Development of the Critically Ill Patient Eye Assessment Scale: A study of validity and reliability.

BACKGROUND: Eye care and assessment of the eye are critical for intensive care patients to prevent ocular complications like dry eye and corneal abrasion. However, there is no measurement tool developed for intensive care patients that examines the risks of ocular complications. AIMS: This study aimed to develop a valid and reliable tool, the Critically Ill Patient Eye Assessment Scale (CIPEAS), for assessing the risk of ocular complications and determining the frequency of eye care. STUDY DESIGN: This study is an instrument development study. This methodological study was conducted with 151 intensive care patients in Turkey between March 2022 and March 2023. Data were collected with the Patient Information Form and the CIPEAS. The data were evaluated using SPSS 23 statistical software. AMOS 21 was used to verify the structure obtained with CFA. Exploration and confirmatory factor analyses were performed to determine the scale's factorial structure. RESULTS: As a result of exploratory factor analysis, a six-item scale consisting of a single dimension was obtained, explaining 59.993% of the total variance. The fit indices of the scale were found to be χ2/SD = 2.653, GFI = 0.954, RMSEA = 0.075, NFI = 0.949 and CFI = 0.967. Cronbach's alpha of the scale was found to be 0.862. CONCLUSION: The CIPEAS was found to be a valid and reliable assessment tool. RELEVANCE TO CLINICAL PRACTICE: The Critically Ill Patient Eye Assessment Scale is a valid and reliable tool for Turkish society for assessing the risk of ocular complications. It is recommended for various national and international studies with different patients in intensive care units.

Gastrointestinal System Symptoms, Psychological Resilience, Emotional Self-Efficacy, and Healthy Living Behaviors in Patients Scheduled for Endoscopy/Colonoscopy.

Gastrointestinal symptoms are very common worldwide. This study aimed to examine the relationship between gastrointestinal system symptoms, psychological resilience, emotional self-efficacy, and healthy living behaviors in patients. The study was conducted in a training and research hospital in Türkiye with 258 patients who had experienced gastrointestinal symptoms and were scheduled for upper endoscopy and/or colonoscopy. The data were obtained by using an information form, the Brief Resilience Scale, the Emotional Self-Efficacy Scale, the Healthy Lifestyle Behaviors Scale, and the Gastrointestinal Symptom Rating Scale. A statistically positive and significant relationship was found between the Emotional Self-Efficacy Scale and the Healthy Lifestyle Behaviors Scale (r = 0.376; p < .05). It was determined that there was a statistically significant negative relationship between the mean Brief Resilience Scale and the Gastrointestinal Symptom Rating Scale scores (r = -0.150; p < .05). In addition, a positive and significant relationship was found between the mean Brief Resilience Scale and the Emotional Self-Efficacy Scale scores (r = 0.374; p < .05). Psychological factors and healthy living behaviors thus clearly affect gastrointestinal system symptoms. For this reason, it is thought that planning interventions to teach self-management through healthy living behaviors and promoting psychological resilience may reduce gastrointestinal system symptoms.

Turkish Adaptation of Romantic Relationship Sabotage Scale: Validity and Reliability Study.

Background: The aim of this study is to perform the Turkish validity and reliability analyzes of the Romantic Relationship Sabotage Scale, which was developed to reveal why couples sabotage the relationship in romantic relationships, and to adapt this scale to Turkish culture. Methods: The study group consisted of 495 individuals who did not have any psychiatric disorders and had a romantic relationship. The similarity of the results obtained with the factor analysis with the original scale showed that the scale provided construct validity. Results: For the criterion correlation validity of the scale, the correlations between the Turkish Romantic Relationship Sabotage Scale-total score and Perceived Romantic Relationship Quality Scale (r = -.384, P < .05), The Love Attitude Scale (altruistic love r = .163, P < .05; friendship love r = -.151, P < .05; passionate love r = -.435, P < .05; practical love r = .220, P < .05; game-playing love r = .213, P < .05; possessive-dependent love r = .439, P < .05), and Self-handicapping Scale (r = .443, P < .05) were calculated. The reliability coefficient for the stability of the scale, which was administered to 102 participants twice with an interval of 4 weeks, was found to be 0.75, revealing that the scale was stable. The Cronbach's internal consistency coefficient on the scale was .81. There was a significant difference between the Turkish form of the Romantic Relationship Sabotage Scale-total score scores, the mean scores of defensiveness, and lack of relationship skills according to gender (P < .05). Conclusion: This study confirms the validity and factor structure of the Turkish version of the Romantic Relationship Sabotage Scale, which is an acceptable tool that can be used to measure the sabotage levels of romantic relationships in individuals.

Social media usage and alexithymia in nursing students.

PURPOSE: To determine the relationship between social media usage characteristics and alexithymia in nursing students. DESIGN AND METHODS: The study was conducted with 272 nursing students between November and December 2018 in Turkey. Data were collected using an information form to determine the sociodemographic and social media usage characteristics of the students, and the Toronto Alexithymia Scale. FINDINGS: According to the results of this study, nursing students use Instagram the most. As time spent on social media increases, the alexithymia score increases and students have difficulty recognizing their feelings. PRACTICE IMPLICATIONS: As the use of social media by nursing students affects their mental process and behavior patterns, the results of social media applications, which witness a wide range of feelings, thoughts, attitudes, and behaviors, should be included in the nursing curriculum.

Effect of chewing gum on stress, anxiety, depression, self-focused attention, and academic success: A randomized controlled study.

Chewing gum is thought to increase focus via a reduction in stress and anxiety. Chewing gum contributes to success by improving short-term memory. This study was conducted to determine the effect of chewing gum on stress, anxiety, depression, self-focused attention, and exam success. A randomized controlled trial was conducted with a total of 100 students. In the long-term (19 days) and short-term (7 days) chewing gum groups, the pretest scores of depression, anxiety, and stress were significantly higher than the posttest scores. Although the posttest scores on the self-focused attention subscale were higher than the pretest scores in long-term chewing gum group, there was no significant difference between the pretest and posttest scores in this group. The academic success mean scores of the long-term experimental group students were higher than those of the other groups. Students are recommended to chew gum before exams in order to overcome exam stress and to enhance exam success. However, chewing gum is not recommended in the long term for students who have difficulty focussing their attention.

The effect of nursing internship program on burnout and professional commitment.

BACKGROUND: Professional commitment is defined as a belief in and acceptance of the values of the profession which is chosen, effort to actualize these values, desire to improve him/herself. Nurses' professional and organizational commitment are influenced by factors such as job stress, job satisfaction and burnout. OBJECTIVE: This study was conducted to determine the effect of nursing internship program on professional commitment and burnout of senior nursing students. DESIGN: A quasi-experimental study with a pretest and posttest without control group design was used. METHODS: Students who were attending nursing internship program and agreed to participate were included in the study. Sample consisted of 101 students. Data were collected with a questionnaire, the burnout measure short version and nursing professional commitment scale. RESULTS: After the nursing internship, 77.2% were pleased to study nursing, 83.2% were pleased to be a senior student, 55.4% did not have any intention to change their profession, 81.2% wanted to work as nurses, and 82.2% were planning career advancement in nursing of the students, 34.7% and 43.6% were found to experience burnout, before and after the nursing internship, respectively (p < 0.05). When the students' mean pre-test and post-test scores on the nursing professional commitment scale were compared, a significant difference was found between mean scores on the total score and "maintaining membership" subscale (p < 0.05). CONCLUSION: This study revealed that after the nursing internship, burnout and professional commitment levels of the students increased.

The psychometric properties of the Turkish version of the Chemotherapy-Induced Peripheral Neuropathy Assessment Tool (CIPNAT).

PURPOSE: Chemotherapy-induced peripheral neuropathy is a common treatment-related adverse effect. It adversely affects the quality of life. Therefore, it is important to evaluate symptoms. The purpose of this study was to evaluate the validity and reliability of Chemotherapy-Induced Peripheral Neuropathy Assessment Tool in Turkish patients. METHODS: A convenience sample of 327 patients, being treated with peripheral neurotoxic chemotherapeutic agents were asked to fill in the questionnaire. The data was evaluated using SPSS 21 (SPSS Inc., Chicago IL, USA) statistical software. The verification of the structure obtained with CFA was provided by AMOS 21.0. Psychometric testing included internal consistency reliability (Cronbach's alpha coefficient and item-total correlations), test-retest reliability, validity (exploratory factor analysis, confirmatory factor analysis and concurrent validity). RESULTS: The Cronbach alpha value of the scale was 0.97. The test-retest reliability results were significantly high. The CIPNAT significantly correlated with the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy. The model was validated by confirmatory factor analysis (χ2/sd = 2.74, GFI = 0.95, AGFI = 0.92, CFI = 0.98, RMSEA = 0.07, and RMR = 0.009). CONCLUSIONS: The Turkish version of the CINAT was found to be reliable and valid with Turkish patients receiving chemotherapy. Use of the CIPNAT may lead to a better understanding of symptom. The CIPNAT can be used in future nursing research and practice as an assessment tool for peripheral neuropathy in patients with cancer who undergo chemotherapy.

Role of Proopiomelanocortin in Preventing Miscarriage.

Objective: To compare the distribution of proopiomelanocortin (POMC) in decidua and placenta samples from missed abortion and voluntary termination cases in order to research the effects in the etiology of missed abortion. Study Design: Decidual materials were collected from patients who were diagnosed with missed abortion (n=19) and legal voluntary termination cases (n=15) under 10 gestational weeks. Materials were divided into 2 groups for examination. For all samples, POMC primary antibody was performed by immunohistochemical staining. The number of stained cells was calculated by using the H-score technique. Results: In the missed abortion group the mean age was 28.7 (18­41), and in the control group the mean age was 27.5 (21­37). POMC immunoreactivity was determined to be lower in the parenchyma and placenta of the missed abortion group than those of the control group. POMC immunoreactivities were found to be higher in both the syncytiotrophoblast and cytotrophoblast cells of the missed abortion group than those of the control group (p<0.005). Conclusion: POMC has become a paradigmatic polypeptide precursor and has a role in the parturition process. Local production of POMC in placenta and decidua may influence pregnancy and may have a role in missed abortion pathogenesis.

Factors Affecting Health-Promoting Behaviors in Nursing Students at a University in Turkey.

This descriptive study was carried out to determine factors affecting health-promoting behaviors in nursing students. The sample consisted of 245 students. A questionnaire about factors affecting lifestyle behavior and the Health Promotion Lifestyle Profile Scale-II were used to collect data from 245 nursing students during the spring semester of the 2012-2013 academic year. A significant difference was found between students with and without diagnosed health problems in terms of their mean scores on the Health Promotion Lifestyle Profile Scale-II subscales of health responsibility, spiritual growth, and interpersonal relations, as well as their total mean scores (p < .05). The exercise, nutrition, spiritual growth, and stress management subscale scores of those students regularly going for health checks were determined to be significantly higher than those of the students who did not obtain regular health checks. Students' healthy lifestyle behaviors were generally found to be at the medium level. This study provides evidence of the need for interventions to help nurses in Turkey.

Relationship among health-related quality of life, depression and awareness of home care services in elderly patients.

AIMS: The present descriptive study was carried out to determine the relationship between health-related quality of life, depression and awareness of home care services among elderly patients. METHODS: Patients aged 65 years or older staying at the surgery and internal medicine clinics were included in the study. The "Patient Introduction Form," "Short Form-36 Quality of Life Questionnaire" and "Geriatric Depression Scale" were utilized in the collection of data. RESULTS: In the present study, it was determined that only approximately half of elderly patients (54.9%) knew the concept of home care, most of them had not previously received home care and requested home care related to medical care. The mean scores were lower in some areas of the quality of life questionnaire in some factors that could influence home care awareness. These factors were determined as: female sex, history of falling, chronic illness, functionally, moderately or severely dependent, no previous receipt of home care and wishing to receive home care. CONCLUSIONS: The home care requirement of elderly patients can be influenced by many physiological, psychological and social factors that can affect their quality of life. Thus, it is of utmost importance that medical professionals evaluate the quality of life of elderly individuals and its influencing factors. Geriatr Gerontol Int 2016; 16: 1211-1219.

Distribution of furin, TNF-α, and TGF-ß2 in the endometrium of missed abortion and voluntary first trimester termination cases.

OBJECTIVE: To identify the role of furin, TNF-α, and TGF-ß2 in human missed abortion pathogenesis. STUDY DESIGN: Decidual materials were collected from patients diagnosed with a missed abortion (n = 10) (missed abortion group) and from legal voluntary termination cases at < 10 gestational weeks (n = 10) (normal pregnancy group). Tissue samples were collected from each group by dilation and curettage under mask anesthesia. For all tissue samples,furin, TNF-α, and TGF-ß2 primary antibodies were performed by immunohistochemical staining. The number of stained cells was evaluated by using the H-score technique. RESULTS: In immunohistochemical examination, the immunoreactivities of furin, TNF-α, and TGF-ß2 were found to be higher in syncytiotrophoblastic cells in the missed abortion group than in the normal pregnancy group (p < 0.005). Additionally, high immunoreactivity of TNF-α and TGF-ß2 molecules was established only in cytotrophoblastic cells of missed abortions (p < 0.005) in examination at decidual cells of the missed abortion group; furin immunoreactivities were detected higher in the missed abortion group than in the control group, but TNF-α and TGF-ß2 immunoreactivity were increased in number in the normal pregnancy group (p < 0.005). CONCLUSION: It is considered that high levels offurin and the 2 furin-related proteins (TNF-α and TGF-ß2), which play important roles in proliferation, invasion, migration, differentiation, and survival of cells, may be the reason of proceeding decidualization, placentation, and prevention from abortion, in spite of terminating thefetal life.

The impact of abdominal massage administered to intubated and enterally fed patients on the development of ventilator-associated pneumonia: a randomized controlled study.

BACKGROUND: Enteral nutrition is one of the major risk factors for ventilator-associated pneumonia. Abdominal massage is assumed to prevent the development of ventilator-associated pneumonia by reducing residual gastric volume. OBJECTIVES: To identify the effect of abdominal massage administered to critically ill patients with mechanical ventilation and continuous enteral feeding on the development of ventilator-associated pneumonia. DESIGN: A randomized controlled design was used in this study. SETTING: This study was performed in a critical care unit of a university hospital in Turkey. PARTICIPANTS: The sample of the study consisted of a total of 32 patients, selected randomly to receive abdominal massage (n=16) and a control group (n=16). The stratified randomization was used in this study. Patients were stratified according to age and gender. METHODS: A fifteen-minute abdominal massage was administered to the patients in the intervention group twice daily. No intervention was administered to the patients in the control group. RESULTS: At the end of monitoring days a reduction, compared to the control patients, was identified. The amount of gastric residual volume and abdominal circumference measurement of the patients in the intervention group had decreased. This reduction was found to be significant in the statistical analysis (p<0.05). Also, although not reaching the statistical significance level, ventilator-associated pneumonia decreased in the intervention group with a ratio of 6.3% compared to the control group (31.3%) (p>0.05). CONCLUSION: This study revealed that abdominal massage administered to intubated and enterally fed patients reduced gastric residual volume and abdominal distension. In addition, a decrease in the ratio of ventilator-associated pneumonia was determined.

Health-related adverse events and associated factors in recreational divers with different certification levels.

BACKGROUND: There is a paucity of research on diving-related health issues and associated factors. This study aimed to examine the health problems encountered during diving and to ascertain the factors associated with adverse events. METHODS: The sample of this descriptive study consisted of 132 recreational divers from diving schools in Ankara. The researchers collected the data using a questionnaire developed according to the relevant literature. RESULTS: Diving-related health issues including barotraumas, nitrogen narcosis, and decompression sickness were mostly dependent on depth. The divers with higher certification levels witnessed diving-related adverse events more frequently and a significant increase in health problems with greater depth attained (p < 0.05). More experienced divers with longer duration of diving (p < 0.05) and greater number of dives reported more health problems associated with diving between 41 and 65 m. Adverse events did not differ according to diving-related educational features (p > 0.05). CONCLUSIONS: The finding implies the importance of adherence to the depth limit of 40 m for recreational divers, being a slow ascend diver, and utilization of a buddy system in order to prevent diving-related adverse events. A data recording system related to diving and regulations particularly for tourist divers in the countries attracting tourists is required.

Comparison of alloplast materials in experimental extraocular muscle surgery.

BACKGROUND: Extraocular muscles may be recessed using implants as spacer material. Silicone retinal band is an example of a spacer used to elongate the superior oblique (SO) tendon in Brown's syndrome and SO overaction; however, complications such as extrusion, scarring and restriction due to the implant have been reported. The purpose of our study was to evaluate and compare fibroblastic and inflammatory reactions to different alloplast materials in a rabbit model. METHOD: Twenty-three rabbit eyes underwent superior rectus (SR) expander surgery, and 9 eyes SR recession surgery. SR expander surgery was performed using either silicone retinal band (240 style; 6 eyes), polytetrafluoroethylene (Gore-Tex; 10 eyes) or porous polyethylene (Medpor; 7 eyes). Twenty eyes were enucleated at 4 weeks and 12 eyes at 8 weeks and examined by light microscopy. The expression of basic fibroblast growth factor (bFGF) was evaluated by immunohistochemical analysis. RESULTS: All alloplast materials induced more inflammatory response compared to control eyes (p < 0.05). Medpor induced a markedly stronger inflammatory response than silicone and Gore-Tex (p < 0.05). Gore-Tex and silicone induced similar inflammatory responses. Gore-Tex implants yielded a slightly higher bFGF expression than silicone or Medpor implants (p = 0.07). CONCLUSION: Polytetrafluoroethylene (Gore-Tex) was found to be similar to silicone in its biocompatibility when used as spacer material in extraocular muscle tendon expander surgery. The high bFGF expression observed in Gore-Tex-implanted eyes suggests porous polymers may promote tissue ingrowth into the implant.

Referral patterns, demographic and clinical features, and visual prognosis of Turkish patients with sarcoid uveitis.

The purpose of this study was to investigate the referral patterns, demographic and clinical features, and visual prognosis of patients with sarcoid uveitis seen at 2 tertiary eye care centers in Turkey. A retrospective study was made of 44 patients with uveitis associated with biopsy-confirmed or presumed sarcoidosis. Thirty-four patients (77%) were female and 10 (23%) were male. The mean age at onset of uveitis was 39.8 years. Twenty-seven patients (61%) were referred without a diagnosis of sarcoidosis and 17 (39%) patients were referred with a diagnosis of systemic sarcoidosis. The duration of uveitis prior to referral was 2-15 years in 52% of the patients in the former group. At presentation, 37 patients (84%) had bilateral and 7 patients (16%) had unilateral uveitis, and 17 patients (39%) had only anterior uveitis. The most common ocular findings were granulomatous keratic precipitates, persistent posterior synechiae, and snowball vitreous opacities. Kaplan-Meier survival analysis estimated the risk of recurrence as 30% at 6 months and 61% at 5 years. New complications developed in 18 patients. Potential visual acuity was better than 0.4 in 80% of eyes. The estimated risk of losing potential visual acuity by at least 2 lines was 7% at 6 months and 43% at 5 years. None of the eyes lost useful vision (> 0.1) under the authors' care. The referral patterns suggest underrecognition of sarcoidosis as a cause of uveitis in Turkey. The demographic and clinical features of these patients were mostly similar to those reported from other countries, suggesting that the diagnosis may not be difficult in Turkish patients but requires an increased awareness of the disease in this population.

Impact of triamcinolone acetonide on retinal endothelial cells in a retinopathy of prematurity mouse model.

PURPOSE: To evaluate the efficacy of different concentrations of triamcinolone acetonide (TA) on retinal endothelial cell proliferation in a retinopathy of prematurity (ROP) mouse model. METHODS: A total of 24 C57BL/J6 mice were exposed to 75% oxygen from postnatal day 7 to day 12. On day 12, 10 mice (group B) were injected with 20 microg intravitreal TA (IVTA) and 14 mice (group C) were injected with 40 microg IVTA in one eye. The contralateral eyes were injected with isotonic saline (control group = group A). Four non-exposed mice served as negative controls (group D). The mice were killed on day 17 and the eyes removed for quantitative analysis of preretinal neovascularization. Neovascularization was quantified by counting the endothelial cell nuclei on the vitreal side of the inner limiting membrane of the retina. RESULTS: The endothelial cell count per histological section was lower in groups B (1.4 +/- 1.7 cells; p < 0.00001) and C (0.9 +/- 1.4 cells; p < 0.000001) compared with the control group (group A, 17.0 +/- 4.8 cells). However, there was no significant difference in cell count between groups B and C (p = 0.430). CONCLUSIONS: Triamcinolone acetonide suppresses endothelial cell proliferation in an ROP mouse model in vivo. There is no difference between dosages of 20 microg and 40 microg IVTA in experimental use in the suppression rates of endothelial cell proliferation.