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Conceptualization of Burnout From the Perspective of the Neuman Systems Model

Due to an incomplete match between Neumans definition of the core response and proposed examples, the core response has been interpreted as solely physiological in nature. As a result, the majority of Neuman systems model-based research has focused on either identification of stressors or the relations between stressors, the flexible line of defense, and normal line of defense invasion while the core response has been largely neglected. The purpose of this paper is to argue for a broader conceptualization of the core response as any and/or all of the person variables proposed by Neuman. The burnout process, which is both psychological and spiritual in nature, was developed as a core response exemplar.

Examination of the Effect of Education About Electroconvulsive Therapy on Nursing Practice and Patient Satisfaction

Introduction: Electroconvulsive therapy (ECT) procedures require the work of a multidisciplinary team that includes an anesthesiologist, a psychiatrist, and a treatment nurse. Electroconvulsive therapy is treated like a minor surgical procedure that requires preoperative preparation and postoperative care. Aim: This research was conducted as a quasi-experimental study for the purpose of evaluating the effect of education about ECT given to nurses who work on a psychiatric ward. Sample: The research pretest sample was composed of 52 ECT procedures in which nurses participated in managing that were conducted between April and October 2006 on the psychiatric ward of Dokuz Eylül University Hospital. The posttest sample was composed of 52 ECT procedures in which nurses participated in managing that were conducted between January and March 2007 on the same psychiatric ward. Data Collection Tool: The observation form for the determination of nursing care in ECT and satisfaction form, which were developed by the researcher from expert opinion, were used for data collection. Data obtained were analyzed using the test for significance between 2 means. Results: The nurses included in the research received a total score of 4 for nursing care in ECT procedure before education and X = 11.5 after education. The difference in the mean scores for nursing care in ECT procedure before and after education was found to be statistically significant (P < 0.05). The mean score for patient satisfaction with nursing care in ECT procedure before education was X = 2.5 and that after education was X = 4.1. The difference between the 2 means was found to be statistically significant. Conclusions: Education given to nurses about ECT improved nursing practice and increased patient satisfaction. For this reason, it is recommended that nursing care in ECT continuing education be planned and given at regular intervals.

Experiences of Newly Diagnosed Breast Cancer Patients in Turkey

Purpose: The purpose of this qualitative study is to describe the experiences of women in Turkey during the diagnostic phase of breast cancer. Design: In the research, the phenomenological approach was used. The data were collected through semistructured in-depth interviews. The sample comprised nine breast cancer patients in the diagnostic phase. Results: The data were categorized into four themes: facing the breast cancer diagnosis, uncertainty, avoidance, and holding on to life. Women experience intense uncertainty about the disease, treatment, and social relationships and thus exhibit avoidance behavior. Implications: Nurses should be aware of psychosocial difficulties suffered during the diagnostic phase and provide care for patients. It is important that nurses provide information about the diagnostic phase to women with breast cancer and encourage them to ask questions and express their feelings.

Nursing Research in Turkey

Nursing was first considered a scientific discipline in universities in Turkey in 1955. Since that time, nursing research in Turkey has been slowly but steadily growing, and faculty at schools of nursing have included nursing research courses in their curricula and held seminars, conferences, and training sessions concentrated on the importance of nursing research. One such important conference, held as a follow-up to the 1996 International Council of Nursing Conference, was the 1996 Fourth National Nursing Congress at Hacettepe University. At this conference, the priorities and important dimensions of nursing research were discussed as well as strategies for development of nursing research in Turkey (Velioğlu & Oktay, 1999). This important conference was followed quickly by a nursing research workshop held at Dokuz Eylul University. As a result of these meetings, the following nursing research priorities were identified: the role of nurses in health promotion, effectiveness of nurses in solving health problems, nursing care standards, policy making, educational standards, basic healthcare services, detection of treatment and rehabilitation needs, development of nursing models, independent nursing functions, quality of nursing care, costeffectiveness, outcomes of nursing education, and improvement of nursing as a profession (Kocaman, 1996). At the same time, recognizing the importance of organizing the conduct of nursing research, the Association for Research and Development in Nursing was founded to evaluate the value of nursing research to patients and nurses and assist in the identification of national nursing research priorities in Turkey (http://www.hemarge.org. tr) (Hemşirelikte, 1996). To this end, four national nursing research symposia were conducted between 1996 and 2008. However, despite these efforts and more than 54 years as a recognized scientific discipline, we are still struggling to determine research priorities. That is, while the health profile of the Turkish people is considered in establishing curricula of Turkish nursing schools, it is not always considered in determining nursing research priorities for individual nurse researchers. Bahar (2004) noted that the most influential studies have been closely linked with national healthcare priorities. Özsoy (2008) reported that of 2,883 master’s theses and doctoral dissertations conducted, 16.1% study knowledge of health-related issues, 16.1% develop measurement scales, and 14.2% study basic nursing interventions. These studies do not reflect the primary health concerns of Turkey, which are problems of the elderly due to increased life expectancy, maternal and perinatal conditions, high infant death rate (29 of 1000 live births compared with Europe’s 8 of 1000 live births), incidence of short stature and low weight to height scores in children, living with disabilities and chronic disease (12.9% of the Turkish population), and infectious disease control (İmamecioğlu et al., 2004; Ministry of Health of Turkey, 2004). In light of this situation, the priorities for nursing research in Turkey were again considered at the 2008 Turkish Association of Research and Development in Nursing Conference. Nurse faculty were called upon to cooperate in developing nursing research programs that consider Turkish health problems and policies. As well, we recognized the need to integrate research findings into practice through the establishment of nursing research departments in hospitals and making full use of national and international data bases to advance knowledge. Finally, the establishment of a National Nursing Research Center affiliated with the Ministry of Health was recommended along with a national electronic health library and funding for nursing research into costeffectiveness of nursing care (Bahar, 2004).

Work Stress and Emotional Exhaustion in Nurses: The Mediating Role of Internal Locus of Control

Background: Burnout is a major problem for nursing. There is a strong relationship between work stress and emotional exhaustion. Although studies report a negative correlation between the internal locus of control and emotional exhaustion and work stress, the number of studies available on the subject is limited. Purpose: This study intends to examine the extent to which the relationship between work stress and emotional exhaustion is mediated by nurses’ internal locus of control. Methods: The study adopted a cross-sectional survey design. The data were analyzed using structural equation modeling techniques. The study sample consisted of 347 nurses who worked in a university hospital in Izmir, Turkey and who agreed to participate in the study. The Work-Related Strain Inventory was used to evaluate the nurses’ work stress level, Maslach Burnout Inventory was used to evaluate their emotional exhaustion levels, and the Locus of Control Scale was used to evaluate the internal locus of control. The variables of the study were based on the Neuman Systems Model. Results: Work stress was positively related to internal locus of control (β = .21, p < .001), which was, in turn, negatively associated with emotional exhaustion (β = −.03, p > 0.1). Internal locus of control was negatively related to emotional exhaustion (β = −.14, p < .001). Work stress is directly (β = .87, p < .001) and indirectly related to emotional exhaustion (mediated by internal locus of control β = .84, p < .001). Work stress is directly (β = .87, p < .001) and indirectly related to emotional exhaustion (mediated by internal locus of control, β = .84, p < .001). Conclusion: Although the relationship between emotional exhaustion and work stress was mediated, the impact of internal locus of control was limited. It is recommended that different variables be included in future studies so that they can mediate the relationship between work stress and emotional exhaustion.

Home-Based Psychoeducational Intervention for Breast Cancer Survivors

Background: It is important to manage psychological distress and improve the quality of life (QOL) in patients after breast cancer treatment. Objective: The aim of this study was to evaluate the effects of a home-based, psychoeducational program on distress, anxiety, depression, and QOL in breast cancer survivors. Methods: The study was a single-group pretest and posttest quasi-experimental design. The data were collected using the Distress Thermometer, the Hospital Anxiety and Depression Scale, and the Turkish version of the World Health Organization Quality of Life Instrument, short form. The home-based, individual, face-to-face psychoeducational program was structured according to breast cancer survivors’ needs and the Neuman Systems Model. Results: A total of 32 Turkish breast cancer survivors participated in this study. There were statistically significant differences in the mean scores for distress, anxiety, and depression in the breast cancer survivors over 4 measurements. The mean scores for all subscales of the QOL at 6 months postintervention were significantly higher than the mean scores at baseline. Conclusions: The results indicated that the psychoeducational program may be effective in reducing distress, anxiety, and depression and in improving the QOL in breast cancer survivors. Implications for Practice: Psychoeducational programs may be effective and should be considered as part of the survivorship care for breast cancer survivors.

Experiences of Turkish survivors of breast cancer: Neuman systems model perspective

Aim The purpose of this qualitative descriptive study was to explain the experiences of Turkish survivors of breast cancer in the light of the Neuman systems model. Methods Interviews were conducted with 14 Turkish survivors of breast cancer. The data were analyzed by using directed content analysis. The data were categorized according to three concepts of the Neuman systems model (stressor, variable, and nursing intervention). Results The Turkish survivors of breast cancer suffered intrapersonal, interpersonal, and extrapersonal stressors but did not receive enough support from healthcare professionals during follow-up appointments. Conclusion Nurses working with the survivors of breast cancer should be aware of stressors and positive and negative variables. The implementation of the Neuman systems model by nurses provides a systematic perspective and helps to increase the effectiveness of survivorship care.

Fear of Recurrence in Turkish Breast Cancer Survivors: A Qualitative Study:

Purpose: Fear of recurrence (FOR) of cancer is a distressing symptom and can negatively affect breast cancer survivors’ quality of life and psychological well-being. The purpose of this qualitative study was to explore Turkish breast cancer survivors’ experiences related to FOR. Design: The data were collected through semistructured interviews, which were conducted with 12 breast cancer survivors. Results: The data were categorized into four themes: the quality of fear, triggers, effects on life, and coping. FOR survivors’ lives in multiple aspects, and the women found it difficult to manage their fear. Implications: Nurses should be aware of FOR in survivors during follow-up care. In addition, it is essential to consider the impact of FOR on life, and survivors should be referred to appropriate resources and support services.

The Effect of a Psychoeducational Program Grounded in the Professional Socialization Theory on the Social Skill Levels of Nursing Students

** H Öner Altıok, Yrd. Doç. Dr. Adnan Menderes Üniversitesi Hemşirelik Fakültesi Ruh Sağlığı ve Hastalıkları Hemşireliği Anabilim Dalı Yazışma Adresi / Address for Correspondence: Adnan Menderes Üniversitesi Hemşirelik Fakültesi Gençlik Cad. No: 7 Efeler / Aydın Tel.: 0 256 21388 66/135 Faks: 0 256 212 42 19 e-posta: ht_oner@hotmail.com *** B Üstün, Prof. Dr. Üsküdar Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Bölümü, İstanbul ÖZ