Family Health Centers Research Articles

A critique of the policy discourse on Primary Health Care Aardram Mission of Kerala.

In 2017, the State of Kerala in India, launched the 'Aardram' mission for health. One of the aims of the mission was to enhance the Primary Health Care (PHC) provisioning in the state through the Family Health Centre (FHC) initiative. This was envisaged through a Comprehensive PHC approach that prioritized preventive, promotive, curative, rehabilitative and palliative services, and social determinants of health. Given this backdrop, the study aimed to examine the renewed policy commitment towards comprehensive PHC and the extent to which it remains true to the globally accepted ideals of PHC. This was undertaken using a Critical Discourse Analysis (CDA) of the policy discourse on PHC. This included examining the policy documents related to FHC and Aardram as well as the narratives of policy-level actors on PHC and innovations for them. Through CDA we examined the discursive representation of PHC and innovations for improving them at the level of local governments in the state. Though the mission envisaged a shift from the influence of market-driven ideas of health, the analysis of the current policy discourse on primary healthcare suggested otherwise. The discourse continues to carry a curative care bias within its ideas of PHC. The disproportionate emphasis on strategies for early detection, treatment and infrastructural improvements meant limited space for dimensions like preventive, protective and promotive, thus digressing from the gatekeeping role of PHC. The subdued emphasis on preventive and promotive dimensions and depoliticization of social determinants of health within a PHC discourse indicates that, in the long run, the mission stands to risk its stated goals of social justice and health equity envisioned in the FHC initiative.

"Psychological Injuries Are Not Visible": Experiences and Perceptions of Midwives and Nurses about Domestic Violence during Pregnancy.

This study aimed to describe perceptions and experiences of nurses and midwives working in primary care about domestic violence (DV) in pregnancy. Data were collected by conducting in-depth face-to-face interviews with 10 midwives and 7 nurses working in seven family health centers between July 17 and August 28, 2020. Five main themes emerged: "The causes of domestic violence," "Difficulty recognizing domestic violence," "Obstacles to revealing domestic violence," "Obstacles to Assisting/Supporting domestic violence in pregnant women," and "Solutions to prevent domestic violence in pregnancy." Midwives/nurses feel inadequate and unprepared to recognize the symptoms of DV and to guide and support women and they are willing to take an active role in managing DV. It is recommended that they should be trained on DV, a monitoring system should be established including primary healthcare services and a measurement tool should be developed.

The Relationship Between Chronic Diseases and Healthy Lifestyle Behaviors of Individuals 65 Years and Older

Aim: This study is designed to examine the differences in health habits among individuals aged 65 and over, based on chronic diseases. Method: All individuals aged 65 and over registered to Unit 13 of Gazikent Family Health Center No. 3 in Gaziemir, Izmir constitute the study group. There were 300 eligible individuals and three of them rejected to participate and the study was completed with 297 participants. Data were collected with Questionnaire Form and Healthy Lifestyle Scale (HLSS). Data were analyzed with Variance analysis, Student t test, Mann-Whitney U test and Kruskall Wallis analysis. Results: The average age of the elderly is 71.9 ± 6.5 (65-94) and 84.2% of them had at least one chronic disease (CD). Mean total HLSS score was 141 ± 20. The lowest mean score was obtained from the physical activity subgroup. HLS general and subgroup mean scores of those with CD were significantly lower (p<0.05). A significant difference was found between mean scores of HLSS and habits, socio-demographic and clinical characteristics (p <0.05). Conclusion: In this study, it was determined that CD is quite common among the elderly and this group has difficulties in maintaining healthy lifestyle.

Prevalence of Burnout Syndrome among Working Physicians in Family Health Centres and Units in Port Said Governorate

Background: The classic symptoms of the syndrome of burnout as described by Maslach et al. are emotional exhaustion, depersonalization, and inefficacy. Prolonged exposure to stress is usually the main cause of emotional exhaustion and it manifests through the loss of enthusiasm for work, feeling helpless, trapped, and defeated. Depersonalization occurs when physicians treat patients indifferently, objectify them, and develop a negative attitude toward their colleagues and profession. Inefficiency, or the lack of a sense of personal achievement, is characterized by the individual’s withdrawal from responsibilities and detachment from the job. 
 Aim: To assess burnout prevalence among physicians of primary health care centers and units in Port Said.
 Subjects and Methods: A cross-sectional study was conducted with simple random sampling of physicians of primary care centers and units. Burnout was measured using the Maslach Burnout Inventory (MBI), a validated 22-item questionnaire considered the gold standard tool for measuring burnout.
 Results: In the current study on 155 physicians, the prevalence of burnout was 65.8% among the studied sample with 80%, 65.8%, and 80% of the subjects displayed high Emotional Exhaustion, Depersonalization, and low Personal Accomplishment, respectively. Female gender, urban setting of the practice, being married, unsatisfactory salary, sleeping hours 4-8 hours, and working in night shifts were all factors that significantly contributed to physicians’ burnout.
 Conclusion: In the current study, a high prevalence of burnout of 65.8% was found among the physicians in PHC centers and units. Gender, setting of the practice, marital status, salary, sleeping hours, and working in night shifts were all factors that significantly contributing to physicians’ burnout.

Noncommunicable Disease Service Utilization from the Upgraded Primary Care Centers: A Cross-Sectional Study from Kerala, India

ABSTRACT Introduction: World Health Organization recommends the integrated management of noncommunicable diseases (NCDs) in primary care. Hence, this study aimed to determine the NCD service utilization from an upgraded primary care center and to find the reasons for nonutilization. Materials and Methods: This community-based cross-sectional analytical study was conducted among 387 individuals aged 30 years and above in a selected upgraded primary care center. A validated semistructured questionnaire was used. A log-binomial regression was done, and adjusted prevalence ratios (aPR) were calculated. Results: The prevalence of utilization of NCD services from upgraded primary care center was 55.3% (95% confidence interval [CI] 50.2–60.3). The screening or treatment service utilization for hypertension, diabetes, and cardiovascular diseases was reported to be 54% (95% CI 48.9–59.1), 37.5% (95% CI 32.6–42.5), and 7.2% (95% CI 4.9–1.3), respectively. The reasons for the nonutilization of services were preference for the private sector (35.3%), distance to the facility (27.2%), and lack of awareness regarding the amenities at family health centers (11.3%). The younger age (aPR = 1.70, 95% CI 1.29–2.23, P = 0.033), unemployment (aPR = 1.46, 95% CI 1.01–2.10, P = 0.043), and social class (aPR = 1.62, 95% CI 1.16–2.26, P = 0.004) were significantly associated with NCD service nonutilization. The willingness to avail of NCD services among nonutilizers was 46.8% and salaried individuals had a high chance of unwillingness (aPR = 5.01, 95% CI 1.69–14.78, P = 0.003) compared to daily waged workers. Conclusion: Nearly half of the participants were not utilized upgraded primary care centers for NCD care. Strengthening outreach services and improving awareness among beneficiaries may improve the utilization in the community.

Changes in cancer screening process in primary care during the covid-19 pandemic.A record-based descriptive study

To reveal the number of cancer screenings in primary care during the pandemic period and whether there is a change in screening compared to the pre-pandemic period.This record-based descriptive study was carried out by evaluating the number of people who applied to family health centers or cancer early diagnosis, screening, and education center (KETEM) units for cancer screening (breast, cervical, and colorectal) for any reason. The study data were scanned between January 2017 and December 2020 and were obtained from the Gaziantep Provincial Health Directorate Cancer Branch.Breast cancer screening was the highest in December 2019 (n=2971), cervical cancer screening was the highest in October 2019 (n=4693), and colon cancer screening was the highest in September 2019 (n=2464). Breast cancer screening was the lowest in August 2020 (n=0), cervical cancer screening was the lowest in May 2020 (n=6), and colon cancer screening was the lowest in February and March 2018. Although the target populations and percentages in breast cancer, cervical cancer and colon cancer screenings increased with the following years, the screening populations and percentages decreased in 2020 compared to other years (percentages, 4.4%, 6.2%, 1.9%).For cancers that can be prevented by early diagnosis, it is of great importance to increase cancer screenings, which have decreased with the pandemic, to the required level.

Frailty and Polypharmacy in Primary Care.

The Clinical Frailty Scale (CFS) is a clinical judgement-based frailty tool developed from the Canadian Study of Health and Aging. Many studies on the measurement of frailty and its effect on clinical outcomes have been conducted on patients hospitalized, especially in intensive care units. The purpose of this study is to examine the relationship between polypharmacy and frailty on outpatient older adult patients in primary care. This cross-sectional study included 298 patients who were aged ≥65years and admitted to Yenimahalle Family Health Center between May-2022 and July-2022. Frailty was evaluated by using CFS. Polypharmacy was defined as five medications or more and "excessive polypharmacy" as 10 medications or more. The medications below five are grouped as "no polypharmacy". There was a statistically significance between age groups, gender, smoking status, marital status, polypharmacy status, and FS (p = .003 and η2: .20; p < .001 and Cohen d: .80; p = .018 and Cohen d: .35; p < .001 and Cohen d: 1.10 and p < .001 and η2: 1.45 respectively). A strong, positive correlation was found between polypharmacy and the frailty score. Polypharmacy, especially excessive polypharmacy, may be a promising adjunct to frailty in identifying older patients whose health is more likely to worsen. Providers in primary care should also consider frailty when prescribing drugs.

Evaluation of the frequency and awareness of obesity among healthcare workers.

The aim of this study is to determine the frequency of obesity in healthcare workers and to evaluate the awareness of obesity by using Obesity Awareness Scale. This descriptive frequency study was conducted between January 1 and March 31, 2021, in 17 Family Health Centers in the Health Training and Research Area. 119 health personnel working in Family Health Centers were included in the study. The Body Mass Index (BMI) classification accepted by the World Health Organization for adults was used to determine obesity. Obesity Awareness Scale adapted to the Turkish language was used to evaluate obesity awareness. The frequency of obesity among healthcare workers was 11.8% and overweight was 37.8%. 51.9% of physicians were overweight, 14.8% were obese; 38.5% of midwives were overweight, 15.4% were obese; 24.4% of the nurses were overweight and 9.8% were obese. The mean BMI of the participants was 18.00±0.52 for underweight, 22.65±1.35 for normal, 27.32±1.43 for overweight, and 31.53±1.68 for obese. The obesity awareness total score average of the participants was 63.97±7.47 (high level). According to the obesity awareness scale sub-dimension mean scores, obesity awareness was 28.7±3.9 (high), nutrition awareness was 20.0±3.1 (high), and physical activity was 15.3±1.8 (good). The frequency of obesity was found to be low, and the awareness of obesity was found to be high among HCWs in Family Health Centers. In addition, obesity was mostly detected in physicians, midwives, and nurses. Urgent act policies are needed to encourage both patients and HCWs to the awareness and prevention of obesity and to have a healthy lifestyle.

Relationship between people's hopeless, intolerance of uncertainty, and their attitude towards violence against women in Turkey.

The purpose of this research to determine the attitudes of individuals living in rural and urban areas on hopelessness, intolerance of uncertainty and violence against women. The research was carried out with 1112 individuals randomly selected from two family health centers determined by lot in a province located in the east of Turkey. This descriptive study utilized the Beck Hopelessness Scale, Intolerance of Uncertainty Scale, the ISKEBE Attitude Scale for Violence against Women. An independent groups t test and multiple regression were used in analysis of the data. It was found that the participants' level of hopelessness was moderate, the level of intolerance to uncertainty was above moderate, and attitudes towards violence against women were high. It was determined that hopelessness and intolerance to uncertainty significantly predicted the attitudes towards violence against women. It is recommended to conduct more research on violence against women, to bring violence against women to the agenda through the media, to give deterrent punishments to individuals when there is an action on the subject, and to provide education on violence against women starting from school age.

A Comparison Quality of Life of Children of Seasonal Agricultural Workers and Local Residents in Turkey

ABSTRACT Objectives Children of seasonal agricultural workers (SAW) live in the worst conditions of agricultural labor and, consequently, face many health risks. Therefore, it is essential to evaluate the quality of life (QoL) of these children. This study aimed to compare the QoL between children of SAW and local residents in semi-rural areas of Eskisehir, Turkey, and determine the factors affecting them. Methods In this cross-sectional study, we included children of SAW living in temporary camp areas and those of local residents visiting the Family Health Center close to the camp areas. Basic sociodemographic data collection forms and the Pediatric Quality of Life (PedsQL) scale were employed for data collection. Univariate and multivariate analyses were used to determine factors that had a significant effect on the QoL. Results We included 324 children of SAW and 256 local children. As per the multivariate analysis, QoL was lower in children aged between 8 and 12 years, with physician-diagnosed chronic diseases, and children of SAW. Also, there was no significant association between gender, parental education levels, family income, number of siblings, school attendance status, and QoL level. Conclusion The QoL of children of SAW families was significantly lower than their peer local children. Therefore, the appropriate authorities must prioritize the planning and implementation of health services for SAW families.

Improving Hepatitis B Screening at Family Health Centers Using Quality Improvement and Electronic Medical Record Tools.

Chronic hepatitis B viral (HBV) infection is associated with significant morbidity and mortality with endemic areas carrying most of the global burden of HBV disease. Current HBV screening rates in the United States are suboptimal. We aimed to improve HBV screening rates at regional family health centers serving high-risk refugee populations by 20% over 2 years. We used quality improvement (QI) methodology and implemented interventions providing electronic medical record (EMR)-enabled HBV screening tools within known clinical workflows. EMR tools captured country-of-origin data to identify persons from HBV-endemic regions with provision of a laboratory order set to ensure performance of appropriate HBV screening tests. The project was initiated prior to the COVID pandemic but continued during the pandemic with imposed social isolation measures. We nevertheless demonstrated 4 statistical process control chart shifts and achieved our QI smart aim. Further, we demonstrated a high HBV detection rate (8.2%-12.8%) among persons identified for screening.

Community mental health care network: an evaluative approach in a Brazilian state

In recent decades, public policies of the Unified Health System (SUS) in Brazil have structured a community mental health care network (RAPS) based on various community actions and services. This study carried out evaluative research on the implementation of the structure and process dimensions of this care network in Minas Gerais, the second most populous state of Brazil, generating indicators that can enhance the strategic management of the public health system in the strengthening the psychosocial care in the state. The application of a multidimensional instrument, previously validated (IMAI-RAPS), in 795 of the 853 municipalities in Minas Gerais was carried out between June and August 2020. Regarding the structural dimension, we noticed an adequate implementation of services like ‘Family Health Strategy,’ ‘Expanded Family Health Center,’ and ‘Psychosocial Care Centers’ but a lack of ‘Beds in General Hospitals’ destinated to mental health care, ‘Unified Electronic Medical Records’ and ‘Mental Health Training Activities for Professionals.’ In the process dimension, adequate implementation of actions such as ‘Multidisciplinary and Joint Care,’ ‘Assistance to Common Mental Disorders by Primary Health Care,’ ‘Management of Psychiatric Crises in Psychosocial Care Centers,’ ‘Offer of Health Promotion Actions,’ and ‘Discussion of Cases by Mental Health Teams’ point to a form of work consistent with the guidelines. However, we detected difficulties in the implementation of ‘Psychosocial Rehabilitation Actions,’ ‘Productive Inclusion,’ ‘User Protagonism,’ ‘Network Integration,’ and practical activities for the effectiveness of collaborative care. We found a better implementation of the mental health care network in more populous, demographically dense, and socioeconomically developed cities, which shows the importance of regional sharing of services that are not possible for small cities. The evaluation practices of mental health care networks are scarce throughout the Brazilian territory, a fact also found in Minas Gerais, highlighting the need for its expansion not only in the scientific sphere but also in the daily life of the various levels of management.

IVF-induced pregnancy and early motherhood among women with a history of severe eating disorders.

There is a higher prevalence of eating disorders among women seeking in vitro fertilization (IVF). Women with a history of eating disorders may be particularly vulnerable to eating disorder relapse during IVF, pregnancy, and early motherhood. The experience of these women during this process has hardly been studied scientifically, despite its high clinical relevance. The overall aim of this study is to describe how women with a history of eating disorders experience the process of becoming a mother through IVF, pregnancy, and the postpartum period. We recruited women with a history of severe anorexia nervosa who had undergone IVF (n = 7) at public family health centers in Norway. Semi-openly, the participants were interviewed extensively first during pregnancy, and then 6 months after birth. The 14 narratives were analyzed using interpretative phenomenological analyses (IPA). All participants were required to complete the Eating Disorder Examination Questionnaire (EDE-Q) and were diagnosed (DSM-5) by using the Eating Disorder Examination (EDE), during both pregnancy and postpartum. All participants experienced a relapse of an eating disorder during IVF. They perceived IVF, pregnancy, and early motherhood to be overwhelming, confusing, a source of severe loss of control, and a source of body alienation. There were four core phenomena that were reported that were strikingly similar across all participants: "anxiousness and fear," "shame and guilt," "sexual maladjustment," and "non-disclosure of eating problems." These phenomena persisted continuously throughout IVF, pregnancy, and motherhood. Women with a history of severe eating disorders are highly susceptible to relapse when undergoing IVF, pregnancy, and early motherhood. The process of IVF is experienced as extremely demanding and provoking. There is evidence that eating problems, purging, over-exercising, anxiousness and fear, shame and guilt, sexual maladjustment, and non-disclosure of eating problems continue throughout IVF, pregnancy, and the early years of motherhood. Therefore, it is necessary for healthcare workers providing services to women undergoing IVF to be attentive and intervene when they suspect a history of eating disorders.

Biochemical analysis of oxidative stress and purinergic system in pregnant women with gestational diabetes mellitus

Background: Pregnancy is characterized as a physiological period with greater sensitivity to insulin resistance and changes in oxidative stress. Purinergic signaling is directly related to diabetes, as this condition modifies the concentration of extracellular ATP and the level of degradation of ATP to adenosine. Objective: Analyze oxidative stress and the purinergic system in pregnant women with Gestational Diabetes Mellitus (GDM) and compare them with low-risk pregnant women (LR). Materials and methods: The research was of a quantitative approach of an experimental nature. The study was carried out at the Clínica da Mulher, which serves high-risk pregnant women, and at the Family Health Centers, which serves low-risk pregnant women, both located in Chapecó, Santa Catarina, Brazil. Results: From the analysis, it was observed that oxidative stress was increased in pregnant women in LR compared to pregnant women with GDM by increasing the concentration of TBARS and reducing the concentration of Carbonyl Protein in pregnant women with LR. Regarding the purinergic system, there was a significant decrease in the hydrolysis of the nucleotides ATP, ADP, and AMP in pregnant women with GDM, and a significant increase in the hydrolysis of ADA, also in pregnant women with GDM. Conclusion: Therefore, pregnant women with GDM have less oxidative stress compared to pregnant women in LR concerning TBARS and Carbonyl Protein markers, thus allowing a greater antioxidant defense mechanism. Furthermore, concerning the purinergic system, there is an increase in the activity of ADA, which is directly related to the immunosuppression process, a necessary condition for the protection of the fetus during the gestational period.

Knowledge and practices about cervical cancer and human papilloma virus among the women and the influencing factors

ABSTRACT Knowledge about Human Papilloma Virus (HPV), timely screening programs and early vaccination are crucial to prevent cervical cancer. Existing studies have reported a lack of knowledge and awareness about HPV, Pap tests and cervical cancers. This study aims to evaluate the knowledge, awareness and behaviors of the women about cervical cancer, HPV and HPV vaccine. This descriptive, cross-sectional design study was carried out at a family health center in Istanbul with the participation of 1050 women from March to July 2021. Information form and HPV Knowledge Scale (HPV-KS) were used for data collection. Descriptive statistics and multiple regression analysis were used for data analysis. The mean score and standard deviation obtained from the HPV-KS were 11.80 ± 8.02. Although 77.5% of the participants had heard about Pap test, 57.9% did not have Pap test before. Besides, although 55.2% and 60.4% of the participants had heard about cervical cancer and HPV vaccine, respectively, only 6.6% had HPV vaccine before. Multiple regression analysis showed that the sociodemographic and clinical variables accounted for 22.7% of the knowledge about HPV (p < 0.001). The participants had low levels of knowledge about cervical cancer and HPV infection and vaccination. The study results can be used to inform educational interventions, which in turn, can increase knowledge in screening recipients.

Domestic Violence: Views of Married Men and Factors Affecting Violence

ABSTRACT Purpose The aim of this study was to investigate the views of married men regarding domestic violence and factors that facilitate this violence against women. Design This cross-sectional, descriptive study was conducted on a sample of married men registered to a Family Health Center in Turkey. Methods This study included 1110 married men. Data were collected using the “Perception of Gender” scale, and a questionnaire. Descriptive statistics and multivariate logistic regression were used for data analysis. Findings It was found that the average score of men on the Perception of Gender Scale was 74.39 ± 19.08. 57% of participants perpetrated violence on their wives, 66% were subjected to domestic violence during childhood and 57% witnessed domestic violence against women during childhood. The most significant factor affecting domestic violence against women was that the man witnessed domestic violence against women during childhood. Conclusion This study demonstrated that married men commonly perpetrated violence on their wives, Witnessing domestic violence against women during childhood was the most significant factor affecting domestic violence against women. Clinical Evidence The study revealed that childhood witness to domestic violence against women was the most significant factor affecting participants’ domestic violence against women.

Challenges Meeting Training Requirements in the Care of Children in Family Medicine Residency Programs: A CERA Study.

In 2014, the Accreditation Council for Graduate Medical Education (ACGME) implemented numeric requirements for family medicine (FM) pediatric patient encounters. Impact on residency programs is unclear. We aimed to identify any difficulties faced by FM program directors (PDs) meeting these numeric requirements. Questions about pediatric training in family medicine residencies were included in a survey of PDs conducted by the Council of Academic Family Medicine Educational Research Alliance (CERA). We performed univariate analysis of the demographic and program characteristics. We then used χ2 tests of independence to test for bivariate associations between these characteristics and our primary outcome: the most difficult ACGME pediatric care requirement to meet. Most programs reported the hospital as the primary location of training (n=131, 46%) and their family medicine practice (FMP) patient population consisted of over 20% pediatric patients (n=153, 56%). Over 80% of program directors reported challenges meeting FM requirements for the care of children. Challenges meeting pediatric requirements were associated with fewer than 20% FMP patients under 19 years of age (P&lt;.0001), fewer than 50% of core FM faculty caring for sick children (P=.0128), and primary location of pediatric training in a family health center (P=.0006). Difficulty meeting ACGME requirements for the care of children in FM residency programs is common, especially for programs with fewer than 20% FMP patients under 19 years of age. Further research is needed to determine how best to assure FM resident competencies in the care of children and adolescents.

Health Literacy, COVID-19 Vaccine Literacy and Related Factors of Individuals Registered with a Family Health Center

Background: This study aimed to examine health literacy and COVID-19 vaccine literacy levels among adults and the factors associated with these levels. Methods: This cross-sectional study was conducted in a family health center in Ankara in October-November-December 2021. The sample consisted of 372 adults who agreed to participate in the study. The Personal Information Form, the Health Literacy Scale, and the COVID-19 Vaccine Literacy Scale were used to collect data. Results: It was determined that 55,6% of the participants were women, 52,2% were between the ages of 40-64, 65,1% were married, 51,6% were university graduates, 50,3% had income equal to their expenses, 39,5% had chronic diseases, 85,8% of them had not contracted COVID-19, and 3,5% had not been vaccinated against COVID-19. The mean score of the Health Literacy Scale was 108.19 (SD=14.63). The mean score of the COVID-19 Vaccine Literacy Scale was 2.74 (SD=0.60). The health literacy and COVID-19 vaccine literacy scores of the elderly, individuals with low education and low income levels were found to be significantly lower (p&amp;lt;0.05). Education level, being vaccinated against COVID-19 or not, and health literacy explained 37% of COVID-19 Vaccine Literacy. Conclusions: The current study found that the health literacy level of the participants was sufficient, and the COVID-19 vaccine literacy level was moderate. It was determined that age group, level of education, and level of income affected these levels. In addition, education level, COVID-19 vaccination status and health literacy level were determined as predictors of COVID-19 vaccine literacy. It is recommended to consider predictive factors to increase COVID-19 vaccine literacy.

Investigation of The Side Effect Profile In People Who Get The Covid-19 Vaccine In A Family Health Center In Izmir

Giriş ve Amaç: Günümüzde dünya genelinde hızla yayılan COVID-19 bir “pandemi” olarak kabul edilmiştir. COVID-19 için etkili bir tedavi bulunmamaktadır. Bu nedenle hasta olmadan kişilerin korunması önemlidir. Bu çalışmada bir Aile Sağlığı Merkezi (ASM)’nde inaktive COVID-19 aşısı uygulanan kişilerde oluşan yan etkilerin sıklığının belirlenmesi ve yan etki oluşumunda etkili olan parametrelerin değerlendirilmesi amaçlanmıştır. Yöntem: Kesitsel tipte olan bu araştırma, İzmir Buca 12 No’lu ASM’de 14 Nisan-14 Haziran 2021 tarihleri arasında gerçekleştirilmiştir. İlgili ASM’de inaktive COVID-19 aşısı olan 560 kişi çalışmaya dâhil edilmiş, kişilerde oluşan yan etkiler ve etkili olabilecek parametreler kaydedilmiştir. Bulgular: Kişilerin %52,7’si kadın ve yaş ortalaması 64,17 ± 10,28 yıldır. İlk aşı sonrası ilk haftada en sık gelişen yan etkiler; %8,6 enjeksiyon yerinde ağrı, %4,1 baş ağrısı ve %4,1 yorgunluk-halsizlik olarak tespit edilmiştir. İkinci aşı sonrasında ise, ilk haftada en sık gelişen yan etkiler; %8,7 enjeksiyon yerinde ağrı, %5,4 yorgunluk-halsizlik, %2,9 baş ağrısı ve %2,7 eklem ağrısı olarak belirlenmiştir. Her iki doz aşıdan sonra görülen enjeksiyon yerinde ağrı, 65 yaşından küçüklerde ve kadınlarda daha sık olduğu bulunmuştur (p&amp;lt;0,05). Pandemi döneminde vitamin/bitki takviyesi alanlarda ilk doz sonrası enjeksiyon yerinde ağrı, baş ağrısı ve eklem ağrısı; ikinci doz aşı sonrasında ise enjeksiyon yerinde ağrı istatistiksel olarak anlamlı düzeyde daha fazla sıklıkta bulunmuştur (p&amp;lt;0,05). Alerji tanısı olan hastalarda birinci doz sonrası enjeksiyon yerinde ağrı ve baş ağrısı; ikinci doz sonrası ise sadece baş ağrısı istatistiksel olarak anlamlı düzeyde daha fazla sıklıkta olduğu görülmüştür (p&amp;lt;0,05). İkinci doz sonrasında yorgunluk-halsizlik sıklığı kanser öyküsü olan kişilerde daha fazla tespit edilmiştir (p=0,001). Sonuç: Çalışma sonucunda inaktive COVID-19 aşısı uygulaması sonrası sık görülen yan etkilerin her iki dozdan sonra da enjeksiyon yerinde ağrı, baş ağrısı ve yorgunluk-halsizlik olduğu saptanmıştır. Ayrıca 65 yaşından küçüklerde, kadınlarda ve alerji öyküsü olanlarda enjeksiyon yerinde ağrı şikayeti daha fazla görülmüştür.

STRONGER TOGETHER: AN EXAMINATION OF FAMILIAL PROTECTIVE FACTORS DURING COVID-19 OUTBREAK

Objective: The stress-producing nature of the COVID-19 pandemic and the sanctions imposed for the protection of public health have affected all segments of society. In this process, many stress materials such as long-term partial closure, the beginning of the process of complete closure and recovery term let more discussion of the problems that occur with the continuous sharing of the same physical environment in the family, more observations about the processes of existing chronic diseases, and family role conflicts happened. In our study, it was aimed to examine the protective factors perceived by individuals in terms of family members and family integrity under the conditions of the COVID-19 pandemic, by some variables. Methods: This study was conducted with Çukurova University Faculty of Health Sciences Nursing Department students. “Sociodemographic Data Form”, The Inventory of Family Protective Factors (IFPF) were used to collect the data. The data were collected by sending the link of the data collection tools created via "Google Forms" to the students’ social media groups. Results: A total of 316 individuals, 79 (25%) men and 237 (75%) women, participated in the study. When the IFPF total score and sub-score averages were analyzed according to gender; it was determined that the mean total score of the scale was significantly higher for the women. In the subsistence level perception groups, a statistically significant difference was found between the total score and the Social Support sub-dimension mean scores (p&amp;lt;0.05). Conclusion: According to the results of our study, it was found that being female, having a better socioeconomic status and being healthier in terms of both chronic and acute mental health had better perceptions of protective factors within the family compared to others. As a result, Family Health Centers (FHC) that can offer solutions for possible problems that are regulating family relations in the face of many negative life events such as pandemics, also can provide "intervention to domestic crisis" and can serve for diagnosis, treatment, rehabilitation and counseling services, and health promotion and preventive services. It is thought that the effective functioning of such organizations may be protective.