The COVID-19 Vaccine Hesitancy Among Healthcare Workers: An Exploration of Hesitancy Reasons and Suggestions to Improve Vaccination Rates.

Objective: Vaccine hesitancy among healthcare workers (HCWs) represents a significant challenge and threat in pandemics. This study aims to identify the predictive factors influencing COVID-19 vaccine hesitancy among HCWs and offer strategies to increase the COVID-19 vaccination rate in healthcare settings. Materials and Methods: This study constitutes the qualitative portion (second part) of a mixed-methods doctoral thesis employing an explanatory design. It was conducted in two distinct pandemic hospitals and involved 23 vaccine-hesitant HCWs. To conduct the interviews, the researchers developed a semi-structured interview form based on the Health Belief Model (HBM). Results: Upon analyzing the in-depth interviews, we identified six primary reasons for vaccine hesitancy and four different sub-reasons that reinforce vaccine hesitancy. We also collected four key suggestions from vaccine-hesitant HCWs that could potentially persuade them to receive the COVID-19 vaccine. Conclusion: This study's findings, which encompass the identification of reasons for COVID-19 vaccine hesitancy, clarification of underlying factors contributing to hesitancy towards the COVID-19 vaccines, and gathering suggestions from HCWs on how to persuade them to get vaccinated, hold significant value for guiding vaccination campaigns during potential future pandemics.

Uptake of COVID-19 vaccines among healthcare workers and the effect of nudging interventions: A mixed methods study.

BACKGROUND: During the coronavirus disease (COVID-19) pandemic, vaccination of healthcare workers (HCWs) has a critical role because of their high-risk exposure and being a role model. Therefore, we aimed to investigate vaccine hesitancy and the role of mandatory polymerase chain reaction (PCR) testing and education for vaccine uptake. METHODS: We conducted an explanatory sequential designed observational mixed-methods study, including quantitative and qualitative sections consecutively in two different pandemic hospitals between 15 September 2021 and 1 April 2022. The characteristics of vaccinated and unvaccinated HCWs were compared. The vaccine hesitancy scales were applied, and the effect of nudging, such as mandatory PCR and education, were evaluated. In-depth interviews were performed to investigate the COVID-19 vaccine hesitancy among HCWs according to Health Belief Model. RESULTS: In total, 3940 HCWs were included. Vaccine hesitancy was more common among males than females, the ancillary workers than other health professions, and nonmedical departments than other departments. After the mandatory weekly PCR request nudge, 83.33 % (130/156) vaccine-hesitant HCWs were vaccinated, and 8.3 % (13/156) after the small group seminars and mandatory PCR every two days. The rate of COVID-19 vaccination was raised from 95.5 % to 99.67  % (3927/3940). At the end of in-depth interviews (n = 13), the vaccine hesitancy determinants were distrust, fear of uncertainty, immune confidence and spirituality, the media effect, social pressure, and obstinacy. CONCLUSIONS: The nudging interventions such as mandatory PCR testing and small group seminars helped raise the rate of COVID-19 vaccination; the most effective one is mandatory PCR.

The effect of the COVID-19 social distancing measures on Turkish women's mental well-being and burnout levels: A cross-sectional study.

Lockdown and social distancing measures during the COVID-19 pandemic increase women's responsibilities and influence their mental health. This study aimed to assess the effect of COVID-19 social distancing measures on mental well-being and burnout levels of women using an online cross-sectional survey in Turkey. The Warwick-Edinburgh Mental Well-being Scale, The Burnout Measure, and Sociodemographic form were used in this study. All analyses were performed on a sample of 438 women aged between 18 and 65. The mean score of mental well-being was 47.86 (SD = 10.04) and the mean score of burnout was 3.86 (SD = 1.16). Being younger than 30 years old (t = 2.14, P = 0.033), having undergraduate education or above (F = 5.09, P = 0.007), part-time working (F = 5.39, P = 0.005), attending to school (t = 2.68, P = 0.008), having COVID-19 symptoms (t = 6.01, P < 0.001), and perceiving spousal emotional support (F = 3.47, P = 0.016) were the factors associated with high burnout. Being older than 30 years old (z = -3.11, P = 0.002), full time working (H = 11.96, P = 0.003), not attending to school (z = -2.09, P = 0.036), perceiving spousal emotional (H = 13.22, P = 0.004), or social (H = 13.11, P = 0.004) support were the factors associated with higher mental well-being. Age (ß = -0.03, P = 0.001), having two or more children (ß = 0.42, P = 0.015), and perceiving COVID-19 symptoms (ß = -0.73, P < 0.001) were the predictors of women's burnout. This study shows that mental well-being and burnout levels of women in Turkey have been considerably affected as a result of social distancing measures taken with the first wave of the pandemic. Findings signal the immediate need for targeted mental health nursing interventions. Therefore, technology-based mental health support programmes are recommended to be designed and utilized by mental health nurses.

A study on the adaptation of the HIV/AIDS-related Stigma Scale into Turkish.

PURPOSE: This study aims to test the validity and reliability of the Turkish version of the HIV/AIDS-related Stigma Scale. DESIGN AND METHODS: The study has a methodological design. The sample included a total of 428 participants. of the participants, 198 were HIV/AIDS patients, 230 were HIV-negative individuals. The data were analyzed using the Exploratory and Confirmatory Factor Analysis. FINDINGS: The Turkish version of the HIV/AIDS-related Stigma Scale was found to be valid and reliable for the Turkish society. Cronbach's α was 0.93 for the community perspectives subscale and 0.89 for the patient perspectives subscale, and all the model fit indices were acceptable. PRACTICE IMPLICATIONS: The level of stigmatization revealed by the scale helps gain an insight into the community and patient perspectives on HIV/AIDS.

The effects of ethnocentrism and some features on intercultural sensitivity in nursing students: A comparative descriptive study.

BACKGROUND: Nurses should provide culturally sensitive care by being aware of the cultural characteristics, values and beliefs of the individuals for whom they are responsible. Nursing education must provide a foundation for the development of intercultural sensitivity. AIM: The purpose of this study was to investigate the effects of ethnocentric attitudes and some characteristics of nursing students on their intercultural sensitivities. METHODS: A comparative descriptive design was used to collect data from nursing students in two universities located in the west and the east of Turkey (N = 535; students from the east: n = 202; students from west: n = 333) Data were collected using the socio-demographic characteristics form, the Intercultural Sensitivity Scale (ISS) and the Ethnocentrism Scale. RESULTS: When both students from east and west in Turkey were compared in terms of ISS total scores, a statistically significant difference was found between the students in terms of pervious place of residence, taking the intercultural nursing course, acquaintance with people of other cultures, having experience abroad and speaking another language (p < .05). When both students from east and west were compared in terms of the ethnocentrism scale total scores, a statistically significant difference was found between the students in terms of the gender, the year of the education, previous place of residence, taking the intercultural nursing course, acquaintance with people of other cultures, having experience abroad and having friends from different countries (p < .05). According to the linear regression analysis, the intercultural sensitivity of students was found to be significantly affected by ethnocentrism. CONCLUSIONS: Intercultural nursing courses and concepts such as intercultural sensitivity and ethnocentrism should be given a more comprehensive place in the curriculum to increase intercultural sensitivities and reduce ethnocentrism.

The relation between quality of life and future expectations for refugee adolescents.

PROBLEM: Refugee children and their families encounter various challenges in a new country. Studies on this issue reveal the presence of negative expectations on the future and life among refugees. This study was conducted to investigate the relationship between quality of life and future expectations in refugee adolescents. METHODS: This descriptive and cross-sectional study was conducted in Turkey. In this study, 76 refugee adolescents between the ages of 12 and 18 participated. The study data were collected between September and December 2019 from two of the schools located in Istanbul. Study data were collected by using Future Expectation Scale for Adolescents (FESA) and Pediatric Quality of Life Questionnaire (PedsQL). FINDINGS: The mean ages of the participants were 15.7 ± 1.1 and all of them were females. A positive relationship was found between future expectations and quality of life. CONCLUSIONS: The results showed that a positive significant relation was detected between quality-of-life scores and future expectations' scores. Understanding the factors affecting future expectations of refugee adolescents will help to plan interventions compatible with issues confronting adolescents.

Ambivalent sexism of nursing students in Turkey and South Korea: A cross-cultural comparison study.

Culture has become increasingly important concepts in nursing in the era of globalization. Nurses' cultural biases and prejudices are huge obstacles to their caring for patients from diverse cultural backgrounds. Therefore, this study examined sexism among nursing students from two patriarchal societies: Turkey influenced by Islam, and South Korea influenced by Confucianism. For this comparative study, we used the survey data from the sample of 560 nursing students, 309 from Turkey and 251 from South Korea. The findings showed that both samples showed high levels of sexism, both hostile and benevolent. When comparing the two samples, Turkish nursing students showed significantly higher sexism than did Korean students. Additionally, in both countries, male participants showed higher scores on sexism, especially hostile sexism. In terms of age, older students in Turkey showed lower levels of benevolent sexism. We hope the findings of this study can provide evidence to develop customized transcultural nursing education content in the context of different ethnicities and to help nurses and nursing students from specific cultural backgrounds in becoming aware of their own cultures.

Psychometric Testing of the Turkish Version of the Stroke Self-Efficacy Questionnaire.

BACKGROUND: When stroke survivors return to their lives in society, they often face issues such as physical or cognitive impairment, dependence on others, social isolation, and reduced self-esteem, which may lead to disastrous consequences in patients' self-perceived self-efficacy and self-confidence in everyday life. Self-efficacy plays an important role in the well-being of stroke patients. Accurate assessment of the stroke patients' self-efficacy by health professionals is critical to obtaining data regarding their functioning levels. PURPOSE: The aim of this study was to evaluate the psychometric properties of the Turkish version of the Stroke Self-Efficacy Questionnaire (T-SSEQ). METHODS: A sample of 185 stroke patients (mean age = 64.78 ± 10.7) was recruited from a university hospital in Izmir, Turkey. Data were collected between April and October 2016. Translation and back-translation processes were used to translate the T-SSEQ into Turkish. Data were analyzed using the Rasch partial credit model with the Winsteps program to investigate the response scale analysis, tests of fit to the model, unidimensionality, local dependency, item and person separation reliability, separation index, and differential item functioning. RESULTS: The Rasch analysis showed goodness of fit for both the activity and self-management subscales. Moreover, both scales were identified as being unidimensional in structure. Furthermore, the participants were able to distinguish between the categories of the response options, and scale reliability was supported for both subscales using Rasch analyses. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: These results indicate that the T-SSEQ is acceptable for use with Turkish stroke patients in both practice and research settings. Furthermore, the questionnaire is suitable for nurses to use in designing interventions and evaluating stroke patients' self-efficacy in clinics, home care, and rehabilitation centers.

Effects on urinary outcome of patients and caregivers' burden of pelvic floor muscle exercises based on the health belief model done at home by post-stroke patients.

OBJECTIVE: The purpose of this study is to investigate the effects of pelvic floor muscle exercises (PFMEs) done by stroke patients at home in line with the health belief model (HBM) on patient care outcomes and caregivers' burdens. METHOD: In the study, a quasi-experimental design with a pre- and post-test control group was used. The study was conducted with 20 patients in the experimental group and 18 patients in the control group. The patients and caregivers were evaluated at baseline and after the 12-week PFME intervention performed at home. The data were analyzed with the chi-square, Mann-Whitney U, Wilcoxon signed rank test and multiple regression analysis. RESULTS: A statistically significant difference was found between the two groups in terms of the mean scores they obtained from the ICIQ-SF and I-QOL, the number of urinary incontinence episodes, pad test after interventions and quality of life scores (p < 0.05), while no statistically significant difference was found between the groups in terms of the mean scores for the Burden Interview (p > 0.05). An increase was determined in the self-efficacy of the patients in the experimental group after the PFMEs (p < 0.05). CONCLUSIONS: Given the results of the present study, it is recommended that in the management of post-stroke urinary incontinence, post-stroke patients should be encouraged to do PFME at home in line with the HBM, and they should be monitored periodically.

Cultural attitudes of society towards tuberculosis patients: A qualitative study.

OBJECTIVE: To evaluate the view on tuberculosis of individuals living in an urban setting. METHODS: This qualitative study was conducted between April and May in 2015 in in the Balcova region of Izmir, Turkey, and comprised healthy adults who did not have tuberculosis. Data was collected via information form of socio-demographic features and a semi-structured questionnaire. Focus group interviews were conducted. Data collection was terminated when data reached saturation point. Data was analysed using content analysis. RESULTS: Data analysis of 26 subjects in all revealed three main themes; information about tuberculosis, perceptions, attitudes and behaviour regarding tuberculosis or tuberculosis patients and stigmatisation and its causes. CONCLUSIONS: Findings showed that participants didn't have sufficient information about tuberculosis, had prejudices and fears about the disease and patients, and isolated them.

Propriedades psicométricas da versão turca da escala Tuberculosis-Related Stigma / Propiedades psicométricas versión turca de la escala Tuberculosis-Related Stigma / Psychometric properties of the Turkish version of the Tuberculosis-Related Stigma scale

Resumo Objetivo O objetivo deste estudo foi investigar a validade e confiabilidade da escala Tuberculosis-Related Stigma. Métodos Estudo metodológico com 263 indivíduos não diagnosticados com tuberculose pulmonar. Também foi utilizada a análise de correlação de Pearson, o coeficiente alfa de Cronbach, correlação item total e análise fatorial dos dados do estudo. Resultados Neste estudo, o coeficiente alfa de Cronbach foi 0,83 para a subescala perspectivas da comunidade e 0,89 para a subescala perspectivas dos pacientes. O RMSEA foi 0,077, NFI: 0,91, CFI: 0,94, RMR: 0,056, SRM: 0,079, GFI: 0,95, AGFI: 0,94, x2: 582,84, DP: 228 e x2/SD: 2,55 (p=0,000). Claramente, todos os índices de ajuste do modelo foram aceitáveis. Conclusão À luz dos resultados, a versão turca da escala Tuberculosis-Related Stigma tem validade e confiabilidade aceitáveis para uso na população turca.

Resumen Objetivo El objetivo de este estudio fue investigar la validez y confiabilidad de la escala Tuberculosis-Related Stigma. Métodos Estudio metodológico con 263 sujetos no diagnosticados con tuberculosis pulmonar. También se utilizó el análisis de correlación de Pearson, el coeficiente alfa de Cronbach, correlación ítem total y análisis factorial de los datos del estudio. Resultados En este estudio, el coeficiente alfa de Cronbach fue del 0,83 para las perspectivas de la subescala de la comunidad y del 0,89 para las perspectivas de la subescala de pacientes. El RMSEA fue del 0,077, NFI: 0,91, CFI: 0,94, RMR: 0,056, SRM: 0,079, GFI: 0,95, AGFI: 0,94, x2: 582,84, DP: 228 y x2 / SD: 2,55 (p = 0,000). Claramente, todos los índices de ajuste del modelo fueron aceptables. Conclusión Conforme los resultados, la versión turca de la escala Tuberculosis-Related Stigma es confiable y posee validez aceptable para su uso en la población turca.

Abstract Objective The aim of this study was to investigate the validity and reliability of the Turkish "Tuberculosis-Related Stigma Scale". Methods This study used methodological design. This methodological study was conducted with 263 with individuals who not being diagnosed as pulmonary tuberculosis. We also used Pearson correlation analysis, Cronbach alpha coefficient, item total correlation and factor analysis for the study data. Results In this study, Cronbach's alpha coefficient was .83 for the subscale community perspectives and .89 for the subscale patient perspectives. RMSEA was 0.077, NFI was 0.91, CFI was 0.94, RMR was 0.056, SRM was 0.079, GFI was 0.95, AGFI was 0.94, x2 was 582.84, SD was 228 and x2/SD was 2.55 (p= 0.000). Clearly, all model fit indices were acceptable. Conclusion In the light of the findings, Turkish version of Tuberculosis-Related Stigma Scale has acceptable validity and reliability for use in Turkish population.

Experiences Related to Urinary Incontinence of Stroke Patients: A Qualitative Descriptive Study.

INTRODUCTION: Poststroke urinary incontinence is a common problem, with a prevalence ranging from 32% to 79%. Urinary incontinence after stroke has negative physiological, psychological, and economic effects, which lead to lifestyle changes for both patients and caregivers. Nurses play an important role in preventing and improving incontinence, understanding the experiences of individuals experiencing incontinence, providing healthcare for them, and implementing behavioral therapy methods. The aim of this study was to determine the experience related to urinary incontinence of stroke patients. METHODS: In this qualitative descriptive study, using semistructured interviews, 15 participants with urinary incontinence after stroke selected through purposeful sampling were interviewed. Data were collected with a semistructured interview form prepared within the framework of the Health Belief Model. All data were analyzed using content analysis. RESULTS: Three main themes were identified: "perception of urinary incontinence," "effects of urinary incontinence," and "management of urinary incontinence." The respondents explained that urinary incontinence also adversely affected their caregivers. They experienced many daily life and psychological problems because of urinary incontinence. In addition, they made several changes to management urinary incontinence such as limiting fluid intake, changing underwear frequently, using waterproof mattress protectors, applying traditional practice, and taking medicine. CONCLUSIONS: This study revealed that stroke patients needed help and support for urinary incontinence management. Nurses should provide information about management and urinary incontinence after stroke.

Psychometric Testing of the Turkish Version of the Skin Cancer and Sun Knowledge Scale in Nursing Students.

The present study aimed assesses the nursing students' knowledge of skin cancer and sun and their sun protection behaviors. This descriptive cross-sectional study was performed from May to June 2014 with a convenience sample of 376 undergraduate nursing students from one nursing faculty located in Izmir. Mean age of the students was 21.56 ± 1.96 years. The mean score that the females obtained from the level of knowledge and protection behaviors scales was significantly higher than that of the males. Older age group (≥22 years) obtained higher scores on the knowledge and protection behaviors scales than younger group (≤21 years). Nursing students' knowledge of, and behavior regarding, skin cancer and sun health were insufficient. Equipping them with the necessary knowledge and behaviors related to skin cancer and sun health by developing training programs and strategies on the issue is of utmost importance.

Oncology nurses' perspectives on safe handling precautions: a qualitative study.

BACKGROUND: Oncology nurses can be exposed to hazardous drugs during their preparation, administration, transfer and storage and elimination of their waste. AIM: This study was directed towards describing attitudes, opinions and experiences of nurses administering these drugs about safe handling precautions. METHODS: A qualitative study design was used. Fifteen nurses working for at least three months involved in preparation, administration and transfer of antineoplastic drugs and management of wastes. FINDINGS: Experiences, viewpoints and attitudes of nurses about safe handling precautions were analyzed in accordance with basic components of Health Belief Model. CONCLUSIONS: Based on experiences, viewpoints and attitudes emphasized most by nurses, the most important factors about safe handling precautions were perceived barriers and cues to action. As well as heavy work schedules and high number of patients per nurse, lack of equipment and insufficient knowledge were found to be barriers to taking safe handling precautions.

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.

Traditional and religious death practices in Western Turkey.

PURPOSE: To investigate death-related traditional and religious practices in Narlidere, a district of Izmir province in Turkey. METHODS: A descriptive design was used (n = 181). The interview form was composed of 28 open-ended questions. The data were collected through face-to-face interviews by the researchers. Descriptive statistics and chi-square significance test were conducted. RESULTS: Of all the participants, 36.5% described death as the end of life. Praying took place first among the religious practices following death. A total of 42.0% said that relatives and friends who joined the burial ceremony shovel some soil into the pit over the corpse in order to express that they would not claim any rights from the deceased person thereafter, and 55.2% stated that they visited the deceased person's home to give social support to his or her relatives. CONCLUSION: We recommended that nurses and physicians be closely acquainted with the prevailing traditions and religious beliefs in the communities where they served.

Sociodemographic characteristics of women who engage in early breast cancer diagnostic behaviors: the case of Turkish women working in a textile factory.

The purpose of this study was to assess behaviors and health beliefs concerning early diagnosis of breast cancer among women working in a textile factory in Turkey. The data were collected with tools designed by the researchers. The study population consisted of 167 women working in a textile factory in Izmir, Turkey. According to their responses, 23.4% of the women performed breast self-examinations and 12.6% received clinical breast examinations. Results indicated that 91.6% of the women had no education about breast cancer. Early methods of detecting breast cancer should be included in workplace education programs.

Knowledge, facilitators and perceived barriers for early detection of breast cancer among elderly Turkish women.

This article deals with elderly Turkish women's experiences with breast self examination, clinical breast examination and mammography screening, as well as perceived barriers and facilitators in the theoretical framework of the Health Belief Model and the Health Promotion Model. This is a qualitative study performed on 46 elderly women aged 60-75 years. Data were collected with focus group interviews and analyzed systematically with qualitative analysis techniques to determine themes concerning knowledge and facilitators of and perceived barriers to early detection of breast cancer among elderly women. Barriers to screening were insufficient knowledge, fear, neglect/postponement, embarrassment/religious beliefs, inability to make an appointment, lack of a physician's recommendation and health professionals' attitudes. Facilitating factors were being informed about screening, fear, awareness of cancer screening, familial history of breast cancer and social support, making an appointment, health professionals' communication and physicians' recommendations. Public health nurses and health professionals from other health disciplines should be aware of elderly women's need for knowledge about screening, understand elderly women's fear and worries about their health and know barriers to and facilitators of screening.

Elder abuse and neglect in a population offering care by a primary health care center in Izmir, Turkey.

The objective of this study is to investigate the prevalence of abuse and neglect of the elderly aged 65 years and older, living with their relative in a primary health care center area and affecting factors. A descriptive study included 331 people aged 65 years. The most frequent type of abuse was psychological abuse and the least frequent was sexual abuse. Female gender, low education levels, living with spouses and children, and perception of familial relationships as average or below average significantly increased abuse. The nurses providing primary health care should be able to identify and observe the elderly at risk of abuse and conduct programs preventing abuse.

A study on development of a scale to assess nursing students' performance in clinical settings.

AIMS: To develop a valid and reliable scale to assess nursing student performance in clinical settings. BACKGROUND: In nursing education, clinical evaluation is important for students, teachers and patients and there is a need to evaluate with valid and reliable scales. DESIGN: Instrument development. METHODS: Data were collected at 2002-2003 and 2003-2004 academic years and 350 evaluations of third and fourth year students formed the study population. In the light of the literature and our experiences, we determined clinical responsibilities of nursing students and wrote 77 items accordingly. These items were discussed twice by 17 teachers at a University School of Nursing and then the items were decreased to 28. Each item was scored between 1 and 10. The structure validity of the scale was evaluated with factor analyses and reliability of the scale with Cronbach's alpha and item-to-total correlation. RESULTS: The item-to-total correlation coefficient was 0.40 and items were excluded with item-to-total correlation coefficient of lower than 0.40. Cronbach's alpha was 0.97. Three factors with an eigenvalue greater than one were extracted. These factors were 'nursing process', 'professionalism' and 'ethical principles' and their Cronbach's alpha values were 0.97, 0.94 and 0.87, respectively. CONCLUSION: This scale can be used to evaluate nursing students' performance in clinical settings. RELEVANCE TO CLINICAL PRACTICE: A valid and reliable tool may allow an objective evaluation of nursing students' performance in clinical settings.