Esra Saatçi

The well-being and treatment satisfaction of diabetic patients in primary care

BackgroundThe quality of life in patients with diabetes is reduced and emotional coping with the disease has great impact on patient well-being.ObjectivesThe aim of this study was to assess the psychological well-being and treatment satisfaction in patients with type 2 diabetes mellitus in primary care.Study Design and SettingPatients (n = 112) with type 2 diabetes mellitus diagnosis for at least six months were enrolled. The Well-Being Questionnaire-22 and the Diabetes Treatment Satisfaction Questionnaire were used. Physical examination and laboratory investigations were performed.ResultsThe rates of the achieved targets were 32.1% for hemoglobin A1c, 62.5% for cholesterol and 20.5% for blood pressure. The mean scores for the general well-being, depression, anxiety, positive well-being and energy were 44.40 ± 13.23 (range = 16-62), 12.65 ± 3.80 (range = 5-18), 10.57 ± 4.47 (range = 1-18), 12.00 ± 4.01 (range = 2-18), and 9.16 ± 2.47 (range = 2-12), respectively. The mean scores for the treatment satisfaction, perception for hyperglycemia and perception for hypoglycemia were 22.37 ± 9.53 (range = 0.00-36.00), 1.71 ± 1.59 (range = 0-6), and 0.51 ± 0.98 (range = 0-6), respectively. There were significant associations between the depression score and the educational status, compliance to diet and physical exercise, and diabetic complications; between the anxiety score and the educational status, glycemic control, compliance to diet and physical exercise; between the energy score and the educational status, compliance to physical exercise, and diabetic complications; between the positive well-being score and the educational status, compliance to diet and physical exercise, complications and type of treatment; between the general well-being score and the educational status, compliance for diet and physical exercise, and complications. Treatment satisfaction was significantly associated to the educational status, glycemic control and compliance to diet and physical exercise. A significant correlation was found between the treatment satisfaction and the well-being.ConclusionsIndividualized care of patients with diabetes should consider improving the quality of life. Psychosocial support should be provided to the patients with type 2 diabetes and the negative effects of psychopathological conditions on the metabolic control should be lessened.

Challenges in access to health services and its impact on quality of life: a randomised population-based survey within Turkish speaking immigrants in London

Background and aimThere are a significant number of Turkish speaking immigrants living in London. Their special health issues including womens health, mental health, and alcohol and smoking habits has been assessed. The aim of this study was to explore the ongoing challenges in access to health care services and its impact on Quality of Life of immigrants.Material and methodsThis cross-sectional population-based study was conducted between March and August 2010 with Turkish immigrants (n = 416) living in London. Of these, 308 (74%) were Turkish and 108 (26%) were Turkish Cypriots. All healthy or unhealthy adults of 17-65 years of age were enrolled. A structured questionnaire with 44 items in five subcategories and 26-items WHOQOL BREF were used.ResultsMean duration of stay for Turkish Cypriots (26.9 ± 13.9 years) was significantly longer than Turkish immigrants (13.3 ± 7.5) (p < 0.001). Turkish immigrants (n = 108, 36.5%) need interpretation more often when using health services than Turkish Cypriots (n = 16, 15%) (p < 0.001). Multivariate analyses suggested significant effects of older age, non-homeownership, low socioeconomic class, poor access to health services, being ill, poor community integration and being obese on physical well-being and also significant effects of low income and poor community integration on perceived overall Quality of Life (WHOQOL) of the participants.ConclusionsThe results of this study demonstrate how the health and well-being of members of the Turkish speaking community living in London are affected by social aspects of their lives. Providing culturally competent care and interpretation services and advocacy may improve the accessibility of the health care.

The developments of general practice/family medicine in Turkey

The current healthcare system of Turkey has failed to meet the health needs of the people. Neither the people who use the healthcare services nor the providers are satisfied with current healthcare delivery. Transition from this system of hospital-based health services towards a general practice-based health care system is the core content of the reform process in Turkey. However, although a period of ten years has elapsed, this process has made little progress and the draft laws from 1994 have not yet been enacted. Retraining general practitioners in primary healthcare (PHC) towards general practice/family medicine (GP/FM) and vocational training in GP/FM are challenging issues for the reform process and for academic general practice departments. Following the decision of the Higher Educational Council (HEC) in 1993, departments of general practice have been established in 21 of the 45 medical schools. Despite many substantial problems, there are promising developments in GP/FM in Turkey.

Hidden Agenda Among Individuals Visiting a Family Physician in Turkey for Routine Health Visits: a Cross-sectional Study

When a patient requests a periodic health examination or a screening test, physicians may assume it is for detection of an asymptomatic disease. In this context, most recommendations for periodic health examinations are based largely on the prevalence of preventable disease in asymptomatic individuals. 1 However, a prospective study has shown that the majority of patients coming in for a routine check-up were motivated by specific symptoms and health concerns and were not Basymptomatic.^ 2 This could be systematically ignored or overlooked during check-up consultations in which physicians may focus on delivering recommended screenings. Unfortunately, however, one in three patients have one or more hidden agendas for their periodic health examination. 3 Patients often use periodic health examinations as a reason for consultation to raise the issue of a specific problem that troubles them, to use the physician as a counselor to discuss problems, to seek reassurance regarding symptoms or to obtain relief. 4 Our study purpose was to evaluate the presence of a hidden agenda among individuals visiting a family physician in Turkey for routine health visits.