The term of “substance” is used to describe drugs used outside the scope
of their medical indication and include several chemical substances. In
Turkey, although substance use is often thought of as a problem for
men, women also have substance-use problems. Women who begin to
participate in their working lives and earn their own income are stated
as important reasons for the increase in substance use.
In this article, alcohol, smoking and drug use in women, and
recommendations for nursing care were examined. Nurses should
assess the substance-use problems in these women while taking into
account their families and should also plan appropriate interventions
using models of proper health protection and development. Training,
consulting and monitoring services should be maintained through
effective interpersonal and communication skills.

The majority of women who are of reproductive age experience
dysmenorrhea on a periodical basis. Dysmenorrhea is seen in 85% of
women in the U.S. and 81.7% in Turkey. The level of pain may be mild
but it can also be severe, and it can prevent women from attending
school or work resulting in serious economic losses. Therefore,
dysmenorrhea treatment has become an important issue. Many women
consider dysmenorrhea to be a condition with which they can cope
and do not seek medical attention. This results in using medications
and complementary treatment methods without consulting health
professionals. Both healthy and unhealthy individuals may use
complementary treatment methods in order to promote health, prevent
diseases, and support conventional medical treatment. Complementary
treatments are used widely throughout the world and have become
an important part of the health sector. Complementary treatment
methods used for dysmenorrhea management include body therapies,
mind – body techniques, vitamin and mineral supplements, and herbal
therapies. However, these methods lead to positive outcomes only if
they are applied correctly. It is important for these treatments to be used
after consulting a health professional. Nurses who work in the  elds of
school, public, and women’s health can recommend complementary
treatments for the management of dysmenorrhea. This article provides
health professionals with an overview of the complementary treatment
methods used for dysmenorrhea.

OBJECTIVE: This research has been conducted to determine what nurses
know about patient safety and to investigate the effects of an in-service
training on their knowledge levels.
METHODS: This is a comparative pre-test and post-test semi-experimental
study. 90 nurses working at the Internal Diseases Department Clinics
of a university hospital participated in the research in March 2011.
The participants were provided with an in-service training regarding
patient safety and they were given questionnaires about patient safety
before and after the training. The data was evaluated in percentages
and by using chi-square test.
RESULTS: It was determined that 15% of the nurses had previously taken
patient safety trainings and 23.3% experienced patient safety problems
during care. When the pre-test and post-test results of the training were
taken into account, it was observed that there were signi cant increases
in the number of correct answers given on the post-test regarding the
subjects of drug safety, blood and blood products, lowering the risk of
infection, lowering the risk of falling, and radiation safety (p=0.000).
CONCLUSION: It has been determined that the patient safety in-service
training program has increased the knowledge levels of the nurses. It
would be bene cial to arrange more in-service training programs on
the subject of patient safety.

OBJECTIVE: To evaluate the effects of an antenatal breastfeeding education
program based on the Dennis Breastfeeding Self-Ef cacy Theory for
mothers’ breastfeeding self-ef cacy and breastfeeding success.
METHODS: A quasi-experimental study was performed in a Maternal
Child Health Center in Izmir, Turkey. A total of 82 out of 109
pregnant mothers (75.2%; 41 intervention and 41 control group)
agreed to participate. Breastfeeding Self-Ef cacy was measured
with the Breastfeeding Self-Ef cacy Short Form Scale and Antenatal
Breastfeeding Self-Ef cacy Short Form Scale, and breastfeeding success
was measured with the LATCH Assessment Tool. Breastfeeding selfef
 cacy was measured before the education, as well as at one-week
postnatal and six-weeks postnatal respectively. At one-week postnatal
and six-weeks postnatal, breastfeeding success was also evaluated. To
determine the effectiveness of the intervention MANOVA, independent
samples t test and paired samples t test were used.
RESULTS: The results indicate that the intervention group had signi cant
higher breastfeeding self–ef cacy and maintained this distinction
in all measurement periods antenatally and postnatally (p<0.01).
Furthermore, the intervention group presented signi cantly better
results in breastfeeding success at one week postnatal (p<0.001) as well
as at 6 weeks (p<0.05).
CONCLUSION: The breastfeeding education program, based on Dennis
Breastfeeding Self-Ef cacy, is effective for improving breastfeeding
self-ef cacy and breastfeeding success. Consequently, the existing
education programs should be reviewed and programs should include
contexts that will improve mothers’ con dence, rather than just be
informative brie ngs.

An increase in the incidence of Type 1 diabetes in the world and
a decrease in the age of onset does not mean a lower quality of life
for diabetic adolescents and children when well-managed. Nurses
providing diabetes education have important responsibilities in
realizing this. Although there are education programs in diabetes
centers by specialist nurses in Turkey, no standardized education has
been established.
The quality of nursing care increases by providing solutionfocused
approaches when theories and models are implemented to
systematize nursing practices and give direction to nursing research.
Standardizing education in nursing care improves the quality of care
and professionalism. In this article, an example is given in order to
illustrate the diabetes education standards for adolescents/children
with Type 1 diabetes by using Type 1 Diabetes Management Model
based on the Health Promotion Model and Mastery Learning Theory.
It is believed that this example may be adapted for the management of
different chronic diseases.

OBJECTIVE: The aim of this study was to determine the knowledge and attitudes of pediatric nurses on the topic of vital signs.
METHODS: The study was conducted at a children’s hospital located in
the province of Izmir, Turkey. One hundred eleven nurses working in
the inpatient wards participated in the study. The following four forms
were used in the study: “The Socio-demographic Questionnaire”, “The
Vital Signs Knowledge Assessment Survey”, “The Vital Signs Attitude
Assessment Survey” and “Case/Patient Follow-up Form”. The Vital
Signs Knowledge and Attitude Assessment Surveys consist of questions
regarding vital signs and the general principles, temperature, pulse,
respiration, blood pressure and pain. The knowledge and attitude
surveys were prepared in accordance with the guidelines published by
the Royal College of Nursing: “Standards for assessing, measuring and
monitoring vital signs in infants, children and young people” and “The
Recognition and assessment of acute pain in children”. The knowledge
survey comprises 46 questions and the attitude survey comprises 19
questions. “The Case Follow-up Form” was prepared according to the
 ndings of moderately severe dehydration.
RESULTS: The average age of nurses who participated in the study was
31.2±6.3. The nurses’ knowledge survey scores were 87.9±7.8 for
general principles, 87.6±10.1 for temperature, 93.1±8.0 for pulse,
96.4±7.4 for respiration, 92.8±7.0 for blood pressure, and 91.8±9.8
for pain. The averages of the attitude survey scores were 81.7±11.99
for general principles, 87.4±15.9 for temperature, 89.6±12.5 for pulse,
95.3±9.8 for respiration, 95.8±12.2 for blood pressure, and 91.0±15.5
for pain. Although 49% of nurses stated that nurses should decide
the frequency of monitoring vital signs, 41.4% of them stated that it
should be ordered (written) by the physician. It was found that there
was a signi cant relationship between the year of work and the attitude
scores of blood pressure measurement. There were differences between
the frequency of nurses’ responses in the case follow-up.
CONCLUSION: According to our  ndings, the nurses’ knowledge and
attitude scores relating to the monitoring of vital signs were quite high.
In order to update nurses’ knowledge and to develop better behaviors
toward monitoring vital signs, in-service trainings following evidencebased
guidelines should be provided, especially for nurses working in
the clinics for a long time.

OBJECTIVE: The purpose of this study is to test the validity and
reliability of the Turkish version of the scale developed by the Delmarva
Foundation which determines the fall risks of inpatients at hospitals.
METHODS: This is a methodological study conducted on 101 inpatients
receiving treatment at a private hospital in the Marmara region of
Turkey between August and October 2007. The scale’s language
validity was ensured and its reliability aspects were assessed with
Kappa analysis inter-observers.
RESULTS: Kappa values relating to the parameters for level of consciousness/
mental status, history of falls, ambulation/elimination status, vision
status, gait and balance, orthostatic changes, medications, predisposing
diseases and equipment issues were found to be between
0.451-0.946 (p<0.001). The scale’s total point Kappa value was determined
to be 0.753 (p<0.001).
CONCLUSION: The scale has been found to be at a suf ciently reliable
level from the stand point of inter-raters reliability. However, studies
of this scale’s scope validity and reliability with similar scales need to
be made.

The most common neurocardiogenic syncope is considered to be
vasovagal syncope. Numerous conditions are responsible for these
vasovagal episodes. The management of syncope is highly successful
when triggers and underlying causes are found.
After a 50-year-old male patient admitted to hospital and diagnosed with
myocardial infarction was given an angiographic stent intervention, a
sandbag compression was applied to the sheath on the femoral artery
in order to control bleeding. While the patient’s vital signs were stable
during the procedure, immediately after the sandbag compression
was applied, the patient developed a sudden onset of hypotension
and bradycardia, and consequent transient unconsciousness and
asystole. After administering atropine of 1mg intravenous bolus to
treat bradycardia and removing the sandbag compression, the patient’s
condition improved. We supposed that the sandbag compression at
the point of intervention raised pain levels. We concluded that the
painful stimulus caused by a heavy sandbag compression may have
triggered the onset of vasovagal syncope in such a patient who showed
no preexisting arrhythmia or abnormal vital signs.