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Missed Opportunities in Adolescent Health: An Overview From Turkey

Yıl 2020, Cilt: 14 Sayı: 4, 588 - 597, 20.12.2020
https://doi.org/10.21763/tjfmpc.742560

Öz

Introduction: Serious health problems and poor health habits persist among adolescents despite access to health information and medical care. The study aimed to determine the status of access to health services, the need for health information, and the preferred source of information among adolescents in Turkey. Method: In this descriptive study, a questionnaire developed by the researchers was applied online to individuals aged 18-25 between September - December 2017. Descriptive statistics were shown with numbers (n) and percentages (%) or mean (m) and standard deviation (± SD). Pearson chi-square and Kruskal Wallis tests were used for data analysis. Results: The mean age of the total 1807 participants was 20.28 (±1.89) and 57% were female. The rate of adolescents whose number of visits to the family physician was accurate to national guidelines was higher among those who had attended public schools and who lived in a nuclear family. This rate was lower among those who continued high school in the lower developed part of Turkey. Only 12% of the adolescents had undergone a full physical examination and few were questioned about psychosocial aspects. The demand for counseling on health topics about risky behaviors differed according to gender. While school was the main ‘past’ source for information, the family physician was the most ‘preferred’ one. Conclusion: Missed opportunities exist in adolescent health. Adolescent health services should be maintained in a multidisciplinary manner. Especially primary care services and school settings should be strengthened to provide accurate health information to young people.

Destekleyen Kurum

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Proje Numarası

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Teşekkür

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Kaynakça

  • 1. Lassi ZS, Salam RA, Das JK, Wazny K, Bhutta ZA. An unfinished agenda on adolescent health: Opportunities for interventions. Semin Perinatol. 2015;39(5):353-360. doi:10.1053/j.semperi.2015.06.005
  • 2. World Health Organisation. Adolescents: health risks and solutions. World Health Organisation. https://www.who.int/health-topics/news-room/fact-sheets/detail/adolescents-health-risks-and-solutions. Published 2018. Accessed April 8, 2019.
  • 3. Tezel B, Aydın S, eds. Infant, Child, Adolescent Screening Guideline. Ankara: T.C. Sağlık Bakanlığı; 2018. https://hsgm.saglik.gov.tr/depo/birimler/cocuk_ergen_db/dokumanlar/yayinlar/Kitaplar/Bebek_Cocuk_Ergen_Izlem_Protokolleri_2018.pdf. Accessed August 21, 2019.
  • 4. Smith GL, McGuinness TM. Adolescent Psychosocial Assessment: The HEEADSSS. J Psychosoc Nurs Ment Health Serv. 2017;55(5):24-27. doi:10.3928/02793695-20170420-03
  • 5. Wong CA, Taylor JA, Wright JA, Opel DJ, Katzenellenbogen RA. Missed opportunities for adolescent vaccination, 2006-2011. J Adolesc Heal. 2013;53(4):492-497. doi:10.1016/j.jadohealth.2013.05.009
  • 6. Klein JD, Allan MJ, Elster AB, et al. Improving adolescent preventive care in community health centers. Pediatrics. 2001;107(2):318-327. http://www.ncbi.nlm.nih.gov/pubmed/11158465. Accessed March 19, 2019.
  • 7. Azzopardi PS, C Hearps SJ, Francis KL, et al. Progress in adolescent health and wellbeing: tracking 12 headline indicators for 195 countries and territories, 1990-2016. www.thelancet.com. 2019;393:1101. doi:10.1016/S0140-6736(18)32427-9
  • 8. Sacks D, Westwood M. An Approach To Interviewing Adolescents. Paediatr Child Heal. 2003;8(9):554-556.
  • 9. World Health Organisation. Stages of adolescent development. World Health Organization. http://apps.who.int/adolescent/second-decade/section/section_2/level2_2.php. Published 2010. Accessed August 20, 2019.
  • 10. Hacettepe University Institute of Population Studies. The 2013 Turkey Demographic and Health Survey. Hacettepe University; 2014.
  • 11. Ham P, Allen C. Adolescent health screening and counseling. Am Fam Physician. 2012;86(12):1109-1116. http://www.ncbi.nlm.nih.gov/pubmed/23316983. Accessed April 17, 2019.
  • 12. Cullu F, Vural M. An Overview on Child Health Care in Turkey. J Pediatr. 2016;177:S213-S216. doi:10.1016/j.jpeds.2016.04.057
  • 13. Daley AM, Polifroni EC, Sadler LS. “Treat Me Like a Normal Person!” A Meta-Ethnography of Adolescents’ Expectations of Their Health Care Providers. J Pediatr Nurs. 2017;36:70-83. doi:10.1016/j.pedn.2017.04.009
  • 14. Irwin CE, Adams SH, Park MJ, Newacheck PW. Preventive care for adolescents: few get visits and fewer get services. Pediatrics. 2009;123(4):e565-72. doi:10.1542/peds.2008-2601
  • 15. Nordin JD, Solberg LI, Parker ED. Adolescent Primary Care Visit Patterns. Ann Fam Med. 2010;8(6):511-516. doi:10.1370/AFM.1188
  • 16. Spencer N, Raman S, O’Hare B, Tamburlini G. Addressing inequities in child health and development: towards social justice. BMJ Paediatr Open. 2019;3(1):e000503. doi:10.1136/bmjpo-2019-000503
  • 17. Tang C, Xu J, Zhang M. The choice and preference for public-private health care among urban residents in China: evidence from a discrete choice experiment. BMC Health Serv Res. 2016;16(1):580. doi:10.1186/s12913-016-1829-0
  • 18. Turkey Statistical Institute. Mortality rates, 2017. Turkey Statistical Institute. http://www.tuik.gov.tr/PreHaberBultenleri.do?id=27592. Published 2017. Accessed August 22, 2019.
  • 19. Jansen D, Saxena S, Azzopardi-Muscat N. Public Health Practice and Policy to Improve Child and Adolescent Health in Europe. J Pediatr. 2017;190:293-294.e2. doi:10.1016/j.jpeds.2017.07.043
  • 20. Broder KR, Cohn AC, Schwartz B, et al. Adolescent immunizations and other clinical preventive services: a needle and a hook? Pediatrics. 2008;121 Suppl(Supplement 1):S25-34. doi:10.1542/peds.2007-1115D
  • 21. Sözen F, Aydemir S, Kut A, Özbakır Z, Eminsoy G. Periodic Health Examination Knowledge, Attitudes and Behavior among Primary Care Physicians: A Descriptive Study of Preventive Care in Turkey. Turkish J Fam Med Prim Care. December 2019:418-426. doi:10.21763/tjfmpc.634371
  • 22. Ünal B, Ergör G, Dinç Horasan G, Kalaça S, Sözmen K. Türkiye Kronik Hastalıklar ve Risk Faktörleri Çalışması. (Ünal B, Ergör G, eds.). Ankara: T.C. Sağlık Bakanlığı; 2013. www.thsk.gov.tr. Accessed June 23, 2020.
  • 23. Elster AB. Comparison of recommendations for adolescent clinical preventive services developed by national organizations. Arch Pediatr Adolesc Med. 1998;152(2):193-198. http://www.ncbi.nlm.nih.gov/pubmed/9491048. Accessed August 24, 2019.
  • 24. Crossen K. Missed opportunities for adolescent friendly care in hospital. J Paediatr Child Health. 2017;53(12):1176-1179. doi:10.1111/jpc.13626
  • 25. Mihalopoulos NL, Stipelman C, Hemond J, Brown LL, Young PC. Universal Lipid Screening in 9- to 11-Year-Olds Before and After 2011 Guidelines. Acad Pediatr. 2018;18(2):196-199. doi:10.1016/j.acap.2017.11.006
  • 26. Preventing Early Pregnancy and Poor Reproductive Outcomes Among Adolescents in Developing Countries.; 2011. https://www.who.int/immunization/hpv/target/preventing_early_pregnancy_and_poor_reproductive_outcomes_who_2006.pdf. Accessed August 25, 2019.
  • 27. David-Ferdon C, Simon TR. Preventing Youth Violence: Opportunities for Action. Atlanta: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; 2014.
  • 28. WHO | Global Strategy for Women’s, Children’s and Adolescent’s Health & Every Woman Every Child Initiative. World Health Organization; 2019. https://www.who.int/life-course/partners/global-strategy/en/. Accessed August 25, 2019.
  • 29. Chapman L, Edbrooke-Childs J, Martin K, et al. A Mobile Phone App to Support Young People in Making Shared Decisions in Therapy (Power Up): Study Protocol. JMIR Res Protoc. 2017;6(10):e206. doi:10.2196/resprot.7694
  • 30. Kuruvilla S, Bustreo F, Kuo T, et al. The Global strategy for women’s, children’s and adolescents’ health (2016–2030): a roadmap based on evidence and country experience. Bull World Health Organ. 2016;94(5):398. doi:10.2471/BLT.16.170431
  • 31. Turkish General Directorate on the Status of Women. Domestic Violence against Women in Turkey. Ankara; 2009. www.ksgm.gov.tr.
  • 32. WHO | Causes of death among adolescents. WHO. 2018. https://www.who.int/maternal_child_adolescent/data/causes-death-adolescents/en/. Accessed September 6, 2019.
  • 33. Kennedy EC, Bulu S, Harris J, Humphreys D, Malverus J, Gray NJ. These issues aren’t talked about at home: a qualitative study of the sexual and reproductive health information preferences of adolescents in Vanuatu. BMC Public Health. 2014;14(1):770. doi:10.1186/1471-2458-14-770
  • 34. Fleary SA, Joseph P, Pappagianopoulos JE. Adolescent health literacy and health behaviors: A systematic review. J Adolesc. 2018;62(November 2017):116-127. doi:10.1016/j.adolescence.2017.11.010
  • 35. Duncan LR, Pearson ES, Maddison R. Smoking prevention in children and adolescents: A systematic review of individualized interventions. Patient Educ Couns. 2018;101(3):375-388. doi:10.1016/j.pec.2017.09.011
  • 36. Lempp T, Heinzel-Gutenbrunner M, Bachmann C. Child and adolescent psychiatry: which knowledge and skills do primary care physicians need to have? A survey in general practitioners and paediatricians. Eur Child Adolesc Psychiatry. 2016;25(4):443-451. doi:10.1007/s00787-015-0757-6
  • 37. Haller DM, Favrod-Coune T, Dvorák C, Herzig L. Prevention of binge drinking in adolescents: do family doctors have a role to play? Rev Med Suisse. 2014;10(430):1062, 1064-1067. http://www.ncbi.nlm.nih.gov/pubmed/24930152. Accessed March 19, 2019.
  • 38. Pinsonneault L, Déry V. Family physicians and treatment of pediatric obesity: findings drawn from the creation of clinical practice guidelines. Can Fam Physician. 2012;58(5):e238, 502. http://www.ncbi.nlm.nih.gov/pubmed/22734166. Accessed March 19, 2019.
  • 39. Karabulutlu Ö, Kılıç M. Üniversite Öğrencilerinin Cinsel Sağlık Ve Üreme Sağlığı Hakkındaki Bilgi Düzeylerinin Belirlenmesi. Anadolu Hemşirelik ve Sağlık Bilim Derg. 2011;14(2):39-45. https://dergipark.org.tr/download/article-file/29495. Accessed August 20, 2019.

Ergen Sağlığında Kaçırılmış Fırsatlar: Türkiye’den Genel Bir Bakış

Yıl 2020, Cilt: 14 Sayı: 4, 588 - 597, 20.12.2020
https://doi.org/10.21763/tjfmpc.742560

Öz

Giriş: Sağlık bilgilerine ve tıbbi bakıma erişilmesine rağmen, ergenler arasında ciddi sağlık sorunları ve kötü sağlık alışkanlıkları devam etmektedir. Bu çalışmada, Türkiye'de ergenlerin sağlık hizmetlerine erişim durumu, sağlık bilgi ihtiyacı ve tercih edilen bilgi kaynağının belirlenmesi amaçlamıştır. Yöntem: Tanımlayıcı nitelikteki bu araştırmada, araştırmacılar tarafından geliştirilen bir anket, 18-25 yaş arası bireylere Eyül – Aralık 2017 arasında, online olarak uygulandı. Tanımlayıcı istatistikler sayı (n) ve yüzde (%) veya ortalama (m) ve standart sapma (± SD) ile gösterildi. Veri analizi için Pearson ki-kare ve Kruskal Wallis testleri kullanıldı. Bulgular: Toplam 1807 katılımcının yaş ortalaması 20.28 (± 1.89) idi ve % 57'si kadındı. Aile hekimini ulusal yönergelere göre uygun sayıda ziyaret emiş olan ergenlerin oranı devlet okullarına devam eden ve çekirdek bir ailede yaşayanlar arasında daha yüksekti. Bu oran Türkiye'nin az gelişmiş bölgelerinde liseye devam edenler arasında daha düşüktü. Ergenlerin sadece % 12'si tam bir fizik muayeneden geçmiş ve çok azı psikososyal yönler hakkında sorgulanmıştır. Riskli davranışlarla ilgili sağlık konularında danışmanlık talebi cinsiyete göre değişmektedir. Bilgi için 'geçmişteki' asıl kaynak okul olsa da, aile hekimi en çok 'tercih edilen' kaynaktı. Sonuç: Ergen sağlığında kaçırılmış fırsatlar bulunmaktadır. Ergen sağlığı hizmetleri çok disiplinli bir şekilde sürdürülmelidir. Gençlere doğru sağlık bilgisi sağlamak için özellikle birinci basamak hizmetleri ve okul ortamları güçlendirilmelidir.

Proje Numarası

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Kaynakça

  • 1. Lassi ZS, Salam RA, Das JK, Wazny K, Bhutta ZA. An unfinished agenda on adolescent health: Opportunities for interventions. Semin Perinatol. 2015;39(5):353-360. doi:10.1053/j.semperi.2015.06.005
  • 2. World Health Organisation. Adolescents: health risks and solutions. World Health Organisation. https://www.who.int/health-topics/news-room/fact-sheets/detail/adolescents-health-risks-and-solutions. Published 2018. Accessed April 8, 2019.
  • 3. Tezel B, Aydın S, eds. Infant, Child, Adolescent Screening Guideline. Ankara: T.C. Sağlık Bakanlığı; 2018. https://hsgm.saglik.gov.tr/depo/birimler/cocuk_ergen_db/dokumanlar/yayinlar/Kitaplar/Bebek_Cocuk_Ergen_Izlem_Protokolleri_2018.pdf. Accessed August 21, 2019.
  • 4. Smith GL, McGuinness TM. Adolescent Psychosocial Assessment: The HEEADSSS. J Psychosoc Nurs Ment Health Serv. 2017;55(5):24-27. doi:10.3928/02793695-20170420-03
  • 5. Wong CA, Taylor JA, Wright JA, Opel DJ, Katzenellenbogen RA. Missed opportunities for adolescent vaccination, 2006-2011. J Adolesc Heal. 2013;53(4):492-497. doi:10.1016/j.jadohealth.2013.05.009
  • 6. Klein JD, Allan MJ, Elster AB, et al. Improving adolescent preventive care in community health centers. Pediatrics. 2001;107(2):318-327. http://www.ncbi.nlm.nih.gov/pubmed/11158465. Accessed March 19, 2019.
  • 7. Azzopardi PS, C Hearps SJ, Francis KL, et al. Progress in adolescent health and wellbeing: tracking 12 headline indicators for 195 countries and territories, 1990-2016. www.thelancet.com. 2019;393:1101. doi:10.1016/S0140-6736(18)32427-9
  • 8. Sacks D, Westwood M. An Approach To Interviewing Adolescents. Paediatr Child Heal. 2003;8(9):554-556.
  • 9. World Health Organisation. Stages of adolescent development. World Health Organization. http://apps.who.int/adolescent/second-decade/section/section_2/level2_2.php. Published 2010. Accessed August 20, 2019.
  • 10. Hacettepe University Institute of Population Studies. The 2013 Turkey Demographic and Health Survey. Hacettepe University; 2014.
  • 11. Ham P, Allen C. Adolescent health screening and counseling. Am Fam Physician. 2012;86(12):1109-1116. http://www.ncbi.nlm.nih.gov/pubmed/23316983. Accessed April 17, 2019.
  • 12. Cullu F, Vural M. An Overview on Child Health Care in Turkey. J Pediatr. 2016;177:S213-S216. doi:10.1016/j.jpeds.2016.04.057
  • 13. Daley AM, Polifroni EC, Sadler LS. “Treat Me Like a Normal Person!” A Meta-Ethnography of Adolescents’ Expectations of Their Health Care Providers. J Pediatr Nurs. 2017;36:70-83. doi:10.1016/j.pedn.2017.04.009
  • 14. Irwin CE, Adams SH, Park MJ, Newacheck PW. Preventive care for adolescents: few get visits and fewer get services. Pediatrics. 2009;123(4):e565-72. doi:10.1542/peds.2008-2601
  • 15. Nordin JD, Solberg LI, Parker ED. Adolescent Primary Care Visit Patterns. Ann Fam Med. 2010;8(6):511-516. doi:10.1370/AFM.1188
  • 16. Spencer N, Raman S, O’Hare B, Tamburlini G. Addressing inequities in child health and development: towards social justice. BMJ Paediatr Open. 2019;3(1):e000503. doi:10.1136/bmjpo-2019-000503
  • 17. Tang C, Xu J, Zhang M. The choice and preference for public-private health care among urban residents in China: evidence from a discrete choice experiment. BMC Health Serv Res. 2016;16(1):580. doi:10.1186/s12913-016-1829-0
  • 18. Turkey Statistical Institute. Mortality rates, 2017. Turkey Statistical Institute. http://www.tuik.gov.tr/PreHaberBultenleri.do?id=27592. Published 2017. Accessed August 22, 2019.
  • 19. Jansen D, Saxena S, Azzopardi-Muscat N. Public Health Practice and Policy to Improve Child and Adolescent Health in Europe. J Pediatr. 2017;190:293-294.e2. doi:10.1016/j.jpeds.2017.07.043
  • 20. Broder KR, Cohn AC, Schwartz B, et al. Adolescent immunizations and other clinical preventive services: a needle and a hook? Pediatrics. 2008;121 Suppl(Supplement 1):S25-34. doi:10.1542/peds.2007-1115D
  • 21. Sözen F, Aydemir S, Kut A, Özbakır Z, Eminsoy G. Periodic Health Examination Knowledge, Attitudes and Behavior among Primary Care Physicians: A Descriptive Study of Preventive Care in Turkey. Turkish J Fam Med Prim Care. December 2019:418-426. doi:10.21763/tjfmpc.634371
  • 22. Ünal B, Ergör G, Dinç Horasan G, Kalaça S, Sözmen K. Türkiye Kronik Hastalıklar ve Risk Faktörleri Çalışması. (Ünal B, Ergör G, eds.). Ankara: T.C. Sağlık Bakanlığı; 2013. www.thsk.gov.tr. Accessed June 23, 2020.
  • 23. Elster AB. Comparison of recommendations for adolescent clinical preventive services developed by national organizations. Arch Pediatr Adolesc Med. 1998;152(2):193-198. http://www.ncbi.nlm.nih.gov/pubmed/9491048. Accessed August 24, 2019.
  • 24. Crossen K. Missed opportunities for adolescent friendly care in hospital. J Paediatr Child Health. 2017;53(12):1176-1179. doi:10.1111/jpc.13626
  • 25. Mihalopoulos NL, Stipelman C, Hemond J, Brown LL, Young PC. Universal Lipid Screening in 9- to 11-Year-Olds Before and After 2011 Guidelines. Acad Pediatr. 2018;18(2):196-199. doi:10.1016/j.acap.2017.11.006
  • 26. Preventing Early Pregnancy and Poor Reproductive Outcomes Among Adolescents in Developing Countries.; 2011. https://www.who.int/immunization/hpv/target/preventing_early_pregnancy_and_poor_reproductive_outcomes_who_2006.pdf. Accessed August 25, 2019.
  • 27. David-Ferdon C, Simon TR. Preventing Youth Violence: Opportunities for Action. Atlanta: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; 2014.
  • 28. WHO | Global Strategy for Women’s, Children’s and Adolescent’s Health & Every Woman Every Child Initiative. World Health Organization; 2019. https://www.who.int/life-course/partners/global-strategy/en/. Accessed August 25, 2019.
  • 29. Chapman L, Edbrooke-Childs J, Martin K, et al. A Mobile Phone App to Support Young People in Making Shared Decisions in Therapy (Power Up): Study Protocol. JMIR Res Protoc. 2017;6(10):e206. doi:10.2196/resprot.7694
  • 30. Kuruvilla S, Bustreo F, Kuo T, et al. The Global strategy for women’s, children’s and adolescents’ health (2016–2030): a roadmap based on evidence and country experience. Bull World Health Organ. 2016;94(5):398. doi:10.2471/BLT.16.170431
  • 31. Turkish General Directorate on the Status of Women. Domestic Violence against Women in Turkey. Ankara; 2009. www.ksgm.gov.tr.
  • 32. WHO | Causes of death among adolescents. WHO. 2018. https://www.who.int/maternal_child_adolescent/data/causes-death-adolescents/en/. Accessed September 6, 2019.
  • 33. Kennedy EC, Bulu S, Harris J, Humphreys D, Malverus J, Gray NJ. These issues aren’t talked about at home: a qualitative study of the sexual and reproductive health information preferences of adolescents in Vanuatu. BMC Public Health. 2014;14(1):770. doi:10.1186/1471-2458-14-770
  • 34. Fleary SA, Joseph P, Pappagianopoulos JE. Adolescent health literacy and health behaviors: A systematic review. J Adolesc. 2018;62(November 2017):116-127. doi:10.1016/j.adolescence.2017.11.010
  • 35. Duncan LR, Pearson ES, Maddison R. Smoking prevention in children and adolescents: A systematic review of individualized interventions. Patient Educ Couns. 2018;101(3):375-388. doi:10.1016/j.pec.2017.09.011
  • 36. Lempp T, Heinzel-Gutenbrunner M, Bachmann C. Child and adolescent psychiatry: which knowledge and skills do primary care physicians need to have? A survey in general practitioners and paediatricians. Eur Child Adolesc Psychiatry. 2016;25(4):443-451. doi:10.1007/s00787-015-0757-6
  • 37. Haller DM, Favrod-Coune T, Dvorák C, Herzig L. Prevention of binge drinking in adolescents: do family doctors have a role to play? Rev Med Suisse. 2014;10(430):1062, 1064-1067. http://www.ncbi.nlm.nih.gov/pubmed/24930152. Accessed March 19, 2019.
  • 38. Pinsonneault L, Déry V. Family physicians and treatment of pediatric obesity: findings drawn from the creation of clinical practice guidelines. Can Fam Physician. 2012;58(5):e238, 502. http://www.ncbi.nlm.nih.gov/pubmed/22734166. Accessed March 19, 2019.
  • 39. Karabulutlu Ö, Kılıç M. Üniversite Öğrencilerinin Cinsel Sağlık Ve Üreme Sağlığı Hakkındaki Bilgi Düzeylerinin Belirlenmesi. Anadolu Hemşirelik ve Sağlık Bilim Derg. 2011;14(2):39-45. https://dergipark.org.tr/download/article-file/29495. Accessed August 20, 2019.
Toplam 39 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Birinci Basamak Sağlık Hizmetleri
Bölüm Orijinal Makaleler
Yazarlar

Asya Banu Babaoğlu 0000-0002-1259-1288

Ülken Tunga Babaoğlu 0000-0003-0275-0537

Sibel Cevizci Bu kişi benim 0000-0001-7979-8892

Buşra Tozduman 0000-0003-0372-6280

Halide Karakaş 0000-0001-8773-6683

Mustafa Tözün 0000-0002-7557-432X

Proje Numarası -
Yayımlanma Tarihi 20 Aralık 2020
Gönderilme Tarihi 25 Mayıs 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 14 Sayı: 4

Kaynak Göster

Vancouver Babaoğlu AB, Babaoğlu ÜT, Cevizci S, Tozduman B, Karakaş H, Tözün M. Missed Opportunities in Adolescent Health: An Overview From Turkey. TJFMPC. 2020;14(4):588-97.

Sağlığın ve birinci basamak bakımın anlaşılmasına ve geliştirilmesine katkıda bulunacak yeni bilgilere sahip yazarların İngilizce veya Türkçe makaleleri memnuniyetle karşılanmaktadır.