İlgi alanları

Sürdürülebilir Kalkınma Amaçları

• 13
• 2
• 2

• MakaleAçık Erişim2026/r/gumushane/13915
  The 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.

  • 
  İncele
• MakaleYalnız künye2026/r/gumushane/13663
  An AI-Supported Virtual Patient Application Using a Structured Prompting Framework to Develop Mental Status Examination Skills in Psychiatric Nursing Internship Students: An Interventional Mixed-Methods Study

  Tuncer, Gülsüm Zekiye; Çetinkaya Duman, Zekiye; Kilinçkaya, Başak

  The aim of this study is to evaluate the effect of an artificial intelligence (AI)-powered virtual patient application (ChatGPT) on the development of Mental Status Examination (MSE) skills in psychiatric nursing internship students and to explore how this process is reflected in their experiences. This study employed a sequential explanatory mixed-method design, consisting of a quantitative pre/post-test phase followed by a qualitative phase. In the quantitative phase, the MSE Competency Assessment scores of 27 undergraduate psychiatric nursing internship students were evaluated using a pre-test/post-test model. In the qualitative phase, in-depth individual interviews were conducted with 18 volunteer students. As part of the intervention, students participated in the “AI-Supported Virtual Patient Intervention: Structured Prompting Framework”. The quantitative findings of the study revealed that the mean MSE Competency Assessment scores increased from 42.00 ± 6.43 in the pre-test to 49.57 ± 3.44 in the post-test (Z = −6.266, p < 0.001). Thematic analysis of the qualitative data yielded five main themes: Skill Development, Learning Experience, Impact of AI, Debriefing, and Limitations. Students reported that the application enhanced their MSE examination and communication skills; they also described a unique learning experience through AI, highlighted the importance of guided support.

  • 
  • 
  İncele
• MakaleAçık Erişim2026/r/gumushane/13618
  The 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.

  • 
  İncele
• MakaleYalnız künye2026/r/gumushane/12240
  Intensive care nurses' perspectives on the quality of nurse-patient communication in the prevention and management of delirium: A qualitative study

  Şengün Inan, Figen; Canbolat, Özlem; Aslan, Kübra; Tuncer, Gülsüm Zekiye

  Background Nurses play a key role in the care of patients with delirium; however, there is a lack of research exploring intensive care nurses' communication-related experiences in this context. Purpose This qualitative study aims to explore nurses' experiences related to communication in the prevention and management of delirium in intensive care settings. Methods This descriptive qualitative study was conducted with nurses working in the intensive care unit of a university hospital in Türkiye. Data were collected through semi-structured individual interviews. The sample consisted of 15 nurses. To ensure the analysis of the data, the content analysis method was used. Results Findings were categorized into five themes: (1) perceptions, (2) elements of effective communication, (3) obstacles to effective communication, (4) results of effective communication, and (5) results of ineffective communication. Conclusion The results revealed that nurses perceived communication in delirium management as an important therapeutic component of nursing care. In their view, effective communication supported patient care and family cooperation. Beyond individual efforts, organizational leaders may play a crucial role in improving delirium care by allocating adequate time and resources to structured educational programs that enhance communication competencies and delirium-specific knowledge.

  • 
  İncele
• MakaleAçık Erişim2025/r/gumushane/14295
  Effect 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.

  • 
  İncele
• MakaleAçık Erişim2025/r/gumushane/14260
  Brain 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.

  • 
  • 
  İncele
• MakaleAçık Erişim2025/r/gumushane/14004
  Investigation 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.

  • 
  • 
  İncele
• MakaleAçık Erişim2025/r/gumushane/12482
  An 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.

  • 
  • 
  İncele
• MakaleYalnız künye2025/r/gumushane/12394
  ChatGPT-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.

  • 
  İncele
• MakaleAçık Erişim2025/r/gumushane/12334
  Nursing 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.

  İncele