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Objective: To measure the effectiveness of health literacy-based motivational interviewing and health education to improve adolescents' nutrition and exercise behaviors., Study Design: A randomized controlled trial., Methods: The study was completed with 63 adolescents (aged 14-15 years) of which 21 were in the motivational interviewing group, 21 were in the health education group, and 21 were in the control group. Data collection tools were applied to all groups before the intervention, after the completion of the intervention (post-test), at the third and sixth month. The data were analyzed using Chi-square test and two-way mixed design ANOVA with Bonferroni test., Results: The mean scores of nutrition and exercise at the post-test, third month, and sixth month of the motivational interviewing and health education groups were significantly higher than the control group. The intervention had a large effect size., Conclusion: Health literacy-based motivational interviewing and health education were effective in improving nutrition and exercise behaviors among adolescents., (Copyright © 2024. Published by Elsevier Ltd.)

Objective: The present study aimed to identify the prevalence and predisposing factors of frailty and social inclusion among community-dwelling older adults., Design: The study was conducted using a cross-sectional design., Sample: The target population consisted of older adults registered in five family health centers in a city in Turkey. The study was completed with 600 older adults., Measurements: The Tilburg frailty indicator (TFI) and the social inclusion scale were used to collect data., Results: The prevalence of frailty in older adults was 60.5%. Multiple logistic regression analysis indicated that the risk of frailty was found to be higher in older adults aged 75 and over (2.5 times), those with low education level (5.8 times), those who were single (2 times), those with chronic diseases (1.8 times), those with unhealthy lifestyle (2.8 times), and those who were dissatisfied with their home living environment (5.9 times). It was found that age, education level, marital status, income, presence of chronic disease, lifestyle, satisfaction with their home living environment, and frailty explained 50% of the variance in social inclusion., Conclusion: The study concluded that most community-dwelling older adults were frail, and social inclusion was lower in those frail. Age, education level, marital status, lifestyle, presence of chronic disease, and satisfaction with their home living environment were found to be predisposing factors for both frailty and social inclusion. Public health nurses could develop strategies to prevent frailty in older adults and increase activities that encourage participation in social life., (© 2024 The Author(s). Public Health Nursing published by Wiley Periodicals LLC.)

Background: Loneliness is a significant public health problem due to the physical, cognitive and psychosocial changes that occur with ageing. Social support and empowerment can be particularly important for older people, alleviating loneliness and improving mental well-being., Purpose: The present study aimed to investigate the mediating role of health empowerment in the relationship between perceived social support and loneliness among nursing home residents., Study Design: The study was conducted with a correlational design and reported based on STROBE checklist., Methods: The study was completed with 277 older adults aged 65 years and over residing in nursing homes. Process Macro Model 4 was conducted to verify the mediating role., Results: The response rate was 95.6%. Most older adults experienced a feeling of loneliness, and the level of social support and empowerment perceived by most of them was high. The study found a mediating role of health empowerment in the relationship between social support and loneliness. Social support was significantly positively correlated with health empowerment and negatively correlated with loneliness. The significant standardised indirect effect of health empowerment on loneliness evidenced a partial mediating role., Conclusion: This study concluded that health empowerment has a partial mediating role in the effect of perceived social support and loneliness., Implications for the Profession And/or Patient Care: Nurses could develop effective strategies for preventing psychosocial problems in nursing home residents. Nurses could contribute significantly as educators, counsellors and leaders in planning interventions to empower older adults., Impact: By empowering older adults regarding healthcare, nurses could increase their perception of social support, improving mental health by increasing effective coping with loneliness. Nurses could design intervention programmes to increase perceived social support, as well as health empowerment levels, and reduce older adults' loneliness in nursing homes., Patient or Public Contribution: Older adults completed the instruments., (Journal of Advanced Nursing© 2024 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Objective: To measure healthy life awareness, blood pressure awareness and insight levels, along with their predisposing factors among adult individuals., Design: A population-based cross-sectional study., Sample: The population consisted of adult individuals in a rural district of a city in Türkiye. Voluntary individuals who visited the population screening, organized as the May Measurement Month activity, were invited to the study (n = 290)., Measurements: The data were collected by a questionnaire, the Healthy Life Awareness Scale (HeLAS), and the Blood Pressure Awareness and Insight Scale (BASIS). Descriptive statistics, Pearson Correlation, and multiple linear regression were used to analyze the data., Results: The mean scores of the HeLAS and the BASIS were 49.62 ± 8.30 and 2.89 ± 1.43, respectively. Income level, regular physical activity habits, and formerly being diagnosed with hypertension were positively associated with a healthy life awareness level. Former diagnosis of hypertension, regular medication usage, and being unemployed were the significant predisposing factors of blood pressure awareness and insight level., Conclusions: Most adult individuals displayed a moderate level of healthy life awareness and a low level of blood pressure awareness and insight. Nurses could take on the leading role in developing healthy lifestyle habits among individuals, ensure medication treatment adherence, and prevent hypertension prevalence., (© 2024 The Author(s). Public Health Nursing published by Wiley Periodicals LLC.)

Aim: This study aimed to examine the physical symptoms, coping strategies for earthquake stress and factors predicting coping strategies among adults staying in tent cities after an earthquake., Design: A cross-sectional design was conducted., Methods: The study sample consisted of 706 adults residing in tent cities in three cities of earthquake-affected regions. Data were collected through face-to-face surveys and the Earthquake Coping Strategies Scale, starting from the 16th day after the earthquake in February-March 2023. Independent samples t-test, one-way analysis of variance, McNemar test and multiple linear regression analysis used for data analysis., Results: The first three physical symptoms with the highest frequency after the earthquake were insomnia, frequent waking and difficulty falling asleep, respectively. Individuals with chronic illnesses, lower education levels, no previous experience with earthquakes and having undamaged homes more frequently used religious coping strategies. Individuals with higher incomes, employed individuals, non-smokers and those with having undamaged homes more frequently used positive reappraisal strategies., Conclusion: The present study concluded that physical symptoms were common among individuals in the post-earthquake period and that many individuals adopted religious coping strategies., Implications for the Profession And/or Patient Care: Nurses can develop effective interventions for preventing physical and mental health problems in the post-earthquake period. They can contribute significantly as caregivers, leaders, researchers and advisors in health monitoring and improvement practices for individuals after earthquakes., Impact: The results of the study are instructive for designing prevention and improvement practices to minimise future destructive effects of earthquakes. Individuals mostly experienced sleep problems and preferred different coping styles in the early post-earthquake period. The physical and mental health of individuals can be improved by early intervention and encouraging effective coping methods after an earthquake., Reporting Method: STROBE checklist., Patient or Public Contribution: No patient or public involvement., (© 2024 The Author(s). Journal of Advanced Nursing published by John Wiley & Sons Ltd.)

Aim: This study was performed to measure the effect of a cultural sensitivity education program in increasing Turkish nurses' intercultural sensitivity and compassion levels., Background: Intercultural care encompasses compassion, an indispensable value of nursing care. The primary purpose of compassion is to ensure the well-being and welfare of the individuals., Design: A parallel group randomized controlled trial., Methods: The study was completed by 64 nurses, 32 in the intervention and 32 in the control groups. A Cultural Sensitivity Education Program was presented to the intervention group. Instruments were given to both groups before the intervention (pre-test), one week after the intervention (post-test) and three months later (follow-up test). Chi-square, and two-way mixed-design variance analysis with Bonferroni Multiple Comparison Test were used to analyze the data., Results: The post-test and follow-up test mean scores of intercultural sensitivity and compassion of the intervention group after the intervention increased significantly compared to the control group. The intervention had a large effect size., Conclusions: The study showed that the cultural sensitivity education program effectively increased the nurses' intercultural sensitivity and compassion levels. Nurse managers could integrate education programs into the in-service education programs to improve the intercultural sensitivity and compassion levels of nurses., Competing Interests: Declaration of Competing Interest All authors declare that they have no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: The present study was conducted to measure the effectiveness of health literacy education on the health literacy level of children in early adolescence., Study Design: A parallel group randomized controlled trial was conducted., Methods: The study group consisted of sixth and seventh-grade students (aged 12-13 years) studying in a secondary school in Ankara. The study was completed by 80 students, 40 in the intervention group and 40 in the control group. The Health Literacy Education program, consisting of four sessions, was presented to the intervention group. The instruments were administered to both groups before the intervention (pre-test), one month (post-test), and three months after the intervention (follow-up test). The data was analyzed using the chi-square test, and the two-way mixed-design variance analysis with Bonferroni Multiple Comparison Test., Results: Before the study, the adolescents in the intervention and control groups were similar regarding descriptive characteristics (p > 0.05). There was no statistically significant difference between the pre-test health literacy mean scores of the intervention and control groups (p > 0.05). After the health literacy education, health literacy post-test scores and follow-up test mean scores of the intervention group increased significantly compared to the control group (p < 0.05). The intervention had a large effect size (F = 414.683; η2 = 0.91) at the 95 % confidence interval., Conclusions: The study revealed that health literacy education was effective in increasing the level of health literacy in early adolescence. It is recommended that health literacy education be added to the school education curriculum of adolescents., (Copyright © 2024 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.)

Aim: The research was conducted to measure the effect of health literacy-grounded web-based education program on health literacy, nutrition and exercise behaviours in adolescents., Background: The increasing prevalence of obesity in adolescents is explained by a sedentary lifestyle and unhealthy diet. Health literacy is essential for adolescents to maintain their healthy behaviours., Methods: The research was conducted as a parallel group randomized controlled trial. The study was completed by 114 adolescents (experimental = 42, control = 72). The Personal Information Form, the Health Literacy Scale for School-Age Children and the Nutrition and Exercise Subscales were used to collect data. A web-based education program was implemented. Two-way mixed design ANOVA with Bonferroni test was used to examine the group, time and group * time interaction of the measurements., Results: There was no statistically significant difference between the experimental and control groups regarding health literacy level, nutrition and exercise behaviours pre-test mean scores (p > 0.05). In the post-test, the mean scores of health literacy and nutrition behaviours in the experimental group were higher than the control group (p < 0.001). However, there was no significant difference in exercise behaviours (p > 0.05). The power and effect size in mean scores changes for health literacy (99.8%, η 2  = 0.039) and nutrition (99.8%, η 2  = 0.039) were moderate., Conclusion: The study concluded that health literacy-grounded web-based education program increased the health literacy levels of adolescents and improved their nutritional behaviours; however, there was no sufficient change in exercise behaviours., (© 2024 John Wiley & Sons Australia, Ltd.)

Background: Mental problems that may lead to many adverse health outcomes are increasing among adolescents. Interventions are needed to prevent mental problems in adolescents., Purpose: The present study aimed to assess the effect of progressive muscle relaxation in reducing stress, anxiety, and depression levels in adolescents., Design and Methods: A quasi-experimental design was performed. The study population consisted of 12th-grade students studying in two high schools in Turkiye. Adolescents were allocated to intervention and control groups in a ratio of 1:2, considering their preferences. A total of 88 students (intervention = 31; control = 57) completed the study. Depression, Anxiety and Stress Scale (DASS-42) were used to collect the data. Online progressive muscle relaxation was implemented in the intervention group over eight weeks., Results: There was a statistically significant difference between the intervention and control groups regarding stress, anxiety, and depression pre-test mean scores. The correction of DASS-42 pre-test mean scores was performed by covariance analysis. There was a statistically significant difference in the post-test stress, anxiety, and depression mean scores of the adolescents in the intervention group according to the corrected DASS-42 pre-test mean scores., Conclusion: The study concluded that progressive muscle relaxation reduced stress, anxiety, and depression in adolescents., Practice Implications: School nurses could implement progressive muscle relaxation to support adolescents in managing stress, anxiety, and depression., Competing Interests: Declaration of competing interest The authors report no actual or potential conflict of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Rationale: Misinformation can lead to adverse outcomes on the health beliefs and behaviors of individuals. Therefore, health literacy skills are needed as a central competency to recognize the trustfulness of health-related knowledge in any resources. To ensure this, a time-efficient, skill-oriented psychometric tools are needed to measure the comprehensive general health literacy level of communities., Aims and Objectives: This research was conducted to evaluate the psychometric properties of the 12-item Health Literacy Survey-Europe (HLS 19 -Q12) regarding Turkish culture., Method: A methodological design was adopted. The population consisted of adult individuals registered to two family health centers in Ankara. The sample was determined based on 5-10 times the number of scale items rule (n total  = 192). A questionnaire and Health Literacy Survey-Europe-Q12 were used to collect data. Language, content and construct validities and internal consistency reliability tests were performed through IBM-SPSS 25.0 and AMOS 24.0 programs. The content validity was determined via the Davis technique. The construct validity was examined by exploratory (EFA) (n 1  = 120) and confirmatory factor analysis (CFA) (n 2  = 72). Internal consistency was evaluated using Cronbach's alpha coefficient. Time invariance was evaluated by test-retest method (n retest  = 32) 4 weeks later., Results: The mean age was 30.17 ± 10.37 (min. 18-max. 61). The Kaiser-Meyer Olkin test result was 0.898, and the Bartlett's Test of Sphericity result was 604.889 (p < 0.001). The model-fit indices showed good fit. The difference between the first and the second measurements was statistically insignificant (t = -1.659, p = 0.107). The Cronbach's alpha was 0.88., Conclusions: The HLS 19 -Q12-TR was a valid and reliable measurement tool in determining the health literacy level of the Turkish adult population. As one of the social determinants of health, easy measurement and generating a general health literacy map of the population is considered a necessity., (© 2024 The Author(s). Journal of Evaluation in Clinical Practice published by John Wiley & Sons Ltd.)

Introduction: Traditional games are essential for children's social inclusion due to cultural values and beliefs. This study was conducted to measure the impact of traditional children's games on internet use, social skills, and stress levels., Methods: A cross-sectional design was carried out. Children who had parental approval and agreed to participate were included in the study ( n = 314). The data were collected using a questionnaire, the Perceived Stress Questionnaire (8-11 years), and the Social Skills Assessment Scale. Linear regression and multinomial logistic regression were performed to analyze the data. Mantel-Haenszel chi-square test was performed to assess the confounding factors for playing traditional games., Results: The children's mean age was 11.58 ( SD = 0.49), and 56.1% were girls. Children who did not play traditional games were more likely to use the internet than those who played traditional games (odds ratio [OR] = 2.16, p = .014). The social skills were significantly associated with daily internet use time (β = 0.164, p = .003), playing traditional games (β = 0.155, p = .008), and frequency of gaming per week (β = 0.123, p = .035). The stress levels were associated with gender (β = 0.120, p = .033) and academic level (β = 0.111, p = .048)., Discussion: Traditional game playing reduced the duration of one sitting and daily internet use. Moreover, outdoor gaming, frequency of playing games, and daily internet use duration were predictors of social skills, whereas being a girl and sixth-grade student were predisposing factors of stress level. Nurses could benefit from traditional games in reducing internet use and stress and improving social skills in children., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: The novel coronavirus disease 2019 has caused psychological distress such as anxiety and fear among nurses worldwide. Nurses are a creditable source of vaccine-related information and have a primary role in building confidence regarding vaccines., Aim: The present study was designed to investigate the fear and anxiety of nurses regarding novel coronavirus disease 2019 (COVID-19) and their attitudes towards the COVID-19 vaccine. The predictors of fear, anxiety and attitudes towards the vaccine were also investigated., Methods: A descriptive and correlational design was used. The study was conducted in three public hospitals from different parts of the Turkey, and 405 nurses from the three hospitals were recruited by stratified sampling., Results: Anxiety and negative attitudes towards the vaccine were positively related to fear of COVID-19. Age and fear were also positively associated with anxiety related to COVID-19. Nurses who had received the vaccine and those who were fearful had a positive attitude towards the vaccine., Conclusion: Psychosocial support programmes should be implemented to improve psychological resilience and coping strategies in nurses and organized education programmes are needed to increase positive attitudes towards vaccination., (© 2023 John Wiley & Sons Australia, Ltd.)

Objective: This study was designed to measure health promotion behaviors, health literacy (HL) levels, and their predisposing factors among adolescents., Design: A cross-sectional design was used., Sample: The study was completed by 1046 students aged 11-14 years., Measurements: Data were collected via the HL for School-Aged Children Scale and the Adolescent Health Promotion Scale., Results: HL was significantly associated with gender, participation in sport activities, and health promotion behaviors. There was no confounding factor for HL. Adolescent health promotion behaviors were significantly associated with academic level, weight perception, participation in sport activities, and HL., Conclusions: Nurses could improve communication and decision-making skills related to health behaviors and learn how to obtain health-related knowledge to promote the health of adolescents., (© 2024 Wiley Periodicals LLC.)

Purpose: The study was carried out to investigate the effect of motivational interviewing on peer bullying and cyberbullying among adolescents., Design: A parallel-group randomized controlled trial., Methods: The study population consisted of ninth-grade (aged 14 years) high school students (n = 200). The study was completed with 48 participants (intervention: 24; control: 24). The data were collected using the Participant Information Form, the Stages of Change Questionnaire, the Peer Bullying Scale, and the Cyberbullying Scale. The intervention group received a preparatory session and five weekly motivational interviewing sessions. Instruments were administered to both groups before the intervention, at the end of the last motivational interviewing session (post-test), and at 3rd- and 6th-month follow-ups. The data were analyzed using chi-square test, independent sample t-test, and two-way mixed-design ANOVA with Bonferroni's test., Results: In the pre-test, no statistically significant difference was observed between the intervention and control groups regarding mean scores for peer bullying and cyberbullying (p > 0.05). Following the motivational interviewing sessions, adolescents in the intervention group had a significantly lower mean score for peer bullying and cyberbullying than the control group at the post-test and follow-up tests (p < 0.001)., Conclusion: The present study concluded that motivational interviewing effectively reduced peer bullying and cyberbullying behaviors among adolescents., Clinical Relevance: Nurses would implement motivational interviewing to prevent bullying behaviors in schools., (© 2024 Sigma Theta Tau International.)

Purpose: This study was conducted to determine adolescents' nomophobia behaviors, eHealth literacy levels, and their predictive factors., Design and Methods: A cross-sectional design was used. The population consisted of ninth, 10th, and 11th-grade adolescents (aged 14-17) in a high school in Turkiye (N = 1013). The study was completed with 719 voluntary adolescents. A questionnaire, the eHealth Literacy Scale, and the Nomophobia Questionnaire were used to collect data. Multiple linear regression was run for data analysis., Results: Of the adolescents, 44.9% were found to have moderate, and 14.8% had severe nomophobia behaviors. Adolescents who were girls, the ninth and 10th graders, who used smartphone two hours or more daily, social media users, who watched videos on the smartphone and surfed on the Internet had higher nomophobia behaviors. Adolescents who were boys, who searched for health information online, found health information on the Internet helpful, and found accessing health resources on the Internet important had higher eHealth literacy levels., Conclusion: Adolescents should be educated about rational smartphone and Internet usage to comprehend the accuracy of health-related information., Practice Implications: School nurses could design activities to increase eHealth literacy to encourage adolescents. Nurses could help proactively prepare nomophobia severity map and an eHealth literacy enhancement curriculum for adolescents to form functional preventive interventions. Nurse leaders can contribute to developing policies and strategies to prevent nomophobia behaviors among adolescents., Competing Interests: Declaration of Competing Interest The authors report no conflict of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: Nursing research is the key to building an evidence-based practice for nursing. It is a necessity for nursing students to be professionals and to be encouraged to conduct research., Aims: This research was conducted to determine the effectiveness of a scientific research education program on the attitudes of nursing students towards research methods., Design: A single group pre and post implementation study., Methods: The sample was composed of the third-year nursing students ( n = 196). A questionnaire, and the Scientific-Research-Methods-Course-Attitude-Scale (SRMC-AS) were used for the data collection. The intervention consisted of theoretical education, group discussions, and research project writing practices lead by the researchers., Results: The difference between mean scores of the SRMC-AS baseline measurement (85.18 ± 9.09), 3rd month (91.20 ± 7.59), and 6th month (90.68 ± 11.16) was statistically significant ( p < 0.05)., Conclusion: The scientific research education program was found effective about positively increasing the attitudes of the students towards the course.

Background: The academic self-efficacy, personal responsibility, and readiness for professional practice of nursing students are important factors for academic achievement, quality of nursing care, and the transition process of new graduate nurses into the profession., Objective: This research was conducted to determine whether sociodemographic variables on their own or in combination with one another have an effect on the academic self-efficacy, personal responsibility, and readiness for professional practice among nursing students., Design: A descriptive and correlational design., Setting: The study was conducted in the nursing department of a state university in Ankara, Turkey., Participants: The sample consisted of 832 nursing students., Methods: The data were collected via the Casey-Fink Readiness for Practice Survey, the Academic Nurse Self-Efficacy Scale, and the Student Personal Responsibility Scale -10. The data were analyzed using descriptive statistics, Multivariate Analysis of Variance, and the Tukey Honesty Significant Difference test., Results: Nursing students who engaged in clinical practice, developed care plans, and participated in case discussions had higher levels of academic self-efficacy, personal responsibility, and readiness for professional practice. Nursing students who were satisfied with studying nursing and desired to work as a nurse after graduation had higher levels of academic self-efficacy, personal responsibility, and readiness for professional practice. First-year students had lower levels of readiness for professional practice, while fourth-year students had significantly higher levels of academic self-efficacy and personal responsibility compared to students in other years., Conclusion: This study demonstrated that variables such as academic level, gender, practical applications for readiness to practice, satisfaction with studying nursing, and desire to work as a nurse after graduation significantly influenced the levels of academic self-efficacy, personal responsibility, and readiness for professional practice., Competing Interests: Declaration of competing interest All authors declare that they have no competing interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Introduction: Intercultural sensitivity in health care improves health care quality due to effective communication, intervention, and increased satisfaction. The present study aimed to compare the intercultural sensitivity of undergraduate nursing students in two different countries and identify predisposing factors of intercultural sensitivity., Methods: A predictive correlational study was conducted with 980 undergraduate nursing students at a university in Turkey and the United States. A questionnaire and the Intercultural Sensitivity Scale were used for data collection., Results: Multiple linear regression revealed that the country in which nursing students were studying, and speaking a second language were found as significant predictors of intercultural sensitivity in the current study. The findings of the two-way variance analysis indicated that the interaction effect between nursing students in two schools and sociodemographic variables was not statistically significant ( p > .05)., Discussion: Nursing students from both universities presented a moderate level of intercultural sensitivity. This level is low compared with previous results reported in the literature. The study findings may help faculty administrators make new arrangements in the nursing curriculum and contribute to providing equal, and non-discriminatory health services to people. Intercultural education programs within the curriculum should be offered as independent courses and/or integrated within courses to develop culturally competent knowledge, awareness, and skills throughout undergraduate nursing education., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objective: This study was performed to investigate fatalism tendency and health beliefs about medication use and to identify predisposing factors of these variables among older adults., Methods: A predictive correlational design was used. The study was completed with 500 older adults. A personal information form, the Fatalism Tendency Scale, and the Drug Use Health Beliefs Scale were used to collect data. Univariate and multiple linear regression analysis was performed for data analysis., Results: Fatalism tendency was found to be high in older adults who used medications prescribed by the physician in different ways, used the medications more than the recommended amount, and used medications at random intervals. Older adults who used over-the-counter medications and discontinued the medications before the due date had lower health beliefs about conscious and prescription medication use., Conclusions: The study concluded that characteristics regarding medication use predicted both fatalism tendencies and medication use health beliefs. Health perception was found to be one of the predisposing factors of medication use health beliefs, whereas education level was another predictive factor of fatalism tendency., Competing Interests: Declaration of Competing Interest The authors report no conflict of interest., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objective: This study aimed to determine the effect of a home visit program on the perceived care burden of family caregivers of adults with asthma., Design: A single-blind randomized controlled trial., Sample: The study was conducted with 30 participants in both the intervention and control groups., Measurements: Care burden was measured via the Zarit Caregiver Burden Scale during the first interview at the pulmonology outpatient clinic and after the last home visit., Intervention: A nurse-led home visit program with five visits over three months included education and health counseling with the intervention group. Control group received standard education given in the outpatient clinic., Results: The mean Zarit Caregiver Burden Scale scores of the intervention group in the post-test were significantly lower than the control group., Conclusions: The current study revealed that the nurse-led home visit program, including education and health counseling, was effective in reducing the care burden for family caregivers of adults with asthma. Nurses can play an active role in preventing the negative effects of caregivers' burden of care, protecting their sense of control, and improving their health. Home visits integrated into the health care system could be effective in reducing the care burden of family members., (© 2023 Wiley Periodicals LLC.)

Objectives: In this study, we determined COVID-19-related fear, anxiety, and coping self-efficacy in individuals with cancer and predicted the risk factors of these parameters., Data Sources: A descriptive and correlational study was conducted in a single cancer center with 396 individuals. The data were collected using the Participant Information Form, the Fear of Coronavirus Scale, the Coronavirus Anxiety Scale, and the Cancer Behavior Inventory Short Form. Approximately 94% of individuals had received the COVID-19 vaccine. The boosting effect of the vaccination on self-confidence (β = 0.209), duration of diagnosis (β = 0.219), and perception of mental health (β = 0.284) was associated with fear of COVID-19. Smoking (β = 0.116), vaccination dose (β = 0.139), disease stage (β = 0.101), perception of physical health (β = -0.262), and perception of mental health (β = -0.112) were associated with coping self-efficacy., Conclusion: We found that most individuals did not have anxiety, had a moderate level of fear, and their coping self-efficacy was satisfactory., Implications for Nursing Practice: The perception of mental health was the common risk factor for fear and coping self-efficacy. Health professionals should be aware of the psychological problems experienced by individuals with cancer, and they should adopt strategies that can increase self-efficacy in coping., Competing Interests: Declaration of Competing Interest The authors have no funding or conflict of interest to disclose., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: The number of refugees, asylum seekers, and migrants is increasing worldwide. It is crucial to determine attitudes and intercultural sensitivities of nursing students towards refugees and individuals from different cultures. These nursing students will be providing healthcare in the future to these diverse communities., Objectives: To determine the attitudes towards refugees and intercultural sensitivity of nursing students and to identify the determinants of these parameters., Design: The study was conducted with a descriptive and correlational design., Settings: Nursing departments of two universities in Ankara, Turkey., Participants: The population of the study consisted of nursing students at two universities (N = 1530). A total of 905 students were included in the study., Methods: Data were obtained by a personal information form, the Attitudes Towards Refugees Scale, and the Intercultural Sensitivity Scale. Linear regression analysis was used to analyze the data obtained from the scales., Results: The participants' mean Attitudes Towards Refugees Scale score was 82.49 ± 16.66 and the Intercultural Sensitivity Scale score was 91.31 ± 11.15. Caring for refugees, intercultural sensitivity, interaction engagement, and respect for cultural differences were associated with attitudes towards refugees. Academic level, income, place of residence, and attitude towards refugees were associated with intercultural sensitivity., Conclusions: Most of the nursing students displayed a negative attitude towards refugees, although they presented a high level of intercultural sensitivity. Integration of refugee-related topics into the nursing education curriculum and designing education programs are recommended to increase awareness and positive attitudes, and to improve cultural competence of nursing students., Competing Interests: Declaration of competing interest All authors declare that they have no competing interests., (Copyright © 2023. Published by Elsevier Ltd.)

Aim: The aim of the present study was to determine the eHealth literacy levels of nursing students and to predict the influencing factors of eHealth literacy., Background: It is essential for nursing students, as the future workforce of the nursing profession, to have proficient ehealth literacy skills., Design: This study was conducted as a descriptive and correlational study., Methods: The sample consisted of 1059 nursing students at nursing departments of two state universities in Ankara, Turkey. The data were collected by a questionnaire and the eHealth Literacy Scale. Multiple linear regression analysis was used to evaluate the data., Results: The mean age of the students was 21.14 ± 1.62 years and 86.2% were female. The mean eHealth literacy score of the students was 29.28 ± 4.73. T Fourth year students had higher eHealth literacy scores than those in any other year of study (p < 0.001). Students who use the Internet frequently and always, those who search for health-related information on the Internet, those who find accessing health information on the Internet important, and those who find the Internet useful when making health-decisions had significantly high eHealth literacy scores (p < 0.05)., Conclusions: The present study revealed that the majority of the nursing students displayed a moderate eHealth literacy level. Academic level, frequency of Internet use, and search for health-related information on the Internet impacted the eHealth literacy of the students. Therefore, eHealth literacy concepts should be integrated into nursing curricula to improve nursing students' skills in using information technology and to increase their health literacy level., Competing Interests: Conflict of Interest None. Disclosure statement The authors declare that they have no conflict interests., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Professional values in nursing are the foundation of ethical practice affecting patient care quality., Aim: The purpose of the present study was to evaluate the development of professional values and ethical sensitivities among new nurses during the COVID-19 pandemic., Methods: A prospective observational study with a pre-test and post-test design was used. The sample constituted students (n = 302). The Nurses Professional Values Scale-Revised and Modified Moral Sensitivity Questionnaire for Student Nurses were used for collecting data., Results: Professional values post-test mean scores of participants were significantly higher than the pre-test scores (p < 0.001). No significant difference was determined between the pre-test and post-test mean scores of ethical sensitivity (p > 0.05)., Conclusion: The current study concluded that the professional values of newly graduated nurses developed during the COVID-19 pandemic, but there was no change in ethical sensitivities., Implications for Nursing and Health Policy: This study provides one of the first pieces of evidence for nursing educators and managers to assess the professional values and ethical sensitivities of newly qualified nurses who may have been affected both during and after the outbreak. Newly qualified nurses should are valued members of the health care institutions, and orientation programmes should be implemented to improve their perceptions of the profession., (© 2022 International Council of Nurses.)

Aim: The current study aimed to determine the prevalence of smartphone addiction, sleep quality and daytime sleepiness of nursing students and to identify the predisposing factors of these parameters., Background: The use of smartphones, which has become an indispensable part of daily life, has various effects on addictive behavior and sleep., Design: The present study was performed with a cross-sectional design., Methods: The population of the study comprised of nursing students attending all grades at two universities (N = 940). A total of 771 students were included in the study. Data were collected through a personal information form, the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale and the Smartphone Addiction Scale. Logistic regression analysis was used to evaluate the data., Results: The prevalence of smartphone addiction was 42.4%. Of the students, 57.3% had poor sleep quality and 82.5% had normal daytime sleepiness. Daily smartphone use duration, owning of a smartphone duration, daytime sleepiness and academic success were significant influencing factors for smartphone addiction (p < 0.05). Daily sleep duration, daytime sleepiness and school region were found significant risk factors for sleep quality (p < 0.05). Sleep quality and smartphone addiction significantly influenced daytime sleepiness (p < 0.05)., Conclusions: The study revealed that almost half of nursing students presented smartphone addiction and more than half of them had poor sleep quality. The prevalence of normal daytime sleepiness among nursing students was high., Competing Interests: Conflict of interest None., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective: Traditional children's games can protect the physical, emotional, and mental health of children. This study was conducted to determine the effect of traditional children's games on internet addiction, social skills, and stress level., Methods: A pre-test/post-test quasi-experimental design with a control group was used. The population of the study consisted of a fifth- and sixth-grade students studying at two secondary schools in a city of Turkey. A total of 42 students - 20 in the intervention group and 22 in the control group - were included in the study. The Family-Child Internet Addiction Scale, the Social Skills Assessment Scale, the Social Skills Scale, and the Perceived Stress Scale in Children (8-11 years) were used to collect the data. The intervention group received eight weeks of traditional children's games., Results: There was no significant difference between the intervention and control groups in terms of internet use, social skills, and stress level in the pre-test (p > 0.05). There was a statistically significant difference between groups in terms of daily and weekly internet use in the post-test (p < 0.05). The mean scores regarding social skills of the intervention group increased after the games compared with the control group (p < 0.05). There was no statistically significant difference between the groups in terms of stress-level mean scores (p > 0.05)., Conclusions: The results showed that traditional children's games may be effective in reducing internet use and increasing social skills, however they do not affect stress level. Childhood is important for physical, cognitive, and psychosocial development. Therefore, in the school settings, traditional children's games can be used for the protection and promotion of children's health., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Aims & Objectives: This study was conducted with family members of patients' in the intensive care unit (ICU) to identify their anxiety level, social support and satisfaction with the ICU., Background: Admission of critical patients to the ICU usually involves the participation of family members., Design: A descriptive-correlational design was used and reported according to the STROBE checklist., Methods: The sample consisted of 250 family members in ICUs in a city of Turkey. Data were collected by the Multidimensional Perceived Social Support Scale, the State-Trait Anxiety Inventory and the Family Satisfaction in the Intensive Care Unit scale., Results: A negative correlation was found between family satisfaction of the ICU and state anxiety (r = -0.349, p < 0.001), and a negative relationship between the satisfaction of the ICU and trait anxiety of the participants (r = -0.151, p < 0.05). There was a significant relationship between the state anxiety level (Adjusted R² = 0.080, F = 8.247, p < 0.001), trait anxiety level (Adjusted R² = 0.185, F = 19.821, p < 0.001), the perceived social support (Adjusted R² = 0.094, F = 9.640, p < 0.001) and satisfaction (Adjusted R² = 0.013, F = 4.161, p < 0.001) of family members and their sociodemographic characteristics., Conclusions: The study concluded that anxiety levels of relatives of the families were high, their social support and satisfaction with the intensive care unit were at a moderate level. There was a correlation between anxiety levels, satisfaction with the intensive care unit, and the perceived social support of families., Relevance to Clinical Practice: Holistic care for the psychosocial needs of families who have a member in the ICU should be planned to increase satisfaction. Nurses should observe families closely for anxiety, allow them to ask questions and include them in the care of their family member., (© 2021 John Wiley & Sons Ltd.)

Background: Professionalization in nursing is interconnected with the acceptance and encouragement of professional role model manners and caring approaches among the nursing students., Objective: To determine the predictors of attitudes towards nursing profession and peer caring behaviors of the nursing students., Design: A single-centered, observational, cross-sectional study., Settings: A university's faculty of health sciences nursing department in Ankara, Turkey., Participants: The population of the study comprised of second and fourth year nursing students (N = 470). The study was completed with 390 students., Methods: The data were collected via a questionnaire, the Attitude Scale for Nursing Profession (ASNP), and the Peer Caring Measurement (PCM) between September and October 2019. Univariate and multivariable linear regression analyses were used to predict the data (p < 0.05)., Results: The mean age of the students was 20.41 (SD = 1.34) and 85.1 % of them were female. The total ASNP mean score was found 160.10 (SD = 15.59). The mean score of the ASNP were higher in females, those whose income was equal or more than expense, those who preferred nursing school willingly, studying nursing pleasantly, those who were eager to work as a nurse, and those who planned to advance in nursing career. The total PCM mean score was 42.10 (SD = 10.45). It was higher in second year students, those whose income was equal or more than expense, and those who planned to advance in nursing career. There was a positively moderate correlation between the ASNP and the PCM total scores (r = 0.314, p < 0.001)., Conclusions: Attitudes of the nursing students towards profession and their peer caring behaviors were highly positive. Improving the attitudes of the nursing students towards the profession via enhancing their peer caring behaviors, novel approaches, such as internship and mentorship, should be implemented into the nursing education., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective: The study aimed to determine the effect of breastfeeding support through social media on women's breastfeeding self-efficacy., Methods: A randomised controlled trial was conducted in the maternity unit of Aksaray University Education and Research Hospital, Turkey. Education and counselling on breastfeeding were given via WhatsApp to women in the intervention group. Women in the control group received routine breastfeeding teaching before discharge from hospital. The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) was administered to both groups immediately after birth and at 3 and 6 months postpartum. The study was completed by 31 women in the intervention group and 37 women in the control group., Results: At 3 and 6 months there was a statistically significant difference in BSES-SF mean scores between the intervention and control groups ( p  < 0.05). BSES-SF scores in the intervention group were higher at 3 and 6 months compared with baseline, while BSES-SF scores in the control group were lower at 6 months compared with baseline., Conclusion: Women's breastfeeding self-efficacy was improved through a social media-based teaching and counselling intervention. Health care professionals should make use of social media tools to improve women's breastfeeding self-efficacy and encourage continuity of breastfeeding.

Aim: This study was conducted to determine media use, positive and negative emotions, and stress levels of adults during the COVID-19 pandemic., Background: Using media tools in the pandemic process has impacted the mental health of individuals. As the COVID-19 outbreak is a new disease fear, anxiety and stress about this situation can cause strong emotions in adults., Methods: The research was carried out using a cross-sectional design. The sample consisted of 1541 adults. The Positive and Negative Emotion Scale, and the Perceived Stress Scale were used to collect the data., Results: The Positive Emotion Scale mean scores were lower (p < 0.05) for those people whose daily media use time was more than 4 h and who followed the developments about COVID-19 through the media once a day. It was found that those with daily media use of more than 4 h/day had higher Perceived Stress Scale scores than those with lower use (p > 0.05)., Conclusion: This study concluded that the use of media in adults increased during the COVID-19 outbreak and that media use was associated with positive and negative emotions and stress levels. Health professionals should assess the effect of the COVID-19 outbreak on mental health in various community groups and develop interventions to prevent negative consequences of increased media use., (© 2021 John Wiley & Sons Australia, Ltd.)

Aim: The aim of the present study was to compare nursing education stress and coping behaviors of nursing students in two different countries., Background: Nursing students face with stress factors affecting academic performance during nursing education. Coping strategies can help students manage their stress levels., Design: This study was performed with a descriptive design at the nursing department of two universities in Turkey and the United States., Methods: The sample consisted of 986 students in total (807 students from Turkey and 179 students from the United States). Data were collected by a questionnaire, using the Nursing Education Stress Scale and the Coping Behavior Inventory., Results: The mean score of Turkish students on the Nursing Education Stress Scale was (68.34 ± 16.57) significantly higher than the United States students (50.91 ± 15.53) (p < 0.05). The mean scores of the sub-groups regarding avoidance, problem solving and transference behaviors of the Coping Behavior Inventory of the Turkish students were significantly higher than that of the United States students (p < 0.05); whereas the mean score of the optimistic coping behavior sub-group of the scale of the Turkish students' was lower (p < 0.05)., Conclusions: This study revealed that the nursing students from different countries had different stress levels in nursing education. The most used coping strategy by the nursing students from two countries was avoidance behaviors. Educational programs should be organized to strengthen students' stress coping skills and to use effective coping strategies., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Aim: The aim of this study was to determine the effect of health education on prevention of low back pain for health caregivers and cleaning workers., Background: Low back pain is a common health problem in the workplace. Health education is important in the prevention and recurrence of low back pain., Methods: A quasi-experimental design with a pre-test and post-test control group was used. The population of the study consisted of health caregivers and cleaning workers working in a university hospital in Turkey. A total of 120 participants, 60 in the intervention group and 60 in the control group, were included in the study. Data were collected between October 2016 and April 2017. A questionnaire, the Oswestry Low Back Pain Scale and the Knowledge Evaluation Form were used to collect data. Health education was given to the intervention group., Results: Following the health education, the mean scores of the Oswestry Low Back Pain Scale in the intervention group were significantly lower than the control group and had a larger effect size., Conclusion: This study provides evidence for the effectiveness of health education in the prevention of low back pain in health caregivers and cleaning workers., (© 2021 John Wiley & Sons Australia, Ltd.)

This study aimed to examine the fear of coronavirus and the health literacy levels of older adults during the pandemic. The sample consisted of 304 older adults from five family health centers in Turkey between April and May 2021. The data were collected using the Fear of COVID-19 Scale and the Health Literacy Scale. The fear of COVID-19 was found to be higher in women, those with chronic diseases, and those who found the epidemic measures insufficient (p < 0.05). The health literacy level was found to be higher in those with high education level, those in the 65-74 age group, and those with not using regular medicine (p < 0.001). The health literacy of older adults was a slightly above moderate level and the fear of COVID-19 was at a moderate level. Health literacy levels of older adults may be increased with written, visual, and verbal health trainings., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Purpose: This research was conducted to investigate the prevalence of internet addiction and psychosocial problems and associated factors among adolescents during the COVID-19 pandemic., Design and Methods: A cross-sectional study was conducted in Turkey. The population was composed of 9th and 10th grade students. The sample consisted of 1572 participants. Data were collected from parents of the students through a questionnaire, the Pediatric Symptom Checklist, and the Parent-Child Internet Addiction Test., Results: The prevalence of psychosocial problems was 20.7%. A few (4.8%) of adolescents had limited internet addiction symptoms. The psychosocial problems risk was significantly higher in adolescents whose fathers did not work, whose family income was less than expense, and whose daily internet use time was more than 3 h and more (p < 0.05). The risk of problematic internet use was significantly higher in males, whose mother's education level was high school and lower, whose family income was less than expense, and whose duration of internet use was 5 years and more (p < 0.05). There was a positive correlation between internet addiction and psychosocial problem mean scores (p < 0.05)., Conclusion: Most of the adolescents were internet users and one in five adolescents was at risk of psychosocial problems. Internet addiction and psychosocial problems were associated with several sociodemographic factors., Practice Implications: This study emphasizes the need for the prevention of excessive internet use and psychosocial problems during COVID-19 pandemic among adolescents. Nurses should organize online trainings for internet addiction and psychosocial problems for adolescents and their parents during the quarantine process., (Copyright © 2021 Elsevier Inc. All rights reserved.)

Aim: The aim of this study was to determine the effect of health literacy education given to nursing students on health literacy level., Background: Health literacy has become an important issue in the field of health. Health literacy is an issue of interest to health professionals as well as individuals., Methods: The study was conducted as a randomized controlled trial. A total of 206 nursing students, 103 in the intervention and 103 in the control group, were included in the study. The intervention group received four weekly training sessions of health literacy education. The research was registered at ClinicalTrials.gov with the registration number NCT04868487., Results: On the baseline assessment, there were no statistically significant differences between the intervention and control group in terms of health literacy level (p > 0.05). In the 1st- week and 12th-week measurements, the health literacy level of the intervention group was significantly higher than control group (p < 0.05)., Conclusion: Health literacy education was effective in increasing the health literacy level of the students. Therefore, the concept of health literacy should be added to the nursing education curriculum., (© 2021 John Wiley & Sons Australia, Ltd.)

Background: The attitude towards the nursing is reflected in a person's behaviour within the nursing profession. Peers can help develop and refine emotional support skills through interpersonal relationships, thus also promoting mutual caring skills. The present study aimed to evaluate the impact of an internship on nursing students' attitudes towards nursing profession and peer caring behaviours., Methods: This prospective observational study was conducted in nursing departments at two universities in Turkey. Totally, 293 nursing students (156 from the first university and 137 from the second university) were included in the study. The questionnaire, the Attitude Towards Nursing Profession Scale, and the Peer Caring Behaviour Scale were used to collect the data. In the first university nursing education, internship is implemented. Peer caring behaviours and their attitude towards nursing were evaluated before and after the internship., Results: After the internship, the mean scores obtained from the Peer Caring Behaviour Scale and physical and emotional assistance sub-dimensions in the first school students increased significantly compared with the second school (P < .05), but no significant difference was found in terms of attitude towards the nursing profession (P > .05)., Conclusion: This study emphasizes that nursing internship positively affects peer caring behaviours. An internship can be added to the nursing education curriculum., (© 2021 John Wiley & Sons Ltd.)

Background: Disease management in individuals with asthma is affected by factors such as avoiding triggers that cause attacks and properly using inhaler devices., Objective: To determine the effect of a theory of planned behavior (TPB) education program on asthma control and medication adherence., Methods: A randomized controlled trial enrolled 30 participants in the intervention group and 30 in the control group. The educational approach was employed in participants in the intervention group for five home visits over 3 months according to the TPB program., Results: Before the education program, all participants in the intervention group and 90% of those in the control group had poorly controlled asthma (P > .05). After the program, all individuals in the intervention group and 20% of the control group had well-controlled asthma (P < .001). There was no statistically significant difference between Morisky Medication Adherence Scale-8 pretest scores in the intervention and control groups in terms of medication adherence (2.37 ± 1.75 and 3.13 ± 1.71, respectively; P > .05). Mean Morisky Medication Adherence Scale-8 scores in the intervention group at posttest (7.50 ± 0.78) were significantly higher than those of the control group (3.93 ± 2.03; P < .001)., Conclusions: This study revealed that asthma control and medication adherence increased in the intervention group after the TPB education program. The program was effective in asthma control and medication adherence for individuals with asthma., (Copyright © 2021 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)

Background: Health literacy is a complex issue affecting the health outcomes of women and their families., Purpose: This study was conducted to determine the health literacy levels and related factors of women attending various courses in family centers of a municipality., Methods: This cross-sectional research was conducted on a sample of women enrolled in various courses at eight family centers in a city center. The sample consisted of 837 women who agreed to participate. The participation rate was 76%. Two different health literacy scales were used to collect data for analysis., Results: Of the women, 50.4% were over 40 years old, 35.2% were high school graduates, 89.6% were not working, 53.2% self-reported their monthly income as equal to their monthly expenses, 88.8% had social security, 28.4% had chronic diseases, 29.2% used medication regularly, 35.2% had visual problems, 7.8% had hearing problems, and 77.9% used the internet. According to the results of the Turkish Health Literacy Scale, 45.9% of the participants were in the inadequate category, 30.6% were in the inadequate and limited category, 16.0% were in the adequate category, and 7.4% were in the excellent category. Women aged 40 years and over, those who were elementary school graduates, those who had visual and hearing problems, those who used eyewear, those whose monthly income was less than expenses, and those who were non-internet users respectively had mean health literary scores that were significantly below the mean score for all participants (p < .05)., Conclusions/implications for Practice: The largest number of participants was categorized has having a "low-insufficient" level of health literacy. Age, educational level, income, having visual and hearing problems, wearing glasses, and internet use were found to affect level of health literacy. For this reason, factors such as age, educational level, income, vision and hearing problems, use of eyeglasses, and internet use should be considered when planning initiatives to increase health literacy in women., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc.)

Background: Health behaviors of adolescents affect their health and well-being into adulthood. This study was conducted to determine the nutrition-exercise behaviors, health literacy level, and related factors in adolescents., Methods: A cross-sectional design was used for this study. Overall, 810 students in grades 6-8 in a Turkish school completed the study. A personal information form, the Nutrition-Exercise Behaviors Scale, and the Health Literacy for School-Aged Children Scale were used for data collection., Results: According to the mean score of the Health Literacy Scale, 21% of the students had a low level of health literacy, 63.8% had a medium level, and 15.2% had a high level. A positive correlation was found between health literacy level and healthy nutrition-exercise behavior (r = 0.345, p < .001), and a positive correlation between health literacy level and meal pattern (r = 0.230, p < .001). A positive correlation (r = 0.385, p < .001) was found between meal pattern and healthy nutrition-exercise behavior. A moderate positive correlation (r = 0.510, p < .001) was found between unhealthy nutrition-exercise behavior and psychological/addicted eating behavior., Conclusion: The present study revealed that nutrition-exercise behaviors and the health literacy of adolescents were at a moderate level and, there was a relationship between nutrition-exercise behaviors and health literacy levels in adolescents. Interventions should be planned and followed through with parents to help adolescents adopt healthy nutrition and exercise behaviors from an early age and to increase their health literacy level. In this context, it is recommended to implement training and intervention programs for adolescents and their families., (© 2021 American School Health Association.)

Purpose: The use of mobile health technologies in the management of oral anticancer agents (OAA) can be beneficial in terms of treatment adherence and symptom management. This study was conducted to investigate the effect of a mobile application developed for patients using OAA on treatment adherence and symptom management., Method: The study was conducted using a randomized controlled trial design, and it was carried out on 77 patients. Data were collected from the Oral Chemotherapy Adherence Scale (OCAS), and the Memorial Symptom Assessment Scale (MSAS). Data were collected at the beginning of the research, and face-to-face interviews were conducted after one, three, and six months. Patients in the intervention group were followed up for six months using the mobile application., Results: It was found that there was no difference between the intervention and control groups in the baseline OCAS mean scores (p > 0.05), and the mean score of the intervention group increased over the first, third- and sixth-month measurements (p < 0.05). It was found that there was no difference between the intervention and control groups in the MSAS mean scores (p > .05), and there was a decrease in the mean MSAS score of the intervention group between the third- and sixth-month follow-up (p < .05)., Conclusion: The present study results showed that the mobile application is effective in managing symptoms and increasing treatment adherence. A well-designed mobile health application that increases treatment adherence, decreases symptom severity, and supports patients' self-management could be beneficial for patients using OAA. CLINICALTRIALS., Gov Identifier: NCT04626830., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

A negative birth experience affects the woman's subsequent pregnancy, and delivery processes negatively, decreases patient satisfaction, and the high anxiety/stress experienced during pregnancy/delivery is transferred to the next generations by epigenetic transmission. In this study, women's birth experiences of Syrian refugees in Turkey aimed to describe in-depth. It was designed as a descriptive phenomenological qualitative study. Fifteen refugee women included in the sample gave birth in Turkey, living in Turkey's southern city. In-depth interviews were conducted with women. Six themes were formed in the results: "quantitatively enough but unsatisfactory service," "not providing autonomy," "think that she was neglected," "no respect to privacy," "feeling loneliness/fear in the delivery room," and "prejudice." The factors that negatively affect the pregnancy and birth experiences of Syrian refugee women are language/communication barriers, the provision of care services that are incompatible with their religious and cultural values, and their prejudice regarding discrimination.

Background: Many physical and psychosocial changes occur in elderly people due to aging. These changes affect the adaptation, coping style, and quality of life of elderly people. This study was conducted to determine the adaptation difficulty to the process of aging and religious coping styles used by elderly people., Methods: The research was conducted as a cross-sectional type. The sample consisted of 505 elderly people from seven family health centres of a city in Turkey. Data were collected via a personal information form, the Assessment Scale of Adaptation Difficulty for the Elderly, and the Religious Coping Scale., Results: The adaptation difficulty for the elderly total mean score was 0.52 (SD = 0.56). The positive religious coping mean score was 23.49 (SD = 5.30), and the negative religious coping mean score was 7.88 (SD = 3.20). While there was a negative weak relationship between the adaptation difficulty for the elderly and the positive religious coping (r = -0.147, P = 0.001), there was no significant relation between the adaptation difficulty for the elderly and the negative religious coping (r = -0.028, P > 0.05)., Conclusions: The results revealed that adaptation difficulty to the process of aging is low, elderly people use positive coping strategies, and adaptation to old age increased as positive coping strategies were used. Factors that affect religious coping must be considered to improve the health of elderly people., (© 2020 Japanese Psychogeriatric Society.)

Purpose: This study was conducted to determine the health literacy and health promotion behaviors of adolescents., Design and Methods: This study used cross sectional and correlational design. The population of the study consisted of 6th, 7th, and 8th grade students from three different secondary schools selected from high, middle, and low income levels. The sample consisted of 2498 students., Results: The mean score of the health literacy scale of the students was 30.26. The mean score of the adolescent health promotion scale was 143.75. The mean scores of health literacy and adolescent health promotion scores of the students in high income level, sixth grade, and have parents with a baccalaureate or graduate degree were significantly higher (p < 0.005). A moderate positive correlation was found between the school age health literacy scale and the adolescent health promotion scale (p < 0.001)., Conclusions: Adolescents' health literacy, and their health promotion behaviors were at moderate level. By integrating a basic health knowledge and healthy lifestyle behaviors course into the student curriculum, health literacy of the students could be increased., Practice Implications: The determination of health literacy and health promotion behaviors in adolescents by nurses in the schools will be a guide for the promotion of enhanced adolescent health., (Copyright © 2020 Elsevier Inc. All rights reserved.)

In the postpartum period, mode of delivery, planned pregnancy, rapid changes in estrogen and progesterone hormone concentrations, quality of care, and environmental conditions affect the postpartum depression and comfort of the women. This study was conducted to evaluate the effect of progressive muscle relaxation (PMR) on the postpartum depression risk and general comfort levels in primiparas. A quasi-experimental design was used with pretest, post-test, and control group. The intervention and control groups consisted of 35 women each. PMR was applied to intervention group for 8 weeks. There was a statistically significant difference between Edinburgh Postnatal Depression Scale pretest and third follow-up scores of the intervention group (p < .05). There was a statistically significant difference between the intervention and control groups in the mean General Comfort Questionnaire scores at the first, second, and third follow-ups (p < .05). PMR may be effective on decreasing the postpartum depression risk and increasing general comfort. PMR could be administered through home visits to help women in postpartum period cope with their mental health problems after discharge., (© 2020 John Wiley & Sons, Ltd.)

Aim: The aim of this study was to determine whether implementation of a healthy lifestyle education programme resulted in improved health literacy levels and healthy life style behaviours., Methods: A one-group pretest-posttest study design was used. This study was carried out with 30 women who were enrolled in a family health centre. A questionnaire comprising the Adult Health Literacy Scale, Healthy Lifestyle Behaviour Scale-II, Perception of Health Scale, and Short Test of Functional Health Literacy was used for data collection. Eight home visits including training and follow-up followed the first interview at the family health centre. The healthy lifestyle training was applied once per week during home visits. After the training sessions were completed, women were followed-up through four home visits biweekly in the second and the third months., Results: The difference between the Adult Health Literacy Scale and Short Test of Functional Health Literacy pretest-posttest mean scores was statistically significant (P < .05). Although the Perception of Health Scale and the Healthy Lifestyle Behaviour Scale-II posttest scores were higher than the pretest scores, the difference between the groups was not statistically significant., Conclusion: The training and counselling intervention visits increased health literacy but did not significantly change the healthy life style behaviours and health perceptions of the women., (© 2019 John Wiley & Sons Australia, Ltd.)

Aim: The aim of this randomised controlled study was to determine the effect of Health Belief Model (HBM)-based health education programme in late adolescent period on coping with premenstrual syndrome (PMS)., Methods: Thirty women both in the intervention and control groups were included. The HBM-based education programme was applied to cope with PMS. The intervention and control groups were followed up for three cycles in terms of PMS symptoms. The data were collected by a questionnaire and the Premenstrual Syndrome Scale., Results: There was a statistically significant difference between the pre-test mean scores and the first, second and third follow-up mean scores; and between the first follow-up mean score and the second and the third follow-up mean scores in the repeated measurements of the intervention group (p <.05). The mean scores of the intervention group were found to be significantly lower than the control group in the second and third follow-ups (p < .05)., Conclusion: In conclusion, HBM-based health education was effective for coping with PMS. It is recommended for dealing with PMS to use HBM-based education programmes, to motivate the students for life style changes, and to identify the obstacles and the benefits perceived about PMS., (© 2020 John Wiley & Sons Australia, Ltd.)

Chewing gum is thought to increase focus via a reduction in stress and anxiety. Chewing gum contributes to success by improving short-term memory. This study was conducted to determine the effect of chewing gum on stress, anxiety, depression, self-focused attention, and exam success. A randomized controlled trial was conducted with a total of 100 students. In the long-term (19 days) and short-term (7 days) chewing gum groups, the pretest scores of depression, anxiety, and stress were significantly higher than the posttest scores. Although the posttest scores on the self-focused attention subscale were higher than the pretest scores in long-term chewing gum group, there was no significant difference between the pretest and posttest scores in this group. The academic success mean scores of the long-term experimental group students were higher than those of the other groups. Students are recommended to chew gum before exams in order to overcome exam stress and to enhance exam success. However, chewing gum is not recommended in the long term for students who have difficulty focussing their attention., (© 2019 John Wiley & Sons, Ltd.)

This literature review was conducted to summarise empirical evidence relating to psychosocial health following ostomy surgery during hospitalisation and after discharge. Both qualitative and quantitative studies were searched from 2000 to 2017 using PubMed, CINAHL, Ebrary, Elsevier, Science Direct, and Scopus. Twenty-seven articles were included that examined the patient's psychosocial health following colostomy or ileostomy surgery. Among the 27 included studies, 11 adopted qualitative research methods and 16 used quantitative designs. Most of the studies were conducted to determine psychosocial problems and emotions of the individuals, their adaptation to the stoma, and their quality of life. Most of the psychosocial problems identified in these studies were poor body image perception and self-respect, depression, sexual problems, and lower psychosocial adaptation. This literature review has illustrated the patient's psychosocial health following stoma surgery. Further studies exploring the effect of psychosocial interventions could be planned., (© 2018 Medicalhelplines.com Inc and John Wiley & Sons Ltd.)

Parental attitude is an important factor for adolescents to establish healthy-unhealthy relationships with their environment and to develop a tendency for violence. This study was performed to determine parental attitudes perceived by high school students and their tendency for violence and the affecting factors. This cross-sectional correlational study was conducted with 2,000 high school students. Data were collected by a questionnaire, Parental Attitude Scale, and Violence Tendency Scale. In the study, it was found that mean scores of the students for democratic attitude were higher than protective or authoritarian attitudes. Factors such as grade level, age, sex, education level of the parents, family type, income level, number of siblings, birth order, state of being exposed to domestic violence, and tendency for violence affected perceived parental attitude. It was also determined that violence tendency of the students was at a moderate level, and students who were studying at higher grades, who were among an older age group in parallel to grade level, who were males, whose mothers were employed, whose fathers had less than an primary education, whose incomes were less than the expenses, and who experienced domestic violence showed more tendency for violence. In addition, it was determined that tendency for violence decreased as democratic parental attitudes perceived by the students increased, and tendency for violence increased as protective and authoritarian attitude increased. It is recommended to plan regular family training programs to inform families about the relationship between family attitude and tenancy for violence, to strengthen the communication between parents and children, and to support and improve parenting skills of the parents.

Health literacy (HL) is a concept that concerns individuals, as well as health systems and health professionals. This study was conducted to determine health literacy and affecting factors of nursing students. A descriptive-cross sectional design was used. First and fourth year nursing students were included in the study (n = 303). A questionnaire and the Adult Health Literacy Scale were used for collection of the data. Most (84.8%) of the students were female and 60.4% were studying in their first year. The mean Adult Health Literacy Scale score of the student nurses was 15.9 ± 3.2. The fourth year nursing students who have health insurance, have chronic disease, use drugs regularly, and have difficulties in reading had higher mean Adult Health Literacy Scale scores (p < 0.05). Although this study indicates that the HL level of the nursing students was found as adequate, it is thought that the higher HL level acquired in the undergraduate education the more competent nursing workforce. The HL concept should be integrated into the nursing curriculum to improve the HL levels of the nursing students. Nurse educators should emphasize the importance of health literacy and patient empowerment in the curriculum., (Copyright © 2018 Elsevier Ltd. All rights reserved.)