E-ISSN 2757-9204

Journal of Education and Research in Nursing

JOURNAL OF EDUCATION AND RESEARCH IN NURSING - J Educ Res Nurs: 21 (2)
Volume: 21  Issue: 2 - June 2024
EDITORIAL
1.Editorial
Sevilay Şenol Çelik
Page VIII

RESEARCH ARTICLE
2.How Satisfied are Students with the Distance Education in the COVID-19 Period?
Mehtap Kavurmacı, Adnan Taşgın, Mehtap Tan, İdris Yıldız
doi: 10.14744/jern.2023.69851  Pages 79 - 84
Background: During the Coronavirus Disease 2019 (COVID-19) epidemic, educational institutions globally, including those in Türkiye, were shut down, transitioning to distance learning (DE).

Aim: This research was carried out to assess the satisfaction of university students with the DE they received during the COVID-19 pandemic.

iMethods: The descriptive study involved 458 students from a state university. Data were collected using the “Distance Education Satisfaction Questionnaire” through Google Forms. The data was analyzed using descriptive tests in the SPSS 20 package program.

Results: The study’s findings indicated that 76% of the participants were female, 34.1% were 2nd-year students, and 25.3% were enrolled in the nursing faculty. Among the participants, 60.3% owned a personal computer, while 98.5% had a smart mobile phone. Students were generally satisfied with the sub-dimensions of “instructor”, “systems used in DE,” “university/faculty management” and “digital content/teaching material” of DE. On the other hand, it was determined that they were not satisfied with the “student” and “assessment and evaluation” dimensions.

Conclusion: The research concluded that students were generally satisfied with distance learning, yet they did not find it as effective and efficient as traditional face-to-face education. To ensure the rapid and effective implementation and continuation of DE in future pandemics, it is recommended that all universities enhance their DE infrastructure.

3.The Experiences of Adolescents with Their First Pregnancy: A Qualitative Research
Ayşegül Dönmez, Zekiye Karaçam
doi: 10.14744/jern.2023.78545  Pages 85 - 91
Background: Adolescent pregnancies are associated with increased health risks, including preeclampsia, premature birth, anemia, infections, mental health issues, low birth weight, and higher mortality rates for both mother and baby.

Aim: This study aimed to examine the experiences of adolescents regarding their first pregnancy.

Methods: This research was performed as a phenomenological study that utilized qualitative research methods. Individually face-to-face interviews were conducted with 19 adolescents using a semi-structured interview form. The qualitative data were analyzed using content analysis and descriptive analysis approaches.

Results: The analysis of data regarding adolescents’ first pregnancy experiences yielded 4 themes and 12 sub-themes. The participating adolescents were aged 16-19; seven of them had received 10 years or more of education, and all lived in the city center. It was found that the adolescents could not adopt behaviors conducive to a healthy lifestyle. Some wished to terminate their pregnancies due to an unwillingness or inability to accept being pregnant. They also received inadequate prenatal care, faced difficulties in baby and personal care, and experienced feelings of loneliness, fear, and rejection towards the baby.

Conclusion: This study examined adolescents’ experiences with their first pregnancies and determined that they did not receive adequate support from healthcare personnel. Some did not wish to become pregnant and faced challenges in baby care and personal hygiene. Providing education and counseling on contraception and healthy lifestyle behaviors can help reduce adolescent pregnancy rates.

4.Examination of the Relationship Between Missed Nursing Care and Job Satisfaction of Pediatric Nurses
Funda Özer, Hatice Yıldırım Sarı
doi: 10.14744/jern.2023.04710  Pages 92 - 98
Background: Missed nursing care is a multifaceted phenomenon defined as neglecting or delaying any or all necessary patient care. Its impact on patient outcomes and quality of care has been established.

Aim: This study aims to assess the prevalence of missed nursing care in pediatric clinics, identify its causes, and explore its relationship with nurses' job satisfaction.

Methods: A cross-sectional study was conducted with 185 pediatric nurses in all inpatient clinics of a training and research hospital from June to December 2021. The Personal and Professional Characteristics Form, the Missed Nursing Care Scale (MISSCARE SURVEY - Pediatric Version), and the Minnesota Satisfaction Scale were utilized. Data were collected from 94 nurses via Google Survey and 91 nurses through self-report on a voluntary basis, and analyzed using descriptive statistics, independent t-tests, one-way analysis of variance, Bonferroni and Pearson correlation tests.

Results: It was found that 83.8% of the nurses participating in the study were female, with ages ranging from 22 to 58 years (mean 32.11 ± 7.84). The most frequently missed nursing care tasks were meeting the nutritional needs of the child according to clinical conditions (34.6%) and assisting the child to get up and walk three times a day or as per the nursing care plan if clinical conditions permit (34.6%). The primary reason for missed care was identified as a lack of labor resources. A statistically significant difference was observed in missed care practices, employment unit, working styles, and overall job satisfaction (P < 0.05).

Conclusion: It was found that nurses were unable to provide at least one required nursing care during their last shift, primarily due to issues related to labor resources. Consequently, it was observed that job satisfaction among nurses decreased as incidents of missed care increased. It is recommended that improvements be made in labor resources as a priority to reduce missed care practices. Additionally, the issue should be further explored through new studies, and essential protocols should be developed to prevent missed nursing care.

5.Adaptation of the TeamSTEPPS® Teamwork Perceptions Questionnaire into Turkish for a Nurse Sample: A Methodological Study
Aysun Yerköy Ateş, Aytolan Yıldırım
doi: 10.14744/jern.2024.81236  Pages 99 - 106
Background: Teamwork is an essential building block in the healthcare system, where team members' perceptions significantly affect teamwork dynamics. Thus, a valid and reliable questionnaire is crucial for evaluating team members’ perceptions.

Aim: The purpose of this study is to adapt and psychometrically test the TeamSTEPPS® Teamwork Perceptions Questionnaire for a nurse sample.

Methods: This cross-sectional validation study included a sample of 365 nurses working in both a university and a private hospital from November to December 2019. The study utilized the Guidelines for Reporting Reliability and Agreement Studies (GRRAS) checklist. The questionnaire was initially translated into Turkish using the back-translation method. Item analysis, an expert panel for content validity, confirmatory factor analysis for construct validity, internal consistency, the test-retest method, and item-total correlation coefficients were employed to verify the questionnaire’s psychometric properties.

Results: The participating nurses, aged between 25-40 years (63.8%), primarily worked in intensive care units (29.6%). The questionnaire was deemed adequate in terms of language and content. Confirmatory factor analysis of the five-dimensional questionnaire indicated a good fit. The Cronbach's alpha for the entire questionnaire was 0.93, with sub-dimensions ranging from 0.91 to 0.94. The five-dimensional model demonstrated acceptable goodness-of-fit indices. The two-way mixed intraclass correlation coefficient for the five-dimensional questionnaire indicated excellent test-retest reliability.

Conclusion: The questionnaire proved to be an acceptable instrument for measuring nurses' perceptions of individual teamwork within their groups.

6.Pilot Study on a Technology-Supported Breastfeeding Program and Its Impact on the Growth of Infants of Adolescent Mothers
Rukiye Çelik, Ebru Kılıçarslan Toruner
doi: 10.14744/jern.2024.85226  Pages 107 - 117
Background: Adolescent mothers often exhibit low breastfeeding rates, leading to an increased likelihood of their infants being introduced to baby formula and food supplements prematurely.

Aim: This study examined the impact of an eight-week technology-supported breastfeeding program on the growth of infants born to adolescent mothers. It also evaluates the program’s effect on the adolescent mothers’ breastfeeding self-efficacy, success, and anxiety levels.

Methods: A randomized controlled trial was conducted with a total of 31 primiparous adolescent mothers and their infants, divided into an intervention group (IG=16) and a control group (CG=15). The intervention group received breastfeeding education, and an electronic booklet (e-booklet) was installed on their Android phones. Additional support included telephone interviews, motivational SMS messages, and telephone consultations on breastfeed-ing. Both groups were followed up face-to-face three times. The study data were collected using descriptive data forms, follow-up forms for infants’ physical growth and breast-feeding, the Postpartum Breastfeeding Self-Efficacy Scale (PBSES), the Spielberger State Anxiety Inventory (STAI), and the LATCH Assessment Tool (evaluating Latch (L), Audible swallowing (A), Type of nipple (T), Comfort (C), and Hold (H)). The data were analyzed using chi-square analysis, Mann-Whitney U test, and Wilcoxon signed-rank test.

Results: The mean ages of the adolescent mothers in the IG and CG were 18.50 ± 0.63 and 18.40 ± 0.63 years, respectively. The mean gestational ages of the infants were 39.0 ± 0.96 weeks (IG) and 38.47 ± 0.74 weeks (CG), with mean birth weights of 3.08 ± 0.32 kg (IG) and 2.94 ± 0.33 kg (CG), respectively. At the third follow-up, infants in the IG showed significantly higher weight and height z-scores than those in the CG (P < 0.05). Adolescent mothers in the IG reported higher self-efficacy and breastfeeding success at the second and third follow-ups (P = 0.001), and exhibited lower anxiety levels at the program’s conclusion (P = 0.001).

Conclusion: In the postpartum period, it is essential to identify adolescent mothers in the risk group by regularly evaluating their self-efficacy, anxiety levels, and breastfeeding successes. These mothers should receive support through appropriate nursing interventions early on. The use of technology by nurses providing breastfeeding education to adolescent mothers can enhance breastfeeding success and contribute to the healthy growth of infants. Implementation of a technology-based breastfeeding program for adolescent mothers represents a significant nursing intervention that benefits the health of both mothers and their infants.

7.Determining the Impact of Cervical Dilation at Admission on Intrapartum Interventions and Labor Satisfaction in Pregnant Women
Ece Kaplan Doğan, Semra Akköz Çevik
doi: 10.14744/jern.2024.12268  Pages 118 - 124
Background: Admission to the delivery room with a low level of cervical dilation is associated with an increased likelihood of cesarean birth, additional birth interventions, and a negative impact on the woman's birth experience and satisfaction.

Aim: This study aimed to evaluate the effect of cervical dilation levels at admission to the delivery room on intrapartum interventions and labor satisfaction.

Methods: This study was conducted as a cross-sectional study and involved 285 pregnant women. It was carried out in the delivery rooms of Cengiz Gökçek Obstetrics and Pediatrics Hospital in Gaziantep, Türkiye, utilizing the “Personal Information Form” and the “Birth Satisfaction Scale” for data collection. T-test, ANOVA test and linear regression test was used for data analysis.

Results: The findings indicate that pregnant women with cervical dilation of 6-10 cm had lower cesarean section rates and reduced use of oxytocin and epidosin. Additionally, episiotomy incisions, vacuum applications, and amniotomy attempts were found to be less frequent in this group. It was discovered that the total mean score on the birth satisfaction scale for multiparous pregnant women was higher than that for primiparous pregnant women (P=0.001), and higher for those who had desired pregnancies compared to women with undesired pregnancies (P=0.037). Satisfaction with delivery was found to be lower among pregnant women with cervical dilation of 0-3 cm (P=0.012), those who received oxytocin induction, and those who underwent an episiotomy (P=0.001). A significant correlation was observed between the level of cervical dilation, parity, desire for pregnancy, and birth interventions with birth satisfaction (R=0.39, R2=0.33, P<0.001). These factors together explain 33% of the total variance in birth satisfaction.

Conclusion: Low levels of cervical dilation at the time of admission to the delivery room are associated with an increase in birth interventions and a decrease in birth satisfaction.

8.Fatigue in Individuals with Post-COVID-19: A Cross-Sectional Descriptive Study
Sümeyra Mihrap İlter, Özlem Ovayolu
doi: 10.14744/jern.2024.88557  Pages 125 - 130
Background: Coronavirus Disease 2019 (COVID-19) continues as an epidemic with high morbidity and mortality rates. Individuals experience physiological and psychological changes after COVID-19, with fatigue being a frequently reported symptom both during and after infection. Fatigue is a multidimensional subjective concept, necessitating evaluation with measurement tools for effective treatment and care planning.

Aim: This study aimed to examine the fatigue levels in individuals who have recovered from COVID-19 through a cross-sectional descriptive approach.

Methods: The study included 300 individuals who had COVID-19 between July 1 and August 1, 2021. Ethics committee approval and permission from the Ministry of Health were obtained prior to the research. Data were collected online using a questionnaire and the Piper Fatigue Scale (PFS), covering socio-demographic characteristics and COVID-19-related processes. Higher PFS scores indicated increased fatigue levels. The data were analyzed using Student’s t-test, One-Way Analysis of Variance (ANOVA), Kruskal-Wallis, and Mann-Whitney U tests.

Results: The majority of participants were aged 34-41, female, married, high school graduates, with chronic diseases, and had transmitted COVID-19 to family members. The average PFS score was 5.50 ± 1.28, with individuals aged 50-57, married, and with chronic diseases reporting higher scores (p < 0.05). Post-COVID-19 symptoms included shortness of breath, fatigue, forgetfulness, cough, and loss of smell. Higher PFS scores were observed in participants with shortness of breath, body pain, cough, difficulty con-centrating, and increased sleep tendency, although these findings were not statistically significant (p > 0.05).

Conclusion: Fatigue persists for months after COVID-19, with individual variations in fatigue levels. Individuals reported various symptoms during and after infection, with the severity of fatigue varying according to these symptoms.

9.An Examination of the Relationship Between Spirituality and Life Satisfaction Among Patients Awaiting Corneal Transplantation in Türkiye
Mehmet Ali Şen, Hasan Genç, Seher Tanrıverdi
doi: 10.14744/jern.2024.12454  Pages 131 - 136
Background: Transplant surgery significantly influences patients’ spirituality and life satisfaction, reflecting the diverse beliefs and cultures of those awaiting the procedure.

Aim: This study aimed to explore the relationship between spirituality and life satisfaction in patients awaiting corneal transplantation.

Methods: This relational descriptive study involved 101 patients on the waiting list for corneal transplantation. Data were collected using a Patient Information Form, the Life Satisfaction Scale, and the Spirituality Scale. Percentage distribution, arithmetic mean, and Pearson correlation analysis were employed for data analysis.

Results: The majority of the participants were married (95%), with 56.4% being male and 26.7% retired. About 46.5% had completed primary education. The mean Life Satisfaction Scale score among the patients was 21.83 ± 8.96, and the mean Spirituality Scale Score was 20.49 ± 4.15 before corneal transplantation. A positive, albeit weak, relationship was found between the patients’ life satisfaction and spirituality levels, which was statistically significant (p < 0.01, r=0.37). Additionally, a weakly positive and significant correlation was noted between age and life satisfaction (p < 0.05, r=0.19).

Conclusion: The study found that patients exhibited high levels of life satisfaction and spirituality, with life satisfaction increasing alongside spirituality. It was therefore concluded that care should be provided to patients with a psychosocial and emotional approach, aiming to meet their spiritual needs and enhance their life satisfaction prior to corneal transplantation.

10.Effect of Breast Cancer Awareness Education in Adolescent Girls: A Quasi-Experimental Study
Ayfer Ekim, Damla Özçevik Subaşı, Ayşe Ferda Ocakçı
doi: 10.14744/jern.2024.99422  Pages 137 - 143
Background: Breast cancer is the most common cancer type among women worldwide. Increasing awareness of breast cancer during adolescence is likely to result in the acquisition of lifelong protective and preventive behaviors.

Aim: The aim of this study is to enhance breast cancer awareness among adolescent girls through a health education program based on the Health Belief Model (HBM).

Methods: This study utilized a single-group pretest-posttest design. The sample group consisted of 79 high school female adolescents. Educational interventions consisted of four teaching sessions, each lasting 60 minutes. Data were collected through the "Participants Information Form" and the "Breast Cancer Awareness Evaluation Form." The data were evaluated using paired sample t-tests and Chi-Square tests.

Results: The mean age of the adolescents was 16.0 ± 0.96 years. Significant changes in the level of knowledge regarding breast cancer symptoms and risk factors were observed after the education. Prior to the educational program, adolescents answered fewer than 50% of the 12 questions about risk factors correctly, whereas after the intervention, the correct answer rate for these questions reached at least 81.0%. Before the intervention, the correct answer rate for symptoms was at least 38.0%, which increased to 79.7% after the intervention. There was a statistically significant difference in the pre-test and post-test correct answer rates for all breast cancer symptoms (P<0.05).

Conclusion: Implementing a health education program based on the Health Belief Model (HBM) during adolescence to enhance breast cancer awareness and instill lifelong preventive health behaviors related to breast cancer is of significant importance.

11.The Impact of Case-Based Education on the Development of Nursing Students’ Clinical Reasoning Skills in Managing Critical Illnesses: A Pilot Randomized Controlled Trial
Ayşegül Öztürk Birge, Sevinç Kutlutürkan
doi: 10.14744/jern.2024.80000  Pages 144 - 153
Background: Nursing students require the development of clinical reasoning (CR) skills to deliver safe and effective care.

Aim: This study aimed to determine the effect of case-based education on the development of CR skills among nursing students in managing critical illnesses.

Methods: The study was conducted from January 20 to June 30, 2021, utilizing a pilot randomized controlled trial design. Twenty-two volunteer students were assigned to either the experimental or control groups through simple randomization. Data were collected using a Student Information Form, the Clinical Reasoning Case Form (CRCF), the Student Satisfaction with Education Questionnaire, and a Form for Views on Education. The data were analyzed using frequency values, Fisher’s exact test, paired/independent samples t-test, Cohen's d coefficient for effect size, intention-to-treat (ITT) analysis, and covariance analysis.

Results: The intervention and control groups were similar in terms of descriptive characteristics (P>0.05), and no significant difference was found between the groups in the pretest scores of the CRCF (P=0.351). In the intervention group, the posttest CR scores significantly increased following the education (P=0.015) with a large effect size [d=0.88 (-1.72-0.02)]. ITT analysis was conducted as one student from the control group did not complete the post-test. The results of the per-protocol and ITT analyses were similar. According to covariance analysis, the pretest scores did not affect posttest scores (P=0.155, η2=0.109). This study was registered on ClinicalTrials.gov with the number NCT05504824.

Conclusion: Case-based education was found to be effective in enhancing the CR skills of nursing students in critical illnesses.

12.Correlation Between Acceptance of Illness and Comfort Level in Patients With Heart Failure: A Descriptive Study
Abdullah Avcı, Meral Gün, Semra Erdoğan
doi: 10.14744/jern.2024.00907  Pages 154 - 160
Background: Acceptance of illness is crucial in chronic diseases such as heart failure (HF), which persists throughout a patient’s lifetime, significantly affecting adaptation to treatment and lifestyle modifications. While the relationship between the acceptance of illness and the quality of life in HF patients is well-documented, its correlation with comfort levels remains unexplored.

Aim: This study aimed to explore the correlation between acceptance of illness and comfort levels among HF patients.

Methods: This descriptive study included 106 HF patients from the cardiology service of a university hospital. The study data was collected between November 2019 and February 2020 through face-to-face interviews using a personal information form, the Acceptance of Illness Scale, and the General Comfort Questionnaire. In the analysis of descriptive statistics, various statistical tests were employed, including Student’s t-test, One-Way Analysis of Variance (ANOVA), Welch’s test for assessing group variances, Bonferroni test, Games-Howell test, and Pearson’s correlation coefficient for analyzing pairwise comparisons.

Results: The study found the average age of the patients to be 67.9 ± 11.6 years. Among these patients, 55.7% were male, the majority (68.9%) were married, nearly half (44.3%) had completed primary education, and a significant majority (73.6%) were not employed. The mean scores for the Acceptance of Illness Scale and the General Comfort Questionnaire were 18.8 ± 7.75 and 2.6 ± 0.40, respectively. Patients who were non-literate, those belonging to low-income and high-income groups, and those who had been diagnosed with HF for four years or longer, exhibited lower mean scores on the Acceptance of Illness Scale compared to other groups (P<0.05). A moderate positive correlation was observed between the total scores of the Acceptance of Illness Scale and the General Comfort Questionnaire (r=0.517, P<0.001).

Conclusion: The study concluded that an increase in the level of illness acceptance among HF patients was associated with an increase in their comfort levels. Consequently, it is recommended that the acceptance of disease in HF patients and their needs concerning environmental, physical, sociocultural, and psychospiritual comfort be regularly assessed in hospital settings. This assessment should inform the planning and implementation of tailored nursing interventions, taking into account the factors that influence these needs.

13.Perception of the Care Concept by Nurses and the Factors Influencing Their Perception: A Qualitative Study
Gülengün Türk, Nesrin Oğurlu
doi: 10.14744/jern.2024.62362  Pages 161 - 166
Background: Caring is a fundamental concept in the nursing discipline. While the term “care” is frequently utilized in nursing literature, its interpretation by nurses is unclear.

Aim: This qualitative study aimed to explore nurses’ perceptions of the care concept and the factors influencing these perceptions.

Methods: Employing a qualitative methodology within a phenomenological research design, this study involved 30 nurses from the medical and surgical departments of a university hospital. Purposeful sampling and in-depth semi-structured interviews were utilized for data collection until data saturation was achieved. The “Nurse Identification Form” and “Evaluation Form for Nurses’ Perception of the Care Concept” were used to gather data. Content analysis was applied to the audio recordings of face-to-face interviews with the nurses.

Results: The average age of the nurses participating in the study was 29.5 ± 5.89 years, and they had an average of 8 years of nursing experience. The majority were female (26 nurses), and more than half had graduate degrees (18 nurses). Half of the participants worked in internal medicine clinics, while the other half were employed in surgical clinics. The study’s findings were categorized into four main themes: definitions of the care concepts by nurses, practitioners of care, factors influencing care, and the significance of care in nursing.

Conclusion: The study concluded that nurses view care as a vital component of the nursing profession. This concept requires further detailed and comprehensive exploration in future research.

14.Experiences of Registered Nurses in Overcrowded Emergency Departments: A Qualitative Study
Özlem Şahin Akboğa, Dilek Gelin
doi: 10.14744/jern.2024.29938  Pages 167 - 173
Abstract |Full Text PDF

15.The Relationship Between Nursing Students’ Therapeutic Communication Skills and Their Perceptions Concerning Care Behaviors
Aylin Aydın Sayılan, Zeynep Cansel Koyun
doi: 10.14744/jern.2024.56254  Pages 174 - 182
Background: In the nursing profession, communication skills and care are defined as two complementary concepts. Communication skills are essential for providing spiritual care, managing symptoms effectively, offering psychosocial support, and facilitating advanced care planning.

Aim: This research aimed to determine the relationship between nursing students’ therapeutic communication skills and their perceptions concerning care behaviors.

Methods: Conducted as a descriptive study, it included second-, third-, and fourth-year students from a university’s nursing department (N=315), with 278 students meeting the inclusion criteria and forming the study sample. Data were collected using an information form, the Therapeutic Communication Skills Scale (TCSS), and the Care Assessment Scale (CAS) between December 2022 and January 2023. Descriptive methods, the independent t-test to compare the scale scores of two independent groups, and Analysis of Variance (ANOVA) to compare more than two independent groups were employed in the data analysis.

Results: The study found that 34.2% of the participants were third-year students, 33.5% were 20 years old or younger, 77.7% were female, and 97.1% were single. The average TCSS score of the nursing students in this study was 66.45±11.59, while the mean CAS score was 279.38 ± 36.59. There was a significant and positive correlation between nursing students’ caring assessment scores and their therapeutic communication skills (r=0.349; P < 0.05). Their communication skills and caring assessment scores also increased with age.

Conclusion: Nursing students demonstrated moderate therapeutic communication skills and a positive approach towards the application and perception of caring behaviors.



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