Medical Response to the February 6, 2023, Earthquakes in Hatay: Challenges Faced in the Deadliest Disaster in the History of Türkiye.

OBJECTIVE: The Kahramanmaras earthquakes struck the north-eastern part of Türkiye and Syria on February 6, 2023. It is well known that timely coordination and provision of emergency medical care in the field is particularly important to save lives after earthquakes. This study aimed to identify the challenges faced by medical responders on the ground. METHODS: This exploratory-descriptive qualitative study was conducted in Hatay, the province most affected by the earthquakes. Data were collected through in-depth semi-structured interviews and field observations, and then analyzed using thematic analysis approach. RESULTS: The study was carried out with 15 first responders from the medical profession. The study revealed 9 themes of challenges faced by medical responders: providing safety and security, human resources management, meeting personal needs, recording data, communication, patient transport, burial procedures, psychological acumen, and logistical problems. Some problems were resolved after 72 h and some continued until day 7. CONCLUSIONS: Inadequate organization of volunteer health workers, communication breakdowns, and logistical problems are some of the main challenges. To address these issues, satellite phones and radio systems can be promoted, as well as disaster-resilient logistical planning and better coordination of volunteers.

Strategies for Strengthening the Resilience of Public Health Systems for Pandemics, Disasters, and Other Emergencies.

OBJECTIVE: The aim of this study was to identify and prioritize strategies for strengthening public health system resilience for pandemics, disasters, and other emergencies using a scorecard approach. METHODS: The United Nations Public Health System Resilience Scorecard (Scorecard) was applied across 5 workshops in Slovenia, Turkey, and the United States of America. The workshops focused on participants reviewing and discussing 23 questions/indicators. A Likert type scale was used for scoring with zero being the lowest and 5 the highest. The workshop scores were analyzed and discussed by participants to prioritize areas of need and develop resilience strategies. Data from all workshops were aggregated, analyzed, and interpreted to develop priorities representative of participating locations. RESULTS: Eight themes emerged representing the need for better integration of public health and disaster management systems. These include: assessing community disease burden; embedding long-term recovery groups in emergency systems; exploring mental health care needs; examining ecosystem risks; evaluating reserve funds; identifying what crisis communication strategies worked well; providing non-medical services; and reviewing resilience of existing facilities, alternate care sites, and institutions. CONCLUSIONS: The Scorecard is an effective tool for establishing baseline resilience and prioritizing actions. The strategies identified reflect areas in most need for investment to improve public health system resilience.

Exploration of nursing students' views on the theory-practice gap in surgical nursing education and its relationship with attitudes towards the profession and evidence-based practice.

AIM: The aim of this study was to explore nursing students' views on the theory-practice gap in surgical nursing education and determine its relationship with attitudes towards the profession and evidence-based practice. BACKGROUND: In nursing education, the discrepancy between the theoretical knowledge and clinical practices is known as the "theory-practice gap". Although this problem was defined many years ago, scientific information on the subject is very limited in terms of surgical nursing. METHOD: This descriptive-analytical and cross-sectional study was carried out in three different universities in the Black Sea Region of Türkiye. The sample consisted of 389 nursing students. The data collection was carried out in May-July 2022 through the use of the following tools: The Attitude Scale for the Nursing Profession (ASNP), the Knowledge, Attitudes and Behaviors Questionnaire for Evidence-Based Practice (KABQ-EBP) and the researchers made form to determine students' views on the theory-practice gap. The data were analysed with Student's t-test, multiple linear regression analysis. RESULTS: 72.8% of the students stated that they thought there was a discrepancy between their theoretical surgical nursing courses and clinical practice. While the total ASNP score of students who thought that there was a discrepancy between theoretical education and clinical practice was lower than that of the other students (p = 0.002), no difference was found among the students in terms of the total KABQ-EBP score (p > 0.05). In the multiple linear regression analysis, it was determined that thinking about gap (ß = -0.125, p = 0.009), gender (ß = -0.134, p = 0.006), willingness to choose the profession (ß = 0.150, p = 0.002) and KABQ-EBP score (ß = 0.247, p < 0.001) had significant effects on nursing students' attitudes towards the profession. In the model, %12 of the total variance was explained by the variables. CONCLUSION: The study shows that the gap between theory and practice for the surgical nursing course is a problem perceived by most students. Also, students who thought that there was a theory-practice gap for the surgical nursing course had a more negative attitude towards the profession, while their attitudes towards evidence-based nursing were not different from others. The results of this study encourage further research to gain a better understanding of the impact of the gap between theory and practice on nursing students.

Worldwide distribution and clinical characteristics of mad honey poisoning cases.

OBJECTIVES: Mad honey poisoning is a common public health problem that can be seen in many parts of the world. In this study, the symptoms and clinical findings of mad honey poisoning cases and their distribution worldwide were investigated based on current data. METHODS: PubMed, Scopus, Web of Science and Google Scholar databases were searched. The demographic characteristics of the cases, clinical findings, amount of consumed honey, duration of hospitalization, and data of the region where mad honey was produced were recorded. RESULTS: 900 cases were identified. The majority of poisoning cases (91.44%) were reported from mad honey produced in Turkey, Nepal (4.67%) came second and Korea (1.56) third. The majority of cases in Turkey were due to honey produced in the Black Sea Region. It was also determined that the mad honey was produced in the west Black Sea Region in most of the cases (35.22%), followed by the east Black Sea Region with a rate of 33.22%. In poisonous cases, it was determined that the mad honey was mostly produced in Rize, followed by Trabzon and Kastamonu, respectively. The most common signs of mad honey poisoning were bradycardia (88.48%) and hypotension (76.04%). CONCLUSION: The majority of cases have been reported from Turkey. When examining where the mad honey was produced in Turkey, it was seen that the western Black Sea Region came first, and the eastern Black Sea Region came second. Rize came first among the provinces, followed by Trabzon and Kastamonu. There is a parallelism between the distribution of mad honey poisoning cases and the distribution areas of Rhododendron species. However, although Rhododendron species show a widespread distribution throughout the world, why the majority of the cases were reported from Turkey draws attention as an issue that needs to be investigated.

Development and psychometric testing of Perceived Preoperative Nursing Care Competence Scale for Nursing Students (PPreCC-NS).

BACKGROUND: For nurses to carry out their responsibilities related to preoperative care in the best possible way, it is very important for them to receive competency-based training and for their competences to be measured with reliable and valid tools in the training process. OBJECTIVE: To develop a measurement tool that evaluates nursing students' perceived competence for preoperative nursing care. DESIGN: A cross-sectional, methodological study. SETTING: Two universities in the Eastern Black Sea Region of Turkey. PARTICIPANTS: A total of 661 second, third and fourth grade nursing students participated in the study. METHODS: Items were created in line with the nursing competencies published by the International Council of Nurses, the competencies in the perioperative period nursing practices published by the European Operating Room Nurses Association, and a review of the literature. Then, to test the content validity, the items were submitted for expert opinion and a pilot implementation was made with 50 nursing students. Furthermore, the construct validity of the scale was tested with exploratory factor analysis (n = 253) and confirmatory factor analysis (n = 350). Test-retest stability was also investigated for the PPreCC-NS (n = 58), in the study. RESULTS: According to the results of the exploratory factor analysis, the Kaiser-Meyer-Olkin value was 0.948, and the Bartlett test χ2 was 7765.23; p < 0.001. Three items with a factor loading value below 0.50 were removed from the scale, and the obtained factor structure explained 62.25 % of the variance. The fit indices of the scale model tested in the confirmatory factor analysis were determined as χ2/df = 2.74, RMSEA = 0.07, CFI = 0.92, GFI = 0.88, AGFI = 0.85, IFI = 0.92. The structure of the draft scale was confirmed with 5 factors and 22 items. The Cronbach alpha values were found to be 0.79-0.96 for the sub-dimensions of the scale and 0.94 for the total scale. Data also showed a good test-retest stability (ICC = 0.72). CONCLUSIONS: This scale is a reliable and valid measurement tool for nursing students to determine their level of perceived competence for preoperative nursing care. It is recommended that the psychometric structure of the scale be evaluated with further studies on larger and more diverse samples.

The Efficacy of Lavender Aromatherapy in Reducing the Overcrowding-Related Anxiety in Health Care Workers.

In general, emergency departments (EDs) are stressful workplaces with excessive workloads and time pressures. Crowding, which is an important problem worldwide disrupting ED functions, leads further increases in the stressors which health care workers are exposed to. Long-term exposure to stressors can lead to anxiety in health care workers. The aim of this study was to determine the effect of aromatherapy on crowding-related anxiety in ED health care workers. Crowding was measured simultaneously with the National Emergency Department Overcrowding Scale objectively and the Health Care Workers' Crowding Perception Evaluation Form subjectively. The state-trait anxiety level was measured at each crowding level according to the health care workers' perception. When perceived crowding was at severely overcrowding level, lavender oil aromatherapy was applied. Anxiety level was measured before and after aromatherapy. Aromatherapy was repeated 3 times on different days. A significant positive correlation was found between state anxiety level and perceived crowding (r = 0.415, p < 0.001). Aromatherapy was found to have a significant correlation in reducing the overcrowding-related anxiety in health care workers (p < 0.05). This study showed that there is a significant correlation between anxiety level and perceived crowding, and aromatherapy is related to a decrease in overcrowding-related anxiety. In EDs, lavender oil aromatherapy can be used as a complementary method in reducing the overcrowding-related anxiety. But further researches are needed to verify that aromatherapy has a causative effect on reducing overcrowding-related anxiety.

Developing Cricothyroidotomy Skills Using a Biomaterial-Covered Model.

INTRODUCTION: Cricothyroidotomy is an advanced and life-saving technique, but it is also a rare and a difficult procedure. The purpose of the present study was to produce a low-cost simulation model with realistic anatomic features to investigate its effectiveness in developing cricothyroidotomy skills. METHODS: This study was performed at a university simulation center with 57 second-year student paramedics and a cricothyroidotomy simulation model. Total scores were assessed using a checklist. This consisted of 13 steps and was scored as misapplication/omission=0, correct performance and timing with hesitation=1, and correct performance and timing without hesitation=2. One of these steps, local anesthesia of the area if time is available, was not performed owing to time limitations. The highest possible score was 24. Data are presented as mean±SD with range, as appropriate. Normal distribution was evaluated using the Kolmogorov-Smirnov test, Student t test, and Mann-Whitney U test, and correlation analysis was used for statistical analysis. RESULTS: Students completed the cricothyroidotomy procedure steps in 116±46 (55-238) s. At performance assessment, the score achieved was 12±5 (2-24). The highest total score of 24 was achieved by 3 students (5%). Total scores exhibited negative and significant correlation with procedure time (r=-0.403, P=0.002). CONCLUSIONS: The model developed in this study is an inexpensive and effective method that can be used in cricothyroidotomy training for student paramedics. We think that repeating the cricothyroidotomy procedure on the model will increase success levels.

Turkish health care providers' views on inappropriate use of emergency department: Who, when and why?

OBJECTIVE: Inappropriate use of emergency departments is recognized globally as a widespread problem. The study was undertaken to determine the perceptions of emergency department personnel regarding inappropriate use of this department. METHODS: The study was undertaken with 124 emergency department employees from six emergency departments in a province of the Eastern Black Sea region of Turkey. Using a questionnaire form designed by the researcher, the data were gathered and analyzed with the chi-square test, numerical and percentage calculations. RESULTS: According to the emergency department employees, more than half of emergency department visits were inappropriate with most visits occurring between the hours of 19:01 and 01:00. In order of occurrence, employees also indicated that most inappropriate use concerned requests for prescription renewals, treatment for pain, and upper respiratory tract infections (URTI). According to the employees, patients made inappropriate use of emergency departments in the belief that these provide services for every kind of health problem. Unfortunately, according to the health care workers this misperception of emergency services results in less effective patient care and a decrease in employee motivation. CONCLUSION: Health team members thought that inappropriate use of emergency services led to negative outcomes in the quality of care and motivation of the workers. Solutions to minimize inappropriate use of emergency departments need to be developed and put into place.