Effect of malpractice claims on orthopedic and traumatology physicians in Turkey: A survey study.

OBJECTIVE: This study aimed to investigate the malpractice claims experienced by orthopedic and traumatology physicians and to determine their effects on burnout, job satisfaction, and clinical practice. METHODS: A questionnaire survey was conducted on orthopedic and traumatology specialists between May 2019 and February 2020. Data collection was carried out via e-survey at "turk-ortopedi" mail group, which is an electronic communication network of orthopedic and traumatology physicians. For data collection, sociodemographic data forms were used including the general characteristics, working conditions, and the malpractice claim events along with the Maslach Burnout Inventory scale to evaluate burnout and the Minnesota Satisfaction Questionnaire to investigate job satisfaction. RESULTS: In total, 353 orthopedic and traumatology physicians (348 men, 5 women), including 37 professors, 41 associate professors, and 275 surgeons, completed the questionnaire. In total, 65.4% of the participants (231 physicians and 471 relevant dossiers) stated that they were currently facing a malpractice claim. Emotional burnout and hesitant behavior in medical practices were significantly higher among the physicians who had undergone an investigation/trial with the claim of malpractice (p<0.05), whereas intrinsic job satisfaction was significantly lower (p<0.05). It was determined that orthopedic and traumatology physicians dealing with arthroplasty, vertebral surgery, hand surgery, and foot/ankle surgeries had undergone significantly more trials (p<0.05). In the evaluation of the burnout levels and job satisfaction scores of the physicians according to the age, academic title, seniority, and institution, it was determined that burnout level decreased with age, those between the ages of 25 and 34 years were exhausted the most, and job satisfaction increased with age. It was also found that burnout level decreased and job satisfaction increased as the academic title became higher, and attending physicians were the most exhausted. Moreover, burnout level decreased as seniority increased, the most senior ones were the ones most exhausted, and job satisfaction increased with seniority. CONCLUSION: Evidence from this study has revealed that malpractice claims cause emotional burnout, low intrinsic job satisfaction, and a hesitant behavior in medical practice for the orthopedic and traumatology physicians. The concept of malpractice alone may result in unnecessary analyses/examinations for patients. LEVEL OF EVIDENCE: Level IV, Diagnostic Study.

Energy-drink consumption and its relationship with substance use and sensation seeking among 10th grade students in Istanbul.

Aim of this study was to determine the prevalence and correlates of energy-drink (ED) consumption among 10th grade students in Istanbul/Turkey. Cross-sectional online self-report survey conducted in 45 schools from the 15 districts in Istanbul. The questionnaire included sections about demographic data, self-destructive behavior and use of substances including tobacco, alcohol and drugs. Also Psychological Screening Test for Adolescents (PSTA) was used. The analyses were conducted based on the 4957 subjects. Rate of those reported a ED consumption once within last year was 62.0% (n=3072), whereas rate of those reported ED consumption at least once in a month was 31.1%. There were consistent, statistically significant associations between genders, lifetime substance use (tobacco, alcohol and drug use), measures of sensation seeking, psychological problems (depression, anxiety, anger, impulsivity) and self-destructive behavior (self-harming behavior and suicidal thoughts) with ED consumption. In logistic regression models male gender, sensation seeking, life-time tobacco, alcohol and drug use predicted all frequencies of ED consumption. In addition to these predictors, anger and self-harming behavior also predicted ED consumption at least once in a month. There were no interactions between the associations of lifetime tobacco, alcohol and drug use with ED consumption. The findings suggest that the ED consumption of male students is related with three clusters of substances (tobacco, alcohol and drug) through sensation seeking and these relationships do not interact with each other.

Effects of lifetime tobacco, alcohol and drug use on psychological and behavioral problems among 10th grade students in Istanbul.

AIMS: The aim of this study was to determine the effects of life-time tobacco, alcohol, and substance use on psychological and behavioral variables among 10th grade students in Istanbul/Turkey. MATERIALS AND METHODS: This study employed a cross-sectional online self-report survey conducted in 45 schools from the 15 districts in Istanbul. The questionnaire featured a section about use of substances, including tobacco, alcohol, and drugs. The depression, anxiety, anger, assertiveness, sensation seeking and impulsiveness subscales of the Psychological Screening Test for Adolescents (PSTA) were used. The analyses were conducted based on 4957 subjects. RESULTS: Logistic regression analyses were conducted with each school with the related and behavioral variables as the dependent variables. Gender, tobacco, alcohol, and drug use being the independent variables. All four independent variables predicted the dependent variables. Lifetime tobacco and drug use had significant effects on all the subscale score, whereas lifetime alcohol use had significant effects on all the subscale scores other than lack of assertiveness, and male gender was a significant covariant for all the subscale scores. Drug use showed the highest effect on dependent variables. Interaction was found between effects of tobacco and alcohol on anxiety, whereas interactions were found between effects of tobacco and drugs on lack of assertiveness and impulsiveness. CONCLUSION: The findings suggested that male students with lifetime tobacco, alcohol or drug use have particularly high risk of psychological and behavioral problems. The unique effects of substance clusters on these problems may be useful in developing secondary preventive practices for substance use and abuse problems in Istanbul.

High risk of Internet addiction and its relationship with lifetime substance use, psychological and behavioral problems among 10(th) grade adolescents.

BACKGROUND: The aim of this study was to investigate the relationship of higher risk of Internet addiction (HRIA) with lifetime substance use, psychological and behavioral factors among Turkish 10(th) grade students. SUBJECTS AND METHODS: Cross-sectional online self-report survey conducted in 45 schools from the 15 districts in Istanbul, Turkey. A representative sample of 4957 10(th) grade students was studied between October 2012 and December 2012. Other than sociodemographic variables the survey included the Addiction Profile Index Internet Addiction Form-Screening Version (BAPINT-SV) and the Psychological Screening Test for Adolescents (PSTA). RESULTS: The participants were classified into two groups as those with HRIA (15.96%) and those with lower risk of Internet addiction. The rate of HRIA was higher in the males. The findings indicated that HRIA is related with negative consequences in school, lifetime use of tobacco, alcohol and/or drug, suicidal thoughts, self-harming and delinquent behaviors. CONCLUSIONS: Male gender, lifetime use of tobacco, alcohol and/or drug, depression, attention deficit and hyperactivity symptoms and lack of assertiveness predicted the HRIA in Turkish 10(th) grade students. Being aware of those with HRIA is important in prevention and management of Internet addiction as well as other important problems among students, such as substance use.

The severity of attention deficit hyperactivity symptoms and its relationship with lifetime substance use and psychological variables among 10th grade students in Istanbul.

AIM: The aim of this study was to determine the severity of attention deficit hyperactivity symptoms (ADHS) and related psychological and behavioral variables among 10th grade students in Istanbul/Turkey. METHODS: Cross-sectional online self-report survey conducted in 45 schools in 15 districts Istanbul. The questionnaire included sections about demographic data and use of substances including tobacco, alcohol and drugs. Also ADHS, depression, anxiety, anger and sensation seeking subscales of Psychological Screening Test for Adolescents (PSTA) were used. The analyses were conducted based on the 4938 subjects. RESULTS: Mean ADHS score was higher in females and among those with a lifetime use of tobacco, alcohol and drug, and having self-harming behavior and suicidal thoughts. ADHS score was correlated with depression, anxiety, anger and sensation seeking scores. In univariate covariance analysis (ANCOVA); depression, anxiety, anger, sensation seeking, lifetime alcohol use and suicidal thoughts predicted the severity of ADHS. CONCLUSIONS: The findings suggest that, since ADHS is associated with depression, anxiety, anger, sensation seeking, lifetime alcohol use and suicidal thoughts among 10th grade students, clinicians should screen suicidality and comorbid psychiatric symptoms routinely in adolescents with ADHS.

Tobacco use among 10th grade students in Istanbul and related variables.

Aim of this study was to determine prevalence of cigarette smoking and hookah use among 10th grade students in Istanbul, Turkey, and to compare sociodemographic, psychological and behavioral variables according to frequency of tobacco use. Cross-sectional online self-report survey conducted in 45 schools from the 15 districts in Istanbul/Turkey. The questionnaire included sections about demographic data, family characteristics, school life, psychological symptoms and use of substances including tobacco, hookah, alcohol, marijuana, volatiles, heroin, cocaine, non-prescribed legal tranquillizers (benzodiazepines, alprazolam etc.) and illegal tranquillizers (flunitrazepam). The analyses were conducted based on the 4957 subjects. Trial at least once in life is observed as 45.4% for hookah use and as 24.4% for cigarette use. Risk of hookah and cigarette use was significantly higher in male students than in female students. Frequency of tobacco use is related with various sociodemographic, psychological and behavioral variables. Our data also shows that using tobacco and alcohol increases the risk of all the other substances use and these effects are interrelated. The data suggest that there is a link between tobacco use and substance use, psychological, behavioral and social factors. There is also a strong association between tobacco use and suicidal behavior as well as self-mutilative, impulsive, hyperactive, delinquent, aggressive and behavioral problems. The illumination of these relationships may be relevant in prevention and management of tobacco use as well as important problems, such as substance use, impulsivity, hyperactivity, delinquent, aggressive self-mutilative and suicidal behavior among 10th grade students in Istanbul.

Non-suicidal self-harm behavior within the previous year among 10th-grade adolescents in Istanbul and related variables.

BACKGROUND: Non-suicidal self-harm behavior (SHB), which is a pervasive and dangerous problem, is frequent among adolescents and it is important to evaluate the associated psychological and social factors to better understand its nature and to plan treatment programs. AIMS: Aim of the present study is to determine the prevalence of SHB and the associated variables such as substance use, psychological, behavioral and social factors among 10th-grade students in Istanbul/Turkey. METHODS: Cross-sectional online self-report survey conducted in 45 schools from the 15 districts in Istanbul/Turkey. A representative sample of 4957 10th-grade students was studied between October 2012 and December 2012. RESULTS: SHB within the previous year were reported by 14.4% of the students (n = 713). Lifetime suicidal thoughts or behavior, tobacco, alcohol and/or drug use, symptoms of depression, anxiety and impulsive, delinquent and aggressive behaviors were also associated with SHB in Turkish 10th-grade students. CONCLUSIONS: The findings of the present study may be relevant in prevention and management of SHB as well as important problems among students, such as substance use, impulsive, delinquent, aggressive and suicidal behavior.