Preoperatif değerlendirme konusunda birinci basamakta çalışan hekimlerin bilgi ve tutumlarının değerlendirilmesi

Yıl 2019, Cilt: 2 Sayı: 2, 150 - 168, 31.08.2019

Demet Laflı Tunay

Öz

Amaç:
Preoperatif değerlendirme,
hastayı bütünüyle iyileştirmekten
ziyade hastaya ait riskleri, tıbbi koşulları
ve tıbbi
bakımı
optimize etme planını ortaya koymaya yönelik, hastanın kapsamlı bir şekilde
değerlendirmesini
yapmaktır.
Preoperatif değerlendirme
multidisipliner bir olay olup dünyada geçerliliği
olan birkaç
modelden biri de birinci basamak hekim modelidir. Bu modelde cerrahi branşın
konsültasyonu
doğrultusunda
preoperatif değerlendirme
aile hekimi, dahiliye doktoru veya kardiyolog tarafından gerçekleştirilir.
Bu çalışmada
birinci basamak aile hekimlerinin preoperatif değerlendirme
konusundaki bilgi düzeyleri
anket çalışması
ile ölçülmek
istenmiştir.

Materyal ve
Metot: Adana il merkezi görev yapan aile hekimliği
uzmanlarına
online anket formu üzerinden, sosyodemografik özellikleri ve Preoperatif değerlendirme
konusunda bilgi, tutum ve uygulamalarını
sorgulayan Avrupa Anesteziyoloji Derneği (ESA)'nin
kardiyak olmayan cerrahi girişim geçiren yetişkinlerin
preoperatif değerlendirilmesine
ilişkin
2011 yılı
kılavuzunda
yer alan tavsiyelerin 2018 yılında
yapılan güncellemesinden uyarlanmış standart anket
uygulandı.

Bulgular:
Katılımcıların %62,50’si aile hekimlerinin
hastalarının preoperatif değerlendirilmesinden
sorumlu olması gerektiğini
düşündüklerini
belirttiler. Aile hekimleri uygulanan ankette düşük
bilgi düzeyi
skoru olan kategorileri koagülasyon bozuklukları(%50,01), kardiyo vasküler
hastalık(%61,87) ve renal hastalık(%67,19) iken yüksek skor alan kategoriler
obezite(%87,51), anemi(%87,51) ve respiratuar hastalık(%75,01) olarak
bulundu. Anket doğru
yanıt
ortalaması
%71,40 olarak bulundu.

Sonuç:
Bu çalışma
birinci basamak hekimlerinin preoperatif hazırlık
konusunda bilgili olmasına
rağmen,
birinci basamak hekim eğitim
programlarında
daha iyi tanımlanmış
bir perioperatif tıp
müfredatına
ihtiyaç
duyulduğunu
ve birinci basamakta hizmet veren hekimlere bu konuda daha fazla eğitim
verilmesinin gerekli olduğunu göstermiştir.

Anahtar
kelimeler: Aile hekimliği, birinci
basamak, Preoperatif değerlendirme

Anahtar Kelimeler

Birinci Basamak, Preoperatif değerlendirme

Kaynakça

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