The Effect of Education and Monitoring via Tele-Nursing to Elderly Cancer Patients Using Oral Anticancer Agents on Self-efficacy and Medication Adherence: A Randomized Controlled Trial.

OBJECTIVES: This study was conducted as a randomized controlled trial to determine the effect of the education and monitoring provided via tele-nursing to elderly cancer patients using oral anticancer agents on their medication treatment adherence self-efficacy and medication adherence. METHODS: The sample of the study consisted of 60 elderly cancer patients who presented to the oncology outpatient clinics of a medical faculty hospital in Turkey. An Elderly Information Form, the Oral Chemotherapy Adherence Scale, the Medication Adherence Self-Efficacy Scale, a Tele-nursing Evaluation Form, and a Telephone Monitoring Form were used to collect data. Patients in the intervention group were sent text messages and educational videos via WhatsApp® for the first four weeks, and after the fifth week, they were monitored by phone for eight weeks. Data collection tools were applied to the control and intervention groups at weeks 1, 8, and 12. Independent samples t-test, Repeated measurements analysis of variance chi-square test, and Pearson correlation test were used to analyze the data. RESULTS: In the study, while there was no significant difference between the mean scores of the intervention and control groups on the pretest application of the Oral Chemotherapy Adherence Scale and the Medication Adherence Self-Efficacy Scale (p > .05), a significant difference was found between the mean posttest scores of the groups (p < .05). CONCLUSIONS: In this study, it was determined that the education and monitoring provided to elderly cancer patients via tele-nursing positively affected their self-efficacy and medication adherence. IMPLICATIONS FOR NURSING PRACTICE: In line with the research results, it is recommended that nurses use tele-nursing applications in the care of elderly cancer patients using oral anticancer agents.

The Turkish adaptation of the Adherence to Asthma Medication Questionnaire.

BACKGROUND: This study was conducted to adapt the Adherence to Asthma Medication Questionnaire (AAMQ-13) into Turkish. METHODS: The research was conducted in the pulmonology outpatient clinic of a state hospital in Nigde/Turkey. The sample consisted of 229 volunteers with asthma for at least one year. First, language and content validity were assessed. After evaluating the language validity and content validity of the questionnaire, internal consistency, split-half reliability, and construct validity were examined. Questionnaire and demographic data were analyzed using numbers, percentages, dependent and independent groups t-tests, correlation analysis. RESULTS: The AAMQ-13-TR has a Cronbach's alpha (α) score of 0.90 (p < 0.001). It has a split-half reliability coefficient of 0.86. The confirmatory factor analysis (CFA) shows that the factor structure of the AAMQ-13-TR agrees well with the two-factor model of the original questionnaire. CONCLUSIONS: This study presented sources of evidence of validity of AAMQ-13-TR in Turkish population.

Intensive care unit nurses' knowledge and attitudes towards older adults with COVID-19: A cross-sectional survey.

BACKGROUND: Older adults constitute the majority of patients admitted to COVID-19 intensive care units (ICUs). The knowledge and attitudes of ICU nurses towards older adults diagnosed with COVID-19 significantly impact the quality of treatment and nursing care they deliver. OBJECTIVE: The objective of this study was to determine the ICU nurses' knowledge and attitudes towards older adults with COVID-19. METHOD: This descriptive and cross-sectional study was conducted between February and October 2021. The sample consisted of 112 ICU nurses from a public hospital and three university hospitals. Demographic data were collected together with the Nurse COVID-19 Knowledge Level Assessment Form (NKLAF) and the Kogan's Attitudes Toward Old People Scale (KAOPS). The data were analysed using the independent-groups t-test, one-way analysis of variance, Mann-Whitney U Test (Z score), Kruskale-Wallis Variance Test, post hoc test, and Spearman's correlation analysis. RESULTS: Intensive care nurses had a mean NKLAF score of 21.29 ± 2.63 (mean difference: 21.24). They had a mean KAOPS score of 129.37 ± 15.20 (mean difference: 129.32). There was no correlation between NKLAF and KAOPS scores (r = 0.163, p > 0.05). Female nurses had a significantly higher mean NKLAF score than their male counterparts (Z: -2.733, p = 0.006). The intensive care nurses with bachelor's degrees had a significantly higher mean KAOPS score than those with associate degrees (KW: 6.888, p = 0.032). CONCLUSION: The results indicate that ICU nurses know enough about COVID-19 and have positive attitudes towards older adults diagnosed with it. Moreover, some descriptive characteristics affect the knowledge and attitudes of ICU nurses towards older adults. Therefore, nurses should consider these factors when planning interventions to enhance their care for older adults.

The effect of web based type 2 diabetes education on diabetes self management.

Objective: This study is a control group intervention study to determine the effect of web-based education on diabetes self-management in individuals with type 2 diabetes. Methods: The study was conducted in the Training and Research Hospital Diabetes Education Unit of Hitit University. The study was completed with 75 people (intervention 38, control 37). The data were obtained in the web site through patient identification form, self-management perception scale in diabetes, diabetes attitude, self-care scale and HbA1c, HDL, LDL values were followed by providing training and counseling. The values followed were viewed at the third and sixth months. Written permission was obtained from ethics committee and participants. The data of the study were evaluated with number, percentage, mean, pearson chi-square, independent t-test, repetitive analysis and variance analysis. Results: Statistically significant decrease in HbA1c and LDL values, diabetes self-management scale, diabetes attitude scale and self-care scale scores were found to be significantly different between the intervention and control groups. Conclusion: Web-based education and follow-up studies are effective in decreasing HbA1c values in increasing diabetes self-management skills of individuals with type 2 diabetes. It is recommended to use as a complementary tool in health care services for type 2 diabetes management.

Internet Use, eHealth Literacy, and Influencing Factors in Turkish Cancer Patients: A Descriptive and Correlational Study.

OBJECTIVES: This study aimed to determine the Internet use, eHealth literacy levels, and influencing factors in Turkish cancer patients. DATA SOURCES: A descriptive and correlational study was conducted in a single cancer center with 296 patients. Data were collected using a personal information form, an Internet Usage Form, and the eHealth Literacy Scale (eHEALS). The data were analyzed using descriptive statistics, the Mann‒Whitney U test, Kruskal‒Wallis test, and multiple linear regression analysis. CONCLUSION: The participants received health-related information from the Internet (36.8%) with a mean total eHEALS score of 22.92 ± 9.67. In the multiple linear regression analysis, the descriptive characteristics of the participants were negatively affected by age (ß = -0.143) and education level (ß = 0.204). The use of the Internet to obtain information about cancer (ß = 0.455) positively affected the level of eHealth literacy. The eHealth literacy of patients is at a level that needs to be improved and there are factors affecting it. IMPLICATIONS FOR NURSING PRACTICE: Nurses should increase patients' eHealth literacy and guide them on how to access accurate information about cancer on the Internet. While doing this, it should be planned to consider the age, education level, and Internet use of the patients.

The effect of nurse-led telephone support on adherence to blood pressure control and drug treatment in individuals with primary hypertension: A randomized controlled study.

AIM: The aim of this study was to evaluate the effect of telephone monitoring, in combination with texts, on medication adherence and blood pressure (BP) control in primary hypertension. METHOD: Data were collected from August to December 2016. Seventy-seven adults were randomized to the intervention and control groups. A 12-week intervention consisted of regular text messages and phone calls. The control group received usual hypertension care. The outcomes were evaluated with blood pressure measurement and medication adherence self-efficacy scale short form. RESULTS: Medication adherence in Week 12 was found to be significantly higher in the intervention group than in the control group. Mean systolic and diastolic BP levels in Weeks 4, 8 and 12 were statistically significantly lower in the intervention group than in the control group (p < 0.05). CONCLUSION: Using text messaging and nurse-led telephone monitoring improved adherence and BP control in adults with hypertensive in primary care.

Perceived social support, mental health, and marital satisfaction in multiple sclerosis patients.

PURPOSE: This study aimed to examine the patients' perceived social support, mental health, and marital satisfaction. DESIGN AND METHODS: Data were collected via Patient Information Form, Barthel Index of Activities of Daily Living, Marital Life Scale, Multidimensional Scale of Perceived Social Support, and General Health Questionnaire for 72 patients. FINDINGS: Multiple sclerosis (MS) patients had a moderate level of marital satisfaction. The perceived social support showed positive correlation with marital satisfaction and negative correlation with mental health disorders in MS. PRACTICE IMPLICATIONS: These results will facilitate the perception of mental problems, marital satisfaction, and social support in MS patients by the nurses.

Assessment of Medication Adherence and Related Factors in Hypertensive Patients: The Role of Beliefs About Medicines.

Low medication adherence is one of the leading causes that affect the achievement of target levels for hypertension. Identifying modifiable factors associated with low adherence is crucial. This study aims to assess medication adherence and the role of beliefs about medicines on medication adherence among hypertensive patients.This cross-sectional study was conducted with 200 hypertension patients.Data were collected using the Morisky-Green-Levine Medication Adherence Scale, and the Beliefs about Medicines Questionnaire [BMQ-Turkish Translation (BMQ-T)]. It was found that the BMQ-T subscales of Specific Concern (ß = 0.358, p = .027) and General Overuse (ß = 0.552, p = .011) had an independent predictor effect on medication adherence scores. In this study, the patients who thought that drugs were overused and had concerns about this were seen to be less adherent with the medication. With regard to patients who use antihypertensive drugs but have uncontrolled blood pressure, their beliefs about drugs should not be ignored when evaluating adherence with drug therapy.

Validity and Reliability of Turkish Version of Reaction Type Scale Against COPD.

OBJECTIVE: The aim of the study is to develop a scale that could assess illness perception and reaction in patients with chronic obstructive pulmonary disease (COPD). MATERIAL AND METHODS: The study was conducted in patients who were admitted in the pulmonary disease departments of a public and a private hospital. The study included 271 COPD patients. The COPD Perception and Reaction Scale, consisting of 54 items, was prepared as a Likert-type 5-point rating scale. In the validity phase of the study, expert judgments were obtained for content validity, and explanatory and confirmatory factor analyses (EFA and CFA) were then performed. The reliability of the scale in terms of internal consistency was tested with the Cronbach's alpha coefficient. RESULTS: According to the results of the EFA, the COPD Perception and Reaction Scale consists of 3 subdimensions and 23 items. Factors are termed behavioral reaction, emotional reaction, and spiritual reaction. According to the CFA, the goodness-of-fit indices obtained (χ2/df = (676.47/227) 2.98 and RMSEA = 0.056, NFI = 0.80, CFI = 0.96, NFI = 0.91, and AGFI = 0.85) suggest that the recommended model for the scale is acceptable. The Cronbach's alpha coefficient was 0.74; Cronbach's alpha values for the subdimensions were calculated as 0.87 for "emotional reaction," 0.76 for "behavioral reaction," and 0.79 for "spiritual reaction." CONCLUSION: The 23-item form of the COPD Illness Perception and Reaction Scale was demonstrated to be a valid and reliable scale for determining the perception and the reaction toward illness in COPD patients in Turkey.

Effect of nurse-led program on the exercise behavior of coronary artery patients: Pender's Health Promotion Model.

OBJECTIVE: To determine the effect of nurse-led program based on Pender's Health Promotion Model on the exercise behaviors of coronary artery patients. METHODS: The two-arm parallel, single-blind, randomized controlled trial was conducted with a total of 62 patients, intervention (n = 32) and control group (n = 30). Intervention group received a nurse-led program based on Pender's Health Promotion Model and routine follow-ups of control group continued. The health perception, perceived exercise self efficacy, perceived exercise benefits/barriers, exercise-related effect, exercise frequency and time were assessed at baseline, 4th, 8th and 12th weeks. The data were evaluated by frequency, percentage, median, mean and standard deviation, chi-square, Friedman and Mann Whitney U tests. RESULTS: Health perception (62.6 ± 9.5; median:67.0; p < 0.001), perceived exercise benefit (105.8 ± 7.4; median:107.0; p < 0.001), perceived exercise self efficacy (71.2 ± 5.4; median: 71.5; p < 0.05), exercise-related effect (31.6 ± 6.0; median:34.0; p < 0.05), exercise frequency (4.8 ± 2.2; median:6.0 days/week; p < 0.05) and time (105.9 ± 53.6; median:130.0 min/week; p < 0.05) were higher and perceived barriers (43.1 ± 3.9; median: 42.0; p < 0.001) were lower in the intervention group at 12th week. CONCLUSIONS: The nurse-led program has been shown to increase the exercise behavior in the intervention group. PRACTICE IMPLICATIONS: Since it enables patients to gain and maintain exercise, it is highlighted the model to be integrated into clinical practice.

Suicide Risk and Depression in Individuals with Chronic Illness.

The study aims to determine the suicide risk and depression in individuals diagnosed with chronic illnesses. The sample of the study comprised of 286 persons. The Information Form developed by the researchers on the basis of the models available in previous research, Suicide Probability Scale (SPS) and Beck Depression Scale (BDS) were used to collect data. Mann Whitney U-test, Kruskal Wallis test and Pearson correlation analysis were used to evaluate the study data. The mean score of the individuals participating in the study with reference to Suicide Probability Scale were found to be 68.80 ± 9.94 and that with reference to Beck Depression Scale 15.68 ± 9.91. Also, a significant positive relationship was found between the mean scores regarding SPS and BDS scales (r: 0.601, p: 0.000 < 0.05). The SPS and BDS mean scores of individuals who said they had poor mental health, low quality of life and low economic status and that of those who had no support from their families were found to be high in respect of statistical significance. In accordance with these findings, chronic illness is a risk factor that might induce depression and suicide ideation and attempt. According to the statistical analysis, the results of this study shown that people with poor mental health, poor quality of life and low economic status and those who had no support from their families especially had more vulnerable to depression and suicidal behaviours compared with other people.

Nursing Students' Knowledge of Palliative Care at a University in Turkey.

BACKGROUND AND PURPOSE: Nursing students must acquire knowledge and skills sufficient to deliver high-quality services. Previous studies indicated that students' palliative care knowledge was insufficient. Few studies evaluating nursing students' palliative care opinions and skills are available in Turkey. This study aimed to determine student nurses' knowledge of palliative care. METHODS: This descriptive survey study included 658 students. Researchers collected the data via a 19-item questionnaire. Frequency, percentage, and mean values were used in analysis of the data. RESULTS: Only 5.3% of participants correctly answered all items, while 26.3% gave correct answers in line with palliative care theoretical framework, and 5.3% gave correct responses for symptom management. Students were found to be quite lacking in palliative care knowledge. IMPLICATIONS FOR PRACTICE: A content increase in the curriculum could improve students' theoretical knowledge. In addition, students can be incorporated, as team members, into the palliative care process beginning at patient diagnosis.

Relationship among health-related quality of life, depression and awareness of home care services in elderly patients.

AIMS: The present descriptive study was carried out to determine the relationship between health-related quality of life, depression and awareness of home care services among elderly patients. METHODS: Patients aged 65 years or older staying at the surgery and internal medicine clinics were included in the study. The "Patient Introduction Form," "Short Form-36 Quality of Life Questionnaire" and "Geriatric Depression Scale" were utilized in the collection of data. RESULTS: In the present study, it was determined that only approximately half of elderly patients (54.9%) knew the concept of home care, most of them had not previously received home care and requested home care related to medical care. The mean scores were lower in some areas of the quality of life questionnaire in some factors that could influence home care awareness. These factors were determined as: female sex, history of falling, chronic illness, functionally, moderately or severely dependent, no previous receipt of home care and wishing to receive home care. CONCLUSIONS: The home care requirement of elderly patients can be influenced by many physiological, psychological and social factors that can affect their quality of life. Thus, it is of utmost importance that medical professionals evaluate the quality of life of elderly individuals and its influencing factors. Geriatr Gerontol Int 2016; 16: 1211-1219.

Factors Affecting Health-Promoting Behaviors in Nursing Students at a University in Turkey.

This descriptive study was carried out to determine factors affecting health-promoting behaviors in nursing students. The sample consisted of 245 students. A questionnaire about factors affecting lifestyle behavior and the Health Promotion Lifestyle Profile Scale-II were used to collect data from 245 nursing students during the spring semester of the 2012-2013 academic year. A significant difference was found between students with and without diagnosed health problems in terms of their mean scores on the Health Promotion Lifestyle Profile Scale-II subscales of health responsibility, spiritual growth, and interpersonal relations, as well as their total mean scores (p < .05). The exercise, nutrition, spiritual growth, and stress management subscale scores of those students regularly going for health checks were determined to be significantly higher than those of the students who did not obtain regular health checks. Students' healthy lifestyle behaviors were generally found to be at the medium level. This study provides evidence of the need for interventions to help nurses in Turkey.

Nurses' and physicians' perceptions of older people and attitudes towards older people: Ageism in a hospital in Turkey.

Abstract Nurses and physicians provide health care for a growing number of older people as a result of the rapid increase in the life expectancies of older people. Health professionals' negative attitudes towards older people affect the quality of health care offered to these individuals. The sample for this study included 110 nurses and 57 physicians working in the medical and surgical clinics of a university hospital. A questionnaire form and the Ageism Attitude Scale (AAS) were used to collect the data. A five-point Likert-type format was utilised for the AAS. The AAS total mean score was 80.02 ± 2.64 for nurses and 83.17 ± 9.09 for physicians. The difference between these mean scores was statistically significant (p < 0.05). For the AAS sub-dimension 'limiting the life of the older people,' the physicians' score (35.14 ± 6.22) was significantly higher than the nurses' score (33.22 ± 3.59). In this study, nurses' and physicians' attitudes, approaches, and considerations were found to be generally positive.

Evaluation of quality of life and anxiety and depression levels in patients receiving chemotherapy for colorectal cancer: impact of patient education before treatment initiation.

BACKGROUND: As a consequence of the improved survival due to the availability of several treatment option cost-effectiveness and health-related quality of life (HRQoL) issues have gained increasing attention in colorectal cancer (CRC). In the present study, we aimed to evaluate quality of life, level of anxiety and depression before and after a 6-month follow-up period in chemotherapy receiving patients with CRC. METHODS: The study was conducted in 50 patients with colon or rectal cancer. All patients were informed and educated about their disease and treatment before getting the treatment and were followed for 6 months, during which they received chemotherapy. A "Questionnaire Form" to collect patient demographic characteristics; the "EORTC QLQ-C30 Scale" and "EQ-5D Scale" to evaluate patient's quality of life; and the "Hospital Anxiety and Depression (HAD) Scale" to evaluate the level of anxiety and depression status of patients, were used as data collecting tools. RESULTS: Quality of life scores in all functional fields were high in the sixth course when compared to the first according to EORTC QLQ-C30 Scale, reaching to statistically significant level in emotional function score compared to the initial ones (P<0.05). Moreover quality of life score measured in the sixth month with EQ-5D was statistically significantly higher than the initial. CONCLUSIONS: These data, shows that with proper patient management, quality of life score, and the anxiety and depression levels improve during the course of treatment.

Nurses' and Physicians' Perceptions of Older People and Attitudes towards Older People: Ageism in a Hospital in Turkey.

Abstract Nurses and physicians provide health care for a growing number of older people as a result of the rapid increase in the life expectancies of older people. Health professionals' negative attitudes towards older people affect the quality of health care offered to these individuals. The sample for this study included 110 nurses and 57 physicians working in the medical and surgical clinics of a university hospital. A questionnaire form and the Ageism Attitude Scale (AAS) were used to collect the data. A 5-point Likert-type format was utilised for the AAS. The AAS total mean score was 80.02±2.64 for nurses and 83.17±9.09 for physicians. The difference between these mean scores was statistically significant (p<0.05). For the AAS subdimension "limiting the life of the older people", the physicians' score (35.14±6.22) was significantly higher than the nurses' score (33.22±3.59). In this study, nurses' and physicians' attitudes, approaches, and considerations were found to be generally positive.