Background:In recent years, so many people have left their counties because of the war or social, political and economic reasons. This study aims to evaluate the applications of Syrian refugees to a public health center to describe the health care provided to them. Method:The study is intended as a two-part in regard with the mixed design of the study. The first part planned as single-center, descriptive study to be performed with health records of the Syrian asylum seekers and refugees admitted İzmir-Karabaglar community health center within one year. In the second part semi-structured interviews with three doctors who were working in the same center, taking care of Syrian patients, was planned to understand their experiences and views on this service. For quantitative data SPSS for windows 20 program is used and descriptive analysis are performed. Thematic analysis was used for evaluating interviews. Results: 891 applications were made to Karabaglar community health center within one year and the median of the applicants was 4. The most prevalent reason for application was enfections (519; 58.2%) and the number of refugees who applied for preventive care was very low ( (90; 10.1%). The number of laboratory tests was 41 (4.6%) patients and the most requested test was urinary analysis. 502 (56.3%) application resulted with a prescription, the number of antibiotics and analgesics were the highest. Doctors who provide service were not satisfied with the care they give. They were having very deep communication problems related with both different cultur and language, hard time to understand patient and the disease. They stated that there is a need of different regulations. Conclusions: Refugees and asylum seekers do not receive the necessary health care they need. Physicians in primary care who take care of these people are thinking that they are not competent and not helpful for these patients. ÖZETGiriş: Son yıllarda milyonlarca insan, savaşlar başta olmak üzere siyasi, ekonomik ve sosyal sebeplerle öz vatanlarından ayrılarak yabancı ülkelere sığınmak zorunda kalmıştır. Çalışmamızda, sayıları gittikçe artan Suriyeli sığınmacıların, aldıkları birinci basamak sağlık hizmetlerini tanımlayabilmek amacı ile bir toplum sağlığı merkezine yapılan bir yıllık başvurular değerlendirilmiştir. Yöntem: Çalışma karma desende olup, iki aşamalı olarak tasarlanmıştır. İlk aşamada, İzmir-Karabağlar toplum sağlığı merkezine bir yıl içerisinde başvuran Suriyeli sığınmacı hastalara ait kayıtlardan elde edilen verilerle, tek merkezli, tanımlayıcı bir araştırma olarak planlanmıştır. İkinci bölümde ise, aynı birimde Suriyeli sığınmacılara, poliklinikte hizmet veren üç doktorla yarı yapılandırılmış görüşme yapılarak deneyimlerini ve görüşlerini aktarmaları istenmiştir. Kantitatif veriler, SPSS 20 programında değerlendirilerek tanımlayıcı analizler yapılmış, görüşmeler ise tematik analiz yöntemi ile değerlendirilmiştir. Bulgular: Karabağlar Toplum Sağlığı Merkezi'ne, bir yıl içerisinde yapılan başvuru sayısı 891 olup, ortanca yaş 4 olarak b...

Despite common use of primary health-care systems, with regard to tertiary hospital presentation, the most important factors for preferring tertiary hospital presentation were caregiver trust in tertiary hospital resources for diagnosis and treatment.

Introduction: Previously, palliative care was an approach brought forward in terminal patients when treatment options were exhausted. However, today, the opinion that palliative care should be initiated in addition to other treatment modalities starting from the moment of diagnosing a life-threatening disease has become prominent. The symptoms of depression and anxiety are common in patients with chronic diseases such as cancer. Moving on from the fact that these findings also manifest in the relatives of patients, this study aims to identify the symptoms of depression and anxiety and to assess these symptoms in the relatives of patients hospitalized in the extensive palliative care center.Methods: Designed as a descriptive cross-sectional study, this survey included a single group without control and was performed by conducting face-to-face interviews after obtaining consent from patient relatives. The questionnaire prepared consisted of the Beck anxiety scale (BAS), Beck depression scale (BDS), the hospital anxiety and depression scale (HADS) together with sociodemographic variables. The study included 102 volunteers and was carried out over a three-month period. Sociodemographic data of the patients were summarized using descriptive statistics. Subgroup analyses were performed using appropriate parametric and non-parametric tests.Results: The study enrolled 102 participants providing care to a relative in the palliative care service. Among these, 61 (59.8%) were women, and 41 (40.2%) were men. The risk for depression was identified as 43.1% (n=44) according to the BAS, and as 91.2% (n=93) according to the HADS. The anxiety rate was 66.7% (n=68) according to the BAS. Among these, 36.7% (n=25) demonstrated mild anxiety, 30.8% (n=21) demonstrated moderate anxiety and 32.3% (n=22) demonstrated severe anxiety. According to HADS, the risk for anxiety was 72.5% (n=74). Conclusion: The fact that the presence of depression and anxiety was significant in the caregivers of patients in the palliative care service warrants careful follow-up and necessary support of both the patients and their caregivers for mood disorders.

Caregivers are an important source of support for patients in palliative care. Comfort is an important concept in nursing care for both patients and their families, and nurses aim to increase comfort. The aim of the study was to determine the comfort level and influencing factors in caregivers of palliative care patients. The research sample consisted of 102 caregivers related to palliative care patients. The data were obtained with an Individual Information Form, the Edmonton Symptom Assessment Scale (ESAS) and the End of Life Comfort Scale (Caregiver/Family). The study was conducted in the palliative care clinic of Aksaray University Training and Research Hospital between October 2018 and April 2019. There was a significant relationship between the total comfort score of the caregivers and the patient's performance status, the caregivers' age, their economic situation, the length of the caregiving period and receiving help in care (social support) ( p < 0.05). Providing comfort is an important function and challenge for holistic nursing care, as comfort is a lifelong need in health and disease. Caregivers in the risk group should be aware of this issue and necessary precautions should be taken.

Diabetes mellitus (DM) is still one of the common chronic problems not only in rural but also the urban cities. While the regulation of blood sugar metabolism is one of the target points, living with DM can trammel primary care physicians. 64 years old female patient who was diagnosed with DM and hypertension for at least 5 years has attended the surgery for nuisance and dysuria. Bacteriuria has detected and blood sugar was 550 mg/dl WBC= 12,48 CRP: 7 HbA1C: 10,4 % Her neurologic examination was normal except she has got urinary incontinence. She was hospitalized with a diagnosis of DM, HT, and cystitis. Metformin 2x1gr, 1x 40 mg, ceftriaxone 2x1gr, and insulin glargine were ordered. Diabetic patient education has been performed. During follow-up, her blood sugar regulation has been settled but she complained of palpitation, ECG has been performed and diagnosed as AF (atrial fibrillation). Her blood pressure was 120/80 and metoprolol infusion was made. INR: 1,44 sec PT=17sn creatine=0,9 mg/dl. Control ECG was at sinus rhythm. While she was in time of recovery, internal medicine consultation has performed and she was planned to discharge. She complained about "could not talk". In her neurologic examination, her left arm has lost strength (3/5) and she could hear and understand what was told but couldn't speak. She was transferred to another health center for detection and treatment as pre-diagnose of Transient Ischemic Attack (TIA). DM never walks alone. At primary health care centers physicians should be aware of chronic conditions as well as the new onset problems to manage.