The effect of itching on sleep quality and comfort in patients with hemodialysis and renal transplantation: A multi-center cross-sectional study.

BACKGROUND: The aim of this study was to determine the effect of itching on sleep quality and comfort in hemodialysis (HD) and renal transplant (Tx) patients with itching. METHODS: This descriptive, correlational seeking and cross-sectional study was conducted in four hospitals affiliated with a private health group in Istanbul between April and June 2021. The sample of the study consisted of 42 patients receiving HD treatment and 49 patients with renal transplantation. Data were collected using the Patient Information Form, 5-D Itch Scale, Richards-Campbell Sleep Questionnaire and General Comfort Questionnaire. RESULTS: There was a significant difference between the HD and renal transplantation groups in the Direction (p = 0.01) and Disability dimension (p = 0.002) of the 5- D Itch scale in favor of the renal transplant group. The mean sleep quality and comfort scores of the groups were similar and moderate. Itching negatively affects sleep quality in patients receiving HD treatment, and 22 % of the change in sleep quality is explained by disability of itching (R2 = 0.22; p = 0.002). Itching negatively affects comfort in both groups. Itching explains 27 % of the change in comfort level in the HD group (R2 = 0.27; p = 0.002) and 25 % of the change in comfort level in the renal transplantation group (R2 = 0.25; p = 0.001). CONCLUSIONS: According the study results during the hemodialysis treatment process, itching is more intense in terms of distribution and disability and affects the quality of sleep of patients. Itching has a significant impact on patients' perception of comfort. Patients experience itching both during HD treatment and after renal transplantation, which significantly impairs their comfort. Therefore, itching should be carefully monitored during renal replacement therapy and its effects on patients should be evaluated.

The effect of nurses' occupational safety perceptions on job satisfaction: A research study conducted in Turkey.

OBJECTIVE: To evaluate the effect of nurses' occupational safety perceptions on the level of job satisfaction. Method: The cross-sectional study was conducted at Acibadem Healthcare Group hospitals in Turkey from January 15 to February 15, 2018, and comprised of professional nurses. Data was collected using the Job Satisfaction Scale and the Occupational Health and Safety Culture Scale. Data was analysed using SPSS 21. RESULTS: Of the 275 nurses, 210(76.4%) were females and 65(23.6%) were males. The overall mean age was 26.50±5.11 years, mean working experience was 57.08±51.56 months and the mean length of current employment was 31.13±32.86 months. There was a positive correlation between nurses' job satisfaction and occupational safety perceptions (p<0.001); between nurses' working conditions and extrinsic satisfaction (p=0.001); and between the working conditions and the nurses' general satisfaction (p=0.008). CONCLUSIONS: High perceptions of occupational safety among the nurses led to greater job satisfaction within the organisation. Also, working conditions had a direct impact on both extrinsic and general job satisfaction.

The reliability and validity of the Turkish version of the postdialysis fatigue scale.

AIM: Haemodialysis (HD) commonly leads to postdialysis fatigue (PDF) and, thus, worsens the quality of life and the clinical outcomes. The aim of this study was to translate, linguistically validate and determine the psychometric properties of the "Postdialysis Fatigue" Scale for Turkish patients with HD. STUDY DESIGN: A methodological study. METHODS: The standard lingual translation and validation methods for the initial translation of the PDF Scale and then assessed the psychometric properties of reliability and validity of the translated scale. Visual analogue scale (VAS) and Piper Fatigue Scale were used to assess concurrent and construct validity. In addition, postdialysis recovery time was used it as an indirect measurement method for PDF. RESULTS: A total of 93 patients participated in the study. The Cronbach's alpha coefficient of PDF was 0.773. There was a statistically significant relationship between the test and retest scores (ICC: 0.973; P < .001). PDF Scale was acceptable with 11 items. There was a positive correlation with a statistically significant relationship was present between the PDF scores and Piper Fatigue Scale (r = .488; P < .001) and VAS score (r = .656; P < .001). There was a statistically significant positive correlation between the PDF Scale and the postdialysis recovery time (r = .270; P = .009), CONCLUSION: The study results have shown that the Turkish form of the PDF Scale is a valid and reliable tool in patients undergoing HD treatment. Postdialysis recovery time may be used as an indirect measurement method to evaluate PDF.

Effect of Emotional State of Nurses Working in Intensive Care on Their Attitudes Toward Death.

The purpose of this study is to investigate the effect of the emotional state of the nurses working in intensive care unit on their attitudes toward death. The study was conducted with the participation of 100 nurses working in intensive care units between July and December 2017. A positive statistically significant correlation was found between the nurses' status of approaching emotions and subscales of Death Attitude Profile (p < .05). It was observed that there was a positive significant correlation between the emotional avoidance scores and neutral acceptance and approach acceptance (r = .281), escape acceptance (r = .335), and fear of death and death avoidance (r = .490) scores (p < .05).

Use of simulation from high fidelity to low fidelity in teaching of safe-medication practices.

OBJECTIVE: To evaluate the effects of simulation techniques on learning outcomes in the teaching of safe drug applications to first year nursing students. METHODS: The semi-experimental study was conducted from February to April 2017, and comprised nursing students of Acibadem Mehmet Ali Aydinlar University. This student satisfaction and selfconfidence in learning scale, medication practice via oral route checklist, and pre- and post-test for safe drug application knowledge Assessment were used for data collection. Following the theoretical lectures, case studies, task trainer practices and scenario with standardised patient were carried out. Baseline knowledge, during-the-scenario performanceand post-scenario level of student's satisfaction and self-confidence were evaluated. Data was analysed using SPSS 18. RESULTS: Of the 58 subjects, 51(87.9%) were female. The overall mean age of the sample was 20.69±1.02 years. There was a statistically significant difference between students' knowledge levels before and after the scenario (p<0.05). Mean performance scoreon safe medication practice was 65.70±5.83. A significant weak positive correlation was found between the students' scores on satisfaction with the simulation and knowledge levels as well as the performance and self-confidence scores (p<0.05 each). Also, there was a strong correlation between the scores on self-confidence scale and the knowledge levels (p<0.01). CONCLUSIONS: Simulation had a positive effect on learning outcomes..

Care Burden and Self-Efficacy Levels of Family Caregivers of Elderly People in Turkey.

The aim of this research was to determine the level of burden and self-efficacy among family caregivers of elderly people in Turkey. This study is descriptive and cross-sectional. A total of 658 family caregivers of elderly people were included in the study. The data were collected with a caregiver's characteristics form, elderly people's characteristics form, the Zarit Burden Interview, the self-efficacy scale, and the Barthell Index. Data were analyzed using SPSS 16.0 program. What are care burden and self-efficacy levels of the caregivers? Is there a relationship between care burden and self-efficacy levels of the caregivers with variables such as age, duration of care, sex, status of education, type of relationship, and status of employment that belong to the caregiver? Is there a relationship between care burden and self-efficacy levels of the caregivers with variables such as age and Bartell Index that belong to the elderly? The caregiver burden score was 38.65 ± 13.73, which indicates a moderate level of burden. The self-efficacy score was 29.31 ± 6.09, which is in the low range of self-efficacy. There were statistically significant differences between the caregiver burden score and the sex of caregivers, status of education, type of relationship, and the elderly person's score on the Bartell Index (P < .05). The relationship between the employment status of caregivers (P = .01), the age of the elderly (P = .01), and the caregivers' score on the self-efficacy scale (P < .05) was found to be statistically significant. Study revealed that the majority of the caregivers experienced moderate levels of care burden and low levels of self-efficacy. These results will provide beneficial information for nurses to provide the holistic nursing care.

Activities of daily living and self-care agency in patients with multiple sclerosis for the first 10 years.

PURPOSE: The aim of the study was to present the effects of the disease and analyze the relationship between activities of daily living (ADL) and self-care in multiple sclerosis (MS) patients who have had the disease for the first 10 years. DESIGN: This study was a descriptive cross-sectional study. METHODS: A total of 67 patients who fit the inclusion criteria of the study and volunteered to participate were included in the sample. Data were collected using the Exercise of Self-Care Agency Scale and the Barthel Index. FINDINGS: The mean age was 38.43±9.92. There was a statistically significant correlation between participants'educational backgrounds and self-care scores and between disease duration and Barthel index score (p<.05). CONCLUSIONS: The self-care levels of patients who have had MS for the first 10 years are medium, and they tend to be mildly dependent in performing their ADL. The duration of MS is positively correlated with level of ADL. CLINICAL RELEVANCE: In this study, it was shown that the duration of the disease in MS patients should be taken into account by rehabilitation nurses to implement effective nursing care.

Coping strategies for activities of daily living in women whose hands affected by systemic sclerosis.

AIMS AND OBJECTIVES: To determine the challenges experienced by women with systemic sclerosis, whose hands affected, while performing activities of daily living and their coping strategies. BACKGROUND: Many of the patients with systemic sclerosis experience difficulties in performing daily activities. One of the most important reasons for that is the impaired hand function due to their diseases. DESIGN: A descriptive cross-sectional design was conducted and questionnaire was used in this study. METHODS: The study was performed in a Rheumatology Department at a tertiary-care hospital in Turkey between April 2010-December 2011. Nineteen patients with systemic sclerosis with hand involvement were enrolled in this study. The data were collected by using both a demographic data form and an Evaluation of Daily Activity Questionnaire. RESULTS: According to Evaluation of Daily Activity Questionnaire, the most scored dimension that patients can do with much difficulty was 'eating' and the dimension that patients unable to do was 'washing/clothes care'. In 'eating' dimension, the most difficult activities were 'opening glass jar', 'opening juice bottle' and 'opening bottle' that requiring the movement of rotation. Their coping strategies for these activities were as follows: try to open with a towel, try to remove the edge of the palm with a knife, use the hand palm and help from someone else (spouse, neighbour, etc.). In 'washing/clothes care' dimension, the most difficult activities were 'turning up hem of a skirt', 'washing up in bowl' and 'cutting out material'. For these activities, they use some coping strategies such as getting help from tailor, washing in the machine instead of hand washing. CONCLUSION: This study demonstrates that impaired hand function affects the daily life activities of patients with systemic sclerosis, and patients have developed some coping strategies to overcome these difficulties. RELEVANCE TO CLINICAL PRACTICE: The coping strategies used by patients can be helpful for the other patients with systemic sclerosis.

Effects of Creative Arts Intervention on Anxiety, Depression and Sleep Quality Among Bone Marrow Transplantation Patients During Protective Isolation.

BACKGROUND: Protective isolation remains part of the standard of care for patients undergoing hematopoietic stem cell transplant in many places of the world. The consequences of protective isolation include increased anxiety and depressive symptoms. OBJECTIVE: The aim of this study was to determine the effects of creative interventions performed during the protective isolation period on anxiety, depression symptoms, and sleep quality of patients who underwent bone marrow transplantation (BMT). INTERVENTIONS/METHODS: This study was a randomized, controlled, pre-post pilot design. A total of 20 patients made up the sample group. Participants were randomly assigned to the experimental (n = 9) or control group (n = 11). Hospital Anxiety and Depression Scale was applied to patients on the first day of admission to the unit and on the day of discharge. Questions prepared by researchers on sleep quantity and quality were administered every day during the patients' hospitalization. The patients in the experimental group carried out creative arts intervention for a total of 60 minutes a day, 3 to 4 days a week, while they were in the unit. RESULTS: There was no difference in depression, anxiety, and sleep quality scores between the groups after intervention. However, depression and anxiety scores significantly decreased after the intervention in the experimental group, and sleep quality scores improved significantly. CONCLUSION: Creative arts intervention may be beneficial for anxiety, depression, and sleep problems among patients undergoing BMT. IMPLICATIONS FOR PRACTICE: Creative arts intervention is effective in coping with anxiety, depression, and sleep problems that patients may experience due to social isolation during the BMT process.

Living with scleroderma: patients' perspectives, a phenomenological study.

In this study, it is aimed to determine the daily life experiences of patients on the basis their own way of statement. Sixteen patients with scleroderma were enrolled to this qualitative study. Data were collected using both a demographic data form and a semi-structured interview form. Study was made on individual patient interview by face-to-face manner. Data were evaluated using Colaizzi's phenomenological data analysis method. Data analysis revealed four categories and nine topics. These categories were (1) physical impact of disease, (2) emotional impact of disease, (3) social impact of disease and (4) patient behaviours for the cope with the disease. As emotional impact, patients imply that they have experienced disappointment, hope to get well and have fears about the future. In the physical impact category, tight skin, limitations of hand skills, swelling of the hands and feet, fatigue, swallowing difficulties and deformation of their bodies were the prominent features. In patients with recognizable disease, difficulty to join to social activities increases and eventually leads to isolation. There was also some evidence that patients who have been supported by their family and close relatives seem to be more optimistic about their disease. Most patients are not willing to communicate with other patients, particularly in an advanced stage. Scleroderma patients imply that they experience several difficulties regarding emotional, physical and social aspects. Individual abilities to cope with the disease were much more improved among patients who have a sustained social support. For advanced patients with apparent deformations, an effective social support system should be introduced.

Medication errors: perspectives of newly graduated and experienced nurses.

UNLABELLED: This study investigated the perspectives of newly graduated and experienced nurses concerning medication errors. This is a descriptive cross-sectional study conducted in a military education and research hospital in Turkey, which was performed between July and August 2009. Totally, 169 nurses were involved in this study: 87 were new graduates and 82 were experienced nurses. The Modified Gladstone's Scale of Medication Errors was used to collect data on rates, causes and reporting of medication errors. The two highest perceived causes of medication errors were nurse exhaustion and nurse distraction. Most medication errors were preventable errors. The reasons for error occurrence and failure to inform co-workers of medical errors were examined. IMPLICATIONS: Training nurses to understand the causes of medication errors and related prevention methods should be provided to newly graduated nurses, and continuous training should be provided.

The reliability and validity of the Turkish version of the Shortened Xerostomia Inventory in hemodialysis patients.

INTRODUCTION: The aim of this study was to translate, linguistically validate, and evaluate the psychometric properties of the Shortened Xerostomia Inventory (SXI) among Turkish patients undergoing hemodialysis (HD). METHODS: The study was conducted with 81 chronic HD patients in the HD units of two state hospitals between June and August 2020. Explanatory factor analysis was implemented to test the construct validity. In addition, the test-retest method was performed to test the reliability and consistency of the scale over time. RESULTS: A total of 81 patients participated in the study. The Cronbach's alpha coefficient of SXI was 0.788. The mean values for the test were 12.84 ± 6.78 and re-test scores was 11.03 ± 6.88. Intraclass correlation coefficient value calculated as 0.992 and accordingly a statistically significant relationship between the test and retest scores (p < 0.001). CONCLUSIONS: Our study showed that the SXI is a valid and reliable measurement tool for Turkish HD patients.

Effectiveness of simulation-based cardiopulmonary resuscitation training programs on fourth-year nursing students.

BACKGROUND: Cardiopulmonary resuscitation (CPR) training for nursing students is important. The aim of study is to examine the effectiveness of a simulation-based CPR training program on the knowledge, practices, satisfaction, and self-confidence of nursing students. METHODS: The study was conducted with a mixed-method design. The quantitative data were obtained by using the "CPR Knowledge Questionnaire," the "Students' Satisfaction and Self-Confidence Scale," and the "CPR Skills Observation Checklist", and the qualitative data were collected by using the "Semistructured Interview Form" in four focus group sessions, each consisting of six participants. RESULTS: The mean pretest CPR knowledge score of the students before the simulation-based CPR training was 5.66 ± 1.97 out of 10.0. The mean posttest CPR knowledge score (8.38 ± 1.30) increased significantly after the simulation (p < 0.001). In addition, the mean posttest CPR skills score was significantly higher than the mean pretest CPR skills score (p < 0.001). Themes from the qualitative data revealed that the students considered the simulation to be an interesting and useful teaching method. These themes were "worries before simulation" and "satisfaction following simulation". CONCLUSION: Simulation-based CPR training improved the levels of knowledge and skills of nursing students. In addition, after the simulation training, satisfaction and self-confidence scores were found to be high.

Examining Knowledge, Skill, Stress, Satisfaction, and Self-Confidence Levels of Nursing Students in Three Different Simulation Modalities.

PURPOSE: The aim of this study was to compare the effect of different simulation modalities on knowledge, skill, stress, satisfaction, and self-confidence levels of students receiving undergraduate education in three nursing schools. METHOD: This was an experimental study. Students applied the scenario of "Respiratory Sounds Assessment" which was prepared according to three different simulation modalities. In the study, the standardized patient, high-fidelity simulation, and partial task trainer were used as simulation modalities. RESULTS: An increase was observed in postpractice knowledge levels of the three groups which had similar knowledge levels before the practice. Virtual Analog Scale stress levels of the students in the standardized patient group were higher than those of others. The students' mean scores of satisfaction in learning were higher in the standardized patient group. The students in the partial task trainer group had lower scores of self-confidence in learning. Skill scores of the students were lower in the standardized patient practice than those in others. CONCLUSION: Simulation-based experiences give students the opportunity of experiencing situations they may experience in the actual practice beforehand. Therefore, this may increase their performance in real practices, as reality increases in the standardized patient group.

Example of a Simulation Design in Nursing Education: Safe Chemotherapy Administration.

Chemotherapy is one of the treatment methods increasingly used in cancer. In this article, we aimed to share our simulation experiences within the scope of the elective course of Cancer Nursing in the Nursing Internship (4th year) program in the process of teaching safe chemotherapy administration methods. Simulation-based experience should be designed to attain specified educational goals and expected results as best as possible. Scenario implementation is based on the criteria of the International Nursing Association for Clinical Simulation and Learning standards. A biologically safe drug preparation cabin in the drug preparation room of a simulation center was used, and a medium-fidelity mannequin-based simulator evaluating the vital signs was utilized as the simulator during the simulation implementation. In the patient history prepared within the scope of the scenario, the students were expected to achieve goals. An analysis was performed by a trainer who followed attentively the implementation during the scenario. In the analysis stage, sessions including 8-10 students were held using the Promoting Excellence and Reflective Learning in Simulation. A checklist was used to evaluate the skill steps of the students objectively. It is thought that this simulation scenario maintained in accordance with the standards of best practice of the International Nursing Association for Clinical Simulation and Learning would guide the readers. The simulation is considered to be an effective method for safe medications, and it is recommended to plan different scenarios according to the levels of students.

Examining the effect of simulation based learning on self-efficacy and performance of first-year nursing students.

BACKGROUND: Self-efficacy is an individual's belief in oneself and in one's own judgment and ability to be successful in a task. Strong self-efficacy allows for the achievement of success, well-being, personal development and the diversification of skills. An individual's perception of his/her self-efficacy plays a key role in adopting behaviors and initiating and sustaining change. AIMS: The first aim of this study is to evaluate the effects of simulation-based learning on the self-efficacy and performance of first-year nursing students. The second aim is to examine students' pre- and post-scenario proficiency in their self-assessment of competence in regard to scenario objectives to compare the students' self-assessment and their instructor's assessment in terms of performance evaluations. METHODS: This semi-experimental study was conducted with sixty-five first-year nursing students. A standardized patient method was used as a simulation technique. Students' self-efficacy and their perceptions of their own competence in completing skills were measured using the General Self-Efficacy Scale and the Proficiency Assessment Form, respectively. Students' actual performance was evaluated via an Objective Structured Clinical Assessment and performance evaluation checklists. RESULTS: The mean self-efficacy score of students was 52.68 (±10.19) before the scenario and 49.59 (±12.90) post-scenario (p = .001). With regard to their scenario objectives, a decrease was observed in students' proficiency in their post-scenario self-assessment of competence. This decrease was only statistically significant in the "Establishing a safe patient unit" objective (t = 2.27; p = .03). CONCLUSIONS: We observed that self-efficacy scores declined in the post-simulation scenario. Using standardized patients in simulation training allows novice nursing students to meet a real patient and to recognize their own true self-efficacy.

Integrating simulation based learning into nursing education programs: Hybrid simulation.

BACKGROUND: Hybrid simulation can be developed with mannequins of any fidelity and tabletop simulators with a standardized patient to create a complex, high-level learning activity. OBJECTIVE: The aim of this study is to analyze the effects of a hybrid simulation technique used with nursing students in a scenario about the emergency setting. METHODS: This one-group pre-test post-test model quasi-experimental study was carried out with 39 students in Ankara, Turkey, from October 2014 to July 2015. RESULTS: Nearly all participants reported that the simulation improved their critical thinking, decision-making skills, and self-confidence before the clinical activity and that they felt as though they were real nurses during the activity (94.7%, 97.3%, 84.2%, and 92.1%, respectively). CONCLUSION: The results of this study support the integration of hybrid simulation experiences throughout the nursing curriculum, as evidenced by positive responses from students through the simulation evaluation questionnaire.

Analysis of the effects of high-fidelity simulation on nursing students' perceptions of their preparedness for disasters.

INTRODUCTION: As disasters may occur any time, health care staff and institutions should be prepared to manage these events. The aim of study is to analyze the effects of high-fidelity simulation on the perceptions of senior nursing students regarding their preparedness for disasters. METHODS: This study used a pretest-posttest design and was conducted as a quasi-experimental investigation. RESULTS: Slightly less than the half of the students (42.5%) expressed that they were prepared to face a disaster. There was a statistically significant difference in their scores on the Scale of Perception of Disaster Preparedness among Nurses between the pre-intervention and postdisaster stage (p < 0.05). CONCLUSION: Supporting simulation activities with drills positively affected nurses' perceptions of disasters.

The reliability and validity of three questionnaires: The Student Satisfaction and Self-Confidence in Learning Scale, Simulation Design Scale, and Educational Practices Questionnaire.

PURPOSE: The purpose of this study was to adapt the "Student Satisfaction and Self-Confidence in Learning Scale" (SCLS), "Simulation Design Scale" (SDS), and "Educational Practices Questionnaire" (EPQ) developed by Jeffries and Rizzolo into Turkish and establish the reliability and the validity of these translated scales. METHODS: A sample of 87 nursing students participated in this study. These scales were cross-culturally adapted through a process including translation, comparison with original version, back translation, and pretesting. Construct validity was evaluated by factor analysis, and criterion validity was evaluated using the Perceived Learning Scale, Patient Intervention Self-confidence/Competency Scale, and Educational Belief Scale. FINDINGS: Cronbach's alpha values were found as 0.77-0.85 for SCLS, 0.73-0.86 for SDS, and 0.61-0.86 for EPQ. CONCLUSIONS: The results of this study show that the Turkish versions of all scales are validated and reliable measurement tools.

The effects of music on the cardiac resuscitation education of nursing students.

PURPOSE: The purpose of this study is to examine the effects of music on the appropriate performance of the rate and depth of chest compression for nursing students. METHODS: This randomized controlled study was conducted in the School of Nursing in Turkey between November 2014 and January 2015. The study's participants were second-year nursing school students with no previous formal cardiac resuscitation training (n=77). Participants were randomly assigned to one of two groups: an intervention group with music and a control group without music. During practical training, the intervention group performed chest compressions with music. The outcomes of this study were collected twice. The first evaluation was conducted one day after CPR education, and the second evaluation was conducted six weeks after the initial training. RESULTS: The first evaluation shows that the participants in the intervention group had an average rate of 107.33±7.29 chest compressions per minute, whereas the rate for the control group was 121.47±12.91. The second evaluation shows that the rates of chest compression for the intervention and control groups were 106.24±8.72 and 100.71±9.54, respectively. CONCLUSION: The results of this study show that a musical piece enables students to remember the ideal rhythm for chest compression. Performing chest compression with music can easily be integrated into CPR education because it does not require additional technology and is cheap.