Syrian refugees' experiences while receiving mental health services and psychiatric nursing care: A qualitative study.

AIM: This study examined the experiences of Syrian refugees in a community centre in Turkiye as they access mental health services and receive psychiatric nursing care. DESIGN: A qualitative design was adopted in the study. METHODS: Data were collected from southern Turkiye between November and December 2021. The researchers conducted three semi-structured focus group interviews. Colaizzi's phenomenological method was followed to analyse the qualitative data. A total of 19 Syrian refugees participated in the focus group interviews. RESULTS: Three key themes related to immigrants' experiences of receiving mental health services and nursing care were identified: barriers to receiving mental health services, coping with negative experiences in Turkiye and satisfaction with mental health services. The participants identified the barriers they experienced while receiving health services as those pertaining to language, discrimination and stigmatization. They also mentioned the methods of coping with these negative experiences in Turkiye. Despite their negative experiences, they expressed satisfaction with the mental health services they received, especially psychiatric nursing care. CONCLUSIONS: This study determined that Syrian refugees face barriers in accessing and receiving mental health services. They stated that mental health professionals in Turkiye approach them with empathy, particularly those in psychiatric nursing. Healthcare professionals may be trained in culturally sensitive care to increase awareness. IMPACT: Studies have frequently examined the experiences of nurses providing care to refugees, but few have focused on evaluating nursing care from the perspective of refugees. Syrian refugees have reported various obstacles in accessing and receiving mental healthcare services. Health professionals, especially psychiatric nurses in mental health psychosocial support centres, must facilitate the processes to eliminate these obstacles. REPORTING METHOD: The consolidated criteria for reporting qualitative research (COREQ) were used. PATIENT OR PUBLIC CONTRIBUTION: No patient or public involvement.

Qualitative and Artificial Intelligence-Based Sentiment Analysis of Turkish Tweets Related to Schizophrenia. / Sizofreniye Yönelik Türkçe Twitter Iletilerin Nitel ve Yapay Zekâ Temelli Duygu Çözümlemesi.

OBJECTIVE: The aim of this study was to qualitatively examine Turkish tweets about schizophrenia in respect of stigmatization and discrimination within a one-month period and to conduct emotional analysis using artificial intelligence applications. METHOD: Using the keyword 'schizophrenia,' Turkish tweets were gathered from the Python Tweepy application between December 19, 2020 and January 18, 2021. Features were extracted using the Bidirectional Encoder Representations from Transformers (BERT) method and artificial neural networks and tweets were classified as positive, neutral, or negative. Approximately 5% of the tweets were qualitatively analyzed, constituting those most frequently liked and retweeted. RESULTS: The study found that, of the total of 3406 schizophreniarelated messages shared in Turkey over a period of one-month, 2996 were original, and were then retweeted a total of 1823 times, and liked by 25,413 people. It was determined that 63.4% of the tweets shared about schizophrenia contained negative emotions, 28.7% were neutral, and 7.71% expressed positive emotions. Within the scope of the qualitative analysis, 145 tweets were examined and classified under four main themes and two sub-themes; namely, news about violent patients, insult (insulting people in interpersonal relationships, insulting people in the news), mockery, and information. CONCLUSION: The results of this study showed that the Turkish tweets about schizophrenia, which were emotionally analyzed using artificial intelligence were found often to contain negative emotions. It was also seen that Twitter users used the term schizophrenia, not in a medical sense but to insult and make fun of individuals, frequently shared the news that patients were victims or perpetrators of violence, and the messages shared by professional branch organizations or mental health professionals were primarily for conveying information to the public.

Experiences of Hearing Parents of Children with Hearing Loss: A Qualitative Study.

This qualitative study was carried out with a phenomenological design to determine the life experiences of the parents of children with hearing loss. The study sample consisted of twenty parents, who did not have hearing loss, of children with hearing loss registered in a special education and rehabilitation center. The data were collected through in-depth interviews in Istanbul between December and January 2022. Colaizzi's phenomenological interpretation method was used for qualitative data analysis. It was determined that parents of children with hearing loss experienced anxiety, sadness, and happiness during diagnosis. They needed more information at first, but then they gained knowledge in the process, and it took work to accept this process. They stated that having a child with hearing loss requires more time, responsibility, and effort than other children. This situation affects their social life, and they experience interpersonal conflicts. When parents were asked how they coped, they said they did it through prayer, social support, or time to themselves. It can be recommended to apply psychosocial intervention programs to the parents of children with hearing loss, especially their mothers, from the first diagnosis process.

Protocol Registration and Reporting of Systematic Review and Meta-Analyses Published in Psychiatric and Mental Health Nursing Journals: A Descriptive Study.

Although it is not mandatory for systematic review and meta-analysis studies, protocol registration is essential in the prevention of biases. This study aims to investigate the protocol registration status and reporting of systematic reviews and meta-analyses published in psychiatric nursing journals. This descriptive study's data were obtained by scanning the 10 mental health and psychiatric nursing journals in which the studies of psychiatric nurses were most frequently published and by examining the systematic reviews and meta-analyses published between 2012-2022. A total of 177 completed studies have been reviewed. It was determined that 18.6% of the examined systematic reviews and meta-analyses had a protocol registration. Almost all (96.9%) of the registered studies were registered with PROSPERO, and 72.7% were registered prospectively. It was determined that the registration status of the studies changed statistically according to the country where the studies' authors were located. When the published studies were examined, it was determined that approximately one out of every five studies were registered. With the prospective registration of systematic reviews, biases could be prevented, and evidence-based interventions can be made based on the knowledge obtained.

The earthquakes in Turkey and their effects on nursing and community health.

BACKGROUND: Severe damage was experienced in 10 provinces in Turkey, and the north of Syria, with the earthquakes that hit Kahramanmaras at midnight and afternoon on February 6, 2023. AIM: The authors aimed to give brief information to the international nursing community about the situation related to earthquakes in the aspects of nurses. CONCLUSION: These earthquakes caused traumatic processes in the affected regions. Many people, including nurses and other healthcare professionals, died or were injured. The results demonstrated that the required preparedness had not been applied. Nurses went to these areas voluntarily or on assignment and cared for individuals with injured. The universities in the country passed to distance education because of the shortage of safe places for victims. This situation also negatively influenced nursing education and clinical practice by interrupting in-person education one more time after the COVID-19 pandemic. IMPLICATIONS FOR NURSING AND NURSING POLICY: Since the outcomes show a need for well-organized health and nursing care, policymakers may consider getting nurses' contributions to the disaster preparedness and management policy-making processes.

Qualitative and Artificial Intelligence-Based Sentiment Analysis of Turkish Twitter Messages Related to Autism Spectrum Disorders.

BACKGROUND: The aim of our study was to conduct an emotional analysis of Turkish Twitter messages related to autism spectrum disorders (ASD). METHODS: An emotion analysis was performed using quantitative and qualitative analysis methods on Turkish Twitter messages shared between November 2021 and January 2022 that contained the words "autism" and "autistic." RESULTS: It was found that 81.5% of the 13,042 messages that constituted the sample of this study contained neutral emotions. The most frequently used words in Twitter messages were autism, a, universe, strong, patience, warriors, and happy. The qualitative analysis revealed three main themes. These themes were: "experiences," "informing society and awareness," and "humiliation." CONCLUSION: In this study, it was found that Turkish Twitter messages related to autism, which were analyzed using artificial intelligence-based emotion analysis, often contained neutral emotions. While the content of these messages, often shared by parents, was related to experiences, and the messages shared by pediatric psychiatrists and rehabilitation center employees were informative in nature, it was determined that the word "autism" was used to insult, which is outside of its medical meaning.

Qualitative and Artificial Intelligence-based Sentiment Analyses of Anti-LGBTI+ Hate Speech on Twitter in Turkey.

The aim of this study was to evaluate hate speech in Turkish LGBTI+-related tweets during a one-month period of artificial intelligence-based sentiment analyses. Turkish tweets related to LGBTI+, were retrieved using Python library Tweepy and were evaluated by sentiment analysis. The researchers then performed a qualitative analysis of the most frequently liked and retweeted tweets (n = 556). Sentiment analysis revealed that 69.5% of tweets were negative, 23.3% were neutral, and 7.2% were positive. The qualitative analysis was grouped under seven themes: LGBTI+ Club; Terrorism and Terrorist Organization Membership; Perversion, Illness, Immorality; Presence in History; Religious References; Insults; and Humiliation. The results of this study show that anti-LGBTI+ hate speech in Turkey is significant in terms of both quality and quantity. As LGBTI+ individuals are at risk for excess mental distress and disorders, it is important to understand the risks and other factors that ameliorate stress and contribute to mental health in social media.

The Safety and Efficacy of Psychosocial Adherence Interventions in Young People with Early Psychosis: A Systematic Review.

BACKGROUND: The role of antipsychotic medication in supporting young people in their recovery from early psychosis is complex and controversial. It is common for young people, often given antipsychotic medication for the first time, to express a choice to stop treatment, potentially increasing the risk of relapse and admission to hospital. Our systematic review aimed to evaluate the safety and effectiveness of psychosocial interventions to enhance antipsychotic medication adherence in young people with early psychosis. METHODS: We reviewed studies using any experimental design of psychosocial interventions specifically focused on enhancing adherence with antipsychotic medication in young people with early psychosis. Cochrane CENTRAL Register, Medline, Embase, PsychINFO and CINAHL were searched on 19 November 2021 without time restriction. Studies were assessed for quality using the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies. RESULTS: Our initial search identified 3469 documents. Following title, abstract and full-text screening, we included three published studies and one unpublished experimental study that met our inclusion criteria. Outcome data were available for three studies that tested adherence-coping-education, adherence therapy, and a health dialogue intervention, all having a positive effect on medication adherence. None of the trials reported data on the safety of the experimental interventions. CONCLUSION: There is a paucity of evidence from high-quality randomized controlled trials that establish the safety and effectiveness of any type of psychosocial intervention to enhance medication adherence in young people with early psychosis. Further high-quality trials are warranted. This review was registered on the Open Science Framework prior to undertaking out initial searches.

Perceptions and Experiences of Adolescents with Mental Disorders and Their Parents about Psychotropic Medications in Turkey: A Qualitative Study.

This descriptive phenomenological study aimed to evaluate the perception and experiences of adolescents with mental disorders and their parents about the use of and adherence to psychotropic medications. A total of 12 semi-structured interviews with adolescents between the ages of 12 to 18 who were attending an outpatient psychiatric clinic for children and adolescents and 12 interviews with parents were conducted between October 2021 and January 2022 in Manisa, Turkey. Colaizzi's phenomenological interpretation method was used for the analysis of the participants' statements. Our study highlights the main positive effects of psychotropic medication and barriers to medication intake and adherence. Positive effects included symptom management and health improvement. Barriers varied from those directly linked to medication effects (e.g., negative side effects or lack of perceived effect) to personal barriers (e.g., forgetting to take medication or feelings of not being oneself due to medication intake) and societal barriers. In general, the barriers were reflected in concerns related to long-term consequences, such as medication dependence, and in concerns about diminished life prospects. Possible recommendations to improve the use of and adherence to psychotropic medication among adolescents include educating adolescents and parents not only about treatment options but also about mental disorders.

Which factors affect internalized stigmatization in adolescents with mental disorders?

PURPOSE: The aim of this descriptive study was to determine the factors affecting internalized stigmatization of adolescents with mental disorders. METHOD: The study data were collected in a university hospital between August 1, 2020 and July 30, 2021 (n = 123), using a Personal information form and the Internalized Stigmatization of Mental Illness-Adolescent Form (ISMI-AF). RESULTS: Gender and the number of hospitalizations were determined to be independent variables with explanatory power in the ISMI-AF, and in the model created with these variables, it was determined that these variables explained 18% of the change in the total points of the ISMI-AF. CONCLUSIONS: It could be recommended that psychosocial programs are developed with the aim of decreasing internalized stigmatization and increasing the psychological resilience of adolescents.

The relationship between stress, anxiety, and depression levels and pseudobulbar affect in patients with multiple sclerosis.

BACKGROUND: Pseudobulbar affect (PBA) has recently been added to the list of mental disorders commonly observed in patients with Multiple Sclerosis (MS). The emotional changes experienced by MS patients may be associated with other mental problems and adversely affect disease prognosis. However, there are limited studies in the international and national literature on this subject. AIM: This study aimed to evaluate the relationship between PBA and stress, anxiety, and depression levels in patients with MS. DESIGN: This is a descriptive, relational, and cross-sectional study. METHODS: A total of 442 MS patients followed in the neurology outpatient clinic of a hospital and registered with the MS Society in Turkey participated in this study. Data were collected using a personal information form, the Turkish version of the Center for Neurologic Study-Lability Scale (CNS-LS), and the Depression Anxiety Stress Scale (DASS). RESULTS: In this study, 63.3% of the patients had PBA, 21% had extremely severe depression, 41.6% had extremely severe anxiety, and 24.9% had severe stress. Correlation analysis revealed weak positive correlations between CNS-LS total score and DASS subscale and total scores. Depression, anxiety, and stress levels accounted for 22.5% of the variation in CNS-LS total score. CONCLUSION: The results of this study indicate that a majority of MS patients in Turkey experience PBA, depression, anxiety, and stress, and that PBA is positively associated with depression, anxiety, and stress. IMPACT STATEMENT: This study, indicates that should be increased consultation-liaison psychiatry services in Turkey, and MS patients should benefit from comprehensive psychiatric services.

Analysis of Substance Use and Mental Disorder Diagnoses in Adolescents with a History of Delinquency: a Cross-sectional Study.

This study aimed to evaluate substance use and comorbid mental disorders in delinquent adolescents presenting to a child and adolescent psychiatry outpatient clinic. This study included 47 adolescents aged 15-18 years and had a history of delinquency. Data were collected using the Addiction Profile Index Adolescent Form (API-A) and an information form. Results indicated that the adolescents' mean age is 16.11 ± 1.05 years, 78.7% had committed crimes against property and 34.0% against the person, and 34.0% were also victims of crime. Mean API-A total scores indicated that their level of substance use was low. In addition, mean API-A total scores showed significant differences according to the adolescents' migration status, age, economic status, school attendance, mental disorder diagnosis, duration of mental disorder, and type of offense (p < 0.05). The benefit provided by timely and appropriate psychosocial interventions may have a key role in solving this problem for adolescents and improving their future as adults.

Evaluation of the Use of Diverse Mental Health Simulation in Nursing Students' Learning Experience: An International Multisite Study.

BACKGROUND: Simulated patients (SPs) in mental health nursing education provide a unique approach to assist student development in complex assessment skills. PURPOSE: The purpose of this international multisite study was to evaluate the use of two diverse mental health SP simulation scenarios on nursing students' satisfaction and self-confidence in learning to care for patients with mental health disorders in the United States (n = 70) and Turkey (n = 90). METHODS: A multisite cross-sectional study design was used. Outcome measures included the Student Satisfaction and Self-confidence in Learning Scale and the adapted Simulation Effectiveness Tool-Modified. Results were analyzed using independent t tests. RESULTS: While students in the United States reported higher perceived self-confidence and satisfaction in learning, both student populations found the intervention effective to their learning (P < .05). CONCLUSION: Using SPs in mental health education allow students to practice their assessment skills learned in classroom and transfer them to the clinical area.

Psychiatric inpatients' view of the therapeutic environment: A Turkish interview study.

PURPOSE: The aim of the study was to determine the feelings, thoughts, and experiences of inpatients in a psychiatric clinic about the therapeutic environment of the clinic. DESIGN AND METHODS: The data were collected in interviews using the phenomenological method and interpreted using Strauss and Corbin's approach to qualitative data analysis. FINDINGS: As a result of the data analysis, four themes, "Activities," "Physical Environment," "Personnel," and "Rules" were determined, and each with a number of related subthemes. PRACTICE IMPLICATIONS: The therapeutic environment is a dynamic space that can be modified according to the needs of the patients. Psychiatric nurses will benefit from responding to the feedback from patients by providing, for example, more activities or additional psychotherapeutic interventions.

Validity and reliability of the internalized stigma of Mental Illness Scale-Adolescent Form.

PURPOSE: The goal of this study was to assess the validity and reliability of the Turkish version of the Internalized Stigma of Mental Illness Scale-Adolescent Form (ISMI-AF). METHODS: A total of 145 adolescents (12-18 years of age) who were diagnosed with at least one mental disorder according to DSM-5-TR participated in the study. Data were collected at a mental health hospital between October 2017 and 2019 using a sociodemographic information form, the ISMI-AF, and Beliefs towards Mental Illness (BMI) Scale. Reliability (Cronbach's alpha, Split-Half, Spearman-Brown, Hotelling T2 test) and validity analyses of the ISMI-AF were performed. SPSS 26.0 and LISREL 8.80 software were used for statistical analyses. RESULTS: The Cronbach's alpha coefficient for total score was .88, Split-Half score was .84, and the Spearman-Brown factor score was .85. Confirmatory factor analysis showed that the scale confirmed to the five-factor structure in adolescents, but factor loadings and reliability coefficients were low in the "stigma resistance" subscale. There was a positive and weak correlation between ISMI-AF and BMI (r = .37, p = .00). CONCLUSION: The ISMI-AF is a valid and reliable measurement tool that can be used in adolescents. This scale can help psychiatric nurses who work in this field identify and address internalized stigma, which is one of the key factors affecting adherence to treatment, especially in adolescents.

Interobserver Reliability of Glasgow Coma Scale Scores for Intensive Care Unit Patients.

BACKGROUND: Intensive care units frequently use the Glasgow Coma Scale to objectively assess patients' levels of consciousness. Interobserver reliability of Glasgow Coma Scale scores is critical in determining the degree of impairment. OBJECTIVE: To evaluate interobserver reliability of intensive care unit patients' Glasgow Coma Scale scores. Methods This prospective observational study evaluated Glasgow Coma Scale scoring agreement among 21 intensive care unit nurses and 2 independent researchers who assessed 202 patients with neurosurgical or neurological diseases. Each assessment was completed independently and within 1 minute. Participants had no knowledge of the others' assessments. RESULTS: Agreement between Glasgow Coma Scale component and sum scores recorded by the 2 researchers ranged from 89.5% to 95.9% (P = .001). Significant agreement among nurses and the 2 researchers was found for eye response (73.8%), motor response (75.0%), verbal response (68.1%), and sum scores (62.4%) (all P = .001). Significant agreement among nurses and the 2 researchers (55.2%) was also found for sum scores of patients with sum scores of 10 or less (P = .03). CONCLUSIONS: Although the study showed near-perfect agreement between the 2 researchers' Glasgow Coma Scale scores, agreement among nurses and the 2 researchers was moderate (not near perfect) for subcomponent and sum scores. Accurate Glasgow Coma Scale evaluation requires that intensive care unit nurses have adequate knowledge and skills. Educational strategies such as simulations or orientation practice with a preceptor nurse can help develop such skills.

Effect of Psychoeducation on Stress in Parents of Children With Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Study.

The current experimental pre-/posttest study sought to determine the effect of psychoeducation on the stress levels of parents of children with attention-deficit/hyperactivity disorder (ADHD). A total of 172 parents participated and were randomly assigned to experimental (n = 86) and control (n = 86) groups. There was no significant difference between mean pretest scores of parents in the experimental and control groups on the Caregiver Stress Scale (p > 0.005); however, significant differences were found between pre- and posttest scores in the experimental group after psychoeducation and at 6-month follow up (p < 0.001). There were also significant differences between pre- and posttest scores and pretest scores and 6-month follow-up scores in the experimental group (p < 0.05). In the light of the findings, psychiatric nurses can use psychoeducation programs to support families of children with ADHD to reduce their stress levels. [Journal of Psychosocial Nursing and Mental Health Services, 58(7), 34-41.].

[Validity and Reliability of the Parents Internalized Stigma of Mental Illness Scale]. / Ebeveynlerin Ruhsal Hastaliklarda Içsellestirilmis Damgalanma Ölçegi’nin Geçerlilik ve Güvenilirligi.

OBJECTIVE: The purpose of this study is to investigate the validity and reliability of PISMI-TR, the Parents Internalized Stigma of Mental Illness scale, which had been previously adapted to the Turkish. METHOD: The data of this methodological study were acquired between June 2017 and August 2018 from the parents of 281 individuals who were diagnosed with a mental disorder and followed up at the adult psychiatry polyclinics of a university hospital, by means of an Information Form, the PISMI-TR scale and the Beliefs toward Mental Illness (BMI) scale. SPSS 22.0 and LISREL 8.89 were used for data analysis. The content and the construct validities were determined for the scale validity and the internal consistency values were calculated for the reliability. RESULTS: The Cronbach's alpha coefficient was 0.87 for the total score of the scale, and it varied in the 0.69-0.81 range for the subscale scores. The confirmatory factor analysis validated a 5-factor structure for the PISMI-TR scale tested on the participants of this study; and the adaptive ad statistical values were at an acceptable level. The factor loading was found to range between 0.34 and 0.74. CONCLUSION: The validity and reliability analyses carried out indicated that the PISMI-TR scale is both valid and reliable. The scale can be used to evaluate the internalized stigma in parents, who play an important role in adherence to treatment of the mentally ill offspring.

Syrian refugees' experiences with mental health services in Turkey: "I felt lonely because I wasn't able to speak to anyone".

PURPOSE: This study examined Syrian refugee adults' experiences with mental health services due to a mental complaint. DESIGN AND METHODS: This qualitative study used a phenomenological design. The data were collected in semi-structured focus group interviews between June and August 2018. A total of 24 individuals participated in the study. The data were analyzed using Colaizzi's method of phenomenological interpretation. FINDINGS: Seven themes were identified by thematic analysis of the interviews: (a) difficulties making appointments, (b) difficulties obtaining medicine, (c) personal rights, (d) lack of information, (e) language barrier, (f) discrimination, and (g) confidence versus anxiety. PRACTICE IMPLICATIONS: Nurses should be aware of the barriers experienced by refugees that affect the quality and accessibility of psychiatric services.

Stigmatization experiences of Turkish parents of patients hospitalized in child and adolescent psychiatric clinics.

PURPOSE: This study determined the stigmatization experiences of parents with a child who received inpatient treatment at the psychiatry clinic in Turkey. METHOD: A qualitative descriptive approach was used. Individual in-depth interviews were conducted. The study sample consisted of 15 parents. The data were evaluated using the thematic analysis method. FINDINGS: According to the data analysis, six themes and eight subthemes were created. These themes were exclusion, labeled, hiding the child's disorder, positive discrimination, coping strategies, and despair. CONCLUSION: This study determined that all participant parents were exposed to stigmatization in many areas and tried to hide their child's diagnosis. PRACTICAL IMPLICATIONS: Mental health and psychiatric nurses should support the patient's parents to share and express both theirs and their child's stigmatization experiences.