Mustafa Levent Özgönül

Kanser; taşıdığı olumsuz anlamı, tedavisinin uzun süreç gerektirmesi ve hastayı ölümle yüzleştirmesi nedeniyle hastanın salt biyolojik varlık boyutunda değil, psikolojik ve sosyal boyutunda da “bozulma”ya yol açmaktadır. Dolayısıyla tanının açıklanması ve uzun tedavi/bakım sürecinde hastaya biyo-psiko-sosyal yaklaşımı elzem kılmaktadır. Bütüncül yaklaşımı (biyo-psiko-sosyal) sunabilmek içinse hastanın değerleri, tercihleri, sosyoekonomik durumu, hastalığı yordayışı ve koşullarının bilinmesi, kısaca hastanın tanınması gerekmektedir. Onkoloji uzmanının hastasını tanıyabilmesiyse inşa ettiği güvene dayalı ve hasta-merkezli ilişkiyle sağlanabilmekte; hasta-hekim ilişkisinde iletişimle etiğin iç içeliğini elzem kılmaktadır. Aksi halde hastanın hekime duyduğu güvenin zedelenmesi, tedaviye uyumunun ve memnuniyetinin azalmasıyla farklı tedavi yöntemlerine başvurması; etik ikilem/ihlaller, etiko-legal sorunlar ve tıbbi kötü uygulama iddiaları söz konusu olabilmektedir. Bu durum özel iletişim araçlarına gereksinimi de beraberinde getirmektedir. Geliştirilen iletişim araçları özellikle kötü haber verme bağlamında yol gösterici olmakla birlikte, hastalığın evresi, kültürel belirleyiciler ve etik yükümlülükler gibi bağlamsal değişkenleri ele almakta sınırlı kalmaktadır. Onkolojide “olması gereken” hasta-hekim ilişkisiyse özneler-arası ilişki olup, Buber’in geliştirdiği “Ben ve Sen” ilişkisi olmalıdır ki iki taraf da etkin ve kişi/özne niteliğini taşıyabilsin. Ayrıca Kuçuradi’nin “değerler ve değerlilik ilişkisi” olarak “etik değerleri”, “kişisel değerleri” ve “ilişki değerleri”ni içeren “etik ilişki”yi de esas alması gerekli görülmektedir. Böylece hastaya yararlı olunurken, hastanın insan değeri ve onuru ile özerkliği ve mahremiyeti korunabilecektir. Bahsedilen mahiyette hasta-hekim ilişkisinin tesisinin onkoloji pratiğinde klinik, etik ve bağlamsal gereksinimleri birlikte gözeten “Bağlama Özel İletişim Algoritması”yla olanaklı kılınabileceği ileri sürülebilir. Nitekim bu algoritma; bağlamın sistematik olarak değerlendirilmesi, iletişim hedeflerinin belirlenmesi, bilgilendirme ve ortak karar verme süreçlerinin yapılandırılması, etik ilişki temelli etkileşimin sağlanması, etik sorun ve çıkar çatışmalarının değerlendirilmesi, mahremiyetin korunarak güven ve sadakate dayalı ilişkinin sürekli kılınması ile geri bildirim ve yeniden değerlendirme aşamalarını içeren süreç odaklı bir yaklaşım olarak yapılandırılmıştır. “Bağlama Özel İletişim Algoritması’nın gerekliliğinin ve esaslarının belirlendiği bu çalışmada, algoritmanın onkoloji pratiğine uygulanabilirliğini saptamak amacıyla ülkemizdeki gereksinimi karşılamaya yönelik olarak yürütülecek araştırmanın kuramsal dayanağını oluşturmaktadır.

This study examines how ethical issues in palliative care are perceived and experienced by healthcare professionals and family caregivers in Türkiye. Using a phenomenological qualitative design, in-depth interviews were conducted with 12 healthcare professionals and 10 family caregivers. Thematic analysis revealed two key themes: “decision-making process” and “service process.” While both groups shared similar ethical concerns, their priorities differed. Healthcare professionals emphasized institutional and professional challenges, whereas family caregivers focused on communication gaps, emotional needs, and inadequate patient-centered care. The findings highlight the complex interaction of professional authority, cultural norms, and institutional constraints shaping ethical practices. Strengthening ethical decision-making requires fostering open dialogue between healthcare teams and families, enhancing ethical awareness, clarifying informed consent, and ensuring fair access to services. These insights contribute to improving ethical standards, education, and research in palliative care. Based on participants’ lived experiences, these findings contribute to strengthening the ethical foundations of palliative care in Türkiye.

The aim of this study was to determine medical school students' body image perceptions and prejudices towards obese individuals, reveal the relationship between these two concepts, determine the influencing factors, and raise awareness of the issue. The sample of the study consisted of 665 medical school students. 'Student Information Form', 'GAMS-27 Obesity Prejudice Scale' and 'Body Appreciation Scale' were used to collect data. For data analysis arithmetic mean, standard deviation, frequency, percentage distribution, t test/one-way analysis of variance, correlation coefficient, Shapiro-Wilk test, Kolmogorov-Smirnov test, Spearman rho correlation coefficient, Kruskal Wallis H test, Mann-Whitney U test and Single One-way ANOVA F test were used. The overall Body Appreciation Scale and GAMS-27 Obesity Prejudice Scale mean scores were 27.57 ± 4.22 and 82.75 ± 10.68, respectively. There was no relationship between the Body Appreciation Scale and GAMS-27 Obesity Prejudice Scale mean scores (p > 0.05). The participants were prejudiced towards obese individuals. Factors such as gender, year of study, participation in sports, perceived body image, and desire to care for an obese patient did not affect the scores on the GAMS-27 Obesity Prejudice Scale and Body Appreciation Scale.

Background: There is a need for training strategies and programs to enable students to actively participate in their learning process by using critical thinking and decision-making skills. Objective: The aim of this study was to compare the traditional lecture-based teaching with the team-based learning method in terms of student satisfaction and in-class learner engagement. Method: This study was conducted using a quasi-experimental design. The population of the research consisted of first-year nursing students (n = 101). During half of the 16-hour course conducted by the researcher, team-based learning was used as the teaching method (intervention group, n=30), and lecture-based (control group, n=59) approach was employed for the remaining 8 hours. The in-class engagement measure was used to assess the in-class engagement of the students. A feedback form composed of five parts was made available to learners in order to reveal their reactions. Results: In-class learner engagement scores and the number of questions asked both by the instructors and students were found to be higher in team-based learning sessions. In four basic feedback areas (preliminary preparation and readiness, discussion, teacher, and general), there was a statistically significant difference between the satisfaction scores of the students in favour of team-based learning. Satisfaction scores regarding the organization, infrastructure, and resources did not differ between team-based learning and lecture-based method. Conclusion: The results have indicated that Team-Based Learning is an effective method for student satisfaction and in-class engagement. The high level of student participation in the lessons conducted with Team-Based Learning is compatible with the nature of method. The findings of the study have also shown that students are open to new methods and prefer learner-centered approaches that support in-class engagement.

Objectives: This research aims to examine the empathic tendencies and altruism levels of students. Materials and Methods: This descriptive study was conducted with the students studying at Vocational School of Health Services between 15.10.2022-28.11.2022. The population of the research consists of 858 students studying at a college. The research sample consists of 408 volunteers who agreed to participate in the research. Socio-demographic Form, Empathic Tendency and Altruism Scale were used in the data collection process. Results: It was determined that the empathic tendency total score of the students participating in the study was 66.5±9.06 (min.20-max.100), and the total score of altruism was 65.2±8.73 (min.20-max.100). It was found that the empathic tendencies of the students differed according to gender. It was found that the level of empathic tendency of female students was higher than that of males. When the altruism behaviour is examined, it has been determined that the level of altruism differs according to the department of education and the status of being a health professional in the family. Conclusion: It was determined that the empathic tendency and altruism levels of the students participating in the study were above the average. In addition, a moderate positive correlation was found between students' empathic tendencies and altruism levels. When the results of the research are evaluated, it is very important to plan and implement educational studies aimed at improving the professional values of students studying in health departments such as empathy and altruism.

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Background: In the context of good medical practices, physicians perform their duty as a role model for their colleagues for the benefit of patients, without any discrimination, by prioritizing professional responsibilities, ethical principles and human values”. In this context, it is important for physicians to receive ethical education based on humanistic and professional values. There are national and international standard setting studies intended to determine the content of ethics education in medicine. The Association for the Evaluation and Accreditation of Medical Education Programs, which continues its efforts to ensure quality assurance, has set a standard for medical faculties related to the professional ethical development of physicians.This study aims to determine opinions of the candidate physicians who are at the graduation stage in medical education on their own competencies against a list of competencies defined in "National Competencies Framework for Medical School Graduates".Methods: This is a cross-sectional study and the target population consists of the candidate physicians who are at the graduation point in the 2019-2020 academic year of Akdeniz University Faculty of Medicine (AUFM) (n=240). A digital data gathering form including two parts was used in the study. In the first part, there were questions about sociodemographic characteristics of the participants. The second part was prepared by the researchers on the basis of the competence list for medical school graduates which is available in the “National Core Curriculum for Undergraduate Medical Education‐2014”. Twenty-four items from the competence list were thought to relevant to ethical issues and used in the study. For each of these 24 items, a five-item likert scale was prepared for the participants to rate themselves on it. The participants filled out the forms online. Results: The self-evaluation scores of the participants did not differ according to their sociodemographic characteristics. Mean and median values for all items are around “4” on the five-point scale. Conclusion: Self- evaluation scores of the participants on ethics related items of the competence list are high which means that they find themselves well-equipped on ethical issues at the graduation point from medical school.

Objective: This study was conducted to determine the approach of nursing students to ethical problems. Material and Method: Descriptive cross-sectional study was conducted between May and June 2019 at Akdeniz University Faculty of Nursing. The data of the study was collected with personal information form and Approach to Ethical Problems in Health Field Scale. In the analaysis of the data; Number, mean, percentage distributions, standard deviation, Cronbach alpha coefficient, Mann-Whitney U test and Kruskal Wallis analysis were performed. Results: When the demographic characteristics of the students participating in the study were examined, it was determined that 67.2% (N = 405) were women. In this study, it was determined that 19.1% (N = 115) of the students were first grade, 24.5% (N = 148) were second grade, 29.7% (N = 179) were third grade and 26.7% (N = 161) were fourth grade. It was determined that 69.7% (N = 420) of the students loved the department. In addition, it was determined that 70.1% (N = 423) of the students took courses on ethics. The level of perception of the basic principles of medical ethics and the level of perception of rules and written ethical codes were found to be statistically higher in male students. It was found that there was a statistically significant difference (U = 33680.5, p = 0.015) between the students' loving of nursing department and the Perceptions Level of Basic Ethics Principles and Perceptions (U = 34647, p = 0.045). There was no significant difference between the sub-dimensions of SAESYÖ according to the classes in which the students were trained. It was found that there was no significant difference between the ethical course taking status of students and the sub-dimensions of SAESYÖ.Conclusion: In this study, the level of perception of the the basic principles of medical ethics and the level of perception about written ethical codes were found to be low and the level of perception of values and standards in medical ethics was found to be moderate.