Behaviors Of Family Physicians To Take Personal Protective Measures In The Covid-19 Pandemic
Year 2021,
, 221 - 230, 29.06.2021
Hüseyin Üçer
,
Erhan Kaya
,
Ayşegül Erdoğan
Abstract
Objective
The COVID-19 disease which emerged in Wuhan city of Hubei province of China in December 2019 has caused a pandemic worldwide. Family physicians who are the first point of contact in the primary health care system, have an important role in individual and social infection control. The aim of this study is to evaluate the behaviors of family physicians to take personal protective measures during the pandemic period.
Materials and Methods
208 physicians (76 females; 142 males) included in the study. Physicians' use of personal protective equipment and their behaviors towards protective measures were questioned in our study. SPSS 22.0 statistical package program was used for data analysis.
Results:
81% of family physicians stated that they felt sufficient to properly wear personal protective equipment and to take it off properly without contamination. It was found that female family physicians wash their hands more than male ones. (p<0.001) While the rate of family physicians who stated that they used less than 5 gloves a day was 66%, the rate of those who stated that they used less than 3 masks per day was 70.4% in their workplace.
Conclusion:
Our findings show that family physicians needed more education and adequate personal protective equipment support in personal protective measure applications. Providing adequate personal protective equipment support via health campaigns to family physicians during the pandemic period is protective for physicians and the society.
References
- KAYNAKLAR
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https://apps.who.int/iris/bitstream/handle/10665/112656/978924l507134_eng.pdf;jsessionid=BE25F8EAA4F631126E78390906%20050313?sequence=1 (accessed June 21, 2020).
13. Ing EB, Xu Q(A), Salimi A, Torun N. Physician deaths from corona virus (COVID-19) disease. Occupational Medicine 2020;70(5):370-374. Doi: 10.1093/occmed/kqaa088.
- 14. Aktürk Z, Dağdeviren N. Aile hekimliğinin kilometre taşları: Millis ve Willard Raporları. Türkiye Aile Hekimliği Uzmanlık Derneği Yayınları 2004:116. ISBN: 975-270-034-9.
- 15. Leeuwenhorst W.P. The work of the general practitioner. Statement by a Working Party of The Second European Conference (1974). Journal of the Royal College of General Practitioners 1977;27(175):117.
- 16. Tai DYH. SARS plague: Duty to care or medical heroism. Ann Acad Med Singap 2006;35(5):374-378.
- 17. Seto WH, Tsang D, Yung RW, Ching TY, Ng TK, Ho M et al. Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory distress syndrome (SARS). Lancet 2003;361:1519-1520. Doi: 10.1016/s0140-6736(03)13168-6.
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- 19. Erasmus V, Daha TJ, Brug H, Richardus JH, Behrendt MD, Vos MC et al. Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infect Control Hosp Epidemiol 2010;31(3):283-294. Doi: 10.1086/650451.
- 20. West GF, Resendiz M, Lustik MB. Assessing Hand Hygiene Attitudes of Inpatient Nursing Personnel in a US Military Hospital. Journal of Hospital Infection 2018;100:2014-2017. Doi: https://doi.org/10.1016/j.jhin.2018.05.012.
- 21. Gencer S. Hastane enfeksiyonlarının önlenmesi ve olmazsa olmazı: EL YIKAMA. Sempozyum Dizisi No:60.2008;(1):71-78.
- 22. World Health Organization. Infection prevention and control during health care when COVID-19 is suspected: interim guidance 19 March 2020. Geneva, Switzerland: WHO;2020.
https://apps.who.int/iris/handle/10665/331495. License: CC BY-NC-SA 3.0 IGO.
- 23. Karabey S, Ay P, Nakipoğlu Y, Derbentli Ş, Esen F. Bir Yoğun Bakım ünitesinde ayrıntılı mikrobiyolojik inceleme sonuçları ışığında el yıkama sıklığının irdelenmesi. Ankem Dergisi 2001;15(1):114-123.
- 24. Demir NA, Kölgelier S, Küçük A, Özçimen S, Sönmez B, Demir LS et al. Level Of Knowledge And Complıance To Hand Hygıene Among Health Care Workers. Nobel Med 2013;9(3):104-109.
- 25. Suen LKP, So ZYY, Yeung SKW, Lo KYK, Lam SC. Epidemiological investigation on hand hygiene knowledge and behaviour: a cross-sectional study on gender disparity. BMC Public Health 2019;19(1):401. Doi: https://doi.org/10.1186/s12889-019-6705-5.
- 26. Suen LKP, Rana T. Knowledge Level and Hand Hygiene Practice of Nepalese Immigrants and Their Host Country Population: A Comparative Study. Int J Environ Res Public Health 2020;17(11):4019. Doi: 10.3390/ijerph17114019.
- 27. White C, Kolble R, Carlson R, Lipson N. The impact of a health campaign on hand hygiene and upper respiratory illness among college students living in residence halls. J Am Coll Health 2005;53:175-181. Doi: 10.3200/JACH.53.4.175-181.
- 28. Boyce JM, Pittet D. Guideline for Hand Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Infect Control Hosp Epidemiol 2002;23(S12):S3-40. Doi: 10.1086/503164.
- 29. Ahmed J, Malik F, Memon ZA, Arif TB, Ali A, Nasim S et al. Compliance and Knowledge of Healthcare Workers Regarding Hand Hygiene and Use of Disinfectants: A Study Based in Karachi. Cureus 2020;12(2):e7036. Doi: 10.7759/cureus.7036.
- 30. Tomas ME, Kundrapu S, Thota P, Sunkesula VCK, Cadnum JL, Mana TSC et al. Contamination of Health Care Personnel During Removal of Personal Protective Equipment. JAMA Intern Med 2015;175(12):1904-1910. Doi: 10.1001/jamainternmed.2015.4535.
- 31. Lau JTF, Fung KS, Wong TW, Kim JH, Wong E, Chung S et al. SARS Transmission among Hospital Workers in Hong Kong. Emerg Infect Dis 2004;10(2):280-286. Doi: 10.3201/eid1002.030534.
- 32. Hu X, Zhang Z, Li N, Liu D, He W, Zhang W et al. Self-reported use of personal protective equipment among Chinese critical care clinicians during 2009 H1N1 influenza pandemic. PLoS One 2012;7(9):e44723. Doi: 10.1371/journal.pone.0044723.
- 33. Tabah A, Ramanan M, Laupland KB, Buetti N, Cortegiani A, Mellinghoff J et al. Personal protective equipment and intensive care unit healthcare worker safety in the COVID-19 era (PPE-SAFE): An international survey. Journal of Critical Care 2020;59:70-75. Doi: https://doi.org/10.1016/j.jcrc.2020.06.005.
- 34. WHO Director. General’s opening remarks at the media briefing on 2019 novel coronavirus, 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-2019-novel-coronavirus-7-february-2020 (accessed Mar 23, 2020).
- 35. Garcia Godoy LR, Jones AE, Anderson TN, Fisher CL, Seeley KML, Beeson EA et al. Facial protection for healthcare workers during pandemics: a scoping review. BMJ Glob Health 2020;5(5):e002553. Doi: 10.1136/bmjgh-2020-002553.
- 36. Delgado D, Wyss Quintana F, Perez G, Sosa Liprandi A, Ponte-Negretti C, Mendoza I et al. Personal Safety during the COVID-19 Pandemic: Realities and Perspectives of Healthcare Workers in Latin America. Int. J. Environ. Res. Public Health 2020;17(8):2798. Doi: https://doi.org/10.3390/ijerph17082798.
- 37. Doctors still without adequate supplies of PPE, major BMA survey finds. https://www.bma.org.uk/bma-media-centre/doctors-still-without-adequate-supplies-of-ppe-major-bma-survey-finds. (accessed June 21, 2020).
- 38. TC Çevre ve Şehircilik Bakanlığı, Çevre Yönetimi Genel Müdürlüğü. Tek kullanımlık maske, eldiven gibi kişisel hijyen malzeme atıklarının yönetiminde COVID-19 tedbirleri.
https://webdosya.csb.gov.tr/db/cygm/icerikler/gng2020-16-cov-d-19-20200408101457.pdf (accessed June 21, 2020).
- 39. Covıd-19 Hastalığına Yönelik Sağlık Kuruluşu, Personel Ve Faaliyet Türüne Göre Kullanılması Önerilen Koruyucu Ekipmanlar. https://covid19bilgi.saglik.gov.tr/depo/enfeksiyon-kontorl-onlemleri/KISISEL_KORUYUCU_EKIPMAN_KULLANIMI.pdf (accessed June 21, 2020).
- 40. Yu EYT, Leung WLH, Wong SYS, Liu KSN, Wan EYF, HKCFP. Executive and Research Committee. How are family doctors serving the Hong Kong community during the COVID-19 outbreak? A survey of HKCFP members. Hong Kong Med J 2020;26(3):176-83. Doi: https://doi.org/10.12809/hkmj208606.
Aile Hekimlerinin Covıd-19 Pandemi Döneminde Kişisel Koruyucu Önlem Alma Davranışları
Year 2021,
, 221 - 230, 29.06.2021
Hüseyin Üçer
,
Erhan Kaya
,
Ayşegül Erdoğan
Abstract
Amaç:
Aralık 2019’da Çin’in Hubei eyaleti Wuhan kentinde ortaya çıkan COVID-19 hastalığı dünya genelinde pandemiye neden olmuştur. Birinci basamak sağlık sisteminde ilk temas noktası olan aile hekimleri bireysel ve toplumsal enfeksiyon kontrolünde önemli bir role sahiptir. Bu çalışmanın amacı aile hekimlerinin pandemi döneminde kişisel koruyucu önlem alma davranışlarını incelemektir.
Yöntem:
Çalışmaya iki yüz on sekiz hekim (76 kadın; 142 erkek) dahil edildi. Anketimizde hekimlerin kişisel koruyucu ekipman kullanımı ve koruyucu önlemlere yönelik davranışları sorgulandı. Veri analizinde SPSS 22.0 istatistik paket programı kullanıldı.
Bulgular:
Aile hekimlerinin %81’i kişisel koruyucu ekipmanların usulüne uygun takılması ve kendisine bulaş olmadan usulüne uygun çıkarılması konusunda kendisini yeterli hissettiğini belirtti. Kadın aile hekimlerinin erkeklere oranla daha fazla ellerini yıkadıkları tespit edildi (p<0.001). İşyerinde günde 5 adetten az eldiven kullandığını belirten aile hekimlerinin oranı %66 iken, günde 3’ten az maske kullandığını belirtenlerin oranı %70.4 idi.
Sonuç:
Bulgularımız aile hekimlerinin kişisel koruyucu önlem uygulamalarında daha fazla eğitime ve yeterli kişisel koruyucu ekipman desteğine ihtiyaç duyulduğunu göstermektedir. Aile hekimlerine sağlık kampanyalarıyla yeterli kişisel koruyucu ekipman desteği sunulması hekimi ve toplumu koruyucu niteliktedir.
References
- KAYNAKLAR
1. Cascella M, Rajnik M, Cuomo A, Scott C. Dulebohn, Raffaela Di Napoli. Features, Evaluation, and Treatment of Coronavirus (COVID-19). In: StatPearls. Treasure Island (FL), StatPearls Publishing 2020;Jan-.
- 2. WHO. Novel coronavirus - China. Jan 12, 2020. http://www.who. int/csr/don/12-january-2020-novel-coronavirus-china/en/ (accessed July 28, 2020).
- 3. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223):497-506. Doi: 10.1016/S0140-6736(20)30183-5.
- 4. Johns Hopkins University & Medicine. Coronavirus COVID-19 Global Cases by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University. https://coronavirus.jhu.edu/map.html (accessed Aug 20, 2020).
- 5. COVID-19 Yeni Koronavirüs Hastalığı. https://covid19bilgi.saglik.gov.tr/tr/ (accessed Aug 20, 2020).
- 6. In Memoriam: Healthcare Workers Who Have Died of COVID-19. https://www.medscape.com/viewarticle/927976#vp_1 (accessed Aug 20, 2020).
- 7. Zhan M, Qin Y, Xue X, Zhu S. Death from Covid-19 of 23 Health Care Workers in China. N Engl J Med 2020;382(23):2267-2268. Doi: 10.1056/NEJMc2005696.
- 8. Sağlık Bakanı Koca Covid-19'la mücadeleyi değerlendi: 7 bin 428 sağlık çalışanı enfekte oldu. https://tr.euronews.com/2020/04/29/sagl-k-bakan-koca-covid-19-la-mucadelede-gelinen-son-noktay-degerlendiriyor (accessed Apr 29, 2020).
- 9. Suleiman A, Bsisu I, Guzu H, Santarisi A, Murad Alsatari M, Abbad A et al. Preparedness of Frontline Doctors in Jordan Healthcare Facilities to COVID-19 Outbreak. Int J Environ Res Public Health 2020;17(9):3181. Doi: 10.3390/ijerph17093181.
- 10. Slota M, Green M, Farley A, Janosky J, Carcillo J. The Role of Gown and Glove Isolation and Strict Handwashing in the Reduction of Nosocomial Infection in Children with Solid Organ Transplantation. Crit Care Med 2001;29(2):405-412. Doi: 10.1097/00003246-200102000-00034.
- 11. Rosenthal VD, Guzman S, Safdar N. Reduction in Nosocomial Infection with Improved Hand Hygiene in Intensive Care Units of a Tertiary Care Hospital in Argentina. Am J Infect Control 2005;33(7):392-397. Doi: 10.1016/j.ajic.2004.08.009.
- 12. WHO Guidelines. Pandemic And Epidemic Diseases. Infection prevention and control of epidemic- and pandemic-prone acute respiratory infections in health care.
https://apps.who.int/iris/bitstream/handle/10665/112656/978924l507134_eng.pdf;jsessionid=BE25F8EAA4F631126E78390906%20050313?sequence=1 (accessed June 21, 2020).
13. Ing EB, Xu Q(A), Salimi A, Torun N. Physician deaths from corona virus (COVID-19) disease. Occupational Medicine 2020;70(5):370-374. Doi: 10.1093/occmed/kqaa088.
- 14. Aktürk Z, Dağdeviren N. Aile hekimliğinin kilometre taşları: Millis ve Willard Raporları. Türkiye Aile Hekimliği Uzmanlık Derneği Yayınları 2004:116. ISBN: 975-270-034-9.
- 15. Leeuwenhorst W.P. The work of the general practitioner. Statement by a Working Party of The Second European Conference (1974). Journal of the Royal College of General Practitioners 1977;27(175):117.
- 16. Tai DYH. SARS plague: Duty to care or medical heroism. Ann Acad Med Singap 2006;35(5):374-378.
- 17. Seto WH, Tsang D, Yung RW, Ching TY, Ng TK, Ho M et al. Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission of severe acute respiratory distress syndrome (SARS). Lancet 2003;361:1519-1520. Doi: 10.1016/s0140-6736(03)13168-6.
- 18. Günaydın M. İnfeksiyon kontrolünde el hijyeni ve önemi. 7. Ulusal Sterilizasyon Dezenfeksiyon Kongresi, 16-20 Mart 2011 Antalya. Kongre Kitabı, s:133-146.
- 19. Erasmus V, Daha TJ, Brug H, Richardus JH, Behrendt MD, Vos MC et al. Systematic review of studies on compliance with hand hygiene guidelines in hospital care. Infect Control Hosp Epidemiol 2010;31(3):283-294. Doi: 10.1086/650451.
- 20. West GF, Resendiz M, Lustik MB. Assessing Hand Hygiene Attitudes of Inpatient Nursing Personnel in a US Military Hospital. Journal of Hospital Infection 2018;100:2014-2017. Doi: https://doi.org/10.1016/j.jhin.2018.05.012.
- 21. Gencer S. Hastane enfeksiyonlarının önlenmesi ve olmazsa olmazı: EL YIKAMA. Sempozyum Dizisi No:60.2008;(1):71-78.
- 22. World Health Organization. Infection prevention and control during health care when COVID-19 is suspected: interim guidance 19 March 2020. Geneva, Switzerland: WHO;2020.
https://apps.who.int/iris/handle/10665/331495. License: CC BY-NC-SA 3.0 IGO.
- 23. Karabey S, Ay P, Nakipoğlu Y, Derbentli Ş, Esen F. Bir Yoğun Bakım ünitesinde ayrıntılı mikrobiyolojik inceleme sonuçları ışığında el yıkama sıklığının irdelenmesi. Ankem Dergisi 2001;15(1):114-123.
- 24. Demir NA, Kölgelier S, Küçük A, Özçimen S, Sönmez B, Demir LS et al. Level Of Knowledge And Complıance To Hand Hygıene Among Health Care Workers. Nobel Med 2013;9(3):104-109.
- 25. Suen LKP, So ZYY, Yeung SKW, Lo KYK, Lam SC. Epidemiological investigation on hand hygiene knowledge and behaviour: a cross-sectional study on gender disparity. BMC Public Health 2019;19(1):401. Doi: https://doi.org/10.1186/s12889-019-6705-5.
- 26. Suen LKP, Rana T. Knowledge Level and Hand Hygiene Practice of Nepalese Immigrants and Their Host Country Population: A Comparative Study. Int J Environ Res Public Health 2020;17(11):4019. Doi: 10.3390/ijerph17114019.
- 27. White C, Kolble R, Carlson R, Lipson N. The impact of a health campaign on hand hygiene and upper respiratory illness among college students living in residence halls. J Am Coll Health 2005;53:175-181. Doi: 10.3200/JACH.53.4.175-181.
- 28. Boyce JM, Pittet D. Guideline for Hand Hygiene in Health-Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Infect Control Hosp Epidemiol 2002;23(S12):S3-40. Doi: 10.1086/503164.
- 29. Ahmed J, Malik F, Memon ZA, Arif TB, Ali A, Nasim S et al. Compliance and Knowledge of Healthcare Workers Regarding Hand Hygiene and Use of Disinfectants: A Study Based in Karachi. Cureus 2020;12(2):e7036. Doi: 10.7759/cureus.7036.
- 30. Tomas ME, Kundrapu S, Thota P, Sunkesula VCK, Cadnum JL, Mana TSC et al. Contamination of Health Care Personnel During Removal of Personal Protective Equipment. JAMA Intern Med 2015;175(12):1904-1910. Doi: 10.1001/jamainternmed.2015.4535.
- 31. Lau JTF, Fung KS, Wong TW, Kim JH, Wong E, Chung S et al. SARS Transmission among Hospital Workers in Hong Kong. Emerg Infect Dis 2004;10(2):280-286. Doi: 10.3201/eid1002.030534.
- 32. Hu X, Zhang Z, Li N, Liu D, He W, Zhang W et al. Self-reported use of personal protective equipment among Chinese critical care clinicians during 2009 H1N1 influenza pandemic. PLoS One 2012;7(9):e44723. Doi: 10.1371/journal.pone.0044723.
- 33. Tabah A, Ramanan M, Laupland KB, Buetti N, Cortegiani A, Mellinghoff J et al. Personal protective equipment and intensive care unit healthcare worker safety in the COVID-19 era (PPE-SAFE): An international survey. Journal of Critical Care 2020;59:70-75. Doi: https://doi.org/10.1016/j.jcrc.2020.06.005.
- 34. WHO Director. General’s opening remarks at the media briefing on 2019 novel coronavirus, 2020. https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-2019-novel-coronavirus-7-february-2020 (accessed Mar 23, 2020).
- 35. Garcia Godoy LR, Jones AE, Anderson TN, Fisher CL, Seeley KML, Beeson EA et al. Facial protection for healthcare workers during pandemics: a scoping review. BMJ Glob Health 2020;5(5):e002553. Doi: 10.1136/bmjgh-2020-002553.
- 36. Delgado D, Wyss Quintana F, Perez G, Sosa Liprandi A, Ponte-Negretti C, Mendoza I et al. Personal Safety during the COVID-19 Pandemic: Realities and Perspectives of Healthcare Workers in Latin America. Int. J. Environ. Res. Public Health 2020;17(8):2798. Doi: https://doi.org/10.3390/ijerph17082798.
- 37. Doctors still without adequate supplies of PPE, major BMA survey finds. https://www.bma.org.uk/bma-media-centre/doctors-still-without-adequate-supplies-of-ppe-major-bma-survey-finds. (accessed June 21, 2020).
- 38. TC Çevre ve Şehircilik Bakanlığı, Çevre Yönetimi Genel Müdürlüğü. Tek kullanımlık maske, eldiven gibi kişisel hijyen malzeme atıklarının yönetiminde COVID-19 tedbirleri.
https://webdosya.csb.gov.tr/db/cygm/icerikler/gng2020-16-cov-d-19-20200408101457.pdf (accessed June 21, 2020).
- 39. Covıd-19 Hastalığına Yönelik Sağlık Kuruluşu, Personel Ve Faaliyet Türüne Göre Kullanılması Önerilen Koruyucu Ekipmanlar. https://covid19bilgi.saglik.gov.tr/depo/enfeksiyon-kontorl-onlemleri/KISISEL_KORUYUCU_EKIPMAN_KULLANIMI.pdf (accessed June 21, 2020).
- 40. Yu EYT, Leung WLH, Wong SYS, Liu KSN, Wan EYF, HKCFP. Executive and Research Committee. How are family doctors serving the Hong Kong community during the COVID-19 outbreak? A survey of HKCFP members. Hong Kong Med J 2020;26(3):176-83. Doi: https://doi.org/10.12809/hkmj208606.