İletişimin hasta memnuniyetine etkisi : Afyonkarahisar örneği

06.03.2018 tarihli ve 30352 sayılı Resmi Gazetede yayımlanan “Yükseköğretim Kanunu İle Bazı Kanun Ve Kanun Hükmünde Kararnamelerde Değişiklik Yapılması Hakkında Kanun” ile 18.06.2018 tarihli “Lisansüstü Tezlerin Elektronik Ortamda Toplanması, Düzenlenmesi ve Erişime Açılmasına İlişkin Yönerge” gereğince tam metin erişime açılmıştır.Sağlık hizmetlerinin kaliteli sunumunda önemli çıktı ölçütlerinden hasta memnuniyeti kavramı, sağlık kurumlarının üzerinde durdukları konuların başında gelmektedir. Etkin sağlık iletişimi ise hasta memnuniyetinin sağlanmasındaki bileşenlerden biri olarak kabul edilmektedir. Bu çalışmada sağlık çalışanı-hasta iletişimi ile hasta memnuniyeti arasındaki ilişkinin saptanması ve sağlık çalışanı-hasta iletişiminin memnuniyet üzerindeki etkilerinin belirlenmesi amaçlanmaktadır. Ayrıca, katılımcıların sosyo-demografik özelliklerine göre hasta memnuniyeti düzeyi ve sağlık çalışanı-hasta iletişiminde bir farklılık olup olmadığı belirlenmektedir. Çalışmanın evreni, Afyonkarahisar il merkezinde faaliyette bulunan 6 sağlık kuruluşundan hizmet alan bireylerden oluşmaktadır. Çalışma söz konusu hastanelerden hizmet alan 510 kişi üzerinde gerçekleştirilmiştir. Veri toplama aracı olarak Makoul tarafından geliştirilen ve Baxter (2015) tarafından uyarlanan "İletişim Değerlendirme Aracı"; Ware ve arkadaşları (1976) tarafından geliştirilen ve Marshall ve Hays (1994) tarafından kısa formu oluşturulan "Hasta Memnuniyeti Ölçeği" ve hastane kullanımı ile katılımcıların sosyo- demografik özelliklerine ilişkin sorulardan oluşan bir anket formu kullanılmıştır. Verilerin analizinde tanımlayıcı istatistiksel yöntemler, korelasyon analizi, regresyon analizi, bağımsız örneklerde t testi ve tek yönlü varyans analizinden yararlanılmıştır. Veriler %95 güven aralığında (p=0,05) analiz edilmiştir. Çalışmanın bulgularına göre iletişim ve hasta memnuniyeti ve hasta memnuniyetinin alt boyutları arasında istatistiksel bakımdan anlamlı ve pozitif yönlü ilişkiler bulunmuştur. Ayrıca hasta-çalışan iletişiminin memnuniyet ve memnuniyetin alt boyutları olan iletişim, teknik kalite, genel memnuniyet, mali kaygılar, erişilebilirlik, kişilerarası tutum ve hekimle geçirilen zaman üzerinde anlamlı etkisi vardır. Katılımcıların cinsiyet ve medeni durumları iletişim ve memnuniyet düzeylerinde anlamlı bir farklılık oluşturmazken; yaş, eğitim durumu, meslek ve gelir durumu iletişim ve memnuniyet düzeylerinde anlamlı farklılık oluşturmaktadır. Sonuç olarak, sağlık hizmetlerinin sunumunda temel unsur kabul edilen iletişimin geliştirilmesi hasta memnuniyetinin arttırılmasını katkı sağlamaktadır. Bu sebeple sağlık çalışanlarının mesleki iletişim becerilerinin geliştirilmesine yönelik olarak eğitim ve sağlık kurumlarında gerekli programların düzenlenmesi önerilmektedir.One of the primary concerns of medical institutions is patient satisfaction as it is one of the important output criteria in terms of quality offer of medical services. Effective health communication is considered as one of the components of assuring patient satisfaction. This study seeks to detect the correlation between the healthcare staff-patients communication and patient satisfaction and reveal the effect of the healthcare staff-patients communication on patient satisfaction. Moreover, this study attempts to show whether patient satisfaction and the healthcare staff-patients communication differ based on socio-demographic characteristics. The population of the study consists of people aged 18 to 65 receiving service from six medical institutions located in the central district of Afyonkarahisar province. The study was conducted with 510 people receiving service from the aforementioned hospitals. Data collection tools are Communication Assessment Tool developed by Makoul and adapted by Baxter (2015) and Patient Satisfaction Questionnaire which was developed by Ware et al. (1976) and a short form of which was prepared by Marshall and Hays (1994). A survey form consisting of questions about hospital use and socio-demographic characteristics of patients was also employed in the study. For data analysis, descriptive statistical methods, correlation analysis, regression analysis, independent samples t-test, and one-way analysis of variance were employed. The data were analyzed at a confidence interval of 95% (p=0.05). The study indicated that there are statistically significant and positive correlations between communication and patient satisfaction as well as sub-dimensions of patient satisfaction. In addition, the communication between patients and health employees has significant effects on satisfaction as well as such sub-dimensions of satisfaction as communication, technical competence, general satisfaction, financial aspects, access to care, interpersonal manners, and time spent with doctor. While no significant differences were detected between the participants' communication and satisfaction levels based on gender and marital status, significant differences were identified based on age, educational background, occupation, and income. All in all, improving communication, which is regarded as one of the fundamental elements of offering healthcare services, contributes to patient satisfaction. Therefore, it is recommended to organize training programs for healthcare employees in educational and medical institutions in order to improve their professional communication skills

The 6th of february earthquake and the Turkish society of pediatric nephrology-organizational aspects of pediatric kidney care

The 6 February 2023 earthquake that struck southern and central Turkey and northern and western Syria had unique drawbacks, such as the occurrence of two strong, destructive earthquakes nine hours apart in multiple and densely populated geographical areas, exposure to unforgiving winter conditions, and increased anxiety and fear due to multiple aftershocks [1, 2]. As of 26 March 2023, >50 000 people have been killed and many more have been injured in Turkey [3]. One recent editorial and a letter emphasized the vital importance of increased awareness of disaster preparedness and rapid action on organizational issues [4, 5]. Nongovernmental organizations including academic medical societies should take responsibility during disasters [6] and work together with other stakeholders. Since an earthquake should be considered a “kidney disaster” because of crush injuries and resultant acute kidney injury [7], the Turkish Society of Pediatric Nephrology (TSPN) took primary responsibility during the immediate and early phases of earthquake

COVID-19 in pediatric nephrology centers in Turkey

Background/aim: There is limited data on COVID-19 disease in children with kidney disease. We aimed to investigate the characteristics and prognosis of COVID-19 in pediatric nephrology patients in Turkey. Materials and methods: This was a national, multicenter, retrospective cohort study based on an online survey evaluating the data between 11th March 2020 and 11th March 2021 as an initial step of a detailed pediatric nephrology COVID-19 registry. Results: Two hundred and three patients (89 girls and 114 boys) were diagnosed with COVID-19. One-third of these patients (36.9%) were between 10–15 years old. Half of the patients were on kidney replacement therapy: kidney transplant (KTx) recipients (n = 56, 27.5%), patients receiving chronic hemodialysis (n = 33, 16.3%) and those on peritoneal dialysis (PD) (n = 18, 8.9%). Fifty-four (26.6%) children were asymptomatic. Eighty-two (40.3%) patients were hospitalized and 23 (28%) needed intensive care unit admission. Fifty-five percent of the patients were not treated, while the remaining was given favipiravir (20.7%), steroid (16.3%), and hydroxychloroquine (11.3%). Acute kidney injury developed in 19.5% of hospitalized patients. Five (2.4%) had MIS-C. Eighty-three percent of the patients were discharged without any apparent sequelae, while 7 (3.4%) died. One hundred and eight health care staff were infected during the study period. Conclusion: COVID-19 was most commonly seen in patients who underwent KTx and received HD. The combined immunosuppressive therapy and frequent exposure to the hospital setting may increase these patients’ susceptibility. Staff infections before vaccination era were alarming, various precautions should be taken for infection control, particularly optimal vaccination coverage

The Effect of Loneliness at Work and Work Stress on Work Alienation and Work Alienation on Performance among Health Employees

This study aims to determine the effect of loneliness at work and work stress on work alienation and work alienation on employee performance among employees in Turkish healthcare institutions. Data collection tools were composed of Loneliness at Work Scale Work Stress Scale, Work Alienation Scale and Performance Scale. The study results revealed that work alienation was influenced by work stress (ρ=0.689) and loneliness at work (ρ=0.433) positively. These influences were statistically significant (p<0.05). In addition, it was found that work alienation had a negative and statistically significant effect on performance (ρ=-0.264) (p<0.05). The performance of health employees decreased with increasing work alienation. It should be noted that low job performance of these employee may lead to irreversible consequences such as death or disability. Viewed from this perspective, the determined factors that cause work alienation in employees (health institutions) play significant role and health institutions are required to take precautionary measures

A clinical overview of paediatric sarcoidosis: Multicentre experience from Turkey

Objectives We aimed to outline the demographic data, clinical spectrum, and treatment approach of sarcoidosis in a large group of patients and sought to figure out the variations of early-onset (EOS) and late-onset paediatric sarcoidosis (LOS). Methods The study followed a retrospective-descriptive design, with the analysis of medical records of cases diagnosed as paediatric sarcoidosis. Results Fifty-two patients were included in the study. The median age at disease onset and follow-up duration were 83 (28.2-119) and 24 (6-48) months, respectively. Ten (19.2%) cases had EOS (before 5th birthday) and 42 (80.7%) cases had LOS. The most common clinical findings at the time of the disease onset were ocular symptoms (40.4%) followed by joint manifestation (25%), dermatological symptoms (13.5%), and features related to multi-organ involvement (11.5%). Anterior uveitis was the most common (55%) one among ocular manifestations. Patients with EOS displayed joint, eye, and dermatological findings more commonly than patients with LOS. The recurrence rate of disease in patients with EOS (5.7%) and LOS (21.1%) were not statistically different (P = .7). Conclusions Patients with EOS and LOS may present with variable clinical features and studies addressing paediatric sarcoidosis cases in collaboration between disciplines will enhance the awareness of this rare disease among physicians and assist early diagnosis with lesser complications

Rhupus syndrome in children: A multi-center retrospective cohort study and literature review

Objective: In this study, we aimed to evaluate the characteristics of pediatric rhupus patients including all the related series in the literature. Methods: Thirty pediatric patients with rhupus syndrome from 12 different centers in Turkey were included in this study. The literature was also reviewed for pediatric patients with rhupus syndrome. Results: The most prominent phenotype of these 30 patients was juvenile idiopathic arthritis (JIA) (60%) at the disease onset and SLE (73.3%) at the last visit. Major SLE-related organ involvements were skin (80%), hematological system (53.3%), and kidney (23.3%). Arthritis was polyarticular (73.3%), asymmetric (66.7%), and erosive (53.3%) in most patients. Hydroxychloroquine (100%), glucocorticoids (86.7%), and mycophenolate mofetil (46.7%) were mostly used for SLE, while glucocorticoids (76.6%), methotrexate (73.3%), and nonsteroidal anti-inflammatory drugs (NSAIDs) (57.6%) were mainly preferred for JIA. Our literature search revealed 20 pediatric patients with rhupus syndrome (75% were RF positive). The most prominent phenotype was JIA (91.7%) at the disease onset and SLE (63.6%) at the last visit. Major SLE-related organ involvements were skin (66.7%), hematological system (58.3%), and kidney (58.3%). Arthritis was polyarticular (77.8%), asymmetric (63.6%), and erosive (83.3%) in most patients. Glucocorticoid (100%), hydroxychloroquine (76.9%), and azathioprine (46.2%) were mostly used for SLE, while methotrexate (76.9%) and NSAIDs (46.2%) were mainly preferred for the JIA phenotype. Conclusion: Our study is the largest cohort in the literature evaluating pediatric rhupus cases. Most of the pediatric patients had polyarticular, asymmetric, and erosive arthritis, as well as organ involvements associated with SLE, including the skin, hematological system, and kidney