Developing the scale of genetic/genomic awareness in pediatric nurses.

OBJECTIVE: In recent years, genomic information and technology have been increasingly integrated into healthcare services for the prevention of genetic diseases, screening, diagnosis, treatment selection, and follow-up of treatment efficacy. The aim of the study was to develop the Scale of Genetic/Genomic Awareness in Pediatric Nurses (SGAPN) and to evaluate its psychometric properties. MATERIAL AND METHODS: This was a methodological study covering the development of the SGAPN and testing its psychometric properties. SGAPN items were developed based on a literature review and were evaluated by content validity. The SGAPN was then tested for internal consistency coefficients, face validity, criterion validity, and construct validity in a convenience sample of 280 pediatric nurses. RESULTS: The SGAPN is a scale consisting of 32 items. Its Cronbach alpha value was calculated as 0.893. It has a structure with three factors including "genetic/genomic information" (13 items), "genetic transmission information" (7 items), and "genetic education and practices" (12 items). The Cronbach alpha values of the factors were 0.845, 0.600, and 0.893, respectively. CONCLUSION: It is suggested that the SGAPN can be used as a valid and reliable scale in the evaluation of the genetic/genomic information, education, and practices of pediatric nurses.

The Differences Between Preterm and Term Birth Affecting Initiation and Completion of Toilet Training Among Children: A Retrospective Case-Control Study.

PURPOSE: This study seeks to investigate the possibility the existence of a difference in terms of start and end dates of toilet training between term and preterm children as well as the possible determining factors. MATERIALS AND METHODS: This study was conducted as a 5-year retrospective case (children born preterm-(32 to <37 weeks) - and control (children born at term (>37 weeks + 1 day)) study. The data were collected with a form consisted of questions about demographic data (12 questions) and toilet traning features (10 questions) through face-to-face interviews with the mothers. A chi-square test and logistic regression analysis were conducted to examine the data. Odds ratio was used as a measure of the relation between levels of the dependent variable. p< .01 and p< .05 values were assumed to be statistically significant. RESULTS: The study examined a total of 133 children including 59 preterm children and 74 children born at term including 60 (45.1%) boys and 73 (54.9%) girls. The possibility of starting toilet training at or before 24 months was found to be 6.4 times greater in full-term children than preterm children (OR=6.493). The logistic regression analysis, which aimed at identifying any variables that might affect end date of toilet training, found that despite the tendency to consider preterm   birth as a factor prolonging the duration of toilet training, the difference was not found to be statistically significant (p= .07). CONCLUSION: This study compared full-term and preterm children in terms of start and end dates of toilet training and found that preterm children start toilet training later than full-term children. Based on the results of the study, it is possible to say that preterm birth, gender and birth order affect start date of toilet training. However there is no difference between term and preterm babies on the end date of toilet training.

Validation of the "Mind the Gap" Scale to Assess Satisfaction with Health Care among Adolescents

Background: At present, more than 90% of adolescents with chronic conditions survive into adulthood as health care users and move pediatric to adult care with their chronic illness. Therefore, the need satisfaction scale focuses specifically on transitional care and reflect the increasing expectations among youth and their parents. Aims: To examine the validity and reliability of the Turkish version of Mind the Gap scale. Study Design: Methodological study. Methods: The Turkish versions of Mind the Gap scale and Patient Assessment of Choronic Illness Care scale were applied to the participants in two tertiary hospitals in Ankara. The validity was evaluated with factor analyses and content-scope validity; the reliability was evaluated with item-total score correlation, internal consistency, and continuity methods. Results: A total of 109 adolescents and 157 parents completed the questionaire. The content validity was confirmed. Exploratory factor analysis was used to determine the factor structure of the scale. Both adolescent and parent scales formed three sub-dimensions and explained 71% and 73% of the variation, respectively. The Cronbach's alpha reliability coefficient of Mind the Gap scale 1 and Mind the Gap scale 2 were 0.89 and 0.87, respectively, with internal consistencies of the parent's scales reaching 0.92 and 0.90. The test-retest reliability coefficients totalled 0.88 and 0.85 for the adolescents and parents, respectively. The suitability of the model was examined with confirmatory factor analysis. Conformity indices and x2/df value of the model were in good fit to data. Conclusion: The Turkish version of the Mind the Gap scale is a valid and reliable scale for evaluating the needs, expectations, and satisfaction of adolescents and their parents in terms of health care.

Validation of Transition Readiness Assessment Questionaire in Turkish Adolescents with Diabetes.

BACKGROUND: Today, more than 90% of adolescents with chronic conditions survive into adulthood and move from pediatric care to adult care for the management of their chronic illness. It is important to grant autonomy and ensure that adolescents/young adults are ready to use the adult health care system prior to the transfer of care. However, the lack of a transition readiness assessment tool that is validated, patient-centered, and appropriate to developmental differences in pediatric care is a major obstacle for the transition of care from pediatric services to adult services. AIMS: This study examined the validity and reliability of the Turkish version of the Transition Readiness Assessment Questionnaire, which assesses the readiness for transition from pediatric to adult health care for adolescents/young adults with diabetes mellitus. STUDY DESIGN: Methodological study. METHODS: Participants were 109 adolescents/young adults with type 1 diabetes mellitus aged 14-21 years. After permission was obtained to adapt the Transition Readiness Assessment Questionnaire, the Turkish Transition Readiness Assessment Questionnaire and self-care scale were administered to participants through face-to-face interviews at two pediatric endocrinology clinics. Validity was evaluated by exploratory and confirmatory factor analysis and content-scope validity assessment; reliability was evaluated by item-total score correlation and continuity methods. Internal reliability was assessed by Cronbach's alpha coefficient and criterion validity assessment. RESULTS: The item analysis, exploratory factor analysis, and confirmatory factor analysis identified five basic dimensions, with high internal consistency (0.89-0.75). The ratio χ2/df and other conformity indices were a good fit to the data. The correlation coefficient in the analyses of test-retest scores was 0.86 for the total scale (p<0.05), and the Cronbach's alpha coefficient was 0.88 for overall scale. CONCLUSION: The Turkish Transition Readiness Assessment Questionnaire is a valid and reliable measure of the transition readiness of adolescents/young adults with diabetes mellitus in Turkey. The Transition Readiness Assessment Questionnaire assesses the self-management abilities and health care transition knowledge of adolescents/young adults with diabetes mellitus who need special health care. It can also serve as a guide for health care professionals in detecting the educational fields that are necessary for acquiring self-management and self-care abilities.

Assessment of a Health Promotion Model on Obese Turkish Children.

BACKGROUND: Studies of childhood obesity have shown that fostering healthy life behaviors is more important than losing weight. However, studies reporting this result did not use a theoretical nursing model, which offers a systematic approach and scientific basis for studying the concepts and principles of nursing practice. PURPOSE: The aim of this study was to determine the effects of an intervention that is based on Nola J. Pender's Health Promotion Model (HPM) on the healthy life behaviors and self-confidence of obese children. METHODS: This quasi-experimental study enrolled 86 obese children and their parents (48 in the experimental group and 38 in the control group) as participants. The data collection tool was composed of an adaptation of a Pender's model-based evaluation form and the "Piers-Harris Self Confidence Scale." The experimental group received HPM-based individual and group education, whereas the control group received routine follow-up only. Whereas qualitative data were analyzed using content analysis, quantitative data were analyzed using a paired t test and Mann-Whitney U or Wilcoxon test. RESULTS: At the end of the education and follow-up program, experimental group participants showed a significant increase in healthy eating habits such as noting food portions (Z = 5.231, p < .001) and choosing water instead of sugary drinks (Z = 4.130, p < .001) and spent significantly less time per day in front of a television or computer (Z = 5.085, p < .001). Furthermore, after the intervention, experimental group participants had reduced their total body mass index standard deviation score (Z = 6.031, p < .001) and had an average self-confidence score that differed significantly from the control group (Z = 3.796, p < .001) and that was significantly higher than the average preintervention score (Z = 5.971, p < .01). CONCLUSIONS: Health professionals must recognize the physical, psychological, and social risks of obesity in children and focus on these problems to identify appropriate solutions. It is recommended that education and nursing follow-up programs be developed based on nursing models. This study found that patient education based on Pender's HPM increased healthy life behaviors (e.g., healthy nutrition and increased exercise time) and decreased sedentary activity substantially in the experimental group. This study further suggests that, although Pender's HPM has not been tested on obese children, this model offers effective guidelines for nursing activities that are targeted on developing healthy life behaviors in children.