Hacettepe University Faculty of Health Sciences Nursing Journal - 2021; 8(2)

Serg�l DUYGULU

2021-03-01

Physical Restraint Use in Intensive Care Units: Causes and Consequences

�zge TURNA, Ayla G�RSOY — 2021-03-01

Aim: This study was conducted to evaluate the reasons for using physical restraints in surgical intensive care units and the consequences that can be seen in patients. Material and Methods: This descriptive study included 81 patients physically restrained in the intensive care unit and 1003 physical restraint evaluations made on these patients. The data collected by questionnaires, Richmond Agitation Sedation Scale and Glasgow Coma Scale were analyzed using Wilcoxon test, Friedman test, and Mann Whitney U test. Results: Physical restraint was applied to 38% of the patients in the intensive care unit. Among the reasons for using physical restraint, the first is to prevent medical equipment removal (87.7%). It was found that the longer the physical restraint time of the patients, the frequency of development of skin and behavioral changes due to restraint increased. Skin changes in the physical restraint area were observed in 47.6% of the patients. The most common changes were skin rash (47.6%), swelling/edema (42.7%), and collapse (22.2%). It was found that as the physical restraint time increased, the agitation levels of the patients decreased significantly (p=0.000), and the mean scores of the Glasgow Coma Scale increased (p=0.002). Conclusion: The results of this study show that physical restraint made in order not to harm the patients themselves causes problems that will negatively affect the comfort of the patients. Considering the result that the problems increase as the physical restraint time increases, it is recommended to make the decision of physical restraint very carefully and to evaluate the patients regularly throughout the process.

360� Assessment in Clinical Training of Nursing and Medical Students: A Scoping Review

�i�dem BAYZAT, �enay SARMASO�LU KILIK�IER — 2021-03-01

Aim: This study aims to comprehensively examine the use of 360� assessment in clinical training of nursing and medical students. Material and Methods: In order to examine the studies in which the clinical training of nursing and medical students was assessed 360�, Academic Search Complete, MEDLINE, Complementary Index, Science Citation Index, Social Sciences Citation Index, ScienceDirect, Journals@OVID, Scopus�, ERIC, and ULAKBIM databases were searched. As a result of the search made with the keywords determined for the articles published in English and Turkish between 1999-2019, 1110 studies were found. Twenty-three studies meeting the study criteria were examined. Results: Seven of the studies reviewed (%30.4) belong to the last five years. Twelve of the studies (%52.1) have a descriptive research design; twenty-one of them (%91.2) were carried out in the field of medical education. It was determined that communication skills (%65.2) were assessed most with 360� assessment, and nurses took part as assessors in twenty-two studies (%95.6). Conclusion: Most of the studies are descriptive and directed to the assessment of residents. Nurses took part as assessors in almost all of the studies. The 360 � assessment has mostly been used for the evaluation of non-technical skills in clinical training.

Assessment of Compassion Satisfaction, Burnout and Compassion Fatigue Levels of the Nurses: A University Hospital Example

Ya�mur �OLAK YILMAZER, Kadriye BULDUKO�LU — 2021-03-01

Aim: This study aims to determine the levels of compassion satisfaction, burnout, and compassion fatigue of nurses and related factors. Material and Methods: This descriptive study was conducted by examining the data of 118 nurses working at Akdeniz University Hospital between April and May 2017. The data were collected with �Personal Information Form� and �Professional Quality of Life Scale� (ProQOL) and analyzed in SPSS 20.0 package program. One-way ANOVA and t-test were used to evaluate the data. Furthermore, Pearson correlation analysis was used to determine the relationship between compassion satisfaction, burnout, and compassion fatigue which are subdimensions of ProQOL. Results: The study has revealed compassion satisfaction, burnout, and compassion fatigue levels of the nurses are associated with age, having children, choosing this profession voluntarily, and working in shifts. It was also found that there is a negative and moderate relationship between compassion satisfaction and burnout levels (r=-0.618; p<0.001) and a positive and significant relationship between burnout and compassion fatigue levels (r=0.580; p<0.001). Conclusion: In this study, it was determined that compassion satisfaction, burnout, and compassion fatigue, which are the basic parameters of the quality of life of employees are associated with personal and professional characteristics.

Health Literacy Level in Individuals Registered to a Family Health Center and Related Factors

Ay�eg�l ILGAZ — 2021-03-01

Aim: This study was carried out to determine the level of health literacy of individuals registered in a Family Health Center and related factors. Material and Methods: This descriptive-relationship-seeking design study was conducted with 320 participants applied to a Family Health Center. Data were collected with personal information form and Turkey Health Literacy Scale-32. Results: 33.8% of participants are inadequate, 42.2% are at the level of problematic/limited health literacy. 58.7% of the participants in the treatment and service dimension of Turkey Health Literacy Scale-32 and 90.0% in the disease prevention/health promotion dimension were at poor and limited/problematic health literacy level. The health literacy level of those with older age, female gender, primary education and below, unemployed, a high number of children (3 and above), those with poor health perception or not bad, those living mostly villages/towns were found to be significantly lower (p<.05). In the logistic regression analysis, the health literacy level of those with primary education and below was found to be 7.4 times lower, those with the female gender was 5.9 times lower, and those with a high number of children was 3.5 times lower (p<.05). Conclusion: Health literacy levels of participants are inadequate; multidisciplinary team interventions are needed to increase this level.

The Relationship between Professional Commitment and Contextual Performance of Nurses

Abdullah BULUT, K�van �EV�K — 2021-03-01

Aim: This study was conducted to investigate the relationship between professional commitment and the contextual performance of nurses. Material and Methods: This is a descriptive relational study conducted between June and July 2019 with 138 nurses working in a university hospital. "Descriptive Characteristics Form", "Nursing Professional Commitment Scale" and "Contextual Performance Scale" were used to collect the data. The data obtained from the study were analyzed on a computer using the number-percentage distributions and correlation analysis in the Statistical Package for Social Science 15.0. Results: It was determined that the total mean score of the Nursing Professional Commitment Scale was 71.22�9.18. The mean scores of Willingness to Make an Effort, Maintaining as Professional Membership, and Belief in Goals and Values, which are sub-dimensions of the Nursing Professional Commitment Scale, were found to be 39.06�7.14, 17.19�6.74, and 14.96�1.92, respectively. The total mean score of the Contextual Performance Scale was determined to be 184.07�24.72. It was found that the mean score for Personal Support, which is one of the sub-dimensions of the Contextual Performance Scale, was 102.96�10.91, and the mean score for Organizational Support was 81.12�17.54. A weak positive correlation between the total score of the Contextual Performance Scale and the total score of the Nursing Professional Commitment Scale was determined (r:0.244, p:0.004). Conclusion: Increasing the level of nurses' professional commitment may be one of the factors that increase the level of contextual performance.

Determination of the Attitudes of the Health Staff Working for the Institutions Providing Primary Health Care Towards Ageism

Funda TUNCER �AH�N, Evrim BAYRAKTAR, Zeliha KAYA ERTEN — 2021-03-01

Aim: This descriptive and correlational study was conducted to determine the attitudes of the health care staff who work for the institutions providing primary health care services in Kayseri. Material and Methods: The study was conducted with 259 individuals who agreed to participate in the study. In the quantitative part of the study, a questionnaire form and the Ageism Attitude Scale were used. In the qualitative part of the research, in-depth interviews were conducted with eight health care personnel who had the highest and lowest scores on the Ageism Attitude Scale and agreed to interview. Mann-Whitney U, Kruskal-Wallis, and chi-square tests were used to analyze the data. The statistical significance level was taken as 0.05 in all tests. Results: In the study, it was found that while male health care personnel wanted to live with the elderly, female health care personnel did not (p <0.05). In the mean score distribution of the ageism attitude scale, it was determined that physicians and health officers had higher positive discrimination scores towards the elderly. Nurses' and midwives' negative discrimination scores against the elderly were higher than the other groups (p<0.05). As the education level increased, the scores of positive discrimination against the elderly also increased. Conclusion: In the research, we can say that healthcare personnel discriminates elderly at different points. The important thing is to reveal the prejudices of the health personnel about the elderly and ensure that the health personnel serving the elderly are aware of these prejudices. We think that this research will give health care professionals an insight.

Nonpharmacological Interventions towards the Sleep Problems in the Elderly: A Systematic Review

G�lfidan BA�ER, Filiz H�SAR — 2021-03-01

Aim: This study aims to perform a systematic review of the randomized controlled studies conducted on nonpharmacological interventions to relieve sleep problems in the elderly. Material and Methods: Google Scholar, Wiley, Web of Science, Springer Link, Scopus, Science Direct, Clinical Key, CINAHL, PubMed, National Thesis Center (https://tez.yok.gov.tr/UlusalTezMerkezi/), Dergipark and Ulakbim databases were searched between April and June 2019. Randomized controlled trials, published between January 2014 and May 2019, reporting nonpharmacological methods used for sleep problems in the elderly were included in the systematic review. Results: As a result of the database search, six studies were used for data collection. In the studies reviewed, the common methods used for the sleep-related problems in the elderly include cognitive behavioral therapy, music therapy, reminiscence therapy, phytotherapy (chamomile extract), acupressure, reflexology, and foot bath. Conclusion: As a result, no side effects of the methods applied were reported in the studies included in this systematic review. All of the methods used seem to have improvements in sleep quality. Although these methods are easily used to solve sleep problems, there is a need to repeat these studies and provide stronger evidence.

The Relationship of Parents� Health Literacy Level with Attitudes and Behaviors Towards Childhood Vaccines

Bekir ERTU�RUL, Sevil ALBAYRAK — 2021-03-01

Aim: The research was conducted to determine the relationship of parents' health literacy level with their attitudes and behaviors towards childhood vaccines. Material and Methods: This descriptive study was conducted with 279 parents with children in the age group of 0-12 months in the Central District of K�r�kkale province. Lot quality technique was used in the sampling. Written permission and ethics committee approval were obtained. The data were collected based on self-reporting using the Descriptive Questionnaire and the Turkish version of the European Health Literacy Scale. Descriptive statistical tests and Chi-Square were used in the analysis of the data. Results: The median age of the parents was 30 years (25-34), with 45.1% of the mothers and 47.4% of the fathers had a university and postgraduate education level. It was determined that the average health literacy score of parents was 30.57�8.30 and that the overall health literacy level of 62.8% was insufficient and problematic-limited. The difference between the average scale score and the state of being a parent and the longest living place was found statistically significant (p<0.05). It was found that 98.6% of parents had their children vaccinated. Conclusion: It was determined that parents' level of health literacy was not related to their attitudes and behaviors towards childhood vaccines.

Neonatal Intensive Care Experiences of Mothers of Premature Babies

2021-03-01

Aim: While a mother expects a healthy baby, she may experience a crisis due to the conditions in the neonatal intensive care units (NICU) following premature birth. It is important to determine the feelings and expectations of mothers to manage this crisis successfully. This study was conducted as a qualitative study to determine the expectations and experiences of the mothers of babies hospitalized in the NICU. Material and Methods: The data were collected through in-depth individual interviews with ten mothers whose babies were hospitalized in the NICU. The obtained data were evaluated by content analysis. Emotions experienced by the mothers, their views on the care of the baby, and their expectations from the nurses were compiled and presented. Results: It was determined that mothers felt anxiety, fear, and sadness about their babies; they wanted to get clear and understandable information about the baby's condition and participate in their babies' care. Conclusion: Nurses are recommended to introduce NICU tomothers, provide clear and understandable information about their babies, support mother-infant interaction and mother's participation in care to cope with the emotions and crisis experienced by mothers whose babies are hospitalized in NICU.

Physiological and Psychological Effects of Music Application on Intensive Care Patients: A Systematic Review

Yasemin SAZAK, Keriman AYTEK�N KANADLI, Nermin OLGUN — 2021-03-01

Aim: This systematic review aimed to determine the physiological and psychological effects of music application on intensive care patients. Material and Methods: A literature search was conducted using the terms �intensive care units�, �music therapy�, �music�, and �critical care� on CINAHL, Pubmed, Medline, Ovid, Web of Science, Complementary Index, Science Direct, Academic Search Complete, Scopus, ULAKB�M National Databases and Google Scholar databases in Turkish and English among studies which were carried out between January 1, 2014 and September 25, 2019. As a result of the search, 12 studies were included in the study. Results: It was found that the application of music had a positive effect in 85.7% of studies evaluating systolic blood pressure, 57.1% of studies evaluating diastolic blood pressure, 33.3% of studies evaluating mean arterial pressure, 70% of studies evaluating pulse rate, 66.7% of studies evaluating respiratory rate, 55.5% of studies evaluating oxygen saturation, 87.5% of studies evaluating anxiety level, 85.7% of studies evaluating pain. Music has also been found to have positive effects on patients' comfort level, sedation level, dyspnea status, weaning time, subjective sleep quality, and serum cortisone levels. Conclusion: It was determined that music application has positive effects on the vital signs, anxiety, sedation, pain, sleep quality, and comfort levels of intensive care patients.

The Effect of Internal Migration on the General and Reproductive Health Status of Women Migrating to Ayd�n Province

Hilmiye AKSU, Hande YA�CAN, Safiye �ZVURMAZ, Mevl�t T�RE — 2021-03-01

Aim: This study aims to determine the general and reproductive health status of women of reproductive age who migrated to Ayd�n Province and the factors affecting them. Material and Methods: The data of this analytical and descriptive study were collected using �General Health Questionnaire� and �Immigrant Women's General and Reproductive Health Status Questionnaire� from 331 women who applied to Family Health Centers of Ayd�n Province. Results: Although 71.3% of the immigrant women stated that they were very satisfied with immigration, the migration negatively affected the economic situation of 14.5% of them. The general health status of 26.9% of the women was found to be risky. The average number of pregnancies, abortions, curettage, and stillbirths of the risky women is higher than the healthy group, and the average age of the first pregnancy, the number of living children, and live births are lower. The mean age of the women at risk was found to be younger (U: 8849.0, p <0.01) and the duration of living in the migrated place was longer than the healthy group (U: 9093.5, p <0.02). The general health status of women was affected by their marriage consent status (X2=10.032; p<0.00). Conclusion: The obstetric findings of risky women were in worse condition, and these findings worsened in direct proportion with the increase in the time spent in the migrated place. Health problems experienced by women include menstrual cycle disorder and mental distress. Immigrant women should be educated about family planning methods, pregnancy, general health scans, and provided psychological support.

A Qualitative Study on the Motivations of Neonatal Intensive Care Nurses

Mukaddes DEM�R ACAR, Elif BULUT — 2021-03-01

Aim: This study was carried out to determine nurses' motivations working in a neonatal intensive care unit (NICU) of a university hospital. Material and Methods: The research was conducted qualitatively with ten neonatal intensive care nurses between May and June 2020. The data were collected through one-on-one interview technique. During the interviews, a semi-structured interview form was used, and an audio recording was made. The data obtained from the interviews were evaluated with the qualitative content analysis method. Results: The average age of the nurses participating in the study is 26, the average working year in the NICU is 4.5 years, and all of them are women. As a result of the content analysis of the in-depth interviews with NICU nurses, two main themes were revealed. It was determined that the first theme was �Success� and sub-themes were baby love, experience, recovery, and the second theme was �Management� and sub-themes were family, team, and workload. Conclusion: It was determined that nurses' love of babies and showing signs of improvement of babies increase their motivations, but the problems caused by the team, communication, and workload difficulties reduce their motivations. It is recommended to adopt teamwork to minimize these difficulties and system-related issues.

Determining Prevalence of Work-Related Musculoskeletal Disorders and Related Factors in Nurses

Behire SAN�AR, Serkan TA�, Demet AKTA� — 2021-03-01

Aim: Musculoskeletal diseases are more common in health professionals than in other professions. Nurses are particularly at risk for work-related musculoskeletal pain. This study aimed to determine the prevalence of work-related musculoskeletal disorders and related factors in nurses. Material and Methods: This study was performed between January 1 and April 30, 2019, with the participation of 611 nurses between the ages of 18-65 who work in inpatient and outpatient units of public hospitals in Ankara and Mersin provinces. However, for some of the variables, the sample sizes varied between 599-609 due to missing observations. The Nordic Musculoskeletal Questionnaire was used to determine the prevalence of work-related musculoskeletal disorders. In the questionnaire, the presence of pain or discomfort was questioned in nine work-related body regions (feet-ankles, knees, thighs-hips, wrists-hands, waist, elbows, back, shoulders, neck) for the last 12 months and seven days. Results: The findings showed that nurses were experiencing problems related to neck (63.5%), back (54.8%), waist (52.0%) regions. The rate of neck, waist and back pain or discomfort in the last seven days was 48.4%, 39.4%, and 38.1%, respectively. Conclusion: The results showed that work-related musculoskeletal disorders are most common among nurses. According to the study results, it is recommended to use more ergogenic supports in the workplace to prevent musculoskeletal disorders in nurses.

Travel Health Services in Turkey and Travel Health Practices in COVID-19 Pandemic

Ay�e DOST, �ura KAYA, Ay�enur SUSOY, Filiz TOS�U — 2021-03-01

With the development of transportation, it is possible to see the increase in travel between cities and countries. Nutritional conditions, food or water hygiene, and common diseases of the region to be traveled can adversely affect the individuals' health. This situation has revealed the concept of travel health. With the increase of travel in recent years, the spread of various infectious diseases has emerged between countries. COVID-19, which started in China on December 31, 2019, and became a global epidemic in a short time, is an example of this situation. The implementation of preventive health services to protect public health is of great importance for travel health services. These practices are offered thanks to travel health nursing, which plays a significant role in travel health services worldwide. It is aimed to prevent the spread of infectious diseases by providing immunization and travel-related consultancy services by nurses in travel health centers in Turkey. This review aims to explain the concept of travel health nursing, which has become widespread in the world, and to provide information about travel health services and nursing practices during the COVID-19 pandemic in Turkey.

Cultural Marginality Theory and Its Use in Nursing

Emel G�VEN — 2021-03-01

With the development of transportation and communication technology, an increase in cultural diversity occurs. The resulting cultural differences affect the quality of care nurses provide to patients with different cultural backgrounds. Heeseung Choi developed the Cultural Marginality Theory to provide a better understanding of the unique experiences of individuals with different cultures and to guide culture-specific care. In the development of the theory, besides the qualitative studies of Choi with immigrants, Culturalization, Cultural Stress, and Marginality Theories have also contributed. While recognizing intercultural conflict, marginal life, and alleviating cultural tension constitute the three basic concepts of the theory, one dimension of the theory is contextual/personal effects. With the recognition of intercultural conflict, marginal life begins. As people encounter marginal life, they try to alleviate cultural tension through adaptation response patterns. Understanding the relationship between the concepts of theory will provide a framework for nurses in providing culture-specific care for migrants. Other uses of the theory include health promotion programs, assessment of culture-specific eating disorders, health inequalities, and cultural therapeutic nurse-patient interaction. The aim of this article is to explain the development of the theory, its concepts, the interrelationships of the concepts, and the use of the theory in nursing.