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Publication Metadata only Adaptation of the menstrual symptom questionnaire into Turkish(Gülhane Military Medical Academy, 2014) Güvenç, Gülten; N/A; N/A; Seven, Memnun; Akyüz, Aygül; Faculty Member; Faculty Member; School of Nursing; School of Nursing; 32470; 42416Aim: It is aimed to adaptation of the Menstrual Symptom Questionnaire into Turkish in this study. Methods: A total of 356 students were included in the methodological study. The demographic data questionnaire, Menstrual Symptom Questionnaire (MSQ), and Visual Anolog Scale for pain (VASP) were used as tools for data collection. The SPSS 15.0 package software was used for the evaluation of the data obtained from the study. Its validty was assesed by using content, structure, criterion related validity and, its reliability was assesed by using internal consistency and consistency over time. Results: The mean age of the participants was 21,35 ± 1.12 years (range, 18-23 years), the mean onset age of menarche was 12,99 ±1,38 years, the mean duration of menstruation was 5,31 ± 1,15 days, and the mean frequency of menstruation was 29,03 ±5,67 days. As a result of factor analysis limited with the three factors, three factors explaining %50.99 of the total variance and loading more than 1 were found. There is also, a strong and statistically meaningful relationship between VAS and MSQ total score (r= 0.603, p<0.000), MSQ Factor 1 (r=0.517, p<0.000), MSQ Factor 2 (r= 0.564, p<0.000) ve MSQ Factor 3 (r=0.429, p<0.000). Cronbach alpha value was measured as 0.92 for the total MSQ score. The correlation coefficient was found as 0.89 (p<0.001) between the test-retest assesments. Conclusion: According to the internal consistency, test-retest stability coefficient and factor analysis and criterion-related validity tests’ results, the Turkish translated version of the MSQ is a reliable, consistent and valid instrument for assessing symptoms regarding menstruation in Turkish adolescents. / AMAÇ: Bu araştırmada, Menstrüasyon Semptom Ölçeğinin Türkçeye uyarlanması amaçlanmıştır.YÖNTEM: Metodolojik tipteki bu araştırmanın örneğini 2012-2013 eğitim ve öğretim yılında Ankaradabir hemşirelik yüksekokulunda okuyan toplam 356 öğrenci oluşturmuştur. Araştırma verilerintoplanmasında, Veri Toplama Formu , Visual Analog Skalası (VAS) ve 2009 yılında, Negriff ve ark.tarafından düzeltilen Menstrüasyon Semptom Ölçeği (MSÖ) kullanılmıştır. İstatistiksel analizlerdeSPSS 15.0 (SPSS, Chicago, IL, USA) kullanılmıştır. Ölçeğin geçerliliği; dil, içerik, yapı ve ölçüt bağıntıl geçerlilik ile güvenilirliği ise iç tutarlık ve zamana göre değişmezlik için gerekli analizler yapılarakdeğerlendirilmiştir.BULGULAR: Bu çalışmada değerlendirilen katılımcıların yaş ortalamalarının 21,35 ± 1,12, ortalamamenarş yaşlarının 12,99 ±1,38, ortalama menstrüasyan sürelerinin 5,31 ± 1,15 gün ve ortalama menstrüalsiklus uzunluklarının 29,03 ±5,67 gün olduğu belirlenmiştir. MSÖnün alt boyut sayısı orijinal ölçekteolduğu gibi üç ile sınırlandırılarak gerçekleştirilen yapılan faktör analizi sonucunda toplam varyansın%50,99unu karşılayan ve özdeğeri 1den yüksek olan 3 faktör bulunmuştur. VAS ile MSÖ toplam puan(r= 0,603, p<0.000), MSÖ Faktör 1 (r=0,517, p<0.000), MSÖ Faktör 2 (r= 0,564, p<0.000) ve MSÖFaktör 3 (r=0,429, p<0.000) puan ortalamaları arasında anlamlı ve güçlü bir ilişki olduğu belirlenmiştir.Cronbach alfa değeri MSÖ toplam puanı için 0.92dir. İki uygulama arasındaki korelasyon katsayısı 0,89hesaplanmıştır.SONUÇ: İç tutarlık katsayısı, test-tekrar test kararlılık katsayısı ve açıklayıcı faktör analizi ve ölçüt- bağıntılı geçerlik analizlerinden elde edilen sonuçlar, MSÖnün Türkçede geçerlik ve güvenirlikbulgularının yeterli düzeyde olduğunu ve Türk adölesanlarında menstrüasyona ilişkin semptomlarındeğerlendirilmesinde kullanılabileceğini göstermektedir.Publication Metadata only Anthropometric indicators and diabetes incidence: results from a national cohort study, Turkey(Oxford University Press (OUP), 2021) Alpay, E. Emli; Ünal, Belgin; Ergör, Gül; Horasan, Gönül Dinç; Sözmen, Kaan; Ekinci, Banu; N/A; Sakarya, Sibel; Faculty Member; School of Medicine; 172028Background: Anthropometric indicators such as Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), and Body Shape Index (ABSI) are used globally to evaluate the risk of type 2 diabetes (T2DM). Our study aimed to investigate associations between different anthropometric indicators and the risk of T2DM using data from a national cohort. Methods: The data on anthropometric measures and other risk factors of diabetes were obtained from Turkey Chronic Diseases and Risk Factors Survey in 2011 (n = 18,477). Disease information for the years 2012-2017 of the cohort has been reached through electronic health records and DM was ascertained by standard ICD-10 Codes. Four logistic regression models were generated based on different groups of confounders: unmodifiable risk factors, behavioral risk factors, comorbidities and socioeconomic variables. Categorical BMI, WC, WHR, WHtR, and ABSI values were used and adjusted RRs (95% CIs) of measurements were computed for men and women separately. Results: Median follow-up year (IQR) was 6,46 (0,06). Between 2012 and 2017, 540 people were diagnosed with new diabetes. All anthropometric measurements except ABSI were associated with T2DM risk in all models. Among the anthropometric measures, BMI showed the strongest effect on incident diabetes, both in men (BMI ≥30; RRadj: 3.06, 95% CI 1.93-4.86) and women (BMI ≥30; RRadj: 2.58; 95%CI 1.73-3.85) in model 4 (adjusting for all confounding factors). WHtR provided the second strongest association with a RRadj of 2.57 in men (95% CI 1.78-3.71) and 2.55 in women (95%CI 1.87-3.47). Conclusions: Independent of other risk factors, individuals with high BMI, WHR, WHtR and WC are at higher risk of developing T2DM. Public health strategies aimed at prevention of weight gain and obesity will probably be the most effective way to struggle with diabetes.Publication Metadata only Connectors as a risk factor for blood-associated infections (3-way stopcock and needleless connector): a randomized-experimental study(Mosby-Elsevier, 2020) Güven, Betül; Kaya, Nurten; Şengül, Tuba; Ocakçı, Ayşe Ferda; Faculty Member; Faculty Member; School of Medicine; 59230; 1729Background: Microorganisms causing catheter-related bloodstream infections colonize to intravenous catheters (IVC)-particularly to connectors mounted to catheters. The aim of this study was to examine the colonization in 3-way stopcock (TWS) connectors and needleless connectors (NCs) that integrated into central, port, and peripheral venous catheters. Methods: This random, experimental study consisted of 180 connectors that were inserted into the IVCs of patients in general surgery, reanimation intensive care, and daily chemotherapy units. Cultures of the connectors were obtained at least 48 hours after connecting to IVCs. Results: This study showed that gram-negative, gram-positive, and other pathogens reproduced, although their colonization level was not high enough to develop an infection. When the results of colonization for patients using TWS and NC were compared, the peripheral venous catheters (using a TWS) resulted in a significantly higher increase in reproduction than in patients using NC (P ≤ .01) and no significant difference in the level of colonization in other types of connectors or catheters (P ˃ .05). Conclusions: The study's results indicated no significant difference between NC and TWSs in terms of reproduction. It should also be noted that connectors integrated into IVC pose a risk in the development of catheter-related bloodstream infections.Publication Metadata only COVID-19 barriers and response strategies for refugees and undocumented migrants in Turkey(Elsevier B.V., 2020) Bahar Özvarış, Şevkat; Mardin, Deniz; Ekzayez, Abdulkarim; Meagher, Kristen; Patel, Preeti; Kayı, İlker; Sakarya, Sibel; Faculty Member; Faculty Member; School of Medicine; School of Medicine; 168599; 172028Introduction: With more than 40 million confirmed cases of COVID-19 globally, the pandemic is continuing to severely challenge health systems around the world. Countries with high numbers of refugees face an additional burden on COVID-19 preventive and curative services made available and accessible to refugees. Turkey hosts the largest number of refugees globally, with a total of 4 million in 2020. Over 98% of refugees in Turkey reside in urban areas in large, crowded cities such as Istanbul, Gaziantep, and Hatay posing severe challenges for all health responses, including COVID-19. This study provides insights and analysis on the current situation for refugees, migrants under temporary protection and undocumented migrants in Turkey by focusing on the right to health and access to health care under pandemic conditions. Its main aim is to discuss the challenges and opportunities for COVID-19 responses relating to refugees, migrants under temporary protection and undocumented migrants in Turkey. Methods: This is a non- systematic and exploratory literature review from academic and grey sources. We reviewed published documents, meeting summaries, media reports/news and policy briefs in Turkish and English on the COVID-19 response in Turkey. Results: Since the start of the COVID-19 outbreak in Turkey, the Ministry of Health (MoH) has taken various steps to provide health care for all residents. However, several challenges arise when providing health care to refugees, migrants under temporary protection and other undocumented migrants including language barrier in accessing reliable information and access to health services for existing chronic conditions. Conclusion: While refugees, migrants under temporary protection and undocumented migrants have been granted access to services for COVID-19 related health problems, social and cultural barriers remain beyond the current legislation. Solidarity and whole-of-society inclusive approaches should always be the guiding principles in the COVID-19 response.Publication Metadata only Cut-off values for anthropometric indices in predicting morbidity and mortality in Turkey: a cohort(Oxford University Press (OUP), 2021) Erkoyun, Erdem; Eren, E. Boncukçu; Ünal, Belgin; Sözmen, Kaan; Horasan, Gönül Dinç; Ekinci, Banu; Ergör, Gül; N/A; Sakarya, Sibel; Faculty Member; School of Medicine; 172028Background: Anthropometric measurements are associated with cardiovascular outcomes and mortality and the association varies by community. This study aims to estimate the incidence of cardiovascular outcomes and all cause mortality and determines their association with the anthropometric measurements. Methods: The data from Turkey Chronic Diseases and Risk Factors Survey were used for the cohort which recruited two 15 years and older adults from each family physicians' list in 2011 in Turkey using simple random sampling (n = 18,477). Family physicians collected the medical history and performed anthropometric measurements. Initially healthy participants for cardiovascular morbidity (coronary heart disease (ICD-10 codes I20.0-I25.0) and stroke (ICD-10 codes I60.0-I69.0) and all participants for all-cause and cardiovascular mortality were followed-up through electronic health records by 2017. Area under the curves (AUCs) were estimated and the adiposity risk was defined as cut-off points determined using Youden Index. The sample was stratified by age-groups (<65, ≥65). Poisson and Cox models were fitted for morbidity and mortality outcomes, respectively. Results: Over six years of follow-up, 5.7% of 15,877 and 1.3% of 16,062 participants developed CHD and stroke respectively. In total, 664 all-cause deaths (4.0%) were observed with 155 caused by CVDs (0.9%). A body shape index (i.e. 0.658 for all-cause mortality among younger men), waist-to-height ratio (i.e. 0.743 for CHD incidence among younger women), and BMI had higher AUCs for the outcomes. Higher anthropometric measurement groups had almost always higher CHD incidence risk in all groups but lower all-cause mortality in older men. Higher body-mass index was associated with lower mortality in younger men. Conclusions: This cohort study in Turkey showed that having higher anthropometric measurements is mostly associated with higher CHD incidence and mostly lower mortality among older men. This association deserves further studies.Publication Metadata only Educational level inequalities in cardiovascular outcomes and all-cause mortality in turkey: a cohort(Oxford University Press (OUP), 2021) Erkoyun, Erdem; Ünal, Belgin; Sözmen, Kaan; Horasan, Gönül Dinç; Ekinci, Banu; Ergör, Gül; N/A; Sakarya, Sibel; Faculty Member; School of Medicine; 172028Background: Recent decades witnessed an increase in the burden of non-communicable diseases including adverse cardiovascular outcomes in low- and middle income countries and the burden was not equal across socioeconomic strata. This study aimed to define educational level inequalities in cardiovascular outcomes and all-cause mortality in a six-years cohort in Turkey. Methods: Non-communicable Diseases and Risk Factors Cohort randomly sampled two adults (>14) from each of the registered family physicians in Turkey in July 2011 (n = 18,477). The family physicians collected demographic data. Incident coronary heart disease (CHD), cardiovascular and all-cause deaths were obtained from electronic health records in the end of 2017. Ridit score transformation was applied to the educational level by gender (illiterate, primary school, secondary school, high school or higher) and then Relative Index of Inequalities by educational level were estimated using Poisson Regression for morbidity and Cox Regression for mortality. Results: There were 17,847 participants in CHD and 18,461 in the mortality cohort. During six-years 1,026 cases were diagnosed with CHD, 185 cardiovascular and 769 all-cause deaths occurred respectively. The inequalities were not significant for all outcomes however Relative Index of Inequalities were close to be significant for CHD incidence among men and all-cause mortality among women (0.721 (0.507 to 1.025) and 1.721 (0.969 to 3.057), respectively). Conclusions: This is the first-ever cohort in Turkey with the aim to define educational level inequalities in cardiovascular outcomes and all-cause mortality. The inequalities may not have been observed due to the low number of outcomes.Publication Metadata only Factors associated with patient activation in a Turkish population with diabetes and/or hypertension(Oxford Univ Press, 2019) Kulak, E.; Karaketir, S. Gorcin; Dogan, E.; Akman, M.; Cifcili, S.; N/A; Department of Business Administration; Department of Industrial Engineering; Sakarya, Sibel; Güneş, Evrim Didem; Örmeci, Lerzan; Faculty Member; Faculty Member; Faculty Member; Department of Business Administration; Department of Industrial Engineering; School of Medicine; College of Administrative Sciences and Economics; College of Engineering; 172028; 51391; 32863Background: Patient activation (PA), which is known to improve health outcomes, describes the knowledge, skills and confidence a person has in managing their own health care. We investigated the extent of PA and associated factors in adults with diabetes (DM) and/or hypertension (HT). This study is the first in Turkey evaluating PA, using the Patient Activation Measure (PAM) scale. The results of the study provide practitioners with information on the characteristics of patients who need support to increase their activation. Methods: We conducted this cross-sectional study in 14 Family Health Centers in Istanbul. The participants were DM and/or HT patients. A questionnaire including the PAM, questions on patient characteristics, life style behaviors, healthcare utilization and health status was applied to 431 patients. Based on PAM score, patients were classified into two activation levels: level 1-2 (poor activation) and level 3-4 (good activation). χ2, t-test and logistic regression (LR) analysis were used. LR analysis was performed for all participants and for women and men separately. Results: Of 431 patients (mean age: 63.6), 65% were women; 45% had a poor activation level (PAL). Based on LR analysis; low socioeconomic status (SES) (OR = 1.6; 95% CI:1.01-2.5), being illiterate (OR = 3.9, 95% CI: 1.5-10.7), being primary school graduate (OR = 2.1, 95% CI:1.1-4.2), lack of adult vaccination (OR = 1.9, 95% CI:1.1-3.1), higher BMI (OR = 1.1, 95% CI: 1.09-1.13) and worse self-reported health (OR = 1.2, 95% CI: 1.1-1.3) were factors associated with low PAL. The latter was associated with low PAL for both sexes; high BMI was an associated factor only among women, while low SES and lack of vaccination were factors only in men. Conclusions: Almost half of the patients had low activation level in our sample. Associated factors may serve as the basis for the development of interventions needed to enhance activation for patients with DM/HT.Publication Metadata only Health-related qol and fatality in chd patients: findings from a national cohort study, turkey(Oxford University Press (OUP), 2021) Alpay, E. Emli; Dinç, Gönül; Ergör, Gül; Sözmen, Kaan; Ekinci, Banu; Ünal, Belgin; N/A; Sakarya, Sibel; Faculty Member; School of Medicine; 172028Background: Although strong association between self-reported health and coronary heart disease (CHD) exists, health related quality of life (HRQOL) has not been conceptualized as a predictor for fatality in CHD patients. We investigated whether HRQOL may predict the risk of death in six years in CHD patients. Methods: There were overall, 614 of CHD cases in the national representative Chronic Diseases and Risk Factors Survey in Turkey, 2011. Baseline self-reported health data on EuroQol- 5 Dimension (EQ-5D) and a Visual Analog Scale (VAS) were used from the same survey. The cases were followed-up for all-cause and CHD specific fatality (ICD-10 diagnostic codes: I20- I25) through electronic health records by 2017. Kaplan Meier and Cox regression models were used for data analysis. Age and sex adjusted HRs [aHR 95% CIs] were estimated for having some or extreme problems in EQ5D domains and VAS. Results: Median follow-up years (IQR) was 6.46 (6.39-6.47). The number of deaths from all causes and CHD were 103 and 26, respectively. Age and sex adjusted HRs for all causes fatality were statistically significant for some or extreme problems in usual activities [2.48 (95%CI 1.60-3.83)], in pain/comfort [2.28 (95% CI 1.44-3.62)], in self-care [2.25 (95% CI 1.46-3.46)] and in mobility [1.85 (95% CI 1.16-2.96)]. Age and sex adjusted HRs for CHD specific fatality were statistically significant for some or extreme problems in self-care [3.45 (95% CI 1.48-8.07)] and pain/comfort [3.07(95% CI 1.19-7.93)]. VAS was negatively associated with overall fatality. Conclusions: In CHD cases, poor self reported health might be a good indicator for overall and CHD specific fatality in 6 years. Especially having some or extreme problems in selfcare and pain/comfort are closely related with overall fatality as well as CHD specific fatality.Publication Metadata only Health-related quality of life and perceived health status of Turkish population(Springer, 2019) Horasan, Gönül Dinç; Selçuk, Kevser Tarı; Sözmen, Kaan; Ergör, Gül; Yardım, Nazan; Sarıoğlu, Gülay; Soylu, Meltem; Keskinkılıç, Bekir; Buzgan, Turan; Hülür, Ünal; Ekinci, Halil; Ekinci, Banu; Ünal, Belgin; N/A; Sakarya, Sibel; Faculty Member; School of Medicine; 172028Purpose: This study was conducted to assess the health-related quality of life (HRQOL) and perceived health status of the Turkish population. Methods: The data came from a nationwide survey, which was conducted by Ministry of Health on prevalence and risk factors for chronic diseases in Turkey, with a representative random sample of 18,477 people aged >= 15 years from Turkey. Each family physician invited two individuals selected from their registered population to the Family Health Center, conducted the survey by face to face interviews using an electronic form. HRQOL was determined using EQ-5D-3L scale. Results: In Turkish population, each four women out of 10, two men out of 10 have problems in pain/discomfort and anxiety/depression dimensions of the scale; three women out of 10, one man out of 10 have some or severe problems in mobility. Proportion of people without health problems (health state 11,111) were 64,1% in men, 40,7% in women. The mean VAS score for males was 71.50.2 (95% CI 70.9-72.1), 66.4 +/- 0.2 (95% CI 65.8-66.9) for females (p < 0.05).The most important determinants of having a problem in any of the five dimensions are age, gender, education, diabetes mellitus, coronary heart disease, stroke, alzheimer, cancer, renal failure. The OR of having some or severe problems in any dimensions was 4.6 (95% CI 38-5.4) for over 65-74 and 7.5 (95% CI 5.8-9.6) for over 75 compared to 15-24 age group. Conclusions: The perceived health level and HRQOL is worse in women, in older age groups, in people from lower socioeconomical status.Publication Metadata only How group education impacts female factory workers' behavior and readiness to receive mammography and Pap smear(Ios Press, 2015) Bahar, Mine; Erdoğan, Hatice; N/A; N/A; Seven, Memnun; Akyüz, Aygül; Faculty Member; Faculty Member; School of Nursing; School of Nursing; 32470; 42416Background: The workplace has been deemed a suitable location for educating many women at once about cancer screening. Objective: To determine how group education about early diagnostic methods for breast and cervical cancer effects women's behavior and readiness to receive mammography and Pap smear. Methods: This semi-interventional study was conducted at a textile factory in Istanbul, Turkey. Female workers (n= 125) were included in the study. A participant identification form and knowledge evaluation form developed for this study, along with the transtheoretical model, were used to collect data. A 45-min interactive group education was given to the participants. Results: Upon contacting participants 3 months after group education, 15.4% (n = 11) stated that they had since received a mammogram and 9.8% (n = 7) a Pap smear. As suggested by the transtheoretical model, group education increased participants' readiness to receive cancer screening, along with their knowledge of breast and cervical cancer. Conclusions: Group education positively impacted women's knowledge of cancer and their readiness to receive mammography and Pap smear. Group education can potentially create awareness of cancer screening tests among women and improve their readiness to receive such tests.