The Determination of knowledge level of family physicians for frailty; A Cross-sectional study

Introduction: Frailty syndrome, which affects the quality of life negatively in patients of 65 years old and over, can be observed from physical inactivity to immobility, and can affect cognitive disorders. General symptoms of frailty are; slowing walking speed, involuntary weight loss, decreased appetite, decreased body mass index (BMI), decreased muscle strength, feeling insufficient while doing physical activity, weakness, fatigue, impaired cognitive functions, and memory loss. Fragility is reversible, but if it is not noticed earlier it can progress to immobility or death. Comprehensive Geriatric Assessment (CGA) is important in detecting a frail elderly. The aim of the study is to determine the knowledge level of family physicians in Erzincan. Methods: This is a cross-sectional study. It is aimed to reach at least 80% of family physicians (FPs) employed actively in 73 primary care units in Erzincan. The researchers applied questionnaire face-to-face to the participants. Erzincan Clinical Research Ethics Committee approval was received for the study. SPSS 23 statistics program was used for data analysis. Results: The frailty questionnaire was applied to 58 FPs. Only 12.1% of FPs correctly answered the question of which word first comes to mind for ‘frailty’. The 74.1% (n: 43) of participants did not consider themselves sufficient for CGA, and 70.7% (n: 41) of participants wanted training on CGA. The answer for question if they evaluate the patients for frailty in homecare visits was yes in 38.2%. Conclusion: It can be said that the ‘frailty’ knowledge level of FPs should be increased in Erzincan. In light of the data obtained, it may be suggested to organize “frailty” and CGA trainings for family physicians. Frailty and CGA should be included in undergraduate medical education and continuous trainings of FPs.

Case presentation from a family physician from the frontline in the pandemic

The World Health Organization China National Office have announced pneumonia cases of unknown etiology from Hubei district of China for the first time on 31st of December 2019. On 7th of January 2020 the etiologic agent has been accepted as a new coronavirus (Covid19) that is not formerly detected in human. World Health Organization classified Covid19 epidemic as “international public health emergency” on the 30th of January, and as a global pandemic on the 11th of March, since Covid19 cases have been detected in 113 countries other than China, where the epidemic has first begun, and because of the expansion of the virus and its severity. Covid19 related studies have been started in our country on the 10th of January 2020 and the first meeting of the T.R. Ministry of Health Scientific Advisory Committee has been realized on 22 January, and due to the preventive measures, the first Covid19 case is seen on 11 March after Europe and Iran, the countries in our neighborhoods. With the case presentations in this article we tried to present a section from the field.

Assessment of usage status and affecting factors about the contraception methods of young adult men

Objective: With this study, we aimed to evaluate the knowledge, usage status and attitudes of young adult men about family planning and contraception methods, a group that has not been studied before in our country, and to determine the influencing factors. Method: This descriptive research was conducted on male individuals between the ages of 18-35 between June 2020 and July 2020 by applying an online e-questionnaire. In the study, a questionnaire form consisting of 25 questions in total and formed after the literature review was applied. The e-questionnaire form developed by the researchers was shared 10 times over the web at three-day intervals. Results: 85.0% of the participants (n = 380) have experienced sexual intercourse at least once in their life. 55.7% of these people (n = 323) throughout their life; 21.1% of them have been with more than one partner in the last year. 89.2% of them do not plan to have a child in the next year. 65.9% of those who have had sexual intercourse have used contraceptive methods in their sexual intercourse. As the education level increases (p = 0.003), the increase in the frequency of using contraceptive methods was found to be statistically significant. Those who use alcohol (p = 0.004) and who think that men should be protected during sexual intercourse (p <0.001), use contraceptive methods more than others. Conclusion: Our study was conducted with a young adult male sample, and as a result, it was observed that more than half of the men used male contraceptive method together. In order to increase these rates, men to intervene in family planning by making a joint decision with their partner, and to increase the knowledge level of men, pre-marital applications should be evaluated as an opportunity, especially in primary health care centers and family health centers.

Behaviors and problems of a medical school students’ related to distance education in pandemic medical education in the pandemic process

Introduction and Aim: In a medical school, to determine whether students have the necessary infrastructure for distance education, students’ access to educational materials, the concerns and expectations of students about the process. Methods: First, second, third, fourth and fifth-year students, continue through distance education in the pandemic process in Cumhuriyet University Medical School, were included in the study. 336 students volunteered to participate in this descriptive research. The data collection tool used in research was created by the researchers. The data collection tool created by the researchers consists of 24 questions that the descriptive variables of students, their study status and problems in distance education process. Results: Students’ 91.4% entered the university’s distance education module. 82.1% of them stated that they studied less than the old working program during this process. Participants’ 19.3% did not have a suitable study environment at home, 19.6% of them did not have a computer and 12.2% of them had an irregular internet connection. There were significant differences between the presence of a suitable environment for home study (p=0.001), the internet access status (p=0.004) and the frequency of study. The answers given by students to the question of their concerns/problems related to this process; concerns about the distance education module (not getting feedback, problems with material adequacy, etc.) (42.3%), the lack of training (39.0%), concerns about the exam (28.9%), decreased will to study (16.7%), fail the class/low grades (14.6%) were gathered in these main categories, respectively. Participants’ 76.5% felt the lack of occupational practice. 61.6% of them demanded the increase of multimedia items in the materials uploaded to the system. Conclusion: Depending on the pandemic, the duration of distance education process remains uncertain. In this process, especially in occupational practice-oriented faculty such as medical faculties, students have concerns related to these deficiencies. In addition, when planning distance education, faculties should consider students’ availability of having devices and internet access.

Evaluation of approaches of gestational diabetes screening test in pregnant women

Objective: The aim of this study to evaluate the approaches of pregnant women to gestational diabetes mellitus (GDM) screening test. Methods: 102 women with gestational age is 24-28 week, at the age of 18 and over, who were not diagnosed with Type I or Type II DM before the pregnancy, with a single pregnancy, were included in the study. Socio-demographic characteristics of pregnant women, risk factors for GDM, whether GDM screening test and the reasons why pregnant women did not have screening test were questioned. Weight, body mass index, plasma glucose measurements and OGTT results of pregnant women with and without GDM risk factors were compared. Results: 53 (51.96%) of 102 pregnant women included in the study did not have GDM screening test. As the reason for not having a test; seven (13.2%) of the pregnant women thought that they should be screened with another method without sugar, six (11.3%) did not recommend by their doctor, six (11.3%) read in the media that test was harmful, six (11.3%) thought that test would harm the baby, and six (11.3%) stated that they did not know about the test. Ten (18,9%) did not report any reason. The rate of women in the risk group for GDM was 87.3%. The highest risk factor was the maternal age above 25 years (79.4%). In addition, 27,4% of pregnant women had first-degree relatives with Type II DM, 8,8% had a history of giving birth more than 4 kg in their previous pregnancy and 3.9% of women were diagnosed with GDM in their previous pregnancy. In pregnant women in the risk group for GDM; the mean age, weight, BMI and 50 g OGTT result were significantly higher than the other group. GDM was detected in six of 49 women had OGTT and all were in the risk group. Conclusion: GDM screening test rates of pregnant women are gradually decreasing. This is not due to educational level or socio-demographic characteristics. Pregnant women receive false information, especially through the media, and the importance of the issue cannot be understood adequately. Health personnel have important duties; risk factors that are proven to be associated with GDM should be questioned at first encounter with pregnant women. Screening test should be performed in early pregnancy in risky pregnant, who do not want to have screening tests should be followed up frequently with blood glucose measurements.

The Quality of life and aging perceptions in the elderly: Baskent University example

Aging is a continuous and universal process that is seen in every living thing without privilege and causes a decrease in all our functions. In the past 40-50 years, the most important concept that has developed with the increase of the elderly population in the world, especially in developed countries, is the aging of societies. Quality oflife (QOL) was defined by the World Health Organization Quality of Life (WHOQOL) Group as “individuals’ perception of their position in life in the context of culture and value systems in which they live, and in relation to their goals, expectations, standards and concerns” In this study, it was aimed to evaluate the quality of life perception and aging perception of elderly patients who applied to family medicine outpatient clinics of a university hospital. The data of this descriptive and cross-sectional study, the questionnaire containing socio-demographic information, and the Turkish version of WHO’s Quality of Life Instrument Older Adults Module (WHOQOL-OLD)-TR and WHO’s Europe Attitudes to Aging questionnaire. (EAAQ)-TR were created. The questionnaires were applied to Baskent University Hospital Family Medicine outpatient clinics and 200 randomly selected volunteers over the age of 65.All scale dimension scores were compared according to demographic characteristics by statistical t-test and variance analysis. As a result, significant positive correlations among the dimensions of QOL and aging attitude (AA) were obtained. Also total scores of QOL and AA were significantly correlated.Moreover QOL dimension scores were significantly correlated to AA dimension scores. Whereas age and gender were significantly related to psychosocial loss dimension, education was significantly related to psychosocial growth, physical change and total aging attitude scores. Additionally higher educated subjects (university degree) had higher mean scores. The presence of a disease was significantly related to physical change and total aging attitude scores. (p< 0.005) Changes in living environments were significantly correlated to physical change dimension. There is a significant positive correlation between WHOQOL-OLD-TR total scores and AYTA-TR total scores. Increasing the quality of life of the rapidly increasing elderly population will be one of the most important goals in the field of health both today and in the future. Family physicians can provide a better primary health care service by evaluating the quality of life and aging perceptions of the elderly and contribute to the development of new policies in this difficult issue.

A case of newly diagnosed ulcerative colitis

Ulcerative Colitis is an inflammatory bowel disease that is frequently encountered in young people, with an attack and can be diagnosed only with pathology. It is not among the first diagnoses that come to mind because of the low frequency of occurrence even in the presence of related symptoms in primary health care services. In our case, we presented a patient who was admitted to our Family Medicine Outpatient Clinic and was diagnosed after ulcerative colitis.

Diabetes mellitus, insulin therapy, oral antidiabetic, rational drug use

Diabetes mellitus (DM); is a metabolic progressive di-sease with a rapidly increasing prevalence. The most important factors in the treatment of DM is the education of individuals with diabetes and rational drug use. Multiple insulin therapy is started with the diagnosis in type 1 DM (T1DM), oral antidiabetic drugs (OAD) and insulin treatments are initiated together according to the glycemic status in Type 2 DM (T2DM). Problems causing irrational drug use related to OAD in DM; advanced age, multidrug use, complex drug intake program, lack of knowledge, drug-related side effects, and patient disbelief. Problems causing irrational drug use related to insulin; hypoglycemia, lipodystrophy, incorrect injection technique, insufficient and high dose administration. This situation appears as macrovascular and microvascular diseases with not reaching target HbA1c values by causing glycemic dysregulation in DM. The success of the holding of treatment in optimal status with prevention for glycemia and metabolic condition raises the quality of life in patients, prolong the patient’s life expectancy and reduces costs. Doctors and insulin educators raising awareness of rational drug use in the diabetic population ensures that correct the irrational behaviors performed in the diabetic population and adopt appropriate behaviors as a lifestyle. Thus it will improve the educational content given to people with diabetes, help to improve diabetes management and behavioral change, thereby achieving appropriate glycemic goals and increasing secondary rational gains from drugs with treatment.

Self Transcendence In Family Practice

Family practice’s contextual, scientific, and comprehensive core competencies need having an altruistic consciousness. As self transcendence stands on the top of modified maslow’s hierarchy of needs, primary care also need to be altrustic.