Person: CÖBEK ÜNALAN, GÜLRU PEMRA
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CÖBEK ÜNALAN
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GÜLRU PEMRA
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Publication Metadata only Depression and anxiety in Türkiye(CRC, New York , 2024-01-01) CÖBEK ÜNALAN, GÜLRU PEMRA; ÇİFÇİLİ, SALİHA SERAP; Tüzün S., Cöbek Ünalan G. P., Çifçili S. S.Publication Metadata only The effect of basic carbohydrate counting on hba1c in type 2 diabetic patients: a non-randomized controlled trial(2022-05-15) UZUNER, ARZU; CÖBEK ÜNALAN, GÜLRU PEMRA; Vural H., Uzuner A., Cöbek Ünalan G. P., Özkan Sınav H.Background:Carbohydrate counting (CC) is considered as a medical nutrition therapy method especially used in Type 1DM (T1DM) patients in basic and advanced levels. Limited number of studies reported that basic CCimproves glycemic control in T2DM patients, and there is need for further studies.Research questions:How the basic CC effects HbA1c levels in T2DM patients using oral antidiabetic drugs, when presented as acomponent of nutrition education by primary care physicians.Method:The study hereby is a non-randomized controlled clinical trial. T2DM patients, aged between 18-75 years,HbA1c levels between 6.5%-10.8% using oral antidiabetic medication, were followed for three months in twogroups; one intervention (IG) (n=33) and one control group (CG) (n=45), in two different Primary CareCenters. General diabetes monitoring principles were applied in both groups; basic CC training was givenadditionally to the IG. The training consisted of three sessions lasting 40 minutes each. An informative CCbooklet was provided to both groups. Beside sociodemographic questionnaire, a healthy nutrition informationscale was applied to all of the participants; HbA1c, other laboratory and anthropometric measurements wereperformed at the beginning and at the 3rd month of the study.Results:The mean age value was 54.58±9.69 (28-73). Male/female distribution was (IG:57.6%/42,4%,CG:53.3%/46,7%). At the third month, HbA1c value decreased within the IG from 7.7% to 7.2% (p:0.002),from 7.49% to 7.46%, in the CG (p:0.851). Comparing two groups, the decrease in HbA1c in the IG washigher than in the CG (-0.5, -0.02, p: 0.018). Third month knowledge score was higher the intervention group’s(<0.001).Conclusions:Basic CC training provided to T2DM patients by primary care physician, improves glycemic control byincreasing CC knowledge level and improving HbA1c.Points for discussion:How to integrate basic CC education at the diabetes management primary care centers?Presentation on 13/05/2022 16:30 in \"Parallel Session G - Theme Papers: Diabetes\" by Hamide Vural.Publication Metadata only How does “home health services” training during family medicine residency influence medical practice of the physicians(2022-10-20) CÖBEK ÜNALAN, GÜLRU PEMRA; APAYDIN KAYA, MEMNUNE ÇİĞDEM; Cöbek Ünalan G. P. , Yigit Ercan E., Apaydın Kaya M. Ç. , Temel K.Background: Family physician who has a key role in the provision of Home Care is considered to take part in this service delivery according to the basic discipline characteristics he/she is expected to provide this service. However, training on this topic doesn't have a standart during residency and there is no data yet on how physicians trained in HHSs and whether the training is effective in practice. Research questions: What kind of training is received during residency, perceptions of the family physicians and how it contributed to their daily practice? Method: Qualitative research method with audio recordings through focus group interviews and face-to-face structured in-depth interviews between 04,September 2021 and 04,February 2022 was used. Snowball method was used to recruit the family physicians who had HHS training during their residency. A total of 64 family medicine specialists were reached; 25 did not meet the inclusion criteria and 22 did not accept to participate in the study, a total of 16 were interviewed. Results: Physicians talked about their achievements, positive and negative experiences during residency training and providing HHSin their practice. Physicians' main argument was the HHS training is an opportunity to learn the basic principles and approaches of Family Medicine discipline. It is irreplaceably important in professional development, professional satisfaction and motivation. So the training methods and curriculum arrangements of Home Care training must be reviewed and best conditions must be integrated. They also mentioned negative experiences, too; the technical, structural and organizational problems during the consultation and referral, security concerns and physical difficulties experienced with the proxies were the emerging categories. Conclusions: HHS practicing physicians mention that HHS, Social Services and Family Medicine/Primary Care are a whole and a unique area to practice comprehensive and biopsychosocial care. So not only the effective training during residency but also the collaboration during practice is essential.Publication Open Access Job satisfaction of family physicians in European countries with different strengths of care coordination(2022-12-01) ÇİFÇİLİ, SALİHA SERAP; CÖBEK ÜNALAN, GÜLRU PEMRA; Şahin S., Çifçili S. S., Cöbek Ünalan G. P.Background. Job satisfaction of family physicians (FPs) is vitally important not only for the well-being of physicians but also for the quality of health services. Coordination of care is one of the core dimensions of strong primary care. However, studies focused on the association between care coordination and the job satisfaction of FPs is scarce. Objectives. To explore whether the factors influencing the job satisfaction of FPs differ in countries with different strengths of coordination. Material and methods. Across-sectional study was conducted among FPs in ten European countries which were divided into three groups in terms of care coordination. An online questionnaire was disseminated by e-mail to groups of FPs. Socio-demographic, working conditions and workload features were included as independent variables. Job satisfaction as the outcome variable was measured with one question. The Chi-square test was used for comparative analysis. Results. 278 FPs (72% of the targeted sample size) participated. The job satisfaction of FPs in strong and medium-level care coordination groups was higher than their counterparts in the weak-level care coordination group (p < 0.001). No association was found between the socio-demographics and workload features with job satisfaction. Only the non-existence of a gate-keeping system was associated with the increased job satisfaction of FPs in the medium-level care coordination group (p = 0.01). Conclusions. Primary health care is responsible for the coordination of care within the gigantic healthcare system, and FPs play a role in guiding patients. Studying the association between care coordination and the job satisfaction of FPs might help to build better healthcare systems. The gate-keeping system deserves special attention in this research area.Publication Open Access Care burden and related factors among informal caregivers of patients with amyotrophic lateral sclerosis(2022-06-01) ÖZAYDIN, AYŞE NİLÜFER; CÖBEK ÜNALAN, GÜLRU PEMRA; Tülek Z., Özakgül A., Alankaya N., Dik A., Kaya A., Cöbek Ünalan G. P., Özaydın A. N., İdrisoğlu H. A.Objective: Amyotrophic lateral sclerosis (ALS) affects the life of the family caregiver as well as the patient. This study aimed to determine the care burden and related factors among family caregivers of Turkish ALS patients. Methods: This descriptive study was conducted with 108 ALS patients and their informal caregivers through face-to-face interviews at home. The data were collected using the ALS Functional Rating Scale, Zarit Burden Interview, European Quality of Life-Five Dimensions Questionnaire, Multidimensional Scale of Perceived Social Support, and the Hospital Anxiety and Depression Scale. Results: The mean age of the caregivers was 48.1 ± 13.4 years; the vast majority were female, and they were either spouses or children of the patients. While 49.1% reported moderate or severe burden, the quality of life was moderate (mean 70.4 ± 22.8). The caregiver burden was related to sex and the functional state of the patient, as well as caregiver factors such as the relation to the patient, sex, health status, time spent for care, and living in the same house with a limited environment. Walking ability, percutaneous endoscopic gastrostomy, tracheostomy, and communication problems were not associated with the burden. Furthermore, burden was associated with the caregiver’s quality of life, social support, anxiety, and depression. Conclusions: The present study draws attention to the fact that the care burden in family caregivers of ALS patients is high and their quality of life is impaired. Our findings reveal that not only ALS patients but also caregivers need to be supported with an organized and planned system.Publication Metadata only The effectiveness of a school-based intervention to decrease the risk of obesity in primary school children: non-randomized clinical study(2022-05-15) CÖBEK ÜNALAN, GÜLRU PEMRA; UZUNER, ARZU; Aksoy L., Uzuner A., Cöbek Ünalan G. P., Cengiz A., Kılıççıoğlu S., Salman U., Öçbe B.Background:The childhood obesity is a growing health problem in our country.There are many intervention studies mostly designed for the management of the overweight and obesechildren, however the childhood obesity necessitates risk assessment and interventions to prevent thedevelopment of obesity.Research questions:What is the risk of obesity among primary school children and the effectiveness of a school based andinteractive intervention planned for risky students and their parents?Method:This is a mixed type design with a cross-sectional study to determine the risk prevalence of obesity followedby a non-randomized controlled study to evaluate the effectiveness of an interactive intervention to decreasethe determined risk.Two different primary schools are selected, one for intervention (IG), the other for the control group (CG);primary year students is the universe. A questionnaire, Food Index (FI) and Family Nutrition and PhysicalActivity tool (FNPA) will be sent to all parents of both schools. The students with fulfilled questionnaires will berecruited in the study, anthropometric measurements will be performed at school. A risk scale defined by theresearchers based on the obesity related questions, BMI, FI and FNPA scores. A total of 165 risky children(55 in IG-110 in CG) will form the sample size. This an eight-weeks and ten-sessions intervention; eight for thestudents only, two for parents, one with all together. The content is designed based on the principles ofhealthy nutrition; the methods will be interactive, including plays and role-plays. A student-parent educationwill be provided to the control group. At the 3rd-6th month following the course measurements and riskquestionnaires will be repeated.Results:Primary outcomes: risk prevalence and the decrease in the risk scores.Conclusions:Our study aims to contribute to primary care by detecting and intervening risky children before obesitydevelops in primary care.Points for discussion:Integration of effective and entertaining child friendly interventions to primary school curriculum could preventchildhood obesity.Presentation on 14/05/2022 15:50 in \"Parallel Session R - One Slide Five Minute Presentations\" by Arzu Uzuner.Publication Open Access The relationship of somatization with fatigue and exhaustion as chief complaints(2020-09-01) CÖBEK ÜNALAN, GÜLRU PEMRA; Ayaz Z., ÜNALAN G. P.BackgroundPublication Metadata only COVID-19 Pandemi Döneminde Üreme Çağındaki Kadınların Birinci Basamakta Sunulan Aile Planlaması Hizmetlerine Erişim Durumlarının Karma Araştırma Yöntemleri ile Değerlendirilmesi(2022-11-01) CÖBEK ÜNALAN, GÜLRU PEMRA; ÇİFÇİLİ, SALİHA SERAP; Koçak M., Cöbek Ünalan G. P., Çifçili S. S.