AKUT MİYOKART ENFARKTÜSÜ GEÇİRMİŞ BİREYLERDE KAÇIRILMIŞ FIRSATLARIN DEĞERLENDİRİLMESİ

Yıl 2025, Cilt: 12 Sayı: 2, 107 - 118, 27.06.2025

Önder Demiröz , Miray Sancaktar Demiröz , Oytun Sevil , Sakine Beyza Üstün , Kürşat Uyğul , Rümeysa Kılıç , Zeynep Tuye Çakır , Seyhan Hıdıroğlu

Öz

Amaç: Bu çalışmanın amacı, İstanbul’da bir üçüncü basamak eğitim ve araştırma hastanesine başvuran ve son iki yıl içerisinde akut miyokart enfarktüsü (MI) geçirmiş bireylerde, primer ve sekonder korunma düzeyinde kaçırılmış fırsatları belirlemek ve risk farkındalığı ile sağlık hizmetlerine başvuru davranışlarını değerlendirmektir.
Gereç ve Yöntem: Bu kesitsel araştırmada, Ocak 2023-Nisan 2023 tarihleri arasında bir kamu hastanesinin kardiyoloji polikliniğine başvuran ve son iki yıl içinde MI tanısı almış 74 birey ile yüz yüze görüşmeler gerçekleştirilmiştir. Geliştirilen yarı yapılandırılmış anket formu ile sosyodemografik özellikler, kardiyovasküler risk faktörleri, sağlık hizmetlerine erişim ve risk farkındalığına ilişkin veriler toplanmıştır. İstatistiksel analizlerde Mann-Whitney U testi ve Pearson Ki-kare testi kullanılmış, anlamlılık düzeyi p<0,05 olarak kabul edilmiştir.
Bulgular: Katılımcıların %83,8’i erkek olup, median yaş 60,5 yıldır. Sigara kullanımı %60,8, hipertansiyon %62,2, diyabet %43,2 ve hiperlipidemi %67,6 oranında saptanmıştır. İlk MI yaşının medianı 53 yıl olarak bulunmuştur. Risk faktörlerine sahip bireylerin yalnızca %40’ı kalp krizi riski hakkında bilgilendirilmiştir. Katılımcıların %23’ü şikayet olmadan hekime başvurduğunu bildirmiştir. Eğitim düzeyi, cinsiyet, sosyal güvence ve ailede kalp hastalığı öyküsü gibi değişkenlerle doktora başvurma davranışı arasında anlamlı bir ilişki saptanmamıştır.
Sonuç: Çalışmamız, MI geçiren bireylerde değiştirilebilir risk faktörlerinin yaygın olduğunu, ancak risk farkındalığının ve koruyucu sağlık davranışlarının yetersiz kaldığını ortaya koymuştur. Bulgular, birinci basamakta koruyucu hizmetlerin güçlendirilmesi, risk gruplarına yönelik sağlık okuryazarlığı programlarının geliştirilmesi ve toplum temelli müdahalelerin artırılması gerektiğini göstermektedir. Ayrıca sosyal tıp perspektifiyle, sağlık hizmetlerine erişimdeki eşitsizliklerin giderilmesi ve bütüncül sağlık politikalarının benimsenmesi önem taşımaktadır.

Anahtar Kelimeler

Miyokart enfarktüsü , Kalp krizi , Risk faktörleri , Kaçırılmış fırsatlar , Birincil koruma

Evaluation of Missed Opportunities in Individuals with Acute Myocardial Infarction

Öz

Objective: This study aimed to identify missed opportunities at the levels of primary and secondary prevention and to evaluate risk awareness and healthcare-seeking behaviors among individuals who experienced acute myocardial infarction (MI) within the past two years at a tertiary education and research hospital in Istanbul.
Materials and Methods: In this cross-sectional study, face-to-face interviews were conducted with 74 individuals who were diagnosed with MI and admitted to the cardiology outpatient clinic between January 2023 and April 2023. Data were collected using a semi-structured questionnaire developed based on the literature, covering sociodemographic characteristics, cardiovascular risk factors, access to healthcare, and indicators of risk awareness. The Mann-Whitney U test and Pearson’s Chi-square test were used for statistical analysis, with a significance level set at p<0.05.
Results: Among the participants, 83.8% were male, and the median age was 60.5 years. The rates of smoking, hypertension, diabetes, and hyperlipidemia were found to be 60.8%, 62.2%, 43.2%, and 67.6%, respectively. The median age at first MI was 53 years. Only about 40% of participants with risk factors had been informed about their risk of heart attack. While 23% of participants reported visiting a physician without symptoms to assess cardiovascular risk, no statistically significant association was found between healthcare-seeking behavior and variables such as education level, gender, presence of social security, or family history of heart disease.
Conclusion: This study revealed that modifiable risk factors are highly prevalent among individuals who experienced MI, yet risk awareness and preventive health behaviors remain inadequate. The findings highlight the necessity of strengthening preventive services at the primary care level, developing targeted health literacy programs, and promoting community-based interventions. From a social medicine perspective, addressing inequalities in healthcare access and adopting comprehensive health policies are crucial for effective prevention.

Anahtar Kelimeler

Myocardial infarction , Risk factors , Missed opportunities , Primary prevention , Health services accessibility

Kaynakça

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