{"id":23274,"date":"2021-08-27T08:00:42","date_gmt":"2021-08-27T05:00:42","guid":{"rendered":"https:\/\/www.klimikdergisi.org\/?p=23274"},"modified":"2021-08-26T20:54:14","modified_gmt":"2021-08-26T17:54:14","slug":"asilar-hakkinda-bilgi-tutum-davranis","status":"publish","type":"post","link":"https:\/\/www.klimikdergisi.org\/tr\/2021\/08\/27\/asilar-hakkinda-bilgi-tutum-davranis\/","title":{"rendered":"Birinci Basamakta \u00c7al\u0131\u015fan Hekimlerin A\u015f\u0131lar Hakk\u0131nda Bilgi, Tutum ve Davran\u0131\u015flar\u0131"},"content":{"rendered":"

G\u0130R\u0130\u015e<\/b><\/h2>\n

G\u00fcn\u00fcm\u00fczde hastal\u0131klar\u0131n \u00f6nlenmesinde en ba\u015far\u0131l\u0131 ve maliyet etkin giri\u015fimlerden biri halen a\u015f\u0131lamad\u0131r (1). A\u015f\u0131lar ile d\u00fcnyan\u0131n \u00e7o\u011fu yerinde \u00e7ocuk felci, kuduz, difteri, tetanoz, bo\u011fmaca, k\u0131zam\u0131k, kabakulak gibi pek \u00e7ok infeksiyon hastal\u0131\u011f\u0131 kontrol alt\u0131na al\u0131nabilmi\u015f ve \u00e7i\u00e7ek hastal\u0131\u011f\u0131 d\u00fcnya genelinde eradike edilebilmi\u015ftir (2,3). 1977\u2019de \u00e7i\u00e7ek hastal\u0131\u011f\u0131n\u0131n eradikasyonundan sonra di\u011fer bula\u015f\u0131c\u0131 hastal\u0131klar\u0131n eradikasyonu i\u00e7in \u00e7al\u0131\u015fmalar ba\u015flat\u0131lm\u0131\u015ft\u0131r. D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc (DS\u00d6) poliomyelit ve k\u0131zam\u0131k eradikasyonunu yak\u0131n gelecek plan\u0131na alm\u0131\u015ft\u0131r (4-6). Bula\u015f\u0131c\u0131 hastal\u0131klardan sonra kronik hastal\u0131klar, alerjiler ve ba\u011f\u0131ml\u0131l\u0131kla m\u00fccadele i\u00e7in de a\u015f\u0131 \u00e7al\u0131\u015fmalar\u0131 s\u00fcrmektedir (7,8).\u00a0<\/span><\/p>\n

A\u015f\u0131ya ba\u011fl\u0131 istenmeyen etkiler (a\u015f\u0131 g\u00fcvenlili\u011fi) ve a\u015f\u0131n\u0131n ilgili hastal\u0131ktan koruyucu etkisi, a\u015f\u0131n\u0131n bireylerde ve toplumda uygulanmas\u0131ndan \u00f6nce belirlenir. Toplumda bir a\u015f\u0131n\u0131n a\u015f\u0131 program\u0131na al\u0131nmas\u0131 o a\u015f\u0131n\u0131n ne \u00f6l\u00e7\u00fcde kullan\u0131labilir oldu\u011fuyla ilgilidir ve a\u015f\u0131n\u0131n uygulanaca\u011f\u0131 toplumda ilgili hastal\u0131\u011f\u0131n epidemiyolojik \u00f6zellikleri d\u0131\u015f\u0131nda o toplumun sa\u011fl\u0131k altyap\u0131s\u0131n\u0131n yeterlili\u011fi ve mevcut kaynaklar\u0131 da g\u00f6z \u00f6n\u00fcnde bulundurularak belirlenir (9-11). Ba\u011f\u0131\u015f\u0131klama, infeksiyonlardan korunmada en etkili ve en g\u00fcvenilir y\u00f6ntemdir. Ancak etkinli\u011fi ve g\u00fcvenilirli\u011finden \u015f\u00fcphe duyma, t\u0131bbi kontrendikasyon, dini-felsefi inan\u00e7, a\u015f\u0131dan rahats\u0131z olma, infeksiyona ki\u015fisel duyarl\u0131l\u0131\u011f\u0131 ve hastal\u0131\u011f\u0131n yay\u0131lma potansiyelini k\u00fc\u00e7\u00fcmseme, hastal\u0131\u011f\u0131n hafif ve yararl\u0131 olabilece\u011fine, a\u015f\u0131dan hastal\u0131k kazan\u0131laca\u011f\u0131na inanma gibi nedenlerle personel bu y\u00f6ntemi uygulamakta zorlanmaktad\u0131r (12). B\u00f6ylelikle a\u015f\u0131 reddi \u00e7a\u011f\u0131m\u0131z\u0131n b\u00fcy\u00fcyen sorunlar\u0131ndan olmu\u015ftur (13). Kamu g\u00fcveni ve inan\u00e7lar\u0131 a\u015f\u0131lama oranlar\u0131n\u0131 \u00f6nemli \u00f6l\u00e7\u00fcde etkilemektedir (14).\u00a0 <\/span>Yap\u0131lan bir \u00e7al\u0131\u015fmada, sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n bilgi ve davran\u0131\u015flar\u0131n\u0131n kendilerine a\u015f\u0131 uygulatmalar\u0131n\u0131 ve hastalar\u0131na a\u015f\u0131 \u00f6nerilerini etkiledi\u011fi g\u00f6r\u00fclm\u00fc\u015ft\u00fcr (15).\u00a0<\/span><\/p>\n

\u00dclkemizde ba\u011f\u0131\u015f\u0131klama, b\u00fcy\u00fck oranda birinci basamak sa\u011fl\u0131k hizmeti veren aile sa\u011fl\u0131\u011f\u0131 merkezlerinde yap\u0131lmaktad\u0131r. A\u015f\u0131lama konusunda ilk ba\u015fvurulan ki\u015filer aile hekimleridir. Bu \u00e7al\u0131\u015fma, Elaz\u0131\u011f ilinde \u00e7al\u0131\u015fan birinci basamak hekimlerinin a\u015f\u0131 hakk\u0131nda bilgi, tutum ve davran\u0131\u015flar\u0131n\u0131 ara\u015ft\u0131rmak amac\u0131yla yap\u0131lm\u0131\u015ft\u0131r.<\/p>\n

\"\"<\/a>

Tablo 1.<\/strong> Ankette kullan\u0131lan Bilgi, Tutum ve Davran\u0131\u015f Sorular\u0131<\/p><\/div>\n

Y\u00d6NTEMLER<\/b><\/h2>\n

Bu \u00e7al\u0131\u015fmada evren olarak Elaz\u0131\u011f il ve il\u00e7elerinde \u00e7al\u0131\u015fan aile hekimleri belirlendi. 186 aile hekiminden izin, rapor veya g\u00f6n\u00fcll\u00fc olmama nedeniyle 165 ki\u015fiye ula\u015f\u0131ld\u0131 (%88.7). Tan\u0131mlay\u0131c\u0131 tipte olan bu \u00e7al\u0131\u015fmaya kat\u0131lanlara, ara\u015ft\u0131rmac\u0131lar taraf\u0131ndan literat\u00fcr taranarak geli\u015ftirilen bir anket formu May\u0131s 2018\u2019de uyguland\u0131. Ankette, demografik bilgi sorular\u0131n\u0131n yan\u0131 s\u0131ra 12 bilgi, 13 tutum ve 5 davran\u0131\u015f sorusu yer ald\u0131 (Tablo 1). \u00c7apraz soru yoktur ve\u00a0 <\/span>her soru 1 puan olarak puanlanm\u0131\u015ft\u0131r. Kat\u0131l\u0131mc\u0131lar ankete ba\u015flamadan \u00f6nce, al\u0131nan bilgilerin bu \u00e7al\u0131\u015fman\u0131n bilimsel platformu d\u0131\u015f\u0131nda kullan\u0131lmayaca\u011f\u0131na dair bilgilendirilmi\u015f, anket ve anket sorular\u0131 hakk\u0131nda gerekli a\u00e7\u0131klamalar yap\u0131lm\u0131\u015ft\u0131r.\u00a0<\/span><\/p>\n

Ba\u011f\u0131ml\u0131 de\u011fi\u015fkenler, do\u011fru cevap say\u0131s\u0131, tutum ve davran\u0131\u015f puan\u0131 olup; ba\u011f\u0131ms\u0131z de\u011fi\u015fkenler, ya\u015f, cinsiyet, medeni durum, kronik hastal\u0131k varl\u0131\u011f\u0131, \u00e7ocuk sahibi olma durumu, \u00e7ocuk say\u0131s\u0131, a\u015f\u0131 fayda-zarar konusunda ara\u015ft\u0131rma yapma durumudur. G\u00f6n\u00fcll\u00fcl\u00fck esas\u0131na dayan\u0131larak yap\u0131lan bu \u00e7al\u0131\u015fma i\u00e7in, 19 Nisan 2018 \/ 8-20 tarih ve say\u0131l\u0131 Etik Kurul onay\u0131 ve gerekli yerlerden di\u011fer izinler al\u0131nm\u0131\u015ft\u0131r.<\/p>\n

Ara\u015ft\u0131rma sonucunda elde edilen veriler SPSS 22.0 program\u0131 ile de\u011ferlendirilmi\u015ftir. \u0130statistiksel de\u011ferlendirmelerde de\u011fi\u015fkenlerin \u00f6zelliklerine g\u00f6re \u03c72<\/i>, Mann-Whitney U, Kruskal Wallis ve Spearman korelasyon testleri kullan\u0131lm\u0131\u015ft\u0131r. Birden fazla de\u011fi\u015fkenin etkisini ara\u015ft\u0131rmak amac\u0131yla \u00e7oklu analizler yap\u0131lm\u0131\u015f ve\u00a0 <\/span>p<0.05 istatistiksel anlaml\u0131l\u0131k olarak kabul edilmi\u015ftir.<\/p>\n

BULGULAR<\/b><\/h2>\n

\u00c7al\u0131\u015fmaya kat\u0131lan aile hekimlerinin %66.7\u2019si erkek olup ya\u015f ortalamas\u0131 40.67\u00b18.85 (min.=25, maks.=63) olarak hesaplanm\u0131\u015ft\u0131r. Kat\u0131l\u0131mc\u0131lar\u0131n %79.4\u2019\u00fc evli, %14.5\u2019i bekar, %6\u2019s\u0131 bo\u015fanm\u0131\u015f, e\u015fi vefat etmi\u015f ve ayr\u0131 ya\u015fayanlardan olu\u015fup, %80\u2019i \u00e7ocuk sahibiydi. Kat\u0131lanlar\u0131n %23.6\u2019s\u0131 pratisyen hekim ve\u00a0 <\/span>%76.4\u2019\u00fc aile hekimi sertifikas\u0131na sahip olarak aile hekimli\u011fi yapmaktayd\u0131. \u00c7al\u0131\u015fmaya kat\u0131lan aile hekimlerinin %70.9\u2019u merkez, %22.4\u2019\u00fc il\u00e7e, %5.5\u2019i belde, %1.2\u2019si k\u00f6y yerle\u015fiminde \u00e7al\u0131\u015fmaktayd\u0131. Kat\u0131l\u0131mc\u0131lar\u0131n %47.5\u2019i a\u015f\u0131n\u0131n faydal\u0131 veya zararl\u0131 olu\u015fu konusunda ara\u015ft\u0131rma yapm\u0131\u015ft\u0131 (Tablo 2).<\/p>\n

\"\"<\/a>

Tablo 2.<\/strong> Kat\u0131l\u0131mc\u0131lar\u0131n Sosyo-Demografik \u00d6zellikleri<\/p><\/div>\n

Kat\u0131l\u0131mc\u0131lar\u0131n %77.6\u2019s\u0131 a\u015f\u0131lar hakk\u0131ndaki en son bilgilerini Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 arac\u0131l\u0131\u011f\u0131yla elde etmi\u015flerdi (Tablo 3).<\/p>\n

\"\"<\/a>

Tablo 3.<\/strong> A\u015f\u0131 Hakk\u0131nda En Son Ne \u015eekilde Bilgi Al\u0131nd\u0131\u011f\u0131<\/p><\/div>\n

Kat\u0131l\u0131mc\u0131lara medyada yer alan a\u015f\u0131 tart\u0131\u015fmalar\u0131n\u0131n konusu kapsam\u0131ndaki d\u00fc\u015f\u00fcnceleri soruldu\u011funda, \u201cA\u015f\u0131lar\u0131n i\u00e7inde zararl\u0131 madde varl\u0131\u011f\u0131\u201d cevab\u0131 %95.2 oran\u0131yla birinci s\u0131rada saptanm\u0131\u015ft\u0131r (Tablo 4).<\/p>\n

\"\"<\/a>

Tablo 4.<\/strong> Medyada Yer Alan A\u015f\u0131 Tart\u0131\u015fmalar\u0131n\u0131n Konusu
Hakk\u0131nda D\u00fc\u015f\u00fcnceler<\/p><\/div>\n

Ara\u015ft\u0131rmaya kat\u0131lan aile hekimlerinin %57.6\u2019s\u0131 \u201cA\u015f\u0131n\u0131n i\u00e7inde civa var m\u0131d\u0131r?\u201d sorusuna \u201cEvet\u201d demi\u015ftir. \u201cCiva vard\u0131r\u201d diyenlerin %71.6\u2019s\u0131 a\u015f\u0131n\u0131n kullan\u0131m \u00f6mr\u00fcn\u00fc uzatmak, %31.5\u2019i etkinli\u011fini artt\u0131rmak ve %5.2\u2019si maliyeti d\u00fc\u015f\u00fcrmek i\u00e7in a\u015f\u0131 i\u00e7eri\u011finde civan\u0131n yer ald\u0131\u011f\u0131n\u0131 belirtmi\u015flerdir.\u00a0<\/span><\/p>\n

\"\"<\/a>

Tablo 5.<\/strong> Tutum Puan\u0131, Davran\u0131\u015f Puan\u0131 ve Do\u011fru Cevap Say\u0131s\u0131n\u0131n De\u011fi\u015fkenlerle \u0130li\u015fkisi<\/p><\/div>\n

\u201cA\u015f\u0131n\u0131n i\u00e7inde civa var\u201d diyen hekimlerin %4.8\u2019i a\u015f\u0131n\u0131n otizm yapt\u0131\u011f\u0131n\u0131 d\u00fc\u015f\u00fcnmekteydi. \u00c7ocu\u011fu olan hekimlerin hepsi \u00e7ocu\u011funa \u00e7ocukluk \u00e7a\u011f\u0131 a\u015f\u0131 takvimini uygulam\u0131\u015ft\u0131. \u00c7al\u0131\u015fmaya kat\u0131lanlar\u0131n %43.6\u2019s\u0131 yak\u0131nlar\u0131na, %33.3\u2019\u00fc kendisine a\u015f\u0131 takvimi d\u0131\u015f\u0131nda a\u015f\u0131 yapt\u0131rm\u0131\u015ft\u0131. Kendilerine eri\u015fkin ba\u011f\u0131\u015f\u0131klamas\u0131 kapsam\u0131nda yap\u0131lan a\u015f\u0131 uygulamalar\u0131nda,\u00a0 <\/span>%52.6 grip, %19.3 hepatit B, %22.8 tetanoz, %1.8 KKK, %1.8 meningokok ve %1.8 kuduz a\u015f\u0131s\u0131 uyguland\u0131\u011f\u0131 g\u00f6r\u00fclm\u00fc\u015ft\u00fcr.\u00a0 <\/span>Yak\u0131nlar\u0131na eri\u015fkin ba\u011f\u0131\u015f\u0131klamas\u0131 kapsam\u0131nda yap\u0131lan a\u015f\u0131 uygulamalar\u0131nda ise\u00a0 <\/span>%34.7 grip, %27.8 rota, %16.7 hepatit B, %11.7 tetanoz, %5.6 pn\u00f6mokok, %2.8 KKK ve %1.4 meningokok uyguland\u0131\u011f\u0131 g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Eri\u015fkin ba\u011f\u0131\u015f\u0131klamas\u0131 kapsam\u0131nda kendilerine ve yak\u0131nlar\u0131na en \u00e7ok uygulanan a\u015f\u0131n\u0131n, grip a\u015f\u0131s\u0131 oldu\u011fu g\u00f6r\u00fclm\u00fc\u015f; kendisi\/e\u015fi gebelik ya\u015fayanlar\u0131n %92.6\u2019s\u0131 ise gebelik tetanoz a\u015f\u0131s\u0131n\u0131 yapt\u0131rm\u0131\u015ft\u0131r.<\/p>\n

Aile hekimlerinin %74.5\u2019i a\u015f\u0131 kampanyalar\u0131na katk\u0131da bulunmu\u015f ve\u00a0 <\/span>%96.4\u2019\u00fc risk gruplar\u0131na grip ve pn\u00f6monokok a\u015f\u0131s\u0131 \u00f6nermi\u015ftir.\u00a0<\/span><\/p>\n

Aile hekimlerinin %73.3\u2019\u00fc hi\u00e7bir a\u015f\u0131n\u0131n uygulanmas\u0131n\u0131 riskli bulmazken; %15.8\u2019i grip a\u015f\u0131s\u0131n\u0131 riskli bulmaktayd\u0131. A\u015f\u0131 olmadan bula\u015f\u0131c\u0131 hastal\u0131klardan korunulabilece\u011fini d\u00fc\u015f\u00fcnenler %18.8\u2019di. Bunlardan %74.4\u2019\u00fc hijyen kurallar\u0131na uyularak, %9.7\u2019si beslenmeyle, %9.7\u2019si sosyoekonomik iyile\u015ftirmeyle ve %6.5\u2019i karantina uygulanarak a\u015f\u0131 olmadan da bula\u015f\u0131c\u0131 hastal\u0131klardan korunulabilece\u011fini d\u00fc\u015f\u00fcn\u00fcyordu.\u00a0<\/span><\/p>\n

Bilgi sorular\u0131n\u0131n do\u011fru cevap say\u0131s\u0131 ortalamas\u0131 7.59\u00b1 2.17 (min.=1, maks.=12), tutum puan\u0131 ortalamas\u0131 10.74\u00b11.54 (min.=5, maks.=13) ve 5 davran\u0131\u015f sorusunun davran\u0131\u015f puan\u0131 ortalamas\u0131 2.82\u00b11.2 (min.=0, maks.=5) olarak tespit edildi. Do\u011fru say\u0131s\u0131nda cinsiyet, aile hekimli\u011fi sertifikas\u0131na sahip olma, medeni durum, \u00e7ocuk varl\u0131\u011f\u0131, kronik hastal\u0131k durumu anlaml\u0131 fark olu\u015fturmam\u0131\u015ft\u0131r (p>0.05) (Tablo 5). Ya\u015f ile do\u011fru say\u0131s\u0131 aras\u0131nda Spearman korelasyon analizi ile ili\u015fki bulunamam\u0131\u015ft\u0131r (p> 0.05) (Tablo 6).<\/p>\n

\"\"<\/a>

Tablo 6.<\/strong> Ya\u015f ile Tutum, Davran\u0131\u015f Puan\u0131 ve Do\u011fru Cevap Say\u0131s\u0131 Aras\u0131nda Korelasyon \u0130li\u015fkisi<\/p><\/div>\n

Tutum puan\u0131, evlilerin evli olmayanlara g\u00f6re (p=0.005), \u00e7ocu\u011fu olanlar\u0131n olmayanlara g\u00f6re y\u00fcksekti (p=0.012). Di\u011fer gruplara g\u00f6re, 46-55 ya\u015f grubunun tutum puan\u0131 y\u00fcksek olup (p=0.025) ya\u015f ile tutum puan\u0131 aras\u0131nda Spearman korelasyon analizi ile pozitif y\u00f6nl\u00fc ili\u015fki bulunmu\u015ftur (p=0.02) (Tablo 6).<\/p>\n

Davran\u0131\u015f puan\u0131, evlilerin evli olmayanlara g\u00f6re (p<0.001), \u00e7ocu\u011fu olanlar\u0131n olmayanlara g\u00f6re (p<0.001), ara\u015ft\u0131rma yapanlar\u0131n yapmayanlara g\u00f6re y\u00fcksekti (p<0.001). Kad\u0131n-erkek, kronik hastal\u0131k varl\u0131\u011f\u0131-yoklu\u011fu aras\u0131nda davran\u0131\u015f puanlar\u0131 a\u00e7\u0131s\u0131ndan anlaml\u0131 fark yoktu (Tablo 5). Di\u011fer gruplara g\u00f6re 46-55 ya\u015f grubunun davran\u0131\u015f puan\u0131 y\u00fcksekti (p<0.001) ve\u00a0 <\/span>ya\u015f ile davran\u0131\u015f puan\u0131 aras\u0131nda Spearman korelasyon analizi ile pozitif y\u00f6nl\u00fc ili\u015fki bulundu (p=0.03) (Tablo 6). Ayr\u0131ca do\u011fru say\u0131s\u0131 ile tutum ve davran\u0131\u015f puan\u0131, tutum puan\u0131 ile davran\u0131\u015f puan\u0131 ili\u015fkili de\u011fildi (p>0.05).<\/p>\n

\u00c7al\u0131\u015fmaya kat\u0131lan aile hekimlerinin \u00e7ocuk sahibi olma durumu ile a\u015f\u0131 fayda zarar konusunda ara\u015ft\u0131rma yapma durumlar\u0131 ili\u015fkili bulunmad\u0131 (p>0.05). Kendine ve yak\u0131nlar\u0131na eri\u015fkin ba\u011f\u0131\u015f\u0131klamas\u0131 kapsam\u0131nda a\u015f\u0131 uygulayanlar\u0131n ve uygulamayanlar\u0131n sorulara do\u011fru cevap verme say\u0131s\u0131 aras\u0131nda anlaml\u0131 fark bulunmad\u0131 (p>0.05). HPV sorular\u0131nda bilmiyorum cevab\u0131 di\u011fer sorulara oranla daha fazla kullan\u0131lm\u0131\u015ft\u0131.<\/p>\n

\u00c7al\u0131\u015fmaya kat\u0131lan aile hekimlerinin %80\u2019i kamu spotu, %72.7 \u2019si Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 bilgilendirmesi, %50\u2019si sa\u011fl\u0131k kurulu\u015flar\u0131nda bilgilendirme ve %17.6\u2019s\u0131 bireysel ara\u015ft\u0131rma ile a\u015f\u0131 hakk\u0131ndaki tart\u0131\u015fmalar\u0131n \u00e7\u00f6z\u00fclebilece\u011fini d\u00fc\u015f\u00fcn\u00fcyordu.<\/p>\n

\u0130RDELEME<\/b><\/h2>\n

Ara\u015ft\u0131rmam\u0131zda aile hekimlerinin ya\u015f aral\u0131\u011f\u0131 25-63 olup ortalamas\u0131 40.67\u00b1 8.85 idi. Sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131nda a\u015f\u0131 bilgi, tutum ve davran\u0131\u015f ile ilgili yap\u0131lan ba\u015fka bir \u00e7al\u0131\u015fmada \u00f6rneklemin ya\u015f aral\u0131\u011f\u0131 24-66 olup ortalama ise 39 idi (16). Her iki \u00e7al\u0131\u015fman\u0131n ya\u015f ortalamalar\u0131n\u0131n benzer oldu\u011fu ve hizmet veren aile hekimlerinin gen\u00e7 ya\u015f grubunda oldu\u011fu g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Ayr\u0131ca \u00e7al\u0131\u015fmam\u0131zda uzman olarak \u00e7al\u0131\u015fan aile hekimi saptanamam\u0131\u015ft\u0131r. Gen\u00e7 ya\u015f grubunun fazlal\u0131\u011f\u0131 ve uzman olarak \u00e7al\u0131\u015fan aile hekiminin bulunmay\u0131\u015f\u0131 a\u015f\u0131 hakk\u0131nda yeterli bilgi d\u00fczeyine sahip olunamamas\u0131na ve a\u015f\u0131 uygulamalar\u0131na yans\u0131yabilece\u011fini d\u00fc\u015f\u00fcnd\u00fcrm\u00fc\u015ft\u00fcr. \u00c7al\u0131\u015fmam\u0131za kat\u0131lan aile hekimlerinin a\u015f\u0131 ile ilgili ara\u015ft\u0131rma yapma oranlar\u0131n\u0131n\u00a0 <\/span>%47.5 oldu\u011funu g\u00f6r\u00fclm\u00fc\u015f ve\u00a0 <\/span>bu oran\u0131n yetersiz oldu\u011fu d\u00fc\u015f\u00fcn\u00fclm\u00fc\u015ft\u00fcr. Ara\u015ft\u0131rma yapanlar\u0131n davran\u0131\u015f puanlar\u0131n\u0131n daha y\u00fcksek olmas\u0131 bu oran\u0131n artt\u0131r\u0131lmas\u0131 gerekti\u011fini g\u00f6stermi\u015ftir.<\/p>\n

\u00c7al\u0131\u015fmaya kat\u0131lanlardan \u00e7ocu\u011fu olan aile hekimlerinin tamam\u0131, \u00e7ocuklar\u0131na Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131\u2019n\u0131n \u00e7ocukluk \u00e7a\u011f\u0131 a\u015f\u0131 takvimini uygulatm\u0131\u015ft\u0131r. Ayr\u0131ca en fazla riskli bulduklar\u0131 grip a\u015f\u0131s\u0131, kendilerine ve yak\u0131nlar\u0131na en \u00e7ok uygulad\u0131klar\u0131 eri\u015fkin \u00e7a\u011f\u0131 ba\u011f\u0131\u015f\u0131klamas\u0131 kapsam\u0131ndaki a\u015f\u0131 olmu\u015ftur. Bizim \u00e7al\u0131\u015fmam\u0131za kat\u0131lan hekimlerin %23.3\u2019\u00fc kendisine grip a\u015f\u0131s\u0131 uygulatm\u0131\u015fken, ba\u015fka bir ara\u015ft\u0131rmada hastane \u00e7al\u0131\u015fanlar\u0131n\u0131n %45.7\u2019sinin her y\u0131l d\u00fczenli olarak grip a\u015f\u0131s\u0131 yapt\u0131rd\u0131klar\u0131 saptanm\u0131\u015ft\u0131r (17). Aile hekimlerinin hastane \u00e7al\u0131\u015fanlar\u0131na g\u00f6re daha az oranda grip a\u015f\u0131s\u0131 uygulatmalar\u0131, aile hekimliklerini hastane ortam\u0131na g\u00f6re grip bula\u015f\u0131 a\u00e7\u0131s\u0131ndan daha g\u00fcvenli bulduklar\u0131n\u0131 d\u00fc\u015f\u00fcnd\u00fcrm\u00fc\u015ft\u00fcr.<\/p>\n

Ara\u015ft\u0131rmam\u0131z sonucunda, \u00e7al\u0131\u015fmaya kat\u0131lan aile hekimlerinin a\u015f\u0131lar hakk\u0131nda bilgiye y\u00f6nelik sorulan 13 soruya ortalama 7.59\u00b12.17 do\u011fru cevap verdi\u011fi bulunmu\u015ftur. Kendilerine ve yak\u0131nlar\u0131na eri\u015fkin \u00e7a\u011f\u0131 ba\u011f\u0131\u015f\u0131klamas\u0131 kapsam\u0131ndaki a\u015f\u0131 uygulayan ve uygulamayanlar\u0131n, a\u015f\u0131lar hakk\u0131nda bilgiye y\u00f6nelik sorulara verilen do\u011fru cevap say\u0131s\u0131 aras\u0131nda anlaml\u0131 fark bulunamam\u0131\u015ft\u0131r (p>0.05). Aile hekimlerinin grip a\u015f\u0131s\u0131 uygulamalar\u0131yla ilgili yap\u0131lan bir \u00e7al\u0131\u015fmada, bu bulgumuzla paralel olarak bilgi d\u00fczeyinin etkisinin s\u0131n\u0131rl\u0131 oldu\u011fu tespit edilmi\u015ftir (17). Bilgi d\u00fczeyinin a\u015f\u0131 uygulamalar\u0131ndaki s\u0131n\u0131rl\u0131 etkisi, aile hekimlerinin bilgilerinin yeterli olmad\u0131\u011f\u0131 a\u015f\u0131 uygulamalar\u0131nda, Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131\u2019n\u0131n \u00f6nerileriyle hareket etti\u011fini d\u00fc\u015f\u00fcnd\u00fcrm\u00fc\u015ft\u00fcr.<\/p>\n

\u00c7al\u0131\u015fmam\u0131z sonucunda ya\u015f ile do\u011fru cevap say\u0131s\u0131 aras\u0131nda ili\u015fki bulunamam\u0131\u015ft\u0131r (p>0.05). Sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 ile yap\u0131lan bir ara\u015ft\u0131rmada da, ara\u015ft\u0131rmam\u0131z\u0131n bulgular\u0131na paralel olarak ya\u015f ile bilgi d\u00fczeyi aras\u0131nda ili\u015fki tespit edilememi\u015ftir (16). Hekimlerin artan ya\u015f ile bilgilerinin azalmad\u0131\u011f\u0131 ancak artmad\u0131\u011f\u0131 da g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Hekimlerin ya\u015flar\u0131 artt\u0131k\u00e7a, tecr\u00fcbelerinin ve bilgi d\u00fczeylerinin de artaca\u011f\u0131 \u015feklindeki beklentimiz, bulgular\u0131m\u0131zla desteklenmemi\u015ftir. Ya\u015f art\u0131\u015f\u0131 ile hekimlerin y\u0131pranmas\u0131 sonucu bilgi d\u00fczeylerini artt\u0131ramad\u0131klar\u0131n\u0131 d\u00fc\u015f\u00fcnd\u00fcrm\u00fc\u015ft\u00fcr.\u00a0<\/span><\/p>\n

Evli olanlar\u0131n, \u00e7ocu\u011fu olanlar\u0131n ve 46-55 ya\u015f grubundan olanlar\u0131n tutum ve davran\u0131\u015f puanlar\u0131, a\u015f\u0131 hakk\u0131nda ara\u015ft\u0131rma yapanlar\u0131n ise davran\u0131\u015f puan\u0131 daha y\u00fcksektir. Ya\u015f ile, tutum ve davran\u0131\u015f puanlar\u0131 pozitif ili\u015fkilidir. Ya\u015f ilerleyip evlilik ve \u00e7ocuk olma durumu a\u015f\u0131 yapt\u0131rma gereklili\u011fi ile kar\u015f\u0131 kar\u015f\u0131ya kalma durumunu ortaya \u00e7\u0131karm\u0131\u015f ve dolay\u0131s\u0131yla bu durum tutum ve davran\u0131\u015f puan\u0131na yans\u0131m\u0131\u015ft\u0131r.\u00a0<\/span><\/p>\n

A\u015f\u0131 uygulamalar\u0131n\u0131n sorumlusu olan hekimlerin do\u011fru say\u0131s\u0131n\u0131n ve\u00a0 <\/span>ba\u011f\u0131\u015f\u0131klama konusundaki bilgi d\u00fczeylerinin yeterli seviyede olmay\u0131\u015f\u0131, halk\u0131n bilgilendirilmesi a\u00e7\u0131s\u0131ndan endi\u015fe vericidir.\u00a0<\/span><\/p>\n

Yap\u0131lan bir \u00e7al\u0131\u015fmada, sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n, toplumun a\u015f\u0131 ile ilgili bilgi kayna\u011f\u0131 olarak ilk s\u0131rada oldu\u011fu tespit edilmi\u015ftir (18). Ayr\u0131ca ba\u015fka bir \u00e7al\u0131\u015fmada bilgilendirilme, a\u015f\u0131 kapsay\u0131c\u0131l\u0131\u011f\u0131n\u0131 artt\u0131rmada temel m\u00fcdahale basama\u011f\u0131 olarak ifade edilmi\u015ftir (19). Bilgilendirme yapacak ki\u015filerin, do\u011fruyu bilmesinin daha temel bir basamak oldu\u011fu a\u015fikard\u0131r. \u00c7al\u0131\u015fmam\u0131za kat\u0131lan aile hekimlerinin %72.7\u2019si Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131\u2019n\u0131n bilgilendirmesi ve %80\u2019i kamu spotlar\u0131yla a\u015f\u0131 konusundaki tart\u0131\u015fmalar\u0131n \u00e7\u00f6z\u00fclebilece\u011fini d\u00fc\u015f\u00fcnmekteydiler. A\u015f\u0131 tart\u0131\u015fmalar\u0131n\u0131n \u00e7\u00f6z\u00fcm\u00fc kapsam\u0131nda, Bakanl\u0131\u011f\u0131n bilgilendirme konusunda sorumlu oldu\u011fu d\u00fc\u015f\u00fcn\u00fclmekteydi. En son bilgi alma \u015fekline bak\u0131ld\u0131\u011f\u0131nda ise en y\u00fcksek oran\u0131n %77.6 ile \u201cSa\u011fl\u0131k Bakanl\u0131\u011f\u0131 arac\u0131l\u0131\u011f\u0131yla\u201d oldu\u011fu g\u00f6r\u00fclmektedir. Sa\u011fl\u0131k hizmeti sunan hekimlerin a\u015f\u0131lama ile ilgili olarak kendi hizmet kapsamlar\u0131ndaki bir konu hakk\u0131nda bireysel olarak ara\u015ft\u0131rma yapmay\u0131 geri planda tuttu\u011fu g\u00f6r\u00fclmektedir. Yani \u00e7al\u0131\u015fmaya kat\u0131lan aile hekimleri Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131\u2019n\u0131 hem kendilerini hem de halk\u0131 bilin\u00e7lendirme konusunda \u00f6n planda tutmaktad\u0131rlar. \u00c7al\u0131\u015fmam\u0131zda, a\u015f\u0131 hakk\u0131nda ara\u015ft\u0131rma yapanlar\u0131n, ara\u015ft\u0131rma yapmayanlara g\u00f6re davran\u0131\u015f puanlar\u0131n\u0131n y\u00fcksek oldu\u011fu tespit edilmi\u015ftir. Bu bulgu aile hekimlerinin ara\u015ft\u0131rma yapmalar\u0131n\u0131n gerekli oldu\u011funu ortaya \u00e7\u0131karm\u0131\u015ft\u0131r.<\/p>\n

Sonu\u00e7 olarak, bu \u00e7al\u0131\u015fma Elaz\u0131\u011f ilindeki, 186 aile hekiminin 165\u2019inin kat\u0131l\u0131m\u0131yla ger\u00e7ekle\u015fmi\u015f olup a\u015f\u0131 uygulamada primer sorumlu olan aile hekimlerinin a\u015f\u0131 ile ilgili bilgilerinin eksik oldu\u011funu, ara\u015ft\u0131rma yapanlar\u0131n davran\u0131\u015f puan\u0131n\u0131n y\u00fcksek oldu\u011funu ve ya\u015f ile tutum ve davran\u0131\u015f puan\u0131n\u0131n pozitif ili\u015fkili oldu\u011funu g\u00f6stermi\u015ftir. Do\u011fru cevap say\u0131s\u0131 herhangi bir de\u011fi\u015fkenle ili\u015fkili bulunamam\u0131\u015ft\u0131r. Aile hekimlerinin %72.7\u2019si Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131\u2019n\u0131n bilgilendirmesi ve %80\u2019i kamu spotlar\u0131yla a\u015f\u0131 konusundaki tart\u0131\u015fmalar\u0131n \u00e7\u00f6z\u00fclebilece\u011fini d\u00fc\u015f\u00fcnmektedir. Bilgi eksikli\u011finin uygulamalara ve topluma yans\u0131yaca\u011f\u0131 g\u00f6z \u00f6n\u00fcne al\u0131narak a\u015f\u0131 uygulay\u0131c\u0131lar\u0131n bilgi ve ara\u015ft\u0131rma eksikli\u011finin toplumu olumsuz y\u00f6nde etkilememesi i\u00e7in, gerekli \u00e7al\u0131\u015fmalar yap\u0131lmal\u0131d\u0131r.\u00a0 <\/span>Bilin\u00e7lendirme \u00e7al\u0131\u015fmalar\u0131, temel uygulay\u0131c\u0131 olan birinci basamak \u00e7al\u0131\u015fanlar\u0131ndan ba\u015flayarak yap\u0131lmal\u0131 ve toplumun bilgilendirilmesinde de rol almalar\u0131n\u0131n gereklili\u011fi vurgulanmal\u0131d\u0131r.\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

G\u0130R\u0130\u015e G\u00fcn\u00fcm\u00fczde hastal\u0131klar\u0131n \u00f6nlenmesinde en ba\u015far\u0131l\u0131 ve maliyet etkin giri\u015fimlerden biri halen a\u015f\u0131lamad\u0131r (1). A\u015f\u0131lar ile d\u00fcnyan\u0131n \u00e7o\u011fu yerinde \u00e7ocuk felci, kuduz, difteri, tetanoz, bo\u011fmaca, k\u0131zam\u0131k, kabakulak gibi pek \u00e7ok infeksiyon hastal\u0131\u011f\u0131 kontrol alt\u0131na al\u0131nabilmi\u015f ve \u00e7i\u00e7ek hastal\u0131\u011f\u0131 d\u00fcnya genelinde eradike edilebilmi\u015ftir (2,3). 1977\u2019de \u00e7i\u00e7ek hastal\u0131\u011f\u0131n\u0131n eradikasyonundan sonra di\u011fer bula\u015f\u0131c\u0131 hastal\u0131klar\u0131n eradikasyonu i\u00e7in \u00e7al\u0131\u015fmalar ba\u015flat\u0131lm\u0131\u015ft\u0131r. […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5129],"tags":[4525,4851,5241],"class_list":["post-23274","post","type-post","status-publish","format-standard","hentry","category-ozgun-arastirma","tag-aile-hekimleri","tag-asi","tag-bilgi-tutum-davranis"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/23274","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/comments?post=23274"}],"version-history":[{"count":3,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/23274\/revisions"}],"predecessor-version":[{"id":23520,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/23274\/revisions\/23520"}],"wp:attachment":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media?parent=23274"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/categories?post=23274"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/tags?post=23274"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}