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Intensive care nurses’ perception of futility Job satisfaction and burnout dimensions

Suffering repeated experiences of moral distress in intensive care units due to applications of futility reflects on nurses’ patient care negatively, increases their burnout, and reduces their job satisfaction. This study was carried out to investigate the levels of job satisfaction and exhaustion suffered by intensive care nurses and the relationship between them through the futility dimension of the issue. The study included 138 intensive care nurses. The data were obtained with the futility questionnaire developed by the researchers, Maslach Burnout Inventory and Minnesota Satisfaction Questionnaire. It was determined that nurses who agreed to the proposition that the application of futility demoralizes health-care professionals had low levels of job satisfaction but high levels of depersonalization. It was determined that nurses had moderate levels of job satisfaction, emotional exhaustion, and personal achievements but high levels of sensitivity. Nurses’ job satisfaction and sensitivities are positively affected when they consider that futility does not contradict the purposes of medicine.

Moral distress in Turkish intensive care nurses

Background: Moral distress is a common problem among professionals working in the field of healthcare. Moral distress is the distress experienced by a professional when he or she cannot fulfill the correct action due to several obstacles, although he or she is aware of what it is. The level of moral distress experienced by nurses working in intensive care units varies from one country/culture/institution to another. However, in Turkey, there is neither a measurement tool used to assess moral distress suffered by nurses nor a study conducted on the issue. Aim/objective: The study aims to (a) validate the Turkish version of the Moral Distress Scale–Revised to be used in intensive care units and to examine the validity and reliability of the Turkish version of the scale, and (b) explore Turkish intensive care nurses’ moral distress level. Method: The sample of this methodological, descriptive, and cross-sectional design study comprises 200 nurses working in the intensive care units of internal medicine and surgical departments of four hospitals in three cities in Turkey. The data were collected with the Socio-Demographic Characteristics Form and The Turkish Version of Moral Distress Scale–Revised. Ethical considerations: The study proposal was approved by the ethics committee of the Faculty of Medicine, Cumhuriyet University. All participating nurses provided informed consent and were assured of data confidentiality. Results: In parallel with the original scale, Turkish version of Moral Distress Scale–Revised consists of 21 items, and shows a one-factor structure. It was determined that the moral distress total and item mean scores of the nurses participating in the study were 70.81 ± 48.23 and 3.36 ± 4.50, respectively. Conclusion: Turkish version of Moral Distress Scale–Revised can be used as a reliable and valid measurement tool for the evaluation of moral distress experienced by nurses working in intensive care units in Turkey. In line with our findings, it can be said that nurses suffered low level of moral distress. However, factors which caused the nurses in our study to experience higher levels of moral distress are inadequate communication within the team, working with professionals they considered as incompetent, and futile care.

Reliability and validity of the Salford-Scott Nursing Values Questionnaire in Turkish

Background: Developing professional values among nursing students is important because values are a significant predictor of the quality care that will be provided, the clients’ recognition, and consequently the nurses’ job satisfaction. The literature analysis showed that there is only one validated tool available in Turkish that examines both the personal and the professional values of nursing students. Objective: The aim of this study was to assess the reliability and validity of the Salford-Scott Nursing Values Questionnaire in Turkish. Design of the study: This study was a Turkish linguistic and cultural adaptation of a research tool. Participants and research context: The sample of this study consisted of 627 undergraduate nursing students from different geographical areas of Turkey. Two questionnaires were used for data collection: a socio-demographic form and the Salford-Scott Nursing Values Questionnaire. For the Salford-Scott Nursing Values Questionnaire, construct validity was examined using factor analyses. Ethical considerations: The study was approved by the Cumhuriyet University Faculty of Medicine Research Ethics Board. Students were informed that participation in the study was entirely voluntary and anonymous. Results: Item content validity index ranged from 0.66 to 1.0, and the total content validity index was 0.94. The Kaiser–Meyer–Olkin measure of sampling was 0.870, and Bartlett’s test of sphericity was statistically significant (x2 = 3108.714, p < 0.001). Construct validity was examined using factor analyses and the six factors were identified. Cronbach’s alpha was used to assess the internal consistency reliability and the value of 0.834 was obtained. Conclusion: Our analyses showed that the Turkish version of Salford-Scott Nursing Values Questionnaire has high validity and reliability.

The Relationship between quality of life and social support in homosexuals living in Izmir, Turkey

It has been well documented that quality of life (QL), an indicator of people’s subjective sense of well-being, is not evenly distributed among people in society. This descriptive study investigated the levels of social support and quality of life in homosexuals living in the city of Izmir in Turkey and the factors affecting the levels of their quality of life and social support, and to determine the relationship between their quality of life and the social support they received. Seventy-two individuals were included in the study by network/ snowball sampling method. The World Health Organization Brief Quality of Life Assessment Scale (WHOQOL-BREF), Multidimensional Scale of Perceived Social Support scale (MSPSS) and socio-demographic questionnaire were used in the research. All the individuals involved were male. According to the Turkish Penal Code, same-sex relations among people over 18 are not considered a crime although secret prostitution is prohibited. Little research has been carried out on homosexuality in Turkey. According to studies in Turkey, attitudes towards gay men and lesbians are usually negative. Yuzgun argued that homosexuals in Turkey are regularly exposed to police terror. One of the major causes of negative attitude is religious beliefs. Of the participants, 60.3% were transsexual and 39.7% were homosexual and their mean age was 30.5 ± 8.9 (16-55). The quality of life scores of homosexuals were lower than were those of heterosexuals, as has been found in other studies. Transsexuals’ and homosexuals’ mean scores for overall quality of life and social support were determined as 53.66 ± 8.29 (33.05-73.43) and 51.68 ± 27.06 (12-154) respectively. The study findings revealed that homosexuals’ scores for perceived social support and quality of life were worse than those of other people and transsexuals’ scores for quality of life, psychological health and social support subscales were better than those of homosexuals (p<0.05). Among the reasons why transsexuals have better quality of life domain scores are that they are perceived by the society as females due to their physical appearance, and that they have overcome the sexual identity problem and thus they see themselves as women. The most important feature designating the quality of life is the parents’ education level (p<0.05). This result can be interpreted to suggest that families with higher education can communicate with their children better and try to understand them more. In addition, the fact that those who become aware of their sexual identity and acknowledge it at an early age, and thus are accepted by their families more easily, can be considered another factor affecting the high scores for the family subscale. Those whose parents’ education was higher than primary school education (n=39; 53.4%), who did not grow up in fragmented families (n=55;75.3%) or who acknowledged their sexual identities after puberty (n= 55; 75.3% ) achieved higher scores for the friends subscale. Not having experienced any sexual assault (n= 16; 21.9%), being aware of the groups dealing with their problems (n=38; 52.1%), not smoking (n=12; 16.4%) and not using alcohol (n=10; 13.7%) or any illicit substance (n=30;41.1%) are among the other variables affecting their quality of life positively. The relationship between social support and the quality of life was determined by the fact that the quality of life increased as social support increased (r=0.328, p=0.005). The data in the literature indicate that social support is important for homosexuals, because the more social support they have the fewer psychological, physical and emotional health problems they experience, but they cannot get enough social support from their families. It is reported that homosexuals who do not get enough social support from their families seek more support from their friends, and that the support from friends affects their psychosocial life positively, as indicated in our study. The study group stated that they mostly shared their problems with their homosexual friends (36.9%), and that the main problem they experienced was being despised because of their sexual identities (36.9%). Struggling against similar problems arising from social pressure, and sharing the same fate, are among the other factors which strengthen friendship. Previous research has suggested that if families of gays and lesbians do not provide the support they need, they receive it from their partners and friends. As found in our study, several other studies in the literature have found that social support improves homosexuals’ quality of life and encourages them to behave positively. Studies also show that social support influences health behaviours. But studies conducted on homosexuals in our society only deal with disease. There is a need to perform more social studies and research to determine the status and needs of homosexuals. It would be appropriate to develop individual training programs and national social service programs in order to improve the social support homosexuals receive and thus their quality of life.

Investigating the psychological resilience, self-confidence and problem-solving skills of midwife candidates

BACKGROUND The high level of psychological resilience, self-confidence and problem solving skills of midwife candidates play an important role in increasing the quality of health care and in fulfilling their responsibilities towards patients. OBJECTIVES This study was conducted to investigate the psychological resilience, self-confidence and problem-solving skills of midwife candidates. DESIGN It is a convenience descriptive quantitative study. SETTINGS Students who study at Health Sciences Faculty in Turkeys Central Anatolia Region. PARTICIPANTS Midwife candidates (N = 270). METHODS In collection of data, the Personal Information Form, Psychological Resilience Scale for Adults (PRSA), Self-Confidence Scale (SCS), and Problem Solving Inventory (PSI) were used. RESULTS There was a negatively moderate-level significant relationship between the Problem Solving Inventory scores and the Psychological Resilience Scale for Adults scores (r = -0.619; p = 0.000), and between Self-Confidence Scale scores (r = -0.524; p = 0.000). There was a positively moderate-level significant relationship between the Psychological Resilience Scale for Adults scores and the Self-Confidence Scale scores (r = 0.583; p = 0.000). There was a statistically significant difference (p < 0.05) between the Problem Solving Inventory and the Psychological Resilience Scale for Adults scores according to getting support in a difficult situation. CONCLUSIONS As psychological resilience and self-confidence levels increase, problem-solving skills increase; additionally, as self-confidence increases, psychological resilience increases too. Psychological resilience, self-confidence, and problem-solving skills of midwife candidates in their first-year of studies are higher than those who are in their fourth year. Self-confidence and psychological resilience of midwife candidates aged between 17 and 21, self-confidence and problem solving skills of residents of city centers, psychological resilience of those who perceive their monthly income as sufficient are high. Psychological resilience and problem-solving skills for midwife candidates who receive social support are also high. The fact that levels of self-confidence, problem-solving skills and psychological resilience of fourth-year students are found to be low presents a situation that should be taken into consideration.

A scale-development study: Exploration of intensive-care nurses’ attitudes towards futile treatments

Abstract The study was conducted to determine the validity and reliability of the tool used to assess nurses’ attitudes towards futility, and to explore intensive-care nurses’ attitudes towards futility. Principal components analysis revealed that 18item scale was made up of four subdimensions that assess Identifying(beliefs), Decision-Making, Ethical Principles and Law, and Dilemma and Responsibilities related to futile treatments. The internal consistency of the scale was in the acceptable range, with a total Cronbach’s alpha value of 0.72. Overall the results of study suggest that scale can be used as a valid and reliable assessment tool to assess nurses’ attitudes towards futility.

A comparison of contribution of informed consent forms with long or short texts with regard to obtaining knowledge by volunteers: A pilot study -

Objective. The objective is to determine which of the two texts giving information about the same issue and one of which id short and one of which is long is more effective in enlightening readers having no pre-knowledge of medical science and whether there is coherence between the scores obtained from the texts. Methods. The sampling of the research planned as experimental is constituted by 66 volunteer female students who are 1st year students at the faculty of agriculture. The group was randomly divided into two and the first group was given the short text and the other one the long text. Then the question from was applied in order to find out how much of the information in the form they learnt. Each true answer given to the questions was scored as 1, and each wrong answer was secored as 0; therefore a total grade was obtained. For data analysis, Mann Whitney-U and t Tests analysis methods have been used. Score averages have been compared using Chi-square statistics and calculated using Odds ratio (OR). Consistency between the average scores of the answers given to short and long forms were evaluated through kapa statistics. Results. 100% of the answers obtained using the long form was above the average, 20% of the answers obtained using the short form was above the average and 80% was below the average. Kappa between the answers in the long and short from was found as 81%. The results obtained from the long form were determined to be seven times better than the short one (OR:7,0). The non-random alignment between responses to the long and short form was found to be 81% (Cohen Kappa: 0.814). When the score average scores obtained from the answers given according to the demographic qualities of the participants, no meaningful relation was found. Conclusions. The long version of the context of informed was found more effective than the short one.