The experiences and thoughts of Turkish family physicians about COVID-19 pandemic: A qualitative study

BACKGROUND

Efforts to contain the SARS-CoV-2 virus would fall short without strong primary health care.

OBJECTIVES

In this study, we aimed to determine the experiences, views and suggestions of family physicians regarding their roles, primary care health systems' preparedness and the challenges/needs for a better organisation during the pandemic via in-depth exploration.

METHODS

Twenty-one family physicians working in different cities of Turkey participated in semi-structured interviews between 15/08/2020-21/01/2021. Convenience sampling was used. We did this qualitative study through interviews by telephone. Participants were asked seven open-ended questions. Thematic analysis was used, which included reading the transcript, identifying significant phrases and formulating meanings and validating meanings through research team discussions to reach consensus, identifying themes.

RESULTS

Ten of the participants were female and the average age of the participants was 39.5 (SD = 10.5) years. Twelve of the family physicians are specialists in family medicine. Four themes were identified: role of primary care in the pandemic, pandemic preparedness of primary care, challenges of working in primary care centres during the COVID-19 pandemics, and approaches to future pandemics.

CONCLUSION

Our study showed that, despite unprepared primary care and undefined roles of family physicians in pandemic planning, family physicians played a significant role in pandemic management.

The Evaluation of Frailty in the Elderly and Affecting Biopsychosocial Factors: A Cross-Sectional Observational Study

Background

We aimed to evaluate the frequency of frailty and the affecting factors in people living in our society over 65 yr old.

Methods

Our descriptive and cross-sectional study included 261 individuals aged 65 and over who applied to Ankara Training and Research Hospital family practice centers and district polyclinics from 1 Jan to 1 Feb 2020. The participants were asked to complete a sociodemographic data form, FRAIL Scale, Katz Daily Living Activities Scale, Lawton&Brody Instrumental Activities of Daily Living Scale and Geriatric Depression Scale Short Form.

Results

According to the FRAIL Scale results: 35 people were found to be frail (13.4%), 115 to be pre-frail (44.1%). No frailty was observed in 111 people (42.5%). While the mean score of the Katz Activities of Daily Living Scale was found to be 5.65±0.71, the mean score of the Lawton&Brody Instrumental Activities of Daily Living Scale was found to be 6.65±1.69. In the geriatric depression evaluation, mild, medium or severe depression was detected in 87 participants (33.2%). As the level of frailty increased, the Geriatric Depression Scale score climbed significantly (P<0.001). In frail individuals, Lawton&Brody Scale scores were significantly lower (P<0.001). In our study: a correlation was found between frailty and female gender, being single, low income, low educational level, obesity, polypharmacy and decreased physical activity. Additionally, as the number of children increase frailty in women increases therewithal.

Conclusion

Elderly people had high frailty. Polypharmacy, depression and reduced physical activity were the more frequent in frail elderly. In frail females, the number of children was significantly higher.

The impact of the COVID-19 pandemic on paediatric emergency service

AIMS

The aims of this research were to review patients visiting the paediatric emergency department over a 6-month period 1 year before and during the pandemic, to review paediatric emergency department referral ratios and to determine whether there were any significant decreases in mortality and morbidity.

METHODS

All patients from the ages of 0 to 18 years visiting the University of Health Sciences, Ankara Research and Training Hospital, paediatric emergency service from April-October 2019 to April-October 2020 with no missing information in their records were involved in this retrospective cross-sectional study.

RESULTS

The total number of paediatric emergency service consultations was 74 739; the number of emergency visits from April to October 2019 was 55 678, whereas it was 19 061 from April to October 2020 in the midst of the COVID-19 pandemic period. There was a 67.7% decrease in consultations during the pandemic period. The mean age of participants from April to October 2019 was 8.11 ± 5.31 years, and 52.4% of cases were male. The mean age from April to October 2020 was 8.58 ± 5.93 years, and 51% of cases were male. COVID-19-related symptoms were higher during the pandemic period (P < .05), with fever and gastroenteritis being the most frequently received diagnosis in both periods. During the pandemic period, the newborn consultation ratio was higher (P > .05), there was a decrease in consultation ratios related to suicide attempts (P < .05), and a threefold increase in death rates was observed (P < .05).

CONCLUSION

In Turkey, where emergency consultation rates are quite high, these decreases look fearsome for secondary injuries that can develop in children. For this reason, families should be made aware of the importance of bringing their children to the hospital during emergencies, and that all necessary health precautions are being taken to decrease the spread of infection in hospitals.

Evaluation of factors affecting the fat phobia level

AIM

The aim of the study was to investigate and evaluate factors affecting levels of negative bias or attitude towards obesity, known as "fat phobia."

METHODS

The study included 583 individuals who agreed to participate in this research among those presented at our outpatient clinics for any reason. Participants were asked to complete a survey after their written consent was received. The survey consisted of two parts: the first related to socio-demographic information; the second including a "Fat Phobia Scale," the "State-Trait Anxiety Inventory" and the "Beck Depression Inventory." Data analysed using SPSS 20 statistical software.

RESULTS

Of the participants, 50.6% were male, and 49.4% were female. Among participants, 49.7% had a weight problem in their family, while 50.6% had experienced weight problems. In addition, 35.7% of participants were overweight, 27.4% severely overweight, 20.1% medium-to-normal weight, 7% severely underweight, 6.7% underweight and 3.1% obese. The median score for fat phobia level did not differ by gender (P = .790) and was 3.07 in both men and women. The fat phobia level did not vary by profession, previous diets, previous weight problems and weight self-assessment (P > .05). There was no significant relationship between fat phobia and age, weight, height, body mass index, state anxiety, trait anxiety and Beck depression score (P > .05).

CONCLUSION

The common opinion across studies on bias is that the effective factor in being free from the relevant bias can be achieved through education. Although fat phobia is a new concept, it is an emotion that is always with us at varying levels. In order to minimise the level of fat phobia as much as possible, to draw attention to this situation and to raise awareness, weight management should be ensured for the health of individuals in addition to psychological sessions.

Evaluation of the effect of the COVID-19 pandemic on sleep disorders and nutrition in children

AIMS

The aim of the study was to evaluate the possible changes in sleep behavior and nutrition in children during the pandemic period.

METHODS

One hundred fourteen parents who accepted to participate in the study aged 18 and over and who had children between the ages of 6 and 16 were included in the study. A questionnaire was carried out after written consents were obtained. In the first part of the questionnaire, there were a total of 9 questions including socio-demographic information and nutritional characteristics, and the second part included the "Sleep Disturbance Scale for Children" (SDSC). The data were analyzed with the SPSS 20 statistical program.

RESULTS

The total number of participants was 114 parents; 64 (56%) of the children were girls and 50 (43.9%) were boys. Among the participants, the number of children who had COVID-19 was 38 (33.3%). There was no statistically significant relationship between going through COVID-19 status and the variables examined in general. The proportion of participants who stated that if the pandemic period was prolonged, COVID-19 would not change their diet was found to be statistically significant (P = .038). The SDSC score was found to be significantly high in girls (P < .05).

CONCLUSION

Sleep and nutritional disorders affect the quality of life for all ages for both genders, and their importance increases even more in extraordinary periods such as pandemic. Sleep problems increasing especially with an accompanying anxiety state may lead to developmental problems as well as deepening psychological disorders.

Family medicine research assistants' experiences during COVID-19 pandemic: A qualitative study

OBJECTIVE

We aimed to learn about the experiences of family medicine research assistants during COVID-19 pandemic and to obtain information about improvement activities that can be done in similar situations.

MATERIALS AND METHODS

The study was conducted with the research assistants of X University Faculty of Medicine, Department of Family Medicine, who worked in the COVID-19 outpatient clinic during the pandemic period. The research was a qualitative research. Data were analysed using a thematic framework method.

RESULTS

In all, 15 research assistants (11 females and 4 males) were included in the study. No remarkable difference was detected in the opinions with respect to their gender and their working period as a physician. The analysis revealed four main themes: emotions experienced during pandemic, working environment, gains and reasons to choose "family medicine."

CONCLUSION

Family medicine research assistants have important roles during pandemic. However, in this period, it is very important to know their views to provide the most accurate management and to meet their training needs.

Evaluation of the effect of the Covid-19 pandemic on smoking addiction levels

AIMS

This study aims to evaluate the changes in smoking addiction levels during the on-going Covid-19 pandemic.

METHODS

This study included 104 participants, ≥18 years old who were previous patients of family health clinics for a variety of reasons in the months preceding the onset of the Covid-19 pandemic. The Fagerström Test for Nicotine Dependence was administered to these patients as part of their initial intakes. The participants were asked to complete a questionnaire related to socio-demographic information and the Fagerström Test for Nicotine Dependence after obtaining agreement to participate during the pandemic period. In addition, written informed consent was obtained. The Statistical Package for the Social Sciences, version 20, was used to analyse the acquired data.

RESULTS

The participants were 48.1% and 51.9% women and men, respectively. The pre-pandemic and Covid-19 pandemic mean smoking addiction scores were 5.03 and 5.6, respectively. The smoking addiction levels before and during the Covid-19 pandemic significantly differed (P < .001). Of the individuals with low smoking addiction levels before the pandemic, 17.6% and 29.4% became moderately and highly addicted, respectively. Of the individuals with moderate smoking addiction level, 6.3% and 43.9% became lowly and highly addicted, respectively.

CONCLUSION

The smoking addiction level may change based on various factors including behavioural changes. While increases in smoking addiction during the pandemic can be observed caused by behavioural changes and anxieties that may arise because of the pandemic, a decrease in addiction levels and even smoking cessation can also be observed during these times because of the more progressive course of Covid-19 in smokers. Health institutions should therefore take advantage of this period and focus more efforts on the cessation of smoking and other substance abuse issues.

Comparison of the feeding behaviour of children attending half-day and full-day school

AIMS

This study compares the self-reported feeding behaviours of children attending half- and full-day school to investigate the effect of time spent at school.

METHODS

A survey was conducted between January 2020 and March 2020 for students aged 6-18 years. Participation was voluntary, and written consent was obtained from parents. Data were collected from 772 students (385 half-day and 387 full-day students). The data were analysed using IBM SPSS V16.0.

RESULTS

The number of meals students ate per day varied based on the amount of time they spent at school, and the difference was statistically significant (P = .011). The percentage of students who reported that they ate four or more meals per day was 15.2% in the full-day group and 7.8% in the half-day group. In terms of dieting status, 3.9% of half-day students and 1% of full-day students reported that they were on a diet.

CONCLUSION

The number of meals and dieting status relate to the amount of time students spend in school. Based on these findings, it is recommended that nutrition education be offered in schools and that school cafeteria menus reflect the advice of nutrition experts.

While studies on COVID-19 vaccine is ongoing, the public's thoughts and attitudes to the future COVID-19 vaccine

OBJECTIVE

In this study, we aim to investigate the thoughts and attitudes of individuals towards the future COVID-19 vaccine.

METHODS

This descriptive study was carried out on the web between 10/06/2020 and 10/07/2020. The sample constitutes all individuals above 18 years of age using social media and smartphone. The e-survey form was shared by the researchers via the web for a month, and those who completed the survey were included in the study and formed the sample of the research.

RESULTS

Seven-hundred and fifty-nine people participated. 49.7% of the participants stated to be vaccinated; 38.4% of them stated to be vaccinated their children against COVID-19; if the vaccine for COVID-19 is developed. The request for the COVID-19 vaccine had relationship with gender, occupation, health insurance, anxiety level, having children and willing to get vaccinated for their children. "Afraid of the side effects of vaccine", "don't think it can be reliable as it will be a new vaccine" and "COVID-19 infection is a biological weapon and the vaccine will serve those who produce this virus" were the most common reasons for rejection of vaccine.

CONCLUSION

In our study, afraid of the side effects of vaccine and not thinking it can be reliable as it will be a new vaccine are the most reasons of indecision and rejection about COVID 19 vaccine. In order for the future COVID 19 vaccination campaign to not fail, media, politicians and healthcare professionals should closely follow the vaccination development processes, inform the public transparently and consider public's concerns.