PubMed İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/20.500.14627/8
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Article The Impact of Home-Based Telerehabilitation Pranayama on Sleep Quality and Wellbeing in Mild to Moderate Obstructive Sleep Apnea Syndrome. A Randomized Controlled Trial(BMC, 2026) Mustafaoğlu, Rüstem; Naci, Baha; Demir, Rengin; Önder, Ömer Önder; Atahan, Ersan; Kaçar Akkoç, ZeynepBackground Obstructive sleep apnea syndrome (OSAS) is a common disorder that causes repeated airway obstruction, disrupted breathing, and fragmented sleep. This study aimed to investigate the effects of Pranayama on sleep quality, daytime sleepiness, quality of life, fatigue, depression, and anxiety in patients with OSAS. Methods This study was designed as an open-label, prospective, randomized controlled trial. OSAS patients meeting the inclusion criteria were randomly assigned to either an Intervention group or a Control group. Pranayama training was applied to the Intervention group for 8 weeks, 7 days a week, and 3 times a day for 15 min. In addition, a single 15-minute session, 3 days a week, was conducted online under the supervision of a physiotherapist. The control group did not receive any intervention. Primary outcome was sleep quality (Pittsburgh Sleep Quality Index, PSQ). Secondary outcomes included daytime sleepiness (Epworth Sleepiness Scale, ESS), Fatigue Severity Scale (FSS), Functional Outcomes of Sleep Questionnaire (FOSQ), Nottingham Health Profile (NHP), and Hospital Anxiety and Depression Scale (HADS). All outcome measures were assessed at baseline and reassessed after the 8-week intervention period. Results Thirty-eight OSAS patients meeting the inclusion criteria were randomly assigned to either an Intervention group 6n = 19 ) or a Control group (n = 19) Four participants (two in each group) were lost to follow-up, leaving the data of participants (17 per group) available for inclusion in the final analysis. In the intervention group, PSQI scores decreased from 9.12 +4.71 to 6.88 +/- 4.45 (p < 0.001) whereas no improvement was observed in the control group. Regarding the primary outcome, the reduction in PSQI scores was significantly greater in the intervention group than in the control group (p < 0.001) The ESS scores also decreased significantly in the intervention group, from 9.41 +/- 6.15 to 7.41 +/- 6.18 6p = 0.006 with a significant between-group difference (p < 0.001) Fatigue severity decreased in the intervention group (FSS change: 0.53 +/- 0.70; p = 0.006 ), with a significant between-group difference 6p = 0.037 The FOSQ score improved markedly, with significant gains in FOSQ total score (-0.38 +/- 0.25 vs. 0.14 +/- 0.22 in controls; p < 0.001) and in activity level and vigilance subdomains (both p < 0.001). The HADS-anxiety scores decreased by 1.94 +/- 3.94 (p = 0.059) and depression scores by 3.06 +/- 2.05 (p < 0.001) in the intervention group, with significant between-group differences for both anxiety (p = 0.008) and depression (p < 0.001). Conclusion Pranayama was an effective adjunct therapy for these OSAS patients, and incorporating it into treatment strategies may enhance patient outcomes. Clinical trial registration number/date NCT04632147/22.10.2020.Article Effectiveness of Escape Room–Based Learning for Patient Safety Education in Nursing Students(BMC, 2026) Demet, Inangil; Kokkiz, Rukiye; Semiz, Demet; Turkmen, KübraBackground Ensuring patient safety is a cornerstone of nursing practice, and its foundation is established during nursing education. The study evaluates the effectiveness of escape room-based learning designed in accordance with the International Patient Safety Goals on nursing students' self-efficacy about patient safety. Methods The study was conducted with senior nursing students from February to May 2024. Data were collected using the Student Information Form, Patient Safety Self-Efficacy Questionnaire, and Satisfaction with Training Methods Scale. The escape room was structured in three phases-prebriefing, simulation, and debriefing-following INACSL standards. Clinical trial number: NCT07179367. Results The average age of the participants was 23.5, and 43.5% had previously completed an elective course on patient safety. Analyses revealed that participants spent the most time, averaging 2.59 min, in the room dedicated to information questions. The average self-efficacy score before the intervention was 61.26, which increased to 71.32 after the intervention, and participants reported a high level of satisfaction. Conclusion This study's findings indicate that patient safety-themed escape room training significantly enhances students' self-efficacy in patient safety, as well as their overall satisfaction and motivation.Article The Practice Environment Scale of the Nursing Work Index Short Form in Turkish: A Psychometric Study(BMC, 2026) Arici, Furkan Cihat; Harmancı Seren, Arzu Kader; Seren, Arzu Kader Harmanci; Ayan, GüzinBackgroundThe work environment is a concept encompassing factors that increase or decrease a nurse's ability to practice the nursing profession competently and provide high-quality care. This study aims to adapt the short form of the Nursing Work Index-Nursing Work Environment Assessment Scale, which is used in many countries to evaluate the nursing work environment, to Turkish.MethodsThe study sample consisted of 711 nurses. For this study, data were collected from the researchers' personal social media accounts (WhatsApp, LinkedIn, and Instagram) between October and December of 2024. The Turkish version of the short form of the Practice Environment Scale from the Nursing Work Environment Index was used to collect the data. After creating the Turkish version of the instrument through translation and back-translation and collecting data, the researchers conducted content validity analyses, construct validity tests, and internal consistency analyses to assess the instrument's psychometric properties.ResultsThe items' content validity ratios were 0.93, and correlation coefficients varied between 0.605 and 0.523. The one structure accounted for 56.122% of the total variance. PES-5 scale findings: chi & sup2;/df 3.76, CFI 0.973, TLI 0.946, SRMR 0.031, RMSEA 0.090, CR 0.62. The standardized factor loadings for the scale items ranged from 0.610 to 0.743. The scale was compatible with its five items and one-factor structure The items' standardized factor loadings ranged from 0.370 to 0.575. The Cronbach's alpha consistency value was 0.804.ConclusionA short form of the practice environment scale of the Nursing Work Index is a valid and reliable tool in Turkish.Article Exploring E-Health Literacy Levels among Turkish Women Diagnosed with Breast Cancer: A Cross-Sectional Study(BMC, 2026) Akkurt, Burcu; Coskunsu, Dilber Karagozoglu; Reyhanioglu, Duygu Aktar; Simsek, Mine; Tosun, Anil; Yilmaz, Nergis; Koseoglu, AygulAccess to digital health information has increased for women diagnosed with breast cancer; however, searching, understanding, and interpreting this information requires adequate e-health literacy. This study aimed to determine the e-health literacy levels of women diagnosed with breast cancer and to examine the relationship between e-health literacy and selected sociodemographic and clinical characteristics. In addition, women's awareness of e-health and telerehabilitation concepts, as well as their internet use patterns, were evaluated to inform future digital health initiatives. Data were collected through face-to-face and online methods using an Information Form to assess participant characteristics and the E-health Literacy Scale to measure e-health literacy. The study included 336 voluntary Turkish-speaking women aged 18 years and older diagnosed with breast cancer.The median e-health literacy score on the E-health Literacy Scale was 25 (range: 8-40), with a mean score of 24.6 +/- 7.62. E-health literacy levels were significantly associated with age, educational level, time since diagnosis, and awareness of e-health and telerehabilitation concepts (p < .05), with lower scores observed among older women. In multivariable linear regression analysis, these sociodemographic and care-related factors jointly explained approximately 47% of the variance in e-health literacy levels. Overall, the findings indicate that women with breast cancer in Türkiye have limited awareness of e-health and telerehabilitation concepts, and that e-health literacy levels are significantly associated with age, educational level, time since diagnosis, and awareness of telerehabilitation. These results underscore the importance of developing targeted digital health education initiatives and awareness-based interventions to enhance e-health literacy and support equitable access to digital health services among breast cancer survivors.Article Effects of Combined Triflow, Deep Breathing and Coughing Exercises on Postoperative Pulmonary Function After Mitral Valve Replacement: A Randomized Controlled Trial(BMC, 2026) Akinci, Naile; Eren, EsraBackground Postoperative pulmonary complications remain a major cause of morbidity after cardiac valve surgery. Although incentive spirometry (Triflow) is routinely used in postoperative care, evidence regarding the additional benefits of combining Triflow with deep breathing and coughing exercises remains limited. This study aimed to evaluate the effects of combined Triflow, deep breathing, and coughing exercises on postoperative pulmonary function in adult patients undergoing mitral valve replacement. Methods This randomized controlled, single-blind trial was conducted between May and August 2025 in a private hospital in Istanbul. A total of 60 adult patients undergoing mitral valve replacement were randomly allocated to an experimental group (n = 30) or a control group (n = 30) using simple randomization. The experimental group performed Triflow combined with deep breathing and coughing exercises, while the control group performed Triflow alone. Results Postoperative SpO(2) levels were significantly higher in the experimental group at T1 (p = 0.009; 95% CI: 0.46-3.14), T2 (p < 0.001; 95% CI: 1.57-3.43), and T3 (p < 0.001; 95% CI: 2.72-4.54). The FEV1/FVC ratio increased significantly in the experimental group compared with the control group at discharge (p < 0.001; 95% CI: 4.46-6.41). Respiratory rate was significantly higher in the experimental group at T1 (p < 0.001; 95% CI: 1.68-4.45), T2 (p < 0.001; 95% CI: 3.34-6.26), and T3 (p < 0.001; 95% CI: 5.23-8.37). Hematocrit levels were significantly lower in the experimental group at T1 (p = 0.039; 95% CI: -8.32 to - 0.24), T2 (p = 0.007; 95% CI: -8.29 to - 1.40), and T3 (p = 0.034; 95% CI: -6.54 to - 0.28). Pain scores were significantly lower in the experimental group at T1 (p < 0.001; 95% CI: -2.82 to - 1.71) and T2 (p < 0.001; 95% CI: -1.98 to - 1.08). Time to first mobilization was significantly shorter in the experimental group (p < 0.001; 95% CI: -2.94 to - 1.26). No postoperative pulmonary complications were observed in either group. Conclusion The combined application of Triflow, deep breathing, and coughing exercises was associated with significant improvements in postoperative pulmonary function, oxygen saturation, pain reduction, and earlier mobilization compared with Triflow alone in patients undergoing mitral valve replacement. These findings suggest that a structured, combined respiratory exercise protocol may provide additional clinical benefits in the early postoperative period.Article The Relationship Between Nurses Anxiety and Attitudes Towards Artificial Intelligence and Examination of Influencing Factors(BMC, 2026) Nirgiz, Cansu; Sari, Merve Kiymac; Cayli, NazanAim to explore the relationships between nurses'anxiety and attitudes toward artificial intelligence (AI) and the factors associated with them. Background Although AI technologies are increasingly integrated into healthcare, research exploring nurses ' psychological readiness and emotional responses to AI remains limited. Existing studies have primarily focused on nursing students or general healthcare professionals, leaving a gap in understanding how practicing nurses perceive and emotionally adapt to AI within real clinical environments-particularly in T & uuml;rkiye, where digital transformation in healthcare is accelerating. Addressing this gap is essential, as nurses play a pivotal role in ensuring the safe and ethical implementation of AI-driven tools in patient care. Methods This descriptive and correlational study included 562 nurses from 14 branches of a private hospital chain across seven Turkish cities between November 2024 and January 2025.This sample was selected because it represents nurses actively engaged in clinical decision-making within healthcare systems that are rapidly adopting AI technologies. According to a power analysis performed in G*Power (rho = 0.25, alpha = 0.05, power = 0.95), the required sample size was 202 participants. Data were collected through an online questionnaire comprising a Descriptive Information Form, the AI Anxiety Scale, and the General Attitudes toward AI Scale. Descriptive statistics, independent samples t-tests, ANOVA (F), Tukey post hoc test, Pearson correlation, and multiple regression analyses were conducted. Ethical approval was obtained from the Fenerbah & ccedil;e University Ethics Committee, and informed consent was obtained digitally. Results Nurses reported moderate anxiety levels and generally positive attitudes toward AI. Male nurses showed an association with lower anxiety levels and higher positive attitude scores than female nurses. Single individuals and those with higher levels of education showed higher positive attitudes toward AI. Those with 0-3 years of experience in the profession were associated with lower anxiety and higher positive attitude scores. Nurses who used AI in practice, were knowledgeable about its use, or perceived it as reliable showed a relationship with lower anxiety and more positive attitudes. Regression analysis showed that each one-unit increase in the learning and AI configuration subscales of the AI Anxiety Scale was associated with a 0.740-and 0.716-point lower score in the total attitude score, respectively. Conclusion The findings suggest that lower levels of anxiety related to learning and AI configuration are associated with more positive attitudes toward AI. Addressing these specific anxiety domains may be related to the successful integration of AI technologies into clinical practice and could be linked to the digital transformation in healthcare.Article Beyond Age: Understanding How Mindful Eating and Food Label Reading Shape Generational Differences in Health Outcomes – A Cross-Sectional Study(BMC, 2025) Altinok, Oyku; Yalcin, Bahar; Deniz, Melike Seyma; Celikayar, Melike Nur; Sevdin, Sezen; Bingul, Bengi Cetiner; Garipagaoglu, MuazzezBackgroundThe 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.MethodThis cross-sectional design study involved 2725 participants from Generations X (n = 786), Y (n = 933), and Z (n = 1006) living in Istanbul, T & uuml;rkiye. 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.ResultsIncreasing 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.ConclusionPoor 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.Article 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; Yildiz Domanic, KubraBackgroundGenerative 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.Article '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, GulBackgroundStudies 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.Article Citation - WoS: 6Citation - Scopus: 6Artificial 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, PolatBackgroundThe 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.