Mebrure Beyza Gökçek

Aim: Earthquakes are natural disasters that affect survivors physically and psychologically. Healthcare workers (HCWs) are both earthquake survivors and aid responders. In our study, we aimed to determine the level of anxiety and depression and related factors in HCWs involved in the treatment, discharge, follow-up, and rehabilitation of earthquake victims. Materials and Methods: The Kayseri City Hospital Institutional Ethics Board approved the study (Approval number: 841, decision date: 23.05.2024). HCWs such as doctors, nurses, health technicians, medical technicians, and medical secretaries who worked in the acute care of earthquake victims in Kayseri City Hospital after the February 6, 2023 earthquake were included in the study. Sociodemographic data form, Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) were applied to the participants. Results: A total of 159 HCWs agreed to participate in our study. According to the BDI scale scores, 18.2% of the participants had mild depression, and 4.4% had severe depression. The presence of anxiety and depression was higher in female participants than in male participants (p=0.012, p=0.005). A statistically significant difference was found in terms of anxiety in HCWs who considered themselves earthquake survivors (p=0.002). While anxiety was higher in participants who thought that HCWs were more affected by the earthquake (p=0.034), both anxiety and depression were higher in participants who believed that HCWs should receive psychological support after the earthquake (p-values were 0.01 and 0.004, respectively). Conclusion: Strategies should be developed before and after disasters such as earthquakes to protect and improve HCWs’ mental health, even if they do not request it.

Background: About a quarter of a million women die from pregnancy-related conditions every year. This study aimed to contribute to the literature by assessing causes and demographic data of maternal deaths in our region. Methods: Our study is retrospective and descriptive. The study sample comprised 36 mothers who died in Kayseri between 2015 and 2019. The assessment was performed on the Provincial Directorate of Health data-“Maternal Death Record Forms”. Patients’ demographic and clinical characteristics and the factors associated with mortality were analyzed. Results: A total of 33 maternal deaths that occurred between 2015 and 2019 were assessed in our study. The mean age of mothers included in the study was 33.3 ± 6.3. Median gestational week was 24.5 (min: 3–max: 39) weeks of pregnancy. The majority of preventable deaths were from indirect causes. Cesarean history was higher in previous pregnancies in preventable maternal deaths (p = 0.006). First-phase and third-phase delay models were higher in preventable maternal deaths (p = 0.008, p = 0.007). Conclusions: The rates of preventable maternal mortality are considerably high. The first-phase delay model has an important place in preventable maternal deaths.

The number of people with chronic diseases in the world and in our country is increasing gradually. Managing risk factors is of great importance. For this reason, the use of various methods is being tried. Disease Management Platform (DMP) is also a method that is being used in our country for this purpose. In the study, a survey of 30 questions about DMP prepared by the researchers was applied to 217 participants. The median age of the participants was 38 (age range 26-59 years) and the median of total tenure was 14 (range 1-35 years). Of the participants, 35% were family health workers, 40.1% were family physicians, and 24.9% were family medicine specialists. Although, 46.5% of the participants thought that DMP could be useful in reducing the incidence of chronic diseases, 86.2% of them stated that requesting tests that are not performed in the Family Health Center in the DMP causes difficulties and therefore they do not find it right. With the acceleration of technological development, it is inevitable that digital systems will be used in the field of health care. We think that providing necessary training to the users and including patients in the system will increase the effectiveness of the applications.

Pregnancy is a life process that progresses with biological, physiological, and psychosocial changes. Especially the challenging factors during the pandemic caused pregnant women to experience more stress than expected. Postpartum depression is one of the important mental health problems that follow giving birth. In our study, we aimed to investigate the relationship between postpartum depression and stress levels during the pregnancy, in a period in which the effects of the pandemic decreased. Our study was conducted on 102 persons with a mean age of 25.8±4.5. The data collection process was carried out using a survey under the supervision of the researchers. The survey consisted of two-stages. In the first stage, the sociodemographic characteristics of the people were questioned, and the Pregnancy Stress Assessment Scale (PSAS) was applied. In the second stage, the Edinburgh Postpartum Depression Scale (EPDS) was applied. PSAS mean score was 97.0±23.7 and SPDS mean score was 8.07±5.55. Pregnant women who have chronic diseases had a higher stress level (p=0.011). EPDS mean score was significantly higher in the group whose pregnancy ended in abortion (p=0.001). The pandemic has been a source of great concern for women in the postpartum period. However, we think these worries must have been decreased with the normalization process. In our study, no relationship was found between postpartum depression and stress level of pregnancy. It was observed that the postpartum psychological state was mostly affected by the postnatal health conditions of the mother and the baby. Closely monitoring the mother's mental health after birth and supporting the mother from medical personnel will help the mother to protect her mental health.

İntihar, kişinin hayatını bilerek sonlandırmak istemesidir. Dünyada ilk on ölüm nedeni arasında sayılmakla birlikte önemli bir halk sağlığı sorunudur. İntihar psikolojik faktörlerden etkilenen en önemli ölüm nedenlerinden biridir. Çalışmamız retrospektif tanımlayıcı bir çalışma olarak tasarlanmıştır. Ölüm bildirim sistemi üzerinden 2019 yılında intihar eden kişiler taranarak toplam 61 kişiye ulaşılmıştır. Demografik özellikleri ve intihar ettikleri tarih, sistemde kayıtlı intihar şekilleri, psikiyatrik hastalık tanıları, kullandıkları ilaçlar değerlendirilmiştir. İstatistiksel veri analizlerinde SPSS 21.0 paket programı kullanılmıştır. 2019 yılında ilimizde toplam 61 kişi intihar etmiştir.%75.4’ü erkek, %24.6’sı kadındır. Yaş ortancası (Q1-Q3) 31 (24.5-46) idi.%62.3’ü kendini asarak, %16.4’ü ise ateşli silah, %21.3’ü diğer şekillerde intihar etmişti. %19.7’sinin psikiyatrik bir hastalığı varken %80.3’ünün ruh sağlığı kliniğine başvurusu bulunmamaktaydı. Erkek cinsiyet ve yaş şiddet içeren intihar vakalarını etkileyen faktör iken (p=0.010, p=0.046)medeni hal ve mesleğin şiddet içeren intihar vakalarını etkilemediği saptanmıştır (p=0.54, p=0.761). Ölüm nedenleri arasında üst sıralarda olan, toplumsal bir sorun olan ve multidisipliner ya da disiplinler arası yönetilmesi gereken bir durumdur. Kişileri, çare arama davranışı yönünden desteklemek gerektiğini düşünmekteyiz. İntiharın azalması için kişilerin bireysel tedavi ve terapisinin sağlanması yanında toplumsal ve yasal değişiklikler de yapmak gerekmektedir.

Kronik hastalıkların ve engelliliğin sıklığı yaşlılıkta artmaktadır. Bu durum sağlık hizmeti sunumunun da değiştirilmesini gerekli kılmıştır. Akut hastalıklardan kronik hastalıkların yönetimine, tedavi odaklı olmaktan bakım ve rehabilitasyona doğru bir yönelim olmuştur. Evde bakım hastaneye transferi zor olan bireyin sağlığını korumak veya iyileştirmek amacıyla sağlanan sağlık hizmetinin tamamıdır. Bu çalışma ile Kayseri’de evde sağlık hizmetleri kapsamında yapılan işlemler ve hasta profilinin değerlendirilmesi amaçlanmıştır. Çalışmamız retrospektif ve tanımlayıcı olarak planlanmıştır. Ocak 2018-Ağustos 2020 tarihleri arasında Kayseri’de verilen evde sağlık hizmetleri değerlendirilmiştir. Hizmet alan 18512 kişinin sosyodemografik özellikleri, kronik hastalıkları, birim tarafından aldıkları hizmetin özelliği dosya tarama yöntemi ile elde edilmiştir. Hastaların yaş ortalaması 76±18.4’dür. En fazla 65 yaş ve üzeri hasta grubu hizmet almıştır. Hastaların %46.6’sı erkektir. Evde sağlık hizmeti alan hastaların en çok nörolojik hastalıkları bulunmaktadır. Hastalara toplam 36749 işlem yapılmıştır. Yara bakımı %20.5 oranında en fazla yapılan işlemdir. Hastaların cinsiyete göre yaş ortalamaları ve ölüm oranları benzerdir. Sonuç olarak, evde sağlık hizmeti alan hastaların büyük kısmını nörolojik hastalıklar ve 65 yaş üzeri hasta grubu oluşturmaktadır. En sık yapılan işlem ise yara bakımıdır. İleri yaş ve nörolojik hastalıklar başta olmak üzere birçok hasta evde sağlık hizmetlerine ihtiyaç duymaktadır. Bu çalışmada olduğu gibi hasta profili ve hizmetlerin tanımlanması etkin bir hizmet sağlanması ve gelecek çalışmalara ışık tutması açısından önem arz etmektedir.

Aim: Diabetes Mellitus is a chronic disorder characterized by high blood glucose and affects millions of people around the world with its complications. We believe that several factors during the pandemic have negatively affected the glycemic control of the patients. This study aimed to compare the glycemic controls of the patients admitted to the family health clinic of Incesu State Hospital before and during the pandemic. Material and Methods: Demographic data, HbA1c values, durations between the two admissions, and body mass indices of a total of 203 patients admitted to the family medicine clinic were assessed. Frequency, mean and standard deviation values were used in the analysis of the data. Results: A total of 203 patients who had HbA1c test before and during the pandemic were included in the study. Mean age of the patients was 60.87±15.24. Of the patients included in the study, 52.7% were female. Mean HbA1c value tested before the pandemic was lower than the mean HbA1c value tested during the pandemic. Conclusion: Increase in time spent at home, decrease in physical exercises and the presence of forcing psychological factors as a result of the measures taken have caused the glycemic control of the patients to impair. The individuals with chronic diseases can be supported by health authorities, which may help to solve the problems.

Introduction : This study was conducted retrospectively, cross-sectional and descriptively to evaluate the telemonitoring results of discharged patients who had been hospitalized due to Covid-19 during the pandemic. Methods : This study was composed of data which were obtained through the folders of 862 patients who had gotten their Covid-19 Polymerase Chain Reaction (PCR) tests positive, were treated in hospital and discharged between 28.08.2020 and 16.09.2020. This study was completed with folders of 760 patients whose data were overall. Descriptive statistics were given as mean, standard deviation, median, minimum and maximum. Percentages were used for categorical data. Also, the Chi-Square test was used to determine differences between the groups in categorical variables. Kolmogorov-Smirnov test was used so as to analyze normal distribution of data. Results : In the study, the age median of patients who stated their clinical condition as good and average, was lower compared to patients whose clinical status was bad (p=0.001). 45% of patients with poor condition were rehospitalized and 35% of them were directed to emergency service (p<0.001). Conclusions : Results have demonstrated that even if those patients were discharged, their problems still continued in their homes, and they need support. Moreover, it is considered that home-monitoring and home attendant care services for elderly patients have to be improved qualitatively. Keywords : Covid-19, Home Care, Discharge Period

Objectives: It is known that vitamins have some effects such as suppressing viral replication, developing anti-inflammatory responses and that they increase immunity in COVID-19. This study aimed to investigate the correlation between the vitamin B12 (Vit B12) serum levels and the prognosis of the disease in patients with COVID-19. Material and Method: A total of 408 participants were included in the study. Sociodemographic information such as age, educational status, serum vitamin B12 levels, hemogram parameters, and clinical findings of the patients who were admitted for follow-up after the end of COVID-19 infection was evaluated retrospectively. Serum vitamin B12 level between 150-200 pg/mL was assessed as mild deficiency, the value between 100-150 pg/mL as severe deficiency and the value under 100 pg/mL as extremely severe deficiency. Results: Median age of the participants was 44.51 (18-88) years. The median Vit B12 level of the patients was 179.50 (75-641). Of the patients, 248 (60.70%) had Vit B12 deficiency. The rates of pneumonia and hospitalization were higher and fatigue and loss of taste/smell were more in patients with Vit B12 deficiency. NLR and PLR which are the inflammatory markers were higher in patients with Vit B12 deficiency. The rates of pneumonia and hospitalization were the highest in the severe Vit B12 deficiency group among the Vit B12 deficiency groups. Conclusion: The clinical progression was worse in COVID-19 patients with Vit B12 deficiency than those who had no Vit B12 deficiency. Therefore, it has been concluded that Vitamin B12 supplement can have positive effects on COVID-19 patients; however, more comprehensive further studies with longer duration and higher number of patients are needed.

Urgent measures were taken for those at the age of 65 and over who were at the risk group all over the world due to the COVID-19 pandemic. It is known that many individuals at the age of 65 and over have experienced anxiety due to the uncertainties. This study aimed to determine the anxiety and death anxiety in individuals aged 65 and over who were isolation at home due to being diagnosed with COVID-19 or being in contact during the pandemic process. The study is descriptive and cross-sectional. It was performed with 656 home-quarantined individuals aged between 65–80 years with positive or negative real-time polymerase chain reaction (RT-PCR) test result. A form including questions about the death anxiety and the Coronavirus Anxiety Scale Short Form prepared by the researchers were administered to the individuals by phone call. Of the participants, 49.5% were male. Median COVID-19 anxiety score was 4 (0–18). Anxiety scores of the male and female participants were similar. Participants with negative polymerase chain reaction (PCR) results and those with death anxiety had higher COVID anxiety scores. Death anxiety has increased by 1.661 times in male gender, 1.983 times in RT-PCR positivity and 0.146 times in the presence of symptoms. Individuals with positive COVID-19 test results or those aged 65 and over who had death anxiety and negative COVID-19 test result but who were in home-isolation due to being a contact had higher anxiety score. For this reason, those with death anxiety can be supported in line with their religious beliefs to reduce anxiety. Those with negative PCR test results in quarantine can be adequately informed about the COVID-19.