{"id":28050,"date":"2023-12-25T16:29:07","date_gmt":"2023-12-25T13:29:07","guid":{"rendered":"https:\/\/www.klimikdergisi.org\/?p=28050"},"modified":"2024-06-25T14:33:58","modified_gmt":"2024-06-25T11:33:58","slug":"saglik-calisanlarinda-covid-19-asilanmasi","status":"publish","type":"post","link":"https:\/\/www.klimikdergisi.org\/tr\/2023\/12\/25\/saglik-calisanlarinda-covid-19-asilanmasi\/","title":{"rendered":"Bir \u00dcniversite Hastanesinde G\u00f6rev Yapan Sa\u011fl\u0131k \u00c7al\u0131\u015fanlar\u0131n\u0131n COVID-19 A\u015f\u0131lanmas\u0131na Yakla\u015f\u0131m\u0131"},"content":{"rendered":"

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

Etkeni \u015fiddetli akut solunum yolu sendromu koronavirus 2 (SARS-CoV-2) olan koronavirus hastal\u0131\u011f\u0131 2019 (COVID-19), 2019 y\u0131l\u0131nda ortaya \u00e7\u0131kt\u0131ktan k\u0131sa bir s\u00fcre sonra k\u00fcresel bir pandemiye neden olmu\u015ftur. Son g\u00fcnlerde d\u00fcnya genelinde infeksiyon insidans\u0131ndaki azalma nedeniyle COVID-19\u2019a kar\u015f\u0131 k\u0131s\u0131tlamalar kald\u0131r\u0131lm\u0131\u015f olmakla birlikte hastal\u0131k t\u00fcm d\u00fcnyada g\u00f6r\u00fclmeye devam etmektedir. \u00dclkemizde, T.C. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 taraf\u0131ndan ilk olgu 11 Mart 2020\u2019de a\u00e7\u0131klanm\u0131\u015f, ilk \u00f6l\u00fcm 15 Mart 2020\u2019de ger\u00e7ekle\u015fmi\u015f, 2 Mart 2023\u2019e kadar yakla\u015f\u0131k 17 milyon ki\u015fi COVID-19\u2019a yakalanm\u0131\u015f ve hastal\u0131k nedeniyle yakla\u015f\u0131k 101 500 ki\u015fi hayat\u0131n\u0131 kaybetmi\u015ftir (1,2).\u00a0<\/span><\/p>\n

D\u00fcnyada COVID-19\u2019a kar\u015f\u0131 ilk a\u015f\u0131lama Aral\u0131k 2020\u2019de yap\u0131lm\u0131\u015ft\u0131r ve \u015fu anda acil kullan\u0131m listesinde olan dokuz a\u015f\u0131 mevcuttur (3). T\u00fcrkiye\u2019de ise CoronaVac a\u015f\u0131s\u0131 (Sinovac Life Sciences, Pekin, \u00c7in), Pfizer-BioNTech\u00a0mRNA a\u015f\u0131s\u0131\u00a0(Comirnaty<\/span>\u00ae<\/span>) ve T.C. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 ve Erciyes \u00dcniversitesi taraf\u0131ndan geli\u015ftirilen inaktif TURKOVAC olmak \u00fczere \u00fc\u00e7 farkl\u0131 a\u015f\u0131 kullan\u0131mdad\u0131r. \u00dclkemizdeki ilk COVID-19 a\u015f\u0131lamas\u0131, CoronaVac ile 13 Ocak 2021 tarihinde sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 i\u00e7in ba\u015flat\u0131lm\u0131\u015ft\u0131r; Pfizer-BioNTech\u00a0mRNA a\u015f\u0131s\u0131\u00a012 Nisan 2021\u2019de ve TURKOVAC 30 Aral\u0131k 2021\u2019de kullan\u0131lmaya ba\u015flanm\u0131\u015ft\u0131r. T\u00fcrkiye\u2019de 30 Ocak 2023 itibariyle y<\/b>\u00fcksek miktarda virusla kar\u015f\u0131la\u015fma riski olan ki\u015filer\/sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 i\u00e7in iki doz temel a\u015f\u0131lama sonras\u0131 iki doz hat\u0131rlatma dozu olmak \u00fczere toplamda d\u00f6rt doz a\u015f\u0131 \u00f6nerilmektedir (4).<\/span><\/p>\n

Sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131, pandemi d\u00f6neminde \u00f6n saflarda yer alarak COVID-19 ile temas\u0131 en fazla olan pop\u00fclasyon i\u00e7erisinde yer alm\u0131\u015ft\u0131r. T\u00fcrkiye\u2019de de COVID-19 a\u015f\u0131lama program\u0131 ba\u015flarken sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 y\u00fcksek risk grubunda yer alarak ilk a\u015f\u0131lanan grup olmu\u015ftur (5). Bununla birlikte a\u015f\u0131 \u00f6nceli\u011fi tan\u0131nm\u0131\u015f olsa da sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131nda y\u0131ll\u0131k rutin a\u015f\u0131lama \u00f6nerilen influenza a\u015f\u0131s\u0131nda oldu\u011fu gibi COVID-19\u2019a kar\u015f\u0131 ba\u011f\u0131\u015f\u0131klamaya y\u00f6nelik de \u00e7e\u015fitli gerek\u00e7elerle a\u015f\u0131 reddi ortaya \u00e7\u0131km\u0131\u015ft\u0131r (6-10). Yap\u0131lan baz\u0131 \u00e7al\u0131\u015fmalarda sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n meslek gruplar\u0131 ile a\u015f\u0131 yapt\u0131rma kararlar\u0131 aras\u0131nda da farkl\u0131l\u0131klar oldu\u011fu tespit edilmi\u015ftir (11). Ancak sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n a\u015f\u0131lanmas\u0131; hem y\u00fcksek riskli grupta yer almalar\u0131 hem hizmet devaml\u0131l\u0131\u011f\u0131n\u0131n aksamamas\u0131 hem de toplum nezdinde a\u015f\u0131lama \u00f6ncesi fikir ald\u0131klar\u0131 bir dan\u0131\u015fman gibi g\u00f6r\u00fclmeleri nedeniyle \u00f6nemlidir (9,12). T\u00fcm bu sebeplerle, sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n COVID-19 a\u015f\u0131s\u0131 konusundaki teredd\u00fctlerinin devam etmesi ve a\u015f\u0131lanmayan sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n varl\u0131\u011f\u0131 t\u00fcm d\u00fcnyada oldu\u011fu gibi T\u00fcrkiye\u2019de de \u00fczerinde durulmas\u0131 gereken \u00f6nemli bir sorundur.\u00a0<\/span><\/p>\n

Bu \u00e7al\u0131\u015fmada, hastanemizde g\u00f6rev yapan sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n COVID-19\u2019a kar\u015f\u0131 a\u015f\u0131lanma durumlar\u0131n\u0131n, meslek gruplar\u0131na g\u00f6re a\u015f\u0131 tipi tercihlerinin ve a\u015f\u0131lanmalar\u0131n\u0131 etkileyen fakt\u00f6rlerin de\u011ferlendirilmesi ama\u00e7land\u0131.<\/p>\n

Y\u00d6NTEMLER<\/h2>\n

\u00c7al\u0131\u015fmam\u0131z, 01 Kas\u0131m 2022-15 Aral\u0131k 2022 tarihleri aras\u0131nda 530 yatakl\u0131 ve 1999 sa\u011fl\u0131k \u00e7al\u0131\u015fan\u0131n\u0131n g\u00f6rev ald\u0131\u011f\u0131 \u00fc\u00e7\u00fcnc\u00fc basamak bir hastanede kesitsel \u00e7al\u0131\u015fma olarak ger\u00e7ekle\u015ftirildi. \u00c7al\u0131\u015fmaya kat\u0131lmay\u0131 kabul etti\u011fine dair yaz\u0131l\u0131 onam al\u0131nm\u0131\u015f olan sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131 \u00e7al\u0131\u015fmaya dahil edildi.\u00a0 <\/span>Veriler y\u00fcz y\u00fcze veya kartopu metodu ile doldurtulan anket formu ile elde edildi. Anket formu; demografik bilgileri, ki\u015finin meslek grubunu, pandemi biriminde \u00e7al\u0131\u015f\u0131p \u00e7al\u0131\u015fmama durumunu, COVID-19 ve influenza a\u015f\u0131lanma bilgilerini ve COVID-19 ge\u00e7irme ve hastane yat\u0131\u015f\u0131n\u0131 sorgulayan 10 soru i\u00e7eriyordu. Tam doz a\u015f\u0131lama; a\u015f\u0131 \u00e7e\u015fidi fark etmeksizin toplamda d\u00f6rt doz a\u015f\u0131 olunmas\u0131 olarak tan\u0131mland\u0131. Yard\u0131mc\u0131 sa\u011fl\u0131k personeli olarak tan\u0131mlanan grup; t\u0131bbi sekreter, teknisyen, i\u015f\u00e7i, memur, g\u00fcvenlik g\u00f6revlisi gibi doktor veya hem\u015fire d\u0131\u015f\u0131 sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131 kaps\u0131yordu.\u00a0<\/span><\/p>\n

D\u00fcnya Tabipler Birli\u011fi Helsinki Bildirgesi\u2019ne uygun olarak y\u00fcr\u00fct\u00fclen \u00e7al\u0131\u015fma i\u00e7in Recep Tayyip \u00dcniversitesi T\u0131p Fak\u00fcltesi Giri\u015fimsel Olmayan Klinik Ara\u015ft\u0131rmalar Etik Kurulu\u2019ndan 6 Ekim 2022 tarih ve 2022\/164 karar numaras\u0131yla onay al\u0131nd\u0131.<\/p>\n

\u0130statistiksel Analiz<\/h3>\n

Verilerin analizi, SPSS (Statistical Package for the Social Sciences) versiyon 26.0 program\u0131 (IBM Corp., Armonk, NY, ABD) ile yap\u0131ld\u0131 ve istatistiksel anlaml\u0131l\u0131k d\u00fczeyi p<\/i><0.05 olarak kabul edildi.\u00a0 <\/span>Deg\u0306is\u0327kenlerin normal dag\u0306\u0131l\u0131ma uygunlug\u0306u analitik y\u00f6ntemler (Kolmogorov-Smirnov ve Shapiro-Wilk testleri) kullan\u0131larak incelendi. Tan\u0131mlay\u0131c\u0131 analizler; normal dag\u0306\u0131l\u0131ma uyan veriler i\u00e7in ortalama, normal dag\u0306\u0131l\u0131ma uymayan veriler i\u00e7in ise ortanca kullan\u0131larak verildi. \u0130statistiksel de\u011ferlendirmede \u00e7apraz tablolar kullan\u0131ld\u0131; \u00e7apraz tablolarda gruplar aras\u0131nda fark bulunup bulunmad\u0131g\u0306\u0131 \u03c72\u00a0testi ve h\u00fccrelerde g\u00f6zlenen deg\u0306erlerin \u03c72 testi varsay\u0131mlar\u0131n\u0131 kars\u0327\u0131lamad\u0131g\u0306\u0131 durumda Fisher testleri kullan\u0131larak kars\u0327\u0131la\u015ft\u0131r\u0131ld\u0131. Say\u0131sal veriler normal da\u011f\u0131ld\u0131\u011f\u0131nda t-testi ile normal da\u011f\u0131lmad\u0131\u011f\u0131nda ise Wilcoxon s\u0131ra toplam\u0131 (\u201crank-sum\u201d) testi ile k\u0131yasland\u0131. G*Power 3.1.9.7 program\u0131 (Heinrich-Heine-Universit\u00e4t D\u00fcsseldorf, D\u00fcsseldorf, Almanya) kullan\u0131larak 0.20 etki b\u00fcy\u00fckl\u00fc\u011f\u00fc, %90 g\u00fc\u00e7 ve %5 hata pay\u0131 ile yap\u0131lan g\u00fc\u00e7 analizi sonucuna g\u00f6re toplamda en az 216 \u00f6rnek say\u0131s\u0131 yeterli bulundu.<\/p>\n

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

Tablo 1.<\/strong> Kat\u0131l\u0131mc\u0131lar\u0131n Klinik ve Laboratuvar \u00d6zellikleri<\/p><\/div>\n

Hastanemizde g\u00f6rev yapan 1999 sa\u011fl\u0131k \u00e7al\u0131\u015fan\u0131ndan 898\u2019ine ula\u015f\u0131ld\u0131. Anket sorular\u0131n\u0131 eksik yan\u0131tlam\u0131\u015f olan 145 ki\u015fi \u00e7al\u0131\u015fma d\u0131\u015f\u0131 b\u0131rak\u0131ld\u0131 ve 744 ki\u015fi \u00e7al\u0131\u015fmaya dahil edildi. Kat\u0131l\u0131mc\u0131lar\u0131n ya\u015f ortanca de\u011feri 32 (17-60 aral\u0131\u011f\u0131nda) y\u0131l olup 452 (%60.8)\u2019si kad\u0131nd\u0131. En fazla ula\u015f\u0131labilen meslek grubunda ilk s\u0131rada hem\u015fireler (%32.3, n=240) ve ikinci s\u0131rada ise t\u0131bbi sekreterler (%20.3, n=151) yer al\u0131yordu. Kat\u0131l\u0131mc\u0131lar\u0131n 691 (%92.9)\u2019i COVID-19\u2019a kar\u015f\u0131 a\u015f\u0131lanm\u0131\u015fken, influenzaya kar\u015f\u0131 a\u015f\u0131lananlar\u0131n say\u0131s\u0131 164 (%22) idi. COVID-19 hastal\u0131\u011f\u0131n\u0131 ge\u00e7irme oran\u0131 %63.6 (n=473), COVID-19 nedeniyle hastanede yat\u0131\u015f oran\u0131 ise %5.9 (n=44) olarak tespit edildi. Ayr\u0131ca kat\u0131l\u0131mc\u0131lar\u0131n hastal\u0131k \u00f6ncesi tam doz a\u015f\u0131lanma oran\u0131 %10.1 (n=65), COVID-19 ge\u00e7irdikten sonra a\u015f\u0131lanma\/a\u015f\u0131lanmaya devam etme oran\u0131 ise %56.9 (n=269) olarak saptand\u0131 (Tablo 1).<\/p>\n

\"\"<\/a>

Tablo 2.<\/strong> Kat\u0131l\u0131mc\u0131lar\u0131n Demografik \u00d6zellikleri ve A\u015f\u0131lanma Durumlar\u0131 Aras\u0131ndaki \u0130li\u015fki<\/p><\/div>\n

Kat\u0131l\u0131mc\u0131lar\u0131n demografik \u00f6zellikleri ve a\u015f\u0131lanma durumlar\u0131 aras\u0131ndaki ili\u015fki incelendi\u011finde; COVID-19\u2019a kar\u015f\u0131 a\u015f\u0131lanma oranlar\u0131n\u0131n kad\u0131nlarda erkeklere g\u00f6re, influenza a\u015f\u0131s\u0131 olanlarda olmayanlara g\u00f6re, doktorlarda hem\u015fireler ve yard\u0131mc\u0131 sa\u011fl\u0131k personeline g\u00f6re istatistiksel a\u00e7\u0131dan anlaml\u0131 olarak daha fazla oldu\u011fu saptand\u0131 (s\u0131ras\u0131yla p<\/i>=0.051, p<\/i><0.001, p<\/i>=0.004). COVID-19 hastal\u0131\u011f\u0131n\u0131 ge\u00e7irdikten sonraki a\u015f\u0131lanma oranlar\u0131 incelendi\u011finde a\u015f\u0131lanman\u0131n erkeklerde kad\u0131nlara g\u00f6re ve influenza a\u015f\u0131s\u0131 olanlarda olmayanlara g\u00f6re istatistiksel a\u00e7\u0131dan anlaml\u0131 d\u00fczeyde daha fazla oldu\u011fu saptand\u0131 (s\u0131ras\u0131yla p<\/i>=0.002, p<\/i>=0.002) (Tablo 2).\u00a0<\/span><\/p>\n

Kat\u0131l\u0131mc\u0131lar\u0131n 156 (%21)\u2019s\u0131 tam doz a\u015f\u0131lanm\u0131\u015ft\u0131. Tam doz a\u015f\u0131 olanlar\u0131n ortanca ya\u015f de\u011ferleri, olmayanlara k\u0131yasla istatistiksel a\u00e7\u0131dan anlaml\u0131 d\u00fczeydeydi (p<\/i>=0.000). Bununla beraber tam doz a\u015f\u0131lanma oranlar\u0131n\u0131n; pandemi biriminde \u00e7al\u0131\u015fm\u0131\u015f olanlarda \u00e7al\u0131\u015fmam\u0131\u015f olanlara g\u00f6re, influenza a\u015f\u0131s\u0131 olanlarda olmayanlara g\u00f6re, doktorlarda hem\u015fireler ve yard\u0131mc\u0131 sa\u011fl\u0131k personeline g\u00f6re istatistiksel a\u00e7\u0131dan anlaml\u0131 olarak daha fazla oldu\u011fu saptand\u0131 (s\u0131ras\u0131yla p<\/i>=0.002, p<\/i>=0.004, p<\/i><0.001) (Tablo 2).<\/p>\n

\"\"<\/a>

\u015eekil 1.<\/strong> Kat\u0131l\u0131mc\u0131lar\u0131n Meslek Gruplar\u0131 ve A\u015f\u0131 T\u00fcrleri Aras\u0131ndaki \u0130li\u015fkinin De\u011ferlendirilmesi<\/p><\/div>\n

\"\"<\/a>

Tablo 3.<\/strong> Kat\u0131l\u0131mc\u0131lar\u0131n Demografik \u00d6zellikleri ve A\u015f\u0131 Tercihleri Aras\u0131ndaki \u0130li\u015fki<\/p><\/div>\n

Kat\u0131l\u0131mc\u0131lar\u0131n demografik \u00f6zellikleri ve a\u015f\u0131lanma durumlar\u0131 aras\u0131ndaki ili\u015fkinin yan\u0131 s\u0131ra meslek gruplar\u0131 ve a\u015f\u0131 t\u00fcrleri aras\u0131ndaki ili\u015fki de\u011ferlendirildi\u011finde; Pfizer-BioNTech a\u015f\u0131 tercihi oranlar\u0131n\u0131n doktorlarda hem\u015fireler ve yard\u0131mc\u0131 sa\u011fl\u0131k personeline g\u00f6re; TURKOVAC a\u015f\u0131 tercihi oranlar\u0131n\u0131n ise yard\u0131mc\u0131 sa\u011fl\u0131k personelinde hem\u015fireler ve doktorlara g\u00f6re fazla oldu\u011fu tespit edildi (s\u0131ras\u0131yla p<\/i><0.001, p<\/i>=0.026) (\u015eekil 1) (Tablo 3).\u00a0<\/span><\/p>\n

\"\"<\/a>

Tablo 4.<\/strong> Demografik \u00d6zellikler ve A\u015f\u0131 Dozlar\u0131 ile COVID-19 Ge\u00e7irme ve Yat\u0131\u015f \u0130li\u015fkisi<\/p><\/div>\n

COVID-19 ge\u00e7iren kat\u0131l\u0131mc\u0131lar de\u011ferlendirildi\u011finde; hastal\u0131\u011f\u0131 ge\u00e7irme oran\u0131n\u0131n kad\u0131nlarda erkeklere g\u00f6re ve hastal\u0131k \u00f6ncesi a\u015f\u0131s\u0131z veya eksik doz a\u015f\u0131l\u0131 olanlarda tam doz a\u015f\u0131l\u0131 olanlara g\u00f6re fazla oldu\u011fu tespit edildi (s\u0131ras\u0131yla p<\/i><0.001, p<\/i><0.001). Ya\u015f, pandemi biriminde \u00e7al\u0131\u015fma durumu ve meslek grubu ile COVID-19 ge\u00e7irme veya COVID-19 nedeniyle hastane yat\u0131\u015f\u0131 aras\u0131nda ise istatistiksel olarak anlaml\u0131 d\u00fczeyde ili\u015fki tespit edilemedi (Tablo 4).\u00a0<\/span><\/span><\/p>\n

\u0130RDELEME<\/h2>\n

COVID-19 pandemisi hayat\u0131 olumsuz etkilerken, pandemi kontrol\u00fcn\u00fc sa\u011flamak ve normal hayata d\u00f6nebilmek i\u00e7in ki\u015fisel koruyucu ekipman kullan\u0131m\u0131, mesafe kurallar\u0131na uyum gibi fakt\u00f6rlerle birlikte a\u015f\u0131 uygulamas\u0131n\u0131n yayg\u0131nla\u015ft\u0131r\u0131lmas\u0131 da son derece \u00f6nemlidir. \u00d6zellikle yap\u0131lan tedaviler ve a\u015f\u0131lanmalar konusundaki davran\u0131\u015flar\u0131 ile topluma \u00f6rnek te\u015fkil eden sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131nda a\u015f\u0131lanma konusundaki karars\u0131zl\u0131klar\u0131n \u00f6n\u00fcne ge\u00e7ilmesi, toplum sa\u011fl\u0131\u011f\u0131 a\u00e7\u0131s\u0131ndan b\u00fcy\u00fck \u00f6nem ta\u015f\u0131maktad\u0131r (13).\u00a0<\/span><\/p>\n

Bu \u00e7al\u0131\u015fma kapsam\u0131nda, Rize il merkezinde hizmet veren \u00fc\u00e7\u00fcnc\u00fc basamak bir hastanede g\u00f6rev yapan sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n pandeminin yakla\u015f\u0131k 30. ay\u0131na denk gelen bir d\u00f6neminde COVID-19\u2019a y\u00f6nelik a\u015f\u0131 tutumlar\u0131 de\u011ferlendirildi. Kat\u0131l\u0131mc\u0131lar\u0131n %92.9\u2019sinin a\u015f\u0131land\u0131\u011f\u0131 tespit edildi. Sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131nda COVID-19 a\u015f\u0131 kabul oran\u0131; Luo ve arkada\u015flar\u0131n\u0131n (14) yapt\u0131\u011f\u0131 bir meta analizde %51, Jorgensen ve arkada\u015flar\u0131n\u0131 yapt\u0131\u011f\u0131 ba\u015fka bir \u00e7al\u0131\u015fmada ise %88.9 olarak bildirilmi\u015ftir. \u00dclkemizde yap\u0131lan baz\u0131 \u00e7al\u0131\u015fmalarda ise a\u015f\u0131lanma oranlar\u0131; birinci basamak sa\u011fl\u0131k kurulu\u015funda hizmet verenlerde %96.8, ikinci basamak sa\u011fl\u0131k kurulu\u015funda hizmet verenlerde %95.5 ve \u00fc\u00e7\u00fcnc\u00fc basamak sa\u011fl\u0131k kurulu\u015funda hizmet verenlerde ise %75.5 olarak bildirilmi\u015ftir (16-18). \u00dclkemizde bizim \u00e7al\u0131\u015fmam\u0131zla yak\u0131n bir zamanda \u00fc\u00e7\u00fcnc\u00fc basamak sa\u011fl\u0131k kurulu\u015funda yap\u0131lan bir \u00e7al\u0131\u015fmada ise a\u015f\u0131lanma oran\u0131 \u00e7al\u0131\u015fmam\u0131zla benzer \u015fekilde %97.7 olarak tespit edilmi\u015ftir (19). \u00a0<\/span><\/p>\n

\u00c7at\u0131ker ve arkada\u015flar\u0131n\u0131n (20) yapt\u0131klar\u0131 \u00e7al\u0131\u015fmada, hem\u015firelerde influenza a\u015f\u0131lanma oran\u0131 %5.7 olarak tespit edilmi\u015ftir. Kurtulu\u015f ve arkada\u015flar\u0131n\u0131n (21) \u00e7al\u0131\u015fmas\u0131nda, pandemi \u00f6ncesi d\u00f6nemde sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n %17.5\u2019inin pn\u00f6mokok ve mevsimsel influenza a\u015f\u0131lar\u0131n\u0131 yapt\u0131rd\u0131klar\u0131 bildirilmi\u015ftir (21). Bizim \u00e7al\u0131\u015fmam\u0131zda ise %22 ile literat\u00fcre g\u00f6re daha y\u00fcksek oranda influenza a\u015f\u0131lanmas\u0131n\u0131n oldu\u011fu g\u00f6r\u00fcld\u00fc<\/p>\n

Sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n COVID-19 hastal\u0131\u011f\u0131n\u0131 ge\u00e7irme oran\u0131; \u00fclkemizde yap\u0131lan \u00e7ok merkezli bir \u00e7al\u0131\u015fmada %36.4, bir di\u011fer \u00e7al\u0131\u015fmada ise %30.1 olarak bildirilmi\u015ftir (17,22). Bizim \u00e7al\u0131\u015fmam\u0131zda ise bu oran %63.6 olup bu sebeple hastaneye yat\u0131\u015f oran\u0131 %5.9\u2019dur. \u00c7al\u0131\u015fmam\u0131z\u0131n g\u00fcncel olmas\u0131 ve pandeminin son d\u00f6nemine denk gelmesi nedeniyle hastal\u0131\u011f\u0131 ge\u00e7irme oranlar\u0131n\u0131n y\u00fcksek oldu\u011fu d\u00fc\u015f\u00fcn\u00fcld\u00fc.\u00a0<\/span><\/p>\n

\u00c7al\u0131\u015fmam\u0131zda, COVID-19 ge\u00e7irmeden \u00f6nce tam doz a\u015f\u0131lanma oran\u0131 %10.1, COVID-19 ge\u00e7irdikten sonra a\u015f\u0131lanma\/a\u015f\u0131lanmaya devam etme oran\u0131 ise %56.9 (n=269) olarak saptand\u0131. Literat\u00fcrde kat\u0131l\u0131mc\u0131lar\u0131n a\u015f\u0131 olmama nedeni olarak COVID-19 hastal\u0131\u011f\u0131n\u0131 ge\u00e7irmi\u015f olmalar\u0131n\u0131 \u00f6ne s\u00fcren \u00e7al\u0131\u015fmalar mevcut olmakla birlikte (9,12) COVID-19 ge\u00e7irenlerde a\u015f\u0131 kabul oranlar\u0131n\u0131n artt\u0131\u011f\u0131n\u0131 g\u00f6steren \u00e7al\u0131\u015fmalar da vard\u0131r (20). Ayr\u0131ca \u00e7al\u0131\u015fmam\u0131zda, erkeklerin ve influenza a\u015f\u0131s\u0131 olanlar\u0131n COVID-19 ge\u00e7irdikten sonra a\u015f\u0131lanmaya daha e\u011filimli olduklar\u0131 g\u00f6sterildi.\u00a0<\/span><\/p>\n

Yap\u0131lan bir\u00e7ok \u00e7al\u0131\u015fmada kad\u0131nlar\u0131n a\u015f\u0131lanma istek oranlar\u0131n\u0131n erkeklerden daha az oldu\u011fu tespit edilmi\u015ftir (9,10,12,21,23,24). Bizim \u00e7al\u0131\u015fmam\u0131zda ise kad\u0131nlar\u0131n erkeklere g\u00f6re COVID-19 a\u015f\u0131lanma oranlar\u0131n\u0131n fazla oldu\u011fu g\u00f6r\u00fcld\u00fc. Bu durumun, yap\u0131lan \u00e7al\u0131\u015fmalar\u0131n a\u015f\u0131 temini \u00f6ncesi d\u00f6nemde yap\u0131lm\u0131\u015f olmas\u0131ndan, o d\u00f6nemde hen\u00fcz a\u015f\u0131 konusunda yeterli bilgi olmamas\u0131ndan, \u00e7e\u015fitli korku ve endi\u015felerin sebep oldu\u011fu bilgi bilgi kirlili\u011finden kaynakland\u0131\u011f\u0131 d\u00fc\u015f\u00fcn\u00fcld\u00fc. Kader ve arkada\u015flar\u0131n\u0131n (12) yapt\u0131\u011f\u0131 \u00e7al\u0131\u015fmada, a\u015f\u0131 olmak istemeyen kat\u0131l\u0131mc\u0131lardan %31\u2019inin \u00e7al\u0131\u015fma sonras\u0131nda a\u015f\u0131 olduklar\u0131n\u0131 tespit etmi\u015f olmalar\u0131 fikir de\u011fi\u015fikli\u011finin g\u00f6r\u00fclebilece\u011fini destekler niteliktedir.<\/span><\/p>\n

\u00c7al\u0131\u015fmam\u0131zda, influenza a\u015f\u0131s\u0131 olanlarda COVID-19 a\u015f\u0131lanma oranlar\u0131 a\u015f\u0131lanmayanlara g\u00f6re istatistiksel y\u00f6nden anlaml\u0131 d\u00fczeyde daha y\u00fcksek saptand\u0131. Bir\u00e7ok \u00e7al\u0131\u015fmada da benzer sonu\u00e7lar mevcuttur (13-15,17,23). Bu durum, influenza a\u015f\u0131s\u0131 olan kat\u0131l\u0131mc\u0131lar\u0131n a\u015f\u0131lar\u0131n hastal\u0131klara kar\u015f\u0131 koruyuculu\u011funa olan inan\u00e7lar\u0131n\u0131n daha kuvvetli oldu\u011fu ve bu sebeple COVID-19\u2019a kar\u015f\u0131 ba\u011f\u0131\u015f\u0131klamaya da daha e\u011filimli olduklar\u0131n\u0131 g\u00f6steriyor \u015feklinde de\u011ferlendirildi. Benzer \u015fekilde baz\u0131 \u00e7al\u0131\u015fmalarda, influenza a\u015f\u0131lanma oranlar\u0131nda pandemi sonras\u0131nda \u00f6ncesine g\u00f6re art\u0131\u015f oldu\u011fu g\u00f6sterilmi\u015ftir (20).\u00a0<\/span><\/p>\n

\u00c7al\u0131\u015fmam\u0131zda, COVID-19 a\u015f\u0131s\u0131 yapt\u0131rm\u0131\u015f kat\u0131l\u0131mc\u0131lar incelenmi\u015f olup doktorlar\u0131n hem\u015fireler ve yard\u0131mc\u0131 sa\u011fl\u0131k personeline g\u00f6re istatistiksel olarak anlaml\u0131 d\u00fczeyde daha fazla a\u015f\u0131land\u0131\u011f\u0131 tespit edildi. Literat\u00fcrdeki bir\u00e7ok \u00e7al\u0131\u015fma da bu sonucu destekler bir \u015fekilde doktorlar\u0131n hem\u015fireler ve di\u011fer sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131na g\u00f6re a\u015f\u0131lanmaya daha meyilli oldu\u011funu g\u00f6stermektedir (9,12,21,24,25).\u00a0<\/span><\/p>\n

Jorgensen ve arkada\u015flar\u0131 (15) Arnavutluk\u2019ta yapt\u0131klar\u0131 \u00e7al\u0131\u015fmada, \u00fc\u00e7 doz a\u015f\u0131 \u00f6nerisine ra\u011fmen sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n %20\u2019den az\u0131n\u0131n \u00fc\u00e7 doz a\u015f\u0131 oldu\u011funu tespit etmi\u015ftir (15). \u00c7al\u0131\u015fmam\u0131zda tam doz a\u015f\u0131nlama oran\u0131 %21 olup bu oran pandemi biriminde \u00e7al\u0131\u015fm\u0131\u015f olanlarda \u00e7al\u0131\u015fmam\u0131\u015f olanlara g\u00f6re, influenza a\u015f\u0131s\u0131 olanlarda olmayanlara g\u00f6re, doktorlarda hem\u015fireler ve yard\u0131mc\u0131 sa\u011fl\u0131k personeline g\u00f6re istatistiksel a\u00e7\u0131dan anlaml\u0131 d\u00fczeyde daha y\u00fcksek saptand\u0131.\u00a0<\/span><\/p>\n

Wang ve arkada\u015flar\u0131 (26) \u00e7al\u0131\u015fmalar\u0131nda, o d\u00f6nemde tam doz a\u015f\u0131lama olarak kabul edilen iki doz a\u015f\u0131lanmas\u0131 olan demans hastalar\u0131n\u0131n COVID-19 ge\u00e7irme oranlar\u0131n\u0131n %8.6-12.4 aras\u0131nda de\u011fi\u015fti\u011fini bildirmi\u015ftir.\u00a0 <\/span>\u00c7ebi ve arkada\u015flar\u0131n\u0131n (27) haz\u0131rlad\u0131klar\u0131 derlemede, \u00fc\u00e7 doz mRNA a\u015f\u0131s\u0131 olman\u0131n Omicron varyant\u0131na kar\u015f\u0131 koruyuculu\u011fu art\u0131rd\u0131\u011f\u0131 sonucuna var\u0131lm\u0131\u015ft\u0131r. Akaishi ve arkada\u015flar\u0131n\u0131n (28) \u00e7al\u0131\u015fmas\u0131nda ise iki doz a\u015f\u0131ya g\u00f6re \u00fc\u00e7\u00fcnc\u00fc doz a\u015f\u0131n\u0131n koruyuculu\u011funun fazla oldu\u011fu bildirilmi\u015ftir. D\u00f6rd\u00fcnc\u00fc doz mRNA a\u015f\u0131s\u0131n\u0131n etkisinin de\u011ferlendirildi\u011fi bir \u00e7al\u0131\u015fmada, d\u00f6rt doz a\u015f\u0131l\u0131 kat\u0131l\u0131mc\u0131lar\u0131n %18-20\u2019sinde hastal\u0131\u011f\u0131n yeniden ge\u00e7irildi\u011fi g\u00f6zlenmi\u015ftir (29). Chariyalertsak ve arkada\u015flar\u0131n\u0131n (30) \u00e7al\u0131\u015fmas\u0131nda, d\u00f6rt doz a\u015f\u0131n\u0131n hastal\u0131\u011f\u0131 \u00f6nleme olas\u0131l\u0131\u011f\u0131n\u0131n y\u00fcksek oldu\u011fu ve \u015fiddetli COVID-19 hastal\u0131\u011f\u0131 ve mortaliteyi \u00f6nleme olas\u0131l\u0131\u011f\u0131n\u0131n ise \u00e7ok y\u00fcksek oldu\u011fu sonucuna var\u0131lm\u0131\u015ft\u0131r. Bizim \u00e7al\u0131\u015fmam\u0131zda ise COVID-19 hastal\u0131\u011f\u0131n\u0131 ge\u00e7irme oranlar\u0131n\u0131n, hastal\u0131k \u00f6ncesi a\u015f\u0131s\u0131z veya eksik doz a\u015f\u0131l\u0131 olanlarda tam doz a\u015f\u0131l\u0131 olanlara g\u00f6re fazla oldu\u011fu tespit edildi.<\/p>\n

\u00c7al\u0131\u015fmam\u0131zdaki tam doz a\u015f\u0131lanan kat\u0131l\u0131mc\u0131lar\u0131n COVID-19 hastal\u0131\u011f\u0131n\u0131 daha az ge\u00e7irdi\u011fi sonucundan yola \u00e7\u0131k\u0131larak, tam doz a\u015f\u0131lanman\u0131n COVID-19 nedeniyle hastane yat\u0131\u015flar\u0131n\u0131 da azaltm\u0131\u015f olabilece\u011fini g\u00f6stermek amac\u0131yla istatistiksel analiz yap\u0131ld\u0131. Ancak istatistiksel analiz sonucunda, tam doz a\u015f\u0131l\u0131 olman\u0131n veya meslek grubunun COVID-19 nedeniyle hastane yat\u0131\u015flar\u0131n\u0131 etkilemedi\u011fi g\u00f6r\u00fcld\u00fc.<\/p>\n

\u00c7al\u0131\u015fmam\u0131zda hastanemizde g\u00f6rev yapan t\u00fcm sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131n\u0131n a\u015f\u0131 profilinin belirlenmesi ama\u00e7land\u0131. Bu nedenle kat\u0131l\u0131m\u0131 art\u0131rmak i\u00e7in ankette sorular k\u0131sa tutulmaya \u00e7al\u0131\u015f\u0131ld\u0131 ve b\u00fcy\u00fck harflerle tek sayfa olarak haz\u0131rland\u0131. A\u015f\u0131 reddi sebepleri belirlenmek istenmi\u015f olmakla birlikte kat\u0131l\u0131m\u0131 art\u0131rmak amac\u0131yla sorgulama yap\u0131lamad\u0131. Bu durum \u00e7al\u0131\u015fman\u0131n en \u00f6nemli k\u0131s\u0131tl\u0131l\u0131\u011f\u0131d\u0131r.<\/p>\n

\u00c7al\u0131\u015fmam\u0131z, b\u00f6lgemizde daha \u00f6nce COVID-19 a\u015f\u0131lar\u0131 ilgili yap\u0131lm\u0131\u015f bir \u00e7al\u0131\u015fma bulunmamas\u0131 ve a\u015f\u0131 reddi ile ilgili literat\u00fcrdeki \u00e7al\u0131\u015fmalar\u0131n \u00e7o\u011funlukla a\u015f\u0131lar kullan\u0131ma sunulmadan \u00f6nce yap\u0131lm\u0131\u015f olmas\u0131 nedeniyle \u00f6nemlidir.\u00a0<\/span><\/p>\n

Sonu\u00e7 olarak; tam doz a\u015f\u0131l\u0131 olma durumu COVID-19 ge\u00e7irme oranlar\u0131n\u0131 azaltmakla birlikte hastane yat\u0131\u015flar\u0131n\u0131 etkilememektedir. Doktorlar\u0131n, hem\u015fireler ve yard\u0131mc\u0131 sa\u011fl\u0131k personeline g\u00f6re tam doz a\u015f\u0131lanmaya daha e\u011filimli oldu\u011fu ancak bunun sonu\u00e7lar\u0131n\u0131n hastal\u0131\u011f\u0131 ge\u00e7irme durumu veya yat\u0131\u015f durumuna yans\u0131mad\u0131\u011f\u0131 tespit edildi. \u0130nfluenza a\u015f\u0131s\u0131 olanlarda olmayanlara g\u00f6re COVID-19 a\u015f\u0131lanma oranlar\u0131n\u0131n daha y\u00fcksek oldu\u011fu g\u00f6sterildi.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

G\u0130R\u0130\u015e Etkeni \u015fiddetli akut solunum yolu sendromu koronavirus 2 (SARS-CoV-2) olan koronavirus hastal\u0131\u011f\u0131 2019 (COVID-19), 2019 y\u0131l\u0131nda ortaya \u00e7\u0131kt\u0131ktan k\u0131sa bir s\u00fcre sonra k\u00fcresel bir pandemiye neden olmu\u015ftur. Son g\u00fcnlerde d\u00fcnya genelinde infeksiyon insidans\u0131ndaki azalma nedeniyle COVID-19\u2019a kar\u015f\u0131 k\u0131s\u0131tlamalar kald\u0131r\u0131lm\u0131\u015f olmakla birlikte hastal\u0131k t\u00fcm d\u00fcnyada g\u00f6r\u00fclmeye devam etmektedir. \u00dclkemizde, T.C. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 taraf\u0131ndan ilk olgu […]<\/p>\n","protected":false},"author":6,"featured_media":28234,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5129],"tags":[4851,5174,5828,3682],"class_list":["post-28050","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ozgun-arastirma","tag-asi","tag-covid-19","tag-influenza-2","tag-saglik-calisani"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/28050","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\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/comments?post=28050"}],"version-history":[{"count":3,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/28050\/revisions"}],"predecessor-version":[{"id":28278,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/28050\/revisions\/28278"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media\/28234"}],"wp:attachment":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media?parent=28050"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/categories?post=28050"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/tags?post=28050"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}