Aylin Baydar Artantaş

Quality Assessment of Clinical Practice Guidelines Developed by Professional Societies in Turkey.

Background Clinical practice guidelines (CPGs) are systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances. There is a limited number of studies on guidelines in Turkey. The quality of Ministry of Health guidelines have formerly been assessed whereas there is no information on the other guidelines developed in the country. Aim This study aims to assess the quality of CPGs that are developed by professional societies that work for the health sector in Turkey, and compare the findings with international guidelines. Methodology Professional societies that work for the health sector were determined by using the data obtained from the Ministry of Internal Affairs. Inclusion and exclusion criteria were defined for selecting the CPGs. Guidelines containing recommendations about disease management to the doctors, accessible online, developed within the past 5 years, citing references for recommendations, about the diseases over 1% prevalence according to the “Statistical Yearbook of Turkey 2012” were included in the study. The quality of CPGs were assessed with the AGREE II instrument, which is an internationally recognized tool for this purpose. Four independent reviewers, who did not participate in the development of the selected guidelines and were trained in CPG appraisal, used the AGREE instrument for assessment of the selected guidelines. Findings 47 professional societies were defined which provided access to CPGs in their websites; 3 of them were only open to members so these could not be reached. 8 CPGs from 7 societies were selected from a total of 401 CPGs from 44 societies. The mean scores of the domains of the guidelines which were assessed by the AGREE II tool were; Scope and purpose: 64%, stakeholder involvement: 37.9%, rigour of development: 35.3%, clarity and presentation: 77.9%, applicability: 49.0% and editorial independence: 46.0%. Conclusion This is the first study in Turkey regarding quality appraisal of guidelines developed by the local professional societies. It adds to the limited amount of information in the literature that comes from Turkey as well as other developing countries.

Knowledge, Attitude and Behaviour of Married Women of 18-49 Age Group About Reproductive Health and Contraception

Amac: Bu calisma ile evli kadinin ureme sagligi ve kontrasepsiyon hakkindaki bilgi duzeylerinin, yontem tercihlerinin, sosyodemografik ozelliklerinin analiz edilmesi ve bunlarin; bilgi, tutum ve davranislari uzerindeki etkilerinin belirlenmesi hedeflenmistir. Materyal ve Metot: Calismada Ankara Ataturk Egitim ve Arastirma Hastanesi semt poliklinikleri ve Kadin Hastaliklari ve Dogum polikliniklerine basvuran 18-49 yas grubu 264 evli kadina yuzyuze gorusme teknigiyle 37 soruluk coktan secmeli yapilandirilmis anket uygulanmistir. Anketlere verilen cevaplar SPSS 15.0 programi araciligiyla analiz edildi. Bulgular: Kadinlarin %65.2’si herhangi bir korunma yontemi kullanmaktaydi. Dogum kontrol yontemleri icerisinde en cok bilinenleri sirasiyla; oral kontraseptif (OKS), rahim ici arac ( RIA), kondom, geri cekme idi. Geleneksel yontemlerden en cok bilineni ise geri cekme yontemi olarak saptandi. En az bilinen yontemler ise, kadin kondomu, vajinal halka ve spermisit tablet, jel ve kopuklerdi. En cok kullanilan yontem, % 28.5 oraninda geri cekme idi. Yas gruplari ile yontem tercihi arasinda istatistiksel olarak anlamli bir iliski vardi. Saglik personelinin (doktor-ebe hemsire) onerisiyle yontem kullanim orani %64.7 idi. Katilimcilardan %79.9’u aile planlamasinin ne oldugunu bilmekte ve dogru tanimlayabilmekteydi. Egitim ve gelir duzeyi arttikca, aile planlamasini bilme durumu da artmaktaydi. Kadinlarin %26.1’inin plansiz gebeligi olmustu. Toplam kadinlarin istemli dusuk (kuretaj) yapma orani %17.4 idi. Sonuc: Ureme sagligi ve kontrasepsiyon yontemleri konusunda bilgi duzeyi hala istenilen seviyede degildir. Plansiz gebeliklerin ve kuretaj oranlarinin yuksek olmasi, karsilanmayan aile planlamasi ihtiyacinin da yuksek oldugunu gostermektedir. Gunumuzde cok cesitli etkin ve modern yontemler mevcut olmasina ragmen, geleneksel yontemler, hala yuksek oranda kullanilmaktadir. Aile planlamasi egitim ve danismanlik hizmetlerinin artirilmasi, yayginlastirilmasi ve surekliligin saglanmasi ile bu konudaki bilgi eksikligi buyuk oranda giderilecek ve yanlis uygulamalarin onune gecilebilecektir. Boylece; kadin sagligi, ureme sagligi ve toplum sagligi daha ileri seviyelere tasinabilecektir.