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Öğe A group of asthma patients' treatment related thoughts based on health belief model and perception of medication success(Gulhane Military Medical Academy, 2012) Çimen, Mesut; Akbolat, Mahmut; Çiftçi, Faruk; Işik, O?uz; Şahin, BayramAIM: This study is a descriptive study which aims to determine the attitude and perceptions of asthma patients about their health and their opinion regarding the success of treatment. METHOD: The study is carried out without any sampling. The participants are 74 patients who were admitted in a public pulmonary disease clinic between April and June 2010. A revised version of Health Belief Model scale for asthma treatment and another scale, which was developed to determine the opinion and observations of patients regarding the success of treatment, are used for data collection. RESULTS: The mean score of attitudes and perceptions of asthma patients, which is defined with the Health Belief Model and which can affect their responsiveness to treatment, is found out 3,37(±0,38) and the attitude and perceptions of patients are positive. The mean value for success treatment is 2,35(±0,49). Since the treatment is deemed to be more successful as it gets closer to 1 hence it can be said that the opinion of asthma patients regarding the success of treatment is positive. In the study, it is found out that the participants have a high admission rate to hospitals and that there is no significant difference for socio-demographic characteristics in the positive attitude development and in their belief in the efficiency of the treatment that they are receiving, of which both are components of health belief model concept. The findings from regression analysis indicate that the duration of the asthma sickness and the number of people living in the household not only affect the perceptions and attitudes of patients that are investigated by health belief model, but also the effectiveness of the treatment and the number of admissions to the Emergency Room in the last 6 months. CONCLUSION: In order to prevent long-term complications, the behavior and attitudes of asthma patients, especially the young ones, regarding asthma should be determined and detailed programs should be organized to educate and inform them. Treatment models, which would enable to receive treatment whilst not to cause any problem in their social and professional life's, should be investigated.Öğe Assessment of cost-effectiveness of surgical clipping and endovascular coil methods in the treatment of unruptured cerebral aneurysms(Dokuz Eylul Univ Inst Health Sciences, 2022) Kar, Ahmet; Şahin, İsmet; Şahin, BayramPurpose: The study aims to assess the cost-effectiveness of endovascular coiling and surgical clipping in the treatment of unruptured cerebral aneurysms. Material and methods: Patients with ICD 10 167.1 and treated with one of the two treatment methods performed at the Hacettepe University Hospitals between January 2013 and December 2015 were included in the study. The cost data in the study were obtained by analyzing patient invoices through the automation program of the university hospital. The effectiveness and treatment costs were assessed using the Markov model with the Social Security Institution's (SSI) perspective. To generate the cost input in the model, the lifetime costs obtained based on the expert's opinions were added to the amounts received from patient invoices. Results: The study results were presented as the incremental cost-effectiveness ratio (ICER). When 3% reduction rate was applied to the costs and effectiveness data, the Quality Adjusted Life Years (QALY) was calculated as 4.39 and 1.84 for the coiling and clipping methods, respectively. Lifetime costs were 66463.40$ and 7900.27$ for the coiling and clipping methods, respectively. The incremental cost-effectiveness rate of endovascular coiling method was 22965.93. Conclusion: The endovascular coiling method was found to be cost-effective because the ICER score of the process is below the threshold.Öğe KNOWLEDGE AND ATTITUDES OF SURGEONS ON THE USE AND STEWARDSHIP OF PROPHYLACTIC ANTIBIOTICS(2023) Kandemir, Aysun; Şahin, BayramThis study aimed to examine the reasons for using and not using surgical antibiotic prophylaxis (SAP), the reasons for inappropriate use, and the opinions and recommendations of the surgeons working in two public hospitals on the use of antibiotics. For this purpose, a questionnaire consisting of open and closed-ended questions developed using the literature was used. Between February 5 and September 6, 2019, when the research was carried out, 54 surgeons from a total of 58 surgeons working in these hospitals were reached and the questionnaire was applied one-to-one. Surgeons mostly rely on the recommendations of books or scientific articles (25.4%). They stated that avoidance of increasing the postoperative infection rate the most in their decision to apply SAP (8.3±2) and the fact that the conditions that fully comply with the information sources (5.9±3.7) were effective in their decision not to apply SAP. Most surgeons stated that they see the inappropriate use of SAP as a major problem and that inappropriate use is mostly due to unnecessary prophylaxis. 75.9% of surgeons think that an antibiotic management program is necessary. In a possible program, it is recommended to use the toolkit and antibiogram package as a strategy to monitor the use and provide feedback and to determine patient risk stratification as a tool. It is thought that the research findings will help the development of antibiotic management and education programs to improve antibiotic use. Also, the results obtained will be beneficial for the antibiotic control team or antibiotic management program planned to be established in hospitals. There is a need for training programs specifically targeting surgeons
