Özgül Karayurt

Adaptation of Champion's Health Belief Model Scale for Turkish Women and Evaluation of the Selected Variables Associated with Breast Self-examination

The purpose of this study was to adapt Champions Revised Health Belief Model Scale for Turkish women and to examine selected sociodemographic variables associated with breast self-examination (BSE). Data were collected from a total of 430 females who were living in one of the Health Center areas located in Izmir, a city in the west of Turkey. Champions revised Health Belief Model Scale was translated into Turkish, validated by professional judges, translated back into English, and then tested. Factor analysis yielded 7 factors: susceptibility, seriousness, barrier 1, barrier 2, confidence, benefits, and health motivation. Significant correlations were found between 2 barriers. Therefore, 2 barriers were considered one barrier subscale. All the items on each factor were from the same construct. Cronbach &agr; coefficients ranged from .58 to .89, and test-retest reliability coefficients ranged from .89 to .99 for the subscales. Women who received low scores on barriers reported greater frequency of BSE practice. Likewise, women having high scores on confidence, benefits, health motivation, susceptibility, and seriousness reported a greater frequency of BSE in the last year. The frequency of BSE practice was higher in high school and university graduates, women with a family history of breast cancer, and women with breast cancer and BSE training. The Turkish version of Champions Revised Health Belief Model Scale was found to be a valid and reliable tool for use with Turkish women. It could be used to evaluate health beliefs about breast cancer and BSE among Turkish women.

Effectiveness of peer education for breast cancer screening and health beliefs in eastern Turkey.

Background: The primary site of cancer in Turkish women is breast cancer. The incidence of breast cancer is increasing in Turkey. Objective: The aim of the research was to educate women 40 years and older to increase their awareness on early detection and diagnosis, to facilitate the use of the early diagnosis methods, to improve the womens beliefs in relation breast cancer, and to increase the use of Cancer Early Diagnosis and Screening Centers available in the city. Methods: The target population of the research was 5000 women. Forty selected women were educated as peer educators. Twenty-five of them were selected as principal peer educator. Each peer educator was expected to educate 200 women. Peer trainers educated their peer and also arranged for the mammography appointment of the women who decided to have theirs taken. Data were obtained before and after the training by Champions Health Belief Model Scale, questionnaire forms, and Cancer Early Diagnosis and Screening Centers data for mammography practice. Results: Breast cancer was detected in 8 women. Statistical analyses showed positive changes in womens health beliefs and breast self-examination knowledge. There were 20.4% of women (n = 1040) who did get mammograms, and 8% (n = 8) of women were found to have cancer in all of those screened. Conclusion: Peer education was found to be effective for increasing the knowledge, beliefs, and practice of women related to breast cancer. Implications for Practice: Peers can reinforce learning through ongoing contact. Peer education can be used to improve early diagnosis of breast cancer and breast cancer awareness in asymptomatic women.

Validation of the Turkish Version of the Brief Pain Inventory in Surgery Patients

The Brief Pain Inventory (BPI) is a comprehensive instrument for pain assessment and has been validated in several languages. A validated Turkish version has not been available until now. The purpose of this study was to determine the reliability and validity of the BPI for assessing pain in patients undergoing abdominal surgery in Turkey. The sample consisted of 178 patients who underwent abdominal surgery in general surgery and in obstetrics and gynecology clinics of a university hospital in Zmir, Turkey. A demographic questionnaire and the BPI were used to collect data. The content validity was tested by requesting opinions of experts. The structure validity of the scale was evaluated with factor analyses and reliability of the scale with Cronbach alpha and with item-to-total correlations. Two factors with an eigenvalue greater than one were extracted, supporting the validity of two-factor structure of the original BPI. Factor loads of these two factors ranged from 0.55 to 0.91. The Cronbach alpha reliability coefficient was 0.79 for the severity scale and 0.80 for the interference scale. The item-to-total correlations of the scale ranged between 0.42 and 0.69. The Turkish version of the BPI (BPI-Tr) is a reliable and valid instrument for assessing postsurgical pain severity and its interference. The BPI-Tr will be useful for clinical assessment of postsurgical pain in Turkey.

Investigation of adaptation after liver transplantation using Roy's Adaptation Model

In this study we explored the adaptation of transplant recipients in Turkey using the Roy Adaptation Model. A descriptive qualitative design was used with data collected from liver transplant recipients in either individual or group interviews between May 2009 and February 2010. Using deductive content analysis, four themes were identified in the data: physiological mode, self-concept mode, role function mode, and interdependence mode. Each theme included both adaptive and ineffective behaviors of liver transplant recipients. The findings of this study indicate that liver transplant recipients need information and support about their ineffective behaviors in all modes of the Roy Adaptation Model. The findings also support the use of a nursing model in the delivery of nursing care for liver transplantation recipients.In this study we explored the adaptation of transplant recipients in Turkey using the Roy Adaptation Model. A descriptive qualitative design was used with data collected from liver transplant recipients in either individual or group interviews between May 2009 and February 2010. Using deductive content analysis, four themes were identified in the data: physiological mode, self-concept mode, role function mode, and interdependence mode. Each theme included both adaptive and ineffective behaviors of liver transplant recipients. The findings of this study indicate that liver transplant recipients need information and support about their ineffective behaviors in all modes of the Roy Adaptation Model. The findings also support the use of a nursing model in the delivery of nursing care for liver transplantation recipients.

The Impact of an Ostomy on the Sexual Lives of Persons With Stomas: A Phenomenological Study.

PURPOSE: The purpose of this study was to describe the lived experiences of persons with stomas related to sexual function and perceptions and their expectations of the ostomy nurses who care for them. DESIGN: Qualitative, phenomenological study. SUBJECTS AND SETTING: Fourteen persons living with an ostomy for least 2 months participated in the study. Data collection occurred at the ostomy and wound care unit at Dokuz Eylul University Hospital in Izmir, Turkey. METHODS: Data were collected using an in-depth interview method. Interviews lasted from 20 to 60 minutes and were audiotaped. These recordings were transcribed and subjected to content analysis. RESULTS: Five themes emerged from the unstructured interviews: (1) changes in sexual life; (2) changes in body image; (3) fear and anxiety experienced during sexual intercourse; (4) psychological impact of sexual problems; and (5) expectations concerning sexual counseling from ostomy nurses. CONCLUSIONS: Study findings suggest that persons with ostomies experience changes in their body image, along with a decrease in sexual desire. Respondents described avoiding sexual intercourse, and abstained from sleeping with their partners. Male respondents described erectile dysfunction, and female respondents reported pain during sexual intercourse (dyspareunia). Participants stated that they did not feel adequately informed about these problems and desired to receive more information and support from ostomy nurses regarding sexual issues. Based on these findings, we recommend that ostomy nurses provide more counseling concerning sexual function and challenges following ostomy surgery.

Psychometric Properties of the Body Image Scale in Turkish Ostomy Patients

PURPOSE To investigate the validity and reliability of the Body Image Scale in Turkish ostomy patients. METHODS This study has a methodological and cross-sectional design. A hundred patients with ostomy lasting for at least 2 months were recruited from an ostomy and wound care unit. FINDINGS Confirmatory factor analyses showed that goodness-of-fit indexes were acceptable. Exploratory factor analyses showed that factor loadings of the scale items varied between 0.74 and 0.91, and a single factor was determined. The Cronbachs alpha value of the scale was 0.94. Item-to-total correlation coefficients ranged from 0.75 to 0.91. CONCLUSION The Turkish version of the Body Image Scale is a valid and reliable tool for evaluating body image in Turkish ostomy patients.

Determination of information and support needs of first degree relatives of women with breast cancer.

BACKGROUND Breast cancer is the most frequent type of cancer among women in the world and the most common cause of deaths from cancer in females. In Turkey, breast cancer comes first in the list of the most frequent ten cancer types seen in women. As the incidence rate of breast cancer is high, many women having breast cancer in the family experience the breast cancer at secondhand. This study was carried out in an attempt to determine the information and support needs of women whose first-degree relatives have breast cancer and to what extent these needs are met. METHODS The research sample consisted of 156 women. Questionnaire Form and Information and Support Needs Questionnaires were used as the data collection tools. RESULTS Information need score averages (x?:3.72±0.19) of women included in the research sampling were found to be higher than their score averages of support needs (x?:3.24±0.41). CONCLUSION Information needs which were indicated by women as very important were related to treatment, symptoms of breast cancer and breast self examination (BSE), while support needs which were indicated by women as very important were learning how to perform BSE, womens anxiety for themselves and their relatives regarding breast cancer and having their breasts examined by a health professional. It is recommended that nurses and other medical staff should give information to women whose first-degree relatives have breast cancer about the disease, its etiology, scanning, diagnosis, treatment options and protection as well as prevention.

Evaluation of the Breast Cancer Train the Trainer Program for Nurses in Turkey

The Breast Cancer Train the Trainer (TTT) program was designed to increase breast cancer awareness, improve knowledge about breast cancer among nurses, and provide quality care for breast cancer patients by trained nurses. A total of three programs were held and 82 nurses from different regions of Turkey attended this training. The educational activities employed several teaching and learning strategies. After completion, we determined that the participating nurses’ knowledge on breast cancer had increased significantly, and they were satisfied with the training received. The Breast Cancer TTT program is a unique educational endeavor for nurses in Turkey, and our results showed that the training achieved its goal. Trained nurses in Breast Cancer TTT programs can help educate women about the importance of breast health and the measures they need to take to protect themselves against breast cancer. At the same time, nurses can also increase and enhance the quality of life in patients with breast cancer. This is an example of a program that can easily be spread throughout the world as it was done from England and Australia to Turkey.

Adaptation of the Information and Support Needs Questionnaire into Turkish to use in women with primary relatives with breast cancer.

Background: Breast cancer is the most frequent type of cancer among women in Turkey. Because of the high incidence of breast cancer, many women have family members who have experienced breast cancer. Objective: The aim of this study was to test the validity and reliability of the Information and Support Needs Questionnaire (ISNQ) for Turkish women, which was originally developed for use in women with primary relatives who had breast cancer. Methods: The study sample included 97 women whose primary female relatives had breast cancer. Data were collected with a Demographic Questionnaire and the ISNQ. The ISNQ was developed by Chalmers et al and was composed of 2 scales: the Importance Scale and the Needs Met Scale. Results: Linguistic validity, translation, back translation, and content validity were tested with expert opinions. Item-to-total correlation scores ranged from 0.22 to 0.72 on the Importance Scale and from 0.23 to 0.60 on the Needs Met Scale. Cronbach α coefficients were.81 and.83 on the Importance Scale and the Needs Met Scale. Conclusions: The ISNQ, adapted into Turkish, was found to have sufficient validity and reliability. Implications for Practice: The questionnaire can be used to determine information and support needs of women whose primary relatives have breast cancer. Nurses and other health professionals can conduct interventions directed toward meeting information and support needs of women whose primary relatives have breast cancer.

We as Spouses Have Experienced a Real Disaster!: A Qualitative Study of Women With Breast Cancer and Their Spouses

Background: Breast cancer is the most common cancer in women in Turkey. The emotional effects of this condition are experienced by the women and their families. Objective: The aim of the study was to describe the experiences of women with breast cancer and their spouses from diagnosis to treatment completion. Methods: This qualitative study with a descriptive qualitative design was conducted at participants’ homes. Fourteen women and their spouses were enrolled in the study (n = 28). Data were collected during in-depth interviews and analyzed with inductive content analysis. Results: The women with breast cancer and their spouses’ experiences were categorized into 4 main themes: “facing breast cancer,” “treatment process,” “coping with disease and treatment,” and “life after treatment.” Subthemes were also identified and described. Conclusions: The women with breast cancer and their spouses reported that they had positive and negative experiences in terms of their physical, psychological, and social status from diagnosis to completion of treatment, indicating that breast cancer is a disease of women and a condition of families. Implications for Practice: Knowledge of these experiences can help nurses plan care that is designed to improve the quality of life of women and their husbands.