Effectiveness of the Use of Animation and Gamification in Online Distance Education During Pandemic.

The study aimed to determine the effects on knowledge and motivation of animation and gamification in online distance education for a diabetes nursing course. This study was a randomized, controlled, prospective study implemented with 70 nursing students. The animation and gamification were applied to the experimental group. Data were collected using the "Diabetes Nursing Knowledge Test," "Instructional Materials Motivation Survey," and "Opinion Form on Diabetes Education Supported by Digital Instruments." There was a statistical difference between the Diabetes Nursing knowledge scores of the groups after the course (P < .05). The students in the experimental group had significantly higher attention and satisfaction and total scores from the Motivation Scale for Teaching Material sub-dimensions compared with the control group (P < .001). The results of our study in generation Z nursing students demonstrated that the use of animation and gamification in online distance learning in nursing students increased their knowledge as well as motivation.

The effect of affective learning on alexithymia, empathy, and attitude toward disabled persons in nursing students: A randomized controlled study.

PURPOSE: To evaluate the effect of affective learning on alexithymia, empathy, and attitude toward disabled persons in nursing students. DESIGN AND METHODS: This prospective, randomized, controlled trial study was implemented among 70 nursing students. Based on transformative learning theory, the affective learning method was applied to the intervention group. Toronto Alexithymia Scale (TAS), Empathic Tendency Scale (ETS), and Attitudes Toward Disabled Person Scale (ATDPS) were administered to both groups. RESULTS: The intervention group showed a statistically and significantly lower score at TAS and higher score at ATDPS compared to the control group, whereas no statistically significant difference was found in ETS score. PRACTICE IMPLICATIONS: Affective learning methods could be implemented in the nursing course for improving students' attitude toward disabled persons, and reducing alexithymia.

The effect of acupressure on sleep quality of older people: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND OBJECTIVE: The effects of acupressure on sleep quality and insomnia symptoms have been studied in various groups of haemodialysis patients, those undergoing surgery, and those living in elderly care homes. The aim of this study is to determine the effect of acupressure on sleep quality in elderly people. METHODS: This study was conducted with a systematic review and meta-analysis. In this study, electronic databases of PubMed, Science Direct, National Thesis centre, Google Scholar, Web of Science, EBSCO were systematically scanned between December 2020 and February 2021 using the keywords "older, elderly, sleep quality, acupressure". The study included 11 articles published in English and Turkish languages without any year limitation. This systematic review and meta-analysis were done by following the PRISMA reporting system. RESULTS: The total sample size of 11 randomized controlled trials included in this systematic review and meta-analysis was 722 (experiment: 363 and control: 359), and the mean duration of acupressure interventions applied was 19.65 ± 11.28 days. The sleep quality of the acupressure group in the elderly was significantly increased compared to the control group (MD: -1.71,%95 CI: -2.31 to -1.11, Z = 5.60, p< 0.00001, I2 = 91%). After the subjects received training for acupressure application and applied acupressure themselves, their sleep quality improved compared to the control group (MD: -0.86, 95% CI: -1.39 to -0.32, p <0.001). CONCLUSIONS: We have utilized meta-analysis to try to reveal statistical significance by pooling small studies with high quality. This meta-analysis provided a potentially effective intervention on the quality of sleep in elderly people.

Validity and reliability of the Turkish version of brief diabetic foot ulceration risk checklist.

OBJECTIVE: This study aims to determine the validity and reliability of the Turkish translation of brief diabetic foot ulceration risk checklist (BDURC). METHODS: This methodological study was conducted at the diabetes clinic of a state hospital in Istanbul, Turkey. The data were collected with the BDURC developed by Zhou et al. in 2018. A study was conducted with 430 patients with Type 2 diabetes. The scale was retested after 4 weeks by 60 participants. Language equivalence of the scale was provided. Experts' opinions were taken about the content validity of the scale. Reliability of the scale was determined with the test-retest reliability, item-total correlation, and internal consistency analysis. RESULTS: Confirmatory factor analysis revealed a two-factor structure with good model suitability. Cronbach's alpha coefficient for the scale and its subscales was 0.79. Test-retest scores showed no statistically significant difference between the items (p>0.05). The reliability index was higher than 0.80. CONCLUSION: The BDURC-TR is a valid and reliable tool that can be used in clinics to identify the risk factors for diabetic foot ulcers in patients with Type 2 diabetes in Turkey.

The effect of Emotional Freedom Techniques on nurses' stress, anxiety, and burnout levels during the COVID-19 pandemic: A randomized controlled trial.

BACKGROUND AND OBJECTIVE: Infectious disease outbreaks pose psychological challenges to the general population, and especially to healthcare workers. Nurses who work with COVID-19 patients are particularly vulnerable to emotions such as fear and anxiety, due to fatigue, discomfort, and helplessness related to their high intensity work. This study aims to investigate the efficacy of a brief online form of Emotional Freedom Techniques (EFT) in the prevention of stress, anxiety, and burnout in nurses involved in the treatment of COVID patients. METHODS: The study is a randomized controlled trial. It complies with the guidelines prescribed by the Consolidated Standards of Reporting Trials (CONSORT) checklist. It was conducted in a COVID-19 department at a university hospital in Turkey. We recruited nurses who care for patients infected with COVID-19 and randomly allocated them into an intervention group (n = 35) and a no-treatment control group (n = 37). The intervention group received one guided online group EFT session. RESULTS: Reductions in stress (p < .001), anxiety (p < .001), and burnout (p < .001) reached high levels of statistical significance for the intervention group. The control group showed no statistically significant changes on these measures (p > .05). CONCLUSIONS: A single online group EFT session reduced stress, anxiety, and burnout levels in nurses treating COVID-19.

Effectiveness of mechano-analgesia and cold application on ecchymosis, pain, and patient satisfaction associated with subcutaneous heparin injection.

The purpose of this study was to investigate the effect of mechano-analgesia and cold application on subcutaneous heparin injection ecchymosis, pain, and patient satisfaction. This was a prospective, controlled, quasi-experimental, and clinical research. The study was conducted during a 10-month period in the Orthopedics and Traumatology wards of a university hospital in Istanbul, Turkey. The 55 patients received 3 subcutaneous heparin injections (165 injections) by the same investigator using additional techniques such as mechano-analgesia and cold application, and without any additional techniques. ShotBlocker for the mechano-analgesia and an ice pack for the cold application were used. Pain and ecchymosis are different according to individual features. Therefore, subcutaneous heparin was administered to the same patients by using 3 different methods. Pain and satisfaction were assessed immediately after the injection by using the visual analog scale. Ecchymosis was assessed with an ecchymosis measurement tool (Opsite FlexiFix) at 48 and 60 hours after the injection. Research findings show that ecchymosis occurred in 6.6% of all injections. The lowest and smallest ecchymosis occurred in cold application, but the difference was not statistically significant among the techniques (P = .178). Use of mechano-analgesia and cold application reduce pain (P = .00). Mechano-analgesia was ineffective for ecchymosis while reducing pain. The satisfaction level was highest with mechano-analgesia, with statistically significant differences among the techniques (P = 0.001). Mechano-analgesia and cold application can be effective in reducing injection pain and increasing patient satisfaction.

Efficacy of Cartoon Viewing Devices During Phlebotomy in Children: A Randomized Controlled Trial.

PURPOSE: The purpose of this study was to examine the efficacy of different cartoon viewing devices during phlebotomy in children. DESIGN: This study was a prospective, randomized controlled trial. METHODS: The study included inpatients from the Biochemical Laboratory of a private university hospital in Turkey and was conducted between September 2017 and April 2018. A computer-based random number generator was used to randomly assign the patients into three groups (virtual reality [VR], tablet, and control) with 40 children each. Data were collected using the Wong-Baker FACES Pain Rating Scale and the Children's Fear Scale. Pain and anxiety scores were reported by children, parents, and observers in tablet and control groups. In the VR group, pain and anxiety were determined only by children's reports. FINDINGS: According to the children reports, the VR group reported significantly less pain and anxiety than those in the tablet and control groups (P < .05). CONCLUSIONS: The cartoon distraction performed using a VR device reduced the perception of pain and anxiety during phlebotomy in school-age children.

The effect of acupressure (GB30) on intramuscular injection pain and satisfaction: Single-blind, randomised controlled study.

AIMS AND OBJECTIVE: To evaluate the effect of acupressure on intramuscular injection pain, satisfaction and vital signs. BACKGROUND: Pain at the injection site may lead to discomfort and may affect patients' compliance to treatment. DESIGN: This was a prospective, single-blind, crossover study. The study complied with the guidelines of Consolidated Standards of Reporting Trials (CONSORT) Checklist. METHODS: Seventy-two healthy volunteer university students received an intramuscular injection of 2 ml sterile saline (%0.9 NaCl) to the ventrogluteal site with and without acupressure on separate days in a random order following a standard procedure by the same investigator. Pain and satisfaction were assessed immediately after the injection with the visual analog scale (VAS) by a researcher blinded to the study. RESULTS: A total of 134 injections were analysed. The result of the study reveals that acupressure alleviates the severity of pain and increases the patient satisfaction. CONCLUSIONS: The findings of this research support that use of acupressure, which is easy and cost-effective, could reduce injection pain when performed on a specific point. RELEVANCE TO CLINICAL PRACTICE: Safe and accurate administration of medications is one of the crucial responsibilities of nurses. Acupressure is a nonpharmacologic approach, which can be effective in decreasing the injection pain and increasing patient satisfaction.

The Effect of Music Therapy and Progressive Muscle Relaxation Exercise on Anxiety Before the First Clinical Practice in Nursing Students: A Randomized Controlled Study.

AIM: This study was carried out to evaluate the effect of music therapy and progressive muscle relaxation exercise on the state and trait anxiety levels before their first clinical practice in nursing students. METHOD: This randomized controlled experimental study sample consisted of 86 nursing students who will be firstly applied to clinical practice. The students were randomly assigned to music (n=30), exercise (n=28), and control (n=28) groups. The data of the study were collected with Student Information Form and State-Trait Anxiety Scale. The music therapy intervention was applied to the music group three times a week for the first 2 weeks. Progressive muscle relaxation exercise was applied alone to the exercise group three times a week for the first 2 weeks in a separate room. No intervention was applied to the control group. This study RCT number is: NCT04540172. RESULTS: The majority of the students was female (81.4%), and the mean age was 19.74±1.38 years. After the interventions, there was a statistical difference between the groups, and this difference was created by the control group (p<0.05). The pre-test and post-test results were compared in the experimental groups, and the state anxiety levels had decreased (p<0.05). There was no significant difference in the trait anxiety levels between the groups (p>0.05). CONCLUSION: Music therapy and muscle relaxation exercises can be used to reduce the state anxiety levels in nursing students before their first clinical practice experience.