Türk Tıp ve Sağlık Bilimleri Dergisi/Turkish Journal of Medicine and Health Sciences

KAPAK SAYFASI-COVER PAGE

2026-09-07T07:15:05+00:00

KAPAK SAYFASI-COVER PAGE

EVALUATION OF THE RELATIONSHIP BETWEEN COGNITIVE STATUS AND DAILY LIVING ACTIVITIES IN PATIENTS OVER 80 YEARS OF AGE FOLLOWED AT A HEALTHY AGING CENTER

2026-09-07T07:48:05+00:00

Objective: Our study aimed to evaluate the relationship between mental status and activities of daily living in patients over 80 years of age who were followed up at the Healthy Aging Center.
Materials and Methods: In our cross-sectional analytical study, 322 individuals aged 80 and over, residing in Karabük and registered at the Healthy Aging Center, were included in the study. The Standardized Mini Mental Test (SMMT) was used to assess mental status, the Katz Activities of Daily Living (ADL) was used to assess basic activities of daily living, the Lawton Activities of Daily Living (LADL) was used to assess instrumental activities of daily living, and a questionnaire including sociodemographic characteristics was administered Results: The study group consisted of 57.01% women and 42.99% men, with an average age of 84.50±4.05. The mean SMMT score was found to be 22.9, and the percentage of elderly individuals with cognitive dysfunction (below the cutoff value) was 41.74%. The mean SMMT score for men was 23.91±4.93, while for women it was 22.15±5.51; men's MMT scores were statistically significantly higher than women's (p<0.01). The Lawton Brody Scale score was 6.24±2.32 for men and 5.29±2.6 for women; men's scores were statistically significantly higher than women's. The EGYA score was 5.7, and 59.7% of the participants were found to be
semi- or fully dependent. The Katz score was 4.96±1.33 for men and 4.61±1.53 for women; men's scores were statistically significantly higher than women's. A low/moderate negative correlation was found between the Lawton Brody Scale score and age, and a moderate positive correlation between the Lawton Brody Scale score and age. A weak negative correlation was found between the MMT score and age, a weak positive correlation between age and BMI, a low/moderate positive correlation between age and KATZ scores, and a moderate positive correlation between age and Lawton Brody Scale scores.
Conclusion: The findings of our study reveal the impact of gender, education, health status, and socioeconomic conditions on cognitive dysfunction and dependence in daily living activities in older adults. Identifying risk factors for cognitive functioning and independence in old age requires a multidisciplinary approach to improve quality of life and reduce dependence. Accordingly, developing strategies tailored to the needs of older adults will contribute to a healthy aging process.
Keywords: Cognitive impairment, Activities of daily living, Mini-mental test, Older adults

INFLAMMATORY BOWEL DISEASE IN CHILDHOOD: RETROSPECTIVE EVALUATION OF DEMOGRAPHIC, CLINICAL AND TREATMENT CHARACTERISTICS IN A SINGLE CENTER

2026-09-07T08:00:20+00:00

Objective: The increasing incidence of inflammatory bowel disease (IBD) in childhood has made it an
important disease in pediatric gastroenterology. This study aimed to evaluate the demographic, clinical,
laboratory, and endoscopic characteristics, treatment modalities, and follow-up outcomes of pediatric
patients with IBD.
Materials and Methods: This retrospective study included 24 pediatric patients with IBD (14 females,
58%) aged 7–18 years who were followed between 2023 and 2025 through a collaboration between the
Departments of Pediatric Gastroenterology and Public Health at Karabük University Faculty of
Medicine. Demographic data, presenting symptoms, physical examination findings, endoscopic features,
and treatment modalities were analyzed.
Results: The mean age was 15.3 years, and 10 patients (42%) were male. Ulcerative colitis (UC) was
diagnosed in 16 patients (67%) and Crohn’s disease (CD) in 8 (33%). Bloody stool was the most common
presenting symptom in UC (100%), whereas abdominal pain predominated in CD (88%). Most patients
(85%) lived in urban areas. Pancolitis was detected in 6 UC patients (38%), while colonic involvement
was observed in 5 CD patients (63%). All UC patients received mesalazine; 6 (38%) also received anti
TNF therapy, 1 (6%) upadacitinib, and 1 (6%) ustekinumab. Among CD patients, 4 (50%) received anti
TNF therapy, 1 (13%) ustekinumab, 1 (13%) Crohn’s Disease Exclusion Diet (CDED) plus azathioprine,
1 (13%) ruxolitinib and 1 (13%) guselkumab. No patient required surgery during follow-up.
Conclusion: Biologic agents and novel targeted therapies have improved disease control in pediatric
IBD and may reduce complications and the need for surgery.
Keywords: Inflammatory bowel disease, pediatric, biologic agents

ATTITUDES AND BEHAVIORS OF PATIENTS WITH TYPE 2 DIABETES MELLITUS REGARDING LIFESTYLE CHANGES

2026-09-07T09:54:42+00:00

Objective: In type 2 diabetes mellitus, which can lead to serious complications, lifestyle changes play a
significant role in reducing the problems that may arise from the disease. The aim of our study is to investigate
the knowledge, approaches, and behaviors regarding lifestyle modification among individuals with type 2
diabetes mellitus who receive services from family health centers.
Method: Between July 1, 2024, and December 31, 2024, a face-to-face questionnaire was administered to 300
patients with type 2 diabetes mellitus who visited the Barış, Safran, Kayabaşı, and Kartaltepe family health
centers affiliated with the Karabük Provincial Health Directorate. The questionnaire consisted of 31 questions
on sociodemographic data, diabetes, and lifestyle changes, and a 12-question Lifestyle Change Barriers Scale.
Results: Of the 300 participants in our study, 152 (50.7%) were male and 148 (49.3%) were female. Participants
ranged in age from 24 to 94 years, with a median age of 60.27. The average body mass index was 30.6. 61.3%
of participants made lifestyle changes. 45.7% prioritized healthy eating, and 36% engaged in regular physical
activity. 27.3% exercised three days a week, and 21.7% exercised for at least 150 minutes per week. Women
had higher disability scores than men, and individuals with income less than expenses had higher scores than
those with income greater than expenses. It was found that scale scores increased significantly as body mass
index increased.
Conclusion: The findings of our study highlight the importance of investigating gender, obesity levels, and
economic factors in developing interventions to support lifestyle changes.
Keywords: Family practice, Lifestyle changes, Type 2 Diabetes mellitus

ANATOMICAL VARIATIONS OF THE INTERNAL JUGULAR VEIN IN CADAVERIC STUDIES AND THEIR CLINICAL IMPLICATIONS

2026-09-07T10:00:50+00:00

Objective, this review was conducted the variations of the internal jugular vein (IJV), responsible for collecting a significant portion of the venous blood from the brain, as detected in cadaver dissections, and to shed light on clinical and surgical sciences with the results obtained, with the goal of minimizing the risk of possible complications during interventions. Materials and Methods, variations in IJV reported in cadaver studies between 1960 and 2026 were examined using Google Scholar, PubMed, and Web of Science databases. Approximately 14.100 articles were accessed. A total of 126 articles have been downloaded. Of the 126 articles initially identified, 81 were excluded (Computed Tomography, Magnetic Resonance Imaging, Ultrasonography, surgery, clinical, review, duplicate studies, and irrelevant studies). The remaining 45 articles comprised 39 cadaver studies, 2 letters to the editor (rare variation), and 4 clinical studies. Results, IJV duplication and fenestration variations were defined as IJV duplication in 2017. Variations were classified into three categories based on their level: Type A, Type B, and Type C. The studies reviewed included approximately 8 duplications,
6 fenestrations, 2 bifurcations, 8 anastomoses, 1 drainage variation, 2 accessory branches, 6 studies related to valve variations, and 7 studies related to IJV diameters. In 2 duplication cases, 2 fenestration cases, and 1 bifurcation case, the portion of the accessory nerve arising from the spinal cord was reported to pass through these venous variations. The present study identified a total of 27 variations of VJI, with the majority of these variations located on the right side. Conclusion, clinically, radiological imaging is important to identify variations in the internal jugular vein neck region prior to surgery on the IJV. In particular, vein diameter assessment is recommended before central venous catheterization to prevent unwanted complications. Variations affecting the IJV can occur not only in the IJV itself but also in adjacent structures.
Keywords: Variation, duplication, , cadaveric, fenestration

IRRITABLE BOWEL SYNDROME (IBS) AND A LOW FODMAP DIET: CURRENT APPROACHES AND CLINICAL FINDINGS

2026-09-07T10:06:33+00:00

Irritable bowel syndrome (IBS) is a chronic, relapsing functional gastrointestinal disorder characterized by ab
dominal pain, bloating, and altered bowel habits in the absence of identifiable organic disease. It is considered
a multifactorial condition within the biopsychosocial model and significantly impairs quality of life.
Current evidence indicates that IBS pathophysiology involves altered gut motility, visceral hypersensitivity,
changes in gut microbiota, increased intestinal permeability, and dysregulation of the gut–brain axis. Among
dietary interventions, the low-FODMAP diet has emerged as an effective strategy for symptom management,
although potential long-term effects such as microbiota alterations and nutrient deficiencies have been reported.
Psychological factors may influence symptom severity and treatment response. Therefore, integrating psycho
logical interventions such as cognitive behavioral therapy and stress management with dietary approaches is
recommended. Recent evidence suggests that multidisciplinary management strategies provide superior out
comes in symptom control and quality of life.
Keywords: Irritable bowel syndrome, low FODMAP diet, gut–brain axis, microbiota, multidisciplinary man
agement

REVIEW OF POSTPARTUM DEPRESSION OF WOMEN WHO GAVE BIRTH DURING COVID-19

2026-09-07T10:13:03+00:00

birth during the COVID-19 pandemic and their associations with sociodemographic, obstetric, and
COVID-19-related factors, fear of COVID-19, and maternal bonding.
Methods: This hospital-based, cross-sectional analytical study was conducted with 236 postpartum
women at Karabük Training and Research Hospital between March 20 and July 20, 2022. Data were
collected through face-to-face interviews using the General Questionnaire, Edinburgh Postnatal
Depression Scale (EPDS), Fear of COVID-19 Scale, and Maternal Attachment Scale. Data were analyzed
using the independent-samples t-test, ANOVA/Welch ANOVA, Pearson correlation analysis, and
multiple linear regression.
Results: The mean total EPDS score was 4.02±5.16. Planned pregnancy and regular prenatal follow-up
were associated with lower EPDS scores, whereas health problems and stress during pregnancy, recalling
childbirth as frightening, neonatal complications, and perceiving infant care as difficult were associated
with higher scores. The obstetric model explained 45% of the variance in EPDS scores. Stress during
pregnancy, a frightening childbirth experience, and perceiving infant care as moderately difficult or
difficult were independently associated with higher EPDS scores. COVID-19 infection status was not
significantly associated with EPDS scores, whereas scores differed according to the timing of infection.
Fear of COVID-19 was weakly negatively correlated with EPDS scores but was not an independent
predictor. Higher maternal bonding was independently associated with lower EPDS scores.
Conclusion: Postpartum depressive symptoms appeared to be more closely associated with obstetric and
psychosocial factors related to pregnancy, childbirth, and infant care than with COVID-19-specific
factors. Assessing stress, adverse childbirth experiences, difficulties in infant care, and maternal bonding
during postpartum follow-up may contribute to the early identification of women with elevated
depressive symptoms.
Keywords: Postpartum depression, COVID-19 pandemic, maternal bonding

EXAMINATION OF HEALTHCARE WORKERS' ATTITUDES TOWARDS HEALTH TECHNOLOGY EVALUATION: A CASE STUDY OF A TRAINING AND RESEARCH HOSPITAL

2026-09-07T10:59:21+00:00

Objective: Healthcare professionals are the main stakeholders in the implementation phase of technologies developed in healthcare delivery. Rapid developments in health technologies make it necessary to systematically evaluate these technologies. Health Technology Assessment (HTA) is an important approach that provides an analysis of the practices used in health services in terms of effectiveness, safety, and cost. Healthcare professionals' knowledge and attitudes toward HTA play a decisive role in the effectiveness of this process. The main purpose of this study is to analyze the attitudes of healthcare professionals working in a training and research hospital toward health technology assessment (HTA) and to determine the effect of demographic variables on these attitudes.
Materials and Methods: The sample of the study, which was designed as a descriptive and cross-sectional study, consists of 312 healthcare professionals. The data were collected using the 23-item “Healthcare Personnel Health Technology Assessment Attitude Scale” consisting of three sub-dimensions: scope, awareness, and benefit. In addition to descriptive statistics, t-test, ANOVA, and Pearson correlation analyses were applied in the analysis of the data.
Results: The participants' total mean HTA attitude score was determined to be 94.71±12.69. The Cronbach's Alpha reliability coefficient of the scale was found to be excellent at 0.941. The participants consist of 37.5% assistant doctors, 11% specialist doctors, and 45% midwives and nurses. The relationships between the dimensions are positive and highly significant (p<0.001). While no significant difference was found according to the gender variable (p>0.05), statistically significant differences (p<0.05) were found in the variables of age, education level, occupation, years of work, and unit.
Conclusion: It was observed that the attitudes of healthcare professionals towards STD were generally high, but this perception strengthened as professional expertise and experience increased. In particular, the fact that specialist physicians have the highest attitude score reflects their role in clinical decision-making processes. It is observed that as the professional experience of midwives and nurses increases, their HTA attitudes also increase. It is recommended that institutional awareness programs and HTA training be expanded and their use increased in the higher education process, and that service standards and quality be improved through decision support systems.
Keywords: Health technologies, healthcare professionals, attitude, healthcare services, evidence-based
practice

THE ROLE AND IMPACT OF INTERNET USE ON DECISION-MAKING PROCESSES OF PREGNANT WOMEN: A CROSS-SECTIONAL STUDY

2026-09-07T11:16:14+00:00

Objective: This study was designed to determine the role and effect of internet use in pregnant women's decision-making processes.
Methods: The research was conducted at a pregnant outpatient clinic of a public hospital in Istanbul
between April-July 2023. The sample size was calculated as minimum 242 using G*Power analysis
(effect size=0.25, alpha=0.05, power=0.80), and 494 pregnant women were included to increase data
reliability. Data were collected using the Personal Information Form and the Internet-Based Decision
Making Scale in Pregnancy (GİYKAÖ) through face-to-face interviews.
Results: 86.2% of pregnant women use social media, and 53.4% prefer the internet due to easy access to information. 46.9% of participants pay attention to and research internet information even if they do not fully believe it. The mean total GİYKAÖ score was 34.31±8.03. University graduates had higher self efficacy (p=0.003) and self-control (p=0.017) scores. Primiparous women (p=0.003), those with nuclear family structure (p=0.032), and those with planned pregnancies (p=0.031) were at higher levels in internet-based decision making.
Conclusion: The internet has become a "second opinion" source for pregnant women and has become
significantly integrated into decision-making processes. It is recommended that health professionals
direct pregnant women to reliable sources within the framework of digital health literacy and question
their internet use.
Keywords: Pregnancy, internet, decision making, digital health literacy, social media

THE EFFECT OF PERCEIVED CHILDBIRTH TRAUMA ON MATERNAL FUNCTIONS

2026-09-07T11:25:42+00:00

This study was conducted to evaluate the relationship between childbirth-related trauma perception and maternal functioning. A cross-sectional and descriptive research design was used, and the sample
consisted of 150 mothers who had delivered vaginally at Sinop Atatürk State Hospital. Data were
collected between June 2025 and January 2026 through face-to-face administration of the Descriptive
Information Form, the Perception of Traumatic Childbirth Scale (PTCS), and the Barkin Index of
Maternal Functioning (BIMF). The statistical analyses showed that the participants’ mean PTCS score
was 125.75±17.47, while their mean total BIMF score was 65.62±24.68. Regression analysis indicated
that the BIMF total score significantly and positively explained the variation in PTCS scores (β=0.262;
p=0.001). However, when the subdimensions of self-care, maternal psychology, infant care, social
support, and adjustment to motherhood were examined separately, none showed an independent
predictive effect on childbirth-related trauma perception (p>0.05). This finding suggests that the overall structure of maternal functioning may be more strongly associated with childbirth-related trauma perception than its individual subdimensions. Accordingly, postpartum care should address not only physical recovery but also mothers’ trauma perceptions, psychological needs, sources of social support, and adjustment to the maternal role. Early identification of childbirth-related trauma perception, strengthening woman-centered care practices, and improving access to psychosocial support services are also recommended.
Keywords: Traumatic Childbirth, Perception of Birth Trauma, Maternal Functioning, Postpartum
Period.

PROFESSIONAL BELONGING AMONG MIDWIFERY STUDENTS FROM AN INTERCULTURAL PERSPECTIV

2026-09-07T11:33:17+00:00

This study was conducted to examine the levels of professional belonging among midwifery students
from an intercultural perspective and to reveal the relationship between belonging and academic and
cultural factors. A total of 188 students studying at a university in Turkey participated in this descriptive study. A socio-demographic information form and the " Midwifery Belonging Scale " were used as data collection tools. Data analysis was performed using the SPSS program. The mean age of the participants was 21.39±1.33 (min:19; max:25), and 13.3% were international students. Of the students, 26.1% were in their second year, 35.6% in their third year, and 38.3% in their fourth year of study. The participants'mean academic grade point average was 2.83±4.60; 81.4% evaluated their academic success as moderate, and 27.7% stated that they worked in the healthcare field.
The mean total score on the Midwifery Belonging Scale was 89.42±10.80. The majority of students stated that they chose the department voluntarily (79.8%), felt a sense of belonging to their profession (87.2%), were satisfied with the department (91%), and intended to work as midwives after graduation (95.7%). Analyses revealed that variables such as grade level, voluntary choice of the department, sense of belonging, departmental satisfaction, and the desire to pursue the profession post-graduation created significant differences in various dimensions of professional belonging (p<0.05). In contrast, no significant differences were found regarding citizenship status, marital status, income perception, or active employment status. According to the correlation analysis, a low-level significant positive relationship was found between age and emotional belonging and professional development. The findings indicate that professional belonging is shaped more by students' motivations and subjective perceptions of belonging than by socio-demographic characteristics. In conclusion, supporting students' motivations and strengthening their perceptions of belonging are of critical importance in enhancing professional belonging.
Keywords: Midwifery, Midwifery student, Professional belonging

THE RELATIONSHIP BETWEEN EDUCATIONAL STRESS AND ATTITUDES TOWARD DISTANCE EDUCATION AMONG MIDWIFERY STUDENTS

2026-09-07T11:48:14+00:00

Objective: This study aimed to examine the relationship between educational stress and attitudes toward distance education among midwifery students. Methods: This descriptive study was conducted in the Department of Midwifery, Faculty of Health Sciences, Karabük University, during the 2023-2024 academic year. The population consisted of 523 midwifery students, and the study was completed with 236 students. Data were collected using a Personal Information Form, the Educational Stress Scale, and the Attitude Scale Toward Distance Education. Descriptive statistics, Independent Samples T test, One-Way ANOVA, and Pearson correlation analysis were used; statistical significance was accepted as p<0.05. Results: The mean age of the students was 20.69±2.03 years. The mean total score of the Educational Stress Scale was 50.45±8.99, and the mean total score of the Attitude Scale Toward Distance Education was 85.69±23.32. No clear correlation was found between total educational stress and total attitude toward distance education scores. A low-level negative significant relationship was found between the self-expectation subdimension and attitudes toward distance education. Foreign students had higher mean attitude scores toward distance education than Turkish students. Conclusion: Midwifery students had moderate educational stress and moderately positive attitudes toward distance education. In practice-based programs, distance education should be supported with laboratory and clinical practice opportunities.
Keywords: Midwifery, educational stress, distance education, student, attitude

RESEARCHING OF THE RELATIONSHİP BETWEEN THE PERIODONTAL DISEASES AND THREAT OF PREMATURE BIRTH

2026-09-07T11:39:43+00:00

Objective: This study aimed to compare periodontal disease findings and the need for dental/periodontal treatment among hospitalized pregnant women diagnosed with threatened preterm birth (TPB) and a control group.
Materials and Methods:This controlled observational study was conducted between June 1 and December 1, 2017, at the University of Health Sciences Zekai Tahir Burak Women’s Health Health Practice and Research Center. The sample included 217 women: 104 pregnant women in the TPB group and 113 uncomplicated puerperal women within 24 hours after delivery in the control group. Data were collected through face-to-face interviews using a researcher developed data collection form and the Periodontal Diseases Evaluation Index for Midwives/Nurses. Mann–Whitney U, chi-square, and t tests were used, and p<0.05 was accepted as statistically significant.
Findings: The gingival index score was 4.12 ± 2.29 in the TPB group and 4.28 ± 2.56 in the control group; the difference was not statistically significant (z=-0.58; p=0.50). According to the index cut-off score, treatment need was 54.8% in the TPB group and 60.2% in the control group, with no significant difference (χ²=0.639; p=0.42).
Conclusion: No statistically significant association was found between periodontal treatment need and TPB in this study. However, the high treatment need in both groups highlights the importance of oral health screening and referral to dental care during pregnancy follow-up.
Keywords: Oral and dental health during pregnancy; Periodontal disease; Risk of preterm birth; Midwifery; Periodontal disease