The epidemiology of injury among adolescents with hearing loss, health beliefs regarding injury and associated factors.

BACKGROUND: Adolescents with hearing loss are more at risk of injury. Their injuries commonly occur at school, in traffic, and other sporting areas and can adversely affect their health. OBJECTIVE: The study aims were to understand the epidemiology of the injuries that occurred among adolescents with hearing loss and to explore their health beliefs regarding injury and their associated factors. METHODS: A cross-sectional study was conducted over the period 2018-2019 with 218 adolescents with hearing loss. A sociodemographic questionnaire, an accident and knowledge questionnaire, the Health Belief Model (HBM)-based Injury Scale and a school accident form were provided by interviewers who were fluent in sign language. Descriptive statistics, the Mann-Whitney U, Kruskal-Wallis tests and regression analysis were used to analyze the responses given to the above instruments. RESULTS: Forty-six percent of the adolescents with hearing loss experienced accidents, with pedestrian (42.9%) and passenger (42.9%) types being the most common traffic-related injuries and bleeding (29.4%) and fracture (23.5%) for school related injuries. Factors that are protective against injuries are higher parental education level (father education: OR 1.08, 95% CI = 0.81-1.44; mother education: OR 0.77, 95% CI = 0.59-1.01), and higher knowledge of traffic signs (right: OR 1.23, 95% CI = 0.62-2.42; green: OR 0.59, 95% CI = 0.28-1.23). Factors that were associated with elevated risk of injuries included worse hearing loss categories (OR 3.39, 95% CI = 1.07-8.99). CONCLUSIONS: Adolescents with hearing loss are commonly injured. Schools should consider education on how adolescents with hearing loss can protect themselves through potential tailored HBM-based injury prevention interventions.

Behaviours of adolescents towards safety measures at school and in traffic and their health beliefs for injuries.

AIM: The aim of this work is to determine the behaviours of adolescents towards safety measures at school and in traffic and their health beliefs for injuries. BACKGROUND: Adolescents are more prone to injuries, as they are more willing to try risky health behaviours. METHODS: This descriptive and cross-sectional study was conducted at high schools in Turkey. The data were collected from high school students based on the self-report method between October 2017 and January 2018. Frequency, percentage, chi-square, t test, and logistic regression were used to analyse the data. RESULTS: A total of 481 adolescents participated in the study. The response rate is 96.05%. As a result of the research, 12.5% of the adolescents reported that they were injured in traffic and 18.9% of them were injured at school. Adolescents who did not have an accident had higher scores of health beliefs than those who had an accident (p < 0.05). The most important predictors of injury are being male (OR: 2.52, 95% CI [1.19, 53.00]), parents' separation (OR: 2.82, 95% CI [0.98, 8.09]), and not believing that traffic rules were safe (OR: 3.15, 95% CI [1.42, 6.97]). CONCLUSION: Adolescents have risky behaviours at school and in traffic, and these risk behaviours are related to demographic characteristics and health beliefs. School nurses should plan health belief model-based injury prevention programs.

Health literacy of hearing-impaired adolescents, barriers and misunderstandings they encounter, and their expectations.

BACKGROUND: Adults who are deaf or hard of hearing (D/HoH) have lower levels of health literacy compared to their counterparts who can hear. It is unclear, however, whether or not this inequality manifests in adolescence. OBJECTIVE OR HYPOTHESIS: This study aims to determine levels of health literacy among D/HoH adolescents and to identify barriers and misunderstandings they encounter as well as their expectations when applying for healthcare services. METHODS: This descriptive study was conducted with 88 D/HoH adolescents over the age of 15. The Health Sciences Faculty granted approval for the study. RESULTS: Of the adolescents, 70.5% had inadequate, 19.3% had limited, 2.3% had adequate and 8% had excellent health literacy levels. Those who had difficulty in communicating with the doctor (25%), those who misused the prescribed medication (13.6%) and those who could not use the medication without help (43.2%) had low THLS scores (<0.05). Those who stated that they did not understand what the nurses said (43.2%) or the health education materials (56.8%) and had significantly low THLS scores (<0.05). Of these adolescents, 55.7% expected their prescriptions or care procedures to be given to them in writing, and 87.5% expected that these would be explained to them in sign language. A significant relationship was observed between hearing disability and health literacy (R = 0.659, R2 = 0.434) (p < 0.01). CONCLUSION: Most D/HoH adolescents have a significantly lower level of health literacy, which is more likely linked with poor communication and misunderstandings concerning medication instructions.

The impact on adolescents of a Transtheoretical Model-based programme on fruit and vegetable consumption.

OBJECTIVE: The present study aimed to evaluate the impact of a Transtheoretical Model-based programme titled 'Fruit & Vegetable-Friendly' on the fruit and vegetable (F&V) consumption of adolescents. DESIGN: A quasi-experimental study. The 'Fruit & Vegetable-Friendly', a multicomponent intervention based on the Transtheoretical Model, was completed in eight weeks. The data were collected one week before the intervention, one week after the completion of the intervention and six months after the post-test with an F&V intake questionnaire and the stages of change, processes of change (α = 0·91), situational self-efficacy (α = 0·91) and decisional balance (α = 0·90 for pros, α = 0·87 for cons) scales. Data were analysed with the Friedman, Wilcoxon and marginal homogeneity tests. SETTING: A public secondary school in Istanbul, Turkey. PARTICIPANTS: Seven hundred and two adolescents. RESULTS: The mean (sd) F&V intake of adolescents in the passive stages rose from the daily average at the time of the pre-test of 3·40 (1·79) portions to 5·45 (2·54) portions on the post-test and to 5·75 (2·70) portions on the follow-up test (P < 0·01). While the students in the passive stages represented 41·6 % of the participants prior to the programme, this rate fell to 23·7 % at the post-test and to 22·7 % at the follow-up. Students in the active stages first represented 58·5 % of the participants; this rate rose to 76·4 % at the post-test and to 77·2 % at the follow-up test. CONCLUSIONS: The programme was effective in increasing the amount of F&V the adolescents consumed on a daily basis.

The Family Management of Childhood Chronic Conditions: Measurement in a Turkish Sample.

PURPOSE: The principal aim of this study was to adapt the FaMM into the Turkish language and test its validity and reliability. DESIGN AND METHODS: Data were collected from a total of 395 parents of children with chronic disease. The FaMM was translated using the translation and back-translation method. The reliability analysis of the FaMM was performed using Cronbach alpha coefficients, item-total correlations and test-retest correlations. Construct validity for the scale was assessed with confirmatory factor analysis (CFA) and exploratory factor analysis (EFA). RESULTS: The overall content validity index was 95%, signifying that the FaMM has good content validity. The CFA of the Turkish version of the FaMM did not confirm the original factorial structure. The model of three subscales for the Turkish FaMM was validated using EFA. The values of ≥0.70 for the Cronbach alpha coefficient, >0.25 for the item-total correlations and >0.40 for the test-retest application correlations for 2 weeks were found to be acceptable levels for the instruments and its subscales. CONCLUSIONS: The FaMM was found to be valid, reliable and appropriate for Turkish culture and psychometric characteristics were satisfactory. PRACTICE IMPLICATIONS: The FaMM can be used in evaluating the management of illness in families with children with chronic disease.

Achieving consensus on the undergraduate curriculum of public health nursing in Turkey.

OBJECTIVE: The aim of this study was to construct a consensus on the undergraduate learning objectives and topics for public health nursing (PHN) in Turkey. DESIGN: A three-round e-mail-based Delphi study was conducted between May and July 2015 with a national sample. SAMPLE: Ninety-one academics from 54 universities were invited as experts to participate by e-mail. Fifty-nine academics from 43 universities participated in the study. MEASUREMENTS: Data were analyzed by computing the median, quartiles one and three, and the interquartile range for each learning outcome and topic. Consensus was considered as less than the interquartile range of 1.2. RESULTS: Experts who participated in the study added 70 learning outcomes, eight main topics, and 278 sub-topics during the first round. Round I generated 170 learning outcomes, 28 main topics, and 385 sub-topics. At the end of Round II, consensus was reached on 126 learning outcomes, 22 main topics and 168 sub-topics. At the end of Round III, consensus was achieved for 126 learning outcomes, 22 main topics, and 169 sub-topics. CONCLUSION: The learning outcomes and topics that were decided upon through a consensus process will contribute to the standardization and development of PHN education.

The effectiveness of a nail-biting prevention program among primary school students.

PURPOSE: This study aimed to demonstrate the effect of a program called "Do Not Bite Your Nails, Cut Your Nails," which is based on a health promotion model to change the nail-biting habit among primary school students. DESIGN AND METHODS: This quasi-experimental study was conducted using the pre- and post-test and interrupted time series design. The study sample included 299 students. Nurse observation form and nail follow-up chart were used to evaluate behavioral outcomes. This program was conducted under the guidance of school nurses and lasted 6 weeks. The data were analyzed using McNemar and Cochran Q tests. RESULTS: The number of those who selected "yes" for "I cut my nails this weekend" and "I didn't bite my nails today" increased. However, the number of the students that selected "yes" for "I pulled out my nails," "I pulled out and ate," "I pulled out my nail skin," "My cuticle bled today," and "My nails hurt today" decreased significantly and statistically compared with pretest, first and second observation, and post-test (P < 0.001). The rate of the students with minimum one abnormal finger was 83.9% according to observations, and 6% following the intervention (P < 0.001). New insights were provided into the program to diminish nail-biting habit. PRACTICE IMPLICATIONS: The program significantly reduced the nail-biting rate among primary school students. The nurse that implement this program will be able to do a comprehensive evaluation of students' nail-biting habits, perform solution-focused interventions, and prevent advanced complications that might develop in connection to nail-biting. Thus, the effectiveness of nursing implementations will improve in the prevention of nail-biting habit, early diagnosis, and changing students' habits. "Do Not Bite Your Nails, Cut Your Nails" program can be applied again in different schools.

Exposure to Violence of Secondary School Children with Visual Impairment.

Although violence is a serious issue that children face all over the world, there is little known about the extent of the violence children with disabilities experience. This study was conducted to identify the frequency of exposure to violence that students with visual impairment experience in any environment, directly or as a witness, and the factors associated with this exposure. The study was conducted as descriptive research at a Secondary School for the Visually Impaired in 2011-2012 with 84 individuals. A questionnaire on demographics, a Violence Exposure Scale, and face-to-face interviews were used as data collection tools. It was found that the large majority of the children with visual impairment in the study had encountered violence on one occasion or more, recently or in the past. The number of students recently exposed to violence was higher than the number of children encountering violence in the past. The mean scores of the students who had recently experienced violence were higher than the scores for exposure to violence in the past. A large majority of the students with visual impairment in the study, all of the boarding students, and most of the day students had been exposed to violence once or more both recently and in the past. It was found that being male, having a congenital visual impairment, and living as a boarding student were risk factors in terms of violence. It may be recommended that school nurses more closely monitor this group of students for signs of violence.

Females' Attitudes Toward Mental Illness: A Sample From Rural Istanbul, Turkey.

BACKGROUND: The beliefs, attitudes and behaviors of the society toward mentally ill patients may prevent these people from seeking help and accessing a successful treatment. OBJECTIVES: The current study aimed to investigate mental illness among Turkish females residing in rural areas and their attitudes toward mental illness. PATIENTS AND METHODS: The current study was inferential cross-sectional. The population of this study consisted of 1000 households registered at the primary healthcare centre in Ademyavuz area who met the study inclusion criteria. The sample size was 387 females. Using the simple random sample selection method, certain females living in these households were included in the study. The socioeconomic status of the population in this region is low and middle-class. The adult population of the region is 10,960. Females comprise 39.8% of Ademyavuz population. The prevalence of mental illness in the district is unknown. Data were collected by face-to-face interviews using a researcher made questionnaire and the opinions about mental illness scale (OMI) in autumn 2008. The interviews were conducted at the participants' houses and lasted for 20 - 30 minutes. The females gave their informed consent and were assured that their information would be treated as strictly confidential. RESULTS: The females in the rural research area had negative attitudes and stigmas about mental illness. The subject of the current study exhibited a total mean score of 155.6 ± 24.5 in terms of their attitudes toward mental illness. Mean scores in the unsophisticated benevolence sub-scale were 42.5 ± 8.2, 34.2 ± 7.9 in the authoritarianism sub-scale, 25.5 ± 6.3 in the mental illness ideology sub-scale, 34.0 ± 7.4 in the social restrictiveness sub-scale, and 20.0 ± 6.0 for the interpersonal etiology sub-scale. The current study found that individuals exhibited more positive attitudes towards mental illnesses as they got older ((Kvx2) = 19.42; P < 0.0001), married people exhibited a more positive attitude towards mental illnesses than singles did (Kvx(2) = 19.42; P < 0.0001), those who considered themselves to have a good economic status exhibited a more negative attitude towards mental illnesses compared to the ones who thought their economic status as poor or average (Kvx(2) = 5.11; P = 0.024). CONCLUSIONS: Nurses have an important role in creating and maintaining a mentally healthy society. It is advisable to provide the public with training and consultancy services within the context of primary healthcare services, especially during home visits to change the negative attitudes of individuals against the mentally ill and prevent approaches that promote social isolation and denouncement.

Internet addiction and physical and psychosocial behavior problems among rural secondary school students.

The aim of this study was to determine secondary school students' levels of Internet addiction and the physical and psychosocial behavior problems they face while using the Internet. This descriptive study was conducted in three state secondary schools in a rural area in the western part of Turkey. This study's sample consisted of 549 students who agreed to participate, with the consent of their families, and who had an Internet connection at home. The data were evaluated using t-tests and variance analyses. In this study the students' score of Internet addiction was at medium level (mean addiction score 44.51 ± 17.90). There were significant differences between the students' Internet addiction scores and the presence of physical behavior problems (going to bed late, skipping meals, eating meals in front of the computer) and psychosocial behavior problems (suffering from conditions such as restlessness, anger, heart palpitations, or tremors when they could not connect to the Internet, decreased relationships with family and friends, feelings of anger, arguing with parents, and finding life boring and empty without an Internet connection).

Breast Cancer Risks and Effectiveness of BSE Training among Women Living in a District of Istanbul.

OBJECTIVE: The purpose of this study to determine the risks associated with breast cancer in women who live in a neighborhood in Istanbul, and to evaluate the effectiveness of breast self-examination (BSE) training. MATERIALS AND METHODS: This study was designed by using a half-experimental model, with women over the age of 18 who visited the community health center in a district of Istanbul, during March/April 2012. Sample selection was not implemented, and 169 women who voluntarily participated in the study were included. Data was collected by face-to-face interview technique with "Demographic Survey Form", "Breast Cancer Risk Assessment Form" and "BSE Training Assessment Scale". After risk assessment, women who wanted to learn BSE (n=109) were given a practical training program lasting approximately 20 minutes that was prepared together with expert consults. RESULTS: 32.1% of the participants regularly performed BSE. Out of those who do not use regular self-examination, 15.4% thought BSE was unnecessary, 44% was afraid to examine herself, and 40.7% did not know how to apply BSE. The mean breast cancer risk score was 135.64±61.33. There were statistically significant differences between breast cancer risk score and the educational status, marital status, and menstrual status. A statistically significant difference was found in pre- and post-training BSE Training Assessment Scale scores. CONCLUSION: The breast cancer risk score was low among women included in this study. However, the vast majority of women did not perform BSE, and those who did were using either irregular or improper practice. It was detected that implementation of planned and in-person training programs were quite effective.