Investigation of the Relationship Between Postpartum-Specific Anxiety and Maternal Attachment and Affecting Factors in a Turkish Sample

Aim: Postpartum-specific anxiety is associated with impaired mother-infant attachment, postpartum depression, reduced probability of breastfeeding, increased risk of infant abuse, and increased probability of anxiety in children and may lead to psychological, cognitive, and psycho-motor disorders in child development. This descriptive and cross-sectional study aims to determine the effect of anxiety level in the postpartum period in women on maternal attachment. Methods: The participants were 384 postpartum women who have a 1-3-month old baby. Data were collected using a personal information form, Postpartum Specific Anxiety Scale, and Maternal Attachment Inventory. Results: It was found that the Postpartum Specific Anxiety Scale in women was at a medium level, while maternal attachment was at a high level. While the Postpartum Specific Anxiety Scale was at higher levels in those who were younger, unemployed, and had no other children, the younger age of the partner increased the Postpartum Specific Anxiety Scale score. No statistically significant relationship was found between Postpartum Specific Anxiety Scale and maternal attachment. Conclusion: It is seen that to evaluate women in terms of anxiety in the postpartum period and to provide the necessary psychosocial support is necessary. The fact that maternal attachment in women was high may have had a positive effect on her relationship with postpartum anxiety. Keywords: postpartum, anxiety, children, bonding

Knowledge, Attitude, And Practice Towards Antibiotic Resistance Among General Practitioners in Polyclinics in Yerevan, Armenia

Aim: The objectives of the study were measuring knowledge, attitude, and practice scores among general practitioners on antibiotic resistance; exploring associations between antibiotics prescribing practice score among general practitioners and their knowledge and attitude scores after adjusting for other factors; and identifying barriers for rational antibiotics prescription by general practitioners. Methods: A cross-sectional study design was used. A self-administered survey was conducted among general practitioners employed in private and public polyclinics in Yerevan, Armenia. All general practitioners, working in Yerevan polyclinics and fluent in the Armenian language, were eligible for the study. The study was conducted in primary healthcare facilities of Yerevan, Armenia. All polyclinics (n=18) serving 30,000 or more populations were included in the study. All general practitioners available in selected polyclinics at the time of the survey were invited to take part in the survey, to target 20 general practitioners from each polyclinic. Results: Overall, 291 general practitioners participated in the study. Knowledge, attitude, and practice mean percent scores were 58.3%, 67.5%, and 63.0%, respectively. In the adjusted analysis, the practice percent score was significantly associated with the attitude percent score, though the relationship between the practice and knowledge scores was insignificant. The main barriers reported by general practitioners: lack of rapid diagnostic tests, high costs of laboratory tests, high costs of some antibiotics, and lack of guidelines. Conclusion: Identified low knowledge, attitude, and practice mean percent scores suggest a need for improvements in these areas. Availability of rapid and inexpensive diagnostic tests, enforcement of prescriptions could potentially prevent the development of antibiotic resistance. Keywords: drug resistance, general practitioners, polyclinics, prescribing

Evaluation of the Knowledge Level of Family Medicine Residents about Mammography and Breast Cancer Screening Programs

Aim: It was aimed to evaluate the level of knowledge of family medicine residents about breast cancer screening program national standards and mammography. Methods: In this cross-sectional study, an online questionnaire was used to measure the knowledge level of family medicine resident doctors about breast cancer and mammography. In addition to demographic information, the questionnaire included questions about the diagnostic advantages of radiological breast imaging methods, the age of onset of breast cancer screening in different risk groups, and the national breast cancer screening program. The questionnaire, prepared through Google forms, was announced on social media channels used by family physicians and kept open for three months. Results: The mean age of 151 physicians was 30.4±4.3. 61.6% of the physicians were female and 38.4% were male. Only 11.9% (n=18) of the participants had previously attended a training/course on mammography. The mean correct answer score was 4.58±1.50 for 9 questions. The test scores of the residents who received specialized training in the education and research hospital were statistically significantly higher than those who received training in the university hospital (4.77±1.86 and 3.64±1.63). The mean score of residents who received previous mammography education was significantly higher than others. Conclusion: Awareness and knowledge levels of family medicine residents about breast cancer screening methods and programs should be increased with multidisciplinary training programs. Keywords: mammography, breast cancer, screening, family practice

Evaluation of Clinical Follow-Up of The Patients Monitored at Home Due To COVID-19 Pandemic

Aim: The most valuable approach to prevent the spread of the novel COVID-19, which is a pandemic today, is to detect, isolate, and treat patients. The majority of patients are mild or asymptomatic cases. These cases are followed up and isolated at home in many countries. With a governmental decision issued in Turkey, it has been deemed appropriate to follow up the suspected, contact or definitive diagnosis patients who do not indicate inpatient treatment, have a mild clinical course, or do not have a risk factor that may lead to a severe course of COVID-19, at home by the family practice units. In this study, we aimed to investigate the characteristics of the patients with COVID-19 who were being monitored at home. Methods: The study was designed as a retrospective cross-sectional observational study. In this study, 321 people who were registered at the Education and Family Health Centers of our hospital and followed up as COVID-19 suspects, contacts, or definitive cases were identified. Home follow-up data of these patients between April 1-30 were obtained retrospectively from the records of family health centers. Data, such as the presence and course of symptoms of people followed at home, their isolation status, medicine usage status, and test results were recorded electronically for further analysis. Results: In this study, 321 patients, 163 (50.28%) males, and 158 (49.22%) females were included. Among 321 patients, 287 (89.41%) were contact patients, 54 (16.82%) were suspected patients, and 28 (8.72%) had a definitive diagnosis. The mean age of the patients was 40.00±20.68. Among the patients included in this study, 27 (8.41%) were hospitalized, symptoms worsened in 8 (2.49%), 5 (1.56%) were re-applied to the hospital, 5 (1.56%) were re-hospitalized, and 28 people (8.72%) were administered medication. Conclusion: The mean age of patients who complied with the measures of isolation was higher than patients who did not. The mean age of hospitalized patients was higher than in non-hospitalized patients. The frequency of observed symptoms was consistent with the previous studies in the literature. Keywords: cough, fever, pandemics, quarantine, SARS-CoV-2

Depression, Anxiety and Sleep Disturbance in Primary Health Care Workers During the COVID-19 Pandemic

Aim: In Turkey, family physicians and family health nurses are among the groups fighting COVID-19 on the frontline. This study was aimed to determine depression, anxiety, and sleep disorders and related factor during the COVID-19 pandemic in FPs and FHNs working in Rize. Methods: Single-centered, a cross-sectional web-based survey study was conducted between July 21-31, 2020 in Rize, Turkey. Demographic characteristics and information related to the COVID-19 pandemic were collected from primary health care workers and depression, anxiety, and sleep quality were evaluated by Beck Depression Inventory, Beck Anxiety Inventory, and Pittsburgh Sleep Quality Index, respectively. A total of 109 primary health care workers were included in the study. Results: While 48 (44%) of the primary health care workers had at least mild depressive symptoms, 46 (42.2%) had the least mild anxiety symptoms. Sleep disturbance was also found in 48 (44%) of them. The frequency of psychological symptoms was higher in women, nurses, and those who thought that their protective equipment was insufficient. Sleep disturbances were more common in primary health care workers with psychiatric illness and who suspect they have had COVID-19 at any time. Conclusion: Primary health care workers had a high rate of depression, anxiety, and sleep disorders. It would be beneficial to make special interventions to promote mental health for primary health care workers, who are among the frontline groups in the fight against COVID-19. Keywords: anxiety, COVID-19, depression, health care worker, sleep disorders

Evaluation of YouTube Videos as a Source of Information on Non-Invasive Prenatal Testing

Aim: Non-invasive prenatal testing is a method that determines the risk of a fetus being born with certain genetic abnormalities. In this study, we aimed to examine the quality of information on YouTube for non-invasive prenatal testing. Methods: The term "Non-invasive prenatal testing" was entered in the YouTube search bar on May 1, 2021, and the top 50 YouTube videos of the non-invasive prenatal testing with the highest number of views were recorded after the exclusion of videos with a non-English language, videos repeated twice and irrelevant videos. Length of the videos, likes, and dislikes were recorded. Videos were evaluated by two obstetricians. A questionnaire consisting of 9 dichotomous questions was conducted to assess whether there was adequate information about non-invasive prenatal testing. In addition, video quality was evaluated with the Global Quality Scale, the Patient Education Materials Assessment Tool and the Journal of the American Medical Association Benchmark Criteria. Results: The mean Global Quality Scale was 2.96±0.62. Most videos answered the question: ‘What is non-invasive prenatal testing?’ (94%), and ‘How is non-invasive prenatal testing done?’ (82%). However, there was a lack of information about the limitation of non-invasive prenatal testing in certain situations (only %16 of videos answered limitations of non-invasive prenatal testing). Three (6%) of the videos had misinformation. The mean Global Quality Scale was 2.96±0.62. The Patient Education Materials Assessment Tool mean value was 72% and 58% in terms of understandability and actionability, respectively. The mean Journal of the American Medical Association Benchmark Criteria score was found as 1.4±0.8. Conclusion: The videos posted about non-invasive prenatal testing on YouTube were of poor-moderate quality. If the quality of the videos increases, patients can have sufficient and accurate information about non-invasive prenatal, especially during these pandemic days. Keywords: health information, prenatal diagnosis, online systems

The First Ten Years with Edirne Red

The Eurasian Journal of Family Medicine (EJFM) is completing its 10th volume with this issue as one of the first products of the dreams of a group of academicians devoted to family medicine. Eurasian Society of Family Medicine (ESFAM) has been established in 2009 with the aim of carrying out scientific education and research activities, supporting ongoing scientific activities, and informing the society, carrying out activities for community education, and establishing a foundation to operate in this field. Shortly after its establishment, the first product of the association was organizing Trakya Family Medicine Congresses (TAHEK). At first, TAHEK was organized as a national congress in 2010 but since 2016 it became an international one with the participation of scientists from many countries (1). Next year on March 23-27, 2022 TAHEK will bring together Family Medicine academicians in Edirne for the 11th time (2). Edirne (Orestia, Orestas, Uscudama, Hadrianopolis, Edrenos, Edrenaboli, Edrene, finally Edirne) being the headquarters of ESFAM, is one of the ancient civilization centers of the world with its eight thousand years of history (3,4). After its conquest by the Turks in 1361, it was the capital of the Ottoman Empire until the conquest of Istanbul in 1453. Edirne has an important place in medical and academic history. The Complex of Sultan Bayezid II, which was opened in 1488, is one of the oldest universities in Europe with its medical faculty and hospital (5,6). In addition, the smallpox vaccine was first used in Edirne, its usage was later disseminated to Istanbul and Europe (7). Another imperial legacy that Edirne has is Edirne Red. Edirne Red was a natural dye obtained from the Rubia Tinctorum plant and very resistant to sunlight and washing, and was used in Turkish carpets and silk and cotton fabrics (8). While preparing the first issue of the Eurasian Journal of Family Medicine in 2012, we have chosen Edirne Red as the color of the cover of our journal, aiming to express our respect for the city where the association was established. Over the years, Trakya Family Medicine Congresses (TAHEK) have become one of the leading Family Medicine congresses of the Eurasian region, especially in the Balkans; It has made significant progress in becoming the meeting point of distinguished Family Medicine researchers and academicians from all over the world. During this time, our journal contributed to the dissemination of thousands of academic papers in the participating countries and increased the number of its followers. Likewise, Eurasian Journal of Family Medicine (EJFM) has enriched the international literature with many researches published over the years. It is a pride for us to express that the Eurasian Journal of Family Medicine has started to be indexed by many respected international scientific indexes. Scopus and DOAJ were added to these indexes this year. At the end of the tenth volume of our journal, we are happy to express our appreciation and gratitude to our authors, reviewers, distinguished international advisory board members, editors and all our stakeholders who shared our dreams and contributed to our products.

Blood Types and Severity of COVID-19

Aim: Since blood types first appeared, their association with diseases caused by microorganisms has been further investigated with several studies for many years. The bond of blood groups described as A, B, AB, and O with coronavirus has been the research subject in many countries.We aimed to elucidate whether there was a relationship between blood types and Rh factor and contracting COVID-19 disease and disease severity. Methods: The study was designed as a retrospective case-control study. Between March 2020 - February 2021, 1110 patients were included (538 cases, 572 controls). Disease severity was classified according to where patients were treated: those who were outpatients considered as “mild disease”, hospitalized in a hospital ward considered as “moderate disease”, and treated in the intensive care unit were considered as “severe disease”. Results: The number of people with blood type A was 447 (40.3%), blood type B was 197 (17.7%), blood type AB was 90 (%8), and blood type O was 376 (33.9%). There was no significant difference between the case and control groups according to the blood types. A 3.93 times increase of developing mild illness was detected compared to the control group in Rh-positive individuals. The rate of developing a severe disease was higher in females with blood type A than a mild disease, and A blood type caused the disease to be severe compared to other blood groups in females. Conclusion: We concluded that blood type A caused more severe disease than other blood types in females, and females with B blood type survived the disease as outpatients. Our study can shed light on pathophysiological investigation of the relationship between COVID-19 disease causing a pandemic with high mortality and virulence and blood types. Keywords: COVID-19 virus, blood group, disease

The Status of Healthcare Professionals’ Having COVID-19 Vaccine and Evaluation of Its Side Effects: A Pandemic Hospital Experience

Aim: Vaccination is one of the most effective and safest preventive health services in the fight against COVID-19. Many people in society have hesitations about the COVID-19 vaccines. We evaluated the vaccination participation rates of healthcare workers to be a positive role model for society. Methods: Between 14 January 2021 and 15 April 2021, 2637 healthcare workers who received 2 doses of 0.5 ml CoronaVac vaccine with 4 weeks intervals were classified as occupation, unit, marital status, age, and gender. Registered side effects were evaluated. Results: It was observed that 65.6% of the healthcare workers were vaccinated and 2.4% (n=62) of the vaccinated workers developed side effects. The mean age of the vaccinated personnel was 34.37±10.04 years. 59.8% (n=1577) of the vaccinated personnel were male and 53.6% (n=1413) were single. The occupational group with the highest vaccination rate was doctors with 78% (n=658). The most common side effect was myalgia in 45.2% (n=28), followed by headache with 38.7% (n=24). About half of those who developed side effects had only one side effect. Conclusion: It was concluded that COVID-19 vaccination differs according to age, gender, and role in the hospital, with the highest vaccination rate among physicians. The vaccination status of healthcare workers who are heavily affected by COVID-19 will positively affect society. Keywords: health personnel, COVID-19, vaccination

Determination of the Problems Experienced by Patients with Chronic Diseases and Their Caregivers During Home Care Process From Nursing Students’ Perspectives: A Phenomenological Study

Aim: This qualitative study was conducted to determine the problems experienced by patients with chronic diseases and their caregivers during the home care process from nursing students' perspectives. Methods: Phenomenological method of qualitative research was used in the study. Data was gathered via in-depth interviews with seven nursing students who had a family member with chronic disease. Students were asked about the problems they and their family members experienced during the home care process with a semi-structured questionnaire. Data obtained from the interviews were analyzed using content analysis. Results: As a result of thematic analysis, problems experienced by the patients with chronic diseases and their caregivers during the home care process are grouped under five main themes. These problems were physical problems, social problems, financial problems, psychological problems, and treatment-related problems. Conclusion: This research revealed that the home care process of patients with chronic diseases causes various problems for both patients and their caregivers. Therefore, it is necessary to be aware of these problems, increase the quality of home care services and ensure the continuity of home care. In this way, physiological, psychological, financial, social, and treatment-related problems can be prevented. Keywords: caregivers, chronic disease, family health, home care, nursing students