SUMMARYBackground
Chronic kidney disease is a growing health problem on a global scale. The increasing prevalence of chronic kidney disease presents an urgent need to better understand the knowledge, confidence and engagement in self-managing the disease.

Objectives
This study examined group differences in patient activation and health-related quality of life, knowledge, self-management and confidence with managing chronic disease across all five stages of chronic kidney disease.

Design
The study employed a descriptive correlational design.

Settings
Participants were recruited from five primary care, three nephrology clinics and one dialysis centre in two Midwestern cities in the United States.

Participants
The convenience sample included 85 adults with hypertension, diabetes mellitus and chronic kidney disease, including kidney failure, who spoke English.

Measurements
Seven measurements were used to collect data via telephone interviews with participants not receiving haemodialysis, and face-to-face interviews with those receiving haemodialysis at the beginning of their treatment session.

Results
Analyses indicated that half the participants were female (50.58%), the mean age was 63.21 years (SD = 13.11), and participants with chronic kidney disease stage 3 were the most activated. Post hoc differences were significant in patient activation and blood pressure self-management and anxiety across chronic kidney disease stages, excluding stage 5.

Conclusion
Engaging patients in the self-management of their health care and enhancing patients’ ability to self-manage their blood pressure may work to preserve kidney health. Healthcare providers should collaborate with patients to develop strategies that will maintain patients’ health-related quality of life, like reducing anxiety as kidney disease progress.

Patient Activation with Knowledge, Self-Management, and Confidence in Chronic Kidney Disease

Industry 4.0 solutions have penetrated the healthcare sector, thus creating challenges that healthcare entities should meet. For this, a proper relationship between human resource management (HRM) within healthcare entities and Healthcare 4.0 is needed. In addition, organizations mainly focus on HRM practices, yet organizational issues are overlooked. In this context, the aim of the article was to analyze and evaluate the involvement and roles of key HRM actors, such as line managers and human resource (HR) specialists (HR departments) within strategic healthcare entities, namely hospitals. It was also important to identify the potential of hospitals to meet the requirements of Healthcare 4.0. A study was performed on a group of 285 Polish hospitals. Five respondents were recruited from each hospital. The total population amounted to 1425 interviewees. Due to the complexity of the research, it was outsourced. The results of the analysis identified that hospitals largely engage line managers in medical personnel management. However, a lack of managerial competence may become a major barrier in coping with challenges created by Healthcare 4.0. Organizational solutions do not support the strategic role of HR specialists; their anchoring in the organizational structures limits the possibility to support the changes required for the transformation towards Healthcare 4.0.

https://www.mdpi.com/2071-1050/12/12/5118/pdf

The Organizational Aspect of Human Resource Management as a Determinant of the Potential of Polish Hospitals to Manage Medical Professionals in Healthcare 4.0

Bu arastirma, Bartin Universitesi Islami Ilimler Fakultesi’nde (n=104), Egitim Fakultesi’nin Sosyal Bilgiler Ogretmenligi Bolumu’nde (n=52) ve BESYO’da (n=94) 2015–2016 ogretim yilinda ogrenim gorenler arasindan rastgele secilen 250 ogrenci uzerinde gerceklestirilmistir. Calismada, universite ogrencilerinin mesleki kaygilari ile hayattaki anlam duzeyleri arasindaki iliskiler incelenmistir. Kisisel Bilgi Anketi, Mesleki Kaygi ve Hayatin Anlam ve Amaci Olcegi, 128’i kiz ve 122’si erkek toplam 250 ogrenciye, 2016 Nisan-Mayis aylari icinde uygulanmistir. Mesleki kaygi ile hayatin anlami arasindaki iliski; cinsiyet, bolum, yas ve ekonomik durum gibi degiskenler acisindan incelenmistir. Arastirma sonucunda, mesleki kaygi ile hayatin anlami arasinda negatif yonde onemli bir iliski (r= -0,279; p<0,001) bulunmustur. Ayrica, ogrencilerin mesleki kaygi duzeylerinde bolum, yas, cinsiyet ve ekonomik durum acisindan anlamli farklilik gorulmezken; hayattaki anlam duzeylerinde bolum ve ekonomik durum acisindan anlamli farkliliklar gorulmustur.

/pdf/universite-ogrencilerinin-mesleki-kaygi-ile-hayattaki-anlam-3rbvnm7cbq.pdf

Üni̇versi̇te öğrenci̇leri̇ni̇n mesleki̇ kaygi i̇le hayattaki̇ anlam düzeyleri̇ arasindaki̇ i̇li̇şki̇ni̇n i̇ncelenmesi̇

Unemployment is one of the most important socio-economic problems waiting to be solved in Turkey as in most countries. It is known that unemployment creates economic, psychological and social effects on individuals. One of the most important impacts of unemployment on individuals is unemployment anxiety. The aim of this study is to determine the factors affecting the unemployment anxiety levels of the students and to determine whether unemployment anxiety differs according to the self-esteem levels of the students. The research was applied to the senior students of the Culinary, Tourism and Hotel Management Program studying at Suleyman Demirel University. Rosenberg Self-Esteem Scale has been utilized for evaluating self-esteem level and the unemployment anxiety scale has been utilized for evaluating unemployment anxiety levels. The analysis was performed on the responses received from 593 participants who were found to be eligible for the study. Furthermore, for analyzing the results, SPSS 22.0 was applied. The existence of the difference between self-esteem and unemployment anxiety was revealed by sample independent t-test analysis. The results revealed that the unemployment anxiety level of the students was below the average, and the level of anxiety of the Tourism and Hotel Management department students was higher than that of the Culinary Program students. A significant difference was found between self-esteem and unemployment anxiety. Accordingly, it was determined that students with low self-esteem have higher unemployment anxiety than those with high self-esteem

/pdf/research-of-the-relationship-between-the-unemployment-3d0sh168gg.pdf

Research of the relationship between the unemployment anxiety and the self-esteem of potential workforce in tourism

The present study was conducted to determine the effect of spiritual care on the anxiety and depression levels of patients receiving hemodialysis treatment. The research was carried out between January and May 2019 in a training and research hospital hemodialysis unit in the Eastern Anatolian Region of Turkey. The research was completed with a total of 71 patients (33 experiments, 38 controls) who received hemodialysis treatment. Regarding in-group comparison, the difference between the mean scores of pre-test and post-test of the patients concerning the anxiety and depression in the experimental group was found to be statistically significant (p ˂ 0.05). It was determined that training for strengthening spirituality was effective in reducing the anxiety and depression levels of patients receiving hemodialysis treatment. It can be suggested that spiritual care should be used as a complementary method in health care practices to increase the effectiveness of the treatment.

The Effect of Spiritual Care on Anxiety and Depression Level in Patients Receiving Hemodialysis Treatment: a Randomized Controlled Trial.

This study aims to examine the relationship between COVID-19 cases/deaths and Google data on lifestyle behaviours and socio-economic variables in Turkey. The data of the research are composed of Google Trends search volume for various words related to socio-economic conditions, nutritional attitudes, indoor behaviour, outdoor activities and confirmed COVID-19 case and death data from the Ministry of Health from 31 December 2019 to 31 January 2021. Spearman correlation analysis was conducted to evaluate the relationship between the Google search volumes of selected keywords and COVID-19 case and deaths. In addition, repeated ANOVA and Bonferroni post-hoc tests were performed to compare the differences in search volumes of selected keywords before and during the COVID-19 outbreak. Correlation analysis showed that the strongest variables in each category were vitamin C, zinc, Zoom, online shopping, hotel, market, gym, unemployment and unemployment benefit. Compared to previous years, during the pandemic, there was a significant increase or decrease in the search volumes of almost all words. These results showed that the COVID-19 significantly changed people's online interests regarding lifestyle behaviours and socio-economic conditions. It is thought that the findings can guide health policies to be followed in reducing the effects of both behavioural changes and negative socio-economic consequences.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/hpm.3342

Association of COVID-19 with lifestyle behaviours and socio-economic variables in Turkey: An analysis of Google Trends.

This study aimed to determine the quality of life of patients with chronic kidney disease who were receiving dialysis treatment. It also aimed to identify the factors affecting the quality of life of these patients. The independent variables analyzed were: patients' sociodemographic characteristics, organizational characteristics, adherence to treatment, patient-physician relationship, and patient activation level. The sample consisted of 328 patients with chronic kidney disease who received services from dialysis units of two university hospitals and two private dialysis centers. Data analysis was performed through multivariate regression. Results showed that receiving treatment from a hospital-based dialysis unit may have a positive effect in patients' quality of life; and patient-physician relationship, patient activity, and adherence to treatment may positively affect quality of life. Thus, planning of health service delivery that focus on improving the quality of life of patients who are more active by allowing them to establish positive relationships with their physicians and to have a better adherence to treatment should be adopted. These findings may provide health managers, health professionals, and individual patients with evidence-based information about treatment management and health service planning processes related to chronic kidney disease.

A conceptual framework of quality of life in chronic kidney disease in Turkey: A patient-focused approach.

Issizlik kuresellesmenin de etkisiyle gittikce buyuyen toplumsal bir sorundur. Ekonomistler ve psikologlar, issizlik konusunu farkli bakis acilari ile ele almislardir. Literatur, issizligin refah ve yasam doyumu uzerinde olumsuz psikolojik sonuclari oldugunu gostermektedir. Bu calisma, saglik yonetimi ogrencilerinin is aramaya basladiklarinda, issiz olmak konusunda endiseli olup olmadiklarini ve yasam doyumu ile issizlik kaygi duzeylerini etkileyen degiskenleri belirlemek amaciyla tasarlanmistir. Calismanin evrenini, Ankara’da bir devlet universitesinde egitim alan 3. ve 4. sinif saglik yonetimi ogrencileri olusturmaktadir. Calismada tum ogrencilere ulasmak amaclanmis; ancak 136 ogrenciye ulasilmistir (%74,5). Arastirmaya katilan ogrencilerin tanimlayici ozelliklerini, issizlik kaygisi ve yasam doyum duzeylerini ortaya koymak icin tanimlayici istatistiklerden yararlanilmistir. Ogrencilerin issizlik kaygi duzeylerini belirlemek amaciyla Ersoy-Kart ve Erdost (2008) tarafindan gelistirilen “Issizlik Kaygisi Olcegi” kullanilmistir. Diener (1985) tarafindan gelistirilen “Yasam Doyum Olcegi” ise ogrencilerin yasam doyum duzeylerini olcmek amaciyla kullanilmistir. Issizlik kaygisi ile diger degiskenler arasindaki iliskiyi analiz etmek icin Pearson Korelasyon analizi yapilmistir. Ayrica, saglik yonetimi ogrencilerinin issizlik kaygisini ve yasam doyumlarini etkileyen degiskenleri ortaya koymak amaciyla regresyon modelleri olusturulmustur. Verilerin analizinde SPSS paket programindan yararlanilmistir. Calisma bulgulari, erkek ogrencilerin is bulamama durumunda %33,3’unun sinavlara hazirlanmayi, %29,2’sinin askere gitmeyi ve %16,7’sinin yuksek lisans yapmayi tercih ettigini gostermistir. Kadin ogrencilerin is bulamama durumundaki tercihleri ise; sinavlara hazirlanmak (%46,1), yuksek lisans yapmak (%39,3) ve kurslara katilmaktir (%9,0).  Ogrencilerin issizlik kaygisi genel puan ortalamasi 2,65±0,601 bulunmustur. Bu ortalamanin orta duzeyde oldugu soylenebilir. Ayrica, ogrencilerin yasam doyumu genel puan ortalamasi 4,56±1,221 olarak bulunmustur. Bununla birlikte, ogrencilerin issizlik kaygisi ve yasam doyumlari arasinda dusuk, negatif ve istatistiksel olarak anlamli bir iliski oldugu sonucuna varilmistir (r= -0,318). Ogrencilerin yasam duzeylerini etkileyen en onemli degisken issizlik kaygisi olarak bulunmustur. Issizlik kaygisi, ogrencilerin yasam duzeyini negatif olarak etkilemektedir (Beta= -0,385). Not ortalamasi ve cinsiyet ise, yasam doyumunu etkileyen diger degiskenlerdir.  Ogrencilerin issizlik kaygi duzeyini anlamli olarak etkileyen faktorler ise etki etme sirasina gore, yasam doyumu, not ortalamasi ve cinsiyet olmustur. Bulgulardan yola cikarak, ogrencilerin issizlige dayali kaygi duzeylerini azaltmanin ve yonetmenin yasam doyumunu artirmada onemli bir etken oldugu soylenebilir.

/pdf/saglik-yonetimi-ogrencilerinin-issizlik-kaygilarini-ve-yasam-3p6o75pywl.pdf

Sağlık Yönetimi Öğrencilerinin İşsizlik Kaygılarını ve Yaşam Doyumlarını Etkileyen Faktörlerin Belirlenmesi

The Competing Values Model developed by Quinn (1988) defines eight roles or behaviours that are required of managers in any organization. The eight roles are innovator, broker, producer, director, coordinator, monitor, facilitator and mentor. While managers may have strengths in certain roles, main goal is to achieve balance using each of the eight roles. The aim of this study is to understand the managerial roles within health services, to determine the factors, which influence these roles, and to explain skills and knowledge required these roles. It can be suggested that based on Quinn's model, studies which defined the differences managerial roles of medical, administrative and support personnel in health care institutions, determined managerial roles according to the ownership of health care institutions and uncovered the factors affected the managerial roles, should be done.

/pdf/managerial-roles-for-health-services-quinn-s-competing-1qxtni7cfl.pdf

Managerial Roles for Health Services: Quinn’s Competing Values Framework (CVF) Model

Introduction : Health care utilization (HCU), which is an important health outcome indicator, can also reflect the effectiveness of self-management in chronic conditions. Patient-centered care can play an important role in minimizing unnecessary service use.Objectives The aim was to determine the effects of treatment adherence, patient activation on HCU in Turkish patients with chronic kidney disease.Methods This study had a cross sectional, descriptive exploratory design. It was conducted with 328 patients. Patients’ HCU was evaluated using hospitalization rate, number of hospital nephrology department visits, emergency department visits, and medications used as well as out-of-pocket payments. Multiple regression models were performed to determine the factors affecting HCU.Results Older age, having a comorbidity, and non-adherence to nutritional recommendations and drug treatments were associated with increased hospital visits. Non-adherence to fluid constraint was associated with more hospitalizations, visits to the emergency department, and drugs used. Study results showed that HCU was increased in patients with non-adherence and low activation.Conclusion: Strategies to reduce HCU should aim to improve treatment adherence and activation. It is recommended to train healthcare managers and support nurses organizationally to empower patients, and plan patient-centered care. 

Gamze Bayin Donar

Papers

Association of COVID-19 with lifestyle behaviours and socio-economic variables in Turkey: An analysis of Google Trends.

A conceptual framework of quality of life in chronic kidney disease in Turkey: A patient-focused approach.

Sağlık Yönetimi Öğrencilerinin İşsizlik Kaygılarını ve Yaşam Doyumlarını Etkileyen Faktörlerin Belirlenmesi

Managerial Roles for Health Services: Quinn’s Competing Values Framework (CVF) Model

Effects of treatment adherence and patient activation on health care utilization in chronic kidney disease