Validity and reliability study in undergraduate healthcare students towards the solution of a neglected problem in working life: Attitude scale towards patients with chronic pain.

BACKGROUND: Chronic pain is the type of pain that healthcare professionals frequently encounter. Health care students' attitudes towards pain management are not sufficient and this negatively affects their chronic pain management. When students cannot manage the chronic pain they will experience professional burnout, depersonalization, and a decrease in compassion and empathy in patient care. Therefore, the first step in improving health care students' attitudes towards patients with chronic pain is to determine their attitudes. OBJECTIVE: This study aims to test the validity and reliability of the Scale for Healthcare Professionals' Attitudes towards Patients with Chronic Pain (HCPAPCP Scale) in healthcare students. METHOD: This quantitative study was conducted with 205 health care students in January-February 2022. Data were collected online with Personal Information Form and the HCPAPCP Scale. To determine the reliability of the scale, internal consistency and test-retest, and for construct validity, exploratory factor analysis and confirmatory factor analysis were performed. RESULTS: The results of the exploratory factor analysis showed that the two-factor scale consisting of 18 items, the factor structure, and the distribution of factors in items were the same as the findings of the original scale. The Cronbach's Alpha coefficient was 0.88 for the first factor and 0.74 for the second factor. Test-retest reliability was 0.60. In confirmatory factor analysis, the model had a good and acceptable fit. CONCLUSION: We found that the HCPAPCP Scale was valid and reliable in healthcare students.

The effect of interactive learning method on nursing students' learning of movement requirement: A randomized controlled study.

BACKGROUND: Interactive learning is one of the active learning methods used to develop students' knowledge and skills. OBJECTIVES: This study was conducted to determine the effect of the interactive learning method with questions prepared according to Bloom's taxonomy on nursing students' learning of the need for movement. DESIGN: It is a randomized controlled study conducted in May 2023. PARTICIPANTS: This study was conducted with 134 first-year nursing students taking the Fundamentals of Nursing course. The students were randomly divided into control (n = 67) and experimental (n = 67). METHOD: The data was collected by using a form delineating descriptive characteristics, a test assessing the necessity of movement knowledge, an analysis of a specific case study, and an assessment form for gathering student opinions on interactive learning. The queries within the data collection form were tailored to align with Bloom's taxonomy. Following the theoretical instruction, each student participated in the mobility needs knowledge test and case analysis (pre-test). The instructional session for the control group involved conventional lecture-style teaching supplemented with a question-and-answer format, while the experimental group received instruction through an interactive learning approach. One week subsequent to this, all students retook the mobility needs knowledge test and case analysis (post-test). Subsequently, feedback regarding the interactive learning method was solicited from the students. RESULTS: The knowledge test revealed a statistically significant difference, with the control group exhibiting a higher median comprehension score in the post-test compared to the experimental group (p < 0.05). Regarding the case analysis, statistical analysis demonstrated that the experimental group surpassed the control group in median scores for comprehension, synthesis, and total scores, with a significant difference (p < 0.05). Additionally, most students expressed favorable opinions toward the interactive learning approach. CONCLUSIONS: It is recommended that studies on interactive learning be repeated in different subjects in nursing education. CLINICALTRIALS: gov ID:NCT05868278.

The effect of virtual game simulation on students' perception of nursing diagnosis and clinical practice: Post-test only randomized controlled trial.

BACKGROUND: The virtual game simulation was prepared for nursing diagnosis and goal setting. OBJECTIVES: To determine the effect of virtual game simulation on nursing students' perception of nursing diagnosis and clinical practice. DESIGN: This study is a post-test randomized controlled trial only. METHODS: The study was conducted with 92 s-year students enrolled in the Nursing Department of a state university in a province of Turkey. Data were collected using the Descriptive Characteristics Form, Perceptions of Nursing Diagnoses Survey, and the Form for Evaluating the Effect of Virtual Game Simulation on Clinical Practice. Virtual game simulations, which are prepared for determining nursing diagnosis and creating goals, are offered to the use of first-year students after the theoretical education of the nursing process. In order to evaluate the effect of virtual game simulations on the perception of nursing diagnosis and clinical practice, second-year students who played the game voluntarily were included in the experimental group, and those who did not play were included in the control group. Students in the control (n = 46) and experimental (n = 46) groups completed the data collection tools prepared online via Google Forms. The relationship between the grouped variants was tested by Chi-Square (χ2) analysis. Mann-Whitney U-test was used because the data did not show normal distribution. RESULTS: It was found that the mean score of the control group was significantly higher than the experimental group in the sub-dimension of the delineation and promotion of the nursing profession and in the total score of the Perceptions of Nursing Diagnoses Survey (PNDS) (p < 0.05). The students in the experimental group made positive statements about the effect of the virtual game simulation on clinical practice, such as, "I can determine nursing diagnoses correctly", "I can create the right target for the patient", and "I understand how to record the data I collect from the patient". The negative statements of the students were as follows: "I have difficulty in collecting data from the patient", "I have difficulty in interviewing the patient" and "I cannot be sure that I have determined all the nursing diagnoses for my patient". CONCLUSIONS: Virtual game simulation was found to be effective in students' perception of nursing diagnosis. It was noted that most of the students expressed positive views regarding the impact of virtual game simulations on clinical practice. It is recommended to use virtual game simulation to support formal education in teaching the nursing process.

Gluteal muscle and subcutaneous tissue thicknesses in adults: a systematic review and meta-analysis.

Background: Nurses often administer intramuscular injections at the gluteal site. This study aimed to determine gluteal muscle and subcutaneous tissue thicknesses in adults. Methods: Systematic review and meta-analysis. The databases Turkish Medline, Ulakbim, National Thesis Center, Cochrane, Web of Science, Science Direct, PubMed, CINAHL Plus with Full text (EBSCO host), OVID and SCOPUS were screened using the keywords 'intramuscular injection', 'subcutaneous tissue thickness', 'muscle tissue thickness' and 'needle length' between April and May 2021. The studies were evaluated with ultrasound. This study was reported according to the PRISMA recommendations. Results: Six studies met the eligibility criteria. The total sample size was 734 (women: 432, men: 302). The V method revealed that the ventrogluteal site had a muscle and subcutaneous tissue thickness of 38.071 ± 2.119 and 19.927 ± 2.493 mm, respectively. The geometric method revealed that the ventrogluteal site had a muscle and subcutaneous tissue thickness of 35.989 ± 4.190 and 19.661 ± 3.992 mm, respectively. The geometric method also revealed that the dorsogluteal site had a thickness of 42.560 ± 8.840 mm. According to the V method, females had thicker subcutaneous tissue at the ventrogluteal site than males (Q = 5.37, df = 1, p = 0.0204). Body mass index did not affect the subcutaneous tissue thicknesses at the ventrogluteal site. Conclusion: The results show that gluteal muscle, subcutaneous and total tissue thicknesses vary across injection sites.

The effects of virtual gaming simulation on nursing students' diagnosis, goal setting, and diagnosis prioritization: A randomized controlled trial.

BACKGROUND: Virtual gaming simulation is a 2D computer game used to enhance the knowledge and skills of nursing students. OBJECTIVES: This research was conducted to investigate the effects of virtual gaming simulation on the nursing diagnosis, goal setting and diagnosis prioritization of first-year nursing students. DESIGN: Randomized controlled trial conducted between March and April 2022. PARTICIPANTS: In this study, 102 first-year nursing students registered in Fundamentals of Nursing-II were included. The students were divided at random into two groups: control (n = 51) and intervention (n = 51). METHOD: Data were collected using the descriptive characteristics form, nursing diagnosis, goal setting, diagnosis prioritization form, virtual evaluation simulation and virtual gaming simulation evaluation form. Didactic training in the nursing process was provided to all students in the classroom simultaneously. The day following the didactic training, the training scenario was explained to the control group in the classroom. On the same day, a simulation of the virtual training scenario developed for the intervention group was played in the computer lab. One week later, the control group completed the nursing diagnosis, goal setting and diagnosis prioritization form prepared for the evaluation scenario in the classroom and the intervention group played the virtual evaluation simulation that was developed based on the same case on the same day in the computer lab. Then, students' opinions regarding virtual gaming simulation were obtained. RESULTS: The findings showed that the mean scores of nursing diagnosis and goal-setting knowledge of the intervention group were significantly higher than those of the control group (p < 0.05), whereas there was no significant difference between the groups regarding the mean scores of diagnosis prioritization knowledge (p > 0.05). CONCLUSIONS: Virtual gaming simulation increased the mean scores of nursing diagnosis and goal-setting knowledge of the students. Most of the students stated positive statements related to virtual gaming simulations.

The relationship between emotional labor level and moral distress.

BACKGROUND: The coronavirus disease (COVID-19) pandemic has implications for health professionals. AIM: The aim of this study was to explain the relationship between emotional labor levels and moral distress in health professionals during the COVID-19 pandemic using the Structural Equation Modeling (SEM) technique. RESEARCH DESIGN: A descriptive and cross-sectional study was adopted. PARTICIPANTS AND RESEARCH CONTEXT: Data were collected between 7 February and 7 March 2021. 302 health professionals who were not on leave (annual leave, sick leave, prenatal and postnatal leave, etc.) at the time of the research and who volunteered to participate in the research were included. Research data were collected using a "Personal Information Form," the "Emotional Labor Scale" and the "Moral Distress Thermometer." ETHICAL CONSIDERATIONS: The Ethics Committee approved the study (dated 07.01.2021 and numbered 2021/1-3). The participants were informed of the study aim and written consent was obtained before completing the survey. FINDINGS: In the present study, the mediator role of emotional labor in the effect of providing service to a patient with COVID-19 and having had COVID-19 on moral distress was examined in health professionals and it was found that there was a correlation between providing service to a patient with COVID-19 and moral distress regardless of whether or not emotional labor had a role in this relationship. CONCLUSION: In this study, the relationship between the level of emotional labor and moral distress in health professionals during the COVID-19 pandemic was evaluated with a structural equation model.

The effect of flipped learning on blood pressure knowledge and self-directed learning skills of first-year nursing students: A randomized controlled trial.

AIM: This study investigated the effect of flipped learning on first-year nursing students' blood pressure knowledge levels and self-directed learning skills. BACKGROUND: Flipped learning is an innovative approach that helps nursing students learn about blood pressure and how to measure how to measure blood pressure accurately. Flipped learning also promotes active and student-centered learning settings and encourages nursing students to develop self-directed skills. DESIGN: This study adopted a pretest-posttest open-label randomized controlled trial. METHOD: The sample consisted of 94 first-year nursing students randomized into experimental (n = 48) and control groups (n = 46). The experimental group participants were trained using the flipped learning model. Data were collected using a personal information form, the Blood Pressure Knowledge Test (BPKT) and the Self-Directed Learning Skills Scale (SDLSS). RESULTS: There was no significant difference in pretest BPKT scores between the experimental and control groups. However, there was a significant difference in posttest BPKT scores between the experimental and control groups (p = 0.011). Moreover, there was a significant difference between the experimental group's mean pretest, posttest and follow-up SDLSS scores (p = 0.009). CONCLUSION: The experimental group had a significantly higher mean posttest BPKT score than the pretest score. They had significantly higher mean posttest SDLSS total and "self-monitoring," "motivation," and "self-confidence" subscale scores than the pretest score.

The impact of a web-based mind map learning technique on students' nursing knowledge of the nursing process.

OBJECTIVE: This research aims to investigate the effects of web-based mind map learning techniques in the nursing process on students' ability to investigate the nursing diagnosis, descriptive characteristics, and the etiological and risk factors. DESIGN: In this experimental study, 91 nursing students enrolled in a state university in a city in Turkey in the 2020-2021 academic year were included. METHODS: Data were collected using a test for determining the level of knowledge about the nursing diagnosis and the factors affecting the diagnosis, case sample, and care plan. In the teaching of the nursing process, the experimental group students (n = 42) experienced the web-based mind map learning technique, while the control group students (n = 49) experienced the lecture and question-answer teaching methods. FINDINGS: The mean scores of the experimental group in terms of reaching the nursing diagnosis, descriptive characteristics, and the etiological and risk factors were significantly higher than the control group (p < 0.05). The findings showed that the experimental group scored significantly higher than the control group in making accurate diagnoses (p < 0.05). CONCLUSIONS: The web-based mind map learning technique used in teaching the nursing process favorably affected the students' ability to determine the nursing diagnosis, descriptive characteristics, and etiological and risk factors. The findings suggest that the web-based mind map learning technique should be used in teaching the nursing process. IMPLICATIONS FOR NURSING PRACTICE: Active learning in nursing process teaching should be promoted using different teaching techniques. Teaching the nursing process with different teaching techniques has the potential to to increase the knowledge and skills of students and thus improve the quality of nursing care.

Health Care Professionals' Attitudes Toward Patients with Chronic Pain: Scale Development Study.

BACKGROUND: One of the obstacles in chronic pain management is the attitude of healthcare professionals. Although literature reports that the negative attitudes of healthcare professionals such as stigmatizing their patients with chronic pain and applying inadequate treatment cause failure in chronic pain management, there is no scale to measure the attitudes of healthcare professionals towards patients with chronic pain. PURPOSE: This study aimed to develop a scale for identifying healthcare professionals' attitudes towards patients with chronic pain. METHOD: We prepared a draft scale in the form of five-point Likert. We applied the draft scale to 379 voluntary healthcare professionals working in two hospitals in 2019. Internal consistency and testretest methods were employed to determine the reliability of the scale. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used for construct validity. FINDINGS: According to the EFA, the scale had two factors explaining 45.68 of the total variant. We labelled the first factor "sensitivity orientation" and the second factor was labelled "misconception orientation". Cronbach Alpha coefficients were 0.88 and 0.75 for the first and second factors respectively. Test-retest method reliability was r = 0.83 in the first factor and r = 0.75 in the second factor. The CFA showed that they were within the limits of acceptable fit values. CONCLUSIONS: Our study found that the scale for healthcare professionals' attitudes towards patients with chronic pain is a valid and reliable tool.

Effect of Fist Clenching on Vein Visibility and Palpability: An Observational Descriptive Study.

No information exists on the minimum number of times that fist clenching should be performed to increase vein visibility and palpability. In this study, the researchers aimed to determine the average number and duration of fist clenching to increase vein visibility and palpability before peripheral intravenous catheter insertion. This observational study included 207 healthy individuals. Participants meeting the inclusion criteria were asked to perform fist clenching. The number and duration of fist clenches performed to increase dorsal metacarpal vein and cephalic vein grade were determined. The participants carried out fist clenching 7.57 ± 4.26 times for the first increase and 22.16 ± 7.93 times for the second increase in dorsal metacarpal vein grade. Fist clenching was carried out 10.05 ± 7.30 times for the first increase and 21.30 ± 7.86 times for the second increase in cephalic vein visibility. A statistically significant, weak, but positive relationship was observed between the duration of fist clenching and the change in dorsal metacarpal vein grade and anxiety level ( r = 0.194, P < .005). However, the relationship was negative between room temperature and the duration of fist clenching in dorsal metacarpal vein grade ( r = -0.207, P = .003). This inexpensive and simple technique should be performed in specified numbers before catheter insertion.

Effect of Acupressure and Abdominal Massage on Constipation in Patients with Total Knee Arthroplasty: A Randomized Controlled Study.

This study was a randomized controlled trial aimed to compare the effects of acupressure and abdominal massage on constipation development for patients with TKA. The patients were randomly assigned to each group: control group (n = 31), acupressure group (n = 30), and abdominal massage group (n = 30). The finding showed that the severity of constipation and straining stool consistency of the groups in which acupressure and abdominal massage was applied are significantly better than the control group (p < .05). When the first defecation times of the groups are analyzed, it is seen that the patients to whom acupressure and abdominal massage are applied defecate significantly earlier than the control group (p < .05). It has been concluded that safe non-invasive acupressure and abdominal massage that can be easily applied by health professions, healthy individuals, and patients is effective on patients with total knee arthroplasty for the prevention of constipation.

Effect of Storytelling Technique on the Attitudes of Nursing Students Toward Death.

This study was conducted to determine the effect of the storytelling technique on the attitudes of nursing students toward death as a mixed research design. The study sample consisted of 94 senior students attending the nursing department of a university in Turkey. Quantitative data were collected by using the introductory characteristics form and the Death Attitude Profile-Revised, while qualitative data were collected through focus group interviews with the semistructured interview form. The data were analyzed according to number, percentage, Wilcoxon test, paired samples ttest, and descriptive analysis method. The mean Death Attitude Profile-Revised Scale score of the students before receiving the relevant education was 4.17 ± 0.21. This score increased to 4.25 ± 0.24 after the students received the education and the difference was found to be statistically significant (p < .05). In the qualitative section of the study, the data obtained from the attitudes of the students toward death were coded, and four themes were determined. The qualitative data obtained from the focus group interviews with the participating students were presented under four themes: the contribution of the storytelling technique to learning, the effect of the storytelling technique on the attitude toward death, thoughts about the storytelling technique, and contribution of the course to knowledge, skills and attitude in giving care to the dying patient. As a result of the study, explaining the subject of death with the storytelling technique was determined to positively affect the attitudes of the students toward death.

Effect of a Vein Imaging Device and of Fist Clenching on Determination of an Appropriate Vein and on Catheter Placement Time in Patients Receiving Chemotherapy: A Randomized Controlled Trial.

BACKGROUND: As the vein structure gets damaged in patients receiving chemotherapy treatment, placement of peripheral intravenous catheter becomes difficult. To increase the success of peripheral intravenous catheter placement, a vein imaging device and fist clenching can be used. OBJECTIVE: The aim of this study was to determine the effect of using a vein imaging device or fist clenching on the determination of an appropriate vein and successful catheter placement time in adult patients receiving chemotherapy. METHODS: One hundred thirty-five patients receiving chemotherapy were randomly assigned to either the vascular imaging device group (n = 45), the fist clenching group (n = 45), or the control group (n = 45). In the vascular imaging group, a vascular imaging device was used to determine the appropriate vein; in the fist clenching group, the patients were asked to open and close their palms to determine the appropriate vein; and in the control group, no interventions except for the process steps were applied and the same nurse carried out the catheter insertion. RESULTS: The durations of determining the appropriate vein and successful peripheral intravenous catheter insertion were shorter in the device group at a significant level (P < .05) compared with the control group. The satisfaction levels of the patients and the nurse were higher in the device group at a significant level (P < .05) compared with the control group. CONCLUSION: The vascular imaging device was effective in determining the proper vein and in successful intravenous catheter insertion time in patients who were receiving chemotherapy. IMPLICATIONS FOR PRACTICE: The use of vein imaging device will have positive results for patients and nurses.

The Challenges of Nurses Who Care for COVID-19 Patients: A Qualitative Study.

This study, which had a qualitative research design, was conducted to identify the challenges experienced by nurses who care for patients diagnosed with COVID-19. The nurses providing one-to-one care to patients diagnosed with COVID-19 in various hospitals in Turkey constituted the population of this study. The maximum variation sampling method was used to determine the sample in the research. In the sample selection, the provinces and hospitals were selected by drawing lots. The sample of the study consisted of 15 nurses who worked in different hospitals in different regions of Turkey, performed one-to-one care of patients diagnosed with COVID-19 between March and April 2020, volunteered to participate in the study, and agreed to be interviewed by the researcher. SRQR guidelines were followed in reporting the study. As a result of the study, 7 difficulties, or 7 themes, were identified. These themes include anxiety and fear of being infected, change in the family order, performing patient care with fear, perception of stigma in society, questioning the nurse's place within the health system, difficulty working with personal protective equipment, and physical damage caused by equipment.

The Development and Effectiveness of a Care Protocol Using the Stevens Star Model of Knowledge Transformation in Female Patients With Stress Incontinence: An Experimental Study.

BACKGROUND: Nurse-led pelvic floor muscle exercise and lifestyle education programs are effective first-line interventions for women with stress incontinence (SI). PURPOSE: To develop an evidence-based stress incontinence care protocol (SICP) using the Stevens Star Model of Knowledge Transformation and evaluate its effect on the frequency and quantity of urinary incontinence, quality of life, pelvic muscle self-efficacy levels, and lifestyle variables of women with SI. METHODS: An SICP was developed on the basis of the Star model. The views of an expert were consulted for testing the content validity of the protocol. Using a pretest-posttest experimental design, 68 women with SI who visited an outpatient clinical at a hospital in Turkey were prospectively enrolled in the intervention (n = 34) and control (n = 34) groups. After obtaining baseline demographic and health history information, participants completed the King's Health Questionnaire, the Broome Pelvic Muscle Exercise Self-Efficacy Scale, a 3-day voiding diary, and a 1-hour pad test. The intervention group received an 8-week program of care according to the Star model-derived SICP, and follow-up assessments were completed by both groups after 8 and 12 weeks. RESULTS: The content validity index for the SICP was 91.9%. The intervention group had a reduced quantity and frequency of urinary leakage, reduced King's Health Questionnaire scores, and increased Broome Pelvic Muscle Exercise Self-Efficacy Scale scores (P < .05). CONCLUSION: Care provided according to the Star model-derived SICP reduced the quantity and frequency of SI and improved the perceived pelvic muscle exercise self-efficacy and quality of life of the participants.

The Effect of Preoperative Video Based Pain Training on Postoperative Pain and Analgesic Use in Patients Undergoing Total Knee Arthroplasty: A Non-randomized Control Group Intervention Study.

This non-randomized control group intervention study was conducted to determine the effect of preoperative video based pain training on postoperative pain and analgesic use in patients undergoing total knee arthroplasty. During the study, the patients in the control (n = 40) received routine care and the patients in the intervention group (n = 40) received video based pain training. It was determined that the mean postoperative pain scores of the intervention group were significantly lower and their pain management was better compared to the control group (p < .05). The intervention group was found to use significantly less paracetamol on operation day compared to the control group (p < .05). The intervention group was determined to benefit from non-pharmacological methods more than the control group did (p < .05). Providing video based pain training to patients undergoing total knee arthroplasty is recommended since it reduces postoperative pain levels and increases the use of non-pharmacological pain control methods.

Effect of music therapy on nursing students' first objective structured clinical exams, anxiety levels and vital signs: A randomized controlled study.

BACKGROUND: Music is a tool that can be used to reduce stress and anxiety, maintain vital signs at normal levels, and increase exam success. OBJECTIVES: This study aimed to determine the effect of music therapy on nursing students' first objective structured clinical exam success, anxiety levels, and vital signs, and to reveal their views about music therapy in the context of an exam. DESIGN: Mixed-pattern single-blind randomized controlled qualitative study. SETTING: Department of Nursing, Faculty of Health Sciences, Ankara, Turkey. PARTICIPANTS: First-year students enrolled in the Fundamentals of Nursing II course were randomly assigned to an experimental (n = 61) or control group (n = 64). Twenty-two (22) experimental group students provided the sample for the qualitative stage. METHODS: Data were collected between February and June 2018 using the Informative Features Form, State-trait Anxiety Inventory, Vital Signs Assessment Form, Skill Checklists, and Focus-group Interview Form. All students completed the theoretical classes, laboratory classes, and small-group studies. The experimental group participated in five music therapy sessions two weeks before the exam. All students' vital signs were measured before and after the exam. Three focus group interviews were conducted with the 22 experimental group students in the week after the exam. RESULTS: The blood pressure values of the experimental group before and after the exam were significantly lower than those of the control group (p < 0.05). No significant difference was observed between exam success and anxiety levels between the two groups. In the focus group interviews, students said they found music therapy suitable for reducing anxiety in their daily lives, but not before the exam. CONCLUSIONS: Music therapy had positive effects on the students' blood pressure but had no effect on exam success or anxiety levels. This study suggests that more music therapy sessions be conducted with different groups of students in greater numbers before different exams.

Obstacles to Providing Urinary Incontinence Care Among Nurses in Turkey: A Descriptive Study.

Nurses play an important role in identifying, evaluating, monitoring, and managing patients with urinary incontinence (UI). PURPOSE: This study was conducted to determine nurses' knowledge, attitudes, practices, and obstacles to managing patients' UI. METHODS: A descriptive study was conducted between September 2017 and February 2018 at 2 university hospitals, 2 private hospitals, and 4 state hospitals in a metropolitan city in Turkey. All registered nurses present at the times of data collection were eligible to participate. After providing informed consent, they were asked to complete a 25-item demographic characteristic questionnaire, a 7-item UI assessment and care implementation form, a 12-item form assessing obstacles faced during UI care provision, a 24-item UI knowledge questionnaire (higher scores indicated more knowledge; a score of 70% correct was considered adequate), and the Urinary Incontinence Attitude Scale. The latter comprised 15 Likert-type questions that measures attitudes toward UI symptoms, treatment, and prevention (maximum score of 60; higher scores infer positive attitude). Data were collected and entered into a software program for statistical analysis including Mann Whitney U, chi-square, and correlation tests. Incomplete forms were excluded. RESULTS: Of the 475 potential participants, 254 nurses completed all forms; 228 (89.8%) were women, 177 (69.7%) had a bachelor's degree, 146 (57.5%) worked in a state hospital, and 105 (41.3%) worked for 2 to 3 years. The mean score for UI knowledge was 15.22 ± 3.43 (range 0-24), and the mean attitude score was 46.40 ± 5.50 (range 15-60). The major nurse- or hospital-related obstacles to providing UI care were a lack of systems for patient follow-up (67.7%) and lack of patient education materials (60.2%). A weak positive correlation was noted between UI knowledge level and attitude (r = 0.263; P = .000). CONCLUSION: Although nurses had a positive attitude toward UI, UI knowledge scores were low. Lack of patient follow-up systems and patient education materials were important obstacles to nurses providing UI care. In addition to addressing these obstacles, postgraduation evidence-based UI education for nurses is needed to optimize care.

Effect of a game-based virtual reality phone application on tracheostomy care education for nursing students: A randomized controlled trial.

BACKGROUND: A game-based virtual reality phone application is used as a simulation to teach psychomotor skills in nursing education. OBJECTIVE: This study aims at determining the effect of a game-based virtual reality phone application on tracheostomy care education for nursing students. DESIGN: Single-blind randomized controlled trial conducted from March-April 2017. SETTING: Department of Nursing, Faculty of Health Sciences, Central Anatolia of Turkey. PARTICIPANTS: A total of 86 first-year nursing students registered in Fundamentals of Nursing-II were included in this study. The students were divided at random into two groups, control (n = 43) and experimental (n = 43). METHOD: The data were collected with an informative features form, a tracheostomy care knowledge test and skill checklists, and a performance assessment form. The control group commenced the study first so that the students did not affect each other. After the students completed the theoretical class, laboratory class, and small group study, they had their knowledge test and skills evaluation. The application featured tracheostomy care and was designed in support of formal education. It was uploaded to the mobile phones of the experimental group at a different phase of the study from the control group. After the experimental group made use of this application for seven days, their last knowledge test and skills evaluation were conducted. RESULTS: The results of this study determined that the suctioning a tracheostomy tube and peristomal skin care average final test scores of the students in the experiment group were higher than the average scores of the students in the control group; this was statistically significant (p = 0.017, p = 0.003). CONCLUSION: The game-based virtual reality phone application was effective in teaching the skill of suctioning a tracheostomy tube for nursing students in the short term, and it is recommended that this application be used in psychomotor skill training.

A Descriptive Study of Turkish Intensive Care Nurses' Pressure Ulcer Prevention Knowledge, Attitudes, and Perceived Barriers to Care.

Nurses should be highly knowledgeable about and have a positive attitude toward pressure ulcer (PU) prevention. PURPOSE: This descriptive study was conducted among intensive care unit (ICU) nurses in 6 hospitals in Turkey to identify their PU prevention knowledge, attitudes, and perceptions of barriers to care. METHODS: The study was conducted between January 1, 2017, and April 30, 2017, using supervised self-reporting, among nurses working in the ICUs of 3 education and research hospitals, 2 university hospitals, and a private hospital in Ankara, Turkey. Three (3) data collection instruments were used: a participant sociodemographic data collection form, the Pressure Ulcer Prevention Knowledge Assessment Instrument (range 0-26, where higher scores indicate more knowledge), and the Attitude Towards Pressure Ulcer Prevention Instrument (range 13-52; a higher score implies a more positive attitude). Frequencies, t tests, analysis of variance, Pearson correlation analysis, and multiple regression analysis were used to analyze the data. RESULTS: Participants (N = 390) were mostly women (339; 86.9%) who had a bachelor's degree (283; 72.6%). The mean knowledge score was 11.54 ± 2.91, and the mean attitude score was 42.96 ± 4.06. The most commonly cited barriers to PU prevention were insufficient staff levels (85.6%) and pressure redistribution materials and equipment (82.6%). Regression analysis of attitude scores showed the following variables affected nurses' attitude toward PU prevention: self-sufficiency in PU risk assessment (ß = 0.28), willingness to learn more about preventing PU (ß = -0.15), gender (ß = -0.15), and knowledge score (ß = 0.14). CONCLUSION: ICU nurses were found to have a low levels of knowledge but positive attitudes toward PU prevention. Policies and procedures should be developed to increase ICU nurse knowledge levels and remove barriers to optimal PU prevention practices.