Evaluation of smoking cessation counseling practices of physicians working in primary health care institutions.

Background/aim: In this study, we aimed to evaluate the self-reported practice of physicians working in primary health care institutions in Elazig Province about smoking cessation counseling. Materials and methods: The population of this cross-sectional study consisted of 262 physicians working in primary health care institutions in Elazig. We aimed to reach the entire population without using the sample selection method and we successfully reached 95.42% (250 people) of the population. A questionnaire form was used for data collection. The data obtained were evaluated by frequency, percentage, mean ± standard deviation, median and minimum-maximum, and binary logistic regression analysis. Results: The mean age of the physicians was 40.86 ± 10.58 years and 68.0% of them were male. Among them, 30.4% (n = 76) were current smokers, 17.6% (n = 44) were former smokers and 52.0% (n = 130) were never smokers. The physicians' frequency of applying the steps of smoking cessation counseling was as follows: 38.8% "Ask", 81.6% "Advice", 68.4% "Assess", 66.8% "Assist", 31.2% "Arrange". Additionally, 16.0% of the physicians received smoking cessation counseling training. Those who had not smoked at least 100 cigarettes in their life applied the "Advice" (p = 0.026) step more frequently. Those who received smoking cessation counseling training applied the following steps more frequently: "Ask" (p = 0.024), "Assist" (p = 0.025), and "Arrange" (p = 0.001). Conclusion: It is seen that the smoking frequency of primary care physicians in Elazig Province is the same as that of the general population, and the frequency of smoking cessation counseling is far behind the target. Physician population is an important target group that should not be ignored in the fight against smoking. In order to increase the frequency of physicians' smoking cessation counseling practice, there is a need to increase the number of physicians who receive smoking cessation counseling training.

Investigation of the Effect of Written and Visual Information on Anxiety Measured Before Magnetic Resonance Imaging: Which Method is Most Effective?

Background and objective: Magnetic resonance imaging (MRI) causes severe anxiety in some patients. Anxiety during MRI leads to prolongation of the procedure and deterioration of image quality, resulting in loss of labor and cost increase. The aim of this study was to investigate the effect of written and visual information on state anxiety in patients undergoing MRI. Material and Methods: A cross-sectional prospective study was conducted with 294 participants. The study was carried out between January 2019 and March 2019 at the Radiology Clinic of the tertiary university hospital. The participants were divided into 3 groups as group 1 (control group), group 2 (written information) and group 3 (visual information). The trait anxiety and state anxiety of the participants were measured by State-Trait Anxiety Inventory (STAI) inventory, which can measure both anxiety status. Results: There was no statistically significant difference between demographic characteristics and trait anxiety scores (p = 0.20) of all three groups. The state anxiety scores of group 3 were statistically lower than the group 2 (p < 0.001) and control group (p < 0.001). The state anxiety scores of group 2 were statistically lower than control group (p < 0.001). Conclusion: MRI anxiety can be reduced by visual and written information. Visual information may be more effective in reducing MRI anxiety than written information.

Age at the onset of menopause and its influencing factors in Turkish women in a rural area.

This study was performed to identify menopausal age and its determining factors in women over 40 residing in the Dogubeyazit district of Agri, located in Eastern Turkey. This cross-sectional study was performed on a sample of 1,068 women, selected by simple random sampling among all district health center records of women aged 40 and greater, who were each attributed a random serial number. While 35.6% of the subjects had not yet reached menopause, 60.5% had entered it spontaneously and 3.9% surgically. Average age at spontaneous menopause was 47.4 ± 3.7 years and that of surgical menopause 45.1 ± 5.0. Age at marriage, age of last pregnancy, and the age of the subject's mother at menopause affected menopausal status. Identifying menopausal age and its determining factors may modify the menopausal status of women and their management of the perimenopausal period.

An analysis of hospital cleaning staff's attitudes and conduct regarding hand hygiene and cleaning.

OBJECTIVE: The aim of this study was to analyze the attitudes and conduct of hospital cleaning staff regarding cleaning and hand hygiene. METHODS: In May and June 2014, the cleaning staff of Elazig Training and Research Hospital participated in this descriptive research. Data was collected by a survey prepared by the researchers. The SPSS program was used to analyze the data. RESULTS: Of the participants, 70.3% of them were male and their mean age was 38.69 ± 6.61. The percentage of those hand washing before starting work was 29.8% for primary school graduates or those with lower education. For those with higher levels of education, the percentage was 68.2% (p < 0.001). The percentage of participants who wash their hands after work was 54.3% for primary school graduates and those with lower levels of education. For those with a higher level of education, the percentage was 84.1% (p < 0.001). The participants' use of personal protective equipment during work was that 97.8% of them used gloves, 39.9% bonnets and 56.5% medical masks. CONCLUSIONS: The attitudes and conduct of the cleaning staff are not sufficiently hygienic. These employees need training before and throughout their employment.

BURNOUT LEVELS OF ASSISTANT PHYSICIANS WORKING AT A TURKISH UNIVERSITY HOSPITAL.

The purpose of the present study was to determine their current levels of burnout and to identify the factors associated with burnout syndrome among assistant physicians who are undergoing further training in medical specialties. The present descriptive study was conducted on assistant physicians at a Turkish university hospital. The participants were subject to a 26-item questionnaire and the Maslach Burnout Inventory (MBI). The mean age of the participants was 29.95 ± 3.79 years. Their mean scores in the three sub-scales of the MBI were as follows: 22.33 ± 8.37 in emotional exhaustion (EE), 8.72 ± 4.74 in depersonalization (D), and 18.76 ± 5.87 in personal accomplishment (PA). While there were no significant discrepancies among the respondents in terms of their mean scores in EE, D and PA depending on their gender, age groups and marital status, those who considered their monthly income levels as "poor" differed significantly from those who regarded their monthly income levels as "good" in terms of their mean scores in EE, D, and PA. In addition, there was a significant difference in terms of the mean scores in EE, D, and PA between the participants who were appreciated by their superiors and those who were not. The participants had high, low and average mean scores in EE, PA and D, respectively, suggesting that they had high levels of burnout in reference to EE and PA and average levels of burnout in reference to D.

The relationship between internet addiction and physical activity levels of university students in a province in eastern Turkey.

BACKGROUND: Internet addiction and physical inactivity are often a major public health problem. OBJECTIVE: This study aimed to determine the relationship between internet addiction (IA) and physical activity (PA) levels of university students in a province in eastern Turkey. METHODS: This cross-sectional study was conducted among 638 students. Internet Addiction Test (IAT), and International Physical Activity Questionnaire (IPAQ) were administered. Chi-square, independent sample t-test, correlation analysis, one-way analysis of variance tests (ANOVA), Tukey HSD test, and multivariate logistic regression analysis were performed. RESULTS: 64.6% of the participants were female, with a mean age of 20.4±2.4 and a mean body mass index (BMI) of 22.3±3.5. 83.4% of the participants were identified as those asymptomatic, 15.2% showed limited symptoms, and 1.4% were pathological internet users according to IAT. A statistically significant difference was found between IAT scores and gender, mother's education level, father's education level, academic success, smoking status, and alcohol use (p < 0.05). According to IPAQ scores, 28.1% of the students were inactive, 56.3% were moderate PA and 15.7% had vigorous PA levels. IPAQ total scores of male participants, smokers, and participants with exercise habits were found to be significantly higher (p < 0.05). The mean score IAT and IPAQ was found to be 30.9±18.9 and 1697.7±1847.0. A negative, significant correlation was found between students' PA and IA levels (p < 0.01). CONCLUSION: It has been observed that IA negatively affects PA. Seminars, conferences, and panels on the internet and physical activity should be organized for university students.

Evaluation of low back pain status and affecting factors in drivers in Turkey: A cross-sectional study1.

BACKGROUND: Low back pain (LBP) is a common public health problem resulting in workforce loss. OBJECTIVE: This study aims to evaluate the LBP status and its affecting factors among drivers in a city in southeast Turkey. METHODS: This cross-sectional questionnaire survey study was conducted among 323 drivers. The chi-square test and logistic regression analysis were used to analyze the data. RESULTS: The mean age of the drivers was 41.7±11.5 years (min: 19, max: 70), and 83.9% were married, and all were men. LBP was found in 59.4% of drivers. It was significantly higher in drivers with poor socioeconomic status, dissatisfied with their life, having a chronic illness, physically inactive, having sleep disorders, exposed to bad road conditions, prolonged vibration, high physical- psychological workload, and a family history of LBP (p <  0.05). There was no significant association between age, education level, and BMI with LBP (p >  0.05). CONCLUSION: There is limited study on this subject in Turkey. Further studies can raise awareness about this issue and create an educational plan.

An intervention study through education: The change in attitudes and knowledge of educators about the COVID-19 vaccine.

BACKGROUND: Reliable and culturally informed health communication is vital in developing positive health behaviors. OBJECTIVE: The aim of this study was to investigate the change in knowledge and attitudes about COVID-19 vaccines by providing training to educators in a province in the east of Turkey. METHODS: A questionnaire developed by the researchers on the basis of the literature was used in this intervention study. It consisted of three parts: socio-demographic information, before education knowledge (BEK) and Attitudes Towards the COVID-19 Vaccine (BEATV), and after education knowledge (AEK) and Attitudes Towards the COVID-19 Vaccine (AEATV). There were 99 teachers, 32 public education teachers, and 144 religious officials who participated in the study. The data were analyzed using SPSS Statistics Pack version 22.0 (IBM, Armonk, NY, USA). Statistical significance value was accepted as p < 0.05. RESULTS: Among the participants, the number of correct answers to all questions increased as a result of the study. There was a positive increase in most of the ATV items after the training. CONCLUSION: Education on COVID-19 vaccines increased awareness as shown by the total number of correct answers and the improved attitude of educators.

The second report from Turkey: waist percentiles for 6-11-year-old children in Elazig Province, Eastern Anatolia.

OBJECTIVE: To construct waist percentiles for 6-11-year-old Turkish children in Elazig Province, Eastern Anatolia. METHODS: This cross-sectional study was performed with 3342 (1708 boys and 1634 girls) children from March to June 2007. Waist circumferences (WC) were measured between the lowest rib and the superior iliac crest, and centile curves were constructed with the Lambda-Mu-Sigma (LMS) method. RESULTS: Towards 6-11 years, WC 50th percentile ranged from 57.54 to 67.04 cm in boys and 55.77 to 64.58 cm in girls. For both genders, WC increased with age. At each age, boys had higher WC values than girls. For the entire sample, mean WC was 62.5 +/- 6.8 cm for boys and 59.8 +/- 6.2 cm for girls. Median WC was 62.0 cm (32.0-90.0) for boys and 59.0 cm (46.0-87.0) for girls. CONCLUSIONS: The large differences in the values obtained worldwide emphasize the necessity of providing population-specific WC reference curves from different populations, which in turn may result in an international reference standard similar to that provided for body mass index.

Exposure of married women to spousal violence: A community-based study in Eastern Turkey.

BACKGROUND: Violence against women deprives women of their rights to enjoy equality, security, dignity, self-worth and fundamental freedoms and devalues them; is one of the most significant social facts that force women to exist at a lower social level than men and constitute a significant obstacle to the formation of healthy societies. This study was conducted to determine the status of exposure to spousal violence of 15 years and older married women living in the city center. METHODS: Family health centers in Elazig Province were visited and 792 married women were selected from the related records by systematic sampling. As a data collection tool, a questionnaire form was used. The questionnaire consists of two parts. In the first part, participants were asked about demographic characteristics such as age, gender, education level, and profession, while in the second part, questions were asked to determine the extent of exposure to violence. Questionnaires were filled out using interview technique by making home visits. RESULTS: It has been found that the low level of education of the wife and her spouse, perception of the economic situation of the family as being bad, and the fact that the woman does not work in an income-generating business can be an important factor in exposing to both physical violence and economic violence by her husband. CONCLUSION: Conclusion: Rate of exposure to spousal violence is high in married women living in the city center of Elazig Province. Education and services should be provided for solving the problem at individual, familial, and social levels.

The relationship between carpal tunnel syndrome, smartphone use, and addiction: A cross-sectional study.

Objectives: This study aims to investigate the use of and addiction to smartphones in individuals with and without carpal tunnel syndrome (CTS). Patients and methods: The cross-sectional study included a total of 404 participants (286 females, 118 males; mean age: 39.7±11.6 years; range, 16 to 75 years) who applied to the Neurology Department of the Firat University Faculty of Medicine, between April 2019 and October 2019. The participants were divided into two groups: 202 patients diagnosed with CTS were included in the case group, and 202 patients and their relatives who did not have hand and wrist complaints were included in the control group. The diagnosis of CTS was made by evaluating the history, physical examination, and electromyography findings. Data were collected with participant information forms and the Smartphone Addiction Scale. Results: It was found that the risk of CTS increased 1.022 times with a one-unit increase in the SAS score and 1.292 times with a 1-h increase in daily smartphone use. Conclusion: Smartphone addiction can be considered as a potential risk factor for CTS; however, the effect of smartphone addiction on CTS severity was not examined in this study. The relationship between disease severity, smartphone use, and smartphone addiction in CTS patients requires further investigation to provide clarification on this issue.

Weight, height and BMI references in Elazig: an east Anatolian city.

The aim of this study was to produce the growth references for Elazig children aged 6-11 years. Data were collected in eight primary schools of Elazig in 2007. Age- and gender-specific height, weight and body mass index (BMI) references were produced with LMS (Lambda-Mu-Sigma) method and compared with reported values in an Anatolian and a metropolitan city. A total of 3342 (1634 females, 1708 males) children aged 6-11 years from among 4258 students were included in the study. Age- and gender-specific height, weight and BMI references were produced. The 3rd-97th percentiles were detected to be higher than the range of percentiles between 6-11-year-old children. We consider that this first local reference for Elazig will provide a useful tool for health planning and monitoring of growth and development.

Determining the frequency of serious adverse reactions of inactive SARS-COV-2 vaccine.

BACKGROUND: Vaccines are a new combat strategy against COVID-19. The success of a large number of vaccines and the continued development of vaccines will change the course of the current pandemic. OBJECTIVE: The aim of the study was to determine the frequency of serious adverse reactions caused by the administration of inactive vaccine administration on healthcare workers during the COVID-19 pandemic. METHODS: The prospective study was conducted among healthcare professionals working in city a Training and Research Hospital and applied to have the second dose of CoronaVac vaccine. The number of personnel included in the study were 329. The data were recorded in the SPSS 23 program and the chi-square test was used for statistical analysis. RESULTS: The average age of the participants in the study was 35.77±9.07. Of the participants, 28.1%were physicians. The frequency ratio of those who stated that they had serious adverse reactions after vaccination was 33.2%. Three most common systemic serious adverse reactions were headache, state of sleep/fatigue, and nausea and vomiting respectively. Serious adverse reactions occurred within 1.14±04 days after vaccine administration. The average duration of serious adverse reactions was determined as 1.68±0.77 days. 62.2%of the participants with serious side effects were women (p < 0.001). Of the participants who had serious adverse reactions, 77.5%were health care professionals (p < 0.01). CONCLUSION: No life-threatening serious adverse reaction was determined regarding the CoronaVac vaccine administered in this study. However, local serious adverse reactions, nausea/vomiting, fever and sleepiness/fatigue occurred frequently. Further studies are required on the newly introduced vaccine.

Evaluation of the Opinions and Knowledge of Medical School Students on Organ Donation and Transplantation.

BACKGROUND: Insufficient organ donation is one of the most significant current problems in medical care. The students of the faculty of medicine could be the strongest supporters of organ donation and transplantation, and may play an important role in increasing organ donation. This study aimed to determine the relevant educational needs of the medical students by evaluating their knowledge and opinions about organ donation and transplantation, according to their grade levels. METHODS: A cross-sectional study was conducted among 395 (83.6%) students in the first, third, and sixth grades of the faculty of medicine. A questionnaire consisting of 42 questions was used to measure their opinions and knowledge about organ transplantation. RESULTS: Among the students who responded, 6.8% (n = 27) had donated their organs and 81.4% of the donors had donation cards, while 73.4% (n = 290) were considering organ donation. The percentages of women and students at the grade six level considering organ donation were significantly higher (P < .05). The study revealed that 38.7% of the students did not have enough knowledge about organ donation, 47.8% stated that they had some knowledge and 61.8% of the students did not know the principles of brain death. The students of all grades reported that most of the information about organ donation and transplantation was obtained from their family and friends. CONCLUSION: As medical students progress through the grade levels, their perceptions and knowledge of organ donation and transplantation also increase positively. Courses on organ donation and transplantation can be added to the curriculum from the very first year of medical education.

The Effects of Secondary Hyperparathyroidism on Circadian Blood Pressure in Hemodialysis Patients.

OBJECTIVE: To determine the relationship between secondary hyperparathyroidism (sHPT) and circadian blood pressure (BP) rthym among patients undergoing hemodialysis treatment. STUDY DESIGN: A descriptive and prospective cohort study. PLACE AND DURATION OF STUDY:   Department of Nephrology, Firat University Hospital, Turkey, between June and December 2019. METHODOLOGY: Eighty-five patients, undergoing hemodialysis three times a week, were included. The BP parameters and circadian blood pressure rhythm were measured by the mobil-o-graph sphygmomanometer. Non-dipper blood pressure phenomenon was defined as a night-time mean artery pressure (MAP)  decrease of <10% from the daytime MAP; sHPT was defined as parathormone >300 pg/ml. RESULTS: Of the 85 participants, mean age was 57.07 ± 14.46 years. In cohort, sHPT rate 58.8% (n =50) and non-dipper blood pressure pattern rate was 64.7% (n = 55). Systolic blood pressure (p=0.001), diastolic blood pressure (p=0.001), and mean arterial blood pressure (p<0.001) were higher in participants with sHPT. sHPT (p = 0.003) was an independent risk factor for non-dipper blood pressure pattern (odds ratio [OR] 0.065, 95% CI: 0.11-0.390). A negative correlation was identified between parathormone and the reduction in night blood pressure (r = -0.346, p=0.001). CONCLUSION: Secondary hyperparathyroidism can cause non-dipper blood pressure pattern by reducing the reduction in night blood pressure. Treatment of sHPT is important in the control of blood pressure and normal circadian blood pressure rhythm in tertiary protection in hemodialysis patients. Key Words: Blood pressure, Circadian rhythm, Hyperparathyroidism secondary, Hemodialysis, Chronic kidney diseases.

Prevalence of Anemia and Associated Risk Factors among Pregnant Women, What is the Role of Antenatal Care in Prevention? A Cross-sectional Study.

OBJECTIVE: To determine the prevalence of anemia with the associated factors in pregnant women and the effect of family medicine practice and antenatal care services provided by family physicians on the prevention of anemia during pregnancy. STUDY DESIGN: Community-based cross-sectional study. PLACE AND DURATION OF STUDY: Family Health Centres in the Elazig region, Turkey from January to June 2019. METHODOLOGY: A total of 495 pregnant women, attending the family health centres, were included. Women were administered a questionnaire related with the anemia and related factors; and hemoglobin values were drawn. Hemoglobin concentration <11 g/dl was classified as anaemic. Sociodemographic, individual dietary diversity and obstetric characteristics of the participants were obtained from structured questionnaire form. Binary logistic regression model was employed to determine the effect of explanatory variables on dependent variable anemia.   Results: The prevalence of anemia during pregnancy was 27.9% (Hb<11.0 gr/dl). Prevalence of anemia was found lower in participants with higher education levels (p=0.005) and having nutrition education (p=0.004). Income status (OR=0.017 [95%Cl:0.002-0.15, p<0.001]), dark tea preference (OR=87.127 [95%Cl:17.68-429.36, p<0.001]), and iron supplementation time (OR=0.945 [95%Cl: 0.91-0.98, p=0.002]) were determined as the independent predictors of anemia in pregnancy. CONCLUSION: Low income, insufficient iron supplementation treatment and dark tea preference were the main predictors of anemia. Most of the factors that cause anemia during pregnancy can be prevented with patient education and supportive treatments. Therefore, the authors recommend applying effective and quality prenatal care and patient education programs to reduce anemia during pregnancy. Key Words: Pregnant women, Anemia, Prenatal care, Family practice, Turkey.

Knowledge, behaviours and anxiety of eastern part of Turkey residents about the current COVID-19 outbreak.

INTRODUCTION: The aim of this study was to assess the knowledge, attitude, and behavior of Eastern part of Turkey residents about the COVID-19 and the relationship between the pandemic and the anxiety levels. METHODS: Cross-sectional study was carried out between 07-21 April 2020 through online questionnaires. The study included 897 people who filled out the form and met the study criteria. The data was collected through a self-administered questionnaire of the socio-demographic characteristics, generalized anxiety disorder scale, opinions about the epidemic, knowledge, and attitude of individuals regarding COVID-19. RESULTS: A total of 897 participants had a mean score of knowledge and attitude of 5.11±1.63 and 46.81±5.65, respectively. Knowledge and attitude score was higher in males (p<0.001) and participants with high education level (p=0.003). Anxiety level was negatively correlated with knowledge (r=-0.156, p<0.001) and attitude scores (r=-0.288, p<0.001). There was a positive significant correlation between knowledge level and attitude score (r=0.194, p<0.001). CONCLUSION: Gender and education levels had a statistical effect on individuals' COVID-19 knowledge and attitude scores. COVID-19 outbreak was associated with high anxiety levels in individuals and it was determined that the anxiety caused by the epidemic negatively affected the knowledge and attitudes of the individuals.

Factors that predict the perception of spirituality and spiritual care of nurses working in high-risk units and the effect of death anxiety.

PURPOSE: Spirituality contributes to the health and well-being of individuals. This study investigates the factors that predict the spirituality perceptions and the effect of death anxiety of nurses. DESIGN AND METHODS: This was a cross-sectional study, 382 nurses working in four public hospitals intensive care and emergency departments setting in two different cities in Turkey. FINDINGS: Variables predicting the total and subscale scores of the Spirituality and Spiritual Care Rating Scale of nurses were determined by linear multiple regression analysis. Except for the religiousness subscale, the satisfaction level of nurses was found to be a significant predictor in total of Spirituality and Spiritual Care Scale. PRACTICE IMPLICATIONS: Nurses working in high-risk units are unclear about their perception of spirituality and spiritual care.

COVID-19 anxiety and hygiene status in vocational schools of health services students in Turkey: A multicenter study.

BACKGROUND: While the coronavirus (COVID-19) pandemic creates fear and anxiety on the students' academic achievement, the risk of an infectious disease may negatively affect education by reducing the concentration ability of students. Thus, it is essential to evaluate the knowledge, behaviors, anxiety levels, and hygiene status of students. OBJECTIVE: This study aimed to investigate the knowledge, behavior change, anxiety, and hygiene status of university students about COVID-19. METHODS: The investigation was conducted with students of three vocational schools of health services located in different provinces of Turkey (n = 1055). Data collected by an online survey consisted of knowledge questions about COVID-19, items about behavior change, the hygiene behavior scale (HBS), and the Generalized Anxiety Disorder 7 (GAD-7) scale. RESULTS: The knowledge scores of women were significantly higher than the scores of men. Of the students, 59.6%showed positive hygiene behaviors, and 31.5%had anxiety. Female students' total HDC scale score was significantly lower than that of men, and the total HDC scale score of those who received hand hygiene education was significantly lower than that of participants who did not receive training, which shows a positive hygiene behavior. The total GAD-7 scale score of women was significantly higher than that of men. More than half of the students showed positive hygiene behaviors, and about a third had anxiety. CONCLUSIONS: Based on the study's results, psychological support and training should be provided to students.

Prevalence and risk factors of overweight and obesity among urban school children in Elazig city, Eastern Turkey, 2007.

BACKGROUND: The prevalence of obesity is increasing dramatically all over the world. Very little data are currently available on the prevalence of childhood obesity in Turkey, and more research on the risk factors is required before preventive public health programmes can be put into practice. AIM: The aim of this study is to determine the prevalence of overweight and obesity and related factors in primary school students in Elazig, a city in eastern Turkey. SUBJECTS AND METHODS: In March-June 2007 a cross-sectional study of children aged 6-11 years old was performed. A total of 1782 girls and 1860 boys were observed. Weight and height were measured. Overweight and obesity using age- and sex-specific body mass index (BMI) cut-off points as defined by the International Obesity Taskforce were used. RESULTS: Prevalence of overweight and obesity were 13.2% and 1.6%, respectively. According to gender, the prevalence of obesity in boys was 2.0% and overweight was 13.9%, while in girls, obesity was 1.2% and overweight was 12.5%. We found that overweight and obesity may be related to factors such as eating while watching television, and eating fast food. CONCLUSION: It was noted as a health problem that there are overweight students aged between 6 and 11 years attending primary schools in Elazig province.