Turkish Version of the Jefferson Scale of Empathy Psychometric Properties

Empathy is an important component of medical education and could be taught throughout the years of medical study. Empathy is a skill that allows establishing a communication by evaluating the views, experiences and worries of the patients’ cognitively. Empathy can improve physicianpatient communication, increase patient satisfaction, establish greater patient compliance, decrease litigation, improve physician’s job satisfaction and prevent physician’s burnout. Therefore measurement of this skill is important. Jefferson Scale of Empathy is an instrument for this purpose and has been translated into 45 languages and used in more than 70 countries. The objective of this study was to evaluate the reliability and construct validity of the Jefferson Scale of Empathy Turkish version. The scale was administered to 600 medical students in one medical school. Cronbach’s alpha coefficient of the Jefferson Scale of Empathy was 0.85 which means a good reliability. Competing models of the latent structure of the Jefferson Scale of Empathy were derived from theoretical and empirical sources and evaluated using confirmatory factor analysis. The best fitting model of the latent structure of the Jefferson Scale of Empathy consisted of three correlated factors corresponding to the “perspective taking”, “compassionate care” and “standing in patient’s shoes” dimensions. The reliability coefficients of these dimensions were 0.84, 0.73 and 0.62 respectively. The Turkish version of the Jefferson Empathy Scale is a reliable and valid measure of the constructs it was intended to assess. This measure was found useful for evaluating empathy among medical student

“The Doctor” Teaches Humanities to Medical Students

Education in humanities is an important part of medical curriculum. With traditional didactic approaches, it is difficult to teach humanities. Using movies and other audio-visual materials can make the teaching of humanities for medical students easier. We used “The Doctor” movie during our family medicine course for educating the last year medical students about communication and patient-doctor relationships, which belongs to the core elements of medical humanities. The movie was evaluated by the students through a questionnaire with structured and open-ended questions and was discussed in the classroom. This study reports the findings of the students’ selfreports and discussions. The overall rating of the movie was 2.5 on a five point Likert scale. There was no significant difference in terms of rating among male and female students. Most of the students found this movie little or not at all emotional. Most of the students reported a positive emotional impact of the movie. Most of the students found the movie more useful than lectures (90.9 %) and journal articles (90.9 %) in teaching the patient-doctor relationships. This proportion was 54.5 % compared to bedside rounds and this finding revealed that students accept the bedside rounds as an important component of learning patient-doctor relationships. We concluded that movies should be an enhancement tool for the curriculum, but not the curriculum. The curriculum with some instructional goals such as understanding, reasoning, critical thinking, and reflection should guide the use of movies

Perceptions of Family Medicine and Career Choice among First Year Medical Students: A Cross-Sectional Survey in a Turkish Medical School

Public attitudes to family medicine in Turkey have lagged behind its rapid academic development. The effect of undergraduate training in primary care on medical students’ attitudes to family medicine has not been assessed. Objectives of this study were to assess the attitudes of first year medical students at Uludag University School of Medicine in Bursa, Turkey to family medicine and to determine their career aspirations. The study was a survey of the first year medical class in 2003–2004. The response rate was 95% (248/261 students). Students were positive about their choice of medicine as a career but had negative opinions of general practice. Female students were more positive in this respect. Initial preference was for specialization in fields other than general practice with little knowledge of the academic specialty of family medicine. Greater undergraduate exposure to family medicine is needed in order to increase knowledge of the field and influence student career choices

Are `Giving bad news` difficult situations for medical students?

Backround: Discussions about end-of-life are difficult issues for physicians to initiate. What about medical students? Do they have enough education about these issues? Aim: In this study our aim was not only to learn their approaches about giving bad news but also to apply a learning method by adding role playing to the elective lesson titled as `giving bad news` to our undergraduate curriculum.Methods: Study group was the third year medical students, who were elected `Approaches to Primary Care Patients` lesson which was given from lecturers of Family Medicine Department. A questionnarie was performed in the beginning and at the end of the lesson. Between these two period a role-playing demonstration was performed from two voluntary students related the subject.Results: Fifteen female (62,5%), 9 male (37;5%), total 24 elective lesson students were par tic i pated. Most of the stu dents (79,2%) stated our pres ent un der grad u ate cur ric u lum de fi cient related giving bad news. More than 90% feeling disturbed, concerned and insecure in giving bad news. After the lesson and role-playing demonstrations more than 90% of the students found this type of training efficacious and practical.Conclusion: Giving bad news is a very important communication skill. As family physicians play a key role on patient care we need to learn the methods and as lecturer to teach them to our medical students. Student integration to the training method can be benefical to internalize the subject. Scripta Scientifica Medica 2007;39(1):95-9

Depression and anxiety among medical students: Examining scores of the beck depression and anxiety inventory and the depression anxiety and stress scale with student characteristics

To evaluate the psychological well-being of medical students a relatively new self-report questionnaire (the depression, anxiety, and stress scale) was used alongside an established instrument (the beck depression and anxiety inventories) in a group of medical students. A total of 928 medical students (49.4% female; 50.6% male) participated voluntarily into this cross-sectional study. Students completed the Turkish versions of the depression anxiety stress scale (DASS), beck depression, and anxiety inventories together with a questionnaire about their socio-demographic characteristics. Mild and moderate levels of depression were found in 30.5% and severe and extremely severe levels of depression in 8.5% of students. Mild and moderate levels of anxiety and stress were present in 35.8% of the participants. Depression and anxiety were more frequently reported by female students. Depression was more frequent among first-year students, students in a poor economic situation and those who were not satisfied with their medical education. The frequency of depression and anxiety were seen to decrease with increasing grades. Bland and Altman plots showed an agreement between beck inventories and depression, anxiety, and stress scales, whereas the agreement between anxiety scales was found to be better than that of depression scales. Depression and anxiety are seen frequently among medical students in Turkey. The psychological distress was influenced only to a modest degree by traditional socio-demographic characteristics. Either the traditional beck inventories or the newer depression anxiety and stress scales can be used for non-clinical screening purposes in individuals

Functional health literacy in a group of Turkish patients: A pilot study

Background: There is currently no objective original measure developed in the Turkish language for evaluating health literacy. However, some instruments originally developed in Western countries and translated into Turkish do exist. Aims: The aim of this study was to translate and adapt the Test of Functional Health Literacy (TOFHLA) into the Turkish language and validate it among a group of Turkish patients. Methods: Interviews were held in an outpatient clinic. Illiterate patients, those with previously diagnosed mental illness and inadequate visual acuity were excluded. Results: Internal consistencies of the reading comprehension and numeracy items were 0.89 and 0.77, respectively. Inadequate health literacy was determined in 28.0% of participants, marginal in 30.0%, and adequate in 42.0%. Among the possible socio-demographic predictors of health literacy, the most significant predictor was the educational level. Participants with lower levels of education had significantly lower levels of health literacy. In general, reading comprehension scores were lower than the numeracy scores. The most disadvantaged groups were women and older people (≥40 years of age) because of their lower levels of education. Discussion: The TOFHLA in the Turkish language seems to be a valid measure. Functional health literacy was found to be inadequate or marginal. Without enhancing the overall educational level, especially of women, efforts to improve health literacy seem to be ineffective. Conclusions: Functional health literacy is related to education. Non-written visual materials should be considered as a temporary solution to improve health literacy in populations with low literacy

Metabolic Syndrome among Women: A Study from Bursa Turkey

AIM: Obesity is one of the risk factors of metabolic syndrome (MetS) and its prevalence is rapidly increasing in Turkey. The purpose of this study was to assess the prevalence of MetS and obesity among women aged 20 years and older. METHOD: This is a cross- sectional study, undergone in a primary health care setting in Bursa /Turkey in the year 2008. A total of 807 women were included in the study. Body weight, height, waist circumference, blood pressure, total and HDL cholesterol, fasting plasma glucose and triglyceride levels were measured. Metabolic Syndrome definition was made according to the International Diabetes Federation (IDF) criteria. RESULTS: The mean age was 42.713.2 years, 96.4% were married, 50.7% had education of less than 8 years, 93.7% were housewives and 85.3% had a monthly family income of $650 or less. The prevalence of MetS and abdominal obesity were 17.5 % and 87.7% respectively. Those with diabetes mellitus and elevated plasma lipids had increased risk of developing MetS 11.3 and 4.5 times more than those without these situations respectively. The risk of MetS increases with age and increasing BMI. CONCLUSION: Obesity is an alarming risk factor for the development of MetS in our study group. [TAF Prev Med Bull 2011; 10(4.000): 421-432

Pap smear screening in the primary health care setting: A study from Turkey

Background: Cervical cancer is one of the ten most frequent cancers in Turkey. It is well known that cervical cancer morbidity and mortality could be significantly reduced with an active cervical smear screening (Pap smear) program. Aims: The aims of this study were: 1) to evaluate the knowledge and attitudes of women about cervical smear testing; 2) to establish a cervical smear screening program and to evaluate the cervical cytological abnormalities that were found; 3) to determine the applicability, limitations and effectiveness of this screening in a primary health care unit. Patients and Methods: A total of 332 married women were included in our study. We collected data concerning socio-demographic and fertility characteristics, and knowledge about Pap smear testing was determined through printed questionnaires. A gynecological examination and Pap smear screening was performed on every woman in our study group. Results: Over ninety percent of our study group had never heard of and had not undergone Pap smear screening before. Of the 332 smears evaluated, 328 (98.8%) were accepted as normal, whereas epithelial cell anomalies were seen in 4 (1.2%), infection in 59 (17.7%), and reactive cell differences in 223 (67.2%) of the smears. Conclusions: The frequency of epithelial cell anomalies in our study group was less than the frequencies reported from Western countries. Knowledge regarding cervical cancer and Pap smear screening was very low. Pap smears can be easily taken and evaluated through a chain built between the primary health care unit and laboratory, and this kind of screening intervention is easily accepted by the population served

The prevalence and clinical features of restless legs syndrome: A door to door population study in Orhangazi, Bursa in Turkey

Background : Restless leg syndrome (RLS) has negative effects on the quality of life of the patients. Epidemiological studies on RLS are limited. Aim : To determine the prevalence of RLS among people aged 40 years and above in Orhangazi district of Bursa, Turkey. Materials and Methods : The study was carried out between 2004 and 2005. This population-based study was conducted in two phases. In the phase 1, residents conducted door-to-door interviews using a short questionnaire to determine the possible cases of RLS. In the phase 2, physicians ascertained the suspected cases of RLS. Diagnosis of RLS was made using the criteria proposed by the International Restless Legs Syndrome Study Group (IRLSSG) and also the rating scale for RLS. Results : Out of 1, 256 subjects screened in phase 1, 1,124 (89.6%) were included in the study. Also, 161 cases with suspected symptoms of RLS were detected in phase 1, 49 of the suspected cases could not be evaluated in phase 2. A diagnosis of RLS was also made in 60 cases during phase 2. Conclusions : We defined the prevalence of RLS as 9.71% among 40 years of age and older population. The prevalence of RLS did not differ by age and was 2.6 times more in women. None of the patients were diagnosed as RLS sought medical care for the symptoms, possibly due to lack of knowledge of patients and physicians about RLS. Prevalence studies help to provide knowledge on morbidity, which is essential for diagnosis and early treatment

Getting Better or Worse? General Health Status of 9 th

Adolescence is a transition phase from childhood to adulthood. In this period, rapid changes and development in their physical, biological, psychological, and social lives take place. While adolescents have to acquire many qualifications, they are faced with many problems, especially those that risk their health. In Turkey, one of the most important issues contributing to risky behaviors is the 1st Phase Nationwide High School Exam. Students must pass this phase in order to be in good high schools and to then pass the 2nd Phase University Exam. Most of their time is spent studying in school or in private teaching institutions, and less time is spent with their families or participating in social activities. In order to examine the effects on 9th grade students after the 1st Phase exams, we conducted this study with 1192 students in Bursa, Orhangazi. Data to evaluate students by socioeconomic status, body mass index (BMI), dietary, smoking, and physical activity behaviors and psychological status were collected via classroom questionnaires. We aimed to determine and evaluate the general characteristics and physical examination findings, to some extent, in a nationally representative sample of 9th grade students a year following the Nationwide High School Exam