E-ISSN 2757-9204

Journal of Education and Research in Nursing

Volume: 20  Issue: 1 - March 2023

Page XI

2.Anxiety and Stress Experiences of Individuals with Chronic Diseases in the COVID-19 Pandemic: Qualitative Research
Seval Gönderen Çakmak, Kamil Gönderen, Serdar Aykut, Sezen Soner
doi: 10.5152/jern.2023.80557  Pages 1 - 6
INTRODUCTION: Coronavirus disease 2019, caused by the severe acute respiratory syndrome coronavirus 2, is a global pandemic resulting in the deaths of more than 3 million people across the world. It has been reported to be more fatal in individuals with chronic diseases than in healthy adults without a diagnosis of hypertension, diabetes, cardiovascular disorders, or respiratory system diseases.Aim: To determine the experiences and attitudes of individuals with comorbidities in relation to the coronavirus disease 2019 pandemic.
METHODS: This qualitative-phenomenological study was conducted with individuals with chronic diseases among the family members of students attending the Healthcare Services Department of Eldivan Vocational School of Health. The sample of the study consisted of 17 individuals with chronic diseases. Data were collected through online interviews conducted between June and July 2020. The obtained data were analyzed using content analysis, and themes were created.
RESULTS: The mean age of the participants was 67.17 years; 47% were men, and 53% were women. From the data obtained through the interviews, 2 main themes emerged in relation to the pandemic experiences of the participants: negative emotions and positive responses. The theme of negative emotions related to the pandemic was further divided into the following sub-themes: fear of death, fear of being in social environments, lack of information about the pandemic, and external pressures. The theme of positive responses had 2 sub-themes: trust in government and spirituality, and individual measures.
DISCUSSION AND CONCLUSION: Individuals with chronic diseases have experienced many positive and negative emotions during the pandemic period. It is recommended to establish emergency information and advice lines for these individuals, provide them with training on health communication and health literacy, and raise their awareness of similar pandemics through practices such as public service announcements.

3.Validity and Reliability Study of the Turkish Version of the Hand-Foot Syndrome Quality of Life Scale
Çiğdem Ökten, Zeynep Özer
doi: 10.5152/jern.2023.21050  Pages 7 - 13
INTRODUCTION: Background: Hand-foot syndrome is a symptom of some antineoplastic drugs which affects blood vessels and surrounding tissues, causing redness, swelling, and pain on the palms and soles and affects quality of life. The study was carried out methodologically in order to adapt the Hand-Foot Syndrome Scale-14, which was developed for the quality of life of individuals receiving chemotherapy who have hand-foot syndrome, into Turkish and to determine its validity and reliability.
METHODS: The research was conducted with 102 patients who received chemotherapy in a University Hospital Chemotherapy Unit. Patient Information Form, National Cancer Institute classification criteria, Hand-Foot Syndrome Scale-14, and Skindex-29 Scale were used to collect data. Translation-back translation technique was used for the language validity of the scale. For the content validity of the scale, 7 experts were consulted. Opinions from experts showed that the correlation between the items of the scale was very strong (Kendall’s W = 0.24, P = .61).
RESULTS: As a result of the explanatory factor analysis, a 3-factor structure with a total variance of 60.31% was obtained. When the Cronbach’s alpha coefficient values were examined for internal consistency validity, it was determined that the total Cronbach alpha value of the scale was 0.86, and the Cronbach’s alpha value of its subscales was 0.84, 0.89, and 0.67, respectively. In addition, it was observed that there was a strong positive correlation between Skindex-29 and Hand-Foot Syndrome Scale-14.
DISCUSSION AND CONCLUSION: The results of the Turkish version of Hand-Foot Syndrome Scale-14 were found to be consistent with the original scale structure, valid and reliable for the Turkish population.

4.Intensive Care Experiences of Patients After Surgery
Güler Yüksel, Hayat Yalın, Fatma Eti Aslan
doi: 10.5152/jern.2023.21063  Pages 14 - 19
INTRODUCTION: Patients hospitalized in the intensive care unit are faced with many factors that can negatively affect the intensive care experience, such as pain, noise, insomnia, and lack of privacy. The study was planned to determine the experiences of patients whose care and treatment were continued in the intensive care unit after surgery during their stay in these units.
METHODS: The study, which was planned quantitatively and descriptively, was conducted between January 2019 and October 2019 with 220 patients in the inpatient clinics of a private hospital. The data were collected by face-to-face interview method within the first 24 hours after the patients were transferred from the intensive care unit in the service rooms where they were hospitalized, using the “patient information form” and “Intensive Care Experience Scale.” Number, percentage, mean, standard deviation, t-test, and 1-way analysis of variance were used for data analysis.
RESULTS: According to the results of this study, 61.4% of the participants in the study were male, and their average age was 58.795 ± 15.503 years. The total mean score of the patients from the Intensive Care Experience Scale was 73.809 ± 5.050. It was found that the satisfaction scores of the patients were significantly different according to the age variable (P <.05). The scores of satisfaction with the care taken were found to be higher in those aged 61 and over than those aged 40 and below (P <.05).
DISCUSSION AND CONCLUSION: As a result of the study, the intensive care experience of patients who had previously been in intensive care and stayed in a single room was positive; however it has been found that problems such as pain, noise, and inability to sleep cause patients to feel discomfort.

5.Factors Affecting Adherence of Recipients to Immunosuppressive Therapy after Liver and Kidney Transplantation
Nurşah Tatoğlu, Özgül Karayurt, Filiz Oğce
doi: 10.5152/jern.2023.21105  Pages 20 - 27
INTRODUCTION: Organ transplantation has important outcomes: decreased mortality, increased graft survival, reduced morbidity, and improved quality of life. One of the most important preventable factors that negatively affect these outcomes and put the success of solid organ transplants at risk in organ transplant recipients is non-adherence to immunosuppressive treatment. The purpose of this study is to examine the adherence of recipients to immunosuppressive therapy after liver and kidney transplantation and affecting factors.
METHODS: This is a descriptive study. A total of 310 patients who underwent liver or kidney transplantation at a university hospital between February and July 2015 were included in the study. Data were collected with Sociodemographic and Clinical Characteristic Form, SF-36 Quality of Life Scale, and Immunosuppressant Therapy Adherence Scale. The Mann–Whitney U test, Fisher’s exact test, and Chi-square test were used to analyze the data. Factors affecting adherence were examined by univariate logistic regression analysis.
RESULTS: The edits made to the sentence ‘Immunosuppressive Therapy Adherence Scale scores of the recipients ranged between 7 and 12 with a mean of 11.34 ± 0.81 and recipients who had Immunosuppressive Therapy Adherence Scale scores of <12 were considered non-adherent. Age, time elapsing after transplantation, total number of drugs used, education on drug use, and the quality of life mental component summary score were found to affect adherence to immunosuppressive therapy. Gender, educational status, marital status, employment status, donor and organ transplant type, and the quality of life physical component summary score were found to be ineffective in adherence to immunosuppressive therapy.
DISCUSSION AND CONCLUSION: Organ transplant recipients adherent to immunosuppressive therapy were found to be older, use a higher number of drugs, and have a higher mental health summary scores than those not adherent to the immunosuppressive therapy. Besides, a higher rate of the recipients adherent to immunosuppressive therapy was found to receive education on medication use and have a shorter time elapsing after transplantation. It can be recommended that nurses should be aware of the factors likely to affect adherence to immunosuppressive therapy, evaluate the adherence regularly by using a valid and reliable tool, and perform effective interventions.

6.Attitudes of Coping with Stress and Self-Care Agency Levels of Nursing Students
Neslihan Komser, Aylin Özakgül
doi: 10.5152/jern.2023.21004  Pages 28 - 34
INTRODUCTION: In cases of deviation from health, such as stress, self-care needs arise. It is important that nursing students develop an effective attitude in coping with stress and have a high level of self-care power. This study was carried out to determine the relationship between nursing students’ stress-coping attitudes and self-care agency levels.
METHODS: A descriptive and correlational design was used in this study. Sample of the study consisted of 416 students studying at a Nursing Faculty in Istanbul in the spring semester of 2017-2018. Data were collected by using Structured Questionnaire Form, the New Brief Coping Styles Inventory, and Exercise of Self-Care Agency Scale, and descriptive statistical methods, Student’s t-test, one-way ANOVA test, Bonferroni test, linear regression, and Pearson correlation analysis were used.
RESULTS: It was observed that the average age of the nursing students was 20.68 ± 1.76 (min: 18-max: 34) years and of which 81.0% were female and 25.0% were fourth-grade students. It was determined that nursing students mostly used the “self-confident approach” as a way of coping with stress. A positive correlation between “self-confident approach” subscale score and self-care agency score was found statistically significant (r: 0.510; P <.01). Family income level, participation in social activities/dealing with hobby, and smoking were found to be independent risk factors for self-care agency.
DISCUSSION AND CONCLUSION: Nursing students should be encouraged to participate in social activities/hobbies to increase their self-care agency. Determining the attitudes of coping with stress and self-care agency of nursing students is important to plan the necessary interventions.

7.Communication Experiences of Nursing students with Children and Their Families: A Qualitative Study
Handan Boztepe, Sevil Çınar Özbay
doi: 10.5152/jern.2022.80707  Pages 35 - 43
INTRODUCTION: The clinical setting is often a stressful and anxiety-provoking environment. In particular, caring for pediatric patients causes students to experience anxiety in the clinic. It is extremely important to learn how to communicate effectively with the child’s parents and family members in overcoming this difficulty and providing effective care. The aim of this study is to determine the communication experiences of students with children and their parents during the clinical education of pediatric nursing course.
METHODS: The phenomenological approach, which is a qualitative research method, was used in the study. The population of the study comprised fourth-year students from the Faculty of Nursing, who accomplished the pediatric nursing course. The study was conducted with 15 students, who agreed to participate voluntarily, via in-depth interviews.
RESULTS: The themes emerging as a result of the interviews conducted with the students were “difficulties and facilitators,” “family-centered care experiences,” and “acquisitions.” In the study, most of the student nurses stated that they felt fear, restlessness, and anxiety when they first came to the service, and they had difficulty in communicating with the hospitalized child and the family. The students stated that they had difficulties in communication especially due to the age and diagnosis of the children.
DISCUSSION AND CONCLUSION: The study revealed that it is necessary to develop students’ skills of communication with children and their families. Accordingly, it is necessary to increase the communication skills of student nurses by organizing trainings. It is recommended to create interactive environments where student nurses can express their difficulties.

8.Views of Intensive Care Nurses on Determining and Meeting the Psychological Care Needs of Patients: A Qualitative Study
Yeliz Aktaş, Leyla Baysan Arabacı
doi: 10.5152/jern.2023.06787  Pages 44 - 51
INTRODUCTION: Patients hospitalized in intensive care units may experience many psychological symptoms such as weakness, hopelessness, anxiety, anger, depression, sleep deprivation, sensory overload, sensory deprivation, agitation, delirium, and difficulty in adjustment. In order to prevent these psychological symptoms, it is possible to define these needs by supporting the patients and providing the necessary psychological care services by the nurses who are experts in their fields. This study was evaluate of the views of intensive care nurses on the psychological care needs of patients.
METHODS: A qualitative descriptive approach was taken in the study. Fifteen intensive care nurses were selected with reference to maximum variation sampling method from purposeful sampling method, and individual in-depth interviews were handed with a semi-structured interview form. The data obtained from the study were analyzed using the content analysis method.
RESULTS: The average age of the nurses participating in the research was 29.8; 40% of them were undergraduates and 53.3% of them worked in tertiary intensive care. Nurses have been working for an average of 7.43 years, and they have worked in intensive care for 4.36 years. As a result of analyses, it was determined that the views of intensive care nurses on patients’ psychological care needs and practice were gathered under 4 main themes. These were psychological care in intensive care, communication, patient reactions, and approach to psychological problems. In addition, sub-themes such as empathy, reassurance, support, holistic care, communication style and difficulties in communication, psychological and physiological reactions, psychological problem solving, and the quality of psychological caregivers were also reached. Eight of the 15 nurses who participated in the interview believed that the psychological care needs of intensive care patients should be met by a specialist nurse (consultation liaison psychiatric nurse).
DISCUSSION AND CONCLUSION: Although nurses are aware of the first- and second-level psychological care needs of patients, their knowledge levels were insufficient in practice, and the intensive pace of work, long working hours, and a stressful work environment meant that they could not meet this need. In the light of this information, specialist psychiatric nurses (consultation liaison psychiatric nurses) should be employed in intensive care units, where the psychological care of patients can be met and intensive care nurses can receive support.

9.Outcomes of Breast Care Nurse Training and Follow-up: Body Image, Anxiety, and Quality of Life
Sema Koçan, Ayla Gürsoy
doi: 10.5152/jern.2023.45578  Pages 52 - 59
INTRODUCTION: The breast care nurse has an important role in helping and guiding women in the decision-making and selection process regarding treatment. The aim of this study was to determine the effects of breast care training and follow-up on the body image, anxiety, and quality of life of patients who had undergone breast cancer surgery.
METHODS: The pre-test–post-test design without a control group study was completed with 34 patients who had undergone breast cancer surgery between May 2017 and May 2019. Patients were given individual training by the breast care nurse and an informative book describing patient care in the perioperative period. A follow-up appointment was also scheduled. Data were collected with the Functional Assessment of Cancer Therapy—Breast Cancer, the Sexual Adjustment and Body Image Scale, the State-Trait Anxiety Inventory, and questionnaires. Percentage, mean, paired samples t-test, repeated measures analysis of variance, and post-hoc analysis were used to analyze data.
RESULTS: The measurements taken 1 month after surgery revealed that when compared to the preoperative period, patients’ state anxiety scores (41.14 ± 2.96) and trait anxiety scores (42.35 ± 3.18) had decreased and the quality-of-life scores had increased. All recorded measurements showed a significant improved difference between state anxiety (P = .009), trait anxiety (P <.001), and quality-of-life (P <.001) mean scores. Furthermore, patients’ scores for all dependent variables had significantly decreased 6 months after surgery compared to 1 month after surgery (P <.001), although the decrease in the body image score was not significant (P >.05). One year after, surgical patients’ body image (P >.05) and quality-of-life (P <.001) mean scores had increased, while the state (P = .009) and trait anxiety (P <.001) mean scores had decreased.
DISCUSSION AND CONCLUSION: The results show that the education and follow-up of the breast care nurse may be effective in reducing the anxiety of the patients and increasing their quality of life. Considering this role of the breast care nurse, who helps and guides women in the decision-making and selection process regarding treatment, it is recommended to inform and support women before surgery and discharge, to plan training accordingly, and to provide a holistic and empathetiac approach to patients.

10.Children with Multiple Sclerosis and Nursing Care Approach
Didem Yüksel Yılmaz, Figen Yardımcı
doi: 10.5152/jern.2023.91668  Pages 60 - 63
Multiple sclerosis is a chronic and progressive disease proceeding with inflammation, demyelination, and degeneration in the central nervous system. Multiple sclerosis is rarely seen in childhood, but it can occur more frequently than it is known in early childhood. Children with multiple sclerosis disease may reach disability levels at an earlier age than adults. Therefore, early diagnosis, optimal treatment, and care management of multiple sclerosis emerging in childhood are important. The goals of this treatment and care management are similar to those of adult multiple sclerosis; however, there are some specific concerns related to pediatric multiple sclerosis. The concerns related to the efficacy and safety of immuno-modulatory treatments used by pediatric multiple sclerosis patients, the continuation of the neurodevelopmental process in children, the pharmacokinetic and pharmacodynamic differences between pediatric and adult multiple sclerosis patients, the interruption of school life of children, and anticipatory anxiety of children and their families are among the major concerns. In this traumatic and challenging process, meeting the physical, emotional, cognitive, and social needs of children and their families is very important for disease management and for the adaptation of children to the disease. In light of this information, the aim of our review article is to give information related to multiple sclerosis disease in childhood and to explain the nursing approach to this disease.

11.Fear of Childbirth and Emotional-Focused Approaches
Gözde Gökçe Işbir
doi: 10.5152/jern.2023.57442  Pages 64 - 70
Fear of childbirth is universal, often non-pathological, harmonious, and situational. Psychosocial approaches, physical exercise, and therapeutic interventions are used in fear of birth. Although fear is an emotion, it is determined that emotion-focused approaches are not used in coping. In emotion-focused approaches, the aim is to reach and effectively transform nonadaptive emotional schemes that are seen as the cause of fear of childbirth within an empathic relationship and environment. Throughout the therapeutic care process, the focus is on the transformation of nonadaptive emotions into adaptive emotions, so that the individual can give adaptive responses to the birth experience. In emotion-focused approaches, (i) attachment and awareness, (ii) association and scrutiny, and (iii) change and transformation approaches are used. The purpose of this article is to create a conceptual framework for addressing the fear of childbirth with emotion-focused approaches.

12.Relaxation-Focused Nursing Program for Women with Adnexal Mass in the Preoperative Period
Samiye Mete, Buse Guler
doi: 10.5152/jern.2023.80912  Pages 71 - 79
Adnexal masses, mostly benign, carry the risk of ovarian cancer in the postmenopausal period. The masses give late symptoms, and the definitive diagnosis is determined by surgery. For this reason, patients experience psychological problems such as anxiety and depression due to uncertainty in the diagnosis and treatment process, the burden of symptoms, the suspicion of cancer, and the lack of knowledge about the procedures to be performed. Relaxation-focused nursing program that will be applied to women in the preoperative period can contribute to the solution of these problems. Relaxation-focused nursing program includes Lazarus' methods of dealing with stress, giving information and using relaxation exercises, to create a positive language and environment, to reduce anxiety. The program was developed by 2 academic nurses who are experienced in obstetrics and gynecology nursing and have hypnosis certification. As a result of the experience of the authors, literature review, and their academic research, it has been shown that the relaxation-focused nursing program used in patients diagnosed with adnexal mass is effective in reducing preoperative anxiety and pain and increasing the level of knowledge. This article explains the relaxation-focused nursing program and how it can be used during the preoperative period for women with adnexal mass/ovarian cancer. The program can be practiced safely as it does not require costs and has no side effects. It was aimed to reduce anxiety and pain because of the practice of this program in preoperative period in patients hospitalized with a diagnosis of an adnexal mass.

13.The Effects of Intestinal Microbiota on Newborn
Şeyma Çatalgöl, Rabia Genc
doi: 10.5152/jern.2021.44711  Pages 80 - 82
The neonatal period is a critical period for gastrointestinal colonization, affecting the adult intestinal microbiota and the individual's lifelong health. The intestinal microbiota begins to form rapidly within a few hours after the newborn comes into contact with the mother's vagina and the environment and is affected by various factors such as the environment, gestational age, mode of delivery, hospitalization, antibiotic use, and diet. The changes in intestinal microbiota composition are reported to be associated with many conditions such as obesity, hypertension, diabetes, autoimmune diseases, allergy, autism, and gastric cancer. Therefore, the neonatal period is a critical period in terms of factors affecting the development of healthy intestinal microbiota. The aim of this review to evaluate the microbiota and the factors affecting the development of the microbiota in newborns.

14.Acknowledgment of Reviewers

Page 83
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