Person: ALTAŞ, ZEYNEP MEVA
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ALTAŞ
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ZEYNEP MEVA
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Publication Open Access Delivering the thinking healthy programme as a universal group intervention integrated into routine antenatal care: a randomized-controlled pilot study(2023-12-01) BORAN, PERRAN; DÖNMEZ, MELİKE; BARIŞ, HATİCE EZGİ; ALTAŞ, ZEYNEP MEVA; HIDIROĞLU, SEYHAN; SAVE, DİLŞAD; BORAN P., DÖNMEZ M., Barış E., Us M. C., ALTAŞ Z. M., Nisar A., Atif N., Sikander S., HIDIROĞLU S., SAVE D., et al.© 2023, The Author(s).Background: Women with perinatal depression and their children are at increased risk of poor health outcomes. There is a need to implement non-stigmatizing interventions into existing health systems which reduce psychosocial distress during pregnancy and prevent perinatal depression. We adapted the WHO-endorsed Thinking Healthy Programme (THP) to be delivered universally to all women attending routine online pregnancy schools in Istanbul, Turkey. This study aimed to evaluate the feasibility and acceptability of this intervention. Methods: This mixed-methods study incorporated a two-arm pilot randomized controlled trial and qualitative evaluation of the feasibility and acceptability of the adapted THP – Brief Group version (THP-BGV) to a range of stakeholders. We recruited pregnant women at 12-30 weeks’ gestation through pregnancy schools within the University Hospital’s catchment area. Women in the intervention arm received five online sessions of the THP-BGV delivered by antenatal nurses. The intervention employed principles of cognitive behaviour therapy to provide psychoeducation, behaviour activation, problem-solving strategies and group support to participants. In the control arm, women received usual care consisting of routine online educational pregnancy classes aided by the antenatal nurses. The women were assessed for depressive symptoms with the Edinburgh Postnatal Depression Scale at baseline and 4-6 weeks post-intervention and also evaluated for anxiety, perceived social support, partner relationship, level of disability and sleep quality. In-depth interviews were conducted with women and other key stakeholders. Results: Of the 99 consecutive women referred to the pregnancy schools, 91 (91.9%) were eligible and 88 (88.8%) consented to participate in the study and were randomized. Eighty-two (83%) completed the final assessments. Our main findings were that this preventive group intervention was feasible to be integrated into routine antenatal educational classes and it was valued by the women and delivery-agents. While the study was not powered to detect differences between intervention and control conditions, we found small trends towards reduction in anxiety and depressive symptoms favoring the intervention arm. No serious adverse events were reported. Conclusions: Given the paucity of preventive interventions for perinatal depression in low and middle-income countries, a fully powered definitive randomized controlled trial of this feasible and acceptable intervention should be conducted. Trial registration: The study was registered at Clinical Trails.gov (NCT04819711) (Registration Date: 29/03/2021).Publication Open Access The changing face of abuse cases in a pediatric intensive care unit: A single-center experience(2022-01-01) ALTAŞ, ZEYNEP MEVA; Varol F., Sahin E., Ozgunay B., Cengiz M., ALTAŞ Z. M. , Guven S.Background: Due to the increase in abuse and neglect cases in recent years, the purpose of this study was to assess child abuse and neglect of patients who were hospitalized and followed up in our pediatric intensive care unit (PICU). Methods: A total of 34 abuse and neglect patients who were admitted to the PICU from August 2020 to March 2021 were included retrospectively in the study. Patients’ clinical and demographic characteristics were obtained from our hospital’s patient record system (HIS). Comorbidities and the mental status of the patients, affected systems, treatments, and outcomes were extracted. Results: In this study, 44.1% (n: 15) of the patients were male and 55.9% (n: 19) were female. Physical neglect such as foreign body aspiration, malnutrition, electrocution, drowning, traffic accident, and body collision was detected in 14 (41.2%) patients. Emotional neglect (taking drugs, alcohol, or suicide) was found in 19 (55.9%) of our patients. Only 1 (2.9%) patient presented with physical abuse. Conclusions: Perception of neglect varies among different cultures. Any infant or child who is admitted to the PICU with a history that is not consistent, a history of delay in seeking medical attention, a previous history of abuse or suspected abuse, or the absence of the primary caretaker at the appearance of illness should signal possible abuse. Health-care professionals should give more attention to these patients to prevent the overlooking and recurrence of neglect and abuse cases due to the intense work tempo in the PICU.Publication Metadata only Evaluation of the impact of the COVID-19 pandemic on routine care of people with chronic disease: a qualitative study(2023-04-01) AYVAZ, İLKNUR; ALTAŞ, ZEYNEP MEVA; SAVE, DİLŞAD; Ayvaz İ., Altaş Z. M., Ekincikli B. T., İpsalalı H. O., Turan S. İ., Kunt K. S., Save D.Background and Objective: Restrictions in the COVID-19 pandemic have affected access to healthcare and caused delays in the routine care of people with chronic diseases. The aim of our study is to reveal the impact of the COVID-19 pandemic on routine care of people with chronic diseases. Methods: Our qualitative study was carried out with 12 people who came to the Cardiology outpatient clinics of tertiary Training and Research Hospital in June 2022 for a routine care due to their chronic diseases. As a data collection tool, a semi-structured questionnaire was used. The data were collected through face-to-face interviews with the participants by taking the necessary protective measures. Thematic analysis method was used in the analysis of the data. After the interviews were transcribed, each transcript was coded using the ATLAS.ti program. The ethics committee approval of the study was obtained. Results: The ages of participants were between 34-73, and 8 of them were male. Participant experiences were categorised into four themes: General Health Status, Routine Care during the Pandemic, Chronic Disease Management during the Pandemic and Patient Expectations of Healthcare. Most of the patients delayed their routine care during the pandemic and their chronic diseases worsened. Among the reasons for not going to the controls, the fear of contagion came to the fore, while some participants mentioned that they could not find an appointment. In terms of their expectations of healthcare, they stated that health institutions should give priority to those with chronic diseases and home health services and online services will provide convenience for them. Conclusion: Delaying hospital admissions for routine care made the management of chronic diseases difficult and worsened the chronic diseases of patients in the long term. Implementation of online health services such as telemedicine can facilitate chronic disease management.Publication Open Access Üniversite öğrencilerinde algılanan stres düzeyi ile yeme farkındalığı arasındaki ilişkinin belirlenmesi(2022-08-01) SAVE, DİLŞAD; ALTAŞ, ZEYNEP MEVA; Altaş Z. M., Save D., Soğukpınar T., Domruk Ö. F., Bayram S., Ladikli Ş. B., Cihanyurdu C.Giriş ve Amaç: Üniversite öğrencileri beslenme sorunlarının en fazla görüldüğü gruplardan biridir. Çalışmada, üniversite öğrencilerindealgılanan stres düzeyi ve yeme farkındalığı arasındaki ilişkiyi belirlemek amaçlanmıştır. Yöntem ve Gereçler: Tanımlayıcı tipteki bu çalışma, İstanbul’da bir devlet üniversitesinin Sağlık Yönetimi (SY), Beslenme ve Diyetetik (BVD) ve Beden Eğitimi ve Spor Öğretmenliği (BESÖ) bölümlerinin 1. ve 4. sınıf öğrencileri ile yürütülmüştür. Katılımcılara sosyodemografik sorular ve Yeme Farkındalığı Ölçeği (YFÖ), Algılanan Stres Ölçeği (ASÖ), Beslenme-Egzersiz Davranış Ölçeği (BEDÖ)’nin egzersizle ilgili 6 sorusu olmak üzere toplam 65 soruluk anket uygulanmıştır. Örneklem hesabı, öğrencilerde yeme farkındalığı yüksekliği oranı %50, güven düzeyi %95, hata payı %5 kabul edilerek toplam 384 kişi bulunmuştur. Her üç bölümün 1. ve 4. sınıf öğrencileri birer tabaka kabul edilerek her sınıftan listeden randomize şekilde 64’er kişinin örnekleme dahil edilmesi hedeflenmiştir. Bulgular: Araştırmaya katılım oranı %68,5’tir (n=263). Katılımcıların %76,4’ü (n=201) kadındır ve %44,1’i (n=116) beslenme ve diyetetik (BVD), %31,2’si (n=82) sağlık yönetimi (SY), %24,7’si (n=65) beden eğitimi ve spor öğretmenliği (BESÖ) bölümündendir. Öğrencilerin %51,0’i (n=134) 1.sınıfa; %49,0’u (n=129) 4.sınıfa devam etmektedir. Katılımcıların %77,1’inin (n=202) yeme farkındalığı yüksek bulunmuştur. Yeme farkındalığı yüksekliği oranı açısından bölümler arasında istatistiksel anlamlı fark bulunmuştur (p=0,007). Öğrencilerin ASÖ puanları ile BEDÖ ve YFÖ puanları arasında anlamlı negatif korelasyon bulunmuştur (sırasıyla r= -0,209, p=0,001; r= -0,224, p<0,001). Tartışma ve Sonuç: Literatüre göre bilinçli farkındalık temelli müdahaleler stresi azaltırken, yeme farkındalığını da arttırabilmektedir. Bu çalışmada da benzer şekilde öğrencilerin stres seviyesi arttıkça yeme farkındalıkları düşmektedir. Üniversite öğrencilerinde yeme farkındalığını arttırmak için stres seviyesini azaltabilecek etkinlikler planlanabilir. Anahtar Kelimeler: üniversite öğrencileri, bilinçli farkındalık, yeme farkındalığı, stresPublication Open Access Can charcoal hemoperfusion treatment be an option for pediatric MIS-C patients? A single-center experience in a tertiary pediatric intensive care unit(2022-08-01) ALTAŞ, ZEYNEP MEVA; Varol F., Sahin E. G. , Cengiz M., Kilic A., ALTAŞ Z. M. , Guven S., Cam H.Introduction Multisystem inflammatory syndrome in children (MIS-C) is a hyper-inflammatory disorder that develops following SARS-CoV-2 infection and has clinical signs that overlap with Kawasaki disease. Immunomodulatory treatments can be used in these patients. One of the alternative treatments reported in the literature is hemoperfusion therapy. In this study, we aim to evaluate our experience of charcoal hemoperfusion therapy in children admitted and followed up with a diagnosis of MIS-C at our Pediatric Intensive Care Unit (PICU). Material and Methods We performed a retrospective evaluation of children diagnosed with MIS-C and children treated with charcoal hemoperfusion who are admitted to our PICU. Results Among 49 MIS-C patients, hemoperfusion therapy was performed on 14 patients. Duration of hospitalization, duration of invasive/non-invasive ventilation, VIS, OFI, PRISM 3 scores, and mortality rates were significantly higher in the charcoal hemoperfusion group before treatment. In patients who did not respond to conventional therapies, we observed a statistically significant decrease in the need for inotrope and invasive mechanical ventilation support and statistically significant improvements in clinical indicators after hemoperfusion therapy. Discussion In our study, we observed a significant clinical and laboratory improvement by charcoal hemoperfusion in our MIS-C patients who had a severe clinical course and multiple organ failure. Conclusion In our opinion, this study is the first report regarding the use of charcoal hemoperfusion therapy in MIS-C patients, and the choice of charcoal hemoperfusion as an initial or rescue therapy is needed to be investigated in large patient groups both in children and adults who are diagnosed with COVID-19 and MIS-C.Publication Open Access Adaptation and integration of the thinking healthy programme into pregnancy schools in Istanbul, Turkey(2023-04-12) BORAN, PERRAN; DÖNMEZ, MELİKE; BARIŞ, HATİCE EZGİ; ALTAŞ, ZEYNEP MEVA; HIDIROĞLU, SEYHAN; SAVE, DİLŞAD; BORAN P., DÖNMEZ M., Atif N., Nisar A., Barış E., Us M. C., ALTAŞ Z. M., HIDIROĞLU S., SAVE D., Rahman A.BACKGROUND: Perinatal mental health is a major public health concern. In Turkey, public hospitals operate pregnancy schools which provides an opportunity to integrate an evidence-based Thinking Healthy Programme (THP) for perinatal depression. The aim of this study is to adapt the THP for universal use in the group setting and to understand its acceptability and feasibility for integration into the existing antenatal care programme for both face-to-face and online delivery. METHODS: Following an expert-led adaptation process using the Bernal Framework, field testing was conducted on a group of women and facilitators followed by in-depth interviews (n:8) and group discussions (n = 13). Data were analysed using Thematic Framework Analysis. RESULTS: Minor but significant adaptations were made to the individually delivered THP for use in the universal group pregnancy schools. Initial findings indicate that the THP-group version was acceptable to its target population and could be integrated into the antenatal care plan for delivery during face-to-face and online group classes. CONCLUSION: THP is transferable to the Turkish cultural and healthcare context. The THP-group version has the potential to add value to Turkey\"s existing perinatal healthcare programme.