Analysis of home care nurses' workload: A time-motion study.

This observational-descriptive time and motion study was conducted to determine how heavy home care nurses' workload is and how they allocate their work time to home healthcare. It was carried out in the home health services of the district municipality.The Information form, Nursing Activities Report Form, Cheltenham Patient Classification Scale were used. The time-motion study method was implemented to perform the workload analysis. The nurses allocated 68.02 minutes to direct care, 61.02 minutes to indirect care, 53.26 minutes to their work unit-related activities, and 119.42 minutes to their personal activities.Among all the activities performed during the day, the longest time was allocated to educational activities. Another area that took a long time was the registration procedures. Performing workload analysis with different methods that will measure many concrete and intangible attempts of home care nurses will contribute to workforce planning in home care services, resolving of the unmet home care needs of patients and continuous quality improvement.

The popularisation of self-care: Tracing the dissemination of Orem's Self-Care Deficiency Nursing Theory into the scientific disciplines.

BACKGROUND: Bibliometric methods may be used to examine research trends, and information visualisation techniques are useful in illustrating the diffusion of knowledge and how theories are applied. OBJECTIVES: The present study aimed to illustrate how Orem's Self-Care Deficiency Nursing Theory (SCDNT) has been cited and applied in nursing science and beyond. METHODS: A bibliometric analysis examined scientific publications that cited Orem's nursing theory. In addition, the diffusion of SCDNT was assessed using data visualisation methods and integration scores of SCDNT versions were calculated to define trends in its theoretical usage in other scientific domains. RESULTS: The information visualisation demonstrated increased usage of SCDTN in different disciplines. Integration scores demonstrated that the scientific community still recognises and uses versions of SCDTN. DISCUSSION: Studying citation patterns helps to identify which publications are still cited and relevant, as well as illustrating the dissemination of theory. Findings may be used in the collection weeding of SCDTN book versions. CONCLUSIONS: Findings provided nursing scientists with a better conceptual understanding of SCDNT diffusion and development. For academic library managers, the findings identify which SCDNT should be retained for historical interest and curriculum needs.

Educational material for social marketing and behaviours linked to early detection of breast cancer.

BACKGROUND: Social marketing is an effective tool to ensure a populationbased behaviour change for a healthy lifestyle. AIM: The aim was to investigate the effects of breast cancer-related printed educational materials on women's behaviours related to early detection and diagnosis of breast cancer within the framework of social marketing. METHOD: This pre-post test one-group study was conducted with 80 women in a family health centre. An interview form, printed educational materials and follow-up form were used to collect the study data. The data were collected at the baseline and through phone calls at the third month. RESULTS: Of the women, 36% had never performed breast self-examination (BSE), 55% had never had clinical breast examination (CBE), and 41% had never had mammography. There were no differences between the measurements made at the baseline and at the third month in terms of performing BSE, and having CBE and mammography. CONCLUSION: The importance of expanding social marketing approaches in terms of global health investments is emphasised. Adoption of positive health behaviours will lead to improvements in health status, as assessed through measures of morbidity and mortality status in cancer.

Social Participation of Older Adults in Rural and Urban Areas: A Cross-Sectional Survey in Turkey.

Social participation is important in terms of active aging and quality of life during old age. This cross-sectional study aimed to determine the social participation of older adults in rural and urban areas in Turkey. Related factors were similarly identified. The sample comprised 1,224 people over the age of 60, with a mean of 69.78 ± 7.48 years. Among the participants, 61.4% live in urban areas. The data were collected in family health centers through face-to-face interview and the Interview Form, Social Participation Assessment Form, and Social Participation Dimension of the Turkish Version of the Aging Module of the World Health Organization Quality of Life (WHOQOL) Scale. The scores obtained from the social participation dimension of the scale among the elderly in urban areas were higher than those obtained among the elderly in rural areas (p = .002). In addition, older adults in the urban areas who talked on the phone several times a month (p = .025), went to concerts, theater/cinema, museum/exhibition, various visual/musical shows (p = .046), and engaged in gardening (p = .032) obtained higher scores in the social participation dimension than the other participants. Health care professionals should take an advocacy role in building relationships with policy makers and create suitable socialization opportunities for older adults in urban and rural areas.

Social participation is important in terms of active aging and quality of life during old age.This is the first study with a huge sample to compare the level of social participation of the elderly in rural and urban areas in Turkey.It provides information on the level of social participation of the elderly in a developing country.

Attitudes and Self-Perception of 10- to 14-Year-Old Students Toward Obese Children.

This cross-sectional study was carried out to investigate the self-perception of primary school students aged 10-14 and their attitudes toward obese children (n = 693). There was a weak, positive, and highly significant correlation between the mean scores for the overall Attitude Toward Obese Children Scale, the Self-Perception Profile for Children Scale, and the Acceptance of Obese Peers subscale (p = .000). There was a weak, positive, and highly significant correlation between all the subscales except for the Rejection of Obese Peer and Social Acceptance and Athletic Competence subscales (p < .01). Self-perception in adolescence is effective throughout life in terms of community mental health. Therefore, it is of great importance to carry out education and awareness-raising studies in schools to gain students positive attitudes and behavior toward individuals with different characteristics.

Nurse-led home modification interventions for community-dwelling older adults with dementia and their impact on falls prevention.

This quasi-experimental study aimed to investigate the effects of nurse-led home modification interventions on the family members of home-dwelling older adults with dementia. The sample consisted of 42 older adults diagnosed with dementia and their family members. A number of validated tools were used. Three home visits were undertaken, a training package with family members was instigated, and the patients were followed up for a 6-month period. It was determined that there was a decrease in falls in the first 3-month period (p=0.002). The number of falls in the second 3-month period was lower in the older adults who had their homes modified (p=0.000). Family-centred, nurse-led home-modification interventions can be effective in the prevention and reducing of falls in older adults with dementia.

The effects of tropicamide and cyclopentolate hydrochloride on laser flare meter measurements in uveitis patients: a comparative study.

PURPOSE: To investigate the effects of 1% cyclopentolate hydrochloride and 1% tropicamide eye drops on aqueous flare measurements by using the laser flare meter. METHODS: One hundred forty eight eyes of 83 patients with inactive uveitis were enrolled. The patients were randomly assigned to receive either 1% tropicamide (Group 1) or 1% cyclopentolate hydrochloride (Group 2) as the mydriatic agent. Best corrected visual acuity (BCVA), intraocular pressure (IOP), aqueous flare reaction levels measured by laser flare meter device (FM 600, Kowa, Kowa Company Ltd, Nagoya, Japan) before and post dilatation agents were evaluated. RESULTS: Group 1 consisted of 75 eyes and Group 2 consisted of 77 eyes. The mean age of Group 1 patients was 34.85 ± 12.60 (range, 12-64) years; the mean age of Group 2 was 36.92 ± 13.30 (range, 12-70) years (p > 0.05). The mean BCVAs of two groups were 0.16 ± 0.43 (range, 0.00-3.10) logMAR and 0.17 ± 0.42 (range, 0.00-3.10) logMAR, respectively. There were no statistically significant differences between Groups 1 and 2 regarding gender or clinical characteristics (p > 0.05). No significant differences were detected in pre- or post-dilatation values between two groups (p = 0.470, p = 0.998). CONCLUSIONS: As a result, anterior chamber flare values in uveitis patients do not differ significantly between 1% tropicamide and 1% cyclopentolate hydrochloride, and both agents can be safely used for dilatation during examination of patients with uveitis.

Investigating intercultural effectiveness of paediatric nurses in a Turkish hospital.

BACKGROUND: Cultural competence, an important part of patient-centred care, has been on the nursing agenda for many years. AIM: The aim of this study was to measure the intercultural effectiveness level of paediatric nurses, and to explore relationships between the level of intercultural effectiveness and some sociodemographic variables in paediatric nurses. METHOD: The study was conducted at Izmir Tepecik Training and Research Hospital's children's clinics in Turkey. A convenience sample of 98 paediatric registered nurses practising at the hospital was evaluated. To collect the study data, a sociodemographic characteristics questionnaire, a Cultural Approach in Nursing Care form and the Intercultural Effectiveness Scale (IES) were used. RESULTS: The participating paediatric nurses' intercultural effectiveness levels were moderate, the problem they experienced most was the language problem and although many of them had not received adequate training in cultural care, based on their experiences, they regarded themselves as culturally competent. CONCLUSION: Cultural competence is vital in multi-ethnic and multicultural societies. Cultural competence training should be provided to nurses during nurse education, or in-service training during their professional life.

Nasogastric Tube Feeding Experiences in Pediatric Oncology Patients and Their Mothers: A Qualitative Study.

The aim of this qualitative research study is to reveal children's and their mothers' views and experiences related to nasogastric tube feeding, which is the most frequently performed nutrition delivery method in pediatric oncology. The present study was carried out at an university pediatric oncology inpatient service. A total of three children and 14 mothers participated in the study. The analysis of the data was conducted according to Kolcaba's Comfort Theory. The findings resulting from the content analysis were explained under four main themes: (1) physical: includes the inability to be fed orally, nasogastric tube intervention, comfort because of feeding, medication administration, and satisfaction; (2) psychospiritual: includes anxiety, fear, distorted body image, and compliance; (3) sociocultural: includes conflicts with the child about feeding and advice on feeding via the nasogastric tube to other mothers and children; and (4) environmental: includes unrestricted/freedom of feeding. Gastroenterology professionals can also provide basic counseling and resources to children and mothers about the importance of maintaining an optimal weight and of enteral nutrition.

Cervical Cancer Knowledge, Self-Efficacy, and Health Literacy Levels of Married Women.

The purpose of this descriptive and relational study is to investigate the relationship between cervical cancer knowledge and self-efficacy and health literacy levels of married women aged 18-65 years. The study sample consisted of 400 married women (18-65 years old) who presented to a family health center. Independent variables were sociodemographic characteristics; dependent variables were cancer knowledge, self-efficacy, and health literacy level. Of the participants, 67% had a Pap smear. The participants' median knowledge score was 13 (min-max = 1-21). As the age increased, so did the knowledge score (p = 0.001). The secondary school graduates had the lowest knowledge level (p = 0.009). The participants' self-efficacy level was moderate (83.18 ± 7.70). As the educational status increased, so did their self-efficacy. Of the participants, 55.2% had a health literacy level of 7th-8th grade. The health literacy level was lower among the literate, primary school graduate, and advanced-age participants (p = 0.000). Increases in the self-efficacy and health literacy levels of the participants positively affected their knowledge status. The participants' cervical cancer and Pap smear screening knowledge levels increased as their self-efficacy levels increased. The literate or primary school graduate participants had the self-efficacy and health literacy levels.

Child-Adolescent Teasing Scale: psychometric properties of the Turkish version.

BACKGROUND: The tools to measure teasing are not available in Turkish literature. This study aimed to examine the psychometric properties and performance of a Turkish version of the Child-Adolescent Teasing Scale (CATS) among a sample of Turkish children. METHODS: Four hundred middle school (grades 5-6-7-8) students comprised the sample. CATS is composed of four subfactors and 32 items. Language equivalence and content validity were assessed by five experts. Psychometric testing included internal consistency reliability (Cronbach's alpha coefficient and item-total correlations), test-retest reliability, construct validity (principal component analysis via oblique rotation and confirmatory factor analysis), and variability (floor and ceiling effects). RESULTS: Of the participants, 52.5% were female. Their mean age was 12.54 ± 1.11. Language equivalence and content validity were assessed by five experts. The Content Validity Index of the scale was .87. The correlation coefficient ranged between .34 and .70. Cronbach's alpha was .92 for the total scale. The test-retest correlation value was r = .87. The scale confirmatory factor analysis showed that the scale had a four-factor structure. These four factors explained 55.51% of the total variance. The reliability coefficient of the relationship between each subscale in relation to the total scores of the scale ranged from .56 to .93. CONCLUSIONS: In conclusion, the Turkish version of the CATS which has good psychometric properties similar to those of the original English version is a valid and reliable tool. While the original scale has 32 items, the Turkish version of the CATS has four factors and 23 items. It can be used to assess teasing in children and adolescents.

Cultural Sensitivity Among Clinical Nurses: A Descriptive Study.

PURPOSE: The purpose of this study was to investigate the cultural sensitivity of nurses working in rural and urban hospitals in Turkey. DESIGN AND METHODS: The sampling of this descriptive and correlational study was composed of only 516 clinical nurses working in inpatient clinics. The data collection tools were the Socio-Demographic Questionnaire and the Intercultural Sensitivity Scale. FINDINGS: A majority of the participating nurses experienced culture-related problems. Intercultural Sensitivity Scale results were partially high. The nurses had more problems in areas related to language barriers, patients' education level, and health perception about disease and religious beliefs when providing health care. Participants who were female, had an undergraduate or graduate education, had received in-service education on cultural care, or had taken transcultural nursing coursework obtained higher scores on the Intercultural Sensitivity Scale and its Interaction Engagement subscale. The cultural sensitivity level was 84.01 ± 9.1 (range = 43-107). The proportion of nurses who had received no in-service education was very high. They wanted to participate in an education program to gain better understanding of the culture of the society in which they lived. CONCLUSIONS: The results of the present study demonstrated that nurses should be prepared in cultural sensitivity and cultural competence. CLINICAL RELEVANCE: Continuing education and formal courses on cultural sensitivity for nursing professionals are essential for optimal health outcomes. Thus, inequalities in health could be prevented and the quality of health care could be improved.

Determination of school-related problems in children treated for cancer.

This descriptive and case-control study was carried out in a pediatric oncology outpatient clinic to determine the school-related physical, social, and psychological problems and problems experienced in academic achievement of children treated for cancer. The sample of the study consisted of 56 Turkish patients with cancer, aged 7-18 years, who were in remission and attending school as well as their parents, a control group of patients who did not have cancer, and their teachers. A Child Information Form, a Child Health Questionnaire Parent's Form of 50 questions, a Behavior Evaluation Scale for Children, and Young People and a Teacher's Report Form were used as data collection tools in the study. Of the children, 30.3% experienced various physical difficulties stemming from cancer therapy that affected their school life. The number of late enrollments, the number of children repeating a grade, and the rates of school absenteeism were also found to be higher in the survivors than in the controls.

Validity and Reliability of the Turkish Version of the Spirituality Instrument-27 (SpI-27©).

Introduction: This methodological study aimed to adapt the Spirituality Instrument-27 (SpI-27©) to the Turkish language and culture. Design: The psychometric study was carried out with 267 individuals who were hospitalized in the cardiology clinic and who were diagnosed with a chronic disease. Data collection tools were the demographic questionnaire and the SpI-27©. The Statistical Package for Social Sciences was used for data analysis and confirmatory factor analysis. Results: The Kaiser-Meyer-Olkin index was 0.848 and Bartlett's test of sphericity was statistically significant (p = 0.000). The root mean square error of approximation was 0.05, the standardized root mean squared residual was 0.04, the adjusted goodness-of-fit index was 0.87, the goodness-of-fit index was 0.92, the nonformed fit index was 0.91, and the comparative fit index was 0.90. Connectedness with others accounted for 38.24 of the total variance, self-transcendence accounted for 11.71, self-cognizance accounted for 10.56, and conservationism and belief accounted for 9.82 of the total variance (total variance was 70.34%). The highest item factor loading of the scale was 0.812 and the lowest one was 0.398. Cronbach's alpha coefficient of the scale was 0.927. Conclusion: This measurement tool will enable researchers to plan and implement nursing interventions accurately and effectively by assessing the spiritual needs of individuals with nonmalignant chronic diseases. The use of this tool in different languages can help diagnose the spiritual needs of nurses working with multicultural and multilingual patients.

Enteral nutrition is feasible in pediatric stem cell transplantation patients.

We aimed to demonstrate whether enteral nutrition (EN) is feasible in daily practice of hematopoietic stem cell transplantation (HSCT).Nutritional records of 100 patients were evaluated. Patients with poor oral intake were fed by EN with tube. A total of 79 patients required nutritional support. Of them, 71 were fed by EN only. Five were fed by EN plus parenteral nutrition (PN),three were fed by PN only. Median duration of EN was 21 days. In the EN only group, 68% gained or maintained their weight. EN should be considered as a feasible option for nutrition support in children undergoing HSCT.

Effectiveness of a discharge-planning program and home visits for meeting the physical care needs of children with cancer.

GOALS OF WORK: The purpose of this study was to investigate the effectiveness of a discharge-planning program on helping caregivers meet the physical care needs of children with cancer. PATIENTS AND METHODS: This research is a quasi-experimental type of study in a pediatric oncology clinic at a university hospital in Izmir/Turkey. The control group had 25 and the experimental group had 24 patients with their caregivers. For the experimental group, discharge planning, discharge teaching, home visits, and telephone consultation were provided and has been planned to investigate the effectiveness of a discharge-planning program on helping caregivers meet the physical care needs of children with cancer between 0-18 years of age. MAIN RESULTS: In the third assessment, the number of patients that needed physical care needs in the experimental and control groups was decreased, and children in the experimental group had a lower number of physical care needs. A decreased number of unplanned admissions to the hospital at the first and third follow-up times, a decrease in unplanned admissions, and higher satisfaction rate were seen in the experimental group caregivers. CONCLUSIONS: A discharge-planning program and a hospital-based home care model had a very significant effect on the care needs of children with cancer and their caregivers. Our findings indicate that a discharge-planning program and a hospital-based home care model had a very significant effect on the care needs of children with cancer and their caregivers.

Health Beliefs, Self-Care Behaviors and Quality of Life in Adults with Type 2 Diabetes.

AIM: Diabetes mellitus is a lifelong metabolic disease accompanied by acute and chronic complications and requires continuous medical care. The aim of this study is to investigate the effect of the diabetes self-management educational intervention given to individuals with type 2 diabetes on their health beliefs, self-care activities, and quality of life. METHOD: A single group randomized quasi-experimental study with the pre- and post-intervention design was conducted in two family health centers (n=60). The self-care activities, health beliefs, and quality of life of patients with type 2 diabetes were investigated. RESULTS: The mean pre- and post-intervention blood glucose subscale scores were 1.57±0.91 and 3.22±1.06, respectively. The mean pre- and post-intervention social/vocational issues subscale scores were 29.26±5.54 and 33.26±3.19, respectively. The mean scores of the quality of life increased in the primary school graduates and in those who previously had no diabetes intervention after the intervention program. It was determined that the mean body mass index values of the participants decreased after the intervention. CONCLUSION: It is recommended to organize and implement periodic diabetes self-management educational intervention programs in family health centers and in centers providing diabetes health care to improve health beliefs and to increase self-care activities and quality of life in individuals with diabetes.

An exploratory study of intercultural effectiveness scale in nursing students.

Culture is a fundamental element of intercultural relationships and contributes to its effectiveness. This methodological study' s purpose is to test the Turkish version of the Intercultural Effectiveness Scale. The scale is a reliable and valid. It is important to include intercultural communication competence in nursing curriculum programs to ensure that students gain all these awareness, skills and behaviors.

Determination of the costs of falls in the older people according to the decision tree model.

PURPOSE OF THE RESEARCH: The primary aim of this study is to hypothetically examine the costs of falls experienced by the older people living in the community and fall prevention interventions implemented by nurses using the decision tree model. The secondary purpose of the study is to determine the factors affecting the cost of falls. THE MATERIALS AND METHODS: This study was planned as a costing and cost-effectiveness study. Two thousand seventy-five patient files were examined by following the research criteria. In the present study, a hypothetical analytical decision tree model was used. Three different scenarios were set up in the study, and the decision tree analyses were performed according to these scenarios. Falls will decrease by 12 % in the pessimistic scenario, by 27 % in the optimal scenario, and by 39 % in the optimistic scenario. The SPSS 22.0 (2014) and TreeAge Pro Suit (2009) programs were used for data analysis. THE PRINCIPAL RESULTS: The average cost for a person admitted to a hospital due to falls was $396.51 ± $1429.35.It was determined that costs varied according to the type of the injury.The results of this present study demonstrated that the three scenarios tested were costly but also more effective. Hence, the applicability of these interventions should be considered by policy makers taking both the costs and effectiveness into account. MAJOR CONCLUSIONS: Multidisciplinary research should be carried out in order to increase the effectiveness of the fall prevention programs to be implemented in the future, and multifaceted fall prevention programs should be developed.

Cancer-Related Stigma and Depression in Cancer Patients in A Middle-Income Country.

OBJECTIVE: The aim of the current study are to determine the depression levels of adult oncology patients in the cancer treatment phase and identify both cancer-related stigma and the factors affecting their depression levels. METHODS: In this correlational study, 303 adult patients who had been treated at a medical outpatient clinic were surveyed using the convenience sampling method. The "questionnaire for measuring attitudes toward cancer - patient version," a sociodemographic characteristics questionnaire, and the beck depression inventory were used. A multivariable linear regression model was used for the analysis. RESULTS: The questionnaire and its subscale scores indicated a positive relationship between depression and attitudes toward cancer. The predictive variables for depression were "being younger than 40-year-old" and "feelings of social exclusion," which accounted for 4% of the total variance. Four factors indicating negative attitudes toward cancer were "being more than 60-year-old," "higher education," "low income," and "feelings of social exclusion," which accounted for 11% of the total variance. CONCLUSIONS: Cancer-related stigma, which underlies patients' emotional and behavioral outlooks, should be reduced in cancer patients. Members of health teams should be sensitive to cancer-related stigma.