Publication: Türkiye'de Görev Yapan Aile Hekimliği Uzmanlık Öğrencilerinin Bel Ağrısı Hakkında Bilgi ve Uygulamaları
Abstract
AMAÇ: Bu çalışmanın amacı Türkiye'de görev yapan aile hekimliği asistanlarının bel ağrısı hakkında bilgi ve uygulamalarını değerlendirmektir. GEREÇ VE YÖNTEM: Bu araştırma 04.08.2022-08.11.2022 tarihleri arasında yapıldı. Türkiye'de aile hekimliği uzmanlık eğitimi alan asistan hekimlerden çalışmayı kabul edenler ile yapılan kesitsel, tanımlayıcı tipte bir anket çalışmasıdır. Hekimlere online anket formu uygulandı. Tüm istatistiksel analizler IBM SPSS sürüm 25.0 kullanılarak gerçekleştirilmiş olup istatistiksel anlamlılık düzeyi p<0,05 olarak kabul edildi. BULGULAR: Çalışmaya 225'i erkek (%65,2) olmak üzere 345 asistan hekim katıldı. Hekimlerin bel ağrısı bilgi puanı ortalama değeri 31,4±4,83'tü. Hekimlerin bel ağrılı hasta yönetiminde kendini yeterli hissetme skoru ortalama değeri 6,43±1,58 saptandı. Hekimlerin bel ağrılı hasta yönetiminde kendini yeterli hissetmesi ile bilgi puanı arasında pozitif yönlü istatistiksel olarak anlamlı bir ilişki saptandı (p=0.002). Hekimler; meslekteki çalışma yılına, asistanlıkta çalışma süresine, bel ağrısı ile ilgili aldıkları en kapsamlı eğitim yerlerine, poliklinikte bel ağrılı hastayla karşılaşma sıklığına, uzmanlık eğitimi sırasında Aile Sağlığı Merkezi'nde (ASM) görev alıp almama durumlarına göre bilgi puanları açısından karşılaştırıldığında anlamlı fark saptanmadı (p>0.05). Hekimlerin uzmanlık eğitimi sırasında Fiziksel Tıp ve Rehabilitasyon (FTR) rotasyonu alıp almama durumuna göre karşılaştırıldığında FTR rotasyonu alan hekimlerin bilgi puanı almayanlara kıyasla daha yüksek saptandı (p=0.012). Hekimlerin %46,7'si geleneksel ve tamamlayıcı tıp uygulamalarını hastalarına önermeyi tercih etmedi. Egzersiz önerisi yönteminin sorgulandığı çoklu yanıt verilebilen soruda hekimlerin %80,3'ü hastalarını FTR hekimine yönlendirmeyi, %55,4 hastalara resimli broşürler vermeyi, %22,9'u ise egzersizleri kendileri göstermeyi tercih etti. Hekimlerin medikal tedavi tercihleri sıklıkla nonsteroidal antiinflamatuar ilaçlar (NSAİİ) ve topikal ilaçlar oldu. Opioidleri tercih etme sıklığı düşüktü. SONUÇ: Hekimlerin ilgili hasta grubu ile tecrübe kazanmasının bilgi puanına herhangi bir etkisi olmadı. FTR rotasyonu yapmış olmanın bel ağrısı bilgi düzeyini arttırdığı görüldü. Hekimlere bel ağrısı ile ilgili verilen eğitimlerin arttırılmasının bel ağrılı hasta yönetimini kolaylaştıracağı düşünüldü. Anahtar Kelimeler: aile hekimi, bel ağrısı, bilgi, uygulama
AIM: The objective of this study is to evaluate the knowledge and practices of family medicine residents working in Turkey about low back pain. MATERIALS AND METHODS: This research was carried out between 04.08.2022 and 08.11.2022. It is a cross-sectional, descriptive survey study conducted with family medicine residents in Turkey who volunteered to participate in this study. An online questionnaire was applied to the physicians. All statistical analysis were performed using IBM SPSS version 25.0 and the statistical significance level was accepted as p<0.05. RESULTS: 345 residents, 225 of whom were male (65.2%), participated in the study. The mean low back pain knowledge score of the physicians was 31.4±4.83. The physicians' mean self-efficacy score in the management of patients with low back pain was found to be 6.43±1.58. A positive statistically significant correlation was found between the physicians' feeling of self-efficacy in the management of patients with low back pain and their knowledge score (p=0.002). When the physicians' knowledge scores were compared according to the years of employment in the profession, the duration of their assistantships, the places where they received their most comprehensive training on low back pain, the frequency of encountering a patient with low back pain in their polyclinics, whether they worked in the Family Health Centers (FHC) during their speciality training, no significant difference was found ( p>0.05). When the physicians were compared according to whether they received Physical Medicine and Rehabilitation (PMR) rotation during their residency training, the knowledge score of the physicians who received PMR rotation was found to be higher than those who did not (p=0.012). 46.7% of the physicians did not prefer to recommend traditional and complementary medicine practices to their patients. In the multi-answer question in which the exercise recommendation method was questioned, 80.3% of the physicians preferred to refer their patients to the PMR physician, 55.4% preferred to give patients illustrated brochures, and 22.9% preferred to show the exercises themselves. Medical treatment preferences of physicians were mostly Nonsteroidal Anti-Inflammatory Drugs (NSAID) and topical drugs. The frequency of opting for opioids was low. CONCLUSIONS: The physicians' experience with the relevant patient group did not have any effect on the knowledge score. It was observed that performing PMR rotation increased the knowledge of low back pain. It was recommended to improve the training provided for the physicians about low back pain as an attempt to facilitate the management of patients with low back pain. Keywords: family physician, low back pain, knowledge, practice
AIM: The objective of this study is to evaluate the knowledge and practices of family medicine residents working in Turkey about low back pain. MATERIALS AND METHODS: This research was carried out between 04.08.2022 and 08.11.2022. It is a cross-sectional, descriptive survey study conducted with family medicine residents in Turkey who volunteered to participate in this study. An online questionnaire was applied to the physicians. All statistical analysis were performed using IBM SPSS version 25.0 and the statistical significance level was accepted as p<0.05. RESULTS: 345 residents, 225 of whom were male (65.2%), participated in the study. The mean low back pain knowledge score of the physicians was 31.4±4.83. The physicians' mean self-efficacy score in the management of patients with low back pain was found to be 6.43±1.58. A positive statistically significant correlation was found between the physicians' feeling of self-efficacy in the management of patients with low back pain and their knowledge score (p=0.002). When the physicians' knowledge scores were compared according to the years of employment in the profession, the duration of their assistantships, the places where they received their most comprehensive training on low back pain, the frequency of encountering a patient with low back pain in their polyclinics, whether they worked in the Family Health Centers (FHC) during their speciality training, no significant difference was found ( p>0.05). When the physicians were compared according to whether they received Physical Medicine and Rehabilitation (PMR) rotation during their residency training, the knowledge score of the physicians who received PMR rotation was found to be higher than those who did not (p=0.012). 46.7% of the physicians did not prefer to recommend traditional and complementary medicine practices to their patients. In the multi-answer question in which the exercise recommendation method was questioned, 80.3% of the physicians preferred to refer their patients to the PMR physician, 55.4% preferred to give patients illustrated brochures, and 22.9% preferred to show the exercises themselves. Medical treatment preferences of physicians were mostly Nonsteroidal Anti-Inflammatory Drugs (NSAID) and topical drugs. The frequency of opting for opioids was low. CONCLUSIONS: The physicians' experience with the relevant patient group did not have any effect on the knowledge score. It was observed that performing PMR rotation increased the knowledge of low back pain. It was recommended to improve the training provided for the physicians about low back pain as an attempt to facilitate the management of patients with low back pain. Keywords: family physician, low back pain, knowledge, practice
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