Sevgi Özcan

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.

Diagnosis of penile fracture in primary care: a case report

IntroductionPenile fracture has been reported with sexual intercourse, masturbation, rolling over or falling on to the erect penis. Classically the history is with a sudden snap, pain, detumescence and a hematoma of the penis with deformity. Immediate surgical treatment is recommended. The patients may delay the admission due to fear and embarrassment or the condition may usually be underreported.Case presentationA 32-year-old man presented to primary care complaining of discoloration of penis without any significant history or symptom. Physical examination revealed swollen, ecchymotic, and deviated circumcised penis.ConclusionAlthough frequent and common diseases represent the majority of daily work, the primary care physician should be alert for possible unexpected history or symptom of a rare and often serious condition.

Fetal health locus of control in a sample of pregnant Turkish women

BACKGROUND/AIM To examine the relationship between sociodemographic and pregnancy features and fetal health locus of control (FHLC) in a sample of pregnant Turkish women. MATERIALS AND METHODS The study was conducted with 256 pregnant women. Data were collected by demographic questionnaire and the FHLC Scale consisting of 3 components: 1) Internality Scale (FHLC-I), 2) Powerful Others Scale (FHLC-P), and 3) Chances Scale (FHLC-C). RESULTS The age of marriage was found to have a positive relation with FHLC-I (r = 0.141) and a negative relation with FHLC-C (r = -0.145) (P < 0.05). The age of first pregnancy was found to have a positive relation with FHLC-I (r = 0.127). Those who have a low educational level (r = -0.258) and income (r = -0.149), who are unemployed (r = -2.839), whose number of pregnancies is high (r = 0.152), who get pregnant unplanned (r = 3.839), and who come to their first prenatal examination late (r = -0.142) have a significantly high score of FHLC-C (P <0.05). CONCLUSION It may be helpful for better outcomes of prenatal care to identify pregnant women who believe that their behavior has little effect on the health of their fetus and that it is controlled by chance.

Family Physician-Led Group Visits for Lifestyle Modification in Women with Weight Problems: A Pilot Intervention and Follow-Up Study

Objective: Lifestyle modification requires extensive information sharing and counseling. However, one-on-one primary care consultations are lacking to cover all necessary components due to time constraints. This preliminary study aims to investigate the feasibility and effects of lifestyle-changing intervention by family physician-led group visits (GVs) on weight management in overweight and obese women. Methods: 60 volunteers fulfilling the inclusion criteria were enrolled. Baseline and 6th month assessments consisted of anthropometric measurements, SF-36 Health Survey, blood variables, exercise test, and resting metabolic rate. Weight maintenance was controlled at the 12th month. Results: Although weight loss among participants varied, the mean body weights were significantly decreased by 8.2% in full-attenders (n = 30). A significant increase in HDL-cholesterol and decreases in heart rate and blood pressure were found. SF-36 summary scales were significantly improved. Weight change was moderately correlated with exercise duration, compliance to diet, and baseline mental component score. It was determined that 62.5% of the participants either lost or maintained body weight at the 12th month. Conclusion: Significant weight loss and quality of life improvement was achieved in this pilot study. GVs may be a promising alternative to primary care consultations for obesity management; however, the high dropout level and diverse outcomes need further assessment.

Health Promotion and the Role of the Family Physicians

Health promotion is boosting individual’s well-being. Physicians who give counselling in health promotion can affect individuals’ health behaviours and enhance their well-being. However, it has been indicated that it becomes more difficult for physicians to offer reliable advice to patients if they do not comply with those pieces of advice themselves. Therefore, it is significant for physicians at first to evaluate their knowledge, attitude and behaviours in this subject, to identify their needs and increase their sophistication. In this paper, the concept of health promotion and the role of the family physicians were discussed.