Hacettepe University Faculty of Health Sciences Nursing Journal - 2022; 9(2)

Edit�rial

Do�. Dr. Serg�l DUYGULU — 2022-08-01

Adaptation of Moral Distress Scale for Nursing Students into Turkish: A Validity and Reliability Study

Mustafa Sabri KOVANCI, Azize ATLI �ZBA� — 2022-08-01

Aim: Nursing students witness ethical and moral problems in health care settings and can even be involved in these situations. A student who wants to act for a solution with a sense of responsibility cannot take action due to his/her position and may feel powerless, inadequate, and helpless. This condition, defined as Moral Distress (MD), should be recognized, evaluated, and intervened by nurse educators to protect students' health, prevent weakness and provide qualified education. The study aims to introduce a valid and reliable measuring instrument to the Turkish Language and Culture that can be used to measure the MD levels of nursing students. Material and Methods: The sample of the study, which was carried out in methodological type, consisted of 410 3rd and 4thgrade nursing students studying at 48 different universities in 35 cities in Turkey. The data were collected online using the Participant Information form and Moral Distress Scale for Nursing Students (MDS-NS). Results: As a result of the explanatory factor analysis, different from the original scale structure, a three-factor structure that explains 47.64% of the total variance was determined. The reliability of the MDS-NS was evaluated with the Cronbach Alpha coefficient, test-retest method, and the item-total correlation coefficient. The Cronbach Alpha coefficient was .94 for the total scale and .85-.92 for the sub-dimensions. Conclusion: With its 41-item and three-factor structure, the MDSNS is a valid and reliable tool for measuring the moral distress of nursing students. It is recommended to utilize MDS-NS in studies conducted to recognize, identify and measure MD, reduce MD and cope with MD.

Bibliometric Analysis of Turkey-based Caregiver Burden Studies Published in International Journals

Fadime Hatice �NC� — 2022-08-01

Aim: The study aim was to bibliometrically test the caregiver burden studies carried out in Turkey and indexed in the Web of Science database. Material and Methods: This was a descriptive screening study. The studies carried out in Turkey and registered in the Web of Science database between 2009-2021 were included. Each of the word indexes, including �caregiver burden�, �care burden�, caregiving burden�, �burden of care� and �burden of caregiving�, was separately screened as the keywords. One hundred twenty-one studies that met the inclusion criteria of the study were enrolled in the sample. Data were analyzed using Microsoft Excell and the VOSviewer program (version 1.6.16). Results: The studies were mainly carried out with the individuals who were caregiving to schizophrenia, cancer, and alzheimer's patients. �Caregiver burden� was the most frequently used keyword. The most cited study was entitled �The perceived burden of care and its correlates in schizophrenia� which was conducted by Gulseren et al. Conclusion: This study will guide researchers on the most cited studies, the most used keywords, the topics studied in this field, and the most used references among the caregiver burden studies performed in Turkey.

Metaphoric Perceptions of Mothers with a Child Diagnosed with Schizophrenia Regarding

R�veyda Y�KSEL, Mehtap KIZILKAYA, Ay�en �ZTUN� KESK�N — 2022-08-01

Aim: This study was conducted to reveal the metaphorical perceptions of the mothers of 53 schizophrenic patientstreated in the community mental health center of a public hospital in a western province about schizophrenia. Material and Methods: The research was conducted with the mothers of 53 schizophrenic patients between June and August 2018, using a basic qualitative research design. The data were collected through an open-ended questionnaire containing the sentence �Schizophrenia is like ��. because ��..�. The content analysis technique was used in the analysis of the data. Results: Considering the common features of 53 metaphors produced by mothers regarding the concept of schizophrenia, metaphors were gathered in 7 different categories. Among the metaphors produced by the mothers, it was observed that the metaphors of Darkness, Cloud, and Empty brain were the most. Conclusion: It was determined that the meanings assigned to the concept of schizophrenia by the mothers are negative in general and have a wide variety.

Problems Experienced by New Nurses and Their Job Stress Levels

Ebru �ZEN BEKAR, Ebru G�KO�LAN — 2022-08-01

Aim: This study was carried out to determine the problems experienced by newly recruited nurses and the job stress levels. Material and Methods: This descriptive and cross-sectional study was conducted with 161 nurses who had a maximum of one-year professional experience and worked in a private hospital and a state hospital between January 2019 and December 2020 in Istanbul. The �Work Stress Scale�, developed by Rizzo, House, and Lirtzman in 1981 and adapted into Turkish by G�ng�r in 1997, was used to determine job stress levels. Frequencies for categorical variables and descriptive statistics for numerical variables were presented to assess the data. The differences between the two independent groups were analyzed using the independent sample t-test. The differences between more than two independent groups were analyzed by One Way Analysis of Variance (ANOVA). Results: It was observed that job stress levels were at a moderate level in all sub-dimensions in terms of �Job Role Uncertainty� (14.27�4.3), �Job Role Incompatibility� (23.95�5.7), and �Job Role Load� (7.71�1.7), and the job stress levels of new nurses were affected by working conditions. Conclusion: The job stress levels of newly recruited nurses are affected by the problems they experience in the working environment. Therefore, manager nurses have essential responsibilities in reducing the job stress levels of newly recruited nurses.

The Turkish Validity and Reliability Study of the Student Satisfaction from the Student Outcomes Survey

2022-08-01

Aim: This study was carried out to examine the validity and reliability of the Turkish form of Student Satisfaction from the Student Outcomes Survey. Material and Methods: The sample of this methodological study consisted of 141 nursing students studying at the Nursing Faculty of a state university. �Student Information Form� and �Student Satisfaction from the Student Outcomes Survey� were used to collect data. The validity and reliability of this survey were evaluated with language, content, construct validity, internal consistency reliability, and test-retest reliability analyses. Results: Content validity was performed after language validity using the translation-back translation, and the content validity index score was determined as 1.0. In the exploratory factor analysis, this survey showed a three-factor structure and explained 64.56% of the total variance. The Cronbach's alpha coefficient was 0.947 for the total scale, 0.867 for the teaching, 0.823 for the evaluation, and 0.925 for the general skills and learning experiences sub-dimension. In reliability analysis against time, it was determined that there was a positive correlation between the two measurements (r=0.634, p<0.001). Conclusion: The study results showed that the scale had a similar structure to the original scale and the Turkish version of the scale was a valid and reliable measurement tool for evaluating the satisfaction of nursing students from vocational education and training.

Evaluation of the Relationship Between Attitudes Towards Gender Roles and Attitudes Towards Dating Violence of a Group of University Students

G�l�ah K�K, Sefa KARAMAN, Esra �ZER, Nazl� �ZBEK, Ay�e KILI� U�AR, G�lten G�VEN� — 2022-08-01

Aim: The aim of this study is to evaluate the relationship between the attitudes towards gender roles and dating violence in a group of university students. Material and Methods: The sample group of this descriptive study consisted of 363 first and second-grade students studying at Bilecik �eyh Edebali University Health Services Vocational School Medical Laboratory Techniques, Child Development, First and Emergency Aid departments in the fall semester of 2018-2019 academic year. �Individual Characteristics Form�, �Gender Roles Attitude Scale�, �Dating Violence Attitude Scale� were used to collect the data. The data were evaluated using the SPSS 21.0 program. Number, percentage, mean, chi-square, Mann Whitney U, Kruskal Wallis and Spearman Correlation tests were used to analyze the data. Results: Female students supported dating violence less than male students and were more egalitarian regarding gender role attitudes. Students who receive social support and think that the society is discriminatory/negative towards girls support dating violence less; those who thought to be neutral were found to be more egalitarian in gender roles. Students who do not support dating violence had a more egalitarian attitude towards gender roles. Conclusion: Gender role attitudes affect attitudes towards dating violence. Female students have more egalitarian attitudes towards gender roles and support dating violence less than male students. It is crucial to determine young people's traditional gender role attitudes and attitudes towards dating violence and change them in an egalitarian direction.

Validity and Reliability of the Turkish Version of the Self- Stigma Scale in Patients with Type 2 Diabetes

Emelnur ULUSOY, Bahire ULUS — 2022-08-01

Aim: To analyze the validity and reliability of the Turkish version of the Self-Stigma Scale (SSS-T), which will help determine the barriers to participation in social life in type 2 diabetes patients. Material and Methods: Necessary permissions were obtained to carry out this methodological study. The research was conducted in a private hospital in Istanbul, with 180 people with type 2 diabetes in 2019. Data were collected with the Patient Identification Form, SSS-T, and Rosenberg Self-Esteem Scale (RSES). Confirmatory factor analysis, content reliability, test-retest reliability, and Cronbach�s alpha analysis were used to analyze the data. Results: Due to the recommendations of experts, language validity, and pilot study findings, 11, 14, and 39 questions were removed from the scale. The scale consisted of 3 sub-dimensions, including cognitive, affective, and behavioral, which explained 61.37% of the total variance. The Cronbach�s of the SSS-T was 0.96 for the total score. Cronbach�s alpha scores for cognitive, affective, and behavioral subscales were 0.92, and 0.87, respectively. Testretest analysis to analyze time invariance revealed a significant relationship between the mean scores (p<0.05). There was a moderately negative significant relationship between the total scores of RSES and SSS-T (r=-0.62). Conclusion: As a result of the explanatory factor analyses, it was seen that the results were close to the original version, and the Turkish version of the SSS-T was valid and reliable for the Turkish language in individuals with Type 2 Diabetes.

Evaluation of Illness Perceptions of Patients Hospitalized with the Diagnosis of COVID-19 in a Pandemic Hospital

Naile ALANKAYA, Feride KURNAZ — 2022-08-01

Aim: This study aimed to determine the perception of the disease and the affecting factors of the patients receiving inpatient treatment due to the diagnosis of COVID-19. Material and Methods: The sample of this descriptive study consisted of 150 patients hospitalized in a pandemic hospital between 01 March and 31 May 2021. Data were collected using the �Patient Descriptive Questionnaire� and the �COVID-19 Disease Perception Scale (COVID-19 DPS)�. Number, percentage, mean, standard deviation, independent sample t-test, and ANOVA test were used in the statistical analysis. Results: The mean age of the patients was 54.14�15.89, 52.0% were female, 44.7% were primary school graduates, 36.7% were retired, 66.7% were married, and 50.0% had at least one chronic disease. COVID-19 DPS mean score was 3.84�0.80; the mean score of the dangerousness sub-dimension was 3.92�0.93; the infectiousness sub-dimension mean score was calculated as 3.78�0.99. A statistically significant difference was found between gender, educational status, adherence to treatment, and the mean score of COVID-19 DPS. Conclusion: It was found that patients diagnosed with COVID-19 have a high perception of illness. It can be said that determining the perception of illness in the light of the findings will facilitate adherence to the disease and treatment.

Associated Factors of Smartphone Addiction in the Students of the Faculty of Health Sciences

G�l ERG�N, Aysun G�ZEL, Emre UMUCU — 2022-08-01

Aim: This study aimed to investigate associated factors of smartphone addiction in the students of a faculty of health sciences. Material and Methods: This is a cross-sectional study. A total of 839 health sciences students participated in our study. The data was collected by Personal Information Form, the Smartphone Addiction Scale-Short Form, the Pittsburg Sleep Quality Index, and the Piper Fatigue Scale. Results: As the smartphone addiction score increases by 0.59 units, the sleep quality total score increases by one unit. The smartphone addiction score decreases by 0.12 units when the fatigue score increases by one unit. It was determined that female students' smartphone addiction scale scores were higher than male students. Conclusion: The female students� Smartphone Addiction Scale scores average were higher than males. In addition, fatigue and sleep problems were more significant in individuals with smartphone addiction. Appropriate Technology Use courses should be added to the curriculum to prevent telephone addiction.

Validity and Reliability Study of the Turkish Version of the Social-Functional Autonomy Measurement System

Ayten K��K, Oya Nuran EM�RO�LU — 2022-08-01

Aim: Social functions are required to be at an optimum level to maintain and develop an individual�s health at all ages. This study aimed to evaluate the validity and reliability of the Turkish version of the Social-Functional Autonomy Measurement System (Social-SMAF Scale) on elders. Material and Methods: This methodological study was conducted to evaluate the validity and reliability of the Social-SMAF scale. The research was conducted with 92 nursing home residents living in three nursing homes in Afyonkarahisar. Results: It was observed that the scale consisting of 6 items explained 70.186% of the total variance. It was found that the scale was collected under one dimension (factor), and its eigenvalue was 3.768. Sampling adequacy was checked for factor analysis to be applicable (Bartlett's Test=211.779; p<0.001 and KMO=0.770). The Cronbach Alpha coefficient for the internal consistency of the social autonomy scale was calculated as 0.80. In the confirmatory factor analysis of the scale, it was determined that it formed a suitable model that could be grouped under a single factor. Conclusion: The �Social-SMAF� scale was valid and reliable in evaluating the social independence of elderly individuals living in Turkish society.

Examining Nursing Students' Homophobic Attitudes, Empathic Skills, and Affecting Factors

P�nar ��EKO�LU �ZT�RK, Song�l DURAN — 2022-08-01

Aim: This study aims to examine the homophobic attitudes and empathy skill levels of nursing students and the influencing factors. Material and Methods: This descriptive study was conducted with 545 students studying nursing departments at two universities between September 2018 and January 2019. The data were collected using a Descriptive Characteristics Information Form, Hudson & Ricketts Homophobia Scale, and the Empathic Skill Scale (Form B). Descriptive statistics (mean, standard deviation, number, percentage), student t-test, one-way analysis of variance, and Pearson correlation analysis were used to evaluate the data. Results: 71.4% of the students participating in the study were women, and the mean age was 20.02�1.47 years. It was determined that 51% of the students knew the concept of Lesbian, Gay, Bisexual, Transgender (LGBT) correctly, and 60.6% of them perfectly explained the concept of homosexuality. The students� Hudson & Ricketts Homophobia Scale total mean score was 98.44�23.19. It was determined that male students, students from the Eastern Anatolian region, and students who misunderstood the concept of LGBT had more homophobic attitudes (p<0.05). The students' Empathic Skills Scale-B Form total score average is 138.23�15.46. It was determined that the students who thought that the nursing approach they would offer to an LGBT patient and the nursing approach they would provide to a heterosexual patient were the same were more empathetic (p<0.05). Conclusion: It was concluded that nursing students, who are the health care providers of the future, have high homophobic attitudes, moderate empathic skills, and empathic skills do not affect homophobic attitudes.

Determination of Knowledge of Nurses Working in Surgical Clinics on Preventing Pressure Injuries

Zehra BA�AYAR, G�lay YAZICI — 2022-08-01

Aim: This study was conducted to determine the knowledge of nurses working in surgical clinics about pressure injuries, prevention, and treatment. Material and Methods: The research sample consisted of 360 nurses working in surgical clinics in a public hospital in Ankara. In the data collection, forms prepared by the researcher by reviewing the literature and taking current guidelines as a source, containing questions to determine the socio-demographic characteristics of nurses and their level of knowledge about pressure injuries, were used. The data were analyzed by number, percentile, Kruskal Wallis H test, and Mann-Whitney U test. Results: The average score of nurses taken from the questions about pressure injuries was found as 51.98�14.52. It was seen that the themes in which average scores are lowest are etiology and risk factors, and the themes in which average scores are highest are treatment and care. It was determined that there was a statistically significant difference between the age, gender, education level, and previous education about pressure injury and the knowledge score averages of the nurses. Conclusion: In preventing pressure injuries, one of the health care quality indicators, nurses' knowledge and ability to identify risk factors are directly effective in prevention, treatment, and care. In parallel with the developments in science and technology, it is recommended to review the current literature on this subject, organize in-service training programs based on current guidelines, encourage nurses� participation in courses or certificate programs, and inform them about in-house policies and procedures.

Management of Oral Mucositis in Pediatric Oncology Patients Receiving Chemotherapy: Evaluation of Evidence-Based Practices

Gizem �AKIR, Naime ALTAY, Ebru KILI�ARSLAN T�R�NER — 2022-08-01

Oral mucositis, which refers to erythematous and painful ulcerative lesions of the oral mucosa, is one of the most common adverse events associated with cancer therapies in the pediatric population. Although the pharmacologic and supportive therapy management of cancer treatment has advanced, the mucositis frequency is still increasing. Different methods and therapeutic agents are used in the prevention and treatment of oral mucositis, including basic oral care protocol, antimicrobial agents, cryotherapy, antiseptic agents, antibiotics, vitamins, cytokines, immune regulators, and herbal methods. Non-medical mouthwashes are recommended in basic oral care protocols. There is no conclusive evidence that mouthwashes contain chlorhexidine, normal saline, sodium bicarbonate, and benzydamine to prevent oral mucositis. Vitamin E can be an effective treatment method in reducing the severity of oral mucositis. Cryotherapy is a preferable treatment method according to the degree of mucositis in cooperative children receiving chemotherapy. There are different results in the literature regarding using chlorhexidine, laser therapy, and glutamine in children. It is recommended to avoid its use until its efficacy is demonstrated in systematic reviews and meta-analysis studies for its use in pediatric oncology patients. This review aims to evaluate the recommended and not recommended agents and practices in the prevention and treatment of oral mucositis in pediatric oncological patients receiving chemotherapy.

Health Services Provided for the Care and Needs of the Elderly, Being Old in the Process of COVID-19 in Turkey

Cihat DEM�REL, Meltem SUNGUR, Serap PARLAR KILI� — 2022-08-01

The coronavirus disease which has become a global health threat, has affected many countries in a short time and it turned into a pandemic. Although it affects all age groups it is known that the diseasecauses more mortality and morbidity in the elderly. Elderly individuals faced many problems in this process. These problems include social isolation, economic burden, and difficulties in meeting basic needs. Elderly individuals experienced difficulties not only physically but also psychologically and economically in this process. World Health Organization has planned different training programs to maintain the psycho-social and physical wellbeing of the elderly. The most effective application in preventing the disease and protecting the elderly individuals is seen as isolation. The first population isolated from social environments in our country to prevent the transmission of infection was elderly. Elderly individuals are isolated in their place of residence. Government measures have been taken in the world and our country to control the pandemic, and some health services have been provided in this process. In this review, attention was drawn to the problems faced by elderly individuals during the pandemic process and the health services provided.