Nurses' attitudes towards telehealth: The development and validation of the nurses' attitudes towards the use of telehealth scale.

AIM: To develop the nurses' attitudes towards use of a telehealth scale (NATUTS) and evaluate its psychometric properties. DESIGN: This methodological study involved two stages: the development of the NATUTS and the testing of the psychometric properties of NATUTS. We followed STROBE guidelines when reporting the study (File S1). METHODS: Items for NATUTS were created using evidence from the literature and presented to eight experts. The scale was tested in a methodological study conducted through a face-to-face survey with nurses working in outpatient and inpatient units of a tertiary hospital in Türkiye. Psychometric properties of the scale, such as structural validity, content validity and internal consistency reliability, were tested. The sample, consisting of 630 nurses, was divided into two separate random groups. Exploratory factor analysis was conducted with the data of the first 330 people, and confirmatory factor analysis was conducted with the data of the remaining 300 people. RESULTS: A 19-item, three-factor structure (Satisfaction, Rejection, Development) was obtained in the newly developed scale. In NATUTS, Factor 1 (α = .93), Factor 2 (α = .86) and Factor 3 (α = .87) measured 64.4% of the total variance. The entire 19-item acceptability survey showed good internal consistency. NATUTS is a brief survey based on research evidence validated in a large Turkish sample. CONCLUSION: Findings show that NATUTS has acceptable content and structural validity and is reliable in measuring nurses' attitudes towards the use of telehealth. Further research can be conducted to develop the scale and strengthen its validity. PATIENT OR PUBLIC CONTRIBUTION: No Patient or Public Contribution.

The effect of nurse-led motivational interviewing based on the trans-theoretical model on promoting physical activity in healthy older adults: A randomized controlled trial.

AIM: The aim of this study was to evaluate the effect of motivational interviewing based on the trans-theoretical model promoting physical activity in older adults. METHODS: A randomized controlled trial study was conducted with 117 older adults (intervention group: 58, and control group: 59) between April and November 2019. The data were collected via a questionnaire, trans-theoretical model scales, the Physical Activity Scale for the Elderly, the Katz Activities of Daily Living scale and a pedometer. The 24-week intervention consisted of regular motivational interviewing. The control group received usual care at the family health centre. RESULTS: Following the intervention, the Intervention Group showed significant improvements Exercise Processes of Change Scale, Exercise Self-Efficacy Scale and Perceived Benefits of the Decisional Balance Scale for Exercise. There was a significant difference between the groups in terms of stages of change. In the Intervention Group, 81.5% were in the contemplation stage in the pre-test, while in the post-test, 70.4% had transitioned to the action stage. In contrast, in the control group, 62.5% were in the contemplation stage initially, but in the post-test, only 9.3% had reached the action stage. The mean number of step counts increased significantly in favour of the Intervention Group, as did the Physical Activity Scale for the Elderly total score. CONCLUSION: The trial indicated that after the trans-theoretical model-based motivational interviewing, the stages of change among the older adults improved, as did their exercise behaviours. It is recommended that the trans-theoretical model and motivational interviewing be used by nurses to improve healthy lifestyle stage behaviours in older adults.

Attitudes towards vaccination among parents of children aged 0-5 years: A scale development study.

BACKGROUND: Vaccination is the most important public health practice for preventing infectious diseases and maintaining health. However, some parents are hesitant to vaccinate their children. DESIGN: This study was designed as an instrument development study. METHODS: This study aimed to develop a scale to measure the attitudes of parents with children aged 0-5 years towards vaccination and to evaluate the validity and reliability of this scale. The data were collected from 691 participants between November 2020 and January 2021. During the development of the scale, experts provided feedback on its technical, content and language dimensions. The data were analysed using exploratory and confirmatory factor analyses for conceptual validity and Cronbach's α and item-level test-retest analyses for reliability. RESULTS: The developed scale is a reliable and valid tool for measuring attitudes towards vaccination among parents (Cronbach's α = 0.97, variance explained by these 28-item two factors = 62.47%). CONCLUSION: This scale can be used as a guide in measuring the attitudes of parents towards vaccination and determining the direction of primary health-care services based on the results of the measurement.

Effectiveness of non-pharmacological community-based nursing interventions for smoking cessation in adults: A systematic review.

OBJECTIVE: The purpose of this systematic review was to determine the effectiveness of non-pharmacological community-based nursing interventions for smoking cessation in adults. METHOD: Studies published between January 1, 2008 and December 31, 2017 were comprehensively searched to 14 databases. Quality Assessment Tool for Quantitative Studies was used to examine the methodological quality of the included studies. The obtained studies were listed on a code table by title, summary, and author/s' name. A narrative synthesis was used interpreting the data. This study was registered to PROSPERO (ID: CRD42018088007). RESULTS: Strong-quality rated three randomized controlled studies were included. Nurses were found to perform intensive behavioral support, brief-advice and mTobacco cessation interventions. These were effective on changing knowledge, belief and attitudes. No sufficient evidence on the cessation rate and the non-relapse rate was found. DISCUSSION: This review puts forward that non-pharmacological community-based smoking cessation interventions by nurses has an impact on changing knowledge, belief and attitudes in adult smokers. Findings can encourage public health nurses to use their counsellor role more actively. Improving the health literacy of the adult smokers via these findings can facilitate their intention to behavior change. Findings can be a useful resource for policy makers and governments in controlling the smoking epidemic.

The Effect of Aromatherapy Application on Cognitive Functions and Daytime Sleepiness in Older Adults Living in a Nursing Home.

Changes in the aging process affect the duration and quality of sleep. Not having a quality night's sleep leads to a reduction in daytime wakefulness in older adults. We examined the effect of aromatherapy on the cognitive functions and daytime sleepiness of older adults living in a nursing home. The research was a pretest and posttest design, which was conducted without a control group. The sample included 39 elders. A rosemary-lemon oil mixture was smelled by elders in the mornings for a week. After a 1-week washout period, lavender oils were smelled in the evenings for a week. After application of the rosemary-lemon oil mixture, the mean score of participants' daytime sleepiness was lower, but that decline was not statistically meaningful (P > .050). After the same application, the mean score of the participants' cognitive functions was significantly lower (P < .001). After application of lavender oil, the scores were significantly lower (P < .001). Lower scores on the scales used indicate lower sleepiness. The results showed that the 2 applications can be used to improve cognitive functions in older adults; in addition, lavender oil has an advantage in reducing daytime sleepiness.

Development of a scale to measure quality of life of overweight women.

PURPOSE: This study presents the results of methodological research that derives evaluation items and tests the validity and reliability of the scale to measure quality of life of the overweight women. METHODS: The scale items were developed by the current researchers directly from the consultation data following a group interviewing process aiming to capture the women's experiences, who are currently receiving primary health care. Pretest interviews were used to ensure that the questions were understood correctly. Six experts determined items for content validity of the scale and the evaluations of experts were scored using a content validity index. The scale is a Likert-type scale, ranging from 1 to 5. The items were tested on a sample of 506 healthy women. The body mass indices of participants were 30 and above. Psychometric analyses included explanatory factor analysis (EFA) and item response theory. Parallel analysis was used to extract factors in EFA. Internal consistency and Spearman Brown split-half test correlation were used for testing reliability. RESULTS: The scale was refined as four final dimensions, comprising 40 items as a whole. The result of Bartlett's Test of Sphericity was found sufficient (χ2 = 14164.92; p < 0.001) and the KMO value was 0.959. This statistically significant value (p < 0.001) indicates that the sampling was sufficient and data had normal distribution. Cronbach's alpha was 0.967. The Spearman Brown coefficient was found to be 0.884. CONCLUSION: It was found that the scale is a valid and reliable assessment tool that can be used to measure the quality of life of overweight women. LEVEL OF EVIDENCE: Methodological study, Level V.

The use of social media among high school students and its relationship with the perception of loneliness: A pilot study.

BACKGROUND: Physical, psychological, and social impairments are becoming more common in the world due to internet use and excessive use. PURPOSE: This study was conducted to determine the relationship between social media addiction (SMA) and the perception of loneliness in the high school period when peer influence is important. METHODOLOGY: This cross-sectional study was conducted with a total of 988 students studying at four high schools in Ankara, the capital city of Turkey, in the fall semester of 2019-2020. The research data were collected using Introductory Information Form, Social Media Addiction Scale (SMAS), and UCLA Loneliness Scale. RESULTS: According to the findings, 67.2% of the students had different degrees of SMA. It was found that 7.8% of the students had a high or very high degree of addiction. Loneliness levels of the students were found to be high (UCLA mean 62.78). A strong negative correlation (p < 0.01) was found between loneliness and all the subscales of the SMAS except the busyness subscale. CONCLUSIONS: The findings demonstrate the social media addiction and the perception of loneliness in high school students are related at a level that cannot be ignored. Future research should evaluate social media addiction and loneliness together with other psychological markers.

Effects of the stages of change model-based education and motivational interview on exercise behavior in diabetic women.

In this study, we examined the effects of exercise education and a motivational interview program, based on the stages of change model (SCM), on stage of change, using cognitive and behavioral methods, perceived benefits and barriers and self-confidence in Turkish women with diabetes. This intervention study was carried out in 2015 on 55 women selected from a family health centers' population. An exercise guide was prepared based on the SCM for the intervention group. The intervention group was followed seven times at 1-month intervals via home visits, and exercise education and the motivational interview program were conducted to identify changes in behavior. The control group received no intervention. Data were collected from both groups using a personal description form, Exercise Stages of Change Scale, Exercise Processes of Change Scale, Exercise Decisional Balance Scale, and Exercise Self-Efficacy Scale. After the exercise program, each group was re-subjected to the same scales. We used a chi-square test and independent and paired sample t-tests to analyze the data. The stages of change, using cognitive and behavioral methods, perceived benefits and self-confidence for exercise in the intervention group significantly improved compared with that in the control group (p < .05). In the intervention group, 81.5% of the participants started exercising. The exercise education and motivational interview program based on SCM positively affected stages of change, using cognitive and behavioral methods, perceived benefits, perceived barriers, and self-confidence for exercise behavior in women with diabetes. We conclude that the education and motivational interview program based on SCM are effective in promoting exercise habit.

[The Postpartum Depression Screening Scale: its reliability and validity for the Turkish population]. / Dogum Sonrasi Depresyon Tarama Olçegi: Türkçe'de geçerlik ve güvenirligi.

OBJECTIVE: The aim of this study was to determine the reliability and validity of the Postpartum Depression Screening Scale (PDSS) for the Turkish population. METHOD: The research was conducted in the province of Ankara between 15 June 2003 and 15 February 2004. The study sample included 445 women in their 2nd-13th postpartum week. Data were collected with a sociodemographic form, PDSS, Beck Depression Inventory (BDI), and Edinburgh Postpartum Depression Scale (EPDS). RESULTS: The internal consistency coefficient (Cronbach's alpha) of PDSS was 0.94, its test-retest reliability was r=0.86 and the coefficient of the two-halves test was r=0.91. Factor analysis of the scale revealed that it was composed of 6 factors with Eigenvalues >1, accounting for 54.69% of the total variance. All items of the Turkish PDSS had a factor load ranging from 0.34 to 0.77 and they all belonged to 1 factor. There was a strong relationship between PDSS, and BDI (r=0.71) and EPDS (r=0.71). Item-to-total correlation coefficients of the Turkish PDSS ranged from 0.35 to 0.68 and item-to-total correlation coefficients of its subscales ranged from 0.31 and 0.71, and they were sufficiently discriminative. CONCLUSION: The research suggests that the validity and reliability of the Turkish PDSS are satisfactory, and that it can be used in Turkey.

Relationship between healthy lifestyle behaviors and health locus of control and health-specific self-efficacy in university students.

AIM: To investigate the relationship between the healthy lifestyle behaviors and the health locus of control and health-specific self-efficacy in university students. METHODS: The study included 572 undergraduate students of a university in the central Anatolia region of Turkey. The data were collected with the General Characteristics Form, the Health-Promoting Lifestyle Profile II, the Multidimensional Health Locus of Control Scale, and the Perceived Health Competence Scale and investigated with the structural equation model. RESULTS: Health-specific self-efficacy was an important predictor of healthy lifestyle behaviors. The Internal health locus of control influenced the healthy lifestyle behaviors through health-specific self-efficacy. The other dimension was the Powerful Others health locus of control that affected healthy lifestyle behaviors, both directly and indirectly, through health-specific self-efficacy. There was a chance that the health locus of control had a negative effect on healthy lifestyle behaviors through self-efficacy. CONCLUSION: Health-specific self-efficacy is an important prerequisite for changes in healthy lifestyle behaviors, which supports Pender's model. The subscales of the health locus of control vary in their effects on healthy lifestyle behaviors, which partly supports Pender's model. Nurses, by using this model, can examine ways of improving these cognitive-perceptual factors and implement health education programs that are directed towards improving them in young persons.

What do midwives and nurses in Turkey know about nutrition in the first six months of life.

OBJECTIVE: to discover what midwives and nurses in Turkey know and advise about nutrition in the first 6 months of life. DESIGN: a descriptive, cross-sectional study. SETTING: health clinics and mother and baby health and family planning centres in the municipality of Ankara. PARTICIPANTS: 301 midwives and nurses selected by stratified, random sampling. FINDINGS: nine questions related to the features and benefits of breast milk. The mean number of questions answered correctly was 7.55 (standard deviation [SD]=1.25). Participants agreed that the babies should be breast fed for the first 6 months of life (n=184; 61.1%) and that complementary food could be introduced at 6 months of age (n=291; 96.7%). Most participants (n=223; 74.1%) recommended that mothers who have to resume work should express and store breast milk, and their babies should be fed with it. Many participants noted that there may be one or more situations when artificial milk should be given in the first 6 months of life (n=286; 95.0%). Almost all of the participants (n=292; 97.0%) gave one or more suggestions of when breast milk was sufficient or insufficient. CONCLUSIONS: most midwives and nurses in this research had adequate knowledge related to babies in the first 6 months of life. However, with continuing education, knowledge deficits can be corrected, and awareness of their roles and responsibilities can be increased in achieving one of Turkey's priority goals for the 21st Century, that of decreasing the baby death rate.

[Frequency and affecting factors of metabolic syndrome in women older than 20 years of age]. / Yirmi yas ve üzeri kadinlarda metabolik sendrom sikligi ve bunu etkileyen faktörler.

OBJECTIVE: Metabolic syndrome (MetS) is a major cause of morbidity and mortality affecting increasing number of people. This was a cross-sectional study aiming to identify the prevalence of MS and risk factors in women aged 20 years and older. METHODS: Study's universe consisted of women aged 20 years and older living in Gölbasi Ali Soydan Health Centre's territory. Eight hundred fifty women were accessed among them. Data were collected by a questionnaire. Measurements were done in the health centre following fasting 12 hours. One way ANOVA, correlation and logistic regression analyses were used for statistical analysis. RESULTS: The mean age was 39.4 years, 62% have primary school education. Prevalence of MetS was found 39.1%; low high-density lipoprotein (HDL) and abdominal obesity were the most common MetS components. On the contrary, education and age had negative correlation with HDL and positive correlation with other MetS components. Age (OR=1.091; 95%CI = 1.071-1.110; p=0.0001), and education lower than middle school (literate OR=2.491; 95%CI = 1.334-2.855; p=0.007; primary school OR=1.841; 95%CI 1.281-2.855; p=0.006) were found to increase MetS risk. CONCLUSION: Even more than half of our study group who has urban life style has two or more MetS components. Because of older age, accelerant factor for MetS, improving of healthy lifestyle behaviors in study group with genetic and environmental risk factors should be primary goal in terms of prevention of cardiovascular diseases and diabetes.

The effects of home monitoring by public health nurse on individuals' diabetes control.

Diabetes is an important health problem that changes the lifestyle of individuals. The ability of individuals to control their disease is directly related to their adaptation to the disease and self-care. The purpose of this study was to determine the effect of home monitoring of individuals with diabetes for the purpose of developing their self-care and their adaptation to diabetes. The research used a quasi-experimental (time series) design study. A convenient sample of 34 patients receiving outpatient diabetes care at Hacettepe University Adult Hospital Endocrinology Clinic participated in the study on a voluntary basis. After being seen for the first time in the clinic, they were followed up for a 6-month period in their homes. At the end of the home monitoring period, these patients with diabetes had a statistically significant decrease in HbA(1c) (glycated hemoglobin; p = .000), fasting blood glucose (p = .001), postmeal blood glucose (p = .000), and systolic blood pressure (p = .007) measurements. Diabetes is a quite frequently seen chronic and progressive disease. Nursing monitoring is important to develop an individual's skills in self-care and to support compliance to diabetes. This study supports the finding that the home monitoring of individuals with diabetes by community health nurse improves diabetic control. It is recommended that individuals with diabetes be monitored not only in the hospital but also in their homes for a comprehensive evaluation.