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Industry 4.0 technology has affected almost every sector in the world. The maritime sector is one of them that has been affected by this technology. In this study, components of the maritime sector were prioritised to find out which of them should comply with this transformation primarily. Many different criteria were taken into consideration for the solution of such problems. Therefore, multi-criteria decision-making (MCDM) methods are required to solve this problem. The Fuzzy AHP (Analytic Hierarchy Process) method was employed for revealing the prioritisation ranking of the industry 4.0 effects on the maritime sector. Afterwards, VIKOR (VlseKriterijumska Optimizacijia I Kompromisno Resenje) method was employed for obtaining the prioritisation level of the maritime sector components for complying with the Industry 4.0 transformation. A group of experts assessed and compared 22 criteria and scored them for each alternative. The proposed method was employed through the experts' assessments. Results were displayed and suggestions were given for further studies. [ABSTRACT FROM AUTHOR]

The negative impact of ah pollution on human health had become a vital issue as a result of the increasing use of fossil fuels in recent years. In this context, maritime transportation is one of the most contaminant sectors by using much more fossil fuels. Ships which have a major role in maritime transport, directly affect human health via its emissions, especially hi marine areas close to tlie land such as around the ports, canals, and straits, hi this study, strategies were gathered by evaluating International Maritime Organization (IMO) regulations, European Union (EU) recommendations and the applications of the ship owner companies to reduce ah pollution stem from ships, and considering the priority perception of these strategies, the effect level of the strategies at the marine areas where ships aie approaching tlie land was analysed by tlie Fuzzy Analytic Hierarchy Process-Visekriterijumska Optimizacija I Kompromisno Resenje (AHPVIKOR) hybrid method. As a result of the study, the most effective strategies appealed as "Forbiddance of Heavy Fuel Oil (HFO) usage on Ships" and "Detection of Low Sulphur Fuel Usage by tlie help of Remote Detector Systems", and it was seen that these strategies w ould be most effective in canal or strait passing of the ships. It was also revealed that tlie relevant expert opinions and IMO regulations meshed together, and it was pohited out die apphcations for increasing fuel quality. [ABSTRACT FROM AUTHOR]

Objectives: This study was conducted to evaluate the effect of telehealth education and art therapy on diet-fluid restriction and anxiety in hemodialysis patients during the COVID-19 pandemic., Methods: This randomized controlled study included 60 hemodialysis patients (30 in the intervention group and 30 in the control group). Data were collected using the Patient Information Form, Dialysis Diet and Fluid Non-Adherence Questionnaire, Beck Anxiety Inventory, and Modified Morisky Scale. Patients were educated about diet and fluid restriction according to their needs. The forms were applied to the patients at the first interview 6th week, and 12th week. Additionally, training on diet and fluid restriction was given at the first meeting, and an educational booklet was distributed to the patients. Thereafter, the patients were video-called one day a week for 12 weeks and the follow-up evaluation form was applied via telephone. The academician, who works at the University's Faculty of Education, Department of Fine Arts, assisted patients in drawing via video conference. Patients' drawing time is 60 minutes in total, two days a week, 30 minutes each time., Results: Following the education and drawing activity, systolic blood pressure, diastolic blood pressure, hemodialysis admission weight, creatinine values, frequency and degree of dietary non-compliance, frequency of non-compliance with fluid restriction, and anxiety levels of patients in the intervention group receiving hemodialysis treatment decreased (P < .05) and their compliance with treatment increased., Conclusion: Telehealth applications and art therapy are effective in improving compliance with diet and fluid restriction and controlling anxiety among hemodialysis patients. Since the use of telehealth methods to meet the educational needs of patients and integrative methods such as art therapy ensures the continuity of care services for patients during epidemic periods, it is recommended to be used in COVID-19 and other possible epidemics in the future.

Background: Hemodialysis is an important health problem that negatively affects psychosocial status and support systems. Through practices such as mandala coloring, individuals transfer the unknowns they experience to the outside and make them visible. This study was conducted to examine the effects of mandala coloring on fatigue, psychological well-being, and factors associate with coping with stress in patients receiving hemodialysis treatment., Methods: The design was a prospective, parallel-group controlled trial. The study was conducted in the dialysis unit of a university hospital in eastern Turkey between April 4 and October 31, 2022, with a total of 60 patients, 30 in the intervention group, and 30 in the control group. The patients in the intervention group colored mandala once a week for 2 h, for a total of 8 weeks. The data were collected face-to-face using a patient information form, a Fatigue Severity Scale, a Psychological Well-Being Scale, and a Ways of Coping Questionnaire., Results: There were improvements in fatigue severity and psychological well-being over the 8-week study period in both the intervention and control groups. Scores were similar at baseline in the control and intervention groups, but better in the intervention groups compared to controls at 4 and 8 weeks for both metrics (p < 0001). Five factors from the Ways of Coping Questionnaire (self-confident approach, optimistic approach, seeking social support, helpless approach, and submissive approach) each improved during the 8-week period in the intervention group (p < 0.001). Three of these five factors improved in the control group as well. Scores for each of the five coping factors were better in the intervention group compared to controls at 4 and 8 weeks (p < 0.001)., Conclusion: Mandala coloring improved fatigue and psychological well-being and was associated with improved patient coping strategies., (© 2024 International Society for Hemodialysis.)

Introduction: Emergency services are the first places where victims and/or perpetrators of different types of violence are brought for medical treatment. Emergency service nurses are the first health workers who first encounter with the forensic case, first communicate and are in an important position in the rapid and accurate continuation of the forensic process. In this study, it was aimed to determine the level of knowledge of emergency department nurses regarding the management of forensic cases., Methods: The study was a cross-sectional, descriptive. Ninety-eight emergency nurses working in the emergency departments of three different public hospitals in the same province participated in the study. Study data were collected with the "Nurse Personal Information Form" and the "Knowledge Levels of Nurses related to the Approaches to Forensic Cases Questionnaire"., Results: 70.4 % of the nurses participating in the study were women, their mean age was (X ± SD = 27.36 ± 5.21). It is seen that 87.8 % of the nurses have a total working time in the emergency unit between 1 and 5 years and 11.2 % have received training on forensic nursing. "Total Knowledge Score" of undergraduate graduate nurses The mean score was higher and there was a significant difference between the groups (p > 0.05). The nurses who received in-service training and forensically evaluated all cases admitted to the emergency department had a higher mean score in the "Knowledge Score Regarding the Duties of Nurses Regarding Forensic Cases" mean was higher and there was a significant difference between the groups (p > 0.05)., Conclusion: We recommend the use of institutional guides/protocols together with in-service training for emergency nurses to provide medically and legally correct forensic care and to have sufficient knowledge., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: The aim of this study was to investigate the symptom management and the functional status of women who underwent surgery for breast cancer., Methods: This cross-sectional descriptive study was conducted in a university hospital surgical oncology clinic. This study was conducted on 80 patients who had undergone breast cancer surgery in the last 5 years in a surgical oncology clinic of a university hospital. Study data were collected using the patient identification form, Symptom-Management Self-Efficacy Scale Related to Chemotherapy in Breast Cancer, and Functional Living Index-Cancer. The data were analyzed with the SPSS program., Results: The mean total score of Symptom-Management Self-Efficacy Scale Related to Chemotherapy in Breast Cancer was found to be 157.28±36.86, and the mean total score of the Functional Living Index-Cancer was found to be 103.79±18.77. When the correlation between the Functional Living Index-Cancer and Symptom-Management Self-Efficacy Scale Related to Chemotherapy in Breast Cancer scales used in the study was examined, it was determined that there was a positive statistically significant correlation (p<0.05) between the subscale and scale total scores., Conclusion: As a result of the study, it was determined that the self-efficacy and functional status of the patients were poor. Their functional status was also determined to be improved as the symptom self-efficacy levels increased.

Objectives: Measuring tools are essential in assessing the quality of care. This study aimed to evaluate the validity and reliability of the Turkish version of the Palliative Nursing Care Quality Scale (PNCQS-T) and the sociodemographic characteristics affecting the quality of care., Methods: This methodological study, whose linguistic equivalence was confirmed by the translation/back translation method, was carried out with the participation of 209 nurses. Personal Information Form and PNCQS-T were used as data collection tools. Construct validity was determined by confirmatory factor analysis (CFA). Reliability was tested with internal consistency and item-total correlation coefficients., Results: Adaptation results showed that the Turkish version of the scale is adequate for linguistic and content validation. The Turkish adaptation's original scale of 20 items was reduced to 18. As in the original scale, all items were combined under a single dimension in the Turkish adaptation. Modified CFA indicated a well-fitting model. PNCQS-T explained 42.1% of the total variance. Cronbach's alpha value was 0.92. The lowest score obtained from the scale is 18; the highest score is 90. Higher scores indicated that the palliative care provided by nurses was of good quality., Significance of Results: The Turkish version of the PNCQS-T is reliable for assessing the quality of palliative care provided by nurses in Turkey.

During the Covid-19 pandemic, all sectors experienced chaotic dynamics worldwide. For example, maritime transport, particularly ports as one of its main elements, had to continue operating in this chaotic environment. Ports developed their own strategies to provide resilience against these challenges. However, any study in the related literature has not been reached that reveals resilience strategies of ports by combining literature review and interviews with port practitioners. As a novelty of the study, it was tried to evaluate resilience strategies of ports by grounding chaos theory. Therefore, this study had two aims: (1) identifying the Covid-19 strategies of Turkish container ports; (2) prioritizing these strategies in terms of impact level. First, interviews were conducted with Turkish container port representatives to find out their resilience strategies. These strategies were then validated with a literature review and new ones were detected. Second, separate relation analyses of the strategies were conducted for the interviews and literature. Finally, ports' resilience strategies against Covid-19 disruptions were prioritized using Fuzzy Analytic Hierarchy Process (AHP) based on the port managers' evaluations. Fuzzy AHP is widely used and accepted in the maritime business literature. This method also diminishes inconsistencies and subjective evaluations by employing fuzzy logic. The results showed that 'Control Mechanism', 'Hygienic Measures', and 'Information Exchange' were the most effective resilience strategies. By using chaos theory, this study helped to theoretically clarify the role of port management approaches to the challenges of the Covid-19 pandemic. These findings can therefore guide container port practitioners in overcoming pandemic conditions., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 Elsevier Ltd. All rights reserved.)

The present study was conducted with the aim of investigating the influence of foot and back massage on blood pressure and sleep quality in females with essential hypertension. Non-pharmacologic methods like massage may be effective for balancing blood pressure and solving sleep problems. This is a randomized controlled study conducted in accordance with CONSORT rules. Females with essential hypertension were applied a total of six sessions of 30 min of foot and back massage twice weekly during 3 weeks. The study included a total of 90 patients of whom 60 were in intervention group (foot massage group, back massage group) and 30 in control group. Data were collected through personal data form (PDF) which included descriptive characteristics, Pittsburgh Sleep Quality Index (PSQI). Six sessions of foot massage and back massage were detected to lead to a reduction in systolic blood pressure (SBP) and diastolic blood pressure (DBP) values and the difference was statistically significant (p < 0.001). A strong statistical difference was found between mean pretest posttest scores of overall and sub-dimensional scores of PSQI in females in intervention group (p < 0.001). Foot and back massage was found to be effective in reducing blood pressure and improving sleep quality., (© 2020. The Author(s), under exclusive licence to Springer Nature Limited.)

Introduction: Some hemodialysis patients may experience problems in completing activities of daily living and adhering to diet and fluid restrictions due to a decrease in self-care power and a loss of competence., Methods: The study was conducted with 78 people assigned to the intervention (N = 38) and control groups (N = 40). Data were collected using the sociodemographic characteristics questionnaire, dialysis diet and fluid nonadherence questionnaire (DDFQ), and fluid control in hemodialysis patients scale (FCHPS). The participants in the intervention group were given the "Nutrition Education Booklet for Dialysis Patients". The participants in the intervention group were trained through four education sessions across 4 months, and the measurement tools were administered to them. The participants in the control group were interviewed twice, once at the onset of the study and once 2 months later and the measurement tools were administered to them., Findings: In the intervention group, a decrease was observed in the pre- and postdialysis interdialytic weight gain, ultrafiltration (UF) volume, and blood pressure values of the patients after the training. There was a statistically significant decrease in the mean scores for the frequency and degree of nonadherence to diet restriction, and for the frequency and degree of nonadherence to fluid restriction in the participants in the intervention group compared to the participants in the control group (P < 0.05). There was a statistically significant increase in the mean scores obtained from the FCHPS and its subscales by the participants in the intervention group compared to the participants in the control group (P < 0.05)., Conclusion: The training given to the hemodialysis patients positively contributed to their adherence to diet and fluid restrictions. The patients' adherence to diet and fluid restriction increased., (© 2019 International Society for Hemodialysis.)

Objectives: This study was performed to determine the pain beliefs of patients and nonpharmacological methods they use to manage their pain., Methods: This was a descriptive study conducted with the participation of 163 patients who were hospitalized in the medical and surgical clinics of a university hospital in May 2011. The study data were collected using personal information forms, a nonpharmacological methods form, and a pain belief scale. The data were evaluated using number, percentage, an independent sample t-test, and analysis of variance., Results: The mean age of the patients was 52.7±16.6 years, and it was determined that 23.3% were hospitalized for urinary system diseases, while 21.5% were hospitalized for musculoskeletal system diseases. It was observed that 93.8% of the patients described experiencing pain in the past, while 22.7% described experiencing severe pain within the previous week. The types of pain most frequently described by the patients were headaches (24.8%), joint pain (21.6%), and lumbar pain (19.6%). It was determined that 72.3% of the patients used medication for pain, and that 49.1% also resorted to nonpharmacological methods for their pain. Frequently preferred nonpharmacological methods included hot and cold therapy, massage, and herbal methods. The mean organic score on the pain belief scale (23.6±4.57) was higher than the mean psychological score (19.9±2.64)., Conclusion: Evaluating the pain beliefs of patients and the nonpharmacological methods used is important for effective management of pain.

Aim and Objectives: To determine the effects of loneliness on illness perception in persons with a chronic disease., Background: How an illness is perceived not only affects all dimensions of a person's life but also plays an important role in his/her coping with the complications and consequences of the disease. One of the factors that influence the illness perception is loneliness., Design: The study is a descriptive study., Methods: The study sample included 206 individuals over the 18 years of age, conscious, having had a chronic illness at least 1 year, having no communication problems and agreeing to participate in the study after being informed about the study. Data were collected with the Personal Information Form, the Illness Perception Questionnaire and the University of California Los Angeles Loneliness Scale. The forms were administered to the participants in an unoccupied patient room, and the data were collected through face-to-face interviews., Results: The results of the study revealed that individuals with a chronic disease perceived emotional symptoms accompanying the disease more intensely that they accepted their disease was a chronic one and that their personal control and treatment control of the disease were at a middle level. The mean score the participants obtained from the University of California Los Angeles Loneliness Scale was 38.49 ± 11.15. There was a significant negative correlation between this mean score and the mean scores obtained from the following subscales consequences, treatment control, illness perception and emotional representations., Conclusion: In this study, it was concluded that the participants perceived their loneliness level as moderate and that their illness perception was negatively affected as their loneliness levels increased., Relevance to Clinical Practice: The knowledge of clinical nurses about perception of patients with chronic illnesses and conditions affecting that perception will enhance compliance with the illness management or treatment strategies. Clinical nurses should observe residents closely for signs of depression and loneliness and support their sense of coherence to reduce emotional and social loneliness., (© 2018 John Wiley & Sons Ltd.)

Aims and Objectives: To determine the effects of cooling suit on fatigue and activities of daily living of individuals with multiple sclerosis., Background: Fatigue is one of the most common symptoms in people with multiple sclerosis and adversely affects their activities of daily living. Studies evaluating fatigue associated with multiple sclerosis have reported that most of the fatigue cases are related to the increase in body temperature and that cooling therapy is effective in coping with fatigue., Design: This study used a two sample, control group design., Methods: The study sample comprised 75 individuals who met the inclusion criteria. Data were collected with study forms. After the study data were collected, cooling suit treatment was administered to the experimental group. During home visits paid at the fourth and eighth weeks after the intervention, the aforementioned scales were re-administered to the participants in the experimental and control groups., Results: The analyses performed demonstrated that the severity levels of fatigue experienced by the participants in the experimental group wearing cooling suit decreased. The experimental group also exhibited a significant improvement in the participants' levels of independence in activities of daily living., Conclusions: The cooling suit worn by individuals with multiple sclerosis was determined to significantly improve the participants' levels of fatigue and independence in activities of daily living., Relevance to Clinical Practice: The cooling suit therapy was found to be an effective intervention for the debilitating fatigue suffered by many multiple sclerosis patients, thus significantly improving their level of independence in activities of daily living., (© 2017 John Wiley & Sons Ltd.)

Introduction: The purpose of this study was to test as a shortened form of the health-related quality of life for patients with epilepsy inventory (QOLIE)., Methods: A study of 148 adult epileptic patients admitted to the Neurology Outpatient Clinic at Cumhuriyet University Hospital in Sivas was used to derive a brief screening tool from a longer instrument (QOLIE-31)., Results: The 10-item questionnaire (QOLIE-10) contains general and epilepsy-specific dimensions grouped into three domains: Epilepsy Effects (memory, physical effects, and mental effects of medication), Mental Health (energy, depression, overall quality of life), and Role Functioning (seizure worry, work, driving, social limits). Cronbach's alpha (measure of internal consistency) was high, as were the associations between QOLIE-10 and the Nottingham Health Profile (NHP). High correlations between QOLIE-10 and NHP domains (emotional reactions, energy, physical mobility, and social isolation) were found., Conclusion: The QOLIE-10 questionnaire is considered to be a valid and reliable tool for use in Turkey. Health professionals are encouraged to use this questionnaire to routinely examine the influences of the disease process in epilepsy patients., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Aims and Objectives: To identify nursing services and assess patient satisfaction in patients who present to the emergency department., Background: Emergency nursing care is a significant determinant of patient satisfaction. Patient satisfaction is often regarded as a reliable indicator of the quality of services provided in the emergency department., Design: This is a descriptive study., Methods: Eighty-four patients who presented to the university emergency department were included in the study. The study data were collected by the Patient Information Form and the Satisfaction Level Form., Results: Emergency nursing services, including history taking, assessing vital signs, preparing the patient for an emergency intervention, oxygen therapy, drug delivery and blood-serum infusion were shown to be more commonly provided compared with other services such as counselling the patients and the relatives about their care or delivering educational and psychosocial services. However, 78·6% of the patients were satisfied with their nursing services. The highest satisfaction rates were observed in the following sub-dimensions of the Satisfaction Level Form: availability of the nurse (82·1%), behaviour of the nurse towards the patient (78·6%) and the frequency of nursing rounds (77·4%)., Conclusions: The most common practices performed by nurses in the emergency department were physical nursing services. Patient satisfaction was mostly associated with the availability of nurses when they were needed. Our results suggest that in addition to the physical care, patients should also receive education and psychosocial care in the emergency department., Relevance to Clinical Practice: We believe that this study will contribute to the awareness and understanding of principles and concepts of emergency nursing, extend the limits of nursing knowledge and abilities, and improve and maintain the quality of clinical nursing education and practice to train specialist nurses with high levels of understanding in ethical, intellectual, administrative, investigative and professional issues., (© 2016 John Wiley & Sons Ltd.)

This cross-sectional study aimed to evaluate the association between medication adherence and Health-Related Quality of Life (HRQoL) in 120 hypertensive patients. Personal Information Form, SF-36 Quality of Life Scale (SF-36 QoL) and Medication Adherence Self-Efficacy Scale (MASES) were used for data collection. Data were analyzed with SPSS program using percentage, mean value, standard deviation, significance test of difference between two means, analysis of variance, Mann-Whitney U test, Kruskal-Wallis test and X²-test. MASES and SF-36 QoL scores of the patients were found to be low. Adherence to medication and compliance were found to be low in males, patients using two or more drugs, and those that did not control their blood pressure regularly. In addition, a statistically significant positive relationship was found between adherence to medication/compliance, self-efficacy and quality of life (p < 0.001). Regular and continuous adaptation programs addressing patients on antihypertensive therapy will improve the quality of life of these patients.

Purpose: The purpose of this study was to evaluate nonadherence to diet and fluid restrictions and its relation with the level of disability in patients on chronic hemodialysis (CH)., Methods: The study design was a descriptive survey. The data were obtained from 186 patients in hemodialysis centers in Turkey. Descriptive statistics including mean scores, standard deviations and frequencies, and correlations analysis and logistic regression were conducted. Data were collected by using a personal information form, the Dialysis Diet and Fluid and Brief Disability Questionnaire., Results: A great majority of hemodialysis patients showed nonadherence to diet and fluid restrictions. In total, 124 patients (66.7 %) reported mild to very severe nonadherence to diet, and 128 patients (68.8 %) reported mild to very severe nonadherence to fluid restrictions. Most of the patients with CH (69.9 %) experienced disability. The results of this study showed that nonadherence was more common among older age, females, low-educated patients and those with higher levels of disability., Conclusions: The results of this study showed that the prevalence of nonadherence to diet and fluid restrictions was high in hemodialysis patients. The significant predictors for diet and fluid nonadherence were: older age, high interdialytic weight gain, and severe disability. Medical professionals must be aware of nonadherence and related factors and assist patients in developing strategies to prevent and respond to this.

Introduction: The purpose of this study was to evaluate reliability and validity of the 31-item Quality of Life in Epilepsy Inventory (QOLIE-31) in Turkish epileptic patients., Methods: This study was performed methodologically. To standardize the inventory, using a standard "forward-backward" translation and cultural adaptation procedure the English version of the QOLIE-31 was translated to Turkish. Language equivalence of the scale was provided. The opinions of experts were considered regarding the content validity of the scale. Reliability of the scale was determined with the test-retest reliability, item-total correlation and internal consistency analysis. For the construct validity, QOLIE-31 was compared with Nottingham Health Profile (NHP) scale and pre validity was determined., Results: One hundred and forty-eight epileptic patients (62 females, 86 males), with a mean age of 32.5 (SD: 10.71) years were enrolled in the study. Content Validity Index of instrument was .85. Alpha reliability was .91. Item-total correlations were between .46 and .74 (p=.001). The mean score for the quality of life of epileptic patients was found to be moderate level (56.4; SD: 17.3). The mean score of Seizure Worry subscale was the lowest (48.9, SD: 29.82), while social function subscale (60.1, SD: 20.12) was found to be highest. As expected, correlations between QOLIE-31 and NHP subscales were fairly strong, particularly between those subscales with close or interdependent content. Thus, Emotional Well-Being correlated with NHP Emotional Reactions, Social Isolation and Pain; Social Function with NHP Social Isolation and Physical Mobility; Seizure Worry with NHP Social Isolation and Emotional Reactions; and Cognitive Function with NHP Energy, Emotional Reactions and Pain., Conclusion: The Turkish version of the QOLIE-31 questionnaire has good structural characteristics, is a reliable and valid instrument and can be used for measuring the effect of epilepsy on the quality of life., Competing Interests: Conflict of Interest: No conflict of interest was declared by the authors.

Purpose: The performance of a planned education model in patients receiving chemotherapy can alleviate the side effects of chemotherapy and thus can increase the quality of the patients' lives. In accordance with this view, this study was conducted with the purpose of examining the effect of planned education given to patients receiving chemotherapy on their symptom control., Methods: The study was quasi-experimental. A sample of 120 patients participated, of which 60 were in the experimental group (EG) and 60 were in the control group (CG). A patient data form and the chemotherapy symptom assessment scale (C-SAS) were used in order to collect the data. Median, Mann-Whitney U test and Wilcoxon signed rank test were used to analyze the data., Results: There were statistically significant decreases in the frequencies of the following symptoms: nausea, vomiting, constipation, pain, infectious signs, problems of mouth and throat, problems of skin and nails, appetite changes, weight loss or weight gain, feeling distressed/anxious, feeling pessimistic and unhappy, unusual fatigue, difficulty sleeping. Also, there were statistically significant decreases in the severity of eleven symptoms and on the discomfort levels of nine symptoms., Conclusion: In the study, the planned education provided by the health-care providers had a positive effect on the symptom control of patients receiving chemotherapy., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Aims and Objectives: To evaluate sexual dysfunction and the factors that affect sexual dysfunction in women with chronic disease., Background: Sexual dysfunction is one of the most common problems in women with chronic disease. There is limited understanding of the related factors of sexual dysfunction in women with chronic disease, with research currently limited to other problems and problems related to chronic diseases., Design: This research was conducted as a descriptive survey., Methods: This study involved 100 female inpatients at clinics of internal medicine of a university hospital. Data were collected with a patients identification form and a female sexual function index (KCFI). Kruskal-Wallis test, test of significance of difference between two means and test of significance of difference between two pairs were used in the data analysis., Results: Sixty-five percentage of women in the sample were defined to have sexual dysfunction. The majority of women expressed pain during sexual intercourse, problems in orgasm and satisfaction, and reluctance to have sex. Older age, being unemployed, being in menopause, fatigue, sleep disorder, and pain and weakness in extremities were the factors that were found to significantly affect the prevalence of sexual dysfunction (p < 0.05)., Conclusions: This study concluded that sexual function of women with chronic disease is affected negatively. Chronic disease-related symptoms, experienced changes in the body and psychosocial problems are changing the lives of women. Ultimately, these changes also affect sexual activity., Relevance to Clinical Practice: Determination of the factors affecting sexual activity in women with chronic disease is important for women' ability to cope with sexual dysfunction and keep it under control. To be able to accomplish this, it is necessary for healthcare personnel, the partners and family to work together., (© 2013 John Wiley & Sons Ltd.)

Introduction: The aim of the study was to evaluate injuries in patients with epilepsy and some factors associated with injury., Methods: This study included 126 epileptic patients who attended a neurology outpatient clinic of a hospital between March 2009 and March 2010. Data were collected using a patient information form and an injury evaluation form. The data were evaluated using percentage, mean and the Chi square test., Result: 82.5% of patients have sustained injury due to an epileptic seizure. Soft tissue injuries were the most common (70.2%), followed by head injury (61.5%), dental and tongue injury (%58.6), burns (24%), and orthopaedic injury (21.2%). The most common site of burns were the upper extremities and the face (36% and 24%, respectively). Burns occurred during cooking in 32% of cases. Five patients had upper extremity fractures. Four patients faced the risk of bathtub drowning. The injuries usually occurred at home. The significant risk factors for injury were generalized tonic-clonic seizures and high frequency of seizures. Twenty-six patients were taken to the emergency unit due to an injury., Conclusion: Injury is a common problem in patients with epilepsy. Dental and tongue injury was the most common seizure-related injury. The risk factors were generalized tonic-clonic seizures, and high frequency of seizures. Patients with epilepsy can lead normal lives but certain precautions are needed to prevent seizure-related injuries., Competing Interests: Conflict of interest: The authors reported no conflict of interest related to this article. Çıkar çatışması: Yazarlar bu makale ile ilgili olarak herhangi bir çıkar çatışması bildirmemişlerdir.

The objective of this study was to examine potential trigger factors in migraine patients. A total of 126 migraine patients were interviewed about possible trigger factors for migraine. The most common trigger factors were emotional stress (79%), sleep disturbance (64%) and dietary factors (44%). Sleep and stress were significant trigger factors in patients with migraine with aura, whereas environmental factors were important trigger factors in patients with migraine without aura. Stress, sleep and environmental factors were important trigger factors in women and differed significantly from men. Trigger factors are frequent in migraine patients, and avoidance of such factors may result in a better control of the disorder.

Caring for a patient undergoing hemodialysis is highly stressful and can negatively affect a caregiver's physical and psychological well-being. This study was conducted to examine the effect of educational support concerning caregiver burden and given to the caregivers of hemodialysis patients. This experimental study was performed with 122 caregivers. Patients' data were collected by means of Personal Information Form and Zarit Caregiver Burden Scale (ZCBS). Characteristics of caregivers of hemodialysis patients were analyzed descriptively in terms of frequencies and percentages for categorical data, means, and standard deviations. Mann-Whitney U test, Kruskall-Wallis test, and percentages were used in the data analysis. The mean ZCBS score was 52.1 ± 8.6 (range, 0-88). Among the caregivers, the mean score of the ZCBS was significantly higher in women, single, young, family relatives as "daughter/sister/brother/daughter-in-law and town/district, high educational level (P < 0.05). Moreover, the mean score of the ZCBS was significantly higher in caregivers who have health problems/diseases. In addition, this study explored the educational needs of home-based such as nutrition (35.2%), dialysis (27.8%), fistula care (20.4%), catheter care (18.8%), the information about chronic kidney disease (18.0%), blood pressure (17.2%), weight control (17.2%), hygiene (3.1%), and travel/exercise (6.5%). The post-educational mean scores (55.0 ± 7.6) of caregiver burden were observed to be lower than the pre-educational scores (43.9 ± 5.2), and the difference was found to be statistically significant. The home-based educational program demonstrated a decrease in the burden of hemodialysis caregivers., (© 2012 The Authors. Hemodialysis International © 2012 International Society for Hemodialysis.)

The objective of this study was to evaluate the use of complementary and alternative medicine (CAM) and related factors among patients with chronic diseases. A cross-sectional study was carried out in outpatient clinics of a general hospital using a random sample of 252 adult patients with chronic diseases. Data included information on patient demographics and socioeconomic factors, as well as items to identify CAM use and the reasons for using CAM. Data were evaluated by Pearson's chi2-test and Fisher's exact test. It was found that 55.9% of study patients applied CAM. A significant number of patients (63.8%) were using CAM for hypertension. This study found that CAM use was associated with female gender, married status, housewives, low income and high levels of education. The present study confirmed the high frequency of CAM use among patients with chronic diseases in a Turkish public hospital.

Purpose: This study investigated the impact of education, provided to individuals, in whom AV fistula was preferred as a vascular access, regarding information and anxiety., Methods: This experimental study was performed on 32 patients undergoing hemodialysis between November 2009 and February 2010 in the Nephrology Clinic of Sivas Cumhuriyet University Hospital. Patients' data was collected by means of Personal Information Form (PIF), AV Fistula Information Form (AV-FIF), and Beck Anxiety Inventory (BAI); education brochures were used in order to inform the individuals. Collected data were assessed with SPSS . Statistical analyses were used in order to assess the data: percentage account, paired samples t test., Results: When comparing information and anxiety score of individuals prior to and following education about AV fistula care, it was seen that information and anxiety scores were low and high respectively, prior to the education. Following education, patients' information and anxiety scores became higher and lower respectively. All these results were statistically significant (P< 0.001)., Conclusions: Education about fistula increased the information level about fistula care and decreased anxiety in patients undergoing hemodialysis. It is important to perform patient education regularly, because it increases the level of orientation towards illness and interventions in patients.

The aim of the study was to evaluate disability in patients with elderly stroke, multiple sclerosis (MS) and epilepsy, and to analyze its relationship with demographic characteristics. We conducted a cross-sectional study involving 113 patients with neurological diseases. The data were collected with a Personal Information Form, the Rivermead Mobility Index (RMI), and the Brief Disability Questionnaire (BDQ) were used. The data were evaluated using percentage, variance analysis, the Kruskal-Wallis test and the Pearson correlation analysis. The study results demonstrate that among three disorders, the severity of disability increased in patients with stroke, epilepsy and MS, respectively. It was also found that in patients with stroke, MS and epilepsy experiencing disability in mobility, 32.7% had experienced moderate physical-social disability, and 63.3% had experienced severe physical-social disability, and that there was a significantly high relationship between mobility disability and physical-social disability. The severity of disability was found to be higher for older age, low level education, self-employed and widows. Especially in stroke patients, disability is a common problem in patients with epilepsy and MS. Detecting the level of disability is very important for decreasing the limitation in elderly patients with neurological illness., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

This study investigated the effects of a diabetes intensive education program (DIEP) on glycosylated hemoglobin (HbA(1)c), body mass index (BMI), and arterial blood pressure (BP). An 8-week randomized-controlled trial was conducted in Cumhuriyet University Hospital. Diabetes patients were randomized to control group (CG; n = 25) and intervention group (IG; n = 25) who received DIEP, including the factors affecting metabolic control and implementation of diabetes guidelines. Primary outcomes included HbA(1)c, BP, and BMI. After the 8 weeks, there was a significant decrease in HbA(1)c mean values for the intervention group. Also, BP significantly decreased from 143/87 to 130/80 mmHg in the IG as compared with an increase from 137/82 to 137/86 mmHg in the CG. In addition, the results demonstrated that DIEP improved the number of patients at goal for BP (130/80 mmHg). Baseline BMI did not change significantly in either group during the course of the study. These findings show that the DIEP may be effective in decreasing HbA(1)c levels and improving adherence to BP control.

The objective of this descriptive and analytical study is to examine mobility disability and life satisfaction in elderly people living in nursing home residences and analyze the relationship between them. The study was conducted over 78 elderly people in two nursing home residences. The data of this study were obtained through a personal information form (PIF), the Rivermead mobility index (RMI) and the life satisfaction scale (LSS). It was detected that life satisfaction levels of elderly people were average, a great majority of them went through mobility disability and there was a significant correlation between mobility and life satisfaction. It was established that in elderly people mobility was affected by the age, gender and chronic diseases while life satisfaction was related to age, education level and health perception level. Disability is a factor that has a significant effect on the life satisfaction of elderly people. The findings of this study will be useful for planning interventions to improve mobility and satisfaction with life among nursing home elders in Turkey., (Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.)

Purpose: The purpose of this study is to assess patients' self-care ability and self-efficacy, to examine the relationship between them and to determine the factors affecting self-care ability and self-efficacy in people undergoing hemodialysis (HD)., Methods: This research was conducted as a descriptive survey study by 138 people with ESRD who were patients of HD units service in Sivas. The data were collected with a Personal Information Form, Exercise of Self-Care Agency (ESCA) Scale and Self-Efficacy Assessment Form. Data collected from the study were analysed using percent, mean, Tukey test, significance test of two means, one-way variant analysis and Kruskal-Wallis test., Results: The study results demonstrate that while there is a correlation between self-care ability and education level, work status, income level and frequency of HD application, factors such as age, gender, education level, work status, income level and frequency of HD application determine self-efficacy. Furthermore, a positive correlation was found between patients' self-care ability and self-efficacy. It was determined that as the level of self-care ability increases self-efficacy level also increases., Conclusions: Hemodialysis application affects patients' self-care ability and self-efficacy levels. There is a positive correlation between self-care ability and self-efficacy. In view of this study's results, it is recommended to organize education programmes to increase self-care ability and self-efficacy levels of HD patients and prepare comprehensive plans including patients' families.

This study was conducted for the purpose of examining the effect of planned education given to persons with type 2 diabetes mellitus (DM) on their metabolic control. The method of the study was a randomly controlled clinical trial. A sample of 50 individuals participated, of which 25 were in the Experimental group (E), and 25 were in the Control group (C). The educational program consisted of three sessions between the educator and persons with diabetes. Before the education program, there was no statistically important significance between the metabolic control parameters of the E group and the C group. In the analysis of the difference between means of the E and C groups, after the third education program, statistically significant differences were found between fasting blood sugar, postparandial blood sugar, urine glucose, hemoglobin A1c, triglyceride, total cholesterol, and low-density lipoprotein cholesterol levels. In the study, regular and repetitive education provided by the nurses had a positive effect on the metabolic values of persons with DM.

Aim: This study aimed to describe fatigue and the factors that affect fatigue in people with multiple sclerosis., Background: Fatigue is the most common symptom and has the greatest effect on multiple sclerosis patients' activities of daily living. There is limited understanding of the level of fatigue experienced by people with multiple sclerosis, with research currently limited to other symptoms and problems related to multiple sclerosis., Design: This research was conducted as a descriptive survey., Methods: The study involved 120 people with multiple sclerosis. The data were collected with a Patient Questionnaire and a Visual Analogue Scale for Fatigue (VAS-F). Variance analysis, Mann-Whitney U-test and Kruskal-Wallis test were used in the data analysis., Results: All of the individuals in the sample experienced fatigue. Their fatigue was also affected by factors such as age, gender, education, marital status, number of children, occupation and duration of illness. In addition, the situations with the greatest effect on their fatigue were taking a hot bath/shower, hot/humid weather, stress, infection and other illnesses causing fever, disturbance in sleep pattern, increase in daily activities and exercise., Conclusions: Fatigue is a symptom that has a significant effect on the daily lives of people with multiple sclerosis. Accordingly, it is recommended that factors affecting fatigue in people with multiple sclerosis be evaluated and that education programmes directed at how to control these factors., Relevance to Clinical Practice: The determination of factors affecting fatigue is important for multiple sclerosis individuals' ability to cope with fatigue and keep it under control. To be able to accomplish this it is necessary for health care personnel, the family and friends to work together.