{"id":24198,"date":"2022-02-22T14:48:53","date_gmt":"2022-02-22T11:48:53","guid":{"rendered":"https:\/\/www.klimikdergisi.org\/?p=24198"},"modified":"2022-03-28T10:23:51","modified_gmt":"2022-03-28T07:23:51","slug":"hekimlerin-asi-yaklasimlari","status":"publish","type":"post","link":"https:\/\/www.klimikdergisi.org\/tr\/2022\/02\/22\/hekimlerin-asi-yaklasimlari\/","title":{"rendered":"COVID-19 Pandemisi S\u00fcrecinde Hekimlerin Profilaksi ve A\u015f\u0131 Uygulamalar\u0131na Yakla\u015f\u0131mlar\u0131: T\u00fcrkiye\u2019den Kesitsel Bir Anket \u00c7al\u0131\u015fmas\u0131"},"content":{"rendered":"<h2 class=\"p1\">G\u0130R\u0130\u015e<\/h2>\n<p class=\"p2\">D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc (DS\u00d6), ilk kez 31 Aral\u0131k 2019 tarihinde, \u00c7in \u00dclke Ofisi taraf\u0131ndan, Hubei eyaleti, Wuhan \u015fehrinde nedeni belirlenemeyen pn\u00f6moni olgular\u0131 oldu\u011fu hakk\u0131nda bilgilendirildi (1). Ocak 2020\u2019de, olgulardan izole edilen virusun yeni bir koronavirus t\u00fcr\u00fc oldu\u011fu tespit edildi (2). Etken, Uluslararas\u0131 Virus Taksonomisi Komitesi (\u201cInternational Committee on Taxonomy of Virusus) taraf\u0131ndan SARS-CoV-2 (\u201csevere acute respiratory syndrome coronavirus-2\u201d) olarak adland\u0131r\u0131lm\u0131\u015f; virusun neden oldu\u011fu klinik hastal\u0131k ise COVID-19 (\u201ccoronavirus disease-2019\u201d) olarak tan\u0131mlanm\u0131\u015ft\u0131r (3). DS\u00d6 taraf\u0131ndan 11 Mart 2020 tarihinde, \u00c7in d\u0131\u015f\u0131ndaki \u00fclkelerde olgu say\u0131lar\u0131n\u0131n k\u0131sa s\u00fcrede katlanarak artmas\u0131 ve \u00f6l\u00fcmlere yol a\u00e7mas\u0131 nedeniyle COVID-19 k\u00fcresel bir pandemi olarak ilan edilmi\u015ftir (4). T\u00fcrkiye\u2019de ilk COVID-19 olgusu 10 Mart 2020\u2019de saptanm\u0131\u015f olup t\u00fcm d\u00fcnyada oldu\u011fu gibi olgu say\u0131lar\u0131nda art\u0131\u015f g\u00f6r\u00fclm\u00fc\u015ft\u00fcr (5).<\/p>\n<p class=\"p3\"><span class=\"s1\">COVID-19 pandemisi ba\u015flang\u0131c\u0131nda, SARS-CoV-2\u2019nin profilaksi ve tedavisinde, etkinli\u011fi ve g\u00fcvenilirli\u011fi randomize kontroll\u00fc \u00e7al\u0131\u015fmalarla kan\u0131tlanm\u0131\u015f bir ila\u00e7 mevcut de\u011fildi. Tedavi se\u00e7enekleri \u00fclkelere g\u00f6re de\u011fi\u015fmekle birlikte g\u00f6zlemsel ve deneysel \u00e7al\u0131\u015fmalara dayan\u0131larak; hidroksiklorokin, remdesivir, favipiravir, azitromisin ve lopinavir\/ritonavir durumun aciliyeti g\u00f6z \u00f6n\u00fcnde bulundurularak COVID-19 olgular\u0131nda kullan\u0131ld\u0131. Etkili bir a\u015f\u0131n\u0131n geli\u015ftirilmesi amac\u0131yla yap\u0131lan \u00e7al\u0131\u015fmalar h\u0131zla devam ederken, farkl\u0131 ila\u00e7 t\u00fcrleri \u00fczerinde bir\u00e7ok klinik ara\u015ft\u0131rma ba\u015flat\u0131ld\u0131 (6).<\/span><\/p>\n<p class=\"p3\">A\u015f\u0131 yoluyla ba\u011f\u0131\u015f\u0131klama, en etkili t\u0131bbi m\u00fcdahalelerden biridir ve halk sa\u011fl\u0131\u011f\u0131 a\u00e7\u0131s\u0131ndan da b\u00fcy\u00fck \u00f6neme sahiptir (7). Bu ger\u00e7e\u011fe ra\u011fmen bir\u00e7ok ki\u015fi a\u015f\u0131lar\u0131n yararlar\u0131ndan \u015f\u00fcphe duyar, g\u00fcvenliklerinden endi\u015fe eder ve a\u015f\u0131ya duyulan ihtiyac\u0131 sorgular; bu bizim \u201ca\u015f\u0131 teredd\u00fct\u00fc\u201d dedi\u011fimiz bir tav\u0131rd\u0131r.\u00a0Teredd\u00fct tutumu, a\u015f\u0131y\u0131 reddetme eyleminden farkl\u0131d\u0131r.\u00a0A\u015f\u0131lanm\u0131\u015f olanlar bile a\u015f\u0131n\u0131n belirli y\u00f6nlerine kar\u015f\u0131 teredd\u00fct ya\u015fayabilir. Hekimler, a\u015f\u0131 bilgisinin ana ve en etkili kayna\u011f\u0131 olduklar\u0131 i\u00e7in, a\u015f\u0131 teredd\u00fct\u00fc tutumunun a\u015f\u0131 kar\u015f\u0131tl\u0131\u011f\u0131na d\u00f6n\u00fc\u015fmemesi i\u00e7in kilit bir role sahiptir. Di\u011fer yanda hekimler, hastalar\u0131na k\u0131yasla daha g\u00fc\u00e7l\u00fc ve sa\u011fl\u0131kl\u0131 hissettikleri i\u00e7in kendilerini a\u015f\u0131ya muhta\u00e7 g\u00f6rmeme e\u011filimindedir (8).<\/p>\n<p class=\"p3\">Sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131, COVID-19 pandemisi ile m\u00fccadelede en \u00f6n safta bulunmakta olup hekimler hastal\u0131\u011f\u0131n tan\u0131, tedavi ve takip s\u00fcrecinde kritik role sahiptir. Hekimlerin kendilerini ve genel olarak toplumu korumak i\u00e7in \u00f6nleyici tedbirler alabilmeleri, hastal\u0131k hakk\u0131nda iyi ve yeterli bilgiye sahip olmalar\u0131na ba\u011fl\u0131d\u0131r. Bu \u00e7al\u0131\u015fmada, COVID-19 pandemisi s\u00fcrecinde hekimlerin SARS-CoV-2 infeksiyonuna y\u00f6nelik profilaksi ve muhtemel a\u015f\u0131 uygulamalar\u0131 hakk\u0131ndaki g\u00f6r\u00fc\u015flerinin 10 soruluk bir anket ile de\u011ferlendirilmesi ama\u00e7land\u0131.<\/p>\n<h2 class=\"p1\">Y\u00d6NTEMLER<\/h2>\n<p class=\"p2\"><span class=\"s2\">\u00c7al\u0131\u015fma,<span class=\"Apple-converted-space\">\u00a0 <\/span>T.C. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 Bilimsel Ara\u015ft\u0131rma Platformu taraf\u0131ndan 2020-05-04T13-44-18 karar numaras\u0131 ve Sa\u011fl\u0131k Bilimleri \u00dcniversitesi Gazi Ya\u015fargil E\u011fitim ve Ara\u015ft\u0131rma Hastanesi Klinik Ara\u015ft\u0131rmalar Etik Kurulu taraf\u0131ndan 24 Temmuz 2020 tarih ve 522 karar numaras\u0131yla<span class=\"Apple-converted-space\">\u00a0 <\/span>onayland\u0131.<\/span><\/p>\n<p class=\"p5\">25 Temmuz- 8 A\u011fustos 2020 tarihleri aras\u0131nda, anket sorular\u0131 ak\u0131ll\u0131 telefonlar i\u00e7in geli\u015ftirilen mesajla\u015fma programlar\u0131 \u00fczerinden hekimlerin bulundu\u011fu mesaj gruplar\u0131na g\u00f6nderildi. Anket sorular\u0131n\u0131n tamam\u0131n\u0131 yan\u0131tlayan farkl\u0131 \u00fcnvan ve \u00e7al\u0131\u015fma ko\u015fullar\u0131na sahip 211 hekim \u00e7al\u0131\u015fmaya dahil edildi. Verilerin istatistiksel analizi \u201cIBM SPSS Statistics for Window. Version 18.0\u201d ( IBM, Armonk, NY, ABD) program\u0131 kullan\u0131larak yap\u0131ld\u0131. Verilerin de\u011ferlendirilmesinde y\u00fczde, aritmetik ortalama, standard sapma gibi tan\u0131mlay\u0131c\u0131 istatistiksel y\u00f6ntemler kullan\u0131lm\u0131\u015f olup de\u011fi\u015fkenler aras\u0131ndaki ili\u015fki <span class=\"s3\">\u03c7\u00b2\u00a0<\/span>ve Fisher\u2019\u0131n kesin testi kullan\u0131larak de\u011ferlendirildi. <i>p<\/i> de\u011feri &lt;0.05 olan de\u011fi\u015fkenler anlaml\u0131 olarak kabul edildi.<\/p>\n<h2 class=\"p1\">BULGULAR<\/h2>\n<div id=\"attachment_24273\" style=\"width: 1082px\" class=\"wp-caption alignright\"><a href=\"https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-1.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-24273\" class=\"wp-image-24273 size-full\" src=\"https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-1.png\" alt=\"\" width=\"1072\" height=\"1582\" srcset=\"https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-1.png 1072w, https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-1-176x260.png 176w, https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-1-366x540.png 366w, https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-1-768x1133.png 768w\" sizes=\"auto, (max-width: 1072px) 100vw, 1072px\" \/><\/a><p id=\"caption-attachment-24273\" class=\"wp-caption-text\"><strong> Tablo 1.<\/strong> Hekimlerin Demografik ve Mesleki \u00d6zellikleri<\/p><\/div>\n<div id=\"attachment_24275\" style=\"width: 1081px\" class=\"wp-caption alignright\"><a href=\"https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-2.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-24275\" class=\"wp-image-24275 size-full\" src=\"https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-2.png\" alt=\"\" width=\"1071\" height=\"1803\" srcset=\"https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-2.png 1071w, https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-2-154x260.png 154w, https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-2-321x540.png 321w, https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-2-768x1293.png 768w\" sizes=\"auto, (max-width: 1071px) 100vw, 1071px\" \/><\/a><p id=\"caption-attachment-24275\" class=\"wp-caption-text\"><strong> Tablo 2.<\/strong> Hekimlerin COVID-19 Hakk\u0131ndaki G\u00f6r\u00fc\u015fleri<\/p><\/div>\n<div id=\"attachment_24277\" style=\"width: 1080px\" class=\"wp-caption alignright\"><a href=\"https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-3.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-24277\" class=\"wp-image-24277 size-full\" src=\"https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-3.png\" alt=\"\" width=\"1070\" height=\"686\" srcset=\"https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-3.png 1070w, https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-3-390x250.png 390w, https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-3-810x519.png 810w, https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-3-250x160.png 250w, https:\/\/www.klimikdergisi.org\/wp-content\/uploads\/2022\/02\/KD.C35.S1_3608-Tablo-3-768x492.png 768w\" sizes=\"auto, (max-width: 1070px) 100vw, 1070px\" \/><\/a><p id=\"caption-attachment-24277\" class=\"wp-caption-text\"><strong> Tablo 3.<\/strong> Hekimlerin Grip A\u015f\u0131s\u0131 Uygulamas\u0131 ile COVID 19 Profilaksi Kullan\u0131m\u0131 ve Muhtemel COVID-19 A\u015f\u0131s\u0131na Yakla\u015f\u0131mlar\u0131 Aras\u0131ndaki \u0130li\u015fki<\/p><\/div>\n<p class=\"p2\">\u00c7al\u0131\u015fmaya kat\u0131lan 211 hekimin ya\u015f ortalamas\u0131 39.3 \u00b1 6.7 olup 57 (%27)\u2019si doktor, 10 (%4.7)\u2019u ara\u015ft\u0131rma g\u00f6revlisi doktor, 113 (%53.6)\u2019\u00fc uzman doktor, 19 (%9.0)\u2019u doktor \u00f6\u011fretim \u00fcyesi, 9 (%4.3)\u2019u do\u00e7ent doktor ve 3 (%1.4)\u2019\u00fc profes\u00f6r doktordu. Kat\u0131l\u0131mc\u0131lar\u0131n 50 (%23.7)\u2019si birinci basamak (aile sa\u011fl\u0131\u011f\u0131 merkezi, toplum sa\u011fl\u0131\u011f\u0131 merkezi vb.), 74 (%35.1)\u2019\u00fc ikinci basamak (devlet hastanesi, \u00f6zel hastane vb.), 82 (%38.9)\u2019si \u00fc\u00e7\u00fcnc\u00fc basamak (e\u011fitim ve ara\u015ft\u0131rma hastanesi, \u00fcniversite hastanesi vb.) ve 5 (%2.4)\u2019i di\u011fer (i\u015fyeri hekimli\u011fi, sa\u011fl\u0131k m\u00fcd\u00fcrl\u00fc\u011f\u00fc vb.) sa\u011fl\u0131k kurulu\u015flar\u0131nda g\u00f6rev yapmaktayd\u0131. Kat\u0131l\u0131mc\u0131lar\u0131n demografik ve mesleki \u00f6zellikleri Tablo 1\u2019de g\u00f6sterilmektedir.<\/p>\n<p class=\"p3\">Ankete kat\u0131lan hekimlerin 186 (%88.2)\u2019s\u0131 COVID-19\u2019a y\u00f6nelik etkin bir profilaksi bulunmad\u0131\u011f\u0131n\u0131 ve 190 (%90)\u2019\u0131 profilaktik bir tedavi almad\u0131klar\u0131n\u0131 beyan etti. Profilaktik tedavi alan hekimlerin 19 (%90.4)\u2019u ise hidroksiklorokin kulland\u0131klar\u0131n\u0131 bildirdi. Hekimler aras\u0131nda mevsimsel (2019-2020) grip a\u015f\u0131s\u0131n\u0131 yapt\u0131ranlar 37 (%17.5) gibi d\u00fc\u015f\u00fck bir say\u0131da olmakla birlikte 167 (%79.1) hekim COVID-19 i\u00e7in grip a\u015f\u0131s\u0131 ile benzer etkinlikte bir a\u015f\u0131 mevcut olsa olmak isteyece\u011fini belirtti. Ankete kat\u0131lan hekimlerin 166 (%78.7)\u2019s\u0131 COVID-19 pandemisi s\u00fcrecinde g\u00f6r\u00fc\u015flerine en fazla de\u011fer verdikleri bilim insanlar\u0131n\u0131n infeksiyon hastal\u0131klar\u0131 uzmanlar\u0131 oldu\u011funu ifade etti (Tablo 2).<\/p>\n<p class=\"p3\">Hekimler aras\u0131nda grip a\u015f\u0131s\u0131 olan ve olmayan gruplar\u0131n COVID-19 profilaksisi kullan\u0131m oranlar\u0131 birbirine yak\u0131nd\u0131 (<i>p<\/i>=0.47). COVID-19 a\u015f\u0131s\u0131 mevcut olsa yapt\u0131raca\u011f\u0131n\u0131 beyan edenler grip a\u015f\u0131s\u0131 olan grupta daha fazla olmakla birlikte istatistiksel olarak anlaml\u0131 fark bulunmad\u0131 (<i>p<\/i>=0.07) (Tablo 3).<\/p>\n<h2 class=\"p1\">\u0130RDELEME<\/h2>\n<p class=\"p2\">COVID-19\u2019un neden oldu\u011fu k\u00fcresel pandemi, 2019 y\u0131l\u0131 Aral\u0131k ay\u0131ndan 2020 y\u0131l\u0131 Kas\u0131m ay\u0131n\u0131n ortalar\u0131na kadar yakla\u015f\u0131k elli be\u015f milyon ki\u015finin infekte olmas\u0131na ve bir milyon \u00fc\u00e7 y\u00fcz binin \u00fczerinde \u00f6l\u00fcme neden olmu\u015ftur (9). SARS-CoV-2 damlac\u0131k yoluyla insandan insana ge\u00e7erek \u015fiddetli pn\u00f6moniye, \u00e7oklu organ tutulumuna ve \u00f6l\u00fcmc\u00fcl sonu\u00e7lara ilerleyebilen bir solunum yolu infeksiyonuna yol a\u00e7maktad\u0131r. SARS-CoV-2 infeksiyonu, asemptomatik olabilece\u011fi gibi semptomatik bireylerde hafif veya hayat\u0131 tehdit edici bulgularla seyredebilir (10). Semptomlar\u0131n ciddiyetine bak\u0131lmaks\u0131z\u0131n, infekte bir birey infeksiyonu yayarak \u00f6zellikle savunmas\u0131z pop\u00fclasyon i\u00e7in daha b\u00fcy\u00fck bir risk olu\u015fturabilmektedir (11). COVID-19 olgular\u0131n\u0131n \u00e7o\u011funlu\u011fu hastal\u0131\u011f\u0131 herhangi bir tedaviye ihtiya\u00e7 duymadan hafif d\u00fczeyde veya asemptomatik olarak ge\u00e7irmekle birlikte hastalar\u0131n bir k\u0131sm\u0131nda hastane yat\u0131\u015f\u0131na gereksinim duyulmaktad\u0131r. Hastal\u0131\u011f\u0131n seyri, bula\u015f yollar\u0131 ve tedavi se\u00e7enekleri konusunda ortaya \u00e7\u0131kan yeni geli\u015fmeler, mevcut bilgilerin g\u00fcnden g\u00fcne h\u0131zl\u0131 bir \u015fekilde de\u011fi\u015fmesine sebep olmaktad\u0131r (12).<\/p>\n<p class=\"p3\">T\u00fcrkiye\u2019de SARS-CoV-2 infeksiyonu tedavisi i\u00e7in T.C. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 Halk Sa\u011fl\u0131\u011f\u0131 Genel M\u00fcd\u00fcrl\u00fc\u011f\u00fc taraf\u0131ndan Bilimsel Dan\u0131\u015fma Kurulu\u2019nun katk\u0131lar\u0131yla \u00fclke ko\u015fullar\u0131na uygun haz\u0131rlanan ve literat\u00fcr verileri \u0131\u015f\u0131\u011f\u0131nda g\u00fcncellenen rehberler olu\u015fturuldu (13). Bu rehberlerde SARS-CoV-2 infeksiyonu tedavisi i\u00e7in in-vitro ve randomize olmayan g\u00f6zlemsel \u00e7al\u0131\u015fmalara dayan\u0131larak hidroksiklorokin, favipiravir, azitromisin ve lopinavir\/ritonavir ila\u00e7lar\u0131n\u0131n tek ba\u015f\u0131na veya kombine olarak kullan\u0131lmas\u0131 \u00f6nerildi. COVID-19 profilaksi tedavisinde bilimsel \u00e7al\u0131\u015fmalara dayan\u0131larak kullan\u0131labilecek bir ajan bulunmamas\u0131na ra\u011fmen \u00e7al\u0131\u015fmam\u0131zda hekimlerin %11.8 \u2018i COVID-19 i\u00e7in etkin bir profilaksi oldu\u011funu ve %10\u2019u profilaktik tedavi ald\u0131\u011f\u0131n\u0131 belirtmi\u015ftir. Profilaktik tedavi alan hekimlerin b\u00fcy\u00fck bir k\u0131sm\u0131 hidroksiklorokin (%90.4) kullan\u0131rken ivermektin (%4.8) ve hemopoetik ila\u00e7lar (%4.8) ile COVID-19 profilaksi tedavisi deneyen hekimler de mevcuttu. Hidroksiklorokin kullanan COVID-19 olgular\u0131nda, etkinlik \u00e7al\u0131\u015fmalar\u0131nda plasebo grubuna g\u00f6re anlaml\u0131 fark bulunmay\u0131p ciddi advers etkiler g\u00f6zlenirken baz\u0131 hekimlerin profilaksi amac\u0131yla bu ajan\u0131 kullanmas\u0131 salg\u0131n\u0131n yol a\u00e7t\u0131\u011f\u0131 kayg\u0131 ve \u00e7aresizlikle a\u00e7\u0131klanabilir (14). Yap\u0131lan randomize kontroll\u00fc bir \u00e7al\u0131\u015fmada, sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131nda SARS-CoV-2 maruziyeti \u00f6ncesi 8 haftal\u0131k profilaktik hidroksiklorokin kullan\u0131m\u0131n\u0131n <span class=\"s1\">klinik fayda sa\u011flamad\u0131\u011f\u0131 g\u00f6sterilmi\u015ftir (15). Ayn\u0131 \u015fekilde, do\u011frulanm\u0131\u015f COVID-19 olgusu ile y\u00fcksek riskli temas \u00f6yk\u00fcs\u00fc olan ve \u00e7o\u011funlu\u011funu sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n olu\u015fturdu\u011fu bir grupta, 5 g\u00fcnl\u00fck hidroksiklorokin profilaksi uygulamas\u0131n\u0131n hastal\u0131k geli\u015fimini \u00f6nlemedi\u011fi bildirilmi\u015ftir (16). <\/span><\/p>\n<p class=\"p3\">Anketimizde hekimlerin mevsimsel grip a\u015f\u0131s\u0131 yapt\u0131rmalar\u0131 sorguland\u0131 ve %17.5 gibi d\u00fc\u015f\u00fck bir oran tespit edildi. T\u00fcrkiye\u2019de yap\u0131lan di\u011fer \u00e7al\u0131\u015fmalar da \u00e7al\u0131\u015fmam\u0131zla uyumlu olup hekimlerin grip a\u015f\u0131s\u0131 uygulama oranlar\u0131n\u0131; \u00dcnver-Ulusoy ve arkada\u015flar\u0131 (17) %11.3, Hayk\u0131r-Solay ve arkada\u015flar\u0131 (18) %13.8 ve Erbay ve arkada\u015flar\u0131 (19) %32.7 olarak tespit etmi\u015ftir. Keske ve arkada\u015flar\u0131n\u0131n (20) \u00e7ok merkezli \u00e7al\u0131\u015fmas\u0131nda, hastanelerde mevsimsel grip a\u015f\u0131lamas\u0131na \u00f6nc\u00fcl\u00fck etmesi gereken infeksiyon kontrol ekibinin grip a\u015f\u0131lama oran\u0131 %39 olarak d\u00fc\u015f\u00fck bir oranda bulunmu\u015ftur. T\u00fcrkiye\u2019de sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131na \u00fccretsiz bir \u015fekilde temin edilmesine ra\u011fmen, mevsimsel grip a\u015f\u0131lama oranlar\u0131n\u0131n d\u00fc\u015f\u00fck seyretmesi, \u00fczerinde tart\u0131\u015f\u0131lmaya de\u011fer bir sorundur.<span class=\"Apple-converted-space\">\u00a0 <\/span>Hekimlerin grip a\u015f\u0131lama oranlar\u0131n\u0131n d\u00fc\u015f\u00fck olmas\u0131n\u0131n yan\u0131nda T\u00fcrkiye\u2019de risk gruplar\u0131nda grip a\u015f\u0131lama oranlar\u0131n\u0131n da \u00e7ok d\u00fc\u015f\u00fck seviyede oldu\u011fu (%12.3) ve grip a\u015f\u0131s\u0131 olmayan risk gruplar\u0131n\u0131n b\u00fcy\u00fck bir k\u0131sm\u0131na (%92.9) hekimleri taraf\u0131ndan grip a\u015f\u0131s\u0131n\u0131n \u00f6nerilmedi\u011fi bilinmektedir (21). COVID-19\u2019un yayg\u0131nl\u0131\u011f\u0131n\u0131n yan\u0131 s\u0131ra influenza viruslar\u0131n\u0131n da epidemi yapmas\u0131 durumunda gerek te\u015fhis, gerek tedavi gerekse izolasyon ve karantina uygulamalar\u0131 a\u00e7\u0131s\u0131ndan salg\u0131n y\u00f6netiminde sorunlar ya\u015fanabilecektir. Hekimlerin mevsimsel grip a\u015f\u0131lama oranlar\u0131n\u0131n istenilen seviyeye \u00e7\u0131kar\u0131lmas\u0131yla COVID-19 y\u00f6netimindeki sorunlar\u0131n daha karma\u015f\u0131k hale gelmesi \u00f6nlenebilecektir. Bununla birlikte 2020-2021 sezonunda grip a\u015f\u0131s\u0131na artan talep nedeniyle sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 ve risk gruplar\u0131 i\u00e7in a\u015f\u0131 temin edilememesi bir ba\u015fka sorun olarak kar\u015f\u0131m\u0131za \u00e7\u0131kmaktad\u0131r.<\/p>\n<p class=\"p3\"><span class=\"s1\">Hekimlerin \u00e7o\u011funlu\u011fu (%79.1), grip a\u015f\u0131s\u0131yla ayn\u0131 etkinlikte bir COVID-19 a\u015f\u0131s\u0131 mevcut olsa bu a\u015f\u0131y\u0131 yapt\u0131rabileceklerini beyan etmi\u015flerdir. Grip a\u015f\u0131s\u0131 olan hekimlerde, olmayanlara g\u00f6re COVID-19 a\u015f\u0131s\u0131 yapt\u0131rma iste\u011fi daha fazla izlendi. Hem\u015fireler aras\u0131nda yap\u0131lan bir anket \u00e7al\u0131\u015fmas\u0131nda da COVID-19 a\u015f\u0131s\u0131n\u0131n mevcut olmas\u0131 durumunda bu a\u015f\u0131y\u0131 yapt\u0131rmak isteyenlerin oran\u0131 %64.6 olarak bulunmu\u015ftur (22). COVID-19 prevalans\u0131n\u0131n topluma nazaran sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131nda daha y\u00fcksek oranda g\u00f6r\u00fcld\u00fc\u011f\u00fc ve \u00f6l\u00fcmlere yol a\u00e7t\u0131\u011f\u0131 yap\u0131lan \u00e7al\u0131\u015fmalarda g\u00f6sterilmi\u015ftir (23). Etkin bir tedavisi olmayan ve her ya\u015f grubunda \u00f6l\u00fcmle seyredebilen COVID-19 i\u00e7in geli\u015ftirilebilecek bir a\u015f\u0131ya sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 aras\u0131nda istenilen seviyelerde ilginin olmamas\u0131 toplum sa\u011fl\u0131\u011f\u0131 a\u00e7\u0131s\u0131ndan endi\u015fe vericidir. <\/span><\/p>\n<p class=\"p3\">Ankete kat\u0131lan hekimler, COVID-19 pandemisi s\u00fcrecinde g\u00f6r\u00fc\u015flerine en fazla de\u011fer verdikleri bilim insanlar\u0131n\u0131n s\u0131ras\u0131yla; infeksiyon hastal\u0131klar\u0131 uzmanlar\u0131, halk sa\u011fl\u0131\u011f\u0131 uzmanlar\u0131, yo\u011fun bak\u0131m uzmanlar\u0131, g\u00f6\u011f\u00fcs hastal\u0131klar\u0131 uzmanlar\u0131 ve mikrobiyoloji uzmanlar\u0131 oldu\u011funu belirtti. Pandemi s\u00fcre\u00e7lerinde uzmanl\u0131k alan\u0131 g\u00f6zetilmeksizin t\u00fcm hekimler aktif rol almal\u0131 ve multidisipliner bir yakla\u015f\u0131mla salg\u0131n y\u00f6netilmelidir. COVID-19\u2019un SARS-CoV-2 kaynakl\u0131 bir infeksiyon hastal\u0131\u011f\u0131 olmas\u0131 nedeniyle pandemi ba\u015flang\u0131c\u0131nda infeksiyon hastal\u0131klar\u0131 uzmanlar\u0131 bu hasta grubuyla ilk kar\u015f\u0131la\u015fan hekim grubu olmu\u015ftur. Salg\u0131n\u0131n h\u0131zla yay\u0131lmas\u0131 ve hasta say\u0131lar\u0131ndaki art\u0131\u015f nedeniyle sa\u011fl\u0131k otoriteleri ve hastane y\u00f6netimleri infeksiyon hastal\u0131klar\u0131 uzmanlar\u0131 \u00f6nc\u00fcl\u00fc\u011f\u00fcnde t\u00fcm hekimlerin s\u00fcrece dahil olmalar\u0131 konusunda karar alm\u0131\u015ft\u0131r. Ankete kat\u0131lan hekimlerin infeksiyon hastal\u0131klar\u0131 uzmanlar\u0131na olan g\u00fcveninin olu\u015fmas\u0131nda, infeksiyon hastal\u0131klar\u0131 uzmanl\u0131k derneklerinin COVID-19 pandemisi s\u00fcrecinde aktif rol almas\u0131; hekimleri ve toplumu medya, sosyal medya ve \u00e7evrimi\u00e7i sunumlar arac\u0131l\u0131\u011f\u0131yla bilgilendirmesi etkili olmu\u015ftur.<span class=\"Apple-converted-space\">\u00a0 <\/span>Mevcut salg\u0131n, infeksiyon hastal\u0131klar\u0131n\u0131n di\u011fer hastal\u0131klardan farkl\u0131 olarak toplumun her kesiminin sosyal, ekonomik ve ruhsal durumunu derinden etkileyebilece\u011fini bir kez daha ortaya koymu\u015ftur.<\/p>\n<p class=\"p3\">Anket \u00e7al\u0131\u015fmam\u0131zda baz\u0131 k\u0131s\u0131tl\u0131l\u0131klar mevcuttu. COVID-19 pandemisi s\u00fcrecinde hekimlerin i\u015f yo\u011funlu\u011fu d\u00fc\u015f\u00fcn\u00fclerek, kat\u0131l\u0131m\u0131n y\u00fcksek tutulabilmesi i\u00e7in soru say\u0131s\u0131 k\u0131s\u0131tl\u0131 tutuldu. Bu nedenle hekimlerin \u00e7al\u0131\u015ft\u0131klar\u0131 co\u011frafi konum, uzmanl\u0131k alanlar\u0131, SARS-CoV-2 maruziyet durumlar\u0131, profilaksi ve a\u015f\u0131 yakla\u015f\u0131mlar\u0131n\u0131n nedenleri ayr\u0131nt\u0131l\u0131 bir \u015fekilde sorgulanamad\u0131.<\/p>\n<p class=\"p3\">Hekimler COVID-19 pandemisi s\u00fcrecinde profilaksi yakla\u015f\u0131mlar\u0131nda genel olarak bilimsel veriler do\u011frultusunda hareket etmektedir. Mevsimsel grip a\u015f\u0131lama oranlar\u0131ndan edindi\u011fimiz tecr\u00fcbeler hekimlerde COVID-19 a\u015f\u0131lama oran\u0131 d\u00fc\u015f\u00fck olursa risk gruplar\u0131ndaki hastalar\u0131n a\u015f\u0131lama oranlar\u0131n\u0131n istenilen seviyede olamayaca\u011f\u0131n\u0131 g\u00f6stermektedir. Kullan\u0131ma girmesi muhtemel COVID-19 a\u015f\u0131lar\u0131 i\u00e7in hekimlerde mevcut olan y\u00fcksek oranlardaki a\u015f\u0131 olma iste\u011finin prati\u011fe d\u00f6n\u00fc\u015febilmesi i\u00e7in kamu otoriteleri, uzmanl\u0131k dernekleri ve medyaya b\u00fcy\u00fck sorumluluklar d\u00fc\u015fmektedir.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>G\u0130R\u0130\u015e D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc (DS\u00d6), ilk kez 31 Aral\u0131k 2019 tarihinde, \u00c7in \u00dclke Ofisi taraf\u0131ndan, Hubei eyaleti, Wuhan \u015fehrinde nedeni belirlenemeyen pn\u00f6moni olgular\u0131 oldu\u011fu hakk\u0131nda bilgilendirildi (1). Ocak 2020\u2019de, olgulardan izole edilen virusun yeni bir koronavirus t\u00fcr\u00fc oldu\u011fu tespit edildi (2). Etken, Uluslararas\u0131 Virus Taksonomisi Komitesi (\u201cInternational Committee on Taxonomy of Virusus) taraf\u0131ndan SARS-CoV-2 (\u201csevere [&hellip;]<\/p>\n","protected":false},"author":5,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5129],"tags":[4851,5174,3663,2859],"class_list":["post-24198","post","type-post","status-publish","format-standard","hentry","category-ozgun-arastirma","tag-asi","tag-covid-19","tag-grip","tag-profilaksi"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/24198","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\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/comments?post=24198"}],"version-history":[{"count":4,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/24198\/revisions"}],"predecessor-version":[{"id":24677,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/24198\/revisions\/24677"}],"wp:attachment":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media?parent=24198"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/categories?post=24198"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/tags?post=24198"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}