Hekimlerin dördüncül korumayı uygularken meslektaşlarına tutum ve davranışları
Küçük Resim Yok
Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Hekimlerin Dördüncül Korumayı Uygularken Meslektaşlarına Tutum ve Davranışları Amaç: Hasta hekim olduğunda, sağlık bakımı veren hekim açısından bazı özel ve zor durumlar ortaya çıkmaktadır. Bu durumların neler olduğunu ortaya çıkarmak amacıyla çalışmamız gerçekleştirilmiştir. Gereç ve Yöntem: Bu çalışmada anketler 01.10.2018-31.12.2018 tarihleri arasında İnönü Üniversitesi Tıp Fakültesi'nde görev yapan gerek teşhis, gerekse tedavi aşamasında birebir hasta ile teması olan dahili ve cerrahi bölümlerin araştırma görevlisi hekimlerine uygulanmıştır. Tıp Fakültesi fakülte sekreterliğinden 320 araştırma görevlisinin dahili ve cerrahi bölümlerde görev yaptığı bilgisi alınmıştır. Araştırmada tamsayım hedeflenmiş olup ancak mevcut kitlenin %81'ine (258/320) ulaşılmıştır. Araştırmada kullanılan veriler ortanca (min-maks) ve sayı (yüzde) olarak özetlenmiştir. Sayısal değişkenlerin normal dağılıma uygunluğu Shapiro-Wilk testi ile incelenmiştir. Uygun olan yerlerde Mann-Whitney U, Pearson ki-kare, Yates düzeltmeli Pearson ki-kare ve Fisher kesin testleri kullanılmıştır. p<0,05 istatistiksel anlamlılık düzeyi olarak kabul edilmiştir. Analizlerde IBM SPSS Statistics 22 paket programı kullanılmıştır. Bulgular: Anket çalışmasına dahili bölümlerden 168 (%65,1) , cerrahi bölümlerden 90 (%34,9) olmak üzere toplam 258 hekim dahil olmuştur. Anket çalışmasında hekim olan hastasına diğer hastalarına göre öncelik sırası tanıyan hekimlerin oranı bölüme göre değerlendirildiğinde dahili bölümlerde %92, cerrahi bölümlerde %100 olarak bulunmuş olup sonuç istatistiksel olarak anlamlı kabul edilmiştir (p=0,005). Çalışmada hekim olan hastasına gerek olmadığını bildiği halde laboratuvar/radyolojik tetkik istemeyenlerin oranı bölüme göre değerlendirildiğinde dahili bölümlerde %58, cerrahi bölümlerde %71 olarak bulunmuş olup sonuç istatistiksel olarak anlamlı kabul edilmiştir (p=0,043). Sonuçlar: Bu araştırmada, hekimlerin dördüncül koruma ile ilgili hassasiyete sahip tutum ve davranışlar sergiledikleri görülmüştür. Ayrıca, konu ile ilgili olarak klinik uzmanlık alanlarının tanı kılavuzları oluşturulurken kanıta dayalı tıbbın göz önünde bulundurulması hastaların aşırı tıbbi müdahaleye bağlı zarar görmesinin engellenmesinde önemli bir adım olacaktır. Anahtar Kelimeler: Aşırı tanı, aşırı tedavi, dördüncül koruma
Attitudes and Behaviors of Physicians to Colleagues in Implementing Quaternary Prevention Aim: When the patient is a physician, some special and difficult situations arise for the health care physician. Our study has been carried out to find out what these situations are. Material and Method: In this study, the questionnaires were applied to the physician of the research assistants of the internal and surgical departments who had contact with the patient during the diagnosis and treatment phase between the dates of 01.10.2018 and 31.12.2018 at İnönü University Faculty of Medicine. It was learned that 320 research assistants from faculty secretariat of Faculty of Medicine were working in internal and surgical departments. In the study, the integer was targeted but 81% (258/320) of the current population was reached. The data used in the research are summarized as median (min-max) and number (percentage). The conformity of numerical variables to normal distribution was investigated by Shapiro-Wilk test. Mann-Whitney U, Pearson chi-square, Years-corrected Pearson chi-square and Fisher's exact tests were used where appropriate. p <0,05 was accepted as statistical significance level. IBM SPSS Statistics 22 package program was used in the analysis. Results: A total of 258 physicians were included in the survey, 168 (65,1%) of the internal departments and 90 of the surgical departments (34,9%). The rate of the physicians who gave the physician who had a priority order according to the other patients was 92% in the internal departments and 100% in the surgical departments and the result was considered statistically significant (p = 0,005). In the study, the rate of those who didn't want laboratory / radiological examination was found to be 58% in the internal departments and 71% in the surgical departments when the physician knew that there was no need for the patient but the results were considered statistically significant (p = 0,043). Conclusion: In this study, it was observed that physicians exhibited attitudes and behaviors that are sensitive about quaternary prevention. In addition, the fact that evidence-based medicine is taken into consideration when establishing diagnostic guidelines of clinical specialties will be an important step in preventing patients from harm due to excessive medical intervention. Key Words: Overdiagnosis, overtreatment, quaternary prevention.
Attitudes and Behaviors of Physicians to Colleagues in Implementing Quaternary Prevention Aim: When the patient is a physician, some special and difficult situations arise for the health care physician. Our study has been carried out to find out what these situations are. Material and Method: In this study, the questionnaires were applied to the physician of the research assistants of the internal and surgical departments who had contact with the patient during the diagnosis and treatment phase between the dates of 01.10.2018 and 31.12.2018 at İnönü University Faculty of Medicine. It was learned that 320 research assistants from faculty secretariat of Faculty of Medicine were working in internal and surgical departments. In the study, the integer was targeted but 81% (258/320) of the current population was reached. The data used in the research are summarized as median (min-max) and number (percentage). The conformity of numerical variables to normal distribution was investigated by Shapiro-Wilk test. Mann-Whitney U, Pearson chi-square, Years-corrected Pearson chi-square and Fisher's exact tests were used where appropriate. p <0,05 was accepted as statistical significance level. IBM SPSS Statistics 22 package program was used in the analysis. Results: A total of 258 physicians were included in the survey, 168 (65,1%) of the internal departments and 90 of the surgical departments (34,9%). The rate of the physicians who gave the physician who had a priority order according to the other patients was 92% in the internal departments and 100% in the surgical departments and the result was considered statistically significant (p = 0,005). In the study, the rate of those who didn't want laboratory / radiological examination was found to be 58% in the internal departments and 71% in the surgical departments when the physician knew that there was no need for the patient but the results were considered statistically significant (p = 0,043). Conclusion: In this study, it was observed that physicians exhibited attitudes and behaviors that are sensitive about quaternary prevention. In addition, the fact that evidence-based medicine is taken into consideration when establishing diagnostic guidelines of clinical specialties will be an important step in preventing patients from harm due to excessive medical intervention. Key Words: Overdiagnosis, overtreatment, quaternary prevention.
Açıklama
Anahtar Kelimeler
Aile Hekimliği, Family Medicine
