Assessment of a Health Promotion Model on Obese Turkish Children.

BACKGROUND: Studies of childhood obesity have shown that fostering healthy life behaviors is more important than losing weight. However, studies reporting this result did not use a theoretical nursing model, which offers a systematic approach and scientific basis for studying the concepts and principles of nursing practice. PURPOSE: The aim of this study was to determine the effects of an intervention that is based on Nola J. Pender's Health Promotion Model (HPM) on the healthy life behaviors and self-confidence of obese children. METHODS: This quasi-experimental study enrolled 86 obese children and their parents (48 in the experimental group and 38 in the control group) as participants. The data collection tool was composed of an adaptation of a Pender's model-based evaluation form and the "Piers-Harris Self Confidence Scale." The experimental group received HPM-based individual and group education, whereas the control group received routine follow-up only. Whereas qualitative data were analyzed using content analysis, quantitative data were analyzed using a paired t test and Mann-Whitney U or Wilcoxon test. RESULTS: At the end of the education and follow-up program, experimental group participants showed a significant increase in healthy eating habits such as noting food portions (Z = 5.231, p < .001) and choosing water instead of sugary drinks (Z = 4.130, p < .001) and spent significantly less time per day in front of a television or computer (Z = 5.085, p < .001). Furthermore, after the intervention, experimental group participants had reduced their total body mass index standard deviation score (Z = 6.031, p < .001) and had an average self-confidence score that differed significantly from the control group (Z = 3.796, p < .001) and that was significantly higher than the average preintervention score (Z = 5.971, p < .01). CONCLUSIONS: Health professionals must recognize the physical, psychological, and social risks of obesity in children and focus on these problems to identify appropriate solutions. It is recommended that education and nursing follow-up programs be developed based on nursing models. This study found that patient education based on Pender's HPM increased healthy life behaviors (e.g., healthy nutrition and increased exercise time) and decreased sedentary activity substantially in the experimental group. This study further suggests that, although Pender's HPM has not been tested on obese children, this model offers effective guidelines for nursing activities that are targeted on developing healthy life behaviors in children.

Cross-cultural adaptation and psychometric assessment of the Turkish version of the Vulnerability to Abuse Screening Scale

Background/aim: The aim of this study was to evaluate the reliability and validity of the Turkish version of the Vulnerability to Abuse Screening Scale (VASS). Materials and methods: This was a methodological study. The sample included 140 elderly individuals. Data were collected by using a questionnaire form, the VASS, and the Geriatric Depression Scale (GDS). The Cronbach alpha value was calculated and test?retest reliability was tested for the reliability analyses. Results: The Cronbach alpha value calculated for the VASS (12 items) was 0.819. There was no difference between test and retest mean scores of the VASS. A statistically significantly positive and strong relationship was found between the test and retest scores of the individuals. A statistically significantly positive and moderate relationship was found between the VASS and GDS scores. Factor analysis revealed that a total of four factors accounted for 63.66% of the total variance with an eigenvalue of >1. These results show that the Turkish version of the VASS is a valid and reliable scale. Conclusion: This study showed that the adoption of the translated VASS in Turkey is reliable and valid to evaluate the risk of abuse in adults over the age of 65.

Development of an assessment scale for treatment compliance in type 2 Diabetes Mellitus in Turkish population: Psychometric evaluation.

OBJECTIVES: Compliance to treatment is important for the management of type 2 diabetes mellitus (DM) and the prevention of complications. The purpose of the study was to develop a scale and test its psychometric properties for the treatment compliance of the diabetic Turkish population. METHODS: This multicenter study was conducted in four training and research hospitals. The convenience sample consisted of 350 patients with type 2 DM. The items of the scale were determined after a literature review and qualitative interviews with the patients. Items were psychometrically analyzed. Content validity of the scale was evaluated using opinions from experts and a pilot study. Principal component analysis and the varimax rotation technique were used to evaluate construct validity in exploratory factor analysis. Criterion validity was evaluated with the Attitudes Towards Diabetes Scale, a subgroup of the Diabetes Care Profile scale. Reliability was evaluated with Cronbach's α coefficient and test-retest analysis of internal consistency. RESULTS: The scale consisted of 7 factors that explained 47.36% of the total variance. The KMO test was conducted to determine whether the sample size was sufficient before the factor analysis. The KMO test result of the data was 0.75. The Cronbach's α value of the sample was 0.77. The test-retest reliability analysis result was r = 0.991. We found a positive correlation between total scores of the developed scale and the Attitudes Towards Diabetes Scale (r = 0.31). CONCLUSION: The results of the study demonstrated that the scale with 30 items is a valid and reliable scale for the evaluation of patient compliance with type 2 DM treatment. Thus, by using this scale, nurses and healthcare providers can evaluate the treatment compliance of patients with type 2 DM.

Care Burden and Self-Efficacy Levels of Family Caregivers of Elderly People in Turkey.

The aim of this research was to determine the level of burden and self-efficacy among family caregivers of elderly people in Turkey. This study is descriptive and cross-sectional. A total of 658 family caregivers of elderly people were included in the study. The data were collected with a caregiver's characteristics form, elderly people's characteristics form, the Zarit Burden Interview, the self-efficacy scale, and the Barthell Index. Data were analyzed using SPSS 16.0 program. What are care burden and self-efficacy levels of the caregivers? Is there a relationship between care burden and self-efficacy levels of the caregivers with variables such as age, duration of care, sex, status of education, type of relationship, and status of employment that belong to the caregiver? Is there a relationship between care burden and self-efficacy levels of the caregivers with variables such as age and Bartell Index that belong to the elderly? The caregiver burden score was 38.65 ± 13.73, which indicates a moderate level of burden. The self-efficacy score was 29.31 ± 6.09, which is in the low range of self-efficacy. There were statistically significant differences between the caregiver burden score and the sex of caregivers, status of education, type of relationship, and the elderly person's score on the Bartell Index (P < .05). The relationship between the employment status of caregivers (P = .01), the age of the elderly (P = .01), and the caregivers' score on the self-efficacy scale (P < .05) was found to be statistically significant. Study revealed that the majority of the caregivers experienced moderate levels of care burden and low levels of self-efficacy. These results will provide beneficial information for nurses to provide the holistic nursing care.

Development and Psychometric Testing of the Turkish-Version Oral Chemotherapy Adherence Scale.

BACKGROUND: To ensure the quality of patient care, the bioavailability of drugs, and the success of the treatment, it is imperative that nurses evaluate the adherence of patients to pharmaceutical treatments using standard measurement tools that are integrated into the treatment process. No scale that uses psychometric analyses to evaluate this adherence in patients who are on oral chemotherapy is currently available. PURPOSE: This study developed and tested the validity and reliability of a Turkish version of the standardized Oral Chemotherapy AdherenceScale (OCAS), a tool that may be used by healthcare personnel to better evaluate patient adherence to their therapies. METHODS: We developed and examined the validity and reliability of the OCAS using a sample of 306 patients with cancer who were receiving oral chemotherapy. A literature review was conducted to generate the items. An expert panel evaluated content validity; preimplementation was used to evaluate face validity, factor analysis was used to evaluate construct validity, and criterion validity was evaluated using the Medication Adherence Self-Efficacy Scale. RESULTS: The Cronbach's alpha calculated for OCAS (19 items) was .738. A highly significant and positive correlation was observed between the test-retest scores of the participants. A positive significant correlation was observed between the total scores of the participants obtained from OCAS and Medication Adherence Self-Efficacy Scale. As a result of the factor analysis performed for the construct validity of the scale, three factors were defined that accounted for approximately 43% of the total variance. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The OCAS has acceptable psychometric properties and is appropriate for use in research and clinical practice settings to evaluate patient adherence to their therapies.

Medication errors: perspectives of newly graduated and experienced nurses.

UNLABELLED: This study investigated the perspectives of newly graduated and experienced nurses concerning medication errors. This is a descriptive cross-sectional study conducted in a military education and research hospital in Turkey, which was performed between July and August 2009. Totally, 169 nurses were involved in this study: 87 were new graduates and 82 were experienced nurses. The Modified Gladstone's Scale of Medication Errors was used to collect data on rates, causes and reporting of medication errors. The two highest perceived causes of medication errors were nurse exhaustion and nurse distraction. Most medication errors were preventable errors. The reasons for error occurrence and failure to inform co-workers of medical errors were examined. IMPLICATIONS: Training nurses to understand the causes of medication errors and related prevention methods should be provided to newly graduated nurses, and continuous training should be provided.

Analysis of patient-related barriers in cancer pain management in Turkish patients.

The purpose of this study was to evaluate the validity and reliability of the Barriers Questionnaire II (BQ-II) for Turkish patients and to define the patient-related barriers to cancer pain management in Turkey. For this, 170 patients with cancer who used or were still using analgesic medication for pain related to cancer participated in the study. It was found that patients have beliefs that may be barriers to optimal pain management, mostly in relation to addiction, and to a small extent, physical side effects. It was ascertained that male, unmarried patients, patients with cancer who also have another chronic disease, patients whose "average pain" intensity is more than 5 for the past 24 hours, and patients who use an inadequate analgesic have more beliefs that may be barriers to optimal pain management. It was concluded that the BQ-II is a valid and reliable scale in Turkey for defining patient-related barriers to cancer pain management.

Global case management: using the case management model for the care of patients with acute myocardial infarction in a military hospital in Turkey.

This study was planned in an experimental manner to use the "case management model" for the care of patients with acute myocardial infarction (MI), and to determine the effect of this method on the quality of care, patient and nurse satisfaction, and the patient's inpatient duration at the hospital. Data for the study were obtained using the Patient Information Form, Acute MI Care Protocol (Clinical Pathway), Care Monitoring Scale and Scoring Form, Acute MI Nursing Care Plan, Patient Education Booklet, and a Patient and Nurse Satisfaction Evaluation Survey. Evaluation results showed that the patient group where the case management model was used had increased quality of care, decreased inpatient stay, and increased satisfaction of the patient and the nurse. Therefore, it was suggested that the case management model be used in healthcare institutions in Turkey, care protocols for various diagnoses be developed, and nurses should be trained as case managers to increase the quality of care at healthcare institutions.

Post-traumatic stress disorder symptoms among military health professionals in Turkey.

This descriptive study investigated traumatic experiences and post-traumatic stress disorder symptoms among military professionals in Turkey. The sample included 225 military health professionals who were in charge in districts in which traumatic events occurred frequently in the past decade. The Impact of Event Scale, Beck Anxiety Inventory, and Symptom Checklist were used to obtain data in the study. More than one-half of the health professionals had experienced at least one traumatic event. Those who had a history of traumatic experience and loss of relatives or friends reported more symptoms than did those who had not experienced traumatic events. As expected, health professionals who had traumatic experiences were more likely to have higher Impact of Event Scale scores than were those who had not experienced physical or psychological trauma. The findings indicate that health professionals are as affected by traumatic events as are those in other settings or occupations. Future research should focus on the long-term effects of post-traumatic stress among health professionals.