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Öğe Assessment of Patient Safety Attitude Levels Among Healthcare Professionals Working in the Operating Room(Erciyes Univ Sch Medicine, 2023) Tamer, Murat; Akbulut, Sami; Cicek, Ipek Balikci; Saritas, Hasan; Akbulut, Mehmet Serdar; Ozer, Ali; Colak, CemilObjective: This study aims to determine the factors affecting the perception levels of operating room (OR) nurses and nurse anesthetists working in the OR regarding patient safety attitudes. Materials and Methods: This study was conducted using face-to-face interviews with 117 healthcare professionals working as OR nurses (n=60) and nurse anesthetists (n=57). The patient safety attitude questionnaire (SAQ), where the reliability analysis was also performed for the SAQ scale. and sociodemographic characteristics were used for this study. Qualitative variables were given as numbers and percentages (%), and the dataset belonging to quantitative variables that met the normal distribution criteria was given as mean (standard deviation), and data of quantitative variables that did not comply with nor-mality were given as median, IQR, and 95% CI of the median.Results: There were significant differences between OR nurses and nurse anesthetists regarding job satisfaction (p=0.015) and total SAQ score (p=0.040). Significant differences were detected between men and women participants regarding smoking (p=0.020) and stress recognition (p=0.040). The reliability analysis of the scale was as follows: total (alpha: 0.791), job satisfaction (alpha: 0.883), teamwork climate (alpha: 0.856), safety climate (alpha: 0.864), perceptions of management (alpha: 0.881), stress recognition (alpha: 0.791), and working conditions (alpha: 0.530).Conclusion: It was shown that the patient safety attitudes of the healthcare professionals participating in this study are above average, although it is still insufficient, where the stress identification score of the female participant was higher, and it was also found that the nurses' job satisfaction and SAQ score were higher.Öğe Effect of Acceptance and Commitment Therapy on Motivation and Adherence to Immunosuppressive Medication in Liver Transplant Recipients: A Randomized Controlled Trial(Wiley, 2025) Saritas, Serdar; Okutan, Serafettin; Saritas, Hasan; Bulbuloglu, SemraBackground: 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.Öğe Effect of the COVID-19 Pandemic on the Psychological Health of Patients Who Underwent Liver Transplantation Due to Hepatocellular Carcinoma(Mdpi, 2023) Akbulut, Sami; Kucukakcali, Zeynep; Saritas, Hasan; Bozkir, Cigdem; Tamer, Murat; Akyuz, Musap; Bagci, NazlicanBackground: The primary aim of this study was to compare liver transplant (LT) recipients with and without hepatocellular carcinoma (HCC) in terms of COVID-19-related depression, anxiety, and stress. Method: A total of 504 LT recipients with (HCC group; n = 252) and without HCC (non-HCC group; n = 252) were included in the present case-control study. Depression Anxiety Stress Scales (DASS-21) and Coronavirus Anxiety Scale (CAS) were used to evaluate the depression, stress, and anxiety levels of LT patients. DASS-21 total and CAS-SF scores were determined as the primary outcomes of the study. Poisson regression and negative binomial regression models were used to predict the DASS and CAS scores. The incidence rate ratio (IRR) was used as a coefficient. Both groups were also compared in terms of awareness of the COVID-19 vaccine. Results: Poisson regression and negative binomial regression analyses for DASS-21 total and CAS-SF scales showed that the negative binomial regression method was the appropriate model for both scales. According to this model, it was determined that the following independent variables increased the DASS-21 total score: non-HCC (IRR: 1.26; p = 0.031), female gender (IRR: 1.29; p = 0.036), presence of chronic disease (IRR: 1.65; p < 0.001), exposure to COVID-19 (IRR: 1.63; p < 0.001), and nonvaccination (IRR: 1.50; p = 0.002). On the other hand, it was determined that the following independent variables increased the CAS score: female gender (IRR:1.75; p = 0.014) and exposure to COVID-19 (IRR: 1.51; p = 0.048). Significant differences were found between the HCC and non-HCC groups in terms of median DASS-21 total (p < 0.001) and CAS-SF (p = 0.002) scores. Cronbach's alpha internal consistency coefficients of DASS-21 total and CAS-SF scales were calculated to be 0.823 and 0.783, respectively. Conclusion: This study showed that the variables including patients without HCC, female gender, having a chronic disease, being exposed to COVID-19, and not being vaccinated against COVID-19 increased anxiety, depression, and stress. High internal consistency coefficients obtained from both scales indicate that these results are reliable.Öğe Evaluation of Nurses' Vaccine Hesitancy, Psychological Resilience, and Anxiety Levels During COVID-19 Pandemic(Aves, 2023) Akbulut, Sami; Boz, Gulseda; Gokce, Ayse; Unsal, Selver; Saritas, Hasan; Kizilay, Erva; Ozer, AliObjective: 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 significantly 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.Öğe Evaluation of the Relationship Between Psychological Well-Being and Immunosuppressant Therapy Adherence in Women with Liver Transplantation(Reial Acad Medicina Illes Balears, 2024) Serin, Emine Kaplan; Duman, Mesude; Saritas, Seyhan Citlik; Saritas, HasanObjective: This study was conducted to evaluate the relationship between psychological well-being and immunosuppressant therapy adherence in women with liver transplantation. Materials and methods: This study was conducted as a descriptive and cross-sectional type. A Personal Information Form, the Immunosuppressant Therapy Adherence Scale (ITAS), and the Psychological Well-Being Scale (PWBS) were used to collect the research data. Results: As a result of the study, a positive and significant correlation was found between immunosuppressant therapy adherence, duration of use and total PWBS scores (p = 0.000). There was a significant relationship between psychological well-being and immunosuppressant therapy adherence. Conclusion: For this reason, nurses should know that therapy adherence is important in increasing psychological well-being in the treatment of female patients with liver transplantation, and these issues should be included in their educationÖğe Evaluation of Vaccine Hesitancy and Anxiety Levels among Hospital Cleaning Staff and Caregivers during COVID-19 Pandemic(Mdpi, 2022) Akbulut, Sami; Gokce, Ayse; Boz, Gulseda; Saritas, Hasan; Unsal, Selver; Ozer, Ali; Akbulut, Mehmet SerdarIt 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.Öğe Factors affecting anxiety, depression, and self-care ability in patients who have undergone liver transplantation(Baishideng Publishing Group Inc, 2021) Akbulut, Sami; Ozer, Ali; Saritas, Hasan; Yilmaz, SezaiBACKGROUND Depression, anxiety, and altered self-care ability are among the most important factors affecting the quality of life of liver transplant recipients. Depending on the severity of the underlying liver disease, signs and symptoms of anxiety and depression may become more pronounced. AIM To evaluate the factors affecting depression, anxiety and self-care abilities of liver transplant recipients. METHODS Recipients who are >= 18 years and who underwent liver transplantation at Inonu University Liver Transplantation Institute were included in this descriptive and cross-sectional study. Sample size analysis showed that the minimum number of recipients should be 301 (confidence level = 95%, confidence interval = 2.5, population = 1382). Three hundred and twenty recipients were interviewed and 316 recipients that have answered the questionnaires accurately were analyzed. The dependent variables were the Beck Depression Scale, State-Trait Anxiety Scale (Form I and II), and Self-Care Agency Scale. The independent variables of the study were sociodemographic characteristics, biliary complications, hepatocellular carcinoma, recommending liver transplantation to other patients, and the interval of out-patient clinic visits. RESULTS Self-care ability scores were lower (P = 0.002) and anxiety scores were higher (P = 0.004) in recipients with biliary complications. On the other hand, in recipients with hepatocellular carcinoma, self-care scores were lower (P = 0.006) while depression (P = 0.003) and anxiety scores (P = 0.009) were higher. Liver transplantation recipients with a monthly income < 3000 Turkish liras had higher depression (P < 0.001) and anxiety (P = 0.003) scores. The recipients who stated that they would not recommend liver transplantation to others had lower self-care scores (P = 0.002), higher depression (P < 0.001), higher state anxiety (P = 0.02), and trait anxiety (P < 0.001) scores. CONCLUSION Presence of biliary complications and hepatocellular carcinoma, low income level, and an obligation for monthly visits to the outpatient clinic are factors that are found to affect self-care capability, depression, and anxiety.Öğe Factors associated with psychological resilience, COVID-19-related anxiety, and COVID-19 vaccine hesitancy among academic professionals(Nature Portfolio, 2026) Akbulut, Sami; Baran, Ayse; Kizilay, Erva; Saritas, Hasan; Sarici, Kemal Baris; Karabulut, Ertugrul; Ozer, AliThis study evaluated psychological resilience, COVID-19-related anxiety, and COVID-19 vaccine hesitancy, together with factors independently associated with these outcomes, among academic professionals during the COVID-19 pandemic. This cross-sectional analytical study was conducted between September and November 2021 among academic professionals at Inonu University, T & uuml;rkiye (n = 718). Data were collected using a structured questionnaire, the Brief Resilience Scale (BRS), and the Coronavirus Anxiety Scale (CAS). Univariate general linear models and multivariable linear regression analyses were used for BRS and CAS scores, while multivariable logistic regression was used for COVID-19 vaccine hesitancy. COVID-19 vaccine hesitancy was present in 42.3% of participants. Chronic comorbidity status was the only variable independently associated with higher CAS scores (B = 1.269; p < 0.001). Higher BRS scores were independently associated with older age category (B = 0.559; p = 0.044), male sex (B = 1.054; p = 0.003), and confidence in healthcare professionals' COVID-19-related knowledge (B = 0.766; p = 0.021), whereas vaccinated participants had lower BRS scores than unvaccinated participants (B = - 1.828; p = 0.006). Vaccine hesitancy was significantly lower among participants aged 45-59 years than among those aged <= 44 years (OR = 0.541; p = 0.002), current smokers (OR = 0.533; p = 0.008), those perceiving COVID-19 vaccines as protective (OR = 0.055; p < 0.001) or undecided about protectiveness (OR = 0.225; p = 0.031), those supporting mandatory vaccination (OR = 0.234; p < 0.001), and those reporting confidence in healthcare professionals' COVID-19-related knowledge (OR = 0.362; p < 0.001). Overall, COVID-19-related anxiety, psychological resilience, and vaccine hesitancy among academic professionals were associated with distinct clinical, demographic, and trust-related factors, highlighting the relevance of health-vulnerability assessment and trust-oriented vaccination communication in academic settings.Öğe Relation between monocyte to high-density lipoprotein cholesterol ratio and prognosis in recipients after liver transplantation(Elsevier, 2025) Okutan, Serafettin; Saritas, Hasan; Saritas, Serdar; Bulbuloglu, Semra; Gunes, HuseyinBackground The end-stage liver diseases require liver transplantation as the life-saving solution. It is known that monocytes/macrophages and high-density lipoprotein cholesterol (HDLC) have important contributions to the development of hepatic inflammation and oxidative stress before liver transplantation. However, the effect of monocyte/HDL-C ratio (MHR) on clinical progression and outcome in the post-transplant period are not fully understood. Our hypothesis is that the MHR value may be associated with poor vs. good outcomes after liver transplantation. Methods In our retrospective study, we included 464 liver transplant recipients. Patients' data were extracted from electronic and other paper records in our teaching/research hospital. The MHR values and other blood parameters (creatinine, total protein, albumin, etc.) were expressed as a mean and standard deviation, which were analyzed by the Pearson correlation test. The relationship between graft dysfunction and MHR was determined by ROC curve analysis. Results The mean age of liver transplant recipients was 45.8 +/- 13.7 years. Nineteen percent of patients had liver failure due to Alcoholic Fatty Liver Disease (AFLD) and 34.5 % had liver failure due to hepatitis B virus. At the end of 3 months after liver transplantation, 84.5 % of liver transplant recipients were alive, 5.8 % experienced graft rejection and 5.17 % had an infection. There was a statistically significant improvement in total protein, albumin, liver function tests, and serum creatinine values of the survivors (all p < 0.05). The MHR levels were significantly higher in patients who died after transplantation in comparison to those who survived before and after liver transplantation and these differences were statistically significant (p < 0.01). Conclusion The increased MHR values of recipients after liver transplantation correlated with their risk of survival. Furthermore, the MHR value increased with increased MELD score and the number of days of hospitalization and was not affected by gender and age. MHR was higher in patients with chronic diseases. Patients with high MHR before and after transplantation should be monitored more closely in the perioperative period.Öğe The Effect of Comedy Therapy on Anxiety and Vital Signs in Liver Transplant Recipients during the Preoperative Period: A Randomized Controlled Trial(Wiley, 2026) Saritas, Hasan; Okutan, Serafettin; Bulbuloglu, Semra; Saritas, Serdar; Guven, Durdane YilmazBackground Patients awaiting liver transplantation often experience preoperative anxiety, which may negatively influence vital signs and physiological stability. Brief, low-cost non-pharmacological interventions such as comedy therapy may help reduce anxiety and improve selected physiological parameters. This study aimed to evaluate the effect of comedy therapy on preoperative anxiety and vital signs in liver transplant recipients. Methods This randomized controlled trial was conducted between April 2024 and May 2025 at a liver transplant institute in Turkey. A total of 120 participants were randomly assigned to an intervention group (n = 60) or a control group (n = 60). During the preoperative period, the intervention group watched 10-min clips from classic Turkish comedy films, while the control group received only routine care. State-trait anxiety inventory (STAI) scores and vital signs (systolic/diastolic blood pressure, heart rate, respiratory rate, and oxygen saturation) were measured before and after the intervention. Data were analyzed using SPSS 26 with p < 0.05 considered significant. Results In the intervention group, STAI scores decreased significantly after comedy therapy (p = 0.001), whereas no significant change occurred in the control group (p = 0.974). Mean pulse, systolic and diastolic blood pressure, and respiratory rate decreased, and oxygen saturation increased significantly in the intervention group (p < 0.05). In the control group, only a limited reduction in blood pressure was noted. Between-group comparisons revealed significant differences in respiratory rate and oxygen saturation (p < 0.05). Conclusion Comedy therapy effectively reduces preoperative anxiety and improves selected physiological parameters in liver transplant recipients. Integrating such low-cost, non-pharmacological interventions into surgical preparation may enhance psychological well-being and promote physiological stability.
