Factors affecting anxiety, depression, and self-care ability in patients who have undergone liver transplantation

It is important to vaccinate individuals working in the field of health who are more at risk compared to society during the pandemic period. The aim of this study was to evaluate the vaccine hesitancy and anxiety levels of hospital cleaning staff and caregivers during the COVID-19 pandemic. This descriptive type cross-sectional study was conducted with 460 hospital cleaning staff and caregivers. Demographic and social characteristics form, Coronavirus Anxiety Scale (CAS), and Vaccine Hesitancy Scale (VHS) adapted to the pandemic were used in the questionnaire form used to collect the data of the study. It was determined that the rates of hesitation against the COVID-19 vaccine and childhood vaccine were 42.2% (n = 194) and 10.9% (n = 50), respectively. Less than half of the participants (44.6%) believe that the COVID-19 vaccine is protective. COVID-19 anxiety (CAS score ≥ 9 point) was detected in 19.6% of participants and statistically significant differences were found between patients with (n = 90) and without (n = 370) anxiety regarding gender (p < 0.001), working unit (p = 0.002), vaccination status (p = 0.023) and history of psychological disease (p = 0.023). It has been shown that the VHS-total scores of those who are not vaccinated, those who are hesitant about vaccination, those who do not think that the vaccine is protective, and those who state that there is no need for a legal obligation in vaccination are higher. When participants were asked about the most anxious situation during the COVID-19 period, the highest response rate was 62.4% for my parents’ exposure to COVID-19. The most anxious situation among participants is their parents’ exposure to COVID-19. Although participants are highly vaccinated, they have serious hesitancy about the COVID-19 vaccine. This study also showed that there was a parallel relationship between COVID-19 anxiety and vaccine hesitancy.

Background: After liver transplantation, recipients continue to receive immunosuppressive drug regimens at varying doses for years to ensure graft function and survival. Although liver transplant recipients are aware of the importance of immunosuppressive drug regimens, treatment compliance may decrease over time due to low motivation, putting recipients at risk of organ rejection. Acceptance and commitment therapy (ACT) appears to be an ideal solution for increasing motivation and, indirectly, treatment compliance. Objective: The aim of this study was to investigate the effect of ACT on adherence to immunosuppressive medication and motivation in liver transplant recipients. Methods: This study was conducted at an organ transplant hospital with the participation of recipients who had completed at least 6 months post‐liver transplant. The sample included n = 140 liver transplant recipients ( n = 70 experimental, n = 70 control). The study was randomized and controlled. The control group received no intervention, while the experimental group underwent an eight‐session ACT program administered by a psychologist. Data collection utilized a personal characteristics form, the Adherence to Immunosuppressive Drug Regimen Scale (AIDRS), the Mindfulness Scale (MS), and the Adult Motivation Scale (AMS). Data analysis was performed using descriptive statistical methods and tests of significance for differences between variables. Findings: According to the homogeneity tests of this study, there was no statistically significant difference between the control and experimental groups in terms of individual characteristics (age, time since transplantation, immunosuppressive drugs, comorbidities, etc.). In the experimental group, the level of adherence to the immunosuppressive drug regimen after ACT was very close to the maximum AIDRS score. In the control group, the level of compliance with the immunosuppressive drug regimen was close to the mean value of the AIDRS. The differences mentioned in both groups were statistically significant ( p < 0.05). In addition, the scores obtained from the MS and YMS were higher than those in the pretest. When the experimental and control groups were compared, the experimental group's final test YMS score was almost twice that of the control group, and this difference was statistically significant ( p < 0.05). Conclusion: The importance of full compliance with the immunosuppressive drug regimen in improving graft function after liver transplantation is well known. The results of this study showed that liver transplant recipients who underwent ACT demonstrated higher adherence to the immunosuppressive drug regimen due to increased motivation and conscious awareness. We recommend the use of ACT to increase adherence to the immunosuppressive medication due to its effectiveness.

Objective: This study aimed to evaluate the vaccine hesitancy, psychological resilience, and anxiety levels of nurses during the COVID-19 pandemic. Materials and Methods: This cross-sectional study was conducted with 676 nurses working at the survey time. Sociodemographic features, the status of hesitancy against the COVID-19 vaccine, the Coronavirus Anxiety Scale, and the Brief Resilience Scale were used in the questionnaire form to collect the data. Results: Most participants (68.6%; n=464) stated they were hesitant about the COVID-19 vaccine. A sig- nificantly higher rate of hesitancy was detected in the age group of 20-39 years, those who did not have COVID-19 vaccine, and those who did not think the COVID-19 vaccine is protective (P < .05). It was determined that 6.8% (n=46) of the nurses had COVID-19 anxiety. A significantly higher rate of anxiety was detected in the age group of 40 years and older, those working in the emergency department, and those working in the COVID-19 unit during the pandemic period (P < .05). The median Brief Resilience Scale score of nurses is 19(6). A negative, weak, and significant relationship was found between the Brief Resilience Scale and Coronavirus Anxiety Scale scores (P = .001). Conclusion: During the pandemic, higher rates of anxiety were detected in healthcare personnel and those working in COVID-19 units. It was also found that as the level of anxiety increased, the level of psychological resilience decreased. To reduce the anxiety level and strengthen the psychological resilience of nurses, the cornerstones of the health system, fast, effective, and curative interventions should be made. Cite this article as: Akbulut S, Boz G, Gokce A, Unsal S, Saritas H, Kızılay E, Ozer A, Serdar Akbulut M, Colak C. Evaluation of nurses' vaccine hesitancy, psychological resilience, and anxiety levels during COVID-19 pandemic. Eurasian J Med., 2023;55(2), 140-146.

Çalışmanın amacı cerrahi ve dahili kliniklerde çalışan hemşirelerin profesyonel değerleri ile hasta güvenliği tutumlarının incelenmesidir. Araştırma tanımlayıcı olarak bir karaciğer nakil enstitüsü ile Orta Karadeniz’de yer alan bir tıp fakültesi hastanesinin dahili ve cerrahi kliniklerinde çalışan 258 hemşireyle, Mayıs 2019-Şubat 2020 tarihleri arasında gerçekleştirilmiştir. Veriler “Hemşire Tanıtım Formu”, “Hemşirelikte Profesyonel Değerler Ölçeği’’ ve “Hasta Güvenliği Tutum Ölçeği’’ ile yüz yüze olarak toplanmıştır. Verilerin değerlendirilmesinde frekans, aritmetik ortalama, ortanca, kruskalwallis varyans analizi, gameshowell testi, bağımsız örneklem t testi, spearman korelasyon ve çoklu regresyon analizi kullanılmıştır. Hemşirelerin Profesyonel Değerler (126.55±20.53) ile Hasta Güvenliği Tutumu Ölçeğinden aldıkları (158.88±27.192) toplam puanların ortalamanın üzerinde olduğu saptanmıştır. Katılımcıların Profesyonel Değerler Ölçeği ve ortalama puanları ile yaş, eğitim durumu, çalışma yılı ve klinikteki pozisyonları arasında anlamlılık bulunmuştur. Hemşirelerin Hasta Güvenliği Tutum Ölçeği ortalama puanları ile yaş ve eğitim durumu arasında istatistiksel olarak fark saptanmıştır. Ancak profesyonel değerleri sadece eğitim düzeyini yordarken, hasta güvenliği tutumunu yaş ve eğitim durumunu yordamıştır. İki ölçek arasındaki ilişkinin pozitif yönde ve anlamlı olduğu belirlenmiştir. Çalışmanın sonucunda hemşirelerin profesyonel değerleri ile hasta güvenliğine ilişkin tutumlarının ortalamanın üzerinde olduğu, bu değer ve tutumların yükseltilmesinde yaşın, eğitimin ve klinik deneyimin önemli olduğu saptanmıştır. Bunun yanı sıra hemşirelikteki profesyonel değerlerin hasta güvenliği tutumunu olumlu etkilediği sonucuna varılmıştır.