Nurses' knowledge of, attitudes towards and awareness of the metaverse, and their future time perspectives: a cross-sectional study.

BACKGROUND: The metaverse is a new and developing technology used in the field of healthcare. The perception of future explains time as a psychological phenomenon rather than a physical one. This study aimed to determine nurses' thoughts of the metaverse and their perceptions of future. METHODS: The study in which the cross-sectional descriptive design was used was conducted with nurses working in a hospital in Trkiye from September 2022 to December 2022. Face-to-face interviews were conducted with 374 nurses who were chosen using the convenience sampling method. Personal Identification Form, Metaverse Scale (MS) and Future Time Perspective Scale (FTPS) were used to collect data. The Statistical Package for Social Sciences (SPSS) for Windows 25.0 program was used to analyse the data. RESULTS: The findings revealed that 81.6% of the nurses believed that they could provide patient education using the metaverse in the future, whereas 46% believed that they could do virtual nursing. The mean scores obtained from the FTPS and MS by the nurses were 3.45 (SD = 0.37) and 3.74 (SD = 0.56), respectively. There was a weak positive relationship between perception of future, and knowledge of, attitudes towards and awareness of the metaverse (r = 0.157, p = 0.002), and a weak, positive relationship between internet use duration and MS (r = 0.169, p = 0.001). CONCLUSIONS: This study underscores the potential of the metaverse in nursing, revealing that nurses are optimistic about its application in patient education and virtual care. We recommend the development of specialized training programs to equip nurses with the necessary skills and knowledge to effectively utilize the metaverse in healthcare settings.

Prognostic importance of prognostic nutritional index and modified Glasgow prognostic score in advanced lung cancer with targetable mutation.

BACKGROUND: Inflammation and nutrition are important parameters that significantly affect survival in various malignancies. Prognostic nutritional index (PNI) and modified Glasgow prognostic score (mGPS) can reflect both inflammatory and nutritional conditions. Therefore, we aimed to evaluate the prognostic value of PNI and mGPS in patients who had the targetable mutation and also received targeted therapy. MATERIALS AND METHODS: Advanced lung cancer patients with EGFR mutation (mut) and ALK rearrangement were enrolled to study, retrospectively. PNI has with the following formula: 10 × serum albumin (g/dl) + 0.005 × peripheral lymphocyte count (per mm3) and threshold value was accepted as 50. Modified GPS was also calculated using albumin and CRP level and patients were scored as range 0 to 2. RESULTS: A total of 182 patients enrolled in the study. 132 and 50 of 182 patients had EGFR mut and ALK rearrangement, respectively. PFS was significantly longer in high PNI group in both the EGFR and ALK rearrangement-positive subgroups (P = 0.004 for EGFR mut-positive group; P = 0.017 for ALK rearrangement-positive group). Additionally, PFS was significantly shortened from mGPS 0 to 2 (P = < 0.001 for EGFR mut-positive group; P = 0.016 for ALK rearrangement-positive group). CONCLUSION: Both PNI and mGPS can be used as a reliable, inexpensive, and easily applicable prognostic index in the advanced lung cancer patients who had the targetable mutation and also received targeted therapy.

"A different country, a different language, a different culture " Educational experiences of international nursing students studying in Turkey: A qualitative study.

AIM: This study was aimed at investigating the educational experiences of international nursing students in Turkey. BACKGROUND: Nursing education has now gained an international dimension, which creates an environment where students from different cultures come together. In Turkey, nursing education is expanding internationally due to the increasing number of international students. DESIGN: A descriptive- phenomenological qualitative study. METHODS: The study data were collected from nursing students who came to Turkey from 17 different countries between April 2023 and July 2023 to study at a nursing faculty in Turkey using a semi-structured interview form. Of these students, 27 constituted the study sample. The data collected were analyzed using the content analysis. The COREQ checklist was used in reporting the study. RESULTS: Four themes emerged: a) challenges, b) gains, c) support needs and d) recommendations. Among challenges reported by the participating students were language barriers, cultural adjustment issues and lack of social support. As for the gains of being a foreign student, they stated that they experienced intercultural interaction and improved their language skills, independence and self-confidence. In the study, the need for language support, provision of psychological assistance and cultural adaptation support for these students and the importance of practical recommendations such as mentoring programs and orientation trainings to improve their educational experience were emphasized. CONCLUSION: In conclusion, in this study, the importance of targeted strategies in nursing education in areas such as language support, psychological assistance and cultural adaptation was emphasized, which helps international students to have a successful educational experience. It was also concluded that mentoring programs and orientation trainings could enrich the educational processes of students by facilitating their adaptation to their new environment. This study is notable in the literature in that students from 17 diverse countries share the same program and the same prerequisites.

Bibliometric and content analysis of ChatGPT research in nursing education: The rabbit hole in nursing education.

AIM: This study was conducted to perform the bibliometric and content analysis of ChatGPT studies in nursing education. BACKGROUND: ChatGPT is an artificial intelligence-based chatbot developed by OpenAI. The benefits and limitations of the use of ChatGPT in nursing education are still discussed; however, it is a tool having potential to be used in nursing education. DESIGN: Bibliometric and content analysis. METHODS: The study data were scanned through Scopus and Web of Science. Bibliometric analysis was carried out with VOSViewer and Bibliometrix software. In the bibliometric analysis, science mapping and performance analysis techniques were used. Various bibliometric data, including most cited publications, journals and countries, were analyzed and visualized. The synthetic knowledge synthesis method was used in content analysis. RESULTS: We analyzed 53 publications to which 151 authors contributed. The publications had been published in 29 different journals. The average number of citations of publications is 8.2. It was determined that most of the articles were published in Nurse Education Today and Nurse Educator journals and that the leading countries were the USA and Canada. It was observed that international cooperation on the issue was weak. The most frequently mentioned keywords in the publications were "ChatGPT", "artificial intelligence" and "nursing". The following three themes emerged after the content analysis: (1) Integration of ChatGPT into nursing education; (2) Potential benefits and limitations of ChatGPT; and (3) Stepping down the rabbit hole. CONCLUSIONS: We expect that the results of the study can give nursing faculties and academics ideas about the current status of ChatGPT in nursing education and enable them to make inferences for the future.

The effect of listening to music and foot reflexology on nausea, pain and anxiety in children during perioperative period: A randomized controlled study.

AIM: The purpose of this research was to examine the effects of listening to music and foot reflexology during the perioperative period on nausea, pain and anxiety in children aged 7-12 years. MATERIAL AND METHOD: The sample for the randomized controlled experimental study included children who underwent outpatient surgery in the Pediatric Surgery Clinic. Research data were collected. A total of 99 children were included in the study with 33 in the music group, 33 in the foot reflexology group, and 33 in the control group. RESULTS: In the preoperative and postoperative periods, Children's Perioperative Multidimensional Anxiety Scale (CPMAS) scores for the music listening and reflexology groups were significantly lower than the control group (p < 0.05). In the postoperative period, the Children's Emotional Manifestation Scale (CEMS) scores for the reflexology and music listening groups after the application were significantly lower than the control group (p < 0.001). Postoperative Baxter Retching Faces (BARF) scores were found to be significantly lower in children who listened to music compared to the control group (p = 0.002). The Children's Hospital of Eastern Ontario Pain Scale (CHEOPS) scores for children in the control group were found to be significantly higher in the postoperative period than for children in the music and reflexology groups (p < 0.001). CONCLUSIONS: As a result, listening to music and reflexology during the perioperative period were effective in reducing anxiety, pain and nausea in children. PRACTICE IMPLICATIONS: In the perioperative period, listening to music and reflexology for children can be recommended as non-pharmacological nursing interventions with low cost and easy implementation.

Mobile learning in nursing education: A bibliometric analysis and visualization.

AIM: This study performed a bibliometric analysis of studies related to mobile learning in the field of nursing education. METHODS: The Scopus database was used to determine the most frequently cited studies on mobile learning in nursing education. VOSviewer and Bibliometrix were employed for bibliometric analysis and visualization. Science mapping and performance analysis was adopted from bibliometric analysis techniques. In addition, a synthetic knowledge synthesis approach was used. RESULTS: A total of 234 publications were published in 107 sources in 2002-2023. The publications had 8797 citations, an average of 88 citations per publication. In terms of total link strength (TLS), links, a number of articles and citations, the US led all other countries in the field. Regarding authors, Hwang was the most frequently cited authors (n = 348). According to trend topics analysis, the keywords "gamification", "simulation", "attitude", "clinical competence" and "online learning" have emerged in the field. CONCLUSION: Research on mobile learning in nursing education has been increasing in recent years. The findings of this study can provide new ideas in the applications of mobile learning in nursing education to researchers or nursing faculties in the field.

Determination of nursing students' attitudes toward and readiness for mobile learning: A cross-sectional study.

BACKGROUND: Mobile learning is a learning method that enables nursing students to learn anytime and anywhere. OBJECTIVES: This study was designed to determine nursing students' attitudes toward and readiness for mobile learning. DESIGN: A descriptive, cross-sectional study design was used. SETTING: The study was conducted at a nursing faculty in Turkey. PARTICIPANTS: The sample size was determined using the stratified randomization method by considering the participants' years at school, and 290 nursing students were included in this study. METHODS: Data were collected using the Sociodemographic Characteristics Questionnaire, Mobile Learning Attitude Scale (MLAS), and Mobile Learning Readiness Scale (MLRS) using the survey method. Statistical Package for the Social Sciences, version 25.0, was used for all data analyses. RESULTS: The mean scores of the participating nursing students obtained from the MLAS and MLRS were 76.48 ± 9.28 and 79.64 ± 16.62, respectively. Compared to first- and second-year students, fourth-year students, those who had mobile learning experience, and those who wanted to use a mobile learning system in the future obtained higher MLAS and MLRS scores. A positive, weak correlation was found between variables, age and level of computer use, and the MLAS and MLRS scores. CONCLUSIONS: It was determined that the attitudes of nursing students toward mobile learning were positive and they were ready for mobile learning. The results of this study can be used in designing and implementing mobile learning systems.

Crizotinib efficacy and safety in patients with advanced NSCLC harboring MET alterations: A real-life data of Turkish Oncology Group.

Crizotinib is a multikinase inhibitor, effective in non-small cell lung cancer (NSCLC) harboring mesenchymal-epidermal transition (MET) alterations. Although small prospective studies showed efficacy and safety of crizotinib in NSCLC with MET alterations, there is limited real-life data. Aim of this study is to investigate real-life efficacy and safety of crizotinib in patients with advanced NSCLC harboring MET alterations. This was a retrospective, multicenter (17 centers) study of Turkish Oncology Group. Patients' demographic, histological data, treatment, response rates, survival outcomes, and toxicity data were collected. Outcomes were presented for the study population and compared between MET alteration types. Total of 62 patients were included with a median age of 58.5 (range, 26-78). Major histological type was adenocarcinoma, and 3 patients (4.8%) had sarcomatoid component. The most common MET analyzing method was next generation sequencing (90.3%). MET amplification and mutation frequencies were 53.2% (n = 33) and 46.8% (n = 29), respectively. Overall response rate and disease control rate were 56.5% and 74.2% in whole study population, respectively. Median progression free survival (PFS) was 7.2 months (95% confidence interval [CI]: 3.8-10.5), and median overall survival (OS) was 18.7 months (95% CI: 13.7-23.7), regardless of treatment line. Median PFS was 6.1 months (95% CI: 5.6-6.4) for patients with MET amplification, whereas 14.3 months (95% CI: 6.7-21.7) for patients with MET mutation (P = .217). Median PFS was significantly longer in patients who have never smoked (P = .040), have good performance score (P < .001), and responded to the treatment (P < .001). OS was significantly longer in patients with MET mutation (25.6 months, 95% CI: 15.9-35.3) compared to the patients with MET amplification (11.0 months; 95% CI: 5.2-16.8) (P = .049). In never-smokers, median OS was longer than smoker patients (25.6 months [95% CI: 11.8-39.3] vs 16.5 months [95% CI: 9.3-23.6]; P = .049). The most common adverse effects were fatigue (50%), peripheral edema (21%), nausea (29%) and diarrhea (19.4%). Grade 3 or 4 adverse effects were observed in 6.5% of the patients. This real-life data confirms efficacy and safety of crizotinib in the treatment of advanced NSCLC harboring MET alteration.

Artificial intelligence and robot nurses: From nurse managers' perspective: A descriptive cross-sectional study.

AIM: This research was planned to identify nurse managers' opinions on artificial intelligence and robot nurses. BACKGROUND: As the concepts of artificial intelligence and robot nurses are becoming widespread in Turkey, nurse managers are expected to guide and cooperate with nurses in the future in regard to these technologies. METHODS: The sample of the study consisted of 326 manager nurses, who were reached via the online questionnaire during the period of September to November 2021. A Nurse Managers Information Form and a Question Form on Artificial Intelligence and Robot Nurses were used to collect data. Data in this cross-sectional descriptive study were collected between September 2021 and November 2021 by the online survey method. The descriptive statistics of the data were analysed with numbers and percentages. The difference between the knowledge of artificial intelligence and robot nurses and demographic characteristics was analysed with the chi-square test. RESULTS: According to the findings, 66.9% of the nurse managers reported having heard the concepts of artificial intelligence and robot nurses previously. 67.2% stated that they thought that robot nurses would benefit the nursing profession, but 86.2% voiced disbelief that robots would replace nurses. CONCLUSIONS: The majority of the participating nurse managers reported that artificial intelligence and robot nurses would not replace nurses but would be beneficial for nurses and would reduce their workload. IMPLICATIONS FOR NURSING MANAGEMENT: It should be ensured that the nurse managers plan the areas in the hospital where artificial intelligence and robot nurses will be used and determine the possible risks. Awareness should be increased with in-service trainings, and patient safety and ethical problems regarding the use of artificial intelligence and robot nurses should be identified.

Effects of music on sleep quality and comfort levels of pregnant women.

OBJECTIVES: This pilot randomized controlled experimental study was conducted to investigate effects of music on sleep quality and comfort levels of pregnant women. METHODS: The sample of the study consisted of 70 pregnant women who met the inclusion criteria and agreed to participate in the study. The pregnant women were assigned to the music (n=35) and control groups (n=35). In the study, the musical pieces composed in Ussak mode were played for the participants in the music group. The pregnant women in the music group were first asked to empty their bladder and then listen to music for 30 min in a semi-Fowler's position with their head and shoulders raised 30°, in a quiet and dim environment, every other day for two weeks before going to sleep. The Pregnant Information Form, Prenatal Comfort Scale (PCS) and Pittsburgh Sleep Quality Index - 1 week (PSQI-1 week) were used to collect the study data. RESULTS: The analysis of the mean scores obtained from the overall PSQI-1 week by the pregnant women in the music and control groups by weeks demonstrated that there was a statistically significant difference between the music and control groups in the second week (p<0.05). There was no statistically significant difference between the two groups in terms of the mean scores they obtained from the overall PCS (p>0.05). CONCLUSIONS: Music increased the sleep quality of the pregnant women in the music group, but had no effect on their comfort levels.

The real-life efficacy and safety of osimertinib in pretreated advanced non-small cell lung cancer patients with T790M mutation: a Turkish Oncology Group Study.

INTRODUCTION: Osimertinib, an irreversible third-generation EGFR-TKI, is the standard of care for second-line treatment of T790M-mutant advanced NSCLC patients whose disease progressed after first-line EGFR-TKI therapy. In this multicenter study, we aimed to determine the real-life efficacy and safety of Osimertinib in pretreated advanced NSCLC patients with T790M mutation. MATERIALS AND METHODS: This retrospective trial included advanced T790M-mutant pretreated NSCLC patients who received Osimertinib from 24 different centers in Turkey. Primary endpoint was time-to-treatment discontinuation (TTD). Secondary endpoints were objective response rate (ORR), overall survival (OS), and safety. RESULTS: Of 163 patients, 68.7% had EGFR exon 19 deletion and 22.7% had exon 21 L858R mutation. Osimertinib was given as second-line treatment in 96 patients (58.9%) and third-line in 48 patients (29.4%). After median of 13-month follow-up, median TTD was 21.6 months with an 82.2% ORR. Estimated median OS was 32.1 months. Grade 3-4 adverse events were seen in 11.7% of the patients. CONCLUSION: Osimertinib is a highly effective option in second- or third-line treatment of NSCLC patients with T790M mutation, with a favorable safety profile.

Investigation of Anxiety Levels of Nursing Students Related to Intravenous Interventions and Factors Affecting the Anxiety.

This descriptive type study was conducted in order to determine the anxiety levels experienced by nursing students during IV intervention and the factors causing anxiety. The study was completed with a total of 260 students, 86 of whom were year-2, 72 were year-3, and 102 were year-4 students, who voluntarily participated in the study. Data were collected online with a Google survey using the Personal Information Form and the Trait Anxiety Inventory. As per the study results, a total of 80.4% of the students were found to experience anxiety during IV interventions, and their trait anxiety (45.10±8.8) levels were moderate. A statistically significant difference was found between the achievement status of the students and their mean trait anxiety score (p<0.05). As a conclusion of the study, the students were found to experience moderate levels of anxiety during IV interventions and their level of anxiety decreased as their achievement levels increased. This was the first study on the subject in our country and new studies are needed.

Does the use of infrared technology (AccuVein AV-500®) for Peripheral Intravenous Cannulation (PIVC) increase the success rate in nursing students? A randomized controlled trial.

BACKGROUND: PIVC is one of the essential procedures of modern medicine, and is one of the most widely used and important treatments in the clinical setting. Nevertheless, it is one of the most difficult skills to teach in nursing education, and it is the skill which causes the most anxiety in nursing students. OBJECTIVES: The aim of the study was to examine the effect of the teaching method using infrared technology on PIVC success, duration, and the level of psychomotor skills and knowledge in the acquisition of PIVC skills in nursing students. METHODS: This was a pre-test post-test randomized experimental study with a control group. The research was conducted in the Skills and Simulation Laboratory of a Nursing Faculty of a university between December 2019 and February 2020 to examine the effects of teaching PIVC measurement via infrared light on students' success rate. A theory lesson on PIVC followed 15 days later by laboratory practical was carried out with all of the students included in the study. The PIVC Knowledge Evaluation Form as a pre-test. The researchers completed the PIVC Skills Performance Test from observation during the application of the checklist. Immediately after the procedure, the PIVC Knowledge Evaluation Form was applied as a post-test. RESULTS: The procedure success rate of the experimental group was 90%, and that of the control group was 46%. Comparing PIVC skill scores between the groups, the difference was found to be statistically significant (Z = -2.741; p < 0.05). The groups' PIVC knowledge levels increased in a similar way. CONCLUSION: Teaching with infrared technology contributes more to students' success in PIVC skills than does standard teaching. Both methods were effective in developing knowledge of PIVC.

[Clinical features of the ALK-mutant non-small cell lung cancer patients who received first-line alectinib treatment]. / Birinci basamak alektinib tedavisi alan ALK mutasyonu pozitif akciger kanseri hastalarinin klinik özelliklerinin degerlendirilmesi.

INTRODUCTION: Lung cancer is the most common cancer type and the leading cause of cancer-related mortality worldwide. The positivity rate of the anaplastic lymphoma kinase (ALK) mutation in non-small cell lung cancer (NSCLC) patients has been reported as 3-7%. This study aimed to investigate the pathological, clinical and demographic characteristics of ALK-mutant NSCLC patients who received first-line alectinib as a tyrosine kinase inhibitor in two different centers. MATERIALS AND METHODS: The study was performed at the Medical Oncology Departments of Ankara City Hospital and Atatürk Chest Diseases and Thoracic Surgery Training and Research Hospital. Patients diagnosed with ALK-mutant NSCLC and received alectinib treatment as a first-line tyrosine kinase inhibitor were enrolled to study and retrospectively analyzed. RESULT: A total of 38 patients (15 males, 23 females) were included in the study. Median age was 56.5. 55.3% of the patients were non-smokers. All of the patients had adenocarcinoma histology. Thirty-four patients (89.5%) were metastatic. Brain metastasis was detected in 44.7% of the patients. Thirty-three patients (86.8%) were using alectinib in first-line treatment. The remaining five patients were seen to have received at least one course of chemotherapy before. The objective response rate was 78.9% with alectinib treatment. The percentage of the patients who experienced at least one side effect was 34.2% and serious side effects were 7.9%. After median 9.5 months follow-up, median progression-free survival (PFS) was not achieved. 24-month PFS was 67% and 24-month overall survival was 84%. CONCLUSIONS: Our results were compatible with previous studies in terms of the clinical, pathological and demographic features of the patients with ALK mutation. We observed that the majority of patients were non-smokers, relatively young, and female patients. The objective response rate and survival results were similar with phase 3 studies.

The effect of EML4-ALK break-apart ratio on crizotinib outcomes in non-small cell lung cancer harboring EML4-ALK rearrangement.

PURPOSE: Anaplastic lymphoma kinase (ALK) gene rearrangement exists in approximately 3-7% of non-small cell lung cancer (NSCLC) and more than 15% split or isolated red signals among 50 tumor nuclei scored in the FISH analysis defines as ALK-positive. The previous studies showed that the high EGFR mutational load related to better outcomes in EGFR mutant NSCLC. Therefore, we aimed to investigate the effect of the ALK break-apart ratio on treatment outcome in metastatic ALK-positive NSCLC. METHODS: The patients (pts) who ALK-positive and treated with crizotinib were retrospectively enrolled. The 30%, 40%, 50%, 60%, and 70% break-apart ratios were determined as a threshold value, and each of these was evaluated separately. Based on the results of these analyses, we detected the optimal threshold value and also performed further investigations. RESULTS: A total of 70 patients were enrolled in the study. The most significant decrease in the risk of the progression or death was detected at the 50% threshold value and it was accepted as the optimal threshold. The median PFS was 17.9 vs. 7.06 months (mo) in the pts with high ALK rearrangement than low (HR: 0.43, 95% CI 0.24-0.76, p 0.004). The median OS was also significant longer in high ALK rearrange group (44.6 mo vs. 16.8 mo; HR: 0.37, 95% Cl 0.1883-0.7315; p 0.004). The intracranial progression during crizotinib treatment was significantly frequent in the pts with high ALK rearrangement (62.5-32.5%, P 0.039) DISCUSSION: In this study, we found that the high break-apart ratio can predict the extent of benefit from targeted therapy in ALK-positive NSCLC patients. Based on the results of this study, the percentage of the ALK rearrangement can be used to predict treatment outcome and to choose the optimal targeted agent in the treatment of metastatic ALK-positive NSCLC.

Real-life comparison of the afatinib and first-generation tyrosine kinase inhibitors in nonsmall cell lung cancer harboring EGFR exon 19 deletion: a Turk Oncology Group (TOG) study.

BACKGROUND: The new second-generation tyrosine kinase inhibitors (TKIs) have superior survival outcome and worse toxicity profile when compared with first-generation TKIs according to the results of clinical trials. However, there are limited studies that investigate the efficacy and safety of the new generation TKIs in real-world patients. Thus, we aimed to compare the efficacy and safety of the afatinib, an irreversible inhibitor of ErbB family receptor, and first-generation TKIs in real-world patients. MATERIALS AND METHODS: We included advanced nonsmall cell lung cancer (NSCLC) patients who had EGFR exon 19del mutation and treated with afatinib or first-generation TKIs as upfront treatment between 2016 and 2020. All patient's information was collected retrospectively. The study cohort was divided as afatinib arm and erlotinib/gefitinib arm. RESULTS: A total of 283 patients at the 24 oncology centers were included. The 89 and 193 of whom were treated with afatinib and erlotinib/gefitinib, respectively. After 12.9 months (mo) of follow-up, the median PFS was statistically longer in the afatinib arm than erlotinib/gefitinib arm (19.3 mo vs. 11.9 mo, p: 0.046) and the survival advantage was more profound in younger patients (< 65 years). The 24-mo overall survival rate was 76.1% and 49.5% in the afatinib arm and erlotinib/gefitinib arm, respectively. Although all-grade adverse event (AE) rates were similar between the two arms, grade 3-4 AE rates were higher in the afatinib arm (30.7% vs. 15.2%; p: 0.004). DISCUSSION: In our real-world study, afatinib has superior survival outcomes despite worse toxicity profile as inconsistent with clinical study results and it is the good upfront treatment option for younger patients and elderly patients who have good performance status.

The Effect of Therapeutic Touch on the Comfort and Anxiety of Nursing Home Residents.

Nurses are increasingly using energy therapies such as therapeutic touch (TT) in many countries. This research aimed at finding out the effects of TT on comfort and anxiety of nursing home residents. This research is a quasi-experimental randomized control study which was conducted to investigate the impact of TT on the comfort and anxiety of older people living in a nursing home in Izmir, Turkey, between August 2015 and 2016. The sample of the study was formed from 60 older people who fitted the selection criteria, 30 in the experimental group and 30 in the control group. Data were collected using a General Comfort Questionnaire (GCQ) and a Situational Anxiety Inventory (STAI). A statistically significant difference was found between the measurements of the TT and control groups. According to the results, TT reduces anxiety and increases the comfort level of older people (p < 0.05). Considering the positive results of TT on comfort levels and anxiety, it can be recommended as an independent nursing practice.

The prognostic values of systemic immune-inflammation index and derived neutrophil-lymphocyte ratio in EGFR-mutant advanced non-small cell lung cancer.

INTRODUCTION: Targeted therapy is the main treatment option for oncogene-addicted non-small cell lung cancer (NSCLC). It is known that inflammation can affect survival. Therefore, we aimed to evaluate the effect of host inflammation on survival and treatment outcome by using the derived neutrophil-lymphocyte ratio (dNLR) and systemic immune-inflammation index (SII). MATERIAL AND METHODS: The advanced epidermal growth factor receptor mutant NSCLC patients diagnosed between 2014 and 2019 were included. SII and dNLR were calculated from pretreatment blood samples. The estimated cutoff for SII and dNLR were 640 and 2, respectively. Progression-free survival and overall survival were calculated by using the Kaplan-Meier test. RESULTS: One hundred thirty six patients enrolled in the study. Of the total patients, 34.6% and 65.4% were SII-low and high, respectively. In addition, 58.1% and 41.9% of the patients were dNLR-low and high groups, respectively. The progression-free survival was better in low SII (22.4 vs. 13.01 months, HR: 0.50; 95% CI 0.32-0.80; P: 0.003) and low dNLR groups (16.9 vs. 13.01 months, HR, 0.58; 95% CI 0.38-0.88; P: 0.011). The overall survival was also significantly longer in SII-low and dNLR-low groups (32.4 vs. 20.4 months; HR, 0.47; 95% CI 0.27-0.81; P: 0.005 for SII and 32.4 vs. 18.4 months HR: 0.40; 95% CI 0.24-0.66; P < 0.001 for dNLR). CONCLUSION: Based on the results of our study, both SII and dNLR can be routinely used as the simple, inexpensive and easily assessable prognostic markers in oncogene-addicted NSCLC.

Validity and reliability study of the Moral Distress Questionnaire in Turkish for nurses.

OBJECTIVE: to determine the validity and reliability of the Turkish language version of the Moral Distress Questionnaire for nurses. METHOD: methodological study whose sample consisted of 200 nurses working in the internal medicine and surgery clinics of a university hospital. Data was collected using the personal information form and the Moral Distress Questionnaire for nurses. RESULTS: in the Main Components Analysis, the items were grouped under three factors. Findings regarding confirmatory factor analysis: chi-square goodness: 2.28, goodness of fit index: 0.88, comparative fit index: 0.88, non-normed fit index: 0.86, root mean square error of approximation: 0.07. The Cronbach's alpha coefficient was found to be 0.79 as a result of the analysis conducted in order to test the internal consistency of the scale. It was seen that these three factors explained 44.92% of the total variance. CONCLUSION: in this present study, the Turkish version of the Moral Distress Questionnaire was found to be valid and reliable for the Turkish society. It is recommended that the Moral Distress Questionnaire for nurses should be used in future studies to be conducted with nurses in order to investigate of issues of ethical dilemma.

The association of clinicopathologic features and peripheral blood parameters with high PD-L1 expression in non-small cell lung cancer.

INTRODUCTION: Programmed death ligand 1 (PD-L1) is a marker that widely used for prediction of response to immunotherapy. Dynamic alteration of PD-L1 expression are the major problems for reflection of the actual status of the PD-L1. So, we aimed to investigate the factors that may be associated with PD-L1 expression in lung cancer. MATERIALS AND METHODS: The patients diagnosed with non-small cell lung cancer were enrolled, retrospectively. The patients were stratified according to PD-L1 expression level as ≥ 50% and < 50%. RESULT: Totally, 217 patients were enrolled. The clinicopathologic features were similar between two groups, except the amount of cigarette consumption. Neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and systemic immune-inflammmotry index were found significantly lower in PD-L1 ≥ 50% (p< 0.001, p= 0.006 and p= 0.003, respectively) and also negatively correlated with PD-L1 level (rho= -0.255, p< 0.001; rho= -0.17, p= 0.013; rho= - 0.185, p= 0.006, respectively). CONCLUSIONS: According to the results of our study, peripheral blood parameters can be used to the prediction of the high PD-L1 expression and can be used for reflection of current PD-L1 expression.