Validity and Reliability of the Instruments to Measure Colorectal Cancer Screening Benefits and Barriers-Turkish Version.

BACKGROUND: Perceptions of benefits and barriers are important determinants in understanding colorectal cancer screening (CRCS) behaviors. There is a need for standardized Turkish tools that measure the benefits and barriers of fecal occult blood test (FOBT) and colonoscopy (COL). OBJECTIVE: The aim of this study was to assess the validity and reliability of the Turkish version of the "Instruments to Measure CRCS Benefits and Barriers." METHODS: This methodological study was carried out in 2 stages in primary care and in 394 adults between the ages of 50 and 70 years. In the first stage, some items of the scales demonstrated low/unacceptable corrected item-total and factor loadings, and in the second stage, it was decided to add emoji-based facial scales, which include emoji expressions. RESULTS: Results with the emoji-based facial scales included internal consistency coefficients of 0.85 for FOBT benefits, 0.79 for FOBT barriers, 0.84 for COL benefits, and 0.86 for COL barriers; the item-total correlations of FOBT varied between 0.39 and 0.73, whereas those of COL varied between 0.38 and 0.76. The factor loadings of all items were higher than 0.40. CONCLUSIONS: The emoji-based facial scale for CRC Screening Benefits and Barriers is a valid and reliable tool for measuring the benefits and barriers perceptions of 50- to 70-year-old Turkish adults. IMPLICATIONS FOR PRACTICE: The Instruments to Measure CRCS Benefits and Barriers-Turkish version can provide insights for nurses and healthcare professionals to understand individuals' perceived FOBT and COL benefits and barriers and to develop effective interventions to increase CRCS rates.

Nursing Students' Intention to Report Medication Errors: Application of Theory of Planned Behavior.

BACKGROUND: Reporting, investigating, and full disclosure of medication errors (MEs) is a fundamental component of patient safety. Therefore, determining nursing students' intention to report MEs is important. PURPOSE: This study examined the factors related to nursing students' intention to report MEs and the use of the Turkish version of the Theory of Planned Behavior Medication Safety Questionnaire (TPB-MSQ-T). METHODS: A descriptive cross-sectional design was used with a sample of 227 undergraduate nursing students in Istanbul, Turkey. Students' intentions to report MEs were measured using an online TPB-MSQ-T. Quantitative analysis was conducted. RESULTS: Attitudes and perceived behavioral control (PBC) were significant predictors of intention to report MEs (P = .05 and P = .01, respectively), but subjective norms did not predict it (P = .11). The Cronbach's α of the questionnaire was 0.88. CONCLUSIONS: Attitude and PBC are important determinants of nursing students' intention to report MEs. The TPB-MSQ-T can be used for identifying the main determinants of intention to report MEs.

The Effects of the Nurse Navigation Program in Promoting Colorectal Cancer Screening Behaviors: a Randomized Controlled Trial.

Although screening programs are known and recommended for the early detection of colorectal cancer (CRC), the screening rates for the fecal occult blood test (FOBT) and colonoscopy are very low among adult individuals. Navigation programs, also known as individualized counseling, have recently begun to be used for increasing screening rates. The purpose of this study was to compare the efficacy of the Nurse Navigation Program versus usual care on CRC screening participation and movement in stage of adoption for CRC screening and to examine perceived benefits of and barriers to CRC screening. This study was designed in line with a pre- and posttest two-group methodology. A total of 110 participants (55 nurse-navigated and 55 non-navigated patients) were studied. Data were collected using the following three tools: a sociodemographic information form, the Harvard Colorectal Cancer Risk Assessment Tool, and Instruments to Measure Colorectal Cancer Screening Benefits and Barriers. Following the Nurse Navigation Program, the FOBT (82 and 84%, respectively) and colonoscopy completion rates (15 and 22%, respectively) were significantly higher in the nurse-navigated group than in the non-navigated group at 3 and 6 months follow-up. Following the program, the benefit perceptions of the nurse-navigated group about CRC screening were improved, and their barrier perceptions were reduced. The results showed that the Nurse Navigation Program had significant effects on CRC screening behavior and health-related beliefs concerning CRC screening. Further assessment of the Nurse Navigation Program in different groups should be performed to observe its effects.

Feasibility of describing community strengths relative to Omaha system concepts.

OBJECTIVES: The purpose was to determine the feasibility of using a standardized language, the Omaha System, to describe community-level strengths. The objectives were: (a) to evaluate the feasibility of using the Omaha System at the community level to reflect community strengths and (b) to describe preliminary results of community strengths observations across international settings. DESIGN AND SAMPLE: A descriptive qualitative design was used. The sample was a data set of 284 windshield surveys by nursing students in 5 countries: Mexico, New Zealand, Norway, Turkey, and the United States. MEASURES: An online survey included a checklist and open-ended questions on community strengths for 11 concepts of the Omaha System Problem Classification Scheme: Income, Sanitation, Residence, Neighborhood/workplace safety, Communication with community resources, Social contact, Interpersonal relationship, Spirituality, Nutrition, Substance use, and Health care supervision. Themes were derived through content analysis of responses to the open-ended questions. RESULTS: Feasibility was demonstrated: Students were able to use the Omaha System terms and collect data on strengths. Common themes were described among the five countries. CONCLUSIONS: The Omaha System appears to be useful in documenting community-level strengths. Themes and exemplar quotes provide a first step in developing operational definitions of strengths at a more granular level.

Impact of a nurse-led sleep programme on the sleep quality and depressive symptomatology among older adults in nursing homes: A non-randomised controlled study.

BACKGROUND: Sleep problems are much more prevalent in nursing home residents than in their community-dwelling counterparts. Cognitive behavioural therapy is likely to improve sleep quality in older adults. However, these interventions have a narrow scope to generalise to nursing home practice, and there are minimal data on the effectiveness of the integration of cognitive behavioural therapy and motivational interviewing in nursing home settings. AIM: The purpose of this study was to investigate the impact of a nurse-led sleep programme on the sleep quality and depressive symptomatology in cognitively intact nursing home residents. METHODS: A non-randomised controlled study design was applied to 52 older adults living in three different nursing homes in the same locality. Then, we categorised our study cohort into the following two groups: intervention group in which the older adults received the nurse-led sleep programme and control group in which the older adults received regular nursing home services. One nursing home was assigned to the intervention, and two were assigned to control. The intervention group participated in four weekly 1-hr sessions performed by the first author. RESULTS: Follow-up assessments conducted at 8 and 12 weeks after the intervention ended revealed that participants in the intervention group experienced a significant improvement in some objective sleep parameters, including awakenings, total wake time, wake after sleep onset and sleep efficiency, as well as a significant decrease in depressive symptomatology. CONCLUSION: To summarise, the results of this study showed that the nurse-led sleep programme improved the sleep quality and reduced depressive symptomatology in cognitively intact nursing home residents. In this context, we can assert that interventions for sleep problems should be individualised by addressing sleep experience and sleep management strategies of older adults living in nursing homes and should be integrated with motivational interviewing techniques.

The Omaha System as a Structured Instrument for Bridging Nursing Informatics With Public Health Nursing Education: A Feasibility Study.

Advancements in healthcare systems include adoption of health information technology to ensure healthcare quality. Educators are challenged to determine strategies to integrate health information technology into nursing curricula for building a nursing workforce competent with electronic health records, standardized terminology, evidence-based practice, and evaluation. Nursing informatics, a growing specialty field, comprises health information technology relative to the profession of nursing. It is essential to integrate nursing informatics across nursing curricula to effectively position competent graduates in technology-laden healthcare environments. Nurse scholars developed and evaluated a nursing informatics case study assignment used in undergraduate level public health nursing courses. The assignment included an unfolding scenario followed by electronic health record charting using standardized terminology to guide the nursing process. The assignment was delivered either online or in class. Seventy-two undergraduate students completed the assignment and a posttest. Fifty-one students completed a satisfaction survey. Results indicated that students who completed the assignment online demonstrated a higher level of content mastery than those who completed the assignment in class. Content mastery was based on posttest results, which evaluated students' electronic health record charting for the nursing assessment, evidence-based interventions, and evaluations. This innovative approach may be valuable to educators in response to the National Academy of Sciences recommendations for healthcare education reform.

Interventions Promoting Breast Cancer Screening Among Turkish Women With Global Implications: A Systematic Review.

BACKGROUND: Breast cancer is a major health concern and remains the most common malignancy in women worldwide and in Turkey. Mammography, clinical breast examination (CBE), and breast self-examination (BSE) are recommended methods to detect early breast cancer in women. Many strategies have been developed to increase the rates of mammography, CBE, and BSE among Turkish women. Despite the benefits of breast cancer screening, these modalities are still underutilized by the majority of Turkish women. AIM: To systematically review the scientific evidence on the effectiveness of various strategies aimed at improving screening behaviors for breast cancer in Turkish women. METHODS: A systematic review of the literature published between 2000 and 2015 was conducted, searching 10 databases of Ovid MEDLINE, PubMed, Cochrane CENTRAL Register of Controlled Trials, CINAHL, PsycINFO, Web of Knowledge, Scopus, Google Scholar, ULAKBIM Turkish Medical Database, and Council of Higher Education Thesis Center. RESULTS: Twenty-three studies were included in the final review. The majority of the studies investigated the effects of multiple strategies to improve BSE. Group education comprised educational sessions, printed and audiovisual materials, which significantly improved BSE, CBE, and mammography screening rates at 3 months, 6 months, and 12 months after the intervention. One-to-one education demonstrated no significant difference in BSE rates at 6-month and 12-month follow-up. However, one-to-one education demonstrated significant differences in CBE and mammography rates at the 3-month follow-up. LINKING EVIDENCE TO ACTION: The use of group education comprising a multicomponent intervention demonstrated an increase in breast-screening behaviors among Turkish women. Further research investigating the duration of educational interventions is needed in order to suggest a "dose response."

Feasibility of Using the Omaha System for Community-level Observations.

OBJECTIVES: The purpose of this study was to determine the feasibility of using a standardized language, the Omaha System, to capture community-level observations to facilitate population assessment and electronic information exchange. The objectives were: (1) to evaluate the feasibility of using the Omaha System at the community level to reflect community observations and (2) to describe preliminary results of community observations across international settings. DESIGN AND SAMPLE: Descriptive. A dataset of 284 windshield surveys (community observations) completed by nursing students in five countries: Mexico, New Zealand, Norway, Turkey, and the United States. MEASURES: The Omaha System Problem Classification Scheme provided standardized terms for assessment of communities in an online checklist of 11 problems and their respective signs/symptoms. RESULTS: Feasibility was demonstrated: students were able to describe community observations using standardized terminology from the Omaha System. Preliminary results describe variations in community signs and symptoms by location. CONCLUSIONS: The Omaha System appears to be a useful tool for community-level observations and a promising strategy for electronic exchange of population health assessments.

Factors associated with bicycle-helmet use among 8-16 years aged Turkish children: a questionnaire survey.

The purpose of this cross-sectional, descriptive study was to assess the rates of helmet and to examine variables related to bicycle helmet use in a sample of 8-16 year old Turkish children. Data were collected from a purposive sample of 1180 students who self-identified as cyclists and 1128 parents or guardians in two state primary schools in two urban municipalities in the northern part of Istanbul, Turkey. Results showed that self-reported helmet use was found prevalent in 4.4% of the children. The most cited reasons for not wearing a helmet were: 'don't own one', 'helmets are uncool', and 'uncomfortable'. Significant differences between helmet users and non-users correlated to gender, age, owning a bicycle helmet, wearing a friend's bicycle helmet and parents or guardian's bicycle helmet use while riding. Only three variables--helmet ownership (OR = 10.028, 95% CI 5.08, 19.79), parents' helmet use (OR = 2.62, 95% CI 1.22, 5.66) and friends' helmet use (OR = 0.16, 95% CI 0.07, 0.37) emerged as significant predictors of the likelihood of helmet use. The relatively low helmet use prevalence points to an urgent need for a multipronged campaign, including strategies such as raising awareness, educating primarly parents and friends, and distributing bicycle helmets for free or at a reduced cost.

Using the Omaha System to describe health problems, interventions, and outcomes in home care in Istanbul, Turkey: a student informatics research experience.

Preparing nursing students to achieve informatics competencies is essential in today's information-intensive healthcare delivery systems. This study aimed to provide hands-on informatics experience to nursing students and to identify the frequency and type of home care clients' health problems, nursing interventions, and outcomes using a standardized nursing terminology, the Omaha System. Data were collected by 159 nursing students on home visits to 598 clients, who received 8657 interventions from students and faculty for 2267 problems, in addition to the services provided by the home care centers. Skin, neuromusculoskelatal function, personal care, nutrition, and urinary function were the most common problems. The most common intervention category was teaching, guidance, and counseling (47%), followed by treatments and procedures (22%), surveillance (22%), and case management (9%). Outcomes evaluation showed significant improvement in 97.5% of the identified problems. Students gained informatics experience in the use of a standardized nursing language in electronic health records, data management, and use of nursing data at the basic practice level. This study demonstrated that the Omaha System was a useful data collection tool for evaluating problems, interventions, and outcomes in home care and a positive teaching and learning tool for baccalaureate nursing education.

The effectiveness of a nurse-delivered breast health promotion program on breast cancer screening behaviours in non-adherent Turkish women: A randomized controlled trial.

BACKGROUND: Few studies have investigated breast health programs to promote rates of having a mammography, clinical breast examination and breast self-examination among non-adherent Turkish women. OBJECTIVES: To determine the effectiveness of a breast health promotion program on mammography and clinical breast examination use, breast self-examination frequency and proficiency (breast self-examination skills and lump detection), breast health knowledge and health beliefs about breast cancer screening in a sample of Turkish women. DESIGN: Experimental (pretest-posttest control group). SETTING: A community-based setting in Istanbul, Turkey. PARTICIPANTS: 190 Non-adherent women (intervention group=97, control group=93) aged 41 and older, residing in Istanbul, Turkey. METHODS: The intervention group (n=97) received a 120-min breast health promotion program based on health belief model including a breast health education, film, breast self-examination instruction, and a booklet, a calendar, a card designed specifically for the study. The control group (n=93) received general information except breast health. Data were collected before the program, immediately after the program, and at 3- and 6-month post-program. The outcome measures are the mammography, clinical breast examination, and breast self-examination frequency, breast self-examination proficiency, breast health knowledge, and health beliefs (perceived susceptibility to breast cancer, benefits to mammography and breast self-examination, barriers of mammography and breast self-examination, confidence in performing breast self-examination). RESULTS: The breast health promotion program significantly increased breast self-examination frequency and proficiency and breast health knowledge. No significant differences existed in mammography and clinical breast examination rates between the two groups at 6 months. The program was effective in increasing perceived susceptibility to breast cancer, perceived benefits of mammography and breast self-examination, and confidence of breast self-examination. No significant difference was found between the two groups for perceived barriers to mammography. CONCLUSIONS: The breast health promotion program was effective in increasing breast self-examination frequency and proficiency in a sample of Turkish women. In addition, it appears to be useful in raising the knowledge of breast health, enhancing confidence in performing breast self-examination, and increasing most health belief levels.

Health beliefs related to breast self-examination in a sample of Turkish women.

PURPOSE/OBJECTIVES: To examine health beliefs and sociodemographic and breast cancer-related variables influencing breast self-examination (BSE) practice. DESIGN: Descriptive, cross-sectional. SETTING: Two vocational training centers in Istanbul, Turkey. SAMPLE: 438 women were selected using a convenience sampling method. Participants had not had breast cancer and were not currently pregnant or breast-feeding. The mean age of participants was 33.51 years (range = 18-67). METHODS: Willing participants were asked to complete a self-administered questionnaire and the Turkish version of Champion's Health Belief Model Scale. The sample was categorized into two groups: performers (i.e., women who performed BSE at least occasionally) and non-performers (i.e., women who had never performed BSE). MAIN RESEARCH VARIABLES: Perceived susceptibility to and seriousness of breast cancer, perceived benefits of and barriers to BSE, confidence in the ability to perform BSE, health motivation, and frequency of BSE practice. FINDINGS: Significant differences between performers and non-performers correlated to age, marital status, health insurance, regular gynecologic visits, and education about breast cancer and BSE. The mean scores of perceived benefits and confidence were noticeably higher in performers. Stepwise logistic regression analysis yielded three significant predictor variables. CONCLUSIONS: Women who had more confidence in their ability to perform BSE, had health insurance, and were informed about breast cancer were more likely to practice BSE. IMPLICATIONS FOR NURSING: Women in Turkey are at great risk for advanced breast cancer and metastatic spread because of their lack of knowledge. Nurses must provide information on breast cancer etiology, risks, prevention, and detection. To promote BSE practice among Turkish women, tailored health education and health promotion programs should be developed based on a specific understanding of women's health beliefs.

Factors associated with breast cancer screening behaviours in a sample of Turkish women: a questionnaire survey.

The purpose of this descriptive correlational study was to identify breast self-examination (BSE) and mammography rates and to examine variables related to the breast cancer screening behaviours in a sample of Turkish women. Data were collected from a convenience sample of 656 women, attending three health centres and two maternal and health centres, using an adapted version of Champion's revised Health Belief Model Scale. Results showed that 17% of the women reported performing BSE on a regular basis. Women, over the age of 40, 25% reported at least one mammography. Higher susceptibility to breast cancer, higher confidence for BSE, lower barriers to BSE, and having heard/read about breast cancer and BSE were significantly associated with performing BSE. Higher seriousness of breast cancer, higher benefits of having mammography, having heard/read about mammography, and having a gynaecologist as a regular physician were significantly associated with having mammography.

Depressive symptomatology among Turkish older adults with low incomes in a rural community sample.

AIMS AND OBJECTIVES: To identify the characteristics that are associated with depressive symptomatology among Turkish older adults with low income. BACKGROUND: Depression is a major threat to mental health in older people, but little is known about older adults with low income at risk for depressive symptomatology in Turkey. DESIGN: This was a cross-sectional study, based in one area of Istanbul. METHODS: The sample included 132 older adults in a rural setting living in Istanbul, Turkey. The participants were 55 years of age or older and chosen from among older adults with low income. Data were collected through a structured interview conducted in the homes of the participants. RESULTS: High depressive symptoms (Geriatric Depression Scale > or =11) were reported by 50% of the participants. Compared with non-depressed individuals, those with depressive symptomatology were more likely to be women, widowed, lack health insurance and to live alone. Depressed participants significantly more often reported chronic health conditions compared to non-depressed participants (OR = 4.11, 95% CI = 1.35, 12.57). Overall well-being scores were significantly higher in men and in the non-depressed group. The result of the Pearson correlation provided support for the association between depression scores and overall well-being scores (r = -0.60). CONCLUSIONS: Depressive symptomatology is prevalent within Turkish older adults with low income. Further research is needed to examine potential risk factors associated with depressive symptomatology for this population. RELEVANCE TO CLINICAL PRACTICE: Findings may assist health care professionals in assessing high-risk older people who could benefit from interventions aimed at minimizing depressive symptoms.

A Turkish language equivalence of the Exercise of Self-Care Agency Scale.

This article is about the pilot test of a Turkish version of the Exercise of Self-Care Agency Scale (ESCA) using a randomized convenience sample of 119 bilingual Turkish adolescents. The instrument was translated into Turkish, back translated, and pilot tested to linguistic equivalence. Bilingual participants were randomly assigned to four groups. Each participant was administered both the English and the Turkish versions of the scale but in different order at 5-week intervals. The results show that the Turkish version of the ESCA was linguistically equal to the English form. Test-retest correlations were acceptably high (r = .80 to .90). Internal consistency of the total scale of the ESCA was adequate, with an alpha coefficient of .89 for the Turkish version and .88 for the English version. Further research in the development of this translated form would need to demonstrate its applicability and generalizability to monolingual Turkish adolescents.

Reliability and validity of the breast cancer screening belief scale among Turkish women.

Breast cancer is the second leading cause of cancer deaths in Turkish women, and the use of breast self-examination (BSE) and mammography remains low in Turkey. Therefore, we need to identify the beliefs, influencing BSE and mammography, and a valid and reliable tool to measure constructs. The Champion's health belief model scale (CHBMS) is a valid and reliable tool to measure beliefs about breast cancer, BSE, and mammography in an English culture. The purpose of this study was to assess the psychometric characteristics of a Turkish version of the CHBMS related to breast cancer, BSE, and mammography. A convenience sample of 656 women was recruited from 3 health centers and 2 maternal and child health centers in Istanbul. The CHBMS was translated to Turkish, validated by professional judges, back translated, and tested. Factor analysis yielded 7 factors for BSE: confidence, seriousness, barriers-BSE, health motivation 1 and 2, susceptibility, and benefits-BSE. For mammography scale, 6 factors were identified: seriousness, benefits-mammography, barriers-mammography, health motivation 1 and 2, and susceptibility. All items on each factor were from the same construct. Cronbach alpha reliability coefficients ranged from.75 to.87 for the subscales. The Turkish version of the CHBMS showed adequate reliability and validity for use in Turkish women. It could easily be used to evaluate the health beliefs about breast cancer, BSE, and mammography. Further refinement is required to study Turkish women's health beliefs and breast cancer screening behaviors in various settings.