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• MakaleYalnız künye2026/r/gumushane/13756
  Emergency Nurses’ Experiences of Digital Silence: A Qualitative Study

  Bal, Betül; Kulakaç, Nurşen

  This study aimed to explore emergency department nurses’ perceptions and experiences of digital silence. A qualitative study was conducted with 14 emergency department nurses from two public hospitals in Turkey. Data were collected through semistructured in-person interviews and analyzed using the Framework Method for qualitative data analysis. Four overarching themes were identified: (i) awareness of digital silence, (ii) types of digital silence, (iii) causes of digital silence, and (iv) strategies for prevention. Digital silence manifests in several forms, including failure or partial completion of data entry, the use of alternative communication channels in place of official digital systems, and disregard for system alarms or alerts. The reasons underlying digital silence stem from both individual factors and organizational factors. Strategies to reduce digital silence involved training, development of user-friendly systems, establishment of nonpunitive reporting environments, and workload management. The results revealed that digital silence extends beyond individual attitudes, representing a multidimensional phenomenon closely associated with institutional structures, organizational culture, and the design features of digital systems. Enhancing system usability, reinforcing technical infrastructure, and promoting digital literacy were identified as key strategies for reducing digital silence behaviors.

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• MakaleYalnız künye2026/r/gumushane/13752
  Integrating 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.

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• MakaleYalnız künye2026/r/gumushane/13520
  The effect of self-selected soothing music on fistula puncture-related pain and comfort levels in hemodialysis patients: a randomized controlled, single-blind, single-center study

  Sayilan, Samet; Sayilan, Aylin Aydin; Kulakac, Nursen

  Purpose: To investigate the effect of music therapy on pain and comfort levels in hemodialysis patients. Methods: The study was completed with 30 experimental patients and a 30-member control group receiving treatment in the hemodialysis unit in a hospital in Western Türkiye. Experimental group patients were allowed to listen to a form of music selected by them for approximately 6 min prior to each procedure. No procedure was performed on the members of the control group. A Visual Analog Scale (VAS) was applied in sessions 1, 6, and 12, and the Hemodialysis Comfort Scale in sessions 1 and 12. The independent sample t test and repeated-measures analysis of variance were employed in data analysis, and Cohen’s d in effect size calculations. Results: Hemodialysis Comfort Scale scores were significantly higher at the end of the study in the experimental group compared to the control group (SMD: 3.54, 95% CI 2.33–4.75) (p < 0.05). Mean VAS scores were significantly lower among the experimental group compared to the control group at the second (6th session) (SMD: 1.94, 95% CI 1.34–2.54) (p < 0.001) and third (12th session) evaluations (SMD: 3.2, 95% CI 1.2.65–3.75) (p < 0.001). VAS scores were also significantly lower in the experimental group at the third evaluation compared to the earlier evaluations (p < 0.05). Conclusion: The patients in the experimental group listened to a form of music of their choice before 12 hemodialysis sessions. Music was found to exhibit a positive effect on pain and discomfort in patients receiving hemodialysis. Trial registration: NCT05574595.

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• MakaleAçık Erişim2026/r/gumushane/12248
  Nurses’ Workplace Discrimination Experiences and Their Reflections on Career Development: A Qualitative Study

  Koroglu Kaba, Nagihan; Apaydin, Emine; Kulakaç, Nurşen

  Aim: This study was conducted to examine how nurses experience discriminatory behaviors in the workplace and how these experiences are reflected in their career development. Background: Although discrimination constitutes a significant challenge in nurses’ professional lives, qualitative research examining how these experiences influence their career development processes remains limited. Methods: This phenomenological study was conducted with nurses working in a public hospital in Turkey. Semi-structured individual interviews were conducted with 21 nurses during the study. Participants were selected from various clinical settings through purposive sampling. Data were analyzed using Colaizzi's seven-step content analysis method. Ethics committee approval was obtained for this study. The Consolidated Criteria for Reporting Qualitative Research checklist guided the study reporting. Results: Five main themes with seven subthemes emerged: (1) Discrimination Experiences (types of discrimination, sources of discrimination, emotions/feelings), (2) Reporting Behavior (decision and consequences of reporting, reasons for not reporting), (3) Impact of Discrimination on Career Development (supportive effect, hindering effect), (4) Coping Strategies, and (5) Suggestions for Preventing Discrimination. Discussion: These themes highlight that discrimination is a multidimensional phenomenon and that holistic approaches must be developed at emotional, structural, professional, and institutional levels to cope with it. Conclusion: For some nurses, discrimination acts as a transformative process that supports career development, while for others, it represents a significant barrier to professional advancement. Implications for Nursing/Nursing Policy: The findings highlight the need to strengthen reporting mechanisms, establish a supportive work culture, and implement inclusive institutional policies that promote career development.

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• MakaleYalnız künye2026/r/gumushane/12237
  Who Is at Risk? Analyzing the Drivers of Intimate Partner Violence Against Women in Turkey

  Türkkan, Tuğba; Hatipoğlu, Ertuğrul; Yücel, İbrahim; Kulakaç, Nurşen; Sipahi, Ferkan; Zeybek, Halil İbrahim

  Violence against women represents a severe violation of human rights and has become a pervasive issue globally. This study aims to examine the risk factors associated with violence against women in a developing country context, specifically Turkey. This study adopted a cross-sectional research design. The study sample comprised 391 women living in a northeastern Turkish province, selected using a stratified sampling method. Participants’ ages ranged from 20 to 60 years, with a mean age of 40.83 years. The findings revealed a positive correlation between the age of both women and their spouses and the likelihood of experiencing physical and verbal violence. Factors such as the number of marriages, duration of marriage, number of children, and spousal infidelity emerged as significant risks for victimization. Additionally, an early age at first marriage, the presence of mental illness, and addiction problems were identified as critical risk factors for women’s victimization in violence. Education and employment were protective factors against violence, with higher educational levels and employment status for women and their spouses reducing the risk. Regression analyses further identified women’s education level, prior exposure to domestic violence, age at first marriage, and the addiction status of the spouse as significant predictors of violence against women. The findings provide valuable insights into the etiology of violence against women. In conclusion, the study has the potential to guide the development of more targeted and effective strategies to combat this pervasive public health and human rights issue.

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• MakaleYalnız künye2025/r/gumushane/19697
  Hemşirelik Öğrencilerinin Afete Müdahalede Öz-yeterlilik ve Stres Düzeyleri ile Afet Risk Algısı Arasındaki İlişki

  Aydin Sayilan, Aylin; Kulakaç, Nurşen

  Amaç: Bu çalışma, hemşirelik bölümü öğrencilerinin afete müdahalede öz-yeterlilik ve stres düzeyleri ile afet risk algısı arasındaki ilişkiyi belirlemek amacıyla gerçekleştirildi. Yöntem: Bu araştırma kesitsel ve ilişki arayıcı olarak planlandı. Araştırmanın örneklemini 15-30 Haziran 2023 tarihleri arasında Türkiye’nin batısında bulunan bir üniversitenin hemşirelik bölümünde öğrenim gören 342 öğrenci oluşturdu. Araştırmada veriler sosyo-demografik soru formu, Görsel Kıyaslama Ölçeği, Afete Müdahale Öz-yeterlilik Ölçeği ve Üniversite Öğrencileri Afet Risk Algısı Ölçeği kullanılarak online veri toplama yöntemiyle toplandı. Verilerin değerlendirilmesinde Mann-Whitney U, Student t-testi, One-Way ANOVA test ve çoklu doğrusal regresyon analizi kullanıldı. Bulgular: Öğrencilerin Afete müdahale öz-yeterlilik puan ortalaması 48,49±0,12, Afet Risk Algısı Ölçeği puan ortalaması 48,11±9,77 olarak bulundu. Kadın öğrencilerin Afete Müdahale Öz-yeterlilik Ölçeği ve Afet Risk Algısı Ölçeği puanlarının erkeklere göre istatistiksel olarak anlamlı bir şekilde daha yüksek olduğu görüldü (sırasıyla p=0,042, p=0,008). Sonuç: Öğrencilerin afet risk algısını etkileyen faktörlerin, afete müdahale öz-yeterlilik ve stres düzeyleri olduğu belirlendi. Öğrencilerin stres düzeyleri arttıkça, risk algılarının da arttığı, afet yönetiminde öz-yeterlilik düzeyleri arttıkça risk algılarının azaldığı görüldü.

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• MakaleAçık Erişim2025/r/gumushane/19491
  The Effect of the Central Venous Catheter Care Bundle on Intensive Care Unit Infection Level: Prospective Control Group Cohort Study

  Özkan, Esra; Kulakaç, Nurşen; Kasap, Reyhan İnce

  Objective: This study aims to determine the effectiveness of a care bundle in preventing central venous catheter-associated bloodstream infections in patients treated in the intensive care unit. Material and Methods: A prospective control group cohort study design. Using 105 patients treated in the intensive care unit (ICU)of a state hospital located in northern Türkiye. Following the training provided to physicians and nurses working in the ICU regarding the care bundle, the intervention was implemented on the patients for 1 year, and daily follow-ups were conducted to monitor the development of catheter infections. Data were collected using patient information form and central venous catheter care bundle data. Results: No significant difference was found between the descriptive characteristics of the experimental and control group patients. Throughout the study period, 5 patients in the control group and only 1 patient in the experimental group developed a central venous catheter-associated bloodstream infection. A decrease in the rate of central venous catheter-associated bloodstream infection was identified in the experimental group (p<0.001). Conclusion: The implementation of the care package approach was found to be highly effective in preventing central venous catheter-associated bloodstream infections, so should be adopted as a routine protocol in patients hospitalized in the ICU with a catheter indication.

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• MakaleAçık Erişim2025/r/gumushane/14303
  The effect of using a local skin cooling device on arteriovenous fistula cannulation pain and comfort level of patients on hemodialysis: A single-blind randomized controlled study

  Demırağ, Hatice; Kulakaç, Nurşen

  Introduction: The study aimed to investigate the impact of the using local skin cooling on arteriovenous fistula cannulation pain and the comfort levels of hemodialysis patients. Methods: The single-blind randomized controlled trial was formed with 50 patients between June 20, 2023, and July 31, 2023, in the hemodialysis units of two state hospitals in Turkey. Patients were randomly assigned to either the experimental group (n = 25) or the control group (n = 25) using the block randomization method. This data were collected through the use of the CoolSense device, the “Patient Information Form,” the “Verbal Category Scale,” and the “General Comfort Scale.” Patients in the experimental group received the local skin cooling for five seconds during arteriovenous fistula cannulation, while the control group followed the standard hospital protocol. The study was registered on Clinical Trials (NCT06144801). Findings: The study revealed that the application of the local skin cooling during arteriovenous fistula cannulation significantly reduced pain and increased patients’ comfort levels, demonstrating an anesthetic effect (p < 0.001). Furthermore, it was observed that as pain levels decreased, patient comfort levels increased (p < 0.001). Discussion: It is concluded that the using lokal skin cooling is an effective tool for reducing pain and enhancing comfort during arteriovenous fistula cannulation in hemodialysis patients.

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• MakaleAçık Erişim2025/r/gumushane/14297
  The Effect of Audio-Visual Methods on Preoperative Anxiety in Children: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  Kulakaç, Nurşen; Ustuner Top, Fadime

  Background: Children presenting to hospitals during the preoperative period are often exposed to procedures that cause significant stress. Through preoperative interventions, nurses play an important role in relieving the anxiety of children and their parents. Objective: This study was conducted to determine the effect of audio-visual methods on preoperative anxiety levels in children. Methods: PubMed (including MEDLINE), Cochrane, EBSCOHost, Web of Science, YÖK National Thesis Center, and Google Scholar databases of randomized controlled studies published in the last 10 years were searched for this meta-analysis. 32 studies were included in the meta-analysis, and the total sample size was 2795. Results: Q According to the results of the meta-analysis using the random-effects model, audio-visual methods had a positive effect on reducing anxiety (SMD: -1.312, %95 CI -1,666-(0,958), Z=-7,260, p < 0,001, Q-value = 556,572 I2 = 94.519). The moderator analysis demonstrated that cartoons (SMD:-1.645, p < 0.001), games (SMD:-1.931, p = 0.001), music (SMD:-0.534, p < 0.001), video showings (SMD:-1.363, p = 0.001), and virtual reality (SMD:-1.782, p < 0.001) reduced preoperative anxiety in children. Conclusions: Audio-visual methods are effective in reducing preoperative anxiety in children. The results of this study may provide pediatric perioperative nurses with additional information to help them decrease anxiety for patients and their families.

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• MakaleYayıncıda açık erişim2025/r/gumushane/14095
  The effect of health literacy, psychological resilience, and internet addiction levels on the fear of COVID-19 in healthcare professionals

  Aydin, Aykut; Aydin Sayilan, Aylin; Kulakac, Nursen

  Background: Healthcare professionals are known to make intensive use of the internet to improve their health literacy, preserve their psychological resilience, resolve uncertainties, and lessen their fear of COVID-19. Although several studies have addressed these concepts, we encountered none examining their relationships with one another. Objective: This research set out to determine the effects of health literacy, psychological resilience, and internet addiction levels on the fear of COVID-19 in healthcare professionals. Methods: The sample in this descriptive, cross-sectional, and correlation-seeking research consisted of 456 health workers. The data were collected using an information form and the Health Literacy Scale (HLS), the Brief Resilience Scale (BRS), Young's Internet Addiction Test-Short Form (YIAT-SF), and the Fear of COVID-19 Scale. Results: The mean age of the health professionals enrolled in the research was 40.80 ± 11.39 years (min 22, max 68), 52.4% were women, 87.1% held bachelor's degrees, 86.8% were married, and 5.9% were working as nurses. The participants’ mean scale scores were 54.97 ± 5.62 for the HLS, 26.95 ± 9.57 for YIAT-SF, 20.57 ± 3.62 for the BRS, and 20.33 ± 2.97 for the Fear of COVID-19 Scale. Conclusions: The healthcare professionals in this study exhibited adequate levels of health literacy and psychological resilience, a moderate level of internet addiction, and still experienced fear of COVID-19. Health literacy, internet addiction, and psychological well-being emerged as important factors in the fear of COVID-19.

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