Hacettepe University Faculty of Health Sciences Nursing Journal - 2023; 10(2) - Current Issue

Editorial

Prof. Dr. Serg�l DUYGULU — 2023-08-01

Evaluation of Chronic Pain in Premature Infants on Invasive and Noninvasive Mechanical Ventilation

Fatma ERT�RK, Emine GE�K�L — 2023-08-01

Aim: This descriptive study was conducted to evaluate chronic pain in premature infants on invasive and noninvasive mechanical ventilation. Material and Methods: The sample of this study consisted of 110 premature infants with a gestational age of ≥25 weeks and ≤36 weeks in the Neonatal Intensive Care Unit. Data were collected between February 2018 and April 2019 with the Descriptive Information Form to determine the infants' characteristics and the Newborn Pain and Discomfort Scale (EDIN). The data were analyzed with tests suitable for normal distribution, and the significance level was accepted as p <.05. Results: It was determined that the average total pain score of premature infants from the EDIN scale was 5.43 � 1.86, and 35.5% of them experienced pain (> 6 points). It was found that the chronic pain scores increased as the length of hospital stay and the duration of mechanical ventilation increased in premature infants who were applied mechanical ventilation (p <.05). It was determined that the average chronic pain score was higher in infants with a risk of impaired skin integrity (p <.01). Conclusions: It has been recommended to give importance to skin assessment of premature infants receiving mechanical ventilation, to perform routine pain assessment, and to take measures to reduce pain in infants whose duration of stay on mechanical ventilation exceeds five days.

The Relationship between Maternal Attachment and Fear of COVID-19 in Mothers who Gave Birth During the Pandemic Period

Melike YAVA� �EL�K, Ebru �ZT�RK �OPUR — 2023-08-01

Aim: It was aimed to examine the relationship between maternal attachment and fear of COVID-19 in mothers who gave birth during the pandemic period. Material and Methods: The data of this descriptive study were collected using a Personal Information Form, Maternal Attachment Scale, and COVID-19 Fear Scale. The study sample consisted of mothers with babies between 0-6 months. Results: It was observed that there was a strong negative correlation between Maternal Attachment and COVID-19 Fear Scale scores of the mothers. It was determined that the mean Maternal Attachment Scale score of the mothers who had COVID- 19 positivity during pregnancy, had COVID-19 positivity in the family members, and did not take their baby to have heel blood sample removed due to the risk of COVID-19 transmission were statistically significantly lower than the other mothers. Conclusions: This study data showed that mothers fearing COVID- 19 had a weak maternal attachment. In addition, according to the results of this study, it can be said that the fear of COVID-19 negatively affects the mother-infant union.

Investigation of the Effect of COVID-19 Vaccine Literacy on COVID-19 Vaccine Attitude

Behire SANCAR, Ay�e Buket DO�AN, Ya�mur S�RMEL�, F�gen �ZCANARSLAN — 2023-08-01

Aim: This descriptive research was conducted to determine the relationship between COVID-19 vaccine literacy and public attitude towards the COVID-19 vaccine. Material and Methods: The research data were collected by convenience sampling between June and September 2021. The population of the research consisted of 1112 individuals aged 18 and over. The data were collected online using a personal information form, the COVID-19 Vaccine Literacy Scale, and the Attitudes Towards the COVID-19 Vaccine (ATV-COVID-19) Scale. Results: The mean COVID-19 Vaccine Literacy scale total score was 2.91�0.43, while the mean ATV-COVID-19 scale total was 3.68�0.76. A statistically significant and positive relationship existed between the participants' COVID-19 VL scale total scores and their ATV-COVID-19 scale total scores. Conclusion: The vaccine literacy of the participants was relatively high, and their attitudes toward the COVID-19 vaccine were positive. As vaccine literacy increased, positive attitudes toward vaccines also increased.

The Effect of Eye Mask and Ear Plug Applications on Sleep Quality in Patients in the Coronary Intensive Care Unit

Fatma �Z, Birg�l CER�T — 2023-08-01

Aim: This study aims to investigate the effect of eye mask and earplug applications on sleep quality in patients hospitalized in the Coronary Intensive Care Unit. Material and Methods: The study was conducted between November 2018 and March 2019 and is a randomized controlled trial designed in a pretest-posttest model. Power analysis was performed to determine the number of participants. With power analysis, 30 patients were assigned to the experimental group and 30 to the control group. Therefore, the study was carried out with 60 patients. Patient Information Form and Richards-Campbell Sleep Scale were used in the data collection. Independent sample t-test, Mann Whitney U test, and paired t-test were used for analysis. Results: The experimental group's mean pre-test sleep quality score was 197.83�113.614, and the mean post-test score was 385.67�64.08. The control group's mean pre-test sleep quality score was 178.83�116.890, and the mean post-test score was 244.33�122.94. A statistically significant difference was found between the pre-test/post-test sleep quality scores of patients in the experimental group (t=-9.335, p=0.000) and the pre-test/posttest sleep quality scores of patients in the control group (t=-2.730, p=0.011). Considering the post-test sleep quality median values of the experimental and control group patients, a statistically significant difference was determined between the groups (Z=- 4.675, p=0.000). Conclusion: It was determined that using eye mask and earplug applications positively affected sleep quality in patients hospitalized in the Coronary Intensive Care Unit.

On Mothers' Breastfeeding Experiences: A Qualitative Study

Aylin TOZLUO�LU, Filiz S�ZER �ZKAN — 2023-08-01

Aim: The study was conducted to determine mothers' breastfeeding experiences and the individual, social and cultural factors that affect these experiences. Material and Methods: The research is a descriptive study using the in-depth interview technique, one of the qualitative research methods. Considering the data saturation situation, two individual interviews were conducted with ten pregnant women who applied to the obstetrics and gynecology outpatient clinic of a state hospital in the Western Black Sea region and agreed to participate in the study in the first and sixth months after delivery. The data were collected with a semi-structured interview form and evaluated using thematic analysis. Results: In the analysis of the data, three main themes (attitudes and behaviors related to breastfeeding, breastfeeding experience, and factors affecting breastfeeding experience) were determined from the first interview and the second interview. It has been observed that mothers breastfeed their babies in the first hour after birth but give them food other than breast milk, and all mothers, except one mother, start supplementary foods before the sixth month. Conclusion: In our study, it is seen that although mothers have knowledge about breastfeeding and the importance of breast milk, they cannot continue breastfeeding successfully. This suggests that breastfeeding education given to mothers is insufficient alone and that individual, environmental, and social factors are effective in the breastfeeding experience.

The Effect of High-Fidelity Simulation on the Level of Nursing Students' Knowledge and Clinical Decision-Making Regarding Nursing Care of Patients with Angina

G�lcan CO�KUN, �erife KARAG�ZO�LU — 2023-08-01

Aim: This study was carried out to determine the effect of highfidelity simulation on nursing students� knowledge and clinical decision-making levels. Material and Methods: The sample of this study consisted of 60 nursing students (simulation=30, control=30) who took the Internal Diseases Nursing course. While the simulation group was taught the angina approach with the scenario-based high-fidelity simulation method, the control group was taught the nursing approach with the classical education method. Data were collected using a pre-and post-knowledge test, Clinical Decision-Making Scale in Nursing, and Simulation Design Scale. Results: It was found that the mean knowledge scores of the simulation group were statistically significantly higher after the application of the high-fidelity simulation method (p=0.013). There was no statistically significant difference between the mean Nursing Clinical Decision-Making Scale scores after clinical practice in both groups (p>0.05). Conclusion: In this study, it was determined that the high-fidelity simulation method in nursing care teaching in patients with angina increased the theoretical knowledge level of the experimental group, and the students had positive thoughts about this method, but the clinical decision-making levels were close to each other in both groups.

Awareness of Nurses on Patient Safety: Strengths and Weaknesses in Ensuring Patient Safety

Melek DATPINAR, Nazan TORUN — 2023-08-01

Aim: This study was conducted to determine the nurses' perception of patient safety and the strengths and weaknesses they encounter in providing patient safety by using the experiences of nurses. Material and Methods: In the study, phenomenological design, one of the qualitative research methods, was used. Semi-structured interview technique was used in the study. The research study group was determined by the purposive sampling method, one of the improbable methods. The sample comprises 45 volunteer nurses working in a private and a university hospital. Results: In the interviews, nurses expressed patient safety as not harming the patient in general, while they expressed the patient safety culture as the attitudes, behaviors, and values displayed by the employees to ensure patient safety. In addition, nurses stated that human and environmental factors affect patient safety and how they manage safety risks in ensuring patient safety. In this context, as a result of the interviews, five main themes "Known about Patient Safety and Patient Safety Culture", "Factors Violating Patient Safety", "Risk Management in Ensuring Patient Safety", "Teamwork in Ensuring Patient Safety - The Importance of Communication", "Providing Continuous Education and Interaction in Sustaining Patient Safety" and thirteen sub-themes were created. Conclusion: As a result of the study, it was seen that nurses were aware of patient safety but not as much awareness of patient safety culture as patient safety. In the study, it was determined that ensuring patient safety, providing regular control in patient care and treatment, paying attention, doing everything right, taking precautions, teamwork, continuous education, and interaction are strengths, while errors caused by human and environmental factors, insufficient number of personnel and excessive workload are weaknesses. Hospital administrators and executive nurses should support and develop nurses to develop nurses' patient safety culture. In addition, nurses should be provided with training for developing patient safety culture and patient safety competencies should be increased by considering their views on safety practices.

Determination of Burnout Status and Professional Commitment of Nurses Caring for Patients Diagnosed with COVID-19 in a Training and Research Hospital

Fatma Nur DUMAN, Ayten �ENT�RK ERENEL — 2023-08-01

Aim: This research was conducted to determine the burnout status and commitment to the profession of nurses who provide care to patients diagnosed with COVID-19 in a training and research hospital. Material and Methods: The research sample comprised 205 nurses caring for COVID-19 patients. In the collection of the data, �Descriptive Characteristics Form�, �Burnout Scale (BS)�, �Commitment to the Profession in Nursing Scale (NPCS)� were used. Results: Nurses' BS mean score was 4.48�1.07, and it was determined that only 1% of them did not experience burnout. It was determined that the burnout status of 36.6% of them was at a crisis level. The average score of NPCS of the nurses was determined to be 68.73�13.14. A significant difference was found between the mean scores of total professional commitment and willingness to make an effort, according to the number of patients the nurses gave daily care to. A significant and negative correlation was found between the levels of professional commitment and burnout levels of nurses. Conclusion: It was determined that almost all nurses working in pandemic service and intensive care units and providing care to COVID-19 patients experienced burnout, their level of professional commitment was above the average level, and commitment to the profession decreased as the level of burnout increased.

Caregiver Burden and Quality of Life of Patient and Caregiver in Burns

Sabri KARAHAN, Zahide TUN�B�LEK — 2023-08-01

Aim: This descriptive study aimed to determine the relationship between burn patients and their caregivers� quality of life and care burden. Material and Methods: The study was conducted at two university hospitals. Thirty burn patients discharged from the hospitals between September 2015 and January 2016 and their 30 caregivers participated in the study. Data were collected face-to-face with the datasheet for patients, the Burn-Specific Health Scale, the datasheet for caregivers, the World Health Organization Quality of Life (QoL)-Brief, and the Zarit Caregiver Burden Interview Scale. Results: The patients� mean QoL scores, and sub-scores were higher than 0.53. The highest caregivers� mean QoL score was for the physical health domain (74.62�16.87). There was a negative correlation between the physical health scores of caregivers and the general health and overall QoL scores of patients (p<0.01). The mean caregiving burden score was 26.63�12.78. There was a negative correlation between the caregiving burden score, social health, and overall QoL scores of patients (p<0.05). Conclusion: The patients demonstrated a moderate level of QoL, while their caregivers demonstrated a high level of QoL. The caregiver burden of the caregivers was low. There was a correlation between patients' QoL and their caregivers� QoL and caregiver burden. It is crucial to prepare the patients and their caregivers to increase QoL and decrease the caregiving burden.

Supportive Care Needs and The Disease Acceptance Level of Hematological Cancer Patients

G�lhayat ��PAL, Selda ARSLAN — 2023-08-01

Aim: The aim of this study was to determine the relationship between supportive care needs and disease acceptance levels of patients with hematological cancer. Material and Methods: This study was conducted as a descriptivecorrelational study. The study was conducted with 184 patients who received outpatient and inpatient chemotherapy at Hematology Department. The questionnaire form, the Short-Form Supportive Care Needs Survey Questionnaire, and the Acceptance of Illness Scale were used to collect the data. Ethics committee permission, institution permission, and written informed consent were obtained for the study. In evaluating the data, independent groups t-test, correlation analysis, and one-way analysis of variance were used together with the Tukey test. Results: In the study, the mean score of Acceptance of the Illness was 26.8�7.0. The mean score of the psychological sub-dimension of the Supportive Care Needs Scale was 27.4�7.8; the health system sub-dimension mean score was 40.6�8.2; the physical subdimension mean score was 16.6�5.2; the patient care subdimension mean score was 12.7�3.6 and sexuality sub-dimension mean score was 7.4�3.4. It has been determined that supportive care needs are affected by sex, marital status, income level, social support perception, presence of chronic disease, metastasis status, and outpatient or inpatient treatment. The increase in the patients' psychological (r=-0.571) and physical care (r=-0.563) need scores decrease the patients' acceptance score of the disease by a moderate level. Conclusion: It was found that as the patients' psychological and physical care needs increased, the disease acceptance level decreased. Considering these results, there is a need to conduct independent and comprehensive research for each type of hematology cancer at specific intervals to determine the patients' acceptance level and unmet care needs.

Effects of Hospital Ethical Climate on Voice Behavior among Oncology Nurses: Mediating Role of Courage

2023-08-01

Aim: Ethical climate is an important organizational characteristic that affects employees' thoughts, attitudes, and behaviors. The voice of the nurses, one of the fundamental employees of the hospitals, is very valuable both in terms of the organizations they work in and the safety of their patients. However, the relationship between hospital ethical climate and voice behavior remains unclear. The aim of this study was to investigate the effects of the ethical climate on oncology nurses� voice behaviors, considering courage as a mediator. Material and Methods: This study was designed as a predictive cross-sectional study. The sample of this study consisted of 71 registered nurses who were employed as staff nurses in inpatient care services in Hacettepe University Oncology Hospital between October and December 2018. Results: There is a positive and significant relation between the hospital�s ethical climate and oncology nurses� voice behaviors, and that courage has a positive partial mediating effect. Conclusion: Since the relationship between a hospital�s ethical climate and nurses� voice behavior contains many different variables, courage can be deemed a mediator in this relationship, but courage is not may directly be effective on its own.

An Overview of the Relationship Between Symptom Status, Self-Management and Care Dependency in Type 2 Diabetes

Damla Nur BOZKAYA, Zehra G�K MET�N — 2023-08-01

Diabetes is a chronic and progressive disease and causes a higher symptom burden in individuals. With the progression of the disease, complications of diabetes increase, individuals may not be able to perform self-management, and along with these, care dependency comes to the fore. Since diabetes lasts a lifetime, progresses with common symptoms, and requires selfmanagement activities, the frequency and severity of symptoms experienced by individuals with Type 2 diabetes, self-management skills, and levels of care dependency should be addressed. Maintaining care and self-management in diabetes throughout life is the most critical issue. Many studies have shown that Type 2 diabetes has not yet been controlled at the desired level, despite important developments in the diagnosis and treatment processes. In this review article, we aimed to provide a broad perspective on the symptoms of diabetes, self-management, and care dependency level in individuals with Type 2 diabetes and the relationship between these variables and to contribute to the care approach of patients with diabetes in this context.

Postpartum Care Guidelines: A Comparative Review Based on Content and Midwifery Care

Elif NACARO�LU, Ayt�l HADIMLI — 2023-08-01

Many guidelines have been developed in the field of women's health to standardize the care provided, and some of them are postpartum care guidelines. Providing care to mothers and newborns in the postpartum period is one of the critical duties of healthcare professionals. Regular updating of the postpartum care guidelines, which provide key information and care recommendations to healthcare professionals in line with evidence-based studies, and their application in line with these updates are especially important in preventing preventable maternal-newborn deaths and providing woman-centered care. In this review it is aimed to compare the postpartum care guidelines of the World Health Organization (WHO), American College of Obstetricians and Gynecologists (ACOG), National Institute for Health and Care Excellence (NICE), and the Postpartum Care Management Guideline (PCMG) of the Turkish Ministry of Health in the context of content and midwifery care. For this purpose, the content of national and international guidelines on postpartum care management and their recommendations in midwifery care were examined, and it was tried to be presented to healthcare professionals from a holistic perspective.