ABSTRACT
OBJECTIVE: Turkey is a developing country undergoing a system change in the prehospital emergency medical services (EMS). The purpose of this study was to evaluate the effects of the institutional structure and legislative framework on the number of ambulance accidents in Turkey. METHODS: During the first phase of the study, ambulance accident data was requested and obtained from the Ministry of the Interior. Similarly, data on ambulance numbers were requested and obtained from the Ministry of Health through the Right to Information law. During the second phase of the study, a survey consisting of 112 EMS personnel viewpoints about the effects of the institutional structure and legislative framework on ambulance accidents was conducted using a structured questionnaire. A total of 209 EMS personnel completed the survey. RESULTS: The number of ambulance accidents increased by 42.5% over the last five years, whereas the area of coverage increased by 57.3% during the same period. The rate of EMS personnel experiencing ambulance accidents was 69.4%. When age, sex, and profession variables were considered, the varying profiles of the ambulance operators were found to have no significant effect on the number of ambulance accidents following the system change. CONCLUSION: The rise in the number of ambulance accidents in Turkey was not significant when compared with the increase in the area of responsibility. The present system change was also found to have no effect on the number of accidents. On the other hand, problematic areas in the institutional structure and the legislative framework increased the risk of accidents.
ABSTRACT
The aim of this study is to assess the knowledge, attitudes, and beliefs of emergency health care provider teams toward the identification and management of abused older people. This cross-sectional analytic study was conducted in four hospitals with emergency medical service. One hundred twenty five emergency room health care personnel in Izmir filled out a questionnaire. Of the respondents, 13.6% had never identified an abused older person. Health care personnel working at a university emergency department had a better knowledge base of elder abuse. Most of the participants felt uncomfortable in asking questions about older people abuse. A majority of them reported that it is difficult to properly intervene on the patient's behalf. Most of the participants perceived elder abuse to be uncommon in Turkey. Generally, older people abuse is unrecognized by health care providers; an extensive training and education effort needs to be developed and implemented.
