Breastfeeding self-efficacy in terms of sleep quality, perceived social support, depression and certain variables: a cross-sectional study of postpartum women in Turkey.

BACKGROUND: Breastfeeding self-efficacy is one of the key factors that affect a healthy and successful breastfeeding process. A mother's belief regarding her ability to breastfeed is influenced by social and psychological factors. This study aimed to investigate the breastfeeding self-efficacy levels of postpartum women, the factors affecting this, and its relationship with sleep quality, social support and depression. METHODS: This descriptive cross-sectional study was conducted in the pediatric department of a tertiary hospital in Ankara, Turkey. Data were collected from 200 postpartum women using the Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF), the Pittsburgh Sleep Quality Index (PSQI), the Multidimensional Scale of Perceived Social Support (MSPSS) and the Edinburgh Postnatal Depression Scale (EPDS). RESULTS: The mean scores of the BSES-SF, PSQI, MSPSS and EPDS were 59.05 ± 8.28, 9.18 ± 3.67, 57.82 ± 18.81, and 8.98 ± 5.89, respectively. A statistically significant negative correlation was found among the BSES-SF, EPDS (r = -0.445, p = 0.001) and PSQI (r = -0.612, p = 0.004), while a positive correlation was found among the BSES-SF, total MSPSS (r = 0.341, p = 0.036), and family support (r = 0.373, p = 0.014) (p < 0.05). In addition, a statistically significant difference was found between the number of births and breastfeeding self-efficacy (F = 3.68; p = 0.001). The linear regression analysis revealed that sleep quality (ß = -0.491, p = 0.001), perceived social support (ß = 0.146, p = 0.015), family support (ß = 0.153, p = 0.013), and depression (ß = -0.228, p = 0.001) emerged as the predictors of breastfeeding self-efficacy. CONCLUSIONS: In this study, the increase in sleep quality and perceived social support positively affected the breastfeeding self-efficacy of postpartum women, while giving birth for the first time and an increase in the risk of depression were negatively affected.

The knowledge, attitudes and practices of healthcare workers on drug hypersensitivity reactions in children: A tertiary centre experience from Turkey.

INTRODUCTION: Adverse drug reactions are an important public health concern that affects doctor and dentist prescriptions and healthcare workers' practice. We planned to evaluate the knowledge, attitudes and practices of healthcare workers in our country about drug hypersensitivity reactions in paediatric patients and to determine the risk factors that may affect them. METHOD: This study was carried out in a capital-located university hospital. Healthcare workers authorized to intervene in children (0-18 age group), including medical doctors, nurses, and dentists, were enrolled in the study. The study questionnaire was developed by paediatric allergy and immunology specialists and paediatric nurses by considering the other studies on the same subject. RESULTS: Three hundred fifty-four (88.5%) out of 400 healthcare workers, whose study survey was distributed, returned to us by filling the questionnaire. According to the groups of the profession, there was a statistically significant difference between the average of correct answers given to the questions evaluating knowledge levels (P < .001). The doctors' knowledge score (M ± SD 18.6 ± 2.1) was the highest. The general attitudes of healthcare workers towards drug hypersensitivity reactions in children were similar and were positive (P < .053). However, general practice patterns were significantly different (P < .001). Nurses were observed to practice more positively than doctors and dentists. As the healthcare worker gets older, his practice score increased by 0.546; on the other hand, being a resident reduced the score from the practice score by 3.770. CONCLUSION: Our results suggest that advanced training programmes must be provided for healthcare workers in learning drug hypersensitivity reactions, particularly in paediatric patients.

A novel assessment tool for clinical care of patients with autoinflammatory disease: juvenile autoinflammatory disease multidimensional assessment report.

OBJECTIVES: To develop and test a new multidimensional questionnaire for assessment of children with auto-inflammatory disease (AID) such as FMF, PFAPA, HIDS, TRAPS in standard clinical care. METHODS: The juvenile auto-inflammatory disease multidimensional assessment report (JAIMAR) includes 16 parent or patient-centered measures and four dimensions that assess functional status, pain, therapeutic compliance and health-related quality of life (physical, social, school, emotional status) with disease outcome. It is proposed for use as both a proxy-report and a patient self-report, with the suggested age range of 8-18 years for use as a self-report. RESULTS: 250 children with FMF were included in the study. Total of 179 forms were filled up by parents and patients, and 71 forms were filled up by parents having children less than 8 years. Completing and scoring the JAIMAR can be done in 15 minutes. For the JAIMAR's dimensions, the Cronbach's alpha coefficient for internal consistency was between 0.507-0.998. There was a significant and a positive correlation between the test-retest scale scores (ICC=0.607-0.966). Concerning construct validity, all factors loadings were above 0.30. For the criterion validity, the correlation level between each dimension and the related scale ranged from medium (r=0.329, p<0.0001) to large (r=0.894, p<0.0001). The parents' proxy-reported and children's self-reported data were outstandingly concordant (r=0.770-0.989). CONCLUSIONS: The development of the JAIMAR introduces a new and multi-dimensional approach in paediatric rheumatology practice. It is a new tool for children with auto-inflammatory dis-ease and it may help enhance their quality of care.

The invisible part of the iceberg: qualitative aspects of childhood vasculitis.

OBJECTIVES: The aim of this study was to develop a multidimensional assessment instrument named 'Juvenile Vasculitis Multidimensional Assessment Report' (J-VAMAR) to measure all the domains of the vasculitis. In this qualitative study, it is primarily aimed to enrich the item generation for the J-VAMAR. METHODS: Twelve children with vasculitis and their mothers (n=12) were enrolled in this study. The data were collected using both a demographic data form and a semi-structured interview form. The study was performed on individual patient face-to face interview. Data were analysed by grounded theory and the N Vivo 9 software program. RESULTS: Four categories were obtained. These categories were (i) physical effects of the illness, (ii) emotional effects of the illness, (iii) social effects of the illness and (iv) experienced challenges related to treatment process. In the physical effect category severe pain, physical limitations, weakness and fatigue; in emotional effect category thought of death, hopelessness and dissatisfaction about body image; in the social effects category decrease in academic performance, absenteeism to school and concealing the sickness from friends were the most common features. In the fourth category, subjects complained of lifelong drug use and frequency of daily drug consumptions. CONCLUSIONS: These results provide evidence-based data for the assessment of children with vasculitis by several domains including physical, emotional and social aspects as well as treatment protocols. The study provides the basis and/or justification for selecting the domains that the developing multidimensional instrument should include.

How simulation training for nursing students in emergency internships affects triage decision-making and anxiety: A quasi-experimental study.

Purpose: This study aimed to determine the effects of simulation-based training on triage decision-making skills and anxiety in fourth-year nursing students. Methods: This study employed an experimental pretest-posttest design and randomly assigned 90 nursing students from adult and pediatric emergency internships to control (n = 48) and intervention groups (n = 42). Although both groups underwent triage decision-making training, only the intervention group received simulation-based triage training. Results: A significant difference in posttest triage decision-making knowledge and anxiety scores was observed between the control and intervention groups (p < 0.05). The posttest triage decision-making knowledge score of the intervention group was significantly higher than the pretest score, whereas the posttest anxiety score was significantly lower. Conclusion: Theoretical triage decision-making training was effective, whereas simulation-based triage training improved the nursing students' knowledge and performance. Therefore, simulation-based training should be integrated into traditional learning methods to improve the triage decision-making skills of nursing students.

Determining Knowledge and Opinions of Neonatal Intensive Care Unit Nurses on Wet-Nursing and Human Milk Banks: A Cross-Sectional Study in Türkiye.

BACKGROUND: Wet nursing and human milk banks are vital sources of human milk for infants unable to breastfeed. RESEARCH AIM: This study aims to determine the knowledge and opinions of neonatal intensive care unit nurses regarding wet-nursing and human milk banks in Türkiye. METHODS: This descriptive cross-sectional study was conducted with 219 neonatal intensive care unit nurses using an online survey comprising 20 questions. The data were collected between August and September 2021. RESULTS: Among the participants, 64.4% (n = 141) expressed that they would be a wet-nurse and 59.8% (n = 131) would search for a wet-nurse if necessary. Some, 47.0% (n = 103) of participants did not know if there were any human milk banks in Türkiye, 53.9% (n = 118) would like to be a donor if human milk banks were established, and 71.7% (n = 157) stated that the establishment of human milk banks should be supported. Religious concerns were the basis for reluctance to donate milk to human milk banks for 60% (n = 51) of the participants. Knowledge was greater and opinions about wet-nursing and human milk banks were more positive for participants with higher education, more time in the neonatal intensive care unit, or work at a tertiary care center. CONCLUSION: The approaches of neonatal intensive care unit nurses towards personally being wet-nurses and milk sharing were generally positive, although more information about human milk banks is needed. Religious beliefs are an important consideration when providing information about milk sharing.

Number of Episodes Can Be Used as a Disease Activity Measure in Familial Mediterranean Fever.

Objective: To evaluate the number of episodes in the past 12 months as an indicator of the overall disease activity status in Familial Mediterranean fever (FMF). Methods: In this cross-sectional study, patients were recruited from tertiary pediatric hospitals. Demographic data, main clinical symptoms of the episodes, treatment modalities, and genetic mutations were recorded. The patients were grouped as no episodes (Group 1), 1-4 episodes (Group 2), and more than 4 episodes (Group 3) according to the number of episodes in the past 12 months. The Pediatric Quality Life Inventory (PedsQL), the Children's Depression Inventory (CDI), and the Wong-Baker FACES Pain Rating Scale (FACES) scores were compared between groups. Concurrent validity between the number of episodes and the patient-reported outcome measures (PROMs) was assessed using Spearman's rank correlation coefficient (ρ). Results: A total of 239 patients were included. There were 74 patients (31%) in Group 1, 99 (41.4%) in Group 2, and 66 (27.6%) in Group 3. Groups were similar according to age, age at diagnosis, gender, consanguinity, family history, history of amyloidosis, clinical symptoms, and in terms of allele frequency (p > 0.05). According to PROMs completed by parents, moderate correlations were found between the number of episodes and the PedsQL score (ρ = -0.48; 95% CI = -0.58 to -0.35, p < 0.001) and between the number of episodes and the Wong-Baker FACES score (ρ = 0.47, 95% CI = 0.35-0.57, p < 0.001). Conclusion: The number of episodes was positively and moderately correlated with patient- and parent-reported outcomes in our cohort. The number of episodes in patients with FMF can be used as a single measure to assess disease activity.

Anxiety, depression, and knowledge level in postpartum women during the COVID-19 pandemic.

PURPOSE: This study aimed to assess anxiety, depression, and knowledge level in postpartum women during the COVID-19 pandemic. DESIGN AND METHODS: This cross-sectional study was conducted on 212 postpartum women using a web-based online survey in Ankara, Turkey. FINDINGS: The prevalence of depression was 34.0%. The mean anxiety and COVID-19 knowledge scores were 42.69 ± 9.93 and 9.69 ± 1.94, respectively. There was a statistically significant difference between the anxiety scores and depression status (p < 0.001) of women. There were statistically significant differences between fear about being infected with COVID-19 for themselves (p = 0.01) and for babies (p = 0.01) and the postpartum depression (PPD). PRACTICE IMPLICATIONS: During the COVID-19 pandemic, early detection and appropriate and timely intervention to prevent and detect anxiety and PPD are crucial to the well-being of a woman.

Turkish Senior Nursing Students' Communication Experience With English-Speaking Patients.

BACKGROUND: Simulation has been widely accepted as a valuable learning method in nursing education programs so that nursing students can learn and develop communication skills. The aim of this study was to evaluate nursing students' communication experience with an English-speaking standardized patient in the context of the Rational Administration of Medicines course. METHOD: Involving both quantitative and qualitative research designs, this descriptive study was conducted with 104 nursing students in Ankara, Turkey, from September 2012 to July 2013. RESULTS: The majority (98.1%) of the participants stated the necessity of improving their English to communicate with English-speaking patients. Three overarching categories, including seven themes, emerged from the description of nursing students' experience: recognition of emotions, experiences during the simulation, and gains. CONCLUSION: Standardized patient practice emphasized the significance of cultural differences, of knowing and using a foreign language, of communication, and of patient safety.