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Öğe Ankara devlet huzurevlerinde diabetes mellitus prevalansı: orjinal araştırma(İzmir Tepecik Eğitim ve Araştırma Hastanesi, 2016) Dursun, Ümit Deniz; Kasım, İsmail; Sümer, Seren; Aksoy, Hilal; Kahveci, Rabia; Koç, Esra Meltem; Gücük, Sebahat; Şencan, İrfan; Özkara, AdemAmaç: Diabetes mellitus prevalansı 65 yaş üstü geriyatrik popülasyonda en fazladır. Huzurevlerinde yaşayanlar sıklıkla yaşlı kişilerdir, düşük fonksiyonel kapasite, yüksek kronik hastalık prevalansı, komplikasyon oranına sahiptirler. Çalışmamızın amacı, Ankara'nın tüm devlet huzurevlerinde, yaşlılarda diyabetes mellitus prevalansını ve risk durumlarını belirlemektir.Yöntem: Ankara devlet huzurevlerinde yaşayan kişilerin tümü çalışmamıza dahil edildi. Katılımcılara sosyodemografik özellikleri, kronik hastalıkları, kullandığı ilaçları öğrenmeye yönelik 21 sorudan oluşan anket uygulandı. DM tanısı almamış olan katılımcılara ayrıca Diyabet Risk Anketi (FINDRISC) uygulandı. Açlık plazma glikozu ölçüldü. Açlık plazma glikozu 126 mg/dl ve üstü olanlar diyabet kabul edildi. Bozulmuş açlık glikozu olanlara 75 g oral glikoz tolerans testi uygulandı. Veriler SPSS (Statistical Program for Social Sciences) sürüm 15.0 istatistik programı kullanılarak %95 güven aralığında, analiz edildi. Çalışmada yer alan değişkenlerin değerlendirilmesinde Shapiro-Wilks testi, ortanca, çeyreklikler arası genişlik-(ÇAG), Mann-Whitney U testi ve Spearman Rho korelasyon katsayısı kullanıldı.Bulgular: Sekiz yüz elli iki kişi ile çalışma yapıldı. Çalışmada diyabet prevalansı %25,5 olarak bulundu. Katılımcıların %12,8'inde bozulmuş açlık glikozu, %1,6'sında bozulmuş glikoz toleransı bulundu. HbA1c değeri elde edilen 62 bireyin HbA1c ortancası 7,0 (ÇAG=2,1) olarak tespit edildi. Risk anketi uygulanan bireylerden elde edilen risk skorları gruplandığında; 31 (%6,3) bireyin riskinin düşük, 241 (%49,7) bireyin riskinin hafif, 125 (%25,8) bireyin riskinin orta olduğu belirlendi. Diyabet gelişme riski yüksek olan 78 (%16,1), diyabet gelişme riski çok yüksek olan 10 (%2,1) birey tespit edildi. Sonuç: Diyabet prevalansı yaşla artmaktadır, bu yüzden bu konuya gerekli önem verilmeli ve önlemler alınmalıdır. Huzurevi gibi yaşlıların toplu olarak yaşadığı yerlerde çalışan kişilerin ise yaşlıların sağlık kontrollerini düzenli yaptırmaları, sağlık çalışanlarının ise yaşlı nüfusu değerlendirirken risk faktörlerini göz önünde bulundurarak takip ve tedavilerini yapmaları gerekmektedir.Öğe Evaluation of dietary habits during pregnancy(Turkish Society of Obstetrics and Gynecology, 2015) Şenol Eren, Nihal; Şencan, İrfan; Aksoy, Hilal; Koç, Esra Meltem; Kasım, İsmail; Kahveci, Rabia; Samur, Gülhan; Özkara, AdemObjective: Pregnancy is a special period of increased nutritional needs during which conscious nutritional support is required. Insufficient and imbalancednutrition in this period of life causes serious conditions that affect both child and mother. This study aimed to evaluate the relationship between pregnancyand nutrition/nutritional habits during pregnancy.Materials and Methods: In this descriptive study, a questionnaire was conducted on a voluntary basis to pregnant women who were admitted to thePregnancy Outpatient Clinic of Obstetrics and Gynecology Department at Ankara Numune Training and Research Hospital. Questions about generalinformation, pregnancy-related information, thoughts and knowledge about breastfeeding, nutritional habits, and meal frequency were asked to pregnantwomen. Three hundred fourteen questionnaires were assessed in the study. SPSS for Windows Version 16.0 and MS-Excel 2007 were used for statisticalevaluations. P<0.05 was accepted as statistical significance.Results: There was a statistically significant relationship between pre-pregnancy body mass index (BMI) and number of pregnancies; level of educationand income levels; number of children and history of caesarian section as an additional problem within previous pregnancies. The change of nutritionalhabits during pregnancy was examined; we found that consumption of fruits (51%) and vegetables (40.8%) increased the most, while intake of tea (26.1%)and redmeat (21%) mainly decreased during pregnancy. It was found that during pregnancy 20.4% of pregnant women had never consumed fish, 13.1%abstained from red meat, and 12.4% excluded white meat from their diet.Conclusions: We believe that this study will help to raise awareness about adequate and balanced nutrition during pregnancy and to define specialnutritional recommendations. © 2015, Turkish Society of Obstetrics and Gynecology. All rights reserved.Öğe Exploring guideline adaptation strategy for Turkey: Is “ADAPTE” feasible or does it need adaptation as well?(Blackwell Publishing Ltd, 2018) Ayhan Başer, Duygu; Kahveci, Rabia; Baydar Artantaş, Aylin; Yaşar, İlknur; Aksoy, Hilal; Koç, Esra Meltem; Kasım, İsmail; Kunnamo, Ilkka; Özkara, AdemRationale, aims, objectives: Clinical Practice Guidelines are mostly developed by 3 methods; namely, de novo, adoption, and adaptation. Nonpublished studies and authors experience shows that most guidelines in Turkey are either by adoption or by adaptation. There is no available local tool for adaptation, so the process is not standardized and most of the time not explicitly defined. The objective of this study is to search for international guideline adaptation tools and test their feasibility in Turkish context, to serve a final goal of developing a unique local strategic tool for guideline adaptation. Methods: The methodological design of this study includes selection of an international tool for Clinical Practice Guideline adaptation, piloting this tool with selected Turkish guidelines, identifying the feasibility of this tool and exploring the needs for adaptation of the tool, drawing recommendations for adaptation of the strategies, and validation of the process by local experts. Results: The study from planning phase to finalizing the guidance, including pilot studies and panel but excluding translation of ADAPTE, lasted 18 months. Nine researchers were involved in the adaptation process and 15 more experts were involved in the validation panel. Following the suggestions of the research team on modifications and validation through the expert panel; 2 steps of the ADAPTE toolkit were rejected, 2 steps were accepted by modification, 7 steps were accepted by additional recommendations. In addition, 2 tools were suggested to be added to the toolkit. Conclusion: This is the first study on adaptation of guidelines in Turkey. Pilot adaptation of 2 guidelines with ADAPTE revealed that ADAPTE is a useful and feasible tool in Turkish setting, but might require certain changes in recommendations and revision of tools. © 2017 John Wiley & Sons, Ltd.Öğe Physicians' attitudes toward home healthcare services in Turkey: A qualitative study(Taylor and Francis Ltd, 2015) Aksoy, Hilal; Kahveci, Rabia; Döner, Pınar; Aksoy, İhsan; Ayhan, Duygu; Koç, Esra Meltem; Şencan, İrfan; Kasım, İsmail; Özkara, AdemBackground: Because of the growth of the older population and the prevalence of chronic diseases, home care services (HCS) have become an important aspect of healthcare worldwide. However, various difficulties and deficiencies are present in the provision of these recently implemented services in Turkey. Modifications to home healthcare services are in progress. Objective: Physicians have an active role in home healthcare services. The present study was performed to examine physicians' attitudes toward this service in detail. Methods: Twenty-six physicians who provide home healthcare services in the city of Ankara were included in the study. We conducted in-depth, semi-structured, face-to-face interviews. The interviews were audio-recorded, transcribed, and qualitatively analysed. Results: Most physicians thought that home care could be provided to patients who are bedridden, are very old, have a chronic disease, have problems leaving the house, or do not have family support. They also expressed displeasure about the abuse of services and discordance of organization between hospitals and primary care centres. They noted that real circumstances in practice were not compatible with regulations and that cooperation and coordination between departments are necessary and important. Conclusion: The current study underlines physicians' interest in and support of the home care system, which has various drawbacks and limitations. Legislation needs to be further changed to improve the quality of service and eliminate deficiencies in home healthcare. © 2015 Taylor & Francis.Öğe The Effects of Diet and Exercise on HbA1c Levels in patients with Type 2 Diabetes under Oral Antidiabetic Treatment(Duzce Univ, 2015) Sonmez, Bilge; Aksoy, Hilal; Ozturk, Omer; Ozturk, Zeynep; Kasim, Ismail; Ozkara, AdemObjective: In this study, we aimed to examine the effects of diet and exercise on diabetes control in type 2 diabetics (NIDDM) who use only oral antidiabetic drugs (OAD). Methods: 217 patients with the diagnosis of NIDDM and using OAD, who admitted to family medicine outpatient clinic between December 2012 and February 2013, were included in the study. Patients were divided into four groups according to their regular diet and exercise. Group 1: Only dieting, Group 2: Only exercising, Group 3: Both dieting and exercising, Group 4: Neither dieting nor exercising. Age, duration of diabetes, body mass index (BMI) and hemoglobin A1c (HbA1c) levels were compared between groups. Results: The mean age of patients participating in the study was 54.5 +/- 10.0 years (p=0.878). 62.7% were women and 37.3% were men. The median duration of diabetes, mean BMI, median HbA1c levels were 36 months, 30.2 +/- 4.6 kg/m(2) and 7.1. Statistically significant difference was not detected (diabetes duration; p=0.188, BMI; p=0,163 and HbA1c; p=0,290). Median HbA1c levels of groups were 7.0; 7.3; 6.8 and 7.2 respectively. No other difference was observed in the other comparisons between groups (p>0.05). Conclusion: There are positive effects of diet and exercise on diabetes control in type 2 diabetics who use only OAD. Diet and exercise have better control in diabetes patients on OAD. However these effects are more noticeable in patients who tackle implement diet and exercise together.Öğe The ideas about advanced life support and affecting factors at the end-stage of life in a hospital in Turkey(Public Library of Science, 2017) Albayrak, Turgay; Şencan, İrfan; Akça, Ömer; Koç, Esra Meltem; Aksoy, Hilal; Ünsal, Selim; Bülbül, İskender; Bahadır, Adem; Kasım, İsmail; Kahveci, Rabia; Özkara, AdemBackground The participation of the people in health decisions may be structured in various levels. One of these is participation in decisions for the treatment. “Advanced directives” is one of the examples for the participation in decisions for the treatment. Aim We wanted to determine the decisions on advanced life support at the end-stage of life in case of a life-threatening illness for the people themselves and their first degree relatives and the factors effecting these decisions. Design and setting The cross-sectional study was conducted with volunteers among patients and patient relatives who applied to all polyclinics of the Ankara Numune Training and Research Hospital except the emergency, oncology and psychiatry polyclinics between 15.12.2012 and 15.03.2013. Method A questionnaire, the Hospital Anxiety Depression (HAD) scale, and Templer’s Death Anxiety Scale (TDA) were applied to all individuals. SPSS for Win. Ver. 17.0 and MS-Excel 2010 Starter software bundles were used for all statistical analysis and calculations. Results The participants want both themselves and their first degree relatives included in end-stage decision-making process. Therefore, the patients and their families should be informed adequately during decision making process and quality communication must be provided. Conclusion Participants who have given their end-stage decisions previously want to be treated according to these decisions. This desire can just be possible by advanced directives.When moral and material loads of end-stage process are taken into consideration, countries, in which advanced directives are practiced, should be examined well and participants’ desire should be evaluated in terms of practicability. © 2017 Albayrak et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Öğe Tip 2 diyabetli hastaların aile hekimiyle iletişimi ile ilgili görüş ve deneyimleri: Kalitatif çalışma(2014) Başer Ayhan, Duygu; Kahveci, Rabia; Aksoy, Hilal; Döner, Pınar; Kasım, İsmail; Şencan, İrfan; Özkara, AdemAmaç. Bu niteliksel çalışmada, Tip 2 diyabetli hastaların takiplerinde birinci basamağı tercih etme durumlarının, birinci basamaktaki DM yönetimine dair görüşlerinin, aile hekimleri ile aralarındaki iletişiminin ve aile hekimleri ile iletişimlerinde etkili olan faktörlerin ve nedenlerinin saptanması amaçlandı. Yöntem. Çalışmamıza araştırmaya katılmaya gönüllü olanlardan, maksimum çeşitlilik örneklemesi ile seçilmiş 20 Tip 2 diyabetli hasta katıldı. Hastalar ile derinlemesine, yarı yapılandırılmış, yüz yüze görüşmeler yapıldı. Görüşmelerin tümü dijital olarak kaydedildi ve yazıya aktarıldıktan sonra kalitatif olarak analiz edildi. Bulgular. DM hastaları, kapsamlı, bütüncül yaklaşımı ve aile sağlığı merkezine kolay ulaşımından dolayı takiplerinde aile hekimini seçebilmektedirler. Aile hekiminde aradıkları özellikler ise samimiyet, ulaşım kolaylığı, empati ve yüksek bilgi düzeyidir. Sonuç. Çalışmamızda, sağlık hizmetleri içinde çok önemli bir yere sahip olan birinci basamak sağlık sistemlerinde çekirdek yeterliliklerinin, DM gibi kronik hastalıkların yönetiminde hastaların aile hekimlerinden beklentileri doğrultusundaki gereken özellikleri karşıladığı saptandı.
