Fear of Cancer and State Anxiety Among Women Undergoing Hysterectomy: A Cross-sectional Study.

BACKGROUND: Fear of cancer may develop after surgery in women who underwent surgery for suspected malignancy in preoperative examinations. It is important from a psychosocial point of view that the fear of cancer and the factors affecting anxiety are determined and necessary interventions are made. OBJECTIVES: The aim of this study was to determine the level of state anxiety, fear of cancer, and influencing factors in women who had hysterectomies with a risk of cancer in the waiting period for the pathology result. METHODS: The research data were collected from 109 women who underwent hysterectomy while waiting for the pathology result on the third or fourth postoperative day. Patients completed the Personal Information Form, State-Trait Anxiety Inventory-I, and Cancer Worry Scale. RESULTS: Women who underwent hysterectomy with the risk of gynecological cancer had high levels of state anxiety and cancer fear after hysterectomy; type of hysterectomy significantly affected cancer fear (P = .022), and social support (P = .015), type of hysterectomy (P = .024), and family history of cancer (P = .022) significantly affected state anxiety. CONCLUSION: The management of these women's concerns can be improved if healthcare professionals know more about the factors affecting their state anxiety and fear. IMPLICATIONS FOR PRACTICE: Health professionals witness patients' most private experiences and play a key role in providing care and support. This study may be foundational in the planning and implementation of nursing interventions to manage causes of anxiety and fear during this waiting period.

Transition to Motherhood of Puerperal Women With Preterm Birth in a Challenging Lifetime: Transition Theory-Based Study.

Background and purpose: Although the transition process to motherhood of mothers who gave birth preterm has been examined using other theories, no studies have yet utilized Meleis's Transition Theory (TT). The aim of this study was to examine the transition process of mothers who gave birth preterm according to Meleis's TT. Methods: This study is a holistic single-pattern qualitative case study. The qualitative research paradigm was used based on the 32-item Qualitative Research Reporting Consolidated Criteria checklist, a guide for qualitative studies. Face-to-face interviews were conducted with 10 preterm mothers using a semistructured interview form between February 2019 and December 2021. The thematic analysis analysis method was used for the data obtained. After the data were transcribed, all the documents were read, and the data were deciphered. Using the notes, the codings were themed as titles and subtitles according to Meleis' TT. Results: Three main themes were determined using Meleis' TT: facilitators and inhibitors of the transition process, response patterns to motherhood, and nursing care. Visiting the baby in the intensive care unit, touching, and expressing milk for the baby were found to be important milestones in the mothers' transition process. Conclusion: Mothers faced numerous problems after premature birth and required support to cope with the transition process. They attempted to adapt to the transition to motherhood with the support of nurses, husbands, and families. Implications for practice: The researchers stated that may assist a healthy transition process by supporting health professionals to understand the problems faced by mothers during the transition to motherhood and to provide nursing care according to mothers' needs.

Effect of cold cabbage leaf application on breast engorgement and pain in the postpartum period: A systematic review and meta-analysis.

The researchers' aims are to determine the effect of cold cabbage leaf application on breast engorgement and pain during the postpartum period through a systematic review and meta-analysis. Between June and September 2021, researchers systematically searched Turkish and English databases using a combination of keywords. We calculated individual and general effect sizes of the studies to evaluate effect sizes. We obtained 25,996 results with the databases search and we included a total of eight studies for analysis. According to the pooled results, we determined that cold cabbage leaf application caused a significant reduction in breast pain, though no significant reduction was seen in breast engorgement. In this systematic review and meta-analysis, we found that cold cabbage leaf application was effective in reducing breast pain, but that more experimental studies are needed to determine its effect on breast engorgement.CALLOUTSBreast engorgement is a common physiological problem for lactating mothers.Researchers state that the results of the eight studies included in the analysis suggested that cold cabbage leaf application was effective in reducing breast pain.More studies are needed to evaluate the effect of cold cabbage application on reducing breast engorgement.

Breast milk expression as a challenge for mothers of premature infants.

The aim of this study was to examine the psychometric properties of the 11-item Breast Milk Expression Experience Scale and determine the level of breast milk expression experience of mothers after preterm delivery in Turkey. 165 mothers who agreed to participate between February 2019 and March 2020 used the Breast Milk Expression Experience Scale (BMEE-S). The general Cronbach alpha coefficient was 0.82 for the BMEE-S. The fit indices calculated by confirmatory factor analysis were χ2 (41) = 87.95, p = .00003, χ2/sd = 2.15, GFI = 0.91, NNFI = 0.93, CFI = 0.95, RMSEA = 0.08 and SRMR = 0.078. The BMEE-S three-factor structure was verified by the confirmatory factor analysis. The BMEE-S was a valid and reliable instrument for mothers of preterm infants. Multiparity and high-risk pregnancy history negatively affected the milk expression experience, whereas spousal support positively affected it.Impact statementWhat is already known on this subject? The risk of infectious diseases, obesity, diabetes, and impaired intellectual development increases in children who do not breast milk (Verduci et al. 2014). International breastfeeding guidelines recommend supporting all mothers to start breastfeeding within one hour of birth, and counselling mothers who are separated from their babies about expressing milk.What the results of this study add? The breast milk expression experience scale is a valid and reliable tool for women who give preterm birth and express milk. The experience of expressing breast milk can affect the amount of milk that passes from mother to baby. Multiparity and high risk pregnancy history of mothers negatively affects the milk expression experience while husband support positively affects the milk expression experience.What the implications are of these findings for clinical practice and/or further research? Our study provides a quantitative examination of the experiences of mothers who are separated from their babies. The BMEE-S should be adapted to different cultures and the experiences of mothers in this process should be determined.

The psychological resilience and perceived stress of the frontline heroes in the pandemic in Turkey: A descriptive study of the COVID-19 outbreak-mutations-normalization triad.

AIM: To determine the psychological resilience and perceived stress levels of healthcare workers in COVID-19 intensive care units. METHODS: The study was conducted with 418 physicians and nurses in Turkey between July and August 2020. The data were collected with an online survey consisting of a personal information form, the Brief Resilience Scale, and the Perceived Stress Scale. RESULTS: The study sample comprised 32.5% physicians and 67.5% nurses. Fear of transmission of COVID-19 from the patients in their care was stated by 92.6% of the physicians and 95.7% of the nurses. Almost all of the participants (99.3%) were afraid of transmitting COVID-19 to their families. The psychological resilience level of the physicians (18.42 ± 2.25) participating in the study was higher than that of the nurses (17.88 ± 2.00), and the perceived stress level was lower. It was determined that most physicians and nurses strengthened their team/work friendship bonds during the pandemic, but the motivation to work decreased. CONCLUSION: The study results suggest that frontline intensive care workers should be closely monitored as a high-risk group for psychological problems. The provision of better personal protective equipment, together with on-going monitoring and provision of psychological support, and strong family support will increase the resilience of frontline healthcare workers.

Breastfeeding attitudes of refugee women from Syria and influencing factors: a study based on the transition theory.

AIMS: This review was designed to systematically examine studies that determine the breastfeeding attitudes of Syrian mothers, and factors influencing their breastfeeding behavior. METHODS: Studies published between 2010 and 2020 were examined using 'Syria OR Syrian mother OR Syrian refugee AND breastfeeding OR breastfeeding practices OR intention OR attitudes OR exclusive breastfeeding' as keywords on PubMed, GoogleScholar, MEDLINE, Scopus, ProQuest, National Thesis Center, Web of Science, ScienceDirect and CINAHL; and five publications meeting the inclusion criteria were included in the study. The researchers independently used JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies and JBI Critical Appraisal Checklist for Systematic Reviews and Research Syntheses, developed by Joanna Briggs Institute, to assess the methodological quality. RESULTS: A total of 6546 studies were accessed as a result of the literature review. Five studies meeting the inclusion criteria were included in the study. Women who are in this process experience a developmental and situational transition according to the framework of Meleis' theory. Factors affecting their breastfeeding attitudes were grouped under three main and four sub-themes. It was determined that personal factors (socioeconomic factors, cultural beliefs, the significance of breastfeeding practice, preparation), factors related to the immediate environment and social factors affect these women's attitudes toward breastfeeding. CONCLUSION: It was found that most of the Syrian women had positive attitudes toward breastfeeding; however, the breastfeeding duration was less than 6 months for most of the refugees. Furthermore, according to the results of the studies, refugee women from Syria who did not receive social support from their spouses and relatives stopped breastfeeding.

Is marital adjustment a way to increase women's identification with the motherhood role during pregnancy?: A correlational assessment.

The researchers sought to determine the correlation level and factors that affect the correlation between pregnant women's marital adjustment and their identification with the motherhood role. A total of 146 healthy, married, and pregnant women were included. There was a negative and significantly low-level correlation between marital adjustment and identification with the motherhood role. The correlation was significant among women who were multiparous, married for six to 10 years, with low level of education, and decided to marry in agreement. The authors of this study suggest promoting marital adjustment may be way to facilitate women's identification with the motherhood role.

Factors associated with antenatal depression during the COVID-19 (SARS-CoV2) pandemic: A cross-sectional study in a cohort of Turkish pregnant women.

PURPOSE: To determine the effect of the COVID-19 pandemic on antenatal depression in Turkish pregnant women. DESIGN AND METHODS: In this cross-sectional study, data were collected from 497 pregnant women between May and July 2020 using the Edinburgh Depression Scale (EDS) to determine the effect of obstetrics history, fear of hospitalization, concerns about the pandemic, birth, and the health of both mother and infant, on antenatal depression during the COVID-19 outbreak in Turkey. FINDINGS: The general EDS mean score of the total group was determined as mean 13.70 ± 6.22, which was higher than the critical cutoff point of 13. According to the multiple linear regression model applied in the study, the best predictive variables for the mean EDS score were determined to be concerned about completing a healthy pregnancy (r = -0.45), social media and news programs related to COVID-19 increasing levels of concern (r = -0.31), fear of hospitalization as the birth approaches (r = -0.45), having bad dreams during the COVID-19 pandemic (r = -0.41), the request for an elective cesarean delivery because of fear of catching COVID-19 (r = -0.40), fear of breastfeeding the infant (r = -0.45), and concerns that their own health would be negatively affected because of the pandemic (r = - 0.39), and these variables affected the mean EDS score negatively (total variance 40.5%, R = 0.642). PRACTICAL IMPLICATIONS: The COVID-19 pandemic has created an urgent need to implement specific antenatal programs to promote the psychological health of pregnant women and reduce antenatal depression during this or similar crises.

A qualitative exploration of fear of cancer recurrence in Turkish cancer survivors who were referred for colposcopy.

We aimed to qualitatively explore factors related to fear of cancer recurrence in women who had a risk of cervical cancer relapse/metastasis and to identify the psychological effect of gynaecological examination and colposcopy in cancer survivors. We conducted the present descriptive study with a qualitative design based on the thematic analysis approach on ten women who under suspicion of new cancer and were admitted to the Gynaecological Oncology Polyclinic of Akdeniz University for colposcopy between July and October 2017 via in-depth interviews. As a result of the interviews, we identified three main themes: colposcopy-related fear, emotions associated with fear of cancer recurrence, and fear of being diagnosed with cancer. Moreover it was determined that women experienced a fear of death, fear of family being affected, fear of stigmatisation by society, and fear of not coping with the treatment process. We found that women with cancer history and undergoing colposcopy because of abnormal cervical cytology in routine oncology controls experienced a significant fear of cancer recurrence. We found that gynaecological examination and colposcopy caused anxiety in patients. Healthcare professions should be aware and help women to cope with the fear of cancer recurrence in the colposcopy process and should determine the social care needs of these patients.

The effect of the COVID-19 pandemic on community mental health: A psychometric and prevalence study in Turkey.

BACKGROUND: COVID-19, which is characterised by life-threatening symptoms, difficulty in breathing, and pneumonia symptoms and requires global emergency intervention, may cause psychological problems such as phobia, fear and anxiety. This study aims to examine the psychometric properties of the Fear of COVID-19 Scale (FCV-19S) in Turkish people and to determine the level of fear of COVID-19 among Turkish people. METHODS: The research was carried out between March and April 2020. A Personal Information Form and the FCV-19S were used to collect the research data. In the validity and reliability stage, 84 people were contacted randomly for data collection. After the validity and reliability analyses of the scale, a total of 431 Turkish people volunteered to participate in the study and answered the questions in the online questionnaire form using a convenience and snowball sampling method. Confirmatory factor analysis, item-total correlation and Cronbach's alpha coefficient were calculated for psychometric evaluation. Bivariate analysis was applied to determine the level of fear of COVID-19. RESULTS: Cronbach's alpha coefficient was 0.89, which is stated to have high reliability. FCV-19S scores of participants were determined to be 21.47 ± 6.28. FCV-19S scores of females were determined as 20.48 ± 6.33 and FCV-19S scores of males were determined as 19.78 ± 7.34 according to the bivariate analysis (p < .05). Age, marital status, having children and living alone or with others, tobacco use and anxiety about going to the hospital during the pandemic did not affect on fear of COVID-19 (p > .05). Particularly being female, the presence of chronic disease requiring long-term medication and rarely taking protective measures recommended by the Ministry of Health and having a chronic disease had a significant effect on higher levels of fear of COVID-19 (p < .05). CONCLUSION: The FCV-19S is a valid and reliable tool for determining the fear of COVID-19. It was found that the fear level of COVID-19 infection was high in Turkish people.

Determination of Self-Efficacy, Body Image and Sexual Adjustment of Women with Breast Cancer.

OBJECTIVE: The determination of the self-efficacy levels of women with breast cancer, as well as their body image (BI) and sexual adjustment status, is very important for their empowerment. The purpose of this study was to determine the self-efficacy, BI, and sexual adjustment levels of women with breast cancer that received chemotherapy, as well as the factors that influence these characteristics. MATERIALS AND METHODS: This descriptive study included women (n=117) that were diagnosed with breast cancer, had received at least two sessions of chemotherapy. The study data were collected using a sociodemographic form which also included questions about the breast cancer. Also, the Strategies Used by Patients to Promote Health (SUPPH) scale, and the Sexual Adjustment and Body Image Scale (SABIS) were used. RESULTS: The average age of the women participating in the study was 56.64±8.78 years. In the study, the women with breast cancer undergone a mastectomy, and those who lacked the support of their spouses, as well as education on sexuality, obtained lower scores on the SUPPH and SABIS. There was a positive correlation between the self-efficacy in self-care and sexual adjustment, sexual functions, and body images. CONCLUSION: This study found that the women with breast cancer had low self-efficacy, and that their former sexual adjustment and low body image had a negative effect on their post-diagnosis sexual functions.

A prevalence and psychometric study on fear of cancer in women with abnormal cervical cytology undergoing colposcopy.

OBJECTIVE: To determine the levels of fear of cancer in women who were referred for colposcopy and to determine validity and reliability of the Cancer Worry Scale (CWS) in gynaecology patients. METHODS: The study was conducted between March-November 2017 with 200 women at the Gynaecologic Oncology Clinic at Akdeniz University Hospital in Turkey. Reliability analysis, confirmatory factor analyzes, and multidimensional sum-score estimation were used for psychometric analyzes. One-way ANOVA and independent samples t-test were also used. RESULTS: Total score for the CWS of the participants was determined as 20.05 ± 7.87 in colposcopy patients. Marital status, information about the Papanicolaou (Pap) smear test and colposcopy, and fear of colposcopy were strongly associated with fear of cancer. We determined that a one-factor structure emerged for the scale and that the total contribution of this factor to the explained variance was 53.35%. CFA was applied to obtain additional evidence of structural validity in line with the scores obtained from the scale. The overall Cronbach's alpha coefficient of the scale was 0.87. CONCLUSIONS: Our study revealed that levels of fear of cancer were high in women who were referred for colposcopy. Furthermore, the CWS was determined as a valid and reliable tool to measure the fear of cancer in women undergoing cervical screening/follow-up for abnormal cytology.

Comorbid anxiety and depression (CAD) at early stages of the pregnancy. A multicultural cross-sectional study.

INTRODUCTION: When anxiety and depression are comorbid (CAD), symptoms are more severe and the response to treatments is worse. Given the links between mood disorders and poor perinatal outcomes, CAD and its correlates deserve special clinical attention during pregnancy. The main objective of this study was to learn about the prevalence of comorbid anxiety and depression (CAD) in early stages of the pregnancy analyzing the relationship between CAD and cultural and sociodemographic factors. METHODS: We have studied a multicultural sample of 514 Turkish and Spanish pregnant women (264 in Málaga, 102 in Istambul and 148 in Antalya) recruited at the moment of their first pregnancy medical check-up between 10 and 12 weeks of pregnancy. These women completed a questionnaire that included the Turkish or Spanish validated versions of the Edinburg postnatal depression scale (EDS), the state and trait anxiety scale (STAI) and a series of questions related to health status, general mood, and sociodemographic variables. RESULTS: We found a CAD prevalence rate of 26.9% and a significant higher prevalence rate among Turkish women (47.6%) when compared to Spanish participants (9.5%) (p<0.001). The multivariate analysis showed that the lack of someone who provided emotional support was the variable that best predicted CAD symptoms. CONCLUSION: The CAD prevalence rate was high and significant differences were found depending on the geographic and cultural context.

Psycho-adaptive changes and psychological growth after childbirth in primiparous women.

PURPOSE: To explore the psycho-adaptive changes and the level of psychological growth after childbirth among first-time mothers. DESIGN AND METHODS: This study used a descriptive qualitative approach. Using the purposeful sampling method, 18 primiparous women who received postnatal care between August and September 2017 were interviewed. FINDINGS: The women's experiences about psycho-adaptive changes were collected under eight main themes. These themes were change in values, change in personality, change in hand skills and time management, change in priorities, change in problem-solving skills, increase in self-esteem, change in social life, and change in relations, respectively. PRACTICAL IMPLICATIONS: Nurses should assume important responsibilities, such as childbirth education needs, psycho-adaptive features of the mothering process, culturally-sensitive antenatal visits, and childcare.

From experiences to expectations: A quantitative study on the fear of childbirth among multigravida women.

There is a strong relationship between women's previous birth experiences and their predetermined expectations. Childbirth expectations play an important role in the women's response to the birthing experience and postpartum period. The negative emotions and expectations, such as fear of childbirth, may result in negative experiences in subsequent childbirths. The aim of this study is to examine the relationship between previous birth experiences and the fear of childbirth in current pregnancy. A sample of 309 healthy women with normal pregnancies was recruited for this study. A chi-square test of independence and a multinomial logistic regression were used to explain the association between previous birth experiences and the fear of childbirth in current pregnancy. The level of childbirth fear that pregnant women feel appears to differ based upon their previous pregnancy experiences. Pregnant women who describe their previous births as happy and proud tend to experience a moderate level of childbirth fear about their current pregnancies, whereas pregnant women who remember their previous births as either fearful or painful have lower levels of childbirth fear. The level of childbirth fear tends to decrease as pregnant women have more children. Gestational week does not seem to be influential on the level of childbirth fear. According to the findings of this study, counterintuitively there is a negative relationship between the previous birth experience and childbirth fear. The level of childbirth fear is lower for pregnant women who remember their previous births as a negative experience compared to those who remember their previous births positively.

Nursing Students' Perceptions of Nursing Metaparadigms: A Phenomenological Study.

BACKGROUND: The paradigm is a vital concept steering the development of a scientific discipline. Paradigms that shape the education, research, and practice steps of a discipline are defined as metaparadigms. PURPOSE: The purpose of this study was to explore the perception of nursing students regarding metaparadigms in nursing at Akdeniz University in Antalya, Turkey. METHODS: This was designed as a descriptive phenomenological study, and data were collected from 13 fourth-year students who were chosen via a purposeful sampling method and interviewed face-to-face using a semistructured format. Data were analyzed using the data analysis steps of Giorgi, who is an expert in descriptive phenomenological studies. RESULTS: Most of the participants in this study associated nursing with humanism. Some of the participants stated that a fundamental building block of the nursing profession is conscience, whereas others stated that nursing is a way to touch people's lives and is now regarded as a professional practice. It has been reported that students have difficulties identifying metaparadigms in nursing and that they believe that human beings have the potential to widen their horizons with wisdom and social skills. According to the participants, the health metaparadigm refers to the harmony between human beings and their environment and to the autonomy of the individual. Moreover, the participants emphasized the well-being of individuals. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The participants in this study characterized humans with well-being, transcendence, adaptation and interaction skills with their environment, and harmony beyond physiological mechanisms, which was considered to be promising for the perception of future nurses. It is recommended for nursing educators to enable their students to raise their professional awareness and to internalize professional values.

Correlates for state and trait anxiety in a multicultural sample of Turkish and Spanish women at first trimester of pregnancy.

OBJECTIVE: The main objective of this research was to assess the potential influence of cultural factors on the anxiety levels of a multicultural sample of Spanish and Turkish pregnant women at the beginning of the pregnancy. METHODS: Between October and December 2017 a total of 250 Turkish and 264 Spanish pregnant women attending their first pregnancy medical check-up between 10 and 12 weeks of pregnancy in three different cities, Istanbul, Antalya and Malaga, were recruited for study. These women completed a questionnaire that included the Turkish or Spanish validated of the state-trait anxiety Inventory, and a series of questions related to health status, general mood, and sociodemographic variables. RESULTS: The mean value for State Anxiety was 47.1 [16-56] (SD 4.2), and mild, moderate and severe State Anxiety was observed in 56.8%, 14.7% and 20.5% of participants, respectively. Mean value for trait anxiety was 46.9 [34-89] (SD 4.6) and 31.4%, 19.7% and 20.2% of participants scored for mild, moderate and severe anxiety respectively. Anxiety scores were significantly higher among Turkish women. In the whole sample, religion, working status, pregnancy planning and perceived partner´s support predicted anxiety at first trimester of pregnancy. Social support and educational level were the most important predictive variables in the Spanish subgroup, while religion, the number of living children and the lack of husband´s support were among Turkish pregnant women. CONCLUSION: Our results confirm the existence of a high prevalence of women´s anxiety at the beginning of the pregnancy and some differences between Turkish and Spanish pregnant women have been observed. We have confirmed that some cultural features like family structure (having more children and cohabitants), the Islamic religion or the lack of perceived partner´s support became the most important vulnerability elements.

Investigation of the Experiences of Mothers Living Through Prenatal Loss Incidents: A Qualitative Study.

BACKGROUND: Fetal death causes women to experience negative feelings after the loss. These lived experiences influence the future pregnancies and maternal health of women negatively. PURPOSE: The aim of this study was to investigate the experiences of women whose pregnancies were terminated because of medical indications. METHODS: A "design for definitive status study" type of qualitative research design was used. Ten women who were hospitalized between April and July 2017 at the Akdeniz University Clinic of Obstetrics and Gynecology and had subsequently experienced pregnancy loss during their hospitalization were enrolled as participants. Thematic analysis was used to analyze the data. RESULTS: The pregnancy loss experiences of participants were investigated under the five main themes of (a) lived experiences before the termination of pregnancy, (b) lived experiences after pregnancy termination, (c) willingness to see the baby after termination, (d) posttermination care requirements, and (e) physical condition of hospital rooms during hospitalization. The participants expressed feelings of hope, fear, and worry over being unsuccessful before fetal death and feelings of loneliness, disappointment, blame, and avoidance after fetal death. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: In the aftermath of fetal death, health professionals should use insightful and empathic communication skills to help mothers cope with their loss. In addition, some of the participants wanted to see their babies, and some did not. Thus, individualized care is very important for women who experience pregnancy loss.

Working and supporting people with dementia when you are a student: a qualitative research.

BACKGROUND: Participation of young people in the care of older people will provide important contributions to improving older people's health. METHODS: This qualitative case study was conducted to clarify the possible difficulties and experiences of student interns at the Blue House Alzheimer's Center for Alzheimer's Patients and Families. Data were collected by focus group interview. RESULTS: It was seen that all students who practice at the Blue House Alzheimer's Patient and Patient Relatives Center willingly choose the gerontology profession. Gerontology is a new field in Turkey and the increasing number of older people leads students to gravitate towards this profession. Students who participated in the present study stated that internship at the nursing home is different to internship at the Alzheimer's care center, and it is much more difficult to empower individuals with dementia. Students stated that they had difficulty constantly meeting patients suffering from dementia, teaching an activity over and over again, caring for patients who constantly talk about their memories of past professional life, the theoretical and practical differences in caring for Alzheimer's disease patients, and the fear of one day suffering from dementia themselves. CONCLUSION: In the most energetic years of their life, incorporating students into the care of Alzheimer's disease patients increased their knowledge and care skills.