The effect of circadian timing program for evening-chronotype individuals with obesity on obesity management and sleep quality: A randomized controlled trial.

OBJECTIVES: The study aimed to investigate the effect of the circadian timing program (SIZAP) developed for evening-chronotype individuals with obesity on obesity management and sleep quality. METHODS: This single-site, randomized controlled trial with an experimental research design was registered in ClinicalTrials.gov. It was reported in accordance with the "Consolidated Standards of Reporting Trials" (CONSORT) randomized controlled trial guidelines. The study sample consisted of 38 evening-chronotype individuals with first-degree obesity, with 19 individuals in each study group. The intervention group's sleep hygiene training was conducted and their lifestyle changes were ensured through SIZAP. The control group followed their normal daily lifestyle. No intervention was made in terms of the dietary practices of both groups. Study data were collected using the personal information form, the anthropometric measurement form, the Horne and Ostberg Morning and Evening Questionnaire (MEQ), the Impact of weight on quality of life-lite (IWQOL-lite), the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the sleep diary, and the data tracked via the website and smart bracelets. RESULTS: It was determined that the participants in the SIZAP group had a statistically significant decrease in the anthropometric measurements and daytime sleepiness (p < 0.05). The sleep quality scores and the scores of the bodily functions sub-dimension of the quality of life scale were significantly better in the intervention group than in the control group (p < 0.05). CONCLUSION: It was found that SIZAP is effective in obesity management in evening-chronotype individuals and increases weight loss success and sleep quality.

Occupational fatigue, compassion competence and caring behaviours of intensive care nurses: A structural equation modelling approach.

BACKGROUND: No previous study has examined the direct effect of occupational fatigue, inter-shift recovery and compassion competence on caring behaviours, including assurance, knowledge-skill, respect and commitment in intensive care nurses. AIM: We studied the direct effect of participating nurses' occupational fatigue, inter-shift recovery and compassion competence levels on their caring behaviours and the relationship among these variables. STUDY DESIGN: This was a descriptive correlational study. All nurses who were registered members of the Turkish Intensive Care Nurses Association were invited to participate in this online survey. This study was conducted with 315 intensive care nurses using convenience sampling between April and July 2022. The data were collected using the Occupational Fatigue Exhaustion/Recovery Scale, which consists of three subscales: acute fatigue, chronic fatigue and inter-shift recovery; the Compassion Competence Scale, including communication, sensitivity and insight subscales; and the Caring Behaviours Inventory-24. In addition, a structural equation model was established using variables correlating with caring behaviours. Independent variables were occupational fatigue, inter-ship recovery and compassion competence; and the dependent variable was caring behaviours in this hypothesized model. RESULTS: Three hundred and fifteen nurses completed the survey (315/1000) with a response rate of 31.5%. The increase in the inter-shift recovery levels of participants was statistically and positively associated with caring behaviours (95% confidence interval [CI]: 0.001-0.011, ß = .154 [moderate effect size], p < .05). The sub-dimensions of the Compassion Competence Scale, that is, communication (95% CI: 0.110-0.443, ß = .251 [moderate effect size]) and sensitivity (95% CI: 0.084-0.427, ß = .241 [moderate effect size]), were statistically and positively associated with the caring behaviours of participants (p < .05). In addition, independent variables accounted for 35% (large effect size) of the total change in caring behaviours (R2 = 0.350). CONCLUSIONS: This study suggests that the high inter-shift recovery and compassion competence levels of intensive care nurses are positively associated with their caring behaviours. RELEVANCE TO CLINICAL PRACTICE: Nursing managers should consider the direct effect of occupational fatigue, inter-shift recovery and the compassion competence levels of intensive care nurses on their caring behaviours to provide high-quality care.

Depression, anxiety, stress, and job performance among Turkish nurses in the early post-earthquake period.

BACKGROUND: Individual and social concerns can negatively affect nurses' mental health during a large-scale earthquake's early stages, making it challenging to perform their professional responsibilities. AIM: This cross-sectional correlational study aimed to examine the relationship between depression, anxiety, and stress levels Turkish nurses experienced during an earthquake's early period. The nurses participating in this study were not directly present in the earthquake-affected area. METHODS: The study was conducted on 232 nurses between February 10 and 25, 2023. The data were collected using the Depression, Anxiety, Stress-21 Scale and the Job Performance Evaluation Form developed by the researchers through a literature review. These were used to investigate nurses' work motivation changes due to the earthquake. The study followed the STROBE checklist for cross-sectional studies. RESULTS: The participants' depression levels were severe, anxiety levels were extremely severe, and stress levels were moderate following the earthquake. Nurses who felt exhausted experienced reduced energy levels toward their work and reported a decrease in their desire, effort, and work motivation to perform well. In addition, they had higher depression, anxiety, and stress scores (p < 0.005). CONCLUSION: Psychological difficulties, including depression, anxiety, and stress experienced by nurses not directly present in an earthquake-affected area, reduced their professional efforts and motivation and negatively affected the patient care process. Further studies should focus on conducting comparative studies in different cultures affected by natural disasters on the longitudinal analysis of the impacts of nurses' psychological distress on their job performance. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Nursing policymakers should be aware of the negative psychological effects experienced by nurses during the early post-earthquake period, even if they are not directly present in the earthquake-affected area. The study recommended that nurses should be provided with psychological support to deal with the negative effects of natural disasters and maintain job performance, including the nursing care process.

Comparing the Efficacy of Zinc Oxide Versus Barrier Creams for Pressure Injury Prevention: A Retrospective Cross-sectional Study.

OBJECTIVE: To compare the efficacy of zinc oxide versus barrier creams for the maintenance of skin integrity in intensive care patients with a risk of pressure injury (PI). METHODS: This was a retrospective and cross-sectional study. The authors included data from 95 patients treated in the neurology and respiratory ICUs of a training and research hospital between January and June 2022. Patients in the neurology ICU were treated with zinc oxide cream (group 1, n = 48), and patients in the respiratory ICU received classic barrier cream (group 2, n = 47). Sociodemographic characteristics and PI data (Braden Scale score, Pressure Ulcer Healing Assessment Scale [PUSH] score, and PI stage) were obtained from each patient's file. RESULTS: The mean PUSH score of the patients who received zinc oxide cream was 3.83 ± 4.39 at discharge versus 6.79 ± 4.40 for the group who received barrier cream. When PUSH scores and PI stages during hospitalization and discharge were compared, the authors found a statistically significant between-group difference in mean discharge scores (P < .05). CONCLUSIONS: Within the limitations of this retrospective study based on patient records, zinc oxide creams had more positive effects on the prevention of PIs than barrier creams.

Development of the sleep quality scale for coronary care patients (SQ-CC).

OBJECTIVES: In this study, it was aimed to develop a valid and reliable measurement instrument to measure sleep quality in coronary care patients. RESEARCH METHODOLOGY/DESIGN: This is a methodological study that was carried out with 201 patients at the coronary care unit of a university hospital. The validity and reliability of the scale were tested using exploratory and confirmatory factor analyses, Cronbach's alpha analysis, and Pearson's correlation analysis. RESULTS: The scale's Cronbach's alpha coefficient was found to be 0.816. There were significant positive relationships between the overall scale and its dimensions. The Pearson's correlation analysis showed a significant negative relationship between the Sleep Quality Scale for Coronary Care Patients and the Richards-Campbell Sleep Questionnaire. CONCLUSION: The Sleep Quality Scale for Coronary Care Patients was determined to be a valid and reliable measurement instrument for assessing the sleep quality of patients who are receiving care in coronary care units. IMPLICATIONS FOR CLINICAL PRACTICE: The scale that was developed in this study can be applied to coronary care patients because it is easy to implement and specific to intensive care settings. This way, the sleep quality levels of patients can be assessed quickly, and nursing interventions for potential problems can be defined. Hence, the emergence of sleep-related health problems can be prevented. Although RCSQ is the most commonly used scale to evaluate the sleep quality of patients treated in the intensive care unit, SQ-CC is thought to be more inclusive in considering noise-, environment-, and patient-related subjective factors. The evaluation of environmental factors can also provide objective data for improvements to be made to eliminate these factors in clinics. Furthermore, the use of this scale in national and international scientific studies where the sleep quality of coronary care patients is evaluated will contribute to not only our colleagues but also the relevant scientific field.

Relationship between burnout levels of nurses and their circadian preference, sleep quality, and personality traits.

Occupational stress and burnout are widely encountered among many healthcare professionals, including nurses and doctors, as well as among members of other professions. For example, nurses, who have disrupted circadian rhythms, are seen to have sleep problems. In addition, their personality traits are also considered to be related with burnout. This study aimed to identify nurses' circadian preference and personality traits along with their effects on sleep quality and their relationship with burnout. In this study, 211 nurses (40 male, 171 female) using the correlational model from quantitative research methods was used since the variables of morningness/eveningness, personality trait, sleep quality, and burnout were aimed to be investigated at once, without intervention, within the predictivity context of the relationship among them. When the scores obtained from the burnout scale were examined, it was observed that the emotional exhaustion and personal accomplishment subdimensions were so close to the median value and mean, while depersonalization was quite low compared to these sub-dimensions. The participants' sleep quality was seen to be at the lowest step of the poor sleep quality class. When the scores obtained from the MESSI scale are examined, it is seen that the scores obtained from the morning affect dimension are above the median value, and the highest average according to the Five-Factor Personality Traits Scale is obtained in the subdimensions of agreeableness and conscientiousness. Female gender, constantly work at night, having a high number of weekly working hours increased burnout level. Additionally Evening chronotype, poor sleep quality, neuroticism, agreeableness, extroversion and conscientiousness personality traits were found to be associated with burnout in this study. In the study, being of different chronotypes, having other personality traits, and varying sleep quality scores were seen to affect the sub-dimensions of burnout.

Anxiety, Dyspnea Management, and Quality of Life in Palliative Care Patients: A Randomized Controlled Trial.

AIM: This study aimed to determine the influence of nursing care grounded on Watson's Human Care Model on anxiety, dyspnea control, and life quality in palliative care patients. METHOD: A randomized controlled study was designed. It was conducted on 64 participants hospitalized in a training and research hospital and 2 state hospital palliative care services in Turkey. The data were collected face to face using the patient information form, the Beck Anxiety Scale, the Hospital Anxiety and Depression Scale, the Medical Research Council Dyspnea Scale, and the Short Form-36 Quality of Life Scale. RESULTS: It was detected that there was no statistically considerable difference in the median points of the Beck Anxiety Scale, Hospital Anxiety and Depression Scale, Medical Research Council Dyspnea Scale, and Short Form-36 domains between the two groups in the pretest. However, the posttest median points were remarkably lower and the posttest median points of the Short Form-36 scale were meaningfully higher in the intervention group (p < 0.05). CONCLUSION: Nursing care grounded on Human Care Model reduced the grade of anxiety and dyspnea in patients and raised their life quality.

Experiences of Patients With Type 2 Diabetes Who Recovered From COVID-19 in the Pandemic Period: A Qualitative Study.

Coronavirus disease 2019 (COVID-19) infection can induce acute and chronic complications by affecting the self-management behaviors of individuals with diabetes. The objective of this study is to examine the physical, psychosocial health, and self-management experiences of type 2 diabetes patients who have recovered from COVID-19, 1 year after the infection. The study adopted a qualitative research design, specifically content analysis. In all, 14 patients with type 2 diabetes who presented to the diabetes outpatient clinic were interviewed by teleconferencing, which lasted approximately 25 to 30 minutes. The Standards for Reporting Qualitative Research guidelines were used. Based on the participants' responses, four main themes were determined: obstacles in activities of daily living, feeling of psychosocial problems, changes in health and treatment management, and patient self-management practices. Amid the pandemic, diabetes nurses should strive to recognize the issues that diabetes patients encounter. To assist patients, telemedicine should be leveraged, and evidence-based practices must be developed.

Effectiveness of Interventions on Death Anxiety and Fear in Adults with Chronic Disease: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

This systematic review and meta-analysis aimed to synthesize the outcomes of various interventions to alleviate death anxiety and fear. Studies published between January 2010 and June 2022 were searched in the ScienceDirect, Scopus, Web of Science, PubMed, Cochrane Library, and CHINAL databases. The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement guidelines were used in this meta-analysis. The results were examined using 95% confidence intervals, p-values, and fixed- or random-effects models based on the heterogeneity test. Sixteen studies involving 1262 participants were included in this systematic review. Interventions in seven studies using the Templer Death Anxiety Scale (TDAS) significantly decreased death anxiety levels in the intervention groups compared to the control groups (z = -4.47; p < 0.001; 95% CI: -3.36 to -1.31). This meta-analysis provides insights into implementing logotherapy, cognitive behavioral therapy, spirituality-based care, and educational interventions for death anxiety and the fear experienced by patients with chronic diseases.

The relationship between chronotype and obesity: A systematic review.

Referring to the hours during a day when a person's physical and cognitive functions are active, the chronotype indicates the differences in individual preferences in sleep timing and other behaviors. The fact that the evening chronotype has been associated with adverse health outcomes has raised the issue of relationship between chronotype and obesity. This study aims to synthesize the evidence regarding the relationship between chronotype and obesity. As part of the study, the PubMed, OVID-LWW, Scopus, Taylor & Francis, ScienceDirect, MEDLINE Complete, Cochrane Library and ULAKBIM databases were screened for the articles published between January 01, 2010 and December 31, 2020. The quality of each study was assessed independently by the two researchers using the "Quality Assessment Tool for Quantitative Studies." Upon evaluating the screening results, a total of seven studies, one of high quality and six of medium quality, were included in the systematic review. The rate of the minor allele (C) genes, which have been associated with obesity, and SIRT1-CLOCK genes, which have an additional effect in favor of resistance against weight loss, is higher in individuals of evening chronotype, and such individuals have been observed to have significantly higher resistance to weight loss. The evening chronotype individuals have been associated with a higher homeostasis model assessment (HOMA) value, higher plasma ghrelin levels, and a tendency toward a higher body mass index (BMI). The evening chronotypes have been reported to adhere less to a healthy diet and have more unhealthy behaviors and eating patterns. A diet adjusted to the chronotype has been seen to be more effective than conventional hypocaloric diet therapy in terms of anthropometric parameters. Most people who eat their main meals late are of evening chronotype, and such people have been determined to lose significantly less weight than those who eat early. It has been shown that bariatric surgery is less effective in weight loss in evening chronotype patients than in morning chronotype patients. The evening chronotypes are less successful in adapting to weight loss treatments and long-term weight control than the morning chronotypes.

The effect of probiotic and synbiotic use on glycemic control in women with gestational diabetes: A systematic review and meta-analysis.

AIMS: To investigate the impact of probiotic/synbiotic use on glycemic control in women with gestational diabetes. METHODS: We searched the PubMed, Medline, Scopus, ScienceDirect, Web of Science, Cochrane Central Register of Controlled Trials, Dergipark, and Council of Higher Education Thesis Center databases through March 2022. Screening was performed according to the population, intervention, comparison, outcome and study type. This systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Review and meta-analyses (PRISMA-2020) statement. RESULTS: Eight RCTs involving 551 patients were included in the meta-analysis. Probiotic use in women with gestational diabetes significantly decreased fasting blood glucose (mean difference: -1.43; 95 % CI: -2.78 to -0.09, p: 0.04) and serum insulin (mean difference: -3.66; 95 % CI: -5.04 to -2.27, p < 0.001). Moreover, the use of probiotics and synbiotics significantly reduced the HOMA-IR level compared to the control group (probiotic group: mean difference: -0.74; 95 % CI: -1.05 to -0.44, p < 0.001; synbiotic group: mean difference: -0.68; 95 % CI: -1.26 to -0.09, p: 0.02). CONCLUSIONS: The use of probiotics in women with GDM reduced fasting plasma glucose, fasting serum insulin, and HOMA-IR levels. In addition, the use of synbiotics decreased HOMA-IR. Probiotic/synbiotic use is promising as a potential therapy to assist in glycemic control in gestational diabetes. Further high-quality studies are required to determine their safety.

Comportamentos de estilo de vida saudável de estudantes universitários e fatores relacionados / Comportamientos de estilo de vida saludable de estudiantes universitarios y factores relacionados / Healthy lifestyle behaviors of university students and related factors

Resumo Objetivo: Determinar comportamentos saudáveis de estilo de vida de estudantes universitários e fatores relacionados. Métodos: Projetado para usar o método de amostragem descritivo e estratificado, o estudo incluiu 2.100 estudantes nos departamentos de Ciências da Saúde, Ciências, Ciências Sociais e Ciências da Educação da Sakarya University, Turquia. O estudo foi realizado entre maio e dezembro de 2015. Foram coletados dados que incluem características sociodemográficas e Health-Promoting Lifestyle Profile II (HPLP II). O teste U de Mann Whitney, o teste de Kruskal-Wallis e a correlação de classificação de Spearman foram utilizados para a análise dos dados. Resultados: O escore mediano dos alunos do HLBS II foi de 2,42 e, para as subdimensões, o escore mediano foi de 2,22 para a responsabilidade em saúde (RS), 2,12 para atividade física (AF), 2,22 para nutrição (N), 2,77 para desenvolvimento espiritual (DE), 2,77 para relacionamento interpessoal (RI) e 2,37 para gerenciamento de estresse (GE). Observou-se que sexo, idade, renda, escolaridade, tabagismo, hábitos nutricionais, índice de massa corporal, participação em cursos relacionados à saúde afetam comportamentos de estilo de vida saudáveis. Conclusão: Observou-se que os alunos apresentaram comportamentos menos responsáveis em relação à atividade física, responsabilidade à saúde e hábitos nutricionais. Para proteger e melhorar a saúde dos alunos, pode ser útil tornar obrigatórios os cursos de promoção da saúde no currículo de todos os departamentos da universidade.

Resumen Objetivo: Determinar comportamientos saludables de estilo de vida de estudiantes universitarios y factores relacionados. Métodos: El estudio, diseñado para usar el método de muestreo descriptivo y estratificado, incluyó 2.100 estudiantes de los departamentos de Ciencias de la Salud, Ciencias, Ciencias Sociales y Ciencias de la Educación de la Sakarya University, Turquía. El estudio fue realizado entre mayo y diciembre de 2015. Se recolectaron datos que incluyeron características sociodemográficas y Health-Promoting Lifestyle Profile II (HPLP II). Para el análisis de datos, se utilizó la prueba U de Mann-Whitney, la prueba de Kruskal-Wallis y la correlación de clasificación de Spearman. Resultados: La puntuación mediana de los alumnos en el HLBS II fue 2,42 y, en las subdimensiones, la puntuación mediana fue 2,22 en responsabilidad en salud (RS), 2,12 en actividad física (AF), 2,22 en nutrición (N), 2,77 en desarrollo espiritual (DE), 2,77 en relaciones interpersonales (IR) y 2,37 en manejo del estrés (ME). Se observó que el sexo, la edad, los ingresos, la escolaridad, el tabaquismo, los hábitos nutricionales, el índice de masa corporal y la participación en cursos relacionados con la salud afectan comportamientos saludables de estilo de vida. Conclusión: Se observó que los alumnos presentan comportamientos menos responsables con relación a la actividad física, la responsabilidad en salud y los hábitos nutricionales. Para proteger y mejorar la salud de los alumnos, puede ser útil hacer obligatorios los cursos de promoción de la salud en el diseño curricular de todos los departamentos de la universidad.

Abstract Objective: This study was conducted to determine healthy lifestyle behaviors of university students and related factors. Methods: Designed to use the descriptive and stratified sampling method, the study included 2100 students studying in the departments of Health Sciences, Science, Social Sciences, and Educational Sciences at Sakarya University, Turkey. The study was conducted between May 2015 and December 2015. Data including socio-demographic characteristics and Health-Promoting Lifestyle Profile II (HPLP II) were collected. The Mann Whitney U test, Kruskal-Wallis test, and Spearman's rank correlation were used for data analysis. Results: The median score of the students on the HLBS II was 2.42 and for the sub-dimensions, the median score was 2.22 for the health responsibility (HR), 2.12 for physical activity (PA), 2.22 for nutrition (N), 2.77 for spiritual development (SD), 2.77 for interpersonal relationships (IR), and 2.37 for stress management (SM). It was observed that gender, age, income, grade level, smoking, nutritional habits, body mass index, attending courses related to health effect healthy lifestyle behaviors. Conclusion: It was observed that students showed the least responsible behaviors with regards to physical activity, health responsibility, and nutritional habits. In order to protect and improve the health of students, it may be useful to make health promotion courses compulsory in the curriculum of all departments in the university.

Sakarya University students' fat phobia levels and attitudes towards obese individuals and their correlation with healthy lifestyle behaviours: Knowledge, attitude and practice (KAP) study.

OBJECTIVE: To evaluate fat phobia levels and attitudes towards obese person among university students to determine their correlation with healthy lifestyle behaviour. METHODS: The knowledge, attitude and practice study was conducted at Sakarya University, Turkey, between May and December 2015, and comprised students of either gender. Data was collected by using the socio-demographic form, fat phobia scale, attitudes toward obese persons scale, and health-promoting lifestyle profile II scale. SPSS 16 was used for data analysis. RESULTS: Of the 2100 students, 1056(50.3%) were male and 2067(98.4%) were in the 17-26 years age group. The mean fat phobia scale score was 3.72±0.63and mean attitudes toward obese persons scale score was 59.95±0.63. Relationship between fat phobia scale, attitudes toward obese persons scale, and health-promoting lifestyle profile II scale scores was significant (p<0.05). CONCLUSIONS: Fatphobia moderately existed among the students.

Dietary habits contributing to the cancer prevention among health college students in Turkey.

This descriptive study was made to evaluate the dietary habits contributing to cancer prevention of 319 health college students. Data collection form included questions about demographic characteristics and 33 statements which evaluate dietary habits contributing to cancer prevention. Among the students, 56.1% consumed fast food outside the home/dormitory twice a week or more and 47% never exercised. Moreover, 63.9% of the students reported that their dietary habits changed negatively and 69% stated that their fruit and vegetable consumption decreased after starting the health college. The students mostly paid attention to preserving food and water consumption while they paid least attention to maintaining healthy weight and whole grain consumption. Female students, those who paid attention to the amount and calorie of the food they consumed, students who did not consume fast food, and students who exercised twice a week or three times a week had better dietary habits contributing to cancer prevention (p<0.05). According to these results we recommend that interventions which will reduce fast food consumption and increase fruit and vegetable consumption and exercising in university students should be implemented. For this purpose, appropriate conditions for preparing and preserving healthy food should be provided as well as increasing the frequency of vegetable containing meals and providing fruits and salads in every meal at school cafeterias.