Tubular graphitic carbon nitride-anchored on porous diatomite for enhanced solar energy efficiency in photocatalytic remediation and energy storage performance.

Dual functional materials can be beneficial for simultaneous application in different fields. Herein, tubular graphitic carbon nitride (TCN) was anchored on natural diatomite (DT) by performing a simple hydrothermal-calcination method and the as-obtained composite (TCN/DT) was utilized in both photocatalytic remediation and thermal energy storage. The optimal sample, TCN/DT/3, could degrade 88.9 % of tetracycline, which was about 2.87 times than that of the pristine TCN. This could be due to extended light absorption ability, altered band structure and enhanced separation rate of photoinduced carrier. The photocatalytic efficiency remained 78.0% after fifth cycle, indicating its reusability feature. The reaction was mainly driven by superoxide radicals as well as holes and hydroxyl radicals mediated the reaction. The TCN/DT/3/Vis system showed good performance at near-neutral pH, also the system could be efficiently performed under tap water and drinking water. On the other hand, the usage of TCN/DT/3 catalyst as a framework for shape-stabilized stearic acid (SA) based composite phase change materials (PCMs) was explored. The composite PCM exhibited higher thermal energy storage capacity accompanied with improved thermal conductivity in comparison with DT/PCM composite. This study presented a novel composite materials which exhibited a synergistic effect between TCN and DT, resulting in high photocatalytic activity and effective thermal energy storage capacity.

Understanding Family Members in the Palliative Phases of Their Loved Ones: A Qualitative Study.

Because of aging and rising rates of chronic diseases, the demand for palliative care services is increasing worldwide, and patients need family members to care for them throughout the palliative care process. This study aimed to investigate the experiences of the relatives of palliative care patients during hospitalization. This was a qualitative study conducted with 15 family members. A topic guide was used to conduct semistructured face-to-face interviews. Content analysis was used to analyze the textual data. As a result of the analysis, 3 main themes, 6 categories, and 24 subcategories emerged. The main themes were "reactions to the admission," "feeling obligated to care," and "coping processes." The interviews revealed that most participants had misconceptions and a lack of knowledge about palliative care. Almost all of the family members expressed that they experienced various emotions during this process and had trouble coping. The significant finding of our study is that culture and religious beliefs have a considerable influence on caregiving. A limited number of studies in the literature provide detailed insight into the state of patient relatives. Therefore, this study is critical in guiding palliative care professionals in understanding the requirements of this vulnerable group.

Sulfonated polyHIPE/nanoclay composites with hierarchically porous structure for efficient removal of endocrine-disrupting hormone from aqueous solution.

The objective of this study is the synthesis of macroporous polystyrene-based polyHIPE/nanoclay (p[HIPE]/NClay) monoliths and post-functionalization of the monoliths through sulfonation to improve the structural and textural properties as well as adsorption performances toward bisphenol A (BPA) as an endocrine-disrupting chemical. The adsorption tests were conducted with raw p(HIPE), nanoclay, p(HIPE)/NClay, and sulfonated samples in order to obtain insights in the adsorption mechanism. The synergy between clay embedding and sulfonation resulted in higher BPA removal performance of p(HIPE)/NClay@S sample (96% removal) when compared with the raw polyHIPE (52% removal). The adsorption efficiency was mainly attributed to the functionality, followed by porosity and hydrophilicity of the as-synthesized materials. Considering the roles of hydrophobic, hydrogen-bonding, and π-π stacking interactions, the adsorption mechanism was discussed by using X-ray photoelectron spectroscopy (XPS) analysis. Moreover, the experimental parameters including solution pH, co-existing anions, ionic strength, and temperature were investigated in detail. The adsorption data were fitted to isotherm and kinetic models. The composite adsorbents also displayed excellent regeneration and stability until the fifth cycle. This research provides fresh insights into the effective adsorptive removal of endocrine-disrupting hormones by sulfonated porous nanoclay-polymer monoliths. PRACTITIONER POINTS: Sulfonated p (HIPE)/nanoclay monoliths were prepared. Bisphenol A adsorption mechanism was explored in detail. Nanoclay incorporation and sulfonation greatly enhanced the removal efficiency. The composite could be used until the fifth cycle.

Development and evaluation of cardiac implantable electronic devices knowledge scale.

BACKGROUND: Patients with cardiac implantable electronic devices (CIEDs) need specific education to successfully adapt to life with new devices in their bodies. This requires specifically-tailored training processes. To determine the educational requirements, robust measurement tools are essential; however, a literature review revealed that no reliable and valid knowledge scale currently exists for patients with CIEDs. OBJECTIVE: The study was conducted to develop and test the psychometric properties of the scale for measuring the knowledge of patients with CIEDs. METHODS: The cross-sectional and descriptive study was conducted with 150 patients with CIEDs. Data were collected with a specially-developed cardiac implantable electronic devices knowledge (CIEDsK) Scale consisting of 14 questions. To determine the reliability of the scale, the following tests were performed: Kuder Richardson-20 reliability coefficient, intraclass correlation (ICC) analysis, and corrected item-total scale correlation analyses. The content validity, predictive validity, and item discrimination index were examined to evaluate the validity of the scale. RESULTS: The Kuder Richardson-20 reliability coefficient indicated very good internal consistency (.92). ICC was .92, demonstrating excellent reliability. Four questions were removed after failing to meet the inclusion criteria for the content validity index (<0.70), the discrimination index (<0.10), and item-total correlation (<0.20). Predictive validity analyses showed that the following were effective in predicting the total score: age, income status, implantation length, and informed by a healthcare professional, however, education level was not. After all analyses, 10 multiple-choice questions remained in the final scale about living with CIEDs. CONCLUSION: The study showed that the CIEDsK scale is valid and reliable for measuring the knowledge of patients with CIEDs in daily practice. Thus, patient-tailored education sessions can be designed according to the knowledge level of the patients determined.

"Be Your Own Doctor" Experiences of Patients With Transcatheter Aortic Valve Implantation During the Pandemic: A Qualitative Study.

Background and Purpose: Although patients have had reduced access to healthcare institutions due to the COVID-19 pandemic and the related preventive measures, there is no current data on how the pandemic has affected patients who underwent transcatheter aortic valve implantation (TAVI), despite their need for close follow-up.This study investigated TAVI patients' experiences with self-care management during the pandemic. Methods: This study adopted a descriptive qualitative design. The sample consisted of 24 patients recruited using purposive sampling. Data were collected by telephone and analyzed using inductive content analysis. Results: The data were grouped under three themes: "vulnerability," "worsening of psychological condition," and "expectations." The most challenging self-care behaviors reported by TAVI patients were determined to be doing regular physical activity, managing their symptoms, complying with treatment, and attending regular check-ups. They also reported experiencing psychological problems such as fear, concern, and abandonment and stated a need for better communication and follow-up at home during the pandemic. Implications for Practice: The pandemic has more than ever demonstrated the importance of effective self-care for cardiovascular patients. Nurses should plan individualized interventions regarding the problems in self-care management that we identified in this study. In this regard, the use of secure digital applications such as telerehabilitation can be effective. Also, nurses should develop community-based and political initiatives to allow sustainable self-care management to be effectively implemented in special patient groups in extraordinary circumstances such as pandemics.

Hierarchical Macroporous PolyDCPD Composites from Surface-Modified Calcite-Stabilized High Internal Phase Emulsions.

High Internal Phase Emulsions (HIPEs) of dicyclopentadiene (DCPD) were prepared using mixtures of surface-modified calcite (mCalcite) and a non-ionic surfactant. Twelve different emulsion formulations were created using an experimental design methodology. Three distinctive levels of the internal phase ratio, the amount of mCalcite loading, and the surfactant were used to prepare the HIPEs. Accordingly, macroporous polyDCPD composites were synthesized by performing ring-opening metathesis polymerization (ROMP) on the HIPEs. The variations in the morphological and physical properties of the composites were investigated in terms of experimental parameters. In the end, five different model equations were derived with a confidence level of 95%. The main and binary interaction effects of the experimental parameters on the responses, such as the average cavity size, interconnecting pore size, specific surface area, foam density, and compression modulus, were demonstrated. The synergistic interaction between the amount of surfactant, the amount of mCalcite loading, and the internal phase ratio appeared to have a dominant role in the average cavity diameter. The solo effect of the internal phase ratio on the interconnecting pore size, foam density, and compression modulus was confirmed. In addition, it was demonstrated that the specific surface area of the composites was mainly changed depending on the amount of mCalcite loading.

Determination of the Fear of COVID-19 and the Quality of Life of Patients With Transcatheter Aortic Valve Implants During the Pandemic.

This study aimed to determine the fear of COVID-19 and the quality of life of patients with transcatheter aortic valve implantation (TAVI) during the pandemic. This descriptive cross-sectional study included 132 TAVI patients. Data were collected using a patient information form, the Fear of COVID-19 Scale (FCV-19S), and the EuroQol-5 Dimension (EQ-5D). The mean FCV-19S score of the patients was 17.37 ± 6.12. The mean EQ-5D index score was 0.56 ± 0.37 and the mean VAS score was 65.5 ± 11.5. As per the dimensions of the EQ-5D index, 75% of the patients had mobility problems. According to the logistic regression analysis results, mobility was the most affected parameter, as demonstrated by the worsening in symptoms during the pandemic (odds ratio: 7.370, 95% CI [2.183, 24.881]). The patients with TAVI had a moderate level of fear associated with COVID-19, and the pandemic negatively affected their quality of life.

Examining the relationship between symptoms watched in lung cancer patients and illness perception.

OBJECTIVE: To examine the relationship between the symptom experience of lung cancer patients and their illness perception of the disease. METHODS: The descriptive and cross-sectional study was conducted from April to September 2015 at the Chemotherapy Treatment Centre of the Medicine Chest Diseases Clinic at the Ege University, Izmir, Turkey, and comprised lung cancer patients of either gender aged >18 years. Data was collected using a predesigned Patient Questionnaire as well as the standard Lung Cancer Symptom Scale, Illness Perception Questionnaire and Karnofsky Performance Scale. The patients' sociodemographic characteristics and data on their illness, the symptoms they experienced and the numerical and percentage distribution of the items on the illness perception scale, mean and standard deviation values were examined. Pearson Correlation analysis was used to examine the correlation between illness perception and Karnofsky Performance Scale scores and other variables. RESULTS: Of the 105 patients, 86(81.9%) were males, 86(81.9%) were married, 49(46.7%) were elementary school graduates, 101(96.2%) were unemployed, and 95(90.5%) were receiving chemotherapy. The overall mean age of the sample was 61.43±8.24 years, the period since diagnosis was 11.38±17.84 months, and the duration of chemotherapy was 4.28±2.37 months. The mean symptom burden score was 22.75±10.85 and the Lung Cancer Symptom Scale score was 22.75±10.85. The mean score of the type of illness domain was 5.53±2.12. The overall mean global quality of life score was 64.30±12.60. CONCLUSIONS: As the symptom burden experienced by the lung cancer patients increased, their perception of the illness became more negative, and the longer the cyclical periods and the period of diagnosis, the patients' control over their illness decreased.

Intensive care experiences of intern nurse students: A qualitative study.

OBJECTIVES: This study aimed to describe the experiences of nursing interns in the intensive care unit (ICU). DESIGN: This study was a descriptive qualitative research. SETTINGS, PARTICIPANTS, METHODS: The study data were collected via focus group interviews of 25 nursing interns in the two different ICUs of a university hospital who had volunteered to participate in the study. There were four focus group interviews in all, one for each of four different groups of nursing interns. The semi-structured interview form was used in the study. RESULTS: Seven themes emerged in the study: fear, awareness of nurses' roles, finding opportunities for self-improvement, difficulty in caregiving, difficulty in communicating with the patients and the care team, experiencing ambivalent feelings related to death, and adaptation to the clinical environment. CONCLUSIONS: Doing one's internship in the ICU was evaluated by the nursing interns in this study as a beneficial practice despite the difficulties involved in it. It is recommended, that intensive-care practices be included in the undergraduate education program for nurses and that appropriate guidance and monitoring be given to the nursing interns in ICUs.

Determining Middle-Aged and Older Adults' Health Beliefs to Change Lifestyle and Health Behavior for Dementia Risk Reduction.

BACKGROUND: Global population is getting older and the prevalence of dementia continuously increases. Understanding the related health beliefs is bound to enable lifestyle-based interventions that maximize public engagement in dementia risk reduction behaviors. The aim of this study was to determine health beliefs on dementia prevention behaviors and lifestyle changes and to determine the factors influencing these beliefs among middle-aged and older people in Turkey. MATERIALS AND METHODS: This descriptive and cross-sectional study was conducted with 284 individuals aged 40 years and older, using nonprobability convenience sampling. Data were collected using a demographic characteristic form and the Turkish version of the Motivation for Changing Lifestyle and Health Behavior for Reducing the Risk of Dementia scale. The study utilized the value, mean, percentage frequency distribution, correlation, independent t test, and the one-way analysis of variance test. RESULTS: The mean age of the participants included in the study was 56.99 ± 12.05, 68.7% of individuals were males. The mean education years of the participants were 11.22 ± 4.55. The majority (72.2%) of participants expressed subjective memory complaints. Presence of family history of dementia was 28.2%. Age, gender, education years, subjective memory complaints, presence family history of dementia, prior experience as a caregiver of dementia, and willingness to know their own risk were determined as essential factors that influence several health belief factors related to dementia risk reduction. CONCLUSION: Our findings indicate that males, older adults, and lower-educated and income are priority groups that should be guided for lifestyle and behavioral changes regarding dementia risk reduction.

Validity and reliability of the Heart Disease Fact Questionnaire (HDFQ): a Rasch measurement model approach.

AIM: The aim of this study was to examine the validity and reliability of Turkish version of the Heart Disease Fact Questionnaire (HDFQ) as a measure to evaluate heart disease risk knowledge in individuals with diabetes. METHODS: This study was conducted in the primary care clinic on 326 individuals with type 2 diabetes. The Davis Method, Confirmatory Factor Analysis (CFA) and the Rasch Measurement Model used in the validity and reliability analyses. RESULTS: The validity analysis results showed Turkish version of HDFQ was content valid. The results of CFA showed the index results were very good fit. All items of the scale and the HDFQ were fit to the Rasch model and the items did not contain any differential item function. Person Separation Index showed HDFQ is reliable tool. CONCLUSIONS: The Rasch Model provides an alternative way in dealing with the challenges faced in classic methods and it is recommended to be used in health sciences. Thus, the results of this study are important. Results show that the Turkish version of the HDFQ can be used for determining awareness of heart disease risk as well as for assessing the effectiveness of implemented interventions among individuals with diabetes.

Cardiovascular Risk, Risk Knowledge, and Related Factors in Patients With Type 2 Diabetes.

Individuals with diabetes must be informed about cardiovascular diseases (CVDs), which is the most important cause of mortality of diabetes, and the interventions should be planned according to their risk status. The aim of this study was to investigate cardiovascular risk, risk knowledge, and related factors in patients with type 2 diabetes. A total of 188 participants were included in this descriptive study. Data were collected using Heart Disease Fact Questionnaire (HDFQ) and Systematic Coronary Risk Evaluation (SCORE) Calculator. Spearman test and multiple regression analysis were used for statistical analysis. Participants did not have sufficient knowledge related to CVD risk factors, and they were in the moderate CVD risk group. CVD risk was lower in subjects with high level of knowledge regarding CVD risk and lower duration of diabetes. Our findings highlight the need for interventions related to CVD, which can reduce its risk. These interventions can be specifically targeted at individuals with advanced age, a long duration of diabetes, low education level, and decreased metabolic control.

Turkish Version of the Motivation for Changing Lifestyle and Health Behavior for Reducing the Risk of Dementia Scale.

OBJECTIVE: This methodological study evaluates the validity and reliability of the Motivation for Changing Life Style and Health Behavior for Reducing the Risk of Dementia scale in Turkish. METHODS: The study enrolled 220 individuals aged 40 years and older between September 2017 and June 2018. The Kendall W analysis and content validity index were used for validity; test-retest and confirmatory factor analyses were used for the reliability analysis. RESULTS: The Turkish version of the Motivation for Changing Life Style and Health Behavior for Reducing the Risk of Dementia scale has valid content. The Cronbach α coefficient of the scale was .809, and the subscales were in the ranges of .781 to .609. A statistically significant, positive correlation was found between the test and retest scores. CONCLUSIONS: These results show that the scale has validity and reliability for use in the Turkish population.

Web-Based Intervention to Improve Implantable Cardioverter Defibrillator Patients' Shock-Related Anxiety and Quality of Life: A Randomized Controlled Trial.

In spite of its effectiveness, implantable cardioverter defibrillator (ICD) patients face psychological problems such as shock-related anxiety due to device shocks. The aim of this study was to evaluate whether a web-based intervention program for ICD patients would reduce shock-related anxiety and improve quality of life compared with usual care. This was a randomized controlled trial study including a total of 76 patients. Data were collected using Turkish versions of the Florida Shock Anxiety Scale and Short Form Health Survey (SF-36) at 0 (baseline), 3, and 6 months. Following intervention, there was a significant decrease in shock anxiety levels of patients and a statistically significant increase in social functioning, role-physical, mental health, vitality, and bodily pain subdimensions of SF-36. While no statistically significant difference was found between groups in terms of summary scores of SF-36, our results suggest that web-based interventions can be useful for ICD patients.

Propriedades psicométricas da versão turca da escala Tuberculosis-Related Stigma / Propiedades psicométricas versión turca de la escala Tuberculosis-Related Stigma / Psychometric properties of the Turkish version of the Tuberculosis-Related Stigma scale

Resumo Objetivo O objetivo deste estudo foi investigar a validade e confiabilidade da escala Tuberculosis-Related Stigma. Métodos Estudo metodológico com 263 indivíduos não diagnosticados com tuberculose pulmonar. Também foi utilizada a análise de correlação de Pearson, o coeficiente alfa de Cronbach, correlação item total e análise fatorial dos dados do estudo. Resultados Neste estudo, o coeficiente alfa de Cronbach foi 0,83 para a subescala perspectivas da comunidade e 0,89 para a subescala perspectivas dos pacientes. O RMSEA foi 0,077, NFI: 0,91, CFI: 0,94, RMR: 0,056, SRM: 0,079, GFI: 0,95, AGFI: 0,94, x2: 582,84, DP: 228 e x2/SD: 2,55 (p=0,000). Claramente, todos os índices de ajuste do modelo foram aceitáveis. Conclusão À luz dos resultados, a versão turca da escala Tuberculosis-Related Stigma tem validade e confiabilidade aceitáveis para uso na população turca.

Resumen Objetivo El objetivo de este estudio fue investigar la validez y confiabilidad de la escala Tuberculosis-Related Stigma. Métodos Estudio metodológico con 263 sujetos no diagnosticados con tuberculosis pulmonar. También se utilizó el análisis de correlación de Pearson, el coeficiente alfa de Cronbach, correlación ítem total y análisis factorial de los datos del estudio. Resultados En este estudio, el coeficiente alfa de Cronbach fue del 0,83 para las perspectivas de la subescala de la comunidad y del 0,89 para las perspectivas de la subescala de pacientes. El RMSEA fue del 0,077, NFI: 0,91, CFI: 0,94, RMR: 0,056, SRM: 0,079, GFI: 0,95, AGFI: 0,94, x2: 582,84, DP: 228 y x2 / SD: 2,55 (p = 0,000). Claramente, todos los índices de ajuste del modelo fueron aceptables. Conclusión Conforme los resultados, la versión turca de la escala Tuberculosis-Related Stigma es confiable y posee validez aceptable para su uso en la población turca.

Abstract Objective The aim of this study was to investigate the validity and reliability of the Turkish "Tuberculosis-Related Stigma Scale". Methods This study used methodological design. This methodological study was conducted with 263 with individuals who not being diagnosed as pulmonary tuberculosis. We also used Pearson correlation analysis, Cronbach alpha coefficient, item total correlation and factor analysis for the study data. Results In this study, Cronbach's alpha coefficient was .83 for the subscale community perspectives and .89 for the subscale patient perspectives. RMSEA was 0.077, NFI was 0.91, CFI was 0.94, RMR was 0.056, SRM was 0.079, GFI was 0.95, AGFI was 0.94, x2 was 582.84, SD was 228 and x2/SD was 2.55 (p= 0.000). Clearly, all model fit indices were acceptable. Conclusion In the light of the findings, Turkish version of Tuberculosis-Related Stigma Scale has acceptable validity and reliability for use in Turkish population.

The effect on patient outcomes of a nursing care and follow-up program for patients with heart failure: A randomized controlled trial.

BACKGROUND: Heart failure is associated with exacerbated symptoms such as dyspnea and edema and results in frequent hospitalization and a poor quality of life. With the adoption of a comprehensive nursing care and follow-up program, patients with heart failure may exhibit improvements in their self-care capabilities and their hospitalizations may be reduced. OBJECTIVE: The purpose of this study was to examine the effect of a nursing care and follow-up program for patients with heart failure on self-care, quality of life, and rehospitalization. DESIGN AND SETTING: This research was conducted as a single-center, single-blind, randomized controlled study at the heart failure outpatient clinic of a university hospital in Turkey. PARTICIPANTS: A total of 90 patients with heart failure were randomly assigned into either the specialized nursing care group (n=45) or the control group (n=45). METHODS: The nursing care and follow-up program applied in the intervention group was based on the Theory of Heart Failure Self-care. Data were collected at the beginning of the trial, and at three and six months after the study commenced. Self-care of the patients was assessed by the Self-Care of Heart Failure Index. Quality of life was assessed with the "Left Ventricular Dysfunction Scale". Rehospitalization was evaluated based on information provided by the patients or by hospital records. RESULTS: A statistically significant difference was found between the intervention and control group with respect to the self-care and quality of life scores at both three and six months. While the intervention group experienced fewer rehospitalizations at three months, no significant differences were found at six months. CONCLUSION: The results obtained in this study show that the nursing care and follow-up program implemented for patients with heart failure improved self-care and quality of life. Although there were no significant differences between the groups at six months, fewer rehospitalizations in the intervention group was considered to be an important result.

Barriers to Medical Error Reporting for Physicians and Nurses.

The purpose of the study was to determine what barriers to error reporting exist for physicians and nurses. The study, of descriptive qualitative design, was conducted with physicians and nurses working at a training and research hospital. In-depth interviews were held with eight physicians and 15 nurses, a total of 23 participants. Physicians and nurses do not choose to report medical errors that they experience or witness. When barriers to error reporting were examined, it was seen that there were four main themes involved: fear, the attitude of administration, barriers related to the system, and the employees' perceptions of error. It is important in terms of preventing medical errors to identify the barriers that keep physicians and nurses from reporting errors.

Effect of Support Group Intervention Applied to the Caregivers of Individuals With Heart Failure on Caregiver Outcomes.

This study was conducted to evaluate the effectiveness of support group intervention applied to the caregivers of individuals with heart failure on caregiver outcomes. Quasi-experimental research was conducted with 69 caregivers as control (n = 35) and intervention (n = 34) groups in the cardiology outpatient clinic of a university hospital. The intervention group participated in support group meetings structured according to the Neuman Systems Model, and the data were collected from both the intervention and control groups before the intervention and 3 and 6 months later. Caregivers in the intervention group had significantly lower burden scores compared with the control group in all subdimensions except objective personal care, in terms of the group × time interaction in a statistical way (P < .05). Caregivers in the intervention and control groups had similar scores of depression symptoms (P > .05). The burden of caregivers in the intervention group showed a statistically significant decrease compared with the preintervention in all dimensions at 3 months. Thus, it is suggested to extend the support group interventions for caregivers of patients with heart failure and conduct these interventions in a longer period.

Psychometric Properties of Turkish Version of the Dutch Objective Burden Inventory.

PURPOSE: The purpose of this study was to assess the psychometric properties of the Dutch Objective Burden Inventory (DOBI) for the Turkish society. METHODS: This is a descriptive, methodological study. The sample was composed of 230 heart failure patients' caregivers. RESULTS: The DOBI was translated using translation and back-translation. The translated Turkish version was submitted to eight experts who analyzed it for its content validity. Scores from the experts were evaluated using the Kendall W analysis, and no statistically significant difference was found among the scores (Kendall W = .13, p = .338). In the confirmatory factor analysis, factor loading was found to be between 0.75 and 1.00 for all subscales. Thus, the DOBI demonstrated acceptable internal consistency (the components displayed α scores from .96 to .99), good test-retest reliability (no statistically significant differences were found, p > .050). CONCLUSIONS: The Turkish version of the DOBI scale is a valid and reliable tool for the Turkish population. It can be used in nursing practices and research.

Turkish patients' decision-making process in seeking treatment for myocardial infarction.

AIM: The purpose of this study was to reveal how Turkish patients experiencing acute myocardial infarction (AMI) for the first time decide to seek medical treatment following the initiation of the symptoms. METHODS: This qualitative study was carried out by using the grounded theory. Data were collected in a university hospital cardiology clinic in Turkey between March 2009 and March 2010. The sample comprised 30 patients having experienced AMI for the first time. The data were collected by an in-depth interview technique via a semistructured interview form. All of the interviews were recorded using a tape-recorder. RESULTS: The median decision-making time was 90 min. Two main themes emerged at the end of the study: "feeling of abnormality" and "thinking the situation is critical". Deciding to seek medical help was found to be a process which emerges with the severity of symptoms, an inability to manage symptoms, fear, and extrinsic factors. CONCLUSION: The results of this study show the importance of being aware of the symptoms when deciding to seek treatment. It is recommended to develop training programs about AMI symptoms and the importance of receiving early medical help by targeting society in general and the individuals with a diagnosis of coronary artery disease and their relatives in particular, and to organize awareness-raising campaigns supported by the media.