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AY, NADİYE PINAR

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AY

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NADİYE PINAR

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  • PublicationOpen Access
    A qualitative study of hand hygiene compliance among health care workers in intensive care units
    (J INFECTION DEVELOPING COUNTRIES, 2019-02-28) TEKER SAYIN, AYŞE GÜLSEN; Ay, Pinar; Teker, Ayse Gulsen; Hidiroglu, Seyhan; Tepe, Pinar; Surmen, Aysen; Sili, Uluhan; Korten, Volkan; Karavus, Melda
    Introduction: Studies indicate that adherence to hand hygiene guidelines is at suboptimal levels. We aimed to explore the reasons for poor hand hygiene compliance. Methodology: A qualitative study based on the Theory of Planned Behavior as a framework in explaining compliance, consisting four focus group discussions and six in-depth interviews. Results: Participants mostly practiced hand hygiene depending on the sense of dirtiness and cleanliness. Some of the participants indicated that on-job training delivered by the infection control team changed their perception of emotionally based hand hygiene to indication based. Direct observations and individual feedback on one-to-one basis were the core of this training. There was low social cohesiveness and a deep polarization between the professional groups that led one group accusing the other for not being compliant. Conclusions: The infection control team should continue delivering one-to-one trainings based on observation and immediate feedback. But there is need to base this training model on a structured behavioral modification program and test its efficacy through a quasi-experimental design. Increasing social cohesiveness and transforming the blaming culture to a collaborative safety culture is also crucial to improve compliance. High workload, problems related to work-flow and turnover should be addressed.
  • PublicationOpen Access
    Research publications from the ATS MECOR program in Turkiye
    (2023-01-01) ARIKAN, HÜSEYİN; AY, NADİYE PINAR; Karakurt Z., Yilmaz O., ARIKAN H., AY N. P., Demir C., Gurkan C. G., Akgun M., Buist S.
    Background: The American Thoracic Society (ATS) Methods in Epidemiologic, Clinical, and Operations Research (MECOR) Program aims to build research capacit in low and middle-income countries. MECOR has three levels, during which students learn to develop a research protocol and write a manuscript. MECOR Turkiye has been offered every year since 2008. Objective: The aim of this paper is to report the number and impact of published articles generated from research questions developed by students in levels 1, 2, and 3 of the ATS MECOR Program in Turkiye between 2008 and 2018. Methods: We collected the research questions developed in all levels of the ATS MECOR Program in Turkiye between 2008 and 2018. We searched Google Scholar, PubMed, Web of Science, and ResearchGate in April 2022 to see how many of these research questions were published as articles and, if published, in which journals. Results: Of the 176 research questions collected, 49 had been developed in level 1, 82 had been developed in level 2, and 45 had been developed in level 3. Of those 176 research questions, 55 (31.3%) generated articles that were accepted for publication. The frequency of published articles based on MECOR-developed research questions increased linearly as the course level in which they were developed increased (18.4% in level 1, 30% in level 2, 46.7% in level 3; P = 0.012; linear-by-linear association, P = 0.003). The median time from the development of the research question to publication was three years overall and did not differ significantly among the course levels (P = 0.36). Of the research questions developed, 43 were published in Science Citation Index or Science Citation Index Expanded–indexed journals. Conclusion: Acceptance of an article for publication is one way to measure the impact of the ATS MECOR Program. Our data describe significant research output among our participants, which increases with their length of participation in the program.
  • PublicationOpen Access
    The Turkish Language and Psychometric Validation of the Bladder Control Self-assessment Questionnaire Evaluating the Lower Urinary Tract Dysfunction
    (GALENOS YAYINCILIK, 2020-12-01) AY, NADİYE PINAR; Hamarat, Mustafa Bilal; Tarhan, Fatih; Can, Utku; Sahlam, Erkin; Ay, Pinar
    Objective: The aim of this study was to develop and validate the Turkish version of the Bladder Control Self-assessment Questionnaire (B-SAQ). Materials and Methods: B-SAQ that comprises two parts and four questions in each section was translated into Turkish, followed by a back-translation into English. The study included 79 and 49 women who were admitted to the urology outpatient clinic with and without complaints of lower urinary tract symptom (LUTS), respectively. Turkish B-SAQ questionnaire was filled for the second time by 67 patients after a two week interval for test-retest correlation. All patients filled the Turkish B-SAQ form, International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF) and Overactive Bladder Screener (OAB-V8) questionnaire. Results: The Cronbach alpha value for B-SAQ was 0.868. Reliability of the test/retest was found to be 0.860 (p<0.001). There were statistically significant differences in B-SAQ scores between the controls and patients (p<0.001). Convergent validity analyzes with ICIQ-SF and OAB-V8 (respectively r=0.61 and r=0.44, p<0.001). The total B-SAQ cut-off score was determined as 7. The sensitivity and specificity of B-SAQ were 96% in women with LUTS. Conclusion: Turkish version of B-SAQ is a valid and reliable questionnaire to evaluate the symptoms and disorders of patients with LUTS.
  • PublicationOpen Access
    Validation of the Turkish version of the DOSE-Nonadherence measure among patients with cardiometabolic conditions
    (2022-10-01) AY, NADİYE PINAR; OKUYAN, BETÜL; Yagmur M., Ay P., Sancar M., Voils C. I., Okuyan B.
    What is known and objective There are no validated self-report measures to assess extent of and reasons for medication nonadherence in the Turkish language. The aim of this study is to evaluate validity and reliability of the Domains of Subjective Extent of Nonadherence Scale, which assesses extent of and reasons for nonadherence in Turkish patients with hypertension, diabetes mellitus and/or dyslipidaemia in community pharmacy settings. Methods The Turkish version of the DOSE-Nonadherence scale was developed through translation and cultural adaption. Psychometric properties of the scale were evaluated in a cross-sectional study among 203 patients who visited six community pharmacies located in Istanbul, Turkey between November 2020 and March 2021. For the extent of nonadherence domain, reliability was estimated through Cronbach\"s alpha, and convergent validity was evaluated with Spearman\"s rank correlation with the validated Turkish version of the Medication Adherence Report Scale (MARS). Reasons for nonadherence were characterized among participants reporting nonadherence to the extent of nonadherence items. The measure was administered at baseline and 2 weeks later to 30 patients to estimate stability of extent scores using the Wilcoxon test and intraclass correlation coefficient. p < 0.05 was set as the level of statistical significance. Results Among the 203 participants (65 male), the median (25th-75th percentiles) age was 59.0 years [51.0-67.0]. Cronbach\"s alpha for the extent of nonadherence scale was 0.86. A moderate negative correlation (r = -0.58; p < 0.001) was found between the extent of nonadherence scores and MARS, supporting convergent validity. The most common reasons for medication nonadherence were forgetfulness (22.5%) and mismatch between the patients\" daily routine and medication taking (17.5%). The intraclass correlation coefficient was 0.97 for extent of nonadherence scores at baseline and 2 weeks (p < 0.001). What is new and conclusion The DOSE-Nonadherence Scale could be used to identify nonadherent patients and their reasons for nonadherence in Turkish patients with chronic cardiometabolic conditions. This scale can be used to evaluate clinical pharmacist-led services to reduce medication nonadherence. Nonadherence could be recorded longitudinally in electronic health records to provide a more accurate picture of medication use. Pharmacists or other providers could administer interventions tailored to patients\" reasons for nonadherence.
  • PublicationOpen Access
    Sequential Measurements of Pentraxin 3 Serum Levels in Patients with Ventilator-Associated Pneumonia: A Nested Case-Control Study
    (HINDAWI LTD, 2018) BİLGİLİ, BELİZ; Bilgin, Huseyin; Haliloglu, Murat; Yaman, Ali; Ay, Pinar; Bilgili, Beliz; Arslantas, Mustafa Kemal; Ozdemir, Filiz Ture; Haklar, Goncagul; Cinel, Ismail; Mulazimoglu, Lutfiye
    Purpose. The main purpose of this study was to investigate the dynamics of pentraxin 3 (PTX3) compared with procalcitonin (PCT) and C-reactive protein (CRP) in patients with suspicion of ventilator-associated pneumonia (VAP). Materials and Methods. We designed a nested case-control study. This study was performed in the Surgical Intensive Care Unit of a tertiary care academic university and teaching hospital. Ninety-one adults who were mechanically ventilated for >48 hours were enrolled in the study. VAP diagnosis was established among 28 patients following the 2005 ATS/IDSA guidelines. Results. The median PTX3 plasma level was 2.66 ng/mL in VAP adults compared to 0.25 ng/mL in non-VAP adults (p < 0.05). Procalcitonin and CRP levels did not significantly differ. Pentraxin 3, with a 2.56 ng/mL breakpoint, had 85% sensitivity, 86% specificity, 75% positive predictive value, and 92.9% negative predictive value for VAP diagnosis (AUC = 0.78). Conclusions. With the suspicion of VAP, a pentraxin 3 plasma breakpoint of 2.56 ng/mL could contribute to the decision of whether to start antibiotics.
  • PublicationOpen Access
    Hand hygiene knowledge, perception and practice of healthcare workers in a Turkish university hospital intensive care unit
    (J INFECTION DEVELOPING COUNTRIES, 2019-08-31) BİLGİN, HÜSEYİN; Sili, Uluhan; Ay, Pinar; Bilgin, Huseyin; Hidiroglu, Seyhan; Korten, Volkan
    Introduction: While improvement of hand hygiene (HH) compliance is considered as the best approach to reduce healthcare-associated infections, the instructional interventions in HH among healthcare workers of intensive care unit (ICU) of our hospital was not successful enough. The following study was conducted to evaluate HH knowledge, perception, practice and effectiveness of the trainings among healthcare workers of ICU in our hospital. Methodology: A cross-sectional study was conducted in the ICU containing 8 medical and 16 surgical beds with 284 filled questionnaires about HH knowledge and 1187 observed opportunities for HH compliance. Results: Overall observed HH compliance rate was 40.6%; lowest compliance was 21.7% for before clean/aseptic procedure indication and highest compliance was 68.6% for after touching a patient indication. Although > 90% healthcare workers correctly identified the World Health Organization's five indications for HH, 82 -85% failed to recognize non-indications, i.e. when it was not necessary to perform HH. Our study showed that 15.1% of healthcare workers neither received nor felt the need for HH training. Conclusions: Despite regular HH trainings, healthcare workers could not differentiate when HH was not required which suggested failure to understand HH rationale. This may explain poor HH compliance rates. A systematic study is needed in order to find out the reasons behind of this noncompliance and improve HH training methods for educating healthcare workers.
  • PublicationOpen Access
    Will plain packaging of cigarettes achieve the expected? Perceptions among medical students
    (2022-10-01) AY, NADİYE PINAR; Ay P., Yasin Y., Elbek O., Guner M., Gezer T., Sonmez U. P., Ceyhan M., Yildiz F., Dagli E.
    INTRODUCTION Plain packaging is one of the critical strategies in eliminating the promotion of tobacco products. Evidence indicates that plain packaging decreases the attractiveness of tobacco products and enhances the effectiveness of health warnings. This study aimed to explore the perceptions of undergraduate medical students of plain packaging and new pictorial warnings before they came into use in Turkey. METHODS This qualitative study was carried out among undergraduate students in a Medical School in Istanbul in 2019. Participants were recruited through purposive sampling, and data were collected through focus group discussions. The participants were asked to discuss their perceptions regarding one original branded pack and ten plain package models. All discussions were audiotaped and thematic content analysis was conducted. RESULTS A total of 72 students participated in the study. None of the students had seen plain packaging before. Most of the students perceived plain packaging as more favorable compared to the branded packs. The terms used to describe plain package were: ‘appealing/desirable’, ‘attractive’, ‘beautiful’, ‘cool/eye-catching’, ‘charming’, ‘elegant’, and ‘special’. Some students indicated that they would have preferred plain packs over the branded ones if both types of products had been in the market and provided they were of the same brand. Pictorials had different impacts based on their content. At the same time, outer body deformities were perceived as ‘real’ and provoked unfavorable feelings; inner organ images were defined as ‘imaginary’ and had little to no impact. CONCLUSIONS Plain packaging was perceived as a more attractive alternative to the conventional branded packs among most participants. We must be aware of the unforeseen effects of plain packaging among different subgroups in the new generations. We suggest using outer body deformities in the pictorials more frequently due to their higher impact.
  • PublicationOpen Access
    Do family physicians perceive electronic cigarette use as a harm reduction strategy for smokers? A survey from Istanbul
    (2022-03-01) AY, NADİYE PINAR; HIDIROĞLU, SEYHAN; Tanriover O., HIDIROĞLU S., AY N. P., Cook R. L.
    Background: E-cigarettes (ECs) are gaining popularity in Turkey among smokers. With the rapid increase of EC consumption, it is important to ascertain how family physicians (FPs) perceive ECs as they play a key role in providing smoking cessation services. Aim: Our main objectives were to determine FPs\" level of awareness and harm reduction perceptions of ECs and to delineate the factors associated with their counseling practices. Methods: This was a cross-sectional study with descriptive and analytical components. Data were collected through questionnaires. Questions mainly focused on demographic characteristics, knowledge and own use of ECs, general attitudes towards ECs, and daily practices while performing counseling on tobacco use. In order to control confounding factors, logistic regression analysis was performed. Findings: Among a total of 271 FPs, 49.1% (n = 133) were males and the median age (IQR) was 41 years (32-46). Almost one-fifth of the FPs (n = 52) reported that they did not provide counseling services to their smoking patients. Only 26.6% (n = 72) of the FPs stated that they felt confident enough to advise patients on smoking cessation. Of the FPs, 6.6% have stated that they have recommended ECs to their patients for smoking cessation with the strategy of harm reduction. Factors associated with providers\" recommendation of ECs to their patients as a harm reduction strategy included \"believing that ECs help smokers to quit, ECs could be vaped in closed areas, and ECs were healthier than combustible tobacco products\". Conclusion: In our study, FPs stated lack of confidence to advice patients on smoking cessation. Furthermore, they recommended ECs to their smoking patients as a harm reduction strategy. FPs\" confidence should be increased with the trainings based on recent evidence on ECs.
  • PublicationOpen Access
    Evidence based public health
    (2011-01-01) AY, NADİYE PINAR; AY N. P.
    Bir toplumda var olan sağlık sorunlarının tanımlanması, tanımlanan sorunlar arasından öncelikli olanların tespit edilmesi ve ardından bu sorunların önlenmesi ile kontrolüne yönelik etkililiği kanıtlanmış müdahale yöntemlerinin oluşturulması, uygulanması ve değerlendirilmesi Halk Sağlığının temel çalışma alanını oluşturmaktadır. Kanıta Dayalı Halk Sağlığı, tüm bu aşamaların gerçekleştirilmesi sırasında güncel bilimsel kanıtların kullanılarak, toplumsal ihtiyaç ve önceliklere yanıt verecek kararlar alınmasını sağlayan yapılandırılmış bir süreçtir. Bu yazıda, Kanıta Dayalı Halk Sağlığı yaklaşımının temel ilkelerinin, güncel örnekler kullanılarak özetlenmesi hedeflenmiştir. Anahtar sözcükler: Kanıta dayalı tıp, kanıta dayalı halk sağlığı, önleme
  • PublicationOpen Access
    Has the cancer-related death trend been changing in Turkey? An evaluation of the period between 2009 and 2019
    (2022-10-01) AY, NADİYE PINAR; TEKER SAYIN, AYŞE GÜLSEN; Teker A. G., AY N. P.
    Background: The objective of this study was to determine the trend of cancer-related death rates between 2009 and 2019 in Turkey for all cancers combined and the five cancer types with the highest mortality: lung, stomach, pancreas, breast, and colon cancers. Methods: Cancer mortality data were obtained from the Turkish Statistical Institute (TURKSTAT) and standardized by age using the World Health Organization (WHO) standard population ratios. The change in cancerrelated mortality over the years was evaluated using Joinpoint Regression Analysis (JRA). Results: Total cancer-related deaths increased by 2.2% annually between 2009 and 2014 and decreased by 2.9% annually between 2014 and 2019 (p < 0.05). Among men; lung cancer-related deaths increased by 2.4% annually between 2009 and 2014 and decreased by 3.4% annually between 2014 and 2019 (p < 0.05), stomach cancer-related deaths decreased by 5.1% annually between 2014 and 2019 (p < 0.05), colon cancer-related deaths increased by 5.8% annually between 2009 and 2015 and decreased by 3.3% annually between 2015 and 2019 (p < 0.05), pancreatic cancer-related deaths increased annually by 5.6% in 2009–2013 (p < 0.05). Among women; lung cancer-related deaths increased by 2.5% annually between 2009 and 2016 (p < 0.05), stomach cancer-related deaths increased annually by 2.3% between 2009 and 2014 and decreased annually by 4.5% between 2014 and 2019 (p < 0.05), colon cancer-related deaths increased by 2.5% annually between 2009 and 2017 (p < 0.05), pancreatic cancer-related deaths increased by 7.4% annually between 2009 and 2013 (p < 0.05) and breast cancer-related deaths increased by 2.2% annually between 2009 and 2019 (p < 0.05). Conclusion: Mortality data in Turkey are collected only by TURKSTAT, which raises concern regarding the incompletion of the data. While this might lead to underestimation, the trend shows that there has been a decrease in total cancer-related deaths in Turkey. Pancreatic cancer, on the other hand, gains a higher proportion in cancer-related deaths in Turkey as in the world. Increasing deaths from lung and breast cancer in women remind of the importance of tobacco control interventions and cancer screening programs.