Melahat Akdeniz | Akdeniz University (original) (raw)
Papers by Melahat Akdeniz
DergiPark (Istanbul University), Mar 30, 2016
Aşılama çocuklar için oldıuğu kadar erişkinler için de önemlidir. Ancak çoğu erişkin yetersiz aşı... more Aşılama çocuklar için oldıuğu kadar erişkinler için de önemlidir. Ancak çoğu erişkin yetersiz aşılanmaktadır. Yeni çalışmalar ortalama yılda 30 bin erişkinin aşı ile önlenebilir hastalıklardan öldüğünü göstermektedir. Erişkin aşılama oranları artmakla birlikte hala Dünya Sağlık Örgütü (DSO) "Sağlıklı Kişiler 2020" hedeflerinden uzaktır. Erişkin aşılaması morbidite ve mortaliteyi önemli oranda azaltmasına rağmen, pek çok erişkin kendileri için gerekli olan aşıların farkında değildir. Özellikle infeksiyon hastalıkları için risk grubunda olan kronik hastalıkları olan bireyler, yaşlılar, sağlık çalışanlarının aşılanmaları pek çok yaşamı koruma potansiyeline sahiptir. ACİP erişkinler için 12 aşı önermektedir. Erişkin aşılaması birinci basamakta rutin hasta bakımının temel elementi olmalıdır.
Turkiye Klinikleri Family Medicine - Special Topics, 2019
The number and proportion of elderly people are increasing due to increased life expectancy and d... more The number and proportion of elderly people are increasing due to increased life expectancy and decreasing fertility rates in the last century. Primary health care will be significantly affected by this increase as the first point of contact in providing health care services to elderly people. Aging is the structural and functional change that occurs in all levels of organism over time, and a non-reversible physiological process that causes gradual decrease in all sorts of physical, mental and social functions. While some changes do not cause much trouble, some changes may prevent the person from doing daily life activities; may increase the susceptibility to some chronic diseases. In order to prevent misdiagnosis, unnecessary tests and treatments, it is important to understand whether the changes occurring in elderly individuals are pathological, and to differentiate between age-related changes and changes due to chronic diseases. Knowledge of aging processes can help family physicians to reduce the burden of disease, improve quality of life, and maintain well-being.
Turkish Journal of Family Practice, Nov 10, 2011
Sistemik aile hekimli¤i Avrupa'da oldukça yeni gündeme gelen bir klinik uygulamad›r. Aile hekimli... more Sistemik aile hekimli¤i Avrupa'da oldukça yeni gündeme gelen bir klinik uygulamad›r. Aile hekimli¤i, aile terapisi ve sistem kuram›n›n birlefltirilmesinden do¤mufltur. Gündelik, bölünmüfl klinik tablo ve durumlar› bir bütün olarak ele alarak yönetmeye çal›fl›r. Sistemik aile hekimli¤i bir aile terapisi yaklafl›m› olmasa da ailelerle çal›flmay› teflvik edip, bireyin sa¤l›¤›na kavuflmas›nda etkili rol alabilecektir.
PubMed, Dec 1, 2011
ABSTRACT This review describes how to manage everything from Parkinson's disease and tic ... more ABSTRACT This review describes how to manage everything from Parkinson's disease and tic disorders to restless legs syndrome and ataxia.
Turkiye Klinikleri Family Medicine - Special Topics, 2015
Erciyes tıp dergisi, Jul 22, 2014
Objective: Home visit is an essential part of primary health care services. In Turkey, as is all ... more Objective: Home visit is an essential part of primary health care services. In Turkey, as is all over the world, need for home visits will increase with aging population. The number of studies carried out by physicians on home visits in Turkey is quite limited. In the present study, we aimed to make a favorable change in family physicians' knowledge and attitudes about home visits via an education on home visits. Materials and Methods: The present study was conducted as a dissertation project. The universe of this study, which is a cross-sectional study, comprised all family physicians, who were working at Family Health Centers (FHCCs) affiliated to Burdur Provincial Directorate of Health and volunteer to participate in the study. A total of 72 family physicians, 37 being in the intervention group and 35 being in the control group, participated in the study. At the beginning of the study, a survey on home visits was performed in both groups; whilst the intervention group received education on home visits, the control group did not. The survey was repeated after three months and the intervention group underwent a core exam. Data obtained were transferred to the Statistical Package for the Social Sciences (SPSS) 18.0 statistics program and were analyzed. Intervention and control groups were compared. Additionally, pre-and post-education results of the intervention group were also compared. Results: Of 72 physicians received the first survey, 39 (54.2%) reported that family physicians should perform home visits and 18 (25%) physicians reported that they should not, whereas 15 (20%) were undecided. Thirty-one (43.1%) of 72 physicians were in the opinion that they performed adequate number of home visits. There were 26 (36.1%) family physicians thinking that the number of home visits they performed was not adequate, whereas 15 (20.8%) family physicians were undecided. Although the number of physicians, who considered the number of home visits they performed adequate, increased after education, it was not statistically significant. Whilst 44.4% (n=32) of the family physicians were eager about home visits, 45.8% (n=33) were not. The rate of eagerness increased after the education. Conclusion: Knowledge and skills of the family physicians were enhanced with the education on home visits as was expected. While the rate of eagerness about home visits was increased, expected increase in the rate of home visits was not achieved.
The Physician and Sportsmedicine, Jun 1, 2020
Sacral stress fractures are rare injuries among professional and amateur athletes and are conside... more Sacral stress fractures are rare injuries among professional and amateur athletes and are considered to be an uncommon source of low back pain. These type of fractures are mainly seen in competitive, highimpact sports, most commonly in long-distance runners. Sacral stress fractures are usually overlooked in young patients presenting with low back pain without any trauma history. Diagnosis of sacral stress fractures is often delayed because the history and physical examination of these patients are not specific and conventional radiographic images are frequently inadequate. A high index of clinical suspicion and further radiologic imaging such as MRI utilization can provide the accurate diagnosis. The treatment mainly includes rest, pain control, nutritional support, and biomechanical optimization. Herein, we report the case of a woman amateur golf player with a sacral stress fracture who complained of aggravating low back pain. To the best of our knowledge, this appears to be the first report of a sacral stress fracture in a golf player and also the first case of this pathology in low-impact sports. Therefore, physicians should keep in mind that stress fractures can also be seen in low-impact sports. We recommend considering stress fractures in the differential diagnosis of non-traumatic, aggravating low back pain in golfers.
HSOA journal of gerontology & geriatric medicine, May 6, 2020
Gerontology and Geriatric Medicine, 2020
Research shows that ADs improve the quality of endof-life care and reduce the burden and cost of ... more Research shows that ADs improve the quality of endof-life care and reduce the burden and cost of health care without increasing mortality (McDaniel et al., 2005; Teno et al., 2007). Unexpected end-of-life situations can happen anytime and at any age. Therefore, ideally, it is recommended that ADs should be created with adults of all ages during an interview between the person, family, and the physician before an acute illness occurs, and in a less stressful environment. The person may review and revise these documents at any time (
Gerofam, 2011
Yaşlı nüfusun oranı hemen hemen tüm ülkelerde artmaktadır. 2050 yılına kadar tüm dünyada yaşlı nü... more Yaşlı nüfusun oranı hemen hemen tüm ülkelerde artmaktadır. 2050 yılına kadar tüm dünyada yaşlı nüfusun oranının daha da artacağı beklenmektedir. Son 50-100 yılda sağlık hizmeti ve teknolojisinde olan gelişmeler sonucunda birçok önlenebilir hastalıklar kontrol altına alınmış ve yüksek doğurganlık hızı azalmıştır. Bu değişimlere paralel olarak insan ömrü uzamış, toplumlar yaşlanmaya başlamıştır. Sonuç olarak yaşlıların sağlık ve sosyal sorunları, kronik ve dejeneratif hastalıklar artmaya başlamıştır. Artan oranda birçok kişi kronik hastalıklar olan kardiyovasküler hastalıklardan, serebrovasküler hastalıklardan, solunum yolları hastalıklarından ve kanserden ölmektedir. Bu hastalıklara ek olarak düşme ve denge kaybı yaşlı nüfusun karşılaştığı ciddi kronik problemler arasındadır. Kaza ve yaralanmalar yaşlı grubun kardiyovasküler hastalıklardan, serebrovasküler hastalıklardan, solunum yolları hastalıklarından ve kanserden sonra beşinci ölüm nedenidir. Sağlık gelişimi kişilerin kendi sağlıklarını korumaları için sorumluluk almalarıdır. Sağlıklı yaşam biçimlerinin benimsenmesi, kişilerin kendi bakımlarına aktif katılımları önemlidir. Hastalığın önlenmesi, yeti yitimi risklerinin azaltılmasına katkıda bulunan "birincil" korunma (örneğin yaşlıların infl uenzaya karşı aşılanması), "ikincil" korunma (kronik hastalıkların erken tanınması), "üçüncül" korunmayı (hastalıkların uygun klinik yönetimi) içerir.
The Journal of Turkish Family Physician, Sep 21, 2010
Saudi Medical Journal, Mar 31, 2021
To determine the relationship between fear of falling (FOF) and upper extremity muscle strength. ... more To determine the relationship between fear of falling (FOF) and upper extremity muscle strength. Methods: This cross-sectional study included 112 hospitalized, mobile patients. Forty-seven (42%) were males and 65 (58%) were females, and the mean age was 72.3. The study was carried out between September 2018 and September 2019 at Balikli Rum Hospital Nursing Homes, Istanbul, Turkey. Patients were tested using geriatric tools (such as Mini-Mental State Examination) and physical tests such as handgrip, key pinch and 6-meter up and go tests. Results: The average annual falling number of elderly people with FOF was statistically significantly higher than that in those without FOF (p=0.001). Right handgrip, left handgrip, right key pinch, and left key-pinch mean values in elderly individuals with FOF were statistically significantly lower than those Original Article without FOF (p< 0.001, p< 0.001, p< 0.001, p< 0.001, respectively). Conclusion: The measurement of upper extremity strength could be a predicting parameter of FOF.
International Journal of Social Psychiatry, Jul 29, 2020
Postgraduate Medicine, Dec 25, 2014
The majority of patients with chronic noncancer pain (CNCP) are managed in the primary care setti... more The majority of patients with chronic noncancer pain (CNCP) are managed in the primary care settings. The primary care family physician (PCFP) generally has limited time, training, or access to resources to effectively evaluate and treat these patients, particularly when there is the added potential liability of prescribing opioids. The aim of this study is to make a favorable change in PCFPs&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; knowledge, attitudes, and practices about opioid use in CNCP via education on assessment of the risk of opioid misuse. The universe of this cross-sectional study comprised 36 family physicians working at Family Health Centers affiliated to Antalya Provincial Directorate of Health who volunteered to participate in the study. Initially, a survey on patients risk assessment was performed in both intervention and control groups; whereas the intervention group received education on assessment of the risk of opioid misuse, the control group did not. The survey was repeated after 6 months and the intervention group underwent a core examination. Data obtained were analyzed with Statistical Package for the Social Sciences 18.0 statistics program. Intervention and control groups were compared. Additionally, pre- and post-education results of the intervention group were also compared. About 61.1% of family physicians reported concern and hesitation in prescribing opioids due to known risks, such as overdose, addiction, dependence, or diversion, and agreed that family physicians should apply risk assessment before opioid use in CNCP. Only 16.6% of PCFP reported that risk assessment is not so necessary, whereas 22.2% of PCFP were undecided. Although 47.2% of the family physicians expressed a willingness to apply risk assessment before starting opioids, the rate of eagerness increased markedly to 77.7% after the education, but the rate of increase in practicing was not statistically significant. Knowledge and competency of the family physicians in managing CNCP were improved as was expected. Although the rate of eagerness about risk assessment of opioid misuse was increased, expected increase in the rate of using risk assessment was not achieved. Further studies are needed to identify the reasons of the difficulties on changing the attitudes and practices of primary care physicians about this subject.
Gerofam, 2011
Yaşlılarda düşme korku ve kaygı yaratan, yaşam kalitesini olumsuz etkileyen, bağımsızlık kaybına ... more Yaşlılarda düşme korku ve kaygı yaratan, yaşam kalitesini olumsuz etkileyen, bağımsızlık kaybına neden olan önemli sağlık sorunudur. Dünya Sağlık Örgütü (DSÖ) düşmeyi yaşlılık döneminin dört dev sorunundan biri olarak kabul eder. En duyarlı grup 75 yaş üstü kişilerdir ve bu kişilerde kaza ile ölümlerin %70'inden düşme sorumludur. DSÖ-Avrupa bölge ofi si 2004 yılında yayınladığı bir raporda 65 yaş üzeri yaşlıların %30'unun, 80 yaş üzeri kişilerin %50'sinin her yıl düştüğünü bildirmektedir. Düşme sonrası yaralı olarak acil servise başvuran yaşlılarda yapılan geniş bir çalışmada da hastaların %2,2'sinin öldüğü saptanmıştır. Düşme basit ekimozlardan yaşamı tehdit eden yaralanmalara kadar pek çok soruna neden olur. Düşme sonucu yaralanan yaşlıların yaklaşık yarısı bakıma muhtaç hale gelmekte, kendileri ve aileleri için bakım sorunu ortaya çıkmaktadır. Yaşlı kişiler düşme sonrası yaralanmasalar bile tekrar düşme korkusu nedeni ile yaşamlarını kısıtlamakta, daha hareketsiz bir yaşamı tercih etmektedirler. Bu da yaşlıların daha da güçsüzleşmesine neden olarak düşme riskini artırmaktadır. Ayrıca düşme düşkünlüğün ve bazı tıbbi sorunların ilk habercisi de olabilir. Yaşlanmanın getirdiği görme ve işitme sorunları, hareket yetkinliğinde azalma gibi fi zyolojik değişiklikler, kronik hastalıklar ve bu hastalıklar nedeni ile alınan ilaçlar, depresyon ve anksiyete gibi ruhsal durum değişiklikleri, hareketsizlik, beslenme yetersizlikleri, yalnız yaşama düşmeye
International Journal of Scientific and Technological Research, Apr 1, 2019
It is aimed to evaluate the information, attitudes and utilization rates of complementary and alt... more It is aimed to evaluate the information, attitudes and utilization rates of complementary and alternative medicine forms of individuals aged 18 years and over who apply two outpatient clinics
Gerofam, 2011
Japan is facing an extraordinary rapid ageing rate: approximately 40% of people will be ≥65 years... more Japan is facing an extraordinary rapid ageing rate: approximately 40% of people will be ≥65 years of age in 2060. 1 The Japanese Ministry of Health, Labour and Welfare (MHLW) have highlighted the importance of primary care physicians for coping with the ageing population and reducing healthcare expenditure. 2 However, a range of stakeholders such as MHLW and the Japan Medical Association (JMA) have been debating the necessity of family medicine as a medical discipline in the Japanese healthcare system. We examined the necessity of family medicine based on the existing discussion in the Japanese healthcare system and propose future research in this area. The main characteristics of the healthcare system in Japan are universal health insurance and a freeaccess system, whereby patients are free to choose any healthcare facility, regardless of their insurance status or severity of illness. 3 All residents of Japan including foreign nationals with a residence card are required by law to be enrolled in a health insurance programme. 4 The free-access system allows patients to visit a hospital directly without referral from a family physician. 3 Although the Japanese healthcare system has achieved better healthcare outcomes, such as long life expectancy and low infant mortality, it is facing two major challenges: financial sustainability of the system and a rapidly ageing population. 3 Therefore, the MHLW has emphasised strengthening primary care. A report on board certification by the MHLW included the competencies of family physicians such as comprehensiveness, continuity of care, and care for people with multimorbidities. 2 However, this and other reports by the MHLW often do not cite peer-reviewed articles, but rather present arguments from the bureaucracy or an 'expert' panel. Also, a review about the Japanese healthcare system by the Organisation for Economic Cooperation and Development (OECD) emphasised a need for strengthening primary care. 5 It indicates that primary care in Japan has been delivered by 'semigeneralists/semi-specialists', which are 'physicians who leave hospital practice after an unspecified amount of time to set up as generalists (with no compulsory further training) in the community.' 5 The OECD review insists on fostering primary care specialists to provide comprehensive and longitudinal care. To achieve this, the review recommended support for the creation of academic departments of
Gerofam, 2011
Alma Ata bildirgesi ile tüm devletler tüm vatandaşların sağlıklarını korumak ve daha iyi bir duru... more Alma Ata bildirgesi ile tüm devletler tüm vatandaşların sağlıklarını korumak ve daha iyi bir duruma getirmek için birincil sağlık bakımını geliştirmek için çalışmalara başlamışlardır. Üretilmek istenilen hizmetlerin bu alanda eğitilmiş uzmanlar tarafından sağlanması istenmiş ve dünyada birçok ülkede ulusal sağlık sistemlerinde reform hareketleri başlamıştır. Temel sağlık hizmetleri sağlık sisteminin merkezine yerleştirilmiştir. Temel sağlık hizmetlerinin ülkelerde farklı gelişmesi üzerine, birinci basamak sağlık hizmetlerinde verilen hizmetlerin ortak tanımı yapılmaya çalışılmıştır. Aile hekimleri ve genel pratisyenlerin (AH/GP) tanımını yapmak üzere 2002 yılda WONCA-Avrupa tanımı ortaya konmuştur. Bu tanıma göre bir aile hekiminin gündelik çalışmalarında sunduğu hizmet birincil bakımın yönetimine yer verme, toplum yönelimli olma, özgün sorun çözme becerileri gösterme, kapsamlı bakım, kişi merkezli bakım ve bütüncül bakım sunma gibi altı çekirdek yeterlik ve 11 temel özellik biçiminde tanımlanmıştır. Bu tanımlama 2005 yılında revize edilmiştir. Aile hekimliği çağdaş birincil sağlık bakımı sunma felsefesidir. Aile hekimleri bu ilkelere uygun olarak sağlık hizmeti sunduklarında basamaklandırılmış bir sağlık sisteminde, sağlık sisteminin merkezinde yer alan birinci basamak sağlık kurumlarında çalışarak Dünya Sağlık Örgütü'nün (DSÖ) 21.yüzyıl hedefl erine yönelebilir. Kişiye yönelik koruyucu sağlık hizmetleri, sağlık eğitimi, birinci basamak tedavi edici hizmetler, evde bakım ile ikinci ve üçüncü basamak
Journal of medical education and curricular development, 2020
BACkGRoUnD: As an important feature in patient-physician communication for both primary and clini... more BACkGRoUnD: As an important feature in patient-physician communication for both primary and clinical care, empathy is one of the basic competencies that physicians should possess. The primary aim of this study was to evaluate the level of empathy among medical students in all years of medical training using two different instruments: the Jefferson Scale of Physician Empathy (for clinical empathy level) and the Toronto Empathy Questionnaire (for general empathy level). MATERIALS AnD METhoDS: This study is a cross-sectional descriptive study conducted in 2017-2018 academic year with students studying at Akdeniz University Faculty of Medicine. Data collection form, Toronto Empathy Questionnaire (TEQ) and Jefferson Scale of Physician Empathy (JSPE) was applied to the students by the researchers. The statistical analysis was carried out by using IBM-SPSS version 23 for Mac OS. T-test, ANOVA test, Spearman and Pearson correlation analysis were used for comparisons. RESULTS: The mean TEQ score of the students was 52.8/65 and the JSPE-S score was 80.3/100. TEQ scores of students increased up to 4th year and then decreased, but the difference between the years was not statistically significant. The third year students' JSPE-S scores were significantly higher than that of the sixth year students. ConCLUSIon: While the clinical empathy levels of medical students decreased significantly after 3rd year, the general empathy levels decreased less. This result shows us that we should review our medical education curriculum and educational environment, and should initiate initiatives, and devote more time to empathy education in order to prevent the decrease in empathy level and increase empathy during medical education.
Klinik Tıp Aile Hekimliği, Mar 30, 2016
Ek 1.1. Çocuk ve ergenlerde aşıların kontrendikasyonlarının taranması için kontrol listesi Hastan... more Ek 1.1. Çocuk ve ergenlerde aşıların kontrendikasyonlarının taranması için kontrol listesi Hastanın adı: Doğum tarihi ../../... Ebeveynler/Bakıcılar için: Aşağıdaki sorular bugün çocuğunuza hangi aşının yapılabileceğini saptamamızda bize yardım edecektir. Herhangi bir soruya yanıtınız "EVET" ise bu çocuğunuzun aşılanmaması gerektiği anlamına gelmemekte; sadece sorulması gereken ek sorular olduğu anlamına gelmektedir. Anlayamadığınız soru varsa lütfen açıklanmasını isteyiniz.
DergiPark (Istanbul University), Mar 30, 2016
Aşılama çocuklar için oldıuğu kadar erişkinler için de önemlidir. Ancak çoğu erişkin yetersiz aşı... more Aşılama çocuklar için oldıuğu kadar erişkinler için de önemlidir. Ancak çoğu erişkin yetersiz aşılanmaktadır. Yeni çalışmalar ortalama yılda 30 bin erişkinin aşı ile önlenebilir hastalıklardan öldüğünü göstermektedir. Erişkin aşılama oranları artmakla birlikte hala Dünya Sağlık Örgütü (DSO) "Sağlıklı Kişiler 2020" hedeflerinden uzaktır. Erişkin aşılaması morbidite ve mortaliteyi önemli oranda azaltmasına rağmen, pek çok erişkin kendileri için gerekli olan aşıların farkında değildir. Özellikle infeksiyon hastalıkları için risk grubunda olan kronik hastalıkları olan bireyler, yaşlılar, sağlık çalışanlarının aşılanmaları pek çok yaşamı koruma potansiyeline sahiptir. ACİP erişkinler için 12 aşı önermektedir. Erişkin aşılaması birinci basamakta rutin hasta bakımının temel elementi olmalıdır.
Turkiye Klinikleri Family Medicine - Special Topics, 2019
The number and proportion of elderly people are increasing due to increased life expectancy and d... more The number and proportion of elderly people are increasing due to increased life expectancy and decreasing fertility rates in the last century. Primary health care will be significantly affected by this increase as the first point of contact in providing health care services to elderly people. Aging is the structural and functional change that occurs in all levels of organism over time, and a non-reversible physiological process that causes gradual decrease in all sorts of physical, mental and social functions. While some changes do not cause much trouble, some changes may prevent the person from doing daily life activities; may increase the susceptibility to some chronic diseases. In order to prevent misdiagnosis, unnecessary tests and treatments, it is important to understand whether the changes occurring in elderly individuals are pathological, and to differentiate between age-related changes and changes due to chronic diseases. Knowledge of aging processes can help family physicians to reduce the burden of disease, improve quality of life, and maintain well-being.
Turkish Journal of Family Practice, Nov 10, 2011
Sistemik aile hekimli¤i Avrupa'da oldukça yeni gündeme gelen bir klinik uygulamad›r. Aile hekimli... more Sistemik aile hekimli¤i Avrupa'da oldukça yeni gündeme gelen bir klinik uygulamad›r. Aile hekimli¤i, aile terapisi ve sistem kuram›n›n birlefltirilmesinden do¤mufltur. Gündelik, bölünmüfl klinik tablo ve durumlar› bir bütün olarak ele alarak yönetmeye çal›fl›r. Sistemik aile hekimli¤i bir aile terapisi yaklafl›m› olmasa da ailelerle çal›flmay› teflvik edip, bireyin sa¤l›¤›na kavuflmas›nda etkili rol alabilecektir.
PubMed, Dec 1, 2011
ABSTRACT This review describes how to manage everything from Parkinson's disease and tic ... more ABSTRACT This review describes how to manage everything from Parkinson's disease and tic disorders to restless legs syndrome and ataxia.
Turkiye Klinikleri Family Medicine - Special Topics, 2015
Erciyes tıp dergisi, Jul 22, 2014
Objective: Home visit is an essential part of primary health care services. In Turkey, as is all ... more Objective: Home visit is an essential part of primary health care services. In Turkey, as is all over the world, need for home visits will increase with aging population. The number of studies carried out by physicians on home visits in Turkey is quite limited. In the present study, we aimed to make a favorable change in family physicians' knowledge and attitudes about home visits via an education on home visits. Materials and Methods: The present study was conducted as a dissertation project. The universe of this study, which is a cross-sectional study, comprised all family physicians, who were working at Family Health Centers (FHCCs) affiliated to Burdur Provincial Directorate of Health and volunteer to participate in the study. A total of 72 family physicians, 37 being in the intervention group and 35 being in the control group, participated in the study. At the beginning of the study, a survey on home visits was performed in both groups; whilst the intervention group received education on home visits, the control group did not. The survey was repeated after three months and the intervention group underwent a core exam. Data obtained were transferred to the Statistical Package for the Social Sciences (SPSS) 18.0 statistics program and were analyzed. Intervention and control groups were compared. Additionally, pre-and post-education results of the intervention group were also compared. Results: Of 72 physicians received the first survey, 39 (54.2%) reported that family physicians should perform home visits and 18 (25%) physicians reported that they should not, whereas 15 (20%) were undecided. Thirty-one (43.1%) of 72 physicians were in the opinion that they performed adequate number of home visits. There were 26 (36.1%) family physicians thinking that the number of home visits they performed was not adequate, whereas 15 (20.8%) family physicians were undecided. Although the number of physicians, who considered the number of home visits they performed adequate, increased after education, it was not statistically significant. Whilst 44.4% (n=32) of the family physicians were eager about home visits, 45.8% (n=33) were not. The rate of eagerness increased after the education. Conclusion: Knowledge and skills of the family physicians were enhanced with the education on home visits as was expected. While the rate of eagerness about home visits was increased, expected increase in the rate of home visits was not achieved.
The Physician and Sportsmedicine, Jun 1, 2020
Sacral stress fractures are rare injuries among professional and amateur athletes and are conside... more Sacral stress fractures are rare injuries among professional and amateur athletes and are considered to be an uncommon source of low back pain. These type of fractures are mainly seen in competitive, highimpact sports, most commonly in long-distance runners. Sacral stress fractures are usually overlooked in young patients presenting with low back pain without any trauma history. Diagnosis of sacral stress fractures is often delayed because the history and physical examination of these patients are not specific and conventional radiographic images are frequently inadequate. A high index of clinical suspicion and further radiologic imaging such as MRI utilization can provide the accurate diagnosis. The treatment mainly includes rest, pain control, nutritional support, and biomechanical optimization. Herein, we report the case of a woman amateur golf player with a sacral stress fracture who complained of aggravating low back pain. To the best of our knowledge, this appears to be the first report of a sacral stress fracture in a golf player and also the first case of this pathology in low-impact sports. Therefore, physicians should keep in mind that stress fractures can also be seen in low-impact sports. We recommend considering stress fractures in the differential diagnosis of non-traumatic, aggravating low back pain in golfers.
HSOA journal of gerontology & geriatric medicine, May 6, 2020
Gerontology and Geriatric Medicine, 2020
Research shows that ADs improve the quality of endof-life care and reduce the burden and cost of ... more Research shows that ADs improve the quality of endof-life care and reduce the burden and cost of health care without increasing mortality (McDaniel et al., 2005; Teno et al., 2007). Unexpected end-of-life situations can happen anytime and at any age. Therefore, ideally, it is recommended that ADs should be created with adults of all ages during an interview between the person, family, and the physician before an acute illness occurs, and in a less stressful environment. The person may review and revise these documents at any time (
Gerofam, 2011
Yaşlı nüfusun oranı hemen hemen tüm ülkelerde artmaktadır. 2050 yılına kadar tüm dünyada yaşlı nü... more Yaşlı nüfusun oranı hemen hemen tüm ülkelerde artmaktadır. 2050 yılına kadar tüm dünyada yaşlı nüfusun oranının daha da artacağı beklenmektedir. Son 50-100 yılda sağlık hizmeti ve teknolojisinde olan gelişmeler sonucunda birçok önlenebilir hastalıklar kontrol altına alınmış ve yüksek doğurganlık hızı azalmıştır. Bu değişimlere paralel olarak insan ömrü uzamış, toplumlar yaşlanmaya başlamıştır. Sonuç olarak yaşlıların sağlık ve sosyal sorunları, kronik ve dejeneratif hastalıklar artmaya başlamıştır. Artan oranda birçok kişi kronik hastalıklar olan kardiyovasküler hastalıklardan, serebrovasküler hastalıklardan, solunum yolları hastalıklarından ve kanserden ölmektedir. Bu hastalıklara ek olarak düşme ve denge kaybı yaşlı nüfusun karşılaştığı ciddi kronik problemler arasındadır. Kaza ve yaralanmalar yaşlı grubun kardiyovasküler hastalıklardan, serebrovasküler hastalıklardan, solunum yolları hastalıklarından ve kanserden sonra beşinci ölüm nedenidir. Sağlık gelişimi kişilerin kendi sağlıklarını korumaları için sorumluluk almalarıdır. Sağlıklı yaşam biçimlerinin benimsenmesi, kişilerin kendi bakımlarına aktif katılımları önemlidir. Hastalığın önlenmesi, yeti yitimi risklerinin azaltılmasına katkıda bulunan "birincil" korunma (örneğin yaşlıların infl uenzaya karşı aşılanması), "ikincil" korunma (kronik hastalıkların erken tanınması), "üçüncül" korunmayı (hastalıkların uygun klinik yönetimi) içerir.
The Journal of Turkish Family Physician, Sep 21, 2010
Saudi Medical Journal, Mar 31, 2021
To determine the relationship between fear of falling (FOF) and upper extremity muscle strength. ... more To determine the relationship between fear of falling (FOF) and upper extremity muscle strength. Methods: This cross-sectional study included 112 hospitalized, mobile patients. Forty-seven (42%) were males and 65 (58%) were females, and the mean age was 72.3. The study was carried out between September 2018 and September 2019 at Balikli Rum Hospital Nursing Homes, Istanbul, Turkey. Patients were tested using geriatric tools (such as Mini-Mental State Examination) and physical tests such as handgrip, key pinch and 6-meter up and go tests. Results: The average annual falling number of elderly people with FOF was statistically significantly higher than that in those without FOF (p=0.001). Right handgrip, left handgrip, right key pinch, and left key-pinch mean values in elderly individuals with FOF were statistically significantly lower than those Original Article without FOF (p< 0.001, p< 0.001, p< 0.001, p< 0.001, respectively). Conclusion: The measurement of upper extremity strength could be a predicting parameter of FOF.
International Journal of Social Psychiatry, Jul 29, 2020
Postgraduate Medicine, Dec 25, 2014
The majority of patients with chronic noncancer pain (CNCP) are managed in the primary care setti... more The majority of patients with chronic noncancer pain (CNCP) are managed in the primary care settings. The primary care family physician (PCFP) generally has limited time, training, or access to resources to effectively evaluate and treat these patients, particularly when there is the added potential liability of prescribing opioids. The aim of this study is to make a favorable change in PCFPs&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; knowledge, attitudes, and practices about opioid use in CNCP via education on assessment of the risk of opioid misuse. The universe of this cross-sectional study comprised 36 family physicians working at Family Health Centers affiliated to Antalya Provincial Directorate of Health who volunteered to participate in the study. Initially, a survey on patients risk assessment was performed in both intervention and control groups; whereas the intervention group received education on assessment of the risk of opioid misuse, the control group did not. The survey was repeated after 6 months and the intervention group underwent a core examination. Data obtained were analyzed with Statistical Package for the Social Sciences 18.0 statistics program. Intervention and control groups were compared. Additionally, pre- and post-education results of the intervention group were also compared. About 61.1% of family physicians reported concern and hesitation in prescribing opioids due to known risks, such as overdose, addiction, dependence, or diversion, and agreed that family physicians should apply risk assessment before opioid use in CNCP. Only 16.6% of PCFP reported that risk assessment is not so necessary, whereas 22.2% of PCFP were undecided. Although 47.2% of the family physicians expressed a willingness to apply risk assessment before starting opioids, the rate of eagerness increased markedly to 77.7% after the education, but the rate of increase in practicing was not statistically significant. Knowledge and competency of the family physicians in managing CNCP were improved as was expected. Although the rate of eagerness about risk assessment of opioid misuse was increased, expected increase in the rate of using risk assessment was not achieved. Further studies are needed to identify the reasons of the difficulties on changing the attitudes and practices of primary care physicians about this subject.
Gerofam, 2011
Yaşlılarda düşme korku ve kaygı yaratan, yaşam kalitesini olumsuz etkileyen, bağımsızlık kaybına ... more Yaşlılarda düşme korku ve kaygı yaratan, yaşam kalitesini olumsuz etkileyen, bağımsızlık kaybına neden olan önemli sağlık sorunudur. Dünya Sağlık Örgütü (DSÖ) düşmeyi yaşlılık döneminin dört dev sorunundan biri olarak kabul eder. En duyarlı grup 75 yaş üstü kişilerdir ve bu kişilerde kaza ile ölümlerin %70'inden düşme sorumludur. DSÖ-Avrupa bölge ofi si 2004 yılında yayınladığı bir raporda 65 yaş üzeri yaşlıların %30'unun, 80 yaş üzeri kişilerin %50'sinin her yıl düştüğünü bildirmektedir. Düşme sonrası yaralı olarak acil servise başvuran yaşlılarda yapılan geniş bir çalışmada da hastaların %2,2'sinin öldüğü saptanmıştır. Düşme basit ekimozlardan yaşamı tehdit eden yaralanmalara kadar pek çok soruna neden olur. Düşme sonucu yaralanan yaşlıların yaklaşık yarısı bakıma muhtaç hale gelmekte, kendileri ve aileleri için bakım sorunu ortaya çıkmaktadır. Yaşlı kişiler düşme sonrası yaralanmasalar bile tekrar düşme korkusu nedeni ile yaşamlarını kısıtlamakta, daha hareketsiz bir yaşamı tercih etmektedirler. Bu da yaşlıların daha da güçsüzleşmesine neden olarak düşme riskini artırmaktadır. Ayrıca düşme düşkünlüğün ve bazı tıbbi sorunların ilk habercisi de olabilir. Yaşlanmanın getirdiği görme ve işitme sorunları, hareket yetkinliğinde azalma gibi fi zyolojik değişiklikler, kronik hastalıklar ve bu hastalıklar nedeni ile alınan ilaçlar, depresyon ve anksiyete gibi ruhsal durum değişiklikleri, hareketsizlik, beslenme yetersizlikleri, yalnız yaşama düşmeye
International Journal of Scientific and Technological Research, Apr 1, 2019
It is aimed to evaluate the information, attitudes and utilization rates of complementary and alt... more It is aimed to evaluate the information, attitudes and utilization rates of complementary and alternative medicine forms of individuals aged 18 years and over who apply two outpatient clinics
Gerofam, 2011
Japan is facing an extraordinary rapid ageing rate: approximately 40% of people will be ≥65 years... more Japan is facing an extraordinary rapid ageing rate: approximately 40% of people will be ≥65 years of age in 2060. 1 The Japanese Ministry of Health, Labour and Welfare (MHLW) have highlighted the importance of primary care physicians for coping with the ageing population and reducing healthcare expenditure. 2 However, a range of stakeholders such as MHLW and the Japan Medical Association (JMA) have been debating the necessity of family medicine as a medical discipline in the Japanese healthcare system. We examined the necessity of family medicine based on the existing discussion in the Japanese healthcare system and propose future research in this area. The main characteristics of the healthcare system in Japan are universal health insurance and a freeaccess system, whereby patients are free to choose any healthcare facility, regardless of their insurance status or severity of illness. 3 All residents of Japan including foreign nationals with a residence card are required by law to be enrolled in a health insurance programme. 4 The free-access system allows patients to visit a hospital directly without referral from a family physician. 3 Although the Japanese healthcare system has achieved better healthcare outcomes, such as long life expectancy and low infant mortality, it is facing two major challenges: financial sustainability of the system and a rapidly ageing population. 3 Therefore, the MHLW has emphasised strengthening primary care. A report on board certification by the MHLW included the competencies of family physicians such as comprehensiveness, continuity of care, and care for people with multimorbidities. 2 However, this and other reports by the MHLW often do not cite peer-reviewed articles, but rather present arguments from the bureaucracy or an 'expert' panel. Also, a review about the Japanese healthcare system by the Organisation for Economic Cooperation and Development (OECD) emphasised a need for strengthening primary care. 5 It indicates that primary care in Japan has been delivered by 'semigeneralists/semi-specialists', which are 'physicians who leave hospital practice after an unspecified amount of time to set up as generalists (with no compulsory further training) in the community.' 5 The OECD review insists on fostering primary care specialists to provide comprehensive and longitudinal care. To achieve this, the review recommended support for the creation of academic departments of
Gerofam, 2011
Alma Ata bildirgesi ile tüm devletler tüm vatandaşların sağlıklarını korumak ve daha iyi bir duru... more Alma Ata bildirgesi ile tüm devletler tüm vatandaşların sağlıklarını korumak ve daha iyi bir duruma getirmek için birincil sağlık bakımını geliştirmek için çalışmalara başlamışlardır. Üretilmek istenilen hizmetlerin bu alanda eğitilmiş uzmanlar tarafından sağlanması istenmiş ve dünyada birçok ülkede ulusal sağlık sistemlerinde reform hareketleri başlamıştır. Temel sağlık hizmetleri sağlık sisteminin merkezine yerleştirilmiştir. Temel sağlık hizmetlerinin ülkelerde farklı gelişmesi üzerine, birinci basamak sağlık hizmetlerinde verilen hizmetlerin ortak tanımı yapılmaya çalışılmıştır. Aile hekimleri ve genel pratisyenlerin (AH/GP) tanımını yapmak üzere 2002 yılda WONCA-Avrupa tanımı ortaya konmuştur. Bu tanıma göre bir aile hekiminin gündelik çalışmalarında sunduğu hizmet birincil bakımın yönetimine yer verme, toplum yönelimli olma, özgün sorun çözme becerileri gösterme, kapsamlı bakım, kişi merkezli bakım ve bütüncül bakım sunma gibi altı çekirdek yeterlik ve 11 temel özellik biçiminde tanımlanmıştır. Bu tanımlama 2005 yılında revize edilmiştir. Aile hekimliği çağdaş birincil sağlık bakımı sunma felsefesidir. Aile hekimleri bu ilkelere uygun olarak sağlık hizmeti sunduklarında basamaklandırılmış bir sağlık sisteminde, sağlık sisteminin merkezinde yer alan birinci basamak sağlık kurumlarında çalışarak Dünya Sağlık Örgütü'nün (DSÖ) 21.yüzyıl hedefl erine yönelebilir. Kişiye yönelik koruyucu sağlık hizmetleri, sağlık eğitimi, birinci basamak tedavi edici hizmetler, evde bakım ile ikinci ve üçüncü basamak
Journal of medical education and curricular development, 2020
BACkGRoUnD: As an important feature in patient-physician communication for both primary and clini... more BACkGRoUnD: As an important feature in patient-physician communication for both primary and clinical care, empathy is one of the basic competencies that physicians should possess. The primary aim of this study was to evaluate the level of empathy among medical students in all years of medical training using two different instruments: the Jefferson Scale of Physician Empathy (for clinical empathy level) and the Toronto Empathy Questionnaire (for general empathy level). MATERIALS AnD METhoDS: This study is a cross-sectional descriptive study conducted in 2017-2018 academic year with students studying at Akdeniz University Faculty of Medicine. Data collection form, Toronto Empathy Questionnaire (TEQ) and Jefferson Scale of Physician Empathy (JSPE) was applied to the students by the researchers. The statistical analysis was carried out by using IBM-SPSS version 23 for Mac OS. T-test, ANOVA test, Spearman and Pearson correlation analysis were used for comparisons. RESULTS: The mean TEQ score of the students was 52.8/65 and the JSPE-S score was 80.3/100. TEQ scores of students increased up to 4th year and then decreased, but the difference between the years was not statistically significant. The third year students' JSPE-S scores were significantly higher than that of the sixth year students. ConCLUSIon: While the clinical empathy levels of medical students decreased significantly after 3rd year, the general empathy levels decreased less. This result shows us that we should review our medical education curriculum and educational environment, and should initiate initiatives, and devote more time to empathy education in order to prevent the decrease in empathy level and increase empathy during medical education.
Klinik Tıp Aile Hekimliği, Mar 30, 2016
Ek 1.1. Çocuk ve ergenlerde aşıların kontrendikasyonlarının taranması için kontrol listesi Hastan... more Ek 1.1. Çocuk ve ergenlerde aşıların kontrendikasyonlarının taranması için kontrol listesi Hastanın adı: Doğum tarihi ../../... Ebeveynler/Bakıcılar için: Aşağıdaki sorular bugün çocuğunuza hangi aşının yapılabileceğini saptamamızda bize yardım edecektir. Herhangi bir soruya yanıtınız "EVET" ise bu çocuğunuzun aşılanmaması gerektiği anlamına gelmemekte; sadece sorulması gereken ek sorular olduğu anlamına gelmektedir. Anlayamadığınız soru varsa lütfen açıklanmasını isteyiniz.