROUND: Children with congenital heart disease are under risk of delayed growth and development. We evaluated physical growth parameters and neurodevelopment in these patients in comparison with normal children and examined the effect of hemodynamic status. METHODS: Patients with congenital heart disease (n= 76) and healthy children (n= 51) aged 1-72 months applied to Mersin University Hospital, Mersin, Turkey were included. Patients with heart failure and those requiring intervention or surgery were classified as hemodynamically impaired (HI group, n= 30), and the others, hemodynamically normal (HN group, n= 46). Growth parameters including weight, height, body mass index (BMI), mid-arm circumference (MAC), and triceps skin fold thickness (TSF) were measured and standard deviations (SD) were determined. Functional development was assessed by Denver Developmental Screening Test-II (DDST II). RESULTS: MAC and BMI values of the group with impaired hemodynamic status were significantly lower than the hemodynamically normal and control groups (MAC P < 0.05 and BMI P < 0.01). In the DDST II, the group with hemodynamic abnormality had more failures in gross motor and fine motor skills than HN group and controls (gross motor P= 0.011, P < 0.001 and fine motor P= 0.028, P= 0.001, respectively) and more failures in language development than the control group (P= 0.001). CONCLUSION: The results showed the importance of hemodynamic status in growth and neurodevelopment of children with congenital heart disease. Besides routine growth parameters, more detailed examinations such as BMI, MAC, TSF, and developmental screening tests appear useful in identifying children with cardiac disease who are under risk for delayed growth and development.