Predicting behavioural intentions towards medication safety among student and new graduate nurses across four countries.

AIMS AND OBJECTIVES: To identify final-year undergraduate students and new graduate nurses' behavioural intentions towards medication safety across four countries. BACKGROUND: Medication errors are a common and avoidable occurrence, being costly for not only patients but also for health systems and society. DESIGN: A multi-site cross-sectional study. METHODS: A self-administered survey was distributed to students and new graduate nurses in South Africa, India, Turkey and Australia. Descriptive statistics were calculated for all survey items. Multiple linear regressions were performed to predict behavioural intentions using the three Theory of Planned Behaviour constructs: attitudes, behavioural control and subjective norms. This study adheres to the STROBE guidelines. RESULTS: Data were analysed for 432 students and 576 new graduate nurses. Across all countries, new graduate nurses reported significantly higher scores on all the TPB variables compared with student nurses. Attitudes towards medication management were found significantly and positively related to intention to practice safe medication management for both student and new graduate nurses. Total perceived behavioural control was significantly and negatively related to intention to practice safe medication management for students. CONCLUSION: Student and new graduate nurses showed favourable attitude, subjective norm, perceived behaviour control and intention in practising medication safety. However, differences in countries require further exploration on the factors influencing attitudes towards medication safety among student nurses and new nurse graduates. RELEVANCE TO CLINICAL PRACTICE: Understanding student and new graduate nurses' medication administration practices is important to inform strategies aimed at improving patient safety. The findings of this study highlight the need for an internationally coordinated approach to ensure safe medication administration by student and new graduate nurses.

An International Research Collaborative to Examine Global Health Resilience Using the MyStrengths+MyHealth Application.

International organizations have called for the development of programs to strengthen global health resilience. This poster describes the development of an international research collaborative to examine whole-person health and resilience using the web-based application MyStrengths+MyHealth (MSMH). MSMH enables individuals to self-report strengths (resilience), challenges, and needs using simplified terms that have been community validated and at the fourth grade US reading level.

Factors Associated with Mammography Screening Among Women Living in Rural Areas.

AIM: This study aims to assess the factors of mammography screening among women living in rural areas. METHOD: The study was planned in a cross-sectional type. The sample of the study consisted of 139 women admitted to two family health centers in Istanbul who were aged 40 and over, literate, not pregnant or breastfeeding, and not diagnosed with breast cancer. Data was collected between July and November 2018. Data were collected using interview form, Breast Cancer Health Belief Model Subscales of Susceptibility, health motivation, mammography benefits, mammography barriers, Mammography Self- Efficacy Scale, Breast Cancer Fear Scale, Breast Cancer Fatalism Scale, and Breast Cancer Risk Assessment Form. Data were analyzed with descriptive statistics, Mann-Whitney U test, Kruskal-Wallis, chi-square test, and logistic regression analysis. RESULTS: Most of the women were in the age group of 40-50 years (66%), graduated primary school (69%), were married (91%), and were not working (80%). Most of the women had middle-income (78%) and health insurance (88%). In the study, the rate of having had mammography in the last 2 years was 25%. The rate of mammography screening was significantly higher in women who knew mammography, who had a referral for mammography screening from health professionals, and who had health insurance (p < .05). Perceived benefits to mammography, perceived barriers to mammography, perceived self-efficacy, and perceived health motivation were significantly higher in women having mammography (p < .05). CONCLUSION: In the study, marital status, receiving health professionals' referral regarding mammography screening, mammography selfefficacy, perceived barriers to mammography, and breast cancer risk level (p < .05) were factors associated with having mammography.

Salutogenic Model-Based Frailty Prevention Program for Pre-Frail Women Aged 55 Years and Over (SAFRAPP): A Study Protocol for a Randomized Controlled Trial.

Background: Frailty is a geriatric syndrome which is more higher among women. Limited evidence suggests a model-based intervention for preventing worsening frailty for women. Purpose: This protocol describes a single-blinded, two-armed randomized controlled study purposing to examine the effectiveness of Salutogenic Model-Based Frailty Prevention Program (SAFRAPP) for pre-frail women. Methods: Eighty-four eligible participants from vocational institutions of a municipality in Turkey is randomly allocated to either the SAFRAPP intervention or the control group. The SAFRAPP is a 6-week online nurse-led intervention program comprising of laughter yoga, health education and case management. The intervention is rooted in the Salutogenic Model, which focuses on strengthening individuals' coping capacity to deal with stressors. The primary outcomes are the frailty and sence of coherence scores and the secondary outcomes are the well-being, quality of life and fear of fall scores, and number of falls and emergency admissions in the past three months. The study data for intervention and control group is obtained at four times: At baseline and at the 3-month, 6-month and 9-month follow-ups. Results: The protocol was registered at ClinicalTrials.gov (identifier number NCT04787432, registration date: 08/03/2021). Eligibility, baseline measurements, randomization, and intervention are completed. The follow-ups are ongoing. Implications for Practice: There is unsufficient evidence regarding the effectiveness of a model-based health promotion interventions for prevention of frailty. The SAFRAPP will provide evidence on prevention of frailty and improving sense of coherence of pre-frail women.

Investigating Adverse Childhood Experiences and Nutrition and Physical Activity Behaviors Using the Omaha System.

The aim of the current study was to examine the relationship between adverse childhood experiences (ACEs) and nutrition and physical activity behaviors using the Omaha System. A descriptive cross-sectional design was used with 227 women recruited from three vocational institutes. Measures included Omaha System Knowledge, Behavior, and Status ratings for nutrition and physical activity; sociodemographic information; and the ACE Questionnaire. Results demonstrated that more than one half of participants had a history of at least one ACE (n = 132; 58.1%), and 33 (14.5%) had four or more. ACEs score was significantly associated with nutrition, but not physical activity behavior. Understanding the links between ACEs and health behaviors and including a brief screening for ACEs in primary care practice settings may help nurses holistically customize health promotion interventions and lead to better health outcomes. The Omaha System can efficiently measure health-related behaviors; examine their relationship to risk factors, such as ACEs; and capture individual and population-level changes. [Journal of Psychosocial Nursing and Mental Health Services, 60(3), 23-30.].

Nursing Students' Intention to Report Medication Errors: Application of Theory of Planned Behavior.

BACKGROUND: Reporting, investigating, and full disclosure of medication errors (MEs) is a fundamental component of patient safety. Therefore, determining nursing students' intention to report MEs is important. PURPOSE: This study examined the factors related to nursing students' intention to report MEs and the use of the Turkish version of the Theory of Planned Behavior Medication Safety Questionnaire (TPB-MSQ-T). METHODS: A descriptive cross-sectional design was used with a sample of 227 undergraduate nursing students in Istanbul, Turkey. Students' intentions to report MEs were measured using an online TPB-MSQ-T. Quantitative analysis was conducted. RESULTS: Attitudes and perceived behavioral control (PBC) were significant predictors of intention to report MEs (P = .05 and P = .01, respectively), but subjective norms did not predict it (P = .11). The Cronbach's α of the questionnaire was 0.88. CONCLUSIONS: Attitude and PBC are important determinants of nursing students' intention to report MEs. The TPB-MSQ-T can be used for identifying the main determinants of intention to report MEs.

Psychometric Testing of the Turkish Version of the Technology Informatics Guiding Educational Reform-Based Assessment of Nursing Informatics Competencies Tool.

Nursing informatics competencies are vital to benefit from information technologies to improve patient outcomes. It is essential to use a reliable and valid instrument for evaluating competencies. The Technology Informatics Guiding Educational Reform-Based Assessment of Nursing Informatics Competencies Tool is a valid and reliable tool used to evaluate nursing informatics competencies in nurses who primarily speak English. This cross-sectional research aimed to evaluate the psychometric properties of a Turkish version of the instrument. Data were collected from 518 nurses working in two university hospitals in Istanbul, Turkey. The tool was translated into Turkish, validated by professional experts, back-translated, and analyzed. Thirty nurses completed the tool twice for test-retest reliability. A four-factor structure identified in exploratory factor analysis (73.64% of the total variance with all items loaded >0.40 [0.44-0.88] for each factor). Cronbach's α reliability coefficients of the subsets were .98 for basic computer skills, .97 for clinical information management, and .98 for information literacy. The total item correlations for subsets were between 0.57 and 0.84. The Turkish version of the Technology Informatics Guiding Educational Reform-Based Assessment of Nursing Informatics Competencies demonstrated sufficient reliability and validity for assessing nursing informatics competencies within Turkish culture.

Refinement, reliability and validity of the Time Capture Tool (TimeCaT) using the Omaha System to support data capture for time motion studies.

AIM: To refine and assess the inter-rater reliability and content validity of the embedded interface of nursing/midwifery activities in the Time Capture Tool (TimeCaT) using an interface terminology, the Omaha System. METHODS: This methodological study was conducted in two Family Health Centers (FHCs) in Turkey with a total of 13 nurses and midwives. In phase one, five nurses/midwives in a FHC were observed for a total of 80 hr, and 84 nursing/midwifery activities were generated and validated with 15 content experts. In phase two, the nursing/midwifery activities were mapped to the Omaha System and inter-rater reliability of the mapping was assessed. The mapping was validated with seven content experts. The nursing/midwifery activities were embedded in the interface of the TimeCaT. In phase three, the embedded interface of the TimeCaT was evaluated while observing eight nurses and midwives in the other FHC. RESULTS: The scale-level content validity index was 0.98 for the generated activities in phase one and 0.96 for the mapped activities in phase two. Kappa statistics for inter-rater reliability was 0.88 for Omaha System problems, 0.83 for categories and 0.83 for targets. The nursing/midwifery activities were adequately mapped to the Omaha System. The embedded interface of the TimeCaT has acceptable inter-rater reliability and content validity values for using in the Turkish FHC context. CONCLUSION: The study results confirm that the TimeCaT using the Omaha System is a valid and reliable tool to measure nursing/midwifery workflow in FHC settings.

An investigation of physical activity among adults in Turkey using the Omaha System.

OBJECTIVES: The aim of this study was to investigate the physical activity (PA) and associated factors among insufficiently active adults attending Family Health Centers in Istanbul, Turkey using the Omaha System. DESIGN AND SAMPLE: This descriptive-correlational study guided by the Ecological Model for Health Promotion used a convenience sample of 335 Turkish adults with insufficient PA behavior defined as an Omaha System PA Behavior rating <4. MEASUREMENTS: Measures included Omaha System problems; Knowledge, Behavior, and Status ratings; demographics; and ecological factors operationalized with the Omaha System Problem Classification Scheme. Data were analyzed using chi-square, independent t tests, and logistic regression. RESULTS: Participants were females (76.7%) and males (23.3%) with a mean age of 38.5 years. Almost half (43.6%) engaged in no appropriate PA Behavior. The most common Physiological, Psychosocial, and Environmental domain problem were oral health (61.2%), mental health (21.5%), and neighborhood/workplace safety (41.2%), respectively. Logistic regression revealed marital status, age, sex, and physiological and environmental domain problems significantly predicted PA behavior. CONCLUSIONS: Interventions tailored to insufficiently active Turkish adults should include assessing for physiological health problems; targeting older, married adults; and advocating for policy change that supports the provision of safe, affordable, accessible, and culturally appropriate places for physical activity.

Method Development for Describing Content of Multitasked Interventions Using the Omaha System.

BACKGROUND: Understanding multitasking within nursing and midwifery is needed for efficient, effective, and cost-effective health services. Methods are needed to measure and analyze multitasking in alignment with the nursing process. The Omaha System operationalizes the nursing process and may be a valuable resource for multitasking analysis. PURPOSE: The purpose of this study was to develop and test a method for describing intervention content of nurse/midwife multitasked interventions using the Omaha System and Time Capture Tool (TimeCaT) in a family health center in Turkey. METHODS: Eight nurses/midwives were observed with TimeCaT in a family health center in 2016. Preidentified 84 nurse/midwife interventions employed in the center were mapped on Omaha System terms and entered in TimeCaT software for data collection. Co-occurring interventions were analyzed using descriptive and inferential statistics and visualization techniques. RESULTS: Of 1066.8 total minutes observed, 34.0% included more than one intervention that occurred at the same time. Caretaking/parenting and postpartum problems, teaching, guidance, and counseling category, and caretaking/parenting skills target were more often multitasked than others. IMPLICATIONS FOR PRACTICE: It was feasible to use the Omaha System and TimeCaT to categorize, describe, and measure multitasking nursing/midwifery interventions. This method may be applied to other time-motion data when more than one co-occurring intervention is recorded.

Feasibility of describing community strengths relative to Omaha system concepts.

OBJECTIVES: The purpose was to determine the feasibility of using a standardized language, the Omaha System, to describe community-level strengths. The objectives were: (a) to evaluate the feasibility of using the Omaha System at the community level to reflect community strengths and (b) to describe preliminary results of community strengths observations across international settings. DESIGN AND SAMPLE: A descriptive qualitative design was used. The sample was a data set of 284 windshield surveys by nursing students in 5 countries: Mexico, New Zealand, Norway, Turkey, and the United States. MEASURES: An online survey included a checklist and open-ended questions on community strengths for 11 concepts of the Omaha System Problem Classification Scheme: Income, Sanitation, Residence, Neighborhood/workplace safety, Communication with community resources, Social contact, Interpersonal relationship, Spirituality, Nutrition, Substance use, and Health care supervision. Themes were derived through content analysis of responses to the open-ended questions. RESULTS: Feasibility was demonstrated: Students were able to use the Omaha System terms and collect data on strengths. Common themes were described among the five countries. CONCLUSIONS: The Omaha System appears to be useful in documenting community-level strengths. Themes and exemplar quotes provide a first step in developing operational definitions of strengths at a more granular level.

[Patient satisfaction with nursing practices about postoperative pain management: A systematic review]. / Hastalarin, ameliyat sonrasi agri yönetimine iliskin hemsirelik uygulamalarindan memnuniyet düzeyleri: Bir sistematik derleme.

OBJECTIVES: The aim of this study was to investigate patient satisfaction with nursing practices regarding postoperative pain management. METHODS: A systematic review of the literature published between 2005 and 2015 was conducted, comprising a search of 7 databases: ScienceDirect, Turkish Medline, PsycINFO, Ovid, Prequest, Google Scholar, and the ULAKBIM Turkish Medical Database. Five articles were identified as eligible for review. The methodological quality of the studies was assessed using the Turkish version of the Joanna Briggs Institute-Meta Analysis of Statistics Assessment and Review Instrument (JBI -MAStARI) Critical Appraisal Checklist. The data were extracted using a standard data extraction form developed for this study, and subsequently evaluated. RESULTS: In the articles eligible for this review, the study samples comprised patients with blunt or penetrating trauma sent to the emergency room (n=418) and those who underwent total knee replacement (n=120); heart, lung, or gastrointestinal system surgery (n=559); or open heart surgery (n=52). The maximum pain score was 7.20±1.95 (min-max: 0-10) and the maximum satisfaction score was 100%. The findings revealed that pharmacological methods were most frequently used for postoperative pain management and non-pharmacological methods were not used sufficiently by nurses. Nevertheless, the patients were satisfied with the postoperative pain relief nursing care. CONCLUSION: In this systematic review, scientific evidence indicated that patient satisfaction with nursing practices related to postoperative pain management was high; however, non-pharmacological methods were used insufficiently in the last decade.

The Omaha System as a Structured Instrument for Bridging Nursing Informatics With Public Health Nursing Education: A Feasibility Study.

Advancements in healthcare systems include adoption of health information technology to ensure healthcare quality. Educators are challenged to determine strategies to integrate health information technology into nursing curricula for building a nursing workforce competent with electronic health records, standardized terminology, evidence-based practice, and evaluation. Nursing informatics, a growing specialty field, comprises health information technology relative to the profession of nursing. It is essential to integrate nursing informatics across nursing curricula to effectively position competent graduates in technology-laden healthcare environments. Nurse scholars developed and evaluated a nursing informatics case study assignment used in undergraduate level public health nursing courses. The assignment included an unfolding scenario followed by electronic health record charting using standardized terminology to guide the nursing process. The assignment was delivered either online or in class. Seventy-two undergraduate students completed the assignment and a posttest. Fifty-one students completed a satisfaction survey. Results indicated that students who completed the assignment online demonstrated a higher level of content mastery than those who completed the assignment in class. Content mastery was based on posttest results, which evaluated students' electronic health record charting for the nursing assessment, evidence-based interventions, and evaluations. This innovative approach may be valuable to educators in response to the National Academy of Sciences recommendations for healthcare education reform.

Interventions Promoting Breast Cancer Screening Among Turkish Women With Global Implications: A Systematic Review.

BACKGROUND: Breast cancer is a major health concern and remains the most common malignancy in women worldwide and in Turkey. Mammography, clinical breast examination (CBE), and breast self-examination (BSE) are recommended methods to detect early breast cancer in women. Many strategies have been developed to increase the rates of mammography, CBE, and BSE among Turkish women. Despite the benefits of breast cancer screening, these modalities are still underutilized by the majority of Turkish women. AIM: To systematically review the scientific evidence on the effectiveness of various strategies aimed at improving screening behaviors for breast cancer in Turkish women. METHODS: A systematic review of the literature published between 2000 and 2015 was conducted, searching 10 databases of Ovid MEDLINE, PubMed, Cochrane CENTRAL Register of Controlled Trials, CINAHL, PsycINFO, Web of Knowledge, Scopus, Google Scholar, ULAKBIM Turkish Medical Database, and Council of Higher Education Thesis Center. RESULTS: Twenty-three studies were included in the final review. The majority of the studies investigated the effects of multiple strategies to improve BSE. Group education comprised educational sessions, printed and audiovisual materials, which significantly improved BSE, CBE, and mammography screening rates at 3 months, 6 months, and 12 months after the intervention. One-to-one education demonstrated no significant difference in BSE rates at 6-month and 12-month follow-up. However, one-to-one education demonstrated significant differences in CBE and mammography rates at the 3-month follow-up. LINKING EVIDENCE TO ACTION: The use of group education comprising a multicomponent intervention demonstrated an increase in breast-screening behaviors among Turkish women. Further research investigating the duration of educational interventions is needed in order to suggest a "dose response."

Factors associated with bicycle-helmet use among 8-16 years aged Turkish children: a questionnaire survey.

The purpose of this cross-sectional, descriptive study was to assess the rates of helmet and to examine variables related to bicycle helmet use in a sample of 8-16 year old Turkish children. Data were collected from a purposive sample of 1180 students who self-identified as cyclists and 1128 parents or guardians in two state primary schools in two urban municipalities in the northern part of Istanbul, Turkey. Results showed that self-reported helmet use was found prevalent in 4.4% of the children. The most cited reasons for not wearing a helmet were: 'don't own one', 'helmets are uncool', and 'uncomfortable'. Significant differences between helmet users and non-users correlated to gender, age, owning a bicycle helmet, wearing a friend's bicycle helmet and parents or guardian's bicycle helmet use while riding. Only three variables--helmet ownership (OR = 10.028, 95% CI 5.08, 19.79), parents' helmet use (OR = 2.62, 95% CI 1.22, 5.66) and friends' helmet use (OR = 0.16, 95% CI 0.07, 0.37) emerged as significant predictors of the likelihood of helmet use. The relatively low helmet use prevalence points to an urgent need for a multipronged campaign, including strategies such as raising awareness, educating primarly parents and friends, and distributing bicycle helmets for free or at a reduced cost.

Attitudes of health professionals towards electronic health records in primary health care settings: a questionnaire survey.

PURPOSE: This study aimed to assess the attitudes of health professionals towards electronic health records (EHRs) in primary health care settings in Turkey. METHODS: A survey was administered to 754 health professionals working in Family Health Centres (FHCs) in seven districts in Istanbul, Turkey. The survey was developed based on extensive literature review, and consisted of 33 statements rated on a five-point Likert-scale. RESULTS: A total of 325 completed questionnaires were received, representing a 43% response rate, with 97% of respondents being satisfied with the EHR system in the FHCs. There were significant differences between health professional groups (physicians and nurses/midwives) in their perceptions of EHRs decreasing paper-based records, data security in EHRs, and costs of EHRs (p < 0.05). Narrative responses indicated ongoing needs in software development, further support of nursing documentation and training. CONCLUSIONS: Overall positive attitudes towards EHRs among primary care health professionals in Turkey suggest strong acceptance and use. Recommendations based on the findings include EHR technology refinements, improved clinical documentation using standardized terminologies, and health professional-informed EHR training.

Using the Omaha System to describe health problems, interventions, and outcomes in home care in Istanbul, Turkey: a student informatics research experience.

Preparing nursing students to achieve informatics competencies is essential in today's information-intensive healthcare delivery systems. This study aimed to provide hands-on informatics experience to nursing students and to identify the frequency and type of home care clients' health problems, nursing interventions, and outcomes using a standardized nursing terminology, the Omaha System. Data were collected by 159 nursing students on home visits to 598 clients, who received 8657 interventions from students and faculty for 2267 problems, in addition to the services provided by the home care centers. Skin, neuromusculoskelatal function, personal care, nutrition, and urinary function were the most common problems. The most common intervention category was teaching, guidance, and counseling (47%), followed by treatments and procedures (22%), surveillance (22%), and case management (9%). Outcomes evaluation showed significant improvement in 97.5% of the identified problems. Students gained informatics experience in the use of a standardized nursing language in electronic health records, data management, and use of nursing data at the basic practice level. This study demonstrated that the Omaha System was a useful data collection tool for evaluating problems, interventions, and outcomes in home care and a positive teaching and learning tool for baccalaureate nursing education.

Mammography self-efficacy scale and breast cancer fear scale: psychometric testing of the Turkish versions.

BACKGROUND: Self-efficacy for mammography and breast cancer fear are important determinants to mammography use. No tools to measure these beliefs of Turkish women have been validated. OBJECTIVE: The purpose of this study was to assess the psychometric characteristics of the Turkish versions of the Mammography Self-Efficacy Scale (MSS-T) and the Champion Breast Cancer Fear Scale (CBCFS-T). METHODS: Mammography Self-Efficacy Scale and Champion Breast Cancer Fear Scale were translated to Turkish language, validated by an expert panel, back translated, and tested. Cronbach α coefficients and item-total correlations were measured to evaluate the reliability of the scales. Exploratory factor analysis was used to estimate construct validity of the scales. Independent t tests, χ(2) tests, and logistic regression analyses were used to test theoretical relationships. RESULTS: Factor analysis yielded 1 factor for MSS-T and 2 factors for CBCFS-T with eigenvalues greater than 1. Internal consistency values presented acceptable Cronbach α levels of .90 for MSS-T and .90 for CBCFS-T, and test-retest reliability correlations were 0.56 for MSS-T and 0.60 for CBCFS-T. CONCLUSIONS: The MSS-T and CBCFS-T demonstrated acceptable preliminary values of reliability and validity. Further psychometric testing is recommended with women living in different regions of Turkey. IMPLICATIONS FOR PRACTICE: The scales can offer insights to nurses and other healthcare professionals about mammography self-efficacy beliefs, emotional needs, and concerns of Turkish women related to breast cancer fear. The scales may be useful as process measures to assess the efficacy of interventions designed to alter self-efficacy and fear and subsequently improve the mammography rates.