Duygu AYHAN BAŞER, Raziye Şule GÜMÜŞTAKIM, Murat ÇEVİK, Ekrem BASARA

COVID-19 Pandemisinin İkinci Dalga Sırasında Aile Hekimliği Klinik Uygulamalarına Etkisi

Giriş/Amaç: Pandemi gibi olağanüstü sağlık durumlarında birinci basamak sağlık hizmetlerinde mevzuat ve çeşitli uygulamalarda sürecin getirdiği çeşitli değişiklikler olduğu görülmektedir. Bu çalışmada, COVID-19 pandemisinin Türkiye'deki aile hekimlerinin bazı klinik uygulamalarına etkilerinin belirlenmesi amaçlanmıştır. Yöntem: Tanımlayıcı tipteki araştırma, 15 Şubat 2021-1 Nisan 2021 tarihleri arasında aile sağlığı merkezlerinde aktif olarak görev yapan aile hekimlerine uygulandı. Evreni, aile sağlığı merkezlerinde aktif olarak görev yapan aile hekimleri oluşturdu. Hekimlere spesifik takipler ve bazı klinik uygulamalarda yaptıkları değişiklikler, başvuru sayısındaki değişiklikler ve bu konuda yaptıkları düzenlemeler online anket soruları ile sorulmuştur. Bulgular: Çalışmaya 912 kişi katıldı. %59,9'u erkekti, %60,2'si 10 yıldan uzun süredir aile hekimliği yapıyordu. %63,9'unda PCR testi, %26,8'inde antikor testi vardı. %16,1'ine COVID-19 teşhisi kondu. Bunların %84'ü pandemi süresince her gün Aile Sağlığı Merkezi'ne (ASM) gitti. Katılımcıların %48,2'si triyaj yaparken, %53,6'sı başvuru sayısının azaldığını belirtti. %65,2'si gebe-bebek-çocuk takiplerini pandemi öncesinde olduğu gibi COVID-19 pandemisi sırasında, %24,7'si randevu ile gerçekleştirmiştir. %54,3'ü ASM düzeninde ve koşullarında değişiklik yaptı. %50,2'si COVID-19 döneminde kronik hastalık takibi yapmadığını, %59,2'si ise sayısında azalma olduğunu belirtti. %66,7'si çocukluk aşılarını pandemi öncesinde olduğu gibi COVID-19 salgını sırasında yaptırmış, %24,7'si randevu ile yaptırmış, %73,6'sı için başvuru sayısı değişmemiştir. Pandemi öncesinde olduğu gibi COVID-19 pandemisinde de %63,6'sı erişkin aşılarını yaptırırken, başvuru sayısı %58,2 arttı ve %73'ü bireyleri teşvik ediyordu. Genel sağlık durum raporu (sürücü ehliyeti, akli ehliyet, iş güvenliği vb.) için gelenlerin sayısı %53 değişmeyerek %23,6 arttı. Sonuç: Pandemi dönemi aile hekimliği klinik uygulamalarında ciddi değişikliklere neden olmuş; aile hekimleri bu dönemde mevcut işlerini yürütmek için çeşitli düzenlemeler yapmışlar ve bu durumu topluma aktarmak için çaba sarf etmişlerdir.

Anahtar Kelimeler:

Covid-19 Pandemic, Family Physicians, Clinical Practices

Impact of COVID-19 Pandemic on Family Medicine Clinical Practices During the Second Wave

Background/Aims: It is seen that there are various changes brought by the process within the legislation and in various practices in primary health care services in extraordinary health situations such as pandemics. In this study, it was aimed to determine the effects of the COVID-19 pandemic on some clinical practices of family physicians in Turkey. Methods: The descriptive study was applied to family physicians working actively in family health centers between February 15, 2021 and April 1, 2021. Family physicians working actively in family health centers formed the universe. Physicians were asked through online-survey questions regarding specific follow-ups and changes they made in some clinical practices, the changes in the number of applications, and the arrangements they made in this regard. Results: 912 people participated in the study. 59.9% were male, 60.2% had been practicing family medicine for more than 10 years. 63.9% had PCR test and 26.8% had antibody test. 16.1% were diagnosed with COVID-19. 84% of them went to Family Health Center (FHC) every day during the pandemic. While 48.2% of them were doing triage, 53.6% of the participants stated that the number of applications decreased. 65.2% of them did their pregnant-baby-child follow-ups during the COVID-19 pandemic as before the pandemic, 24.7% carried out by appointment. 54.3% made a change in the FHC layout and terms. 50.2% stated that they did not follow up on chronic diseases during the COVID-19 period, 59.2% stated that there was a decrease in the number. 66.7% of them made their childhood vaccinations during the COVID-19 pandemic as before the pandemic, 24.7% carried out by appointment, and the number of applications for 73.6% did not change. 63.6% of them made adult vaccines during the COVID-19 pandemic as before the pandemic, the number of applications increased by 58.2%, and 73% were encouraging individuals. The number of those who came for general health status reports (driver's license, mental ability, job security, etc.) did not change by 53%, but increased by 23.6%. Conclusion: The pandemic period has caused serious changes in family medicine clinical practices; family physicians have made various arrangements to carry out their current work in this period and have made an effort to convey this situation to the public.

Keywords:

Covid-19 Pandemic, Family Physicians, Clinical Practices,

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