E-ISSN 2757-9204

Journal of Education and Research in Nursing

JOURNAL OF EDUCATION AND RESEARCH IN NURSING - J Educ Res Nurs: 21 (1)
Volume: 21  Issue: 1 - March 2024
EDITORIAL
1.Editorial
Sevilay Şenol Çelik
Page XII

RESEARCH ARTICLE
2.Determination of Emergency Nurses’ Willingness to Care for COVID-19 Patients and Related Factors during the Pandemic
Didem Kandemir, Hatice Erdoğan, Öykü Kara
doi: 10.14744/jern.2023.88614  Pages 1 - 10
Background: The willingness of emergency nurses to participate in the treatment and care of infected patients, as essential and important members of the health-care team, is crucial for a dynamic response to epidemics.

Aim: This study was carried out to determine the willingness of emergency nurses to care for coronavirus disease 2019 (COVID-19) patients and related factors.

Methods: This descriptive and cross-sectional study was conducted with 203 nurses in the emergency departments of seven hospitals designated as pandemic hospitals in Istanbul, with an online survey developed in line with the literature. The data were analyzed in the Statistical Package for the Social Sciences program using an independent-sample t-test, Chi-square test, and logistic regression model.

Results: In this study, it was determined that 53.7% of the emergency nurses were not willing to care for COVID-19 patients, 23.2% had trouble keeping their jobs, and 27.6% were considering changing their departments or professions. There was a significant difference between the willingness and the variables of marital status, having a child, institution, and training status specific to COVID-19 patients (P < 0.05). The determining factors in the willingness of the nurses were the confidence in their knowledge and skills in managing COVID-19 and the belief that they would be protected from COVID-19 (P < 0.05).

Conclusion: This study has revealed that most emergency nurses were not willing to participate in the care of COVID-19 patients. The willingness of nurses to work throughout the pandemic can be improved by increasing the preparedness of nurses for the epidemic with adequate training and psychological support, providing social support, raising the sense of security, and applying effective communication strategies.

3.Childhood Obesity: Pathways between Mothers’ Health Literacy and Behaviors and Self-Efficacy of Eating and Physical Activity in Their Children
Nebahat Bora Güneş, Işın Alkan, Rabiye Akın Işık, Osman Dağ, Hilal Özcebe
doi: 10.14744/jern.2023.83009  Pages 11 - 19
Background: Childhood obesity is a rapidly growing global public health issue. To combat this issue and promote a healthy body weight for children, encouraging children to adopt healthy eating and physical activity (PA) habits is crucial. However, the factors underlying children’s eating and PA behaviors are complex, and the health literacy (HL) of mothers, PA habits of parents, as well as self-efficacy.

Aim: The aim of this study was to investigate how mothers’ sociodemographic factors, HL, body mass index (BMI), and PA levels affect their children’s BMI, nutritional and PA behaviors, and related self-efficacy.

Methods: This cross-sectional study included 320 children aged 8–12 and their mothers. Data were collected using questionnaires for mothers (Sociodemographic Data Form, Türkiye HL Scale-Short Form, International PA Questionnaire) and for children (sociodemographic data form, anthropometric measurement form, nutritional behavior scale, PA Questionnaire, self-efficacy for healthy eating, PA self-efficacy scale). Path analysis was conducted to illustrate the structure of the variables.

Results: The mothers had an average age of 38.0±5.37 years, with approximately half of the participants having two children. The results of the path analysis revealed that mothers’ education level and HL were significant predictors of their PA and BMI. In addition, mothers’ PA levels had a positive effect on their children’s duration of PA. The mother’s HL, mother’s BMI, and children’s PA levels and nutritional behaviors were also identified as factors that affect children’s BMI z-scores.

Conclusion: Enhancing the HL of mothers is a potent strategy in preventing childhood obesity, as it can lead to children achieving the recommended BMI z-scores and PA levels. As part of their usual care practices, nurses should adopt a family-centered approach that assesses mothers and children together.

4.Validity and Reliability of the Turkish Version of the Scale for Measuring Well-Being of Children in Lockdown
Dilek Demir Kösem, Şenay Demir, Murat Bektaş, İlknur Bektaş, Naiara Berasategi
doi: 10.14744/jern.2023.34202  Pages 20 - 28
Background: Due to the COVID-19 pandemic, millions of people, including children, have been confined to their homes to maintain social distance. It would be beneficial to evaluate the well-being of children from a holistic perspective under the difficult conditions experi-enced during that period.

Aim: This study was conducted to evaluate the validity and reliability of the Turkish version of the Well-Being of Children in Lockdown Scale (WCLS).

Methods: This methodological, descriptive, correlational study was conducted with 406 parents with children aged 3–14 years between January 2022 and April 2022. Study data were collected with a sociodemographic data collection form and the WCLS using the online survey technique. Factor analysis, Cronbach’s alpha, and item-total score analysis were used in the evaluation of the data.

Results: It was determined that the scale consisted of 22 items and six dimensions and that six dimensions explained 61.02% of the total variance. In both exploratory and confirmatory
factor analysis (CFA), it was determined that all factor loads were >0.30. In the CFA, all of the fit indices were found to be >0.85, and the root mean square errors of approximate was <0.080. Cronbach’s alpha coefficient was found as 0.89 for the total scale and >0.70 for all of the dimensions.

Conclusion: As a result of the analyses and evaluations conducted in this study, it was found that the WCLS was a valid and reliable measurement tool for the Turkish sample. The Scale for Measuring Well-being of Children in Lockdown can help evaluate the well-being of children during lockdown holistically, considering physical, mental, and social aspects, and facilitates the timely performance of interventions.

5.Ethical Attitude Levels of Surgical Nurses in Nursing Care: A Cross-sectional Study
Seher Ünver, Cansu Ersin, Nefise Özlem İşler
doi: 10.14744/jern.2023.33270  Pages 29 - 33
"Background: Surgical nurses have several ethical responsibilities, and it is important to examine the ethical attitudes of nurses to determine the existing ethical attitude level and to minimize possible ethical problems.
Aim: This study aimed to determine the ethical attitude levels of surgical nurses in nursing care.
Methods: This descriptive and cross-sectional study was carried out with 143 nurses who were working at surgical units of a university hospital between October 15, 2021 and January 17, 2022. Data were collected using the “Ethical Attitude Scale in Nursing Care” instruments. The descriptive statistics, the Mann–Whitney U-test, the Kruskal–Wallis H test, and Spearman’s correlation test were used for data analysis.
Results: Among the nurses, 65% were working in surgical wards, and 72% had received training on ethics as a lesson in educational processes and/or as in-service training. The ethical attitude level of nurses was found to be over the moderate level. Nurses who received training on ethics had statistically significantly higher ethical attitude scores than those who did not (U = 1594.000, P =.036). A statistically significant correlation was found between ethical attitude score and clinical experience duration (r =.207, P =.013).
Conclusion: Among surgical nurses working in many specific surgical units (surgical wards, intensive care units, and operating room), their ethical attitude levels in nursing care are influenced by having longer clinical experience duration and receiving training on ethics. Therefore, ethics education is beneficial in dealing with ethical problems and should be carried out with different programs during or after nursing education."

6.Measuring Parents’ Vaccination Attitudes: Psychometric Properties of Turkish Version of the Vaccination Attitudes Examination Scale
Evrim Kızıler, Sibel Küçük, Dilek Uludaşdemir, Perver Karşıgil
doi: 10.14744/jern.2023.58630  Pages 34 - 42
Background: Despite the important role of vaccines in preventing disease and disability of children each year, vaccine hesitancy and refusal among parents are increasing. This threatens child and public health in terms of the recurrence of eradicated diseases, such as pertussis, measles, and polio.

Aims: The study aimed to examine the psychometric properties of the Turkish version of the vaccination attitudes examination (VAX-TR) scale.

Methods: In this methodological study, VAX-TR was administered to 138 Turkish parents aged 25–63 (M = 35.39; Standard deviations = 6.67). The original vaccine attitudes scale translated into Turkish using translation/back-translation method. Descriptive statistics were analyzed, content validity index was calculated, Kaiser-Meyer-Olkin (KMO) value and Bartlett’s sphericity test were examined for the sampling adequacy. The explanatory (explanatory factor analysis [EFA]) and confirmatory factor analyses (CFA) were performed for structure validity. Cronbach’s alpha value and item-total score correlations were evaluated for internal consistency.

Results: Cronbach alpha internal consistency coefficient of the scale was 86. The total variance disclosure rate for four factors (mistrust of vaccine benefit, worries about unforeseen future effects, concerns about commercial profiteering, and preference for natural immunity) was found to be 69.6%. The results of the KMO test and Bartlett’s test were statistically significant. Validating factor analysis compatibility values were χ2: 60.858, DF = 48, χ2/DF = 1.27, root mean squared error approximation = 0.044, root mean square residual = 0.063, standardized root mean square residual  = 0.064, comparative fit index (CFI) = 0.93, adjusted goodness of fit index  = 0.89, CFI = 0.98, and normed fit index = 0.94.

Conclusion: The VAX-TR seems to be a valid tool to evaluate vaccination attitudes and hesitancy in the Turkish parents with children aged 0–18 years.

7.Investigation of Fear of COVID-19 and Attitudes toward COVID-19 Vaccine among Individuals Undergoing Coronary Artery Bypass Surgery
Aylin Özakgül, Özkan Sir, Ebubekir Kaplan, Hatice Kaya
doi: 10.14744/jern.2023.02134  Pages 43 - 49
Background: Individuals who have undergone coronary artery bypass graft (CABG) surgery experience fear about the possibility of contacting the coronavirus disease of 2019 (COVID-19), in addition to their current situation after surgery. The level of fear is a determining factor in the attitudes of individuals toward vaccination.

Aim: The study aims to investigate the fear of COVID-19 and attitudes toward the COVID-19 vaccine among individuals undergoing CABG surgery.

Methods: The study was carried out with 152 followed up individuals who applied to the cardiovascular surgery outpatient unit of a training and research hospital between March 2021 and June 2021 as part of their follow-up appointments. Data were collected using the Fear of COVID-19 Scale and the Attitude toward the COVID-19 Vaccination Scale. Descriptive, parametric (one-way analysis of variance), and nonparametric (Mann–Whitney U and Spearman Correlation) tests were used to analyze the study results.

Results: The mean age of the patients was 60.39 ± 5.71, 56.6% were male, and 67.8% were illiterate. It was determined they had a moderate fear of COVID-19, and their positive attitude toward the COVID-19 vaccine was above average. A high level of fear was determined among individuals with a history of COVID-19 (40.1%) and who are also considering getting vaccinated (76.3%); however, 23.7% of individuals undergoing CABG surgery did not consider getting the COVID-19 vaccine.

Conclusion: In the study, individuals had a moderate fear of COVID-19. Individuals who have undergone CABG surgery in the high-risk group and their relatives should be provided with education and counseling on the individual and social positive effects of the COVID-19 vac-cine. Multicenter studies with larger samples are recommended for attitudes toward the COVID-19 vaccine among individuals undergoing CABG surgery.

8.Evaluation of Knowledge, Attitude, and Opinion of the Faculty of Health Sciences Students Toward Human Papilloma Virus (HPV) and HPV Vaccines
Cansu Ağralı, Derya Kaya Şenol, Nisanur Siğin, Büşra Akkuş
doi: 10.14744/jern.2023.75032  Pages 50 - 57
Background: Human papillomavirus (HPV) is one of the most common sexually transmitted infections in the world, and cervical cancer, which has been proven to be associated with HPV, is the third-most common cancer in women in the world.

Aim: This study aimed to evaluate the knowledge, attitude, and opinion of the Faculty of Health Sciences students toward the HPV and vaccination.

Methods: The study was conducted using a cross-sectional research design. The sample of the research consisted of 576 students studying at the Faculty of Health Sciences of a university. The data were collected using the forms prepared online, including an introductory information form and the Human Papillomavirus Information scale. The data were evaluated using percentage, standard deviation, frequency, mean, median, minimum–maximum values, Mann–Whitney U test, and Kruskal–Wallis tests.

Results: It was determined that 19.8% of the students were studying at the department of midwifery, 36.8% were studying at the department of nursing, and 2.1% had a family history of cervical cancer. Those who were studying at the midwifery and nursing departments had been living in a small town for a long period, and learned about HPV during undergraduate education was found to have a higher level of knowledge on HPV screening tests and vaccination. Had the intent to be vaccinated and had already been vaccinated, received training from the health-care professionals on HPV vaccine, and advocated that the opinion of family members about vaccination is not of importance and all genders should be vaccinated were found to have a higher level of knowledge on HPV screening tests and vaccination (P < 0.001).

Conclusion: Students studying at the faculty of health sciences should have more information about sexually transmitted diseases since they represent future health-care professionals.

9.Evaluating the Relationship between Nursing Students’ Environmental Awareness and Sensitivity and Their Environment Literacy
Hülya Fırat Kılıç, Sinem Dağ Canatan, Arzu Abiç, Nur Demet Gök
doi: 10.14744/jern.2023.54614  Pages 58 - 64
Background: When the effects of climate problems on social life started to be seen, one reaction was an increase in awareness of environmental protection and environment sensitivity.

Aim: The aim of this study was to determine the relationship between the environmental awareness and sensitivity of nursing students and their environmental literacy.

Methods: The study was conducted as a descriptive and correlational study. The research sample consisted of 316 students studying in a degree program in Nursing at a foundation university in Northern Cyprus in the spring semester of the academic year 2020–2021. An Environmental Literacy Scale and an Environmental Awareness and Sensitivity Scale were used in the study to collect data. The Mann–Whitney U-test and the Kruskal–Wallis H test and Spearman test were used for data analysis.

Results: It was found that 65.5% of the students were female, and 45.9% were in the 20-21-year age group, 27.8% smoked cigarettes, 74.4% had heard of the concept of the environment, and 22.8% took part in environment activities. It revealed that the students’ total scores on the Environment Literacy Scale were 76.81 ± 11.59. The overall mean obtained on the Environment Awareness and Environmental Sensitivity Scale was 139.74 ± 19.32.

Conclusion: The students’ environmental literacy and their environmental awareness and sensitivity were found to be at a good level. It was seen that as students’ environment literacy levels rise, their environmental awareness and sensitivity also rise. Lessons and seminars should be added to the curriculum of nursing schools to develop environmental literacy levels.

10.Illness Perception in Breast Cancer Patients: A Mixed-Method Research
Fatma Tok Yıldız, Funda Evcili, Hesna Gürler
doi: 10.14744/jern.2023.77200  Pages 65 - 71
Background: Breast cancer is perceived as a fatal disease causing physical, psychological, and sexual problems. The perception of the individuals regarding their disease affects the treatment process and physical/mental/social health. Therefore, identifying the perception of patients regarding breast cancer may help to reduce anxiety and improve quality of life.

Aim: This study was conducted to investigate the perceptions of patients with breast cancer regarding illness.

Methods: This mixed-method study was carried out between June and September 2019 at the oncology clinic of a university hospital. The study sample consisted of 17 patients. The data were collected face to face using a semi-structured interview form and the illness perception questionnaire. The qualitative data were analyzed using thematic analysis, and the main themes were determined.

Results: The mean age of the patients was 55.47±15.23, the disease stage of four of the patients was stage I, nine received chemotherapy, and six had metastasis The patients obtained the highest mean score from personal management (20.52±2.03) and the lowest mean score (10.64±3.87) from the duration (cyclical) perception. It was found that the patients saw psychological attributions as the cause of their illness. The content analysis determined six main themes and eight sub-themes. The themes were body image, spirituality, social/professional support, fear/sadness, awareness of early diagnosis, and role change.

Conclusion: It was concluded that the patients perceived breast cancer as a chronic disease with negative consequences. It was also determined that the patients believed in the cyclical nature of the disease, and their negative emotions provoked by the illness were high.

11.The Relationship between Nursing Students’ Attitudes Toward Evidence-Based Nursing and Their Critical Thinking Dispositions
Seçil Erden Melikoğlu, Berna Köktürk Dalcalı, Burcu Dedeoğlu Demir
doi: 10.14744/jern.2023.52223  Pages 72 - 77
Background: Critical thinking disposition is significant for nurses to carry out their care practices in line with accurate and up-to-date evidence.

Aim: The purpose of this study is to determine nursing students’ attitudes toward evidence-based nursing and their critical thinking dispositions and to examine the relationship between them.

Methods: A descriptive correlational design was used in the study. The sample of the study consisted of a total of 163 2nd, 3rd, and 4th-year nursing students at a university in Türkiye. Data collection tools included a student information form, the evidence-based nursing attitude questionnaire (EBNAQ), and the critical thinking disposition scale (CTDS). Data were collected online through Google Forms and analyzed using descriptive, correlational, and linear regression analyses.

Results: The students’ CTDS scores were 198.77 ± 39.71 and EBNAQ scores were 61.83 ± 9.78. It was determined that nursing students’ attitudes toward evidence-based nursing and their critical thinking dispositions were at a high level and that there was a significant positive relationship between the students’ attitudes toward evidence-based practice and their
critical thinking dispositions (r = 0.595, P = 0.001). It was found that gender, school year, and critical thinking dispositions predicted students’ attitudes toward evidence-based practice.

Conclusion: Evidence-based practice and critical thinking skills, which form the basis of clinical decision-making and quality care delivery, should be developed throughout nursing education and be imparted to nursing students. It is necessary to develop comprehensive teaching strategies and integrate them into the undergraduate program to help nursing students develop their critical thinking dispositions and attitudes toward evidence-based practice.



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