Sürdürülebilir Kalkınma Amaçları

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• MakaleAçık Erişim2026Scopus SJRQ1/r/gumushane/12186
  Turkish 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.

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• MakaleAçık Erişim2025Scopus SJRQ1/r/gumushane/13998
  The Effect of Music on Fear and Anxiety of Children During Tomography: A Randomized Controlled Double-Blind Study

  Kurudirek, Fatma; Demir Barbak, Zülbiye; Demir İmamoğlu, Zeynep; Çiftci, Kamile; Delice, Orhan

  Aim: This study was conducted to determine the effect of a musical intervention during computed tomography (CT) on fear, anxiety and vital signs of children. Method: This randomized, double-blind controlled trial was conducted according to the Consolidated Standards of Reporting Studies (CONSORT) guidelines. The study sample included children aged between 6 and 10 years who met the inclusion criteria and underwent CT scan in the emergency department of a public hospital in eastern Turkey between 18 April and 20 May 2023. The research was completed with a total of 60 children, randomized to one of two groups. The nursing intervention of the study was playing music. Data were collected through face-to-face interviews using the Child and Family Information Form, the Children's Fear Scale (CFS), Children's Anxiety Meter-State (CAM-S) and the Vital Signs Monitoring Form (pulse, blood pressure and oxygen saturation). Ethical principles were followed in the research. Results: The level of fear, anxiety, pulse rate and respiratory rate of the children in the musical intervention group during CT scanning were lower than in the control group (p < 0.05). No difference was found between the groups in terms of oxygen saturation (p < 0.05). Conclusion and Recommendations for Implementation: The results of this study suggest that musical intervention during CT scanning in children is effective in reducing the level of fear and anxiety and stabilizing vital signs. By using such nonpharmacologic methods, nurses can provide support to children and alleviate emotional difficulties during procedures. Trial Registration: NCT06086509. Summary: What is already known about this topic? Music therapy is recognized as an effective nonpharmacologic intervention to reduce fear and anxiety in paediatric patients undergoing medical procedures. Previous studies have shown that musical intervention during CT scans can calm children, potentially reducing the need for sedation and improving compliance. Knowledge gaps remain regarding the specific effects of music on physiological parameters like pulse and respiratory rates during paediatric CT scans. What this paper adds? This study demonstrates that musical intervention during CT scans significantly reduces fear and anxiety levels in children aged 6–10 years. The research findings show that music intervention can also stabilize vital signs, such as pulse and respiratory rates, during CT scans, suggesting a relaxed physiological state. The results support the idea that incorporating music into paediatric imaging procedures can enhance patient comfort and improve the quality of the imaging process by encouraging children to remain still. The implications of this paper: Incorporating music therapy into routine paediatric imaging procedures can reduce anxiety, improve patient cooperation and potentially reduce the need for sedatives. Future research could explore the optimal types of music, volume levels and delivery methods to maximize the calming effects on children during various medical procedures. Training programs for paediatric healthcare providers can include education on the benefits of nonpharmacologic interventions, like music therapy, to reduce anxiety and improve patient outcomes in clinical settings.

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• MakaleAçık Erişim2025Scopus SJRQ1/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.

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