The Effect of a Repeated Standardized Patient-Based End-of-Life Care Training Program on Nursing Students' Knowledge, Attitudes, and Emotions Toward End-of-Life Patients.

BACKGROUND: Sufficient knowledge of end-of-life care, positive attitudes, and emotions regarding death and dying are essential criteria for showcasing favorable palliative care educational results to undergraduate nursing students. However, nursing students have negative attitudes toward end-of-life care and know little about it. AIM: This study aimed to examine the effect of a repeated standardized patient-based training program (intervention) on nursing students' knowledge, attitudes, and emotions about end-of-life patients. METHOD: This study adopted a pretest-posttest quasi-experimental research design. The sample consisted of 50 fourth-year nursing students divided into intervention (n = 25) and control (n = 25) groups. All participants attended the intervention. The intervention group attended the intervention twice, while the control group attended it only once. Data were collected using a personal information form, the Frommelt Attitudes Toward Care of the Dying Scale, the Positive and Negative Affect Schedule, and the End-of-Life Care Nursing Questionnaire. The data were analyzed using descriptive statistics, Pearson's Chi-square test, dependent groups t test, Pearson-Spearman, Mann-Whitney test, Wilcoxon test, and Friedman test. RESULTS: The intervention helped participants learn more about end-of-life care (χ2 = 27.167, P = .000; F = 42.725, P = .000) and develop more positive attitudes toward end-of-life patients (F = 13.279, P = .000; F = 6.934, P = .000). The intervention also helped participants develop communication skills. CONCLUSION: Universities should integrate repeated standardized patient-based into nursing curricula.

The effectiveness of serious games designed for infection prevention and promotion of safe behaviors of senior nursing students during the COVID-19 pandemic.

BACKGROUND: Reminding health care workers, especially senior students, of the critical role they play in preventing COVID-19 transmission is more important than ever, therefore it is vital to reinforce graduate students' intrinsic motivation to implement infection prevention and control guidelines. Serious games are an interesting intervention that could improve adherence to COVID-19 safe behaviors to lower the high prevalence of nosocomial infections. These games, as a type of technology-enhanced simulation, can increase student satisfaction and engagement while still conveying vital ideas. For this reason, this study aimed to develop a serious game and evaluate its effectiveness to prevent the spread of infection and develop safe behaviors during the COVID-19 pandemic. METHODS: In total, 62 nursing students completed a socio-demographic questionnaire, COVID-19 information form, and game usability form, with the students' responses analyzed pre-test and post-test. RESULTS: Serious game implementation significantly increased senior students' knowledge of infection and safe behaviors concerning COVID-19. The students also considered the practice of serious games an effective teaching strategy. Favorite aspects of the serious game according to students' statements; It was reported as reflecting the real hospital environment, including the nursing care process and roles, being informative, being compatible by phone, and each stage of the game tested a new knowledge. CONCLUSION: Employing serious games for nursing skills development is an appropriate teaching method for infection prevention and promotion of safe behaviors among senior nursing students during the COVID-19 pandemic. This game can be obtained free of charge for research and educational purposes.

Psychometric properties of Turkish version of insulin delivery device satisfaction (IDSS) scale in patients with type 2 diabetes.

BACKGROUND/AIM: Various new insulin delivery devices (e.g., insulin pumps, digital insulin pens, continuous subcutaneous insulin infusion) and features have been introduced over the last decade, and even more are in development. Despite their benefits, however, usage rates remain low. This study aimed to evaluate the validity and reliability of the Insulin Device Satisfaction Scale (IDSS) in the Turkish population. MATERIALS AND METHODS: This cross-sectional methodological study included 150 patients with type 2 diabetes mellitus. Descriptive statistics, Cronbach's alpha, confirmatory factor analysis, and test-retest correlation were used for reliability and construct validity analyses. RESULTS: The IDSS was first translated into Turkish by two experts, then sent to a committee of 9 experts for content validity analysis. The total Cronbach's alpha value of the scale was 0.763. Goodness-of-fit indicators of the scale model were χ2 = 126.96, χ2/sd = 2.59, root mean square error of approximation = 0.076, comparative fit index = 0.90, incremental fit index = 0.91, non-normed fit index = 0.91, and normed fit index = 0.91. CONCLUSIONS: Our findings demonstrate that the Turkish version of the IDSS is valid and reliable in the Turkish population. The IDSS can be used in nursing research and practice to evaluate Turkish patients' satisfaction with insulin devices.

Metaphoric Perceptions of Covid-19 Patients Related to the Disease.

This study aimed to explore metaphoric perceptions of patients with COVID-19 including treatment process, family relationships, and mental health via using metaphors. Purposive sampling was used to include participants. Totally 46 patients diagnosed with COVID-19 were included in the study. The metaphor-based data collection process was carried out with three open-ended questions. The metaphors compiled according to questions and grouped by 13 themes according to analysis. Patients explained to COVID-19 process by using 91 different metaphors. Most frequently used metaphors by patients; black hole/dark for the treatment process of COVID-19, steel for family relationships, sea metaphor for mental health. This study, it was determined that individuals are afraid of death, have a serious perception of uncertainty, and their family relationships and this process negatively affected their family relationships and mental states. Nurses have important responsibilities to increase the quality of patient care.

The Effect of Two Different Simulation Modalities in Palliative Care Teaching on Nursing Students' Knowledge, Satisfaction, Self-confidence, and Skills: A Randomized Controlled Trial.

Nursing students from developing countries have limited opportunities to experience palliative care. Standardized patient and low-fidelity simulations can provide realistic palliative care experiences for students. However, limited research is available on simulation-based education in Palestine. Testing and using these two types of simulation methods may be the best solution for developing countries that lack adequate resources. This study aimed to test the effects of low-fidelity simulation compared with standardized patient simulation in palliative care teaching on nursing students' knowledge, satisfaction, confidence, and skills. The study was a randomized controlled trial of 70 nursing students in their sophomore year. Students' knowledge was assessed with the Palliative Care Quiz for Nursing test; satisfaction and confidence with the Learner Satisfaction and Self-confidence in Learning; and skills rated by two researchers. Students' knowledge improved significantly on the posttest compared with the pretest, without significant differences between both groups. The findings showed that the utilization of the two methods in students' clinical training for scenario has the same effect on the satisfaction and confidence. The skills of the standardized patient group improved significantly more than the low-fidelity group. The study revealed that both simulation modalities are effective for palliative care nursing students.

Turkish validity and reliability study of type 2 diabetes stigma assessment scale

Background/aim: Stigma has a high incidence and adversely affects people with diabetes. In this context, patients face difficulties such as fear of losing their jobs, travel restrictions, isolation from social life, problems related to mental health, and feeling of wellness. The aim of this study was to investigate the validity and reliability of the stigma assessment scale in individuals with type 2 diabetes. Materials and methods: The study sample consisted of 153 diabetic individuals. The validity of language, content, and construct were examined to evaluate the validity of the type 2 diabetes stigma assessment scale. Cronbach's alpha was used to assess internal consistency reliability. Results: The content validity index of 19 items which were detected as significant was found to be 0.86. The Cronbach's alpha coefficient of the scale is 0.92. The results of the item analysis show that all factor loads are significant (t-value > ±1.96). The coefficient of correlation between type 2 diabetes stigma assessment scale and test­retest technique was 0.82. Conclusion: It was concluded that the stigma assessment scale is a valid and reliable measurement tool in individuals with type 2 diabetes mellitus. Nurses may use this tool to better understand and help relieve the prevalence and severity stigma of individuals with type 2 diabetes in Turkey.

Effect of Reflexology on the Constipation Status of Elderly People.

BACKGROUND: The current literature shows that one of the alternative therapies used to control constipation is reflexology. This study was conducted to assess the effect of reflexology on the constipation status of elderly people. METHODS: This study was randomized clinical trial conducted from at the private nursing home in the Ankara Province. At the nursing home, 60 eligible elderly people were randomly assigned into experimental (n = 30) and control (n = 30) groups. The experimental group received foot reflexology massage for 1 month three times per week for 30 min. Reflexology was initiated from the patient's right foot. The foot was relaxed primarily by applying effleurage followed by shaking, rotation, and stretching methods. The practice ended by applying solar plexus pressure on both feet. For elderly people in the control group foot surface massage without pressure was applied to simulate the interventions similar to the experimental group. The scale scores before and after reflexology were noted for the experimental group, and those for the control group, which did not receive any reflexology massage, were also determined. RESULTS: After the implementation of reflexology, the rate of emptying bowels on alternate days increased in the experimental group as opposed to that in the control group (P < 0.001). In this study, reflexology was found to improve the quality of life of the elderly and decrease the severity of constipation. CONCLUSION: Foot reflexology massage was found to be effective in relieving the constipation of elderly people. Therefore, reflexology is recommended as part of nursing care to reduce the constipation status of elderly people.

The impact of standardized patient interactions on nursing students' preventive interventions for pressure ulcers.

AIM: This study was performed as a quasi-experimental study using a standardized patient simulation program in order to explore the effects of education on the performance and knowledge of undergraduate nursing students with respect to pressure ulcer prevention. METHODS: The study sample consisted of 38 students who completed the study. After the theoretical education portion, the students first knowledge and performance scores were evaluated with the standardized patient program. Demonstration education with the standardized patient and a second standardized patient practice were then performed. Afterwards, a debriefing session was held under the supervision of the researcher. After three months, the second knowledge and performance score evaluation was performed with the standardized patient. Knowledge and performance scores were compared after theoretical training and three months after simulation training. RESULTS: The mean score of 38 students were 43.68 ± 9.06 and 75.92 ± 16.84 on the pre- and post-tests, respectively. Preliminary points were significantly lower than post-test points (p < 0.001). The median performance score was 7.89 (min-max: 0-73.68) in the first simulation and 86.84 (min-max: 63.16-100.00) in the second simulation. There was a statistically significant change between the two performance scores (p < 0.001). CONCLUSION: In this study, it was determined that the level of knowledge and performance persisted in the evaluations after comprehensive training using standardized patient simulations. This study confirmed standardized patient practice as an efficient learning modality for nursing students in the long-term.

Care under the guidance of pressure injury prevention protocol: a nursing home sample.

Pressure injury is a healthcare problem frequently encountered in nursing homes. This study evaluated the effects of the care delivered under the guidance of a protocol for pressure injury prevention at a nursing home. It was implemented in four phases. In the pre-protocol period, the pressure injury incidence and nurses' care practices were evaluated. In the second phase, nurses were trained to use the protocol. In the third phase, the nurses provided care under the guidance of the protocol (post-protocol period). In the fourth phase, the incidence of pressure injury and nurses' care practices were compared between the pre- and post-protocol periods. The average age of the older residents was 78.40±7.12 years, and all were at high or very high risk of pressure injury according to the Braden scale scores. Some 30% were bed bound; 90% had faecal and urinary incontinence; and 70% had malnutrition. The results showed that the pressure injury incidence reduced from 17.39% in the pre-protocol period to 10.87% in the post-protocol period, while the nurses' care practices improved in the post-protocol period. Thus, use of pressure injury-prevention protocols can reduce the incidence of these injuries in vulnerable care home residents.

The effect of case management with haemodialysis patients on the health perception and the symptoms: The case of Turkey.

OBJECTIVE: To establish whether case management had an effect on health perceptions and symptom relief in haemodialysis patients. METHODS: The quasi-experimental study was conducted from March to December 2013 in Ankara, Turkey, at three private dialysis centres providing haemodialysis therapy. It comprised chronic haemodialysis patients who were divided into experimental and control groups. In the first interview, the experimental group was provided with extensive training about haemodialysis and a three-month follow-up was conducted through case management. The control group was provided training only in the final interview. Data was collected using the scale for perception of health in haemodialysis patients and the scale for complaints/symptoms in haemodialysis patients. SPSS 20 was used for analysis. RESULTS: Of the 80 patients, 40(50%) were in each group. There was no significant difference in scale for perception of health in haemodialysis patients scores between first and final interviews (p>0.05), whereas the scale for complaints/symptoms in haemodialysis patients scores were lower in the final interview compared to the first p<0.05). In the control group, the scale for perception of health in haemodialysis patients scores were higher in the final interview compared to first (p<0.05). CONCLUSIONS: Case management was found to be an effective method for minimising negative health perceptions and complaints and symptoms in haemodialysis patients.