The Effect of Neonatal Intensive Care Nurses' Attitudes Towards Palliative Care on Death Anxiety and Burnout: An Analytic Cross-Sectional Study.

This study aimed to determined the effect of neonatal intensive care nurses' attitudes towards palliative care on death anxiety and burnout. This was an analytic cross-sectional study conducted with 215 neonatal intensive care nurses working a children's hospital with Turkey's largest NICU bed capacity. The mean Neonatal Palliative Care Attitude Scale total score was 3.04 ± 0.78, and the mean scores of the organization, resources, and clinician subscales were 3.16 ± 0.86, 2.87 ± 0.80, and 3.10 ± 0.97, respectively. The participants' mean Death Anxiety Scale score was 57.65 ± 21.46, and the mean Burnout Inventory score was 39.21 ± 17.61. The organization subscale explained 17% of the variance in death anxiety, and the organization and resources subscales explained 31% of the variance in burnout. Neonatal intensive care nurses' palliative care attitudes are moderate; they face obstacles in providing and improving their attitudes in this field. The high level of obstacles increases nurses' death anxiety and burnout.

The effects of Kinesio taping and breathing exercises on pain management after gynaecological abdominal surgery: A randomized controlled study.

AIM: This study aimed to evaluate the effects of Kinesio taping and breathing exercises on pain management after gynaecological abdominal surgery. METHODS: This randomized controlled study was conducted with 132 participants at a public hospital between June 2017 and 2018. The Kinesio taping method was applied once, immediately after the surgery during the hospital stay and breathing exercises were performed three times a day for 30 min on the first, second and third post-operative days. RESULTS: The median age of the women was 47 years. The mean body mass index was 27.6 ± 5.0 kg/m2 . When the intervention and control groups were compared, the level of women's pain in the Kinesio taping group was significantly reduced. There was also a statistically significant difference in terms of the passage of gas and defecation time and wound healing in groups with Kinesio taping. CONCLUSIONS: Kinesio taping has been shown to be an effective intervention in the management of acute pain after surgery. The results of this study suggest that future studies may be indicated to study taping in other surgical conditions.

Attitudes toward dating violence among Turkish university students: The relationships with self-esteem level and gender roles.

The current study aimed to determine the relationships between attitudes toward dating violence, self-esteem, and gender roles. Men supported dating violence more than women, and the attitudes toward gender roles and self-esteem level were found to have a significant positive correlation with attitudes toward dating violence. For women, attitudes toward gender roles and levels of self-esteem predicted attitudes toward dating violence. The only significant variable in predicting attitudes toward dating violence in men was their attitude toward gender roles. The prevention activities should begin with identifying the risk factors.

The relationship of perceived social support, personality traits and self-esteem of the pregnant women with the fear of childbirth.

This research was conducted to examine the relationship of perceived social support, personality traits, and self-esteem of pregnant women with fear of childbirth. The study was performed between April 15, 2016 and May 15, 2016 using face-to-face interviews with 128 pregnant women who were at 28-40 weeks of pregnancy. A negative correlation between the fear of childbirth and the levels of social support perceived by pregnant women and a positive correlation between the fear of childbirth and self-esteem were observed. Furthermore, a negative correlation between the fear of childbirth and extraversion, self-discipline, and openness to development and a positive correlation between the fear of childbirth and neurotic personality traits were noted. Hence, we propose that social support status, personality traits, and self-esteem of pregnant women should be viewed as risk factors for the fear of childbirth.

The Fathers' Fear of Childbirth Scale: a Turkish validity and reliability study.

PURPOSE: Fathers' Fear of Childbirth Scale (FFCS) was developed specifically to measure fathers' fear of childbirth. The aim of this study was to investigate the Turkish validity and reliability of the FFCS. DESIGN: This study used a cross-sectional and methodological design. METHODS: The population of the study consists of 315 pregnant spouses who were registered at a hospital in Ankara, Turkey, between August 11 and 5 November 2021. The mean age of expectant fathers are 31.57 (5.88). After translating the FFCS to Turkish, a confirmatory factor analysis was conducted to examine its construct validity. Concurrent validity was established by examining the correlation between the FFCS-Turkish with the Fear of Birth Scale (FOBS) and the male version of the Childbirth Fear-Prior to Pregnancy scale (M-CFPP). Both internal consistency and test-retest reliability were examined for the FFCS-Turkish. Results: The scope validity index of the scale was found to be 0.96. Based on the results of confirmatory factor analysis, a two-factor structure with 17 items was verified. The fit indices were found to be χ2 = 309.610, χ2/df = 2.76, root mean square error = 0.075, goodness of fit index = 0.89, comparative fit index = 0.93, and adjusted goodness of fit index = 0.86. All fit indices were at good levels. A strong correlation was found between the FFCS and the FOBS and M-CFPP scales within the scope of concurrent validity. Cronbach's alpha reliability coefficient for the entire scale was 0.93. The test-retest reliability was also high. CONCLUSIONS: The FFCS is a valid and reliable scale and measurement tool that can be used on Turkish expectant fathers.

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

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

Validity and reliability of the Family Empowerment Scale for parents of children with cleft lip and/or palate.

BACKGROUND: Empowerment is recognized as a crucial concept in strengthening the position of parents in healthcare services. This study aimed to evaluate the validity and reliability of the Turkish Family Empowerment Scale (FES). METHODS: This methodological study was conducted between January and March 2021, with 348 family members actively caring for their children in the age group of 0-18 years with cleft lip and/or palate (CL/P). The English FES was translated into Turkish using back translation and modified so that it is generic and convenient for all families. The construct validity, internal validity, internal consistency, and split-half test reliability and responsiveness of the Turkish FES were examined. RESULTS: The original FES structure with three factors (family, health services provided to the child and community participation) and 34 items was verified in Turkish culture. This obtained structure can explain 66% of the variance of the relevant concept. Scores of parents ranged between 34 and 170 points. Increasing scores indicated a positive significance regarding family empowerment. The Cronbach's α reliability coefficient of the scale was calculated as 0.976. CONCLUSION: The study findings and the goodness-of-fit values indicated that the FES and its Turkish version are a valid and reliable measurement instrument to be used in Turkish culture.

Complex decongestive therapy in a patient with poliomyelitis, bilateral lymphoedema and a deep wound: a case study.

OBJECTIVE: The aim of this case report is to describe the results of complex decongestive therapy (CDT) in a patient with poliomyelitis and bilateral lymphoedema, and to emphasise the effect of CDT on wound healing. METHOD: A 48-year-old female patient was given CDT for bilateral grade 3 lymphoedema in the lower extremities and a deep wound on the right foot. She had been diagnosed with poliomyelitis sequela and mobilised with a wheelchair for 26 years. The lymphoedema on both legs and the wound on the right foot sole had been present for five years and eight months, respectively. Detailed wound care had been performed previously upon the green, malodorous infected wound, without healing. The patient received skin care education, manual lymphatic drainage, multilayer bandaging and exercises for 4 weeks in a total of 20 sessions. The improvement was assessed by limb volumes prior to and at the end of the treatments. RESULTS: The right and left lower limb volumes were decreased significantly at the end of treatments (3042cm³ (R) and 3165cm³ (L) before versus 2702cm3 (R) and 2401cm3 (L) afterward). The wound size decreased considerably and the green malodorous flow ceased. The patient continued self-massage and self-bandaging after hospital discharge. The control follow-up, one month later, revealed a completely healed wound with maintained volume. CONCLUSION: In conclusion CDT for a duration of 4 weeks in a female patient with poliomyelitis, bilateral lymphoedema and an infectious hard-to-heal wound, improved both the lymphoedema and wound healing.

Determining the relationship between magnet properties of hospitals and the professional values of the nurses: A cross-sectional study.

AIM: To identify the relationship between the characteristics of hospitals in recruiting and retaining nurses (magnet properties) and nurses' professional values. BACKGROUND: In Turkey, there are a limited number of hospitals with the characteristics to enable nurses to stay in their institutions. The magnet properties of these hospitals and the professional values of the nurses working in these hospitals are not known. METHODS: This descriptive cross-sectional research included 612 nurses working in six hospitals accredited by the Joint Commission International. Data were collected using the Nursing Professional Values Scale-Revised (NPVS-R) and the Essentials of Magnetism Scale (EOM II). RESULTS: The mean NPVS-R score was high 102.0 (26-130). However, the mean EOM II score was found to be low at 2.2 (1.0-3.4). As the magnet properties of the hospitals increased, the professional values of the nurses decreased. CONCLUSION: There was a negative correlation between the magnet properties of hospitals and the professional values of the nurses. IMPLICATIONS FOR NURSING MANAGEMENT: The findings of this study highlight the necessity of creating a working environment with high magnet characteristics, which also includes the professional values of nurses. Nurse managers should investigate the reasons behind the low magnet properties of hospitals, raise awareness, and plan interventions to increase magnet properties of hospitals. Creating a supportive working environment, promotion of the salaries and work environment and decreasing workload are some of the important intervention areas in attracting and keeping nurses in the institution.

Individualized Care: Perceptions of Gynecologic Oncology Patients and Nurses.

The purpose of the descriptive study was to assess the individualized care perceptions of gynecologic oncology patients and nurses. The study was conducted between June 1, 2015, and September 30, 2015, at a university hospital and at a training and research hospital in Ankara, Turkey. The study sample included 152 patients who received inpatient treatment at the selected hospitals' gynecologic oncology clinics, and 29 nurses are working at these clinics. The number of the patients was determined by using One-Sample t-Test Power Analysis. The questionnaire was filled by the researcher using face-to-face interview method. The data were analyzed by using Independent Samples t Test, the Mann-Whitney U test, ANOVA, and Kruskal-Wallis H tests. The Kolmogorov-Smirnov and Shapiro-Wilk tests were used to determine whether distribution of the parameters was normal. Patients' perception on "nurses support their individuality" was found to be X̅ = 3.07 ± 0.97 and their perception on "nurses provide individual care" was X̅ = 2.33 ± 0.69. As patients' perception on "nurses support their individuality" increased, their perception on "nurses provide individual care service" also increased (r = 0.736; p = 0.001). The patients' satisfaction with care was at a moderate level (63.16 ± 14.97). The level of perception on "nurses support the individuality of patients during care practices (X̅ = 1.65 ± 0.58) and provide individual care service to the patients (X̅ = 1.61 ± 0.62)" was low. Nurses stating that they supported the individuality of patients provided individual care to their patients (r = 0.828; p = 0.001). The nurses' perception on "they support patients' individuality" and "they provide individual care service" was lower than patients' perception on "nurses support their individuality" and "nurses provide individual care." The nurses' job satisfaction (general satisfaction) was at a moderate level (3.08). In this study, nurses' perception on individualized care was lower than patients' perception.

Attitudes of Oncology Nurses Towards Care of Dying Patients and the Principles of Dying with Dignity and Their Views on Good Death.

This study investigated oncology nurses' attitudes toward caring for dying patients, their principles of dying with dignity, and their views on good death. This descriptive study included 257 oncology nurses working at two university hospitals, an educational research hospital and a state hospital in Turkey. Data were collected using the descriptive characteristics information form, the Frommelt Attitudes toward Care of the Dying scale, the Assessment Scale of Attitudes toward the Principles of Dying with Dignity, and the Good Death Scale. The nurses obtained mean scores of 99.53 ± 7.76 on the Frommelt Attitudes toward Care of the Dying scale, 26.84 ± 12.45 on the Assessment Scale of Attitudes toward the Principles of Dying with Dignity, and 57.23 ± 7.48 on the Good Death Scale. The nurses' personal and professional characteristics influenced their attitudes toward caring for dying patients, the principles of dying with dignity, and their views on good death.

The association of missed nursing care and determinants of satisfaction with current position for direct-care nurses-An international study.

AIM: To describe the association of missed nursing care and to identify the determinants of satisfaction with current position for direct-care nurses. BACKGROUND: Missed nursing care and job satisfaction are important issues regarding quality patient care and safety in health care, globally. METHOD: This was a cross-sectional quantitative study using MISSCARE Survey data. Participants were 7,079 nursing staff providing direct patient care in hospitals in Australia, Iceland, Turkey and the USA. Multivariable nested models were used to identify the relationship between missed nursing care and nurses' satisfaction with current position. RESULTS: More missed nursing care was associated with less satisfaction with current position. Other determinants of job satisfaction included country, nursing experience, overtime worked, adequacy of staffing and the number of shifts missed during the previous 3 months. CONCLUSION(S): Internationally, more missed nursing care is associated with less nursing job satisfaction and is influenced by work experience, overtime worked, levels of staffing and absenteeism. IMPLICATIONS FOR NURSING MANAGEMENT: This study identifies that the association between missed nursing care and satisfaction with nursing position is of global concern. Other factors requiring the attention of nurse managers are staffing levels, absenteeism and work experience.

Effects of Reflexology and Progressive Muscle Relaxation on Pain, Fatigue, and Quality of Life during Chemotherapy in Gynecologic Cancer Patients.

PURPOSE: Our aim was to investigate the effect of reflexology and progressive muscle relaxation (PMR) exercises on pain, fatigue, and quality of life (QoL) of gynecologic cancer patients during chemotherapy. METHODS: Eighty participants were randomly assigned to one of four groups: reflexology, progressive muscle relaxation (PMR) exercises, both (reflexology + PMR), or a control group. Data were collected with a general data collection form, Brief Pain and Fatigue inventories, and Multidimensional Quality-of-Life Scale-Cancer. RESULTS: In reflexology and reflexology + PMR groups, a significant decrease in pain severity and fatigue and an increase in QoL were found (p < .05). In the PMR alone group, pain severity and fatigue decreased significantly (p < .05), but there was no significant change identified in QOL (p > .05). CONCLUSIONS: Reflexology and PMR exercises given to gynecologic cancer patients during chemotherapy were found to decrease pain and fatigue and increase QoL.

The effects of amniotic fluid and foetal cord blood cotinine concentrations on pregnancy complications and the anthropometric measurements of newborns.

Our objective was determining the effects of amniotic fluid (AF) and fetal cord blood (FCB) cotinine concentrations on pregnancy complications and the anthropometric measurements in the newborns whose mothers underwent amniocentesis. This study was conducted as a case-control study, in Turkey. A total of 250 pregnant women with amniocentesis indication were recruited into the study and the cotinine levels in the AF and FCB were determined. A smoking habit did not statistically affect the incidence of pregnancy complications (p>.05). The birth weights of the newborns were negatively correlated with the AF cotinine levels. The incidences of low birth weight, low Apgar scores and RDS were positively correlated with higher levels of cotinine in AF and FCB. It is important for healthcare staff to provide training and consultancy services for the health improvement of pregnant women and the prevention of smoking during pregnancy. Impact statement What is already known on this subject? The pre-pregnancy smoking habit usually continues during the pregnancy. A significant negative correlation was present between the foetal cord blood cotinine levels and the birth weight. What do the results of this study add? The anthropometric measurements of the newborns born from mothers with high AF cotinine levels were lower than newborns born from mothers with low amniotic fluid cotinine levels. Respiratory Distress syndrome is more often determined in newborns born from mothers with high AF cotinine levels. What are the implications of these findings for clinical practice and/or further research? Future studies should be performed to investigate the effects of cigarette smoking on the health problems, the growth characteristics and the neurological development of newborns and infants within the first year of life.

The impact of the using high-fidelity simulation and standardized patients to management of postpartum hemorrhage in undergraduate nursing students: A randomized controlled study in Turkey.

We examined the efficiency of different simulation methods for the improvement of knowledge and skills of nursing students in the management of postpartum hemorrhage. A total of 84 nursing students participated in the study. Data were obtained using a Semi-Structured Questionnaire Form, Student Satisfaction Evaluation Form, Effective Communication Skills Checklist, Spielberger's State-Trait Anxiety Inventory, and Skills Evaluation Form for Postpartum Bleeding Management. We suggest that the use of different simulation methods may be effective in improving the knowledge and skills of nursing students in the management of postpartum hemorrhage.

Determinants of nurse absenteeism and intent to leave: An international study.

AIM: To determine factors associated with nurses' intent to leave their positions and absenteeism. BACKGROUND: There is a recognized global shortage of nurses but limited data describing and determining factors associated with nurse absenteeism and intent to leave. METHODS: This study involved a secondary analysis of the results from direct-care registered nurses' responses to the MISSCARE Survey, with data from seven countries included. Multi-level modelling was used to determine nurse characteristics and working environment factors associated with nurse absenteeism and intent to leave. RESULTS: The level of absenteeism and intent to leave varied significantly across countries, with registered nurses in Lebanon reporting the highest intention to leave within 12 months (43%) and registered nurses in Iceland and Australia the highest level of absenteeism (74% and 73%, respectively). Factors associated with outcomes included perceived staffing adequacy of unit, job satisfaction, and age of the nurse. CONCLUSIONS: A significant difference between countries was identified in nurse absenteeism and intent to leave. Increased perception of unit staffing inadequacy, lower job satisfaction, less nurse experience, and younger age were significant contributors to nurse absenteeism and intent to leave. IMPLICATIONS FOR NURSING MANAGEMENT: These findings suggest that regardless of country and hospital, by ensuring that units are adequately staffed and increasing job satisfaction, younger, less experienced nurses can be retained and absenteeism reduced.

Sexual and Reproductive Health Education Needs, Gender Roles Attitudes and Acceptance of Couple Violence According to Engaged Men and Women.

This descriptive study was aimed to evaluate the attitudes of the engaged men and women who are of legal age to marry towards gender roles and acceptance of couple violence, and determine their sexual/reproductive health education needs. It was conducted in two marriage registry offices in Ankara, Turkey. The study sample consisted of 740 participants. Data were collected by using semi-structured form, Gender Roles Attitude Scale and Acceptance of Couple Violence Scale. It was found that the engaged couples had educational needs concerning sexual/reproductive health; socio-demographic characteristics such as gender, age, education, residence, and income level created significant differences in the attitudes related to accepting gender roles and violence; and having an egalitarian attitude towards gender roles decreased the rate of accepting violence between the couples. Results indicate that premarital counseling is a promising strategy to support engaged couples' sexual/reproductive health needs, and increase their awareness about gender based couple violence in communities.

Factors affecting performance and productivity of nurses: professional attitude, organisational justice, organisational culture and mobbing.

AIM: To identify relationships among variables affecting nurses' performance and productivity, namely professional attitudes, organisational culture, organisational justice and exposure to mobbing. BACKGROUND: The determination of the factors affecting performance and productivity is important for providing efficient nursing services. These factors have been investigated in the literature independently, but the relationship among them has not been clearly identified. METHODS: This cross-sectional questionnaire study included 772 nurses working in a University Hospital accredited by Joint Commission International. RESULTS: The professional attitude score of the nurses was high (4.35 ± 0.63). However, their organisational justice (2.22 ± 1.26) and organisational culture (2.47 ± 0.71) scores were low. Nurses were subjected to mobbing at a high level (0.82 ± 0.78). As the organisational justice increased, the organisational culture increased and the mobbing decreased. As the organisation culture decreased, the mobbing increased. CONCLUSIONS: There was a positive correlation between organisation culture and organisational justice of the nurses and a negative correlation with mobbing. IMPLICATIONS FOR NURSING MANAGEMENT: The results of the study are essential for improving nurses' performance and productivity.

The Effect of Gum Chewing, Early Oral Hydration, and Early Mobilization on Intestinal Motility After Cesarean Birth.

AIM: The aim of the study was to investigate the effect of gum chewing, early oral hydration, and early mobilization after cesarean birth on intestinal sounds, passing gas, and intestinal evacuation. DESIGN: Randomized controlled study. SETTING: This study was conducted at the Obstetrics Service of the one Obstetrics and Child Diseases Hospital. PARTICIPANTS: A total of 240 females divided into 8 groups of 30 subjects each were included within the scope of the sample. METHODS: The women who underwent cesarean birth were divided into eight groups by using 2(3) factorial test levels, depending on the use of three different methods of gum chewing, early oral hydration, and early mobilization. No intervention was applied to the women in the control group. For the other seven groups, the intestinal sounds were checked every 30 minutes with a stethoscope over the abdomen and the first time of passing gas and the first evacuation time were recorded by asking the mother. The data were evaluated with numbers, mean, and percentage calculations, Student's t test, one-way variance analysis, correlation, and Tukey HSD test. RESULTS: The intestinal sounds were heard earlier, gas was passed earlier, and bowel movements were earlier in the first group that received all interventions compared to the other groups (p < .05). The patient could not be discharged before 48 hours had passed after the cesarean birth according to the hospital protocol and the time of discharge was therefore not affected by interventions. LINKING EVIDENCE TO ACTION: All of the three different interventions, such as gum chewing, early oral hydration, and early mobilization after cesarean birth, increase intestinal motility. The interventions are recommended during postoperative routine care to shorten hospital stay and prevent postoperative ileus.

Psychometric Properties of the Turkish Form of a New Scale for Nurse Leaders: Coaching-Based Leadership Scale.

Background: In the current literature, no existing scale that can measure nurse specific coaching-based leadership has been found. Purpose: The study was conducted to determine the Turkish validity and reliability of the Coaching-Based Leadership Scale (CBLS). Methods: The research is methodological. The study was conducted in two sample groups for the employees' and leaders' versions of the scale. Results: The confirmatory factor analysis of the scale revealed that both the employees' and leaders' versions have a 16-item, four-factor structure, and the fit indices were confirmed as follows: for the employees' version: Chi-square (χ2) = 361.948, χ2/degrees of freedom (df) = 4.022, root mean square error of approximation (RMSEA) = 0.133, goodness of fit index (GFI) = 0.808, comparative fit index (CFI) = 0.941, Tucker-Lewis index (TLI) = 0.821, and standardized root mean square residual (SRMR) = 0.0317, and for the leaders' version: χ2 = 180.121, χ2/df = 1.896, RMSEA = 0.104, GFI = 0.809, CFI = 0.970, TLI = 0.962, and SRMR = 0.0177. The obtained fit indices indicated a good fit. The scale-item-total score correlations were found to range from r = 0.816 to r = 0.952 for the employees' version and from r = 0.922 to r = 0.968 for the leaders' version, which were determined to be at an acceptable level. It was determined that the Cronbach's alpha (α) reliability coefficient of the scale was 0.98 in the employees' version and the Cronbach's α coefficients of its subdimensions were 0.93 for working alliance, 0.96 for open communication, 0.97 for learning and development, and 0.96 for progress and results. In the leaders' version, the Cronbach's α reliability coefficient was 0.99, while the Cronbach's α coefficients of its subdimensions were found to be 0.93 for working alliance, 0.96 for open communication, 0.97 for learning and development, and 0.96 for progress and results. Conclusion: It has been determined that the CBLS is a valid and reliable measurement tool for Turkish nursing employees and managers.