Theory-based nursing interventions in adults with coronary heart disease: A systematic review and meta-analysis of randomized controlled trials.

PURPOSE: This systematic review and meta-analysis aimed to synthesize the outcomes of theory-based nursing interventions for coronary heart disease management. DESIGN AND METHODS: Web of Science, Scopus, Science Direct, and PubMed databases were electronically searched from January 2013 to August 2021. The Preferred Reporting Item for Systematic Reviews and Meta-analyses statement guidelines was followed for this meta-analysis. Randomized controlled trials on patients with coronary heart disease, using a theory-based nursing intervention were eligible. Methodological quality was examined by two authors using the Modified Jadad Scale. Based on the heterogeneity test, the results were analyzed using a pool of data with 95% confidence intervals, p-values, and fixed or random-effect models (PROSPERO registration number X). FINDINGS: A total of 1030 studies were initially retrieved, and 8 randomized controlled trials were eventually included in the meta-analysis after screening. The big majority (81.3%) of participants were males, and the mean age was 54.8 (SD = 8.7) years. This meta-analysis found theory-based nursing interventions had no significant effect on blood lipid profile, blood pressure, and healthy lifestyle. However, these interventions significantly reduced fasting blood glucose, and body mass index and improved the physical and psychological domains of quality of life. CONCLUSIONS: The evidence from this meta-analysis reveals that theory-based nursing interventions have a positive effect on fasting blood glucose, body mass index, and quality of life. However, their effects on blood lipid profile, blood pressure, and a healthy lifestyle are inconclusive. The results of this metanalysis are largely based on a few trials and were limited in terms of the number of outcomes. Conducting well-designed randomized controlled trials with adequate power is needed to make a firm conclusion on the influence of theory-based nursing interventions on patient outcomes in the CHD population. CLINICAL RELEVANCE: Considering the high mortality and morbidity of coronary heart disease, nurses may play a significant role in coronary heart disease management by providing interventions that are based on a certain theoretical framework. This meta-analysis provides insights into the implementation of theory-based nursing interventions in heart attack survivors or those newly diagnosed with coronary heart disease led by nurses and lasting longer than 6 months in coronary heart disease. In addition, future studies should consider enhancing the content of training programs for a healthy lifestyle within the theory-based nursing interventions and compare the effects of these interventions on acute and chronic coronary syndromes.

Symptom status, body perception, and risk of anxiety and depression in breast cancer patients receiving paclitaxel: a prospective longitudinal study.

BACKGROUND: Paclitaxel regimen which is widely used in clinical treatment causes many negative physical and psychological consequences on women with breast cancer (BC). This longitudinal study firstly aimed to investigate symptom status, body perception changes, and the risk of anxiety and depression in BC patients receiving during paclitaxel regimen. MATERIALS AND METHODS: This descriptive and prospective study was conducted with 84 BC patients receiving paclitaxel regimen. "Chemotherapy Symptom Assessment Scale (C-SAS)," "Body Perception Scale (BPS)," and "Hospital Anxiety and Depression Scale (HADS)" were applied at five time points (T1, before the first Paclitaxel infusion; T2, at the end of first cycle; T3, at the end of fourth cycle; T4, at the end of eighth cycle; T5, at the end of twelfth cycle). Data was analyzed using descriptive statistics, Cochrane Q, and linear mix model regression analysis. RESULTS: The frequency of needling and numbness in hands and feet, pain, and skin or nail changes significantly increased in the subsequent assessment points (T2, T3, T4, and T5) compared to the initial assessment (T1) (p < 0.05). The mean scores of BPS significantly decreased at T2, T4, and T5 compared to T1 (F = 8.152, p < 0.001). The mean scores of the anxiety subscale of the HADS scale decreased at the T3, T4, and T5 compared to T1 (F = 6.865, p < 0.001), and the mean scores of the depression subscale significantly increased at the T5 compared to T1 (F = 3.708, p = 0.006). CONCLUSIONS: The oncology nurse should comprehensively evaluate the patients who scheduled to receive paclitaxel treatment, and provide counseling to the patients during these specific weeks. Better management of the symptoms that increase with the paclitaxel regimen with repeated interviews under the supervision of the nurse will also prevent the deterioration of body perception. In addition, since the risk of depression increases over time in patients receiving paclitaxel, nurses should periodically screen the risk of depression, and timely consult the patients for the appropriate support.

Benson Relaxation Technique Combined With Music Therapy for Fatigue, Anxiety, and Depression in Hemodialysis Patients: A Randomized Controlled Trial.

This study aimed to investigate the effects of the Benson relaxation technique combined with music therapy on fatigue, anxiety, and depression levels of patients undergoing hemodialysis. This randomized controlled study was conducted with 61 patients (30 patients in the intervention group, 31 patients in the control group) in a province located in Turkey. This 8-week, randomized, clinical trial was carried out in 2 hemodialysis units. After the patients in both groups were informed about the study, the Piper Fatigue Scale and the Hospital Anxiety and Depression Scale were administered to the patients. All subdomain scores of the Piper Fatigue Scale in the intervention group were significantly lower at weeks 4, 8, and 10 than those of the control group (P < .05). The intervention group had significantly lower Anxiety subscale scores than those of the control group at week 10 (P < .05). Similarly, Depression subscale scores were significantly lower in the intervention group at weeks 8 and 10 than those in the control group (P < .05). The findings suggest that Benson relaxation technique combined with music therapy is an effective approach to manage fatigue, anxiety, and depression symptoms related to hemodialysis.

Classical Massage and Relaxation Exercise on Symptom Status and Quality of Life in Advanced Stage Patients With Heart Failure: A Randomized Controlled Trial.

This randomized controlled study aimed to investigate the effects of classical massage (CM) and Benson relaxation exercise (BRE) on symptom status and quality of life (QoL) in patients with heart failure (HF). Seventy-two patients with HF were recruited from 4 hospitals in Ankara, Turkey. The study sample was allocated to a CM (n = 24), BRE (n = 26), or control group (n = 22) based on the New York Heart Association classification of HF (stages III and IV) through stratified randomization. The intervention groups received either CM or BRE twice daily for 7 days (total of 14 sessions). The control group received only routine care. The scores of symptom status decreased in the CM and BRE groups at the end of the intervention (first week) as compared with the control group (P < .05). Nevertheless, at the end of the monitoring period, no significant differences were detected between the 3 study groups at baseline (P = .474), week 1 (P = .936), and week 3 (P = .668) in terms of QoL scores. The CM and BRE showed beneficial effects in the management of HF symptoms in advanced stage HF patients who were hospitalized and received intensive treatment.

Effects of Aloe vera in adults with mucocutaneous problems: A systematic review and meta-analysis.

AIMS: To analyse the different types of Aloe vera (AV) effects on various mucocutaneous problems among adults. DESIGN: A systematic review and meta-analysis. DATA SOURCES: An exhaustive scanning of PubMed, Medline, ScienceDirect, and Google Scholar databases was conducted from January 2000-December 2019. REVIEW METHODS: Randomized controlled trials (RCTs) publishing reports on the effects of AV in various mucocutaneous problems, psoriasis, burn, wound-healing were included. The standardized mean differences (SMD) with 95% confidence Intervals (CIs) were determined for the main outcomes, heterogeneity was analysed using the I2 test and the risk of bias in the studies was reviewed by the Cochrane risk of bias assessment tool. RESULTS: The study included 23 trials with a total of 4,023 participants. Six trials were included in the meta-analysis. The results indicated no significant differences in pain scores as assessed by the Visual Analog Scale (VAS) (SMD = 0.11, 95% CI: -0.37 to 0.59). The Psoriasis Area Severity Index (PASI) scores were significantly lower following AV gel application in two of the studies (SMD = -1.32 95% CI: -1.86 to -0.78). Considering results in a systematic manner, AV accelerated tissue epithelialization and wound-healing process (N = 3), reduced oral mucositis (N = 3), and improved quality of life (N = 1). CONCLUSION: AV might have beneficial effects in reducing pain scores and the severity of mucocutaneous problems compared with placebo, especially with limited mild to moderate adverse effects. IMPACT: AV may be used as an alternative and integrative approach to reducing symptom severity in mucocutaneous problems and the wound-healing process. High quality and well-designed RCTs are still needed to elucidate the effects of AV in a variety of dosages and forms among adults with mucocutaneous problems.

The Prevalence of Complementary and Integrative Health Approach Use and Quality of Life Among Patients With Heart Failure: A Cross-sectional, Descriptive, and Comparative Study.

This study aimed to determine the prevalence of complementary and integrative health approach (CIHA) use in patients with heart failure (HF) and compare quality of life (QoL) between CIHA users and nonusers. This was a cross-sectional, descriptive, and comparative study including 130 patients with HF in Turkey. The data were collected using the sociodemographic and CIHA information form and the Kansas City Cardiomyopathy Questionnaire (KCCQ). The mean age was 64.51 ± 10.40 years. Furthermore, 26.1% of the participants had used at least one form of CIHA in the previous year. The most used CIHA was herbal therapies (94.2%). The total scores of the KCCQ were 47.70 ± 9.50 in the study, and a statistically significant difference was found in the total scores of the KCCQ between CIHA users and nonusers. The findings of this study revealed that more than a quartile of patients with HF used at least one form of CIHA. Further prospective studies are warranted to follow up with patients having HF who use any form of CIHA for a longer period and determine other parameters that directly influence QoL.

Progressive Muscle Relaxation and Mindfulness Meditation on Neuropathic Pain, Fatigue, and Quality of Life in Patients With Type 2 Diabetes: A Randomized Clinical Trial.

PURPOSE: To examine the effects of progressive muscle relaxation and mindfulness meditation on the severity of diabetic peripheral neuropathic pain (DPNP), fatigue, and quality of life in patients with type 2 diabetes. DESIGN: An assessor-blinded prospective randomized controlled trial. METHODS: Participants were randomly assigned to the relaxation group (RG; n = 28), meditation group (MG; n = 25), or control group (CG; n = 24). The mean age of participants was 64.2 ± 8.1 years in the RG, 61.6 ± 8.0 years in the MG, and 64.1± 6.6 years in the CG. Patients in the intervention groups performed progressive muscle relaxation or mindfulness meditation at their home for 12 weeks, 20 min daily. The CG received only an attention-matched controlled education on pancreas anatomy and diabetes. Data collection was performed at baseline and at weeks 12 and 14 using the VAS, FACIT Fatigue Scale (FACIT-F), and Neuropathic Pain Impact on Quality of Life Questionnaire (NePIQoL). FINDINGS: VAS scores were significantly lower in the RG and MG at week 12 (p < .05) and were statistically significant in the RG at week 14. Additionally, fatigue severity decreased significantly in the RG at weeks 12 and 14, compared to that in the CG (p < .05). While no significant difference was found in the quality of life scores between the study groups at weeks 12 and 14 (p > .05), a significant improvement in quality of life scores in the RG were provided at week 12 compared to those at baseline and week 14 (p < .05). CONCLUSIONS: Both progressive muscle relaxation and mindfulness meditation had a positive impact on providing pain relief in patients with DPNP. Moreover, progressive muscle relaxation also appeared to have a beneficial effect on fatigue. CLINICAL RELEVANCE: Based on the results, progressive muscle relaxation and mindfulness meditation can be recommended as supportive therapies for the management of DPNP.

The effects of nurse-driven self-management programs on chronic obstructive pulmonary disease: A systematic review and meta-analysis.

AIMS: To analyse the effects of nurse-driven self-management (SM) programs on physical and psychosocial health variables in people with chronic obstructive pulmonary disease (COPD). DESIGN: A systematic review and meta-analysis. DATA SOURCES: An exhaustive scanning of PubMed, Cochrane Controlled Register of Trials, CINAHL, ScienceDirect and Medline databases between January 2010-December 2019 was conducted for this meta-analysis. REVIEW METHODS: Randomized controlled trials (RCTs) related to nurse-driven SM programs in COPD population were included. The standardized mean differences with 95% confidence intervals were determined for the main variables and heterogeneity was analysed using the I2 test. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used. RESULTS: Twelve studies were included. The results indicated that significant difference in physical health scores based on COPD Assessment Tool (CAT) and walking distance according to the 6-min walk distance (6MWD) test in the intervention groups compared with the control groups. About psychosocial health findings, the quality of life increased and the Hospital Anxiety and Depression Scale (HADS) scores decreased following SM programs. All of the studies had good quality (varying from 5-8 points) according to The Modified Jadad Scale. CONCLUSION: Nurse-driven SM programs may contribute to prognosis in patients with COPD. Due to methodological weaknesses in the included trials, high-quality RCTs are needed to better determine the effects of nurse-driven SM programs in the management of COPD. Nurse-driven SM programs may be employed as a useful strategy to improve health status and QOL and psychosocial health in the COPD population, as well. IMPACT: Current evidence shows that nurse-driven SM programs could be safely integrated into the clinical practice for patients with COPD. Future studies are warranted that evaluating the effects of nurse-driven SM programs on other frequently observed COPD symptoms such as dyspnoea, fatigue and sleep disturbance.

Mind-Body Interventions for Individuals With Heart Failure: A Systematic Review of Randomized Trials.

BACKGROUND: The effects of mind-body interventions (MBIs) (eg, Tai Chi, yoga, meditation) for individuals with heart failure (HF) have not been systematically evaluated. METHODS AND RESULTS: We performed a systematic review of randomized controlled trials (RCTs) examining the effects of MBIs in HF. We extracted participant characteristics, MBI procedure, outcomes assessed, and main results of English-language RCTs before October 2016. We identified 24 RCTs (n = 1314 participants) of 9 MBI types: Tai Chi (n = 7), yoga (n = 4), relaxation (n = 4), meditation (n = 2), acupuncture (n = 2), biofeedback (n = 2), stress management (n = 1), Pilates (n = 1), and reflexology (n = 1). Most (n = 22, 95.8%) reported small-to-moderate improvements in quality of life (14/14 studies), exercise capacity (8/9 studies), depression (5/5 studies), anxiety and fatigue (4/4 studies), blood pressure (3/5 studies), heart rate (5/6 studies), heart rate variability (7/9 studies), and B-type natriuretic peptide (3/4 studies). Studies ranged from 4 minutes to 26 weeks and group sizes ranged from 8 to 65 patients per study arm. CONCLUSIONS: Although wide variability exists in the types and delivery, RCTs of MBIs have demonstrated small-to-moderate positive effects on HF patients' objective and subjective outcomes. Future research should examine the mechanisms by which different MBIs exert their effects.

Perspectives of Oncology Nurses on Complementary and Alternative Medicine in Turkey: A Cross-Sectional Survey.

In Turkey, between 22.1% and 84.1% of patients with cancer use complementary and alternative medicine (CAM). However, few CAM-related studies have focused on the perspective of oncology nurses. This study aimed to determine the knowledge, attitudes, and practices of Turkish oncology nurses regarding CAM. A descriptive cross-sectional survey of 127 participants was conducted in Ankara, Turkey. A semistructured questionnaire including characteristics, knowledge, attitudes, and practices of oncology nurses toward CAM was administered to participants. We found that more than half of nurses (54.0%) surveyed had no information on CAM modalities. Most oncology nurses (81.1%) used audiovisual media sources to obtain CAM information. Many nurses (81.3%) reported not using any CAM in cancer care, and only 26.8% recommended CAM to patients. Most nurses used CAM to accelerate wound healing (19.7%) and to manage symptoms, including constipation and diarrhea (8.8%) and anxiety (7.9%). Music (52.8%), massage (49.6%), and exercise (48.8%) were stated to be beneficial. Important barriers to use CAM for patients with cancer involved a lack of knowledge (60.6%); needing physician approval to apply any CAM methods to patients (52.1%); legal and institutional issues (47.2%); and limited educational, training, or certificate programs (44.1%). There is a need for increased knowledge about CAM by oncology nurses, considering their vital role in symptom management of patients with cancer. This can be achieved through solving legal and institutional problems, structured and comprehensive education/training programs, and the integration of CAM therapy into cancer care guidelines.

Aromatherapy Massage for Neuropathic Pain and Quality of Life in Diabetic Patients.

PURPOSE: This study aimed to examine the effects of aromatherapy massage on neuropathic pain severity and quality of life (QoL) in patients suffering from painful diabetic neuropathy. DESIGN AND METHODS: This open-label randomized controlled clinical study was conducted in a university hospital endocrine outpatient clinic in Turkey. The study sample consisted of 46 patients, randomly allocated to an intervention group (n = 21) and a control group (n = 25). The intervention group received aromatherapy massage three times per week for a period of 4 weeks. The control group received only routine care. Data were collected from patients using the Douleur Neuropathique questionnaire, the visual analog scale, and the Neuropathic Pain Impact on Quality of Life questionnaire. FINDINGS: Neuropathic pain scores significantly decreased in the intervention group compared with the control group in the fourth week of the study. Similarly, QoL scores significantly improved in the intervention group in the fourth week of the study. CONCLUSIONS: Aromatherapy massage is a simple and effective nonpharmacological nursing intervention that can be used to manage neuropathic pain and improve QoL in patients with painful neuropathy. CLINICAL RELEVANCE: Aromatherapy massage is a well-tolerated, feasible, and safe nonpharmacological method that can be readily integrated into clinical settings by nursing staff. The essential oils rosemary, geranium, lavender, eucalyptus, and chamomile can be safely used by nurses in the clinical setting, if applicable. However, training and experience of nurses in aromatherapy massage is critical to achieving positive results.

The Effects of Aromatherapy Massage and Reflexology on Pain and Fatigue in Patients with Rheumatoid Arthritis: A Randomized Controlled Trial.

Nonpharmacologic interventions for symptom management in patients with rheumatoid arthritis are underinvestigated. Limited data suggest that aromatherapy massage and reflexology may help to reduce pain and fatigue in patients with rheumatoid arthritis. The aim of this study was to examine and compare the effects of aromatherapy massage and reflexology on pain and fatigue in patients with rheumatoid arthritis. The study sample was randomly assigned to either an aromatherapy massage (n = 17), reflexology (n = 17) or the control group (n = 17). Aromatherapy massage was applied to both knees of subjects in the first intervention group for 30 minutes. Reflexology was administered to both feet of subjects in the second intervention group for 40 minutes during weekly home visits. Control group subjects received no intervention. Fifty-one subjects with rheumatoid arthritis were recruited from a university hospital rheumatology clinic in Turkey between July 2014 and January 2015 for this randomized controlled trial. Data were collected by personal information form, DAS28 index, Visual Analog Scale and Fatigue Severity Scale. Pain and fatigue scores were measured at baseline and within an hour after each intervention for 6 weeks. Pain and fatigue scores significantly decreased in the aromatherapy massage and reflexology groups compared with the control group (p < .05). The reflexology intervention started to decrease mean pain and fatigue scores earlier than aromatherapy massage (week 1 vs week 2 for pain, week 1 vs week 4 for fatigue) (p < .05). Aromatherapy massage and reflexology are simple and effective nonpharmacologic nursing interventions that can be used to help manage pain and fatigue in patients with rheumatoid arthritis.

Update on occupational health nursing through 21st century requirements: A three-round Delphi study.

BACKGROUND: Occupational health nurses have promoted health and practiced at a strategic level for many years, and are closely aligned with public health and policies, workplace and environmental regulations, and changes in the nursing profession. OBJECTIVE: This study was carried out to create a consensus text on the definition, qualifications, responsibilities, and education of occupational health nurses based on the 21st century requirements. DESIGN AND METHODS: A Delphi panel of public health nursing academicians, occupational health nurses, other health professionals, faculty members of public health, and occupational physicians. A consensus-building approach using three rounds of e-Delphi technique were used, with 45 participants in the first round, 41 in the second round, and 36 in the third round. Data were collected in all three rounds with Google Forms between October 28, 2021, to February 28, 2022. Qualitative content analysis was performed in the first round, and mean, standard deviation, median, and mode values were presented based on the answers to the 5-point Likert questions in the second and third rounds. Values of at least 80 % and above were used for the consensus text in the third round. RESULTS: 62.2 % of the participants were female. The mean age was found 47.71 ± 11.03 years. The experts reached a consensus on the definition of occupational health nurse by emphasizing professionalism, effective communication, record keeping, nursing knowledge, skills, equipment, and competence in the field, with a participation of 91.7 %. A consensus was reached on the qualifications including observation, examination, evaluation, research, health promotion, compliance with confidentiality and ethical rules, and working in harmony with the team, with a participation of 94.4 %. The responsibilities of occupational health nurses included to create a healthy and safe workplace, participate in periodic health examinations, maintain effective communication with employees, acting in accordance with ethical principles, provide continuous professional development, and perform health education and promotion, guidance, and counseling. Experts specified that occupational injuries and diseases, duties, authorities, and responsibilities of the occupational health nurse, occupational health and safety legislation, health education, risk assessment, effective communication, and health literacy need to be integrated into the content of certificate program with 97.7 % participation. A maximum of 500 h for the total duration of the certificate training was suggested. CONCLUSIONS: The expert panel opinions provide a wide perspective for competencies, and educational standards of occupational health nurses. The results could assist in initiating the infrastructure of multidisciplinary postgraduate education programs, developing national and international collaborations, and increasing the number of scientific events should contribute to the professional development of occupational health nursing. Future research should focus on imbedding these consensus items in national and international certificate programs to prepare qualified advanced occupational health nurses.

Complementary and alternative therapies from the Turkish Physician's perspective: An embedded mixed-method study.

PURPOSE: This study aimed to elucidate the attitudes of Turkish physicians toward complementary and alternative medicine (CAM). METHODS: This mixed-method study was carried out on Turkish physicians (n = 103). Eight participants were personally interviewed in detail. The attitudes of the physicians were obtained after the quantitative phase and were analyzed using qualitative content analysis. Data were collected using the Holistic Complementary and Alternative Health Questionnaire (HCAMQ), and socio-demographics. RESULTS: The mean HCAMQ scores were 34.98 ± 4.65. Prevailing themes were: (1) the placement of CAM in medicine, (2) unclear aspects of CAM, (3) underlying factors of attitudes toward CAM, (4) acceptance of CAM subject to conditions, (5) reactions to CAM usage, and (6) popular CAM approaches and their positive effects. CONCLUSION: The majority of physicians were skeptical about CAM but reported being non-judgmental toward patients that had used CAM. However, they also highlighted that considering evidence-based outcomes.

Effects of progressive muscle relaxation combined with music on stress, fatigue, and coping styles among intensive care nurses.

AIM: To examine the effects of progressive muscle relaxation combined with music on stress, fatigue and coping styles amongst intensive care unit (ICU) nurses. DESIGN: A randomised controlled trial of 56 nurses aged 18  years and older, with at least three months experience. The intervention group (n = 28) received a 20 minute session comprising progressive muscle relaxation combined with music for a total of eight weeks in the form of group sessions, while the control group (n = 28) received only a single-time face-to-face attention-matched education (20  minutes). The data collection tools were administered at baseline, at week four, eight and twelve. SETTING: Internal Medicine, Anaesthesia, and Coronary Intensive care Unit of a training and research hospital. MAIN OUTCOME MEASURES: Primary outcome: Stress level. Secondary outcome: Fatigue severity and coping styles. RESULTS: Stress scores in the intervention group decreased significantly at week 8 and week 12 (p < 0.05). Similarly, the fatigue scores were observed to be significantly lower in the intervention group at week 8 and week 12 in comparison to those in the control group (p < 0.05). The scores of coping styles, obtained for the acceptance sub-dimension were significantly higher in the intervention group compared to the control group at week 4, 8, and 12 (p < 0.05). The use of instrumental support, venting and the emotional support scores were observed to be significantly higher in the intervention group compared to the control group at week 12 (p < 0.05). CONCLUSION: The results indicated that progressive muscle relaxation combined with music appears to be effective in decreasing stress and fatigue, and in improving the coping styles amongst intensive care nurses. Future studies should be conducted on a larger scale to make conclusions with higher probability.

Usage and attitudes related to complementary and alternative medicine among Turkish academicians on the basis of the five-factor model of personality: A multi-centered study.

OBJECTIVES: As the popularity of complementary and alternative medicines (CAM) is increasing, it is important to understand the characteristics of people that make them to be attracted toward CAM and influence their attitudes. The purpose of the present study was to examine the associations between the socio-demographic characteristics of people as assessed by the a five-factor model and the attitudes toward CAM modalities among Turkish academicians. DESIGN: An online survey was completed by 227 academicians who were working in three leading universities of Turkey. MAIN OUTCOME MEASURES: The academicians were queried anonymously on socio-demographics and which CAM modalities they utilized, by filling out the Ten-Item Personality Inventory (TIPI) and the Holistic Complementary and Alternative Health Questionnaire (HCAMQ). RESULTS: In regard to the intention of using a CAM modality in the academicians, 75.3% of the academicians specified an intention to use at least one form of CAM in their lives. Among all the academicians surveyed, 38.8% reported using at least one form of CAM in the previous year. The most widely used forms of CAM observed were herbal therapies and mind-body therapies (18.5%), touch-based therapies (15.4%), and multi-vitamin (4.8%). The ratio of CAM usage in the previous year was observed to be lower in the academicians working in the health-related professions. The present study also identified that the academicians with openness personality-type exhibited greater positive attitudes toward CAM (p < 0.05). CONCLUSIONS: The findings of the present study indicated that the academicians who are open to experience, as assessed by the five-factor model of personality, exhibited greater positive attitudes toward CAM. More than 60% of academicians agreed that CAM should be integrated into the curriculum, the remaining participants were unsure and disagreed. Therefore, the required feasibility studies to integrate CAM courses into the curriculum of Turkish medical and nursing schools are recommended as a priority.

The Perceived Caregiver Burden Among Turkish Family Caregivers Providing Care for Frail Older Adults.

PURPOSE: The older population has reached to 8.5%, and the prevalence of frailty is reported as 39.2% in Turkey. The purpose of the study was to assess caregiver burden in families who care for frail older adults in Turkish culture. METHOD: This descriptive study was conducted in Turkey between June and October 2017. Frail older adults who had no severe cognitive impairment were included. Data were measured using the Older Adult Information Form, Edmonton Frailty Scale, Caregiver Information Form, and Zarit Burden Interview. RESULTS: In total, 131 older person/caregiver dyads were analyzed; the Zarit Burden Interview mean score was 37.59 ± 18.20. Caregivers with less education and providing care more than 8 hours experienced a higher burden ( p < .05). The severity of frailty significantly correlated with the caregiver scores ( R = .36, p < .01). CONCLUSION: The caregiver burden in Turkish family caregivers was found mild to moderate and correlated with the degree of frailty. Policymakers should focus on culture-specific formal caregiver services.

Effects of progressive muscle relaxation and mindfulness meditation on fatigue, coping styles, and quality of life in early breast cancer patients: An assessor blinded, three-arm, randomized controlled trial.

PURPOSE: This study aimed to investigate the effects of progressive muscle relaxation (PMR) and mindfulness meditation (MM) on fatigue, coping styles, and quality of life (QOL) in patients with early breast cancer receiving adjuvant paclitaxel. METHODS: The participants were randomly assigned to either a 12-week (PMR) (n = 31) and MM (n = 32) interventions or control group (CG) (n = 29). The intervention groups continued PMR or MM for 20-min every day, for a total of 12 weeks. The CG received only a single time attention-matched education (15-min) on breast cancer before the start of the paclitaxel regimen. Data collection tools included the Patient Information Form, Brief Fatigue Inventory (BFI), Brief COPE, and Functional Living Index-Cancer (FLIC). Data were collected at baseline, week 12, and week 14. RESULTS: A significant reduction in the BFI scores was reported in the PMR and MM groups when compared with the CG at weeks 12 and 14 (p = .002). Similarly, the use of emotional support and positive reframing sub-dimension scores of Brief COPE were significantly higher in the PMR and MM than in the CG at weeks 12 (p = .017) and 14 (p = .042). Furthermore, the planning and active coping sub-dimension scores were significantly higher in the PMR and MM than in the CG at week 14 (p = .000). Regarding QOL scores, no significant differences were observed between the groups at weeks 12 (p = .486) and 14 (p = .095). CONCLUSIONS: PMR and MM are effective interventions that if initiated concurrently with the adjuvant paclitaxel demonstrate similar effects on fatigue and coping styles.

Diabetic Peripheral Neuropathic Pain From the Perspective of Turkish Patients: A Qualitative Study.

INTRODUCTION: Diabetic peripheral neuropathy (DPN) affects almost 30% to 50% of patients with diabetes, 40% to 60% of whom suffer from diabetic peripheral neuropathic pain (DPNP). Few studies have focused on individual experiences of DPNP in patients with diabetes. The purpose of this qualitative study was to elucidate the effects of DPNP on daily life and individual feelings regarding living with DPNP from the perspective of Turkish patients. METHOD: A total of 14 patients were interviewed, and interpretative phenomenological analysis was used to identify themes. RESULTS: Findings indicated four main themes, including (a) physical limitations, (b) difficulties with daily routines, (c) social limitations, and (d) psychological impacts such as emotional changes, and being a burden on family. CONCLUSION: This study revealed that the majority of patients carry significant concerns about becoming a burden on their family and are afraid of becoming dependent on others because of DPNP. IMPLICATION FOR PRACTICE: For the effective management of DPNP, health professionals need to consider using a holistic approach to address difficulties in daily living such as physical limitations and sexual problems.