Validity and Reliability of the Turkish Version of the Questionnaire for the Assessment of Dysphagia in Multiple Sclerosis.

INTRODUCTION: The aim of this study was to investigate the validity and reliability of the Turkish version of the Questionnaire for the Assessment of DYsphagia in MUltiple Sclerosis (DYMUS) that has been developed for evaluating dysphagia in patients with multiple sclerosis. METHODS: This methodological study was conducted in the neurology clinic and outpatient department of a training hospital between March 15 and September 15, 2015. The study included 117 patients aged 18 years and over who had a definite diagnosis of multiple sclerosis, could communicate in Turkish, and volunteered to be included. Data were collected using a descriptive information form, the DYMUS, and the Eating Assessment Tool (EAT-10). The scale was translated and back translated to determine the language validity, and a specialist was consulted to make sure the content was valid. We used the EAT-10 and Kurtzke's Expanded Disability Status Scale (EDSS) concurrently to test the criterion-related validity. The test-retest procedure was used at 1-week intervals for 37 patients in this study. Descriptive statistics, factor analysis, Kappa analysis, reliability analysis, and correlation analysis were used to analyze the data. RESULTS: Factor analysis revealed that the scale was bifactorial, and this was consistent with its original form. There were positive and statistically significant relationships between the DYMUS and EAT-10 (r=0.90, p<0.001) and the mean EDSS scores (r=0.49, p<0.001). The internal consistency of the total scale was high (Cronbach's alpha coefficient= 0.91). The Cronbach's alpha coefficients pertaining to dysphagia for solids and liquids were determined to be 0.88 and 0.83, respectively. The total scale and subscales demonstrated a high test-retest reliability (r=0.79-0.95, p<0.001). CONCLUSION: In this study, the Turkish version of the DYMUS was found to be a valid and reliable tool for evaluating dysphagia in patients with multiple sclerosis.

Predictors of Health Behaviors in Turkish Female Nursing Students.

PURPOSE: This study was conducted to determine the health behaviors of Turkish female baccalaureate nursing students and to examine the impact of sociodemographic and health-related factors and their mothers' health behaviors on the health behaviors of nursing students. METHODS: This cross-sectional study included 337 nursing students and 337 mothers. Data were collected using self-administered questionnaires that included a personal information form, the Perception of Health Scale and the Health-Promoting Lifestyle Profile-II (HPLP-II). Descriptive statistics, one-way analysis of variance, Student's t test, Pearson's correlation coefficients and linear regression analysis were used for data analysis. RESULTS: The total HPLP-II mean score of the students was 131.98 ± 17.15 (item M = 2.61, SD = 0.33). Among the subscales of the HPLP-II, the spiritual growth had the highest mean subscale score, followed by the interpersonal relations subscale, while the physical activity had the lowest mean subscale score. Significant predictors of health behaviors of the students were school year (unstandardized ß = .09, p = .012), total score for the Perception of Health Scale (unstandardized ß = .02, p < .001), and the mothers' total HPLP-II score (unstandardized ß = .33, p < .001), after controlling for specific variables. CONCLUSIONS: This study demonstrated that the students who were attending the first-year program, those with higher levels of perceptions of health and those whose mothers had better health behaviors were more likely to have better health behaviors. The results of this study emphasize the importance of making culturally appropriate interventions by taking into account the factors contributing to the health behaviors of nursing students.

Predictors of coping in a group of Turkish patients with physical disability.

AIM AND OBJECTIVE: To describe coping strategies used and determine the influence of demographic/health-related variables and perceived social support to the prediction of coping strategies in patients with physical disabilities. BACKGROUND: The period of psychosocial adaptation following a physical disability is very stressful. The use of effective coping strategies may be helpful in adapting to disability. However, no information is available about the coping strategies used by Turkish patients with physical disability. DESIGN: The study was designed as a cross-sectional survey. The data were obtained from 51 patients with physical disability in a rehabilitation centre in Ankara, Turkey between May 2004-September 2005. METHODS: Data were collected using a questionnaire form, the Multidimensional Scale of Perceived Social Support and the Coping Strategy Indicator. Descriptive statistics, reliability analysis, Mann-Whitney U tests, Kruskal-Wallis test, chi-square test, Pearson's correlation coefficients and stepwise multivariate regression analysis were conducted. RESULTS: The most frequently used coping strategy was problem-solving, followed by avoidance coping and seeking social support. Significant predictors of overall coping strategies were age, financial status, the caregiver's presence and perceived social support, after controlling for specific variables. CONCLUSIONS: This study demonstrated that patients who were older and had a caregiver were more likely to use problem-solving strategy. Seeking social support was more common among patients who had a caregiver and those with more perceived support from friends, whereas patients who had financial difficulties used more avoidance coping. RELEVANCE TO CLINICAL PRACTICE: Better understanding the coping strategies used by individuals with physical disabilities and factors affecting coping is provide interventions that reduce the stress and support their adaptation. Nurses should be aware of the factors that affect to coping strategies used to deal with stress.

The assessment of adherence of hypertensive individuals to treatment and lifestyle change recommendations.

OBJECTIVE: Most of studies about adherence in hypertension highlight the adherence to the medical treatment but do not include the adherence to the other recommendations, such as lifestyle modifications. The factors effective on adherence to each type of recommendation may differ. Accordingly, we aimed in this study to show that nonadherence to each recommendation should be assessed individually. METHODS: The study, which was designed as cross-sectional and descriptive, included 150 patients who were followed by the outpatient clinics for at least one year. A data collecting form with 44 questions was prepared by the investigators, and the patient adherence was assessed in five categories: medicine-related adherence, diet-related adherence, exercise-related adherence, measurement-related adherence and smoking related adherence. The face-to-face interview method was used to collect data. Statistical analysis was accomplished by Chi-square test and logistic regression analysis. RESULTS: Of 150 subjects included in the study, 94 (63%) were female and mean age was 56+/- 12 (20-81) years. Mean duration of drug use was 6.5+/- 6.5 years and the mean number of drugs used was 1.6+/- 0.8. The adherence to recommendations of medication, diet, exercise, home-blood measurement and smoking were 72%, 65%, 31% , 63% and 83%, respectively. Each patient was adherent to at least one recommendation, while 11% of patients were adherent to one recommendation, 23% - to two, 29% - to three, 24% - to four and 13% - to five. According to the regression analysis, factors effective on each type of adherence were found to be different from others. The presence of three or more types of adherence was related to income level (OR= 0.297; 95%CI - 0.132-0.666; <0.001) and presence of any other chronic disease (OR=2.329; 95% CI - 1.114-4.859; p=0.002). CONCLUSION: The rates of adherence to medicine and life-style changes were generally found to be low in hypertension. The cause of nonadherence is different according to the type of adherence. Each recommendation should be assessed individually in terms of adherence.