Aylin Özakgül

Background: Adherence to oral antiviral therapy is essential to reduce progression from chronic hepatitis B (CHB) to cirrhosis and hepatocellular carcinoma. Aim: To evaluate the effect of education on oral antiviral use on medication adherence and quality of life (QoL) in patients with CHB. Methods: This randomised controlled trial included 60 of 105 eligible patients with CHB. All completed the study. The intervention, delivered by the researcher, consisted of individualised education and telephone counselling tailored to patients’ learning needs and focused on medication adherence. The control group received usual care. Data were collected using the MARS-5, MedTake test, LDSI, SF-12 and PLNS at baseline and 3 months. Data were analysed using SPSS 26. Results: At baseline, there were no significant differences between the groups in medication adherence and laboratory parameters ( p > 0.05). Mean baseline PLNS scores were 154.43 ± 3.61 in the control group and 162.63 ± 9.6 in the intervention group. At 3 months, the proportion of patients achieving medication adherence above 80% was significantly higher in the intervention group ( p < 0.01). The intervention group showed significant improvements in MARS-5, MedTake Test scores, SF-12 and LDSI scores, with lower HBV-DNA, ALT and AST levels ( p < 0.01). Conclusion: Individualised education may improve medication adherence and QoL in patients with CHB.

This study aims to determine the knowledge levels and attitudes of intensive care nurses regarding Medical Device–Related Pressure Injuries (MDRPI). This descriptive cross‐sectional study was conducted with 229 nurses working in intensive care units in Türkiye who were reached using the snowball sampling method. The data were collected using the ‘Nurse Information Form’, the ‘MDRPI Knowledge Questionnaire’, and the ‘Attitude Questionnaire Regarding MDRPI’. The intensive care nurse's total mean MDRPI Knowledge score was 14.75 ± 3.08, while the total mean Attitude Questionnaire score was 47.23 ± 5.50. In addition, significant positive correlations were observed between the MDRPI Knowledge and Attitude ( r = 0.520, p < 0.001). Nurses who had previously provided care to patients who developed MDRPIs were found to have higher total scores on both the Knowledge and the Attitude Questionnaire ( p < 0.05). In this study, intensive care nurses generally have positive attitudes toward MDRPIs; however, their knowledge is moderate and requires improvement. Moreover, indicating that attitudes became more positive as knowledge levels increased. The knowledge levels of intensive care nurses should be continuously enhanced through in‐service training programs aligned with current evidence‐based practices. In addition, educational programs should also focus on improving attitudes toward MDRPI prevention.

This study was conducted to examine the relationship between environmental literacy and global warming knowledge levels among future healthcare professionals who will play a role in protecting and promoting public health. The study was conducted using a comparative and correlational design to examine the relationship between environmental literacy and global warming knowledge levels among students in the Faculty of Health Sciences at a foundation university. Data were collected from 258 students between April 5 and June 4, 2024, through an online survey in accordance with the principles of personal data protection and confidentiality. The Student Information Form, the Environmental Literacy Scale for Adults (ELSA), and the Global Warming Knowledge Scale (GWKS) were used for data collection. The data were analyzed using descriptive statistics, the Mann-Whitney U test, the Kruskal-Wallis test, and Spearman's correlation analysis. The results were evaluated at a 95% confidence interval and a significance level of p < 0.05. It was determined that the students scored 83.42 ± 11.10 on the ELSA and 107.68 ± 15.03 on the GWKS, and that these scores were above the average level. The environmental awareness levels of students who reported having received education on the environment and global warming were found to be significantly higher. It was also found that students who were members of environmental organizations/clubs/similar institutions and who were willing to engage in voluntary work had higher levels of environmental concern, awareness, and environmental literacy. In addition, a positive correlation was found between global warming knowledge and environmental literacy (r = 0.34). The results of the study indicate that environmental literacy is significantly associated with students' levels of knowledge about global warming. It is recommended to integrate courses on environmental literacy into the curriculum to increase the knowledge levels of future healthcare professionals regarding global warming. STROBE checklist. Not applicable.

Background: End-of-life care is administered to individuals in the terminal stages of their life, typically when their health is steadily declining. This form of care is integral to palliative care, encompassing the alleviation of physical symptoms; the delivery of emotional, social, and spiritual assistance; and the honoring of the preferences of both patients and their families. Aim: This research aimed to explore the attitudes and behaviors of intensive care nurses regarding end-of-life care and the experience of death. Design: This study employed a descriptive and correlational research design. The participant pool comprised 306 nurses actively engaged in the intensive care units of a hospital during the period from June to December 2022. Methods: Data were gathered through the utilization of 3 instruments: “Individual Characteristics Form,” “The Scale of the Attitudes and Behaviors of Intensive Care Unit Nurses Intended for End-of-Life Care,” and the “Death Attitude Profile-Revised.” Results: The results indicated that the attitudes and behaviors of nurses concerning end-of-life care and death were, on average, at a moderate level. Married nurses, those with postgraduate education, individuals working in the intensive care unit, those with 11 or more years of experience, and those who perceived their knowledge about end-of-life issues as adequate demonstrated more favorable attitudes and behaviors towards end-of-life care compared to other groups. Conclusions: The study revealed that nurses with postgraduate education and those employed in the intensive care unit exhibited more favorable attitudes towards death. To enhance these attitudes and provide necessary support, it is advisable to implement supportive interventions and organize in-service training programs.

This study explores nurses' perceptions of how climate change may impact wound and ostomy care, focusing on their awareness, experiences, and perceived challenges in clinical practice. It also aims to contribute to the development of sustainable care strategies in nursing. A sequential mixed‐methods design was used to collect quantitative data from 95 certified wound and ostomy nurses and conduct four focus group discussions with 23 nurses. The study followed the ‘Global Model for Operationalizing Sustainability in Nursing’, and qualitative data were analysed using thematic analysis. Nurses demonstrated moderate‐to‐high awareness of climate change, with the highest score in the ‘expectations’ subdimension (76.78 ± 10.21). Most nurses (96.9%) believed that rising temperature and humidity would increase wound infections, and 93.8% anticipated adverse effects on skin integrity based on clinical experience. Regarding stoma complications, 94.8% identified fungal infections and 89.6% reported peristomal moisture‐related damage as significant concerns. Four key themes emerged: (1) Structural factors (Cultural Bridging and Resource Evaluation), (2) Process (Nurses' Actions and Educational Activities), (3) Outcome (Observed Changes and Professional Adaptation), and (4) Future perspective (Nurses' Leadership and Sustainability). This study reveals nurses' perceptions that climate change may affect wound and ostomy care. While based on subjective reports rather than empirical data, these findings reflect common clinical concerns. Highlighting the need for climate‐focused education and planning, the study calls for greater integration of environmental awareness into nursing practice to support adaptive, patient‐centred care.

Background: Creutzfeldt–Jakob disease (CJD) is a progressive, contagious, and rare fatal neurodegenerative disease of the central nervous system. Its annual worldwide incidence is approximately 1–2 cases per one million, with no known nursing care and medical treatment. Thus, sharing of experiences is important. Aim: This study aimed to examine the nursing care for three patients diagnosed with CJD in line with the Model of Living and to discuss nurses’ experiences of providing care. Study design: This study used both the retrospective design and case study methods. It included three patients diagnosed with CJD who were hospitalized in the neurology ward of a university hospital in Istanbul between 2018 and 2023 and 11 nurses involved in the care of these patients. Data were collected from health records and through semistructured interviews. The health records of the patients were retrospectively analyzed and the data were systematically analyzed in line with the Model of Living. Data obtained from the face-to-face interviews with the nurses were analyzed using Malterud’s systematic text condensation method. Results: Patient care was handled specifically according to the patients’ admission and discharge status, in line with the Model of Living. From the qualitative data obtained in the case study, six main themes and eight subthemes were identified within the scope of the Strengths, Weaknesses, Opportunities and Threats analysis of nursing care experiences. The main themes were professional knowledge and experience, corporate support, lack of knowledge, emotional and physical difficulties, coping with difficulties, professional visibility, individual differences and coping with rare diseases. Conclusions: The greatest emotional difficulty of nurses was the fear of infecting/transmitting the disease.While caring for patients with CJD, nurses experienced fear of contamination and could not answer the questions of the patient’s relatives because of the uncertainty in the prognosis, potentially causing stress in them. Relevance to clinical practice: This study nurses may guide training modules or structured care recommendations on caring for patients with CJD. Clinical trial number: Not applicable.

Background: It has been reported that factors such as immobility, pain, invasive interventions, separation from family, presence of unfamiliar people, constant noise and frequent sleep interruptions in intensive care units cause deterioration in comfort and sleep problems associated with deterioration in comfort, high levels of anxiety and restlessness. Aim: The aim of this randomized controlled trial was to investigate the effect of nursing care based on Kolcaba's Comfort Theory on the comfort, satisfaction and sleep quality of intensive care unit patients. Study Design: The sample of the study consisted of 40 experimental and 40 control group patients who agreed to participate in the study between April 2023 and July 2023. The data were collected by the Patient Information Form, General Comfort Questionnaire (GCQ), Newcastle Satisfaction with Nursing Scale (NSNS), Richard‐Campbell Sleep Questionnaire (RCSQ) and Comfort Behaviour Checklist (CBC). Patients in the control group received conventional care by intensive care nurses. Patients in the experimental group received individualized nursing care based on the Comfort Theory of Kolcaba during their stay in the intensive care unit. The SPSS 26 program was used for statistical analyses of the data. Results: The experimental and control groups were homogeneous in terms of demographic and disease characteristics, and no significant difference was found between the groups in terms of pre‐test GCQ, NSNS, RCSQ, CBC and pain level mean scores. Compared with the pre‐test evaluation of the experimental group, the post‐test GCQ, NSNS, RCSQ and CBC total scores increased ( p < 0.001). There was a significant difference in GCQ, NSNS, RCSQ and CBC levels between the experimental and control groups ( p < 0.001). There was a significant decrease in pain scores between the experimental and control groups ( p < 0.001). Conclusions: As a result of this study, it was found that nursing care based on Comfort Theory of Kolcaba had a positive effect on the comfort, satisfaction and sleep quality of intensive care patients. Relevance to Clinical Practice: Nursing care based on the Comfort Theory can be considered an appropriate method in clinical practice, especially in improving the quality of care of patients in the coronary intensive care unit.

Aim: To describe the self‐reported mental health of nurses from 35 countries who worked during the COVID‐19 pandemic.Background: There is little occupationally specific data about nurses' mental health worldwide. Studies have documented the impact on nurses’ mental health of the COVID‐19 pandemic, but few have baseline referents.Methods: A descriptive, cross‐sectional design structured the study. Data reflect a convenience sample of 9,387 participants who completed the opt‐in survey between July 31, 2022, and October 31, 2023. Descriptive statistics were run to analyze the following variables associated with mental health: Self‐reports of mental health symptoms, burnout, personal losses during the pandemic, access to mental health services, and self‐care practices used to cope with pandemic‐related stressors. Reporting of this study was steered by the STROBE guideline for quantitative studies.Results: Anxiety or depression occurred at rates ranging from 23%–61%, with country‐specific trends in reporting observed. Approximately 18% of the sample reported experiencing some symptoms of burnout. The majority of nurses’ employers did not provide mental health support in the workplace. Most reported more frequently engaging with self‐care practices compared with before the pandemic. Notably, 20% of nurses suffered the loss of a family member, 35% lost a friend, and 34% a coworker due to COVID‐19. Nearly half (48%) reported experiencing public aggression due to their identity as a nurse.Conclusions: The data obtained establish a basis for understanding the specific mental health needs of the nursing workforce globally, highlighting key areas for service development.Implications for nursing policy: Healthcare organizations and governmental bodies need to develop targeted mental health support programs that are readily accessible to nurses to foster a resilient nursing workforce.

Background: Relatives of patients admitted to the intensive care unit (ICU) play a crucial role in the care of their loved ones. After a patient's admission to the ICU, family members may be vulnerable to conditions such as depression, anxiety or post‐traumatic stress disorder, which can lead to moral concerns.Aim: The aim of this study was to determine the relationship between the spiritual care needs of family members of patients hospitalized in the ICU and their satisfaction with the ICU.Study Design: In this study, a cross‐sectional and correlational design was used. The study was conducted with 291 patient relatives who could be reached by face‐to‐face questionnaire. Data were collected using the ‘Personal Information Form’, ‘Family Satisfaction Scale in Intensive Care Unit (FS‐ICU‐24)’ and ‘Spiritual Care Needs Inventory’.Results: Spiritual Care Needs Inventory (SCNI) total score was determined as 58.00 ± 15.91. The mean total score of FS‐ICU‐24 was 86.38 ± 7.12. No significant correlation was found between the mean SCNI total score and the FS‐ICU‐24 total score (r = .084; p > .05).Conclusions: As a result of this research, it was determined that the spiritual care needs of the patients' relatives were at a medium level and their satisfaction with intensive care was high.Relevance to Clinical Practice: Institutions should establish spiritual care support units for individuals with patients in ICUs and examine the effects of this on individuals.

Erken mobilizasyon, yoğun bakım ünitesine kabul edilen hastaların rehabilitasyonunu iyileştirmek için güvenli ve etkili bir tedavi stratejisi olarak kabul edilir ve kritik hastalar için kanıtlanmış faydalar sağlamaktadır. Erken dönemde hastaların mobilizasyonu gelişebilecek fiziksel ve psikososyal sorunların önlenmesinde önemli rol oynamaktadır. Hemşireler hastalar için olağan faaliyetlerini yürütürken erken mobilizasyon uygulamasını yoğun bakım ünitesine kolaylıkla entegre edebilirler. Hemşireler erken mobilizasyon uygulamasını sağlayabildiklerinde hastaların iyileşmesinde önemli gelişmeler sağlanmış olacak ve sonuç olarak hastaların önceki fiziksel yeteneklerini kazanmalarına yardımcı olunacaktır. Çeşitli klinik araştırmalar, erken mobilizasyonun kas ve el kavrama gücünü artırabildiğini ve yoğun bakım ünitesiyle ilişkili güçsüzlük ve deliryum insidansını azaltabildiğini, böylece bağımsız yaşam yeteneğini geliştirebildiğini ve yoğun bakım ünitesinde kalış ve hastanede kalış sürelerini kısaltabildiğini göstermiştir. Ayrıca, mobilizasyon protokollerinin eksikliği ve buna bağlı güvenlik kaygıları, kritik hastalarda erken mobilizasyonun uygulanmasının önünde bir engeldir. Bu nedenle, erken mobilizasyonun uygulanmasına yönelik uygun yöntemlerin belirlenmesi, bu hastalardaki potansiyelinin artırılması açısından önemli bir zorunluluktur. Tüm yoğun bakım çalışanına erken mobilizasyon protokolünün kullanımına ilişkin eğitim verilmesi önerilmektedir. Bu derlemede, erken mobilizasyonun tanımı, önemi ve erken mobilizasyonda hemşirenin rolüne yer verilmiştir.