Family physicians in an Eastern Turkish City need training on child abuse and neglect: A cross-sectional study.

AIM: The study's purpose was to determine the knowledge, competencies, and approaches of family physicians in recognizing the signs of child neglect and abuse. METHODS: This cross-sectional study was conducted between 1 March and 30 August 2019 in the Erzurum province in Turkey. The population of the study was family physicians working in primary care. The data were collected with an instrument that included the Scale of Diagnosing the Symptoms and Risks of Child Abuse and Neglect (SDRCAN) and a socio-demographic information form. RESULTS: The mean age was 37.40 ± 8.78 years (min. 26, max. 60). Of the participants, 103 (n = 58.5%) were men. The most common types of encountered child abuse/neglect were physical abuse or neglect (each 27.8%, n = 49). Having received education on child abuse/neglect among participants was only 44.9% (n = 79). On the other hand, the rate of having encountered any child abuse/neglect was 40.3% (n = 71). Another result of this study is the proportion of family physicians feeling weak regarding history taking (30.7%, n = 54), physical exam (17.0%, n = 30), and cooperation with the authorities (13.1%, n = 23). Additionally, the different responses among the participants about action in case of encountering child abuse/neglect were remarkable. Being a woman was one prominent factor that increased the SDRCAN score (P < 0.001). CONCLUSION: The awareness and knowledge of family physicians in Erzurum about child maltreatment are inadequate. We recommend focusing on child maltreatment, especially in medical faculties, including this issue in the standard core curriculums, and organizing intermittent in-service training programs during the post-graduate working period.

Burnout among family physicians in Turkey: A comparison of two different primary care systems.

AIM: The objective of this study was to determine the prevalence of burnout syndrome and associated factors among family physicians before and after family medicine system (FMS). MATERIALS AND METHOD: The first part of the study was conducted in 2008 (pre-FMS) and the second part in 2012 (post-FMS). Physician's burnout was investigated by using the Maslach Burnout Inventory (MBI). In total, 139 physicians had been participating pre-FMS and 246 physician's post-FMS. RESULTS: The mean pre-FMS emotional exhaustion score was 15.7 ± 5.8, increasing significantly to 17.14 ± 7.5 post-FMS (P = 0.045). Mean pre-FMS and post-FMS depersonalization and reduced personal accomplishment scores were similar (P > 0.05). Age was negatively correlated with depersonalization in this study (P = 0.012) and positively correlated with personal accomplishment (P = 0.001). The primary care physicians in the post-FMS period were older, female physicians had a greater preference for primary care, and the levels of married doctors were higher. In addition, a higher level of physicians also owned their own home and cars compared to the pre-FMS period. A negative correlation has been reported between physicians' burnout levels and home or car ownership in the present study. CONCLUSION: Our findings suggest that physicians working under the family medicine system, a new primary care model, are at greater risk of emotional exhaustion, but that no change has occurred in terms of personal accomplishment or depersonalization, despite this new system.

Prevalence of obesity among adolescents in Eastern Turkey: A cross-sectional study with a review of the local literature.

BACKGROUND: The World Health Organization defines obesity as an abnormal or excessive fat accumulation that can damage health. AIMS: This study aims to evaluate the prevalence of obesity and risk factors in high school students in Erzurum City Center. STUDY DESIGN AND METHODS: A cross-sectional study was conducted. The number of students participating in the study was 845, including 47.6% females and 52.4% males. Data collection was done by surveys filled in under supervision. Anthropometric measurements were performed by the researchers. Predictions of the Extended International Obesity Task Force were used for body mass index. Parents' body mass indexes were calculated by self-report and classified according to cut-off points for adults in the world health community. A systematic review of the local literature published between 2004 and 2013 was drafted. RESULTS: In girls and boys, the frequency of overweight was 26.9% and 25.7%, respectively, while the frequency of obesity was 12.4% and 9.5%. A logistic regression analysis was performed to reveal significant risk factors for overweight/obesity. Weekly exercise status [odds ratio = 3.0, 95% confidence interval CI (1.2-7.8)] and school transfer % CI = (1.1-7.2) were important independent risk factors for obesity. The local literature showed a 4.3-fold increase in the prevalence of obesity within 10 years. CONCLUSION: The prevalence of obesity and overweight in adolescents requires the implementation of effective programs to fight this epidemic. Health education targeting peers and their parents, peer education, screening of risk groups, and controlling the sale of unhealthy foods can be some interventions.

Rational drug use and prescribing behavior of family physicians in Erzurum, Turkey.

BACKGROUND: Widespread irrational medical prescription adversely affects the outcomes of patient health and medical services. AIM: This study aims to investigate the determinants of medical prescription behavior of family physicians in Erzurum Province. MATERIALS AND METHODS: This cross-sectional descriptive study was conducted during August-December 2016 on a voluntary sample of 191 out of 234 physicians (81.6%) working at family health centers in the districts of Erzurum. Physicians were visited at their workplaces, and data were collected using a self-administered and structured, 45-item questionnaire. RESULTS: The mean age of the physicians was 34.7 ± 7.9 years, and 70.7% (n = 135) of the participants were males. About 83.8% (n = 160) of physicians responded "yes" or "sometimes" to the question "Do you prescribe medicine on demand of the patients?" The two most important factors that affected the prescribing behavior of the participants were the pharmacology lectures attended during medical education (50.8%) and the prescribing experience acquired during clinical internship (46.0%). Presentations given by the representatives of drug companies, in-service training programs after graduation, and Internet/mobile phone applications had the lowest rate of contribution as behavioral determinants. The participants perceived having sufficient information in the areas of indication for use (77.5%) and daily dose (72.8%). Only 4.2% of participants deemed their knowledge of medication costs sufficient. Pharmacology lessons were found to be more effective in the prescribing behaviors of the physicians who had less than 10 years of professional experience (Chi-square = 12.131; P = 0.002). CONCLUSION: Rational medical prescription continues to be a trouble among family physicians. The study findings suggest a substantial knowledge gap in participating physicians occurring after graduation and clinical internship training, in the areas of costs of medicine and rational medical prescribing.

Levels of burnout and their associated factors among physicians working in Northeast Anatolia.

CONTEXT: The concept of burnout is a condition seen in occupational groups working face-to-face with people and resulting in emotional exhaustion, depersonalization, and low professional productivity. AIMS: The purpose of this study was to determine burnout levels and associated factors in physicians practicing in Erzurum, Northeast Anatolia, Turkey. SETTINGS AND DESIGN: This research was designed as a cross-sectional descriptive study. The research sample size was calculated at 663 participants with a 99% confidence interval and a 3% margin of error using Epi Info software. A 10% incomplete or nonresponse rate was added, for a target cohort of 730 individuals. Seven hundred and eleven physicians agreeing to take part were enrolled. SUBJECTS AND METHODS: A questionnaire consisting of questions concerning sociodemographic characteristics and the Maslach Burnout Inventory (MBI) was used as the data collection tool. The questionnaires were distributed by the authors and completed by the physicians in person. STATISTICAL ANALYSIS: Descriptive data were expressed as percentage, mean, median, and standard deviation. Data were analyzed using the Kruskal-Wallis and Mann-Whitney U tests and binary logistic regression analysis. P < 0.05 was regarded as statistically significant. Statistical analyses were performed on SPSS 15.00 software. RESULTS: The mean age of the physicians in the study was 34.4 ± 7.7 years. Mean MBI subdimension scores were 15.6 ± 7.0 for emotional exhaustion, 5.7 ± 3.9 for depersonalization, and 21.0 ± 4.4 for personal accomplishment. Mean emotional exhaustion and depersonalization scores were significantly higher and personal accomplishment scores significantly lower in physicians aged under 25, not taking vacations, working in public hospitals, who were working as research assistants. CONCLUSIONS: Burnout levels among the participants were low (emotional exhaustion in 75%, depersonalization in 76.2%, and low personal accomplishment in 69.6%).

The opinions of adults about the ban on cigarette sales to minors.

BACKGROUND: Selling of tobacco products to minors has been banned since 1996 by the tobacco control law in Turkey. However, it is also important for the public to support practices that prevent the access of tobacco products to minors. In addition, every individual has the responsibility of carrying out society based programs that restrict access to tobacco products especially to children and the youths. Social sensitivity is considered an important factor in the prevention of tobacco use. This study aims to learn about the opinions and attitudes of adults with regards to minors access to tobacco products. METHODS: The study was a descriptive study conducted in nine city centers in Turkey. The total number of participants reached was 3241. The questionnaire was developed by the research team and consisted of 22 questions concerning knowledge and behaviors of adults on restriction of tobacco sales to minors and their observations with regards tobacco sales to minors. Data was collected through face to face interview. Pearson chi-square test was used for the bivariate analysis whereas logistic regression was investigate the relationship between "the participant's response against tobacco sales to minors" and the following explanatory variables; "age", "educational status", "income level", "working status", "minors access to cigarettes", "smoking ratio in high school" and "sales of tobacco to minors". RESULTS: More than half of the participants (60.5%) belonged to the age group 25-44 years, 61.3% graduated from high school or university. Most of the participants were smoker (39.2%) or ex-smoker (19.1%), and 41.7% of the participants was non-smoker. A greater proportion of the participants (76.2%) believed that smoking prevalence was greater than 40% among high school students. One in four (27.8%) adults did not know that tobacco control law bans sell of tobacco products to minors in Turkey. More than half of the participants (57.1%) ever witnessed tobacco sales to minors and 63.6% of them did not act when confronted with the event. Almost all (96.8%) of the respondents thought that access of minors to tobacco products was not difficult. The results of logistic regression of participant's response against tobacco sales to minor and related factors for current smokers showed that respondents who believed smoking ratio in high school was 4-5 adolescent out of 10 (aOR: 1.59; 95% CI: 1.09-2.34) were more likely to give a warning or informing the police or other people as compared to respondents whose perception on the smoking ratio among high school students was 6-7 adolescents out of 10. The results of logistic regression of non-smokers' response against tobacco sales to minor were who are from higher educational level, higher economic status, working status and who believed smoking ratio in high school was 4-5 adolescent out of 10 and 2-3 adolescent out of 10 were more likely to give a warning or informing the police or other people as compared to the others. CONCLUSIONS: Although laws prohibiting the sale of tobacco products to the under age group is very important with regards to accessibility of minors to tobacco products, most of the study participants believed that minors can still easily access tobacco products, and more than half of the participants did not act when confronted with the event. The education, information and monitoring program most especially as it concerns salesman, should be reviewed and strengthened to obey the rules on sales of tobacco products to minors. Education program should be carried out to increase the knowledge and awareness of the community for sale of tobacco to minors. Social sensitivity is important for the prevention of tobacco use and every individual have a responsibility in carrying out this society based program, most especially as it related to prevention of tobacco usage among children and youths.