Attitudes of Different Religions Toward Surrogacy: Analysis of 11 Countries' Situation Using Machine Learning Approach and Artificial Neural Networks.

Individuals may develop different attitudes on bioethics in general and reproductive ethics in particular, due to the effects of different sociocultural environments. Individuals' attitudes toward surrogacy are affected positively or negatively depending on religious and cultural environments. This study was conducted to determine and compare the attitudes of different religions toward surrogacy. This study is cross-sectional and collected from individuals living in Turkey, India, Iran, the Turkish Republic of Northern Cyprus, Madagascar, Nepal, Nigeria, Pakistan, Mexico, England, and Japan between May 2022 and December 2022. The study was conducted with individuals belonging to Islam, Christianity, Hinduism, Buddhism, and Atheism. The study was conducted with 1177 individuals from different religions who agreed to participate in the study by snowball sampling method. The introductory Information Form and "Attitude Questionnaire Toward Surrogacy" were used as data collection tools. R programming language 4.1.3 was used for regression analysis with machine learning approach and artificial neural networks, and SPSS-25 was used for other statistical analyses. There was a significant difference between the total mean score of the individuals' Attitudes toward Surrogacy Questionnaire and their religious beliefs (p < 0.05). When the results of the analysis of the regression model with the dummy variable, which was carried out with the aim of revealing the effects of religious belief on the attitude toward surrogacy, are examined, statistical estimates of the regression model show that the model is significant and usable F(4,1172) = 5.005, p = 0.001). It explains 1.7% of the total variance of the level of religious belief's attitude toward surrogacy. In the regression model, when the t-test results regarding the significance of the regression coefficient are examined, among the participants, it was determined that the mean score of those who believed in Islam (t = - 3.827, p < 0.001) and those who believed in Christianity (t = - 2.548, p < 0.001) was lower than the mean score of those who believed in Hinduism (Constant) (p < 0.05). Individuals' attitudes toward surrogacy differ according to their religion. The best performing algorithm for the prediction model was random forest (RF) regression. The contributions of the variables to the model were calculated with Shapley values (Shapley Additive Explanations (SHAP)). The SHAP values of the variables in the best performing model were examined to avoid bias in terms of comparison in the performance criterion. SHAP values (Shapley Additive Explanations) show the contribution or importance of each variable in the estimation of the model. It is determined that the most important variable that should be in the model to predict the Attitude Toward Surrogacy Survey variable is the Nationality variable. It is recommended that studies on attitudes toward surrogacy should be conducted by taking religious and cultural values into consideration.

Investigation of the impact of paediatric hospices on the quality of care of paediatric nurses.

BACKGROUND: The establishment of paediatric hospices improves the quality of care of paediatric nurses. AIM: To examine the effect of establishing paediatric hospices on the quality of care of paediatric nurses. METHODS: Data was collected between 22 October 2022 and 25 February 2023. An online survey method was used to collect sociodemographic data and paediatric hospice data for paediatric nurses and a scale was used to determine the opinions of nurses working in the field of paediatrics. A total of 300 paediatric nurses who voluntarily participated in the collection of the research data were selected with the convenience sampling method, with written consent. SPSS 26.0 data analysis programme was used in the statistical analysis of the data obtained in the study, and Independent Sample t-test and ANOVA analysis were used in the analysis of the data. FINDINGS: Of the participating paediatric nurses, 60.9% were women, 39.1% were men, 41.1% were married, 65.9% were between the ages of 22-33, and 71.6% worked at a paediatric hospice. There was no significant difference in paediatric hospice scale scores according to sociodemographic variables such as gender, age, marital status, education level and the health institution worked by paediatric nurses (p>.05). There was a significant difference in paediatric hospice scale scores according to hospice information. It was determined that the establishment of paediatric hospices had an effect on the quality of care (p<.01). CONCLUSION: Paediatric nurses felt that the establishment of paediatric hospices would improve the quality of care of children at the end of life. It is recommended that applications and studies on the establishment and structuring of paediatric hospices should be carried out by expanding the samples, not only in the field of paediatric nursing, but also in all nursing fields.