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Öğe Evaluation of Bone Mineral Density in Terms of Veiling, Socioeconomiical Status and Educatiional Level in Turkish Women Over 40 Years. Veiling May Be A Risk Factor For Osteoporosis(Galenos Yayincilik, 2006) Bahceci, Mithat; Ertem, Meliksah; Saka, Gunay; Gokalp, Deniz; Karacomak, Zuhre; Akdeniz, Nurten; Tuzcu, AlpaslanBackground and aims: Headscarf is a mild kind of veiling, worn for various intentions. We aimed to evaluate effect of veiling, educational status, living area and nutrition on BMD in women over 40 years. Subjects and methods: Four hundred thirty nine moslem women, living in different region (suburb and house provided to workers) of Diyarbakir, aged over 40 years (with mean age 48,9+ 11,3 years) were included to study. The predicted factors influencing BMD were investigated by using a questionnaire. Body weights and heights were measured. BMI was expressed as weight (kilograms) per height (meters) squared. Body fat percent and fat mass were determined by bioelectric impedance. Bone Mineral Density (BMD) was determined with radiographic absorptiometry (RA) in three middle fingers. Results: Living in suburban region (p=0.0001), family history of osteoporosis (p<0.002), low education level (p=0.0001), insufficient calcium intake (p<0.001), parity over 4 (p=0.0001), low body height (p=0.0001), veiling (p=0.0001) and low body weight (p< 0.002) and height (p=0.0001) and duration of menopause (p=0.0001) were the factors with negative effects on BMD. Prevalence of osteoporosis was also higher in illiterate women (p=0.0001), women living in slum (p=0.0001), veiled women (p=0.0001), insufficient nutritional status (p< 0.03) and positive family history for osteoporosis (p< 0.002). Conclusions: In addition to well known factors for osteoporosis such as living in slum, illiteracy, high parity number, insuficient nutrition, and duration of menopause; veiling may also be an important factor for low BMD. Veiled women should be screened for low BMD and osteoporosis regularly.Öğe The evaluation of the opinions and attitudes of healthcare personnel of the province Diyarbakir against influenza A (H1N1) and the vaccination(Landes Bioscience, 2011) Sevencan, Funda; Ertem, Meliksah; Ozcullu, Neval; Dorman, Vedat; Kubat, Namik KemalIn this study it was aimed to evaluate the opinions and attitudes of healthcare personnel of the province Diyarbakir against Influenza A(H1N1) and the vaccination and to determine the undesired effects after the vaccination. In this descriptive study, 1691 healthcare personnel participated. The participants were asked about their opinions about being included in the risk group or not, status of advising and having Influenza A(H1N1) vaccination, reasons of having or not having the vaccination, their opinions and attitudes about the pandemic and influenza vaccine and the practices of the press and the Ministry of Health. Of participants, 49.6 % stated that they advised pandemic influenza vaccination. Of healthcare personnel, 35% stated that they had pandemic influenza vaccine. Age, sex, profession, having seasonal influenza vaccine, using Media and the Ministry of Health as a source of information were important factors for the status of advising and having Influenza A(H1N1) v vaccine. The healthcare personnel should be informed about the purpose and practices of protection programs. It might be suggested to use press, which is regarded as the most important communication media, in accordance with the conditions in order to achieve suitable risk communication with the society.Öğe How do Medical Students Perceive Professional Attitudes? A Multi-Center Study(Kuwait Medical Assoc, 2010) Bati, Ayse Hilal; Sarikaya, Ozlem; Senol, Yesim; Ertem, Meliksah; Caliskan, Deniz; Buyukakkus, AlperObjectives: To determine the attitude of students from different medical schools towards the medical profession and evaluate the effect of gender and year of medical education Design: Multi-center cross-sectional study Setting: Six medical schools located in different geographical regions of Turkey Subjects: All the first and final year medical students (n = 1941) at these schools participated after the study protocol was approved in these schools Interventions: A Medical Profession Attitude Scale (MPAS) was administered to the students to determine the attitude of students towards the medical profession. Another questionnaire was established to see any association between attitudes and demographic characteristics. Mann-Whitney U test was used for the statistical analysis done using the SPSS for PC 13.0. Main Outcome Measures: Attitude of students towards the medical profession, the year at the medical school and gender Results: 78.7% of the first and final year students could be accessed. The Cronbach alpha reliability coefficient for the freshmen and seniors was 0.94 and 0.95, respectively, and 0.95 for the whole group. First year students' scores for all subscales were significantly higher. Similarly, the female students had higher scores. Conclusions: Final year students' lower scores may be related to concerns regarding confidence and competence arising during the clinical years where self-image as a doctor evolves. Providing professional education during the medical course becomes an increasingly important issue to prevent deterioration in professional attitudes. The individual qualifications, values, attitudes and behaviour will improve in the following years.Öğe An Implementation for Integration of Cervical Smear Screening with Family Planning Services in the District of Diyarbakir Province of Turkey 2001(Medi+World Int, 2005) Ceylan, Ali; Ertem, Meliksah; Kilinc, Nihal; Uzunlar, Ali Kemal; Ozkaynak, VeysiContext: Cervical smear screening may have an important influence on early detection and prevention of cervical cancer morbidity and mortality and should be widely introduced particularly into primary health care settings. Objective: We tried to integrate cervical cancer screening programme with a family planning service in a family planning clinic. Design: Volunteer women, who can speak the local language, were assigned to educate residential women on cervical cancer and to refer them to a family planning clinic. All nurses working in the family planning clinic were trained on how to perform cervical smear. Setting: The study was conducted in Huzurevleri district of Diyarbakir-Turkey. Participants: The Pap test results of 503 women who gave informed consent and attended the family planning clinic for cervical smear test were the participants of the study. Women's practices and previous Pap test history were also discussed. Main Outcome Measure: To examine the effect of factors influencing Pap test history frequency tabulates, chi-square and logistic regression analyses were performed. Results: Within one year, 503 Pap test were investigated. Although 361 women (71.8%) attended clinic previously, only 37 women (7.4%) had a Pap test. Illiteracy and history of induced abortion were the factors affecting Pap test usage. Adjusted odds ratio for illiterate women, who had not had a Pap test before, was 2.80 (95% CI: 1.3-6.3) and for women who had never induced abortion was 3.88 (95% CI: 1.3-12.0). Conclusion: Integration of cervical cancer screening with family planning services may avoid missed opportunities. Especially illiterate women should be reached because of their risks.Öğe Infant Feeding Knowledge and Practices of Mothers with 6-24-Month-Old Babies in the Baby-Friendly City of Diyarbakir(Mary Ann Liebert, Inc, 2012) Ipekci, M. Mujde; Ertem, MeliksahObjective: This study examined factors related to breastfeeding behavior of mothers in the Baby-Friendly City of Diyarbakir, Turkey. Subjects and Methods: The study was cross-sectional. The cluster sample technique was used in which 992 mothers from 50 clusters were contacted. Data were collected by face-to-face interview. The breastfeeding behavior of the mothers and the demographic variables affecting such behavior were recorded and collected. Analysis was performed by chi(2) test, and logistic regression used to estimate relative risks and 95% confidence intervals (CIs). Results: We found that 78.3% of the mothers breastfed their babies for the first 6 months and that 92.4% gave their babies colostrum. The risk of not giving colostrum increased 2.7-fold (95% CI = 1.25-5.75) in mothers giving birth at home compared with those giving birth in a hospital (p = 0.011). The same risk increased 3.99-fold (95% CI = 2.00-7.93) in mothers with no knowledge of breastfeeding compared with mothers instructed on the subject by health professionals (p < 0.0001). Conclusion: The breastfeeding behavior on the part of mothers giving birth with the help of healthcare personnel and receiving information on the subject is positive.Öğe Injury or body fluid splash incidence rate during three months period in elective surgery procedures, at Dicle University Hospital, Diyarbakir, Turkey(Turkish Assoc Trauma Emergency Surgery, 2008) Ertem, Meliksah; Dalar, Yasemin; Cevik, Ugur; Sahin, HayrettinBACKGROUND In this study we aimed to determine the prevalence of sharp injuries (SI) and blood and body fluid (BBF) splashes in health care workers during elective surgery procedures (ESP). This study would help to plan the preventive measures for injuries and BBF splashes. METHODS All ESP were recorded during three months period and SI and BBF splashes were analyzed in Hospital of Dicle University. Hospital employees who reported SI or BBF splashes were interviewed about the types of devices causing injury and the circumstances of the injury. RESULTS During three months period, 1988 ESPs were recorded. SIs were reported in 111 procedures (5.6%) and BBF splashes were in 145 (7.3%). Incidence rate of SI was 2.8 per person year in teaching staff, 5.6 in residents, 6.3 in nurses and 1.5 for other health care workers. Incidence rate of BBF splashes was 14.5 per person year in trainers, 6.9 in residents, 8.4 in nurses, respectively. Duration of ESP, start time of ESP and number of employed personnel in the ESP were the factors that significantly influenced SI incidence. Duration of ESP and total person worked in ESP was effective on BBF splashes. SI was occurred in 14.4 of mandibulofacial, 12.2% of general surgery, 10.5% of chest surgery and 8.4% of brain surgery ESP. BBF splashes occurred in 14.4% of general surgery's, 13.5% of urology's, 14% of chest surgery's, 14.7% of cardiovascular surgery's ESP. The most frequently injured tissue was index finger (33.9%) and the pollex finger (31.4%). CONCLUSION SIs and BBFs are important health risks for health professionals who are involved in surgery, as it is in all other medical practices. SI and BBF splashes should be monitored and preventive measures should be planned urgently.Öğe Levels of Health Care Utilization in Patients with Type 2 Diabetes Mellitus(Aves, 2006) Acemoglu, Hamit; Ertem, Meliksah; Bahceci, Mithat; Tuzcu, AlpaslanObjective: A diabetic patient should be provided a planned care and professional help throughout his life. Although sustained health-care is important for the disease, few patients, especially in developing countries, can reach health-care facilities and treatment. In the planning of the health-care policies, it is very important to know how many patients can reach these facilities. Aim of the study was to determine and compare the level of health care facility use by the patients with type 2 diabetes mellitus among the patients who use various health care facilities. Materials and Methods: The data was obtained via structured questionnaire which were filled by face to face interviews made between October 2002 and December 2002. The level of health care facility use was measured according to the Diabetes Care Scale and the affecting factor of using were studied. Results: Generally, level of health care facility use was found to be low among diabetics; moreover, chronic complications were high among diabetics and they were not appropriately advised by the health care professionals. The Diabetic Care Scale score was found to be significantly higher in the patients who admit to university hospital (43.3 +/- 19.3) compared with those who admit to other health care centers (30.3 +/- 19.1)(p=0.0001). Of the patients, 79.6% had at least one chronic complication, the 13.6% had no problem to reach the diabetes nurse, and 59.6% had no problem to reach the doctor. But it was found that 47.6% of the patients were not using their drugs regularly. In our study, 52% of patients were able to be evaluated for HbA1c. Conclusion: In Diyarbakir, the place of the study, the scores show that diabetic patients have difficulties to reach to the health care system. Because effective health care is very important for the diseases like diabetes, the barriers for the patients to use of preventive health care system should be eliminated. National Diabetes control program should be distributed to the general country and the medical service presented to the patients should be effective in all steps. Standard diagnosis and treatment guidelines should be prepared and the patients should be examined according to these guidelines. Once the diabetes diagnosis is confirmed, every patient should be given diabetes education.Öğe Opinions of Physicians and Nurses About Patient Communication in Dicle Univerty Research Hospital(Istanbul Univ, Fac Nursing, 2007) Arda, Hamdiye; Ertem, Meliksah; Baran, Gulbeyaz; Durgun, YeterPatient satisfaction is outcome of good communication with health staff and is seen as a dimension of quality of care. From the hospital's perspective, clinical staff and managers ought to be interested in communication because effective diagnosis and treatment depend on clear communication with patients. In Research Hospital of Dicle University we performed a study to evaluate the status of patient and health staff communication and to understand the causes of communication problem. This study is cross sectional descriptive one. By using a questionnaire we interviewed face to face with 110 physicians and 138 nurses. The items of questionnaire were determined by using qualitative interviewing technics and by clinical observations. 78,2% of the physicians and 85,5% of nurses stated that they had some communication problem with patients or patient relatives. 58% of the nurses and 57,3% of physicians join the idea of they can not understand us because their education level is so low. 68,9% of nurses and 67,3% of physicians joined the idea of our business is very hard that we can not do effective communication. Frequently heavy duty and turns, insufficient staff, fatigue were the other causes of insufficient communication. To establish quality of health care and to give effective health services communication is the key element. But heavy duty and turns prejudices through patients were the main obstacles for good communication. Both managemental and educational interventions should be developed to give high quality health services.Öğe Opinions on early-age marriage and marriage customs among Kurdish-speaking women in southeast Turkey(Professional, Managerial & Healthcare Publications Ltd, 2008) Ertem, Meliksah; Kocturk, TahireObjectives For women, marriage before the age of 18 years has adverse consequences for physical, mental and emotional well-being and constitutes a barrier for continued education. According to a national survey, about 50% of all women in Eastern Turkey were aged under 18 years at first marriage. Methods This study explored women's opinions and experiences of early marriage and culture-specific marriage customs in the province of Diyarbakir, a region of Turkey populated mostly by people of Kurdish ethnicity. A random sample of 966 women aged 15 years or older living in urban and rural areas of the province completed a questionnaire on age at marriage and social status. Qualitative data on women's opinions and experiences were also collected through focus group interviews with 90 women. Results The frequency of early marriage ranged from 19% in the youngest age group to 63% in women aged 60 years or older. Analysis of focus group interviews through a qualitative modified content method showed that girls were considered marriageable some years after the menarche and considerations regarding the protection of family honour were key factors leading parents to arrange the early marriage of their daughters, sometimes without their consent. Some culture-specific marriage customs included cradle betrothal, cousin marriage and berdel (exchange of brides between two families). Conclusion There is a need for public health and family planning workers to create greater awareness of the adverse consequences of early marriage through parental arrangements.Öğe Post abortion family planning counseling as a tool to increase contraception use(Biomed Central Ltd, 2009) Ceylan, Ali; Ertem, Meliksah; Saka, Gunay; Akdeniz, NurtenBackground: To describe the impact of the post-abortion family planning counseling in bringing about the contraceptive usage in women who had induced abortion in a family planning clinic. Method: The Diyarbakir Office of Turkish Family Planning Association (DTFPA) is a nonprofit and nongovernmental organization which runs a family planning clinic to serve the lower socioeconomic populations, in Diyarbakir-Turkey. Post abortion counseling is introduced by using proper communication skills and with using appropriate methods to women. In this study we introduced contraceptive usage of women who had induced abortion one year ago and followed by DTFPA's clinic. Results: 55.3% of our clients were not using contraceptive methods before abortion. At the end of the one year, 75.9% of our followed-up clients revealed that they were using one of the modern contraceptive methods. There was no woman with IUD before induced abortion. At the end of one year 124 (52.3%) women had IUD. A modern method was introduced immediately after abortion was the most important factor increasing modern method usage. Conclusion: Our results advocate that post-abortion counseling may be an effective tool to increase the usage of contraceptives. Improved and more qualified post-abortion family planning counseling should be an integral part of abortion services.
