Effect of Spirituality on Psychological Resilience and Hope in Patient-Family Caregiver Dyads Experiencing Gynecological Cancer: An Actor-Partner Interdependence Analysis.

BACKGROUND: Women experiencing gynecological cancer (GCPs) and family caregivers (FCGs) use spirituality to cope with cancer. However, the dual relationship between the impact of spirituality on psychological resilience and hope among both GCPs and FCGs has not yet been explored. OBJECTIVE: To examine the interdependent relationship between spirituality, psychological resilience, and hope of women with gynecological cancer and their FCGs at the dyadic level. METHODS: In this cross-sectional study, 107 dyads were recruited from the gynecological oncology departments of 2 university hospitals in Ankara, Turkey. The GCPs and FCGs completed a Patient/Family Caregiver Information Form, Spiritual Well-being Scale, Connor-Davidson Resilience Scale, and Dispositional Hope Scale. Data were analyzed using descriptive statistics and Pearson's correlations. This study used the Actor-Partner Interdependence Model. RESULTS: Spirituality of both GCPs and FCGs had a significant positive effect on their psychological resilience ( B = 0.918, P < .001; B = 0.435, P < .001, respectively) and hope ( B = 0.350, P < .001; B = 0.246, P < .001, respectively). However, the spirituality of GCPs and FCGs did not have a partner effect on psychological resilience ( B = -0.150, P < .052; B = -0.150, P = .052, respectively) and hope ( B = -0.012, P = .810; B = 0.073, P = .157, respectively). CONCLUSIONS: Spirituality of GCPs and their FCGs positively affected their psychological resilience and hope, but the effect on each other was limited. IMPLICATIONS FOR PRACTICE: Health professionals, especially nurses, should focus on tailoring spiritual care interventions to the unique needs of each individual within the GCP and FCG dyads. Personalized approaches that recognize and address the specific spiritual concerns of patients and caregivers may be more effective in promoting psychological resilience and hope.

The tendency and affecting factors of nursing students' Xenophobia toward refugees from the perspective of ecological systems theory: A convergent parallel mixed method study.

AIM: This study aims to develop a comprehensive understanding of nursing students' xenophobic tendencies toward refugees and affecting factors from the perspective of Ecological Systems Theory. BACKGROUND: Nursing students' xenophobia toward refugees may negatively affect their care for patients. To effectively prevent xenophobia, it is essential to identify its underlying factors. DESIGN: A convergent parallel mixed method. METHODS: This study was conducted with third and fourth-grade nursing students at a university in Turkey. In the quantitative phase, online surveys were used, employing convenience sampling, with 227 participants. In the qualitative phase, purposive sampling was used and data were collected through in-depth interviews with 17 participants on the Zoom platform. Data were obtained using the Participant Information Form, Xenophobia Scale and Semi-Structured Interview Form. RESULTS: Nursing students who are male, in their third year, have low economic status, lack immigrant friends, lack immigrants in the family members, receive information about immigrants from social media and live in regions with a high concentration of immigrants have higher levels of xenophobia (p<0.05). In the qualitative phase, our study results showed that negative experiences with refugees, economic and social worries, perception of security threats, cultural conflicts and negative media messages toward refugees can lead to xenophobia. In addition, students stated that lessons about immigrants and caring for them in clinics can improve their ability to empathize with immigrants. CONCLUSION: Nursing curriculums should cover immigrant care and interaction to combat xenophobia, which can improve empathy skills and raise awareness.

The Effect of Neonatal Intensive Care Nurses' Attitudes Towards Palliative Care on Death Anxiety and Burnout: An Analytic Cross-Sectional Study.

This study aimed to determined the effect of neonatal intensive care nurses' attitudes towards palliative care on death anxiety and burnout. This was an analytic cross-sectional study conducted with 215 neonatal intensive care nurses working a children's hospital with Turkey's largest NICU bed capacity. The mean Neonatal Palliative Care Attitude Scale total score was 3.04 ± 0.78, and the mean scores of the organization, resources, and clinician subscales were 3.16 ± 0.86, 2.87 ± 0.80, and 3.10 ± 0.97, respectively. The participants' mean Death Anxiety Scale score was 57.65 ± 21.46, and the mean Burnout Inventory score was 39.21 ± 17.61. The organization subscale explained 17% of the variance in death anxiety, and the organization and resources subscales explained 31% of the variance in burnout. Neonatal intensive care nurses' palliative care attitudes are moderate; they face obstacles in providing and improving their attitudes in this field. The high level of obstacles increases nurses' death anxiety and burnout.

The effect of COVID-19 fear on midwifery students anxiety, self-confidence.

BACKGROUND: Several studies have investigated independently of clinical education, it has been emphasized that students experience fear, anxiety, sadness and uncertainty during the pandemic. AIM: This study aimed to investigate the effect of fear of COVID-19 on the level of anxiety and self-confidence of midwifery students who did their clinical internship during the pandemic. METHODS: Convenience sampling yielded 181 senior midwifery students who had experienced clinical internships during the COVID-19 pandemic. Two state universities conducted an online cross-sectional predictive study from February to June 2021. Data were collected by an Information Form, the COVID-19 Fear Scale, the State-Trait Anxiety Inventory, and the Self-Confidence Scale. RESULTS: The study findings were that the students' fear of COVID-19 (16.72 ± 4.89), state anxiety (52.65 ± 8.41), and trait anxiety (48.66 ± 6.80) were above average, and their self-confidence was moderate. The result indicated that midwifery students' fear of COVID-19 increased, their state anxiety increased (p < 0.01), and their self-confidence decreased (p < 0.01). Fear of COVID-19 accounted for 47% of state anxiety, 6% of trait anxiety, and 22% of self-confidence. CONCLUSION: The level of COVID-19 fear of midwifery students who did clinical internships during the pandemic negatively affected their anxiety and self-confidence levels (Tab. 4, Ref. 34). Text in PDF www.elis.sk Keywords: pandemic, midwifery, fear of COVID-19, anxiety, self-confidence.

First death experiences of newly graduated nurses: A qualitative phenomenological study.

Newly graduated nurses typically face death for the first time during the transition to their professional careers. This encounter can cause nurses to experience compelling emotions and make it difficult for them to manage and cope with the process of adaptation to the profession and the death process of the patient. This study aims to retrospectively examine and reveal the first death experiences of newly graduated nurses (N = 15) using a retrospective phenomenological method. Analysis of the responses of the newly graduated nurses revealed three themes: first encounter with death, nothing is like before, and support need. Newly graduated nurses realized that their first death experiences change their perspectives on life and profession and that nursing touches human life.

Supportive care needs in predicting the acceptance of illness among gynecological cancer patients undergoing therapy: a cross-sectional study.

PURPOSE: This study aimed to examine the effect of supportive care needs and related factors in the acceptance of illness by gynecological cancer patients undergoing therapy. METHODS: A cross-sectional design was adopted. The study included 190 gynecologic cancer patients by convenience sampling method. The personal information form, Acceptance of Illness Scale, and Supportive Care Needs a Survey-Short Form were used for data collection. ANOVA, t-test, Pearson's correlation test, and hierarchical regression analysis were used for analyzing the data. RESULTS: Most participants (72.6%) had moderate acceptance of illness, and the Supportive Care Needs a Survey-Short Form total score was a moderate level, at 84.93 ± 18.86. All the patients stated that their need for supportive care had caused them much concern, thus needing additional help. The acceptance of illness was negatively related to unmet supportive care needs (r =-0.515, p = 0.001) and all its subscales [health care service and informing, psychology, sexuality, daily life, (r = -0.343, r = -0.447, r = -0.341, r = -0.408, respectively; p < 0.05)]. Hierarchical regression analyses indicated unmet psychology (ß = -0.305), daily life (ß = -0.205) and sexuality needs (ß = -0.167), perceived income (ß = 0.290), and occupation (ß = -0.167), explaining 45% of the acceptance of illness. CONCLUSIONS: Acceptance of illness of gynecological cancer patients undergoing therapy needs to be improved. Perceived income and occupation are positive predictors, and unmet psychology, daily life, and sexuality needs are negative predictors of acceptance of illness.

Influence of technical, cognitive and socio-emotional factors on digital literacy in nursing students assessed using structural equation modeling.

BACKGROUND: Digital literacy is one of the 21st-century skills that nursing students should develop and acquire. Several factors influencing digital literacy have been identified, but the predictive role of technical, cognitive, and socio-emotional factors in digital literacy remains unexplored in nursing students. OBJECTIVE: This study aimed to explore the digital literacy level and determine the predictive role of technical, cognitive, and socio-emotional factors in digital literacy among nursing students in Turkey using a structural equation modeling (SEM)-based approach. DESIGN: A web-based, predictive, cross-sectional study. SETTINGS: This study was conducted among first-, second-, third- and fourth-year students in a nursing faculty located in the capital of Turkey in the academic year 2021-2022. PARTICIPANTS: Overall, 210 nursing students were recruited for this study. METHODS: The use of a digital literacy model guided data collection. Data were collected between 8 and 28 June 2022 using online Google Forms. The data were analyzed using descriptive statistics and SEM. RESULTS: Nursing students' digital literacy mean score was 67.29 (13.60). Internet self-efficacy (ß = 0.31, p < 0.001), online information search strategies (ß = 0.20, p = 0.003), and online privacy concerns (ß = 0.14, p = 0.024) were positive predictors, whereas social media use (ß = -0.13, p = 0.032) was a negative predictor of digital literacy. Among these variables, Internet self-efficacy had the most significant influence on the digital literacy level. The four variables contributed to 22 % of variance in the digital literacy level. CONCLUSIONS: This study shows nursing students' digital literacy level is above average. Our findings suggest that technical, cognitive, and socio-emotional factors influence digital literacy.

"I Am Grateful for Every Day I Live": A Qualitative Study on the Spiritual Experiences of Women With Gynecological Cancer.

BACKGROUND: Considering the life-threatening nature of gynecological cancers, spirituality and religious beliefs may play a key role in the experiences of the patients during the disease process and their coping. OBJECTIVE: The aim of this study was to understand the spiritual experiences of Muslim women with gynecological cancer during the disease process. METHODS: A qualitative, phenomenological, and hermeneutic approach was followed in the research. Fourteen women with gynecological cancer in Turkey were interviewed individually. The thematic analysis approach of Braun and Clarke was used to evaluate the data. RESULTS: The results of the data analysis revealed 3 themes (consisting of 9 subthemes): (1) reaction to cancer: spiritual distress (fear of death, perception of punishment, fear of obscurity and uncertainty, and being a cause of spiritual distress in the family); (2) reaction to cancer: spiritual well-being (accepting whatever may come from Allah, strengthening the faith in Allah); and (3) spiritual resources for coping with cancer (religious practices, hobbies and complementary practices, and family support). CONCLUSIONS: The results of the study shed light on the cases that may cause spiritual distress and improve the spiritual well-being that is experienced by Muslim women with gynecological cancer during the disease process; they also reveal that religion has an effect on the experiences during the cancer process and the coping methods. IMPLICATIONS FOR PRACTICE: Healthcare professionals who care for Muslim women with gynecological cancer should plan spiritual care by being aware of the cultural characteristics and religious beliefs of these women and their families.

Effectiveness of Virtual Reality Simulation Among BSN Students: A Meta-analysis of Randomized Controlled Trials.

This study aimed to evaluate the effect of virtual reality simulation in nursing education in five domains: knowledge, skill performance, self-confidence, self-efficacy, and satisfaction. Randomized controlled trials were obtained from the databases SCOPUS, Web of Science, PubMed, and EBSCO from inception until September 2021. The standardized mean differences with 95% confidence intervals were determined for the main variables, and heterogeneity was analyzed using the I2 test. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) Checklist was used. Meta-analysis was performed using the Stata 15.0 software. Among the 2074 records identified, 18 trials were included. The meta-analysis of these trials indicated that virtual reality simulation caused a significant improvement in knowledge with a moderate effect, skill performance with a moderate effect, and satisfaction with a moderate effect compared with the control group. However, virtual reality simulation did not significantly influence self-confidence and self-efficiency. The findings of this study suggested that virtual reality simulation might significantly benefit knowledge, skill performance, and satisfaction but not self-confidence and self-efficiency. Further well-designed randomized controlled trials with a larger sample size are recommended to confirm these findings.

Effects of COVID-19 fear and anxiety on attitudes towards complementary and alternative medicine use in women with gynecological cancer during the COVID-19 pandemic.

OBJECTIVE: Patients with gynecological cancer commonly use complementary and alternative medicine (CAM) methods to cope with the disease. However, despite the existence of treatment strategies, the effect of fear and anxiety caused by coronavirus disease 2019 (COVID-19) pandemic on attitudes about CAM use is unclear. This study was carried out to investigate the effect of fear and anxiety experienced by patients with gynecological cancer during the COVID-19 pandemic on their attitudes towards the use of CAM. METHODS: This is a cross-sectional and descriptive study that included 177 women with gynecological cancer; participants were recruited from a social networking site for cancer patients in Turkey between June and December 2021. Data were collected using an online survey that included the Personal Information Form, the Fear of COVID-19 Scale, the Coronavirus Anxiety Scale, and the Attitude Towards Holistic Complementary and Alternative Medicine Scale. Descriptive statistics, t-test, Pearson's correlation test, and simple linear and multiple regression analyses were performed to analyze the data. RESULTS: During the pandemic, 55.4% of the participants reported using CAM methods, but only 22.6% were using CAM before the pandemic. The participants who used CAM during the pandemic also scored higher on the fear of COVID-19 and coronavirus anxiety scales (20.69 ± 5.37 and 13.09 ± 6.29, respectively) compared to the participants who did not use CAM (9.29 ± 2.72 and 6.35 ± 2.06, respectively). Fear of COVID-19 accounted for 52% of the CAM attitude score, while coronavirus anxiety accounted for 15% of the CAM attitude score. Fear of COVID-19 and coronavirus anxiety together accounted for 53% of CAM attitude. CONCLUSION: Gynecological cancer patients with high levels of COVID-19-related anxiety and fear during the pandemic used CAM more. Given that the psychological effects of the pandemic will continue in the coming years, CAM use should be evaluated as a coping strategy, especially due to the COVID-19-related anxiety and fear experienced by patients with gynecological cancer. While the rational and effective CAM methods should be supported, strategies should be developed to prevent misuse of CAM and its interference in prescribed medical treatments. Please cite this article as: Uslu-Sahan F, Yesilcinar I, Kurt G, Hancer E, Guvenc G. Effects of COVID-19 fear and anxiety on attitudes towards complementary and alternative medicine use in women with gynecological cancer during the COVID-19 pandemic. J Integr Med. 2023; 21(4): 377-384.

Predictors of health professional students' attitudes toward LGBTI individuals: A cross-sectional study from Turkey.

AIM: This study aimed to examine the relationships between the demographic characteristics, knowledge, and attitude of health professional students toward lesbian, gay, bisexual, transgender, and intersex (LGBTI) individuals. METHODS: A total of 860 undergraduate health professional students were enrolled in this analytical cross-sectional study. RESULTS: The attitudes of health professional students toward LGBTI individuals are moderately positive. Some variables such as gender, faculty/department, mother's working status, having knowledge about LGBTI, having friends who are openly LGBTI, and thoughts about being an LGBTI explained 17.1 % of the variance in attitudes toward LGBTI individuals. CONCLUSION: Since negative attitudes may prevent LGBTI individuals from receiving effective health care, courses that increase students' awareness of their own prejudices and knowledge of LGBTI health and communication should be integrated into undergraduate programs.

Quality of Sexual Life and Attitudes toward Menopause among Postmenopausal Women Living in Northern Cyprus: A Cross-sectional Study.

Background: Most middle-aged women in the menopausal period consider sexuality an important part of life. The aim of the present study was to investigate the factors affecting the quality of sexual life and attitudes toward menopause in postmenopausal women and the effects of their attitudes toward menopause on the quality of sexual life. Materials and Methods: This cross-sectional study was conducted with postmenopausal women in the Turkish Republic of Northern Cyprus between July 2021 and April 2022. The research sample consisted of 255 postmenopausal women. The Attitudes Toward Menopause Scale and the Sexual Quality of Life Scale (SQLS) were used to collect data. The questionnaire forms were administered online. The data were analyzed using the independent t-test, analysis of variance, Tukey's test, Pearson's correlation, and linear regression analysis. Results: The mean score of the participants on the SQLS was 43.54 ± 12.56 and the mean score of the Attitudes Toward Menopause Scale was 60.39 ± 16.29. The study revealed that variables such as age, level of education, employment status, duration of menopause, and knowledge about menopause have an effect on women's sexual life quality. In addition to the listed variables, income level was found to affect attitudes toward menopause. A positive attitude toward menopause causes an increase in the level of sexual life quality (ß = 0.544, R2 = 0.30, F = 106.260, R = 0.544, P = 0.001). Conclusions: The attitudes of postmenopausal women toward menopause are an important determinant of their sexual life quality. For this reason, it is recommended to develop and implement training programs that can improve sexual health of women and their attitudes toward menopause.

Transformational leadership practices of nurse managers: the effects on the organizational commitment and job satisfaction of staff nurses.

PURPOSE: This study aims to investigate the perception of nurse managers and staff nurses regarding the transformational leadership (TL) style of nurse managers and determine the effects of the TL practices on organizational commitment and job satisfaction of staff nurses. DESIGN/METHODOLOGY/APPROACH: This cross-sectional and descriptive study was conducted with 153 nurses (17 nurse managers and 136 staff nurses) working in a university hospital. Data were collected from participants through a demographic questionnaire, leadership practices inventory (self/observer), organizational commitment scale and job satisfaction scale. FINDINGS: The self-assessment of the TL practices of the nurse managers were more favourable than the assessment of the leadership practices made by staff nurses. The TL practices of the nurse managers accounted for 9% of the total organizational commitment and 24% of the total job satisfaction of the staff nurses. ORIGINALITY/VALUE: The results indicated that leadership practices by nurse managers need to show greater awareness of the effects of these leadership practices on the organizational commitment and job satisfaction of their staff nurses. Hospitals need to consider how they develop, support and encourage because of the positive impact TL has on health priorities and retention of staff.

Interprofessional simulation-based training in gynecologic oncology palliative care for students in the healthcare profession: A comparative randomized controlled trial.

BACKGROUND: Preprofessional palliative care education may be inadequate, leaving a gap in health professional students' knowledge and understanding of managing patients with gynecologic cancer and their families. Interprofessional simulation-based training may be useful in helping health professional students gain the necessary skills required for palliative care. OBJECTIVE: This study aimed to determine the effectiveness of different simulation methods used for interprofessional training on gynecologic oncology palliative care knowledge, interdisciplinary education perceptions, and teamwork attitudes of health professional students and to compare these methods. DESIGN: A comparative randomized controlled trial was conducted with a pre-test and two post-tests. SETTINGS: This study was conducted at a university in Ankara, Turkey, in 2016-2017. PARTICIPANTS: A convenience sample of 84 interprofessional students (nursing, medical, nutrition-dietician, and social work) was used in the study. METHODS: Students were stratified by their profession and randomized by four blocks into high-fidelity simulation, hybrid simulation, and a control group. Data were collected using a semi-structured questionnaire form, palliative care knowledge test, interdisciplinary education perception scale, and teamwork attitudes questionnaire. RESULTS: The high-fidelity simulation and hybrid simulation groups improved their palliative care knowledge, interdisciplinary education perception, and teamwork attitudes from pre-test to first and second post-tests compared to the control group. CONCLUSION: The introduction of high-fidelity simulation and hybrid simulation or hybrid simulation-based interprofessional training in undergraduate education can increase students' palliative care knowledge, interdisciplinary education perception, and teamwork attitudes. Training programs that are used together with high-fidelity simulation and hybrid simulation applications in interdisciplinary training should be integrated into the undergraduate curricula of future cooperating health professions.

Hopelessness, Death Anxiety, and Social Support of Hospitalized Patients With Gynecologic Cancer and Their Caregivers.

BACKGROUND: Gynecologic cancer can create hopelessness and death anxiety and alter the lifestyle of the affected women and their caregivers. Perceived social support may facilitate coping with this illness. OBJECTIVE: The aim of this study was to determine whether hospitalized patients with gynecologic cancer and their caregivers differ in feelings of hopelessness and death anxiety and how those conditions may be related to their social support. METHODS: Two hundred patients with gynecologic cancer and their 200 caregivers from 1 university hospital were enrolled in this descriptive correlational study. Study measures included a demographic form, the Perceived Social Support Scale, the Beck Hopelessness Scale, and the Thorson-Powell's Death Anxiety Scale. Data were analyzed using Student t test, Pearson correlation test, and linear regression analyses. RESULTS: Patients had higher hopelessness and death anxiety compared with caregivers (P < .001). Patients' perceived social support explained 35% of the total variance in hopelessness and 28% of the variance in death anxiety; caregivers' perceived social support explained 40% of the total variance in hopelessness and 12% of the variance in death anxiety. CONCLUSION: Patients felt hopelessness and death anxiety in greater rates than caregivers. Social support had a significant effect on hopelessness and death anxiety of patients and their caregivers. IMPLICATIONS FOR PRACTICE: Nurses, who are the healthcare professionals spending time with patients and families from diagnosis forward, need to evaluate patients and their caregivers for hopelessness and death anxiety and consider their social support systems during this evaluation.

Factors affecting performance and productivity of nurses: professional attitude, organisational justice, organisational culture and mobbing.

AIM: To identify relationships among variables affecting nurses' performance and productivity, namely professional attitudes, organisational culture, organisational justice and exposure to mobbing. BACKGROUND: The determination of the factors affecting performance and productivity is important for providing efficient nursing services. These factors have been investigated in the literature independently, but the relationship among them has not been clearly identified. METHODS: This cross-sectional questionnaire study included 772 nurses working in a University Hospital accredited by Joint Commission International. RESULTS: The professional attitude score of the nurses was high (4.35 ± 0.63). However, their organisational justice (2.22 ± 1.26) and organisational culture (2.47 ± 0.71) scores were low. Nurses were subjected to mobbing at a high level (0.82 ± 0.78). As the organisational justice increased, the organisational culture increased and the mobbing decreased. As the organisation culture decreased, the mobbing increased. CONCLUSIONS: There was a positive correlation between organisation culture and organisational justice of the nurses and a negative correlation with mobbing. IMPLICATIONS FOR NURSING MANAGEMENT: The results of the study are essential for improving nurses' performance and productivity.