Investigation of nursing students' emotional states toward challenging situations in clinical practice and metaphorical perceptions of the concept of a nurse.

AIM: This study aims to determine nursing students' emotions toward the challenging situations they encounter in clinical practice and their metaphorical perceptions of the concept of a nurse. BACKGROUND: Challenging situations in clinical practice negatively affect nursing students' perceptions of the nursing profession and their professional learning and development. DESIGN: The study is based on quantitative, metaphorical and picture-drawing analysis. METHODS: The quantitative and qualitative parts of it were conducted with 200 nursing students attending their first and second years in the 2021-2022 academic year. The Draw a Picture of a Cactus Test was carried out with 30 students in clinical practice. The data were collected using the "Sociodemographic Information Form" and the "Semi-structured Interview Form". Content analysis techniques, descriptive statistics, picture analysis and psychological tests were used to evaluate the data. The study was reported based on Standards for Reporting Qualitative Research (SRQR). RESULTS: Nursing students involved in the study produced 37 metaphors related to the "concept of a nurse" and three most expressed ones were "mother, lifeguard and helper." The metaphors produced by nursing students were categorized under six roles: "caregiver, educator, supporter, researcher, administrator and therapeutic/rehabilitator". The pictures drawn by the students about the challenging situations in clinical practice and the expressions they used were associated with self-centeredness (n=21), being attentive (n=19), aggression toward peers (n=13), low motivation (n=11) and need for protection (n=11). Nursing students experienced feelings of loneliness, passivity and anxiety when navigating difficult conditions in clinical practice. CONCLUSIONS: Metaphors and picture drawing allow a unique approach to the concept of nursing and nursing students' emotional states toward challenging situations in their clinical practice.

Health-risk behaviors and peer pressure of adolescents in the child protective services in Türkiye: A cross-sectional study.

PROBLEM: This study was carried out to investigate the health-risk behaviors and peer pressure of adolescents aged 12-18 years in need of protection at child protective services. METHODS: The data of this cross-sectional study were collected using individual interviews with 85 adolescents living in child homes and child homes buildings complex between February 25 and May 31, 2019. The data were collected using the "Descriptive Information Form," the "Health-Risk Behaviors Questionnaire," and the "Peer Pressure Questionnaire." FINDINGS: The results of study in adolescents were 34.1% were in the risk group in terms of weight, and 41.2% had a psychiatric problem. Among the health-risk behaviors of adolescents; 56.5% did not pay attention to daily nutrition, 51.8% had fast food every day, 54.1% injury behaviors were doing dangerous sports, only 15.3% wore seat belts, 78.8% did not exercise three or more days per week, 38.8% watched television and computer three or more hours per day, 27.1% used painkillers without consulting a doctor, 24.7% applied the health recommendations they read on the internet, 20.0% of the adolescents reported that they went on a diet without consulting the healthcare personnel, and 14.1% voluntary vomited to lose or maintain their weight. And 21.2% of the adolescents were exposed to peer pressure. CONCLUSIONS: It was concluded that adolescents in need of protection at child protective services have health-risk behaviors and low-level peer pressure.

The association of fear of COVID-19 on occupational stress in pediatric nurses: Examining the mediating role of psychological well-being.

PURPOSE: This study investigated the associations of fear of COVID-19 with occupational stress and the mediating role of psychological well-being in pediatric nurses. METHODS: This cross-sectional study was conducted between December 2021 and February 2022. The sample consisted of 464 pediatric nurses from public or university hospitals in Türkiye. Data were collected using a sociodemographic characteristics questionnaire, the Fear of COVID-19 Scale, the Occupational Stress Scale, and the Psychological Well-Being Scale. The data were analyzed using Pearson's correlation and regression analysis. RESULTS: Participants' fear of COVID-19 was positively associated with their occupational stress (F = 17.263; p < 0.001) but negatively associated with their psychological well-being (F = 10.575; p = 0.001). Their psychological well-being was negatively associated with their occupational stress (F = 22.084; p < 0.001). Nurses fear of COVID-19 explained three and 2 % of their occupational stress and psychological well-being, respectively. Nurses' psychological well-being explained 4 % of their occupational stress. The results showed that participants' psychological well-being did not mediate between their fear of COVID-19 and occupational stress. CONCLUSION: Pediatric nurses fear COVID-19 but have an above-mean level of occupational stress and psychological well-being. In conclusion, psychological well-being does not mediate between pediatric nurses' fear of COVID-19 and occupational stress. PRACTICE IMPLICATIONS: The pandemic was a traumatic experience for pediatric nurses. Hospital administrators and nurse managers must monitor the psychosocial health of pediatric nurses and support them in times of crisis.

The emotional neglect potentials of nurses working in the COVID-19 service towards their children: A qualitative study.

PURPOSE: This study aims to examine in depth the potential child emotional neglect behaviors of nurses working in the COVID-19 service, and their feelings, thoughts, and experiences regarding the causes and effects on their children. DESIGN AND METHODS: The study was designed as a qualitative study based on a descriptive phenomenological approach. A purposeful sample of service providers (N = 22) in the COVID-19 clinics of the region's largest hospital in northeast Turkey in terms of education and patient care were recruited for the study. The data were collected through semi-structured interviews using the individual in-depth face-to-face interview method. The interviews were audio-recorded, transcribed verbatim, and analyzed with Braun and Clarke's thematic analysis method. The research was reported by following Consolidated criteria for reporting qualitative research-COREQ. RESULTS: The findings enabled the identification of four unique themes expressed by the participants: parent-child interaction, social impact, physiological impact, and psychological impact. The first theme consists of adversely affected time nurses spent with their children, decreased physical contact, and communication problems; the second theme includes nurses' and their children's social isolation and social stigma; the third theme includes a change in eating habits and daily activities; the fourth theme includes fear of losing parents and emotional change. CONCLUSIONS AND PRACTICE IMPLICATIONS: To prevent the increased emotional neglect potential due to the COVID-19 pandemic, it is necessary to regulate the working conditions of parents who are nursing professionals and support the parent/child emotionally and psychologically.

Assessment of nurses' respect for patient privacy by patients and nurses: A comparative study.

AIMS: To determine whether nurses respect or violate patient privacy by comparing nurses' and patients' opinions. BACKGROUND: Although nurses want to respect patient privacy, they can sometimes violate patient privacy or not pay enough attention. METHOD: This comparative and cross-sectional study was conducted with 357 patients and 305 nurses in 12 public hospitals in Trabzon, Turkey. Data were collected with an information form and the Patient Privacy Scale. Reporting is consistent with the STROBE checklist for cross-sectional studies. RESULTS: The total mean score of the patient privacy scale was 4.6 ± 0.39 for nurses and 4.5 ± 0.41 for patients, and no significant difference was found between their scores (U = 52999.0; p = .554). Further, the nurses (U = 14358.0; p = .000) and the patients (U = 13272.5; p = .006) in the public hospitals had statistically significantly higher overall privacy scores than those in the training and research hospitals. The overall privacy scale scores were higher and more statistically significant in the patients hospitalised in surgical clinics than those hospitalised in clinics for internal diseases (U = 8514.0; p = .005) and in single compared to married patients (U = 12364.5; p = .034). CONCLUSION: Nurses respected patient privacy highly according to both nurses and patients, and there was no significant difference between their views. However, nurses working in training and research hospitals and internal diseases clinics need to improve their approaches to patient privacy. RELEVANCE TO CLINICAL PRACTICE: The results of this study could be used to reduce patient privacy vulnerabilities in complex hospitals and clinics such as training and research hospitals and to improve institutional policies and activities regarding patient privacy. By comparing the results of patients and nurses, the study provided more consistent and accurate data about patient privacy.

Development of a medical error scale for nurses in Turkey.

BACKGROUND: Medical errors can have an adverse effect on patients, health care providers and health care organizations. Determining the likelihood of such errors is important to implement appropriate and effective solutions to minimize errors. AIMS: The aim of this study was to develop a valid and reliable scale to evaluate the likelihood of medical errors by Turkish nurses. METHODS: The draft scale (with 94 items) was developed based on primary references and the opinions of nursing experts. Content validity was assessed using 15 nursing experts. Construct validity of the scale was assessed with exploratory and confirmatory factor analyses using 298 nurses at a university hospital in Trabzon, Turkey. To assess test-retest reliability of the scale, another group of 50 nurses were included. RESULTS: The content validity index of the scale was 0.82, Cronbach alpha was 0.89, and item-total correlation values ranged from 0.31 to 0.54. Kaiser-Meyer-Olkin was 0.81, Bartlett test was 5909.75, P < 0.0001, and the anti-image correlations ranged between 0.63 and 0.90. In the four rotations done with varimax rotation, 42 items were excluded because their factor loadings were less than 0.45. The final scale had 43 items and six subscales: falls, blood and blood products transfusion, medication practices, care practices, communication, and other controlled practices. The six-subscale structure was confirmed by confirmatory factor analysis, and the fit between the scale and its subscales was good. CONCLUSION: The scale is a valid and reliable tool to collect consistent data on medical errors in the patient-related practices of nurses.

The Investigation of Unplanned Hospital Visits and Admissions in the Children Receiving Chemotherapy.

This study aimed to determine incidence, risk factors of unplanned hospital visits children receiving chemotherapy. The study was conducted with 65 children. Data were collected using form consisting of questions regarding causes of their unplanned hospital visits. Chi-square test were used analysis of data. Three quarters of children receiving chemotherapy were determined to have unplanned hospital visits, majority of them were found to be admitted. Knowing high-risk factors for unplanned hospital visits and admissions of children receiving chemotherapy and applying appropriate interventions for discharge education and home care regarding these factors may contribute to reduce unplanned hospital visits.

The effect of theoretical and simulation training on medical errors of nurse students in Karadeniz Technical University, Turkey.

OBJECTIVE: To assess the efficacy of theoretical training related to medical errors and patient safety and practical simulation training on students' knowledge and skill levels.. METHODS: This experimental study was conducted from March 28 to May 18, 2016, at nursing department of a university and comprised of students attending the third grade of the nursing school. The subjects were divided into two equal experimental and control groups. The experimental group, among other things, received simulation training that involved a demonstration and subsequent one-to-one practice. Data was collected on a proforma that included demographic information, pretest and post-test scores, checklists for pre-assessments and final assessments related to nursing practices. RESULTS: There were 62 nurses divided into two groups of 31(50%) each. The difference between post-test scores of the concerning theoretical training about medical errors and patient safety was statistically significant (p<0.05). Pre-assessment of the groups concerning practical training on nursing skills and medical errors revealed no statistically significant difference (p>0.05), while there was a significant difference between their final assessments (p<0.05). CONCLUSIONS: Theoretical education increased students' levels of knowledge regarding medical errors and patient safety, and the the practical simulation training reduced malpractices by improving skills.

The malpractices of student nurses in clinical practice in Turkey and their causes.

OBJECTIVE: The study was conducted to identify whether or not student nurses made the medical errors as well as the reasons for the errors. METHODS: A study was conducted with 1067 student nurses studying at 12 universities in Turkey. The data were collected by using medical error scale and a questionnaire on demographic characteristics and malpractices. RESULTS: Overall 28% of the student nurses performed malpractice during clinical practice. Medical errors included failure of complying with sterility and asepsis rules (32%), wrong identification of patient identity (19%), and administrating wrong dosage of medications (12%). They obtained a mean score of 4.19±0.62 from the overall scale and the lowest score was 3.9±0.78 for drug administrations. CONCLUSIONS: Nursing students perform considerable amount of malpractice and they should especially improve concerning administration of drugs.

The Effect of Empathy Training on the Empathic Skills of Nurses.

BACKGROUND: The profound impact of empathy training on quality nursing care has been recognized. Studies have shown that there has been little improvement in nurses' communication skills, and that they should work to enhance this area. Relevant training will lead to an improvement in nurses' empathic skills, which in turn, will enable them to understand their patients better, establish positive interpersonal relationships with them, and boost their professional satisfaction. OBJECTIVES: To reveal the effect of empathy training on the empathic skills of nurses. PATIENTS AND METHODS: This study was conducted as an experimental design. The research sample consisted of 48 nurses working at the pediatric clinics of Farabi hospital of Karadeniz Technical University in Turkey (N = 83). Two groups, an experimental group (group 1) and a control group (group 2) were determined after questionnaires were supplied to all nurses in the study sample. At first, it was intended to select these groups using a random method. However, since this may have meant that the experimental and control groups were formed from nurses working in the same service, the two groups were selected from different services to avoid possible interaction between them. The nurses in the Group 1 were provided with empathy training through group and creative drama techniques. Pre-tests and post-tests were conducted on both groups. Data was collected via a questionnaire designed around the topic "empathic skill scale-ESS", developed by Dokmen. The Kolmogorov Smirnov test was employed to assess whether the measurable data was suitable for normal distribution. Data was presented as numbers and percentage distributions, as mean ± standard deviation and Chi-square, and as student t tests and paired t tests. The level of significance was accepted as P < 0.05. RESULTS: The nurses in the experimental group had a mean score of 146.7 ± 38.8 and 169.5 ± 22.1 in the ESS pre-test and post-test, respectively. Although the nurses in the control group had a pre-test mean score of 133.7 ± 37.1, which increased to 135.1 ± 51.7 after the training, no statistically significant difference was found (P = 0.886). A comparison of the groups indicated that they scored similarly in the pre-test. However, the experimental group scored significantly higher than the control group in the post-test (P = 0.270 and P = 0.015, respectively). CONCLUSIONS: In the light of these findings, it is recommended that communication skills should be widely included in in-service training programs; similar studies should be conducted on broader control groups formed through randomization; and a comparison should be made between the findings.

Evaluating medical errors made by nurses during their diagnosis, treatment and care practices.

AIMS AND OBJECTIVES: The aim of this study was to determine whether the nurses committed medical errors and to identify the types of and reasons for the medical errors. BACKGROUND: Medical errors have recently emerged as a significant issue both in Turkey and around the world because they result in the death and disability of a number of people each year. DESIGN: This study was a descriptive study. METHOD: The study was conducted with 1092 nurses working at a university hospital, 12 public hospitals and a private hospital in Trabzon. RESULTS: Twenty-two per cent of the nurses stated that they had made medical errors endangering patient safety, and 4% stated that their medical errors had injured a patient. Of the nurses who made a medical error, 10% indicated that a patient's treatment was delayed and 6% stated that the patient experienced side effects. In addition, 23% of the nurses stated that they had committed medical errors such as delaying/not administering a patient's treatment and 20% stated that they had made medical errors such as using instruments without first checking them. Eighty-three per cent of the nurses stated that they had committed a medical error due to fatigue, 82% were reported to be caused by the hospital's administration due to the limited number of nurses on duty and 75% were caused by physicians and other medical personnel due to a lack of communication. CONCLUSION: Two of five nurses had committed a medical error throughout their career; these errors were due to fatigue, a limited number of nurses and communication problems, and patients were harmed because of these errors. RELEVANT TO CLINICAL PRACTICE: The results of this study could be used to take precautions against nursing medical errors in Turkey and to enhance institutional policies and activities regarding medical errors and patient safety.

The effects of peer education on university students' knowledge of breast self-examination and health beliefs.

This study was carried out to determine the effects of peer education on breast self-examination (BSE) knowledge and health beliefs. 180 female university students were trained in BSE by the nursing students. Students instructed in groups by their peers showed a much higher degree of BSE knowledge. It was also found that perceived confidence of the students educated both individually and in groups increased afterward. Study results further revealed that the methods used for peer instruction do not affect students' sub-dimensions of health beliefs differently after the education.

A different approach to breast self-examination education: daughters educating mothers creates positive results in Turkey.

Breast cancer is a common cancer among women, and early detection is important for breast cancer mortality and morbidity. The aim of this study was to determine the effects of daughters teaching their mothers about breast self-examination (BSE) and its health beliefs. In the study's first stage, 168 university students were trained by the School of Health students about BSE through group training methods. Then, these trained university students were asked to train their mothers about BSE. Data were collected before the training and then again after the training (1 month later). The study instruments included questionnaire forms and the Champion Health Belief Model Scale. The results were analyzed using paired- and unpaired-sample t test, analysis of variance, bivariate correlation analysis, and stepwise multiple regression analysis. The results show that women's knowledge level increased 2-fold after training, and the knowledge level difference between pretraining and post-training was significant (P = .000). The mothers' background information (hear-read) and BSE practice (P = .006 and .006, respectively) before the training process were found to be significant predictors of sociodemographic and other variables influencing the mothers' knowledge levels. The training increased the perceived benefit (P = .032) and confidence (P = .000) significantly. It was found that there was a negative but significant correlation between perceived barriers and BSE knowledge after the education (P = .019). It was found that mothers' knowledge level about BSE was higher after the education. Furthermore, perceived barriers decreased while other subscales increased. Education from daughter to mother can be used as a BSE training approach to increase women's knowledge about BSE.

Comparison of three educational interventions on breast self-examination knowledge and health beliefs.

BACKGROUND: This study was designed to investigate the effectiveness of various training methods for breast self-examination (BSE) knowledge, practice, and health beliefs. METHODS: The quasi-experimental investigation was carried out in an area where two community health care centers are located, in the city of Trabzon, Turkey. Divided randomly into three groups, 1,342 women were instructed in BSE using individual or group training or by way of pamphlets. Data were gathered in four stages: during the pretraining and one month, six months and twelve months after training. RESULTS: All of the training methods used in the study produced a significant increase in the participants' BSE knowledge, but individually trained women scored higher than did the others. Regardless of the training method, BSE instruction improved the women's perceived confidence and benefits, while their perceived barriers declined. The variables influencing BSE practice were found to be BSE practice at the pretraining period, perceived confidence in and benefits from BSE six months after BSE instruction, and health motivation one year after training. No significant difference was found in women's BSE performance scores one year after training. CONCLUSION: This study in which three training methods were used enabled us to assess the effectiveness of instruction on BSE performance and competence. In addition, it provided us with valuable information on how training methods can influence health beliefs related to BSE.