PubMed İndeksli Yayınlar Koleksiyonu

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Effectiveness of Individual Psychoeducational Interventions for Caregivers of Stroke Patients: A Systematic Review and Meta-Analysis
(Springer/Plenum Publishers, 2025) Kelani, Hesham; Ali, Hossam Tharwat; Naeem, Ahmed; Salamah, Hazem Mohamed; Ismail, Ali; Younes, Youmna Atef; Khandelwal, Priyank
Stroke is a major cause of disability, and patients who suffer strokes have limited mobility and functional tasks, necessitating daily reliance on caregivers. However, caregivers of stroke patients often experience depression and anxiety, negatively impacting their mental health and reducing their quality of life. Psychoeducational interventions may be a solution to support the well-being of stroke caregivers. This study is performed to assess the overall effectiveness of individual psychoeducational interventions for caregivers of stroke patients. A thorough search of Scopus, PubMed, Web of Science, and Cochrane databases was performed for published studies in English up to June 2023. Clinical trials assessing the efficacy of psychoeducational interventions on quality of life, depression, or care burden among stroke caregivers compared to usual care were included. A total of 18 clinical trials, 16 randomized clinical trials (RCTs), and two non-RCTs, with a total of 2007 patients, were included. The study's pooled results revealed a significant increase in the quality of life in the group receiving psychoeducational interventions compared to the comparison group (SMD = 0.34, 95% CI 0.13-0.55, p value = 0.002), while no significant difference was found in terms of depression (SMD = - 0.05, 95% CI - 0.23 to 0.14, p value = 0.62) or caregiver burden (SMD = - 0.61, 95% CI - 1.65 to 0.44, p value = 0.25). Psychoeducation programs should be considered as a supportive intervention to improve quality of life in caregivers; however, their impact on depression and caregiver burden remains inconclusive. However, further studies with a larger sample size are needed to confirm the results.
Beyond Age: Understanding How Mindful Eating and Food Label Reading Shape Generational Differences in Health Outcomes – A Cross-Sectional Study
(BioMed Central Ltd, 2025) Altınok, Ö.; Yalcin, B.; Deniz, M.Ş.; Çelikayar, M.N.; Sevdin, S.; Bingül, B.Ç.; Garipaǧaoǧlu, M.
Background: The increasing prevalence of obesity and diet-related chronic diseases poses a considerable threat to public health. Consequently, understanding generational differences in dietary behaviors has gained growing importance. This study aims to examine the direct and indirect effects of generational cohort on anthropometric indicators and self-rated diet quality (SRDQ), mediated through mindful eating and food label reading attitudes. Method: This cross-sectional design study involved 2725 participants from Generations X (n = 786), Y (n = 933), and Z (n = 1006) living in Istanbul, Türkiye. Participants’ sociodemographic characteristics and anthropometric measurements, including body mass index (BMI), waist circumference (WC), and waist–hip ratio (WHR), were recorded. Data on SRDQ were collected, alongside responses to the Mindful Eating Questionnaire and the Food Label Reading Attitude Scale. Descriptive statistics, one-way analysis of variance, and chi-square tests were applied to the data. The direct and indirect effects of generation groups were analyzed using structural equation modeling. Results: Increasing mindful eating scores were associated with higher label reading attitude and SRDQ scores, while they were related to lower anthropometric risk indicators. Higher label reading attitudes showed an association with reduced WHR and increased SRDQ. Generation Z participants reported significantly lower scores for mindful eating, label reading attitude, anthropometric measures, and SRDQ than Generation X participants. Lower mindful eating scores were related to increased BMI among Generation Z, whereas lower label reading attitude scores were positively associated with WC and WHR. Furthermore, poor mindful eating and label reading attitudes and the combined effects of low mindful eating and label reading attitudes were linked to lower SRDQ. Conclusion: Poor mindful eating and label reading attitudes in Generation Z may threaten long-term health sustainability and increase the risk of developing chronic diseases. Combining generation-specific public health strategies with interventions aimed at improving nutritional literacy and mindful eating habits from an early age could enhance individual and societal health outcomes. © 2025 Elsevier B.V., All rights reserved.
Evaluating and Comparing Student Responses in Examinations from the Perspectives of Human and Artificial Intelligence (GPT-4 and Gemini)
(BMC, 2025) Domanic, Kubra Yildiz; Baycan, Sukran
BackgroundGenerative Artificial Intelligence (AI) models, such as ChatGPT (GPT-4) and Gemini, offer potential benefits in educational settings, including dental education. These tools have shown promise in enhancing learning and assessment processes, particularly in dental prosthetic technology (DPT) and oral health (OH) programs.ObjectiveThis study aimed to evaluate the accuracy, reliability, and consistency of GPT-4 and Gemini AI models in answering examination questions in dental education. The study focused on multiple-choice questions (MCQs), true/false (T/F) questions, and short-answer questions (SAQs).MethodsAn exploratory study design was used with 30 questions (10 MCQs, 10 T/F, and 10 SAQs) covering key topics in DPT and OH education. ChatGPT and Gemini were tested with the same set of questions on two separate occasions to assess consistency. Responses were evaluated by two independent researchers using a predefined answer key. Data were analyzed using descriptive statistics, the Kappa coefficient for agreement, and the Chi-square test for categorical variables.ResultsChatGPT demonstrated high accuracy in MCQs (90%) and T/F questions (85%) but showed reduced performance in SAQs (60%). Gemini's accuracy ranged between 60% and 70%, with the highest accuracy in SAQs (70%). ChatGPT showed significant consistency across testing dates (Kappa = 0.754; p = 0.001), whereas Gemini's responses were less consistent (Kappa = 0.634; p = 0.001).ConclusionWhile both AI models offer valuable support in dental education, ChatGPT exhibited greater accuracy and consistency in structured assessments. The findings suggest that AI tools can enhance teaching and assessment methods if integrated thoughtfully, supporting personalized learning while maintaining academic integrity.
Effects of an Adapted Dance Exercise Program on Trunk Control, Balance and Functional Mobility in Children and Adolescents with Cerebral Palsy: Randomized Controlled Study
(Taylor & Francis inc, 2025) Yekdaneh, Asena; Arman, Nilay
Aims: The study aimed to investigate whether an 8-week adapted dance exercise program (ADEP), delivered in addition to conventional physiotherapy, would improve trunk control, balance, functional mobility, and quality of life (QoL) in children and adolescents with cerebral palsy (CP) compared with conventional physiotherapy alone. Methods: Thirty participants with CP (Gross Motor Function Classification System Level I - II) were randomly assigned to the ADEP group (n = 15) or the control group (n = 15). Both groups received conventional physiotherapy, while the ADEP group additionally performed physiotherapist-choreographed dance exercises accompanied by music, twice a week for 8 weeks. Outcomes included the Trunk Control Measurement Scale (TCMS) for trunk control, the Pediatric Balance Scale (PBS) for balance, the Timed Up and Go (TUG) for functional mobility, and the Pediatric Outcomes Data Collection Instrument (PODCI) for QoL. Results: The ADEP group showed significantly greater improvements than the control group in TCMS-Total (Delta = 10.53 vs 3.50, p < .001), TCMS-selective motor control (Delta = 6.00 vs 1.42, p < .001), TCMS-dynamic sitting balance (Delta = 7.53 vs 2.28, p < .001), and PODCI-Global scores (Delta = 4.61 vs -1.71, p < .001). Both groups improved in PBS and TUG, but between-group differences were not significant. Effect sizes indicated large improvements in trunk control in favor of the ADEP group. Conclusions: An 8-week ADEP program, when combined with conventional physiotherapy, produced clinically meaningful gains in trunk control and QoL in children and adolescents with CP. These findings support the use of dance-based rehabilitation as a feasible and engaging adjunct to physiotherapy.
Implementation of an AI-Enhanced Motor and Cognitive Intervention: A Case Study in Developmental Delay
(Routledge Journals, Taylor & Francis Ltd, 2025) Bektas, Selen Aydoner; Bumin, Gonca
This study aimed to explore the implementation of an AI-enhanced motor and cognitive intervention for a 7-year-old child with developmental delay. A case study design was employed using an A-B framework (pre-test, intervention, post-test) over 12 weeks. The intervention incorporated AI-based tools such as Lumosity, Just Dance, and Cogmed for tailored motor and cognitive activities. The Bruininks-Oseretsky Test of Motor Proficiency-2 Brief Form (BOT-2 BF) and the Dynamic Occupational Therapy Cognitive Assessment for Children (DOTCA-Ch) were used to evaluate outcomes. Post-intervention, significant improvements were observed in BOT-2 BF and DOTCA-Ch scores, indicating enhanced motor coordination, and cognitive abilities. AI-enhanced interventions demonstrated the potential to address developmental delays by providing adaptive, engaging, and effective therapeutic activities. The findings highlight the feasibility of integrating AI tools into therapy, with implications for broader adoption in addressing developmental challenges. Further research is recommended to explore generalizability and long-term effects.
Multisensory Stimulation by Mothers: Impact on Neonatal Pain and Maternal Anxiety During Heel Blood Collection: A Randomized Controlled Trial
(Springernature, 2025) Akkaya-Gul, Aysenur; Ozyazicioglu, Nurcan; Celikboya-Kabadayi, Ezgi
OBJECTIVE: This study aimed to evaluate the effects of maternal multisensory stimulation on neonatal pain and maternal state anxiety during heel blood collection in neonates. STUDY DESIGN:A randomized controlled trial was conducted from July 2019 to January 2020 in neonatal units, with 80 newborns in intervention(n = 40) and control (n = 40) groups. In the intervention group, mothers provided multisensory stimulation (speech, touch, skin odor, breastfeeding, eye contact), while the control group received routine care. Neonatal Infant Pain Scale (NIPS) and maternal state anxiety inventory were evaluated. RESULTS:NIPS scores and maternal anxiety were significantly lower in the intervention group (p < 0.001). A positive correlation was found between NIPS and maternal anxiety in the intervention group (r = 0.372, p = 0.018). CONCLUSIONS: Maternal multisensory stimulation reduces neonatal pain and maternal anxiety. These findings emphasize the importance of pediatric nurses considering neonatal comfort and maternal emotional well-being during medical procedure. CLINICAL TRIAL REGISTRATION: The protocol for this randomized controlled experimental trial is registered on ClinicalTrials.gov. The clinical trial registration number is https://clinicaltrials.gov; NCT05606458.
Effects of the HEP® (Homeostasis-Enrichment Approach in Preterm Infants with Increased Developmental Risk: A Randomized Controlled Study
(Frontiers Media S.A., 2025) Sirma, Gamze Cagla; Zengin Alpozgen, Ayse; Balikci, Aymen
Background and objectives: This study investigated the effectiveness of the Homeostasis-Enrichment-Plasticity (HEP) Approach in preterm infants with increased developmental risk, compared to the Traditional Treatment (TT) intervention for physical and occupational therapy.
Materials and methods: Twenty-nine preterm infants (adjusted age, 4-10 months) were randomly assigned to two groups: the HEP Approach group and the TT group. The Peabody Developmental Motor Scales-2 (PDMS-2), Test of Sensory Functions in Infants (TSFI), and Beck Anxiety Inventory (BAI) were administered pre-and post-intervention. The intervention was implemented weekly for 12 weeks.
Results: The baseline characteristics of the infants were similar. At the end of the treatment, a significant time effect was observed in motor skills and sensory functions across both groups, with improvements in all PDMS-2 and TSFI subtests (p < 0.05). Significant time x group interactions showed greater improvements in the HEP Approach group compared to the TT group for Fine Motor Quotient: F = 10.818, p = 0.003; Gross Motor Quotient: F = 5.691, p = 0.024; and Total Motor Quotient: F = 21.109, p < 0.001. For TSFI, the HEP Approach group showed greater improvements in Adaptive Motor Functions (F = 13.794, p = 0.001), Visual-Tactile Integration (F = 7.410, p = 0.011), and Total score (F = 11.316, p = 0.002). No significant time*group interactions were found for Reactivity to Tactile Deep Pressure, Ocular Motor Control, and Reactivity to Vestibular Stimulation (p > 0.05). Parental anxiety, measured by BAI, decreased significantly in both groups (F = 8.72, p = 0.006), but no significant time x group interaction was found (p > 0.05), indicating similar reductions in both groups. Conclusion: The HEP Approach demonstrated superior outcomes compared to the TT intervention in improving motor skills and sensory functions in preterm infants, while both interventions reduced caregiver anxiety.
'I Feel Like the Burden of the World Is on My Shoulders': A Phenomenological Qualitative Study on the Life Experiences of Adult Children of Parents with Schizophrenia
(BMC, 2025) Pehlivan Saribudak, Tugba; Dag, Zeynep; Ozturk, Ayse; Dikec, Gul
BackgroundStudies investigating the experiences of adult children of parents with schizophrenia (ACPS) are limited, and no qualitative study examining this issue in T & uuml;rkiye has been previously conducted. This study aimed to examine the life experiences of ACPS providing primary care.MethodsThis phenomenological qualitative study was conducted with 14 ACPS in acute clinics of a regional psychiatric hospital in Istanbul between March and August 2024. Data were collected through in-depth interviews and analyzed using Colaizzi's seven-step analysis method.ResultsData analysis revealed five main themes: (1) Difficult beginning of life, (2) Being a caregiver without receiving care, (3) Emotional storm, (4) Disruption of the flow of life, and (5) Coping. The study found that adult children who cared for their parents could not remember their childhood, had to grow up early without parents, and experienced violence. Adult children had difficulty carrying the burden of care, experienced various emotions at the same time, and care disrupted their lives. They were both using adaptive and maladaptive coping methods.ConclusionsThis study determined that ACPS experienced significant childhood stressors and difficulties providing care in adult life that changed the flow of their daily lives while challenging their ability to cope. Psychiatric nurses have essential tasks to support ACPS in coping with difficult life experiences and reducing their care burdens. They should inform ACPS about schizophrenia, regularly monitor their mental health, and implement initiatives that will protect or improve their mental health.Clinical trial registrationNot applicable.
Machine Learning Model for Predicting Multidrug Resistance in Clinical Escherichia Coli Isolates: A Retrospective General Surgery Study
(MDPI, 2025) Tolan, Huseyin Kerem; Aydin, Irfan; Tanyildizi-Kokkulunk, Handan; Karakus, Mehmet; Akkaya, Yuksel; Kaya, Osman; Isman, Ferruh Kemal
Background/Objectives: Escherichia coli is one of the leading causes of surgical site infections (SSIs) and poses a growing public health concern due to its increasing antimicrobial resistance. High rates of extended-spectrum beta-lactamase (ESBL) production among E. coli strains complicate treatment outcomes and emphasize the need for effective surveillance and control strategies. Methods: A total of 691 E. coli isolates from general surgery clinics (2020-2025) were identified using MALDI-TOF MS. Antibiotic susceptibility data and patient variables were cleaned, encoded, and used to predict resistance using the Random Forest, CatBoost, and Naive Bayes algorithms. SMOTE addressed class imbalance, and model performance was assessed through various validation methods. Results: Among the three machine learning models tested, Random Forest (RF) showed the best performance in predicting antibiotic resistance of E. coli, achieving median accuracy, precision, recall, and F1-scores of 0.90 and AUC values up to 0.99 for key antibiotics. CatBoost performed similarly but was less stable with imbalanced data, while Naive Bayes showed lower accuracy. Feature importance analysis highlighted strong inter-antibiotic resistance links, especially among beta-lactams, and some influence of demographic factors. Conclusions: This study highlights the potential of simple, high-performing models using structured clinical data to predict antimicrobial resistance, especially in resource-limited clinical settings. By incorporating machine learning into antimicrobial resistance (AMR) surveillance systems, our goal is to support the advancement of rapid diagnostics and targeted antimicrobial stewardship approaches, which are essential in addressing the growing challenge of multidrug resistance.
Artificial Intelligence in Nursing Practice: A Qualitative Study of Nurses' Perspectives on Opportunities, Challenges, and Ethical Implications
(BMC, 2025) Bodur, Gonul; Cakir, Hanife; Turan, Suzan; Seren, Arzu Kader Harmanci; Goktas, Polat
BackgroundThe study aims to explore nurses' views on the effects of artificial intelligence (AI) in nursing, focusing on their understanding, practical applications, ethical considerations, and perceived opportunities and threats.MethodsThis qualitative study used semi\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\:-$$\end{document}structured interviews to gain comprehensive insights from clinical nurses, adhering to the Standards for Reporting Qualitative Research for methodological rigor. After obtaining ethical approval, researchers conducted semi\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\:-$$\end{document}structured interviews with 25 clinical nurses. The interviews explored nurses' perceptions of AI, including its basic concepts, applications in nursing practice, ethical and social implications, and potential benefits and drawbacks.ResultsThe analysis identified four overarching themes: (1) Nurses' Conceptualizations of Artificial Intelligence, (2) Opportunities of AI in Nursing Practice, (3) Threats of AI in Nursing Practice, and (4) Ethical and Psychological Concerns in AI-Based Nursing Practice. The findings revealed that nurses had a foundational understanding of AI and its definitions. They acknowledged both the positive and negative impacts of AI technologies on their practice. Nurses expressed that AI could reduce workload, enhance patient care, and improve efficiency. However, they also articulated significant threats, including concerns over professional redundancy, emotional disconnection in caregiving, de-skilling, and the risk of dehumanizing the healthcare environment. Additionally, ethical and psychological concerns emerged, such as ambiguity in accountability, threats to data security and patient safety, unsuitability in psychiatric care contexts, staff surveillance anxiety, and risks of misuse or systemic bias.ConclusionThe study concluded that while nurses possess a basic understanding of AI, the effective and ethical integration of AI technologies in nursing requires targeted training, institutional preparedness, and robust interdisciplinary collaboration. To ensure AI complements rather than compromises nursing values, it is imperative to equip nurses with skills in digital literacy, ethical reasoning, and critical engagement with AI tools. The findings highlight the necessity of structured education programs and policy development that address both the technological and humanistic dimensions of AI use in healthcare. Future research should actively incorporate patient and public voices to ensure that AI-driven transformations in care remain aligned with the principles of patient-centeredness and human dignity.
Psychometric Properties and Transcultural Adaptation of Turkish Version of the Basel Assessment of Adherence to Immunosuppressive Medication Scale
(Baskent Univ, 2025) Koken, Zeliha Ozdemir; Ordin, Yaprak Sarigol; Seren, Arzu Kader Harmanci
Objectives: This study aimed to translate BAASIS (Basel Assessment of Adherence to Immunosuppressive Medication Scale) into Turkish and to test the psychometric properties of the translated Turkish version of the instrument. Materials and Methods: In this single-center crosssectional study, we included 100 kidney transplant recipients in a university hospital in a western city of Turkiye. The Translation and Cultural Adaptation Report from Professional Society for Health Economics and Outcomes Research was used for the transcultural adaptation of BAASIS to Turkish. We tested the validity of the BAASIS Turkish version by the level of evidence according to the American Educational Research Association guidelines: content validity, internal structure, and relations to other variables. We calculated item-total correlations of the BAASIS Turkish version to examine internal consistency reliability. Results: The content validity index score of BAASIS was calculated as 1.00, indicating agreement between the experts. Exploratory factor analysis evaluated the internal structure of BAASIS, and the coefficients for inter-item correlations ranged from 0.170 to 0.395. The Immunosuppressive Treatment Adherence Scale and the BAASIS nonadherent scores were significantly correlated (r = 0.673, P < .001). The coefficients for item-total correlation analyses ranged from 0.160 to 0.470. Conclusions: The BAASIS Turkish version has acceptable psychometric properties. The scale can be used in clinical practice and research projects in transplantation to assess immunosuppressive medication adherence.
Detection of Candida (Candidozyma) Auris by Molecular Methods and Investigation of Clinical Symptoms of Patients in a Tertiary Hospital in Istanbul
(K Faisal Spec Hosp Res Centre, 2025) Akkaya, Yuksel; Erdin, Begum Nalca; Aydin, Irfan; Ozel, Ayse Serra; Yilmaz, Ahmet Munir; Cilkiz, Mustafa; Toraman, Zulal Asci
BACKGROUND: Candidozyma auris is resistant to many antifungals, spreads rapidly and causes deaths in patient groups with comorbid factors. OBJECTIVES: The aim of this study was to determine the virulence of C. auris, antifungal resistance genes and clinical characteristics of the patients. DESIGN: Retrospective cohort SETTING: Single-center MATERIAL AND METHODS: This study was conducted between August 2022 and December 2023 at & Uuml;mraniye Training and Research Hospital. ITS1-5.8S-ITS2 and ITS1-ITS4 gene regions of the rDNA gene of C. auris isolates identified by VITEK MS v.3.2 were amplified by polymerase chain reaction (PCR) method. These regions were partially sequenced using the Sanger method. The presence of C. aurisspecific CDR1, ERG11, MDR1, ACT1, SAP5, HYR3, ALS5, IFF4, FUR1, PLB3, PGA26 and PGA52 gene regions were determined by PCR. Antifungal susceptibility testing of C. auris was performed with VITEK 2 Compact AST YS08 and SYO. MAIN OUTCOME MEASURES: Variations in C. auris isolates, antifungal resistance and clinical characteristics of patients SAMPLE SIZE: Forty-four isolates from 31 patients RESULTS: According to gene regions, nine different variations were identified in our hospital, with VAR-1 being the most common. Twenty-five (80.6%) of the patients died and isolation of the causative agent was between days 1-30 in 13 (41.9%) patients. Antibiotic use, ICU admission rate, and central venous catheter use in patients were 29 (93.6%), 28 (90.3%), and 21 (67.7%), respectively. Hypertension, diabetes mellitus (DM) and septic shock were found in 14 (45.2%), 13 (41.9%) and 10 (32.3%) patients, respectively. Antifungal resistance rates of the isolates were determined as 97.7% and 84.1% for amphotericin B and fluconazole, respectively. No resistance to micafungin and caspofungin was detected. The survival rate with echinocandin use was 22% (4 patients). CONCLUSION: Identification of gene regions is valuable in determining the pathogenicity of C. auris. . Due to the presence of comorbidi- ties in patients with C. auris, , it is not possible to determine the exact proportion of deaths attributable to C. auris alone. LIMITATIONS: Single center setting; gene regions could not be ex- pressed.
Protective Effect of Artichoke (Cynara scolymus L.) Leaf and Receptaculum Extracts Against Hepatic Encephalopathy in Bile Duct Ligated Rats
(Springer/Plenum Publishers, 2025) Kam, Ozkan; Bebitoglu, Berna Terzioglu; Sener, Goksel; Oguz, Elif; Erdogan, Nurettin Fatih; Kilickap, Andac; Hatiboglu, Nebile
Hepatic encephalopathy (HE), complication of liver dysfunction, leads to neurocognitive impairments. Artichoke (Cynara scolymus L.) has been traditionally used for its antioxidant, anti-inflammatory and hepatoprotective properties. This study evaluates artichoke leaf and receptaculum extracts in cholestasis and HE in a rat model. Wistar rats were divided into 6 groups: sham-control, bile duct ligation (BDL), and BDL with low/high-dose leaf or receptaculum extracts. After BDL, physiological saline and extracts (250/500 mg/kg) were administered orally for 28 days. Cognitive activity was evaluated using Morris water maze and novel object recognition tests on day 28. Artichoke extract regulated liver enzymes and bilirubin at high-doses and significantly increased antioxidant enzyme activities reduced by BDL. Elevated 8-Hydroxyguanosine (8-OHdG) levels decreased in liver and brain tissues. Similarly, artichoke extracts reduced cytokine and hydroxyproline (HP) levels elevated by cholestasis. Following BDL, Na+/K+-ATPase levels in brain and liver tissues decreased, while artichoke extract reversed this. Artichoke, particularly high-dose receptaculum, improved impaired performance and increased time in the target quadrant after BDL. Both artichoke leaf and receptaculum extracts improved recognition. Artichoke treatments, especially high-dose receptaculum, reduced hepatic and neuronal damage and improved histological appearance. These findings highlight the therapeutic potential of artichoke extracts for liver fibrosis and related neurocognitive disorders.
Emergency Department Nurses’ Knowledge and Practices Related to Extravasation Injuries of Non-Cytotoxic Medications
(Turkish Association of Trauma and Emergency Surgery, 2025) Kuğu, Emre; Akyüz, Nuray; Tıbbi Hizmetler ve Teknikler Bölümü
BACKGROUND: Extravasation of non-cytotoxic medications can lead to serious complications such as pain, tissue necrosis, limb loss, and even death. This descriptive cross-sectional study aims to assess the knowledge levels of emergency department (ED) nurses regarding extravasation incidents involving non-cytotoxic medications and to highlight the importance of effective management and prevention. METHODS: The study was conducted in the EDs of three hospitals in Istanbul, Türkiye, between November 19, 2020 and December 31, 2020. A total of 100 ED nurses participated in the study. Inclusion criteria required nurses to be working full-time in the EDs during the study period and to provide written and verbal consent. The study utilized a survey to assess sociodemographic characteristics, knowledge of non-cytotoxic medications (e.g., epinephrine), symptoms of extravasation, prevention strategies, and intervention practices. RESULTS: The mean age of the nurses was 29.43 years, with 57% female and 73% holding a bachelor’s degree. Among participants, 52% had 0-3 years of ED experience. Ninety-one percent reported not receiving education on extravasation after graduation, and 82% indicated no extravasation protocol was in place at their workplace. Knowledge about non-cytotoxic medications causing extravasation significantly increased with ED experience (p=0.035). Nurses in units with an extravasation protocol had significantly higher knowledge levels (p=0.007). Female nurses demonstrated better knowledge of extravasation symptoms than male nurses (p=0.012). Nurses with a bachelor’s or higher degree had significantly better knowledge than others (p=0.015). The knowledge rate for the extravasation care protocol was 64%, with the most recognized protocol item being “immediately stop the infusion” (97%) and the least recognized being “aspirate the medication not to exceed 3-5 mL” (33%). Strong correlations were found between non-pharmacological factors and knowledge of non-cytotoxic medications (r=0.601; p<0.001), as well as between knowledge of extravasation care protocols and non-pharmacological factors (p<0.001). CONCLUSION: The study highlights the need for targeted education and the establishment of institutional protocols for managing and preventing extravasation in EDs. Nurses' knowledge significantly impacts their adherence to prevention and care protocols. To ensure patient safety, it is important to provide ongoing education and implement evidence-based intervention protocols for the management of extravasation in ED settings. © 2025 Elsevier B.V., All rights reserved.
Measuring Shoulder Abduction Strength Using 2 Different Dynamometers: Comprehensive Intrarater and Interrater Reliability and Validity
(Turkish Assoc Orthopaedics Traumatology, 2025) Atli, Ecenur; Topaloglu, Mahir; Hosbay, Zeynep; Ozdincler, Arzu Razak; Fizyoterapi Ve Rehabilitasyon Bölümü
Objective: The purpose of this study is to investigate the intrarater and interrater reliability of handheld dynamometer (HHD) measurements in assessing isometric muscle strength of the shoulder abductors and to compare these results with those obtained using a fixed dynamometer (FD). Methods: The study involved 25 voluntary participants, all over the age of 18, asymptomatic (with no injuries in the upper extremity), and not engaged in overhead sports. The participants were evaluated twice by 2 different testers who were experienced in orthopedic rehabilitation, at 90 degrees of shoulder abduction in the scapular plane. On the first measurement day, Tester 1 performed measurements using both HHD and FD, while on the second measurement day, both testers used only the HHD. A 3-to 7-day interval separated the 2 measurement sessions. Paired-samples t-tests were used to evaluate the systematic bias between the testers. Spearman's rank correlation coefficient, intraclass correlation coefficient, standard error of measurement, and minimal detectable change were calculated. The statistical significance level was accepted as P < .05. Results: Data from 22 participants (15 women, 7 men; mean age: 23.00 +/- 3.19 years) were analyzed, as 3 individuals did not attend the final assessment. A strong correlation (r = 0.772) was found between Tester 1's HHD measurements and FD, while a similarly strong correlation (r = 0.748) was observed for Tester 2's HHD measurements. Excellent intrarater reliability (intraclass correlation coefficient [ICC]= 0.941) was found between Tester 1's measurements, and excellent interrater reliability (ICC= 0.889) was found between testers. Conclusion: Handheld dynamometer has demonstrated excellent interrater and intrarater reliability and high validity for assessing shoulder abductor muscle strength in research and clinical use. Since the muscle strength of testers using the HHD may influence the results, the FD may be a more appropriate option when the study population is stronger than the testers. Studies involving different clinical populations and testers with varying experience levels are needed to improve the relevance of the results. Level of Evidence: Level III, Diagnostic Study.
Psychometric Evaluation of the Person-Centred Climate Questionnaire - Staff Version
(BMC, 2025) Arici, Furkan Cihat; Harmanci Seren, Arzu Kader; Edvardsson, David; Hemşirelik Bölümü
BackgroundValid and reliable instruments are needed to assess person-centredness that serve as quality care indicators. Person-Centred Climate Questionnaire - staff version is an interculturally used tool to evaluate person-centredness in clinical settings. This study aimed to examine the psychometrics of the tool in the Turkish language.MethodsThis was a methodological study involving a sample of 140 nurses. One of the researchers collected data using the Turkish version of the questionnaire-staff version in a private hospital in Istanbul. After performing the language validity steps, the researchers analysed the content validity ratios of the items and the questionnaire's content validity index, and they performed exploratory and confirmatory factor analysis to validate the construct. The internal consistency of the subdimensions and the questionnaire was determined utilising a Cronbach's Alpha test.ResultsThe content validity ratios of the items ranged from 0.84 to 1, and the correlation coefficients ranged from 0.50 to 0.69. The three-factor structure accounted for 70.40% of the total variance. The items' standardised factor loads were between 0.501 and 1.140. The Cronbach's alpha consistency value was 0.90.ConclusionThe staff version of the questionnaire is an adequately valid and reliable instrument in the Turkish language.
Consensus Paper on Candida Auris by Türkiye EKMUD, ID-IRI, THSK of Ministry of Health of the Republic of Türkiye, KLIMUD, TMC, TARD, and TYBD
(Tubitak Scientific & Technological Research Council Turkey, 2025) Agalar, Canan; Erdem, Hakan; Cag, Yasemin; Arda, Bilgin; Balik, Recep; Bastug, Aliye; Arikan Akdagli, Sevtap; Tıbbi Hizmetler ve Teknikler Bölümü
Candida auris is an emerging fungal pathogen that has become a critical global health concern due to its high antifungal resistance and potential to cause nosocomial outbreaks. Since its initial identification in Japan in 2009, C. auris has spread rapidly, posing significant treatment challenges across various healthcare settings worldwide. The biofilm formation ability of C. auris enhances its resilience against disinfectants and antifungal agents, complicating infection control in healthcare environments. This consensus report was developed by a collaboration between several Turkish medical societies including the Turkish Society of Infectious Diseases and Clinical Microbiology Specialty (EKMUD), the Turkish Society of Anesthesiology and Reanimation (TARD), the Turkish Intensive Care Society (TYBD), the Infectious Diseases-International Research Initiative (ID-IRI), the Clinical Microbiology Specialist Society (KLIMUD), the Turkish Microbiology Society (TMC), and the Public Health Institution of T & uuml;rkiye (PHIT) under the Ministry of Health. The report provides a comprehensive overview of C. auris and its management, with a focus on the epidemiology, antifungal resistance mechanisms, recommendations for diagnostic and therapeutic challenges, infection control and prevention measures, and surveillance of C. auris. This consensus report aims to establish standardized diagnostic protocols, improve national surveillance systems, and promote effective infection control measures to mitigate C. auris-related health risks in T & uuml;rkiye. It also offers comprehensive national recommendations and addresses the need for interinstitutional collaboration, improve public health, and strengthen the healthcare response to this pathogen.
Effect of Progressive Muscle Relaxation on Postoperative Pain in Laparoscopic Living Kidney Donors: A Randomized Controlled Trial
(BMC, 2025) Akinci, Naile; Hemşirelik Bölümü
Aim This study aimed to evaluate the effect of progressive muscle relaxation on postoperative pain in laparoscopic living kidney donors. Design This was a randomized controlled, single-blind trial. This study was conducted in accordance with the CONSORT statement. Methods This study was conducted between January and September 2023 and included 62 patients (study group = 31, control group = 31) who met the inclusion criteria and underwent laparoscopic living donor nephrectomy in the transplant service of a private hospital in Istanbul province. A power analysis was performed to calculate the sample size and the power of the study (G*Power 3.1). Study data were collected using a patient information form, a postoperative patient follow-up and evaluation form to record the total number of bolus requests and administrations via of boluses with the PCA device and additional analgesic needs, and the Visual Analog Scale (VAS). The data obtained in the study were analyzed on the SPSS 22.0 statistical software. Results Additional analgesic requirements did not differ significantly between groups where progressive muscle relaxation exercises were applied and the VAS score and bolus requirement were significantly lower than in the control group (p < 0.05). Anxiety levels were also significantly reduced in the experimental group compared to both their pre-test scores and the control group (p < 0.05). Although the time to resume oral intake did not differ significantly between the groups (X-2 = 5.020; p = 0.170 > 0.05), the time to start mobilization was significantly earlier in the experimental group (X-2 = 8.808; p = 0.012 < 0.05). As a result of the study, it was found that progressive muscle relaxation exercises reduced postoperative pain, bolus requirements, and anxiety in patients undergoing living donor nephrectomy. Additionally, these exercises facilitated earlier mobilization following surgery.
Turkish Translation and Cross-Cultural Adaptation of the Pelvic Floor Dysfunction-SENTINEL Screening Tool: A Methodological Study
(Springer London Ltd, 2025) Celenay, Seyda Toprak; Dusgun, Elif Sena; Arslan, Mesut; Kaya, Derya Ozer; Terapi ve Rehabilitasyon Bölümü
Introduction and Hypothesis To translate and perform cultural adaptation of the Pelvic Floor Dysfunction-SENTINEL (PFD-SENTINEL) screening tool into Turkish and to establish its reliability and validity for female athletes. Methods The study included 200 female athletes (mean age 22 +/- 4 years). The translation of the PFD-SENTINEL, which comprised the symptoms related to PFD and item sections related to general risk factors and sports-related risk factors, was performed in accordance with international recommendations. The severity of PFD symptoms was assessed with the Pelvic Floor Distress Inventory-20 (PFDI-20). Psychometric analyses consisted of assessing the following: internal consistency reliability using the Kuder-Richardson-20 (KR-20) coefficient, construct validity using confirmatory factor analysis, and criterion validity. Results The reliability was acceptable for the PFD-SENTINEL items assessed using the KR-20, at 0.581, indicating moderate internal consistency. All fit indices except standardized root mean square residual indicated a perfect fit for the final models. Criterion validity was supported by positive correlations between the PFD-SENTINEL symptom score and the PFDI-20 score (r = 0.724, p < 0.001) and between the PFD-SENTINEL item score and the PFIQ-20 scores (r = 0.334; p < 0.001). Conclusions The Turkish version of the PFD-SENTINEL is a reliable and valid instrument to screen for PFD in female athletes.
Unraveling the Persistent Renal Impact of Intrauterine Growth Restriction and Catch-Up Growth: Integrating Morphological Insights with Metabolomic Profiling
(Springer, 2025) Esrefoglu, Mukaddes; Koktasoglu, Fatmanur; Bayindir, Nihan; Cimen, Fatma Bedia Karakaya; Kirmizikan, Seda; Hekimoglu, Emine Rumeysa; Selek, Sahabettin; Tıbbi Hizmetler ve Teknikler Bölümü
The study aimed to investigate the long-term effects of IUGR and consequent catch-up growth on metabolic health by using a comprehensive approach that included histopathological, immunohistochemical, biochemical, and metabolomics analyses. Sprague-Dawley pregnant rats either undergo bilateral uterine artery ligation or a sham surgery on the 19th day of gestation. The offspring reached catch-up growth, kidney samples were collected at postnatal weeks 2, 4, and 8 for analysis. IUGR rats exhibited a spectrum of changes including reduced glomeruli number, proliferating cell number, altered oxidative stress markers, various enzymes involved in Krebs cycle, mitochondrial dynamics, and energy metabolism. Examination of the 8-week-old cohort identified a broader spectrum of metabolic alterations, notably in the biosynthesis of phenylalanine, tyrosine, and tryptophan, phenylalanine, tyrosine, glyoxylate, dicarboxylate, pyruvate, alanine, aspartate, and glutamate metabolism, glycolysis/gluconeogenesis and citrate (TCA) cycle. Our metabolomics analysis provides insights into the potential disease susceptibility of individuals born with IUGR, including obesity, diabetes, hypertriglyceridemia, cardiovascular diseases, and mental retardation. These findings underscore the intricate interplay between intrauterine conditions and long-term metabolic health outcomes, highlighting the need for further investigation into preventive and therapeutic strategies to mitigate the risk of metabolic diseases in individuals with a history of IUGR.

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