The Correlation Between Comfort Level and Quality of Life in Female Patients With Urinary Incontinence: Structural Equation Modeling Approach.

PURPOSE: The aim of this study was to develop a model to determine the correlation between comfort level and quality of life in women with UI. DESIGN: Cross-sectional, descriptive correlational research design with causal modeling. SUBJECTS AND SETTING: The study was conducted in the urology outpatient clinic of a university hospital in the Central Anatolia region of Turkey. The sample comprised 233 women admitted to the outpatient clinic between December 2017 and May 2018. Participants had a mean age of 52.5 (SD = 13.9) years. METHODS: Data were collected using a researcher-designed Descriptive Characteristics Form, the Incontinence Quality of Life (I-QOL) form, the Urinary Incontinence and Frequency Comfort Questionnaire (UIFCQ), and the Short Form-36 (SF-36). Multivariate correlations were analyzed using structural equation modeling; an AMOS covariance-based structural equation model was developed. RESULTS: The correlational pathway between I-QOL, UIFCQ, and SF-36 was statistically significant. As a result of the confirmed model, I-QOL scores were moderately correlated with SF-36 scores (r = .65, P = .001) and highly correlated with UIFCQ scores (r = .76, P = .001). Mean UIFCQ scores were moderately correlated with SF-36 scores (r = .66, P = .001). The structural equation modeling resulted in a model with a good fit. CONCLUSIONS: The higher the comfort level, the higher the UI-specific and health-related quality of life. Risk factors related to UI should be monitored, and necessary training and counseling should be provided to eliminate this common problem.

The effect of simulation on auscultation skills, self-confidence and anxiety levels in nursing students: A randomized controlled trial.

AIM: This study evaluated the effect of simulation on auscultation skills, self-confidence and anxiety levels. BACKGROUND: Auscultation is an essential topic in nursing education and patient care. Simulation is efficacious in improving auscultation skills and self-confidence and reducing anxiety levels. It is a valuable educational approach whose effects should be evaluated and disseminated in the context of auscultation. DESIGN: This study had a randomised controlled trial design. METHODS: The study was conducted with second-year nursing students enrolled at a university in Turkey. One group of students studied auscultation of heart, lung and bowel sounds with a simulated patient (n = 28), the second group with a high fidelity simulator (n = 30) and the third group with traditional education (n = 28). Data were collected using a demographic information form, auscultation control list and Nursing Anxiety and Self-Confidence with Clinical Decision Making Scale. The students' psychomotor auscultation skills, self-confidence and anxiety levels were evaluated. Data on auscultation skills were assessed after the intervention, while data on self-confidence and anxiety levels were collected at baseline, after the intervention and after clinical practices throughout the academic year. RESULTS: Anxiety and self-confidence levels showed statistically significant differences in intragroup evaluation. The self-confidence levels of the groups working with simulation did not change much in the follow-up test conducted after the end of clinical practices. The mean skill scores in the auscultation control list showed a statistically significant difference between the groups. CONCLUSIONS: Simulation and traditional approaches are effective in learning auscultation skills. However, the positive effects of simulation, particularly in enhancing students' self-confidence and reducing anxiety levels, appear to be more permanent and impactful than traditional education. Therefore, it is recommended that simulation be prioritized for teaching auscultation skills.

The effect of a stress management program on first-year nursing students' clinical stress: A randomized controlled experimental study.

BACKGROUND: Clinical clerkships lie at the core of nursing education and are crucial for developing professional skills. However, nursing students, especially freshmen, often encounter significant stress during their clinical experiences. OBJECTIVES: This study investigated the effect of a stress management program on first-year nursing students' clinical stress levels. DESIGN: This randomized controlled experimental study adopted a pretest-posttest-follow-up test research design. SETTINGS AND PARTICIPANTS: Participants were recruited using simple randomization. The sample consisted of 64 first-year nursing students (intervention = 32; control = 32) from the nursing department of the faculty of health sciences of a university in Türkiye. METHODS: Participants were randomized into intervention and control groups. The intervention group attended a stress management program, one weekly session for five weeks (intervention). The research was conducted between 21.02.2022 and 20.05.2022. Data were collected using a personal information form, the Perceived Stress Scale, the Physio-Psycho-Social Response Scale, and the Coping Behavior Inventory. The data were collected pretest and posttest the intervention and two months follow-up test. The data were analyzed using the two-way repeated measures analysis of variance (ANOVA). RESULTS: The changes in the Perceived Stress Scale mean scores, group*time interaction, were statistically significant (p < 0.05). The results showed that the changes in the Coping Behavior Inventory "problem-solving" subscale mean scores, group*time interaction, were statistically significant (p < 0.05). The multiple comparisons showed a statistically significant difference in posttest Physio-Psycho-Social Response Scale "social behavioral symptoms" and "emotional symptoms" subscale scores between the intervention and control groups (p < 0.05). The multiple comparisons showed a statistically significant difference in posttest Coping Behavior Inventory "problem-solving" and "avoidance" subscale scores between the intervention and control groups (p < 0.05). CONCLUSION: The stress management program helps first-year nursing students experience less stress and develop problem-solving skills before they perform clinical clerkships. It also allows them to suffer from fewer emotional and social behavioral symptoms and exhibit fewer avoidance behaviors.

Gluteal muscle and subcutaneous tissue thicknesses in adults: a systematic review and meta-analysis.

Background: Nurses often administer intramuscular injections at the gluteal site. This study aimed to determine gluteal muscle and subcutaneous tissue thicknesses in adults. Methods: Systematic review and meta-analysis. The databases Turkish Medline, Ulakbim, National Thesis Center, Cochrane, Web of Science, Science Direct, PubMed, CINAHL Plus with Full text (EBSCO host), OVID and SCOPUS were screened using the keywords 'intramuscular injection', 'subcutaneous tissue thickness', 'muscle tissue thickness' and 'needle length' between April and May 2021. The studies were evaluated with ultrasound. This study was reported according to the PRISMA recommendations. Results: Six studies met the eligibility criteria. The total sample size was 734 (women: 432, men: 302). The V method revealed that the ventrogluteal site had a muscle and subcutaneous tissue thickness of 38.071 ± 2.119 and 19.927 ± 2.493 mm, respectively. The geometric method revealed that the ventrogluteal site had a muscle and subcutaneous tissue thickness of 35.989 ± 4.190 and 19.661 ± 3.992 mm, respectively. The geometric method also revealed that the dorsogluteal site had a thickness of 42.560 ± 8.840 mm. According to the V method, females had thicker subcutaneous tissue at the ventrogluteal site than males (Q = 5.37, df = 1, p = 0.0204). Body mass index did not affect the subcutaneous tissue thicknesses at the ventrogluteal site. Conclusion: The results show that gluteal muscle, subcutaneous and total tissue thicknesses vary across injection sites.

The effect of flipped learning on blood pressure knowledge and self-directed learning skills of first-year nursing students: A randomized controlled trial.

AIM: This study investigated the effect of flipped learning on first-year nursing students' blood pressure knowledge levels and self-directed learning skills. BACKGROUND: Flipped learning is an innovative approach that helps nursing students learn about blood pressure and how to measure how to measure blood pressure accurately. Flipped learning also promotes active and student-centered learning settings and encourages nursing students to develop self-directed skills. DESIGN: This study adopted a pretest-posttest open-label randomized controlled trial. METHOD: The sample consisted of 94 first-year nursing students randomized into experimental (n = 48) and control groups (n = 46). The experimental group participants were trained using the flipped learning model. Data were collected using a personal information form, the Blood Pressure Knowledge Test (BPKT) and the Self-Directed Learning Skills Scale (SDLSS). RESULTS: There was no significant difference in pretest BPKT scores between the experimental and control groups. However, there was a significant difference in posttest BPKT scores between the experimental and control groups (p = 0.011). Moreover, there was a significant difference between the experimental group's mean pretest, posttest and follow-up SDLSS scores (p = 0.009). CONCLUSION: The experimental group had a significantly higher mean posttest BPKT score than the pretest score. They had significantly higher mean posttest SDLSS total and "self-monitoring," "motivation," and "self-confidence" subscale scores than the pretest score.

Spiritual Care Needs of Patients with Urinary Incontinence and Affecting Factors: A Cross-Sectional Descriptive Study in Turkey.

This study was conducted to determine the spiritual care needs of patients with urinary incontinence and various influencing factors. Determining the spiritual care needs of individuals with urinary incontinence may make patients feel more hopeful, peaceful, and stronger. It can also encourage individuals towards positive health behaviors, and can help nurses in choosing appropriate coping methods. A descriptive and cross sectional study was conducted with 220 patients with urinary incontinence who applied to the urology outpatient clinic of a university hospital in Turkey. In the study, data were collected using the descriptive features form, the incontinence severity index, and the Spiritual Care Needs Inventory. Kruskal-Wallis test and Mann-Whitney U test were used to evaluate the data. This study is reported following the STROBE recommendations. In this study, mean scores of the patients' spiritual care needs scale and the severity of incontinence, age, gender, and the effect of urinary incontinence on daily life, determined that there was a statistically significant difference between the state of being disturbed by urinary incontinence, the state of performing religious rituals regularly, the state of incontinence affecting religious rituals, the importance of religious beliefs in daily life, and the level of defining spirituality (p < 0.05). In this study, it was determined that the spiritual care need scores of the patients with urinary incontinence were above the medium level, and the sub-dimension scores of meaning and hope, caring, and respect were high. In this context, it is very important to consider the spiritual care needs of patients with urinary incontinence problems.

Spiritual Care Competence of Nurses.

Background Health care has become more patient centered, and spiritual care has become more critical during the past several decades because researchers have identified associations between met spiritual needs and positive health outcomes. This study investigated nurses' spiritual care competence. Method A cross-sectional, descriptive research design was used. The study sample consisted of 201 nurses of a training and research hospital. Data were collected using a sociodemographic characteristics questionnaire and the Spiritual Care Competence Scale (SCCS). Results The participants had a mean age of 27.62 ± 5.28 years. They had a mean SCCS score of 3.88 ± 0.50. Three factors affected participants' spiritual care competence. First, head nurses had a higher mean SCCS score than nurses (4.16 ± 0.26 vs. 3.87 ± 0.50). Second, participants who met patients' spiritual care needs had a higher mean SCCS score than those who could not (4.02 ± 0.54 vs. 3.09 ± 1.12). Third, participants who could diagnose patients for spiritual care had a higher mean SCCS score than those who could not (p < .05). Conclusion These nurses had above-average spiritual care competence. Universities and health care institutions should provide nurses with training to help them develop spiritual care competence. [J Contin Educ Nurs. 2022;53(5):225-231.].

Determining digital burnout in nursing students: A descriptive research study.

BACKGROUND: Nursing students have been spending much more time on digital platforms for educational purposes since the onset of the COVID-19 pandemic. However, prolonged screen time can cause digital burnout. This paper investigated digital burnout levels in nursing students. DESIGN: This was a descriptive study. SETTINGS: The study population consisted of 443 nursing students of the faculty of health sciences of a university in the 2020-2021 academic year. The sample consisted of 361 nursing students who agreed to participate in the study and filled out the data collection forms. Participants were recruited using convenience sampling. The participation rate was 81.5%. PARTICIPANTS: First-, second-, third-, and fourth-year nursing students. METHODS: Data were collected using a descriptive characteristics questionnaire and the Digital Burnout Scale (DBS). The data were analyzed using number, percentage, and mean (minimum, maximum) and the student t-test, One way ANOVA, Kruskal-Wallis test, and Mann-Whitney U test. RESULTS: Participants had a total DBS score of 72.28 ± 18.92. They had a mean DBS "digital aging," "digital deprivation," and "emotional exhaustion" subscale score of 37.57 ± 10.02, 15.66 ± 5.89, and 19.54 ± 5.60, respectively. Participants who spent more than five hours a day online had higher DBS scores than those who spent less than five hours a day online (p < 0.05). Participants who were always stressed out had higher DBS scores than those who were sometimes or never stressed out (p < 0.05). CONCLUSION: Participants had above-average digital burnout levels, which were affected by the average time spent online per day, stress level, physical and psychological health, and economic status. The curriculum should teach nursing students how and how much to use digital media.

Effect of Storytelling Technique on the Attitudes of Nursing Students Toward Death.

This study was conducted to determine the effect of the storytelling technique on the attitudes of nursing students toward death as a mixed research design. The study sample consisted of 94 senior students attending the nursing department of a university in Turkey. Quantitative data were collected by using the introductory characteristics form and the Death Attitude Profile-Revised, while qualitative data were collected through focus group interviews with the semistructured interview form. The data were analyzed according to number, percentage, Wilcoxon test, paired samples ttest, and descriptive analysis method. The mean Death Attitude Profile-Revised Scale score of the students before receiving the relevant education was 4.17 ± 0.21. This score increased to 4.25 ± 0.24 after the students received the education and the difference was found to be statistically significant (p < .05). In the qualitative section of the study, the data obtained from the attitudes of the students toward death were coded, and four themes were determined. The qualitative data obtained from the focus group interviews with the participating students were presented under four themes: the contribution of the storytelling technique to learning, the effect of the storytelling technique on the attitude toward death, thoughts about the storytelling technique, and contribution of the course to knowledge, skills and attitude in giving care to the dying patient. As a result of the study, explaining the subject of death with the storytelling technique was determined to positively affect the attitudes of the students toward death.

An Investigation of Pain Beliefs, Pain Coping, and Spiritual Well-Being in Surgical Patients.

This study investigated pain beliefs, pain coping, and spiritual well-being in surgical patients. The study adopted a cross-sectional, descriptive, and correlational research design. The sample consisted of 213 voluntary patients admitted to a surgery clinic between April and November 2019. Data were collected using a demographic characteristics questionnaire, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale-12 item (FACIT-Sp-12), the Pain Beliefs Questionnaire (PBQ), and the Pain Coping Questionnaire (PCQ). Number, percentage, mean, and Spearman's correlation were used for analysis. Participants had a total FACIT-Sp-12 score of 25.99 ± 8.43. They had a mean PBQ "organic beliefs" and "psychological beliefs" subscale score of 4.44 ± 0.64 and 4.96 ± 0.68, respectively. They had a mean PCQ "self-management," "helplessness," "conscious coping attempts," and "medical remedies" subscale score of 15.83 ± 6.15, 9.41 ± 4.63, 8.72 ± 3.66, and 7.46 ± 5.33, respectively. Spiritual well-being was weakly and positively (r = 0.445, p < 0.000) correlated with self-management and moderately and negatively correlated (r = - 0.528, p < 0.000) with helplessness. Participants with higher organic and psychological beliefs had lower spiritual well-being. The results indicate that nurses should evaluate both pain and spiritual well-being in patients.

The Development and Effectiveness of a Care Protocol Using the Stevens Star Model of Knowledge Transformation in Female Patients With Stress Incontinence: An Experimental Study.

BACKGROUND: Nurse-led pelvic floor muscle exercise and lifestyle education programs are effective first-line interventions for women with stress incontinence (SI). PURPOSE: To develop an evidence-based stress incontinence care protocol (SICP) using the Stevens Star Model of Knowledge Transformation and evaluate its effect on the frequency and quantity of urinary incontinence, quality of life, pelvic muscle self-efficacy levels, and lifestyle variables of women with SI. METHODS: An SICP was developed on the basis of the Star model. The views of an expert were consulted for testing the content validity of the protocol. Using a pretest-posttest experimental design, 68 women with SI who visited an outpatient clinical at a hospital in Turkey were prospectively enrolled in the intervention (n = 34) and control (n = 34) groups. After obtaining baseline demographic and health history information, participants completed the King's Health Questionnaire, the Broome Pelvic Muscle Exercise Self-Efficacy Scale, a 3-day voiding diary, and a 1-hour pad test. The intervention group received an 8-week program of care according to the Star model-derived SICP, and follow-up assessments were completed by both groups after 8 and 12 weeks. RESULTS: The content validity index for the SICP was 91.9%. The intervention group had a reduced quantity and frequency of urinary leakage, reduced King's Health Questionnaire scores, and increased Broome Pelvic Muscle Exercise Self-Efficacy Scale scores (P < .05). CONCLUSION: Care provided according to the Star model-derived SICP reduced the quantity and frequency of SI and improved the perceived pelvic muscle exercise self-efficacy and quality of life of the participants.

Correlation Between Spiritual Well-being and Quality of Life in Patients With Urinary Incontinence: A Cross-sectional Descriptive Study.

Urinary incontinence (UI) increases the risk of medical complications and psychosocial, physical, and emotional problems. PURPOSE: This cross-sectional descriptive study investigated the correlation between spiritual well-being (SWB) and quality of life (QOL) in patients with UI. METHODS: Patients with UI visiting an outpatient urology clinic of a university hospital in Turkey were invited to participate. Data were collected using the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being 12 Item Scale (FACIT-Sp-12) (range 0-48 with higher scores indicating better SWB) and the Incontinence Quality of Life Questionnaire (I-QOL) (range 0-100 with higher scores indicating better QOL). RESULTS: The sample consisted of 383 patients. Most were female (235; 61%), had completed high school (169; 44%), had experienced UI for an average of 3.54 years (SD 3.44), and were between 21 and 92 years of age (mean 52.7; SD 14). The mean I-QOL score was 65.31 ± 19.71 with subscores ranging from a low of 59.69 for social embarrassment to a high of 71.44 for psychosocial impact. The average FACIT-Sp-12 score was 28.00 ± 6.08. Overall I-QOL and FACIT-Sp-12 scores were weakly positively correlated (r = .235). CON- CLUSION: In this study both QOL and SWB scores were good; higher UI-specific QOL scores and some subscores were asso-ciated with higher SWB scores and subscores. Incontinence QOL should be determined together with SWB in patients with UI.

The relationship between moral sensitivity and medical errors attitude in nursing students.

The aim of this descriptive and correlational study was to determine the relationship between nursing students' moral sensitivity and attitudes towards medical errors. The study sample consisted of 309 fourth graders of the school of nursing of a university. Data were collected using a Descriptive characteristics form, the Moral Sensitivity Questionnaire (MSQ) and the Medical Errors Attitude Scale (MEAS). Participants had a mean MSQ and MEAS score of 91.31 ± 21.29 and 3.77 ± 0.44, respectively. There was a negative correlation between MEAS and MSQ scores, indicating that the higher the moral sensitivity, the higher the participants' awareness of medical errors and error reporting. It is, therefore, recommended that students be offered moral education based on different teaching methods to help them develop positive attitudes towards medical errors.

Obstacles to Providing Urinary Incontinence Care Among Nurses in Turkey: A Descriptive Study.

Nurses play an important role in identifying, evaluating, monitoring, and managing patients with urinary incontinence (UI). PURPOSE: This study was conducted to determine nurses' knowledge, attitudes, practices, and obstacles to managing patients' UI. METHODS: A descriptive study was conducted between September 2017 and February 2018 at 2 university hospitals, 2 private hospitals, and 4 state hospitals in a metropolitan city in Turkey. All registered nurses present at the times of data collection were eligible to participate. After providing informed consent, they were asked to complete a 25-item demographic characteristic questionnaire, a 7-item UI assessment and care implementation form, a 12-item form assessing obstacles faced during UI care provision, a 24-item UI knowledge questionnaire (higher scores indicated more knowledge; a score of 70% correct was considered adequate), and the Urinary Incontinence Attitude Scale. The latter comprised 15 Likert-type questions that measures attitudes toward UI symptoms, treatment, and prevention (maximum score of 60; higher scores infer positive attitude). Data were collected and entered into a software program for statistical analysis including Mann Whitney U, chi-square, and correlation tests. Incomplete forms were excluded. RESULTS: Of the 475 potential participants, 254 nurses completed all forms; 228 (89.8%) were women, 177 (69.7%) had a bachelor's degree, 146 (57.5%) worked in a state hospital, and 105 (41.3%) worked for 2 to 3 years. The mean score for UI knowledge was 15.22 ± 3.43 (range 0-24), and the mean attitude score was 46.40 ± 5.50 (range 15-60). The major nurse- or hospital-related obstacles to providing UI care were a lack of systems for patient follow-up (67.7%) and lack of patient education materials (60.2%). A weak positive correlation was noted between UI knowledge level and attitude (r = 0.263; P = .000). CONCLUSION: Although nurses had a positive attitude toward UI, UI knowledge scores were low. Lack of patient follow-up systems and patient education materials were important obstacles to nurses providing UI care. In addition to addressing these obstacles, postgraduation evidence-based UI education for nurses is needed to optimize care.

An evaluation of the effectiveness of a planned training program for nurses on administering intramuscular injections into the ventrogluteal site.

BACKGROUND: Nurses commonly use the dorsogluteal area for administering intramuscular injections. Since the dorsogluteal area has the potential of leading to serious complications, the ventrogluteal area is recommended as the best alternative. OBJECTIVE: This study was carried out to determine the level of knowledge nurses have about the ventrogluteal site and the effects of the training provided in this context. METHOD AND DESIGN: The study was of quasi-experimental design with a single group based on a pre-test/post-test time sequence and was conducted with 81 nurses who consented to participate in the research at a University Hospital. Data in the research were collected with a questionnaire on the identifying features of the nurses and a questionnaire that contained statements about the ventrogluteal area. RESULTS: The results of the study revealed that before the training, 76.5% of the nurses most commonly used the dorsogluteal area and 7.4% the ventrogluteal region. Four months after the training, however, it was found that the rate of nurses using the dorsogluteal area had fallen (48.1%) while the rate of using the ventrogluteal site rose (34.6%). It was seen that there was a significant difference between the nurses' pre-training and post-training knowledge scores and their scores four months after the training. CONCLUSION: It was concluded that the training offered the nurses about the ventrogluteal area had a positive impact on their knowledge and practices and that the nurses came away from the training with raised awareness about the subject and an increased level of knowledge.