Publications by authors named "Sezer Kisa"

35 Publications

Cultural Sensitivity in Interventions Aiming to Reduce or Prevent Intimate Partner Violence During Pregnancy: A Scoping Review.

Trauma Violence Abuse 2021 Jun 10:15248380211021788. Epub 2021 Jun 10.

Department of Nursing and Health Promotion, Oslo Metropolitan University, Norway.

Intimate partner violence (IPV) around the time of pregnancy is a recognized global health problem. Ethnic minorities and immigrant pregnant women experiencing IPV require culturally responsive health services. The aim of this scoping review was to identify aspects of cultural sensitivity in interventions to prevent or reduce IPV among ethnic minorities and immigrant pregnant women in high-income countries. Eight databases were searched in November 2019. Any type of scientific research, quantitative, qualitative, or mixed methods studies regarding interventions against IPV among pregnant women were considered for inclusion. Resnicow et al.'s definition of cultural sensitivity was used to identify aspects of cultural sensitivity. Ten papers relating to nine interventions/studies met our inclusion criteria. These studies, which included randomized controlled trials, a mixed methods study, a program evaluation, and a longitudinal study, were conducted in Australia, Belgium, Norway, and the United States. Aspects of surface cultural sensitivity, including the translation of intervention content into the language of the target group(s) and the involvement of bilingual staff to recruit participants, were identified in eight studies. Deep structure aspects of cultural sensitivity were identified in one study, where the intervention content was pretested among the target group(s). Results that could be related to the culture-sensitive adaptions included successful recruitment of the target population. Three studies were planning to investigate women's experiences of interventions, but no publications were yet available. This scoping review provides evidence that culturally sensitive interventions to reduce or prevent IPV among immigrant pregnant women are limited in number and detail.
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http://dx.doi.org/10.1177/15248380211021788DOI Listing
June 2021

Prevalence of Fatigue and Associated Factors Among Cancer Patients Attending Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia.

Cancer Manag Res 2021 24;13:1909-1916. Epub 2021 Feb 24.

Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.

Background: Fatigue is a subjective and distressing symptom in cancer patients and has profound effects on daily life. The rates of fatigue during treatment are reported to be 25-90%. Its causes are secondary to their treatment course, cancer itself and associated factors.

Purpose: To assess the prevalence of fatigue and associated factors among cancer patients at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia, 2019.

Patients And Methods: A cross-sectional study design was conducted on cancer patients undergoing treatment in Tikur Anbessa Specialized Hospital. A sample of 278 was selected using systematic random sampling technique and Brief Fatigue Inventory questionnaire was used for data collection. The data were entered into EPI data version 3.1 and transferred to SPSS version 24 for analysis. Bivariate and multivariable logistic regression were conducted to summarize the data. The significant statistical test was determined at 95% confidence interval and at p<0.05.

Results: The mean age of the participants was 44.9 ± 14 years. The prevalence of fatigue identified by this study was 208 (74.8%). Age, stage of cancer, presence of infection, type of cancer, and type of treatment had shown a significant association with fatigue [AOR = 3.15, 95% CI: (1.35-7.34)], [AOR = 0.02, 95% CI: (0.003-0.172)], [AOR = 4.15, 95% CI: (1.06-16.07)], [AOR = 5.19, 95% CI: (1.59-16.90)], [AOR = 0.18, 95% CI: (0.07-0.462)] respectively.

Conclusion: The prevalence of fatigue in cancer patients in this study was high. Risk factors were age of the patients, stage of cancer, presence of infection, cervical cancer and radiation therapy.
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http://dx.doi.org/10.2147/CMAR.S291298DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7917325PMC
February 2021

Dysphagia and its impact on the quality of life of head and neck cancer patients: institution-based cross-sectional study.

BMC Res Notes 2021 Jan 7;14(1):11. Epub 2021 Jan 7.

Department of Nursing, School of Nursing & Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

Objective: Impaired swallowing is a primary medical concern in head and neck cancer (HNC) patients. Swallowing therapy and supportive care to relieve swallowing problems among HNC patients are recommended. However, no data shows the effect of dysphagia on the quality of life (QoL) among Ethiopian patients. This cross-sectional study aimed to assess swallowing function and its impact on QoL.

Results: The sample included 102 HNC patients who visited oncology clinics at Tikur Anbessa Specialized Hospital. Majority were male (53.90%), employed (70.6%), single (57.80%), and completed some level of formal education (66.60%) with a mean age of 42.58 years (SD ± 14.08). More than half of the patients (69.6%) medical expenses were covered by the government. Most were suffering from advanced stage HNC (59.80%), squamous cell carcinoma (62.70%), and the most prevalent tumor location was nasopharynx (40.20%). The mean MDADI score was 53.29 (SD ± 15.85). Being female, low income, suffering from laryngeal cancer, advanced tumor, and undergoing a single modality therapy were crucial determinants of poor QoL related to swallowing problems. It is recommended to assess swallowing related QoL of patients using a validated tool and be included in treatment protocols.
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http://dx.doi.org/10.1186/s13104-020-05440-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7791825PMC
January 2021

Estimating global injuries morbidity and mortality: methods and data used in the Global Burden of Disease 2017 study.

Inj Prev 2020 10 24;26(Supp 1):i125-i153. Epub 2020 Aug 24.

Department of Pharmacy, Adigrat University, Adigrat, Ethiopia.

Background: While there is a long history of measuring death and disability from injuries, modern research methods must account for the wide spectrum of disability that can occur in an injury, and must provide estimates with sufficient demographic, geographical and temporal detail to be useful for policy makers. The Global Burden of Disease (GBD) 2017 study used methods to provide highly detailed estimates of global injury burden that meet these criteria.

Methods: In this study, we report and discuss the methods used in GBD 2017 for injury morbidity and mortality burden estimation. In summary, these methods included estimating cause-specific mortality for every cause of injury, and then estimating incidence for every cause of injury. Non-fatal disability for each cause is then calculated based on the probabilities of suffering from different types of bodily injury experienced.

Results: GBD 2017 produced morbidity and mortality estimates for 38 causes of injury. Estimates were produced in terms of incidence, prevalence, years lived with disability, cause-specific mortality, years of life lost and disability-adjusted life-years for a 28-year period for 22 age groups, 195 countries and both sexes.

Conclusions: GBD 2017 demonstrated a complex and sophisticated series of analytical steps using the largest known database of morbidity and mortality data on injuries. GBD 2017 results should be used to help inform injury prevention policy making and resource allocation. We also identify important avenues for improving injury burden estimation in the future.
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http://dx.doi.org/10.1136/injuryprev-2019-043531DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571362PMC
October 2020

Under-reporting of COVID-19 cases in Turkey.

Int J Health Plann Manage 2020 Sep 3;35(5):1009-1013. Epub 2020 Aug 3.

School of Health Sciences, Kristiania University College, Oslo, Norway.

Having an accurate account of the number of national COVID-19 cases is essential for understanding the national and global burden of the disease and managing COVID-19 prevention and control efforts. There is also substantial under-reporting of COVID-19 cases and deaths in many countries. In this article, the COVID-19 under-reporting problem in Turkey is addressed, and examples and reasons for the under-reporting are discussed.
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http://dx.doi.org/10.1002/hpm.3031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7436880PMC
September 2020

Global injury morbidity and mortality from 1990 to 2017: results from the Global Burden of Disease Study 2017.

Inj Prev 2020 10 24;26(Supp 1):i96-i114. Epub 2020 Apr 24.

Faculty of Health Sciences - Health Management and Policy, American University of Beirut, Beirut, Lebanon.

Background: Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries.

Methods: We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs).

Findings: In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505).

Interpretation: Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.
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http://dx.doi.org/10.1136/injuryprev-2019-043494DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571366PMC
October 2020

Global, Regional, and National Burden of Calcific Aortic Valve and Degenerative Mitral Valve Diseases, 1990-2017.

Circulation 2020 05 29;141(21):1670-1680. Epub 2020 Mar 29.

Institute of Family Medicine and Public Health, University of Tartu, Tartumaa, Estonia (M.J.).

Background: Nonrheumatic valvular diseases are common; however, no studies have estimated their global or national burden. As part of the Global Burden of Disease Study 2017, mortality, prevalence, and disability-adjusted life-years (DALYs) for calcific aortic valve disease (CAVD), degenerative mitral valve disease, and other nonrheumatic valvular diseases were estimated for 195 countries and territories from 1990 to 2017.

Methods: Vital registration data, epidemiologic survey data, and administrative hospital data were used to estimate disease burden using the Global Burden of Disease Study modeling framework, which ensures comparability across locations. Geospatial statistical methods were used to estimate disease for all countries, because data on nonrheumatic valvular diseases are extremely limited for some regions of the world, such as Sub-Saharan Africa and South Asia. Results accounted for estimated level of disease severity as well as the estimated availability of valve repair or replacement procedures. DALYs and other measures of health-related burden were generated for both sexes and each 5-year age group, location, and year from 1990 to 2017.

Results: Globally, CAVD and degenerative mitral valve disease caused 102 700 (95% uncertainty interval [UI], 82 700-107 900) and 35 700 (95% UI, 30 500-42 500) deaths, and 12.6 million (95% UI, 11.4 million-13.8 million) and 18.1 million (95% UI, 17.6 million-18.6 million) prevalent cases existed in 2017, respectively. A total of 2.5 million (95% UI, 2.3 million-2.8 million) DALYs were estimated as caused by nonrheumatic valvular diseases globally, representing 0.10% (95% UI, 0.09%-0.11%) of total lost health from all diseases in 2017. The number of DALYs increased for CAVD and degenerative mitral valve disease between 1990 and 2017 by 101% (95% UI, 79%-117%) and 35% (95% UI, 23%-47%), respectively. There is significant geographic variation in the prevalence, mortality rate, and overall burden of these diseases, with highest age-standardized DALY rates of CAVD estimated for high-income countries.

Conclusions: These global and national estimates demonstrate that CAVD and degenerative mitral valve disease are important causes of disease burden among older adults. Efforts to clarify modifiable risk factors and improve access to valve interventions are necessary if progress is to be made toward reducing, and eventually eliminating, the burden of these highly treatable diseases.
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http://dx.doi.org/10.1161/CIRCULATIONAHA.119.043391DOI Listing
May 2020

Global trends of hand and wrist trauma: a systematic analysis of fracture and digit amputation using the Global Burden of Disease 2017 Study.

Inj Prev 2020 10 13;26(Supp 1):i115-i124. Epub 2020 Mar 13.

Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, USA.

Background: As global rates of mortality decrease, rates of non-fatal injury have increased, particularly in low Socio-demographic Index (SDI) nations. We hypothesised this global pattern of non-fatal injury would be demonstrated in regard to bony hand and wrist trauma over the 27-year study period.

Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study 2017 was used to estimate prevalence, age-standardised incidence and years lived with disability for hand trauma in 195 countries from 1990 to 2017. Individual injuries included hand and wrist fractures, thumb amputations and non-thumb digit amputations.

Results: The global incidence of hand trauma has only modestly decreased since 1990. In 2017, the age-standardised incidence of hand and wrist fractures was 179 per 100 000 (95% uncertainty interval (UI) 146 to 217), whereas the less common injuries of thumb and non-thumb digit amputation were 24 (95% UI 17 to 34) and 56 (95% UI 43 to 74) per 100 000, respectively. Rates of injury vary greatly by region, and improvements have not been equally distributed. The highest burden of hand trauma is currently reported in high SDI countries. However, low-middle and middle SDI countries have increasing rates of hand trauma by as much at 25%.

Conclusions: Certain regions are noted to have high rates of hand trauma over the study period. Low-middle and middle SDI countries, however, have demonstrated increasing rates of fracture and amputation over the last 27 years. This trend is concerning as access to quality and subspecialised surgical hand care is often limiting in these resource-limited regions.
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http://dx.doi.org/10.1136/injuryprev-2019-043495DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7571361PMC
October 2020

Survival status and associated factors of death among cervical cancer patients attending at Tikur Anbesa Specialized Hospital, Addis Ababa, Ethiopia: a retrospective cohort study.

BMC Cancer 2019 Dec 16;19(1):1221. Epub 2019 Dec 16.

Oslo University Collaboration Unit, Oslo, Norway.

Background: Cervical cancer is a cancer of uterine cervix caused mostly by sexually-acquired infection called Human papillomavirus (HPV. In developing region of the globe, fewer than 50% of women with cervical malignancy survive more than 5 years. Therefore, the objective of this study was to assess survival status and associated factors of death among cervical cancer patients attending at Tikur Anbesa Specialized Hospital (TASH), Ethiopia.

Methods: Facility based retrospective cohort study was conducted from March to April 2019 at Tikur Anbesa Specialized Hospital oncology center. Data was collected from patient's chart using pre-tested and structured checklist prepared in English and analyzed using STATA14.2. Cox regression model was used to identify Variables that affected survival.

Result: The overall survival rate was 38.62% at 5 years. There were a significance differences in survival experience between categories of stage of cervical cancer, age of patients, comorbidity, substance use, base line anemia and treatment modalities. Being stage IV [AHR = 11.76; 95% CI (4.02-34.4)],being advanced age [AHR = 5.99; 95% CI (2.1-17.08)], being comorbid [AHR = 1.58; 95%CI(1.14-2.19)], using substance [AHR = 1.56;95% CI(1.09-2.22)] and being anemic [AHR = 1.6;95% CI(1.11-2.36)] increased the risk of death.

Conclusion: The overall survival rate was lower than high- and middle-income countries and Significant factors of death after diagnosis of cervical cancer were; advanced FIGO stage, base line anemia, comorbidity, substance use, advanced age and treatment modality. Authors recommend that it is better to expand cervical cancer early screening programs and treatment facilities, strengthen awareness in collaboration with public medias about cervical cancer prevention, screening and treatment options.
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http://dx.doi.org/10.1186/s12885-019-6447-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916089PMC
December 2019

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017.

Nature 2019 10 16;574(7778):353-358. Epub 2019 Oct 16.

School of Health Sciences, Madda Walabu University, Bale Goba, Ethiopia.

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2-to end preventable child deaths by 2030-we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000-2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations.
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http://dx.doi.org/10.1038/s41586-019-1545-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6800389PMC
October 2019

Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-Years for 29 Cancer Groups, 1990 to 2017: A Systematic Analysis for the Global Burden of Disease Study.

JAMA Oncol 2019 12;5(12):1749-1768

Department of Family and Community Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

Importance: Cancer and other noncommunicable diseases (NCDs) are now widely recognized as a threat to global development. The latest United Nations high-level meeting on NCDs reaffirmed this observation and also highlighted the slow progress in meeting the 2011 Political Declaration on the Prevention and Control of Noncommunicable Diseases and the third Sustainable Development Goal. Lack of situational analyses, priority setting, and budgeting have been identified as major obstacles in achieving these goals. All of these have in common that they require information on the local cancer epidemiology. The Global Burden of Disease (GBD) study is uniquely poised to provide these crucial data.

Objective: To describe cancer burden for 29 cancer groups in 195 countries from 1990 through 2017 to provide data needed for cancer control planning.

Evidence Review: We used the GBD study estimation methods to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life-years (DALYs). Results are presented at the national level as well as by Socio-demographic Index (SDI), a composite indicator of income, educational attainment, and total fertility rate. We also analyzed the influence of the epidemiological vs the demographic transition on cancer incidence.

Findings: In 2017, there were 24.5 million incident cancer cases worldwide (16.8 million without nonmelanoma skin cancer [NMSC]) and 9.6 million cancer deaths. The majority of cancer DALYs came from years of life lost (97%), and only 3% came from years lived with disability. The odds of developing cancer were the lowest in the low SDI quintile (1 in 7) and the highest in the high SDI quintile (1 in 2) for both sexes. In 2017, the most common incident cancers in men were NMSC (4.3 million incident cases); tracheal, bronchus, and lung (TBL) cancer (1.5 million incident cases); and prostate cancer (1.3 million incident cases). The most common causes of cancer deaths and DALYs for men were TBL cancer (1.3 million deaths and 28.4 million DALYs), liver cancer (572 000 deaths and 15.2 million DALYs), and stomach cancer (542 000 deaths and 12.2 million DALYs). For women in 2017, the most common incident cancers were NMSC (3.3 million incident cases), breast cancer (1.9 million incident cases), and colorectal cancer (819 000 incident cases). The leading causes of cancer deaths and DALYs for women were breast cancer (601 000 deaths and 17.4 million DALYs), TBL cancer (596 000 deaths and 12.6 million DALYs), and colorectal cancer (414 000 deaths and 8.3 million DALYs).

Conclusions And Relevance: The national epidemiological profiles of cancer burden in the GBD study show large heterogeneities, which are a reflection of different exposures to risk factors, economic settings, lifestyles, and access to care and screening. The GBD study can be used by policy makers and other stakeholders to develop and improve national and local cancer control in order to achieve the global targets and improve equity in cancer care.
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http://dx.doi.org/10.1001/jamaoncol.2019.2996DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6777271PMC
December 2019

Intermittent auscultation fetal monitoring during labour: A systematic scoping review to identify methods, effects, and accuracy.

PLoS One 2019 10;14(7):e0219573. Epub 2019 Jul 10.

Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, Oslo, Norway.

Background: Intermittent auscultation (IA) is the technique of listening to and counting the fetal heart rate (FHR) for short periods during active labour and continuous cardiotocography (CTC) implies FHR monitoring for longer periods. Although the evidence suggests that IA is the best way to monitor healthy women at low risk of complications, there is no scientific evidence for the ideal device, timing, frequency and duration for IA. We aimed to give an overview of the field, identify and describe methods and practices for performing IA, map the evidence and accuracy for different methods of IA, and identify research gaps.

Methods: We conducted a systematic scoping review following the Joanna Briggs methodology. Medline, EMBASE, Cinahl, Maternity & Infant Care, Cochrane Library, SveMed+, Web of Science, Scopus, Lilacs and African Journals Online were searched for publications up to January 2019. We did hand searches in relevant articles and databases. Studies from all countries, international guidelines and national guidelines from Denmark, United Kingdom, United States, New Zealand, Australia, The Netherlands, Sweden, Denmark, and Norway were included. We did quality assessment of the guidelines according to the AGREEMENT tool. We performed a meta-analysis assessing the effects of IA with a Doppler device vs. Pinard device using methods described in The Cochrane Handbook, and we performed an overall assessment of the summary of evidence using the GRADE approach.

Results: The searches generated 6408 hits of which 26 studies and 11 guidelines were included in the review. The studies described slightly different techniques for performing IA, and some did not provide detailed descriptions. Few of the studies provided details of normal and abnormal IA findings. All 11 guidelines recommended IA for low risk women, although they had slightly different recommendations on the frequency, timing, and duration for IA, and the FHR characteristics that should be observed. Four of the included studies, comprising 8436 women and their babies, were randomised controlled trials that evaluated the effect of IA with a Doppler device vs. a Pinard device. Abnormal FHRs were detected more often using the Doppler device than in those using the Pinard device (risk ratio 1.77; 95% confidence interval 1.29-2.43). There were no significant differences in any of the other maternal or neonatal outcomes. Four studies assessed the accuracy of IA findings. Normal FHR was easiest to identify correctly, whereas identifying periodic FHR patterns such as decelerations and saltatory patterns were more difficult.

Conclusion: Although IA is the recommended method, no trials have been published that evaluate protocols on how to perform it. Nor has any study assessed interrater agreements regarding interpretations of IA findings, and few have assessed to what degree clinicians can describe FHR patterns detected by IA. We found no evidence to recommend Doppler device instead of the Pinard for IA, or vice versa.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0219573PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6619817PMC
February 2020

Perceptions and predictors of dating violence among nursing and midwifery students.

J Adv Nurs 2019 Oct 5;75(10):2099-2109. Epub 2019 Apr 5.

Department of Nursing, Faculty of Health Sciences, Gaziantep University, Gaziantep, Turkey.

Aims: To determine the prevalence and predictors of victimization and perpetration of dating violence among nursing and midwifery students.

Design: A cross-sectional study design.

Methods: The sample consisted of nursing and midwifery students (N = 603) at the largest state university in southeastern Turkey. Data were collected with a validated, investigator-designed survey instrument between September 2015 and January 2016.

Findings: Most participants had been exposed to dating violence. Jealousy, controlling behaviour, and restrictions on another's social life were not perceived as violent behaviour in dating relationships. There was no significant relationship of dating violence with gender, smoking, place of residence, or marijuana use. Exposure to parental violence and alcohol use were found to be the strongest predictors of being a perpetrator of violence in the dating violence perpetration model.

Conclusion: The findings highlight the lack of recognition of dating violence among nursing and midwifery students. The perceptions of students should be enriched by adding content on violent behaviours in the curriculum of nursing and midwifery programmes.

Impact: Efforts to reduce and stop dating violence have a crucial role in preventing future violence in established relationships. We acknowledge that the prevalence of dating violence among nursing and midwifery students is high. Psychological and verbal violence are extremely common and most are not recognized as violent behaviours by the students. This study contributes to the understanding of violent behaviours related to dating violence among nursing and midwifery students for establishing healthy relationship.
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http://dx.doi.org/10.1111/jan.13982DOI Listing
October 2019

Perceptions and predictors of dating violence among nursing and midwifery students.

J Adv Nurs 2019 Oct 5;75(10):2099-2109. Epub 2019 Apr 5.

Department of Nursing, Faculty of Health Sciences, Gaziantep University, Gaziantep, Turkey.

Aims: To determine the prevalence and predictors of victimization and perpetration of dating violence among nursing and midwifery students.

Design: A cross-sectional study design.

Methods: The sample consisted of nursing and midwifery students (N = 603) at the largest state university in southeastern Turkey. Data were collected with a validated, investigator-designed survey instrument between September 2015 and January 2016.

Findings: Most participants had been exposed to dating violence. Jealousy, controlling behaviour, and restrictions on another's social life were not perceived as violent behaviour in dating relationships. There was no significant relationship of dating violence with gender, smoking, place of residence, or marijuana use. Exposure to parental violence and alcohol use were found to be the strongest predictors of being a perpetrator of violence in the dating violence perpetration model.

Conclusion: The findings highlight the lack of recognition of dating violence among nursing and midwifery students. The perceptions of students should be enriched by adding content on violent behaviours in the curriculum of nursing and midwifery programmes.

Impact: Efforts to reduce and stop dating violence have a crucial role in preventing future violence in established relationships. We acknowledge that the prevalence of dating violence among nursing and midwifery students is high. Psychological and verbal violence are extremely common and most are not recognized as violent behaviours by the students. This study contributes to the understanding of violent behaviours related to dating violence among nursing and midwifery students for establishing healthy relationship.
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http://dx.doi.org/10.1111/jan.13982DOI Listing
October 2019

Predictors of marital adjustment among child brides.

Arch Psychiatr Nurs 2018 10 13;32(5):670-676. Epub 2018 Mar 13.

Oslo Metropolitan University, Faculty of Health Sciences, Department of Nursing and Health Promotion, Kjeller, Oslo, Norway. Electronic address:

The researchers aim was to examine the predictors of marital adjustment among child brides in Turkey. The sample included 246 women who were between 18 and 49 years of age, got married while under the age of 18, not divorced, who spoke Turkish or Kurdish, by using convenience sampling method. We used a marital adjustment scale and a survey form to collect data. Our findings indicated that marital adjustment was low among child brides. The factors affecting women's marital adjustment were duration and types of the marriage, number of pregnancies and physical violence. The incidence of physical violence was inversely correlated with the scores of marital adjustment of women, while the women's age, education, income level, number of living children, age, and the education level of their partner was not correlated. The results of this study would be useful for nurses, midwives, social workers, and counselors who assist women who are facing domestic violence.
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http://dx.doi.org/10.1016/j.apnu.2018.03.006DOI Listing
October 2018

Knowledge and perception of female nursing students about human papillomavirus (HPV), cervical cancer, and attitudes toward HPV vaccination.

J Am Coll Health 2019 Jul 5;67(5):410-417. Epub 2018 Oct 5.

a Department of Nursing , Gaziantep University, Faculty of Health Sciences , Gaziantep, Turkey.

The researchers aimed to evaluate the knowledge and perceptions of first-year female nursing students about human papillomavirus (HPV), cervical cancer (CC), and HPV vaccination. The sample included 690 female nursing students from sampled universities between April and June 2015. Students were surveyed by using a pretested HPV and CC awareness questionnaire. More than half of the students (65.1%) answered questions incorrectly with a mean HPV knowledge score of 6.085 ± 3.38. The majority of students (82.6%) did not hear HPV vaccine. Only, 2.8% of the students had been vaccinated. A statistically significant relationship was found between HPV knowledge score and hearing about HPV vaccine ( = 28280.500,  = .015), and believing HPV vaccine protectiveness ( = 14.153,  = .001). This study highlights the lack of knowledge and low level of awareness about HPV, CC, and HPV vaccination among first-year nursing college students.
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http://dx.doi.org/10.1080/07448481.2018.1484364DOI Listing
July 2019

Traditional practices for maternal and newborn care among Turkish postpartum women.

Appl Nurs Res 2018 02 7;39:148-153. Epub 2017 Nov 7.

Oslo and Akershus University College of Applied Sciences, Faculty of Health Sciences, Department of Nursing and Health Promotion, Kjeller, Oslo-Norway. Electronic address:

Aim: Researchers used descriptive study design to examine the traditional practices of women in relation to maternal and newborn care in the postpartum period.

Methods: 523 postpartum women included who were between 15 and 49years of age, had at least one child, and had no medical complications that affect the mother-infant health. A questionnaire was used to collect data. Comparisons were made between the responses about the women's knowledge of traditional practices and other variables.

Results: We found that women widely used traditional practices such as putting Koran (Holy book for Muslims) and packing needle under the mother's pillow to prevent mother from "al basması", pouring lead in a cup over the head of the newborn to repel evil spirits, and covering the baby's face with a piece of yellow cloth to prevent neonatal jaundice. The rate of using postpartum traditional practices increased with age and number of pregnancies and decreased with education (p<0.05).

Conclusion: Educational activities are recommended to increase awareness of harmful traditional practices in the field of reproductive health for nurses and midwives. Health professionals should pay special attention to less educated, older and primiparous women from rural areas enable them to reinforce positive cultural practices, and discourage them from using harmful ones by providing non-critical scientific explanations.
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http://dx.doi.org/10.1016/j.apnr.2017.11.018DOI Listing
February 2018

Opinions and attitudes of obstetricians and midwives in Turkey towards caesarean section and vaginal birth following a previous caesarean section.

J Int Med Res 2017 Dec 12;45(6):1739-1749. Epub 2017 Jan 12.

3 Department of Health Policy & Management, Global Health, Economics & Finance Concentrations, Jackson State University, Jackson, MS, USA.

Aim To determine the opinions and attitudes of Turkish obstetricians and midwives to caesarean section (C-section) and vaginal birth following a C-section. Methods The study involved obstetricians and midwives who were working in a state women's hospital and two private hospitals in Gaziantep, Turkey. Participants were asked to complete questionnaires on sociodemographic data and provide opinions about C-section. Results A total of 88 midwives and 22 obstetricians participated in the study. Approximately one-third of midwives believed caesarean rates were high at their institution and more than 50% thought that the rate should be reduced. In contrast, although approximately 80% of obstetricians thought that caesarean rates in their institutions ranged between 25-50%, only 18% believed the rate was high and 68% believed that the rate of should be reduced. Midwives and obstetricians tended to agree on most suggested reasons for high C-section rates. When asked about interventions that may reduce the C-section rates, midwives and obstetricians had opposing views. However, most participants agreed that prenatal childbirth preparation courses would be beneficial. Conclusions This study showed that most midwives and obstetricians believe the rate of C-section at their institution is high and should be reduced.
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http://dx.doi.org/10.1177/0300060516663998DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5805182PMC
December 2017

Predictors and measurement of satisfaction with postpartum care in a government hospital.

Nurs Health Sci 2017 Jun 28;19(2):198-203. Epub 2017 Feb 28.

Department of Obstetrics and Gyneocology, Erciyes University Medical School Research and Practice Hospital, Kayseri, Turkey.

In this study, the predictors of satisfaction with postpartum care at a government hospital were evaluated. The descriptive research sample included 300 mothers in their postpartum period. Data were collected using a questionnaire and the Postpartum Nursing Care Evaluation Scale. The regression analysis undertaken showed that mothers who received prenatal care had a significantly higher evaluation score (compared to those who had not received prenatal care), as had mothers who had a caesarean delivery (compared to vaginal birth), as well as those who had received support from friends and relatives during their postpartum period (compared to those who did not receive such support). Our recommendation is that postpartum nursing care be improved for mothers who deliver vaginally, have not received prenatal care, were unintentionally pregnant, and have problems with breastfeeding. The results will help nurses who work with an international population of postpartum women to give professional, systematic, and patient-centered care to postpartum mothers in order to increase patient satisfaction.
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http://dx.doi.org/10.1111/nhs.12327DOI Listing
June 2017

What Do Married Couples Think About Induced Abortion?

J Sex Marital Ther 2017 Nov 28;43(8):736-746. Epub 2016 Nov 28.

b Department of Nursing Science , Institute of Health and Society, University of Oslo , Oslo , Norway.

This study examined the opinions of married couples concerning induced abortion in a sample of 674 married couples obtaining services at a large obstetrical/gynecological outpatient service. Although approximately half of the sample were not using birth control, a similar percentage felt that curettage (selective abortion) should never be performed. A larger percentage felt that selective abortion is a sin and should be banned. Sex differences in attitudes were minimal. Couples may benefit from a birth control education program in a hospital that is designed to cover abortion in order to provide accurate information in a more professional environment.
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http://dx.doi.org/10.1080/0092623X.2016.1263704DOI Listing
November 2017

Opinions of women towards cesarean delivery and priority issues of care in the postpartum period.

Appl Nurs Res 2016 May 14;30:70-5. Epub 2015 Nov 14.

Gaziantep University, Faculty of Health Sciences, Department of Nursing, Gaziantep, Turkey. Electronic address:

This study was conducted, in order to determine the opinions of women who had a cesarean delivery and the problems that they faced in the postpartum period. This descriptive study was conducted with 337 women who delivered babies by cesarean section. The data were collected using a semi-structured questionnaire. The results of the study showed that 53.4% of women underwent cesarean delivery for the first time, and 83.1% said that it was the obstetrician's decision to have a cesarean delivery. More than half of the women (61.1%) had a negative experience with cesarean delivery due to postpartum pain (44.7%) and inability to care for their infant (35.9%). The most common problems associated with cesarean delivery were postpartum pain (96.1%), back pain (68.2%), problems passing gas (62.0%), bleeding (56.1%), breastfeeding problems (49.6%) and limitation of movement (43.6%) respectively. Understanding the the opinions and problems of women towards cesarean delivery assists healthcare professionals in identifying better ways to provide appropriate care and support.
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http://dx.doi.org/10.1016/j.apnr.2015.11.004DOI Listing
May 2016

Opinions and Attitudes About Vasectomy of Married Couples Living in Turkey.

Am J Mens Health 2017 05 3;11(3):531-541. Epub 2015 Dec 3.

2 Gaziantep University, Gaziantep, Turkey.

This study was conducted as a descriptive study, designed to determine the opinions and attitudes of married couples living in Turkey about vasectomy. The sample consisted of 350 women. Researchers used a questionnaire to collect data. Descriptive statistics and chi-square analysis were used. The results showed that 14% of women and 43.0% of men were of the opinion that undergoing a vasectomy procedure was a sin. Chi-square analysis determined statistically significant differences between the male and female groups ( p < .05). More than 88.0% of the men were not willing to have vasectomy and 35.4% thought that vasectomy had a negative effect on marriage and sexual health. In addition, 58.9% thought that vasectomy had a negative effect on men's health. Women were more likely than men to see vasectomy as merely a cultural taboo instead of a sin. Sociocultural factors, such as ideas that contraception is the woman's responsibility, that sterilized men lose status in society, or that sterilized men lose authority in the family, as well as misconceptions about vasectomy such as concerns about sexual functioning, psychological effects, and effects on physical strength, were determined to be the main barriers for vasectomy use in Turkish culture. The study recommends determining strategies for overcoming sociocultural barriers by raising awareness and increasing the utilization of vasectomy. Couple-specific family planning programs can make an important contribution toward improving awareness of the benefits of vasectomy.
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http://dx.doi.org/10.1177/1557988315620275DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5675235PMC
May 2017

Quality of sexual life and its effect on marital adjustment of Turkish women in pregnancy.

J Sex Marital Ther 2014 8;40(4):309-22. Epub 2013 Oct 8.

a Department of Nursing, Faculty of Health Sciences , Gazi University , Besevler , Ankara , Turkey.

Pregnancy is an important period of a woman's life that can affect marital relationships because of decrease in the sexual function. This study aimed to examine the effect of sexual life on the marital adjustment of 607 healthy, pregnant women using the self-administered Sexual Quality of Life Questionnaire-Female and the Marital Adjustment Scale. Results showed that 30% of the pregnant women experienced problems during sexual intercourse and 50% had painful intercourse. The median total score of the Sexual Quality of Life Questionnaire-Female for pregnant women was 35.5, and the median total score of the Marital Adjustment Scale was 41.0. The authors found a positive moderate level correlation between the sexual quality of life for women and their marital adjustment for being pregnant (r = 0.468, p =.001). The results imply that the variance in the sexual activity during the childbearing period does occur and pregnant women need to be assessed regularly with regards to their sexuality by health care providers in a professional atmosphere.
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http://dx.doi.org/10.1080/0092623X.2012.751071DOI Listing
December 2014

Determination of the use of traditional practices to ease labour among Turkish women.

Int J Nurs Pract 2013 Feb;19(1):65-73

Department of Nursing, Mersin University School of Health, Mersin, Turkey.

The purpose of this study was to determine the use of traditional practices to ease labour among Turkish women. Face-to-face interviews were conducted with 809 women by using an investigator-designed questionnaire. The mean age of the women was 28.9 ± 8.33 years (min = 15, max = 74), 49.4% were between 20-29 years of age and more than half (56.2%) of the women had had one to two pregnancies. The results showed that traditional practices were known and applied mostly by the women who were at an advanced age, less educated and who lived in rural areas. In addition, the knowledge and application status of traditional practices related to religious beliefs were found to be very high compared with superstitious practices. It was suggested that nurses provide culturally competent care that requires a commitment by the individual nurse to develop, refine and use specific skills in the care of women.
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http://dx.doi.org/10.1111/ijn.12025DOI Listing
February 2013

Determinants of family planning use among Turkish married men who live in South East Turkey.

Am J Mens Health 2013 May 8;7(3):255-64. Epub 2013 Jan 8.

Faculty of Health Sciences, Department of Nursing, Şahinbey, Gaziantep University, Gaziantep 27310, Turkey.

This study assesses the determinants of family planning methods use by Turkish married men in South East Anatolia. A descriptive and cross-sectional survey research design was used among 1,352 men aged 20 to 52 years who lived in South East Turkey. A pilot-tested questionnaire was used to collect data. Descriptive statistics, chi-square, and multivariate regression analysis were used. The rate of nonusage of contraceptive methods among the participants was 60.4%. Within the nonusers, 34.9% reported a religious prohibition and 9.4% had misconceptions about family planning. Chi-square analysis determined four factors that were significantly related to the men's usage of contraception. These factors are the following: the men's age, educational level, number of existing children, and their perception of their household income level. These four factors were also subjected to multivariate regression analysis, the results of which were used to compute odds ratios for each value of each factor indicating the likelihood for using contraception by men within each group. Male-specific family planning programs can make an important contribution to the overall efforts to improve the usage of contraceptives by men. It is important to note that family planning services and education programs related to family planning should be appropriate for men.
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http://dx.doi.org/10.1177/1557988312471556DOI Listing
May 2013

Turkish nursing students' knowledge and perceptions regarding virginity.

Nurse Educ Today 2013 Feb 8;33(2):110-5. Epub 2012 Mar 8.

Gaziantep University, Faculty of Health Sciences, Department of Nursing, Gaziantep, Turkey.

The aim of this study was to describe the level of knowledge and perceptions of the Turkish nursing students regarding virginity, the virginity examination and the hymen repair. A convenience sample was used for the study purpose. An investigator designed questionnaire was administered to a total sample of 781 undergraduate nursing students originating from two universities in Mersin and Gaziantep, Turkey, respectively. The results showed that the participating nursing students agreed that a man must marry a virgin woman and the students' opinions had been affected by the social pressures and the social values regarding virginity. In additon, it was found that the repair of the hymen was acceptable by the participating students. The findings of this study addressed and highlighted the gap in the knowledge on virginity related violence so as to improve the educational programmes and clinical practice within the context of preparing nurses for an extended role in violence against women.
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http://dx.doi.org/10.1016/j.nedt.2012.01.016DOI Listing
February 2013

Examination of midlife women's attitudes toward menopause in Turkey.

Nurs Health Sci 2012 Jun 9;14(2):148-55. Epub 2012 Feb 9.

Department of Nursing, Gazi University, Ankara, Turkey.

This study used a cross-sectional descriptive design to examine the attitudes of 154 Turkish women aged ≥ 40 years towards menopause. A questionnaire and the Menopause Attitudes scale were used. The mean score of the attitudes was determined as 34.70 ± 8.56. Most women in the study had negative attitudes towards menopause. The majority of women with positive attitudes were older, well educated and had used hormone replacement therapy (P < 0.05). Using multiple linear regression analysis, age and education level were found to be statistically significant (P < 0.001). A statistically significant difference was found between the women in the premenopausal and menopausal years in terms of sexuality after menopause (P < 0.05). This study suggests that Turkish women 40 years and older have negative attitudes towards menopause and their primary concern in the premenopausal period is sexuality after menopause. Counseling of women on menopause-related issues in gynecology clinics is recommended.
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http://dx.doi.org/10.1111/j.1442-2018.2011.00671.xDOI Listing
June 2012

Examining barriers to emergency contraception use.

Appl Nurs Res 2012 Aug 20;25(3):158-63. Epub 2011 Apr 20.

Department of Nursing, Gazi University, Faculty of Health Sciences, Besevler, Ankara-Turkey, 06500.

Using a cross-sectional survey research design, this study examined barriers to emergency contraception (EC) use among a sample of 318 Turkish women. Only 34% of the respondents reported being aware of EC methods, and about 20% had actually used EC. More than 90% of the participant women considered use of EC methods as a sin. The results of the study showed that the major barriers to EC use are lack of awareness and common misconceptions about EC methods. This study highlights the need of education for Turkish women regarding EC to increase awareness and dispel misconceptions related to EC.
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http://dx.doi.org/10.1016/j.apnr.2010.12.001DOI Listing
August 2012

Association of depression and anxiety with oocyte and sperm numbers and pregnancy outcomes during in vitro fertilization treatment.

Psychol Rep 2009 Jun;104(3):796-806

Gazi University School of Nursing, Ankara, Turkey.

To estimate association of depression and anxiety scores with oocyte and sperm numbers and pregnancy rates during in vitro fertilization (IVF) treatment, 80 Turkish couples were administered the Spielberger State and Trait Anxiety and Beck Depression Inventories. A significant correlation (r = -.25) obtained between Depression and women's oocyte pickup data and number of oocytes, showed that low oocyte numbers w ere associated with higher Depression. No significant relation was found for sperm counts with Anxiety and Depression scores on the day of oocyte pickup and sperm collection, but sperm motility was weakly and inversely correlated with Depression scores. Women with high State Anxiety score on the oocyte pickup day had significant lower pregnancy rates, as did those with higher Depression. Counseling of couples by health professionals on fertility-related issues to be implemented in IVF units is advisable.
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http://dx.doi.org/10.2466/PR0.104.3.796-806DOI Listing
June 2009

Validity of the symptomatic approach used by nurses in diagnosing vaginal infections.

J Clin Nurs 2009 Apr;18(7):1059-68

School of Nursing, Gazi University, Ankara, Turkey.

Aims And Objectives: To examine the validity and effectiveness of a symptomatic approach based on symptoms, administered by a nurse working in women's health area, in identifying vaginal infections in women with or without vaginal discharge.

Design: Survey.

Methods: Between November 2005-August 2006, 300 married women were included. A questionnaire and vaginal discharge assessment form were used for data collection. The modified algorithm of a symptomatic approach without speculum examination was used to manage participants. Three diagnoses were made for each participant. The first diagnosis was made by the research nurse using the vaginal discharge assessment form; the second diagnosis is the clinical diagnosis which was made after the gynaecological examination by a physician; and the third diagnosis is the microscopic diagnosis made by the physician when assessing the collected specimens.

Results: In the methodological part of this study, the sensitivity, specificity, positive predictive value and negative predictive value of the symptomatic approach were 91.5, 69.7, 87.7 and 77.5%, respectively. The symptomatic approach had 27.7% sensitivity for bacterial vaginosis, 16.6% for trichomonas vaginalis and 62.8% for candida albicans, compared to the microscopic results. The sensitivity of the approach was higher for the identification of candidiasis compared to bacterial vaginosis and trichomonas vaginalis.

Conclusion: From the results, it is suggested that the symptomatic approach model can be used by nurses who work in women's health area to diagnose vaginal infections.

Relevance To Clinical Practice: This study showed that trained clinician nurses will be able to diagnose and manage vaginal infections - especially candidiasis - by using the symptomatic approach. Moreover, the symptomatic approach will encourage women not to delay or fail to seek treatment for their health problems, especially for vaginal infections in conservative societies.
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http://dx.doi.org/10.1111/j.1365-2702.2008.02702.xDOI Listing
April 2009
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