{"id":28630,"date":"2024-06-29T12:42:01","date_gmt":"2024-06-29T09:42:01","guid":{"rendered":"https:\/\/www.klimikdergisi.org\/?p=28630"},"modified":"2024-06-29T15:32:44","modified_gmt":"2024-06-29T12:32:44","slug":"covid-19-asisi-bir-kesikli-secim-analizi","status":"publish","type":"post","link":"https:\/\/www.klimikdergisi.org\/tr\/2024\/06\/29\/covid-19-asisi-bir-kesikli-secim-analizi\/","title":{"rendered":"\u00dcniversite \u00d6\u011frencilerinin COVID-19 A\u015f\u0131s\u0131 Tercihlerinin Kesikli Se\u00e7im Y\u00f6ntemi ile De\u011ferlendirilmesi"},"content":{"rendered":"

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

COVID-19 salg\u0131n\u0131n\u0131 kontrol alt\u0131na almak i\u00e7in pek \u00e7ok \u00fclkede farkl\u0131 y\u00f6ntemlerle a\u015f\u0131lar geli\u015ftirilmi\u015ftir (1). \u00dclkemizde COVID-19\u2019a kar\u015f\u0131 a\u015f\u0131lama 14 Ocak 2021 tarihinde CoronaVac a\u015f\u0131s\u0131 (Sinovac Life Sciences, Pekin, \u00c7in) ile ba\u015flam\u0131\u015f ve risk gruplar\u0131na g\u00f6re a\u015f\u0131 uygulama stratejisi izlenmi\u015ftir; 02 Nisan 2021 tarihinden itibaren de iste\u011fe ba\u011fl\u0131 olarak Pfizer-BioNTech\u00a0mRNA a\u015f\u0131s\u0131\u00a0(Comirnaty<\/span>\u00ae<\/span>) a\u015f\u0131s\u0131 uygulanmaya ba\u015flanm\u0131\u015ft\u0131r. T.C. Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 ve Erciyes \u00dcniversitesi taraf\u0131ndan geli\u015ftirilmi\u015f olan Turkovac (ge\u00e7ici ad\u0131 ERUCOV-VAC) a\u015f\u0131s\u0131 ise 22 Aral\u0131k 2022\u2019de acil kullan\u0131m olay\u0131 alarak 29 Aral\u0131k 2021 tarihinden itibaren kullan\u0131lmaya ba\u015flanm\u0131\u015ft\u0131r (2). G\u00fcncel verilere g\u00f6re 18 ya\u015f ve \u00fczeri n\u00fcfusun %85.7\u2019si iki doz a\u015f\u0131l\u0131d\u0131r (3).<\/span><\/p>\n

COVID-19 pandemisi s\u00fcrecinde, hastal\u0131\u011fa ve etkene ili\u015fkin bilgiler yeni olduklar\u0131 i\u00e7in s\u00fcrekli g\u00fcncellenmi\u015fler ve bu kapsamda g\u00f6r\u00fc\u015f bildiren uzmanlar zaman zaman birbirleriyle \u00e7eli\u015fen bilgiler vermi\u015flerdir. Bu durum a\u015f\u0131lar\u0131n sorugulanmas\u0131na neden olmu\u015ftur. A\u015f\u0131larla ilgili yanl\u0131\u015f bilgilerin ve komplo teorilerinin internette ve sosyal medyada yay\u0131lmas\u0131 sorunu ile COVID-19 salg\u0131n\u0131 s\u0131ras\u0131nda da kar\u015f\u0131la\u015f\u0131lm\u0131\u015ft\u0131r (4). Gen\u00e7ler, sosyal medyay\u0131 ve t\u0131bbi konularda bilgi almak i\u00e7in interneti daha s\u0131k kullanma e\u011filiminde olduklar\u0131 i\u00e7in a\u015f\u0131 tutumlar\u0131 a\u00e7\u0131s\u0131ndan sosyal etkilere daha a\u00e7\u0131k olabilirler (5).<\/span><\/p>\n

Sa\u011fl\u0131k ara\u015ft\u0131rmalar\u0131n\u0131n, tedavi se\u00e7eneklerinin, sa\u011fl\u0131k teknolojilerinin de\u011ferlendirilmesinin ve mevzuatta yap\u0131lan d\u00fczenlemelerin hasta merkezli hale gelmesiyle, sa\u011fl\u0131k hizmeti payda\u015flar\u0131n\u0131n tercihlerini \u00f6l\u00e7mek daha \u00f6nemli hale gelmi\u015ftir (6). Kesikli se\u00e7im y\u00f6ntemi, bireylerin tercihlerini belirlemek i\u00e7in kullan\u0131l\u0131r; herhangi bir \u00fcr\u00fcn veya hizmetin \u00f6zellikleri (veya nitelikleri) ile tan\u0131mlanabilece\u011fini ve bireylerin bu \u00f6zelliklere g\u00f6re se\u00e7im yapt\u0131\u011f\u0131 varsay\u0131m\u0131na dayan\u0131r (7). Veri toplama arac\u0131 olarak anket formlar\u0131 kullan\u0131l\u0131r. Anket sorular\u0131 hipotetik olarak olu\u015fturulmu\u015f niteliklerle tan\u0131mlanan \u00fcr\u00fcn veya hizmetlerden olu\u015fan se\u00e7im setleridir. Kat\u0131l\u0131mc\u0131lar\u0131n yapt\u0131klar\u0131 se\u00e7imlerin analiz edilmesiyle niteliklerdeki de\u011fi\u015fikliklerin tercih \u00fczerindeki etkisi dekompozisyon y\u00f6ntemiyle hesaplan\u0131r (8,9). \u00dcr\u00fcn veya hizmete ait \u00f6zellikler aras\u0131ndaki marjinal ikame oran\u0131 tahmin edilebilir; b\u00f6ylece mali olan ve olmayan nitelikler birbirleriyle kar\u015f\u0131la\u015ft\u0131r\u0131labilir. Mali olmayan niteliklerin birbirleriyle ne \u00f6l\u00e7\u00fcde takas edilebilece\u011fi hesaplanabilir; \u00fcr\u00fcn veya hizmetin \u00fccreti gibi mali bir \u00f6zelli\u011fin olmas\u0131 durumunda ise di\u011fer \u00f6zelliklerdeki iyile\u015ftirmeler i\u00e7in kat\u0131l\u0131mc\u0131lar\u0131n yapabilece\u011fi \u00f6deme miktar\u0131\/\u00f6deme isteklili\u011fi (\u201cwillingness to pay\u201d) belirlenebilir. Ayr\u0131ca \u00f6zellikleri verilen bir \u00fcr\u00fcn ya da hizmetin tercih edilme olas\u0131l\u0131\u011f\u0131 hesaplanabilir (10). Sa\u011fl\u0131k hizmetleriyle ilgili tercihlerin belirlenmesinde kullan\u0131lan farkl\u0131 y\u00f6ntemler vard\u0131r. Kesikli se\u00e7im y\u00f6ntemi, tesad\u00fcfi fayda teorisi, t\u00fcketici teorisi ve se\u00e7im psikolojisi gibi teorik dayanaklar\u0131 nedeniyle sa\u011fl\u0131k hizmetleriyle ilgili tercihleri belirlemede kullan\u0131lan tutum temelli de\u011ferleme y\u00f6ntemlerine tercih edilir (8,11).<\/p>\n

Bu \u00e7al\u0131\u015fmada, bir \u00fcniversitede \u00f6\u011frenim g\u00f6rmekte olan gen\u00e7lerin COVID-19 a\u015f\u0131s\u0131na ili\u015fkin tercihlerinin kesikli se\u00e7im y\u00f6ntemi ile incelenmesi ama\u00e7land\u0131.<\/p>\n

Y\u00d6NTEMLER<\/h2>\n

Kesitsel olarak ger\u00e7ekle\u015ftirilen bu \u00e7al\u0131\u015fma, \u00fcniversitede \u00f6\u011frenim g\u00f6rmekte olan \u00f6\u011frencilerle 2022 y\u0131l\u0131n\u0131n Ocak ve \u015eubat aylar\u0131nda ger\u00e7ekle\u015ftirildi. \u00d6\u011frenciler \u00e7al\u0131\u015fmaya g\u00f6n\u00fcll\u00fc olarak kat\u0131ld\u0131. Ula\u015f\u0131lmas\u0131 hedeflenen \u00f6rneklem b\u00fcy\u00fckl\u00fc\u011f\u00fc; Johnson ve Orme (12,13) taraf\u0131ndan geli\u015ftirilen ve planlanan se\u00e7im seti say\u0131s\u0131 ve boyutlara ait alt maddelerin birlikte de\u011ferlendirildi\u011fi form\u00fcl kullan\u0131larak 56 olarak hesapland\u0131. \u00c7al\u0131\u015fmaya alt grup analizleri de dahil edildi\u011fi i\u00e7in istatiksel g\u00fcc\u00fc art\u0131rmak amac\u0131yla \u00f6rneklem b\u00fcy\u00fckl\u00fc\u011f\u00fc \u00fc\u00e7 kat art\u0131r\u0131larak 160 \u00f6\u011frenciye ula\u015f\u0131lmas\u0131 hedeflendi ve tabakal\u0131 k\u00fcme \u00f6rnekleme metoduyla s\u0131n\u0131flar ve b\u00f6l\u00fcmler belirlendi.<\/p>\n

\"\"<\/a>

Tablo 1.<\/strong> Se\u00e7im Setlerinde Verilen A\u015f\u0131lar\u0131n \u00d6zellikleri ve Alt Maddeler<\/p><\/div>\n

\"\"<\/a>

Tablo 2.<\/strong> \u00d6rnek Bir Se\u00e7im Seti<\/p><\/div>\n

Se\u00e7eneklerde verilen a\u015f\u0131lar\u0131n \u00f6zellikleri, literat\u00fcr ara\u015ft\u0131rmas\u0131n\u0131n ard\u0131ndan 10 \u00f6\u011frenciyle yap\u0131lan yar\u0131 yap\u0131land\u0131r\u0131lm\u0131\u015f g\u00f6r\u00fc\u015fme ile belirlendi. Son olarak iki ile \u00fc\u00e7 aras\u0131 alt boyuttan olu\u015fan alt\u0131 \u00f6zellik belirlendi (Tablo 1) ve JMP Pro version 14.0 (SAS Institute, Cary, ABD) program\u0131yla 60 se\u00e7im seti olu\u015fturuldu. Her bir se\u00e7im setinde birisi \u201chi\u00e7biri\u201d olmak \u00fczere \u00fc\u00e7 se\u00e7enek yer ald\u0131 (Tablo 2). Her kat\u0131l\u0131mc\u0131ya 10 se\u00e7im seti sunulacak \u015fekilde alt\u0131 grup olarak anket haz\u0131rland\u0131. Bir se\u00e7im seti de rasyonalite kontrol\u00fc amac\u0131yla eklendi; burada verilen se\u00e7eneklerdeki a\u015f\u0131lar\u0131n biri daha etkin, daha uzun s\u00fcre koruyucu ve yan etki s\u0131kl\u0131\u011f\u0131 daha d\u00fc\u015f\u00fck olacak \u015fekilde d\u00fczenlenmi\u015f olup kat\u0131l\u0131mc\u0131lar\u0131n bu se\u00e7enekteki a\u015f\u0131y\u0131 se\u00e7ip se\u00e7medi\u011fi kontrol edildi. Ankete, kat\u0131l\u0131mc\u0131lar\u0131n sosyodemografik \u00f6zellikleriyle birlikte COVID-19 infeksiyonu hakk\u0131ndaki g\u00f6r\u00fc\u015flerine ili\u015fkin sorular da eklendi.\u00a0 \u00a0<\/span><\/p>\n

\u00c7al\u0131\u015fma i\u00e7in Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131 Bilimsel Ara\u015ft\u0131rma Platformu\u2019nda 25 Ekim 2021 tarihinde izin al\u0131nd\u0131. K\u00e2tip \u00c7elebi \u00dcniversitesi Sosyal Ara\u015ft\u0131rmalar Etik Kurulu 18 Kas\u0131m 2021 tarih ve 0498 karar numaras\u0131yla \u00e7al\u0131\u015fmay\u0131 onaylad\u0131.<\/p>\n

\u0130statistiksel Analiz<\/h3>\n

Veriler Microsoft Excel program\u0131nda (Microsoft Corp. Washington, ABD)\u00a0program\u0131nda d\u00fczenlendi; tan\u0131mlay\u0131c\u0131 analizlerde frekans, y\u00fczde, ortalama ve standart sapma de\u011ferleri kullan\u0131ld\u0131. A\u015f\u0131n\u0131n \u00f6zelliklerinin tercih a\u011f\u0131rl\u0131klar\u0131 Stata\u00ae<\/span> 15.0 (Stata Corporation, ABD) program\u0131nda karma lojit (\u201cmixed logit\u201d) model kullan\u0131larak hesapland\u0131. A\u015f\u0131n\u0131n niteliklerinin takas edilebilirlik olas\u0131l\u0131klar\u0131 Hole (14) taraf\u0131ndan geli\u015ftirilen \u201cmixlpred\u201d komutu kullan\u0131larak hesapland\u0131.<\/p>\n

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

Tablo 3.<\/strong> Kat\u0131l\u0131mc\u0131lar\u0131n Sosyodemografik \u00d6zellikleri<\/p><\/div>\n

\u00c7al\u0131\u015fmaya 242 \u00f6\u011frenci kat\u0131lm\u0131\u015f olup 10 \u00f6\u011frenci se\u00e7im sorular\u0131n\u0131 cevaplamad\u0131\u011f\u0131 i\u00e7in, 5 \u00f6\u011frenci ayn\u0131 se\u00e7ene\u011fi i\u015faretledi\u011fi i\u00e7in, 32 \u00f6\u011frenci ise rasyonalite kontrol sorusunda beklenen se\u00e7ene\u011fi i\u015faretlemedi\u011fi i\u00e7in analize dahil edilmedi. Analize dahil edilmeyen grup ile dahil edilen grup aras\u0131nda sosyodemografik \u00f6zellikler ve COVID-19 infeksiyonuna ve a\u015f\u0131lanmaya ili\u015fkin \u00f6zellikler bak\u0131m\u0131ndan anlaml\u0131 d\u00fczeyde bir fark bulunmad\u0131. Analize dahil edilen 195 \u00f6\u011frenciye ait sosyodemografik \u00f6zellikler Tablo 3\u2019te sunuldu.<\/p>\n

\"\"<\/a>

Tablo 4.<\/strong> COVID-19 \u0130nfeksiyonu ile \u0130li\u015fkili Baz\u0131 \u00d6zellikler<\/p><\/div>\n

\"\"<\/a>

Tablo 5.<\/strong> COVID-19 A\u015f\u0131s\u0131na \u0130li\u015fkin G\u00f6r\u00fc\u015fler<\/p><\/div>\n

Kat\u0131l\u0131mc\u0131lar\u0131n %24.1\u2019i COVID-19 infeksiyonu ge\u00e7irdi\u011fini ve %28.7\u2019si temasl\u0131 oldu\u011funu belirtti. Kat\u0131l\u0131mc\u0131lar aras\u0131nda a\u015f\u0131 olma oran\u0131 %97.4 idi. A\u015f\u0131 olanlar\u0131n neredeyse tamam\u0131n\u0131n iki doz ve \u00fczeri a\u015f\u0131 oldu\u011fu tespit edildi; %81.8\u2019i mRNA a\u015f\u0131s\u0131 oldu\u011funu bildirdi. A\u015f\u0131 olma kararlar\u0131n\u0131 etkileyen fakt\u00f6rlere bak\u0131ld\u0131\u011f\u0131nda; en s\u0131k olarak \u201chastal\u0131ktan korunma iste\u011fi\u201d ve \u201ca\u015f\u0131 olman\u0131n salg\u0131n\u0131n bitmesi i\u00e7in toplumsal bir sorumluluk oldu\u011fu d\u00fc\u015f\u00fcncesi\u201d \u00f6ne \u00e7\u0131kmaktayd\u0131 (Tablo 4). Kat\u0131l\u0131mc\u0131lar\u0131n COVID-19 a\u015f\u0131lar\u0131na ili\u015fkin g\u00f6r\u00fc\u015fleri Tablo 5\u2019te verildi. A\u015f\u0131lar\u0131n g\u00fcvenli oldu\u011funa kat\u0131lma oran\u0131 %70.3, a\u015f\u0131 olman\u0131n toplumsal ba\u011f\u0131\u015f\u0131kl\u0131\u011fa katk\u0131 sa\u011flayaca\u011f\u0131na kat\u0131lma oran\u0131 ise %89.2 idi.<\/span><\/p>\n

\"\"<\/a>

Tablo 6.<\/strong> A\u015f\u0131 \u00d6zelliklerinin Tercihlere Etkisi<\/p><\/div>\n

A\u015f\u0131 tercihlerinin soruldu\u011fu se\u00e7im setlerinde kat\u0131l\u0131mc\u0131lardan 12\u2019si sorular\u0131n yar\u0131dan fazlas\u0131nda \u201chi\u00e7biri\u201d se\u00e7ene\u011fini; 31 kat\u0131l\u0131mc\u0131 da 1-5 aras\u0131 se\u00e7im setinde \u201chi\u00e7biri\u201d se\u00e7ene\u011fini i\u015faretlemi\u015fti. Karma lojit model sonu\u00e7lar\u0131na g\u00f6re a\u015f\u0131y\u0131 tan\u0131mlamak \u00fczere se\u00e7ilen t\u00fcm \u00f6zellikler a\u015f\u0131n\u0131n tercih edilmesi \u00fczerinde anlaml\u0131 \u015fekilde etkiliydi. A\u015f\u0131n\u0131n \u00f6zellikleri i\u00e7inde tercih a\u011f\u0131rl\u0131\u011f\u0131 en y\u00fcksek olan etkinlikti. Di\u011fer \u00f6zellikler tercih a\u011f\u0131rl\u0131klar\u0131na g\u00f6re ciddi yan etki s\u0131kl\u0131\u011f\u0131, bula\u015ft\u0131r\u0131c\u0131l\u0131\u011f\u0131 azaltma, koruyuculuk s\u00fcresi, \u00fcretim yeri ve \u00fcretim teknolojisi \u015feklinde s\u0131ralanmaktayd\u0131 (Tablo 6).<\/p>\n

\"\"<\/a>

\u015eekil 1.<\/strong> Tercih Sim\u00fclasyonu<\/p><\/div>\n

Di\u011fer t\u00fcm nitelikler sabit tutuldu\u011funda (ceteris paribus) COVID-19 a\u015f\u0131 \u00f6zelliklerindeki iyile\u015ftirmelerin, o a\u015f\u0131n\u0131n se\u00e7ilmesi olas\u0131l\u0131\u011f\u0131nda yapaca\u011f\u0131 de\u011fi\u015fim \u015eekil 1\u2019de verildi. Bir a\u015f\u0131n\u0131n etkinli\u011finin %50\u2019den %90\u2019a \u00e7\u0131kar\u0131lmas\u0131 o a\u015f\u0131n\u0131n tercih edilme olas\u0131l\u0131\u011f\u0131n\u0131 %34; bula\u015ft\u0131r\u0131c\u0131l\u0131\u011f\u0131 azaltma d\u00fczeyinin %50\u2019den %90\u2019a \u00e7\u0131kar\u0131lmas\u0131 %23; yan etki s\u0131kl\u0131\u011f\u0131n\u0131n on binde 1 yerine milyonda 1 olmas\u0131 %24 ve \u00fc\u00e7 nitelik birlikte %77 art\u0131rmaktad\u0131r.<\/p>\n

\u0130RDELEME<\/h2>\n

Bu \u00e7al\u0131\u015fmada \u00fcniversite \u00f6\u011frencilerinin COVID-19 a\u015f\u0131 tercihleri kesikli se\u00e7im metoduyla ara\u015ft\u0131r\u0131ld\u0131. Kat\u0131l\u0131mc\u0131lar\u0131n %24.1\u2019i COVID-19 infeksiyonu ge\u00e7irmi\u015f, %97.4\u2019\u00fc a\u015f\u0131 olmu\u015f ve %81.8\u2019i mRNA a\u015f\u0131s\u0131 olmu\u015ftu; %70\u2019inden fazlas\u0131n\u0131n COVID-19 a\u015f\u0131lar\u0131na ili\u015fkin g\u00f6r\u00fc\u015fleri olumlu idi. A\u015f\u0131y\u0131 tan\u0131mlay\u0131c\u0131 olarak se\u00e7ilen alt\u0131 \u00f6zelli\u011fin tamam\u0131 tercihler \u00fczerinde etkili bulundu. Kat\u0131l\u0131mc\u0131lar; etkinli\u011fi, bula\u015ft\u0131r\u0131c\u0131l\u0131\u011f\u0131 azaltma d\u00fczeyi ve koruyuculuk s\u00fcresi y\u00fcksek, yan etki s\u0131kl\u0131\u011f\u0131 d\u00fc\u015f\u00fck olan, ithal ve yeni y\u00f6ntemlerle geli\u015ftirilmi\u015f a\u015f\u0131lar\u0131 tercih ettiler. T\u00fcrkiye\u2019de \u00fcniversite \u00f6\u011frencileriyle yap\u0131lan ba\u015fka bir \u00e7al\u0131\u015fmada, \u00f6\u011frencilerin %89.2\u2019si a\u015f\u0131 olmu\u015f ve %86.7\u2019s\u0131na Comirnaty\u00ae a\u015f\u0131s\u0131 yap\u0131lm\u0131\u015ft\u0131r. S\u00f6z konusu \u00e7al\u0131\u015fmada, kat\u0131l\u0131mc\u0131lar\u0131n COVID-19 infeksiyonu ge\u00e7irme s\u0131kl\u0131\u011f\u0131 %30.7 olarak bildirilmi\u015ftir (15). Benzer bir \u00e7al\u0131\u015fmada a\u015f\u0131 olanlar\u0131n oran\u0131 %86 olup COVID-19 ge\u00e7irme s\u0131kl\u0131\u011f\u0131 %24.9 bulunmu\u015ftur (16). Bir di\u011fer \u00e7al\u0131\u015fmada, \u00f6\u011frencilerin %98.1\u2019i a\u015f\u0131 yapt\u0131rm\u0131\u015f ve %22.4\u2019\u00fc COVID-19 infeksiyonu ge\u00e7irmi\u015ftir (17). Bu sonu\u00e7lar \u00e7al\u0131\u015fmam\u0131z\u0131n sonu\u00e7lar\u0131yla benzerdir. <\/span><\/p>\n

\u00d6\u011frencilerin COVID-19 a\u015f\u0131lar\u0131yla ilgili d\u00fc\u015f\u00fcncelerine ili\u015fkin Yalman ve arkada\u015flar\u0131 (15) taraf\u0131ndan yap\u0131lan \u00e7al\u0131\u015fmada, kat\u0131l\u0131mc\u0131lar\u0131n %35.9\u2019unun a\u015f\u0131 ile ilgili d\u00fc\u015f\u00fcncesi olumsuzken ba\u015fka bir \u00e7al\u0131\u015fmada COVID-19 a\u015f\u0131lar\u0131n\u0131 g\u00fcvenli bulmayanlar\u0131n oran\u0131 %5.9 olarak bildirilmi\u015ftir (18). S\u00fctl\u00fc ve arkada\u015flar\u0131n\u0131n (17) \u00e7al\u0131\u015fmas\u0131nda ise \u00f6\u011frencilerin yar\u0131s\u0131 a\u015f\u0131 teredd\u00fct\u00fc ya\u015fam\u0131\u015ft\u0131r. Eren (16)\u2019in \u00e7al\u0131\u015fmas\u0131nda, \u00f6\u011frencilerin COVID-19 fark\u0131ndal\u0131\u011f\u0131 y\u00fcksek ve a\u015f\u0131 teredd\u00fct\u00fc ortalaman\u0131n alt\u0131nda olarak raporlanm\u0131\u015ft\u0131r. \u00c7al\u0131\u015fmalar\u0131n salg\u0131n\u0131n farkl\u0131 d\u00f6nemlerinde yap\u0131lmas\u0131 a\u015f\u0131 ile ilgili fikirler hakk\u0131nda farkl\u0131 sonu\u00e7lar \u00e7\u0131kmas\u0131na neden olmu\u015f olabilir. \u00d6\u011frencilerin sosyoekonomik ve COVID-19 infeksiyonundan etkilenme durumlar\u0131n\u0131n farkl\u0131 olmas\u0131n\u0131n yan\u0131 s\u0131ra ve sa\u011fl\u0131k bilimleri b\u00f6l\u00fcmlerinde \u00f6\u011frenim g\u00f6ren \u00f6\u011frenci y\u00fczdesinin de\u011fi\u015fken olmas\u0131 da sonu\u00e7lardaki fark\u0131 a\u00e7\u0131klayabilir. A\u015f\u0131 ile ilgili g\u00f6r\u00fc\u015fler de\u011fi\u015fken olmakla birlikte a\u015f\u0131lanma y\u00fczdesi olduk\u00e7a y\u00fcksektir. Bu durum pandemi durumunda kontrol\u00fcn sa\u011flanmas\u0131 i\u00e7in bireylerin toplumsal fayday\u0131 g\u00f6zetti\u011fine i\u015faret etmektedir.<\/span><\/p>\n

COVID-19 a\u015f\u0131 tercihlerine ili\u015fkin farkl\u0131 \u00fclkelerden kesikli se\u00e7im analizi \u00e7al\u0131\u015fmalar\u0131 yay\u0131mlanm\u0131\u015ft\u0131r. Kanada\u2019da yap\u0131lan ara\u015ft\u0131rmada a\u015f\u0131 tercihlerinde \u00f6nemlilik s\u0131ras\u0131na g\u00f6re; etkililik, yan etki, koruyuculuk s\u00fcresi, a\u015f\u0131n\u0131n \u00fcreticisi, kimin taraf\u0131ndan \u00f6nerildi\u011fi, a\u015f\u0131 olmak i\u00e7in gereken bekleme s\u00fcresi ve \u00f6ncelikli n\u00fcfus etkili bulunmu\u015ftur (19). Hong Kong\u2019da \u00fcniversite \u00f6\u011frencileriyle yap\u0131lan bir \u00e7al\u0131\u015fmada s\u0131ras\u0131yla; yan etki ciddiyeti, etkililik, \u00fcretim yeri, doz say\u0131s\u0131 ve \u00fccreti etkili fakt\u00f6rler olarak belirlenmi\u015f; influenza a\u015f\u0131s\u0131 olmu\u015f olman\u0131n veya sa\u011fl\u0131k bilimleri alanlar\u0131nda e\u011fitim g\u00f6rmenin tercihler \u00fczerine anlaml\u0131 etkisi bulunmam\u0131\u015ft\u0131r (20). Yine Hong Kong\u2019da \u00fcniversite \u00f6\u011frencileriyle yap\u0131lan ba\u015fka bir \u00e7al\u0131\u015fmada s\u0131ras\u0131yla; karantina uygulanmamas\u0131 ve a\u015f\u0131 etkilili\u011fi en \u00f6nemli fakt\u00f6rlerken koruyuculuk s\u00fcresi ve ciddi yan etki s\u0131kl\u0131\u011f\u0131 daha az olmakla birlikte tercihler \u00fczerinde anlaml\u0131 d\u00fczeyde etkili bulunmu\u015ftur (21). Birle\u015fik Krall\u0131k\u2019ta gen\u00e7 eri\u015fkinlerle yap\u0131lan \u00e7al\u0131\u015fmada s\u0131ras\u0131yla; a\u015f\u0131 etkinli\u011fi, yan etki riski, koruyuculuk s\u00fcresi tercih a\u011f\u0131rl\u0131\u011f\u0131 en y\u00fcksek nitelikler olarak tespit edilmi\u015ftir (22). \u00c7al\u0131\u015fmam\u0131zda da a\u015f\u0131 etkilili\u011fi ve yan etki s\u0131kl\u0131\u011f\u0131 literat\u00fcrle uyumlu \u015fekilde en \u00f6nemli fakt\u00f6rlerdi; bula\u015ft\u0131r\u0131c\u0131l\u0131\u011f\u0131 azaltma \u00f6zelli\u011fine literat\u00fcrde rastlanmamakla birlikte tercihleri etkileyen \u00f6zellikler aras\u0131nda \u00fc\u00e7\u00fcnc\u00fc \u00f6nem s\u0131ras\u0131ndayd\u0131. Gen\u00e7 ya\u015f grubu i\u00e7in hastal\u0131\u011f\u0131n daha hafif seyirli ilerlemesine kar\u015f\u0131n \u00fclkemizde aile bireyleriyle birlikte ya\u015fama veya ziyaret k\u00fclt\u00fcr\u00fc bula\u015ft\u0131r\u0131c\u0131l\u0131\u011f\u0131 azaltman\u0131n neredeyse yan etki kadar etkili bir \u00f6zellik olmas\u0131n\u0131 a\u00e7\u0131klayabilir. Bununla birlikte \u00e7al\u0131\u015fmaya kat\u0131lan \u00f6\u011frencilerden a\u015f\u0131 olanlar\u0131n %66\u2019s\u0131n\u0131n motivasyonunun toplumsal ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131n geli\u015fmesi olmas\u0131 da bunu desteklemektedir. Bu \u00e7al\u0131\u015fmada a\u015f\u0131 uygulama zorunlulu\u011fu ile ilgili d\u00fczenlemeler (g\u00f6n\u00fcll\u00fcl\u00fck esas\u0131na dayal\u0131 veya okul, seyahat ya da baz\u0131 sosyal etkinlikler i\u00e7in zorunlu olmas\u0131) niteli\u011fi yar\u0131 yap\u0131land\u0131r\u0131lm\u0131\u015f g\u00f6r\u00fc\u015fmelerde kat\u0131l\u0131mc\u0131lara sunuldu ancak en fazla \u00f6nem verdikleri nitelikler aras\u0131na girmedi\u011finden \u00e7al\u0131\u015fmaya al\u0131nmad\u0131.<\/span><\/p>\n

\u00c7al\u0131\u015fmam\u0131zda koruyuculuk s\u00fcresi a\u015f\u0131 tercihinde daha az etkili olmakla birlikte \u00f6nemli bir fakt\u00f6rd\u00fc. Bu sonu\u00e7ta salg\u0131n\u0131n devam edip etmeyece\u011fine dair bilinmezlik etkili olmu\u015f olabilir. A\u015f\u0131n\u0131n \u00fcretim yeri ve \u00fcretim teknolojisinin tercih a\u011f\u0131rl\u0131\u011f\u0131 da benzer \u015fekilde daha d\u00fc\u015f\u00fckt\u00fc. \u00dclkemizde hem inaktif a\u015f\u0131lar olan CoronaVac ve Turkovac hem de mRNA a\u015f\u0131s\u0131 Comirnaty\u00ae iste\u011fe ba\u011fl\u0131 olarak uygulanmaktayd\u0131 ve bu \u00e7al\u0131\u015fman\u0131n verilerinin topland\u0131\u011f\u0131 d\u00f6nemde Turkovac a\u015f\u0131s\u0131 yeni kullan\u0131ma ge\u00e7mi\u015fti. S\u00f6z konusu d\u00f6nemde inaktif ve aktif a\u015f\u0131lar\u0131n etkinli\u011fine ve varyantlara y\u00f6nelik yeni ara\u015ft\u0131rmalar yay\u0131mlanm\u0131\u015f, medyada da konu g\u00fcndeme getirilmi\u015ftir (23-26). Bu durum CoronaVac ve Comirnaty\u00ae a\u015f\u0131lar\u0131n\u0131n tercih a\u011f\u0131rl\u0131\u011f\u0131n\u0131n daha y\u00fcksek olmas\u0131n\u0131 a\u00e7\u0131klayabilir.<\/span><\/p>\n

Analize dahil edilen \u00f6\u011frencilerin neredeyse tamam\u0131n\u0131n a\u015f\u0131 olmu\u015f olmas\u0131 \u00e7al\u0131\u015fmam\u0131z\u0131n k\u0131s\u0131tl\u0131l\u0131klar\u0131ndand\u0131r. A\u015f\u0131 ile ilgili teredd\u00fctleri olan \u00f6\u011frenci say\u0131s\u0131 azd\u0131r. Bu nedenle \u00e7al\u0131\u015fma sonu\u00e7lar\u0131 a\u015f\u0131 g\u00fcvensizli\u011fi olan \u00f6\u011frencilerin tercihlerini yans\u0131tmayabilir. Benzer \u015fekilde \u00e7al\u0131\u015fman\u0131n tek merkezli yap\u0131lmas\u0131 bulgular\u0131n t\u00fcm pop\u00fclasyon i\u00e7in genellenmesini de m\u00fcmk\u00fcn k\u0131lmamaktad\u0131r. Di\u011fer yanda, \u00fclkemizdeki gen\u00e7 bireylerin COVID-19 a\u015f\u0131 tercihlerine y\u00f6nelik yap\u0131lan ilk \u00e7al\u0131\u015fma niteli\u011finde olmas\u0131 ve rasyonalite sorular\u0131yla cevaplar\u0131n kontrol edilmesi \u00e7al\u0131\u015fmam\u0131z\u0131 g\u00fc\u00e7l\u00fc y\u00f6nleridir.<\/p>\n

\u00c7al\u0131\u015fmam\u0131za kat\u0131lan \u00fcniversite \u00f6\u011frencilerinin neredeyse tamam\u0131 COVID-19 a\u015f\u0131s\u0131 olmu\u015fken %70\u2019inden fazlas\u0131n\u0131n a\u015f\u0131ya ili\u015fkin g\u00f6r\u00fc\u015flerinin olumlu oldu\u011fu g\u00f6r\u00fcld\u00fc. A\u015f\u0131 tercihlerini etkileyen fakt\u00f6rler \u00f6nem s\u0131ras\u0131na g\u00f6re; a\u015f\u0131n\u0131n etkililik d\u00fczeyi, ciddi yan etki s\u0131kl\u0131\u011f\u0131, bula\u015ft\u0131r\u0131c\u0131l\u0131\u011f\u0131 azaltma d\u00fczeyi, koruyuculuk s\u00fcresi, \u00fcretim yeri ve \u00fcretim teknolojisi idi. Etkilili\u011fi ve bula\u015ft\u0131r\u0131c\u0131l\u0131\u011f\u0131 azaltma d\u00fczeyi iyile\u015ftirilip yan etki s\u0131kl\u0131\u011f\u0131 azalt\u0131ld\u0131\u011f\u0131 takdirde a\u015f\u0131lar\u0131n tercih edilme oran\u0131 %77\u2019ye kadar artmaktayd\u0131. Literat\u00fcrden farkl\u0131 olarak a\u015f\u0131 etkinli\u011fi yan\u0131nda bula\u015ft\u0131r\u0131c\u0131l\u0131\u011f\u0131 azaltma d\u00fczeyinin tercihlere etkisinin y\u00fcksek olmas\u0131 da \u00e7al\u0131\u015fmam\u0131z\u0131n \u00f6nemli bulgular\u0131ndan biridir.<\/p>\n

Sonu\u00e7 olarak; bu \u00e7al\u0131\u015fman\u0131n sonu\u00e7lar\u0131 benzer bir salg\u0131n durumunda toplumsal ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131 sa\u011flamak i\u00e7in gen\u00e7lerin veya hastal\u0131k riski d\u00fc\u015f\u00fck gruplar\u0131n a\u015f\u0131lanmaya ikna olmalar\u0131 i\u00e7in yol g\u00f6sterici olabilir. Salg\u0131n kontrol\u00fcnde; toplum kat\u0131l\u0131m\u0131n\u0131n \u00f6nemini vurgulamak ve a\u015f\u0131 gibi salg\u0131nla m\u00fccadele mekanizmalar\u0131yla ilgili g\u00fcncel bilgi \u00fcretmek ve payla\u015fmak \u00f6ncelikli olmal\u0131d\u0131r.<\/p>\n

Ek Dok\u00fcmanlar\u0131 g\u00f6r\u00fcnt\u00fclemek i\u00e7in t\u0131klay\u0131n\u0131z.<\/strong><\/em><\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

G\u0130R\u0130\u015e COVID-19 salg\u0131n\u0131n\u0131 kontrol alt\u0131na almak i\u00e7in pek \u00e7ok \u00fclkede farkl\u0131 y\u00f6ntemlerle a\u015f\u0131lar geli\u015ftirilmi\u015ftir (1). \u00dclkemizde COVID-19\u2019a kar\u015f\u0131 a\u015f\u0131lama 14 Ocak 2021 tarihinde CoronaVac a\u015f\u0131s\u0131 (Sinovac Life Sciences, Pekin, \u00c7in) ile ba\u015flam\u0131\u015f ve risk gruplar\u0131na g\u00f6re a\u015f\u0131 uygulama stratejisi izlenmi\u015ftir; 02 Nisan 2021 tarihinden itibaren de iste\u011fe ba\u011fl\u0131 olarak Pfizer-BioNTech\u00a0mRNA a\u015f\u0131s\u0131\u00a0(Comirnaty\u00ae) a\u015f\u0131s\u0131 uygulanmaya ba\u015flanm\u0131\u015ft\u0131r. T.C. […]<\/p>\n","protected":false},"author":6,"featured_media":28814,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5129],"tags":[4851,5174,5897],"class_list":["post-28630","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ozgun-arastirma","tag-asi","tag-covid-19","tag-kesikli-secim-yontemi"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/28630","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=28630"}],"version-history":[{"count":4,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/28630\/revisions"}],"predecessor-version":[{"id":28987,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/28630\/revisions\/28987"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media\/28814"}],"wp:attachment":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media?parent=28630"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/categories?post=28630"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/tags?post=28630"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}