Background: In primary care, measurement of the ankle-brachial index (ABI) by using hand Doppler ... more Background: In primary care, measurement of the ankle-brachial index (ABI) by using hand Doppler is recommended for screening of peripheral arterial disease. Despite being relatively a simple procedure, the ABI is rarely measured in primary care due to unpracticality of the hand Doppler method. Oscillometry is an accessible, reliable, and an easy to use method for the measurement of ABI. With a little training, it can be used by anybody. Aim: The aim of the study is to compare the oscillometric method with a reference test (i.e. hand Doppler) for the screening of peripheral arterial disease (PAD) and arterial stiffness (AS) in primary care. Methods: A prospective observational diagnostic study was designed. Participants were 45 years of age or older. A survey including demographic data, risk factors, and symptoms of the peripheral arterial disease was applied to the participants besides measuring ABI both by Doppler and oscillometric methods. Results: Three hundred and forty participants included in our study with 59.78 ± 9.8 mean age. 60.9% of the participants were men. Even though the results of the oscillometric calculations were higher, a strong correlation was observed between the measurements of two methods. Using the Doppler-derived ABI, as the gold standard, and 0, 9 as a cutoff point, the sensitivity and specificity of the oscillometric method was 74.4% and 100%, respectively, with an area under the curve of 0.98 (95% CI: 0.96-0.99). Conclusion: Oscillometry seemed to be a reliable screening method in primary care both for peripheral arterial disease and AS.
Objective: Violence has recently increased in almost every facet of life, but more noticeable in ... more Objective: Violence has recently increased in almost every facet of life, but more noticeable in workplaces. Doctors and other healthcare professionals are among the most frequently targeted and victimized professionals. Healthcare professionals are in danger due to multiple types of violence that can occur in healthcare institutions, resulting from patients, patients' family, or anyone else; threatening conduct, verbal threats, financial abuse, physical abuse, and sexual assault. The current study aims to understand how patients perceive the violence encountered by healthcare workers and to clarify whether there was or wasn't a connection between the participants' ideas and their levels of aggression. Finding out what the patients believe about violence against doctors is important to create action plans to implement these attitudes in a non-violent way. Method: The volunteers who applied to Family Health Centers by any reason were required to complete a survey that ask...
Diabetes mellitus (DM) is still one of the common chronic problems not only in rural but also the... more Diabetes mellitus (DM) is still one of the common chronic problems not only in rural but also the urban cities. While the regulation of blood sugar metabolism is one of the target points, living with DM can trammel primary care physicians. 64 years old female patient who was diagnosed with DM and hypertension for at least 5 years has attended the surgery for nuisance and dysuria. Bacteriuria has detected and blood sugar was 550 mg/dl WBC= 12,48 CRP: 7 HbA1C: 10,4 % Her neurologic examination was normal except she has got urinary incontinence. She was hospitalized with a diagnosis of DM, HT, and cystitis. Metformin 2x1gr, 1x 40 mg, ceftriaxone 2x1gr, and insulin glargine were ordered. Diabetic patient education has been performed. During follow-up, her blood sugar regulation has been settled but she complained of palpitation, ECG has been performed and diagnosed as AF (atrial fibrillation). Her blood pressure was 120/80 and metoprolol infusion was made. INR: 1,44 sec PT=17sn creatine...
Turkish Journal of Family Medicine and Primary Care
Amaç: Tükenmişlik sendromu özellikle sağlık çalışanları arasında önemli bir sorundur. Bireysel be... more Amaç: Tükenmişlik sendromu özellikle sağlık çalışanları arasında önemli bir sorundur. Bireysel beceri ve başarı duygusu ne kadar yüksekse, tükenmişlik sendromu olasılığı o kadar düşüktür. Araştırmanın amacı, aile hekimlerinin tükenmişlik ve iş doyum düzeylerini ölçmektir. Yöntemler: Çalışmaya kırsal ve kentsel alanda çalışan aile hekimlerinin verileri dahil edilmiştir. Çalışma, Maslach Tükenmişlik Envanteri, Minnesota İş Doyum Anketi kullanılarak tükenmişlik ve iş doyum düzeylerini ölçmek için tasarlanmıştır. Çalışma alanı ve diğer etmenlerle ilişkileri de incelenmiştir. Bulgular: Maslach duyarsızlaşma alt ölçeği, yalnız yaşayanlarda, bulunduğu yeri kırsal olarak tanımlayanlarda ve sürekli tıp eğitimine (STE) katılmayanlarda (p=0,02, p=0,01, p=0,03) anlamlı olarak daha yüksek bulundu. Maslach kişisel başarı puanı, bulunduğu yeri kırsal olarak tanımlayanlarda düşük (p=0,01) iken, kadınlarda ve STE'ye katılmayanlarda daha yüksek bulundu (p=0,02, p=0,03). Ayrıca yaş arttıkça Maslac...
Turkish Journal of Family Medicine & Primary Care, 2022
Aim: Burnout syndrome is a major problem, especially among health care workers. The higher the se... more Aim: Burnout syndrome is a major problem, especially among health care workers. The higher the sense of individual skills and achievement, the lower the likelihood of burnout syndrome. The objective of the study is to measure the level of burnout and job satisfaction of family physicians. Methods: Both data of the Family Physicians (FPs) who are working in rural and urban has been included in the study. The study is designed to measure their level of burnout and job satisfaction using the Maslach Burnout Inventory, Minnesota Work Satisfaction Questionnaire. Their relationship with the working area and other factors is also analyzed. Results: Maslach depersonalization subscale was found to be significantly higher in those who lived alone, those who defined their location as rural, and those who did not participate in continuing medical education (CME) (p=0.02, p=0.01, p=0.03). While Maslach personal achievement score was low in those who define their location as rural (p=0.01) it was found to be higher in women and those who did not participate in CME (p=0.02, p=0.03). In addition, as age increases, Maslach emotional burnout and depersonalization scores decrease and personal success scores increase (r =-0.169,-0.205, 0.163 and p=0.00, p=0.00, p=0.00). Conclusions: Emotional and total burnout scores decreased with age, and that attending CME increased personal achievement. CME could be a beneficial tool not only to support FPs but also to prevent burnout.
Varfarin sik kullanilan ancak kullanim dozu pek cok ilac ve yiyeceklerde etkilenen bir ilactir. K... more Varfarin sik kullanilan ancak kullanim dozu pek cok ilac ve yiyeceklerde etkilenen bir ilactir. Kanamaya neden olabileceginden izlemi onemlidir. Hastalar Protrombin Zamani standart degeri olan INR (International Normalized Ratio) ile izlenmekte ve farkli tanilarda hedef degerler 2-3,5 arasinda degismektedir. 76 yasindaki kadin hasta kolesistektomi operasyonu sonrasi serebrovaskuler olay gecirmistir. Hastanin sekel olarak sag ayaginda kuvvet kaybi mevcuttur. Hastaya bakan 77 yasindaki esi ve profesyonel bakicisi evde saglik hizmetleri (ESH) birimine basvurmustur. Vital bulgulari normal olan hastanin vucudunda ekimozlar goruldu. Ayrica gluteal bolgesinde basi yaralari, sag ayakta kuvvet kaybi belirlendi. Hasta 5-6 aydir bu durumda ve morluklari bakim sirasindaki carpmalara baglanmis. Kanama riski nedeniyle acil servise sevk edildi. Ilk degerlendirmesinde INR: 6,6 olup yaygin ekimoz disinda kanama tespit edilmedi. Varfarin uc gun kesildi ve tedavi rejimi yeniden duzenlendi. Oniki gun s...
Giris : Palyatif bakim, onceleri, tedavi edici yaklasimlarin tukendigi, son donem hastalarda gund... more Giris : Palyatif bakim, onceleri, tedavi edici yaklasimlarin tukendigi, son donem hastalarda gundeme gelen bir yaklasimken, gunumuzde, yasami tehdit eden hastaliklarin tanisindan itibaren, tedavi edici yaklasimlarla ek olarak gundeme gelmesi gerektigi gorusu hakimdir. Kanser gibi kronik hastaliklarda depresyon ve anksiyete belirtileri sik olarak saptanmakla birlikte hasta yakinlarinda da bu bulgularin saptanmasindan yola cikilarak tasarlanan bu arastirmada kapsamli palyatif bakim merkezinde yatarak tedavi gormekte olan kanser hastalarinin yakinlarinda depresyon ve anksiyete belirtilerinin saptanmasi ve degerlendirilmesi amaclanmaktadir. Yontem : Tanimlayici-kesitsel tipte tasarlanan arastirma kontrol grubu olmadan tek grup uzerinden yapilan bir anket calismasi olup, hasta yakinlarinin onami alindiktan sonra, yuz yuze gorusme teknigi ile uygulandi. Hazirlanan anket, sosyodemografik degiskenler ile beraber, Beck anksiyete olcegi (BAO), Beck depresyon olcegi (BDO), hastane anksiyete ve...
Amac: Bu calismanin amaci kadinlarin Pap smear test taramasina iliskin inanclarini degerlendirmek... more Amac: Bu calismanin amaci kadinlarin Pap smear test taramasina iliskin inanclarini degerlendirmektir. Gerec ve Yontem: Arastirma, arastirmaci tarafindan gelistirilen Pap smear testi icin Saglik Inanc Modeli Olcegini iceren bir anket araciligiyla gerceklestirilmistir. Katilimcilar, Izmir’de bir Aile Sagligi Merkezi’ne kayitli 18-70 yas arasi 266 kadindi. Pap smear testi taramasina iliskin inanclari Saglik Inanc Modeli Olcegi kullanilarak degerlendirildi. Bulgular: Ortalama ilk cinsel iliski yasi 21,67±4,5 (min:13-maks:45 yil) idi, %86,5’i tek partner oldugunu ve %41,0’i (n=109) hic Pap smear testi yaptirmadigini ifade etti. Daha once Pap smear testi yapilmis kadinlarin hassasiyet, ciddiyet, avantaj ve motivasyon, saglik motivasyonu alt olcek puanlari yuksekti, ancak engeller ortalama puanlari dusuktu. Ciddilik, saglik motivasyonu alt olcekleri ile Pap smear testi yapilmasi arasinda fark vardi (p=0,021, p=0,006), Saglik Inanc Modeli Olcegi’nin ciddiyet ve saglik motivasyonu puanlari o...
Objective: Family planning is one of key responsibilities of family physicians; providing birth c... more Objective: Family planning is one of key responsibilities of family physicians; providing birth control methods, and ensuring its practical application remains important for maternal and child health. The aim of this study is to determine the contraception methods used by the individuals who applied to Family Health Centers (FHC) and to reveal the relationship between family planning methods chosen.
Caregivers are an important source of support for patients in palliative care. Comfort is an impo... more Caregivers are an important source of support for patients in palliative care. Comfort is an important concept in nursing care for both patients and their families, and nurses aim to increase comfort. The aim of the study was to determine the comfort level and influencing factors in caregivers of palliative care patients. The research sample consisted of 102 caregivers related to palliative care patients. The data were obtained with an Individual Information Form, the Edmonton Symptom Assessment Scale (ESAS) and the End of Life Comfort Scale (Caregiver/Family). The study was conducted in the palliative care clinic of Aksaray University Training and Research Hospital between October 2018 and April 2019. There was a significant relationship between the total comfort score of the caregivers and the patient's performance status, the caregivers' age, their economic situation, the length of the caregiving period and receiving help in care (social support) ( p
Background: In recent years, so many people have left their counties because of the war or social... more Background: In recent years, so many people have left their counties because of the war or social, political and economic reasons. This study aims to evaluate the applications of Syrian refugees to a public health center to describe the health care provided to them. Method: The study is intended as a two-part in regard with the mixed design of the study. The first part planned as single-center, descriptive study to be performed with health records of the Syrian asylum seekers and refugees admitted İzmir-Karabaglar community health center within one year. In the second part semi-structured interviews with three doctors who were working in the same center, taking care of Syrian patients, was planned to understand their experiences and views on this service. For quantitative data SPSS for windows 20 program is used and descriptive analysis are performed. Thematic analysis was used for evaluating interviews. Results: 891 applications were made to Karabaglar community health center within one year and the median of the applicants was 4. The most prevalent reason for application was enfections (519; 58.2%) and the number of refugees who applied for preventive care was very low ((90; 10.1%). The number of laboratory tests was 41 (4.6%) patients and the most requested test was urinary analysis. 502 (56.3%) application resulted with a prescription, the number of antibiotics and analgesics were the highest. Doctors who provide service were not satisfied with the care they give. They were having very deep communication problems related with both different cultur and language, hard time to understand patient and the disease. They stated that there is a need of different regulations. Conclusions: Refugees and asylum seekers do not receive the necessary health care they need. Physicians in primary care who take care of these people are thinking that they are not competent and not helpful for these patients.
In Turkey, mandatory referral system is not applied. Caregivers, for their children, apply direct... more In Turkey, mandatory referral system is not applied. Caregivers, for their children, apply directly to health care providers at all levels. This application allows patients to apply to university hospitals with all kinds of health problems. In this study, causes of caregivers to contact the university hospital in the case of their child's illness will be discussed. Our research was planned as a cross-sectional descriptive study. We worked in Dokuz Eylul University Faculty of Medicine, with 217 caregivers whose children admitted to the outpatient clinic of General Pediatrics Department from April 4(th) to 11(th) , 2013. We administered a questionnaire investigating demographic data, causes of applying to the university hospital. Mann-Whitney U test was used for comparing means of groups and Pearson chi-square test for comparing ratios between groups. P value < 0.05 was considered to be statistically significant. 54.5 % of participants expressed their houses were far from the hospital. The most frequent complaints were related to the respiratory tract, among which the most frequent complaint was cough. Onset time of symptoms in 58.3% of patients was expressed as 7 days or more before applying date, 48.9% had never applied to another institution before. Most common reason for preferring university hospital, was being able to have done the necessary tests (88.1%), CONCLUSIONS: Despite common usage of primary health care systems, among the causes of applying tertiary care hospitals, prolongation of duration of symptoms of the patient and proximity of university hospital to home had significant priority. This article is protected by copyright. All rights reserved.
Background: In primary care, measurement of the ankle-brachial index (ABI) by using hand Doppler ... more Background: In primary care, measurement of the ankle-brachial index (ABI) by using hand Doppler is recommended for screening of peripheral arterial disease. Despite being relatively a simple procedure, the ABI is rarely measured in primary care due to unpracticality of the hand Doppler method. Oscillometry is an accessible, reliable, and an easy to use method for the measurement of ABI. With a little training, it can be used by anybody. Aim: The aim of the study is to compare the oscillometric method with a reference test (i.e. hand Doppler) for the screening of peripheral arterial disease (PAD) and arterial stiffness (AS) in primary care. Methods: A prospective observational diagnostic study was designed. Participants were 45 years of age or older. A survey including demographic data, risk factors, and symptoms of the peripheral arterial disease was applied to the participants besides measuring ABI both by Doppler and oscillometric methods. Results: Three hundred and forty participants included in our study with 59.78 ± 9.8 mean age. 60.9% of the participants were men. Even though the results of the oscillometric calculations were higher, a strong correlation was observed between the measurements of two methods. Using the Doppler-derived ABI, as the gold standard, and 0, 9 as a cutoff point, the sensitivity and specificity of the oscillometric method was 74.4% and 100%, respectively, with an area under the curve of 0.98 (95% CI: 0.96-0.99). Conclusion: Oscillometry seemed to be a reliable screening method in primary care both for peripheral arterial disease and AS.
Objective: Violence has recently increased in almost every facet of life, but more noticeable in ... more Objective: Violence has recently increased in almost every facet of life, but more noticeable in workplaces. Doctors and other healthcare professionals are among the most frequently targeted and victimized professionals. Healthcare professionals are in danger due to multiple types of violence that can occur in healthcare institutions, resulting from patients, patients' family, or anyone else; threatening conduct, verbal threats, financial abuse, physical abuse, and sexual assault. The current study aims to understand how patients perceive the violence encountered by healthcare workers and to clarify whether there was or wasn't a connection between the participants' ideas and their levels of aggression. Finding out what the patients believe about violence against doctors is important to create action plans to implement these attitudes in a non-violent way. Method: The volunteers who applied to Family Health Centers by any reason were required to complete a survey that ask...
Diabetes mellitus (DM) is still one of the common chronic problems not only in rural but also the... more Diabetes mellitus (DM) is still one of the common chronic problems not only in rural but also the urban cities. While the regulation of blood sugar metabolism is one of the target points, living with DM can trammel primary care physicians. 64 years old female patient who was diagnosed with DM and hypertension for at least 5 years has attended the surgery for nuisance and dysuria. Bacteriuria has detected and blood sugar was 550 mg/dl WBC= 12,48 CRP: 7 HbA1C: 10,4 % Her neurologic examination was normal except she has got urinary incontinence. She was hospitalized with a diagnosis of DM, HT, and cystitis. Metformin 2x1gr, 1x 40 mg, ceftriaxone 2x1gr, and insulin glargine were ordered. Diabetic patient education has been performed. During follow-up, her blood sugar regulation has been settled but she complained of palpitation, ECG has been performed and diagnosed as AF (atrial fibrillation). Her blood pressure was 120/80 and metoprolol infusion was made. INR: 1,44 sec PT=17sn creatine...
Turkish Journal of Family Medicine and Primary Care
Amaç: Tükenmişlik sendromu özellikle sağlık çalışanları arasında önemli bir sorundur. Bireysel be... more Amaç: Tükenmişlik sendromu özellikle sağlık çalışanları arasında önemli bir sorundur. Bireysel beceri ve başarı duygusu ne kadar yüksekse, tükenmişlik sendromu olasılığı o kadar düşüktür. Araştırmanın amacı, aile hekimlerinin tükenmişlik ve iş doyum düzeylerini ölçmektir. Yöntemler: Çalışmaya kırsal ve kentsel alanda çalışan aile hekimlerinin verileri dahil edilmiştir. Çalışma, Maslach Tükenmişlik Envanteri, Minnesota İş Doyum Anketi kullanılarak tükenmişlik ve iş doyum düzeylerini ölçmek için tasarlanmıştır. Çalışma alanı ve diğer etmenlerle ilişkileri de incelenmiştir. Bulgular: Maslach duyarsızlaşma alt ölçeği, yalnız yaşayanlarda, bulunduğu yeri kırsal olarak tanımlayanlarda ve sürekli tıp eğitimine (STE) katılmayanlarda (p=0,02, p=0,01, p=0,03) anlamlı olarak daha yüksek bulundu. Maslach kişisel başarı puanı, bulunduğu yeri kırsal olarak tanımlayanlarda düşük (p=0,01) iken, kadınlarda ve STE'ye katılmayanlarda daha yüksek bulundu (p=0,02, p=0,03). Ayrıca yaş arttıkça Maslac...
Turkish Journal of Family Medicine & Primary Care, 2022
Aim: Burnout syndrome is a major problem, especially among health care workers. The higher the se... more Aim: Burnout syndrome is a major problem, especially among health care workers. The higher the sense of individual skills and achievement, the lower the likelihood of burnout syndrome. The objective of the study is to measure the level of burnout and job satisfaction of family physicians. Methods: Both data of the Family Physicians (FPs) who are working in rural and urban has been included in the study. The study is designed to measure their level of burnout and job satisfaction using the Maslach Burnout Inventory, Minnesota Work Satisfaction Questionnaire. Their relationship with the working area and other factors is also analyzed. Results: Maslach depersonalization subscale was found to be significantly higher in those who lived alone, those who defined their location as rural, and those who did not participate in continuing medical education (CME) (p=0.02, p=0.01, p=0.03). While Maslach personal achievement score was low in those who define their location as rural (p=0.01) it was found to be higher in women and those who did not participate in CME (p=0.02, p=0.03). In addition, as age increases, Maslach emotional burnout and depersonalization scores decrease and personal success scores increase (r =-0.169,-0.205, 0.163 and p=0.00, p=0.00, p=0.00). Conclusions: Emotional and total burnout scores decreased with age, and that attending CME increased personal achievement. CME could be a beneficial tool not only to support FPs but also to prevent burnout.
Varfarin sik kullanilan ancak kullanim dozu pek cok ilac ve yiyeceklerde etkilenen bir ilactir. K... more Varfarin sik kullanilan ancak kullanim dozu pek cok ilac ve yiyeceklerde etkilenen bir ilactir. Kanamaya neden olabileceginden izlemi onemlidir. Hastalar Protrombin Zamani standart degeri olan INR (International Normalized Ratio) ile izlenmekte ve farkli tanilarda hedef degerler 2-3,5 arasinda degismektedir. 76 yasindaki kadin hasta kolesistektomi operasyonu sonrasi serebrovaskuler olay gecirmistir. Hastanin sekel olarak sag ayaginda kuvvet kaybi mevcuttur. Hastaya bakan 77 yasindaki esi ve profesyonel bakicisi evde saglik hizmetleri (ESH) birimine basvurmustur. Vital bulgulari normal olan hastanin vucudunda ekimozlar goruldu. Ayrica gluteal bolgesinde basi yaralari, sag ayakta kuvvet kaybi belirlendi. Hasta 5-6 aydir bu durumda ve morluklari bakim sirasindaki carpmalara baglanmis. Kanama riski nedeniyle acil servise sevk edildi. Ilk degerlendirmesinde INR: 6,6 olup yaygin ekimoz disinda kanama tespit edilmedi. Varfarin uc gun kesildi ve tedavi rejimi yeniden duzenlendi. Oniki gun s...
Giris : Palyatif bakim, onceleri, tedavi edici yaklasimlarin tukendigi, son donem hastalarda gund... more Giris : Palyatif bakim, onceleri, tedavi edici yaklasimlarin tukendigi, son donem hastalarda gundeme gelen bir yaklasimken, gunumuzde, yasami tehdit eden hastaliklarin tanisindan itibaren, tedavi edici yaklasimlarla ek olarak gundeme gelmesi gerektigi gorusu hakimdir. Kanser gibi kronik hastaliklarda depresyon ve anksiyete belirtileri sik olarak saptanmakla birlikte hasta yakinlarinda da bu bulgularin saptanmasindan yola cikilarak tasarlanan bu arastirmada kapsamli palyatif bakim merkezinde yatarak tedavi gormekte olan kanser hastalarinin yakinlarinda depresyon ve anksiyete belirtilerinin saptanmasi ve degerlendirilmesi amaclanmaktadir. Yontem : Tanimlayici-kesitsel tipte tasarlanan arastirma kontrol grubu olmadan tek grup uzerinden yapilan bir anket calismasi olup, hasta yakinlarinin onami alindiktan sonra, yuz yuze gorusme teknigi ile uygulandi. Hazirlanan anket, sosyodemografik degiskenler ile beraber, Beck anksiyete olcegi (BAO), Beck depresyon olcegi (BDO), hastane anksiyete ve...
Amac: Bu calismanin amaci kadinlarin Pap smear test taramasina iliskin inanclarini degerlendirmek... more Amac: Bu calismanin amaci kadinlarin Pap smear test taramasina iliskin inanclarini degerlendirmektir. Gerec ve Yontem: Arastirma, arastirmaci tarafindan gelistirilen Pap smear testi icin Saglik Inanc Modeli Olcegini iceren bir anket araciligiyla gerceklestirilmistir. Katilimcilar, Izmir’de bir Aile Sagligi Merkezi’ne kayitli 18-70 yas arasi 266 kadindi. Pap smear testi taramasina iliskin inanclari Saglik Inanc Modeli Olcegi kullanilarak degerlendirildi. Bulgular: Ortalama ilk cinsel iliski yasi 21,67±4,5 (min:13-maks:45 yil) idi, %86,5’i tek partner oldugunu ve %41,0’i (n=109) hic Pap smear testi yaptirmadigini ifade etti. Daha once Pap smear testi yapilmis kadinlarin hassasiyet, ciddiyet, avantaj ve motivasyon, saglik motivasyonu alt olcek puanlari yuksekti, ancak engeller ortalama puanlari dusuktu. Ciddilik, saglik motivasyonu alt olcekleri ile Pap smear testi yapilmasi arasinda fark vardi (p=0,021, p=0,006), Saglik Inanc Modeli Olcegi’nin ciddiyet ve saglik motivasyonu puanlari o...
Objective: Family planning is one of key responsibilities of family physicians; providing birth c... more Objective: Family planning is one of key responsibilities of family physicians; providing birth control methods, and ensuring its practical application remains important for maternal and child health. The aim of this study is to determine the contraception methods used by the individuals who applied to Family Health Centers (FHC) and to reveal the relationship between family planning methods chosen.
Caregivers are an important source of support for patients in palliative care. Comfort is an impo... more Caregivers are an important source of support for patients in palliative care. Comfort is an important concept in nursing care for both patients and their families, and nurses aim to increase comfort. The aim of the study was to determine the comfort level and influencing factors in caregivers of palliative care patients. The research sample consisted of 102 caregivers related to palliative care patients. The data were obtained with an Individual Information Form, the Edmonton Symptom Assessment Scale (ESAS) and the End of Life Comfort Scale (Caregiver/Family). The study was conducted in the palliative care clinic of Aksaray University Training and Research Hospital between October 2018 and April 2019. There was a significant relationship between the total comfort score of the caregivers and the patient's performance status, the caregivers' age, their economic situation, the length of the caregiving period and receiving help in care (social support) ( p
Background: In recent years, so many people have left their counties because of the war or social... more Background: In recent years, so many people have left their counties because of the war or social, political and economic reasons. This study aims to evaluate the applications of Syrian refugees to a public health center to describe the health care provided to them. Method: The study is intended as a two-part in regard with the mixed design of the study. The first part planned as single-center, descriptive study to be performed with health records of the Syrian asylum seekers and refugees admitted İzmir-Karabaglar community health center within one year. In the second part semi-structured interviews with three doctors who were working in the same center, taking care of Syrian patients, was planned to understand their experiences and views on this service. For quantitative data SPSS for windows 20 program is used and descriptive analysis are performed. Thematic analysis was used for evaluating interviews. Results: 891 applications were made to Karabaglar community health center within one year and the median of the applicants was 4. The most prevalent reason for application was enfections (519; 58.2%) and the number of refugees who applied for preventive care was very low ((90; 10.1%). The number of laboratory tests was 41 (4.6%) patients and the most requested test was urinary analysis. 502 (56.3%) application resulted with a prescription, the number of antibiotics and analgesics were the highest. Doctors who provide service were not satisfied with the care they give. They were having very deep communication problems related with both different cultur and language, hard time to understand patient and the disease. They stated that there is a need of different regulations. Conclusions: Refugees and asylum seekers do not receive the necessary health care they need. Physicians in primary care who take care of these people are thinking that they are not competent and not helpful for these patients.
In Turkey, mandatory referral system is not applied. Caregivers, for their children, apply direct... more In Turkey, mandatory referral system is not applied. Caregivers, for their children, apply directly to health care providers at all levels. This application allows patients to apply to university hospitals with all kinds of health problems. In this study, causes of caregivers to contact the university hospital in the case of their child's illness will be discussed. Our research was planned as a cross-sectional descriptive study. We worked in Dokuz Eylul University Faculty of Medicine, with 217 caregivers whose children admitted to the outpatient clinic of General Pediatrics Department from April 4(th) to 11(th) , 2013. We administered a questionnaire investigating demographic data, causes of applying to the university hospital. Mann-Whitney U test was used for comparing means of groups and Pearson chi-square test for comparing ratios between groups. P value < 0.05 was considered to be statistically significant. 54.5 % of participants expressed their houses were far from the hospital. The most frequent complaints were related to the respiratory tract, among which the most frequent complaint was cough. Onset time of symptoms in 58.3% of patients was expressed as 7 days or more before applying date, 48.9% had never applied to another institution before. Most common reason for preferring university hospital, was being able to have done the necessary tests (88.1%), CONCLUSIONS: Despite common usage of primary health care systems, among the causes of applying tertiary care hospitals, prolongation of duration of symptoms of the patient and proximity of university hospital to home had significant priority. This article is protected by copyright. All rights reserved.
Amaç : Aile hekimi yaklaşımı ile takip etmeye devam ettiğimiz Aksaray Eğitim ve Araştırma Hastane... more Amaç : Aile hekimi yaklaşımı ile takip etmeye devam ettiğimiz Aksaray Eğitim ve Araştırma Hastanesi’nde Ocak 2018-Ocak 2019 arasında takip edilen hastaların yaş, cinsiyet, tanı, yatış süresi ve izlem sonucu yönünden verilerin toplanıp bakım verilen hedef grubun ve ihtiyaçların belirlenmesi amaçlanmıştır. Kesitsel tanımlayıcı planda yapılan çalışma sonuçlarında, grup ortalamalarının karşılaştırılması için Mann Whitney-U testi, gruplar arası ortalamaların karşılaştırılması için Pearson Ki-kare testi kullanıldı. İstatistiksel anlamlılık için p<0.05 kabul edildi.
Bulgular : Hastaların demografik verilerine bakıldığında 181(%56,6) erkek, 139 (%43,4) kadın hasta toplamda 320 hasta takip edilmişti. Hastaların ortalama yaşı 72,19, yaşların ortancası 75’ti(min:15, maks:99). Hasta yaş grubu cilt kanseri olan pediatrik hasta dışında erişkin hastalardan, çoğunlukla geriatrik yaş grubundan oluşmaktaydı. Hastaların yatış tanıları incelendiğinde en sık izlenen tanılar; 31 hastada serebrovasküler hastalık, 29 hastada pnömoni, 17 hastada Alzheimer hastalığı, 13 hastada bronş ve akciğer malignitesi, 11 hastada mide malignitesi tanısı şeklinde izlenirken daha farklı gruplardan çok sayıda onkolojik tanı izlenmişti. Hastaların sağlık güvenceleri incelendiğinde en sık 98 kişi ile BAĞ-KUR, farklı alt gruplardan SGK mensupları, 33 Emekli Sandığı ve az sayıda (n:17) yurtdışı sigortalı hasta bulunmaktaydı. 3 hasta işsizlik ödeneğinden faydalanmaktaydı. Hastaların 276’sı (%86,2) aynı hekim tarafından yatırılarak takip edilmişti. Aile hekimi uzmanı takibi dışında anestezi ve dahiliye tarafından hasta izlemi yapılmıştı. Hastaların servis izlemi sonuçları incelendiğinde 11 hasta kurum dışına, 41 hasta kurum içinde sevk edilirken, 112 (%35) hasta vefat etmişti. Hastaların izlem tanıları ve yatış için başvuru sırasındaki hastanın genel durumu ve beklenen yaşam süresi göz önüne alındığında bu ölüm oranı palyatif bakım ortalamaları ile uyumludur. Tek gün yatmış olarak izlenen hastalar tüm grubun %18,4’ünü oluşturmakta idi ve destek tedaviden fayda görmek için hastaneye başvurusu gecikmiş ve vefat ile sonuçlanmış hastalardı.
Sonuç : Yaş ve tanılara bağlı ihtiyaçların özellikleri ve hasta-hasta yakınlarının bilgi ve eğitim ihtiyacı açısından Aile Hekimlerinin üstlendiği rolün kıymetini vurgulamak için çalışmamızın diğer çalışmalar için de yol gösterici olacağını düşünmekteyiz.
Anahtar Kelimeler: palyatif bakım, geriatri, aile hekimliği, evde-bakım hizmetleri
Background: Human papillomavirus (HPV) is considered a primary cause of uterine cervical cancers... more Background: Human papillomavirus (HPV) is considered a primary cause of uterine cervical cancers. To reduce the incidence of cervical SCC, the first step is to diagnose and treat SIL through and also to go further co-factors should be discovered. Evaluation of STIs is important to diagnose and treat patients with abnormal cervical cytology. Aim : The objective of the project is to improve clinical care. Methods: We will use an interactive approach for this workshop. Presenters will alternate clinical cases and more theoretical points as medical and the legal parts as also. To manage this issue by protecting time will be held during the workshop. To manage with the patients who diagnosed as ''HPV +'' by using cervical screening. Sexual Transmitted Diseases (STDs) and HPV + cases are also part of GPs/FMs daily practice that should not be ignored. The presentation of the group works;
1. Physicians recognize themselves: What kind of screening program could be used in their country and what about the opportunities and obstacles? 2. Understand the Patient: The health care needs of STDs and HPV + individuals and the duties of primary care 3. How to approach different types of the patients 4. Ethical and legal issues Results and Conclusions: We think that this workshop, specifically will be useful for the GPs/ FMs ’’. The knowledge and skills to deal with patients who are diagnosed as STDs and HPV + to inform patients and GPs/FMs due to giving no harm and not be harmed. This would be an important learning opportunity.
Background Violence can be seen in every aspect of human life, is important and growing public he... more Background Violence can be seen in every aspect of human life, is important and growing public health problem in the world. Violence is reported as mostly seen in the family atmosphere and against women (WHO). Violence against women is a phenomenon extremely common in the world, regardless of culture, economic development and education level. According to the "Survey of Violence against Women in Turkey”; exposure to family violence in any period of life is high. Although violence against women, children and elder is common all over the world, reflected in a small number of forensic medicine. In many cases of domestic violence in communities having great risk of exposure, socially it is considered normal. Domestic violence often not reported for reasons such as lack of awareness, security, shame and fear. Wounded individuals physically and psychologically, referral to health organizations and judicial authorities in time is important for people health as well as detection of medical evidence. Domestic violence, as it directly affects woman suffering violence, children growing up in violent environments negatively affected by physical and mental aspects. This situation defines vicious cycle of violence; domestic emphasizes the importance of combating violence. Method Discussions will be carried out by forming working groups. Workshop Program Topics • Convention on preventing and combating violence against women and domestic violence (Istanbul Convention) • Family Protection Law No. 6284 on the Prevention of Violence against Women • Workshop (Case studies - legal and social aspects of the evaluation) • Available coordination and cooperation related to violence against women cases and problems • Solutions to improve the possibilities of coordination and cooperation and functionalized • Conclusion and Evaluation We believe that with this workshop producing solutions which contribute to the production by demonstrated the problems and experience. The results will be presented as a declaration.
Keywords: Domestic Violence, Family Medicine, Forensic Medicine
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Bulgular : Hastaların demografik verilerine bakıldığında 181(%56,6) erkek, 139 (%43,4) kadın hasta toplamda 320 hasta takip edilmişti. Hastaların ortalama yaşı 72,19, yaşların ortancası 75’ti(min:15, maks:99). Hasta yaş grubu cilt kanseri olan pediatrik hasta dışında erişkin hastalardan, çoğunlukla geriatrik yaş grubundan oluşmaktaydı. Hastaların yatış tanıları incelendiğinde en sık izlenen tanılar; 31 hastada serebrovasküler hastalık, 29 hastada pnömoni, 17 hastada Alzheimer hastalığı, 13 hastada bronş ve akciğer malignitesi, 11 hastada mide malignitesi tanısı şeklinde izlenirken daha farklı gruplardan çok sayıda onkolojik tanı izlenmişti. Hastaların sağlık güvenceleri incelendiğinde en sık 98 kişi ile BAĞ-KUR, farklı alt gruplardan SGK mensupları, 33 Emekli Sandığı ve az sayıda (n:17) yurtdışı sigortalı hasta bulunmaktaydı. 3 hasta işsizlik ödeneğinden faydalanmaktaydı. Hastaların 276’sı (%86,2) aynı hekim tarafından yatırılarak takip edilmişti. Aile hekimi uzmanı takibi dışında anestezi ve dahiliye tarafından hasta izlemi yapılmıştı. Hastaların servis izlemi sonuçları incelendiğinde 11 hasta kurum dışına, 41 hasta kurum içinde sevk edilirken, 112 (%35) hasta vefat etmişti. Hastaların izlem tanıları ve yatış için başvuru sırasındaki hastanın genel durumu ve beklenen yaşam süresi göz önüne alındığında bu ölüm oranı palyatif bakım ortalamaları ile uyumludur. Tek gün yatmış olarak izlenen hastalar tüm grubun %18,4’ünü oluşturmakta idi ve destek tedaviden fayda görmek için hastaneye başvurusu gecikmiş ve vefat ile sonuçlanmış hastalardı.
Sonuç : Yaş ve tanılara bağlı ihtiyaçların özellikleri ve hasta-hasta yakınlarının bilgi ve eğitim ihtiyacı açısından Aile Hekimlerinin üstlendiği rolün kıymetini vurgulamak için çalışmamızın diğer çalışmalar için de yol gösterici olacağını düşünmekteyiz.
Anahtar Kelimeler: palyatif bakım, geriatri, aile hekimliği, evde-bakım hizmetleri
Aim : The objective of the project is to improve clinical care.
Methods: We will use an interactive approach for this workshop. Presenters will alternate clinical cases and more theoretical points as medical and the legal parts as also. To manage this issue by protecting time will be held during the workshop.
To manage with the patients who diagnosed as ''HPV +'' by using cervical screening. Sexual Transmitted Diseases (STDs) and HPV + cases are also part of GPs/FMs daily practice that should not be ignored.
The presentation of the group works;
1. Physicians recognize themselves: What kind of screening program could be used in their country and what about the opportunities and obstacles?
2. Understand the Patient: The health care needs of STDs and HPV + individuals and the duties of primary care
3. How to approach different types of the patients
4. Ethical and legal issues
Results and Conclusions: We think that this workshop, specifically will be useful for the GPs/ FMs ’’. The knowledge and skills to deal with patients who are diagnosed as STDs and HPV + to inform patients and GPs/FMs due to giving no harm and not be harmed. This would be an important learning opportunity.
Keywords: Domestic Violence, Family Medicine, Forensic Medicine