Hatay'da Aile Hekimlerinin kronik hastalık yönetimini etkileyen faktörler ve hasta yönelimli yaklaşımı
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Dosyalar
Tarih
2022
Yazarlar
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Yayıncı
Hatay Mustafa Kemal Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bulaşıcı olmayan kronik hastalıklar öncelikli halk sağlığı sorunlarındandır. Bu çalışmanın amacı; Hatay ilinde aile sağlığı merkezlerindeki hekimlerin kronik hastalık yönetimini etkileyen faktörleri ve hasta yönelimli yaklaşımlarını sosyodemografik faktörler ve işleyiş açısından değerlendirmektir. Yöntem: Kesitsel nitelikteki araştırma 2021 yılında Google Formlar ile yapılmıştır. Evren Hatay'da aile sağlığı merkezleri'ndeki 502 aile hekimidir. Tüm evrene ulaşılması hedeflenmiş, toplam 308 (%61,3) hekim katılmıştır. Sosyodemografik özellikler, işleyiş, kronik hastalık yönetimi, Hasta Hekim Yönelim Ölçeği, Kronik Hastalık Bakımını Değerlendirme Ölçeği'nin Hekim Perspektifi'ni içeren 89 soruluk anket uygulanmıştır. Bulgular: Bir aile hekimine düşen ortalama nüfus 3400±645,3, ortalama günlük başvuru sayısı 63,8±24,0 ve ortalama muayene süresi 6,7±3,5 dakika idi. En sık başvuru "muayene" ve "ilaç yazdırma" içindi. Hem yönetiminde hem tedaviye uyumda sorun yaşanan hastalıklar diyabet ve obezite idi. Hekimlerin %44,5'ine göre kronik hastalık yönetimindeki yeterlilikleri "orta-zayıf" olup engelleyen nedenler "hastaların bilgi ve farkındalığının yetersizliği", "ilaç dışı ve ilaç tedavisine uyum sağlanmaması", "zaman azlığı" idi. Katılımcıların Hasta Hekim Yönelim Ölçeği toplam ortalaması 44,8±6,8 idi. Kronik Hastalık Bakımını Değerlendirme Ölçeği Hekim Perspektifi toplam ortalaması 3,41 idi. Sonuçlar: Hekimlerin yarıya yakınına göre kronik hastalık yönetim yeterlilikleri "orta-zayıf" olup genç hekimlerde yeterlilik daha azdır. Hekimlerde hasta yönelimli yaklaşım yerine "hastalık yönelimli" yaklaşım hâkimdir. Bu durum kayıtlı nüfus, günlük başvuru sayısı ve muayene süresi ile ilişkilidir. Aile hekimlerinin kronik hastalık bakım verme düzeyi "orta-iyi" olup iş yükleri azaltılıp motivasyonlarının ve sağlık iş gücü sayısının iyileştirilmesi görüşü ortaya çıkmıştır. Mezuniyet öncesi tıp eğitimi müfredatının güçlendirilmesi, sürekli ve düzenli mesleki eğitim gerekliliği düşünülmüştür.
Aim: Non-communicable chronic diseases are among the priority public health problems. The aim of this study; To evaluate the factors affecting chronic disease management and patient-oriented approaches of physicians in family health centers in Hatay in terms of sociodemographic factors and functioning. Method: The cross-sectional study was conducted with Google Forms in 2021. Evren is 502 family physicians in family health centers in Hatay. It was aimed to reach the entire universe, and a total of 308 (61.3%) physicians participated. A questionnaire consisting of 89 questions was applied, including sociodemographic characteristics, functioning, chronic disease management, Patient Physician Orientation Scale, and Physician Perspective of the Chronic Disease Care Assessment Scale. Results: The mean population per family physician was 3400±645.3, the mean number of admissions per day was 63.8±24.0 and the mean examination time was 6.7±3.5 minutes. The most frequent referrals were for "examination" and "drug prescribing". Diseases that had problems in both management and adherence to treatment were diabetes and obesity. According to 44.5% of the physicians, their competence in chronic disease management was "moderate-weak", and the reasons that prevented them were "lack of knowledge and awareness of the patients", "non-adherence to non-drug and drug treatment", "lack of time". The total mean of the participants' Patient Physician Orientation Scale was 44.8±6.8. The total mean of the Chronic Disease Care Assessment Scale Physician's Perspective was 3.41. Conclusion:According to nearly half of the physicians, the chronic disease management competencies are "moderate-weak" and the competency is less in young physicians. Instead of the patient-oriented approach, the "disease-oriented" approach is dominant in physicians. This situation is related to the registered population, the number of applications per day and the examination period. The level of caregiving for chronic diseases of family physicians is "moderate-good", and the view that their workload will be reduced and their motivation and number of health workforce should be improved. Strengthening the undergraduate medical education curriculum and the necessity of continuous and regular vocational education are considered.
Aim: Non-communicable chronic diseases are among the priority public health problems. The aim of this study; To evaluate the factors affecting chronic disease management and patient-oriented approaches of physicians in family health centers in Hatay in terms of sociodemographic factors and functioning. Method: The cross-sectional study was conducted with Google Forms in 2021. Evren is 502 family physicians in family health centers in Hatay. It was aimed to reach the entire universe, and a total of 308 (61.3%) physicians participated. A questionnaire consisting of 89 questions was applied, including sociodemographic characteristics, functioning, chronic disease management, Patient Physician Orientation Scale, and Physician Perspective of the Chronic Disease Care Assessment Scale. Results: The mean population per family physician was 3400±645.3, the mean number of admissions per day was 63.8±24.0 and the mean examination time was 6.7±3.5 minutes. The most frequent referrals were for "examination" and "drug prescribing". Diseases that had problems in both management and adherence to treatment were diabetes and obesity. According to 44.5% of the physicians, their competence in chronic disease management was "moderate-weak", and the reasons that prevented them were "lack of knowledge and awareness of the patients", "non-adherence to non-drug and drug treatment", "lack of time". The total mean of the participants' Patient Physician Orientation Scale was 44.8±6.8. The total mean of the Chronic Disease Care Assessment Scale Physician's Perspective was 3.41. Conclusion:According to nearly half of the physicians, the chronic disease management competencies are "moderate-weak" and the competency is less in young physicians. Instead of the patient-oriented approach, the "disease-oriented" approach is dominant in physicians. This situation is related to the registered population, the number of applications per day and the examination period. The level of caregiving for chronic diseases of family physicians is "moderate-good", and the view that their workload will be reduced and their motivation and number of health workforce should be improved. Strengthening the undergraduate medical education curriculum and the necessity of continuous and regular vocational education are considered.
Açıklama
Anahtar Kelimeler
Halk Sağlığı, Public Health, Hatay, Aile Hekimi, Kronik Hastalık Yönetimi, HHYÖTR-14, Hatay, Family Physician, Chronic Disease Management, PPOSTR-14
