Psychosocial consequences of the COVID-19 pandemic and its effects on professional resilience and self-care on nurses: an example of Ankara.

The COVID-19 pandemic has significantly impacted nurses, who are frontline care providers, with high infection risk, disease transmission to relatives, and adverse psychosocial effects. This descriptive and correlational study examines the psychosocial impact of COVID-19 on 224 nurses, focusing on their professional resilience and self-care during active care of COVID-19 patients from December 2022 to August 2023. Data was collected through demographic information forms, questionnaires, and scales. Structural equation modeling was used for the relational dimension of the study. The mean score of the nurses' COVID-19 Pandemic Psychosocial Impact Scale was 85.43 (SD = 22.08), while the Skovholt Practitioner Professional Resiliency and Self-Care Inventory had a mean score of 135.64 (SD = 19.73). A statistically significant low-level negative relationship between the scale scores (r = -0.220). The COVID-19 pandemic's psychosocial impact scores significantly impact personal vitality and stress, indicating a direct negative effect on these factors, according to structural equation modeling results.

Emotional labor among Turkish nurses: A cross-sectional study.

Nurses are the closest healthcare providers to patients and emotional labor is the most invisible part of nursing work. However, the management of emotions to promote organizational goals and to ensure patient satisfaction may have both positive and negative impacts on nurses' working life. The purpose of this cross-sectional, descriptive study was to examine the emotional labor behaviors of nurses and their opinions on emotional labor. Two hundred nineteen nurses working at public hospitals in Ankara between September and December 2018 participated to this study. Data were collected using the sociodemographic characteristics form and "The Scale of Emotional Labor Behavior for Nurses." Nurses had higher scores on the deep and sincere emotional acting subdimensions of the emotional labor scale than the surface acting subdimension. Findings suggest that nurses act deeply and intimately, instead of surface acting. Most of the nurses expressed that nurses were emotionally affected when caring for patients; however, nurses had to control their feelings toward patients and behave professionally to meet the expectations of their managers, which may lead to an implicit emotional dissonance. Based on the results of this study, we suggest to support nurses emotionally and to incorporate the topic of emotional labor into educational programs.

Nurses' Perspectives and Experiences Regarding Organ Transplantation in Turkey: A Qualitative Study.

As professionals, nurses are often required to provide care for patients from different cultural and religious backgrounds during an organ transplantation process. It is therefore important to understand the views and experiences of nurses regarding the organ transplantation process. The aim of this study was to explore nurses' perspectives and experiences in providing care to donors and transplant recipients. In this descriptive qualitative study, semistructured in-depth interviews were conducted with 17 nurses in Turkey. The qualitative interviews were analyzed using thematic analysis. At the end of the study, four themes were represented: nurses' characteristics, nurses' roles and responsibilities, nurses' views on organ transplantation, and nurses' experiences with providing care. The results of the study revealed that nurses have positive and negative attitudes about organ transplantation, and they need education on this topic. In addition, considering the cultural factors and religious beliefs that prevent organ donation, cooperation between health professionals and religious authorities is necessary. Furthermore, support systems should be developed to reduce the problems that nurses face. The relevant authorities should collaborate to increase the number of donors by informing the public that the religious view is favorable to organ donation.

Effects of using standardized patients on nursing students' moral skills.

BACKGROUND: Nurses and nursing students increasingly confront ethical problems in clinical practice. Moral sensitivity, moral reasoning, and ethical decision-making are therefore important skills throughout the nursing profession. Innovative teaching methods as part of the ethics training of nursing students help them acquire these fundamental skills. AIM: This study investigated the effects and potential benefits of using standardized patients in ethics education on nursing baccalaureate students' moral sensitivity, moral reasoning, and ethical decision-making by comparing this method with in-class case analyses. RESEARCH DESIGN: This is a quasi-experimental study. PARTICIPANTS AND RESEARCH CONTEXT: The sample comprised 89 students in Hacettepe University's Faculty of Nursing. Following lectures describing the theoretical components of ethics, students were randomly assigned to two working groups, one using standardized patients and the other using in-class case analyses. Data were collected using the Moral Sensitivity Questionnaire, Rest's Defining Issues Test, and the Nursing Dilemma Test. All data were analysed using IBM SPSS Statistics Version 23. ETHICAL CONSIDERATIONS: Ethical approval and official permission were obtained. All participating students completed informed consent forms. FINDINGS: According to the results, the moral sensitivity of students in the standardized patient group significantly improved over time compared to those in the case analysis group, while the mean scores of students in both groups for moral reasoning and ethical decision-making were not statistically significant. CONCLUSION: Based on our results, we recommend the use of both standardized patients and case analysis as appropriate teaching methods in ethics education.

Turkish adaptation and psychometric characteristics of the Nursing Authority and Autonomy Scale.

AIM: To adapt the Nursing Authority and Autonomy Scale (NAAS) into Turkish the Nursing Authority and Autonomy Scale (NAAS) to Turkish and assess its psychometric properties for Turkish nurses and nurse managers. BACKGROUND: The NAAS is a tool that specifically measures nursing authority and autonomy from the perspectives of nurses and nurse managers. METHODS: The study sample consisted of 160 nurse managers and 266 staff nurses. Content validity was assessed using expert approval. Construct validity was assessed using confirmatory factor analysis. Internal consistency was assessed using Cronbach's α, and the test-retest reliability was assessed using Pearson's correlation coefficients. RESULTS: The model achieved a good fit. The internal reliability of the NAAS' authority and autonomy in nursing practice and importance of nursing practice subscales were .84. The Cronbach's α of the instrument was .88. The test-retest scores within an interval of 3 weeks were statistically not significant. CONCLUSIONS: The Turkish version of the NAAS has good psychometric properties and this scale can be employed to measure nurses' authority and autonomy. IMPLICATION FOR NURSING MANAGEMENT: Nurse managers and educators should use an appropriate scale such as NAAS in order to assess nurses' clinical authority and autonomy to improve patient outcomes and develop nurses.

Effects of Web-Based Instruction on Nursing Students' Arithmetical and Drug Dosage Calculation Skills.

Drug dosage calculation skill is critical for all nursing students to ensure patient safety, particularly during clinical practice. The study purpose was to evaluate the effectiveness of Web-based instruction on improving nursing students' arithmetical and drug dosage calculation skills using a pretest-posttest design. A total of 63 nursing students participated. Data were collected through the Demographic Information Form, and the Arithmetic Skill Test and Drug Dosage Calculation Skill Test were used as pre and posttests. The pretest was conducted in the classroom. A Web site was then constructed, which included audio presentations of lectures, quizzes, and online posttests. Students had Web-based training for 8 weeks and then they completed the posttest. Pretest and posttest scores were compared using the Wilcoxon test and correlation coefficients were used to identify the relationship between arithmetic and calculation skills scores. The results demonstrated that Web-based teaching improves students' arithmetic and drug dosage calculation skills. There was a positive correlation between the arithmetic skill and drug dosage calculation skill scores of students. Web-based teaching programs can be used to improve knowledge and skills at a cognitive level in nursing students.

Nursing students' perceptions of faculty members' ethical/unethical attitudes.

BACKGROUND: Through education, individuals acquire knowledge, skill and attitudes that facilitate professional socialization; it involves intellectual, emotional and psychomotor skill development. Teachers are role models for behaviour modification and value development. OBJECTIVE: To examine students' perceptions of faculty members' ethical and unethical attitudes during interactions in undergraduate nursing. RESEARCH DESIGN: This descriptive study consisted of two phases. In Phase I, we developed an instrument, which was administered to nursing students to assess validity and reliability. Exploratory factor analysis yielded 32 items. Cronbach's α was 0.83, and test-retest reliability was good. In Phase II, a 32-item version of the instrument was administered to nursing students from another university. Participants and research context: Participants included 219 nursing students from one university in Phase I and 196 from another university in Phase II. The study was conducted at the universities attended by the participants. Ethical considerations: Ethical approval was granted by the institutions involved, and all participants provided informed consent. FINDINGS: In Phase I, the instrument demonstrated good psychometric properties for measuring nursing students' perceptions of faculty members' ethical and unethical behaviours. In Phase II, students considered certain professional and personal qualities, including respecting confidentiality and students' private lives and assuming an impartial stance during interactions in the classroom, examinations, or clinical practice, ethical. They considered using obscene examples or unprofessional speech during teaching, selling textbooks in class, using university facilities for personal interests, engaging in romantic relationships with students, and humiliating students in front of patients or staff in clinical settings unethical. CONCLUSION: Results of this study suggest that nurse educators should be aware of their critical role in the teaching-learning process, and they must scrutinize their attitudes towards students from an ethical point of view.

Effects of planned group interactions on the social adaptation of individuals with an intestinal stoma: a quantitative study.

AIMS AND OBJECTIVES: To investigate the effects of a planned group interaction method on the social adjustment of individuals with an intestinal stoma. BACKGROUND: Individuals with a stoma often experience physiological, psychological and social problems that affect their social adaptation. DESIGN: Quasi-experimental. METHODS: The population included ileostomy and colostomy patients registered at the Gazi University Health Research and Implementation Centre Stoma therapy Unit between September 2011-June 2012. They were assigned to experimental (n = 23) and control (n = 27) groups based on their willingness to attend planned group interaction meetings. Experimental group members participated in the 'planned group interaction method' for six weeks. Control group members only received routine care services. Weekly group interaction meetings lasted for average of 90 minutes. The Ostomy Adjustment Inventory and Psychosocial Adjustment to Illness Scale-Self-Report Scale were administered to experimental group members on three occasions: prior to the first group meeting, after the six-week meeting process ended and during the first month after group meetings ended. Control group evaluations were conducted simultaneously. RESULTS: Experimental group members' ostomy adjustment mean scores after planned group interaction meetings gradually increased. No changes occurred in the control group's average scores. The experimental and control groups' average psychosocial adjustment scores eventually changed and showed a tendency towards adjustment. Experimental group members aged 51-60 and 61-70, who were married, had primary and higher education, had permanent stomas, had stomas for periods between 12 months or less and 61 months and longer and had sufficient stoma care knowledge demonstrated higher adjustment values (p < 0·05). Furthermore, experimental group members reported they received psychological support during interactions and learned how to solve problems encountered in stoma care and daily life. CONCLUSIONS: Planned group interactions effectively enhanced the social adjustment of patients with a stoma. RELEVANCE TO CLINICAL PRACTICE: Group interaction methods should be included in nursing care practices for individuals with a stoma.

Knowledge about anti-tuberculosis treatment among nurses at tuberculosis clinics.

Nurses are primary responsible for Direct Observation Therapy Strategy and administration of anti-tuberculosis (TB) medications. Lack of knowledge might result with medication errors and ineffective TB control. The purpose of this study was to assess knowledge of nurses about anti-TB treatment. A descriptive cross-sectional study was conducted in Turkey with 208 nurses employed at TB and lung disease clinics of health-care settings in Ankara. Data were collected through a questionnaire, which included questions about demographics and a knowledge test with true-false questions related to TB treatment. Overall scores were high with a mean score of 18.5 out of 24, but there was knowledge deficiency in effects and side-effects of anti-TB drugs. Knowledge is foundational for any practice and for TB control. Clinical experience and continuing education after graduation influence the level of knowledge.

Evaluation of nursing documentation on patient hygienic care.

This study was conducted to evaluate nursing documentation on patient hygienic care and to analyze the consistency between actual care given by nurses and that of documented in nursing record. Data were collected from 85 nurses employed at critical care units, on whom 255 sets of observations were performed through a structured participant observation form, which could be used to record the observation episodes and to audit nursing records. Results indicated that the most frequent performed hygienic care was oral care, perianal care, hand washing and bed bathing. The consistency between actual patient hygienic care and its documentation was 77.6%. The quality of nursing records was poor and inadequate to reflect individualized nursing care. Results suggest that more emphasis is needed in nursing practice and nursing education on the quality of record keeping in nursing to increase its evidential value.

Trust in nurse-patient relationships: a literature review.

The aim of this study was to report the results of a literature review of empirical studies on trust within the nurse-patient relationship. A search of electronic databases yielded 34 articles published between 1980 and 2011. Twenty-two studies used a qualitative design, and 12 studies used quantitative research methods. The context of most quantitative studies was nurse caring behaviours, whereas most qualitative studies focused on trust in the nurse-patient relationship. Most of the quantitative studies used a descriptive design, while qualitative methods included the phenomenological approach, grounded theory, ethnography and interpretive interactionism. Data collection was mainly by questionnaires or interviews. Evidence from this review suggests that the development of trust is a relational phenomenon, and a process, during which trust could be broken and re-established. Nurses' professional competencies and interpersonal caring attributes were important in developing trust; however, various factors may hinder the trusting relationship.

Ethical decision-making and professional behaviour among nurses: a correlational study.

This study examined the relationship between nurses' ethical decision-making levels and their professional behaviours. Data were collected from 225 nurses who were recruited from university hospitals in Ankara using proportionate sampling. Data were analysed using descriptive statistics and Pearson correlations. Most of the nurses were familiar with ethical dilemmas in nursing practice. The Nursing Principled Thinking level was above average, while the Practical Consideration level was average. Nurses' professionalism level was low. There was a positive but weak correlation between professional behaviours of the nurses and their ethical decision-making levels. Increasing nurses' professionalism level can provide a positive contribution to the ethical decision-making level.

Trust and trustworthiness in nursing: an argument-based literature review.

Caring requires nurses to establish trusting relationships with patients and to be trustworthy professionals. This article provides insight into the conceptual understanding of trust and trustworthiness in nursing through an argument-based literature review of 17 articles published between 1980 and 2010. Trust is characterized as an attitude relying with confidence on someone. The importance of trust relationships is considered by addressing the imbalances of power in nurse-patient relationships as they increase the vulnerability and dependency of the truster. Trust is considered as a process, and time, reliance on others, risk and fragility are identified as basic attributes of trust. However, trustworthiness is inadequately explored in the nursing ethics literature. Nurse educators have a responsibility to ensure that nurses are equipped with the attitudes and knowledge that are needed to establish trusting nurse-patient relationships.

Game-based learning in undergraduate nursing education: A systematic review of mixed-method studies.

AIM: To investigate game-based learning in nursing education and summarize findings of its impact on nursing students' learning outcomes. BACKGROUND: Nurses are the first point of contact for care and make up the largest proportion of the global health workforce. To respond effectively to the care needs of the population, nurses need to be adequately trained during their professional education. Game-based learning is increasingly becoming a strategy to complement simulation strategies in nursing education. DESIGN: A systematic review of mixed-methods studies. METHODS: A search was conducted in the electronic databases Medline, PubMed, Science Direct, Scopus and Web of Science. Quantitative, qualitative and mixed methods studies on nurse education published in English between 2000 and 2020 were considered. The Mixed Methods Assessment Tool was used for quality assessment. Data abstraction and synthesis was performed using a data extraction form. RESULTS: A total of 46 studies from the 15 countries were included. The included studies were eight quantitative randomized controlled trials, 12 quantitative non-randomized controlled trials, 15 quantitative descriptive, five qualitative and six mixed methods studies. The results showed that game-based learning was used for many different courses or content in nursing education. Simulation games were the most used game type. Game-based learning facilitated the achievement of learning outcomes primarily in the cognitive domain. Some gamification elements and design-related aspects of game-based environments were evaluated as positive and negative. Game-based learning is a useful approach to assessing learning outcomes in only three studies. CONCLUSION: Game-based learning is a useful method to achieve learning outcomes mainly in the cognitive domain, with some positive and negative aspects. Further research should investigate the effects of games on affective and behavioral learning outcomes, as well as the use of games to assess learning outcomes. Potential limitations of this review are that some studies could not be identified because of access issues and that some studies included participants other than nursing students.

Views of nursing students on using standardized patient and in-class case analysis in ethics education.

BACKGROUND: It is important to use student-centred, active teaching strategies in ethics education to develop students' skills in dealing with ethical problems. OBJECTIVES: This study sought the opinions, suggestions, and thoughts of students receiving ethics education with in-class case analysis (ICCA) and standardized patient (SP) practice. RESEARCH DESIGN AND PARTICIPANTS: A phenomenological and interpretive design based on qualitative interviews was used. The sample was 86 nursing students in 8 focus groups. RESULTS: The mean age of participants was 21.40 ± 0.844, and most of the participants were female (n = 76). Themes obtained from the student interviews were 1) impact on knowledge, skills and emotions, 2) learning process, 3) decision making process, 4) recommendations for the future practice. CONCLUSIONS: The students stated that both teaching methods were beneficial in ethics education; they understood the subject better, gained multi-directional thinking skills, and their awareness of ethical problems increased. Thus, ICCA and SP practice are teaching methods that should be used in nursing ethics education.

Leyla Dinç interviewed by Elizabeth Niven.

The intention behind this series of interviews with members of the Nursing Ethics Editorial Board by other Board members is to introduce members of the Board to readers. Here, Elizabeth Niven from New Zealand interviews Leyla Dinç, from Turkey. Elizabeth and Leyla have known each other for over five years. The interview was conducted by email.

Psychometric Evaluation of the Caring Behaviors Inventory in Turkish Nurses and Patients.

BACKGROUND AND PURPOSE: Instruments developed specifically to measure nurse caring behaviors need to be assessed in different cultural contexts. The purpose was to translate the Caring Behaviors Inventory (CBI) into Turkish and evaluate its psychometric properties. METHODS: This was a methodological study with 356 nurses and 363 patients. Linguistic, content validity, and construct validity tested for the validity of scale. Internal consistency and test-retest were calculated for reliability of scale. RESULTS: Exploratory factor analysis identified 30 items that could be categorized under three factors. Cronbach's α for the CBI was .97 for nurses and .99 for patients. CONCLUSIONS: The Turkish version of the CBI is a valid and reliable instrument for measuring caring behaviors.

Turkish nurses' perceptions of professional values.

This study aimed to examine the professional values of nurses in Turkey. This descriptive cross-sectional study was conducted with 310 nurses employed at public, university, and private hospitals between May-June 2015. Data were collected using a data collection form and the Nurses' Professional Values Scale-Revised, and they were analysed using descriptive statistics. Associations between socio-demographic variables and mean scores were analysed using the Kruskal-Wallis test. Nurses had higher scores on perception of professional values, and education level and years of professional experience were associated with higher scores. Results indicated that trust and justice were the most prominent professional values, whereas altruism and obedience were less favoured values. Overall, results indicated that participants' had a strong professional value orientation, and education level and professional experience influenced nurses' scores on professional values. Nurses' professional values reflect their understanding of how care should be provided, which health care policy makers and nurse managers who make decisions on providing more humanistic health care should consider. Further studies using the Nurses' Professional Values Scale-Revised, and other reliable and culture-specific instruments are recommended.

The effects of using high-fidelity simulators and standardized patients on the thorax, lung, and cardiac examination skills of undergraduate nursing students.

BACKGROUND: Existing research literature indicates that the use of various simulation techniques in the training of physical examination skills develops students' cognitive and psychomotor abilities in a realistic learning environment while improving patient safety. OBJECTIVES: The study aimed to compare the effects of the use of a high-fidelity simulator and standardized patients on the knowledge and skills of students conducting thorax-lungs and cardiac examinations, and to explore the students' views and learning experiences. DESIGN: A mixed-method explanatory sequential design. SETTINGS: The study was conducted in the Simulation Laboratory of a Nursing School, the Training Center at the Faculty of Medicine, and in the inpatient clinics of the Education and Research Hospital. PARTICIPANTS: Fifty-two fourth-year nursing students. METHODS: Students were randomly assigned to Group I and Group II. The students in Group 1 attended the thorax-lungs and cardiac examination training using a high-fidelity simulator, while the students in Group 2 using standardized patients. After the training sessions, all students practiced their skills on real patients in the clinical setting under the supervision of the investigator. RESULTS: Knowledge and performance scores of all students increased following the simulation activities; however, the students that worked with standardized patients achieved significantly higher knowledge scores than those that worked with the high-fidelity simulator; however, there was no significant difference in performance scores between the groups. The mean performance scores of students on real patients were significantly higher compared to the post-simulation assessment scores (p<0.001). CONCLUSIONS: Results of this study revealed that use of standardized patients was more effective than the use of a high-fidelity simulator in increasing the knowledge scores of students on thorax-lungs and cardiac examinations; however, practice on real patients increased performance scores of all students without any significant difference in two groups.