Özet:

Amaç: Birinci basamak sağlık hizmetlerinin etkin ve verimli sunulmasında periyodik sağlık muayenesi (PSM) önemli bir yere sahiptir. Ülkemizde kişilerin PSM hakkındaki bilgi, tutum ve davranışlarını gösteren çalışmalar sınırlı sayıdadır. Bu çalışmanın amacı; bir üniversite hastanesi örnekleminde hastaların PSM hakkındaki farkındalıklarını tanımlamak ve beklentilerini öğrenmektir. Yöntem: Tanımlayıcı tipteki bu araştırma, bir üniversite hastanesi semt polikliniğine Eylül 2013 – Şubat 2014 tarihleri arasında herhangi bir nedenle başvuran 18 yaş ve üzeri kişilerden istatistiksel güç analizi ile 3400 kişilik evrenden belirlenen 1280 kişinin katılımıyla yürütülmüştür. Hazırlanan anket formu görüşmeyi kabul eden kişilere eğitim verilmiş olan üç anketör tarafından yüz yüze görüşme yöntemiyle uygulanmıştır. SPSS 20,0 istatistik paket programı kullanılmıştır. Tanımlayıcı veriler ortalama, standart sapma, frekans dağılımı ve yüzde olarak sunulmuştur. Değişkenler arasındaki ilişki ki-kare testi kullanılarak değerlendirilmiştir. PSM ziyaret sıklığına etki eden faktörler, lojistik regresyon analiziyle değerlendirilmiştir. İstatistiksel anlamlılık değeri p <0,05 olarak kabul edilmiştir. Bulgular: Yaş ortalaması 37,2±15,4 (18-82), erkek kadın oranı 1:1,6 olan katılımcıların %38,1’i erkek, %56,3’ü evli, %53,4’ü en az bir çocuk sahibi, %72,3’ü yüksek okul mezunudur. Katılımcıların %32,8’i en az bir kronik hastalığa sahiptir. %65,7’si PSM amaçlı klinisyene başvurduğunu belirtirken, %53,2’si koruyucu hekimliğin tanımını doğru yapmıştır. Katılımcılar, birbirini takip eden iki PSM’ye başvuru süresini ortalama 12,7±11,4 ay olarak önermiştir. Yapılan lojistik regresyon analizi sonucunda PSM’ye yıllık olarak gitme durumunu etkileyen faktörler cinsiyet, aylık gelir, iş durumu, kendisinde ve birinci derece akrabasında kronik hastalık olma durumu olarak bulunmuştur. Katılımcılara göre PSM’de kadın, erkek ve çocuklar için yapılması istenen testler arasında farklılıklar vardır. Sonuç: Katılımcılarda PSM ile ilgili bir farkındalık vardır, fakat PSM’nin uygulama ilkeleri hakkındaki bilgileri yetersizdir. Azımsanamayacak bir kısmı PSM ile Check-up’ın aynı anlama geldiğini düşünmektedir. Aile hekimlerinin PSM’nin uygulamasını kolaylaştıracak, toplumun mevcut sağlık sorunlarını kapsayan ve standart hale getirilmiş uygun tarama rehberleriyle desteklenmeleri birinci basamakta verilen hizmeti daha kaliteli ve sürdürülebilir hale getirecektir. Objective: Periodical health examination (PHE) has an important place in providing effective and efficient primary health care services. The goal of PHE is decreasing mortality and morbidity rates of people by identifying their risk factors and early symptoms of their treatable diseases when they are asymptomatic. As the awareness on the importance of chronical diseases became more widespread, the idea of “preventive care” started to come into prominence in social health perception and national health politics. The annual application number of a person to a family physicians is 2.9 in Turkey. That is why; family physicians have an important role with health counseling and early diagnosis of diseases. Studies that show the knowledge, attitude and behavior of people in our country regarding PHE are limited in number. The purpose of this study is to identify the awareness of patients and learn their expectations regarding PHE within a university hospital sample. Methods: This descriptive study was carried out with 1280 people of 18 years or older who have applied to a university hospital neighborhood outpatient clinic for any reason between September 2013-December 2014. A prepared questionnaire was filled using face to face interview with people who have accepted to do the interview by three interviewers. The questionnaire was consisted of 27 questions: the first 15 was about individuals’ descriptive features, habits, having chronical diseases themselves or their relatives; and the next 10 was about their knowledge, attitude, behavior and prectice regarding PHE. The last two questions aimed to identify the benefits of PHE and its differences from a check-up. For statistical analysis, SPSS 20.0 package program was used. Descripictive data was presented as mean, standard deviation, frequency and percentage. The relationship between the variables is evaluated using the chisquare test. Factors affecting the frequency of PHE applications are evaluated using the logistic regression analysis. The statistical significance value was accepted as p <0.05 within 95% confidence level. Results: The mean age was 37.2±15.4 (18-82), 38.1% of the participants were men, 56.3% were married, 53.4% had at least one child and 72.3% had university degree. 32.8% of the participants had at least one chronical disease. 86.2% of them (1104 people) stated that they have consulted with a clinician for the PHE the previous year, while 65.7% (841 people) of them stated that they have applied a clinician for PHE once in a life time and 53.2% of them have described preventive medicine correctly. The mean time between two PHE’s was 12.7±11.4 months. According to the results of the logistic regression analysis there was a statistically significant difference among participants in their decision to consult with physicians for PHE according to their age groups, their gender, if they are employed or not, their income level, if they are smoking or consuming alcohol regularly and if they or their close relatives had any chronical diseases (p<0.05). According to the participants, the most requested examinations for PHE by age and gender were; mammography with women (73.1%), prostate specific antigen measurement with men (74.8%) and vaccination with children (77.2%). Conclusion: The participants had some awareness regarding PHE but their knowledge about its principals is limited. According to the data gathered, more than half of the participants described the preventive medicine correctly and applications for PHE helped patients to early diagnoses and treatment if they had any health problem. However, the frequency of the PHE and the patients’ knowledge on examination, screening and health promotion seems inadequate. There is also a lack of knowledge on the different examinations for women, men and children that should be done during PHE. Supporting family physicians with screening tools which are standardized and relevant to community health needs, would ease performing PHE and make the primary care services better and sustainable.

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