Browsing by Author "Vatansever, Kevser"
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Item Ethical problems in an era where disasters have become a part of daily life: A qualitative study of healthcare workers in Turkey(Public Library Science, 2017-01-14) Vatansever, Kevser; Civaner, M. Murat; Pala, Kayıhan; Uludağ Üniversitesi/Tıp Fakültesi/Tıp Etiği Anabilim Dalı.; Uludağ Üniversitesi/Tıp Fakültesi/Halk Sağlığı Anabilim Dalı.; 0000-0002-0983-4904; 0000-0001-5376-3499; F-7816-2013; S-4188-2019; 24075622600; 6603159416Background: Natural disasters, armed conflict, migration, and epidemics today occur more frequently, causing more death, displacement of people and economic loss. Their burden on health systems and healthcare workers (HCWs) is getting heavier accordingly. The ethical problems that arise in disaster settings may be different than the ones in daily practice, and can cause preventable harm or the violation of basic human rights. Understanding the types and the determinants of ethical challenges is crucial in order to find the most benevolent action while respecting the dignity of those affected people. Considering the limited scope of studies on ethical challenges within disaster settings, we set upon conducting a qualitative study among local HCWs. Methods Our study was conducted in six cities of Turkey, a country where disasters are frequent, including armed conflict, terrorist attacks and a massive influx of refugees. In-depth interviews were carried out with a total of 31 HCWs working with various backgrounds and experience. Data analysis was done concurrently with ongoing interviews. Results Several fundamental elements currently hinder ethics in relief work. Attitudes of public authorities, politicians and relief organizations, the mismanagement of impromptu humanitarian action and relief and the media's mindset create ethical problems on the macro-level such as discrimination, unjust resource allocation and violation of personal rights, and can also directly cause or facilitate the emergence of problems on the micro-level. An important component which prevents humanitarian action towards victims is insufficient competence. The duty to care during epidemics and armed conflicts becomes controversial. Many participants defend a paternalistic approach related to autonomy. Confidentiality and privacy are either neglected or cannot be secured. Conclusion Intervention in factors on the macro-level could have a significant effect in problem prevention. Improving guidelines and professional codes as well as educating HCWs are also areas for improvement. Also, ethical questions exposed within this study should be deliberated and actualized with universal consensus in order to guide HCWs and increase humane attitudes.Item Exposure of medical students to pharmaceutical marketing in primary care settings: Frequent and influential(Springer, 2009-12) Sarıkaya, Özlem; Vatansever, Kevser; Civaner, Murat; Uludağ Üniversitesi/Tıp Fakültesi/Deontoloji Anabilim Dalı.; 24075622600It is known that interaction between pharmaceutical companies and medical professionals may lead to corruption of professional values, irrational use of medicine, and negative effects on the patient-physician relationship. Medical students frequently interact with pharmaceutical company representatives and increasingly accept their gifts. Considering the move toward early clinical encounters and community-based education, which expose students early to pharmaceutical representatives, the influence of those gifts is becoming a matter of concern. This study examines the frequency and influence of student exposure to drug marketing in primary care settings, as well as student perceptions of physician-pharmaceutical company relationships. This was a two-phase study consisting of qualitative research followed by a cross-sectional survey. Clinical experience logbooks of 280 second-year students in one school were analysed, and the themes that emerged were used to develop a survey that was administered to 308 third-year students from two medical schools. Survey results showed a 91.2% exposure to any type of marketing, and 56.8% of students were exposed to all classes of marketing methods studied. Deliberate targeting of students by pharmaceutical representatives, in particular, was correlated with being less sensitive to the negative effects of and having positive opinions about interactions with pharmaceutical companies. The vast majority of students are exposed to drug marketing in primary care settings, and may become more vulnerable to that strategy. Considering that medical students are vulnerable and are targeted deliberately by pharmaceutical companies, interventions aimed at developing skills in the rational use of medicines and in strategies for coping with drug marketing should be devised.Item Medical students' opinions about the commercialization of healthcare: A cross-sectional survey(Springer, 2016-06) Balcıoğlu, Harun; Vatansever, Kevser; Civaner, M. Murat; Uludağ Üniversitesi/Tıp Fakültesi/Tıp Etiği Anabilim Dalı.; 0000-0001-5376-3499; S-4188-2019; 24075622600There are serious concerns about the commercialization of healthcare and adoption of the business approach in medicine. As market dynamics endanger established professional values, healthcare workers face more complicated ethical dilemmas in their daily practice. The aim of this study was to investigate the willingness of medical students to accept the assertions of commercialized healthcare and the factors affecting their level of agreement, factors which could influence their moral stance when market demands conflict with professional values. A cross-sectional study was conducted in three medical schools in Turkey. The study population consisted of first-, third-, and sixth-year students, and 1,781 students participated in total. Students were asked to state if they agreed with the assertions of commercialized healthcare. Of all students, 87.2 per cent agreed with at least one of the assertions, and one-fifth (20.8 per cent) of them agreed with more than half of the assertions. First-year students significantly agreed more with some assertions than third- and sixth-year students. Being female, having mid-level family income, choosing medicine due to idealistic reasons, and being in the third or sixth years of medical study increased the probability of disagreement. Also, studying in a medical school that included integrated lectures on health policies, rights related to health, and health inequities, along with early field visits, increased the probability of disagreement. This study suggests that agreement with the assertions of commercialized healthcare might be prevalent among students at a considerable level. We argue that this level of agreement is not compatible with best practice in professional ethics and indicates the need for an educational intervention in order to have physicians who give priority to patients' best interests in the face of market demands.Item Olağandışı durumlarda sağlık hizmetleri eğitimi: Mezuniyet öncesi tıp eğitimi için önemli bir gereklilik(Aves, 2011-09) Vatansever, Kevser; Balcıoğlu, Harun; Yavuz, Cavit Işık; Sarıkaya, Özlem; Civaner, Murat; Uludağ Üniversitesi/Tıp Fakültesi/Tıp Tarihi & Etik Anabilim Dalı.; 24075622600Gereksinimlerin yerel kaynakların kapasitesini aştığı durumlar” biçiminde tanımlanan olağandışı durumların sıklığı, çeşitliliği ve yıkıcılığı, dünyada ve ülkemizde artış göstermektedir. Sağlık sistemlerinin doğrudan yaşadığı altyapı ve insan gücü kayıplarının yanı sıra toplumun sağlık hizmeti gereksiniminin artması, çok-disiplinli ve gönüllü ekiplerle çalışma zorunluluğu, yerine getirilmesi gereken görevlerin çokluğu ve çeşitliliği gibi sorunlar, durumu daha da karmaşıklaştırmaktadır. Bu sorunlarla baş etmek için en temel araçlardan birisi, sağlık çalışanlarının olağandışı durumlara yönelik olarak eğitilmesidir. Ancak dünyada ve Türkiye’de olağandışı durumlara hazırlıklı olma ve etkili yanıt verme eğitimi açısından çok umutlu bir tablo olduğunu ileri sürmek güçtür. Çok sayıda program uygulanıyor olsa da, programlar çoğunlukla kurumların birbiriyle işbirliği yapmadan düzenlediği, içerik açısından önemli eksikler taşıyan, hedef grup kapsayıcılığı yetersiz ve farklı sektörlerden olağandışı durum çalışanlarının eşgüdümünü desteklemeyen niteliktedir. Bu çalışmada dünyada ve Türkiye’de sağlık alanında olağandışı durum eğitimiyle ilgili durum gözden geçirilmekte ve gereksinimlerin tanımlanması amaçlanmaktadır. Ayrıca bir örnek olarak, mezuniyet öncesi tıp eğitimi için çekirdek yeterlik hedefleri belirlenmekte ve bir program önerisi sunulmaktadır. Program önerisi hazırlanırken, eğitim programlarının etkililiğini güvenceye almak amacıyla önerilen eğitim programı geliştirme basamakları izlenmiştir. Bu amaçla, çeşitli yöntemlerle eğitsel gereksinimler belirlenmiş; olağandışı durum tıbbıyla ilgili temel kaynaklar incelenerek öğrenme hedefleri seçilmiş ve öğrenme hedeflerine uygun öğretme yöntem ve teknikleri kararlaştırılmıştır.