The Knowledge, Attitudes, and Practices of Parents Regarding Sun Protection for Their Children.

OBJECTIVE: To evaluate the knowledge, attitudes, and practices of parents toward protecting their children against skin cancer and the sun. METHODS: This cross-sectional study was performed in Turkey from March through October 2022. The authors used a questionnaire investigating the parents' and children's characteristics, attitudes, and practices toward sun protection and the Skin Cancer and Sun Knowledge (SCSK) scale to collect data. RESULTS: Of 465 parents, 60.2% were women, 83.2% were light-skinned, 20.2% perceived their children as risk-free, 43.8% perceived their children as low risk in terms of skin cancer, 14.6% examined their children from head to foot, 62.3% applied sunscreen to their children, 9.7% made them wear long-sleeved clothing, 60.0% made them wear headgear, 61.1% made them remain in the shade or under a sunshade, and 32.3% made them wear sunglasses. The mean parental SCSK scale score was 14.3 ± 4.1. Scale scores were higher among those who perceived their children as being at high risk for skin cancer (P = .000), whose children had not experienced red or painful sunburn in the previous year (P = .000), and who informed their children about sun protection (P = .000). CONCLUSIONS: Although knowledge of skin cancer and solar protection was high, parental perception of the risk of skin cancer was very low, and attitudes toward skin examination were also very relaxed.

Obesity Bias and Stigma, Attitudes, and Beliefs Among Intern Doctors: a Cross-sectional Study from Türkiye.

BACKGROUND: The purpose of this study was to determine intern physicians' attitudes and beliefs toward obesity and individuals with obesity and the frequency at which they encounter discriminatory language in their work environments. METHODS: This cross-sectional study was performed with intern physicians at the Ondokuz Mayis University Medical Faculty in Samsun, Türkiye. A questionnaire was employed for data collection (Appendix). Two hundred eighteen (82.2%) interns took part in the study. The questionnaire consisted of 53 questions in five sections, and included the attitudes toward obese persons (ATOP) and beliefs about obese persons (BAOP) scales. RESULTS: The interns most frequently cited genetic factors (98.1%) and endocrine disorder-metabolic disorders (98.1%) as non-behavioral causes of obesity, and overeating (96.2%) and physical immobility (96.2%) as behavioral causes. Lifestyle changes and exercise were most frequently recommended for treatment. The interns' attitudes toward individuals with obesity were very slightly negative, but close to neutral. Analysis showed that 46.8% of the interns reported hearing members of academic staff, intern physicians, or health workers make negative or derogatory comments or jokes about obese patients during their education, while 22.0% reported witnessing an obese patient being subjected to discriminatory treatment in the hospital environment. CONCLUSION: Medical faculties must develop curricula aimed at comprehensively addressing obesity-related bias. Such a curriculum should allow students to reflect on their biases, be aimed at reducing the effect of those biases on patient communication, and involve strategies directed toward eliminating those effects from physicians' treatment decisions.

Knowledge, attitudes and practices of general practitioners and paediatricians towards Group A beta-haemolytic streptococcal tonsillopharyngitis: A cross-sectional study from Türkiye.

BACKGROUND AND OBJECTIVES: General practitioners (GPs) and paediatricians are very important in the management of sore throat in terms of providing correct diagnosis and treatment. The aim of this study was to evaluate the knowledge, attitudes and practices of GPs and paediatricians towards Group A beta-haemolytic streptococcal (GABHS) tonsillopharyngitis. METHOD: Three vignettes/case studies, in which the causative agents were GABHS, Epstein-Barr virus (EBV) and non-EBV viral infection, were presented as part of a questionnaire sent to paediatricians and GPs to elicit information regarding their diagnosis and treatment of tonsillopharyngitis. RESULTS: In all, 236 physicians responded to the questionnaire (126 paediatricians, 106 GPs). GPs registered more accurate diagnoses of GABHS tonsillopharyngitis and tended to administer more symptomatic treatment in the case of non-EBV tonsillopharyngitis than paediatricians. Paediatricians requested more tests in the diagnosis of GABHS tonsillopharyngitis than GPs. DISCUSSION: Most GPs and paediatricians possess adequate knowledge regarding GABHS diagnosis and the differential diagnosis of patients. Differences between the hospital and general practice settings may have affected the approach to symptomatic treatment and requesting tests.

The willingness and attitudes of medical students regarding organ donation and transplantation: a cross-sectional study from Turkey.

OBJECTIVE: Positive attitudes and motivation on the part of medical students concerning organ donation and transplantation are very important in terms of the growing need for these. This study aimed to evaluate the willingness and attitudes of medical students toward organ donation and transplantation. METHODS: This cross-sectional study was performed at a state university in Turkey in February-March 2020. The questionnaire investigated sociodemographic characteristics and willingness toward organ donation and transplantation and contained the Organ Donation Attitude Scale. RESULTS: A total of 309 medical students participated, of which 71.2% were willing to donate their organs. Medical students' willingness to donate organs increased depending on gender, academic year, receipt of education on the subject, discussing donation with family and friends, possession of an organ donation card, knowledge of the organ donation system, and willingness to receive organ donation if necessary. Positive attitudes toward organ donation increased after discussing the subject with family and friends, possessing an organ donation card, and knowing the path to be followed for organ donation. CONCLUSION: Medical students exhibited high willingness and positive attitudes regarding organ donation and transplantation. However, education on the subject of organ donation and transplantation is needed.

The predictive value of galectin-3 levels on left atrial low voltage areas assessed by high-density mapping in patients with paroxysmal atrial fibrillation.

Aims: Galectin-3 is an inflammation biomarker that is associated with atrial fibrosis and plays a role in the development of atrial fibrillation (AF). Low voltage areas (LVAs) identified using an electroanatomical mapping system represent the presence of fibrotic tissue. The present study aimed to determine the relationship between coronary sinus (CS) serum sampling of galectin-3 levels and the presence and extent of LVA in patients with paroxysmal AF. Methods: A total of 115 consecutive paroxysmal AF patients underwent pulmonary vein isolation (PVI) included prospectively in the study. Voltage mapping was performed before PVI during sinus rhythm guided by multipolar high-density mapping catheter and LVAs were defined as regions where bipolar peak to peak voltage was <0.5 mV. Galectin-3 levels were measured via enzyme-linked immunosorbent assay. Results: CS serum sampling of galectin-3 levels was significantly higher in paroxysmal AF patients with LVA than those without LVA (16.5 ± 3.7 ng/ml vs. 10.2 ±2.7 ng/ml, respectively, p < .001). CS serum sampling of galectin-3 levels was significantly higher in paroxysmal AF patients with moderate and severe LVA than in paroxysmal AF patients with mild LVA (17 ± 3.5 ng/ml and 20.1 ± 1.3 ng/ml vs. 13.3 ± 2.3 ng/ml, respectively, p = .002). In the multivariate analysis female gender (odds ratio [OR] = 7.537, 95% confidence interval [CI]: 1.011-56.195; p = .049), left atrium volume (OR = 1.326, 95% CI: 1.052-1.67; p = .017), and CS serum sampling of galectin-3 levels (OR = 1.704, 95% CI: 1.169-2.483; p = .006) were significant and independent predictors for LVAs. Conclusion: In this study, we found that the CS serum sampling of galectin-3 levels increased with the extent of LVA and was an independent predictor for the presence of LVA.

The relationship between school burnout, sense of school belonging and academic achievement in preclinical medical students.

The purpose of the study was to evaluate the relationship between school burnout, sense of school belonging, and academic achievement in medical students. This cross-sectional study was performed with students at the Ondokuz Mayis University Medical Faculty (Samsun, Turkey) between 1 and 31 May 2019. Six hundred one (71.0%) first, second, and third-year students were included in the study. A questionnaire was employed as the data collection method. The questionnaire consisted of two parts. The first part consisted of questions investigating sociodemographic information produced by the authors by scanning the literature. The second part consisted of the School Burnout Inventory and the Psychological Sense of School Membership Scale. The relationship between the sense of school belonging, school burnout, and academic achievement was evaluated using structural equation modeling. The structural equation modeling analysis determined that school burnout played a mediating role in the relationship between the sense of school belonging and academic achievement in preclinical medical students. As the sense of belonging to the school increases in preclinical medical students, academic achievement increases. School burnout in preclinical medical students increases as a sense of school belonging decreases. Academic achievement among preclinical medical students decreases as school burnout levels increase. Increasing the sense of school belonging can be effective in preventing school burnout and increasing academic achievement.

The willingness and attitudes of medical students regarding organ donation and transplantation: a cross-sectional study from Turkey

SUMMARY OBJECTIVE: Positive attitudes and motivation on the part of medical students concerning organ donation and transplantation are very important in terms of the growing need for these. This study aimed to evaluate the willingness and attitudes of medical students toward organ donation and transplantation. METHODS: This cross-sectional study was performed at a state university in Turkey in February-March 2020. The questionnaire investigated sociodemographic characteristics and willingness toward organ donation and transplantation and contained the Organ Donation Attitude Scale. RESULTS: A total of 309 medical students participated, of which 71.2% were willing to donate their organs. Medical students' willingness to donate organs increased depending on gender, academic year, receipt of education on the subject, discussing donation with family and friends, possession of an organ donation card, knowledge of the organ donation system, and willingness to receive organ donation if necessary. Positive attitudes toward organ donation increased after discussing the subject with family and friends, possessing an organ donation card, and knowing the path to be followed for organ donation. CONCLUSION: Medical students exhibited high willingness and positive attitudes regarding organ donation and transplantation. However, education on the subject of organ donation and transplantation is needed.

Are patients with obesity "scapegoats"? The obesity prejudice levels of health care workers in Turkey.

OBJECTIVE: This study assessed obesity prejudice levels, attitudes, and perceptions of health care workers toward individuals with obesity and the relationship between health care workers' perceptions of own and society's weight bias, healthy lifestyle preferences, body mass index, and other factors with obesity prejudice levels. METHODS: This cross-sectional and descriptive study was conducted with 700 health care workers in Turkey via an online survey addressing characteristics, perceptions, and attitudes toward obesity including an obesity prejudice scale. Categorical variables were expressed as frequencies and percentages. The χ² test was applied to compare categorical variables. The distribution of the data was evaluated by the Kolmogorov-Smirnov test. Normally distributed data were compared by an independent sample t-test, while the Mann-Whitney U and Kruskal-Wallis tests were used for comparing non-normally distributed data. RESULTS: Participants' mean age was 40.2±11.3 years and 67.9% were women. Notably, 57.9% worked at tertiary health care centers, 85.9% were physicians, and 64.8% were family physicians; 25% were prejudicial, while 58.1% tended to have prejudice toward individuals with obesity. Obesity prejudice scores were significantly higher among those who were in close contact with and who stated their preference for patients with obesity. CONCLUSIONS: Half of the participants tended to have prejudice, and one-fourth were prejudicial toward individuals with obesity. These results highlight the necessity of raising awareness of health care workers to reduce prejudicial attitudes that may negatively impact patients with obesity. Stigmatizing experiences might be detrimental, reducing the quality of life with long-term consequences for emotional and physical health.

Sleep quality and related factors in a sample of Turkish healthcare workers during the COVID-19 pandemic: A cross-sectional study.

BACKGROUND: Increasing workloads and psychological pressure have led to fatigue among healthcare workers during the COVID-19 pandemic. Increasing stress and social isolation can also lead to sleep problems. The purpose of this study was to evaluate sleep quality and related factors among healthcare workers during the COVID-19 pandemic in Turkey. METHODS: The data in this cross-sectional study were collected using an online questionnaire. This included sociodemographic data, the Multidimensional Scale of Perceived Social Support, the National Stressful Events Survey PTSD Short Scale and the Pittsburgh Sleep Quality Index. RESULTS: Two hundred seventy-eight physicians, 104 nurses and 52 dentists were enrolled. The total prevalence of poor sleep quality was 56.7%. The prevalence of poor sleep quality was 67.3% in nurses, 55.4% in physicians and 42.3% in dentists. Poor sleep quality was more prevalent among women, nurses, hospital workers, frontline workers, individuals with <5 years of work experience, those with low social support and individuals with increased traumatic stress levels. High levels of social support and family social support were identified as protective factors against poor sleep quality. Multivariate regression analyses showed that poor sleep quality was significantly associated with working in hospitals and high traumatic stress levels during the COVID-19 pandemic. CONCLUSIONS: Poor sleep quality was common among healthcare workers during the COVID-19 pandemic. Working in hospitals and high traumatic stress levels were identified as factors associated with poor sleep quality.

Parents' willingness and attitudes concerning the COVID-19 vaccine: A cross-sectional study.

INTRODUCTION: This study aimed to evaluate the parents' willingness and attitudes concerning the COVID-19 vaccine. METHOD: This cross-sectional study was performed using a self-administered online survey, covering parents' and their children's characteristics, parents' willingness and attitudes towards the COVID-19 vaccine. A total of 1035 parents participated. RESULTS: Analysis showed that 36.3% of parents were willing to have their children receive the COVID-19 vaccine and that 59.9% were willing to receive it themselves. In addition, 83.9% were willing to have their children vaccinated with the COVID-19 vaccine if the mortality rates associated with COVID-19 in children increased following a mutation. After adjusting for significant variables, willingness to receive the COVID-19 vaccine (AOR = 24.91; 95% CI = 10.93-56.76), willingness for their children to participate in a COVID-19 vaccine trial (AOR = 11​.87; 95% CI = 2.41-58.40] and advising others to receive the COVID-19 vaccine [AOR = 7.82; 95% CI = 2.50-24.49] were associated with greater parents' willingness for their children to receive the COVID-19 vaccine. CONCLUSIONS: Parents' willingness for their children to receive the COVID-19 vaccine was low. The only characteristics of either parents or children found to affect the parents' willingness for children to receive the COVID-19 vaccine was the parents being healthcare workers. Parents' willingness and positive attitudes towards the COVID-19 vaccine are factors that increase acceptance of the COVID-19 vaccine for their children.

The willingness to accept the COVID-19 vaccine and affecting factors among healthcare professionals: A cross-sectional study in Turkey.

INTRODUCTION: While discussions on the effectiveness of COVID-19 vaccines continue, healthcare professionals' attitudes and their growing fear and anxiety during the pandemic process are not yet fully known. In this study, we aimed to investigate the COVID-19 vaccine acceptance and affecting factors in healthcare professionals. METHODS: This was a cross-sectional online survey conducted in 1574 healthcare professionals consisting of physicians, nurses, dentists, pharmacists, and healthcare personnel in Turkey in December 2020. Demographic, attitudinal, and Fear of COVID-19 Scale scores of healthcare professionals were investigated in this survey. RESULTS: About 84.6% of healthcare professionals declared willingness to accept the COVID-19 vaccine whenever possible. Most physicians (90.4%) stated to receive the COVID-19 vaccine, while 66.5% of nurses, 73.9% of healthcare personnel, also preferred to have it as soon as the vaccine was available. Factors affecting the willingness to accept the COVID-19 vaccine were found to be advanced age, male gender, working in a primary health care center, living with family, having a child, having a chronic disease, having high Fear of COVID-19 Scale (FC-19S) scores. While the group with the highest vaccine rejection rate was nurses with 33.5%, FC-19S scores were significantly higher in nurses who wanted to be vaccinated. In multivariate regression analyses, factors related to the acceptance of the COVID-19 vaccine were identified as advanced age, routine adult vaccination, no history of COVID-19, and recommendation of the COVID-19 vaccine. CONCLUSION: A high proportion of healthcare professionals declared their willingness to accept the COVID-19 vaccine, and hence, this will play a leading role in optimizing the vaccination rate of the entire population while combating the pandemic.

Prevalence of Depression, Anxiety, Distress and Insomnia and Related Factors in Healthcare Workers During COVID-19 Pandemic in Turkey.

The purpose of this study was to evaluate the prevalence of depression, anxiety, distress, and insomnia and related factors in healthcare workers during the COVID-19 pandemic in Turkey. We applied the study survey online to HCWs during the pandemic in Turkey between 23 April and 23 May 2020. We used the sociodemographic data form, Patient Health Questionnaire-9, General Anxiety Disorder-7, Insomnia Severity Index, and Impact of Event Scale-Revised. Six hundred twenty (66.0%) of the 939 HCWs taking part in the study were female, 580 (61.8%) were physicians, 569 (60.6%) were working on the front line. Seven hundred twenty-nine (77.6%) participants exhibited depression, 565 (60.2%) anxiety, 473 (50.4%) insomnia, and 717 (76.4%) distress symptoms. Depression, anxiety, insomnia, and distress symptoms were significantly greater among females, individuals with a history of psychiatric illness, and individuals receiving psychiatric support during the COVID-19 pandemic. HCWs serving in Turkey during the COVID-19 pandemic experienced high levels of depression, anxiety, insomnia, and distress symptoms. Female gender, being a nurse, working on the front line, history of psychiatric illness, and being tested for COVID-19 were identified as risk factors for mental health problems.

Psychosocial Factors Affecting Smartphone Addiction in University Students.

Smartphone addiction is a recent concern that has resulted from the dramatic increase in worldwide smartphone use. The purpose of this cross-sectional study was to evaluate psychosocial factors affecting smartphone addiction in university students. The study was performed among students at the Ondokuz Mayis University Samsun School of Health (Samsun, Turkey) on October-December 2015. Four hundred ninety-four students possessing smartphones and agreeing to participate were included. A sociodemographic data form produced by the authors and consisting of 10 questions was administered together with a questionnaire involving the Smartphone Addiction Scale-Short Version (SAS-SV), the Flourishing Scale, the General Health Questionnaire, and the Multidimensional Scale of Perceived Social Support. The questionnaires were applied in a class environment at face-to-face interviews. SAS-SV scores of 6.47% of students were "significantly higher" than the participating group mean SAS-SV score. Multiple regression analysis revealed that depression, anxiety and insomnia, and familial social support statistically, significantly predicted smartphone addiction. Further studies of smartphone addiction in different age groups and with different educational levels are now needed.

Changes in Empathy during Medical Education: An Example from Turkey.

OBJECTIVE: Empathy is a key element of patient- physician communication; it is relevant to and positively influences patients' health. In this study we aimed to present the Turkey example for the empathy change during the medical faculty training. METHODS: This cross-sectional study was carried out at Ondokuz Mayis University, Faculty of Medicine, Department of Family Medicine, Samsun, Turkey. in first three years students of medicine during September 2014 to June 2015. Turkish adapted form of the student version of Jefferson empathy scale and sociodemographic questionnaire was used and data was assessed with the SPSS program. RESULTS: Total 511 students (52.5% female, 47.5% male), from first three years of medical faculty participated in the study. Two hundred thirty three (44.5%) students were from the First Year class, while 130 (27.1%) and 148 (28.4%) of them were from Second and Third Year respectively. The mean age was 20.63±2.73 years. Significant differences in the empathy scores were observed among first three years in medical school as like as between gender. CONCLUSION: Although medical schools tend to raise students with higher empathy levels, medical education itself is more scientific based than humanistic approach, and makes medical students more tough and insensitive to the problems of patients. Patient-centered approach and empathy training should be implemented in the curriculum during whole medical education.

Insulin initiation status of primary care physicians in Turkey, barriers to insulin initiation and knowledge levels about insulin therapy: A multicenter cross-sectional study.

AIMS: Our aim was to evaluate the insulin initiation status, barriers to insulin initiation and knowledge levels about treatment administered by primary care physicians (PCP). METHODS: We conducted our study in accordance with a multicenter, cross-sectional design in Turkey, between July 2015 and July 2016. A questionnaire inquiring demographic features, status of insulin initiation, obstacles to insulin initiation and knowledge about therapy of the PCPs was administered during face-to-face interviews. RESULTS: 84 PCPs (19%) (n=446, mean age=41.5±8.4years, 62.9% male and 90.0% ministry certified family physicians) initiated insulin therapy in the past. Most of the stated primary barriers (51.9%, n=230) were due to the physicians. The most relevant barrier was "lack of clinical experience" with a rate of 19% (n=84 of the total). The average total knowledge score was 5.7±2.0 for the family medicine specialist, and 3.8±2.1 for the ministry certified family physicians (p=0.000, maximum knowledge score could be 10). CONCLUSIONS: The status of insulin initiation in Turkey by the primary care physicians is inadequate. Medical education programs and health care systems may require restructuring to facilitate insulin initiation in primary care.

The attitudes of family physicians toward a child with delayed growth and development.

Aim The purpose of this study was to assess the attitude of family physicians toward a child with delayed growth and development. BACKGROUND: Primary healthcare professionals play a key role in monitoring growth and development, the best indicator of the child's health status. If delayed growth and development can be detected early, then it is usually possible to restore functioning. METHODS: This descriptive study was performed in Samsun, Turkey, in May and June 2015. In total, 325 family physicians were included. The study consisted of two parts. In the first session of the research, the story of an 18-month-old child with delayed growth and development was presented using visual materials. An interview between the child's mother and a member of primary healthcare staff was then enacted by two of the authors using role-playing. Subsequently, participants were given the opportunity to ask the mother and member of primary healthcare staff questions about the case. During the sessions, two observers observed the participants, took notes and compared these after the presentation. In the second part of the study, the participants were asked to complete a questionnaire consisting of three open-ended questions. Findings When asking questions of the mother, family physicians generally used accusatory and judgmental language. One of the questions most commonly put to the mother was 'Do you think you are a good mother?' Family physicians were keen to provide instruction for the patient and relatives. Family physicians to a large extent thought that the problem of a child with delayed growth and development can be resolved through education. CONCLUSIONS: Family physicians' manner of establishing relations with the patient and relatives is inappropriate. We therefore think that they should receive on-going in-service training on the subject.

Better knowledge and regular vaccination practices correlate well with higher seasonal influenza vaccine uptake in people at risk: Promising survey results from a university outpatient clinic.

BACKGROUND: The knowledge, beliefs, opinions, and attitudes of patients and their relatives regarding seasonal influenza vaccination were evaluated. METHODS: This descriptive study was undertaken in the outpatient clinics of Baskent University Hospital. There were 566 responders who completed a self-administered questionnaire. RESULTS: The mean age of participants was 48.35 years, and 16.8% were ≥65 years. Of the responders, 21.7% were vaccinated this year, whereas 57.8% did not desire to get it. Vaccination rates were significantly higher among responders ≥65 years of age (56.4%), those having at least 1 chronic illness (46.5%), and those who were vaccinated regularly every year (22.2%). Half of the responders did not know that the vaccine was reimbursed for people at risk. The most common reason for refusing the influenza vaccine was not getting the flu frequently (51.2%). Fear of side effects, concerns about vaccine's effectiveness, and belief that vaccine causes the flu were other common reasons for not being vaccinated. Of the responders, 77% believed that getting official information or a recommendation from a physician would influence their decision about seasonal influenza vaccination. CONCLUSIONS: People who are at risk or vaccinated regularly display a higher vaccine uptake and better knowledge of influenza and vaccination. The opinions and attitudes of this study population may assist in developing strategies for changing attitudes of the public toward influenza vaccination.

Family Physicians' Knowledge, Attitudes, and Practices Toward Colorectal Cancer Screening.

The purpose of this study was to assess family physicians' knowledge, attitudes, and practices toward colorectal cancer (CRC) screening. The population in this cross-sectional study consisted of 290 family physicians working in Samsun, Turkey, contacted between 15 June and 15 July 2015 and agreeing to participate. A questionnaire prepared by the authors on the basis of the relevant literature was applied at face-to-face interviews. The first part of the questionnaire inquired into sociodemographic information, while the second contained questions evaluating family physicians' knowledge, attitudes, and practices toward CRC screening. Physicians completed the questionnaire in approximately 10 min. 65.9 % of the family physicians in the study were men. Mean age of the participants was 43.40 ± 6.54 years, and mean number of years in service was 18.43 ± 6.42. The average number of patients seen by physicians on a daily basis was 51-99. CRC screening was performed by 83.1 % of physicians. The fecal occult blood test (FOBT) was recommended at the correct frequency by 30.7 % of physicians and colonoscopy by 11.7 %. A further 68.6 % of physicians followed no CRC guideline. Only 3.8 % of those reporting using a guideline were able to name it. The great majority of physicians in this study apply CRC screening. However, family physicians lack sufficient information concerning the ages at which screening tests should be started and concluded and how frequently they should be performed. They also do not attach sufficient importance to CRC guidelines. This results in excessive demand for screening tests.