Family Health Centers Research Articles

Prevalence of Female Genital Mutilation in Northern Upper Egypt

Background: The utilization of the word “mutilation” reinforces the very fact that the practice may be a serious violation of girls' and women's rights. This term also establishes a transparent distinction from male circumcision and emphasizes the gravity and harmfulness of the act. Although FGM is practiced in some communities within the belief that it's a religious requirement, research shows that FGM predates Islam and Christianity. Aim: the study was conducted to assess Prevalence of Female Genital Mutilation in Northern Upper Egypt. Subject & Methods: A descriptive cross-sectional study was used. The study population consisted of 2837 females in family health centers (FHCs) in different sitting at Beni-Suef. Α Structured Interviewing Questionnaire sheet was used to collect data. Results: Most of the studied participants were rural residents (70.4%). Non-mutilated females constituted 28.6% of the studied females. About 81.3% and 44.5% of circumcised females are from rural and married females. There was a significant association between the illiteracy of father and mother and rural residence and the FGM by barber and dayah. Conclusion: The prevalence of FGM/C is still high despite the health consequences of the procedure. Recommendations: Design and disseminate brochures work on the health effect of female genital mutilation in health centers and hospitals.

Relationship between Females' Knowledge and Attitude and Intention of Female Genital Mutilation

Background: The terms female genital cutting (FGC) and female genital mutilation/cutting (FGM/C) are often used among practicing communities and individuals. These concepts emphasize the significance of adopting nonjudgmental vocabulary when working with practitioners. When discussing the matter in practice communities, terms like excision or genital cutting are also acceptable. Aim: The present study was carried find to estimate relationship between level of knowledge, attitude and intentions of females toward the practice of FGM. Subject & Methods: Descriptive Cross-sectional study carried out in family health centers (FHCs) in different sitting at Beni-Suef Governorate on a convenient sample. Structured Interviewing Questionnaire sheet which includes three sections: (I): Females' Knowledge of females regarding FGM/C, (II): Attitudes of females regarding FGM/C. (III): Intention to practice FGM/C. Results: About 76.9% of females know that FGM/C practice is illegal and 61.7% did not know that there is a punishment for parents seeking FGM/C, and 70.4% did not know that prison is the type of punishment for parents in Egyptian law. Only 25.7% of females had good knowledge regarding FGM/C, 35.5% had an unfavorable attitude towards. About 79.4% of females who experienced FGM/C had the intention to mutilate their daughters in the future. Almost all females with unfavorable attitudes towards FGM/C (78.7%) had the intention to practice FGM/C in the future, followed by 17.6% of females with neutral attitudes and only 3.7% of females with a favorable attitude. Conclusion: The highest proportion of females did not know that there is a punishment for parents seeking FGM/C, and most of them did not know that prison is the type of punishment for parents in Egyptian law and did not know that there is a punishment for physicians performing FGM/C in Egyptian law as well. The proportion of females who had the intention to practice FGM/C increased with the decrease in the level of knowledge. Recommendations: Enhancement of females' knowledge and negative attitude toward Female Genital Mutilation should be established by educational programs.

Perceived Stress and Hopelessness in COVID-19 Contacts

Aim: We aimed to determine the perceived stress and hopelessness levels in COVID-19 patient contacts.Materials and Methods: The study included all COVID-19 contacts who presented to a family health center in Niğde, Turkey between August and October 2020. The data were collected from contacts who were reached daily for a period of 14 days using the Beck Hopelessness Scale (BHS) and the Perceived Stress Scale (PSS). The data were analyzed using the SPSS package program, and p<0.05 was considered significant. Results: While 55.8% of the participants were female, 71% were married, and 46.9% had a chronic disease. The mean age of the participants was 53.44 years. Their mean BHS and PSS scores were 4.40±3.33 and 25.07±5.98, respectively. A statistically significant relationship was found between the participants’ places of residence and occupations and their mean BHS loss of motivation subscale scores (p<0.05). Among the participants, homemakers, those living in districts, towns, or villages, and those with chronic diseases had significantly higher PSS total scale and.stress-distress subscale mean scores than the others. A statistically significant positive correlation was found between the ages of the participants and their PSS total scale and stress-distress subscale scores (p<0.05). Conclusion: Although the hopelessness levels of the participants were found low, their stress levels were determined to be high, and most of them thought the pandemic was exaggerated. Due to the psychological consequences of the COVID-19 pandemic such as shock, denial, anxiety, worry, and stress in people, it is important to strengthen crisis and stress management efforts and increase awareness, coping and social support resources by prioritizing high-risk groups such as healthcare workers, women, the elderly, those with chronic diseases, and COVID-19 contacts.

Does family medicine reduce household health expenditures: evidence from Türkiye.

Türkiye introduced a family medicine-centered primary healthcare model in 2005 as part of the Health Transformation Program, which aimed to reduce household healthcare expenditures, improve access to health services, and reduce the crowding-out effect in first-stage hospital institutions. We investigate the impact of the family medicine program on household healthcare expenditures in Türkiye, focusing on doctor visits, medication prescriptions, and hospitalization expenditures. Using data from a large representative household survey, we employ a difference-in-differences approach combined with the entropy-balancing matching technique. Our robust findings show that living in a province exposed to the family medicine program reduced household doctor visit expenditures by over 40 percent. We also find a significant negative association between the family medicine program and expenditures regarding doctor visits and medication prescriptions in the long run. Greater efforts are now needed to ensure the quality of services offered by family health centers, such as improving the doctor-to-patient ratio.

Breast Milk and Breastfeeding Knowledge among Reproductive-Age Women at a Family Health Center

Breast Milk and Breastfeeding Knowledge among Reproductive-Age Women at a Family Health Center

CARE PRACTICES AND CHALLENGES EXPERIENCED BY PUBLIC HEALTH NURSES DURING ACUTE AND CHRONIC PANDEMIC PERIOD

Aim: This study aimed to determine the challenges experienced by Public Health Nurses (PHN) in delivering care to society during the acute and chronic periods of the pandemic and different care application methods. Method: This qualitative and descriptive study was conducted between January and February 2022. Phenomenological approach was used as a qualitative research method. The sample of the study consisted of 21 public health nurses working in family health centers. Data were obtained with a semi-structured interview form and descriptive information form containing sociodemographic characteristics. The interviews were recorded. Malterud's analysis method used in qualitative data analysis. Results: Four main themes were identified as "psychosocial situation, measures/precautions, difficulties, and solution methods" regarding care practices and challenges experienced by PHN during acute and chronic periods of a pandemic. Thirteen sub-themes under these main themes were differentiated according to acute and chronic periods. The mean age, and duration of working of PHNs participating in the study was 37.8 and 16.3 years, respectively. Conclusion: PHNs were negatively affected psychologically due to prejudices, fears, and uncertainty during the acute period of the pandemic, and in the chronic period, they faced aggressive, impatient, and anti-vax attitudes of the public. While during the acute period, telephone monitoring, telemedicine management, and difficulties in persuading the public were at the forefront of care practices, education, guidance, and counseling services for long-term health problems of people became a priority in the chronic period.

The Effect of Breastfeeding Education in a Family Health Center on Breastfeeding Attitudes and Behavior

The Effect of Breastfeeding Education in a Family Health Center on Breastfeeding Attitudes and Behavior

Periodic Eye Examinations and Health Literacy Among Type 2 Diabetes Mellitus Patients

Aim: The aim of this study was to investigate the relationship of periodic eye examinations with health literacy in Diabetes Mellitus (DM) patients. Methods: A cross-sectional study was designed. Patients with a diagnosis of DM registered at the Family Health Center were invited to participate. Of the 198 registered DM patients, 101 agreed to participate in the study (response rate: 51%). Sociodemographic characteristics and physical examination findings of the patients were recorded. Their knowledge about diabetes follow-up was questioned. The patients were asked the Newest Vital Sign (NVS) and European Health Literacy Survey Questionnaire Short Form (HLS-EU-Q16) questions and the answers were recorded. Results: HLS-EU-Q16 showed a significant difference with the eye examination of patients with DM (p=0.041). The NVS scale showed a significant difference with DM control (p=0.032), DM diet (p=0.008), and eye examination (p=0.002). And, NVS also showed a significant difference with eye examination (p=0.015) in the last 1 year. Conclusions: Participation in the study was limited. According to the NVS results from the health literacy scales, the condition of DM patients having disease control and eye check-ups was positively associated with health literacy. We think that improving health literacy of DM patients may have a positive effect on disease control and prevention of complications.

Expanded Family Health Center: an analysis based on fundamental teamwork concepts and attributes.

Primary Care work is based on sharing and meeting various knowledge to achieve comprehensiveness. In this rationale, the Extended Family Health and Primary Care Center (NASF-AB) acts as a strategy for teamwork. We aimed to investigate the NASF-AB work process from the fundamental teamwork concepts and attributes. This evaluative, qualitative study was developed from 2018 to 2020, observing the NASF-AB and family health teamwork process, and focus groups with 43 professionals from both teams. Our analysis considered NASF-AB theoretical, methodological, and operational concepts. The results refer to a work attentive to the particularities of the territory aligned with health responsibility, besides recognizing NASF-AB support in clients' autonomy by establishing a bond.

TRIZ approach to the relevant problem for the transport of assay tubes: A case study on family health centers in Amasya

TRIZ approach to the relevant problem for the transport of assay tubes: A case study on family health centers in Amasya

Kırsalda Yaşayan Yaşlılarda Polifarmasi Yaygınlığı: Kesitsel Bir Çalışma

Objective: This study aimed to determine the prevalence of polypharmacy and its associated factors in older adults living in rural areas. Material and Methods: This cross-sectional study included a total of 585 older adults aged ≥65 years living in a town in western Türkiye. Data were collected through face-to-face interviews at family health centers using a questionnaire prepared by the authors in line with the literature. The data collected for the research were analyzed using the SPSS for Windows 25.0. Descriptive statistical methods were used to evaluate data. In addition, a logistic regression analysis was performed to identify the influential factors in the presence of polypharmacy. The results were evaluated at a significance level of p<0.05. Results: The prevalence of polypharmacy was 24.1%. In addition, 51.6%, 52.1%, and 12.1% older adults used at least one over-thecounter drug, herbal medicines along with prescribed medications, and alternative treatment methods, respectively. However, older patients with four or more chronic diseases were exposed to polypharmacy approximately nine times (95% confidence interval 3.02-26.75) more than those with 1-3 chronic diseases. Conclusion: Approximately one-quarter of the older adults had polypharmacy, which was affected by multiple variables. The older adults should be evaluated for prescription and non-prescription drug use, and the rational drug use education should be provided.

Quality of life and psychosocial risks in primary care workers in an urban area.

Health workers are exposed to a wide variety of risks in their workplaces, including psychosocial risks, which are increasingly taking on special importance, with primary health care being little studied in this area, despite having taken great responsibilities in the COVID-19 pandemic. To analyze the relationship between psychosocial risks and quality of life in health team workers in Family Health Centers Antofagasta, Chile, in 2021, in the context of the COVID-19 pandemic. This was a quantitative study, analytical, descriptive, cross-sectional type with 78 workers from the Primary Care health team of three Family Health Centers in the city of Antofagasta. The Superintendência de Seguridad Social/Instituto Sindical de Trabajo, Ambiente y Salud 21 brief version and the World Health Organization Quality of Life instrument-Abbreviated version instrument were applied. The presence of a globally high psychosocial risk stands out, being this classified as high risk/level 1. The professional groups with the highest risks were nursing technicians and nurses; regarding quality of life, the dimension with the lowest score was psychological health, with a mean of 73.6. A negative relationship between psychosocial risks in the workplace and workers' quality of life was evidenced In this hostile scenario, it is imperative that nurses, at a tactical and strategic level, promote workers' health, cultivate healthy work environments, promote labor relations, and exercise more empathetic leadership as care managers.

Urinary Incontinence in Turkish Women: A Qualitative Study on Daily Life and Sexual Health.

The study was performed to determine how urinary incontinence (UI) affects women's daily lives and sexual health and how UI is perceived. Qualitative descriptive phenomenological design was used. The study was conducted in a family health center in Konya, Turkey, with official permission of the ministry of health. Study participants comprised 101 women with UI, but data from 12 women were excluded because they refused to respond to questions; therefore, data analysis is based on responses from 89 respondents. Data were compiled via in-depth interviews using a semistructured questionnaire. Data collection and analysis processes were carried out simultaneously. Study data were examined using phenomenological content and thematic analyses. Document portraits and a code map of data were created using qualitative data analysis software. Participants' mean age was 46.25 (SD: 11.68) years. Thirty-three codes were identified to detect the effects of UI on women's daily lives. These codes were reviewed and combined into 5 main themes: religious issues, sexual problems, feeling restricted, psychological exposure, and internalization. Urinary incontinence causes women to experience environmental, psychological, and religious challenges during daily life. Healthcare professionals should give counsel and assistance by determining the issues for women with UI to promote coping with problems and offer referral for specialist care when necessary.

THE EFFECT OF MALE CONDOM AND WITHDRAWAL METHODS ON WOMAN’S SEXUAL LIFE

Aim: The aim of the study is to determine the effect of male condom and withdrawal method on women's sexual life. Method: A cross-sectional and analytical study was conducted among married women aged 15-49 who were protected by condom and withdrawal method in Family Health Centers (FHCs) No. 2 and 12 in Aydın city center (N= 518, C: 58.1%, WD: % 41.8). Data were collected in women's homes by self-reporting method using the Data Collection Form and the Female Sexual Function Index (FSFI). Descriptive statistics, Chi-Square, Mann Whitney U, Kruskall Wallis H and multiple regression analysis were used to evaluate the data, and p&lt;0.05 was considered as significant. Results: Among women with an average age of 34.97±6.49, the rate of those receiving method-specific counseling was lower for withdrwal method (13.4% vs 23.3%, p&lt;0.05). Satisfaction and sexual desire are higher in those who use withdrawal, and the perception of a good sexual life is higher in those who use condoms (p&lt;0.05). 38% of the participants have a FSFI score of 29.78±5.73. Sexual dysfunction is 35.9% for condom and 41% for withdrawal. With condom, there is less sexual dysfunction in dimensions other than sexual satisfaction (p&lt;0.05). The number of times a week one had sexual intercourse, the method used and the woman's sexual evaluation of herself have a positive effect on her sexual functions, while having problems with sexual life and the duration of using the method have a negative effect. These variables explain 20.1% of female sexual disfunction, and the currently used method explains 1.1% (p&lt;0.05). Conclusion: Male condom and withdrawal method affect women's sexual life and sexual dysfunction increases with withdrawal method. For this reason, awareness training should be organized for couples about the effects of male contraceptives on sexual life, family planning services should include sexual counseling, and its continuity should be ensured by starting before marriage.

Núcleo Ampliado de Saúde da Família: análise a partir dos conceitos fundamentais e atributos do trabalho em equipe

Abstract Primary Care work is based on sharing and meeting various knowledge to achieve comprehensiveness. In this rationale, the Extended Family Health and Primary Care Center (NASF-AB) acts as a strategy for teamwork. We aimed to investigate the NASF-AB work process from the fundamental teamwork concepts and attributes. This evaluative, qualitative study was developed from 2018 to 2020, observing the NASF-AB and family health teamwork process, and focus groups with 43 professionals from both teams. Our analysis considered NASF-AB theoretical, methodological, and operational concepts. The results refer to a work attentive to the particularities of the territory aligned with health responsibility, besides recognizing NASF-AB support in clients’ autonomy by establishing a bond.

The Level of Knowledge, Behaviors, and Attitudes on Rational Use of Drugs of Patients Who Applied to the Family Health Center in Istanbul, T&amp;#252;rkiye: A Cross-Sectional Study

The Level of Knowledge, Behaviors, and Attitudes on Rational Use of Drugs of Patients Who Applied to the Family Health Center in Istanbul, T&amp;#252;rkiye: A Cross-Sectional Study

The Experience of Establishing a Family Health Center without Population and Service Building: A Qualitative Study

The Experience of Establishing a Family Health Center without Population and Service Building: A Qualitative Study

Patient satisfaction and health system responsiveness among attendants to family health centres and units affiliated with universal health insurance in Port Said Governorate

Patient satisfaction and health system responsiveness among attendants to family health centres and units affiliated with universal health insurance in Port Said Governorate

Effectiveness of the ChAdOx1 nCoV-19 Vaccine against Laboratory-confirmed Cases of COVID-19: A Test-negative Case-control Study from Central Kerala, India

Introduction: The COVID-19 pandemic continues to impact livelihoods worldwide, and in the absence of specific antivirals, the vaccine remains the main weapon against it. Assessing the effectiveness of vaccines against Coronovirus Disease 2019 (COVID-19) in practice is crucial as COVID-19 variants continue to emerge, and public health decisions must be supported by scientific risk-benefit considerations. Aim: To determine the Vaccine Effectiveness (VE) of two doses of the ChAdOx1 nCoV-19 (Covishield) vaccine in preventing laboratory-confirmed COVID-19. Materials and Methods: A test negative case control design was used to determine the VE in total of 702 individuals which included 351 laboratory confirmed cases using Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) and 351 controls who tested negative among those who attended the testing sites of the Urban Family Health Centre of Government Medical College Kottayam, Kerala, India from July 2021 to September 2021. Details regarding vaccination status, sociodemographic factors, symptoms, and co-morbidities were collected from consented and eligible participants. The collected information was entered into a proforma, which was later entered into MS Excel and analysed using R software version 4.1.3. The groups were compared using binary logistic regression to calculate the adjusted Odds Ratio (aOR) with adjustment for gender, age group, education, occupation, presence of symptoms, and comorbidity status. VE% was calculated as 100 * (1-aOR). Results: The median age (interquartile range) of cases and control was 44 (33-57) years and 50 (35-60) years, respectively. The VE of two doses of the ChAdOx1 nCoV-19 vaccine in protecting against laboratory-confirmed COVID-19 was 87% (95% CI 78-92), with an aOR of 0.13. A separate analysis was conducted to determine the VE among symptomatic individuals, which showed a VE of 89% (95% CI 79-94), with an aOR of 0.11. Conclusion: Two doses of the ChAdOx1 nCoV-19 vaccine are protective against laboratory-confirmed cases of COVID-19.

Burnout in primary healthcare physicians and nurses in Turkey during COVID-19 pandemic.

Due to additional responsibilities and uncertainties during the COVID-19 pandemic, primary healthcare (PHC) workers are at increased risk of burnout. To determine and compare the burnout levels and related factors in PHC nurses and family physicians (FPs) during the COVID-19 pandemic. An online survey was delivered to PHC workers. Non-random sampling method was used. To evaluate burnout, the Maslach Burnout Inventory was used, which investigates burnout in three categories: emotional exhaustion (EE), depersonalization (DP) and reduced personal accomplishment (PA). Multivariate linear regression was used to analyze factors associated with burnout for FPs and nurses separately. Among the participants, 55.7% were nurses, the mean age was 42.34. FPs and nurses experienced similar levels of burnout in terms of EE. Family physicians had higher levels of low PA and DP. Based on the results of the multivariate analysis, while higher EE levels were significantly associated with unequal distribution of workload and communication problems within the Family Health Center for physicians, the unequal distribution of PPE, lack of appreciation by patients or colleagues and restrictions on work-related rights were relevant factors for nurses. Lack of appreciation and restrictions of the rights were associated with increased DP scores in both groups. Unequal distribution of workload was also associated with reduced PA among FPs. PHC physicians and nurses are affected by burnout in different ways under the conditions of the COVID-19 pandemic based on gender, socioeconomic status and working conditions. To protect the mental health of PHC workers in the next public health emergency, clarification in the organization of services, empowering PHC workers in emergency risk communication and provision of timely, adequate and free PPE is essential. It is also crucial to ensure the rights of health workers through macro policy changes especially during emergencies.