Selda Secginli

Health beliefs related to breast self-examination in a sample of turkish women

PURPOSE/OBJECTIVESnTo examine health beliefs and sociodemographic and breast cancer-related variables influencing breast self-examination (BSE) practice.nnnDESIGNnDescriptive, cross-sectional.nnnSETTINGnTwo vocational training centers in Istanbul, Turkey.nnnSAMPLEn438 women were selected using a convenience sampling method. Participants had not had breast cancer and were not currently pregnant or breast-feeding. The mean age of participants was 33.51 years (range = 18-67).nnnMETHODSnWilling participants were asked to complete a self-administered questionnaire and the Turkish version of Champions Health Belief Model Scale. The sample was categorized into two groups: performers (i.e., women who performed BSE at least occasionally) and non-performers (i.e., women who had never performed BSE).nnnMAIN RESEARCH VARIABLESnPerceived susceptibility to and seriousness of breast cancer, perceived benefits of and barriers to BSE, confidence in the ability to perform BSE, health motivation, and frequency of BSE practice.nnnFINDINGSnSignificant differences between performers and non-performers correlated to age, marital status, health insurance, regular gynecologic visits, and education about breast cancer and BSE. The mean scores of perceived benefits and confidence were noticeably higher in performers. Stepwise logistic regression analysis yielded three significant predictor variables.nnnCONCLUSIONSnWomen who had more confidence in their ability to perform BSE, had health insurance, and were informed about breast cancer were more likely to practice BSE.nnnIMPLICATIONS FOR NURSINGnWomen in Turkey are at great risk for advanced breast cancer and metastatic spread because of their lack of knowledge. Nurses must provide information on breast cancer etiology, risks, prevention, and detection. To promote BSE practice among Turkish women, tailored health education and health promotion programs should be developed based on a specific understanding of womens health beliefs.

Reliability and Validity of the Breast Cancer Screening Belief Scale Among Turkish Women

Breast cancer is the second leading cause of cancer deaths in Turkish women, and the use of breast self-examination (BSE) and mammography remains low in Turkey. Therefore, we need to identify the beliefs, influencing BSE and mammography, and a valid and reliable tool to measure constructs. The Champions health belief model scale (CHBMS) is a valid and reliable tool to measure beliefs about breast cancer, BSE, and mammography in an English culture. The purpose of this study was to assess the psychometric characteristics of a Turkish version of the CHBMS related to breast cancer, BSE, and mammography. A convenience sample of 656 women was recruited from 3 health centers and 2 maternal and child health centers in Istanbul. The CHBMS was translated to Turkish, validated by professional judges, back translated, and tested. Factor analysis yielded 7 factors for BSE: confidence, seriousness, barriers-BSE, health motivation 1 and 2, susceptibility, and benefits-BSE. For mammography scale, 6 factors were identified: seriousness, benefits-mammography, barriers-mammography, health motivation 1 and 2, and susceptibility. All items on each factor were from the same construct. Cronbach alpha reliability coefficients ranged from .75 to .87 for the subscales. The Turkish version of the CHBMS showed adequate reliability and validity for use in Turkish women. It could easily be used to evaluate the health beliefs about breast cancer, BSE, and mammography. Further refinement is required to study Turkish womens health beliefs and breast cancer screening behaviors in various settings.

Mammography self-efficacy scale and breast cancer fear scale: psychometric testing of the Turkish versions.

Background: Self-efficacy for mammography and breast cancer fear are important determinants to mammography use. No tools to measure these beliefs of Turkish women have been validated. Objective: The purpose of this study was to assess the psychometric characteristics of the Turkish versions of the Mammography Self-Efficacy Scale (MSS-T) and the Champion Breast Cancer Fear Scale (CBCFS-T). Methods: Mammography Self-Efficacy Scale and Champion Breast Cancer Fear Scale were translated to Turkish language, validated by an expert panel, back translated, and tested. Cronbach &agr; coefficients and item-total correlations were measured to evaluate the reliability of the scales. Exploratory factor analysis was used to estimate construct validity of the scales. Independent t tests, &khgr;2 tests, and logistic regression analyses were used to test theoretical relationships. Results: Factor analysis yielded 1 factor for MSS-T and 2 factors for CBCFS-T with eigenvalues greater than 1. Internal consistency values presented acceptable Cronbach &agr; levels of .90 for MSS-T and .90 for CBCFS-T, and test-retest reliability correlations were 0.56 for MSS-T and 0.60 for CBCFS-T. Conclusions: The MSS-T and CBCFS-T demonstrated acceptable preliminary values of reliability and validity. Further psychometric testing is recommended with women living in different regions of Turkey. Implications for Practice: The scales can offer insights to nurses and other healthcare professionals about mammography self-efficacy beliefs, emotional needs, and concerns of Turkish women related to breast cancer fear. The scales may be useful as process measures to assess the efficacy of interventions designed to alter self-efficacy and fear and subsequently improve the mammography rates.

Attitudes of health professionals towards electronic health records in primary health care settings: A questionnaire survey

Purpose: This study aimed to assess the attitudes of health professionals towards electronic health records (EHRs) in primary health care settings in Turkey. Methods: A survey was administered to 754 health professionals working in Family Health Centres (FHCs) in seven districts in Istanbul, Turkey. The survey was developed based on extensive literature review, and consisted of 33 statements rated on a five-point Likert-scale. Results: A total of 325 completed questionnaires were received, representing a 43% response rate, with 97% of respondents being satisfied with the EHR system in the FHCs. There were significant differences between health professional groups (physicians and nurses/midwives) in their perceptions of EHRs decreasing paper-based records, data security in EHRs, and costs of EHRs (pu2009<u20090.05). Narrative responses indicated ongoing needs in software development, further support of nursing documentation and training. Conclusions: Overall positive attitudes towards EHRs among primary care health professionals in Turkey suggest strong acceptance and use. Recommendations based on the findings include EHR technology refinements, improved clinical documentation using standardized terminologies, and health professional-informed EHR training.

Factors associated with bicycle-helmet use among 8-16 years aged Turkish children: A questionnaire survey

The purpose of this cross-sectional, descriptive study was to assess the rates of helmet and to examine variables related to bicycle helmet use in a sample of 8–16 year old Turkish children. Data were collected from a purposive sample of 1180 students who self-identified as cyclists and 1128 parents or guardians in two state primary schools in two urban municipalities in the northern part of Istanbul, Turkey. Results showed that self-reported helmet use was found prevalent in 4.4% of the children. The most cited reasons for not wearing a helmet were: ‘dont own one’, ‘helmets are uncool’, and ‘uncomfortable’. Significant differences between helmet users and non-users correlated to gender, age, owning a bicycle helmet, wearing a friends bicycle helmet and parents or guardians bicycle helmet use while riding. Only three variables – helmet ownership (OR = 10.028, 95% CI 5.08, 19.79), parents’ helmet use (OR = 2.62, 95% CI 1.22, 5.66) and friends’ helmet use (OR = 0.16, 95% CI 0.07, 0.37) emerged as significant predictors of the likelihood of helmet use. The relatively low helmet use prevalence points to an urgent need for a multipronged campaign, including strategies such as raising awareness, educating primarly parents and friends, and distributing bicycle helmets for free or at a reduced cost.

Using the Omaha System to describe health problems, interventions, and outcomes in home care in Istanbul, Turkey: a student informatics research experience.

Preparing nursing students to achieve informatics competencies is essential in today’s information-intensive healthcare delivery systems. This study aimed to provide hands-on informatics experience to nursing students and to identify the frequency and type of home care clients’ health problems, nursing interventions, and outcomes using a standardized nursing terminology, the Omaha System. Data were collected by 159 nursing students on home visits to 598 clients, who received 8657 interventions from students and faculty for 2267 problems, in addition to the services provided by the home care centers. Skin, neuromusculoskelatal function, personal care, nutrition, and urinary function were the most common problems. The most common intervention category was teaching, guidance, and counseling (47%), followed by treatments and procedures (22%), surveillance (22%), and case management (9%). Outcomes evaluation showed significant improvement in 97.5% of the identified problems. Students gained informatics experience in the use of a standardized nursing language in electronic health records, data management, and use of nursing data at the basic practice level. This study demonstrated that the Omaha System was a useful data collection tool for evaluating problems, interventions, and outcomes in home care and a positive teaching and learning tool for baccalaureate nursing education.

Interventions Promoting Breast Cancer Screening Among Turkish Women With Global Implications: A Systematic Review

Background: Breast cancer is a major health concern and remains the most common malignancy in women worldwide and in Turkey. Mammography, clinical breast examination (CBE), and breast self‐examination (BSE) are recommended methods to detect early breast cancer in women. Many strategies have been developed to increase the rates of mammography, CBE, and BSE among Turkish women. Despite the benefits of breast cancer screening, these modalities are still underutilized by the majority of Turkish women. Aim: To systematically review the scientific evidence on the effectiveness of various strategies aimed at improving screening behaviors for breast cancer in Turkish women. Methods: A systematic review of the literature published between 2000 and 2015 was conducted, searching 10 databases of Ovid MEDLINE, PubMed, Cochrane CENTRAL Register of Controlled Trials, CINAHL, PsycINFO, Web of Knowledge, Scopus, Google Scholar, ULAKBIM Turkish Medical Database, and Council of Higher Education Thesis Center. Results: Twenty‐three studies were included in the final review. The majority of the studies investigated the effects of multiple strategies to improve BSE. Group education comprised educational sessions, printed and audiovisual materials, which significantly improved BSE, CBE, and mammography screening rates at 3 months, 6 months, and 12 months after the intervention. One‐to‐one education demonstrated no significant difference in BSE rates at 6‐month and 12‐month follow‐up. However, one‐to‐one education demonstrated significant differences in CBE and mammography rates at the 3‐month follow‐up. Linking Evidence to Action: The use of group education comprising a multicomponent intervention demonstrated an increase in breast‐screening behaviors among Turkish women. Further research investigating the duration of educational interventions is needed in order to suggest a “dose response.”