Adaptation of a patient activation measure (PAM) into Turkish: reliability and validity test.

BACKGROUND: Patient activation is a central concept in chronic illness care model. Activated patients have ability and willingness to manage their health. OBJECTIVE: Aim of this study was to test the reliability and validity of a Patient Activation Measure. METHODS: Research sample consisted of 130 patients who had diabetes, hypertension or rheumatoid arthritis. Data was collected through socio-demographic information form and a Patient Activation Measure (PAM). Reliability and validity of PAM were analyzed. RESULTS: Internal consistency reliability coefficient of the PAM was α: .81. Correlation coefficients between item and total scale scores varied from .38 to .66. Result of explanatory factor analysis Kaiser Meyer Olkin coefficient was .75 and Barlett test was x2: 646.870; p: 0. 000. Result of confirmatory factor analysis, model fit indexes were x2/df: 1.59, RMSEA: 0.071, CFI: 0.96, NNFI: 0.95. The result of Rasch analysis, reliability coefficient varied from 0.83 to 0.87 and in validity assesment, item fit statistics for INFIT varied from 0.68 to 1.53 and for OUTFIT varied from 0.65 to 1.54. CONCLUSION: PAM has enough validy and reliability for use in determining activation scores and level of the patients in Turkey. It could be used in planing appropriate interventions for the activation level and help to improve self management.

Coping with Stress among Pregnant Women with Gestational Diabetes Mellitus.

Introduction: The stress of pregnancy itself, gestational diabetes mellitus (GDM) that develops during pregnancy is also a stressor, because it can cause serious maternal and fetal health problems. The aim of this study was to examine the relationships between the characteristics of pregnant women with GDM and their styles of coping with stress. Methods: This descriptive cross-sectional study was conducted on 126 pregnant women with GDM. The sample consisted of patients who applied to the diabetes mellitus training polyclinic of a training and research and university hospital in southeastern Turkey, Data were evaluated using descriptive statistics, Kolmogorov-Smirnov normality tests, Spearman's rho and Pearson Correlation analysis, the Student's t-test, Mann-Whitney U-test and Kruskal-Wallis- test by SPSS software (version 13.0). Results: It was determined that a planned pregnancy, a high educational level, a first pregnancy and weight gain were important factors in the women with GDM in the study who coped effectively with stress during pregnancy. Unemployment and a second or subsequent pregnancy were important factors in the women with GDM< who coped ineffectively with stress during pregnancy. In addition, it was determined that the hemoglobin HbA1c levels of the pregnant women with GDM with "optimistic" and "submissive" approaches towards coping with stress were lower. Conclusion: It was determined that pregnant women with optimistic and submissive approaches towards coping with stress had lower HbA1c levels. It is suggested that randomized controlled studies be conducted to further determine the coping styles of patients with GDM.

Experiences of family caregivers of cancer patients receiving chemotherapy.

BACKGROUND: Cancer is a disease which affects not only patients but also their families physically and emotionally. The purpose of this study was to determine the needs, challenges and ways of coping of caregivers of cancer patients. MATERIALS AND METHODS: In the study, a phenomenological approach was used. Data were collected through semi-structured individual interviews. The study sample comprised 16 family members providing care for a cancer patient. RESULTS: The study findings are grouped under four main themes: the impact of caregiving, masking feelings, experienced challenges and expectations, and coping. During the caregiving process, patient relatives are affected physiologically, psychologically and socially. It was determined that patient relatives hid their feelings and avoided talking about the disease for fear that they might upset the patient, and that they had difficulty in coping with the patient's reactions during the treatment process. Family members had difficulties arising from the health system, hospital conditions and treatment in addition to transportation and financial problems. Support is very important in coping, but it was determined that some of the relatives of patients did not receive adequate support. Patient relatives expect that health care professionals should provide them with more information about their patient's condition and the course of the disease that their patients should be dealt with by the physicians specialized in cancer, and that psychological support should be provided both for them and for their patient. CONCLUSIONS: During the caregiving process, family members are faced with many difficulties and they exhibit different coping behaviors which health care professionals should take into account.

An analysis of the cultural problems encountered during caregiving by the nurses working in two different regions of Turkey.

The aim of this study was to identify the cultural problems encountered during caregiving by the nurses working in two university hospitals located in western and eastern Turkey. This descriptive, comparative study was conducted between July 2008 and October 2009 with 338 nurses who volunteered to take part in the study. The study data were collected using an individual description questionnaire consisting of 10 questions and another questionnaire consisting of 14 questions to identify the cultural problems encountered by nurses when giving care. The study showed with respect to training received on transcultural nursing that only 59 nurses had this training, but the percentage was higher in the nurses working at the hospital in the west (54.2%) (P > 0.05). It was found that a large number of nurses in the sample group (n = 286) gave care to at least one individual from another culture, but the percentage was significantly higher in the nurses working in the west (56.7%) than in the nurses working in the east (43.3%) (P < 0.05). When the problems experienced by the nurses during caregiving because of cultural characteristics of patients were explored, it was found that they experienced problems mostly in 'communication', and the percentage of those having problems was higher in the nurses working in the west (60.8%) (P > 0.05). The problem experienced in this area was mostly because of the fact that patients 'did not speak Turkish' (63.8%). In conclusion, the nurses gave care to patients from different cultures, and most of them had trouble when giving care to patients from different cultures.

Herbal therapies used by hypertensive patients in Turkey.

The purpose of this study was to determine herbal therapies used by the patients for regulation of blood pressure. This descriptive study was conducted in three districts of Izmir, Turkey. The study group included 193 patients with hypertension diagnosis who admitted to a primary care center and accepted to participate in the study. Data were collected through an investigator-made questionnaire including questions about socio-demographic features and herbal therapies used for regulation of blood pressure. Percentiles and chi-square statistics tests were used to evaluate the data through SPSS 11.0 program. The subjects included in the study had suffered from hypertension for 8.28 ± 7.92 years, and 95.9% of them received medication to treat their hypertension. Of all hypertensive patients, 51.3% used herbal therapies for the treatment of hypertension. The patients used herbal therapies most commonly when they felt ill. There were no statistically significant difference between the use of herbal therapies and gender, education, marital status, having health insurance and income level. Health professionals who provide primary health services, especially nurses, need to follow patients regularly and provide patient education on antihypertensive therapy. Nurses must plan the necessary training programs by evaluating the data about, whether the hypertension patients use herbal therapies that can affect their health negatively or not.

Complementary and alternative medicine use among people with diabetes in Turkey.

The aim of this study was to investigate use of complementary and alternative medicines, and factors that affect use of these agents, in individuals with diabetes. This cross-sectional and descriptive study was performed at the outpatient clinics of four hospitals in Turkey with 396 diabetic individuals between October 2006 and March 2007. In this study, 34.6% of the participants were using complementary and alternative medicine in addition to conventional medicine; 73% of these individuals had not informed their doctors and nurses about their complementary and alternative medicine practice. Nurses, as health care providers, should not ignore complementary and alternative medicine options. Instead, they should try to determine the rate of complementary and alternative medicine use among their patients and understand their effects and the reasons for use of these agents. Nurses should learn more about these medicines and educate their patients.