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Öğe Üniversite öğrencilerinde sağlık anksiyetesinin aşı karşıtlığına etkisi(Hitit Üniversitesi, 2025) Kızıltepe, Gizem; (İren) Akbıyık, DeryaAim: The aim of this study was to evaluate the relationship between health anxiety and vaccine hesitancy among university students, to examine the effects of sociodemographic variables on this relationship, and to identify differences in health anxiety and vaccine hesitancy levels among students from different faculties and class levels. Materials and Methods: The cross-sectional and analytical study was conducted in 2025 with a total of 345 participants, consisting of students from the Faculty of Medicine (1st and 6th years), the Faculty of Sport Sciences (1st and 4th years), and the Faculty of Theology (1st and 4th years) of a state university. After obtaining the necessary permissions for the selected faculties, the students were approached on the scheduled days, and detailed information about the study was provided collectively. Voluntary students were asked to provide informed consent and complete the data forms. Data were collected using a Sociodemographic Data Form, the Short Version of the Health Anxiety Inventory, and the Long Form of the Vaccine Hesitancy Scale. For the analyses, descriptive statistics, the Mann-Whitney U test, the Kruskal-Wallis test, Spearman's correlation, and linear regression methods were employed. Results: No direct significant relationship was found between health anxiety and vaccine hesitancy. There were significant differences in health anxiety scores (p=0.005) and vaccine hesitancy scores (p<0.001) among faculties. Medical students had higher health anxiety scores than Sports Sciences students (p=0.008) and lower vaccine hesitancy scores compared to other faculties (p<0.001). Female students had higher health anxiety scores than male students (p<0.001). Students with a family history of comorbid disease and those with a healthcare worker in the family had lower vaccine hesitancy scores. Students who reported a negative change in their attitudes toward other vaccines after the pandemic had higher vaccine hesitancy scores (p<0.001). Conclusion: The findings indicate that vaccine attitudes among university students cannot be explained solely by knowledge levels but are influenced by multidimensional factors such as health anxiety, risk perception, field of education, and social environment. Developing tailored and faculty-specific vaccine awareness programs may contribute significantly to improving vaccine acceptance and public health. Keywords: Health anxiety, Vaccine hesitancy, University studentsÖğe Acil servise başvuran akut kalp yetmezliği hastalarında roth skorunun yatış ve taburculuğu ön görmedeki etkinliğinin değerlendirilmesi: Prospektif, gözlemsel kohort çalışması(Hitit Üniversitesi, 2025) Barındık, Mert; Öztürk, AhmetINTRODUCTION AND OBJECTIVE: Acute heart failure (AHF) accounts for a significant proportion of emergency department (ED) admissions presenting with dyspnea. Recurrent hospitalizations in patients with heart failure (HF) are not only associated with increased mortality but also contribute to a higher workload and resource utilization within the healthcare system. The Roth score is a scoring system developed to assess the degree of hypoxemia in patients with dyspnea. Several studies conducted after the introduction of the Roth score have evaluated its utility in guiding discharge decisions for patients with respiratory distress. Given that patients with AHF often experience recurrent hospital admissions, elevated mortality, and a considerable burden on healthcare systems, a simple and effective scoring tool that aids in determining hospital admission or discharge decisions could significantly improve patient management. The primary objective of this study was to evaluate the effectiveness of the Roth score in predicting hospital admission or discharge decisions in patients diagnosed with AHF in the emergency department. The secondary objective was to determine the effectiveness of the Roth score in predicting 7-day readmissions among patients who were discharged after receiving treatment for AHF. MATERIALS AND METHODS: This study was designed as a prospective, observational cohort study conducted in the emergency department of a tertiary care hospital between February 1, 2025, and July 31, 2025. Adult, non-pregnant patients aged 18 years and older who presented to the ED with suspected acute heart failure were eligible for inclusion. Informed consent was obtained from all patients deemed suitable for inclusion and who agreed to participate. Demographic characteristics, vital signs, medication history, comorbidities, administered treatments in the ED, laboratory parameters, and patient outcomes (admission, discharge, or revisit) were recorded. The Roth score—defined as the maximum number reached and the duration of counting aloud after a deep breath—was measured by the primary physician at the time of presentation and again prior to discharge or consultation. Subsequently, the relationship between Roth scores and clinical outcomes, including hospital admission, in-hospital mortality, and 7-day ED revisits, was analyzed statistically. A p-value <0.05 was considered statistically significant. RESULTS: A total of 106 patients were included in the final analysis, of whom 47.2% (n=50) were female. The median age of the patients was 77.5 years (IQR 72–84). The median initial Roth count was 8 (IQR 6–12.8) and the median post-treatment Roth count was 10 (IQR 7–15). The median initial Roth duration was 5 seconds (IQR 3–6) and the post-treatment median duration was 5 seconds (IQR 4–7). When the relationship between hospital admission or discharge and Roth scores was examined, both count and duration values measured at presentation were significantly lower in hospitalized patients compared to those who were discharged. Similarly, post-treatment Roth scores (both count and duration) remained significantly lower among hospitalized patients. The difference between the initial and final Roth counts was significantly greater in discharged patients (p<0.001 for all parameters), indicating a more pronounced improvement in dyspnea. When Roth scores were analyzed according to mortality and 7-day ED revisit status, no statistically significant differences were found. In multivariate analysis, lactate (OR 0.505 [0.260–0.980]), troponin I (OR 0.995 [0.990–0.999]), and final Roth duration (OR 2.459 [1.399–4.321]) were identified as independent predictors of discharge (p = 0.043, p = 0.016, and p = 0.002, respectively). CONCLUSION: In conclusion, in patients presenting to the emergency department with acute heart failure, the Roth score provided valuable information as a simple and rapid bedside tool for predicting hospital admission or discharge requirements. Lower Roth scores were associated with more severe clinical presentations, whereas higher scores were indicative of safe discharge. However, based on current evidence, the Roth score should be regarded as a supportive triage tool, not as a standalone determinant of clinical decision-making. Future studies with larger, multicenter cohorts are warranted to validate the Roth score across different populations and to further explore its association with clinical outcomes. Such research will help define the potential of the Roth score as a routine decision-support tool in the emergency management of acute heart failure.Öğe Menopoz semptomlarının yaşlanma anksiyetesi ile ilişkisi(Hitit Üniversitesi, 2025) Şimşek, Ümit; Akbıyık, DeryaObjective: This study aims to evaluate the relationship between physical, psychological, and urogenital symptoms experienced by women during menopause and aging anxiety. The study investigates the direction of the relationship between the severity of menopausal symptoms and the level of aging-related anxiety, as well as the sociodemographic, obstetric, and health-related factors influencing this relationship. Materials and Methods:This cross-sectional and descriptive study was conducted between January 27 and June 31, 2025, with 240 literate women aged 45–64 who applied to the Uğurludağ Family Health Center in Çorum and were in the menopausal period. Data were collected through face-to-face interviews using a Sociodemographic Information Form, the Menopause Rating Scale, and the Anxiety about Aging Scale. The data were analyzed using SPSS version 30. Results: The majority of participants were primary school graduates and unemployed, with 91.25% having entered menopause naturally. The most frequently reported menopausal symptoms were psychological and somatic complaints, while urogenital complaints were reported less frequently. Women who were employed, had a low level of education, and whose spouses were retired had higher symptom scores. Significant but directionally variable relationships were found between menopausal symptoms and the subdimensions of aging anxiety. Somatic and psychological complaints related to menopause were positively associated with psychological concerns about aging. In contrast, negative associations were observed with fear of loss and concerns about physical appearance. Weak inverse relationships were found between urogenital symptoms and aging anxiety. Conclusion:The study reveals that menopausal symptoms are influenced not only by biological changes but also by various factors such as educational background, employment status, body image, social support, knowledge level, and general health condition. Menopausal symptoms can affect women's aging-related concerns both positively and negatively, with psychological symptoms emerging as the strongest indicators of aging anxiety. The underreporting of urogenital symptoms in rural areas may result from limited expression of sexual health issues. The findings highlight the necessity of supporting women not only physiologically but also psychosocially during the menopausal period, and underscore the importance of developing holistic approaches in women's healthcare. Keywords: Menopausal symptoms, Aging anxiety, Women's health, Psychosomatic complaintsÖğe Obez çocuk ve adolesanlarda serum Metrnl (subfatin) düzeylerinin belirlenmesi(Hitit Üniversitesi, 2025) Demirbaş, Samet Can; Peltek Kendirci, Havva NurObjective: Obesity is associated with insulin resistance, dyslipidemia, and cardiometabolic disorders, and metabolic changes that begin at an early age can lead to serious long-term health problems. Therefore, examining the biomolecules associated with childhood obesity is crucial for understanding the mechanisms of the disease. Metrnl (Meteorin-Like/Subfatin) is a newly identified adipose tissue-derived hormone that is particularly effective in metabolic disorders such as diabetes, cardiovascular disease, and dyslipidemia. The role of this molecule in childhood obesity and insulin resistance has not yet been clearly established. This study aimed to determine serum Meteorin-like levels in obese children and adolescents and compare these values with those of their healthy peers. Materials and Methods: This observational, case-control study was conducted at the Departments of Pediatrics and Pediatric Endocrinology of Hitit University Erol Olçok Training and Research Hospital. The study included 60 obese children aged 10–18 years with a BMI-SDS ≥ +2 according to age and sex, and 30 healthy children with a BMI-SDS between −2 and +2 SDS. The obese group was further divided into two subgroups based on the presence or absence of insulin resistance, as determined by the HOMA-IR value. Serum Meteorin-like (Metrnl) levels were measured using the ELISA method, and their associations with biochemical and anthropometric parameters were evaluated. Statistical analyses were performed using SPSS version 22.0, and a p-value of <0.05 was considered statistically significant. Results: Obesity and insulin resistance led to significant changes in metabolic and biochemical parameters. Serum Meteorin-like levels exhibited a bidirectional change according to the presence of obesity and insulin resistance (p=0.005). While Meteorin-like levels measured at 40.06 ± 7.36 ng/mL in the control group were significantly reduced in obese children without insulin resistance (33,19±11,14), they increased again in obese children with insulin resistance (42,12±13,02). Positive correlations were observed between Meteorin-like levels and HOMA-IR and fasting insulin, while no significant association was found with hepatic steatosis. Conclusion: The bidirectional variation in meteorin-like levels with obesity and insulin resistance suggests that this protein may be both an indicator and an adaptive response to metabolic stress. Further studies with larger samples are needed to elucidate the dynamic role of the meteorin-like molecule in childhood obesity. Keywords: Childhood Obesity, Subfatin, Insulin Resistance, HOMA-IRÖğe Dijital sağlık ekosisteminde uzaktan sağlık hizmetlerine yönelik tutumlar ve sağlık okuryazarlığı arasındaki ilişki(Hitit Üniversitesi, 2025) Çağıl, Nisanur; Oğulluk, MustafaObjective: This study examined the relationship between health literacy levels and individuals' attitudes towards telemedicine services, as well as the effect of sociodemographic data on this relationship. Materials and Methods: This cross-sectional and descriptive study was conducted between April and June 2025 with 1,312 teachers meeting the inclusion criteria, working in all public schools affiliated with the Ministry of National Education in the central district of Çorum province. Data were collected through face-to-face interviews. Participants were administered the Turkish Health Literacy Scale-32 (TSOY-32), the Attitude Scale Towards the Use of Telemedicine Services, and a Sociodemographic Data Form prepared by the researchers through a review of relevant literature. Statistical analyses and calculations were performed using Statistical Package for the Social Sciences (SPSS) version 30. Results: According to the overall classification of the Turkish Health Literacy Scale (TSOY-32), 28.6% of participants had inadequate, 43.6% had problematic–limited, 17.0% had sufficient, and 10.7% had excellent health literacy levels. When health literacy levels were compared with sociodemographic variables, only income level was found to have a statistically significant positive correlation (p<0.05). The mean score of participants on the Attitude Scale Towards the Use of Telemedicine Services (USHKYTÖ) was 61.24±13.2, with a median value of 63, indicating a moderate-to-good level. Scores of married individuals, those with a master's degree, and those whose income exceeded expenses were found to be significantly higher (p<0.05). Participants whose first source of health-related information was the internet had significantly higher USHKYTÖ scores compared to those whose first source was a healthcare professional or healthcare institution (p<0.001). No statistically significant relationship was found between the total score of TSOY-32 and the total score of USHKYTÖ (p>0.05). Conclusion: In conclusion, individuals' attitudes towards telemedicine services are influenced not only by their level of knowledge but also by socioeconomic conditions, experiences, and access to healthcare services. Factors such as the increasing average age of the population, the growing number of bedridden individuals and those with chronic diseases, and the rising importance of labor loss due to industrialization highlight the increasing importance of telemedicine applications in healthcare. In light of this information, raising public awareness, improving access to telemedicine services, and developing relevant policies in this direction are important both for the sustainability of healthcare systems and for societal and individual benefits. Keywords: Health literacy, Telemedicine, Digital health ecosystemÖğe İntravitreal enjeksiyon yapılan hastaların sklera kalınlığındaki değişimin ön segment optik kohorens tomografi ile değerlendirilmesi(Hitit Üniversitesi, 2025) Yılmaz, Safiye Beyzanur; Şahin, TayfunObjective: This study aimed to evaluate the effects of intravitreal injections on scleral thickness and other ocular layers in patients followed at our retina unit compared to a healthy control group. Materials and Methods: The study included 100 eyes of 100 patients (54 males, age range: 45–90 years, mean age: 69.83 ± 8.54) who received intravitreal injection therapy for diabetic retinopathy, age-related macular degeneration, or retinal vein occlusion. The injected eyes and fellow (non-injected) eyes of these patients, as well as the right eyes of 100 healthy individuals (52 males, mean age: 69.96 ± 8.45) within the same age range, were evaluated. After comprehensive ophthalmologic examinations, axial length measurements and specular microscopy evaluations were performed for all participants. Using anterior segment optical coherence tomography, the thicknesses of the conjunctiva, episclera-tenon's capsule, and sclera were measured in four quadrants. Results: In the superotemporal quadrant, which corresponds to our injection site, scleral thickness was higher in the fellow eyes compared to the injected eyes, and in the injected eyes compared to control eyes. Superonasal scleral thickness, inferotemporal scleral thickness, inferonasal conjunctival thickness, and inferonasal scleral thickness were higher in both the injected and fellow eyes compared to control eyes. A statistically significant difference was observed in superotemporal episclera-tenon's thickness based on diagnosis within the injected eye group (p = 0.019, p < .05); specifically, the DRP group showed significantly greater thickness compared to the YBMD group. When comparing by number of injections, eyes that had received only 3 injections exhibited higher superotemporal episclera-tenon's thickness than eyes that had received 10 or more injections. A weak negative correlation was found between the number of injections and superotemporal episclera-tenon's thickness (r = −0.301, p = 0.002; p < .01). It was estimated that for every 10 injections, there may be a reduction of approximately 21.47 μm in superotemporal episclera-tenon's thickness. Conclusion: Due to the potential thinning of the sclera and other layers following repeated intravitreal injections, altering the injection quadrant may be advisable, especially in patients anticipated to require a high number of injections. Keywords: Anterior Segment Optical Coherence Tomography, Scleral Thickness, Intravitreal Injection, Anti-VEGF, Dexamethasone ImplantÖğe Aile sağlığı merkezinde fırsatçı EKG taramasının geriatrik yaş grubunda atriyal fibrilasyonu yakalamadaki önemi(Hitit Üniversitesi, 2025) Ürünoğlu, Mustafa Yasin; Akbıyık, DeryaAim: The aim of this study is to determine the prevalence of atrial fibrillation (AF) through opportunistic ECG screening among patients presenting to Family Medicine clinics. The study also seeks to identify both previously diagnosed and undiagnosed cases of AF, examine comorbid conditions potentially associated with AF, and assess whether patients with AF who are at high risk of stroke based on calculated risk scores are receiving appropriate anticoagulant therapy. Materials and Methods: The sample size representing the geriatric patient population aged 65 and over, registered at Mecitözü Family Health Center, consisting of 2533 individuals, was calculated using Epi-info v7.2.6.0 software , and the minimum sample size was determined to be 558. However, to better reflect the prevalence of AF in our region, a total of 1161 individuals aged 65 and over, who visited our Family Health Center within one year and consented to participate in the study, were included. Volunteers were asked to complete a data form that included sociodemographic information and comorbidities. AF screening was conducted using an ECG. The risk of stroke was calculated using the CHA2DS2VA score. Results: In our study, the prevalence of atrial fibrillation (AF) among individuals aged 65 years and older was determined to be 11,8%. When analyzed by gender, the prevalence of AF was found to be 14% in women and 10,1 % in men. Among the individuals diagnosed with AF, 16,79% had not previously been diagnosed, indicating they were undiagnosed cases. In the overall study population, the rate of undiagnosed AF among individuals aged 65 and older was 2%. Among participants with a confirmed diagnosis of AF, the most common comorbidities were hypertension (99,27%), coronary artery disease (89%), hyperlipidemia (73%), obesity (67,9 %), vascular disease (57%), heart failure (48,2%), and diabetes mellitus (40,87%). In terms of stroke risk, 99,27% of individuals with AF were found to have an indication for anticoagulant therapy. According to the CHA₂DS₂-VA scoring system, the mean stroke risk score was 4,19 ± 1,5, and the median score was calculated as 4. Among patients with a known diagnosis of AF, 99.1 % were classified in the high-risk group for stroke, and 84.95% of these individuals were receiving anticoagulant therapy. However, within the overall study population, 29.41% of individuals who were eligible for anticoagulation were not receiving treatment. This indicates that 3.44% of the general population consisted of individuals who required but were not receiving anticoagulant therapy. Conclusion: The data obtained in our study indicate that the prevalence of atrial fibrillation (AF), the rate of undiagnosed AF, and the proportion of individuals who are not receiving anticoagulant therapy despite having an indication are higher than those reported in the international literature. These findings strongly highlight the importance of AF screening in primary healthcare settings. Through effective screening programs implemented at the primary care level, undiagnosed and untreated AF cases can be identified and directed to appropriate treatment, thereby preventing serious complications such as ischemic stroke. Keywords: Stroke probability, Prevalence, Diagnosedatrialfibrillation, Undiagnosed atrial fibrillation, Anticoagulant therapy, Geriatric patientÖğe Kardiyovasküler hastalıklar risk faktörleri bilgi düzeyi ile sağlık anksiyetesi arasındaki ilişki(Hitit Üniversitesi, 2025) Öz, Abdurrahman; Oğulluk, MustafaIndroduction and Aim: Anxiety can be affected when people are being informed about something related to their health. In the literature, there are studies examining the relationship between health literacy and health anxiety. However, since there is not enough data showing the relationship between health literacy and knowledge level, this study aimed to examine the relationship between knowledge level of cardiovascular disease risk factors and health anxiety. In preventive health services, information and screening studies are important with the aim of increasing awareness of cardiovascular disease risk factors. This research was planned with the idea that it can direct information and screening studies and contribute to the economies and health systems of countries by preventing diseases and unnecessary hospital admissions. Materials and Methods: This study was designed as descriptive, cross-sectional and prospective. The study population consists of individuals aged 20-65 who met the inclusion criteria and visited the Family Medicine outpatient clinic at Çorum Erol Olçok Training and Research Hospital. After obtaining the necessary permissions and approvals, volunteer adults who applied to the Family Medicine outpatient clinic were asked to fill in the Sociodemographic Data Form, Cardiovascular Diseases Risk Factors Knowledge Level Scale, and Health Anxiety Inventory. The data were analyzed with IBM SPSS Statistics 23.0 program. Results: The mean age of 303 participants was 33.45±9.07 years and 65.3% were female. According to the Body Mass Index, 48.2% of the participants were normal weight, 33.3% were overweight, 53.8% had a history of cardiovascular disease in their first-degree relatives, and the mean score of the knowledge level scale of cardiovascular diseases risk factors was 21.55±4.66. Women (p=0.003), single people (p=0.000), university graduates and above (p=0.000), people in the health profession group (p=0.000), people whose income is higher than their expenses (p=0.000), people with a history of cardiovascular disease in first-degree relatives (p=0.024), people who have never smoked (p=0.000), people aged 20-30 years (p=0.000) and people with a normal body mass index (p=0.001). 024), those who had never smoked (p=0.000), those aged between 20-30 years (p=0.000) and those with a normal body mass index (p=0.001) had a significantly higher level of knowledge about cardiovascular disease risk factors. The mean score of the Health Anxiety Inventory was 15.38±6.67. Health Anxiety was significantly higher in women (p=0.000). No significant relationship was found between the level of knowledge of cardiovascular disease risk factors and health anxiety (p=0.150). Conclusion: As the knowledge level of those with normal body mass index increases, their health anxiety also increases, but no significant relationship was found for all other variables. The fear of losing their healthy bodies of those with normal weight may increase their health anxiety as their level of knowledge increases. In this respect, it is important for individuals to access accurate and reliable information. It may also be recommended to repeat this study in different geographical regions and to examine the effect of regional differences. Keywords: Cardiovascular Diseases, Risk Factors, Health AnxietyÖğe Yabancı uyruklu göç artışının tüberküloz insidansı ve direnç durumuna etkisi(Hitit Üniversitesi, 2025) Yılmaz, Havle; Arı Yılmaz, YaseminAim: This study aimed to examine the demographic characteristics of patients diagnosed with tuberculosis in Çorum between 2014-2023, and to investigate the effects of increased foreign immigration on tuberculosis case numbers and drug resistance patterns. Materials and Methods: Demographic data of patients, tuberculosis localization, drug resistance status, and their relationship with increased foreign immigration were evaluated retrospectively. Tuberculosis patient data were obtained from the Çorum Tuberculosis Dispensary records. Population data for Çorum and the size of the foreign population were acquired from the Turkish Statistical Institute's population statistics portal. Statistical analysis of the data was performed using IBM SPSS Statistics 21.0 software. The significance level was accepted as p<0.05 for all statistical analyses. Findings: Among the 502 patients examined between 2014-2023, 479 (95,4%) were Turkish citizens, while 23 (4,6%) were of foreign nationality. Generally, the disease was more prevalent in males and occurred more frequently in the 18-45 age group. The proportion of foreign patients showed a fluctuating trend over the years, with immigrants from countries such as Iraq (60,87%) and Afghanistan (13,04%) representing a significant share of cases. The average ten-year incidence was 8,68 per 100,000 for Turkish citizens and 18 per 100,000 for foreign nationals. General drug resistance was detected in only 1 case among foreign patients (4,3%), while 10 cases were observed among Turkish citizens (2%). The single MDR-TB case (4,3%) in the foreign patient group was classified as a relapse case and was transferred out as a treatment outcome. Conclusion: The increase in foreign immigration affects tuberculosis incidence and particularly the drug resistance profile. Access to healthcare services should be ensured for foreign nationals. Our findings provide important information to enhance the effectiveness of tuberculosis control programs and improve health services for the immigrant population.Öğe Neovasküler yaşa bağlı maküla dejenerasyonu hastalarında intravitreal bevacizumab tedavisinin koroid ve retina dokuları üzerine etkisi(Hitit Üniversitesi, 2025) Bolat, Sabriye; Cevher, SelimAim: To evaluate retinal and choroidal structural changes in naïve neovascular age-related macular degeneration patients treated with bevacizumab over a 3-month period. Materials and Methods: The study was designed prospectively, included 50 eyes of 50 treatment-naïve patients. A comprehensive ophthalmological examination was performed. Central macular thickness (CMT) and nasal, temporal, and subfoveal choroidal thicknesses (SFCT) measured by enhanced depth imaging mode of optical coherence tomography (EDI-OCT). Thickness of retinal layers obtained through macular OCT segmentation. The ImageJ software was used to binarize OCT scans and measure total choroid area (TCA), luminal area (LA), and stromal area (SA). Choroidal vascularity index (CVI) was defined as the ratio of LA to TCA. Patients received three doses of bevacizumab injections at monthly intervals. Measurements were performed before injection, one month after the 1st, 2nd, and 3rd injections. Results: CMT significantly decreased from 355.6±96.81 μm to 296.24±74.94 μm and SFCT showed a significant reduction after treatment from 226.02±82.32 μm to 220.02±80.83 μm (p<0.05). A significant improvement in best-corrected visual acuity was observed compared to baseline (p<0.05). Significant reduction was noted in the retinal nerve fiber layer, inner nuclear layer, and outer nuclear layer compared to pre-treatment values (p<0.05). However, no significant changes was observed in other layers of retina (p>0.05). TCA, which was 0.38±0.12 mm² at baseline, significantly decreased to 0.36±0.12 mm² in the post-treatment period (p=0.007), and LA, which was 0.24±0.08 mm² at baseline, significantly decreased to 0.23±0.08 mm² at the end of treatment (p=0.021). No significant differences were found in CVI, SA, or LA/SA values between pre- and post-treatment periods (p>0.05). Conclusion: The significant reduction observed in SFCT, TCA, and LA, along with the decrease in CMT and retinal layers, indicates that bevacizumab is effective not only on retinal layers but also on choroidal structures in the short term period. Keywords: Anti-VEGF, Choroidal vascularity index, Image binarization, Segmentation, Subfoveal choroidal thicknessÖğe Toplum kökenli üriner sistem enfeksiyonlarında etken bakterilerin antibiyotik duyarlılıklarının incelenmesi ve tedavi uygunluğunun değerlendirilmesi(Hitit Üniversitesi, 2025) Köroğlu, Ayşe; Akdoğan, ÖzlemAim: In our study, we aimed to examine the resistance profile of microorganisms found to be causative agents in patients with community-acquired urinary tract infections admitted to the Infectious Diseases and Clinical Microbiology outpatient clinic of our hospital, to determine local resistance rates and to evaluate the appropriateness of empirical antimicrobial therapy used in treatment. Material and Method: Within the scope of the study, between 01.01.2025 and 31.07.2025, face-to-face interviews were conducted with 276 patients with urinary tract infection symptoms who applied to the Infectious Diseases and Clinical Microbiology Outpatient Clinic of Çorum Erol Olçok Training and Research Hospital. Demographic characteristics, symptoms, microorganisms isolated from urine cultures and antibiotic resistance rates were analyzed. The appropriateness of empirical treatments initiated to the patients was evaluated. The data obtained from the study were analyzed using IBM SPSS Statistics v30.0 software. Significance level was accepted as p<0.05 in all statistical tests. Results: In our study, 44.57% (n=123) were diagnosed with simple cystitis and 55.43% (n=153) with complicated urinary tract infection. 69.93% (n=193) were female and 30.07% (n=83) were male. The most common microorganism isolated from urine cultures was E. coli with 63.77% (n=176). This was followed by Klebsiella spp. with 19.20% (n=53). When the antibiotic susceptibilities of the microorganisms isolated from urine cultures were analyzed, the highest susceptibility was observed for carbapenems (98.13%-99.26%). The lowest susceptibility rates were found in ampicillin (32.60%) and amoxicillin-clavulanic acid (45.05%). The most frequently preferred agents in empirical treatment were cefixime 25% (n=68), ceftriaxone 23% (n=62), nitrofurantoin 18% (n=50). When the appropriateness of empirical antibiotic treatment was analyzed, 83% (n=229) were found to be appropriate, deescalation was performed in 6% of the cases, and treatment was changed according to the antibiogram in 11% (n=31). Conclusion: In our study, the high resistance rates of community-acquired urinary tract infections were noteworthy. It was observed that the agent options that can be used in empirical treatment with local resistance rates below 20% are limited. It is important to present data on local antimicrobial resistance in order to evaluate risk factors for resistance and to determine empirical treatment strategy. High resistance rates remind us that rational antibiotic use should be emphasizedÖğe Aile hekimliği asistanlarının kronik hastalık izlemlerinde teletıp uygulamaları ile ilgili değerlendirmeleri: Nitel bir çalışma(Hitit Üniversitesi, 2025) Metin Kıdam, Hatice; Akbıyık, DeryaAim: The aim of this study is to explore, using qualitative methods, family medicine residents' general evaluations of telemedicine applications in chronic disease follow-up processes and the needs that emerge during residency training. Based on the findings, the study aims to develop educational and structural recommendations to support the safe and effective use of telemedicine in family medicine training and primary care practice Materials and Methods: This study was conducted using a qualitative research design, employing semi-structured in-depth interview techniques. Focus group discussions were audio-recorded with residents who had not yet completed six months of residency training, while individual interviews were conducted with physicians who had completed their second year of residency. All recordings were transcribed and thematically analyzed using the MAXQDA software. During the analysis, codes, subthemes, and themes were generated through an inductive approach, and anonymization was ensured by assigning the code K for newly-started residents and R for residents who had completed their second year. Results: Participants described telemedicine as a healthcare service independent of time and place. Among the advantages of telemedicine, ease of access, process monitoring in chronic disease management, reduction of workforce loss, user-friendly digital systems (e-Nabız, MHRS), and enhanced physician safety were prominent. Conversely, the absence of physical examination, concerns about malpractice, privacy-related problems, difficulties in identity verification, inadequacy of technological infrastructure, and issues related to digital health literacy were identified as disadvantages. Participants considered telemedicine an effective complementary tool particularly in chronic disease follow-up, counseling and preventive care practices, infectious disease monitoring, and in patients with limited access to healthcare services. Additionally, numerous suggestions were offered for the feasibility of telemedicine, including triage, standardization, legal clarity, training, and equipment support. Conclusion: Family medicine residents stated that telemedicine is appropriate for chronic disease follow-up, counseling, and process monitoring but emphasized that it cannot replace face-to-face evaluation in situations requiring physical examination or involving clinical uncertainty. The study concluded that effective and safe implementation of telemedicine in primary care requires clarification of the legal framework, strengthening of privacy and security standards, improvement of digital infrastructure, structuring of telemedicine training programs, and enhancement of digital literacy. Keywords: Telemedicine, family medicine, chronic disease follow-up, qualitative researchÖğe Ergenlerde dijital bağımlılık ve zihinsel dayanıklılık ilişkisi(Hitit Üniversitesi, 2025) Bulut Şahin, Merve; (İren) Akbıyık, DeryaObjective: This study aimed to examine the relationship between digital addiction levels and mental toughness among adolescents. Materials and Methods: This research was designed as a cross-sectional, descriptive, quantitative, and correlational study. It was conducted among adolescents studying at various high schools in the city center of Çorum, Turkey. Data were collected using a Sociodemographic Information Form, the Digital Addiction Scale for Adolescents, and the Mental Toughness Scale for Adolescents – Short Form. The obtained data were analyzed through descriptive statistics, group comparisons, correlation, and multiple regression analyses. Results: Female students had significantly higher digital addiction scores compared to males. As daily internet usage increased, the risk of addiction rose markedly. In contrast, parental control over internet use and time spent with family emerged as protective factors that reduced digital addiction. Regarding mental toughness, the mother's educational status and the device used for internet access created significant differences. Students whose mothers had a university degree had lower resilience levels, and those accessing the internet via computer scored lower compared to mobile phone users. No significant associations were found between resilience and gender, number of siblings, daily internet usage, or time spent with family. Conclusion: No direct significant relationship was detected between digital addiction and mental toughness. The findings highlight that family support and parental monitoring play an important role in preventing digital addiction, while mental toughness is a dynamic construct influenced by environmental factors. Therefore, preventive programs at the family, school, and community levels are recommended.Öğe Gebelerde sosyodemografik veriler ile eş desteğinin uyku kalitesine etkisi(Hitit Üniversitesi, 2025) Özbil Zengin, Hatice; Oğulluk, MustafaIndroduction and Aim: Pregnancy is a period marked by numerous physical and psychosocial changes. These changes also affect the sleep quality of pregnant women. Studies in the literature emphasize the importance of sleep quality during pregnancy and the support received from partners. The aim of this study is to examine the effect of sociodemographic data and partner support on sleep quality. In this context, sociodemographic variables such as age, education level, employment status, and gestational age, as well as the perception of spousal support during pregnancy, were examined; the relationship between these factors and sleep quality was evaluated. The study aims to provide a holistic perspective that considers both individual and social factors that may affect sleep quality during pregnancy. Materials and Methods: This study was conducted as a cross-sectional, descriptive, and analytical study. The study population consisted of pregnant women aged 18-49 who met the inclusion criteria and attended the Obstetrics and Gynecology Department's Pregnancy Follow-up Clinic and Pregnancy School at Çorum Erol Olçok Training and Research Hospital. After obtaining the necessary permissions and approvals, informed consent was obtained from the volunteers, and participants were asked to complete the Sociodemographic Data Form, the Perception of Spousal Support Scale in Pregnant Women, and the Pittsburgh Sleep Quality Index. The data were analyzed using Jamovi (version 1.0) software. Results: The study included 240 pregnant women, 41,25% of whom were aged 25-29 and 53,33% of whom were in their third trimester. The participants' mean PUKI score was 6,44 (SD=2,69), with 75% having a PUKI score of 5 or above. Pregnant women aged 35 and over had better sleep quality compared to those aged 18-24 (p=0,036) and 25-29 (p=0,002). Pregnant women in the third trimester had poorer sleep quality compared to those in the first trimester (p=0,001) and second trimester (p=0,001). The total GEDAÖ mean score was 66,76 (SD=12,90). The age of the pregnant woman (p=0,003) and the age of the partner (p=0,004) age of 35 years or older, marriage duration of 5 years or longer (p=0,001), number of pregnancies of 3 or more (p=0,001), having 2 or more living children (p=0,001), and not having a helper in the same household (p=0,035). No significant relationship was found between perceived spousal support during pregnancy and sleep quality (p=0,198). Conclusion: Sleep quality improved with increasing maternal age but was found to be poor in advanced pregnancy weeks. The perception of spousal support among pregnant women was found to be associated with variables such as age, duration of marriage, pregnancy, and number of children. Accordingly, in prenatal care, it is recommended to adopt a holistic approach, inquiring about the sleep profile of pregnant women alongside their medical condition and assessing the level of support within the family. Keywords: Pregnancy, Sleep Quality, Spousal SupportÖğe Aile hekimliğinde yaşlının kendini ihmali ve Beden Kitle İndeksi arasındaki ilişki(Hitit Üniversitesi, 2025) Bekdemir, Mithat; Akbıyık, DeryaTHE RELATIONSHIP BETWEEN ELDERLY SELF-NEGLECT AND BODY MASS INDEX IN FAMILY MEDICINE Objective: Self-neglect in the elderly is a common and difficult-to-detect condition. In cases of self-neglect, irregular eating habits will lead to changes in weight. Weight changes manifest as obesity due to weight gain or weakness due to weight loss. (BMI) body mass index is used to evaluate these changes. BMI is a simple, easy, and applicable parameter used to assess weight changes. Neglect, along with obesity or weakness, can cause new health issues and exacerbate existing health problems. By evaluating the relationship between neglect and BMI in the elderly, the aim is to prevent health issues that may arise or worsen as a result. Materials and Methods: The study was conducted between February 1, 2025, and June 30, 2025, at the Çorum Uğurludağ Family Health Center with 285 individuals aged 65 and older through face-to-face interviews. During the interviews with the participants, after reading and signing the informed consent form, height and weight measurements were taken, BMI was calculated, and the Socio-Demographic Data Form (Appendix 4) and the Istanbul Faculty of Medicine Self-Neglect Screening Scale for the Elderly (Appendix 5) data collection tools were completed by the participants. Findings: The study found no statistically significant relationship between body mass index (BMI) categories and self-neglect (p=0.669). When the (BMI) distribution in the study group was examined, the vast majority of participants (83.5%) had a BMI of 25.0 or higher, indicating obesity; of these, 46.7% had a BMI of 25.0–30.0, indicating first-degree obesity, and 36.8% had a BMI of 30.0 or higher, indicating second-degree obesity. Individuals with a BMI of 18.5–25.0, which is considered normal, made up a smaller group (16.1%), while the proportion of participants in the underweight category (BMI <18.5) was extremely low (0.4%). While 71.6% of the study participants reported not neglecting themselves, a significant proportion (28.4%) exhibited self-neglect behavior. When examining the sociodemographic characteristics of individuals exhibiting self-neglect behavior (28.4%), significant differences were found between age groups (p<0.001). The rate of self-neglect was lower in the 65-74 age group (49.4%), while it increased significantly in those aged 75 and above (75-84 age group: 43.2%, 85+ age group: 7.4%). Self-neglect increased with age. A strong relationship was found between educational status and self-neglect (p<0.001), with the rate of self-neglect decreasing as educational level increased. In the study, neglect rates were higher among those living alone (18.5%) and those living with their children (13.6%) than among those living with their spouses (63.0%). When evaluated according to income status based on sociodemographic data, the neglect rate was significantly higher in the group with income lower than expenditure (58.0%) (p<0.001). Results: This study also found no statistically significant relationship between self-neglect and BMI categories. The study revealed that advanced age, low educational level, living alone, and economic difficulties are important factors that increase the risk of self-neglect in older adults. In terms of BMI, it was found that the vast majority of participants (83.5%) were obese. Keywords: Family Medicine, Elderly, Self-Neglect, Body Mass Index (BMI), Geriatrics.Öğe Laparoskopik kolesistektomi uygulanan hastalara ultrasonografi eşliğinde yapılan subkostal transversus abdominis plan bloğu ile rekto-interkostal fasiyal plan bloğunun postoperatif analjezik etkinliklerinin karşılaştırılması(Hitit Üniversitesi, 2025) Kitaplı, İbrahim; Kayır, SelçukAim: Severe postoperative pain is observed in patients following laparoscopic cholecystectomy. Currently, peripheral nerve blocks, which are a part of multimodal analgesia, are widely used in postoperative pain management. This study investigated the effects of subcostal transversus abdominis plane nerve block (STAP), recto-intercostal fascial plane block (RIFPB) on postoperative NRS scores and tramadol consumption. Material and method: This study was designed as a prospective, randomized, double-blind trial. Seventy-two patients scheduled for laparoscopic cholecystectomy were included in the study. One group received a bilateral STAP block (group S, n=35), while the other group received a bilateral recto-intercostal fascial plan block (RIFPB) (group R, n=35). For the peripheral nerve blocks, STAP was administered with 20 mL of 0.25% bupivacaine per side, RIFPB with 20 mL of 0.25% bupivacaine per side. These blocks were performed after the surgery but before the termination of general anesthesia. The postoperative NRS scores and tramadol consumption were compared between the groups. Results: The groups were similar in terms of ASA scores and demographic characteristics. The rates of dermatomal involvement at the midclavicular line at T5 and T10 in the 2nd postoperative hour were found to be statistically significantly different between the groups (P=0.01 and P=0.044, respectively). Additionally, a statistically significant difference was observed between the groups in terms of T6–T9 dermatomal involvement at the midaxillary line at both the 2nd and 24th postoperative hours (P<.001). A statistically significant difference was also found between the groups regarding the time to mobilization (P=0.005). Furthermore, postoperative nausea and vomiting scores at hour 0 differed significantly between the groups (P=0.046). Conclusion: In laparoscopic cholecystectomy procedures, both the STAP block and the RIFPB are effective in postoperative pain management. RIFPB may provide more effective analgesia compared to the STAP block alone, as it also targets the lateral cutaneous branches of the abdominal nerves in addition to those innervated by the STAP block.Öğe Kronik böbrek hastalığı olanlarda serum proprotein konvertaz subtilisin/ keksin tip 9 düzeyinin endotel disfonksiyonu ve subklinik ateroskleroz ile ilişkisi(Hitit Üniversitesi, 2025) Avcı, Ahmet; Eser, BarışObjective: This study aims to investigate the relationship between serum PCSK9 values and subclinical atherosclerosis and endothelial dysfunction in patients with chronic kidney disease. Materials and methods: A total of 127 participants over the age of 20 those receiving hemodialysis (HD) (n=30), those receiving continuous peritoneal dialysis (PD) (n=36), stage 3-4 CKD (n=31), and non-CKD control group (n=30) participants] were included in this clinical cross-sectional study. Flow-mediated dilatation (FMD) for ED, endothelial deceleration time (EDT) for left ventricular diastolic dysfunction (LVDD), and carotid intima media thickness (CIMT) for subclinical atherosclerosis were measured by echocardiography. Blood samples were taken for simultaneous PCSK9 measurements. Results: Of the 122 participants who participated in the study, 30 (24.5%) were in the control group, 31 (25.4) in the stage 3-4 CKD patient group, 31 (25.4) in the peritoneal dialysis group, and 30 (24.5%) in the hemodialysis patient group. Although no significant difference was found between the study groups in FMD BASE and FMD HYPEREMIA; FMD ratio was found to be significant (P values, respectively; 0.552; 0.435; 0.001). A significant difference was found between the CIMT groups (both 0<.001). E/e', one of the parameters indicating LVDD was found to be significantly different (P:0.009). Conclusion: There was a statistically significant difference in endothelial dysfunction and subclinical atherosclerosis in chronic kidney disease patients compared to the healthy group. However, no significant difference was found in PCSK9 correlation. Keywords: Proprotein convertase subtilisin/kexin type 9, chronic kidney disease, endothelial dysfunction, subclinical atherosclerosisÖğe İzole hipertansiyon hastalarında nondipper kalp hızı varlığının ventriküler aritmiler ile ilişkisi(Hitit Üniversitesi, 2025) Sarıhan, Abdullah; Bekar, LütfüObjective: In healthy individuals, the increase in parasympathetic tone during nighttime leads to a decrease in heart rate. When this decrease does not occur or happens minimally, it is an indicator of increased sympathetic activity. This condition could be an important mechanism that may increase the susceptibility to ventricular arrhythmias, especially in hypertensive individuals. The aim of this study is to compare the frequency of ventricular arrhythmias and other clinical parameters between cases with and without a heart rate decrease during the night in isolated hypertensive patients monitored by a rhythm Holter. Materials and Methods: A total of 229 isolated hypertensive patients (mean age 58.2±12.5 years, 89 (38.9%) male) who underwent transthoracic echocardiography, rhythm Holter, and amulatory blood pressure monitoring and applied to the Department of Cardiology at Hitit University Faculty of Medicine in the last 12 months up until March 2025 were included in this study. The cases included in the study were divided into two groups based on their nighttime heart rate decrease in the rhythm Holter: the 'dipper' group, with a decrease of 10% or more, and the 'non-dipper' group, with a decrease of less than 10%. The primary comparisons were made between these two groups. Then, according to the Lown classification, patients in the low Lown class (Lown 0) were compared with those in the high Lown class (Lown 1-4), and the same comparisons were repeated between these two groups. Parameters that were significantly different between the Lown class 0 and Lown class 1-4 groups were included in multivariate analysis, aiming to identify independent and significant parameters that may influence the development of cardiac arrhythmias in isolated hypertensive patients. Results: In Holter rhythm analyses, 170 patients (mean age 57.8±12.2 years, 66 [38.8%] male) with a nocturnal heart rate decrease of ≥10% were classified as the dipper group, while 59 patients (mean age 59.3±13.4 years, 23 [29%] male) with a decrease of <10% were classified as the non-dipper group. There was no significant difference between the dipper and non-dipper groups in terms of baseline demographic parameters, laboratory values, or medications used. When transthoracic echocardiographic parameters were compared between the two groups, interventricular septal thickness (11.9±1.6 vs. 11.3±1.4 mm; p=0.005), posterior wall thickness (11.7±1.6 vs. 11.3±1.6 mm; p=0.047), left ventricular (LV) mass (193.8±47.1 vs. 174.7±48.6 g; p=0.009), LV mass index (103.9±26.2 vs. 95.3±28.2 g/m²;VIII p=0.040), presence of LV hypertrophy (78% vs. 60.6%; p=0.016), and presence of concentric hypertrophy (55.9% vs. 37.6%; p=0.014) were significantly higher in patients with non-dipper heart rate compared to those with dipper heart rate. When Holter rhythm parameters were compared between the two groups, both the number of ventricular extrasystoles (1039 [8– 1600] vs. 120 [0–321] beats; p<0.001) and the number of atrial premature beats (451 [3– 1366] vs. 129 [0–445] beats; p<0.001) were found to be significantly higher in the non-dipper heart rate group. Comparing the Lown classification between the two groups, arrhythmia frequency was observed to be higher in patients with non-dipper heart rate (p<0.001). Based on Lown classification, 139 patients (mean age 57.2±13.4 years, 58 [41.7%] male) were categorized in Lown class 0, and 90 patients (mean age 59.8±10.8 years, 31 [34.4%] male) in Lown class 1–4. No significant differences were observed between these groups in terms of baseline demographic characteristics, laboratory findings, or medications used. However, echocardiographic parameters such as interventricular septal thickness (11.8±1.6 vs. 11.3±1.5 mm; p=0.005), posterior wall thickness (11.7±1.6 vs. 11.2±1.6 mm; p=0.011), LV mass (187.8±47.2 vs. 174.3±49.3 g; p=0.040), LV mass index (102.8±26.2 vs. 94.1±28.6 g/m²; p=0.021), presence of LV hypertrophy (73.3% vs. 59.7%; p=0.036), and presence of concentric hypertrophy (52.2% vs. 36%; p=0.015) were significantly higher in patients in the Lown class 1–4 group compared to the Lown class 0 group. Additionally, 24-hour average systolic blood pressure (p=0.015), daytime average systolic blood pressure (p=0.014), and nighttime average systolic blood pressure (p=0.011) were significantly higher in the Lown class 1–4 group among ambulatory blood pressure monitoring parameters. When rhythm Holter parameters were compared between these two groups, both the number of ventricular extrasystoles (908 [122–2509] vs. 0 [0] beats; p<0.001) and the number of atrial premature beats (671 [122–1863] vs. 52 [0–360] beats; p<0.001) were found to be significantly higher in the Lown class 1–4 group. Furthermore, non-dipper heart rate status was more frequently observed in the Lown class 1–4 group (89.9% vs. 50%; p<0.001). In correlation analysis, a weak but statistically significant negative correlation was detected between percentage change in heart rate and both LV mass (r= -0.256; p=0.018) and LV mass index (r= -0.243; p=0.031). In multivariate analysis, the presence of concentric hypertrophy (Relative Risk: 2.879; 95% Confidence Interval: 1.843–9.829; p=0.041) and a nocturnal heart rate decrease of less than 10% (Relative Risk: 9.616; 95% Confidence Interval: 4.563–20.261; p=0.001) were identified as independent predictive parameters for the development of cardiac arrhythmias.Öğe Aile hekimliğinde malpraktis korkusu ve defansif tıp uygulamaları(Hitit Üniversitesi, 2025) Eldemir, İsa; (İren) Akbıyık, DeryaAim: Malpractice lawsuits are increasing worldwide. Physicians are also developing defensive behaviors to avoid making medical errors and to protect themselves from these lawsuits. This study aims to compare the malpractice fears and defensive medical attitudes of family physicians in light of current demographic data, to reduce these fears of physicians, to prevent defensive medical practices that we do not want to occur, and to contribute to health policies. Materials and Methods: In this study, demographic data form, fear of malpractice scale and defensive medicine practices attitude scale were sent digitally to 186 contracted family physicians working in Çorum province between 01.07.2024 and 30.09.2024. Physicians who approved to participate in the study were asked to fill out the data sets via Google Forms. Results: The sample was formed by 168 (90.3%) of the 186 physicians constituting the study universe. 72% of the participants were aged 40 and over, 71% were male, and 80,4% were general practitioner family physicians. A high level of fear of malpractice was detected in 80,36% of the participants. As the fear of malpractice increases, positive defensive medicine and negative defensive medicine scores increase. As the physician's age, length of time in the profession, and length of time working at the family health center increase, the fear of malpractice, positive defensive medicine, and negative defensive medicine scores decrease. If the physician has malpractice lawsuit experience in his/her close circle or if a complaint is made, the fear of malpractice and defensive medicine scores increase. The defensive medicine attitude knowledge level of male physicians was found to be significantly higher than that of female physicians. The defensive medicine knowledge levels of physicians who follow up patients on the disease management platform and who have lawsuit experience due to malpractice or defensive medicine attitude against themselves or their close circle were found to be higher. Conclusions: As a result of this study, a widespread and high level of fear of malpractice was found among all family physicians. When the literature is examined, it is seen that this fear has increased over the years. It was observed that a high level of fear triggers defensive medical attitudes, and among these attitudes, detailed record keeping and more detailed explanations to patients, which have the lowest cost to the health system, are the highest. On the other hand, it was determined that physicians are greatly affected by malpractice news in the media and hesitate to make decisions based solely on their own clinical experiences.Öğe Anne depresyonu ile anne bebek bağlanması arasındaki ilişki(Hitit Üniversitesi, 2025) Arık, Büşra; Akbıyık, DeryaAim:In the context of primary care, where family physicians address health problems through a biopsychosocial approach, it is crucial to identify risk factors that may adversely affect maternal bonding within the community they serve. Such factors can potentially compromise the infant's relationship not only with the mother but also with others in their environment. Understanding these influences is essential for delivering effective, high-quality, and holistic healthcare services. This study aims to examine the social and psychological determinants that impact mother-infant bonding. The findings are expected to enhance the quality of follow-up and intervention practices in primary healthcare settings and contribute positively to both maternal and infant well-being. Materials and Methods: The study was carried out between October 1 and December 31, 2024, with the participation of 21 out of 33 family health centers and 70 out of 100 family medicine units in the city center of Çorum. A total of 86 mothers, who had given birth within the past 0–6 weeks, were literate, volunteered to participate, and were able to use a smartphone, were included in the study. After collecting sociodemographic data, participants were asked to complete the Maternal Attachment Inventory and the Edinburgh Postnatal Depression Scale, both of which have been validated for use in Turkish, via Google Forms. Results: In terms of educational background, 1.16% of participants had completed primary school, 12.79% middle school, 40.7% high school, 39.53% university, and 5.81% held a postgraduate degree. Regarding occupational status, 11.63% were unemployed, 50% were housewives, 30.23% were public servants, and 8.14% were self-employed.In terms of income, 24.42% reported that their income was less than their expenses, 53.49% stated it was balanced, and 22.09% reported having an income higher than their expenses. A total of 17.44% of participants had a history of stillbirth or giving birth to a child with disabilities, while 82.56% had not experienced such outcomes. The majority (98.84%) reported that their current baby was healthy.The most recent pregnancy was planned in 88.37% of cases, and 23.26% were considered high-risk pregnancies. About 46.51% of participants reported having someone to assist with infant care at home. Prior to pregnancy, 4.65% had been diagnosed with a psychiatric disorder, and 1.16% reported using psychiatric medication. A total of 36.05% experienced job loss or economic changes due to the pregnancy. The mean score on the Maternal Attachment Inventory (MAI) was 4.36 (±3.21), with a median score of 4 (range: 0–16). The mean score on the Edinburgh Postnatal Depression Scale (EPDS) was 11.48 (±6.76), with a median score of 10 (range: 0–28). According to EPDS results, 65.12% of participants were not at risk for depression, while 34.88% were identified as being at risk.EPDS scores were found to be significantly higher among employed participants compared to housewives, and among those with education above high school compared to those with lower educational levels (p<0.05). Participants whose income was either below or above their expenses had significantly higher EPDS scores compared to those whose income and expenses were balanced (p<0.01).EPDS scores were also significantly higher among participants whose most recent pregnancy was unplanned, those with high-risk pregnancies, those without support for infant care at home, and those who experienced job loss or economic hardship due to pregnancy (p<0.05).MAI scores were significantly higher among employed mothers compared to housewives, and among those whose monthly income exceeded their expenses compared to those whose income was equal to or less than their expenses (p<0.05). Additionally, mothers whose most recent pregnancy was unplanned or considered high-risk had significantly higher MAI scores compared to those with planned or low-risk pregnancies (p<0.05). Conclusions: Through our study conducted within family medicine units operating at the primary healthcare level, various social and psychological factors that may influence the bonding between mother and infant have been identified. Postpartum depression, anxiety, and past traumas can reduce a mother's sensitivity and her capacity to provide adequate care for her infant. Maternal psychological well-being, social support systems, the infant's health status, economic conditions, and cultural dynamics all play a critical role in establishing secure attachment. Therefore, developing comprehensive support mechanisms is essential to facilitate a healthy mother-infant relationship. The findings are expected to contribute positively to maternal and infant health by enhancing the quality of follow-up processes in primary care, strengthening mother-infant bonding, and promoting a holistic approach to care. Keywords: Maternal-infant bonding, Depression, family medicine, Primary heal
