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Article Citation - Scopus: 1Anxiety and Depression After Cesarean: Non-Pharmacological Evidence Based Practices;(Dokuz Eylul University, 2022) Terzioğlu,F.; Gençbaş,D.; Boztepe,H.; Doğu,N.; Akdeniz,C.; Yüceer,B.The purpose of this review is to examine the non-pharmacological evidence-based practices of anxiety and depression after a cesarean section delivery. Postpartum anxiety and depression have increased in the last decade, the rates of postpartum depression are around 13% worldwide. In the postpartum period, women may experience anxiety and depression due to the operation they have undergone; such as being in an unfamiliar environment, facing new technological equipment and encounters with the medical teams, the post-operative pain, the new roles women undertake as mothers. One of the factors that increase anxiety and depression in the postpartum period is the type of delivery. In Turkey, the rate of cesarean delivery is comparatively high, which is approximately 52%. Anxiety and depression after cesarean section develop due to fear and concern such as the complications that may occur during and after the mother's anesthesia, the possibility delaying breastfeeding her baby, and experiencing pain. Non-pharmacological evidence-based applications such as reiki, acupressure, hand and foot massage, yoga, reflexology, aromatherapy, skin to skin care, nursing care protocols were found to be effective in studies conducted to reduce anxiety and depression after cesarean-section. Nurses who have critical roles and responsibilities in pre-and post-cesarean care practices are recommended to include these evidence-based non-pharmacological practices in routine care practices. © 2022, Dokuz Eylul University. All rights reserved.Article Citation - WoS: 40Citation - Scopus: 53Impacts of Covid-19 Pandemic Period on Depression, Anxiety and Stress Levels of the Healthcare Employees in Turkey(Elsevier Ireland Ltd, 2021) Tengilimoglu, Dilaver; Zekioglu, Aysu; Tosun, Nurperihan; Isik, Oguz; Tengilimoglu, OnurThe COVID-19 pandemic has turned into a public health issue since December 2019 and has risen in all countries in the world. The healthcare employees taking part in the pandemic will eventually be affected by the process. The aim of the study is to determine the levels of the anxiety, depression, and stress of the healthcare employees during the COVID-19 pandemic in Turkey. As the data collection tool, an e-survey was used. In the first section, Depression, Anxiety and Stress Scale (DASS-21) was used. In the second section of the survey, the problems experienced by the healthcare employees during the pandemic and their working media were aimed to be defined. In the last section, the socio-demographic features of the employees were investigated. 2076 healthcare employees participated in the study. The results showed that the major cause of the anxiety or stress among healthcare employees comes from the fear to contaminate the COVID-19 virus to their families (86.9%). It was observed that the levels of depression, anxiety and stress of female employees are higher than that of male employees (p < 0.003). The highest depression, anxiety and stress levels of healthcare employees come from the pandemic, emergency, and internal services (p < 0.001). Health managers and policymakers need to make a move immediately to find solutions for the physical and psychological needs of the health employees. On the other hand, in order to minimize the risk, preparation of the work power plans beforehand and inclusion of obligatory referral chain into health services can be suggested.Article Citation - WoS: 10Citation - Scopus: 8Beyond expectations: disease duration and psychological burden in psoriatic arthritis(Springer Heidelberg, 2023) Kilic, Gamze; Kilic, Erkan; Tekeoglu, Ibrahim; Sargin, Betul; Cengiz, Gizem; Balta, Nihan Cuzdan; Nas, KemalThis study aims to investigate the relationship between disease duration and psychological burden in PsA and to identify the risk factors associated with psychological distress. Patients with PsA who met CASPAR classification criteria enrolled by Turkish League Against Rheumatism (TLAR)-Network. Patients were categorized into three groups based on disease duration: early stage (< 5 years), middle stage (& GE; 5, < 10 years), and late stage (& GE; 10 years). All patients underwent clinical and laboratory assessment using standardized protocol and case report forms. The associations between psychological variables and clinical parameters were assessed by a multivariate analysis. Of the 1113 patients with PsA (63.9% female), 564 (%50.7) had high risk for depression and 263 (%23.6) for anxiety. The risk of psychological burden was similar across all PsA groups, and patients with a higher risk of depression and anxiety also experienced greater disease activity, poorer quality of life, and physical disability. Multivariate logistic regression revealed that female gender (OR = 1.52), PsAQoL (OR = 1.13), HAQ (OR = 1.99), FiRST score (OR = 1.14), unemployment/retired (OR = 1.48) and PASI head score (OR = 1.41) were factors that influenced the risk of depression, whereas the current or past enthesitis (OR = 1.45), PsAQoL (OR = 1.19), and FiRST score (OR = 1.26) were factors that influenced the risk of anxiety. PsA patients can experience a comparable level of psychological burden throughout the course of their disease. Several socio-demographic and disease-related factors may contribute to mental disorders in PsA. In the present era of personalized treatment for PsA, evaluating psychiatric distress can guide tailored interventions that improve overall well-being and reduce disease burden.Article Citation - WoS: 29Citation - Scopus: 32Effects of Exercise Training on Anxiety in Diabetic Rats(Elsevier, 2019) Caliskan, Hasan; Akat, Firat; Tatar, Yakup; Zaloglu, Nezahet; Dursun, Ali Dogan; Bastug, Metin; Ficicilar, HakanDiabetes mellitus (DM) is a common health problem, which manifests itself with chronic hyperglycemia and impaired insulin action. The prevalence of anxiety disorders tends to be high in the diabetic population. Exercise has a well-known anxiolytic effect, also demonstrated on rodents, but the effect of exercise on the DM-induced anxiety is still unknown. Female, Wistar albino rats were randomly divided into four groups (n=8) (C; EX; DM; DM+EX). DM was induced by injection (i.p.; 50 mg/kg) of Streptozotocin (STZ). Rats exercised in moderate intensity on the treadmill (15m/min; 5 degrees; 30 min) for 5 weeks. Anxiety-like behavior (ALB) was evaluated by Open field test (OFT) and Elevated Plus Maze (EPM). According to OFT, central time and central entry have increased with in EX but not in DM+EX. There was no difference between C and DM. Central latency time didn't differ among groups. Unsupported rearing increased in both EX and DM+EX. There was no significant decrease in DM. Freezing time was significantly increased in the DM group. Exercise training reduced freezing time both in diabetic and non-diabetic animals. EPM results were similar. Time spent in open arm was increased significantly in exercise groups compared to their sedentary matches, and freezing time data were also parallel to OFT. Our study revealed that diabetes had shown an anxiogenic effect, which was not severe, and it only manifested itself on some behavioral parameters. Exercise training was reduced anxiety-like behavior both in diabetic and non-diabetic rats. However, because of the nature of exercise studies, it is hard to separate the anxiolytic effect of exercise from the alteration of locomotion.Article International Students' Adaptation in Ankara: The Mediating Roles of Anxiety and Self-Esteem(Pergamon-Elsevier Science Ltd, 2025) AlQaifi, FatenWith globalization, the appeal of studying abroad has grown among university students seeking better educational and career opportunities. However, adapting to a new culture often presents significant challenges, especially as international students face language barriers, cultural differences, and stressors that affect their anxiety, self-esteem, and identity development. Despite the importance of these factors, research on this topic in Turkey remains limited. This study addresses this gap by assessing general anxiety levels of students and examining the relationship between adaptation and identity development among international students, using cross-sectional quantitative methods and self-reported questionnaires. Data from 488 participants were analyzed using SPSS and SmartPLS. Results indicate that both anxiety and self-esteem partially mediate the relationship between identity development and adaptation. Anxiety negatively associates with both identity development and adaptation, while self-esteem shows positive associations with both. Proficiency level and previous travel experience were identified as significant factors influencing students' adaptation. These findings offer valuable insights for universities, policymakers, and other stakeholders in creating a supportive environment that enhances the adaptation experience of international students.Article A comprehensive investigation of biopsychosocial determinants influencing primary dysmenorrhea among university students(Routledge Journals, Taylor & Francis Ltd, 2024) Yalvac, Canan Oksuz; Topal, Cansu Akdag; Boztepe, HandanDysmenorrhea, characterized by pain and related symptoms, significantly impacts women's quality of life in work and education, prompting a comprehensive evaluation of associated factors. The objective of this study was to utilize structural equation modeling (SEM) to analyze and assess the biopsychosocial factors influencing dysmenorrhea among university students. Three hundred and thirty-nine university students were included in this cross-sectional descriptive study. Data were collected using the Participant Information Form, the Beck Anxiety Scale (BAS), the Beck Depression Scale (BDS), the Multidimensional Scale of Perceived Social Support (MSPSS), the Adverse Childhood Experiences Scale (ACES), the Pain Catastrophizing Scale (PCS) and the Visual Analogue Scale (VAS). It was determined that the variables of pain onset (t = 3.24, p < .05) and age at menarche (t = -2.16, p < .05) showed a significant relationship with the model. The variables of the PCS (t = 16.87, p < .001), BDS (t = 3.06, p < .05), and BAS (t = 5.13, p < .001) showed a significant relationship with the model. Social factors in the model were examined, and a family history of dysmenorrhea and the ACES variables did not contribute significantly to the model (p > .05). The study indicates primary dysmenorrhea influenced by biological and psychological factors. Nurses should conduct holistic assessments and provide comprehensive care for affected women.Article Citation - WoS: 25Citation - Scopus: 32In Covid-19 Health Messaging, Loss Framing Increases Anxiety With Little-To Concomitant Benefits: Experimental Evidence From 84 Countries(Springernature, 2022) Dorison, Charles A.; Lerner, Jennifer S.; Heller, Blake H.; Rothman, Alexander J.; Kawachi, Ichiro I.; Wang, Ke; Coles, Nicholas A.The COVID-19 pandemic (and its aftermath) highlights a critical need to communicate health information effectively to the global public. Given that subtle differences in information framing can have meaningful effects on behavior, behavioral science research highlights a pressing question: Is it more effective to frame COVID-19 health messages in terms of potential losses (e.g., "If you do not practice these steps, you can endanger yourself and others") or potential gains (e.g., "If you practice these steps, you can protect yourself and others")? Collecting data in 48 languages from 15,929 participants in 84 countries, we experimentally tested the effects of message framing on COVID-19-related judgments, intentions, and feelings. Loss- (vs. gain-) framed messages increased self-reported anxiety among participants cross-nationally with little-to-no impact on policy attitudes, behavioral intentions, or information seeking relevant to pandemic risks. These results were consistent across 84 countries, three variations of the message framing wording, and 560 data processing and analytic choices. Thus, results provide an empirical answer to a global communication question and highlight the emotional toll of loss-framed messages. Critically, this work demonstrates the importance of considering unintended affective consequences when evaluating nudge-style interventions.Article Citation - WoS: 14Citation - Scopus: 14Impact of Obesity on Quality of Life, Psychological Status, and Disease Activity in Psoriatic Arthritis: a Multi-Center Study(Springer Heidelberg, 2022) Gok, Kevser; Nas, Kemal; Tekeoglu, Ibrahim; Sunar, Ismihan; Keskin, Yasar; Kilic, Erkan; Tuncer, TirajeThis article aims to evaluate the possible effect of obesity on quality of life, psychological status, and other clinical variables in Psoriatic arthritis (PsA). PsA patients have been recruited by the Turkish League Against Rheumatism-Network from various centers in Turkey in this cross-sectional study. Patients with a body mass index (BMI) >= of 30 kg/m(2) were considered obese. Differences among patients with regard to obesity status were assessed with health-related quality of life measures (PsA Quality of Life Questionnaire [PsAQoL]), psychological status (Hospital Anxiety and Depression Scale [HADS]), and disease activity parameters (the Disease Activity index for PSoriatic Arthritis [DAPSA], Disease Activity Score 28-C-reactive protein [DAS28-CRP], Bath Ankylosing Spondylitis Disease Activity Index [BASDAI], Psoriasis Area and Severity Index [PASI]), physical functions (Ankylosing Spondylitis Functional Index [BASFI], Health Assessment Questionnaire [HAQ], and Health Assessment Questionnaire for the spondyloarthropathies [HAQ-S]). Pain was assessed using visual analog scale of pain (VAS-P), and fatigue was evaluated using visual analog scale of fatigue (VAS-F) and Functional Assessment of Chronic Illness Therapy (FACIT). A total of 1033 patients with PsA, 650 (62.9%) non-obese and 383 (37.1%) obese were included in the study. The PsAQoL, HADS-Anxiety, HADS-Depression, DAPSA, DAS28-CRP, BASDAI, BASFI, HAQ and HAQ-S scores of the obese group were higher than the non-obese group (p < 0.05). VAS-P and PASI scores were similar between group of patients with and without obesity. Obese patients had higher median scores of VAS-F and FACIT than non-obese patients (p < 0.05). Linear regression analysis showed that BMI affects the quality of life, depression, and disease activity. Consequently, obesity has significant associations with higher disease activity, lower QoL, risk of anxiety, depression, and fatigue. Therefore, obesity should also be taken into account in the management of PsA patients.
