Wos İndeksli Açık & Kapalı Erişimli Yayınlar
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Item Perspective of Turkish Medicine Students on Cancer, Cancer Treatments, Palliative Care, and Oncologists (ARES Study): a Study of the Palliative Care Working Committee of the Turkish Oncology Group (TOG)(2020) Oktay, Esin; Levent, Mustafa; Gelincik, Hakan; Aktas, Gizem; Yumuk, Fulden; Koral, Lokman; Arpaci, Erkan; Keser, Murat; Akan, Ali; Kaci, Ebru; Karadurmus, Nuri; Degirmencioglu, Serkan; Turan, Merve; Uyeturk, Ummugul; Cabuk, Devrim; Avci, Nilufer; Toprak, Omer; Ergen, Arzu; Urvay, Semiha; Bayram, Evrim; Petekkaya, Emine; Nayir, Erdinc; Paydas, Semra; Yavuzsen, Tugba; Senler, Filiz Cay; Yaren, Arzu; Barutca, Sabri; Sahinler, Ismet; Ozyilkan, Ozgur; Tanrıverdi, Ozgur; 0000-0001-8825-4918; 30446981; AAD-2817-2021Cancer is one of the most common causes of death all over the World (Rahib et al. in Cancer Res 74(11):2913-2921, 2014; Silbermann et al. in Ann Oncol 23(Suppl 3):iii15-iii28, 2012). It is crucial to diagnose this disease early by effective screening methods and also it is very important to acknowledge the community on various aspects of this disease such as the treatment methods and palliative care. Not only the oncologists but every medical doctor should be educated well in dealing with cancer patients. Previous studies suggested various opinions on the level of oncology education in medical schools (Pavlidis et al. in Ann Oncol 16(5):840-841, 2005). In this study, the perspectives of medical students on cancer, its treatment, palliative care, and the oncologists were analyzed in relation to their educational status. A multicenter survey analysis was performed on a total of 4224 medical school students that accepted to enter this study in Turkey. After the questions about the demographical characteristics of the students, their perspectives on the definition, diagnosis, screening, and treatment methods of cancer and their way of understanding metastatic disease as well as palliative care were analyzed. The questionnaire includes questions with answers and a scoring system of Likert type 5 (absolutely disagree = 1, completely agree = 5). In the last part of the questionnaire, there were some words to detect what the words "cancer" and "oncologist" meant for the students. The participant students were analyzed in two study groups; "group 1" (n = 1.255) were phases I and II students that had never attended an oncology lesson, and "group 2" (n = 2.969) were phases III to VI students that had attended oncology lessons in the medical school. SPSS v17 was used for the database and statistical analyses. A value of p < 0.05 was noted as statistically significant. Group 1 defined cancer as a contagious disease (p = 0.00025), they believed that early diagnosis was never possible (p = 0.042), all people with a diagnosis of cancer would certainly die (p = 0.044), and chemotherapy was not successful in a metastatic disease (p = 0.003) as compared to group 2. The rate of the students that believed gastric cancer screening was a part of the national screening policy was significantly more in group 1 than in group 2 (p = 0.00014). Group 2 had a higher anxiety level for themselves or their family members to become a cancer patient. Most of the students in both groups defined medical oncologists as warriors (57% in group 1 and 40% in group 2; p = 0.097), and cancer was reminding them of "death" (54% in group 1 and 48% in group 2; p = 0.102). This study suggested that oncology education was useful for the students' understanding of cancer and related issues; however, the level of oncology education should be improved in medical schools in Turkey. This would be helpful for medical doctors to cope with many aspects of cancer as a major health care problem in this country.Item The Effect of Nutritional Status on Quality of Life in Palliative Care Patients(2020) Serdar, Karaca Ahmet; Can, Seven Mehmet; Gokce, Aylaz; Yuce, Bircan Huseyin; Feza, Yarbug Karakayali; 0000-0001-6456-1868; AAK-5337-2021One of the most important problems of palliative care patients is that patients cannot be fed sufficiently. In our study, we aimed to investigate the effect of nutrition on quality of life in palliative care patients. A total of 216 patients who were hospitalized for palliative care interviewed face-to-face during the period between October 2018 and May 2019 and their nutritional status was determined. Mini Nutritional Assessment test was applied to patients at the same time quality of life questionnaire short form 36 test. A total of 216 patients (132 (61.1%) female, 84 (38.9%) male) were included in the study. The mean age of the patients was 77.01 +/- 13.0 years, the mean body mass index was 24.15 +/- 5.41 kg/m(2), and the mean value of Mini Nutritional Assessment was 14.20 +/- 7.01. The patients were divided into 3 groups according to their nutritional status. In groups of patients with palliative care according to their nutritional status, 3 groups were compared with the sub-dimension scores of the quality of life scale short form 36, and the physical function, physical role limitation, energy/vitality, emotional health, and perception of general health. Malnutrition is frequently observed in palliative care patients. Malnutrition affects the quality of life negatively. During palliative care, whose aim is to improve the quality of life, the nutritional status of patients should be evaluated and patients should be given nutritional supplements when necessary.Item Training for awareness of one's own spirituality: A key factor in overcoming barriers to the provision of spiritual care to advanced cancer patients by doctors and nurses(2019) Sav, Sultan; 0000-0003-0361-7498; 30187841; V-9745-2019ObjectiveWhen patients feel spiritually supported by staff, we find increased use of hospice and reduced use of aggressive treatments at end of life, yet substantial barriers to staff spiritual care provision still exist. We aimed to study these barriers in a new cultural context and analyzed a new subgroup with unrealized potential for improved spiritual care provision: those who are positively inclined toward spiritual care yet do not themselves provide it.MethodWe distributed the Religion and Spirituality in Cancer Care Study via the Middle East Cancer Consortium to physicians and nurses caring for advanced cancer patients. Survey items included how often spiritual care should be provided, how often respondents themselves provide it, and perceived barriers to spiritual care provision.ResultWe had 770 respondents (40% physicians, 60% nurses) from 14 Middle Eastern countries. The results showed that 82% of respondents think staff should provide spiritual care at least occasionally, but 44% provide spiritual care less often than they think they should. In multivariable analysis of respondents who valued spiritual care yet did not themselves provide it to their most recent patients, predictors included low personal sense of being spiritual (p < 0.001) and not having received training (p = 0.02; only 22% received training). How developed a country is negatively predicted spiritual care provision (p < 0.001). Self-perceived barriers were quite similar across cultures.Significance of resultsDespite relatively high levels of spiritual care provision, we see a gap between desirability and actual provision. Seeing oneself as not spiritual or only slightly spiritual is a key factor demonstrably associated with not providing spiritual care. Efforts to increase spiritual care provision should target those in favor of spiritual care provision, promoting training that helps participants consider their own spirituality and the role that it plays in their personal and professional lives.Item Human Development Index and its association with staff spiritual care provision: a Middle Eastern oncology study(2019) Kav, Sultan; 0000-0003-0361-7498; 30895381; V-9745-2019BackgroundAlthough staff spiritual care provision plays a key role in patient-centered care, there is insufficient information on international variance in attitudes toward spiritual care and its actual provision.MethodsA cross-sectional survey of the attitudes of Middle Eastern oncology physicians and nurses toward eight examples of staff provision of spiritual care: two questionnaire items concerned prayer, while six items related to applied information gathering, such as spiritual history taking, referrals, and encouraging patients in their spirituality. In addition, respondents reported on spiritual care provision for their last three advanced cancer patients.ResultsSeven hundred seventy responses were received from 14 countries (25% from countries with very high Human Development Index (HDI), 41% high, 29% medium, 5% low). Over 63% of respondents positively viewed the six applied information gathering items, while significantly more, over 76%, did so among respondents from very high HDI countries (p value range, p<0.001 to p=0.01). Even though only 42-45% overall were positively inclined toward praying with patients, respondents in lower HDI countries expressed more positive views (p<0.001). In interaction analysis, HDI proved to be the single strongest factor associated with five of eight spiritual care examples (p<0.001 for all). Significantly, the Middle Eastern respondents in our study actually provided actual spiritual care to 47% of their most recent advanced cancer patients, compared to only 27% in a parallel American study, with the key difference identified being HDI.ConclusionsA country's development level is a key factor influencing attitudes toward spiritual care and its actual provision. Respondents from lower ranking HDI countries proved relatively more likely to provide spiritual care and to have positive attitudes toward praying with patients. In contrast, respondents from countries with higher HDI levels had relatively more positive attitudes toward spiritual care interventions that involved gathering information applicable to patient care.