Turkish version of the SHARE-Frailty Instrument for primary care: reliability and validity in the nursing home setting.

In Turkey, physical frailty instruments have not been studied in the nursing home setting. We determined the reliability and validity of a Turkish version of the SHARE-Frailty Instrument for primary care (SHARE-FI) in Turkish nursing home residents. Cronbach's alpha reliability analysis was performed to determine internal consistency. Factor analysis was conducted to explore construct validity. Concurrent validity was assessed by correlation with the Care Dependency Scale (CDS). One hundred and fifty-one residents were included (mean age 73 years, 41% women). Fifty (33.1%) were identified as non-frail, 49 (32.5%) as pre-frail, and 52 (34.4%) as frail by SHARE-FI. The overall Cronbach's alpha coefficient was 0.81. Factor analysis identified two components accounting for 69% of the variance, with the first and most important component being handgrip strength. SHARE-FI groups were significantly correlated with CDS scores (p<0.05). The Turkish version of SHARE-FI had good reliability and validity in a nursing home setting.

The effect of music on delirium, pain, sedation and anxiety in patients receiving mechanical ventilation in the intensive care unit.

OBJECTIVES: To examine the effects of music for patients under mechanical ventilation support in the intensive care unit on their delirium, pain, sedation, and anxiety. RESEARCH METHODOLOGY/DESIGN: A single-blind, randomized, controlled trial. SETTING: The study was conducted with delirium positive patients between August 2020 and September 2021 in the medical/surgical intensive care unit of a university hospital in Turkey. METHODS: The study sample was selected through a simple and stratified randomization method; patients who met the inclusion criteria were assigned to the music, noise reduction or control group. The data were collected by using a Confusion Assessment Method for the ICU (CAM-ICU), CAM-ICU-7, Critical Care Pain Observation Tool (CPOT), Richmond Agitation-Sedation Scale (RASS), Facial Anxiety Scale (FAS), PRE-DELIRIC model, and Glasgow Coma Scale (GCS). The interventions were repeated twice a day for five days. RESULTS: A total of 36 patients were included, with 12 patients in each group. Significant decreases were found in the severity of delirium and pain and the level of sedation and anxiety in the music compared to the other groups (p < 0.05). The number of patients with delirium and the number of days with mechanical ventilation was found to be significantly lower in the music group compared to the other groups (p < 0.05). CONCLUSION: Music intervention may be used as a nursing intervention to control delirium, pain, need for sedation and anxiety in intensive care unit patients. However, additional studies with larger sample is needed to validate findings.

Adaptation of Diabetic Empowerment Scale-Short Form to Older Individuals and to Turkish Language: Validity and Reliability Study.

OBJECTIVE: The empowerment of old people is important in order for them to gain control over their own lives and to raise their quality of life. The purpose of this study was to adapt the Diabetes Empowerment Scale-Short Form (DES-SF) to old people and to the Turkish language, and to determine its validity and reliability. MATERIALS AND METHODS: This methodological type study was conducted between 1 January and 30 March 2017 with 106 old people fitting the criteria of acceptance in the study who attended the geriatrics clinic of a university hospital. In determining validity, language equivalence, content, and predictive validity were used, while reliability was tested with temporal invariance, Cronbach's alpha coefficient, and item total correlation. We examined its reliability and validity via item analyses, content validity (expert panel), confirmatory factor analyses, and construct validity (exploratory factor analyses). RESULTS: The Cronbach's alpha of the scale was 0.883. The scale items were grouped under a single factor in accordance with the original. Confirmatory and exploratory factor analysis showed good fit signs. CONCLUSION: After conducting validity and reliability testing on the adaptation of the Diabetic Empowerment Scale-Short Form to old people and the Turkish language, it is was concluded that it is a reliable scale to determine the empowerment levels of old people. Based on the statistical analyses applied to evaluate the validity and reliability of the scale obtained by adapting the DES-SF to old people, it was inferred that it is an instrument with high validity and reliability. The scale is a short and practical instrument to evaluate the empowerment levels of old people. The new name of the scale is the elderly empowerment scale.

Assessing psychometric properties of Turkish version of the stressor scale for emergency nurses.

OBJECTIVES: This study was carried out as a methodological study to adapt the stressor scale for emergency nurses to Turkish and to test its validity and reliability. MATERIALS AND METHODS: Data were collected between April 2019 and December 2019 from 250 emergency nurses working in the emergency department of two different universities and two state hospitals. The scale was reapplied to 40 emergency nurses from the sample group 3 weeks after the first application. For the validity studies of the scale, language validity, content validity, and construct validity studies were used, and for the reliability studies, internal consistency and test-retest reliability methods were used. RESULTS: It was found that the content validity index of the final form was determined as 0.92 (0.78-1.00) according to expert opinions, the scale explained 69.19% of the total variance in four subdimensions, the Cronbach's alpha value was 0.90, and the test-retest intraclass correlation coefficient value was 0.97. CONCLUSION: It was concluded that the reliability and validity of the scale was high for Turkish society.

Attitudes Toward Patient Safety and Tendencies to Medical Error Among Turkish Cardiology and Cardiovascular Surgery Nurses.

BACKGROUND: Patient safety and medical errors are among the most discussed topics in recent years. Identifying and reporting medical errors is one of the most significant steps toward the adoption of measures to increase patient safety. OBJECTIVES: The goal of this descriptive, cross-sectional study was to evaluate attitudes toward patient safety and the tendencies to medical error among cardiology and cardiovascular surgery nurses in Turkey. METHODS: The study sample consisted of nurses who worked in the cardiology and cardiovascular surgery departments of a University Hospital in Izmir, the third largest city in Turkey. A total of 103 nurses working in the day shift of the mentioned departments volunteered and participated in the study. A "Nurse Information Form," a "Patient Safety Attitude Questionnaire (PSAQ)," and a "Malpractice Tendency Scale in Nursing-(MTSN)" were used as data collection instruments. RESULTS: The mean ± 1 standard deviation of the nurses' PSAQ scores were 141.86 ± 18.39, whereas their MTSN scores were 237.20 ± 18.12. Although no statistically significant difference could be evidenced between cardiology and cardiovascular surgery nurses in their total MTSN scores (t = -0.99, P = 0.32), their PSAQ scores showed a significant difference (t = 2.34, P = 0.02). CONCLUSIONS: This study showed that the tendencies to medical error among cardiology and cardiovascular surgery nurses working in a Turkish facility were low, whereas their attitudes toward patient safety were not at a particularly satisfactory level. The cardiology nurses were found to have a more positive attitude toward patient safety than their colleagues in cardiovascular surgery.

VALIDATION OF EDMONTON FRAIL SCALE INTO ELDERLY TURKISH POPULATION.

PURPOSE: The purpose of this methodological study was to assess the validity and reliability of Turkish version of the "Edmonton Frail Scale" (EFS). METHOD: 130 individuals aged 65 and over residing at the Izmir Narlidere Nursing Home between September 2011 - April 2012 who agreed to participate in the study constituted the sample for the research. Individuals with communication problems (deafness, blindness or language barriers) and problems with manual dexterity were not included in the study. The EFS is composed of 11 items, with a minimum score of zero and a maximum score of 17. Initially, the scale was translated into Turkish and then back translated in order to ensure language equivalence. Six experts were consulted with regard to content validity and agreement among the experts was assessed using Kendall's W. When testing the reliability of the EFS, the scale was re-administered to 30 participants two-three weeks after the initial administration in order to determine its consistency over time and agreement between the first and second administration was analysed using the kappa statistic. Pearson's Moment Correlation Coefficient and Cronbach's Alpha were also used to establish reliability. FINDINGS: The overall Cronbach's alpha value for the scale was 0.75. An "item analysis" calculated item-total correlation coefficients of between 0.12-0.65 for scale items, and the item-total correlation for item six was found to be less than 0.20. This item solicits the number of medications used by the subject, and since the number of medications used is significant in the determination of frailty it was not removed from the scale. The scale was found to be highly consistent over time (Kappa (κ) = Min: 0.95, Max: 1.00) CONCLUSION: EFS indicators were found to be sufficiently reliable and valid for the Turkish population. Accordingly, it is recommended that this scale be used in determining the frailty of older individuals.

Symptom management in Behcets disease.

OBJECTIVE: To determine the symptoms experienced by patients diagnosed with Behcet's Disease and how they cope with them. METHODS: The qualitative study was conducted from September 2013 to March 2014 at Ege University Medical Faculty Hospital, Turkey, comprising patients having all symptoms of Behcet's Disease. Data was collected through semi-structured focus-group interview form. The findings were assessed using Theory of Unpleasant Symptoms and Symptom Management Theory. SPSS 20 and Nvivo 10 were used for data analysis. RESULTS: Of the 35 patients, 16(45.8%) were female and 19(54.2%) were male. The symptoms affected patients' lives, and the patients used either positive or negative symptom management strategies, leading to either positive or negative results during symptom management. CONCLUSIONS: Behcet's Disease patients needed effective symptom management.

Prevalence of anemia and malnutrition and their association in elderly nursing home residents.

PURPOSE: Malnutrition is one of the most important geriatric syndromes in the elderly. The aim of this study was to investigate the association between anemia and malnutrition in elderly nursing home residents. MATERIALS AND METHODS: Local nursing home residents over 60 years old in the Izmir were included in the study. Blood samples were taken from study participants for hemogram, iron, ferritin, total iron-binding capacity, vitamin B12 and folic acid analysis. WHO criteria were used to define anemia. Causes of anemia were classified as iron deficiency, vitamin B12 or folic acid deficiency, anemia of chronic disease or other hematologic causes. Anemia was defined as the dependent variable and malnutrition was defined as the independent variable. Correlation between MNA scores and Hb levels was determined using Pearson correlation analysis. The slope of causality between malnutrition and anemia was determined using the χ (2) test and logistic regression analysis. RESULTS: The study included 257 elderly nursing home residents with a mean age of 78.5 ± 7.8 years. The overall prevalence of anemia was 54.9 %; 35.8 % of the study participants were at risk of malnutrition and 8.2 % were malnourished. Anemia risk was 2.12-fold higher in participants at risk of malnutrition and 5.05-fold higher in those with malnutrition. In the participants with malnutrition or malnutrition risk, the most common cause of anemia was anemia of chronic disease (57.1 and 46.5 %, respectively). CONCLUSION: The prevalence of anemia among elderly nursing home residents is high in Turkey. Malnutrition and malnutrition risk increase the incidence of anemia.

Pain and fatigue in elderly cancer patients: Turkey example.

The aim of this study was to evaluate the pain and fatigue levels of elderly cancer patients and to examine whether pain is an independent variable in fatigue development. A total of 250 elderly cancer patients undergoing treatment in the outpatient chemotherapy units and internal medicine clinic at 2 hospitals were enrolled. A "Patient Information Form," the "McGill Melzack Pain Questionnaire," and the "Brief Fatigue Inventory" were used as data instruments. It was determined that all patients had pain and that the mean present pain intensity score was 2.70 ± 0.99, the mean worst pain intensity score was 4.40 ± 0.86, and the mean least pain intensity score was 1.40 ± 0.66. Whereas the existing fatigue severity score of the patients with fatigue (43.6%) was 6.27 ± 2.06, the mean usual fatigue severity of the patients in the last 24 hours was 6.19 ± 1.63 and that the mean worst fatigue severity score in the last 24 hours was 7.29 ± 1.57. When the regression analysis carried out between the pain and fatigue intensities is examined, it was determined that pain is an independent variable in increasing fatigue and that there is a statistically significant relationship (P < .05). It is important that nurses develop strategies to prevent and determine activities to decrease the pain and fatigue of the patients while planning and implementing their holistic care in a relevant manner.

Features of pressure ulcers in hospitalized older adults.

BACKGROUND: The objectives of this study were to examine the prevalence and risk of pressure ulcers (PrUs) among hospitalized patients 65 years or older in a university hospital setting and to assess the potential for prevention and healing in that population. METHODS: The retrospective study conducted at the general medicine departments of Ege University Hospital in Izmir, Turkey, included 209 patients (115 females, 94 males) 65 years or older, who had been admitted to the hospital for a variety of reasons between April 1, 2011, and October 1, 2011. The following tools were used to collect data: a data collection form to identify the sociodemographic and medical characteristics of the patients, the Braden Risk Assessment Scale to assess the risk of PrUs, and a form to monitor PrUs, which included the site of the PrU, the category, and the PUSH (Pressure Ulcer Scale for Healing) score, a tool for tracking changes in PrUs status applied at weekly intervals. RESULTS: The mean patient age was 73 (6.4) years. The prevalence of PrUs was 5.8% during the hospital stay. Pressure ulcers appeared most frequently in the ischeal tuberosity area (40%), and 45.2% of all PrUs observed were category II. The comorbidities of the patients who had PrUs were as follows: rheumatoid arthritis, 40% (n = 5); acute renal failure, 24% (n = 3); multiple myeloma, 8% (n = 1); chronic renal failure, 8% (n = 1); pneumonia, 8% (n = 1); and acute lymphoblastic leukemia, 8% (n = 1). CONCLUSIONS: Pressure ulcers are a common healthcare complication in the older adult population, with potentially severe consequences. The most important intervention that healthcare professionals can make to reduce PrUs is to determine and address risk factors.