The effects of mandala coloring on fatigue, psychological well-being, and coping with stress in patients receiving hemodialysis treatment.

BACKGROUND: Hemodialysis is an important health problem that negatively affects psychosocial status and support systems. Through practices such as mandala coloring, individuals transfer the unknowns they experience to the outside and make them visible. This study was conducted to examine the effects of mandala coloring on fatigue, psychological well-being, and factors associate with coping with stress in patients receiving hemodialysis treatment. METHODS: The design was a prospective, parallel-group controlled trial. The study was conducted in the dialysis unit of a university hospital in eastern Turkey between April 4 and October 31, 2022, with a total of 60 patients, 30 in the intervention group, and 30 in the control group. The patients in the intervention group colored mandala once a week for 2 h, for a total of 8 weeks. The data were collected face-to-face using a patient information form, a Fatigue Severity Scale, a Psychological Well-Being Scale, and a Ways of Coping Questionnaire. RESULTS: There were improvements in fatigue severity and psychological well-being over the 8-week study period in both the intervention and control groups. Scores were similar at baseline in the control and intervention groups, but better in the intervention groups compared to controls at 4 and 8 weeks for both metrics (p < 0001). Five factors from the Ways of Coping Questionnaire (self-confident approach, optimistic approach, seeking social support, helpless approach, and submissive approach) each improved during the 8-week period in the intervention group (p < 0.001). Three of these five factors improved in the control group as well. Scores for each of the five coping factors were better in the intervention group compared to controls at 4 and 8 weeks (p < 0.001). CONCLUSION: Mandala coloring improved fatigue and psychological well-being and was associated with improved patient coping strategies.

Multicenter evaluation to determine the deficiencies of emergency nurses in forensic case management.

INTRODUCTION: Emergency services are the first places where victims and/or perpetrators of different types of violence are brought for medical treatment. Emergency service nurses are the first health workers who first encounter with the forensic case, first communicate and are in an important position in the rapid and accurate continuation of the forensic process. In this study, it was aimed to determine the level of knowledge of emergency department nurses regarding the management of forensic cases. METHODS: The study was a cross-sectional, descriptive. Ninety-eight emergency nurses working in the emergency departments of three different public hospitals in the same province participated in the study. Study data were collected with the "Nurse Personal Information Form" and the "Knowledge Levels of Nurses related to the Approaches to Forensic Cases Questionnaire". RESULTS: 70.4 % of the nurses participating in the study were women, their mean age was (X ± SD = 27.36 ± 5.21). It is seen that 87.8 % of the nurses have a total working time in the emergency unit between 1 and 5 years and 11.2 % have received training on forensic nursing. "Total Knowledge Score" of undergraduate graduate nurses The mean score was higher and there was a significant difference between the groups (p > 0.05). The nurses who received in-service training and forensically evaluated all cases admitted to the emergency department had a higher mean score in the "Knowledge Score Regarding the Duties of Nurses Regarding Forensic Cases" mean was higher and there was a significant difference between the groups (p > 0.05). CONCLUSION: We recommend the use of institutional guides/protocols together with in-service training for emergency nurses to provide medically and legally correct forensic care and to have sufficient knowledge.

Investigation of symptom management and functional state of women who underwent breast cancer surgery.

OBJECTIVE: The aim of this study was to investigate the symptom management and the functional status of women who underwent surgery for breast cancer. METHODS: This cross-sectional descriptive study was conducted in a university hospital surgical oncology clinic. This study was conducted on 80 patients who had undergone breast cancer surgery in the last 5 years in a surgical oncology clinic of a university hospital. Study data were collected using the patient identification form, Symptom-Management Self-Efficacy Scale Related to Chemotherapy in Breast Cancer, and Functional Living Index-Cancer. The data were analyzed with the SPSS program. RESULTS: The mean total score of Symptom-Management Self-Efficacy Scale Related to Chemotherapy in Breast Cancer was found to be 157.28±36.86, and the mean total score of the Functional Living Index-Cancer was found to be 103.79±18.77. When the correlation between the Functional Living Index-Cancer and Symptom-Management Self-Efficacy Scale Related to Chemotherapy in Breast Cancer scales used in the study was examined, it was determined that there was a positive statistically significant correlation (p<0.05) between the subscale and scale total scores. CONCLUSION: As a result of the study, it was determined that the self-efficacy and functional status of the patients were poor. Their functional status was also determined to be improved as the symptom self-efficacy levels increased.

Psychometric properties of the Turkish version of the Palliative Nursing Care Quality Scale.

OBJECTIVES: Measuring tools are essential in assessing the quality of care. This study aimed to evaluate the validity and reliability of the Turkish version of the Palliative Nursing Care Quality Scale (PNCQS-T) and the sociodemographic characteristics affecting the quality of care. METHODS: This methodological study, whose linguistic equivalence was confirmed by the translation/back translation method, was carried out with the participation of 209 nurses. Personal Information Form and PNCQS-T were used as data collection tools. Construct validity was determined by confirmatory factor analysis (CFA). Reliability was tested with internal consistency and item-total correlation coefficients. RESULTS: Adaptation results showed that the Turkish version of the scale is adequate for linguistic and content validation. The Turkish adaptation's original scale of 20 items was reduced to 18. As in the original scale, all items were combined under a single dimension in the Turkish adaptation. Modified CFA indicated a well-fitting model. PNCQS-T explained 42.1% of the total variance. Cronbach's alpha value was 0.92. The lowest score obtained from the scale is 18; the highest score is 90. Higher scores indicated that the palliative care provided by nurses was of good quality. SIGNIFICANCE OF RESULTS: The Turkish version of the PNCQS-T is reliable for assessing the quality of palliative care provided by nurses in Turkey.

The effects of activities of daily living education on the independence and life satisfaction of elders.

PURPOSE: The aim of this study is to examine the effect of education on the independence levels and life satisfaction (LS) of the elderly in their activities of daily living (ADL). FINDINGS: The level of independence in maintaining the ADLs of the elderly in the intervention group that received training increased compared to the elderly group that was not trained. LS increased in the intervention group that received training. the number of education is an effective factor in LS. As the number of education increased, the level of LS increased in the intervention group. CONCLUSION: There is a linear relationship between independence in maintaining ADLs and LS in the elderly, and as the level of independence increases in the elderly, their LS also increases. In the study, there is a significant relationship between ADL and LS before and after education, and education high affected activity levels and LS.

The influence of foot and back massage on blood pressure and sleep quality in females with essential hypertension: a randomized controlled study.

The present study was conducted with the aim of investigating the influence of foot and back massage on blood pressure and sleep quality in females with essential hypertension. Non-pharmacologic methods like massage may be effective for balancing blood pressure and solving sleep problems. This is a randomized controlled study conducted in accordance with CONSORT rules. Females with essential hypertension were applied a total of six sessions of 30 min of foot and back massage twice weekly during 3 weeks. The study included a total of 90 patients of whom 60 were in intervention group (foot massage group, back massage group) and 30 in control group. Data were collected through personal data form (PDF) which included descriptive characteristics, Pittsburgh Sleep Quality Index (PSQI). Six sessions of foot massage and back massage were detected to lead to a reduction in systolic blood pressure (SBP) and diastolic blood pressure (DBP) values and the difference was statistically significant (p < 0.001). A strong statistical difference was found between mean pretest posttest scores of overall and sub-dimensional scores of PSQI in females in intervention group (p < 0.001). Foot and back massage was found to be effective in reducing blood pressure and improving sleep quality.

The effect of a hemodialysis patient education program on fluid control and dietary compliance.

INTRODUCTION: Some hemodialysis patients may experience problems in completing activities of daily living and adhering to diet and fluid restrictions due to a decrease in self-care power and a loss of competence. METHODS: The study was conducted with 78 people assigned to the intervention (N = 38) and control groups (N = 40). Data were collected using the sociodemographic characteristics questionnaire, dialysis diet and fluid nonadherence questionnaire (DDFQ), and fluid control in hemodialysis patients scale (FCHPS). The participants in the intervention group were given the "Nutrition Education Booklet for Dialysis Patients". The participants in the intervention group were trained through four education sessions across 4 months, and the measurement tools were administered to them. The participants in the control group were interviewed twice, once at the onset of the study and once 2 months later and the measurement tools were administered to them. FINDINGS: In the intervention group, a decrease was observed in the pre- and postdialysis interdialytic weight gain, ultrafiltration (UF) volume, and blood pressure values of the patients after the training. There was a statistically significant decrease in the mean scores for the frequency and degree of nonadherence to diet restriction, and for the frequency and degree of nonadherence to fluid restriction in the participants in the intervention group compared to the participants in the control group (P < 0.05). There was a statistically significant increase in the mean scores obtained from the FCHPS and its subscales by the participants in the intervention group compared to the participants in the control group (P < 0.05). CONCLUSION: The training given to the hemodialysis patients positively contributed to their adherence to diet and fluid restrictions. The patients' adherence to diet and fluid restriction increased.

Aquatic Exercise Program for Individuals With Osteoarthritis: Pain, Stiffness, Physical Function, Self-Efficacy.

PURPOSE: This research was conducted to determine the effects of an aquatic exercise program on pain, stiffness, physical function, and self-efficacy in individuals with osteoarthritis. DESIGN: A randomized controlled trial. METHODS: Participants in the experimental group participated in the aquatic exercise program three times a week for 8 weeks; participants in the control group did not. FINDINGS: The mean scores of the experimental group on the pain, stiffness, and difficulty in carrying out physical functions subscales of the Western Ontario and McMaster Universities Osteoarthritis Index decreased significantly, whereas those of the control group decreased very little. The mean scores of the experimental group on the Arthritis Self-Efficacy Scale and the isokinetic muscle strength measurements increased, but those of the control group did not change in the final measurements. The difference between the groups was statistically significant. CONCLUSIONS: Through the study, it was determined that the aquatic exercise program decreased pain, stiffness, and difficulty in carrying out physical functions and increased self-efficacy and muscle strength of individuals with osteoarthritis. CLINICAL RELEVANCE: The aquatic exercise program can be used by nurses as a reference in the management of osteoarthritic patients' health status.

[Pain beliefs of patients and the nonpharmacological methods they use to manage the pain]. / Hastalarin agri inançlari ve agriyi yönetmede kullandiklari ilaç disi yöntemler.

OBJECTIVES: This study was performed to determine the pain beliefs of patients and nonpharmacological methods they use to manage their pain. METHODS: This was a descriptive study conducted with the participation of 163 patients who were hospitalized in the medical and surgical clinics of a university hospital in May 2011. The study data were collected using personal information forms, a nonpharmacological methods form, and a pain belief scale. The data were evaluated using number, percentage, an independent sample t-test, and analysis of variance. RESULTS: The mean age of the patients was 52.7±16.6 years, and it was determined that 23.3% were hospitalized for urinary system diseases, while 21.5% were hospitalized for musculoskeletal system diseases. It was observed that 93.8% of the patients described experiencing pain in the past, while 22.7% described experiencing severe pain within the previous week. The types of pain most frequently described by the patients were headaches (24.8%), joint pain (21.6%), and lumbar pain (19.6%). It was determined that 72.3% of the patients used medication for pain, and that 49.1% also resorted to nonpharmacological methods for their pain. Frequently preferred nonpharmacological methods included hot and cold therapy, massage, and herbal methods. The mean organic score on the pain belief scale (23.6±4.57) was higher than the mean psychological score (19.9±2.64). CONCLUSION: Evaluating the pain beliefs of patients and the nonpharmacological methods used is important for effective management of pain.

Effects of loneliness on illness perception in persons with a chronic disease.

AIM AND OBJECTIVES: To determine the effects of loneliness on illness perception in persons with a chronic disease. BACKGROUND: How an illness is perceived not only affects all dimensions of a person's life but also plays an important role in his/her coping with the complications and consequences of the disease. One of the factors that influence the illness perception is loneliness. DESIGN: The study is a descriptive study. METHODS: The study sample included 206 individuals over the 18 years of age, conscious, having had a chronic illness at least 1 year, having no communication problems and agreeing to participate in the study after being informed about the study. Data were collected with the Personal Information Form, the Illness Perception Questionnaire and the University of California Los Angeles Loneliness Scale. The forms were administered to the participants in an unoccupied patient room, and the data were collected through face-to-face interviews. RESULTS: The results of the study revealed that individuals with a chronic disease perceived emotional symptoms accompanying the disease more intensely that they accepted their disease was a chronic one and that their personal control and treatment control of the disease were at a middle level. The mean score the participants obtained from the University of California Los Angeles Loneliness Scale was 38.49 ± 11.15. There was a significant negative correlation between this mean score and the mean scores obtained from the following subscales consequences, treatment control, illness perception and emotional representations. CONCLUSION: In this study, it was concluded that the participants perceived their loneliness level as moderate and that their illness perception was negatively affected as their loneliness levels increased. RELEVANCE TO CLINICAL PRACTICE: The knowledge of clinical nurses about perception of patients with chronic illnesses and conditions affecting that perception will enhance compliance with the illness management or treatment strategies. Clinical nurses should observe residents closely for signs of depression and loneliness and support their sense of coherence to reduce emotional and social loneliness.

Validity and Reliability of the Quality of Life in Epilepsy Inventory (QOLIE-10) For Turkey.

INTRODUCTION: The purpose of this study was to test as a shortened form of the health-related quality of life for patients with epilepsy inventory (QOLIE). METHODS: A study of 148 adult epileptic patients admitted to the Neurology Outpatient Clinic at Cumhuriyet University Hospital in Sivas was used to derive a brief screening tool from a longer instrument (QOLIE-31). RESULTS: The 10-item questionnaire (QOLIE-10) contains general and epilepsy-specific dimensions grouped into three domains: Epilepsy Effects (memory, physical effects, and mental effects of medication), Mental Health (energy, depression, overall quality of life), and Role Functioning (seizure worry, work, driving, social limits). Cronbach's alpha (measure of internal consistency) was high, as were the associations between QOLIE-10 and the Nottingham Health Profile (NHP). High correlations between QOLIE-10 and NHP domains (emotional reactions, energy, physical mobility, and social isolation) were found. CONCLUSION: The QOLIE-10 questionnaire is considered to be a valid and reliable tool for use in Turkey. Health professionals are encouraged to use this questionnaire to routinely examine the influences of the disease process in epilepsy patients.

Effect of the cooling suit method applied to individuals with multiple sclerosis on fatigue and activities of daily living.

AIMS AND OBJECTIVES: To determine the effects of cooling suit on fatigue and activities of daily living of individuals with multiple sclerosis. BACKGROUND: Fatigue is one of the most common symptoms in people with multiple sclerosis and adversely affects their activities of daily living. Studies evaluating fatigue associated with multiple sclerosis have reported that most of the fatigue cases are related to the increase in body temperature and that cooling therapy is effective in coping with fatigue. DESIGN: This study used a two sample, control group design. METHODS: The study sample comprised 75 individuals who met the inclusion criteria. Data were collected with study forms. After the study data were collected, cooling suit treatment was administered to the experimental group. During home visits paid at the fourth and eighth weeks after the intervention, the aforementioned scales were re-administered to the participants in the experimental and control groups. RESULTS: The analyses performed demonstrated that the severity levels of fatigue experienced by the participants in the experimental group wearing cooling suit decreased. The experimental group also exhibited a significant improvement in the participants' levels of independence in activities of daily living. CONCLUSIONS: The cooling suit worn by individuals with multiple sclerosis was determined to significantly improve the participants' levels of fatigue and independence in activities of daily living. RELEVANCE TO CLINICAL PRACTICE: The cooling suit therapy was found to be an effective intervention for the debilitating fatigue suffered by many multiple sclerosis patients, thus significantly improving their level of independence in activities of daily living.

Evaluation of emergency department nursing services and patient satisfaction of services.

AIMS AND OBJECTIVES: To identify nursing services and assess patient satisfaction in patients who present to the emergency department. BACKGROUND: Emergency nursing care is a significant determinant of patient satisfaction. Patient satisfaction is often regarded as a reliable indicator of the quality of services provided in the emergency department. DESIGN: This is a descriptive study. METHODS: Eighty-four patients who presented to the university emergency department were included in the study. The study data were collected by the Patient Information Form and the Satisfaction Level Form. RESULTS: Emergency nursing services, including history taking, assessing vital signs, preparing the patient for an emergency intervention, oxygen therapy, drug delivery and blood-serum infusion were shown to be more commonly provided compared with other services such as counselling the patients and the relatives about their care or delivering educational and psychosocial services. However, 78·6% of the patients were satisfied with their nursing services. The highest satisfaction rates were observed in the following sub-dimensions of the Satisfaction Level Form: availability of the nurse (82·1%), behaviour of the nurse towards the patient (78·6%) and the frequency of nursing rounds (77·4%). CONCLUSIONS: The most common practices performed by nurses in the emergency department were physical nursing services. Patient satisfaction was mostly associated with the availability of nurses when they were needed. Our results suggest that in addition to the physical care, patients should also receive education and psychosocial care in the emergency department. RELEVANCE TO CLINICAL PRACTICE: We believe that this study will contribute to the awareness and understanding of principles and concepts of emergency nursing, extend the limits of nursing knowledge and abilities, and improve and maintain the quality of clinical nursing education and practice to train specialist nurses with high levels of understanding in ethical, intellectual, administrative, investigative and professional issues.

Disability is associated with nonadherence to diet and fluid restrictions in end-stage renal disease patients undergoing maintenance hemodialysis.

PURPOSE: The purpose of this study was to evaluate nonadherence to diet and fluid restrictions and its relation with the level of disability in patients on chronic hemodialysis (CH). METHODS: The study design was a descriptive survey. The data were obtained from 186 patients in hemodialysis centers in Turkey. Descriptive statistics including mean scores, standard deviations and frequencies, and correlations analysis and logistic regression were conducted. Data were collected by using a personal information form, the Dialysis Diet and Fluid and Brief Disability Questionnaire. RESULTS: A great majority of hemodialysis patients showed nonadherence to diet and fluid restrictions. In total, 124 patients (66.7 %) reported mild to very severe nonadherence to diet, and 128 patients (68.8 %) reported mild to very severe nonadherence to fluid restrictions. Most of the patients with CH (69.9 %) experienced disability. The results of this study showed that nonadherence was more common among older age, females, low-educated patients and those with higher levels of disability. CONCLUSIONS: The results of this study showed that the prevalence of nonadherence to diet and fluid restrictions was high in hemodialysis patients. The significant predictors for diet and fluid nonadherence were: older age, high interdialytic weight gain, and severe disability. Medical professionals must be aware of nonadherence and related factors and assist patients in developing strategies to prevent and respond to this.

ADHERENCE TO THERAPY AND QUALITY OF LIFE IN HYPERTENSIVE PATIENTS.

This cross-sectional study aimed to evaluate the association between medication adherence and Health-Related Quality of Life (HRQoL) in 120 hypertensive patients. Personal Information Form, SF-36 Quality of Life Scale (SF-36 QoL) and Medication Adherence Self-Efficacy Scale (MASES) were used for data collection. Data were analyzed with SPSS program using percentage, mean value, standard deviation, significance test of difference between two means, analysis of variance, Mann-Whitney U test, Kruskal-Wallis test and X²-test. MASES and SF-36 QoL scores of the patients were found to be low. Adherence to medication and compliance were found to be low in males, patients using two or more drugs, and those that did not control their blood pressure regularly. In addition, a statistically significant positive relationship was found between adherence to medication/compliance, self-efficacy and quality of life (p < 0.001). Regular and continuous adaptation programs addressing patients on antihypertensive therapy will improve the quality of life of these patients.

Validity and Reliability of the Quality of Life in Epilepsy Inventory (QOLIE-31) for Turkey.

INTRODUCTION: The purpose of this study was to evaluate reliability and validity of the 31-item Quality of Life in Epilepsy Inventory (QOLIE-31) in Turkish epileptic patients. METHODS: This study was performed methodologically. To standardize the inventory, using a standard "forward-backward" translation and cultural adaptation procedure the English version of the QOLIE-31 was translated to Turkish. Language equivalence of the scale was provided. The opinions of experts were considered regarding the content validity of the scale. Reliability of the scale was determined with the test-retest reliability, item-total correlation and internal consistency analysis. For the construct validity, QOLIE-31 was compared with Nottingham Health Profile (NHP) scale and pre validity was determined. RESULTS: One hundred and forty-eight epileptic patients (62 females, 86 males), with a mean age of 32.5 (SD: 10.71) years were enrolled in the study. Content Validity Index of instrument was .85. Alpha reliability was .91. Item-total correlations were between .46 and .74 (p=.001). The mean score for the quality of life of epileptic patients was found to be moderate level (56.4; SD: 17.3). The mean score of Seizure Worry subscale was the lowest (48.9, SD: 29.82), while social function subscale (60.1, SD: 20.12) was found to be highest. As expected, correlations between QOLIE-31 and NHP subscales were fairly strong, particularly between those subscales with close or interdependent content. Thus, Emotional Well-Being correlated with NHP Emotional Reactions, Social Isolation and Pain; Social Function with NHP Social Isolation and Physical Mobility; Seizure Worry with NHP Social Isolation and Emotional Reactions; and Cognitive Function with NHP Energy, Emotional Reactions and Pain. CONCLUSION: The Turkish version of the QOLIE-31 questionnaire has good structural characteristics, is a reliable and valid instrument and can be used for measuring the effect of epilepsy on the quality of life.

Effect on symptom control of structured information given to patients receiving chemotherapy.

PURPOSE: The performance of a planned education model in patients receiving chemotherapy can alleviate the side effects of chemotherapy and thus can increase the quality of the patients' lives. In accordance with this view, this study was conducted with the purpose of examining the effect of planned education given to patients receiving chemotherapy on their symptom control. METHODS: The study was quasi-experimental. A sample of 120 patients participated, of which 60 were in the experimental group (EG) and 60 were in the control group (CG). A patient data form and the chemotherapy symptom assessment scale (C-SAS) were used in order to collect the data. Median, Mann-Whitney U test and Wilcoxon signed rank test were used to analyze the data. RESULTS: There were statistically significant decreases in the frequencies of the following symptoms: nausea, vomiting, constipation, pain, infectious signs, problems of mouth and throat, problems of skin and nails, appetite changes, weight loss or weight gain, feeling distressed/anxious, feeling pessimistic and unhappy, unusual fatigue, difficulty sleeping. Also, there were statistically significant decreases in the severity of eleven symptoms and on the discomfort levels of nine symptoms. CONCLUSION: In the study, the planned education provided by the health-care providers had a positive effect on the symptom control of patients receiving chemotherapy.

Use of complementary and alternative medicine among patients with chronic diseases.

The objective of this study was to evaluate the use of complementary and alternative medicine (CAM) and related factors among patients with chronic diseases. A cross-sectional study was carried out in outpatient clinics of a general hospital using a random sample of 252 adult patients with chronic diseases. Data included information on patient demographics and socioeconomic factors, as well as items to identify CAM use and the reasons for using CAM. Data were evaluated by Pearson's chi2-test and Fisher's exact test. It was found that 55.9% of study patients applied CAM. A significant number of patients (63.8%) were using CAM for hypertension. This study found that CAM use was associated with female gender, married status, housewives, low income and high levels of education. The present study confirmed the high frequency of CAM use among patients with chronic diseases in a Turkish public hospital.

Effects on caregiver burden of education related to home care in patients undergoing hemodialysis.

Caring for a patient undergoing hemodialysis is highly stressful and can negatively affect a caregiver's physical and psychological well-being. This study was conducted to examine the effect of educational support concerning caregiver burden and given to the caregivers of hemodialysis patients. This experimental study was performed with 122 caregivers. Patients' data were collected by means of Personal Information Form and Zarit Caregiver Burden Scale (ZCBS). Characteristics of caregivers of hemodialysis patients were analyzed descriptively in terms of frequencies and percentages for categorical data, means, and standard deviations. Mann-Whitney U test, Kruskall-Wallis test, and percentages were used in the data analysis. The mean ZCBS score was 52.1 ± 8.6 (range, 0-88). Among the caregivers, the mean score of the ZCBS was significantly higher in women, single, young, family relatives as "daughter/sister/brother/daughter-in-law and town/district, high educational level (P < 0.05). Moreover, the mean score of the ZCBS was significantly higher in caregivers who have health problems/diseases. In addition, this study explored the educational needs of home-based such as nutrition (35.2%), dialysis (27.8%), fistula care (20.4%), catheter care (18.8%), the information about chronic kidney disease (18.0%), blood pressure (17.2%), weight control (17.2%), hygiene (3.1%), and travel/exercise (6.5%). The post-educational mean scores (55.0 ± 7.6) of caregiver burden were observed to be lower than the pre-educational scores (43.9 ± 5.2), and the difference was found to be statistically significant. The home-based educational program demonstrated a decrease in the burden of hemodialysis caregivers.

Trigger factors in migraine patients.

The objective of this study was to examine potential trigger factors in migraine patients. A total of 126 migraine patients were interviewed about possible trigger factors for migraine. The most common trigger factors were emotional stress (79%), sleep disturbance (64%) and dietary factors (44%). Sleep and stress were significant trigger factors in patients with migraine with aura, whereas environmental factors were important trigger factors in patients with migraine without aura. Stress, sleep and environmental factors were important trigger factors in women and differed significantly from men. Trigger factors are frequent in migraine patients, and avoidance of such factors may result in a better control of the disorder.