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INTRODUCTIONEvery business is established to serve the needs of its target customers and satisfy them by fulfilling their demands and needs and as a result obtain the goals they set for themselves.1 The situation is the same for the health sector and even if the goals, service providers, form of provision and ownership of institutions change the ultimate goal is still to satisfy the patient and fulfill the existential purpose.The human factor has a major importance for the inputs, processes and outputs in healthcare services. A great part of service receivers are formed by patients and their relatives. Many factors such as problems experienced by these people from time to time in defining and expressing their demands and needs, the psychological states of service providers and receivers, patients who are in a hurry to receive service and healthcare workers who try to devote a fair share of attention to each patient affect the provision and results of healthcare services. ABSTRACT Background:The purpose of the study is to identify the frequency of encounters with difficult patients, the level of patient difficulty and the demographic characteristics of difficult patients from the perception of healthcare workers. Methods: The data have been obtained from the health workers who are employed at a public hospital in the city of Ankara and are in interaction with patients. The data have been obtained with the "difficult patient and healthcare personnel interaction survey". Results: It has been determined that approximately 2 out of every 10 patients (=2.11) which the healthcare workers encounter during the day are difficult patients and the level of difficulty of these patients is low (=3.62). It has been found that there is a medium level, positive and significant relationship between patient difficulty and seductive behavior and that seductive behavior has a significant effect on patient difficulty. It has been found that there is a medium level, positive and significant relationship between the discomfort experienced by the personnel and seductive behavior and that seductive behavior has a significant effect on the discomfort experienced by the personnel. Conclusions: As a result, it can be seen that nearly a fifth of all patients are perceived as difficult by healthcare workers. It is believed that healthcare workers should be informed about the characteristics of difficult patients and the aspects which should be taken into consideration while interacting with these patients and thereby more effective form of communication will be established at medical institutions.

This study aims at developing scale measuring attitudes of physicians against clinical practice guidelines (CPGs) and investigate whether the attitude of physicians against CPGs has an effect on the use of CPGs. ‘The Physicians’ Attitudes Against CPGs and The Use of CPGs’ was developed and used to collect data from the physicians working in a public education and research hospital. Physicians’ attitudes that were constructed as an upper latent variable were significant, positive and highly effective on the use of CPGs. Furthermore, the attitude upper latent variable explained 30% of the variance in the observed variable for the use of CPGs. The attitude upper latent variable was affected significantly, positively and at a remarkably high level by positive attitude latent variable while it was affected significantly, negatively and at a remarkably high level by negative attitude latent variable. Physicians’ attitudes against CPGs were found to be a highly important factor in the use of CPGs. And it was also observed that physicians’ positive attitudes against CPGs affected the use of CPGs in a positive way while negative attitudes had negative effect on use of CPGs.

Giriş ve amaç: Günümüz sağlık sisteminde rekabet avantajı elde etmek isteyen her bir sağlık işletmesi için kalite ve akreditasyon çalışmalarının önemi her geçen gün artmaktadır. Bu çalışmaları sağlık çalışanlarının bakış açısıyla değerlendirerek kurum kültürüne çevirmek çok önemlidir. Bu çerçevede hazırlanan bu çalışma ile çalışanlar açısından kalite ve akreditasyon faaliyetlerini değerlendirmek amaçlanmıştır. Gereç ve yöntem: Araştırma akredite bir özel hastaneyi, Sağlık Bakanlığı Kamu Hastanesini ve Asker Hastanesini kapsayacak şekilde üç merkezde gerçekleştirilmiştir. Elde edilen veriler Statistical Package for Social Science for Windows (SPSS 15) veri tabanında değerlendirilmiştir. Bulgular ve sonuç: Çalışma sonucunda, akredite özel hastane çalışanlarının kalite ve akreditasyon faaliyetleri konusunda yüksek düzeyde bilgi sahibi oldukları ( X :3,65); Sağlık Bakanlığı Hastanesi çalışanlarının üst yönetim tarafından kalite ve akreditasyon faaliyetlerine katılmaya teşvik edildiği ( X:3,06); ve Asker Hastanesi'nde kalite çalışmalarının hastanenin rekabet gücünü artıracağının değerlendirildiği ( X:3,28) yönünde bulgulara ulaşılmıştır.

Objective: In this study, the relationships between work family conflicts, work stress that may arise from these conflicts, job dissatisfaction and turnover intention of employees were investigated. Method: The research was carried out with healthcare professionals working in a public hospital during the Covid-19 process. The causal screening design was used in the research conducted with the quantitative research method. Data were collected with the questionnaire technique. Work family conflict scale, work stress scale, job dissatisfaction scale and turnover intention scale were used in the research. The construct validity of the scales was evaluated by confirmatory factor analysis. In addition, the convergent and discriminant validity of the scales were examined. The reliability of the scales was evaluated with Cronbach's alpha and composite reliability coefficients. In the research model tested by path analysis, direct, indirect and total effects were examined. Results: As a result of the analysis, it was determined that the scales used in the research had construct validity and that the scales had convergent and discriminant validity. The scales were found to be reliable. In the path analysis, it was determined that work family conflict and work stress did not have significant direct effects on turnover intention, but had significant indirect effects. It has been observed that job dissatisfaction has a mediating role in these indirect effects. Conclusion: It has been evaluated that the research findings can be useful for policy makers and health managers. Appropriate policies should be developed on the issues of work family conflict, work stress and job satisfaction in order to lower the turnover intention of the employees. Particular attention should be paid to the issue of job satisfaction in determining these policies.