Gökçe Hayriye BARDAKÇI, Melike GÖKTAŞ, Sevilay SIRÇA, İrem DEMİRALP, Yasemin ASLAN

COVID-19 Pandemi Döneminde Sağlık Sistemine Duyulan Güvenin Çok Boyutlu Olarak Değerlendirilmesi

Bu çalışmada, COVID-19 pandemi döneminde sağlık sistemine duyulan güvenin çok boyutlu olarak değerlendirilmesi amaçlanmıştır. Çalışma tanımlayıcı tipte kesitsel bir araştırmadır. Çalışmanın evrenini Bandırma’da yaşayan 18-65 yaş arası okur-yazar bireyler, örneklemini ise çalışmaya gönüllü olarak katılan 393 birey oluşturmuştur. Veri toplama aracı olarak “Sağlık Hizmetleri Sistemi Çok Boyutlu Güven Ölçeği” ve “Kişisel Bilgi Formu” kullanılmıştır. İstatistiksel analizler için NCSS 2007 programı kullanılmıştır. Ölçeğin Cronbach’s Alpha katsayısı 0,908 bulunmuştur. Çalışmada COVID-19 pandemi döneminde sağlık hizmetleri sistemine duyulan güvenin orta düzeyde olduğu tespit edilmiştir. Katılımcıların %61,3’ünün koronavirüse hiç yakalanmadığı ve %89,8’inin COVID-19 aşısı yaptırdığı bulunmuştur. Yaş grubuna göre sağlık hizmeti maliyetini karşılayan kişi/kuruma güven puanları arasında istatistiksel olarak anlamlı farklılık olduğu, 18-25 genç yaş grubunun güven düzeyinin, 26-45 yaş grubundan daha yüksek olduğu bulunmuştur. Eğitim düzeyine göre sağlık hizmeti maliyetini karşılayan kişi/kuruma güven puanları arasında da istatistiksel açıdan anlamlı farklılık olduğu, ön lisans ve lisans mezunu katılımcıların güven düzeyinin ortaöğretim mezunlarından daha yüksek olduğu bulunmuştur. Çalışmada kronik hastalığı olan katılımcıların güven düzeyi hastalığı olmayanlardan düşük bulunmuştur. Pandemi döneminde sağlık sistemine duyulan güven düzeyinin ölçülmesi ve özellikle düşük güven düzeyi üzerinde etkili olan faktörlerin belirlenerek, bu alanlara yönelik politikalar geliştirilmesi önerilmektedir.

Anahtar Kelimeler:

COVID-19, Sağlık sistemine güven, Pandemi, Sağlık politikası

Multidimensional Evaluation of Trust in Healthcare System During The COVID-19 Pandemic

This study aimed to evaluate trust in the healthcare system in a multidimensional manner during the COVID-19 pandemic. The study was a descriptive cross-sectional study. Individuals between the ages of 18 and 65 living in Bandırma constituted the population of the study, and 393 participants who willingly consented formed the sample. The “Multidimensional Trust in Health Care Systems Scale” and the “Personal Information Form” served as data collection tools. The statistical evaluation involved using NCSS 2007, and Cronbach's alpha coefficient of the scale was calculated to be 0.908. According to the research findings, there was a moderate level of trust in the healthcare system during the COVID-19 pandemic. Participants who had never experienced the coronavirus comprised 61.3%, and among them, 89.8% received the COVID-19 vaccine. It was determined that the statistically significant difference between the trust level of the person/institution that covers the health care costs according to the age group. The confidence level of the 18–25 young age group was more significant than the 26–45 older age group. There was also a statistically significant difference between the trust level of the person/institution that covers the health care costs according to the education level, and the trust level of the associate and undergraduate graduates is higher than the secondary school graduates. In line with the results of the study, participants without chronic diseases had a higher trust level compared to those with chronic diseases. It is advisable to measure the level of trust in the healthcare system during the pandemic and to formulate policies, particularly by identifying the factors influencing the low level of trust.

Keywords:

COVID-19, Trust in healthcare system, Pandemic, Health policy,

PDF

___

Abelson, J., Miller, F. A. ve Giacomini, M. (2009). “What does it mean to trust a health system? A qualitative study of Canadian health care values”. Health Policy, 91 (1), 63-70. https://doi.org/10.1016/j.healthpol.2008.11.006.
Ahnquist, J., Wamala, S.P. ve Lindström, M. (2010). “What has trust in the health-care system got to do with psychological distress? Analyses from the national swedish survey of public health”. International Journal for Quality in Health Care, 22 (4), 250-258. https://doi.org/10.1093/intqhc/mzq024.
Ahorsu, D. K., Lin, C. Y., Yahaghai, R., Alimoradi, Z., Broström, A., Griffiths, M. D., Pakpour, A. H. (2022). “The mediational role of trust in the healthcare system in the association between generalized trust and willingness to get COVID-19 vaccination in Iran”. Human Vaccines & Immunotherapeutics, 18 (1), 1-8. https://doi.org/10.1080/21645515.2021.1993689.
Anand, T. N. ve Kutty, V. R. (2015). “Development and testing of a scale to measure trust in the public healthcare system”. Indian Journal of Medical Ethics, 12 (3), 149-157. https://doi.org/10.20529/IJME.2015.044.
Antinyan, A., Bassetti, T., Corazzini, L. ve Pavesi, F. (2021). “Trust in the healthcare system and COVID-19 treatment”. Frontiers in Psychology, 12, 643758. https://doi.org/10.3389/fpsyg.2021.643758.
Armstrong, K. ve Freiberg, A. A. (2017). “Challenges and opportunities in disclosing fnancial interests to patients”. JAMA, 317 (17), 1743-1744. https://doi.org/10.1001/jama.2017.2656.
Baker, D.W. (2020). “Trust in health care in the time of COVID-19”. JAMA, 234 (23), 2373-2375. https://doi.org/10.1001/jama.2020.23343.
Balog-Way, D. H. P., McComas, K. A. (2020). “COVID-19: refections on trust, tradeofs, and preparedness”. Journal of Risk Research, 23, 838-848. https://doi.org/10.1080/13669877.2020.1758192
Bárcena, A., Cimoli, M., García-Buchaca, R., Yáñez, L.F. ve Pérez, R. (2018). The 2030 agenda and the Sustainable Development Goals. An opportunity for Latin America and the Caribbean. Santiago: United Nations publication.
Bayburt, B. (2022). Kriz döneminde güven duygusu: COVID-19 pandemisi örneği. Oğuzhan Sosual Bilimler Dergisi, 4 (1), 16-30.
Beller, J., Schäfers, J., Haier, J., Geyer, S. ve Epping, J. (2022). “Trust in Healthcare during COVID-19 in Europe: vulnerable groups trust the least”. Journal of Public Health, 1-10. https://doi.org/10.1007/s10389-022-01705-3.
Büssing, A., Recchia, D. R., Hübner, J., Walter, S., Büntzel, J., Büntzel, J. (2021). “Tumor patients’ fears and worries and perceived changes of specific attitudes, perceptions and behaviors due to the COVID-19 pandemic are still relevant”. Journal of Cancer Research and Clinical Oncology, 147 (6), 1673–1683. https://doi.org/ 10.1007/s00432-021-03573-y
Cado, V. (2020). “Positive patient experience in eye care during COVID19: A case from Eye Hospital Sistina Oftalmologija”. Journal of Patient Experience, 7, 103-111. https://doi.org/10.35680/2372-0247.1474.
Cado, V. (2022). “Trust as a factor for higher performance in healthcare: COVID 19, digitalization, and positive patient experiences”. IJQHC Communications, 2(2), 1-3. https://doi.org/10.1093/ijcoms/lyac011
Chan, H. F., Brumpton, M., Macintyre, A., Arapoc, J., Savage, D. A., Skali, A., Stadelmann, D. ve Torgler, B. (2020). “How confidence in health care systems affects mobility and compliance during the COVID-19 pandemic”. PLoS One, 15(10), e0240644. https://doi.org/10.1371/journal.pone.0240644.
Costa-Font, J. ve Vilaplana-Prieto, C. (2023). “Trusting the health system and COVID 19 restriction compliance”. Economics and Human Biology, 49, 101235. https://doi.org/10.1016/j.ehb.2023.101235.
Çaparlar, C. Ö. ve Dönmez, A. (2016). “What is scientific research and how can it be done?” Turkish Journal of Anaesthesiology and Reanimation, 44 (4), 212-218. https://doi.10.5152/TJAR.2016.34711.
Davey, L. (1990). “The application of case study evaluations”. Practical Assessment, Research, and Evaluation, 2 (9), 1-2. https://doi.org/10.7275/02g8-bb93.
Dinç, L., Korkmaz, F. ve Karabulut, E. (2013). “A validity and reliability study of the multidimensional trust in health-care systems scale in a Turkish patient population”. Social Indicators Research, 113 (1), 107-120. https://doi.org/10.1007/s11205-012-0084-y.
Egede, L. E. ve Ellis, C. (2008). “Development and testing of the multidimensional trust in health care systems scale”. Journal of General Internal Medicine, 23 (6), 808-815. https://doi.org/10.1007/s11606-008-0613-1.
Galasso, V., Pons, V., Profeta, P., Becher, M., Brouard, S. ve Foucault, M. (2020). “Gender differences in COVID-19 attitudes and behavior: Panel evidence from eight countries”. Proceedings of the National Academy of Sciences, 117 (44), 27285-27291. https://doi.org/10.1073/pnas.2012520117.
Gille, F., S. Smith. ve N. Mays. (2015). “Why public trust in health care systems matters and deserves greater research attention”. Journal of Health Services Research & Policy, 20 (1), 62-64. https://doi.org/10.1057/s41285-020-00129-x.
Gille, F., S. Smith. ve N. Mays. (2021). “What is public trust in the healthcare system? A new conceptual framework developed from qualitative data in England”. Social Theory & Health, 19, 1-20. https://doi.org/10.1057/s41285-020-00129-x.
Gilson, L. (2003). “Trust and the development of health care as a social institution”. Social Science and Medicine, 56 (7), 1453-1468. https://doi.org/10.1016/s0277-9536(02)00142-9.
Gopichandran, V. ve Chetlapalli, S.K. (2013). “Factors ınfluencing trust ın doctors: A community segmentation strategy for quality ımprovement in healthcare”. BMJ Open, 3 (12), e004115. https://doi.org/10.1136/bmjopen-2013-004115.
Güreşçi, M. (2020). “COVID-19 salgınında Türkiye’de kriz yönetimi iletişimi: T.C. Sağlık Bakanlığı”. Avrasya Sosyal ve Ekonomi Araştırmaları Dergisi (ASEAD), 7 (5), 53-65.
Harris, S. M. ve Sandal, G. M. (2021). “COVID-19 and psychological distress in Norway: the role of trust in the healthcare system”. Scandinavian Journal of Public Health, 49 (1), 96-103. https://doi.org/10.1177/1403494820971512.
Irmak, N. ve Duğan, Ö. (2022). “Kriz iletişiminde güven inşa etmenin rolü: COVID-19 pandemi sürecinde Sağlık Bakanlığı’nın açıklamaları üzerine bir araştırma”. Nosyon: Uluslararası Toplum ve Kültür Çalışmaları Dergisi, 9, 1-10.
Ivanyi, P., Park-Simon, T., Christiansen, H., Gutzmer, R., Vogel, A., Heuser, M., Golpon, H., Hillemanns, P. ve Haier, J. (2021). “Protective measures for patients with advanced cancer during the Sars-CoV-2 pandemic: quo vadis?” Clinical and Experimental Metastasis, 38 (3), 257-261. https://doi.org/10. 1007/s10585-021-10083-1
Karagöz, Y. (2014). SPSS 21.1 Uygulama Biyoistatistik. (1.basım). Ankara: Nobel Akademik Yayıncılık.
Kumbasar, A. (2016). Sağlık Politikaları. İstanbul Üniversitesi Açık ve Uzaktan Eğitim Fakültesi Yayınları: İstanbul.
Leibrecht, M. ve Scharler, J. (2020). “Trust dynamics after fnancial distress: evidence from euro member countries”. Applied Econonics Letter, 29 (2), 91-96. https://doi.org/10.1080/13504851.2020.1855308.
Lindholt, M. F., Jørgensen, F., Bor, A. ve Petersen, M. B. (2021). “Public acceptance of COVID-19 vaccines: cross-national evidence on levels and individual-level predictors using observational data”. BMJ Open, 11, e048172. https://doi.org/10.1136/bmjopen-2020-048172.
Masters, G. A., Asipenko, E., Bergman, A. L., Person, S. D., Brenckle, L., Moore Simas, T. A., Ko, J. Y., Robbins, C. L. ve Byatt, N. (2021). “Impact of the COVID-19 pandemic on mental health, access to care, and health disparities in the perinatal period”. Journal of Psychiatric Research, 137, 126-130. https://doi.org/10.1016/j.jpsychires.2021.02.056.
Mayer, R. C., Davis, J. H. ve Schoorman F. D. (1995). “An integrative model of organizational trust”. The Academy of Management Review, 20 (1), 709-734. https://doi.org/10.2307/258792.
McPake, B., Normand, C., Smith, S. ve Nolan, A. (2020). Health Economics: An International Perspective (4th Ed). Londan and New York: Routledge.
Stewart, C. (May 12, 2020). How much do you trust the health authorities handling the new coronavirus outbreak? https://www.statista.com/statistics/1105056/levels-of-trust-in-the-health-authorities-handling-covid-19-in-norway/ (10.05.2023).
O’Hara, L., Rahim, H. F. A. ve Shi, Z. (2020). “Gender and trust in government modify the association between mental health and stringency of social distancing related public health measures to reduce COVID-19: a global online survey”. MedRxiv, 2020.07.16.20155200. https://doi.org/10.1101/2020.07.16.20155200.
Ozawa, S. ve Sripad, P. (2013). “How do you measure trust in the health system? A systematic review of the literatüre”. Social Science and Medicine, 91, 10-14. https://dx.doi.org/10.1016/j.socscimed.2013.05.005.
Ren, L.L., Wang, Y.M., Wu, Z.Q., Xiang, Z.C., Guo, L., Xu, T., Jiang, Y.Z., Xiong, Y., Li, Y.J., Li, X.W., Li, H., Fan, G.H., Gu, X.Y., Xiao, Y., Gao, H., Xu, J.Y., Yang, F., Wang, X.M., Wu, C., Chen, L., Liu, Y.W., Liu, B., Yang, J., Wang, X.R., Dong, J., Li, L., Huang, C.L., Zhao, J.P., Hu, Y., Cheng, Z.S., Liu, L.L., Qian, Z.H., Qin, C., Jin, Q., Cao, B. & Wang, J.W. (2020). “Identification of a Novel Coronavirus causing severe pneumonia in human: A descriptive study”. Chinese Medical Journal, 133 (9), 1015-1024. https://dx.doi.org/10.1097/CM9.0000000000000722.
Sağlık Bakanlığı. (2020). Genel Koronavirüs Tablosu. https://covid19.saglik.gov.tr/TR-66935/genel-koronavirus-tablosu.html (08.05.2023).
Sağlık Bakanlığı. (2023). COVID-19 Bilgilendirme Platformu. https://covid19.saglik.gov.tr/ (08.05.2023).
Samlani, Z., Lemfadli, Y., Errami, A.A., Oubaha, S. ve Krati, K. (2020). “The impact of the COVID-19 pandemic on quality of life and well-being in Morocco”. Archives of Community Medicine and Public Health, 6 (2), 130-134. : https://dx.doi.org/10.17352/2455-5479.000091.
Shah, A., Pereira, P. ve Tuma, P. (2021). “Quality Improvement at Times of Crisis”. BMJ, 373, n928. https://doi.org/10.1136/bmj.n928.
Sloan, M,. Gordon, C., Harwood, R., Lever, E., Wincup, C., Bosley, M., Brimicombe, J., Pilling, M., Sutton, S., Holloway, L. ve D'Cruz, D. (2021). “The impact of the COVID-19 pandemic on the medical care and health-care behaviour of patients with lupus and other systemic autoimmune diseases: a mixed methods longitudinal study”. Rheumatology Advances Practice, 5 (1), 1-29. https://doi.org/10.1093/rap/rkaa072.
Şirin, H. ve Özkan, S. (2020). “Dünyada ve Türkiye’de COVID-19 epidemiyolojisi”. KBB ve BBC Dergisi, 28, 6-13.
Tabachnick, B. G. ve Fidell, L. S. (2000). Using Multivariate Statistics. (4th ed.). Needham Heights, MA: Allyn & Bacon.
Türk Dil Kurumu Sözlüğü. Güven. https://sozluk.gov.tr/(10.05.2023).
Türkiye Cumhuriyeti Cumhurbaşkanlığı Strateji ve Bütçe Başkanlığı. (2019). 100.Yıl Türkiye Planı. On Birinci Kalkınma Planı (2019-2023).
Udow-Phillips, M. ve Lantz, P. M. (2020). “Trust in public health is essential amid the COVID-19 pandemic”. Journal of Hospital Medicine, 15 (7), 431–433. https:// doi.org/10.12788/jhm.3474.
Usta, D. (2016). Hastaların Sağlık Bakım Sistemlerine Duydukları Güven. Yüksek Lisans Tezi, Hacettepe Üniversitesi, Sağlık Bilimleri Enstitüsü, Ankara.
Van Der Schee, E. (2016). Public Trust in Health Care: Exploring The Mechanisms. NIVEL: Utrecht.
Vinck, P., Pham, P. N., Bindu, K. K., Bedford, J. ve Nilles, E. (2019) “Institutional trust and misinformation in the response to the 2018–19 Ebola outbreak in North Kivu, DR Congo: a population-based survey”. The Lancet Infectious Diseases, 19 (5), 529–536. https://doi.org/10.1016/S1473-3099(19)30063-5.
World Health Organization. (‎2007)‎. Everybody's business-strengthening health systems to improve health outcomes: WHO's framework for action. World Health Organization. https://apps.who.int/iris/handle/10665/43918.
Wong, M. C. S., Wong, E. L. Y., Huang, J., Cheung, A. W. L., Law, K., Chong, M. K. C., Ng, R. W. Y., Lai,. C. K. C., Boon, S. S., Lau, J. T. F., Chen, Z. ve Chan, P. K. S. (2021). “Acceptance of the COVID-19 vaccine based on the health belief model: a population-based survey in Hong Kong”. Vaccine, 39 (7), 1148-1156. https://doi.org/10.1016/j.vaccine.2020.12.083.
Yazıcıoğlu, Y. ve Erdoğan, S. (2004). SPSS Uygulamalı Bilimsel Araştırma Yöntemleri (4.Baskı). Ankara: Detay Yayıncılık.
Yeşiloğlu, H.H. (2020). Sağlık Hizmetleri ve Hemşirelik Bakımına İlişkin Güven. Yüksek Lisans Tezi, Karabük Üniversitesi, Lisansüstü Eğitim Enstitüsü, Karabük.