Sağlık Bilimleri Fakültesi / Faculty of Health Sciences
Permanent URI for this collectionhttps://hdl.handle.net/11727/1402
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Item Experiences Of Physicians On Defensive Medicine: A Qualitative Study From Türkiye(INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT, 2024-02-11) Baskici, Cigdem; Dagdevir, Sude NurThis study aimed to investigate the experiences of physicians regarding defensive medicine (DM) practices. A qualitative study was developed with a descriptive phenomenological approach and the study was conducted in a university hospital in Turkiye. Data were collected between 1 February 2022 and 15 March 2022 via face-to-face, in-depth interviews from 21 participants. Inductive content analysis, which is very suitable for use in health-related research, was used. The analysis of the interview data resulted in 3 main themes, 9 themes, and 24 sub-themes. Main themes described the experiences of physicians: reasons for DM practices, consequences of DM practices, and measures to prevent DM practices. The findings showed the multidimensional nature of DM practices that must be considered in the strategies to be developed to prevent this behavior.Item The Relationship Between Biological Rhythm And Perceived Social Support, Coping Styles And Medication Adherence İn Patients With Bipolar Disorder İn Türkiye(ARCHIVES OF PSYCHIATRIC NURSING, 2024-03-15) Ucgun, Tugce; Oksuz, EmineIntroduction: The disruption of biological rhythm (sleep, eating patterns, hormonal secretions, activities, and social life etc.) in individuals diagnosed with bipolar disorder makes it challenging to balance the mood of the patient and facilitates recurrence. Although social support, coping with stress, and medication adherence are known to affect prognosis, no study has been found to investigate the relationship between these factors and biological rhythm. Aim: This descriptive and correlational design study investigated the relationship between perceived social support, coping styles and medication adherence, and biological rhythm in individuals diagnosed with bipolar disorder. Method: This study was conducted with 111 patients receiving treatment in the outpatient clinics of the psychiatry department of two public hospitals in Ankara, Turkey. Biological Rhythm Interview of Assessment in Neuropsychiatry (BRIAN), Multidimensional Scale of Perceived Social Support (MSPSS), Coping Style Inventory (CSI), and Morisky Medication Adherence Scale (MMAS) were used for data collection. Results: The biological rhythm total and subscales scores were significantly and negatively related to perceived social support total, and subscales scores (p < 0.005). The biological rhythm total and most of its subscales scores were significantly and negatively related to medication adherence (p < 0.005). The biological rhythm total and domain scores were significantly and negatively related to seeking social support, self-confident, and optimistic subscales of CSI while significantly and positively related to helpless and submissive (p < 0.005). Discussion: In this study, a positive relationship was found between increased perceived social support, effective coping with stress, and adherence to medication. This study highlights that these factors may be helpful for the regulation of biological rhythm.Item "Being in the Digital Box". Academic Staff Experiences in Online Practical Teaching: A Qualitative Study From Six Universities and Countries(HELIYON, 2024-03-04) Baskici, Cigdem; Aytar, Aydan; Ersoy, Halil; Wiktsrom-Grotell, Camilla; Arell-Sundberg, Marina; Neves, Hugo; Coutinho, Veronica; Blazeviciene, Aurelija; Vaskelyte, Alina; Soderlund, Anne; Fritz, Johanna; Strods, Raimonds; Jansone-Ratinika, Nora; Kav, SultanThe COVID-19 pandemic has caused radical changes in education, as in everything else, bringing many challenges. Despite all the difficulties, the COVID-19 pandemic has enormous opportunities for online teaching and the use of digital technologies. A comprehensive understanding of this period is needed to investigate these opportunities. Thus, this study aims to explore the academic staff's experiences of online teaching and the use of digital technologies in practical skills -based courses in health care education. This study was conducted at six universities from six countries (Turkiye, Sweden, Finland, Portugal, Latvia, Lithuania). Data were collected between June 17, 2021 and November 30, 2021 via a focus group with an in-depth interview technique. 22 focus group interviews were conducted with a total of 117 participants. Colaizzi's method was used to evaluate the data to discover, comprehend, and define the experiences of academic staff. The analysis of the interview data resulted in 6 themes, 25 subthemes and 56 categories that captured participants' experiences regarding online teaching of practical skills and using digital technologies in health care education. The findings of the study provide crucial information that will help online teaching and digital technology for practical skills be successfully integrated.Item Health Literacy In Older Adults Receiving Hemodialysis In Turkey: A Cross-Sectional Study(THERAPEUTIC APHERESIS AND DIALYSIS, 2024-01-10) Ugurlu, Ziyafet; Kav, Sultan; Eler, Cigdem Ozdemir; Kaya, Semiha; Korkmaz, YaseminIntroductionThis study aimed to determine the health literacy level and related factors of older adults receiving hemodialysis treatment.MethodsA cross-sectional study was conducted at the five dialysis centers, using the information form and Turkish Health Literacy Survey-32 (THLS-32). A total of 336 older adults receiving hemodialysis treatment participated.ResultsThe general health literacy score was found to be 25.69 +/- 14.47. Based on the health literacy assessment scores, 62.5% of the participants were in the category of inadequate and limited level of health literacy. The lower level of education, perceived health status, income, and getting help in reading and writing were statistically significant predictors of the health literacy score.ConclusionThe health literacy of older adults receiving hemodialysis treatment was inadequate and limited. Findings of this study emphasize the importance of integrating health literacy assessment in clinical care settings and supporting the health literacy of older adults receiving hemodialysis treatment.Item Empathy And Lgbti Perspectives Among University Nursing Students In Turkiye(ARCHIVES OF PSYCHIATRIC NURSING, 2024-12) Topal, Cansu Akdag; Ucgun, Tugce; Gurel, ReyyanObjective: The research aims to understand the factors influencing nursing students' attitudes towards the LGBTI community, given the importance of culturally competent and inclusive care in healthcare. Method: A descriptive and relationship-seeking design was used. The study was completed by 386 nursing students. Data were collected with "Personal Information Form, LGBTI Attitude Scale (LGBTI-AS) and Toronto Empathy Scale (TEQ)". Hierarchical regression analysis was used to identify predictors of attitudes towards LGBTI individuals among nursing students. Results: The total mean score of the Awareness to LGBTI Attitude Scale was 2.47 +/- 1.0 (moderate attitudes). The findings revealed that female students and senior nursing students exhibited more positive attitudes, while those with friendships with LGBTI individuals and higher empathy levels showed greater acceptance and understanding towards the LGBTI community (p p < 0.001). The results showed that 22 % of the total variance in the LGBTI attitude could be explained in model 3 (F = 27.43, R2 variation = 0.224, p = 0.001). Conclusion: The study highlights the importance of integrating LGBTI-related content into nursing curricula and promoting empathy-building activities. These findings underscore the significance of empathy in shaping positive attitudes and emphasize the need for comprehensive educational strategies to promote inclusivity in healthcare.Item Biomonitoring of Oxidative-Stress-Related Genotoxic Damage in Patients with End-Stage Renal Disease(TOXICS, 2024-02-09) Yuzbasioglu, Yucel; Hazar, Merve; Dilsiz, Sevtap Aydin; Yucel, Cigdem; Bulut, Mesudiye; Cetinkaya, Serdar; Erdem, OnurChronic kidney disease (CKD), a common progressive renal failure characterized by the permanent loss of functional nephrons can rapidly progress to end-stage renal disease, which is known to be an irreversible renal failure. In the therapy of ESRD, there are controversial suggestions about the use of regular dialysis, since it is claimed to increase oxidative stress, which may increase mortality in patients. In ESRD, oxidative-stress-related DNA damage is expected to occur, along with increased inflammation. Many factors, including heavy metals, have been suggested to exacerbate the damage in kidneys; therefore, it is important to reveal the relationship between these factors in ESRD patients. There are very few studies showing the role of oxidative-stress-related genotoxic events in the progression of ESRD patients. Within the scope of this study, genotoxic damage was evaluated using the comet assay and 8-OHdG measurement in patients with ESRD who were undergoing hemodialysis. The biochemical changes, the levels of heavy metals (aluminum, arsenic, cadmium, lead, and mercury) in the blood, and the oxidative biomarkers, including superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and malondialdehyde (MDA) levels were evaluated, and their relationship with genotoxic damages was revealed. Genotoxicity, oxidative stress, and heavy-metal levels, except mercury, increased significantly in all renal patients. DNA damage, 8OHdG, and MDA significantly increased, and GSH significantly decreased in patients undergoing dialysis, compared with those not having dialysis. The duration and the severity of disease was positively correlated with increased aluminum levels and moderate positively correlated with increased DNA damage and cadmium levels. In conclusion, this study revealed that the oxidative-stress-related DNA damage, and also the levels of Al and Cd, increased in ESRD patients. It is assumed that these changes may play an important role in the progression of renal damage. Approaches for reducing oxidative-stress-related DNA damage and heavy-metal load in ESRD patients are recommended.Item Differences in Eating Behaviours and Mothers Attitudes Between Baby-Led Weaning vs. Traditional Spoon-Feeding Approaches in Turkiye(APPETITE, 2024-12-01) Karagoz, Incilay; Bayram, Sinem); Caliskan, Hilal; Yilmaz, Can SelimThis study was aimed to examine the differences in eating behaviours and mothers attitudes between baby-led vs. traditional spoon-feeding approaches and its effect on eating behaviours in preschool children. The study was conducted with 150 mothers of children aged 2-6, who applied to the Pediatrics Polyclinic of Bas,kent University Ankara Hospital, between December 2022 and February 2023. Sociodemographics, biochemical parameters were recorded to form. Maternal attitudes and eating behaviours of children were evaluated with Mother's Attitudes Towards the Feeding Process Scale (MATFP) and Early Childhood Adaptive Eating Behaviour Scale (ECAEB), respectively. The mean age of the children was 43.80 +/- 11.04 months and 51.3% of them were girls. A weak negative correlation was found between the ECAEB total scores and the child age (r = -0.196, p < 0.05). A moderate positive correlation was found between the total scores of the MATFP and ECAEB (r = 0.699, p < 0.001). There wasn't significant difference between the MATFP total scores who chose baby-led weaning or traditional feeding (p > 0.05). According to the ECAEB; aggression and reaction to main meal order subgroup scores of children who consumed pureed vegetables until the ninth month were higher than those who didn't consume them (p < 0.05). Mothers who prefer the TSF offer their babies more blenderized and pureed foods, while those who prefer the BLW serve fork-mashed, steamed and sliced foods (p < 0,05). As the mothers' subscale scores for negative affect during meals, attitudes about insufficient/unbalanced feeding, negative feeding strategies, forced feeding, reaction to viewpoint of others increase, so did their subscale scores for child reluctance, eating refusal associated with sensory causes, aggression, reaction to main meal order increase. Consequently, it's believed that maternal attitudes and actions should be taken into account while evaluating the eating habits of toddlers.Item Economic Burden Of Short-Acting Beta-2 Agonist (Saba) Overuse Among Asthma Patients In Türkiye: A Cost Analysis With Respect To The Updated Gina Treatment Recommendations(BMC PULMONARY MEDICINE, 2024-10-21) Yorgancioglu, Arzu; Aksu, Kurtulus; Cura, Ceyhun; Yaman, Yigit; Dinc, Melda; Malhan, SimtenBackgroundThis cost of illness study aimed to determine economic burden of short-acting beta 2-agonist (SABA) overuse in T & uuml;rkiye from payer perspective with respect to the updated GINA 2022 treatment recommendations.MethodsA total of 3,034,879 asthma patients comprised the study population, via estimations extrapolated from the T & uuml;rkiye arm of the global SABINA III study. The economic burden (costs related to the drug use and severe exacerbations) was compared in subgroups of overall (>= 0 canisters/year) vs. GINA-recommended (0-2 canisters/year, hypothetical population) SABA use and in subgroups of appropriate use (0-2 canisters/year, real population) vs. overuse (>= 3 canisters/year) of SABA with extrapolation of SABINA T & uuml;rkiye data to the T & uuml;rkiye asthma population.ResultsRecommended SABA use was predicted to prevent 127,505 of 157,512 severe exacerbations per year in mild asthma patients and 2,668,916 of 3,262,800 severe exacerbations per year in moderate-severe asthma patients. Annual cost burden of not applying recommended SABA use (overall [>= 0 canisters/year] vs. GINA-recommended [0-2 canisters/year] SABA use) in mild asthma and moderate-severe asthma patients was calculated to be 20.43 million and 427.65 million in terms of severe exacerbations, and to be 829,352 and 7.20 million in terms of drug costs, respectively. The total annual economic burden arising from not applying recommended SABA use was estimated to be 456.11 million. Appropriate use (0-2 canisters/year) vs. overuse (>= 3 canisters/year) of SABA was associated with decreased frequency of severe exacerbations per year in mild asthma (from 129,878 to 27,634) and moderate-severe asthma (from 2,834,611 to 428,189) patients. SABA overuse in mild and moderate-severe asthma patients was estimated to yield an additional annual cost of 16.38 million and 385.59 million, respectively in terms of severe exacerbations, and a total 11.30 million additional drug cost. The overall annual economic burden arising from SABA overuse was estimated to be 413.27 million.ConclusionsThe estimated annual total economic burden arising from not applying recommended SABA use (456.11 million) and SABA overuse (413.27 million) with respect to the updated GINA 2022 treatment recommendations indicates the substantial cost burden of SABA overuse to the Turkish National Health System, corresponding up to 26% of the total direct cost of asthma reported in our country.Item Development, Validity, and Reliability of the Auditory and Speech Performance Test for Children(CANADIAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY AND AUDIOLOGY, 2024-05-02) Hancer, Hale; Kiziltan, Erhan; Tan, Pinar Civak; Gokmen, Dery; Hayme, Serhat; Yilmaz, Suna TokgozAuditory processing and speech processing disorders negatively affect school -aged children. To minimize these negative effects, individuals in the risk group should benefit from the positive contribution of early intervention with a comprehensive evaluation. The aim of this study was to develop the Auditory and Speech Performance Test for Children and analyze its validity and reliability. In the development of the Auditory and Speech Performance Test for Children, discrimination and recognition subtasks were built for both auditory and speech performance. Meaningful and meaningless minimal pairs were used in the subtasks. A silent background was used for auditory performance, and noise stimuli were combined into minimal pairs for speech performance. Audiovisual materials were integrated into the finger-tapping test. The Auditory and Speech Performance Test for Children was administered to 307 children with typical development and to 80 children with specific learning disabilities. The Auditory and Speech Performance Test for Children calculated children's reaction times for pressing speed and accuracy of pressing the correct key. The data were analyzed for content, construct validity, internal consistency, and test -retest reliability. The content validity index value was found to be high (.89-1.0). The Auditory and Speech Performance Test for Children was explained as a two -factor model using exploratory factor analysis (eigenvalue = 1.92, total variance = 66.65%). It was found to be discriminative according to age, groups, subtests, and 27% bottom and top scores (all were significant atp < .001). Internal consistency (.77-.90) and test -retest values (.89-.93) of the Auditory and Speech Performance Test for Children in the total test scores were calculated within reliable values. In conclusion, we developed a valid and reliable screening tool for auditory and speech performance in children.Item Subcortical Auditory Processing and Speech Perception in Noise Among Individuals With and Without Extended High-Frequency Hearing Loss(JOURNAL OF SPEECH LANGUAGE AND HEARING RESEARCH, 2024-05-16) Colak, Hasan; Aydemir, Berfin Eylul; Sakarya, Merve Deniz; Cakmak, Eda; Alniacik, Asuman; Turkyilmaz, Meral DidemPurpose: The significance of extended high -frequency (EHF) hearing (> 8 kHz) is not well understood so far. In this study, we aimed to understand the relationship between EHF hearing loss (EHFHL) and speech perception in noise (SPIN) and the associated physiological signatures using the speech-evoked frequency-following response (sFFR). Method: Sixteen young adults with EHFHL and 16 age- and sex-matched individuals with normal hearing participated in the study. SPIN performance in right speech-right noise, left speech-left noise, and binaural listening conditions was evaluated using the Turkish Matrix Test. Additionally, subcortical auditory processing was assessed by recording sFFRs elicited by 40 -ms /da/ stimuli. Results: Individuals with EHFHL demonstrated poorer SPIN performances in all listening conditions (p < .01). Longer latencies were observed in the V (onset) and O (offset) peaks in these individuals (p <= .01). However, only the V/A peak amplitude was found to be significantly reduced in individuals with EHFHL (p < .01). Conclusions: Our findings highlight the importance of EHF hearing and suggest that EHF hearing should be considered among the key elements in SPIN. Individuals with EHFHL show a tendency toward weaker subcortical auditory processing, which likely contributes to their poorer SPIN performance. Thus, routine assessment of EHF hearing should be implemented in clinical settings, alongside the evaluation of standard audiometric frequencies (0.25-8 kHz).