Interventions to improve ethical decision-making skills in nursing students: A systematic review.

BACKGROUND: Interventions to improve ethical decision-making are available in nursing education. Evidence of its effectiveness is essential. OBJECTIVE: This review examined the effectiveness of interventions to improve nursing students' ethical decision-making skills. METHODS: A structured search was performed in Google Scholar, Web of Science, Science Direct, Pubmed, Scopus, Cochrane Library, Elsevier, CINAHL EBSCO, and ULAKBIM. The Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instruments (JBI-MAStARI) was used to assess the quality of studies. ETHICAL CONSIDERATIONS: Ethical approval was not required for this systematic review. FINDINGS: The final review was composed of six studies of published between January 2013 and 2023. Nine different teaching methods applied to students. Although the importance of ethical decision-making skills in solving ethical problems that nurses may encounter at any time is known, it is thought that there is a lack of data in the literature in the last 10 years. The last 10 years were chosen as this aims to provide a review based on the most current, relevant and quality information. The review indicated that all of the teaching methods improved ethical decision-making. CONCLUSION: Different teaching methods can be used in the nursing education curriculum to meet the learning needs of nursing students in ethical decision-making.

Nursing interventions to prevent pressure injury among open heart surgery patients: A systematic review.

BACKGROUND: Nurses are vital in identifying and preventive pressure injuries (PIs) in hospitalized patients undergoing open heart surgery. Interventions to prevent PIs are crucial for every critical patient, and it's essential to recognize that preventing PIs involves a complex intervention. AIM: To examine the nursing interventions for the prevention of PI in patients with open heart surgery. METHOD: A systematic review study. Web of Science, Science Direct, PubMed, Scopus, MEDLINE Ultimate, CINAHL Ultimate, ULAKBIM, Cochrane Library, Google Scholar and university library databases were scanned. The initial search performed in the databases was updated on 4 February 2023, and on 7 April 2024, for potential publications included in that period. Data between February 2013 and April 2024 were scanned. The databases were searched with the keywords 'pressure injury', 'nursing interventions' and 'open heart surgery'. The systematic compilation process was carried out in accordance with the guidelines in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guide. RESULTS: Seventeen studies were examined using nursing interventions that applied to the selected study population. Care packages included an inflatable head pad, a pressure sensor mattress cover, multi-layer silicone foam, pressure-reducing coatings, endotracheal tube (ETT) repositioning and cuff pressure regulation. Interventions to reduce PI in open heart surgery patients are applied in the preadmission, perioperative and postoperative periods. CONCLUSION: It was concluded that care packages, inflatable head pads, pressure sensor bedspreads, multi-layered silicone foam, pressure-reducing covers, ETT repositioning and cuff pressure regulation were effective in all nursing interventions. The strength of the available evidence was rated from strong to weak. RELEVANCE TO CLINICAL PRACTICE: These findings reveal an efficient combination of multi-component nursing interventions for preventing PIs in planning patient care in the intensive care. The interventions that are used throughout the patient's entire care process are crucial for the prevention of PIs.

Missed nursing care: A cross-sectional and multi-centric study from Turkey.

AIM: The aim of this study is to explore the extent of missed nursing care in Turkey and identify its predictors. DESIGN: This was a descriptive, cross-sectional, multicentre study. METHODS: A total of 477 nurses working in seven public hospitals participated in this study from March to July 2019. The survey included two components: a personal and professional characteristics data form and the MISSCARE survey. RESULTS: The study revealed that emotional support, patient bathing and ambulation were the most frequently missed nursing care activities. An inadequate number of assistive personnel and staff, along with an unexpected increase in patient volume, were identified as the primary reasons for missed nursing care. Of the 21 missed nursing care activities, nine predictive models showed statistical significance (p < 0.05). Factors such as the type of unit, years of work experience, working hours, number of patients cared for in a shift and intention to leave the unit were found to be significant predictors of seven missed nursing care activities (p < 0.05). CONCLUSION: This study found that numerous variables influence each care activity, which suggests the need to devise more targeted and specific strategies to minimize missed nursing care. Thorough investigation into the impact of these strategies on each care activity is essential.

Investigation of the prevalence of pressure ulcers and patient-related risk factors in hospitals in the province of Erzurum: A cross-sectional study.

BACKGROUND: Pressure ulcers are a significant health care problem all across the world due to their associated high mortality and morbidity rates and high health care costs. The prevalence of pressure ulcers serves as one of the most important indicators of the quality of nursing care. STUDY AIM: This study aims to determine the prevalence of pressure ulcers and patient-related risk factors in inpatients receiving treatment in the province of Erzurum, located in the eastern part of Turkey. DESIGN: This is a cross-sectional study. PARTICIPANTS: which included 832 inpatients hospitalized for at least 24 h after admission in five hospitals in the province of Erzurum. All of the study patients were 18 years of age or older and agreed to participate in the research. Patients hospitalized in the obstetric, emergency, and pediatric clinics were excluded from the study (due to the low probability of pressure ulcers in these clinics). INSTRUMENTS: For the collection of data, the "Introductory Information Form" was used to learn the socio-demographic and clinical characteristics of the patients, and the "Braden Risk Assessment Scale" was used to determine the risk of pressure ulcers. The stage of the pressure ulcers of the patients was determined according to the classification of the National Pressure Ulcer Advisory Panel (NPUAP). METHODS: Since the study was planned as a point prevalence study, research data were gathered by the researchers and interviewers on a single day designated for each hospital during the first week of October 2016. RESULTS: Among the patients included in the study, 53.1% were male, mean age was 56.62 ±â€¯17.95, 57.2% were treated in internal clinics, and the mean hospital stay was 9.02 ±â€¯13.36 days. In terms of the patients' risk of pressure ulcers, it was determined that 28% were at risk. The overall prevalence of pressure ulcers was calculated to be 12.7% (for stages I-IV), with the overall prevalence decreasing by 6.7% when the patients with stage-I were excluded. Furthermore, it was found that 48.3% of the pressure ulcers were stage-I, and that the sacral region (37.3%) was the most affected region. According to the logistic regression analysis conducted to determine the factors, along with their weights, that affect the development of pressure ulcers, the age of the patient, the duration of the hospital stay, the presence of incontinence, albumin level problems, and a Braden score below 17 were found to have an impact (p < 0.05). CONCLUSION: In this study, the prevalence of pressure ulcers was calculated to be 12.7%, with the highest prevalence found in intensive care clinics (35.3%). The age of the patient, the duration of the hospital stays, the presence of incontinence, albumin level problems, and a Braden score below 17 were found to be effective in the development of pressure ulcers.

Motivational Interviewing With Pender's Health Promotions Model: Diabetics Self-Management Behavior.

The purpose of the study was to determine the effects of motivational interviewing as based on Pender's health promotion model (HPM) on diabetes self-management behavior among individuals with Type 2 diabetes. Apart from their routine care, the individuals in the intervention group were given a 30-45-minute motivational interview based on Pender's HPM once a week for three months. Statistically significant differences were determined between the groups in the total score of the scales and its sub-dimensions (p < .05). The intervention applied in the present study can be used as an effective and easy method through which to develop and maintain diabetes self-management behaviors.

Assessment of four different methods in subcutaneous heparin applications with regard to causing bruise and pain.

Subcutaneous administration of the anticoagulant heparin sodium is a frequently performed nursing intervention. Subcutaneous heparin injection often causes problems such as bruise, pain, induration, and hematoma at the injection site. Bruising that result from heparin injections may lead to anxiety, disruption of body image, the rejection of the treatment in patients, and the reduction of the reliance of patient to nurse. The purpose of this study was to determine and compare the effects of four different injection technique pain and on bruising associated with subcutaneous heparin. The research involved ninety-five patients. Each subject received four injections by the same investigator using four different techniques. Site bruising was measured at forty-eight and seventy-two after each injection. The bruising size was measured using milimetric transparent palyethylene wrap and the verbal pain scale. There was significant difference in the incidence or size of bruises and pain perception the subject among techniques. Results of the study show that use of air lock technique without aspiration and two-minute cold application to the area of injection with methods reduce bruise and pain.

The effect of aroma massage on constipation in elderly individuals.

BACKGROUND: Constipation is a health problem commonly seen in the elderly individuals. Abdominal massage is thought to stimulate the rectal loading by increasing intra-abdominal pressure. PURPOSE: To determine effects of aromatherapy massage on constipation in the elderly individuals. METHODS: Forty eight elderly individuals with constipation were randomized to aromatherapy massage, and control groups. Massage was applied with oil blend to the experimental group during 3 weeks, once a day and lasting 15 min. RESULTS: During aroma massage and after aroma massage in intervention group, mean scores related to 'defecation number', 'amount of feces' and 'consistency of feces' were increased and these increases were statistically significant. The mean scores related to 'straining during defecation' and 'feeling of incomplete discharge of feces' were decreased. CONCLUSION: It was determined that aroma massage practice has increased 'frequency of defecation', 'amount of feces' and 'consistency of feces' but decreased the 'straining during defecation' and 'feeling of incomplete discharge of feces'.

The effect of education on self-care agency and rational drug use of patients with COPD.

OBJECTIVE: This study examined the effects of education given to patients diagnosed with the COPD on self-care agency and rational drug use. METHODS: This study has a pretest-posttest quasi-experimental design. Participants were divided into two groups, those who received training with the COPD Guide booklet (n = 40) and routine clinical care (n = 43). RESULTS: As a result of the study found a statistically significant difference between the self-care agency and rational drug use scale post-test mean scores of the patients in the intervention and control group in favor of the intervention group (p < 0.01). CONCLUSION: Education on COPD management increased patients' self-care agency and their information, attitudes, and behaviors regarding rational drug use. PRACTICE IMPLICATIONS: Clinicians can integrate a COPD Guide into routine care for patients with COPD.

The effect of education given to patients with type 2 diabetes mellitus on self-care.

This research was performed as a single group pretest--posttest experimental design to determine the effect of education given to patients with type 2 diabetes mellitus on self-care. The research was performed between October 2007 and June 2008 in the Internal Medicine Outpatient Clinics located in A and B Blocks of Erzincan State Hospital. The research population included 100 patients with type 2 diabetes mellitus who attended the above mentioned units between the specified dates and met the inclusion criteria. Patients were subjected to a pretest using a patient identification form, Diabetes Self-Care Scale (DSCS) form in Turkish language and metabolic control parameters. A statistically significant difference was found between the mean values of pre-education and posteducation DSCS scores with an increase in mean posteducation scores. These results demonstrate that the education given to patients improves their self-care and metabolic control variables.

Using self-efficacy theory to educate a patient with chronic obstructive pulmonary disease: A case study of 1-year follow-up.

Self-efficacy is important in determining which activities or situations an individual will perform or avoid. This is a case study report to explore the utility of structured education programme on strengthening self-efficacy in an older adult with chronic obstructive pulmonary disease (COPD). To comprehensively evaluate this intervention, a combined qualitative and quantitative approach was used. Although qualitative data were collected following the interview guide, quantitative data were collected by the demographic data form and the COPD Self-Efficacy Scale (CSES) at the preprogramme and postprogramme stage. The patient's self-efficacy scores improved after 8 weeks of the structured education programme and remained relatively constant on all the repeated measurements after education. Qualitative data were identified as 'difficulties' and 'facilities'. This study indicates that, by applying a self-efficacy theory, a planned education programme could be useful in improving both short-term and long-term self-efficacy in patients with COPD.

Evaluation of patient education provided by clinical nurses in Turkey.

The purpose of this study was to determine the practices of patient education provided by nurses in hospital clinics. The data were collected using a questionnaire form developed by the researcher in the light of relevant literature. The questionnaire form included questions to help determine descriptive characteristics of nurses and practices of patient education. Statistical analysis was performed using percentages. Most of the nurses (82.4%) did not define a certain place or time for patient education, almost all of the nurses (98.9%) did not record the education process, and patients' family/relatives were not included in the education (82.4%). The results of this study have shown that clinical nurses do not adequately implement the phases of patient education. During nursing education, nurses' knowledge and skills in patient education should be developed, and they should be made to fully internalize their educational role.

Development of the Attitude Scale for Nursing Profession.

There is a need to have an appropriate instrument to measure the attitudes towards nursing profession. This study was carried out to develop an Attitude Scale for Nursing Profession (ASNP). The population of the study is composed of final-year students of high schools, the patients, the nurses and students of nursing department. A total of 600 participants were included in this study. The people in the sampling group were asked to write a composition containing their feelings and thoughts about nursing. These compositions were analysed and 89 items about positive and negative attitude were determined. These items were presented to expert opinion and after necessary editions, reliability and validity analyses were conducted. The resulting ASNP consists of 40 items across the following three domains: properties of nursing profession prefer to nursing profession, general position of nursing profession. The final model in confirmatory factor analysis showed that this 40-item ASNP indicated a good fit of the model. The value of the Cronbach's α for the total scale was 0.91. The ASNP is determined to be quite highly valid and reliable, sufficient measuring instrument to determine attitude towards the profession.

Reliability and validity of the scale of patient perception of hospital experience with nursing care in a Turkish population.

AIM AND OBJECTIVES: This study aimed to adapt an English version of the survey tool Patient Perception of Hospital Experience with Nursing Care for Turkish patients and to evaluate its psychometric properties. BACKGROUND: Patient satisfaction is used as an important indicator of care quality and frequently included in health care planning and evaluation. In Turkey, although a review of the literature identified several tests that measured patient satisfaction with hospitalisation services, there are few studies that measured both patients' satisfaction and patients' perceptions. DESIGN: This study was conducted at the Research and Application Hospital of Ataturk University in Erzurum, Turkey with a convenience sample of 150 patients who were discharged from medical and surgical clinical units. METHODS: Experts' viewpoints were used to determine language validity of the scale, and factor analysis was used to determine the structural validity of the scale. Cronbach's α reliability coefficient, item analysis, test-retest analysis were conducted to evaluate the reliability of the scale. Data were collected using the Patient Perception of Hospital Experience with Nursing Care Scale and Socio-demographic form. RESULTS: It was determined that Patient Perception of Hospital Experience with Nursing Care showed a one-factor structure, Cronbach's α reliability coefficient was 0·92 and item-total point correlations were between 0·36-0·74. In addition, it was found that the test-retest correlation value was 0·90, which was found to be statistically significant (p<0·001). CONCLUSIONS: The validity and the reliability of the Patient Perception of Hospital Experience with Nursing Care Scale are extremely high, and it is an adequate measurement scale to determine patients' satisfaction with nursing care. RELEVANCE TO CLINICAL PRACTICE: We suggest that the scale can be used in nursing research projects to evaluate the patient satisfaction and the quality of nursing care.

Impact of Training Based on Orem's Theory on Self-Care Agency and Quality of Life in Patients With Coronary Artery Disease.

BACKGROUND: Coronary artery disease (CAD) is a primary cause of death worldwide. CAD negatively affects individuals because it reduces their functional skills and self-care abilities and disrupts quality of life. PURPOSE: This study was designed to assess the impact of a training program based on Orem's self-care deficit nursing theory (SCDNT) on self-care abilities and quality of life in patients with CAD. METHODS: This study was conducted using a randomized, controlled, pretest/posttest experimental design. One hundred two patients with CAD were divided evenly into either the intervention or control group, with sample randomization based on gender, age, low-density lipoprotein cholesterol level, and Self-Care Agency Scale scores. For both groups, interviews were conducted in two sessions held, respectively, at the hospital and at home. Study data were collected using the patient information form, Self-Care Agency Scale, MacNew Heart Disease Health-Related Quality of Life Questionnaire (MacNew), Quality of Life Questionnaire (15D), and training booklet. RESULTS: A highly significant difference was found between the two groups in terms of the average posttest scores on the Self-Care Agency Scale, MacNew, and 15D. For the intervention group, the posttest scores on the Self-Care Agency Scale, MacNew, and 15D were significantly higher than the pretest scores, whereas average pretest and posttest scores on these measures were similar for the control group. CONCLUSIONS: The training program developed in this study based on Orem's SCDNT improved self-care agency as well as disease-specific and overall quality of life in patients with CAD. Nurses should pay attention to the CAD-related educational level of patients when teaching them how to live with their disease. Moreover, nurses should use Orem's SCDNT to strengthen the self-care agency of these patients to increase quality of life and the effectiveness of related education efforts. Finally, medical institutions and governments should develop appropriate education policies for patients at risk of CAD and for those with CAD.

The effect of the application of cold on hematoma, ecchymosis, and pain at the catheter site in patients undergoing percutaneous coronary intervention.

OBJECTIVE: This study was conducted to determine the effect of the application of cold on hematoma, ecchymosis, and pain in patients undergoing percutaneous coronary intervention. METHODS: It is a quasi-experimental study with a control group. A total of 200 patients (100 in the control group and 100 in the experimental group) were included in the research. In the experimental group, a cold pack was applied to the bottom of the sandbag for the first 15 min after withdrawing the femoral arterial catheter. Both groups were assessed and followed up at the first 15th minute and 4th, 48th and 72 nd h. RESULTS: After the femoral arterial catheter was withdrawn, ecchymosis and hematoma were smaller and pain was less in the experimental group at the catheter entry site compared to the control group, and the difference was statistically significant (P < 0.01). CONCLUSION: It was determined that the application of cold reduced the formation of hematomas, ecchymoses and pain in patients after the withdrawal of the femoral arterial catheter.

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.

Factors affecting medication adherence in patients with hypertension.

The aim of this study descriptive study was to evaluate concordance with medication and those factors that affect the use of medicine in patients with hypertension. Data were collected using a questionnaire completed by 750 patients with hypertension between December 25, 2003, and April 30, 2004, in an outpatient hypertension clinic in Erzincan, Turkey. It was found that 57.9% of the patients did not use their medicines as prescribed. Forgetfulness, aloneness, and negligence were ranked as the top three reasons for this non-concordance, accounting for almost half (49.3%) of all patients with hypertension studied; price (expensive medicines) accounted for another quarter (26.5%). A statistically significant relationship with non-concordance was found for age, education level and profession. Patients' lack of knowledge related to the complications of hypertension was also found to have a statistically significant relationship with not taking medicines as prescribed. Gender, location of residence and salary were not found to be statistically related to concordance. These results indicate the need to educate patients with hypertension on how to use their medicine regularly and indicate also the target populations for this.

Family support, perceived self-efficacy and self-care behaviour of Turkish patients with chronic obstructive pulmonary disease.

AIM: The purpose of this study was to describe family support, self-efficacy perception and self-care behaviour among patients with chronic obstructive pulmonary disease and to ascertain the relationship between these variables. BACKGROUND: It is important to work at improving confidence in the patients' ability to follow a self-care regimen by increasing self-efficacy. Family support also plays an important role in self-care activities. METHOD AND DESIGN: The study design is descriptive and correlational. Of 230 patients with chronic obstructive pulmonary disease who were recruited for the study, 200 agreed to participate. The patients were recruited by the first author from an outpatient clinic in the Department of Chest Disease of a university hospital and a pulmonary hospital in Erzurum, eastern Turkey. Data were collected by using a demographic data form, the Perceived Social Support from Family Scale, the Chronic Obstructive Pulmonary Disease Self-efficacy Scale and the Alberto Chronic Obstructive Pulmonary Disease Self-care Behaviour Inventory. RESULTS: Although most participants (91.5%) perceived that they had family support and more than three quarters (73.0%) of the participants engaged in an adequate amount of self-care behaviours, only twenty five participants' (12.5%) perceived self-efficacy as high. There were statistically significant positive relationships between family support and self-care behaviour (r=0.302; p=0.01) and between self-efficacy and self-care behaviour (r=0.186; p=0.01). There was also a statistically significant positive relationship between family support and self-efficacy (r=0.412; p=0.01). CONCLUSION: The results of the study demonstrated weak to moderate, but statistically significant, relationships between family support and self-care behaviours, self-efficacy and self-care behaviour and family support and self-efficacy in Turkish patients with chronic obstructive pulmonary disease. RELEVANCE TO CLINICAL PRACTICE: The assessment of the family support, self-efficacy and self-care behaviours of the patients with chronic obstructive pulmonary disease should be an essential part of nursing practice. The study also provides the foundation for the conduct of future studies of self-care training for managing patients with chronic obstructive pulmonary disease.