Araştırma Makalesi
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Aile Hekimliği Polikliniklerinde COVID-19 Pandemisinin Anksiyete Düzeyi, Hasta Yaklaşımı ve Orofarengeal Muayene Üzerine Etkisi: Türkiye Genelinde Tanımlayıcı Bir Araştırma

Yıl 2024, Cilt: 8 Sayı: 2, 194 - 200, 27.08.2024
https://doi.org/10.46332/aemj.1403282

Öz

Amaç: COVID-19'un ruh sağlığı üzerindeki etkilerine ilişkin çok sayıda yayın bulunmasına rağmen, bu etkilerin hekimlerin hastalara yaklaşımını nasıl etkilediğine ilişkin veriler sınırlıdır. Bu çalışmada aile hekimliği (AH) polikliniklerine üst solunum yolu enfeksiyonu belirtileri ile başvuran hastaların fizik muayenesine aile hekimlerinin yaklaşımı, etkileyen faktörler ve aile hekimlerinin anksiyete düzeyi ile ilişkisinin değerlendirilmesi amaçlandı.

Araçlar ve Yöntem: 19.03.2022-25.04.2022 arasında aile hekimlerine sosyodemografik bilgiler, farklı yaşlardaki üst solunum yolu enfeksiyonu semptomları olan hastalara hekimlerin yaklaşımını değerlendiren olası vaka senaryoları ve Koronavirus Anksiyete Ölçeği'ni içeren online anket formu gönderildi.

Bulgular: Çalışmaya toplam 376 aile hekimi dahil edildi. Aile hekimleri, pandemi öncesi üst solunum yolu enfeksiyonu semptomlarıyla başvuran hastaların %99'una orofarenks ve solunum sistemi muayenesi yaptıklarını bildirmişti. Ancak pandemiyle birlikte hastayı muayene öncesi COVID-19 test merkezine yönlendirmek gibi kaçınma davranışlarının arttığı, orofarenks ve akciğer muayenelerinin daha düşük oranlarda yapıldığı bildirilmiştir. Koronavirus Anksiyete Ölçeği skorlarına göre aile hekimlerinin %5.1'inde tedavi gerektirebilecek düzeyde koronavirüs ile ilişkili işlevsiz anksiyete mevcuttu. Orofaringeal muayene, dil basacağı kullanımı ve akciğer oskültasyonu anksiyete grubunda daha düşüktü (sırasıyla p=0.002; p=0.012; p<0.001).

Sonuç: Aile hekimlerinin Koronavirus Anksiyete Ölçeği skorları düşük olmasına rağmen, koronavirüs ilişkili anksiyetesi mevcut olan hekimlerde daha fazla olmak üzere, farklı yaş gruplarında orofarengeal muayene oranlarının azaldığı belirlendi. Pandemi sonrasında fizik muayeneden kaçınma davranışının devam etmesini önlemek için hekimlerin biyopsikososyal iyilik halleri desteklenmeli ve ihtiyaçları belirlenmelidir.

Kaynakça

  • 1. Ciotti M, Ciccozzi M, Terrinoni A, Jiang W-C, Wang C-B, Bernardini S. The COVID-19 pandemic. Crit Rev Clin Lab Sci. 2020;57(6): 365-388.
  • 2. World Health Organization (WHO). Coronavirus disease (COVID-19) pandemic. https://www.who.int/europe/emergencies/situations/covid-19#:~:text=On%205%20May%202023%2C%20more,the%20definition%20of%20a%20PHEIC. Accessed date 11 December, 2023.
  • 3. World Health Organization (WHO). WHO Coronavirus (COVID-19) Dashboard. https://covid19.who.int/. Accessed date 04 December, 2023.
  • 4. Struyf T, Deeks JJ, Dinnes J, et al. Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID-19 disease. Cochrane Database Syst Rev. 2020;7(7):Cd013665.
  • 5. Artandi MK, Stewart RW. The Outpatient Physical Examination. Med Clin North Am. 2018;102(3):465-473.
  • 6. Chan JYK, Tsang RKY, Yeung KW, et al. There is no routine head and neck exam during the COVID-19 pandemic. Head Neck. 2020;42(6):1235-1239.
  • 7. Hornuss D, Laubner K, Monasterio C, Thimme R, Wagner D. [COVID-19 associated pneumonia despite repeatedly negative PCR-analysis from oropharyngeal swabs]. Dtsch Med Wochenschr. 2020;145(12):844-849.
  • 8. Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry. 2020;7(4):300-302.
  • 9. Jakovljevic M, Bjedov S, Jaksic N, Jakovljevic I. COVID-19 Pandemia and Public and Global Mental Health from the Perspective of Global Health Securit. Psychiatr Danub. 2020;32(1):6-14.
  • 10. Çevik H, Ungan M. The impacts of the COVID-19 pandemic on the mental health and residency training of family medicine residents: findings from a nationwide cross-sectional survey in Turkey. BMC Fam Pract. 2021;22(1):226.
  • 11. Xiang YT, Yang Y, Li W, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry. 2020;7(3):228-229.
  • 12. Lee SA. Coronavirus Anxiety Scale: A brief mental health screener for COVID-19 related anxiety. Death Stud. 2020;44(7):393-401.
  • 13. Evren C, Evren B, Dalbudak E, Topcu M, Kutlu N. Measuring anxiety related to COVID-19: A Turkish validation study of the Coronavirus Anxiety Scale. Death Stud. 2022;46(5):1052-1058.
  • 14. Türkiye Cumhuriyeti Sağlık Bakanlığı. Covid-19 Bilgilendirme Platformu: Sağlık Personeline Yönelik. https://covid19.saglik.gov.tr/TR-66260/saglik-personeline-yonelik.html. Accessed date 2 April, 2022.
  • 15. Gholami M, Fawad I, Shadan S, et al. COVID-19 and healthcare workers: A systematic review and meta-analysis. Int J Infect Dis. 2021;104: 335-346.
  • 16. Türk Toraks Derneği. Sağlık Çalışanları Aileleriyle Birlikte COVID-19 Hastalığına Yakalanıyor. https://www.toraks.org.tr/site/community/news/10018. Accessed date 30 May, 2022.
  • 17. Türkiye Cumhuriyeti Sağlık Bakanlığı. COVID-19 Aşısı Bilgilendirme Platformu: Günlük Aşı Verileri. https://covid19asi.saglik.gov.tr/. Accessed date 11 December, 2023.
  • 18. Türkiye Cumhuriyeti Sağlık Bakanlığı. Covid-19 Bilgilendirme Platformu: Aşı Uygulanacak Grup Sıralaması. https://covid19asi.saglik.gov.tr/TR-77707/asi-uygulanacak-grup-siralamasi.html. Accessed date 30 May, 2022.
  • 19. Kader C, Erbay A, Demirel MS, et al. Evaluation of Attitudes and Behaviors of Healthcare Professionals towards COVID-19 Vaccination/Saglik Calisanlarinin COVID-19 Asilamasina Yonelik Tutum ve Davranislarinin Degerlendirilmesi. Klimik Journal. 2022;35(1): 30-36.
  • 20. Savkin R, Oztop M, Bayrak G, Buker N. Factors affecting fear, obsession, and anxiety Associated with COVID-19: a cross-sectional study in patients admitted to University Hospital Outpatient Clinics. Erciyes Med. J.2022;44(3):263-269.
  • 21. Uslu Y, Bektemür G, Öztürk GZ, Egici MT, Çetinkaya E. Evaluation COVID-19 and Professional Anxiety of Medical Faculty Students. Hamidiye Med. J. 2022;3(1).
  • 22. Türk Tabipleri Birliği (TTB) Aile Hekimliği Kolu (AHEK). Aile Hekimliğinde Halkın COVID-19 Aşılanması Sürecinde Yönetim Krizi Sürüyor. https://www.ttb.org.tr/kollar/_ahek/haber_goster.php?Guid=6d94b7ac-6a1a-11eb-88fd-c02d9f991fd1. Accessed date 05 June, 2022.
  • 23. Önal S, Kaya G. Pandemi Sürecinde Uzaktan Hasta Takibi Uygulamalarında Tele-Tıp Ve Birinci Basamaktaki Yeri. Klinik Tıp Aile Hekimliği. 2020;12(3):98-106.
  • 24. Türk Tabipleri Birliği (TTB) Aile Hekimliği Kolu (AHEK). Aile hekimliğinde COVID-19 salgın yönetiminde sorunları büyüyor. https://www.ttb.org.tr/kollar/COVID19/haber_goster.php?Guid=cc04f5da-7bd8-11ea-a12d-7aee3f6e69c5. Accessed date 05 June, 2022.
  • 25. Newell F. Framework for patient and public participation in primary care commissioning. England. NHS. 2016.
  • 26. Gelfman DM. Will the Traditional Physical Examination Be Another Casualty of COVID-19? Am J Med. 2021;134(3):299-300.
  • 27. Inouye SK. Creating an anti-ageist healthcare system to improve care for our current and future selves. Nat Aging. 2021;1(2):150-152.
  • 28. Özger İlhan S. Mezuniyet Öncesi Tıp Eğitimi Çekirdek Programı. 2020.
  • 29. Ludvigsson JF. Children are unlikely to be the main drivers of the COVID-19 pandemic - A systematic review. Acta Paediatr. 2020;109(8): 1525-1530.
  • 30. WONCA Europe. The European definition of general practice/family medicine. Spain: WONCA. 2002.

Effect of the COVID-19 Pandemic on Anxiety Level, Patient Approach and Oropharyngeal Examination in Family Medicine Outpatient Clinics: A Nationwide Descriptive Study in Turkey

Yıl 2024, Cilt: 8 Sayı: 2, 194 - 200, 27.08.2024
https://doi.org/10.46332/aemj.1403282

Öz

Purpose: Although numerous publications on the effects of COVID-19 on mental health exist, limited data exists on how these effects affect physicians' approaches to patients. This study aimed to evaluate family physicians' (FPs) approach to the physical examination of patients who applied to family medicine (FM) outpatient clinics with upper respiratory tract infection (URTI) symptoms, the influencing factors, and the relationship with FPs’ anxiety levels.

Materials and Methods: An online questionnaire form containing sociodemographic information, probable case scenarios evaluating the physicians' approach to patients with URTI symptoms at different ages, and the Coronavirus Anxiety Scale (CAS) sent to FPs between 19.03.2022-25.04.2022.

Results: The study included a total of 376 FPs. FPs reported conducting oropharyngeal and respiratory system examinations in 99% of patients presenting with URTI symptoms before the pandemic. However, avoidance behaviors such as directing patients to COVID-19 testing centers before examination increased during the pandemic, leading to lower rates of oropharyngeal and lung examinations. According to CAS scores, 5.1% of FPs exhibited coronavirus-related dysfunctional anxiety levels requiring treatment. Oropharyngeal examination, use of tongue depressors, and lung auscultation were significantly lower in the anxiety group (p=0.002, p=0.012, p<0.001, respectively).

Conclusions: Although FPs' mean CAS scores were low, it was determined that oropharyngeal examination rates of different age groups of patients were decreased, particularly among physicians experiencing coronavirus-related anxiety. To prevent the continuation of avoidance behaviors from physical examinations post-pandemic, it is crucial to support the biopsychosocial well-being of physicians and identify their needs.

Etik Beyan

After the approval of the Scientific Research Platform of the Turkish Ministry of Health and the Ethics Committee of Hatay Mustafa Kemal University (17.03.2022/Decision no:02), permission for the scale to be used was obtained.

Kaynakça

  • 1. Ciotti M, Ciccozzi M, Terrinoni A, Jiang W-C, Wang C-B, Bernardini S. The COVID-19 pandemic. Crit Rev Clin Lab Sci. 2020;57(6): 365-388.
  • 2. World Health Organization (WHO). Coronavirus disease (COVID-19) pandemic. https://www.who.int/europe/emergencies/situations/covid-19#:~:text=On%205%20May%202023%2C%20more,the%20definition%20of%20a%20PHEIC. Accessed date 11 December, 2023.
  • 3. World Health Organization (WHO). WHO Coronavirus (COVID-19) Dashboard. https://covid19.who.int/. Accessed date 04 December, 2023.
  • 4. Struyf T, Deeks JJ, Dinnes J, et al. Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID-19 disease. Cochrane Database Syst Rev. 2020;7(7):Cd013665.
  • 5. Artandi MK, Stewart RW. The Outpatient Physical Examination. Med Clin North Am. 2018;102(3):465-473.
  • 6. Chan JYK, Tsang RKY, Yeung KW, et al. There is no routine head and neck exam during the COVID-19 pandemic. Head Neck. 2020;42(6):1235-1239.
  • 7. Hornuss D, Laubner K, Monasterio C, Thimme R, Wagner D. [COVID-19 associated pneumonia despite repeatedly negative PCR-analysis from oropharyngeal swabs]. Dtsch Med Wochenschr. 2020;145(12):844-849.
  • 8. Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry. 2020;7(4):300-302.
  • 9. Jakovljevic M, Bjedov S, Jaksic N, Jakovljevic I. COVID-19 Pandemia and Public and Global Mental Health from the Perspective of Global Health Securit. Psychiatr Danub. 2020;32(1):6-14.
  • 10. Çevik H, Ungan M. The impacts of the COVID-19 pandemic on the mental health and residency training of family medicine residents: findings from a nationwide cross-sectional survey in Turkey. BMC Fam Pract. 2021;22(1):226.
  • 11. Xiang YT, Yang Y, Li W, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry. 2020;7(3):228-229.
  • 12. Lee SA. Coronavirus Anxiety Scale: A brief mental health screener for COVID-19 related anxiety. Death Stud. 2020;44(7):393-401.
  • 13. Evren C, Evren B, Dalbudak E, Topcu M, Kutlu N. Measuring anxiety related to COVID-19: A Turkish validation study of the Coronavirus Anxiety Scale. Death Stud. 2022;46(5):1052-1058.
  • 14. Türkiye Cumhuriyeti Sağlık Bakanlığı. Covid-19 Bilgilendirme Platformu: Sağlık Personeline Yönelik. https://covid19.saglik.gov.tr/TR-66260/saglik-personeline-yonelik.html. Accessed date 2 April, 2022.
  • 15. Gholami M, Fawad I, Shadan S, et al. COVID-19 and healthcare workers: A systematic review and meta-analysis. Int J Infect Dis. 2021;104: 335-346.
  • 16. Türk Toraks Derneği. Sağlık Çalışanları Aileleriyle Birlikte COVID-19 Hastalığına Yakalanıyor. https://www.toraks.org.tr/site/community/news/10018. Accessed date 30 May, 2022.
  • 17. Türkiye Cumhuriyeti Sağlık Bakanlığı. COVID-19 Aşısı Bilgilendirme Platformu: Günlük Aşı Verileri. https://covid19asi.saglik.gov.tr/. Accessed date 11 December, 2023.
  • 18. Türkiye Cumhuriyeti Sağlık Bakanlığı. Covid-19 Bilgilendirme Platformu: Aşı Uygulanacak Grup Sıralaması. https://covid19asi.saglik.gov.tr/TR-77707/asi-uygulanacak-grup-siralamasi.html. Accessed date 30 May, 2022.
  • 19. Kader C, Erbay A, Demirel MS, et al. Evaluation of Attitudes and Behaviors of Healthcare Professionals towards COVID-19 Vaccination/Saglik Calisanlarinin COVID-19 Asilamasina Yonelik Tutum ve Davranislarinin Degerlendirilmesi. Klimik Journal. 2022;35(1): 30-36.
  • 20. Savkin R, Oztop M, Bayrak G, Buker N. Factors affecting fear, obsession, and anxiety Associated with COVID-19: a cross-sectional study in patients admitted to University Hospital Outpatient Clinics. Erciyes Med. J.2022;44(3):263-269.
  • 21. Uslu Y, Bektemür G, Öztürk GZ, Egici MT, Çetinkaya E. Evaluation COVID-19 and Professional Anxiety of Medical Faculty Students. Hamidiye Med. J. 2022;3(1).
  • 22. Türk Tabipleri Birliği (TTB) Aile Hekimliği Kolu (AHEK). Aile Hekimliğinde Halkın COVID-19 Aşılanması Sürecinde Yönetim Krizi Sürüyor. https://www.ttb.org.tr/kollar/_ahek/haber_goster.php?Guid=6d94b7ac-6a1a-11eb-88fd-c02d9f991fd1. Accessed date 05 June, 2022.
  • 23. Önal S, Kaya G. Pandemi Sürecinde Uzaktan Hasta Takibi Uygulamalarında Tele-Tıp Ve Birinci Basamaktaki Yeri. Klinik Tıp Aile Hekimliği. 2020;12(3):98-106.
  • 24. Türk Tabipleri Birliği (TTB) Aile Hekimliği Kolu (AHEK). Aile hekimliğinde COVID-19 salgın yönetiminde sorunları büyüyor. https://www.ttb.org.tr/kollar/COVID19/haber_goster.php?Guid=cc04f5da-7bd8-11ea-a12d-7aee3f6e69c5. Accessed date 05 June, 2022.
  • 25. Newell F. Framework for patient and public participation in primary care commissioning. England. NHS. 2016.
  • 26. Gelfman DM. Will the Traditional Physical Examination Be Another Casualty of COVID-19? Am J Med. 2021;134(3):299-300.
  • 27. Inouye SK. Creating an anti-ageist healthcare system to improve care for our current and future selves. Nat Aging. 2021;1(2):150-152.
  • 28. Özger İlhan S. Mezuniyet Öncesi Tıp Eğitimi Çekirdek Programı. 2020.
  • 29. Ludvigsson JF. Children are unlikely to be the main drivers of the COVID-19 pandemic - A systematic review. Acta Paediatr. 2020;109(8): 1525-1530.
  • 30. WONCA Europe. The European definition of general practice/family medicine. Spain: WONCA. 2002.
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Tıp Bilimleri (Diğer)
Bölüm Bilimsel Araştırma Makaleleri
Yazarlar

Nazife Alpman 0000-0003-2445-5192

Hüsna Sarıca Çevik 0000-0002-4292-4696

Yavuzalp Solak 0000-0001-5274-7606

Erken Görünüm Tarihi 20 Ağustos 2024
Yayımlanma Tarihi 27 Ağustos 2024
Gönderilme Tarihi 11 Aralık 2023
Kabul Tarihi 20 Mayıs 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 8 Sayı: 2

Kaynak Göster

APA Alpman, N., Sarıca Çevik, H., & Solak, Y. (2024). Effect of the COVID-19 Pandemic on Anxiety Level, Patient Approach and Oropharyngeal Examination in Family Medicine Outpatient Clinics: A Nationwide Descriptive Study in Turkey. Ahi Evran Medical Journal, 8(2), 194-200. https://doi.org/10.46332/aemj.1403282
AMA Alpman N, Sarıca Çevik H, Solak Y. Effect of the COVID-19 Pandemic on Anxiety Level, Patient Approach and Oropharyngeal Examination in Family Medicine Outpatient Clinics: A Nationwide Descriptive Study in Turkey. Ahi Evran Med J. Ağustos 2024;8(2):194-200. doi:10.46332/aemj.1403282
Chicago Alpman, Nazife, Hüsna Sarıca Çevik, ve Yavuzalp Solak. “Effect of the COVID-19 Pandemic on Anxiety Level, Patient Approach and Oropharyngeal Examination in Family Medicine Outpatient Clinics: A Nationwide Descriptive Study in Turkey”. Ahi Evran Medical Journal 8, sy. 2 (Ağustos 2024): 194-200. https://doi.org/10.46332/aemj.1403282.
EndNote Alpman N, Sarıca Çevik H, Solak Y (01 Ağustos 2024) Effect of the COVID-19 Pandemic on Anxiety Level, Patient Approach and Oropharyngeal Examination in Family Medicine Outpatient Clinics: A Nationwide Descriptive Study in Turkey. Ahi Evran Medical Journal 8 2 194–200.
IEEE N. Alpman, H. Sarıca Çevik, ve Y. Solak, “Effect of the COVID-19 Pandemic on Anxiety Level, Patient Approach and Oropharyngeal Examination in Family Medicine Outpatient Clinics: A Nationwide Descriptive Study in Turkey”, Ahi Evran Med J, c. 8, sy. 2, ss. 194–200, 2024, doi: 10.46332/aemj.1403282.
ISNAD Alpman, Nazife vd. “Effect of the COVID-19 Pandemic on Anxiety Level, Patient Approach and Oropharyngeal Examination in Family Medicine Outpatient Clinics: A Nationwide Descriptive Study in Turkey”. Ahi Evran Medical Journal 8/2 (Ağustos 2024), 194-200. https://doi.org/10.46332/aemj.1403282.
JAMA Alpman N, Sarıca Çevik H, Solak Y. Effect of the COVID-19 Pandemic on Anxiety Level, Patient Approach and Oropharyngeal Examination in Family Medicine Outpatient Clinics: A Nationwide Descriptive Study in Turkey. Ahi Evran Med J. 2024;8:194–200.
MLA Alpman, Nazife vd. “Effect of the COVID-19 Pandemic on Anxiety Level, Patient Approach and Oropharyngeal Examination in Family Medicine Outpatient Clinics: A Nationwide Descriptive Study in Turkey”. Ahi Evran Medical Journal, c. 8, sy. 2, 2024, ss. 194-00, doi:10.46332/aemj.1403282.
Vancouver Alpman N, Sarıca Çevik H, Solak Y. Effect of the COVID-19 Pandemic on Anxiety Level, Patient Approach and Oropharyngeal Examination in Family Medicine Outpatient Clinics: A Nationwide Descriptive Study in Turkey. Ahi Evran Med J. 2024;8(2):194-200.

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