Sürdürülebilir Kalkınma Amaçları
Yayınlar
- MakaleYalnız künye2027Serial mediating role of belonging and state mindfulness in the relationship between clinical learning environment and caring behaviors in nursing students
Özalp, Cemal; Tuncer, Metin; Kaya, Abdulsamed; Şahin, Fatih
Aim: The study aimed to examine the relationship between clinical learning environment and caring behaviors in nursing students and to test the serial mediating roles of belonging and state mindfulness in this relationship. Background: The psychosocial mechanisms linking the clinical learning environment to caring behaviors remain unclear, particularly the combined roles of belonging and state mindfulness. Design: The study had a cross-sectional design and was conducted in line with the STROBE guidelines. Methods: The sample consisted of 452 undergraduate nursing students studying at a state university in Turkiye. The data were collected between December 2025 and January 2026 using the Personal Information Form, Clinical Learning Environment Scale, Nursing Department Belonging Scale, State Mindfulness Scale, and Caring Behaviors Inventory. Results: The clinical learning environment was found to be positively correlated with sense of belonging (B = 0.412, p < .001). Sense of belonging significantly predicted both State Mindfulness (B = 0.607, p < .001) and caring behaviors (B = 0.857, p < .001). State mindfulness is also a significant predictor of caring behaviors (B = 0.734, p < .001). Indirect effects analyses indicated that the clinical learning environment was associated with caring behaviors through sense of belonging and through the sequential pathway involving both sense of belonging and state mindfulness. However, the direct effect of the clinical learning environment on caring behaviors was not significant. Additionally, the indirect effect of the clinical learning environment on caring behaviors through state mindfulness alone was not significant. Conclusions: The results of the study showed that the clinical learning environment is associated with nursing students' caring behaviors indirectly through sense of belonging and state mindfulness, rather than directly.
- MakaleAçık Erişim2026Olgu Temelli Yapay Zekâ Eğitim Uygulamasına Yönelik Hemşirelik Son Sınıf Öğrencilerinin Görüşleri: Tanımlayıcı Nitel Çalışma
Tuncer, Metin; Tuncer, Gülsüm Zekiye; Yalcinkaya, Turgay
Amaç: Olgu temelli yapay zekâ uygulamalarının hemşirelik eğitimine etkili ve güvenli bir şekilde entegrasyonu, hemşirelik öğren cilerinin çağdaş eğitim ihtiyaçlarını karşılamak açısından önemli bir gerekliliktir. Bu nedenle araştırmanın amacı, hemşirelik son sınıf öğ rencilerinin yapay zekâ destekli olgu temelli eğitim uygulamasına iliş kin deneyimlerini ve görüşlerini derinlemesine incelemektir. Gereç ve Yöntemler: Tanımlayıcı nitel araştırma deseninde yürütülen bu ça lışma, bir devlet üniversitesinde öğrenim gören 15 gönüllü son sınıf hemşirelik öğrencisiyle gerçekleştirilmiştir. ChatGPT-4o tabanlı olgu temelli bir eğitim uygulaması yapan gönüllü katılımcılar ile yarı yapı landırılmış görüşmeler yoluyla veriler yüz yüze bireysel yöntemle top lanmıştır. Görüşmeler, içerik analizi yöntemiyle değerlendirilmiştir. Bulgular: Analiz sonucunda, (1) Öğrenme sürecine katkısı, (2) Kulla nım kolaylığı ve erişilebilirlik, (3) Geleneksel eğitimle kıyaslama ve (4) Güvenilirlik ve sınırlılıklar olarak 4 ana tema ortaya çıkmıştır. Ka tılımcılar, ChatGPT’nin klinik akıl yürütme becerilerini desteklediğini, bilgiye hızlı erişim sağladığını ve yargılamayan bir öğrenme ortamı sunduğunu ifade etmiştir. Ancak bilgi tutarsızlıkları, kaynak belirtme mesi ve komutlara duyarlılık gibi sınırlılıklar da vurgulanmıştır. Sonuç: Çalışma, ChatGPT destekli olgu temelli eğitimin hemşirelik öğrenci lerinin öğrenme sürecine katkı sunduğunu ve geleneksel eğitimi ta mamlayıcı bir potansiyel taşıdığını göstermektedir. Bu tür uygulamaların hemşirelik eğitimine etkili biçimde entegre edilebilmesi için öğretim elemanı rehberliğinde yapılandırılmış senaryolarla yürü tülmesi, öğrencilerin komut oluşturma ve eleştirel düşünme becerileri nin desteklenmesi önerilmektedir.
- MakaleAçık Erişim2026The effect of eHealth-based guided self help interventions for binge eating disorder : a meta-analysis of randomized controlled trials
Tuncer, Gülsüm Zekiye; Tuncer, Metin
With rapid technological advancements, eHealth-based guided self-help interventions have become accessible, flexible, cost-effective, and stigma-reducing treatment options for binge eating disorder (BED). This meta-analysis evaluated the effectiveness of these interventions in individuals diagnosed with BED or showing BED symptoms, based on eight randomized controlled trials with 1,575 participants. Intervention length varied between a single session to four months. Six studies focused solely on web-based guided self-help interventions, one study implemented a hybrid approach combining face-to-face and online components, and another study employed two distinct online guided self-help methods. The interventions included psychoeducational modules, therapist feedback, online behavior monitoring, and self-assessments. eHealth-based guided self-help significantly reduced binge eating psychopathology (SMD: 0.53; 95% CI: 0.20–0.86) and objective binge eating (OBE) days (SMD: 0.49; 95% CI: 0.12–0.85) compared to controls. These interventions offer effective solutions for individuals facing barriers to traditional treatment access.
- MakaleYalnız künye2026Exposure to Violence and Therapeutic Communication in Nursing Students
Erol, Ahmet; Tuncer, Metin
Background: – Workplace violence negatively affects the professional development of nursing students. Objectives: – To investigate nursing students’ exposure to violence, violence-management competence, and therapeutic communication during clinical practice. Methods: – A descriptive, cross-sectional, correlational study involves 530 nursing students. Data were collected between September 2024 and February 2025 using a Sociodemographic Form, the Workplace Violence Competence Scale, and the Therapeutic Communication Skills Scale. Results: – Violence was reported by 32.8% of students, mainly verbal (60.9%) and psychological (47.1%), often by patients or relatives. Communication skills correlated positively with violence management competence, explaining 18.1% of the variance. Higher self-confidence, problem-solving, voluntary choice of profession, and prior education were associated with better outcomes. Conclusions: – Nursing students are at substantial risk of violence during clinical practice, and their ability to manage it is enhanced by therapeutic communication and supportive factors, underscoring the need to strengthen curricula and faculty preparation.
- MakaleYalnız künye2026Integrating Artificial Intelligence Into Nursing Care Planning: A Comparative Evaluation of Psychosocial Care for Patients With a Stoma
Kulakaç, Nurşen; Tuncer, Metin
This methodological study evaluated and compared the content quality and appropriateness of nursing care plans developed by nurses and artificial intelligence (AI) for addressing the psychosocial problems of patients with stomas. Two nursing care plans addressing the psychosocial needs of a patient with a stoma were developed: 1 generated by nurses and 1 generated by an AI system. The content quality and appropriateness of the care plans were independently evaluated by 12 experts, including nursing academics and clinical nurses, using the DISCERN measurement tool. Inter-rater reliability was assessed using the intraclass correlation coefficient (ICC). The mean DISCERN score of the nurse-generated care plan was significantly higher than that of the AI-generated care plan (P=.008). Inter-rater agreement demonstrated good agreement. The findings indicate that nurse-generated care plans demonstrate superior content quality and overall integrity compared to AI-generated plans. AI-generated care plans exhibit potential as supportive tools in nursing care planning.
- MakaleAçık Erişim2026The Effect of a Psychiatric Nurse–Led AI-Based Online Group Guided Self-Help Program on Eating Behaviours and Body Image among Overweight and Obese Women Nurses: A Randomized Controlled Trial
Tuncer, Gülsüm Zekiye; Duman, Zekiye Çetinkaya; Tuncer, Metin
Aim: This study aimed to evaluate the effectiveness of a psychiatric nurse–led, AI-supported online group guided self-help programme on eating behaviours, body image, and body mass index (BMI) among overweight and obese women nurses. Method: A randomised controlled experimental design with pre-test, post-test, and three-month follow-up assessments was employed. Forty-four overweight and obese women nurses were randomly assigned to intervention (n = 22) and control (n = 22) groups. The intervention consisted of an 8-week online group guided self-help programme supported by a large language model (LLM), under the leadership of a psychiatric nurse. Participants did not interact directly with the LLM; all AI-generated feedback was clinically reviewed and delivered by the researcher. Results: The intervention group demonstrated significant reductions in emotional eating and external eating, along with significant improvements in body image scores and adaptive coping strategies. A significant decrease in BMI was also observed from baseline to three-month follow-up. Between-group comparisons at post-test and follow-up indicated statistically significant differences favouring the intervention for eating behaviours and selected body image–related outcomes, whereas between-group differences in BMI were not statistically significant. Conclusion: A multi-component online group guided self-help intervention incorporating structured AI-assisted feedback under psychiatric nurse leadership may represent a promising approach to improving eating behaviours, body image, and weight-related outcomes among overweight and obese women nurses.
- Derleme MakaleYalnız künye2026Immunosuppressant adherence levels in kidney transplant recipients measured by electronic monitoring devices: A systematic review and meta-analysis
Tuncer, Metin; Yalcinkaya, Turgay; Erol, Ahmet; Özalp, Cemal
Background: Kidney transplantation improves survival and quality of life in patients with end-stage renal disease; however, long-term graft success depends on adherence to immunosuppressive therapy. Objective: To quantify adherence levels among kidney transplant recipients using electronic monitoring devices. Methods: PubMed, Web of Science, Scopus, and the Cochrane Library were systematically searched for studies published between 2000 and 2025. A random-effects meta-analysis was conducted including studies that assessed adherence using electronic monitoring devices. Results: Seven studies with a total of 1025 kidney transplant recipients were included. The pooled mean adherence measured using electronic monitoring devices was 94.39%. In studies with monitoring durations of three months or longer, adherence decreased to 90.50%. Substantial heterogeneity was observed across studies. Conclusion: Although electronically measured adherence appears generally high, its decline over longer monitoring periods indicates that adherence is dynamic and may decrease over time. However, these estimates should be interpreted cautiously because electronic monitoring devices cannot confirm actual medication ingestion. Furthermore, intentionally non-adherent patients may be less likely to participate in or remain engaged with electronic monitoring studies and may therefore be underrepresented, potentially leading to an overestimation of true adherence. Even modest reductions in adherence may carry important clinical consequences, underscoring the need for sustained monitoring.
- MakaleAçık Erişim2026Protecting the Privacy of Patients With Impaired Consciousness in Intensive Care: A Qualitative Study
Tuncer, Metin; Özalp, Cemal; Keskin, Azra
Background: Maintaining privacy in intensive care units (ICUs) is challenging because of high workload, invasive procedures, continuous monitoring and shared care environments. Patients with impaired consciousness may be particularly vulnerable because their ability to express privacy preferences, assert personal boundaries and advocate for themselves is limited. Aim: To explore intensive care nurses' experiences of protecting privacy when caring for patients with impaired consciousness. Study Design: A descriptive qualitative study was conducted with 20 intensive care nurses in Türkiye between March and April 2026. Data were collected through semi-structured online interviews and analysed using inductive thematic analysis. The study was reported in accordance with the Consolidated Criteria for Reporting Qualitative Research guidelines. Findings: Four themes were identified: the marginalisation of privacy under clinical priorities; structural and process-related constraints on privacy in intensive care; loss of subjectivity and the mechanisation of care in patients with impaired consciousness; and ethical and psychosocial implications of privacy violations. Conclusions: Privacy in intensive care is shaped not only by individual ethical awareness but also by workload, environmental conditions, care routines and communication practices. Patients with impaired consciousness have the same rights to privacy and dignity as other patients; however, their reduced ability to express preferences, assert personal boundaries and advocate for themselves may make privacy violations less visible and increase their dependence on nurses for protection. Relevance to Clinical Practice: Protecting the privacy of patients with impaired consciousness in ICUs requires structured care routines, standardised bedside communication, minimisation of unnecessary exposure during procedures and targeted ethical awareness training to support dignity in everyday practice.
- MakaleAçık Erişim2026Turkish Adaptation, Psychometric Validity and Measurement Invariance of the Reasons for Implicit Rationing of the Nursing Care Scale
Özalp, Cemal; Gerçek, Abdullah; Tuncer, Metin
Aim: This study aimed to adapt the Reasons for Implicit Rationing of Nursing Care Scale into Turkish and evaluate its validity, reliability and measurement invariance among nurses in Türkiye. Background: Implicit rationing of nursing care may compromise care quality and patient safety and is influenced by organizational, resource-related and communication factors. A culturally valid instrument is needed to identify the factors contributing to implicit rationing of nursing care within the Turkish healthcare context. Design: A methodological, cross-sectional psychometric validation study. Method: Data were collected between July and December 2025 from nurses working in a public hospital in Türkiye. The source population comprised 900 nurses and 411 nurses were included in the final sample using convenience sampling. Data were collected using the Personal Information Form and the Reasons for Implicit Rationing of Nursing Care Scale. Construct validity was examined using exploratory and confirmatory factor analyses on randomly divided samples. Convergent and discriminant validity and gender-based measurement invariance were assessed. Reliability was evaluated using Cronbach's alpha, McDonald's omega and the intraclass correlation coefficient. Results: The Kaiser–Meyer–Olkin value was 0.936, indicating that the data were suitable for factor analysis. Exploratory factor analysis revealed a two-factor structure consistent with the original scale, explaining 74.30% of the total variance. Confirmatory factor analysis demonstrated acceptable model fit. Convergent validity was supported, whereas the heterotrait–monotrait ratio value indicated borderline discriminant validity. Measurement invariance across genders was largely supported at the configural, metric and scalar levels. The scale demonstrated high internal consistency and temporal stability, with a Cronbach's alpha value of 0.941, a McDonald's omega value of 0.932 and an intraclass correlation coefficient value of 0.873. Conclusion: The Turkish version of the Reasons for Implicit Rationing of Nursing Care Scale is a valid, reliable and gender-invariant instrument. It can be confidently used in Turkish clinical settings to assess factors contributing to implicit rationing of nursing care.
- MakaleAçık Erişim2025Adaptation of the Friedman Life Balance Scale in Nursing Students into Turkish: Methodological (Validity and Reliability) Study
Tuncer, Metin; Tuncer, Gülsüm Zekiye; Yigit, Tülay Tuğçe
Objective: The aim of this study is to adapt the Friedman Life Balance Scale (FLBS), originally developed in the USA, into Turkish and to examine its validity and reliability for assessing life balance among nursing students. Material and Methods: This methodological study was conducted with a sample of 688 nursing students enrolled in the faculty of nursing between November 2023-February 2024. The data were collected using the Satisfaction with Life Scale (SLS), the Warwick-Edinburgh Mental Well-Being Scale Short Form (WEMWBSF), and the FLBS. Initially developed in English, the 15-item scale comprising 3 sub-dimensions underwent Turkish language and content validity procedures. Results: The factor analysis results of the FLBS indicated that the construct validity was satisfactory. Exploratory factor analysis revealed a 3-factor structure accounting for 55.9% of the total variance. The goodness of fit values (χ2 /df=3.516; Comparative Fit Index=0.953; Normed Fit Index=0.936; Incremental Fit Index=0.954; Tucker-Lewis Index (TLI)=0.931; Root Mean Square Error of Approximation=0.060) of the model obtained with this 3-factor confirmatory factor analysis were good. The internal consistency Cronbach’s alpha score of the FLBS was 0.861. In parallel form reliability of the FLBS, there was a low-level positive relationship between the FLBS and SLS (r=0.348, p<0.001) and a moderate positive relationship between the FLBS and WEMWBS (r=0.594, p<0.001). Conclusion: In this study, the Turkish version of the FLBS is a reliable and valid measurement tool for measuring life balance in nursing students. FLBS is a short and practical scale to measure life balance. It is thought that the FLBS can be used to measure life balance in students and health professionals.
- MakaleAçık Erişim2025As if I don't belong here. First-Year Experiences of International Nursing Students at University - A Qualitative Study
Tuncer, Gulsum Zekiye; Tuncer, Metin
Background: The rapid adaptation of international nursing students to university life enables them to actively continue their education without disruption in the following years. Identifying the challenges faced by these students, who are future nursing professionals, is essential fortheir adaptation and professional development. Aim: This study aimed to explore the perspectives of international nursing students regarding their first-year experiences at university. Methods: This study employed a descriptive qualitative research design. The Consolidated Criteria for Reporting Qualitative Research (COREQ) was used for reporting. The sample consisted of 13 international nursing students enrolled in the Faculty of Nursing at a university. Data were collected through face-to-face, individual, in-depth interviews using semi-structured interview questions. Content analysis was used to analyze the data. Results: The mean age of the nursing students was 23.3 years. Among the participants, seven were women, 11 had been residing in Turkiye for approximately one year, 12 were from Iran, and one was from Iraq. Three key themes emerged in this study: Facilitators of Adaptation, Challenges, and Coping. The students identified several facilitators of adaptation, including similarities between the Turkish economy and culture and their home countries' economies and cultures, proficiency in the Turkish language, studying at a nursing school aligned with their career goals, and receiving social support from their relatives. However, they also faced challenges such as language barriers, cultural differences, discrimination, social isolation, homesickness, and academic and clinical difficulties. Conclusion: International nursing students may encounter language barriers, cultural differences, and education-specific challenges during their first year of nursing school. In this context, developing support mechanisms to guide these students in their academic and social lives will facilitate their ability to cope with these difficulties.
- MakaleAçık Erişim2025Effect of eHealth Interventions on Medication Adherence in Kidney Transplant Recipients: Meta-Analysis of Randomised Controlled Trials
Tuncer, Metin; Tuncer, Gülsüm Zekiye
Background: Kidney transplant recipients must take immunosuppressive drugs for life, and medication non-adherence is a primary risk factor for graft loss and death. With the advancement of technology, electronic health applications are widely used in chronic disease management and offer the potential to improve medication adherence in kidney transplant recipients. Aim: This meta-analysis aims to evaluate randomised controlled trials (RCTs) that assess the effectiveness of eHealth interventions in improving medication adherence among kidney transplant recipients. Methods: This study, which was designed as a systematic review and meta-analysis, followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) protocols in the planning and reporting phases. Electronic databases and manual literature searches were the two main data sources. Full-text RCTs in PubMed, Medline, Web of Science and Scopus databases were systematically searched. The searches covered studies from 2014 to March 2024. Results: The search yielded 524 articles. Eight RCTs with 779 participants were included in the analysis. The meta-analysis results indicated that, compared with the control group, adherence rates (RR: 1.19; 95% CI: 1.06–1.35; p = 0.01. Heterogeneity: Q = 8.69; p = 0.28; I2 = 19%) and adherence scores (SMD: 0.17; 95% CI: 0.05–0.29; p = 0.02. Heterogeneity: Q = 0.45; p = 0.93; I2 = 0%) significantly increased in the eHealth intervention group compared with the control group. Conclusion: The findings of this report show that eHealth interventions to improve medication adherence in kidney transplant recipients show favourable outcomes compared with standard care. We recommend eHealth interventions to improve long-term survival and patient outcomes in kidney transplant recipients.
- MakaleAçık Erişim2025Brain Drain-Related Perspectives of Senior Nursing Students in Türkiye: A Qualitative Study; [Türkiye'deki Son Sınıf Hemşirelik Öğrencilerinin Beyin Göçüyle İlgili Görüşleri: Nitel Bir Çalışma]
Tuncer, Metin; Tuncer, Gülsüm Zekiye
Objective: This study was aimed at investigating the brain drain-related perspectives of nursing students who wanted to emigrate in depth. Methods: The study has the descriptive qualitative research design. The population of the study comprised 13 senior nursing students studying at the Faculty of Nursing of a university and intending to emigrate abroad. Data were collected through face-to-face individual in-depth interviews. The interviews were audio-recorded after the participants’ permission was obtained. This study adopted a qualitative research design based on inductive content analysis to explore the participants’ perspectives in depth. Results: In this study, three themes emerged from the students' opinions: "Perception of brain drain", "Motivation behind brain drain" and "Challenges". The first theme reflected students’ varied views on migration, including both positive and negative perceptions, a growing social trend towards emigration, and feelings of hopelessness and dissatisfaction with nursing in Türkiye, leading to the formation of personal migration plans. The second theme captured motivations such as the influence of relatives and role models abroad, favourable personal conditions, attractive opportunities overseas, language efforts, and openness to new experiences. The final theme focused on challenges, including push factors like poor working conditions and low wages, barriers such as language and time constraints, and emotional concerns such as loneliness and cultural adjustment. Conclusion: The study showed that nursing students’ intention to emigrate stems from mixed perceptions of brain drain, strong personal and social motivations, and various emotional and structural challenges. Addressing these issues may help mitigate future nurse migration.
- MakaleAçık Erişim2025Investigation of the relationship between attitudes toward migration and life satisfaction of nurses working in Turkey
Tuncer, Metin; Tuncer, Gülsüm Zekiye; Turan, Şeyma; Khorshtd, Leyla
Background: Nurse migration contributes to the nursing shortage in developing countries. Understanding nurses' attitudes toward migration and related factors is crucial for policy-making and healthcare workforce planning in Turkey. Aim: This study aimed to investigate the relationship between nurses' attitudes toward migration and their life satisfaction in Turkey. Methods: The study included working nurses with social media accounts on a social media platform in Turkey who followed nursing-related content. A sample of 423 nurses completed an online survey. Independent variables included nurses' sociodemographic characteristics and inclination toward migration, while dependent variables were life satisfaction and migration attitude levels. Data were collected via an online questionnaire, incorporating the Brain Drain Attitude Scale (BDAS) and Life Satisfaction Scale (LSS), between April and May 2023. Results: The study found a negative correlation between nurses' life satisfaction levels and their attitudes toward migration (r = −.349, p <.001). Nurses dissatisfied with their profession (F = 6.575, p <.05), lacking professional support (F = 8.641, p <.05), and lacking social support (F = 6.307, p <.05) scored higher on the BDAS. Conversely, those satisfied with their profession (F = 31.455, p <.05), receiving professional support (F = 26.307, p <.05), and social support (F = 33.990, p <.05) scored higher on the LSS. Conclusion and implications for nursing: The study revealed that decreased life satisfaction among nurses in Turkey correlates with increased migration attitudes. These results underscore the need for strategies to enhance nurses' job satisfaction and support systems to mitigate migration tendencies. This study contributes valuable insights into the high inclination of Turkish nurses toward emigration.
- MakaleAçık Erişim2025Evaluation of ChatGPT-4, Gemini, Claude, and Copilot in Generating Nursing Diagnoses Based on NANDA-I Taxonomy II: A Comparative Cross-Sectional Study
Tuncer, Metin; Yalcinkaya, Turgay
Aim: To evaluate the capability of large language models to generate nursing diagnoses based on NANDA-I Taxonomy II and assess their performance across domains and overall. Background: Large language models are emerging tools in nursing, showing potential to aid in diagnosis generation and education. However, their accuracy and applicability in clinical and educational settings remain underexplored. Methods: This cross-sectional comparative study used 10 realistic patient scenarios based on NANDA-I Taxonomy II, covering 12 domains. The study aimed to evaluate the capability of four models to generate nursing diagnoses based on patient scenarios. The responses were assessed by five nursing experts for accuracy and alignment with NANDA-I Taxonomy II in a single-blind evaluation process. Results: All models demonstrated similar performance across different domains and overall, with Claude attaining the highest overall performance score. Expert evaluations indicated moderate interrater reliability. Discussion: Small variations between models and occasional omissions suggest that expert review is still required before clinical use. Conclusions: Large language models are not yet sufficiently reliable for independent use in clinical settings and nursing education. Their application as supportive tools necessitates a cautious approach. Moreover, the development of specialized models designed to address the unique demands of the nursing field would be advantageous. Implications for nursing: When large language models are used in nursing practice, their limitations should be considered, and the outputs they produce should be verified by nurses. Implications for nursing policy: Ensuring the safe integration of artificial intelligence tools into nursing necessitates the establishment of robust regulatory policies to safeguard patient safety, the deployment of effective systems to monitor models’ performance, and the development of comprehensive guidelines and training programs.
- MakaleAçık Erişim2025An Examination of Relationships Between Postural Habits and Awareness of Fatigue and Musculoskeletal Discomfort in Nurses
Tuncer, Metin; Tuncer, Gülsüm Zekiye; Turan, Şeyma; Khorshtd, Leyla
Introduction: Prolonged fatigue, caused by the hospital's demanding workload and physical demands, can increase strain on the musculoskeletal system, leading to musculoskeletal issues that may negatively impact nurses' job performance and quality of life. High postural awareness, on the other hand, can help nurses develop correct posture and movement habits, reducing the risk of experiencing discomfort, thus preserving their physical health and supporting workforce sustainability. Therefore, it is of particular importance to determine the relationship of postural awareness to fatigue and musculoskeletal discomfort in nurses working in a hospital environment with heavy working conditions and many ergonomic risks. Aim: The aim of this study was to describe the postural habits, awareness, occupational fatigue levels and musculoskeletal disorders of nurses working in hospitals and to examine the relationships between these factors. Method: This study used a quantitative cross-sectional design. The study sample consisted of 132 nurses working in a hospital in Türkiye. The data for the study were collected between July and October 2023 using the Occupational Fatigue Exhaustion/Recovery Scale (OFER), Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) and Postural Habits and Awareness Scale (PHAS). Results: A significant positive, low-level correlation was found between the Recovery subscale of the OFER scale and the Postural Habits subscale of the PHAS scale (r = 0.277, p < 0.05). A significant negative, moderate-level correlation was observed between the Chronic Fatigue subscale of the OFER scale and the Postural Habits subscale of the PHAS scale (r = −0.311, p < 0.001). Additionally, a significant negative, moderate-level correlation was found between the Acute Fatigue subscale of the OFER scale and the Postural Habits subscale of the PHAS scale (r = −0.326, p < 0.001). Conclusion: This study found that as nurses' correct postural habits improved, both acute and chronic fatigue decreased, whereas recovery increased. It is suggested that interventions aimed at enhancing postural awareness and promoting correct postural habits in nurses may also positively influence occupational fatigue and exhaustion.
- MakaleYalnız künye2025ChatGPT-4 in Nursing Research: A Methodological Evaluation of Bias Risk in Randomized Controlled Trials
Tuncer, Metin; Tuncer, Gülsüm Zekiye
Background: Conducting bias assessments in systematic reviews is a time-consuming process that involves subjective judgments. The use of artificial intelligence (AI) technologies to perform these assessments can potentially save time and enhance consistency. Nevertheless, the efficacy of AI technologies in conducting bias assessments remains inadequately explored. Aim: This study aims to evaluate the efficacy of ChatGPT-4o in assessing bias using the revised Cochrane RoB2 tool, focusing on randomized controlled trials in nursing. Methods: ChatGPT-4o was provided with the RoB2 assessment guide in the form of a PDF document and instructed to perform bias assessments for the 80 open-access RCTs included in the study. The results of the bias assessments conducted by ChatGPT-4o for each domain were then compared with those of the meta-analysis authors using Cohen's weighted kappa analysis. Results: Weighted Cohen's kappa values showed better agreement in bias in the measurement of the outcome (D4, 0.22) and bias arising from the randomization process (D1, 0.20), while negative values in bias due to missing outcome data (D3, −0.12) and bias in the selection of the reported result (D5, −0.09) indicated poor agreement. The highest accuracy was observed in D5 (0.81), and the lowest in D1 (0.60). F1 scores were highest in bias due to deviations from intended interventions (D2, 0.74) and lowest in D3 (0.00) and D5 (0.00). Specificity was higher in D5 (0.93) and D3 (0.82), while sensitivity and precision were low in these domains. Conclusions: The agreement between ChatGPT-4o and the meta-analysis studies in the same RCT assessments is generally low. This indicates that ChatGPT-4o requires substantial enhancements before it can be used as a reliable tool for bias risk assessments. Clinical Relevance: The AI–based tools have the potential to expedite bias assessment in systematic reviews. However, this study demonstrates that ChatGPT-4o, in its current form, lacks sufficient consistency, indicating that such tools should be integrated cautiously and used under continuous human oversight, particularly in evidence-based evaluations that inform clinical decision-making.
- MakaleAçık Erişim2025Nursing students' cybersecurity practices and perceptions and cybersecurity crime awareness: A cross-sectional study
Yalcinkaya, Turgay; Tuncer, Metin; Tuncer, Gülsüm Zekiye; Erol, Ahmet; Cinar Yucel, Sebnem
Background: Cybersecurity has become a critical issue with the increasing use of digital platforms in healthcare. Understanding nursing students' cybersecurity practices, perceptions, and cybercrime awareness is essential for improving healthcare security and developing strategies to mitigate cyber threats. Aim: This study aimed to determine nursing students' cybersecurity practices, perceptions, and cybercrime awareness. Design: A descriptive cross-sectional design was used. Setting: The study was conducted between April and June 2024 at a School of Nursing within a public university in Türkiye. Participants: A total of 434 undergraduate nursing students participated in the study. Methods: Data were collected face-to-face using a paper-and-pencil technique. The data collection tools used included the Personal Information Form, Cyber Security Scale (CSS), and Cyber Crime Awareness Scale (CAS). Data analysis utilised descriptive statistical methods, Pearson correlation analysis, independent samples t-test, ANOVA, and linear regression analysis. Results: The study revealed that 92.9 % of the students had not received any prior cybersecurity education. The mean CSS score was 87.50 ± 11.40, and the mean CAS score was 174.75 ± 36.75. A moderate positive correlation was found between the CSS and CAS scores (r = 0.576, p < 0.01). A positive relationship was found between computer usage skills and CSS scores (r = 0.190, p < 0.01), while a weak negative correlation was observed between internet usage duration and CSS scores (r = −0.095, p < 0.05). No relationships were identified between the CSS score and age, gender, or cybersecurity education. Linear regression analysis showed that higher computer usage skill levels were significantly associated with increased CSS scores (B = 1.129, p < 0.001). Conclusions: The findings highlight the importance of integrating cybersecurity education into the nursing curriculum. Enhancing cybersecurity awareness and practices may help protect patient data and support safer healthcare by better preparing nursing students for cyber threats.
- MakaleAçık Erişim2025Turkish Version of the Sense of Belonging in Nursing School Scale: Validity and Reliability for Nursing Students
Tuncer, Metin; Tuncer, Gülsüm Zekiye; Yalçınkaya, Turgay; İnce, Merve; Yücel, Şebnem Çınar; Khorshid, Leyla
Background: While a sense of belonging may be necessary for human motivation, the disruption of this sense of belonging among nurses can have implications for patient care and safety. Aim: This article was aimed at assessing the sense of belonging experienced by nursing students in three different settings (clinic, classroom, and student group) by conducting the validity and reliability of the Sense of Belonging in Nursing School (SBNS) scale, adapting it to the Turkish language and culture, and reporting the results. Methods: The study was conducted in a nursing faculty between March and July 2023. The study sample comprised 193 nursing students. We performed the content validity assessment of the 19-item SBNS scale after conducting a structural validity analysis using exploratory factor analysis and confirmatory factor analysis (CFA). The Cronbach’s alpha and item-total score correlations were examined to assess the scale’s internal consistency. Results: The Kaiser–Meyer–Olkin measure of sampling adequacy for the SBNS instrument was 0.903, and the result of Bartlett’s test of sphericity was significant (χ² = 3182.764, p = 0.000), indicating that the scale was suitable for factor analysis. The eigenvalue analysis identified a four-factor structure explaining 76.74% of the total variance. These four factors were subsequently named as follows: (1) clinical compliance, (2) social belonging, (3) school support, and (4) clinical support. The goodness-of-fit values for the model obtained from the CFA were χ2/SD = 2.15, comparative fit index = 0.947, goodness-of-fit index = 0.852, normed fit index = 0.906, incremental fit index = 0.948, and root mean square error of approximation = 0.077, suggesting that the model fit was acceptable, and the four-factor structure was well distributed. The scale exhibited high internal consistency (α = 0.933). Discussion: The SBNS scale is a reliable and valid instrument for measuring the sense of belonging experienced by nursing students in three different environments. Further research is needed to establish its predictive validity. Conclusions and Implications for Nursing: This study was conducted, and there was no scale used in the Turkish literature to measure nursing students’ sense of school belonging; thus, it is the first in this sense.
- MakaleAçık Erişim2025Self-Regulation of Eating Behaviors Among Young Women Nurses and Nursing Students: Its Relationship With Eating Habits
Tuncer, Gülsüm Zekiye; Tuncer, Metin
The primary aim of this study is to adapt the Self-Regulation of Eating Behavior Questionnaire (SREBQ) to the Turkish culture among young women nurses and nursing students. The secondary aim is to investigate the factors associated with self-regulation of eating behavior in this population. The sample consisted of 773 young women nurses and nursing students who were included in the study between June and July 2024. In accordance with the first aim of the study, the construct validity of the SREBQ instrument was confirmed through EFA. The Cronbach's alpha coefficient for the SREBQ was found to be 0.78. There were very low positive correlations between the SREBQ score and the SRS (r = 0.252) and TREQ-CR (r = 0.136) scores, as well as low negative correlations with the TREQ-EE (r = −0.355) and TREQ-UE (r = −0.406) scores (p < 0.001). The 5-item SREBQ has been found to be a valid and reliable instrument for the population of young women nurses and nursing students in the Turkish language. The results indicate that as self-regulation of eating behavior increases in this population, overall self-regulation skills improve, while disordered eating behaviors decrease.