Sıdıka Kaya

The Turkish version of the safety attitudes questionnaire: psychometric properties and baseline data

Objective To test the psychometric soundness of the Safety Attitudes Questionnaire (SAQ) in Turkish hospitals, examine differences in perceptions of safety and provide baseline data. Methods The SAQ (inpatient version) was translated with the back-translation technique into Turkish. Ten out of 50 teaching hospitals belonging to the Ministry of Health in Turkey were selected randomly. The Turkish version of the SAQ was administered to a sample of 2000 care givers at 10 hospitals. The factor structure of the responses was tested by confirmatory factor analysis. Cronbach alphas were calculated, and the mean and percentage positive safety attitude scores were assessed. Results The response rate was 67.5%. Cronbach alphas of six factors (teamwork climate, safety climate, job satisfaction, stress recognition, perceptions of management, and working conditions) ranged from 0.66 to 0.77. Goodness-of-fit indices from the confirmatory factor analysis showed a reasonable model fit. There was a substantial variability among hospitals in terms of items and factors. Baseline data for the Turkish hospitals are presented. Conclusion The Turkish translation of the SAQ showed satisfactory internal psychometric properties. Attitudes relevant to safety culture vary widely by hospital and indicate a need for improvement. Survey findings provide a baseline for future benchmarking.

Perceptions of nurses on the impact of accreditation on quality of care

Purpose – This article aims to investigate perceptions of Turkish nurses on the impact of accreditation on quality of care and the effect of accreditation on quality results. Design/methodology/approach – This study was performed as a cross-sectional, questionnaire-based survey on 258 nurses who started working in the hospital before it was accredited and continued to work during and after accrediation and who therefore knew both the hospitals pre-accrediation and post-accreditation periods. In this study, descriptive statistical analyses (means and standard deviations) were carried out to explore the views of the participants on “quality results,” “benefits of accreditation” and “participation of employees.” “Quality results” was considered to be the dependent variable, while “benefits of accreditation” and “participation of employees” were accepted as the independent variables. The relationship between the dependent variable and the independent variables was tested using Pearson correlation and multipl...

Violence against doctors and nurses in hospitals in Turkey

ABSTRACT Purpose: This study shows the rates of violence experienced by doctors and nurses and their ensuing responses including reporting rates and any effects experienced because of the violence. Method: The Survey for Investigating the Violence on Medical Employees was administered to 254 doctors and nurses. Data were analyzed using chi-square and logistic regression analysis. Results: Of the participants, 74.4% had been exposed to some form of violence. Most of the participants, 87.3%, experienced verbal violence; 12.2% experienced physical violence; and 0.5% experienced sexual violence. Logistic regression analysis indicated that married doctors and nurses are at risk of experiencing violence 0.5 times greater when compared with unmarried or widowed doctors and nurses (p = 0.026). The experience of violence differs by hospital type (p = 0.038) and years working in the healthcare industry (p = 0.042). Differences were also found regarding exposure to violence between doctors and nurses in terms of time of day (p = 0.031) and the work being performed (p < 0.001). The most cited cause of violence (50.8%) was the healthcare system. Verbal response was the most frequent reaction to violence (24.4%), with loss of occupational performance (58.2%) being the most cited negative outcome. Approximately 9.3% of the victims reported the violence to judicial authorities. A lengthy judicial proceeding was chosen as the most significant hindrance to reporting the violence (45.8%). Discussion: This study reveals the effects of violence and reporting rates at two hospitals in Turkey, and it implies that underreporting of violence is an important issue. Therefore, hospital management should take measures to increase reporting and take necessary actions when violence is reported.

The relationship between burnout and mobbing among hospital managers

Background: Mobbing and burnout can cause serious consequences, especially for health workers and managers. Level of burnout and exposure to mobbing may trigger each other. There is a need to conduct additional and specific studies on the topic to develop some strategies. Research objectives: The purpose of this study is to determine the relationship between level of burnout and exposure to mobbing of the managers (head physician, assistant head physician, head nurse, assistant head nurse, administrator, assistant administrator) at the Ministry of Health hospitals. Research design: The “Leymann Inventory of Psychological Terrorization” scale was used to measure the level of exposure to mobbing and the “Maslach Burnout Inventory” scale was used to measure the level of burnout of hospital managers. The relationship between level of burnout and exposure to mobbing was analyzed by Pearson’s Correlation Analysis. Participants and research context: The population of this study included managers (454 managers) at the Ministry of Health hospitals in the metropolitan area of Ankara between September 2010 and May 2011. All the managers were tried to conduct, but some managers did not want to reply to the questionnaire and some managers were not found at their workplace. Consequently, using a convenience sampling, 54% of the managers replied to the questionnaire (244 managers). Ethical consideration: The approval of the study was granted by the Ministry of Health in Turkey. Furthermore, the study was evaluated and accepted by the Education, Planning and Coordination Council of one of the education and research hospitals in the study. Findings: Positive relationships were found among each subdimension of the mobbing and emotional exhaustion and depersonalization. A negative relationship was found between each subdimension of the mobbing and personal accomplishment. Discussion: In hospitals, by detecting mobbing actions, burnout may be prevented. Conclusion: Exposure to mobbing and burnout could be a serious problem for head nurses who are responsible for both the performance of the nurses and organization. Additionally, head nurses who are faced with mobbing and burnout are more likely to provide suboptimal services which could potentially result in negative outcomes. Therefore, this study draws attention to the importance of preventing these attitudes in the organization.

Medical tourism developments within Turkey

Turkey has a considerable share of worldwide tourism, and has become a popular destination more recently in terms of medical tourism. The Turkish healthcare system has gone through a radical structural change since 2003 and Turkey has made significant investments in health services in both the private and public sectors. Data from the Ministry of Health suggest that the number of international patients receiving health services in Turkey grew from 74 000 in 2008 to approximately 262 000 in 2012. Not all patients travelling to Turkey are individuals who pay out-of-pocket. There are also state-state relations and reimbursements. Turkey also provides health services to citizens of the countries that have rights to receive medical help within the scope of the Social Security Agreements and its own citizens living abroad. Turkey has many competitive advantages including high-quality and low-price services, hospitals at international standards and international accreditation, educated and experienced human resources, short waiting times, and its history, geography, attractions and climate that make it popular for visitors. In this chapter, the development and current state of medical tourism, relevant politics and regulation, and the future development of medical tourism in Turkey are examined.

The effect of nurses’ empowerment perceptions on job safety behaviours: a research study in Turkey

Objective. This study aimed to investigate the effect of nurses’ empowerment perceptions on job safety behaviours. Methods. A survey of 377 nurses working in five hospitals in Turkey was conducted using the conditions of work effectiveness questionnaire, psychological empowerment instrument, universal precautions compliance scale and occupational health and safety obligations compliance scale. Relations between variables were tested using Pearsons correlation and path analysis. Results. There was a moderate and statistically significant relationship between psychological and structural empowerment and complying with universal safety measures and meeting occupational health and safety obligations. Also, an increase of 1 unit on the level of psychological empowerment was found to correspond to an increase of 0.37 units on the level of universal precautions compliance and to an increase of 0.46 units on the level of occupational health and safety obligations compliance. As such, an increase of 1 unit in structural empowerment corresponds to an increase of 0.53 units on the level of universal precautions compliance and to an increase of 0.36 units (total effect) on the level of occupational health and safety obligations compliance. Conclusions. The findings reveal that empowerment is a valuable tool for nurses’ positive job safety behaviours.

A comprehensive framework identifying readmission risk factors using the CHAID algorithm: a prospective cohort study

Objective To identify frequency of readmission after discharge from internal-medicine wards, readmission risk factors, and reasons and costs of readmission. Design Prospective cohort study. Setting A tertiary-care hospital in Turkey. Participants 2622 adult patients discharged from internal-medicine wards of the hospital between 1 February 2015 and 31 January 2016. Main outcome measures Thirty day all-cause readmission rates, reasons and costs of readmission. To identify readmission risk factors Chi-square Automatic Interaction Detector (CHAID) analysis was conducted. Results The same hospital readmission rate was 17.9%, while the same hospital or different-hospital readmission rate was 21.3%. Receiver operating characteristic (ROC) curve analysis showed that the predictive performance of the CHAID algorithm was high. According to the CHAID algorithm, the most significant readmission risk factor was the main diagnosis of neoplasm at the index admission. In other diagnosis groups, higher Charlson comorbidity score, higher level of education, having a regular physician, and three dimensions of Readiness for Hospital Discharge Scale were significant risk factors for readmission. The most frequent reason for readmission was neoplasm, and the total cost of readmissions was ~

Reliability of a hospital utilization review method in Turkey

900 000. Conclusions The CHAID algorithm for readmissions had a high predictive strength and provided details that aid physicians in decision-making. Measures must be taken from initial diagnosis to post-discharge follow-up, to minimize readmissions, especially in patients with neoplasm.