{"id":25263,"date":"2022-08-22T15:08:32","date_gmt":"2022-08-22T12:08:32","guid":{"rendered":"https:\/\/www.klimikdergisi.org\/?p=25263"},"modified":"2022-10-13T14:44:49","modified_gmt":"2022-10-13T11:44:49","slug":"covid-19-asisina-yaklasim","status":"publish","type":"post","link":"https:\/\/www.klimikdergisi.org\/tr\/2022\/08\/22\/covid-19-asisina-yaklasim\/","title":{"rendered":"Pandeminin Bir Y\u0131l Sonras\u0131nda COVID-19 A\u015f\u0131s\u0131na Toplumsal Yakla\u015f\u0131m"},"content":{"rendered":"

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

\u0130lk olarak Aral\u0131k 2019\u2019da \u00c7in\u2019in Vuhan \u015fehrinde ortaya \u00e7\u0131kan SARS-CoV-2 infeksiyonu salg\u0131n\u0131n\u0131, D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc (DS\u00d6) 30 Ocak 2020\u2019de \u201culuslararas\u0131 \u00f6neme sahip halk sa\u011fl\u0131\u011f\u0131 acil durumu\u201d<\/i> olarak, 11 Mart 2020\u2019de ise pandemi olarak ilan etmi\u015ftir (1, 2). Bu k\u00fcresel tehdidin \u00fcstesinden gelebilmek i\u00e7in sosyal mesafe, el hijyeni ve maske takma gibi \u00f6nleyici tedbirlerin kombinasyonu, toplumda COVID-19\u2019un bula\u015fmas\u0131n\u0131 azaltmak i\u00e7in \u00f6nemli kilit uygulamalard\u0131r. Bu korunma tedbirlerine ek olarak en k\u0131sa s\u00fcrede, a\u015f\u0131lama s\u0131ras\u0131 gelir gelmez a\u015f\u0131 olmak ve a\u015f\u0131lamayla ilgili yerel y\u00f6nergeleri takip etmek \u00e7ok \u00f6nemlidir (3, 4).\u00a0<\/span><\/p>\n

DS\u00d6 taraf\u0131ndan kullan\u0131m\u0131 onaylanm\u0131\u015f birden fazla COVID-19 a\u015f\u0131s\u0131 vard\u0131r. \u0130lk a\u015f\u0131lama program\u0131 Aral\u0131k 2020\u2019den itibaren ba\u015flat\u0131lm\u0131\u015f olup uygulanan a\u015f\u0131 dozlar\u0131n\u0131n say\u0131s\u0131 \u00fclkemizde de oldu\u011fu gibi DS\u00d6 internet sayfas\u0131nda COVID-19 panosunda g\u00fcncellenerek yay\u0131nlanmaktad\u0131r (5). Bu a\u015f\u0131lar\u0131n t\u00fcm\u00fc, v\u00fccudun ba\u011f\u0131\u015f\u0131kl\u0131k sistemine, COVID-19\u2019a neden olan virusu g\u00fcvenli bir \u015fekilde sokmay\u0131 ve yok etmeyi \u00f6\u011fretmek i\u00e7in tasarlanm\u0131\u015ft\u0131r. Hastal\u0131\u011fa neden olmayan ancak ba\u011f\u0131\u015f\u0131kl\u0131k tepkisi olu\u015fturan inaktif virus i\u00e7eren a\u015f\u0131lar (inaktif a\u015f\u0131lar), attenue virus i\u00e7eren, hastal\u0131\u011fa neden olmayan ancak ba\u011f\u0131\u015f\u0131kl\u0131k yan\u0131t\u0131 olu\u015fturan a\u015f\u0131lar (canl\u0131 attenue a\u015f\u0131lar), g\u00fcvenli bir ba\u011f\u0131\u015f\u0131kl\u0131k tepkisi olu\u015fturmak i\u00e7in COVID-19 virusunun yap\u0131s\u0131n\u0131 taklit eden protein par\u00e7alar\u0131n\u0131 kullanan protein bazl\u0131 a\u015f\u0131lar, g\u00fcvenli ba\u011f\u0131\u015f\u0131kl\u0131k tepkisi olu\u015fturmak i\u00e7in COVID-19 virusunun RNA par\u00e7alar\u0131n\u0131 ta\u015f\u0131yan hastal\u0131k d\u0131\u015f\u0131 viruslar\u0131 kullanan viral vekt\u00f6r a\u015f\u0131lar\u0131 ve kendi ba\u015flar\u0131na g\u00fcvenli bir ba\u011f\u0131\u015f\u0131kl\u0131k tepkisi ortaya \u00e7\u0131karan proteinler \u00fcretmek i\u00e7in RNA ve DNA par\u00e7alar\u0131n\u0131 kullanan m-RNA ve DNA a\u015f\u0131lar\u0131 bulunmaktad\u0131r (6).\u00a0<\/span><\/p>\n

COVID-19 pandemisi s\u00fcrecinde sa\u011fl\u0131\u011f\u0131n sosyal belirleyicileri, s\u00fcrveyans sistemi, korumaya odakl\u0131 halk sa\u011fl\u0131\u011f\u0131 uygulamalar\u0131 \u00fczerinde durulmu\u015f olup (7, 8) korunmada a\u015f\u0131n\u0131n kabul edilirli\u011finin sa\u011flanmas\u0131 ve a\u015f\u0131 reddinin azalt\u0131lmas\u0131 i\u00e7in problemin ele al\u0131nmas\u0131 ve yap\u0131lacak m\u00fcdahaleler \u00f6nemlidir (9, 10). A\u015f\u0131y\u0131 yapt\u0131rmak ve g\u00fcven duymak i\u00e7in do\u011fru bilgiye ula\u015f\u0131lmas\u0131 gerekmektedir (11). \u00c7\u00fcnk\u00fc DS\u00d6\u2019ye g\u00f6re a\u015f\u0131 teredd\u00fcd\u00fc ve a\u015f\u0131 reddi d\u00fcnyada en \u00f6nemli on k\u00fcresel sa\u011fl\u0131k tehdidi aras\u0131nda yer almaktad\u0131r (12). Toplum ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131 a\u00e7\u0131s\u0131ndan yeterli koruma d\u00fczeyine ula\u015fmak i\u00e7in geni\u015f bir pop\u00fclasyonun (%60-%90) a\u015f\u0131lanmas\u0131 zorunludur (6). Toplumun a\u015f\u0131 fark\u0131ndal\u0131\u011f\u0131 ve a\u015f\u0131ya yakla\u015f\u0131m\u0131n\u0131n bilinmesi, s\u00fcrecin do\u011fru y\u00fcr\u00fct\u00fclmesi a\u00e7\u0131s\u0131ndan de\u011ferli olacakt\u0131r.\u00a0<\/span><\/p>\n

Bu \u00e7al\u0131\u015fmada, bireylerin COVID-19 a\u015f\u0131s\u0131na yakla\u015f\u0131m\u0131 ve fark\u0131ndal\u0131\u011f\u0131n\u0131 artt\u0131rmak amac\u0131yla, a\u015f\u0131 ile ilgili bilgi ve davran\u0131\u015flar\u0131n\u0131 tespit etmek ama\u00e7land\u0131.<\/span><\/p>\n

Y\u00d6NTEMLER<\/h2>\n

\u00c7al\u0131\u015fma 1 Haziran 2021- 30 Temmuz 2021 tarihleri aras\u0131nda yap\u0131ld\u0131. Ara\u015ft\u0131rmac\u0131lar taraf\u0131ndan yap\u0131lan literat\u00fcr taramas\u0131n\u0131n ard\u0131ndan veri toplama formu haz\u0131rland\u0131. \u00dc\u00e7 b\u00f6l\u00fcm ve 27 sorudan olu\u015fan veri toplama formunun dokuz sorudan olu\u015fan ilk b\u00f6l\u00fcm\u00fc sosyo-demografik \u00f6zellikleri; 11 sorudan olu\u015fan ikinci b\u00f6l\u00fcm\u00fc, COVID-19 hastal\u0131\u011f\u0131n\u0131 ge\u00e7irme durumu, a\u015f\u0131ya yakla\u015f\u0131m\u0131 ve a\u015f\u0131yla ilgili tutumlar\u0131; yedi sorudan olu\u015fan son b\u00f6l\u00fcm ise COVID-19 hastal\u0131\u011f\u0131 ve a\u015f\u0131s\u0131 ile ilgili bilgileri sorgulamaktayd\u0131. \u00c7al\u0131\u015fma, kat\u0131l\u0131mc\u0131larla \u00e7evrimi\u00e7i olarak payla\u015f\u0131lan veri toplama formu arac\u0131l\u0131\u011f\u0131yla ger\u00e7ekle\u015ftirildi. \u00c7al\u0131\u015fmaya kat\u0131l\u0131m\u0131 sa\u011flamak i\u00e7in sosyal medyada duyurular ve internet ba\u011flant\u0131s\u0131 payla\u015f\u0131mlar\u0131 yap\u0131ld\u0131. \u00c7al\u0131\u015fmaya kat\u0131l\u0131mda, 18 ya\u015f \u00fczerinde olmak ve g\u00f6n\u00fcll\u00fc olmak yeterli kabul edildi. \u00c7al\u0131\u015fma sonunda, eksik doldurulan veya tutars\u0131z cevaplar\u0131 bulunan veri toplama formlar\u0131 \u00e7al\u0131\u015fma d\u0131\u015f\u0131 b\u0131rak\u0131ld\u0131.<\/p>\n

\u00c7al\u0131\u015fma i\u00e7in Necmettin Erbakan \u00dcniversitesi \u0130la\u00e7 ve T\u0131bbi Cihaz D\u0131\u015f\u0131 Ara\u015ft\u0131rmalar Etik Kurulu\u2019ndan 21 May\u0131s 2021 tarih ve 2021\/3264 karar numaras\u0131yla onay al\u0131nm\u0131\u015ft\u0131r.<\/p>\n

\u0130statistiksel Analiz<\/h3>\n

Verilerin istatistiksel analizi, SPSS (\u201cStatistical Package for the Social Sciences\u201d) versiyon 27.0 program\u0131 (IBM Corp., Armonk, NY, ABD)\u00a0 kullan\u0131larak yap\u0131ld\u0131. Say\u0131sal verilerin \u00f6zetlenmesinde; ortalama\u00b1standart sapma ve ortanca (1. \u00e7eyreklik-3. \u00e7eyreklik) de\u011ferleri, kategorik verilerin \u00f6zetlenmesinde ise say\u0131 ve y\u00fczdelikler kullan\u0131ld\u0131. Kategorik de\u011fi\u015fkenler aras\u0131ndaki ili\u015fkiyi g\u00f6stermek amac\u0131yla \u03c72 testi yap\u0131ld\u0131. \u00c7al\u0131\u015fmada; kat\u0131l\u0131mc\u0131lar\u0131n ya\u015f\u0131, COVID-19 a\u015f\u0131s\u0131 ile ilgili bilgi edinme kaynaklar\u0131 ve COVID-19 hastal\u0131\u011f\u0131 ve a\u015f\u0131lama ile ilgili \u00f6nermelere verilen cevaplar\u0131yla bir model olu\u015fturuldu. A\u015f\u0131 teredd\u00fcd\u00fc\/reddini \u00f6ng\u00f6rmek i\u00e7in olu\u015fturulan model, lojistik regresyon analizinde \u201cForward LR\u201d metodu kullan\u0131larak incelendi. Model uyumu i\u00e7in Hosmer-Lemeshow testi kullan\u0131ld\u0131. P<0.05 de\u011feri istatistiksel olarak anlaml\u0131 olarak kabul edildi.\u00a0<\/span><\/span><\/p>\n

BULGULAR<\/h2>\n
\"\"<\/a>

Tablo 1.<\/strong> Kat\u0131l\u0131mc\u0131lar\u0131n Sosyo-Demografik \u00d6zellikleri ve Alerji\/Hastal\u0131k \u00d6yk\u00fcs\u00fc<\/p><\/div>\n

\u00c7al\u0131\u015fmaya, ya\u015f ortalamas\u0131 39.75\u00b111.27 olan ve 655 (%55.7)\u2019i kad\u0131n toplam 1176 ki\u015fi d\u00e2hil edildi. Ara\u015ft\u0131rmaya kat\u0131lanlar\u0131n 842 (%71.6)\u2019si evli, 928 (%78.9)\u2019i \u00fcniversite\/lisans\u00fcst\u00fc mezunuydu. Kat\u0131l\u0131mc\u0131lar\u0131n sosyo-demografik \u00f6zellikleri, alerji ve kronik hastal\u0131k \u00f6yk\u00fcs\u00fcn\u00fcn varl\u0131\u011f\u0131 Tablo 1\u2019de verildi.\u00a0<\/span><\/p>\n

\"\"<\/a>

Tablo 2.<\/strong> Kat\u0131l\u0131mc\u0131lar\u0131n COVID-19 Ge\u00e7irme Durumlar\u0131 ve A\u015f\u0131 ile \u0130lgili D\u00fc\u015f\u00fcnceleri<\/p><\/div>\n

\u00c7al\u0131\u015fmaya d\u00e2hil edilen 1176 ki\u015finin 306 (%26.0)\u2019s\u0131 COVID-19 hastal\u0131\u011f\u0131 ge\u00e7irdi\u011fini belirtti.\u00a0 <\/span>Kat\u0131l\u0131mc\u0131lar\u0131n hastal\u0131\u011f\u0131 ge\u00e7irme durumu, a\u015f\u0131ya yakla\u015f\u0131m\u0131, a\u015f\u0131yla ilgili tutumlar\u0131 Tablo 2\u2019de verildi.\u00a0<\/span><\/p>\n

\"\"<\/a>

Tablo 3.<\/strong> Kat\u0131l\u0131mc\u0131lar\u0131n A\u015f\u0131 Tercih Nedenleri ve A\u015f\u0131 Sonras\u0131 G\u00f6r\u00fclen Yan Etkiler<\/p><\/div>\n

Kat\u0131l\u0131mc\u0131lardan 978 (%83.2)\u2019i a\u015f\u0131 oldu\u011funu veya s\u0131ras\u0131 geldi\u011finde a\u015f\u0131 olaca\u011f\u0131n\u0131 belirtirken, 114 (%9.7)\u2019\u00fc a\u015f\u0131 konusunda teredd\u00fct\u00fc oldu\u011funu, 84 (%7.1)\u2019\u00fc a\u015f\u0131 olmay\u0131 reddetti\u011fini veya s\u0131ras\u0131 geldi\u011finde a\u015f\u0131 olmayaca\u011f\u0131n\u0131 belirtti. Kat\u0131l\u0131mc\u0131lar\u0131n a\u015f\u0131 tercihinde \u00f6ncelikli nedenin hangisi oldu\u011fu ve a\u015f\u0131 sonras\u0131nda kar\u015f\u0131la\u015ft\u0131\u011f\u0131 yan etkiler Tablo 3\u2019te verildi.<\/p>\n

\"\"<\/a>

Tablo 4.<\/strong> A\u015f\u0131 Kabul\u00fc veya Teredd\u00fcd\u00fc\/Reddi ile Sosyo-demografik \u00d6zelliklerin Kar\u015f\u0131la\u015ft\u0131r\u0131lmas\u0131<\/p><\/div>\n

A\u015f\u0131 kabul\u00fcn\u00fcn; evli olan kat\u0131l\u0131mc\u0131larda bek\u00e2r olanlara g\u00f6re, COVID-19 hastal\u0131\u011f\u0131n\u0131 ge\u00e7irmeyenlerde ge\u00e7irenlere g\u00f6re istatistiksel olarak anlaml\u0131 ve y\u00fcksek d\u00fczeyde oldu\u011fu g\u00f6r\u00fcld\u00fc (p<\/i><0.001). Ayr\u0131ca kronik hastal\u0131\u011f\u0131 olmayanlarda a\u015f\u0131 teredd\u00fct\u00fc\/reddi kronik hastal\u0131\u011f\u0131 olanlara g\u00f6re istatistiksel olarak anlaml\u0131 d\u00fczeyde ve daha y\u00fcksekti (p<\/i><0.001) (Tablo 4).\u00a0<\/span><\/p>\n

\"\"<\/a>

Tablo 5.<\/strong> Kat\u0131l\u0131mc\u0131lar\u0131n A\u015f\u0131ya Yakla\u015f\u0131mlar\u0131 ile COVID-19 Hakk\u0131ndaki \u00d6nermelere Verilen Cevaplar\u0131n Kar\u015f\u0131la\u015ft\u0131r\u0131lmas\u0131<\/p><\/div>\n

COVID-19 pandemisinden kurtulmak i\u00e7in en etkin yolun a\u015f\u0131lama oldu\u011funu d\u00fc\u015f\u00fcnenlerde, bu d\u00fc\u015f\u00fcnceyi desteklemeyenlere g\u00f6re; COVID-19 a\u015f\u0131s\u0131na g\u00fcvenenlerde, g\u00fcvenmeyen ve karars\u0131z olanlara g\u00f6re a\u015f\u0131 kabul\u00fc daha y\u00fcksekti (p<\/i><0.001) (Tablo 5).\u00a0<\/span><\/p>\n

\"\"<\/a>

Tablo 6.<\/strong> A\u015f\u0131 Reddi \u00dczerine Etkili Fakt\u00f6rlerin Belirlenmesine \u0130li\u015fkin Kurulan Lojistik Regresyon Modeli<\/p><\/div>\n

\u00c7al\u0131\u015fmada, a\u015f\u0131 reddi \u00fczerinde etkili olacak fakt\u00f6rlerin belirlenmesi i\u00e7in; ya\u015f, COVID-19 a\u015f\u0131s\u0131 ile ilgili bilgilerin edinildi\u011fi kaynaklar ve COVID-19 hastal\u0131\u011f\u0131 ile ilgili verilen \u00f6nermelere verilen cevaplar ile bir model olu\u015fturuldu. Kurulan lojistik regresyon modelinin, a\u015f\u0131 reddinin %53.3\u2019\u00fcn\u00fc a\u00e7\u0131klad\u0131\u011f\u0131 belirlendi (Nagelkerke R\u00b2=0.533). S\u00f6z konusu model, a\u015f\u0131 kabul\u00fc, teredd\u00fcd\u00fc ve reddini %89.1 oran\u0131nda do\u011fru tahmin etmektedir. Lojistik regresyon modeline g\u00f6re a\u015f\u0131 reddi \u00fczerine etkili olan de\u011fi\u015fkenler Tablo 6\u2019da g\u00f6sterildi. Ya\u015f azald\u0131k\u00e7a COVID-19 a\u015f\u0131 teredd\u00fct\/ret oran\u0131 0.928 kat artmakta idi. A\u015f\u0131 ile ilgili bilgiyi genelde televizyon arac\u0131l\u0131\u011f\u0131yla edinenlerde a\u015f\u0131y\u0131 reddetme olas\u0131l\u0131\u011f\u0131 11.603 kat daha fazla iken; doktor ve sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131ndan bilgi edinmeyenlerde di\u011ferlerine g\u00f6re a\u015f\u0131y\u0131 reddetme olas\u0131l\u0131\u011f\u0131 1.685 kat daha fazlayd\u0131. A\u015f\u0131y\u0131 reddetme olas\u0131l\u0131\u011f\u0131; a\u015f\u0131n\u0131n hastal\u0131ktan iki y\u0131l boyunca korumayaca\u011f\u0131n\u0131 d\u00fc\u015f\u00fcnenlerde d\u00fc\u015f\u00fcnmeyenlere g\u00f6re 1.944 kat y\u00fcksek iken; a\u015f\u0131n\u0131n yan etkisinin \u00e7ok oldu\u011funu d\u00fc\u015f\u00fcnenlerde 4.129 kat daha y\u00fcksekti. Pandemiden kurtulman\u0131n en etkili yolunun a\u015f\u0131 oldu\u011funu d\u00fc\u015f\u00fcnmeyenlerde a\u015f\u0131 reddi, bu d\u00fc\u015f\u00fcnceye sahip olanlara g\u00f6re 11.119 kat daha y\u00fcksek bulundu.\u00a0<\/span><\/p>\n

\u0130RDELEME<\/h2>\n

COVID-19 a\u015f\u0131s\u0131na yakla\u015f\u0131m\u0131 de\u011ferlendirmeyi ama\u00e7layan bu \u00e7al\u0131\u015fmada, kat\u0131l\u0131mc\u0131lar\u0131n <\/span>\u00e7o\u011funlu\u011fu a\u015f\u0131 olmu\u015f (%75.1) veya s\u0131ras\u0131 geldi\u011finde a\u015f\u0131 olaca\u011f\u0131n\u0131 (%8.1) belirtmi\u015ftir.\u00a0<\/span>\u00c7in\u2019de \u00fclke \u00e7ap\u0131nda yap\u0131lan bir \u00e7al\u0131\u015fmada a\u015f\u0131 yapt\u0131ran veya yapt\u0131rmak istedi\u011fini ifade edenlerin oran\u0131 bu \u00e7al\u0131\u015fmayla benzer bulunurken, ABD\u2019de yap\u0131lan benzer bir \u00e7al\u0131\u015fmada ise bu oran %67 ile daha d\u00fc\u015f\u00fck bulunmu\u015ftur (13, 14). A\u015f\u0131 teredd\u00fct\u00fc ve reddi ile ilgili 33 \u00fclkenin \u00e7al\u0131\u015fmalar\u0131n\u0131n de\u011ferlendirildi\u011fi derlemede a\u015f\u0131 kabul oran\u0131 en y\u00fcksek \u00fclkeler %91.3 – %97 oranlar\u0131 aral\u0131\u011f\u0131yla \u00c7in, Endonezya, Malezya ve Ekvador iken; a\u015f\u0131 kabul oran\u0131 en d\u00fc\u015f\u00fck \u00fclkeler %23.6-%58.9 oranlar\u0131 aral\u0131\u011f\u0131yla Kuveyt, \u00dcrd\u00fcn, \u0130talya, Rusya, Polonya, Fransa ve ABD olarak tespit edilmi\u015ftir (15). \u00dclkemizde COVID-19 a\u015f\u0131s\u0131na y\u00f6nelik tutumu de\u011ferlendiren bir \u00f6l\u00e7ek kullan\u0131larak yap\u0131lan \u00e7al\u0131\u015fmada ise kat\u0131l\u0131mc\u0131lar\u0131n a\u015f\u0131ya kar\u015f\u0131 orta d\u00fczeyde olumlu tutuma sahip olduklar\u0131 sonucuna ula\u015f\u0131lm\u0131\u015ft\u0131r (16). T\u00fcrkiye\u2019de yap\u0131lan ba\u015fka bir \u00e7al\u0131\u015fmada da kat\u0131l\u0131mc\u0131lar\u0131n %54.7\u2019si uygunlu\u011fu Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 taraf\u0131ndan a\u00e7\u0131klanan a\u015f\u0131y\u0131 yapt\u0131raca\u011f\u0131n\u0131 ifade ederken (17); yine T\u00fcrkiye\u2019de pandemi ile ilgili olaylar\u0131n zaman \u00e7izelgesine kar\u015f\u0131l\u0131k gelen \u00fc\u00e7 d\u00f6nemde a\u015f\u0131lara kar\u015f\u0131 tutum ve g\u00fcven durumunun ara\u015ft\u0131r\u0131ld\u0131\u011f\u0131 bir ba\u015fka \u00e7al\u0131\u015fmada, \u00e7al\u0131\u015fman\u0131n \u00fc\u00e7\u00fcnc\u00fc d\u00f6neminde COVID-19 yay\u0131l\u0131m\u0131ndaki art\u0131\u015fa paralel olarak a\u015f\u0131 teredd\u00fct\u00fc ve reddinin %43.9\u2019dan %58.9\u2019a y\u00fckseldi\u011fi tespit edilmi\u015f; COVID-19 a\u015f\u0131s\u0131n\u0131n kabul edilebilirli\u011fini art\u0131rmak halk\u0131n g\u00fcvenini kazanmak i\u00e7in, risk alg\u0131s\u0131n\u0131 ve davran\u0131\u015fsal fakt\u00f6rleri g\u00f6z \u00f6n\u00fcnde bulundurman\u0131n gereklili\u011fi vurgulanm\u0131\u015ft\u0131r (18). Toplumlar\u0131n a\u015f\u0131ya yakla\u015f\u0131m\u0131ndaki oranlar\u0131n farkl\u0131 olmas\u0131, pandeminin etkisinin her \u00fclkede hatta \u00fclke i\u00e7indeki b\u00f6lgelerde bile farkl\u0131 hissedilmesinden ve devletlerin a\u015f\u0131ya yakla\u015f\u0131m ve tedarikleri ile ilgili tutum farkl\u0131l\u0131klar\u0131ndan kaynaklan\u0131yor olabilir. Ayr\u0131ca s\u00f6z konusu \u00e7al\u0131\u015fmalar\u0131n yap\u0131ld\u0131\u011f\u0131 tarihlerin farkl\u0131l\u0131klar\u0131 ve hatta o d\u00f6nemdeki \u00f6l\u00fcm say\u0131lar\u0131 da a\u015f\u0131ya yakla\u015f\u0131mda etkili olabilir. \u00c7al\u0131\u015fmam\u0131zda ise kat\u0131l\u0131mc\u0131lar\u0131n e\u011fitim d\u00fczeyinin y\u00fcksek olmas\u0131n\u0131n da a\u015f\u0131 kabul oran\u0131 y\u00fcksekli\u011fini etkiledi\u011fini d\u00fc\u015f\u00fcnmekteyiz.\u00a0<\/span><\/span><\/p>\n

\u00c7al\u0131\u015fmam\u0131z\u0131n sonu\u00e7lar\u0131na g\u00f6re; COVID-19 pandemisinden kurtulmak i\u00e7in en etkin yolun a\u015f\u0131lama oldu\u011funu d\u00fc\u015f\u00fcnenlerde ve COVID-19 a\u015f\u0131s\u0131na g\u00fcvenenlerde a\u015f\u0131 kabul oran\u0131 daha y\u00fcksektir. A\u015f\u0131n\u0131n faydas\u0131na inanan ki\u015filerde, a\u015f\u0131 uygulamas\u0131n\u0131n daha y\u00fcksek olmas\u0131 da beklenen bir sonu\u00e7tur.<\/p>\n

Daha \u00f6nce yap\u0131lan baz\u0131 \u00e7al\u0131\u015fmalarda, kad\u0131n cinsiyette ve e\u011fitim d\u00fczeyi azald\u0131k\u00e7a a\u015f\u0131 kabul oran\u0131 daha d\u00fc\u015f\u00fck olarak tespit edilmi\u015ftir (19-21). \u00c7al\u0131\u015fmam\u0131zda ise literat\u00fcrden farkl\u0131 olarak, cinsiyet ve e\u011fitim d\u00fczeylerine g\u00f6re a\u015f\u0131ya yakla\u015f\u0131m oranlar\u0131 benzer bulunmu\u015ftur. Bunun sebebi \u00e7al\u0131\u015fman\u0131n verilerinin \u00e7evrimi\u00e7i olarak toplanmas\u0131 ve kat\u0131l\u0131mc\u0131lar\u0131n \u00e7o\u011funun y\u00fcksek e\u011fitim seviyesine sahip olmas\u0131ndan kaynaklan\u0131yor olabilir.\u00a0<\/span><\/p>\n

\u00c7al\u0131\u015fmam\u0131zda a\u015f\u0131 karars\u0131zl\u0131\u011f\u0131n\u0131n en \u00f6nemli nedenleri; a\u015f\u0131 geli\u015ftirme s\u00fcrecinin h\u0131zl\u0131 olmas\u0131 ve uzun d\u00f6nem etkilerinin bilinmemesi, a\u015f\u0131n\u0131n yan etkileri, a\u015f\u0131n\u0131n etkinli\u011fine inanmama olarak tespit edildi. Yap\u0131lan farkl\u0131 \u00e7al\u0131\u015fmalarda da a\u015f\u0131y\u0131 yapt\u0131rma ihtimali d\u00fc\u015f\u00fck olan ki\u015filerin farkl\u0131 nedenleri olmakla birlikte ba\u015fl\u0131ca endi\u015feleri aras\u0131nda a\u015f\u0131ya g\u00fcvensizlik ve a\u015f\u0131n\u0131n yan etkilerinden \u00e7ekinme yer almaktad\u0131r (22-25). Yeni geli\u015ftirilen ve uzun d\u00f6nem etkileri bilinmeyen bir a\u015f\u0131 i\u00e7in, g\u00fcvenmeme ve yan etkiler konusunda endi\u015felerin olmas\u0131 muhtemeldir. \u00c7al\u0131\u015fmam\u0131zda da a\u015f\u0131 hakk\u0131nda yeterli, do\u011fru ve g\u00fcvenilir bilgiye sahip olmama da a\u015f\u0131 karars\u0131zl\u0131\u011f\u0131n\u0131n \u00f6nemli nedenleri aras\u0131ndad\u0131r. COVID-19 pandemisi s\u00fcrecine; insanlar\u0131n ihtiya\u00e7 duyduklar\u0131nda g\u00fcvenilir kaynak ve rehberlik bulmalar\u0131n\u0131 zorla\u015ft\u0131ran, baz\u0131lar\u0131 do\u011fru ve baz\u0131lar\u0131 yanl\u0131\u015f olan a\u015f\u0131r\u0131 bilgi bollu\u011fu bir \u201cinfodemi\u201d olarak e\u015flik etmi\u015ftir (1). Do\u011fru olmayan bilgilendirmelerin artmas\u0131 da a\u015f\u0131ya olan g\u00fcvenin azalmas\u0131nda bir etken olmu\u015f olabilir. A\u015f\u0131lar\u0131n etkili ve g\u00fcvenli olduklar\u0131 kan\u0131tlanm\u0131\u015f olsa dahi farkl\u0131 nedenlerle a\u015f\u0131lar\u0131n reddedilmesi m\u00fcmk\u00fcnd\u00fcr. Bu nedenle; a\u015f\u0131ya olan g\u00fcveni artt\u0131rma \u00e7abas\u0131n\u0131n yan\u0131 s\u0131ra do\u011fru ve yeterli bilgiye ula\u015f\u0131m\u0131n sa\u011flanmas\u0131 y\u00f6n\u00fcndeki \u00e7al\u0131\u015fmalar a\u015f\u0131 karars\u0131zl\u0131\u011f\u0131n\u0131n \u00fcstesinden gelinmesinde de\u011ferli olabilir.<\/p>\n

\u00c7al\u0131\u015fmam\u0131zda; a\u015f\u0131 olanlar\u0131n sadece \u00fc\u00e7te biri kas eklem a\u011fr\u0131s\u0131, halsizlik, a\u015f\u0131 yerinde a\u011fr\u0131-k\u0131zar\u0131kl\u0131k, ba\u015f a\u011fr\u0131s\u0131, ate\u015f gibi her a\u015f\u0131da kar\u015f\u0131la\u015f\u0131labilecek hafif yan etkiler geli\u015fti\u011fini ifade ederken, \u00fc\u00e7te ikisinde hi\u00e7bir yan etki bildirilmedi. Bu bilginin de toplumla payla\u015f\u0131lmas\u0131, a\u015f\u0131 karars\u0131zl\u0131\u011f\u0131n\u0131n \u00fcstesinden gelinmesinde destek olabilir.<\/p>\n

\u00c7al\u0131\u015fmam\u0131zda, kronik hastal\u0131\u011f\u0131 olmayanlarda a\u015f\u0131 teredd\u00fcd\u00fc ve reddi kronik hastal\u0131\u011f\u0131 olanlara g\u00f6re istatistiksel olarak anlaml\u0131 d\u00fczeyde daha y\u00fcksek bulundu. Literat\u00fcrle benzer olan bu bulgunun nedeni hastal\u0131\u011f\u0131n \u00f6zellikle kronik hastal\u0131\u011f\u0131 olan bireyleri daha fazla etkilemesi ve daha mortal seyretmesi olabilir (19, 26). Ayr\u0131ca evli olan kat\u0131l\u0131mc\u0131lar\u0131n a\u015f\u0131 kabul\u00fcn\u00fcn bek\u00e2r olanlara g\u00f6re y\u00fcksek olmas\u0131 da literat\u00fcrle uyumludur (27). Bu durum aile sorumlulu\u011funu \u00fcstlenen ebeveynlerin koruma i\u00e7g\u00fcd\u00fcs\u00fc ile a\u015f\u0131 kabul\u00fcne meyilli oldu\u011fu \u015feklinde de\u011ferlendirilebilir.<\/p>\n

Bulgular\u0131m\u0131za g\u00f6re; COVID-19 a\u015f\u0131s\u0131na ili\u015fkin bilgiler en fazla doktor ve sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131ndan edinilirken, internet\/sosyal medya bunu takip etmektedir. Ayr\u0131ca a\u015f\u0131 kabul\u00fc veya teredd\u00fcd\u00fc\/reddini \u00f6ng\u00f6rmek i\u00e7in kurulan lojistik regresyon modelinde de a\u015f\u0131 ile ilgili edinilen bilgi kaynaklar\u0131n\u0131n etkisi g\u00f6r\u00fclmektedir. Daha \u00f6nce yap\u0131lm\u0131\u015f bir\u00e7ok \u00e7al\u0131\u015fmada, internet ve sosyal medya i\u00e7eriklerinden bilgi edinen kullan\u0131c\u0131lar\u0131n a\u015f\u0131lamay\u0131 reddetme oranlar\u0131 daha y\u00fcksek bulunmu\u015ftur (28, 29). Literat\u00fcrle uyumlu olarak \u00e7al\u0131\u015fmam\u0131zda da a\u015f\u0131 ile ilgili bilgi kayna\u011f\u0131 sosyal medya\/internet ortam\u0131 olanlar\u0131n a\u015f\u0131ya kar\u015f\u0131 olumsuz tutum sergilemeleri istatistiksel olarak anlaml\u0131 d\u00fczeyde daha y\u00fcksektir.\u00a0 <\/span>Yine literat\u00fcrle benzer olarak a\u015f\u0131 ile ilgili bilgi i\u00e7in internet ve sosyal medya yerine doktor\/sa\u011fl\u0131k \u00e7al\u0131\u015fan\u0131ndan bilgi almay\u0131 tercih edenlerde a\u015f\u0131 kabul\u00fc daha fazla g\u00f6r\u00fclmektedir (14).\u00a0<\/span><\/p>\n

Sonu\u00e7 olarak; ba\u011f\u0131\u015f\u0131klama, salg\u0131n hastal\u0131klar\u0131n \u00f6nlenmesi ve kontrol alt\u0131na al\u0131nmas\u0131nda insanl\u0131k tarihindeki en ba\u015far\u0131l\u0131 halk sa\u011fl\u0131\u011f\u0131 m\u00fcdahalelerindendir. COVID-19 a\u015f\u0131s\u0131 ile ilgili teredd\u00fctler veya a\u015f\u0131 reddine ba\u011fl\u0131 a\u015f\u0131lanmama sadece sa\u011fl\u0131k alan\u0131nda de\u011fil, ba\u015fta sosyal ve ekonomik alanda olmak \u00fczere bir\u00e7ok alanda olumsuz etkiye neden olmaktad\u0131r. Bu nedenle a\u015f\u0131 reddi ve karars\u0131zl\u0131\u011f\u0131n\u0131n nedenlerini iyi irdelemek ve bu nedenleri ortadan kald\u0131r\u0131c\u0131 stratejiler belirleyip uygulamak \u00f6nemlidir. \u00c7al\u0131\u015fmam\u0131z\u0131n bulgular\u0131nda da g\u00f6r\u00fcld\u00fc\u011f\u00fc gibi, COVID-19 a\u015f\u0131s\u0131 ile ilgili bilgilere televizyon ve haberlerden ula\u015fanlarda, virusten korunmak i\u00e7in t\u00fcm toplumun a\u015f\u0131 olmas\u0131 gerekti\u011fine inanmayanlarda ve COVID-19 a\u015f\u0131s\u0131n\u0131n yan etkisinin \u00e7ok oldu\u011funa inanlarda a\u015f\u0131 reddi\/teredd\u00fcd\u00fc daha fazlad\u0131r. Korumada \u00f6nemli ad\u0131mlar\u0131m\u0131zdan olan maske, mesafe ve hijyen \u00f6nlemlerine devam etme gereklili\u011fine inanmayanlarda da bu oran daha y\u00fcksektir.\u00a0<\/span><\/p>\n

\u00d6n\u00fcm\u00fczdeki s\u00fcre\u00e7te; toplum ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131n\u0131 sa\u011flamak ad\u0131na, a\u015f\u0131 teredd\u00fcd\u00fcn\u00fc\/reddini azaltmak ve kabul\u00fc art\u0131rmak i\u00e7in, a\u015f\u0131lar\u0131n g\u00fcvenilirli\u011fi ve gereklili\u011fi hakk\u0131ndaki do\u011fru bilginin halka daha iyi nas\u0131l ula\u015ft\u0131r\u0131labilece\u011fi ve ba\u015fta karars\u0131zlar olmak \u00fczere reddin nedenlerine y\u00f6nelik neler yap\u0131lmas\u0131 gerekti\u011fi ile ilgili \u00e7al\u0131\u015fmalara ihtiya\u00e7 vard\u0131r.<\/p>\n","protected":false},"excerpt":{"rendered":"

G\u0130R\u0130\u015e \u0130lk olarak Aral\u0131k 2019\u2019da \u00c7in\u2019in Vuhan \u015fehrinde ortaya \u00e7\u0131kan SARS-CoV-2 infeksiyonu salg\u0131n\u0131n\u0131, D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc (DS\u00d6) 30 Ocak 2020\u2019de \u201culuslararas\u0131 \u00f6neme sahip halk sa\u011fl\u0131\u011f\u0131 acil durumu\u201d olarak, 11 Mart 2020\u2019de ise pandemi olarak ilan etmi\u015ftir (1, 2). Bu k\u00fcresel tehdidin \u00fcstesinden gelebilmek i\u00e7in sosyal mesafe, el hijyeni ve maske takma gibi \u00f6nleyici tedbirlerin kombinasyonu, […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5129],"tags":[5099,5380,5484],"class_list":["post-25263","post","type-post","status-publish","format-standard","hentry","category-ozgun-arastirma","tag-asi-reddi","tag-asi-tereddutu","tag-covid-19-asilari"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/25263","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\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/comments?post=25263"}],"version-history":[{"count":4,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/25263\/revisions"}],"predecessor-version":[{"id":25773,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/25263\/revisions\/25773"}],"wp:attachment":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media?parent=25263"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/categories?post=25263"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/tags?post=25263"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}