Preoperatif değerlendirme konusunda birinci basamakta çalışan hekimlerin bilgi ve tutumlarının değerlendirilmesi

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Demet Laflı Tunay

Volume 2 · Issue 2 · pp. 150–168

Published: 2019-08-31

Abstract

Amaç : Preoperatif de ğ erlendirme, hastayı bütünüyle iyile ş tirmekten ziyade hastaya ait riskleri, t ı bbi ko ş ullar ı ve t ı bbi bak ı m ı optimize etme planını ortaya koymaya yönelik, hastanın kapsamlı bir ş ekilde de ğ erlendirmesini yapmakt ı r. Preoperatif de ğ erlendirme multidisipliner bir olay olup d ü nyada ge ç erlili ğ i olan birka ç modelden biri de birinci basamak hekim modelidir. Bu modelde cerrahi bran ş ı n kons ü ltasyonu do ğ rultusunda preoperatif de ğ erlendirme aile hekimi, dahiliye doktoru veya kardiyolog tarafından gerçekle ş tirilir. Bu çalı ş mada birinci basamak aile hekimlerinin preoperatif de ğ erlendirme konusundaki bilgi d ü zeyleri anket ç al ı ş mas ı ile ö l çü lmek istenmi ş tir. Materyal ve Metot : Adana il merkezi görev yapan aile hekimli ğ i uzmanlar ı na online anket formu üzerinden, sosyodemografik özellikleri ve Preoperatif de ğ erlendirme konusunda bilgi, tutum ve uygulamalar ı n ı sorgulayan Avrupa Anesteziyoloji Derne ğ i (ESA)'nin kardiyak olmayan cerrahi giri ş im ge ç iren yeti ş kinlerin preoperatif de ğ erlendirilmesine ili ş kin 2011 y ı l ı k ı lavuzunda yer alan tavsiyelerin 2018 y ı l ı nda yapılan güncellemesinden uyarlanmı ş standart anket uyguland ı . Bulgular : Katılımcıların %62,50’si aile hekimlerinin hastalarının preoperatif de ğ erlendirilmesinden sorumlu olmas ı gerekti ğ ini d ü ş ü nd ü klerini belirttiler. Aile hekimleri uygulanan ankette dü ş ü k bilgi d ü zeyi skoru olan kategorileri koagülasyon bozuklukları(%50,01), kardiyo vasküler hastalık(%61,87) ve renal hastalık(%67,19) iken yüksek skor alan kategoriler obezite(%87,51), anemi(%87,51) ve respiratuar hastalık(%75,01) olarak bulundu. Anket do ğ ru yan ı t ortalamas ı %71,40 olarak bulundu. Sonuç : Bu çalı ş ma birinci basamak hekimlerinin preoperatif haz ı rl ı k konusunda bilgili olmas ı na ra ğ men, birinci basamak hekim e ğ itim programlar ı nda daha iyi tan ı mlanm ı ş bir perioperatif t ı p m ü fredat ı na ihtiya ç duyuldu ğ unu ve birinci basamakta hizmet veren hekimlere bu konuda daha fazla e ğ itim verilmesinin gerekli oldu ğ unu g ö stermi ş tir. Anahtar kelimeler : Aile hekimli ğ i, birinci basamak, Preoperatif de ğ erlendirme

Keywords: Birinci Basamak; Preoperatif değerlendirme

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