Schizophrenia and medication adherence: Associated factors.

BACKGROUND: Schizophrenia is a chronic condition that requiring maintenance treatment with antipsychotic medication. Medication adherence is essential to improve the symptoms of this health problem reduce relapses and readmissions and achieve treatment goals. The rate of challenges associated with medication adherence in schizophrenia is reported to be 26.5-85.1 %. PURPOSE: This study was conducted to determine factors associated with medication adherence in individuals diagnosed with schizophrenia. METHODS: A descriptive correlational research design was used. The study was completed with a total of 162 participants diagnosed with schizophrenia, between February-June 2021, at a Community Mental Health Center. Regression analysis (Model: enter and stepwise) was used to determine associated factors. RESULTS: The mean medication adherence score of individual diagnosed with schizophrenia indicated that more than half of the participants (52 %) had poor medication adherence. In individual diagnosed with schizophrenia, medication attitudes, level of internalized stigma, the status of regular attendance to appointments, belief in recovery, and using medicines as prescribed were complicating factors for medication adherence (p < 0.05). CONCLUSIONS: Medication adherence in individuals with diagnosed schizophrenia may be multifactorial. Mental health professionals should consider associated factors and implement a personalized treatment plan in this direction for strengthening adherence to medication treatment.

Patient perspectives about multiple sclerosis: A metaphor study.

AIM: Determining patients' perceptions of multiple sclerosis, a disease with varying symptoms and prognosis for each individual, can significantly contribute to directing care and treatment. Metaphors may be an opportunity to determine perceptions of this unique illness experience. The aim of this study was to reveal the perceptions of patients with multiple sclerosis about "multiple sclerosis" through metaphors. METHODS: This study was conducted with metaphor analysis technique based on phenomenological method. The sample included 184 patients with multiple sclerosis. Data was collected face-to-face between July 2022 and January 2023. Each participant was interviewed individually and was asked to fill in the blanks in the sentence, "multiple sclerosis is like… because…". Content analysis was performed for metaphors. RESULTS: The study revealed five main themes and twelve subthemes that provided insight into the participants' multiple sclerosis perceptions. The themes address (i) Manipulator multiple sclerosis; ambiguous multiple sclerosis, attritive multiple sclerosis, controller multiple sclerosis, demander multiple sclerosis, and conditional multiple sclerosis (ii) Temporal multiple sclerosis; cyclical multiple sclerosis and perpetual multiple sclerosis (iii) Follower multiple sclerosis; unaccepted multiple sclerosis, partner multiple sclerosis and ambusher multiple sclerosis (iv) Different multiple sclerosis; bittersweet multiple sclerosis and unique multiple sclerosis (v) Restorative multiple sclerosis. CONCLUSION: This study demonstrated that patients with multiple sclerosis mostly had negative perceptions regarding their relationship with multiple sclerosis. The results place a responsibility on healthcare professionals to improve how patients adapt to multiple sclerosis. This study's results can bridge theoretical knowledge and practice.

The effects of sigma-1 agonist fluvoxamine on experimental induced tardive dyskinesia model in rats.

Tardive dyskinesia (TD) is a persistent involuntary complex movement disorder that is known to occur with long-term antipsychotic treatment. Despite being a well-recognized complication of this treatment, its symptoms are often masked by the antipsychotic agents, only to become apparent upon reducing or terminating the treatment. In an effort to advance our understanding of TD pathophysiology and to identify potential therapies, the current study aimed to establish an animal model of TD by administering haloperidol to rats and to evaluate the efficacy of fluvoxamine, a selective serotonin reuptake inhibitor (SSRI), in ameliorating TD symptoms. The study compared the behavioral and biochemical parameters of rats that were treated with either fluvoxamine, tetrabenazine, haloperidol, or saline (control group). The biochemical parameters of interest included the brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), superoxide dismutase (SOD), and malondialdehyde (MDA). To achieve the study objectives, 32 male Wistar Albino rats were assigned to four different groups. The control group received physiological saline for six weeks. The haloperidol group received 1 mg/kg/ip haloperidol for the first three weeks, followed by two weeks of saline. The haloperidol+fluvoxamine group received 1 mg/kg/ip haloperidol for the first three weeks, followed by 30 mg/kg/ip fluvoxamine. The haloperidol+tetrabenazine group was administered 1 mg/kg/ip haloperidol for the first three weeks, followed by 5 mg/kg/ip tetrabenazine. Behavioral assessments of the rats were performed by measuring vacuous chewing movements. Subsequently, samples were collected from the hippocampus, striatum, and frontal lobe tissues of the rats, and BDNF, NGF, SOD, and MDA levels were measured. The results of the study demonstrated significant differences between the groups with respect to behavioral observations. Furthermore, SOD levels in the hippocampus, as well as BDNF, NGF, and SOD levels in the striatum of the haloperidol+fluvoxamine group were significantly higher than those observed in the haloperidol group. Conversely, MDA levels in the hippocampus were significantly lower in the haloperidol+fluvoxamine group than in the haloperidol group. These findings provide evidence of the beneficial effects of fluvoxamine, acting as a sigma-1 agonist, in treating TD symptoms induced experimentally. The observed benefits were supported by the biochemical investigations performed on brain tissue samples. Therefore, fluvoxamine may be considered as a potential alternative treatment for TD in clinical practice, although further research is needed to corroborate these findings.

Social Jetlag in adolescents: From a nursing perspective.

PROBLEM: Social Jetlag (SJL) is a condition leading to many important physical, mental, behavioral, and cognitive problems in adolescents. METHODS: The sample of this study, which used a descriptive and correlational design, consisted of 247 high school students. The SJL parameters were informed by the literature, while chronotype was identified using the Morningness-Eveningness Scale for Children. The factors associated with SJL were determined using a structured questionnaire. FINDINGS: Students' SJL value was 2 h 10 min ± 01:11. As students' tendency to be an evening chronotype increased, the SJL value increased, as well (r = -0.472; p < 0.001). In terms of SJL, student's grade level (ß = -0.167; p = 0.004) and chronotype (ß = -0.438; p < 0.001) were a negative risk factor, while spending time in bed with TV/computer/smartphone before sleeping (ß = 0.127; p = 0.031) was a positive risk factor. CONCLUSIONS: The students had a high SJL value. The results might be useful for nurses to develop intervention strategies to improve adolescents sleep habits.

The gray zone of patient-nurse communication: Inappropriate sexual behavior.

PURPOSE: This review was written to examine the incidences of inappropriate sexual behavior (ISB) and to study the responsibilities of nurses in the management of ISB. CONCLUSIONS: When nurses experience ISB, they tend to describe this situation as harassment. However, the use of the phrase "harassment" indicates inadequate professionalism because although disturbing, not every incidence of ISB is an expression of adult sexuality. Some patients are also likely to use this type of behavior to mask their existing life stress. As a result, nurses have difficulty interpreting and managing behavior that falls in this gray zone. PRACTICE IMPLICATIONS: To support nurses, we recommended that studies that define ISB, determine its prevalence, evaluate it, and guide nurses in the management of ISB should be carried out.

Randomized controlled trial of the effects of nursing care based on a telephone intervention for medication adherence in schizophrenia.

PURPOSE: Our aim was to determine the effects of "Telephone Intervention Problem Solving" (TIPS) on medication adherence among individuals diagnosed with schizophrenia. DESIGN AND METHODS: This randomized controlled trial was conducted with 45 patients. TIPS was applied to the intervention group for 2 months, whereas the control group received routine care. FINDINGS: We found that the rate of voluntary continuation of medicine (P < 0.001), belief in the necessity of medication (P = 0.008) and medication adherence scores were higher in the intervention group (P < 0.001). PRACTICAL IMPLICATIONS: This study may serve as a guide for applying telephone communication to clinical interventions in psychiatric nursing.

[The Effect of Tele-Nursing Practices to the Schizophrenia Patient Care: A Systematic Review]. / Tele-Hemsirelik Uygulamalarinin Sizofreni Hastalarinin Bakimina Etkisi: Sistematik Derleme.

OBJECTIVE: This study is a systematic review that was conducted in an attempt to evaluate the tele-nursing interventions being used in the schizophrenia patient care and the efficiency of these interventions. METHOD: The study was conducted by checking the Pubmed, Cinahl, Science Direct, Wiley Interscience, Ulakbim Medicine Database and the Turkish Medline database. The English keywords were translated with "nursing by telephone" that is the only term involved in the MeSH (Medical Subject Headings) index for English keywords and TST (Turkish Scientific Terms) for Turkish keywords. A total of six articles that met the inclusion criteria were involved in the evaluation. RESULTS: According to the study findings that were evaluated within the scope of the systematic review, it was observed that the tele-nursing interventions were limited with Telephone Intervention Problem Solving-TIPS. It was determined that the TIPS intervention extended the time spent by schizophrenia patients in society and decreased the duration of days being spent at the hospital after every rehospitalization and the number of applications for rehospitalization. It was also observed to increase the adherence to the psychiatric medication and social functioning, decrease the level of psychiatric symptoms after the discharge. Besides, the face-to-face interviews being conducted before the TIPS intervention were observed to develop the verbal communication skills of patients. CONCLUSION: According to this systematic review, the quantitative limitation of relevant studies is limited with the phone applications of tele-nursing interventions; however, it has positive results.

Web-based training: readiness and perceptions of nurses.

This study was conducted as a descriptive study in order to determine the views of nurses working a university hospital on web-based training. Population consisted of all the nurses working in the hospital. It was found out that nurses use computer at the moderate level (46.5 %), they benefit from Internet at a good level (46.5 %), almost all of them use Internet to make searches about professional issues (94.6%), they want to update their professional knowledge (90.1%) and they find it difficult to reach information on such grounds as time constraint (81.1 %) and lack of appropriate environment (62.1 %) and they want to receive a web-based training (87.1 %). It is important that web-based training programmes be generalised in the field of nursing where there exists a time problem, studies as regards to how to integrate these programmes into continuing education be increased and their results be reflected on the practices.