Patients with diabetic foot ulcers: A qualitative study of patient knowledge, experience, and encountered obstacles.

BACKGROUND: Patients with diabetes may experience diabetic foot ulcers, which are long-term complications of the disease and can occur due to uncontrolled hyperglycemia. Foot ulcer development is accelerated due to the negligence of the patient and the healthcare professional. OBJECTIVE: To determine patient knowledge, experiences, and barriers associated with diabetic foot ulcers. METHODS: This was a qualitative descriptive study based on content analysis. The study was conducted with patients admitted to a wound care outpatient clinic in a public hospital in Turkey. The data were collected through detailed telephone interviews. Data saturation was achieved for 11 patients. MAXQDA 20 software was used for the data analysis. The COREQ checklist was utilized to guide the reporting of the studies. RESULTS: Five themes and 14 subthemes were identified. Themes: etiology; impact; treatment process; barriers; recommendations. According to Theme 1, neglect, pressure, trauma and chronic diseases can lead to diabetic foot wounds. According to Theme 2, physical and psychological effects were observed in the participants. According to Theme 3, participants' treatment management and compliance with treatment affected the diabetic foot recovery process. In Theme 4, it was observed that participants with diabetic foot wounds had difficulties performing daily living activities and physical activities. In Theme 5, the participants' recommendations for individuals with diabetic foot ulcers included regulating blood sugar, maintaining a healthy lifestyle, providing foot protection and care, and providing professional health support. CONCLUSION: Diabetic foot ulcers developed due to the negligence of patients and physicians. Patients were also afraid of foot amputation. The development of foot ulcers is preventable through the provision of training to spread awareness regarding blood sugar control and diabetic foot ulcers. Early self-recognition of diabetic foot ulcers by patients, along with early intervention attempts by healthcare professionals, are important.

The Effect of Tub Bathing on the Skin and Bilirubin Levels of Babies Receiving Tunnel and Light-Emitting Diode Phototherapies: A Randomized Controlled Trial.

OBJECTIVE: To investigate the effects of tub bathing on the skin and bilirubin levels of newborns receiving tunnel and light-emitting diode phototherapy. METHODS: In this randomized controlled trial, hospitalized newborns diagnosed with hyperbilirubinemia treated with a tunnel or light-emitting diode device were randomly assigned to either the experimental (bath) or control (no bath) groups using a computer program. The skin integrity moisture balance of all groups was recorded using the Newborn Skin Condition Score at 6, 12, and 24 hours after phototherapy, and their total serum bilirubin measurements were evaluated. RESULTS: A statistically significant difference was observed in the babies' total serum bilirubin levels; this decrease was the highest in the experimental groups. Further, the skin integrity-moisture balance was higher in the experimental groups than in the control groups; it was highest in the tunnel-experimental group and lowest in the tunnel control group. CONCLUSIONS: These results show that bathing is effective in reducing total bilirubin levels. This study adds to the evidence on skin integrity and moisture balance in newborns who were bathed during phototherapy.

Relationship between cultural intelligence and career and work adaptability in nursing students.

Objectives: To investigate the relationship between cultural intelligence and career and work adaptability among nursing students. METHODS: The descriptive, cross-sectional study was conducted at Kilis 7 Aralik University Nursing Department in Turkey from April to May 2019, and comprised nursing students of either gender. Data was gathered using Cultural Intelligence Scale and Career and Work Adaptability Questionnaire. Data was analysed using SPSS24. RESULTS: Of the 277 subjects, 162(58.5%) were females and 115(41.5%) were males. The overall mean age was 21.21±1.81 years. The mean Cultural Intelligence Scale score was 95.17±18.16. The mean Career and Work Adaptability Questionnaire score was 115.69±19.38. There was a positive correlation between the total scores and subscale scores of both the scales (r=598, p<0.001). The student's father's occupation, desire to work overseas, feeling like a good fit for nursing, and feeling prepared for professional life significantly affected cultural intelligence (p<0.05). The student's father's occupation significantly affected career and work adaptability (p=0.001). Conclusion: There was a positive correlation between the total scores and subscale scores of Cultural Intelligence Scale and Career and Work Adaptability Questionnaire.

Hypoglycaemic confidence levels and experiences related to the hypoglycaemia of patients with diabetes: A mixed methods study.

AIMS: This study had three aims: to determine the hypoglycaemic confidence levels of participants, to identify factors affecting hypoglycaemic confidence levels of participants and to assess experiences related to hypoglycaemia of participants. DESIGN: The explanatory-sequential-mixed method was used in this study. METHODS: The quantitative stage included a sample of 177 people, and the qualitative stage included a sample of 18 people. Data of the study were collected between April and June 2023 with the Hypoglycemic Confidence Level Scale, Personal Information Form and Semi-Structured Interview Form. Descriptive statistics, independent samples t-test, one-way ANOVA and multiple linear regression analysis were used for quantitative data analysis. For the qualitative data analysis, content analysis was performed in the MaxQda program. RESULTS: The scale items are scored between 1 and 4, and an increase in the score obtained from the scale indicates an increase in confidence levels. The mean hypoglycaemic confidence level score of the participants was 3. The data obtained in the qualitative stage were grouped under three main themes: Experiences Related to Hypoglycaemia, Reasons for Experiencing Hypoglycaemia and Managing Hypoglycaemia. CONCLUSION: Identifying hypoglycaemic confidence levels and hypoglycaemia experiences of patients with diabetes can guide health professionals, especially nurses, in promoting person-centred care interventions. IMPACT: The study discussed the hypoglycaemic confidence levels of diabetic patients and their experiences related to hypoglycaemia. The factors affecting the hypoglycaemic confidence level of the participants were educational status, income status, fear of experiencing hypoglycaemia, ability to self-administer insulin, receiving hypoglycaemia training and frequency of experiencing hypoglycaemia. The results of this study may provide guidance for the development of appropriate prevention and coping strategies for hypoglycaemia. Identifying the experiences of patients with diabetes with hypoglycaemia can guide health professionals, especially nurses, in promoting person-centred care interventions. REPORTING METHOD: The Good Reporting of a Mixed Methods Study (GRAMMS) checklist was used for reporting. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.

Psychometric properties of the pediatric ward nurses' caring self-efficacy scale: A Turkish validity and reliability study.

PURPOSE: To translate the 51-item Pediatric Ward Nurses' Caring Self-Efficacy Scale into Turkish and to test the validity and reliability of the Turkish version of the scale in the Turkish population. DESIGN AND METHODS: The study was conducted with 308 nurses working in the pediatric/pediatric wards of two hospitals in Turkey between September 2021 and January 2022. A Personal Information Form, the Pediatric Ward Nurses' Caring Self-Efficacy Scale, and the Nursing Profession Self-Efficacy Scale (NPSES) were used to determine the care self-efficacy levels of the research sample. RESULTS: The Cronbach alpha value of the scale, which was adapted to Turkish culture, was 0.982, and the test-retest reliability coefficient was 0.994. Factor loads varied between 0.40 and 0.89. The Kaiser-Meyer-Olkin sample fit coefficient of the scale was 0.963 and the Barlett sphericity test χ2 value was 15,259.02 (p < 0.001). It was determined to have a six-factor structure in Turkish culture and showed good fit indices for the Turkish scale (GFI = 0.93, CFI = 0.97, TLI = 0.96 and RMSEA = 0.09). CONCLUSIONS: The Pediatric Ward Nurses' Caring Self-Efficacy Scale was found to be valid and reliable for sensitively detecting changes in the care self-efficacy levels of nurses working in pediatric wards. PRACTICE IMPLICATIONS: The scale can be used by professionals interested in scientific knowledge about pediatric population.

Experiences of intensive care nurses providing care to the victims of Kahramanmaras earthquakes.

BACKGROUND: Two earthquakes of magnitude 7.7 and 7.6 occurred in the Turkish province of Kahramanmaras in 2023. The earthquakes resulted in serious losses of life and property in 11 provinces, and the injured were transferred to other provinces for treatment and care. To date, no studies on the experiences of intensive care nurses providing care to earthquake victims after the Kahramanmaras earthquake sequence have been identified. AIM: The aim of the present study is to explore the experiences of intensive care nurses providing care to earthquake victims who were transferred to other provinces. STUDY DESIGN: A qualitative descriptive research design with conventional content analysis was used. Snowball sampling was used in the selection of intensive care nurses. Data saturation was achieved with 20 nurses. In-depth interviews were conducted with the participants through phone between March 8 and March 15, 2023. MAXQDA 20 software was used for data analysis. The COREQ checklist was used to guide the reporting of the study. RESULTS: Twenty nurses were recruited. Four themes emerged from the data: challenges in caregiving processes; psychological challenges; ethical situations; urgent need for training and support. CONCLUSIONS: After the Kahramanmaras earthquake sequence, described by some as the disaster of the century, nurses encountered patients with unique needs that they had never encountered before and tried to cope with the constantly changing health conditions. For this reason, they were affected psychologically and experienced challenges in caregiving processes. RELEVANCE TO CLINICAL PRACTICE: Conducting comprehensive training for diseases common among earthquake victims, developing new protocols for providing care to earthquake victims, developing more action plans for nurses, and psychologically supporting intensive care nurses would facilitate the caregiving processes.

Development of the diabulimia knowledge level scale.

The aim of this study was to develop the Diabulimia Knowledge Level Scale. The nurses voluntarily participated in the research (n = 384). The Diabulimia Knowledge Level Scale consists of 19 items and four factors. The four factors that make up the scale according to the results of Exploratory Factor Analysis explain 68.53 % of the total variance. The total Cronbach alpha coefficient of the scale was found to be 0.92. The Diabulimia Knowledge Level Scale is the first scale developed to determine the level of diabulimia knowledge among nurses. The scale is valid and reliable.

Correlation between cultural competence, xenophobia, and attitudes towards brain drain in nursing students.

This study aimed to determine the correlation between cultural competence, xenophobia, and attitudes to brain drain in nursing students. Individuals with high levels of intercultural competence have more successful social and emotional interactions with people from various cultural backgrounds. A cross-sectional and correlational design was used. This study was conducted on 473 nursing students from two different provinces neighboring the Syrian border between October 28th and December 28th, 2021. An information form and nurse cultural competence, xenophobia, and attitude scales for brain drain were used to collect data. A negative nonsignificant correlation between cultural competence and xenophobia and a positive nonsignificant correlation between cultural competence and attitude towards brain drain were found. The students had high levels of cultural competence and positive attitudes towards brain drain, and a moderate level of xenophobia. Socio-demographic characteristics affected cultural competence, xenophobia, and attitudes towards brain drain.

Nurses' spirituality and resilience during the month of Ramadan.

OBJECTIVE: To examine the relationship between spirituality and resilience among nurses during Ramadan. Methods: The cross-sectional, descriptive study was conducted at a state hospital in Turkey in May and June 2019, which coincided with the fasting month of Ramadan. The sample comprised nurses of either gender. Data was collected using a socio-demographic instrument, the Spirituality and Spiritual Care Rating Scale and the Resilience in Midlife Scale. Data was analysed using SPSS 24. RESULTS: Of the 207 nurses, 145(70%) were female and 62(30) were male. Most of the nurses were aged 25-29 years 88(42.5%). Also, 86(41.5%) were married and 167(80.7%) had university education. Age affected religiosity (p=0.038), and there was a positive correlation of resilience with the spiritual care subscale and the spirituality total score (p<0.05). Besides, education status affected resilience (p=0.042). Conclusion: In order to increase spirituality among nurses, information should be provided during their education and training programmes about the importance of spirituality.

Relationship between individual innovativeness and 21st century skills of nursing and midwifery students: A cross sectional study.

BACKGROUND: Individual innovativeness and 21st century skills are important for students to utilize their knowledge, think critically, follow innovations, use new technologies, take risks and be creative and entrepreneurial. University education can increase nursing and midwifery students' individual innovativeness and 21st century skills. There are a limited number of studies examining the individual innovativeness and 21st century skills of nursing and midwifery students. OBJECTIVES: To examine the relationship between the individual innovativeness and 21st century skills of nursing and midwifery students. DESIGN: A cross-sectional online study. SETTINGS: Students in the nursing and midwifery department of a state university located in the west of Türkiye were included in this study conducted between November 2021 and May 2022. PARTICIPANTS: A total of 748 nursing and midwifery bachelor students were recruited. METHODS: Research data were collected with "Data Collection Form", "Individual Innovation Scale" and "Multidimensional 21st Century Skills Scale". Number, percent, mean and standard deviation were calculated. Independent samples t-test, one-way analysis of variance, correlation coefficients, and simple linear regression were used in data analysis. RESULTS: The mean score of individual innovativeness was 67.21±7.86 and the total mean score of the multidimensional 21st century skills scale was 3.92±0.42. A good positive correlation was determined between the individual innovativeness scale total score and the 21st century skills scale total (r=0.736, p<0.01). Individual innovativeness had a predictive effect on 21st century skills. CONCLUSIONS: It was determined that students were inquisitive about adopting innovations. The 21st century skills of the students were found to be sufficient. There was a positive correlation between individual innovativeness and 21st century skills. Nursing and midwifery students, who are health professional candidates, should have individual innovativeness and 21st century skills in order to follow the innovations in the field of healthcare and integrate these innovations into patient care in the future. Developing innovative projects and taking part in innovation-related scientific events and competitions can improve the individual innovativeness and 21st century skills of students.

Experiences of Patients With Type 2 Diabetes Who Recovered From COVID-19 in the Pandemic Period: A Qualitative Study.

Coronavirus disease 2019 (COVID-19) infection can induce acute and chronic complications by affecting the self-management behaviors of individuals with diabetes. The objective of this study is to examine the physical, psychosocial health, and self-management experiences of type 2 diabetes patients who have recovered from COVID-19, 1 year after the infection. The study adopted a qualitative research design, specifically content analysis. In all, 14 patients with type 2 diabetes who presented to the diabetes outpatient clinic were interviewed by teleconferencing, which lasted approximately 25 to 30 minutes. The Standards for Reporting Qualitative Research guidelines were used. Based on the participants' responses, four main themes were determined: obstacles in activities of daily living, feeling of psychosocial problems, changes in health and treatment management, and patient self-management practices. Amid the pandemic, diabetes nurses should strive to recognize the issues that diabetes patients encounter. To assist patients, telemedicine should be leveraged, and evidence-based practices must be developed.

The unknown impact of multiple myeloma: assessing the impact of financial well-being on quality of life of caregivers.

PURPOSE: Patients with multiple myeloma and their caregivers are financially burdened, and their quality of life is significantly affected by treatment costs and care expenses. The aim of our study is to examine the impact of financial well-being of the caregiver on the life quality of patients with multiple myeloma. METHODS: The study included 113 patients with multiple myeloma and 113 caregivers in two hospitals located in Western Turkey. This study evaluated the demographic characteristics of patients and their caregivers, financial status, financial well-being, and quality of life of caregivers. Simple linear regression analyses were used to examine the impact of financial well-being on caregiver quality of life. RESULTS: The average age of multiple myeloma patients and caregivers is 64.00 ± 11.05 and 48.02 ± 11.4, respectively. Of patients, 50.4% and 62.8% of their caregivers were female. It is determined that 51.3% of the patients were diagnosed in 1-5 years, 85% received chemotherapy, and 80.5% had an ECOG performance status between 0 and 1. Caregivers' quality of life and financial well-being were found to be low. On one hand, while caregivers' financial well-being (ß = - 1.003; t = - 3.831; p = .000) negatively affected the quality of their lives, their financial satisfaction (ß = 2.507; t = 3.820; p = .000) positively affected the quality of their lives, on the other hand. CONCLUSIONS: Caregivers' quality of life declined as their financial well-being got worse. Decreased quality of life of caregivers may affect the quality of care they provide to patients with MM. Hence, this study recommends the following. First, nurses who care for patients with MM should always assess the financial situation of patients and caregivers. Second, patient navigators, hospital billing specialists, and social workers should provide financial guidance to multiple myeloma patients and caregivers and provide help in solving their financial problems. Finally, policies that support the financial situation of patients and caregivers should be developed.

The effect of probiotic and synbiotic use on glycemic control in women with gestational diabetes: A systematic review and meta-analysis.

AIMS: To investigate the impact of probiotic/synbiotic use on glycemic control in women with gestational diabetes. METHODS: We searched the PubMed, Medline, Scopus, ScienceDirect, Web of Science, Cochrane Central Register of Controlled Trials, Dergipark, and Council of Higher Education Thesis Center databases through March 2022. Screening was performed according to the population, intervention, comparison, outcome and study type. This systematic review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic Review and meta-analyses (PRISMA-2020) statement. RESULTS: Eight RCTs involving 551 patients were included in the meta-analysis. Probiotic use in women with gestational diabetes significantly decreased fasting blood glucose (mean difference: -1.43; 95 % CI: -2.78 to -0.09, p: 0.04) and serum insulin (mean difference: -3.66; 95 % CI: -5.04 to -2.27, p < 0.001). Moreover, the use of probiotics and synbiotics significantly reduced the HOMA-IR level compared to the control group (probiotic group: mean difference: -0.74; 95 % CI: -1.05 to -0.44, p < 0.001; synbiotic group: mean difference: -0.68; 95 % CI: -1.26 to -0.09, p: 0.02). CONCLUSIONS: The use of probiotics in women with GDM reduced fasting plasma glucose, fasting serum insulin, and HOMA-IR levels. In addition, the use of synbiotics decreased HOMA-IR. Probiotic/synbiotic use is promising as a potential therapy to assist in glycemic control in gestational diabetes. Further high-quality studies are required to determine their safety.

Effect of white noise on alleviating the pain of new-born during invasive procedures.

OBJECTIVES: In painful operations like invasive procedures, it is aimed to analyze the effect of making the new-born listen to white noise CD by using the NIPS pain scale. METHODS: This is a randomized control trial of research made on 60 new-borns, ranging from 0-28 day-old, 28 gestational weeks and over, and coming to the intensive care unit in Gaziantep Cengiz Gokcek Maternity and Children Hospital in Turkey. New-borns in the experimental group on invasive procedures were exposed to white noise CD. New-borns were recorded while they were listening to white noise during an invasive procedure. Then, the NIPS pain scale on the questionnaire form and efficiency of white noise have been evaluated by comparing the new-borns' duration of crying. RESULTS: New-borns' duration of crying has been found statistically significant in the Independent Samples T-test (p < .05) which was performed between two independent groups with a 95% confidence interval. Duration of crying in the group being exposed to white noise (18.20 sec) has been determined lower than that of the control group (44.96 sec). CONCLUSION: In the end, the use of white noise CD on new-born during the invasive procedure has been determined to be applicable.

The Effect of Earmuffs on Physiological Parameters in Preterm Infants: A Systematic Review.

Noise may cause stress responses such as apnea, hypoxemia, changes in oxygen saturation and augmented oxygen consumption secondary to elevated heart and respiratory rates. Moreover, stress results in increased intracranial pressure, abnormal sleep patterns, hearing impairment, and bronchopulmonary dysplasia, retinopathy of prematurity, intraventricular hemorrhage, periventricular leukomalacia, retardate development and alterations in the neuroendocrine system. Herein, this study aimed to discuss the effects of earmuffs on physiological parameters in preterm infants. The relevant and available peer-reviewed publications from 2012 to 2018 from various databases were analyzed. For the assessment of the studies, the full-text accessible studies were included for analysis. The retrieved documents were analyzed using VOSviewer regarding the geographical distributions of the documents with their numbers and citations, keywords proposed by the researchers. All records with the term "earmuffs OR earmuff" in the "article title, abstract, keywords" were retrieved from different databases. Accordingly, 396 documents containing the word "earmuffs OR earmuff" were recorded. The search was then restricted for publications that contain the words "noise AND nursing AND preterm" in the title and abstracts (TITLE-ABS-KEY (earmuffs OR earmuff)) AND (noise AND nursing AND preterm) (Scopus=390; Web of Science=1, Medline=2; Cochrane=1; Embase=1= Pubmed=1=n=396). After inclusion and exclusion criteria, 7 documents were recorded and then evaluated for the present study. As a conclusion, the effects of earmuffs on physiological parameters of preterm infants have not been clearly understood and reported yet. Along with the present documents, it is not clear that the use of earmuffs reduces stress and provides physiological stability in preterm infants born between approximately 28-32 weeks. The studies with a larger sample size are needed for validation of information reported in the articles analyzed herein.