The effect of the intensive care unit nurse manpower on care behaviours and stress level on the nurses.

BACKGROUND: Nurses working in the intensive care units (ICU) regarding the work-index-nursing work environment, the effect level ICU environment has on the nurses' care behaviors and stress levels of the nurses should be determined. OBJECTIVE: The study aimed to investigate the effect of the nurse manpower on care behaviours and stress level of the nurses working in the ICU. METHODS: This was a cross-sectional and correlational study. The sample of the study consisted of 123 nurses working in the ICUs. The data were collected using the survey form, Distress Thermometer (DT), The Practice Work Environment Scale of the Nursing Work Index (PES-NWI), and Caring Behaviors Scale-24 (CBS-24). RESULTS: The mean age of nurses in the ICU was 30.2±5.6 and the mean of working time in the intensive care unit of nurses in the ICU was 3.7±3.1 years. The mean of the DT was 4.8±3.4, and the mean score of PES-NWI was 2.6±1.0 and the mean score of CBS-24 was 4.7±1.1 in nurses in the ICU. The regression model which was studied to investigate the relationship between caring behaviors and stress and nurse manpower of nurses working in intensive care unit was significant. CONCLUSION: Care behaviors and stress levels of nurses working in intensive care units are negatively affected by insufficient nurse manpower.

Caregiving burden, depression, and anxiety in family caregivers of patients with cancer.

PURPOSE: The purpose of this cross-sectional study was to determine the caregiving burden, depression and anxiety of family caregivers of Turkish patients with cancer and the affecting factors. METHODS: This cross-sectional study was conducted between January-May 2018 with one hundred and fifty-eight caregivers and one hundred and fifty-eight patients with cancer who were treated at a university hospital in Edirne, Turkey. Data were collected with a questionnaire form, Zarit Burden Interview (ZBI) Scale and the Hospital Anxiety Depression Scale (HADS). RESULTS: This study found that 51.3% of the patients with cancer were male, 70.3% of the caregivers were female and more than half of them (57.0%) were the spouses of the patients. The mean ZBI score of the caregivers was 24.62 ± 14.19. There was a positive relationship between the ZBI scores and HADS scores of family caregivers (p < 0.05). As the caregiving burden of caregivers increased, their anxiety and depression levels were increased too. It was found that as the caregiving duration of family caregivers increased, the caregiving burden increased, and caregivers' anxiety depression scores got worse (p < 0.05). In the multivariate analysis, the duration of caregiving per day/hours, ECOG score and the age of the caregiver independently affected the caregiving burden (p < 0.05). As the functional status of the patient with cancer got worse, caregiving burden increased. Caregiving burden was found to be higher in those who were younger, female and giving care for longer times per day (p < 0.05). CONCLUSION: This study found that as the caregiving burden and caregivers' daily patient care duration increased, the level of anxiety and depression increased too. Caregivers of patients with cancer should take appropriate psychological intervention to decrease their distress. In addition, we thought that healthcare professionals must consider the factors affecting the caregiving burden which affect the patient care directly.

Evaluation of nursing students' epilepsy-related knowledge and attitudes.

AIM: This study evaluated the knowledge and attitudes of nursing students toward epilepsy. METHOD: The descriptive and cross-sectional study was conducted with the voluntary participation of 161 nursing students in their 2nd, 3rd, and 4th years of study who were registered at the summer school of Trakya University, Faculty of Health Sciences in the 2017-2018 academic year. The data were collected through a research questionnaire form and the Epilepsy Knowledge and Attitude Scales. The normal distribution of the data was tested using the one-sample Kolmogorov-Smirnov test. Nonparametric tests were used since the data were not normally distributed. Descriptive statistics (mean, standard deviation, range, numbers, and percentages), the Mann-Whitney U test, the Kruskal-Wallis test, and Spearman's correlation test were used in the data analysis. FINDINGS: Half of the nursing students (55.9%) were females with a mean age of 22.14 ±â€¯1.81 years, and 43.5% of the students were third-year students. Of the students, 90.7% were informed about epilepsy from sources including their school/course/instructor (64%), the television/internet (10.6%), and healthcare professionals (6.8%). The mean scores obtained on the Epilepsy Knowledge Scale (EKS) and the mean score on the Epilepsy Attitude Scale (EAS) were 10.23 ±â€¯4.24 and 57.66 ±â€¯8.83, respectively. A significant positive correlation was found between the knowledge and attitude scores of the students regarding epilepsy (p < .001). As the students' knowledge increased, their attitudes also increased positively toward epilepsy. The female students had a more positive attitude toward epilepsy than did the male students. Further, the students who had knowledge about epilepsy and who provided care for patients with epilepsy had higher scores and displayed more positive attitudes toward epilepsy (p < .05). CONCLUSION: This study determined that the participating nursing students had a moderate level of knowledge regarding epilepsy. In addition to theoretical knowledge of epilepsy, the experience of caring for a patient with epilepsy had a positive effect on the students' attitudes. The nursing education curriculum should place greater focus on epilepsy and interventions for epilepsy seizures.

Pain experiences of patients with advanced cancer: A qualitative descriptive study.

PURPOSE: Uncontrolled pain, especially in patients with advanced cancer, affects quality of life negatively and causes negative physical and psychological conditions. The aim of this study was to explore the pain experiences of patients with advanced cancer and how they manage with pain, and to present a view of pain management approaches of nurses from the perspectives of the patients. METHODS: This was a qualitative descriptive study of sixteen hospitalized patients with advanced cancer. Data were collected using semi-structured interviews with patients. Data were analysed by Colaizzi's phenomenological method. RESULTS: This study found that patients with advanced cancer who had pain experienced anxiety, helplessness, hopelessness and many restrictions in daily life as well as inability to manage with pain. Most of the patients with advanced cancer were not satisfied with their nursing care with regard to pain management. The themes that emerged were pain perception and experiences, effects of pain on daily life, pain management and management strategies and the patients' perspectives about nursing approaches to pain. CONCLUSIONS: This study demonstrated the difficulties of patients with advanced cancer who experienced pain in their daily lives, yet lack pain management strategies. Furthermore, nurses' caring approaches to patients with advanced cancer who experienced pain was found inadequate. Oncology nurses should provide educational interventions in order to enhance knowledge and skills about pain assessment and non-pharmacologic and pharmacologic strategies used in pain management.

Student nurses' perceptions of aggression: An exploratory study of defensive styles, aggression experiences, and demographic factors.

Throughout the clinical learning process, nursing students' perception of aggression might have implications in terms of their future professional behavior toward patients. Using a descriptive cross-sectional design, we investigated the relationships between student nurses' perceptions of aggression and their personal characteristics, defense styles, and a convenience sample of 1539 experiences of aggressive behavior in clinical practice. Information about the students' personal features, their clinical practice, and experiences of aggressive behavior was obtained by questionnaire. The Turkish version of the Perception of Aggression Scale and Defense Styles Questionnaire-40 were also used. Students were frequently exposed to verbal aggression from patients and their relatives. And perceived patient aggression negatively, perception of aggression were associated with sex, defense styles, feelings of safety, and experiences of aggressions during clinical practice. Of interest is the reality that student nurses should be prepared for untoward events during their training.

A comparison of men and women's experiences of chemotherapy-induced alopecia.

PURPOSE: The effect of alopecia on men and women has not been fully documented in the literature, especially for Turkish cancer patients. The aim of this study was to determine the incidence of chemotherapy-related alopecia and how it affects the body image and quality of life of Turkish male and female cancer patients, in order to identify variables that may be important in the perception of this problem. METHODS: This descriptive study was carried out between November 2010 and June 2011 at Istanbul University Institute of Oncology; 201 men and 204 women attended. A face-to-face interview was performed during chemotherapy, and the effects of alopecia on cancer patients were assessed using the Patient Information Form, Body Image Scale, and Nightingale Symptom Assessment Scale. RESULTS: The study group consisted of 55.1% female and 44.9% male patients. Most of the patients experienced partial or total alopecia during chemotherapy. There were no differences between men and women with regard to body image in respect of degree of alopecia, but the body image of the male and female patients who had partial or complete alopecia was lower than that in patients who had no alopecia; psychological well-being of women was lower than that in men, because the incidence of alopecia was higher in women. CONCLUSIONS: This study contributes new knowledge on the cultural characteristics of Turkish patients, which may assist other researchers working with different international populations. Alopecia is a difficult side effect for both men and women. Health professionals should assess and educate patients differently from the current standard.

Attitudes of Turkish midwives and nurses working at hospitals towards people living with human immunodeficiency virus/acquired immune deficiency syndrome.

Health professionals caring for people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) show poor or negative attitudes because of fear of contagion. Therefore, it is important to know the attitudes of midwives' and nurses' towards people living with HIV/AIDS. The aim of this descriptive and cross-sectional study is to assess the attitudes of Turkish midwives and nurses working at hospitals to people living with HIV/AIDS and to identify factors that affect these attitudes. A group of 46 midwives and 192 nurses working in hospitals were included in the study. Data were collected through AIDS Attitude Scale. Age, professional experience, number of children and marital status influenced the attitudes of the participants towards people living with HIV/AIDS. We concluded that higher level of education appear to positively influence the attitudes of the participants. Education programmes including evidence-based nursing implications might be planned to improve positive attitudes and to prevent stigmatization of people living with HIV/AIDS.

Nursing students' perceptions about nursing care plans: a Turkish perspective.

This descriptive study was planned in order to assess self-perceived sufficiency levels of nursing students at preparing nursing care plans and also determine the effect of these plans on students' occupational development. Sample of the study was consisted of 55 nursing students who were taking oncological training. Data were collected by using Personal Information Form and Student Care Plan Evaluation Form. Non-parametric tests were used in data analysis. Students perceived themselves 'insufficient' although assessing reproductive neurological and cardiovascular systems, respectively, and also interpreting results of hemogram and urine tests. No significant difference was found between the initial and last nursing care plans prepared by the students during clinical training. Sixty % of students reported that preparing and implementing nursing care plans had favourable effects on their occupational development. Results suggest that students should be well prepared before clinical training programmes and also nursing care plans should be revised and used in more proper and practical ways in order to enhance students' occupational development.

Effects of alopecia on body image and quality of life of Turkish cancer women with or without headscarf.

PURPOSE: The aim of this study was to find out the effects of chemotherapy-related alopecia on body image and quality of life of Turkish women who have cancer with or without headscarves and factors affecting them. METHODS: This descriptive study was conducted with 204 women who received chemotherapy at the Istanbul University Institute of Oncology, Turkey. The Patient Description Form, Body Image Scale and Nightingale Symptom Assessment Scale were used in data collection. Statistical analyses were performed using descriptive statistics and non-parametric tests. Logistic regression analysis was done to predict the factors affecting body image and quality of life of the patients. RESULTS: No difference was found between women wearing headscarves and those who did not in respect of their body image. However, women who wore headscarves who had no alopecia felt less dissatisfied with their scars, and women not wearing headscarves who had no alopecia have been feeling less self-conscious, less dissatisfied with their appearance. There was difference in terms of quality of life: women wearing headscarves had worse physical, psychological and general well-being than others. CONCLUSION: Although there were many important factors, multivariate analysis showed that for body image, having alopecia and wearing headscarves; and for quality of life, having alopecia were the variables that had considerable effects.

Non-pharmacological interventions used by cancer patients during chemotherapy in Turkey.

PURPOSE: Although there are many non-pharmacological practices being recommended for symptom management, most patients prefer to use pharmacological interventions. This study assesses the non-pharmacological interventions used by cancer patients for symptom management during chemotherapy and the factors affecting its use. METHOD: This study was conducted at the Istanbul University Institute of Oncology, Turkey, with 202 patients. Personal characteristics, illness-related characteristics, symptom severity and non-pharmacological interventions used by the patients were assessed by using Patient Description Form, ECOG and Nightingale Symptom Assessment Scale. RESULTS: Most of the patients in this study were living in Istanbul, 58.4% were women, 78.7% were married and their mean age was 48.82 ± 1.44. Most of the patients experienced different symptoms related to chemotherapy, but only a small number of patients preferred to use and benefited from the non-pharmacological interventions in their symptom management. There were different factors affecting the well-being of the patients, but only being young was found to be an important variable in the use of psychological interventions (OR 3.06 [95% CI 1.17-7.96]). CONCLUSIONS: Physicians remain the central figure in the treatment of cancer patients, so oncologists and oncology nurses should be more proactive and innovative in their patient care, education, and counseling to maximize the use of non-pharmacological interventions that may be helpful in symptom management. Further research evaluating the use and effectiveness of non-pharmacological interventions on symptom management in cancer patients is needed.

Hypoglycemia Fear and Self-efficacy of Turkish Patients Receiving Insulin Therapy.

PURPOSE: The purpose of this study was to determine hypoglycemia fear and self-efficacy levels of patients receiving insulin and the factors affecting these levels. METHOD: In total, 345 diabetic patients who met the inclusion criteria participated in this descriptive, correlational study. Patients were invited to participate in the study during their regular visits to the diabetes outpatient clinic of Istanbul University, Istanbul Medicine Faculty. Data were collected using a patient-information form as well as the Hypoglycemia Fear Survey and Confidence in Diabetes Self-care Scale. RESULTS: It was found that patients who had type 1 diabetes, received intensive insulin therapy and experienced more frequent and severe hypoglycemia had more hypoglycemia worry and fear. It was also determined that patients who had type 1 diabetes and received intensive insulin therapy had higher self-efficacy levels than patients who had type 2 diabetes and received conventional therapy. CONCLUSION: The effects of experiences of frequent and severe hypoglycemia in patients with diabetes emphasize the need for programs that support diabetes-specific self-efficacy and also guide and teach hypoglycemia prevention.

Quality of life and complementary and alternative medicine use among cancer patients in Turkey.

AIM: The purpose of this study was to assess the relationships between quality of life and use of complementary and alternative medicine (CAM) among Turkish cancer patients. METHODS: This cross-sectional study was conducted in Istanbul University Institute of Oncology, Turkey. Two-hundred patients were invited and informed consent was obtained, however 179 cancer patients completed the study. The Patient Characteristics form, The Nightingale Symptom Assessment Scale and The Functional Assessment of Cancer Therapy Scale were used in the evaluation of the patients' characteristics and quality of life. RESULTS: Some form of CAM had been used by 71.5% of the sample. Frequently used CAM methods appeared to be religious practices (68.2%) and only 37.4% of the patients used herbs. However, female patients, single patients, and individuals with metastatic disease and worse quality of life showed a tendency to use CAM more often. More than one-third of our patients began to use CAM immediately after being diagnosed with cancer and factors associated with CAM use varied according to the type of CAM. Although CAM use did not affect the patients' quality of life, logistic regression analysis revealed that gender, type of cancer diagnosis and education level were important factors to be considered in different CAM therapies. CONCLUSION: CAM use is common in cancer patients in Turkey. More discussion about CAM use should take place between patients and health professionals to inform the patients' decisions.

Comparison of the health-promoting lifestyles of nursing and non-nursing students in Istanbul, Turkey.

Undertaking a health-related course at university can facilitate an awareness of health-promoting lifestyles. We carried out a descriptive and cross-sectional study with 1616 university students in Istanbul, Turkey. Students from the nursing schools were compared to those from the schools of social sciences using a Turkish version of the Health-promoting Lifestyle Profile (HPLP) II after a validation study. The nursing students had more positive health-promoting lifestyles than those of the non-nursing students. Furthermore, fourth-year nursing students had higher scores in most of the subscales of the HPLP II than did the students from the lower years; conversely, the fourth-year non-nursing students had lower scores. The sociodemographic variables, self-perceived health status, relations with family and friends, and self-perceived academic performance were associated with the HPLP. The implications are discussed for the curricula and on-campus facilities that focus on health promotion activities.