Hope and psychological resilience in primary caregivers of patients with a chronic mental illness followed in a community mental health center.

PURPOSE: The aim of this study is to examine hope and psychological resilience in primary caregivers of patients with a chronic mental illness. DESIGN AND METHODS: The descriptive study was conducted on 297 caregivers in community mental health centers in Turkey. Data were collected using the Introductory Information Form, Dispositional Hope Scale and the Resilience Scale for Adults. FINDINGS: Hope and psychological resilience of primary caregivers of patients with a chronic mental illness were moderate. To sociodemographic and caregiver characteristics; caregivers who are over 40 years old, lost his/her spouse, low education level, housewife or retired, unemployed, who evaluated their incomes low, mother, living in the same house with the patient, caring for ten years or more, caring for another patient and not getting help in care had lower hope and resilience levels. Compared to patients with a diagnosis of bipolar disorder, caregivers of patients with schizophrenia had lower hope and psychological resilience levels. CONCLUSIONS: Primary caregivers of patients with a chronic mental illness should be supported in terms of hope and psychological resilience.

Effectiveness of online education in teaching breast self- examination.

BACKGROUND: This research evaluated the effectiveness of an online education model in teaching breast self- examination to university staff and students. MATERIALS AND METHODS: 1,679 women participated in a breast self-examination online training program. Breast self-examination knowledge evaluation forms developed by Maurer (1997) were used in the research and were evaluated on a 100 point scale. Paired t-test and McNemar's Test statistics were employed. RESULTS: The participants scored an average of 46.5 (14.0%) on knowledge on breast self-examination before training, but 77.4 (11.0%) one month after education and 76.7 (9.52%) after six months. There was a clear significant difference between these knowledge levels (p<0.05). Similarly, while the rate for systematic practice of breast self-examination among women was 30.8% before training it increased to 47.8% afterwards. Again the difference was significant (p<0.05). CONCLUSIONS: Online education is an effective method for teaching breast self-examination to women.

Quality of life, depression, and anxiety among hepatitis B patients.

This descriptive cross-sectional study was designed to determine the depression and anxiety levels, and their effects, on quality of life of patients with chronic Hepatitis B. Chronic infection with Hepatitis B virus has a profound effect on health-related quality of life. Medications, including interferon, that are commonly used to treat chronic viral Hepatitis B may cause depression as an adverse effect. However, little is known about the impact of depression and anxiety on quality of life in patients with Hepatitis B. A total of 96 patients aged between 15 and 61 years were included in the study. Slightly more than half of them (52%) were female. Three scales-the Beck Depression Inventory, Beck Anxiety Scale, and Short Form of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF)-were used in the study. The scores obtained from the BDS in 91.7% of the patients were above the cutoff value of 17. Moreover, 80 patients received interferon. There was a negative correlation between the physical, environmental, and cultural areas on the Beck Anxiety Scale and WHOQOL-BREF (Turkish) (p< .05). A high level of depressive symptoms was established in this study, and the physical, environmental, and cultural aspects of quality of life were determined to increase as the anxiety level increased.

Cigarette dependence among males and females aged 50+ living in Izmir, Turkey.

BACKGROUND: Smoking, the most important preventable cause of death overall, is also the leading cause of cancer-related mortality. Tobacco consumption has a direct or indirect relationship with most types of cancer. In Turkey, the second leading cause of death is cancer, with lung cancer the most prevalent. OBJECTIVE: The aim of this study was to determine the level of cigarette dependence among men and women aged 50+, living in Izmir. METHODS: This research is a descriptive and cross-sectional field study, carried out with the participation of a total of 2,497 subjects. RESULTS: It was found that 48.8% of the participants used to be smokers, and 95.5% of the smoking participants had been smoking for at least 11 years at the time of study. 36.1% of the participants were being exposed to secondhand smoke at home, and almost one third of the smokers (29%) had a moderate level of dependence. CONCLUSIONS: Continuing education may help high-risk groups develop good habits for a healthier lifestyle such as smoking less and quitting smoking, thereby reducing the level of morbidity and mortality of most common types of cancer.

Turkish hysterectomy and mastectomy patients - depression, body image, sexual problems and spouse relationships.

The aim of this study was to compare hysterectomy and mastectomy patients in terms of depression, body image, sexual problems and spouse relations. The study group comprised 94 patients being treated in Ege University Radiation Oncology Clinic, Tulay Aktas Oncology Hospital, Izmir Aegean Obstetrics and Gynecology Training and Research Hospital for breast and gynecological cancer (42 patients underwent mastectomy, 52 patient underwent hysterectomy). Five scales were used in the study: Sociodemographic Data Form, Beck Depression Scale, Body Image Scale, Dyadic Adjustment Scale, Golombok Rust Sexual Functions Scale. Mastectomy patients were more depressive than hysterectomy patients (t = 2.78, p < 0.01). Body image levels of the patients were bad but there was no significant difference between the two patient groups (p > 0.05). Hysterectomy patients had more problems in terms of vaginismus (t = 2.32, p < 0.05), avoidance of sexual intercourse (t = 2.31, p < 0.05), communication (t = 2.06, p < 0.05), and frequency of sexual intercourse than mastectomy patients (t = 2.10, p < 0.05). As compared with compliance levels between patients and spouses; hysterectomy patients had more problems related to expression of emotions than mastectomy patients (t = 2.12, p < 0.05). In conclusion, body image was negative, mastectomy was associated with more depression and hysterectomy with greater sexual problems and difficulties with spouse relationships.

Relationships between psychosocial adjustment and hopelessness in women with breast cancer.

OBJECTIVE: Several physical, psychological and social variables influence women with breast cancer. This study was designed to analyze the relationship between psychosocial adjustment and hopelessness in a group of such women in Turkey. METHOD: The subjects were 90 women with breast cancer recruited at Ege University School of Medicine Department of Radiation Oncology Nurse Counsellor Unit and Tulay Aktas Oncology Hospital Outpatient Chemotherapy Unit. Data were collected using an Introductory Information Form and Psychosocial Adjustment to the Illness Scale - Self-Report (PAIS-SR) and the Beck Hopelessness Scale (BHS) and analyzed by Pearson Correlation Analysis. RESULTS: The mean age of the women was 49.4 ± 11.0. It was found that the level of psychosocial adjustment of 63.3% of the women was 'poor'. A positive relationship was determined between PAIS-SR mean score and BHS mean score of the women with breast cancer (r = 0.731, p < 0.01). CONCLUSION: It was observed that as the psychosocial adjustment worsens, as the level of hopelessness of the women increases. In the light of this relationship, it was concluded that the attempts to increase hope and therefore the support for the psychosocial adjustment of patients should play a vital role in increasing their quality of life.

Relations between breast and cervical cancer prevention behaviour of female students at a school of health and their healthy life style.

Regular breast self-examination (BSE) and pap-smear tests are the two of the positive heath behaviors for improving, promoting and protecting the health of adolescent girls. The present quasi-experimental research was carried out with the purpose of analyzing the relations between breast and cervical cancer prevention behavior of female students at a School of Health and their health lifestyle. The research was conducted at Canakkale Onsekiz Mart University School of Health between November 2008 and February 2009. A total of 77 female students attending the first and second grades were included in the sample. Education pertinent to the matter was provided and evaluation was made three months later. A knowledge evaluation form for breast and gynecological examination, the Healthy Life-Style Behavior Scale (HPLP), was used in data collection. Number percentages, the McNemar Bowker test, the t test and the Mann Whitney U test were used in the evaluation. Despite the information they had received, not all of the students performed regular breast self-examination (BSE) prior to the education. For 24.7% (n=19) the reason for not doing regular BSE was their having no symptoms and for 29.9% (n=23) it was due to thinking that they would not have breast cancer. The reason for not having pap smear test was a virgin status. Three months after the education, knowledge level scores of the students increased approximately three and a half times (from 23.8-9.8) to 81.2-8.0). The rate of having regular BSE was 88.3% after three months, however; there was no pap smear test probably due to the fact that it was a taboo. When the rate of having regular BSE three months after the education and HLPL scores were compared, the scores of those having it regularly and the scores of those not having it regularly were found to be close and no statistically significant difference was detected (p> 0.05). In conclusion, consultancy service units should be established to comprehend the barriers perceived by adolescent girls who do not have regular health screening, to make appropriate strategic planning in order to eradicate the hindrances in Muslim societies and to enhance the motivation of youth with continuous education.

Socio-demographic factors and the practice of breast self examination and mammography by Turkish women.

OBJECTIVE: The health beliefs and experiences of women related to preventive behavior must be understood within the cultural context. The present study was conducted to assess socio-demographic characteristics affecting breast cancer health beliefs of Turkish women. METHODS: This research was conducted in an area covered by three neighborhood public education centres in Bornova, Izmir. The data were collected from 382 women over 40 years of age who were selected using a stratified random sampling method, using a descriptive information form and the Champion's Health Belief Model Scale (CHBMS). Data was analyzed by t test, variance analysis and Duncan test. RESULTS: Some 40.6 % of women performed BSE, and 34.0% had undergone mammography. There was a significant difference in CHBMS total mean score of women according to age, marital status, family type, regarding information about breast cancer. Variation in scores on susceptibility, seriousness, benefits, barriers, health motivation, and confidence were observed regarding women who performed BSE (p<0.05) but not mammography. CONCLUSION: The effective socio-demographic characteristics of breast cancer health beliefs of women should be considered in the design of breast health promotion and screening programs because they are likely to have a bearing on Turkish women's attitudes regarding the value they perceive in cancer screening.

Breast cancer screening behavior in Turkish women: Relationships with health beliefs and self-esteem, body perception and hopelessness.

The purpose was to examine breast cancer screening behavior in Turkish women, the reasons for not doing screening and the relationship between health beliefs and levels of self-esteem, body perception, and hopelessness. This research was conducted as a descriptive, correlational study in an area covered by three neighborhood primary health care clinics in Bornova, Izmir. The data were collected between April and November 2006 from 382 women over 40 years of age who were selected using a stratified random sampling method and a descriptive information form, Champion's Health Belief Model Scale (CHBMS), the Rosenberg Self-Esteem Scale (RSES), the Body Cathexis Scale (BCS) and the Beck Hopelessness Scale (BHS). The breast cancer screening methods used by women participating in the research were, respectively, mammography (34%), clinical breast examination (14.1%), breast self-examination (BSE) (59.4%). The reasons why women did not do breast cancer screening methods were determined to be: not having any symptoms, neglect, not sensing the need, and not knowing how BSE is done. In the examination of the women's CHBMS subscale score means and RSES, BCS and BHS score mean a statistically significant relationships were determined between Benefits-BSE, Barriers-BSE, Confidence, Health motivation, Benefits-mammography and barriers-mammography subscale score means and RSES, BCS and BHS mean scores (p<0.01). It was found out that women with high level of self-esteem, high level of hope for the future and with a positive body perception have more positive health beliefs on breast cancer screening.

Nursing interventions and factors affecting physical, psychological and social adaptation of women with breast cancer.

Breast cancer and the associated physical problems may cause people to experience different psychological and social adaptation processes. Nursing interventions can affect physical, psychological and social adaptation in such women and help to prevent and overcome depression and anxiety. It should be stressed that both physical and psychosocial well-being enhance health and quality of life.

Health education needs of patients with schizophrenia and their relatives.

The purpose of this study was to determine the health education needs of patients with schizophrenia and their relatives. A total of 80 patients and 80 relatives were included in the study. The data were collected using Descriptive Characteristics Questionnaire and Evaluation of Health Educational Needs Form. The subjects that patients and their relatives felt they had the greatest need to learn more about were general information about schizophrenia, coping with symptoms of schizophrenia, and communication and social relationships. It was determined that the patients' health education needs were affected by their employment status, income level, and longest place of residence, and their relatives' health education needs, by their marital status, degree of family relationship, educational level, income level, whether or not they were a member of an association or group, and whether or not they had received education about schizophrenia. On the basis of the health education needs identified by the patients with schizophrenia and their relatives, a health education program should be prepared.

Effects of emotional support-focused nursing interventions on the psychosocial adjustment of breast cancer patients.

The purpose was to examine the effect of emotional support-focused nursing interventions on the psychosocial adjustment of breast cancer patients. The research was conducted in the Radiation Oncology Department of Ege University Medical Faculty Hospital and at Talay Aktas Oncology Hospital in Turkey. There were 30 newly diagnosed breast cancer patients included in the sample. Emotional support-focused nursing interventions were administered in seven sessions individually with each patient. A total of 210 hours of meetings with the patients were conducted. Data were collected by administering a pre-test and post-test in two phases with the patients using a Descriptive Information Form and the Psychosocial Adjustment to Illness Scale - Self Report (PAIS-SR). The patients mean age was 44.5 (SD=6.38) years and the mean duration of illness was 6.46 (SD=1.99) months. In the comparison of the PAIS-SR pretest and post-test mean scores it was determined that there was a significant increase in patients adaptation to health care orientation (p=0.001), domestic environment (p<0.01), sexual relationships (p<0.05), extended family relationships (p<0.001) and social environment (p<0.001), and a significant decrease in psychological distress (p<0.001). However, there was no change in patients vocational adjustment (p<0.05). According to these findings emotional support-focused nursing interventions had a part in increasing patients psychosocial adjustment.