INTRODUCTION: Clinical decision making is an essential part of the nursing process adopted by nurses and nursing students as a problem-solving approach. The aim of this study was to investigate the effect of virtual patient simulation on fourth-year nursing students’ clinical decision-making and problem-solving skills.
METHODS: The study was designed as quasi experimental research and included 73 fourth-year nursing students. The study was conducted between December 2018 and May 2019. Sociode-mographic data form, Clinical Decision-Making in Nursing Scale, and Problem-Solving Inventory were used to collect the data. After the pretest, the students undertook virtual patient simulation. Subsequently, the post-test was administered.
RESULTS: Mean age was 22.06±0.34 years, and 93.2% of the participants were female. The mean pretest score for problem-solving skills was 110.68 ± 13.57, and the mean post-test score was 108.66 ± 18.41, and no significant difference was established between the 2 scores (P >.05). In addition, the mean pretest score for clinical decision-making skills was 153.94 ± 12.57, and the mean post-test score was 152.71 ± 13.36, and no significant difference was found between the 2 scores (P >.05).
DISCUSSION AND CONCLUSION: The results indicated that virtual patient simulation does not affect fourth-year nursing students’ clinical decision-making and problem-solving skills.

INTRODUCTION: This study aims to identify prenatal distress and the contributing factors in high-risk pregnant women.

METHODS: This descriptive study was conducted among 241 high-risk pregnant women at Etlik Zübeyde Hanım Health Application and Research Center in Ankara, Turkey. Sampling was performed using the simple random sampling method. Data were collected using the sociodemographic form and the Tilburg Pregnancy Distress Scale. Data analysis was performed using the Mann-Whitney U test, Kruskal-Wallis H test, and posthoc test. The significance level was taken as P <.05.
RESULTS: The average age of the pregnant women was 28.61 ± 5.8 years, and the Tilburg Pregnancy Distress Scale total mean score was found to be 29.05 ± 11.6. A statistically significant difference was found between the Tilburg Pregnancy Distress Scale total mean scores and the variables such as pregnant women’s educational level, their income level, the place where they spent their childhood, their wanting of the pregnancy, and the number of children they had (P <.05).

DISCUSSION AND CONCLUSION: More than half of the high-risk pregnant women were found to experience distress. In addition, it was found that some sociodemographic and obstetric variables impacted the distress levels.

INTRODUCTION: This is a cross-sectional study conducted to evaluate the impact of adaptation to pregnancy on breastfeeding self-efficacy perception of women who applied to the Gynecology and Obstetrics Outpatient Clinic of a public hospital between March 1, 2018 and May 30, 2018.
METHODS: A total of 140 pregnant women were included in the study. Data were analyzed using Statistical Package for the Social Sciences 21 program. Shapiro-Wilk test was used for testing the normal distribution of the data, and the Levene test was used to test for homogeneity of variance. Student's t-test was used for comparing 2 independent means, 1-way analysis of variance was used for comparing >2 independent means, and Turkey posthoc test was used for pairwise comparisons. The Pearson correlation coefficient was calculated in the linear relationship between 2 continuous variables.
RESULTS: There was a statistically significant difference between the educational groups, spouses, and coeducation levels of the women and the mean scores of the Pregnancy Breast-feeding Self-Efficacy Scale. There was a statistically significant difference in the mean total Prenatal Self-Assessment Scale score by training groups (P =.004). In the second half of the pregnancy period, compliance with total Prenatal Self-Assessment Scale scores was found to increase (P =.019). A positive and weak relationship was found between the Pregnancy Breastfeeding Self-Efficacy Scale score and the Prenatal Self-Assessment Scale score (r = 0.202, P =.017).
DISCUSSION AND CONCLUSION: It has been found that the belief in breastfeeding self-efficacy increases significantly as women’s compliance with pregnancy increases. In all polyclinics where pregnant women use actively, it is recommended that breastfeeding and breast milk training be widely conducted and that pregnant women are encouraged to use breast milk polyclinic and pregnancy school.

INTRODUCTION: Bu araştırma, üçüncü trimesterdeki gebelerin prenatal bağlanma ile algıladıkları sosyal destek düzeyleri arasındaki ilişkinin belirlenmesi amacıyla tanımlayıcı olarak yapılmıştır.
METHODS: Araştırmanın örneklemini 21 Temmuz-22 Eylül 2017 tarihleri arasında bir kamu hastanesinin Non Stres Test Polikliniği’ne başvuran 152 gebe oluşturmaktadır. Araştırmanın verileri anket formu, Çok Boyutlu Algılanan Sosyal Destek Ölçeği ve Prenatal Bağlanma Envanteri kullanılarak toplanmıştır. Elde edilen veriler; tanımlayıcı istatistikler, iki grup ortalamaları karşılaştırması için student’s t testi, ikiden fazla grup ortalamaları karşılaştırması için one way ANOVA testi kullanılarak değerlendirilmiştir. Sürekli iki değişken arasındaki ilişkiyi belirlemek için Pearson korelasyon katsayısı kullanılmıştır.
RESULTS: Gebelerin Sosyal Destek Ölçeği’nden aldıkları puan ortalamalarının “57.93 ± 13.76”, Prenatal Bağlanma Envanteri’nden aldıkları puan ortalamalarının “61.84 ± 10.07” olduğu bulunmuştur. Öğrenim düzeyi lise ve üzeri olan gebelerin sosyal destek ve prenatal bağlanma düzeylerinin daha düşük olduğu belirlenmiştir. Buna ek olarak abortus öyküsü ile gebelik sayısı üç ve üzeri olan gebelerin prenatal bağlanma düzeylerinin daha düşük olduğu bulunmuştur. Gebelerin Çok Boyutlu Algılanan Sosyal Destek Ölçeği ve Prenatal Bağlanma Envanteri’nden aldıkları puan ortalamaları arasında orta düzeyde pozitif yönde anlamlı bir ilişkinin olduğu saptanmıştır.
DISCUSSION AND CONCLUSION: Gebelerin algıladıkları sosyal destek düzeyleri arttıkça prenatal bağlanma düzeylerinin de artış gösterdiği belirlenmiştir. Araştırmadan elde edilen sonuçlar doğrultusunda prenatal dönemde bağlanmayı arttırmak için anahtar rol oynayan hemşirelerin verecekleri bakımda, gebelerin sosyal destek kaynaklarını ve düzeylerini belirleyerek sosyal destek ile prenatal bağlanma arasındaki ilişkiyi ve etkileyen faktörleri göz önünde bulundurmaları önerilmektedir.

INTRODUCTION: The incidence of delirium in patients who underwent open-heart surgery can cause them to face many short- and long-term complications. Having comprehensive information on the incidence and risk factors of delirium in patients who underwent open-heart surgery is essential for preventive care. Owing to the lack of studies in this regard, this study was conducted with the aim of investigating the incidence of delirium and its associated risk factors among patients undergoing cardiac surgery in a cardiac intensive care unit.
METHODS: This is a cross-sectional descriptive study conducted in the cardiac surgery intensive care unit of Booali Sina Hospital in Qazvin, Iran in 2018. The study sample comprised 230 patients who underwent open-heart surgery. For data collection, a demographic checklist and the Neelon and Champagne Confusion Scale were used. Data collection started in the evening before cardiac surgery and continued every day until patients left the intensive care unit. Collected data were then analyzed using descriptive tests and a nonlinear logistic regression model by Statistical Package for the Social Sciences, version 23.
RESULTS: Of all the patients who participated in this study, 53.5% showed some degree of delirium; 17 patients (7.4%) showed symptoms of moderate-to-severe delirium, 16 patients (7%) showed symptoms of mild delirium, and 90 patients (39.1%) developed confusion. Among the variables studied in this study, older age, history of renal diseases, history of stroke, the use of intraoperative cardiopulmonary bypass, clamp time, postoperative fibrillation, and postoperative stroke significantly predicted delirium (P <.05).
DISCUSSION AND CONCLUSION: More than half of the patients reported some degree of delirium. Therefore, it is necessary to take preventive measures into consideration in this regard.

INTRODUCTION: This study was conducted to determine what nurses think about the use of evidence-based practice in their clinical work.
METHODS: The study was carried out as qualitative research in March 2019 with nurses working in the clinical departments of a state university hospital in Istanbul. Thirteen nurses met for discussions in two focus groups and provided the data in a semi-structured questionnaire. Content analysis was used in the data analysis. The results of the study revealed four main themes and fourteen subthemes. The main themes could be identified as the meaning of evidence, the benefit of evidence-based practice, barriers standing in the way of adopting evidence-based practice, and beliefs and expectations about evidence-based practice.
RESULTS: Nurses believe that evidence-based practice can not only empower them in their professional development in the processes of problem-solving and decision-making but can also contribute to achieving professionalism in their vocation. However, nurses state that they are confronted by major barriers that stand in their way on a personal and organizational level and also in terms of available training opportunities.
DISCUSSION AND CONCLUSION: Nurses say that evidence-based practice, which is not widely used in the clinical setting in Turkey, is important in order to raise the quality of patient care and to enable the strengthening of the profession itself. They point out however that there are various individual, institutional and educational barriers that are obstacles to using scientific evidence in their practice. It is in this context that our recommendation is that nursing undergraduate and graduate curriculums should be adapted to clinical practice and strategies should be created to increase cooperative efforts.

INTRODUCTION: The aim of this study was to investigate the impact of a psychological empowerment program on manager nurses' psychological distress and professional quality of life.


METHODS: This study had a quasi-experimental design in a single-group pre-post-test model. This study was conducted with 20 manager nurses working in an education and research hospital in Izmir, Turkey. The psychological empowerment program consists of 2 sessions running for 8 hours, 4 hours each. The General Health Questionnaire was used to evaluate distress levels, and the Professional Quality of Life Scale was used to evaluate the professional quality of life levels of the manager nurses. Data were evaluated by paired t-test.
RESULTS: After the psychological empowerment program, it was found that the level of distress, compassion fatigue, and burnout of the nurses decreased and that their compassion satisfaction increased.
DISCUSSION AND CONCLUSION: It is seen that psychological empowerment interventions directed toward manager nurses reduce the mental risks of nurses. In this sense, it is recommended that empowerment programs be implemented for manager nurses in institutions and that the effectiveness of these programs with research designs that have high levels of evidence be evaluated.

INTRODUCTION: The purpose of this study was to determine the level of practice of the roles and functions of pediatric nurses.
METHODS: The study was conducted with 80 nurses working in pediatric services of a university hospital and a state hospital. Nurse information form and Scale of Practice of Roles and Functions of Pediatric Nurses were used for data collection. Independent group t-test and one-way analysis of variance were used for statistical evaluation of the data.
RESULTS: The level of practice of roles and functions of nurses working in pediatric units of university and state hospitals was high. Although there were no significant differences among nurses in relation to their gender, age, marital status, educational status, experience in the profession, and experience in their current department and hospital (P >.05), there were significant differences among the nurses in relation to their work settings (P <.05).
DISCUSSION AND CONCLUSION: It is important to improve the quality of the care that pediatric nurses are aware of with regard to the physical, emotional, mental, and social needs of children and their families. For this reason, it is recommended that pediatric nurses should specialize in the field and receive training in order to be aware of and to use the roles of nursing effectively.

INTRODUCTION: The aim of this study is to determine the eye health problems or visual defects of students in an elementary school and to provide care and treatment when necessary.
METHODS: The sample of this cross-sectional descriptive study consisted of 2,136 students in a primary school. In the process of data collection, student identification information form, vision screening form, and feedback form of teachers about screening developed by the researchers were used. Frequency and percentages were used to define categorical variables. Categorical variables were compared by the chisquare test.
RESULTS: From the results of the eye examination, blepharitis, strabismus, and inability to focus (2.2%) were the most common. According to the result of the visual acuity scan, the prevalence of refractive error was found to be 18.9%. A statistically significant difference was found between the suspicion of refractive error according to the age group (χ2 =50.071, P <.001). Feedback was obtained from 75.4% of the students who suspected refractive errors in any of their eyes. Of these students, 33.2% went to a doctor’s examination, 42.6% were given spectacles, 10.9% were started on medication, and 3% were given both medication and spectacles. The results of the screening show that 56.4% of the students who have a suspected refractive error in any of their eyes and who go to the doctor’s examination are detected correctly.
DISCUSSION AND CONCLUSION: It should be noted that nurses play a key role in the provision and maintenance of school health services. In addition, it is recommended that research on the roles of nurses in identifying other problems that may be raised by screening be conducted and that nurses should be employed in schools.

INTRODUCTION: The application of peripheral venous catheters in neonatal units is a widely utilized technique including risks in newborns. The aim of this study is to determine the incidence, risk factors, and complications of peripheral venous catheterization attempts in newborns.
METHODS: This descriptive study, treatment and care of a university hospital neonatal intensive care unit in the 87 neonatal peripheral venous catheters 406 applications were observed in Turkey. The research was applied between July-October 2019. The variables of the study were gender, age, week of gestation, catheterization site, and type of catheter, insertion attempt number, catheter length of stay, and complication.
RESULTS: 406 catheters were monitored for 36.5 ± 13.8 hours and 118 of 246 catheters were removed after the completion of the treatment (Success 47.97%). The most preferential regions were the dorsal region (58.13%) and the cubital fossa (14.22%) and the dorsal area of the feet (15.04%). The most common complications were found to be infiltration/extravasation (35.77%) and phlebitis (8.94%).
DISCUSSION AND CONCLUSION: The preferential application locations are the dorsal hand and the cubital fossa, with less complication, longer catheterization, and less procedure for catheterization. The dorsal region on hand is recommended as the first choice in terms of fewer trials for cannulation.

INTRODUCTION: The purpose of this descriptive study is to investigate the relationship between social support and self-care agency in elderly patients who are hypertensive.
METHODS: This study was conducted with 150 patients who were hypertensive aged ≥65 who applied to the cardiology outpatient clinic of Firat University Hospital (Elazığ, Turkey). Patient information form, including sociodemographic and disease-related data, Self-Care Agency Scale, and Multidimensional Scale of Perceived Social Support were used for data collection. Independent t-test for pairwise comparison, Kruskal-Wallis test for multiple group comparison, and Pearson’s correlation analysis for correlation between the study variables were used to assess the data.
RESULTS: The correlation analysis made between self-care agency and social support revealed that self-care agency had a positive and significant correlation with family support (r=0.944, P <.001), friend support (r=.380, P <.001), significant other support (r=.386, P <.001), and total support (r=.406, P <.001). It was found that patients with high self-care agency mean scores had high mean scores of support from family, friends, and significant other and total support.
DISCUSSION AND CONCLUSION: This study revealed that there was a significant correlation between self-care agency and social support in elderly patients who are hypertensive and that social support increased self-care agency. According to these results, attention should be paid to the social support used by patients who are hypertensive.

INTRODUCTION: Epilepsy is a disease mostly seen in the central nervous system. The number of people affected is quite high in the World and in Turkey. Individuals with epilepsy and their families need to be trained to control the disease and reduce their anxiety. In effective management of the disease; self-efficacy, quality of life, and having knowledge about disease are important. Informing patients and parents about epilepsy by nurses plays an important role in increasing the success of disease management. The aim of this systematic review study is to determine the effect of planned education for adults with epilepsy on disease management and to provide evidence that healthcare professionals can benefit from.
METHODS:
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Pharmacologic and non-pharmacologic methods are used in management of labour pain. In use of pharmacologic methods, the only role of woman in pain management role and control is to adapt passively. At the same time, pharmacologic methods and interventions require complex technologies and experienced personnel. In the event that pain control is enough, non-pharmacologic methods have many advantages compared to pharmacologic methods. They do not slow down the labour and do not have side effects or allergy risks. Distraction and focusing, which means drawing attention from pain to another direction, is one of the methods for coping with labour pain. Distraction and focusing are used to prevent transmission of painful stimulants to central neural system. It enables the pregnant woman to draw her attention from the pain and focus on other stimulants during contractions. Some object/ instrument/implementation can be used for distraction and focusing. The aim of this paper is to explain the place of stereogram cards prepared specifically for labour in enabling the pregnant woman to cope with pain during her contractions. Stereogram focusing cards during labour (DSO-K) are designed specifically with oxytocic images. Consisting of 10 different cards, DSO-K enables women to draw their attention from pain during labour. As one of the non-pharmacologic methods implemented in labour, the method of focusing with DSO-K might be included among effective methods of relieving labour pain. The method of focusing with DSO-K is a safe, non-invasive independent method which does not require doctor’s solicitation for nurses and midwives during labour. It is one of the easy, accessible and cheap methods that woman can use on her own and each woman can benefit during labour.

As in protection from healthcare-associated infections, protection from all infectious agents requires an evidence-based, scientifically supported infection control program. Today, all over the world, the World Health Organization and the Centers for Disease Control and Prevention shed light on the needs of countries by publishing a comprehensive infection control program. A novel coronavirus disease 2019 pandemic has been announced by these organizations at a global scale as of January 30, 2020, and the attention of the whole world has been drawn to infection prevention practices. The leading, cheapest, and most reliable measure among the infection prevention practices is hand hygiene. Practicing proper hand hygiene has a significant influence on the transmission of infectious agents by contact. Proper hand hygiene practices are inevitable in preventing infections, both in healthcare institutions and in public areas. It has been observed that hand hygiene practices are also vital for the novel coronavirus disease 2019 pandemic announced as of 2020. Therefore, performing hand hygiene practices correctly and at the right time in light of the guidelines published by the World Health Organization, Centers for Disease Control and Prevention, and the Turkish Society of Hospital Infections and Control will be an important step in ensuring effective infection control. The aim of this review is to describe hand hygiene and emphasize its importance in the light of guidelines on pandemic processes and hand hygiene.

The COVID-19 outbreak is becoming a global public health issue. Physical, social and psychological effects affect societies. The epidemic process causes uncertainty, anxiety, and anxiety about treatment and when to end. Why reveals the concepts of social distance and social isolation that you use for removal and removal. In this direction, it was aimed to reflect COVID-19 to the psychosocial structure of the society in our study.

Colorectal cancers are the third leading cause of cancer-related deaths worldwide. Stoma surgery still remains a surgical treatment and life-saving procedure for colorectal cancers. Stoma care nurses play an important role in ensuring the continuity of care in the process until and after the discharge of patients with a stoma. They can help patients cope with the diagnosis, teach practical skills related to stoma care and provide supportive counselling. However, recent advances in technology, as robotic and laparoscopic procedures shortened hospital stay, patient and their families do not have enough time for stoma care counselling during their stay. In our country, due to the scarcity of the number of stoma care nurses and designated colorectal surgery units, individuals with stoma fail to acquire the necessary information related to stoma care. These patients and relatives have to deal with many problems after being discharged. To fill this gap, Stoma-Mobile (STOMA-M) application is designed to provide a standardized basic stoma care approach to patients and caregivers. In this article, the description, development purpose and the characteristics of STOMA-M application for those who suffer from STOMA-M and their relatives, and the health care professionals will be shared. In this article, the purpose of STOMA-M application, development purpose and characteristics of STOMA-M applications will be discussed. With STOMA-M application, individuals with a stoma will have the necessary information about stoma care, living with stoma and complication management. STOMA-M is intended to be a guide for patients who have undergone stoma surgery, their caregivers, stoma and wound care nurses, physicians and other healthcare professionals.

Determining the level of the emotional labor of nurses who play an important and indispensable role in the health system has become one of the most important issues. It is thought that nurses experience a lot of emotional labor as a result of many factors such as spending more time with patients and having more empathy and feeling emotions because the majority of occupational members are women. To increase the service quality of nurses, strategies should be developed to make nurses' emotional labor behaviors more positive. Within this framework, all nurses, especially the managing nurses, should be provided with training on patient communication, emotion management, and emotional labor behavior. First, it is necessary to increase the awareness of nurses who engaged in superficial behavior, study the reasons that lead them to this behavior, and try to eliminate these factors. In addition, by examining the emotion management and emotional labor behaviors of students in nursing education, it can be suggested to address the issues that support the empowerment of nursing students in the emotional dimension.

Colorectal Cancers is the third type of cancer in the world among men, second among women and third among both sexes. Despite Colorectal Cancer early diagnosis practices, which are met free of charge by national cancer screening programs, the participation rates of individuals in screening programs are insufficient; these rates are even lower in poor individuals. Various models have been developed by behavioral scientists to identify and evaluate the factors that affect individuals' participation in cancer screenings. Health Belief Model is one of the most effective models in explaining behaviors towards cancer screening. In the literature, there are studies that try to define the factors that lead individuals to perform colorectal cancer screening on the basis of Health Belief Model. The aim of this review is to show the various applications used on the basis of Health Belief Model to increase the participation of low socioeconomic level individuals in colorectal cancer screening. Nurses should also play a more active role in model-based interventions to increase colorectal cancer screening rates in poor individuals.

Our study case M is a boy aged 168 days. His height was 61 cm, and his weight was 9,000 g. Nasopharyngeal and throat swabs were taken from the patient admitted to the emergency department with complaints of coughing, wheezing, and difficulty in breathing to conduct a polymerase chain reaction test. According to the result of the polymerase chain reaction test, the infant was diagnosed with coronavirus disease 2019 and was hospitalized in the relevant service. The patient underwent computed tomography on the same day, and his lung findings confirmed the diagnosis of coronavirus disease 2019. Because respiratory findings indicated tachypnea, humidified high-flow nasal oxygen therapy was started. If an infant receiving humidified high-flow nasal oxygen therapy is in the at-risk group, this poses risk both for the parents and for healthcare professionals. The aim of conducting this case study was to reduce the high risk of transmission of coronavirus disease 2019 from patients diagnosed with the disease and receiving humidified high-flow nasal oxygen therapy and to create a resource for the planning and implementation of correct nursing interventions. In the patient, diagnoses of the risk of infection transmission, ineffective respiratory patterns, social isolation, disruption of skin integrity, anxiety and lack of information, and interventions related to these diagnoses were discussed in light of the literature.