Mean Individual Scores Research Articles

Work-related stress among nurses: a comparative cross-sectional study of two government hospitals in Ghana

BackgroundOccupational stress is increasing globally and affecting all workplaces and countries’ health professionals. Despite its significant impact on healthcare delivery, limited studies have actually compared the prevalence, causes, effects, and coping strategies of stress among nurses working in hospitals with variation in capacity and function in Ghana. We, therefore, examined and compared the prevalence, causes, effects and coping strategies of occupational stress among nurses working in a secondary care and tertiary hospital in Ghana.MethodsWe conducted a health facility-based cross-sectional study among 248 nurses from two hospitals (Volta Regional Hospital [VRH] and Ho Teaching Hospital [HTH]). The Perceived Stress Scale (PSS) and Weiman Occupational Stress Scale (WOSS) were used to measure the nurses’ stress levels and causes of occupational stress respectively. A self-reported checklist was used to measure both the effects of stress and strategies. Descriptive analyses and t-tests were performed, and statistical significance was measured at the 0.05 level.ResultsThe majority of nurses 77.8% experienced a moderate level of perceived stress. The total individual mean scores of the nurses from the two hospitals (VRH = 3.02 and HTH = 3.09) were 34% and 37% respectively higher than the established WOSS individual average of 2.25. Nursing difficult patients (t=-1.1196, p = 0.037), Unfriendly relationships with superiors, colleagues, and subordinates (t=-2.3333, p = 0.020), working with incompetent staff (t=-1.3129, p = 0.037) were the statistically significant stressors among nurses in the HTH. Whereas, long work hours (t = 2.0841, p = 0.038) and needle-stick injuries (t = 2.6669, p = 0.008) were the statistically significant stressors among nurses from the VRH. Headache (VRH = 73.8% and HTH = 97.9%), Fatigue (VRH = 68.9% and HTH = 83.5%), Frustration VRH = 50.5% and HTH = 68.3%) and Lack of Concentration (VRH = 81.6% and HTH = 80.0%) were most common effects of occupational stress reported.ConclusionThe majority of nurses reported moderate levels of stress, with the two institutions’ stressors differing. Key causes of stress were needle stick injuries, long hours, dealing with challenging patients and strained interpersonal relationships. Common side effects were headaches, exhaustion, irritability, and trouble focusing. To accelerate progress towards achieving the sustainable development goal (SDG) 3.4 of promoting mental health and well-being by 2030, the 2012 Mental Health Act of Ghana and the Occupational Health and Safety Regulations, should fully and effectively be implemented in health facilities across the country.

Effect of progressive muscle relaxation exercises on symptoms of premenstrual syndrome: A single-blind randomızed controlled trial

AimThis study was carried out to determine the effect of progressive muscle relaxation exercises (PMR) on premenstrual syndrome (PMS) symptoms. MethodsThe study was designed in a single-blind randomized controlled type. The study was conducted in a hospital in Western Türkiye. Seventy-nine single women who experienced PMS who met the inclusion criteria were randomly assigned to the experimental group in which PMR would be applied, and the control group to continue their routine coping habits regarding PMS. PMR were applied to the experimental group every day for 8 weeks. At the end of 8 weeks, the experimental and control groups were re-evaluated with the Premenstrual Syndrome Scale (PMSS). ResultsAt the beginning of the study, it was observed that the individual, health characteristics and PMSS mean scores of the women in the experimental and control groups were similar (p > 0.05). At the end of eight weeks, it was seen that the mean PMSS score of the experimental group was lower than that of the control group, and the difference was statistically significant (p < 0.001). When in-group comparisons were made at the end of the exercise program, no significant difference was found in the mean PMSS score of the control group compared to the beginning (p > 0.05). The PMSS score of the experimental group decreased significantly and the difference was statistically significant (p < 0.001). ConclusionIn this study, it was seen that PMR were effective in improving PMS.

The Effect of Self-Stigma on Self-Esteem and Treatment Compliance in Individuals with Type-2 Diabetes: An Example in the Southeast of Türkiye

Introduction: The aim of the study is to examine the effect of self-stigma on self-esteem and treatment compliance in individuals with Type-2 diabetes. Methods: This descriptive and correlational study was conducted with type 2 diabetes patients who applied to a hospital in southeast Turkey. The study was carried out between June and December 2022. The sample of the study consists of 172 patients who agreed to participate in the study. Participant Introductory Questionnaire, Self Stigma, Rosenberg Self-Esteem, and Morisky Medication Adherence Scale forms were used to collect data. Results: In the study, the mean scores of patients’ self-stigma, self-esteem, and treatment adherence were 51.16±15.41, 17.84±3.31, and 5.66±2.25, respectively. The results also indicated that there was a significant negative correlation between the mean scores of individuals’ self-stigma, self-esteem, and adherence to treatment (p

Perceived Spousal Support and Activities of Daily Living in Individuals With COPD.

The relationship between perceived spousal support and activities of daily living in patients with chronic obstructive pulmonary disease (COPD) is unclear. The aim of this study was to explore the relationship between spousal support perceived by those with COPD and their activities of daily living. This study was a cross-sectional and descriptive study. Data collection was conducted between September 2022 and April 2023. A Data Gathering Form, the Spousal Support Scale, and the London Chest Activity of Daily Living Scale were used to collect data. A total of 132 adults were included in this study. The mean (SD) scores of individuals with COPD for perceived spousal support and activities of daily living were 62.40 (14.66) and 32.91 (15.72), respectively. Levels of perceived spousal support and activities of daily living varied according to sex, employment status, admission to the emergency service or hospitalization, use of antidepressants, and the severity of the illness (P < .05). Those with better spousal support felt less dyspnea when performing the activities of daily living (r = -0.205, P < .05). Knowing the potential factors affecting perceived spousal support and activities of daily living can provide an opportunity to determine appropriate strategies to increase the level of independence of individuals with COPD. Educational interventions to help spouses understand COPD may help increase spousal support.

Training interprofessional teams in geriatric emergency medicine: A modified team-based learning approach

BackgroundOlder adults deserve special healthcare provision in every branch of medicine. Turkey currently does not have geriatric emergency medicine (GEM) subspecialty training. Thus, interprofessional training for healthcare professionals involved in GEM services is required. Team-based learning (TBL) seems suitable to implement such training. We aimed to develop and implement a training program for healthcare professionals engaged with GEM services, and evaluate the program considering teacher and learner satisfaction and knowledge retention. MethodsThis was a design-based study in which a one-day GEM training program was developed based on the literature and expert opinions. The program was applied to 54 physicians, 98 nurses, 70 health officers, and 102 paramedics using a modified version of TBL. Teams included at least one representative from each profession. TBL was modified by adding a 1-h lecture and eliminating peer evaluation. Feedback forms, individual and group tests of TBL, and a retention test conducted six months later were used for program evaluation. ResultsThe mean group test score was higher than that of individual tests in all professions. Physicians’ individual test scores were higher than those of other professions, but this difference disappeared in the group test. The retention test mean score was higher than the individual test mean score but lower than that of the group test. Teacher and learner satisfaction was high. ConclusionWe implemented a training program using a modified TBL approach to teach GEM to relevant healthcare professionals; it yielded promising results regarding knowledge gain and retention, as well as teacher and learner satisfaction. The instruction design and method used in this study can be applied to multidisciplinary team training.

Factors Influencing the Knowledge and Attitudes of Hospice Care Practitioners in Guangxi, China: A Cross-Sectional Study.

Practitioners in China who implement hospice care services include doctors, nurses, and careworkers. These individuals play an important role in the holistic care of patients at the end of life and their families. This study aimed to provide baseline data to develop hospice care services and improve relevant policies by investigating the knowledge and attitudes of hospice care practitioners (HCPs) and analyzing influencing factors. This cross-sectional descriptive study used stratified sampling and quota sampling. The HCPs were from nursing homes, medical institutions, integrated medical and nursing institutions, and community health service centers in Guangxi Zhuang Autonomous Region. We examined HCPs' demographic characteristics and scores on a self-designed Chinese scale to measure their knowledge and attitudes(K&A scale). A total of 1821 HCPs completed surveys from May 2022 to July 2022. The data were analyzed using descriptive statistics, univariate analysis and multiple linear regression. The standard score of the K&A scale of 1821 HCPs was 61.62 (SD=9.78), and the individual mean scores of knowledge and attitudes were 76.42 (SD=28.13) and 58.69 (SD=11.31), respectively. The final multiple linear regression analysis indicated that the main factors that influenced the K&A score were monthly income, job satisfaction, and the hospice care-related system (HCS). The HCPs in this study displayed moderate mean scores for knowledge and a less favorable attitude toward hospice care. Monthly income, job satisfaction and the HCS were the common factors that influenced HCPs' K&A. The results suggest the need to strengthen targeted and professional training for HCPs, increase their welfare and benefits, and improve indigenous policies of hospice care.

An investigation of stigma and self-management in individuals diagnosed with epilepsy

AimThe complex nature of epilepsy disease confronts individuals with difficulties such as stigma. Stigma has a negative impact, particularly on individuals' coping with the disease. It is important for individuals diagnosed with epilepsy to adopt many self-management behaviors so that they can control these situations. This study aims to measure the stigma and self-management levels of individuals diagnosed with epilepsy and determine the relationship between stigma and self-management. MethodsThis descriptive and associational study was conducted in the Neurology Outpatient Clinic of a Training and Research Hospital and 295 patients were included in the sample based on various inclusion criteria such as having a diagnosis of epilepsy for at least six months and not having any psychiatric disorder that would prevent reading and comprehension. Data were collected through the Descriptive Information Form, the Stigma Scale of Epilepsy, and the Epilepsy Self-Management Scale. Data analysis was performed using IBM SPSS Statistics Standard Concurrent User V 26 statistical package program. FindingsThe Stigma Scale of Epilepsy total mean score was found 60.62 ± 15.40 in individuals diagnosed with epilepsy. The mean scores for the sub-scales were found 7.08 ± 2.20 for the false beliefs sub-scale, 18.86 ± 4.97 for the discrimination sub-scale, 21.64 ± 7.07 for the social isolation sub-scale, 8.46 ± 3.18 for the inadequacy sub-scale, and 5.45 ± 1.41 for the stigma resistance sub-scale. The ESMS total mean score of individuals diagnosed with epilepsy was found to be 140.54 ± 15.33. The mean scores for the ESMS sub-scales were 44.76 ± 4.29 for the medicine management sub-scale, 20.29 ± 5.98 for the information management sub-scale, 30.49 ± 4.80 for the safety management sub-scale, 23.95 ± 4.34 for the seizure management sub-scale, and 21.02 ± 4.65 for lifestyle management sub-scale. A significant and negative relationship was found between the Epilepsy Self-Management Scale (ESMS) and the Stigma Scale of Epilepsy. ConclusionThis study found that individuals experienced a moderate level of stigma and had high levels of self-management. Stigma was found to decrease with the increase in the self-management level. In this regard, it is recommended to conduct intervention studies to increase self-management levels and reduce stigma for individuals diagnosed with epilepsy.

Correlates of desire for children among women

Objective: To describe levels of desire for children and identify factors influencing women’s desire for children (DFC). Design: Descriptive correlational study. Setting: Participants were recruited from a Qualtrics online panel. Participants: 228 women from the following nations: Columbia, South America, Dominican Republic, Ghana, Honduras, India, Nigeria, Philippines, United Kingdom, and the USA. Methods: DFC was measured using the Modified Index of Parenthood Motivation (MIPM), a 14-item self-reporting tool, and the Motives Toward Parenthood Scale (MTPS), a 30-item tool with four subscales. Results: MIPM was related to education levels, employment status, the number of children she had, and her parity. One-way ANOVA revealed significant relationships between MIPM with race and nationality. As shown in Mean DFC Scores by Nationality, post hoc tests revealed significant differences in mean MIPM scores when comparing Colombians to Nigerians, Ghanaians to both Colombians and Honduran participants, and finally, significant differences in mean MIPM scores when comparing between Philippine and Colombian, as well as Honduran participants. Subjective norms, consequences, and individual costs mean scores were below midpoints. Conclusion: Participants with increased DFC had increased education, were employed, had more children, and had been pregnant more times than participants with decreased DFC. Women who identified as Black had significantly greater DFC than those who identified as White or Hispanic. Women from Nigeria, Ghana, and the Philippines had significantly greater DFC than participants from Colombia and Honduras. Participants disagreed with subjective norms but agreed with the positive consequences of motherhood.

Association of pain neurophysiology knowledge and application amongst UK chiropractic students: A cross-sectional study.

To investigate if chiropractic placement students in the United Kingdom are aware of current pain evidence and how they relate this to the management of chronic pain patients. Moreover, to gain an understanding of how this can lead to improved pain education planning and engagement in the future. The revised Neurophysiology of Pain Questionnaire and the researchers' own questionnaire were administered online to chiropractic placement students. The aggregated total number of correct responses and the individual mean scores were calculated. Statistical analysis included tests of normality and difference using the Kolmogorov-Smirnov, Mann-Whitney U, Kruskal-Wallis, and Χ2 tests. There was an overall response rate of 21.6% (n = 50). The mean score achieved on the revised neurophysiology of pain questionnaire was 37.8%. A significant difference between individual mean scores on the revised Neurophysiology of Pain Questionnaire was observed between male and female participants. No differences in mean score were observed between age, number of chronic pain patients seen, and previous qualifications. For the study-specific questionnaire, statistically significant differences were found in mean score for previous qualifications, number of patients seen, and sex. Chiropractic placement students in the United Kingdom appear to have a lower level of pain knowledge than other health care professionals and education institutions may wish to consider how to best address this within their curricula.

The effects of core stability exercises on proprioception and balance in children with hemiplegic cerebral palsy

Background: Trunk control is necessary to maintain the body position, to ensure stabilization in the change of position, to perform activities of daily living and for activity. At the same time, it allows maintaining an upright posture, regulating weight transfer, controlled movement against gravity, controlling and changing body position for balance and function. In this study, it was aimed to examine the effects of core exercises on proprioception and balance in children with hemiplegic cerebral palsy. Material and methods: The research was conducted using a single-group pre-test post-test experimental design. The population of the study consisted of 20 people aged 4-12, diagnosed with hemiplegic cerebral palsy, who received training and treatment at a private educational institution between November 2021 and October 2022, and met the criteria for inclusion in the study. The “Trunk Impairment Scale” and “Pediatric Berg Balance Scale” were used to collect the data. In the evaluation of the data; numbers, percentages, standard deviation, mean, minimum and maximum values, Independent Samples t-test and Wilcoxon test were used. Results: It was determined that the difference between the pre-test-post-test pediatric balance scale and static sitting balance, dynamic sitting balance, coordination sub-dimensions mean scores and trunk impact scale mean scores of individuals was statistically significant (p&lt;0.05). Conclusions: Core stability exercises applied to children with hemiplegic cerebral palsy had positive effects on proprioception and balance. Keywords: Balance, Cerebral Palsy, Proprioception, Rehabilitation

The Effect of Motivational Interview-Based Counseling in Individuals With Amputation: A Randomized Controlled Trial in Turkey.

This randomized controlled experimental study determined the effect of motivational interview-based counseling on the coping strategies and perceived social support levels in individuals with amputations due to chronic disease. A randomized controlled trial was conducted. The study was completed in the orthopedics and traumatology department with 48 patients. Data were collected using a descriptive information form, the Coping Strategies Scale, and the Multidimensional Scale of Perceived Social Support. Independent samples t test, paired t test, and chi-square test were used for data analysis. The scores of the Coping Strategies Scale and the Perceived Social Support Scale of individuals in the intervention group significantly increased in the posttest after motivational interview-based counseling compared to their pretest scores. It was determined that the Coping Strategies Scale and Perceived Social Support Scale subdimension scores and total mean scores for individuals in the intervention group in the posttest were higher than the mean scores for individuals in the control group. The difference between the groups was significant. The motivational interview-based counseling given to individuals with amputation because of chronic disease increased their coping strategies and perceived social support levels.

Prevalence of oral impacts on daily performances among adolescents living with HIV at a tertiary paediatric hospital in Johannesburg, South Africa

To determine the prevalence of oral impacts on daily performance among HIV positive adolescents attending a wellness program at a Tertiary Hospital Johannesburg. A cross-sectional study design was conducted where a clinical examination was performed to determine the intra oral mucosal lesions, decayed, missing, filled teeth (DMFT) and Significant Caries Index (SiC). The Child-Oral-Impact on Daily-Performance (Child-OIDP) questionnaire was interviewer-administered to the adolescents at the tertiary paediatric hospital. There were n=208 adolescents with mean age 15.3 years (SD: 2.19; range 9.6-19.9 years). Fifty-five percent of the adolescents were female and 32% of had unemployed parents. About 39% rated their oral health as poor. More than 70% reported not accessing dental services six months prior. The most reported oral conditions were toothache (28.4%), unwanted colour of teeth (24.5%) and bleeding gums (24.0%). The dental caries prevalence was 87%, the DMFT was 3.9 (SD: 3.2; range 0-16) and the SiC was 7.6 (range 4-16). The participants had very minimal restorations (11.7%). The most common mucosal condition identified was linear gingival erythema (27.4%). The prevalence of at least one oral impact was 82% whilst the three mostly impacted activities were difficulty cleaning teeth (53.4%) eating food (51.2%) and enjoying being with people (48.9%). The distribution of the overall impact scores was skewed .The scores ranged from 0-56 with a median of 6 and a mean score of 9.3 (SD = 10.5). The individual mean score range was, 0 to 9, the highest being ‘smiling or laughing’ at 2.8. A poor self-rated oral (p = 0.00) and not being satisfied with appearance of teeth and mouth (p = 0.05) was related to the overall impact score. There was a high prevalence of oral impacts, dental caries and the symptoms related to dental caries. The most impacted activity was cleaning teeth and eating. These activities are related to the symptoms reported. It is imperative that dental caries and the symptoms are managed well to reduce the impacts on the adolescents’ daily oral activities.

Development and Evaluation of Educational Games Using Lumi Education in General Biology 1 for STEM Students: Basis for Recommended Supplementary Teaching Materials

This study aimed to assess the perceived effectiveness of the educational games and the overall performance of the students after it was introduced to them. A descriptive-comparative method of research was utilized. Respondents of this study were twenty-six (26) Grade-12 STEM students. Researcher-made validated questionnaire based on a 5-point Likert scale was used for data collection. The findings of this study revealed that the contents used for educational games were about the cell cycle and cell membrane. Most Essential Learning Competencies were focused on describing, identifying, relating, and explaining biology contents. All of the educational games were rated strongly agree by the respondents. Students enjoyed the games and increased their motivation, interest, cooperation, and participation which transcribed better performance in class. Individual mean scores per lesson indicate that students fully understood the cell cycle concept: mitosis and meiosis. However, further interventions are needed to fully comprehend the function of the cell membrane components and transport mechanisms in the cell. Data analysis also shows a significant difference in the respondent’s responses on the perceived effectiveness of educational games and their mean scores when grouped according to gender. On the other hand, there was no significant relationship between the perceived effectiveness of educational games and the performance of students. A proposed action plan was designed to further improve the effectiveness of educational games in enhancing students learning in General Biology 1. Also, the researcher recommends that teachers may try to develop their games using Lumi Education software.

Environmental scan of mobile apps for promoting sexual and reproductive health of adolescents in low- and middle-income countries.

Adolescence is a period of emotional, mental, and physical change. To increase health seeking behaviors, reduce risky sexual behavior, and improve sexual and reproductive health (SRH) knowledge, adolescents require support and access to SRH services. Providing evidence-informed SRH knowledge to adolescents in low- and middle-income countries (LMICs) can be a challenge as they face unique barriers such as lack of confidentiality, fear of refusal, and stigma from cultural norms. Increasing availability of mobile apps necessitates a comprehensive evaluation of the quality and classification of these SRH mobile applications so that accurate and evidence-based information is reaching its users. Failure to provide SRH services can have damaging effects throughout their development. Provide an overview of current adolescent SRH (ASRH) mobile applications targeting adolescents in LMICs by evaluating their quality and classifying their characteristics. 21 search terms related to ASRH mobile apps was developed. These terms were searched in the Apple IOS store and Google Play stores. Inclusion and exclusion criteria were used to screen these apps. Resulting apps were assessed using the Mobile App Rating Scale (MARS) tool. Data extracted was used to rank order each app and identify any gaps in quality. Search strategy yielded 2,165 mobile apps. Of these, only 8 were assessed using the MARS tool. Functionality subdomain scored highest at 4.6, while Information scored lowest at 2.5. None of the assessed apps contained information on the MARS items: Evidence base and Goals. Too Shy to Ask had the highest individual app mean score of 4.1, while e-SRHR scored lowest at 2.3. The goal of this study is to classify and rate the quality of mobile apps designed to promote ASRH behaviors and knowledge in LMICs. Numerous apps were reviewed and all of them failed to provide evidence-based and goal oriented SRH information. Strengths include ease of use, navigation, and gestural designs. Weaknesses include evidence base, goals, willingness to pay, customization, and interactivity. These findings can be potentially used to guide future app development and educate decision makers responsible for policy changes.

A mixed-methods evaluation of the Tobacco Retailer Advanced Compliance (TRAC) online training (e-learning) program.

Tobacco vendor training is recognized as an essential element to reduce youth access to tobacco. The TRAC training program was developed utilizing best-practices in tobacco retailer training, adult instruction, and e-learning. The objective of this mixed-methods study is to evaluate the acceptability, usability and knowledge impact of an online tobacco retailer program. An interview guide and evaluation questionnaire were used to collect data on usability and acceptability. To test learner knowledge, each module included a final set of 15 questions randomly chosen and posed to participants before and after the training. Content analysis, chi-squared tests, Student's t-tests, and paired tests were utilized for data analysis. The evaluation was conducted in Alberta, Canada in 2020. A total of 128 participants enrolled in the study. The main themes revealed in the qualitative aspect of the evaluation were: the training was easy to navigate, engaging, informative, and beneficial to the staff's daily work. Compared with the pre-training test, a significantly higher post-training test score, mean and (SD), was recorded for clerks who completed the clerk training module [59.1 (12.8) vs 75.5 (11.1), t=8.6378, p<0.001], and managers who completed the managers training module [51.5 (11.1) vs 73.1 (12.3), t=7.6446, p<0.001]. Similarly, a higher number of participants achieved the passing score of 80% in the post-training test in all three groups. The online training was found to be acceptable and effective in increasing the mean individual score in the knowledge test and in increasing the percentage of participants achieving the passing score. The TRAC training is the first known tobacco retailer training course to employ best practices in tobacco retailer training, adult instruction, and e-learning. Further evaluation of long-term outcomes on employee behavior and on overall compliance with tobacco legislation is recommended.

Patient experience of chronic illness care and complementary integrative health use: a cross-sectional study of patients with hypermobility spectrum disorders (HSD) and Ehlers–Danlos syndromes (EDS)

Purpose Hypermobility spectrum disorders (HSD) and Ehlers–Danlos syndromes (EDS) are frequently underdiagnosed, contributing to patient dissatisfaction in the healthcare system. This study evaluated the health service utilization, care, and subjective experiences of living with chronic illness among adults with HSD and EDS in the United States and Canada. Methods This was an anonymous, web-based, cross-sectional healthcare survey. The survey obtained basic demographic information, the Patient Assessment of Chronic Illness Care (PACIC+), as well as responses to questions on the use of healthcare and integrative medicine. Results A total of 353 surveys were received. The most common complementary therapies used were physical therapy (82%), massage (68%), yoga (58%), chiropractic (48%), and meditation (43%). Mean (SD) summary PACIC and PACIC 5 As scores were 2.16 (0.77) and 2.25 (0.83), respectively. Across all PACIC domains, mean scores of individuals whose typical doctor visit was 30 min or at least an hour were significantly higher than those of individuals who indicated typical visits of 15 min (all p < 0.0001 by one-way ANOVA). There was widespread agreement on the importance of patient-provider relationship and trust, physicians’ understanding of the individual’s complete medical history, and prioritization of physical and emotional safety (>95% agree or strongly agree to each). Conclusion Individuals with HSD or EDS report low satisfaction with chronic illness care and commonly seek out complementary and self-administered therapies, likely in an attempt to manage symptoms. Respondents reported a desire for greater time and attention from physicians. Results from this study could educate the healthcare community to improve support mechanisms for HSD and EDS populations. IMPLICATIONS FOR REHABILITATION Patients with hypermobility spectrum disorders (HSD) or Ehlers–Danlos syndromes (EDS) express a desire for patient-centered care and peer support from other individuals with HSD or EDS. Individuals with HSD or EDS have typically seen multiple doctors for their condition and their satisfaction with chronic care, as measured by the Patient Assessment of Chronic Illness Care (PACIC+), is low. The use of various complementary and integrative health treatments, as well as specialized diets, is common in this population, and might be beneficial for symptom management. Healthcare delivery for HSD and EDS may require a multidisciplinary healthcare team, as complementary and self-care modalities are typically used in addition to physical therapy, pain medication, and other conventional care.

The effect of supportive and educational nursing care on quality of life and HE4 gene expression in patients with ovarian cancer.

Ovarian cancer is one of the most common malignancies in women and is also the fifth leading cause of cancer death in women worldwide. In recent years, the survival rate of patients with this disease has been long, and at the same time, more emphasis is on their quality of life. Therefore, the present study was conducted to investigate the effect of supportive and educational care of nurses on the life quality of patients with ovarian cancer. The expression of the HE4 gene was also evaluated as a diagnostic marker of ovarian cancer to assess the role of supportive and educational care of nurses in improving the physical health of these patients. In this study, which was a quasi-experimental study, 45 patients with ovarian cancer participated. The instrument was demographic information and quality of life questionnaires related to Beckman Institute, which were completed in two stages before and after patients' training and support sessions. HE4 gene expression was also assessed by Real-time PCR technique. Finally, the obtained data were analyzed using SPSS software and statistical tests. Based on the results, the mean score of quality of life before the intervention was 51.73 ± 13.91, and after the intervention was 60.46 ± 13.80 (P <0.001). Also, in all four dimensions of quality of life, the mean score of individuals after the intervention increased compared to before the intervention, but this difference was recognized as significant in only two dimensions of physical and mental health (P <0.001). The results of HE4 gene expression also showed that supportive and educational care of nurses had a significant effect on the expression of this gene. Therefore, this study confirmed the positive effect of educational and supportive programs in improving the quality of life of patients with ovarian cancer. In general, the design and implementation of such programs are proposed more widely and based on patients' educational and supportive needs.

Examination of behavioral intention toward E-learning: a case of University of the Third Age students

ABSTRACT This study was aimed at determining the factors that affect the intentions of University of the Third Age (UTA) students toward e-learning systems by using Structural Equation Modeling. For this purpose, factors such as Self-Efficacy, Experience, Social Norms, Enjoyment, and Anxiety, suggested as external factors in the General Extended Technology Acceptance Model for E-Learning (GETAMEL) model, were included in the UTATAM model developed within the scope of this research. The research was carried out with a total of 210 students studying at The University of the Third Age at Akdeniz University and Ege University. The results of the study indicate that the Experience factor has a strong effect on Anxiety, Self-efficacy, and Perceived Enjoyment. In addition, it was found that Anxiety, Self-efficacy, and Social Norms were effective on perceived Ease of Use, while Perceived Enjoyment and Social Norms were effective on Perceived Usefulness. On the other hand, while the mean scores of Perceived Usefulness and Social Norms were higher in favor of female, the mean scores of Experiences were higher in favor of male. The results indicated that participants’ age and lifestyle did not affect the mean scores of individuals in terms of all factors. In terms of Behavioral Intentions, the average population of countries has been increasing rapidly in recent years. The results of this research study are crucial for shedding light on educational institutions and other relevant institutions in order to determine the factors that affect the intentions of UTA students toward the use of e-learning systems.

Exploring EFL Higher Education Learners’ Attitudes Toward Writing Skills Process

Learners' writing attitudes have been heavily debated as a research topic. The main objective of this current investigation is to explore the learners' attitudes towards the writing process and functions at the higher education level. It is designed as a quantitative approach, with the design as survey research. Thirty-five learners of the English Study Program of FKIP Universitas Islam Indragiri were chosen as the samples. The researcher utilized a questionnaire designed on a Likert scale in obtaining the data. Then the data was analyzed using descriptive statistical analysis, which included individual scores, percentages, mean scores, and attitude level. The findings indicate that the learners' attitudes toward the writing process and functions ranged in the mean score of 3.83, which was categorized as a positive attitude. Therefore, it can be inferred that they have good skills for writing because they have a positive attitude toward writing.

74 The Association Between Burn Injury and Peer Relations: A preschool-libre1-5 Study

IntroductionChildren ages one to five years old are naturally curious and build their personality and social skills through interactions with others. Positive peer relations are especially important after a burn injury as bullying and peer rejection can delay development of social skills. This study assessed the association between burn injuries and burn survivors’ ability to connect with and maintain peer relations in this age group using the Preschool-LIBRE 1-5 (Life Impact Burn Recovery Evaluation).MethodsThe Preschool-LIBRE1-5 was field-tested with 426 parents of burn survivors. Each item was scored on a 5-point Likert scale ranging from 0 (never) to 4 (always). Data was recoded for selected items such that higher scores denote better functioning. Classic test theory methods were used to assess the peer relation items from a social functioning domain. Individual items and mean scores in the domain were examined. Multiple linear regression analyses (controlling for gender, race and ethnicity, pain severity, burn injury to critical area, burn size, and age at survey completion) measured the association between demographic and clinical characteristics and calculated a peer relation score based on multiple imputation samples.ResultsThe mean age was 3.06 + 1.41 years, mean time since injury of 1.16 + 1.34 years, mean total body surface area (TBSA%) of 4.21 + 7.92, and 55.16% male and 74.18% white. Items from peer relations item pool (n=15) were identified as a unidimensional scale (α=0.92, item-total correlations for all 15 items >0.4, ratio of the 1st and 2nd eigenvalues (8.729/1.287=6.78) = > 4). The mean peer relation score was 2.86 + 0.76. The two items with the lowest and highest score were “My child would ask for things nicely when playing with other children” (x̄ = 2.09) and “My child liked to play near and be with family members and friends (x̄ = 3.59) respectively. Results indicated that age was a significant predictor, such that older age at survey completion was significantly associated with higher peer relation score (β = 0.16, p < 0.0001). With each year of age increase, peer relationship score increased by 0.16 + 0.21 points.ConclusionsPreschool-aged burn survivors, as reported by parents, often had the ability to connect with peers through imitation and participating in play activities, and maintained peer relationships well. These findings emphasize the importance of promoting early interventions that build social skills, allowing for positive interactions with peers and improving social functioning in the long-term.