Since the early 1990s, the primary care system in Turkey has undergone fundamental changes. In the first decade of the millennium family doctor scheme was introduced to the Turkish primary care sector and the name of the primary care doctors (PCDs) changed from "general practitioner" (GP) to "family doctor" (FD). This study aims to give an insight into those changes and to compare the service profiles of PCDs in 1993 and 2012. Data, based on cross sectional surveys among Turkish doctors working in primary care are derived from the 1993 European GP Task Profile study (n=199) and the 2012 Quality and Costs of Primary Care in Europe (QUALICOPC) study (n=299). The study focuses on the changes in the primary care service provision based on selected aspects such as the first contact of care, preventive care, and the knowledge exchange and collaboration with other health professionals. Compared to GPs in 1993, FDs in 2012 reported that their involvement in treatment of chronic diseases, first contact care, antenatal and child health care have increased. FDs have more contact with other primary healthcare workers but their contact with hospital consultants have decreased. Overall, the services provided by PCDs seem to be expanded. However, the quality of care given by FDs and its effects on health indicators are needed to be explored by further studies.

ÖZET:Bir kamu hastanesinde çalışan hemşirelerin kateter ilişkili üriner sistem enfeksiyonlarının önlenmesi hakkındaki bilgi durumları Amaç: Araştırma, İstanbul Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi'nde çalışan hemşirelerin, üriner sistem enfeksiyonlarını önlemek üzere üriner kateter kullanımına ilişkin bilgi durumlarını değerlendirmek amacıyla yapılmıştır. Gereç ve Yöntem: Hastanede çalışan toplam 469 hemşirenin 111'i yoğun bakım, 271'i klinik hemşiresi olmak üzere %82'sine tanımlayıcı nitelikte anket uygulanmıştır. Veriler, hemşirelerin demografik özelliklerini, bilgi durumlarını belirlemeye yönelik 5 puanlı likert türünde hazırlanmış anket formu ile toplanmış, sayı, yüzde, aritmetik ortalama, tek yönlü Anova ve Kruskal Wallis testleri kullanılarak değerlendirilmiştir. Bulgular: Ön lisans düzeyinde eğitim seviyesinde, 30 yaş üstünde, bayan, mesleki deneyimi 11-15 yaş arasında olan hemşirelerin katater ile ilişkili üriner sistem enfeksiyonlarının önlenmesinde bilgi durumlarının diğer gruplara göre yüksek olduğu saptanmıştır. Yoğun bakım hemşirelerinin üriner kateterizasyonun endikasyonları ve kateteri olan hastada dikkat edilecek genel noktalar konusunda yeterli bilgiye sahip olmadıkları, üriner kateteri yerleştirme sırasındaki uygulamalara ilişkin bilgi durumlarının da yeterli olduğu belirlenmiştir. Sonuç: Araştırma, hemşirelerin eğitim durumunun, yaşının, cinsiyetinin ve mesleki deneyim sürelerinin kateter ile ilişkili üriner sistem enfeksiyonları önleme konusundaki bilgi durumlarını etkilediğini göstermiştir. Hemşirelerin kateter ilişkili üriner sistem enfeksiyonları hakkında yeterli eğitim almadıkları saptanmıştır. Üriner kateteri yerleştirme sırasındaki uygulamalara ilişkin bilgi durumlarının yeterli olduğu fakat kateter bakımı, idrar torbası kullanımı ve üriner kateterizasyonun endikasyonları konusunda yeterli bilgiye sahip olmadıkları saptanmıştır. Anahtar kelimeler: Enfeksiyonları önleme, hemşirelik girişimleri, üriner sistem infeksiyonu ABSTRACT:Level of knowledge of the nurses work in a public hospital about the prevention of catheter associated urinary tract infections Objective: To evaluate the level of knowledge of the nurses in Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, about the use of a urinary catheter to prevent urinary tract infections. Materials and Method: A descriptive research was held in 82% of a total of 469 nurses, 111 of whom work in intensive care unit, and 271 work in the clinics and a survey was performed. Data was collected by using a five-point Likert type survey which was prepared to show demographic features and level of knowledge. The numerical values, percentages and the arithmetic mean were evalueted with Oneway Anova and Kruskal-Wallis tests. Results: The level of knowledge of nurses who have associate degree, older than 30 years, woman in gender, and have duration of professional experience of 11-15 years were found to be higher, compared to the others in prevention of catheter-associated urinary tract infections. ICU nurses have inadequate k...

Objective:Overweight or obesity may cause many chronic illnesses. Furthermore, several studies have shown that high body mass index is associated with mortality and morbidity among the elderly. Therefore, obesity or being overweight could adversely affect the performance of activities of daily living. In this study our aim was to investigate the association between Body Mass Index and Activity of Daily Living in Homecare Patients.Method:The records of 2016 from the homecare unit of Sisli Hamidiye Etfal Training and Research Hospital were retrospectively reviewed. During this period, 1105 patients visited this facility. Unconscious or bedridden patients (hemiplegia, hemiparesia, and tetraparesis) and patients with incomplete data were excluded from the study. Therefore, the survey was completed with 250 files, which included all the data needed for our research. Age, gender, Body Mass Index and Barthel Index scores were recorded to the statistical program; p≤0.05 was considered as statistically significant.Results:One hundred fifty one (60.4%) were women, and 99 (39.6%) were men. The relations between gender and age, weight, and Barthel index scores were not statistically significant. There was a significant positive correlation between weight and Barthel index scores as well as between Body Mass Index and Barthel index scores (r = 0.190; p = 0.003). The patients were divided into two groups: Group-I (underweight and normal weight) and Group-II (overweight and obese). Group-II exhibited a much higher ability to perform Activity of Daily Living than Group-I (p = 0.002).Conclusion:Some studies report that obesity is protective against Activity of Daily Living, but the opposite is reported in some others. Our study showed increased values of Body Mass Index and Activity of Daily Living ability, which are indicative of protective effects. The relationship between Body Mass Index and physical disability is not yet proven to be linear.

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Objectives:We aimed to analyse the data on violence against healthcare workers in an hospital according to the White Code (WC) reports implemented, to prevent such violence events and discuss some solutions about it. Materials and Methods: In the study, WC data of Hamidiye Etfal Training and Research Hospital for years 2016 and 2017 were obtained and examined with appropriate statistical methods. Results: 209 violence events were declared. 191 of the healthcare workers were victims of violence in these two years. 18 of them were exposed to violence twice in this period. Violence against healthcare workers was more common among women, doctors, emergency staff and the personel under 40 years of age. Number of physical violence victims were 57. The high rate of physical violence was found to be related to the male gender, serving as a security personnel and being in the emergency department (p<0.05), but age was not related. Conclusion: Violence against health workers is a important problem, particularly in emergency departments. In order to solve the problem, unnecessary admissions to emergency departments should be prevented. In-service trainings should be provided for all health workers, but firstly for emergency service workers and security staff. Awareness-raising trainings should be provided to the service-users and existing punishments should be made deterrent.