The effect of health literacy on health behaviors in a sample of Turkish adolescents.

PURPOSE: Health literacy is a strong factor in the health outcomes and behaviors of adolescents. This study was conducted to examine the health literacy levels of adolescents, their health behaviors, and the effect of health literacy on health behaviors. DESIGN AND METHODS: This cross-sectional study was conducted with a total of 649 adolescents between the ages of 14 and 18. Data were collected using the Adolescent Lifestyle Profile II (ALP-R2) and the Health Literacy Scale for School-Age Children (HLSAC). A multiple regression analysis was conducted to determine the effects of health literacy on health behaviors and the factors associated with health behaviors. RESULTS: The mean total ALP-R2 score of the participants was 114.35 ± 17.48, and their mean HLSAC score was 28.95 ± 5.79. Among the participants, 26% had low health literacy, 61.9% had moderate health literacy, and 12% had high health literacy. The regression analysis revealed that the health literacy levels of the participants significantly predicted all dimensions of health behaviors and total health behaviors (p < 0.001). The health literacy levels of the participants, the community where the adolescent lived, their participation in social activities, family relationships, friend relationships, and health perceptions significantly predicted their total health behaviors (R2 = 0.347; p < 0.001). CONCLUSIONS: The health literacy levels and health behaviors of adolescents were found to be moderate, and their health behaviors increased as their levels of health literacy increased. The results showed that the health literacy and health behaviors of adolescents need to be improved. IMPLICATIONS FOR PRACTICE: Nurses should provide training to increase the healthy lifestyle behaviors and health literacy of adolescents.

Investigating Adverse Childhood Experiences and Nutrition and Physical Activity Behaviors Using the Omaha System.

The aim of the current study was to examine the relationship between adverse childhood experiences (ACEs) and nutrition and physical activity behaviors using the Omaha System. A descriptive cross-sectional design was used with 227 women recruited from three vocational institutes. Measures included Omaha System Knowledge, Behavior, and Status ratings for nutrition and physical activity; sociodemographic information; and the ACE Questionnaire. Results demonstrated that more than one half of participants had a history of at least one ACE (n = 132; 58.1%), and 33 (14.5%) had four or more. ACEs score was significantly associated with nutrition, but not physical activity behavior. Understanding the links between ACEs and health behaviors and including a brief screening for ACEs in primary care practice settings may help nurses holistically customize health promotion interventions and lead to better health outcomes. The Omaha System can efficiently measure health-related behaviors; examine their relationship to risk factors, such as ACEs; and capture individual and population-level changes. [Journal of Psychosocial Nursing and Mental Health Services, 60(3), 23-30.].

Health literacy and diabetes self-care in individuals with type 2 diabetes in Turkey.

AIM: The aim of this study was to examine the relationship between health literacy and diabetes self-care in individuals with type 2 diabetes. METHODS: This cross-sectional study was conducted with 207 individuals with Type 2 diabetes at a diabetes outpatient clinic of a foundation university hospital in Istanbul, Turkey. The data were collected using a sociodemographic and illness characteristics questionnaire, the Turkish version of the European Health Literacy Survey Questionnaire (HLS-EU-Q-TR), and the Diabetes Self-Care Scale (DSCS). Data were analyzed using descriptive statistics, one-way ANOVA, Student's t-test, Pearson correlation test, and multiple regression analysis. RESULTS: It was found that 81.5% of individuals with type 2 diabetes were at an inadequate or limited and problematic level of health literacy. The DSCS mean scores of patients with an inadequate health literacy level were significantly lower than that of patients at other levels of health literacy. It was determined that education level, exercise status, and HLS-EU-Q-TR scores were significantly related to diabetes self-care (R² = 0.245, p < 0.001). CONCLUSION: The study found that individuals with type 2 diabetes had higher diabetes self-care if they had a high education level, regularly exercised, or had high HLS-EU-Q-TR mean scores.

The effect of illness perception on life quality in psoriasis patients.

Psoriasis is a chronic disease that has negative effects on quality of life. Understanding the illness perception of psoriasis is important for effective management of the disease and improving quality of life. The aim of this study was to determine the relationship between illness perception and quality of life in psoriasis patients. This cross-sectional study was performed with 306 patients who applied to a psoriasis outpatient clinic of a university hospital in Istanbul, Turkey. Data were collected using a sociodemographic characteristics and disease information form, the Dermatology Life Quality Index (DLQI), the Revised Illness Perception Questionnaire (IPQ-R) and the Psoriasis Area Severity Index (PASI) score. Data were analyzed using descriptive statistics, Kruskal-Wallis test and Mann-Whitney U test, Spearman correlation analysis, and multiple regression analysis. A positive relationship was found between scores on the DLQI and scores on the IPQ-R subscales of Illness identity, Consequences, Emotional representations, Time (cyclic), Personal attributions, External attributions, and Chance. A negative correlation was determined between DLQI scores and scores on the IPQ-R subscales of Treatment control and Illness coherence. Furthermore, there was a positive correlation between the PASI score and the DLQI scores and scores on the IPQ-R subscales of Consequences and Emotional representation. Multiple regression analysis showed that illness identity, PASI scores, treatment control, illness coherence, consequences, and personal attributions were significantly associated with quality of life (R2 = 0.365, p < 0.01). The quality of life of the psoriasis patients who associated their symptoms with the disease, who had a high PASI score, thought that they were adversely affected by the disease, and who saw personal attributions as the cause of the disease was negatively affected. The quality of life of patients who thought that their disease could be kept under control and who understood their disease was positively affected.

The Relationship Between Health Literacy and Illness Self-Care Management in Turkish Patients With Cancer.

OBJECTIVES: To determine the relationship between health literacy and illness self-care management in individuals with cancer. SAMPLE & SETTING: 207 individuals with cancer undergoing treatment in the chemotherapy unit of a university hospital in Istanbul, Turkey. METHODS & VARIABLES: Data were collected using a sociodemographic and illness characteristics questionnaire, the European Health Literacy Survey Questionnaire-Turkish Version (HLS-EU-Q-TR), and the Self-Care Management Process in Chronic Illness. Data were analyzed using descriptive statistics, one-way analysis of variance, student t test, Pearson correlation test, and multiple regression analysis. RESULTS: 86% of individuals displayed an inadequate or problematic to limited level of health literacy. Extended family status and HLS-EU-Q-TR score were significant predictors of self-care management. IMPLICATIONS FOR NURSING: Nurses can organize health programs designed to improve the level of health literacy in the population, but they should take into consideration the health literacy levels of their patients.

Predictors of Caregiver Burden in Caregivers of Bedridden Patients.

BACKGROUND: Caregivers are at risk of experiencing caregiver burden. It is therefore important to determine the caregiver burden of caregivers who provide care to bedridden patients and related factors. PURPOSE: The aim of this study was to determine the caregiver burden of caregivers who provide care to bedridden patients and the factors that impact this burden. METHODS: This cross-sectional study was executed at a state hospital in Istanbul, Turkey, on bedridden patients registered in the home healthcare unit and their caregivers. During study period, the researchers made 312 visits to patients and their caregivers. A sociodemographic questionnaire, the Burden Interview, and the Katz Index of Independence in Activities of Daily Living were used to collect data. Descriptive statistics, an independent sample t test, one-way analysis of variance, and stepwise multiple regression analysis were used for data analysis. RESULTS: The participants reported a moderate level of caregiver burden. Existing caregiver health problems, caregiver employment status, the ability of the caregiver to maintain his or her own good health, type of home, and the degree of patient dependence in terms of activities of daily living were each found to be significant predictors of caregiver burden. CONCLUSIONS/IMPLICATIONS OF PRACTICE: The support provided to caregivers by home healthcare units is important in terms of protecting the physical, mental, and social health conditions of caregivers and preventing the exacerbation of caregiver burden.

Psychometric Characteristics of the Turkish Version of Adolescent Lifestyle Profile R2.

BACKGROUND AND PURPOSE: The purpose of this study was to adapt and assess cultural and psychometric properties of the Adolescent Life Style Profile (ALP-R2) in Turkish adolescents. METHODS: The sample of the study consisted of 945 students aged 12-18 years. Data were collected using the Turkish translation of the ALP-R2. Psychometric testing of the ALP-R2 included internal consistency, item-total correlation, test-retest correlation, and construct validity with confirmatory factor analysis (CFA). RESULTS: The total Cronbach's α coefficient was .88, and the subscales ranged from .55 to .76. The CFA results showed that the structure of the model/scale has an acceptable goodness of fit. CONCLUSION: The study shows that the Turkish version of the ALP-R2 is a reliable and valid scale that can be used to assess healthy lifestyle domains in Turkish adolescents.

The effect of nurse education on the self-esteem and assertiveness of nursing students: A four-year longitudinal study.

BACKGROUND: The nurse education program affects many aspects of personal development. Nursing students gain skills in critical thinking and analysis and also develop communication and management skills. The four-year program may also have an effect on students' assertiveness and self-esteem. OBJECTIVES: This study was conducted to determine the impact of the four-year higher nursing school educational program on students' self-esteem and assertiveness. DESIGN: Descriptive longitudinal design. SETTING: The study took place at a Foundation University in Istanbul, Turkey over the period 2006-2010. The students' levels of self-esteem and assertiveness were assessed at the beginning and end of the first, second, third and fourth years of the program.

Behavior of College Students in Health Related Departments Towards Early Diagnosis of Breast Cancer.

OBJECTIVE: The study was performed in order to determine the behavior of college students studying in health related departments for the early diagnosis of breast cancer. MATERIALS AND METHODS: This study is a cross sectional study. 336 female students studying in School of Nursing and School of Health Sciences at a foundation university in Istanbul were included. A questionnaire directed to collect data regarding the participants' socio-demographic characteristics and their behavior on the early diagnosis of breast cancer was used. Data were evaluated by descriptive statistics and chi-square test. RESULTS: The mean age of students was 21.26±1.94, and 30.7% of the participants majored in nutrition, 29.2% in nursing, 22.9% in midwifery, 17.3% in physical therapy and rehabilitation departments. It was determined that 53.3% of the students made regular breast self-examination (BSE), and 88.1% did not get a clinical breast examination (CBE) within the last year. It was noticed that students who had BSE training, made more BSE and CBE as compared to those who did not get any education. Students with family history of breast cancer was performing more BSE that those without a family history. It was identified that students with BSE training and family history of breast cancer used BSE at a higher rate. CONCLUSION: It was identified that students with BSE training and family history of breast cancer usage of techniques to perform a BSE at a higher rate.