Suchergebnisse

Bu çalışma, 2003 sonrası Türk sağlık alanındaki kurumsal değişim sürecinde, Sağlık Bakanlığı ile Tabipler Odası ve sendikalar arasında yaşanan güç mücadelesinin zamanla nasıl bir seyir izlediğini ortaya koymayı amaçlamaktadır. Çalışmada, özel olarak değişen güç dengeleriyle beraber kurumsal girişimci olarak nitelenilecek AK Parti'li Sağlık Bakanlığının ne tür güç mekanizmalarına, muhalif aktörler olarak da Tabipler Odası ve sendikaların ne tür direniş taktiklerine başvurdukları anlaşılmaya çalışılmıştır. Bunun için doküman incelemeleri ve kurumsal aktör temsilcileri ile görüşmeler yapılmıştır. Elde edilen verilerin Lawrence vd.'nce (2001) tanımlanan güç mekanizmaları ve Della Porta ve Andretta (2002) tarafından açıklanan direniş taktiklerine göre sınıflandırılmasıyla, kullanılan güç mekanizmaları ve sergilenen direniş taktiklerinin güç dengelerine paralel olarak değiştikleri ortaya çıkmıştır. Araştırma bulguları, genel olarak, kurumsal girişimcinin güçlendikçe olaysal güç mekanizmalarından sistemik güç mekanizmalarına doğru, muhalif aktörlerin de, güç kaybettikçe şiddet seviyesi düşük direniş taktiklerinden şiddet seviyesi yüksek taktiklere doğru bir seyir izlediğini göstermektedir ; This study aims to find out, during the institutional change occurred in the Turkish health care field, how the power struggles between the Ministry of Health as an institutional entrepreneur and the Turkish Medical Association as well as the Unions as opposing actors changed during the period of 2003-2014. The study specifically focused on understanding the kind of power mechanisms used by the Ministry of Health ruled by Justice and Development Party and the resistance tactics exhibited by both the Medical Association and Unions as opposing actors, along with changing power balances over years. For this purpose, we carried out document examinations and interviews. Categorizing the data based on power mechanisms identified by Lawrence et al. (2001) and resistance tactics described by Della Porta and Andretta (2002), we found out that the power mechanisms applied by the Ministry of Health and the resistance tactics displayed by opposing actors have changed in conjunction with the changing power levels and balances. The research results specifically show that institutional entrepreneur, as getting stronger in the field, would rather more systemic and less episodic mechanisms while opposing actors tended to display higher level intensity resistance tactics as they lose their power over years.

The COVID-19 pandemic has affected all segments of society. In this study, the level of anxiety, grief, anger and perceived stress related to pandemic conditions were evaluated in multiple sclerosis (MS) cases, healthcare professionals and lay public and, the stress experienced by individuals with MS was compared with health care professionals and lay public.
Study sample were composed of 63 persons with MS, 59 healthcare professionals (HCP), and 99 healthy volunteers (HV). All participants were administered UCLA-Covid-19 screening test, Posttraumatic Stress Disorder - symptom checklist, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7 Scale, Impact of Events Scale, K-10 scale and Trait Anger Scale. Socio-demographic features of the groups were almost same except for female preponderance and relatively low education in MS group. Hospitalization, test-positivity and quarantine rates due to COVID-19 did nor differ among groups. Pandemic conditions have made everyone feel helpless and hopeless, however, this was remarkably much more evident in HCPs. The most significant concern related with COVID-19 was contracting the disease for persons with MS, transporting the disease to their family members for HCP, and job/income loss due to lockdown for HVs. The stress level experienced by individuals with MS and health care professionals was significantly higher than that of healthy volunteers. In a similar way, the perceived stress level was the same in MS and HCP groups, but significantly higher than in the HV group. Persons with MS were as anxious and depressed as HCPs. Nevertheless, HVs stated that they experienced more psychological distress than both HCPs and persons with MS. Our results yield that depression, anxiety and stress were high among persons with MS during the pandemic.

Bu makalede sağlık hizmet anlayışındaki değişmelerin toplumun içinde bulunduğu sosyo-ekonomik ve kültürel yapının yanı sıra bilimsel gelişmelerle de yakından ilişkisi bulunduğu varsayımından hareket edilmiştir. "Sağlık Emek Sürecinin Dönüşümü" olarak da adlandırılan süreci anlayabilmek için mevcut çalışmalar Weed'in (2005) "sistematik tarama" (systematic review) ve Elias'ın (1977; 2000) "yöntembilimsel ilişkiselcilik" (methodological relationalism) olarak belirlediği tarzda değerlendirilmiştir. Araştırma bulguları Türkiye'de 1980 sonrasında egemen olan rejimin "esnek sermaye birikimi" ve buna bağlı olarak sanayisizleşme ve özelleştirme olduğunu göstermiştir. Türkiye'de Neo-liberal politikalarla Güneydoğu Avrupa Modeli uygulanırken temel ilke özellikle sağlık alanında hizmet sunumu ile bunun finansmanının birbirinden ayrılmasıdır. İkinci temel özellik ize merkez-dışı (adem-i merkeziyetçi) yönetime geçilmesidir. Kuşkusuz tüm değişmeler, bazı ilkelere bağlanmışsa da hizmetin finansmandan ayrılması hizmet kalitesini olumsuz etkilemiştir. Çünkü harcamalarda kısıntı yapılması ve işletme mantığı ile maliyetin düşürülmesi beklenmektedir. Ancak hastanelerin bazı gerekliler yerine daha fazla karlı olan işlemlerde yoğunlaşmaları söz konusudur. Ayrıca teşhis ve tedavi sürecindeki denetleyici kısıtlamalar da hekimlik mesleğinin icrası kadar kalitesini de olumsuz etkileyebilmektedir. Hekimlerin gerekli gördüğü tetkikler fiyatlandırma yönetmeliği uyarınca kısıtlandığında ortaya çıkan sonuç hekimin mesleki özerkliğinin kısıtlanmasından başka bir şey değildir. ; In this paper it is assumed that there is a close relationship between the health policy changes and socioeconomic structural changes of the Turkish society. Certainly scientific developments and globalization process are also important on social transformations of any society. Therefore, at the beginning of this paper in order to understand the process that is called " Transformation of Health Work Process" , historical background of health system in Turkey is reviewed based on relevant literature. " Systematic review" method (Weed,2007) and process based sociology namely " methodological relationalism" (Elias,1977) are used to achieve study purposes. Findings revealed that we live in a period that is called " flexible" period in terms of capital accumulation. This period starting from 1990's is characterized by non-industrialization and privatization. In Turkey Southern European Model is applied based on Neoliberal Policies which mainly separates finance from health services. Second characteristic future is application of decentralization of administrative system. Majority of hospitals are transformed from social to economic organizations who run after profits by applying high numbers of operations to get money from insurances. Although there are some regulations to be followed, separation of services from finance also reduced the quality of health care. Besides some malpractices are observed regarding expensive unnecessary operations. Furthermore, some supervisory limitations on diagnostic and treatment processes can be interpreted lack of professional freedom of physicians

University education may influence attitudes toward gender roles. The awareness of students in the field of health services about the gender inequalities they will encounter both during the education process and in the future while providing health services will play a role in providing health services in a more effective and equitable way. In order for university students to approach men and women with an egalitarian perspective at an early age, their gender stereotypes must first decrease and their perspectives on social relations must change positively. Therefore, university education can play an important role in influencing gender perception and attitudes towards gender roles. There is no special course on prejudice and discrimination in the training programs of Vocational Schools of Health Services that train health technicians in Turkey. Based on this, this study aimed to examine the effect of the training program given to raise awareness of prejudice, stereotypes and discrimination on the gender perception and attitude of students who will provide health care in the future. For this purpose, answers were sought to the following questions: Is there a difference in students' gender perceptions of prejudice and discrimination before and after training? Are there any differences in students' gender role attitudes regarding prejudice and discrimination before and after education? Is there a relationship between gender perception and attitudes towards gender roles? As a method, a single-group the pretest-posttest semi-experimental method was used. The research was conducted with students taking the Prejudice and Discrimination course at the Vocational School of Health Services. 95 second-grade students participated in the research. The reason why sophomore students from the Disabled Care and Rehabilitation program, the Pharmacy Services program, and the Occupational Therapy Program were selected in the study is that the "Prejudice and Discrimination" course is given in the second-grade student spring semester. Descriptive Information Form, Gender Roles Attitude Scale (GRAS), and Gender Perception Scale (GPS) were used to collect data. Before the course program started, GRAS and GPS were administered to the participants as a pretest. Afterwards, a fourteen-week course period on "Prejudice and Discrimination" was carried out. At the end of the course, GRAS and GPS were administered to the participants as posttests. According to the students' descriptive characteristics, it was found that the mean age of the participants in the study was 21.6±3.3, and that 73.7% of them were female. According to the study, most students' mothers (56.9%) and fathers (38.9%) had completed elementary school. The families of 73.7% of the participants are nuclear families. The students' average number of siblings was found to be 2.8±2.1, and the majority (51.6%) of them had both brothers and sisters. The investigation discovered that 43.2% of the students lived primarily in the city center. Most students who participated in the study said that the Black Sea region was where they spent most of their lives (46.3%). The research revealed that prejudice and discrimination training provided via online distance education methods did not affect the gender perception and gender role attitudes of second-year Vocational School of Health Services students (respectively; p = 0.890, p = 0.976). However, a positive relationship was found between gender perception and attitudes towards gender roles (pretest r = 0,825, p < 0,01; posttest r = 0,893, p< 0,01). While the total scale score of women was higher than men according to GPS and GRAS scores according to sex before the training (GPS, p = 0.002; GRAS, p

ÖZETTürkiye gibi geç kapitalistleşen ülkelerde sosyal politikanın ve sosyal politika tartışmalarının çok geri planda kaldığını görülmektedir. Türkiye'de bu sistem 1940'larda oluşmaya başlamıştır. Memurları ve formel sektörde çalışan işçileri kapsayan sistem, çalışan nüfusun çok büyük bir kısmını dışarıda bırakmaktadır. 1971 yılında, kendi hesabına çalışanları sigorta kapsamına alan Bağ-Kur'un kurulmuştur. Fakat primlerini kendileri ödemek durumunda olan Bağ-Kurlular çoğu zaman bu primleri ödeyemeyip, dolayısıyla haklarından mahrum kalmışlardır. 1992'de başlayan ve ihtiyaç tespiti yöntemleriyle yoksulların sağlık hizmetlerine ulaşımını sağlayan Yeşil Kart uygulaması (Bugünkü uygulaması Genel Sağlık Sigortası ) sağlık konusundaki sorunları çözmeye çalışmaktadır.1986'da kurulan ve "FAK FUK FONU" olarak da bilinen "Sosyal Dayanışma ve Yardımlaşmayı Teşvik Fonu", yeni yoksullukla baş edebilmek için yeni yöntemler geliştirmek gerektiği gerçeğine tepki olarak ortaya çıkmaktadır. 1980'lerde ANAP döneminde ve 1990'larda çok ciddi bir işlevi olmayan fonun çoğu zaman başka amaçlarla kullanıldığını görülmektedir. Sistematik sosyal yardım uygulamalarına benzer bir şekilde ilk kez 1999 depreminden ve 2001 krizinden sonra, Ecevit hükümeti döneminde kullanılmaya başlanan bu fonun işlevi, daha sonra iktidara gelen AKP hükümeti döneminde önem kazanmaktadır.Çalışmada Türkiye' de yoksulluk ve yoksullukla mücadele daha çok kurumlar açısından ele alınmaktadır. Yoksullukla mücadele yöntemleri, çözümleri ve etkili olup olamadıkları araştırılmaktadır. Çalışma 3 bölümden oluşmaktadır. İlk bölümde yoksulluk kavram, çeşit ve ölçümlerine odaklanılmakta, ikinci bölümde Türkiye'de yoksullukla mücadele eden kurumlar incelenmekte, üçüncü bölümde ise Biga İlçesinde yoksulluk analizine ve yoksullukla mücadele eden kurum ve derneklere yer verilmektedir.ABSTRACTIn countries, that lately capitalized such as Turkey,it's seen both the social policy and the discussions of the social policy remain at the background. , In Tuurkey, this system has started to ocur in 1940's. The system that including formel sector workers and servants, has left out the vast majority of working popilation. In 1971, Bağ-kur , which takes the self-employed people to insurance coverage , was established. But , Bağ-kur enrollees, which are in case of to pay their own primiums, mostly couldn't pay that primiums, thus deprived of their rights. Green Card Application (Today's General Health Insurance Application) starting in 1992 and providing the poor people to reach the health service by identifing needs, tried to solve the problems in health care.'' The social aid and Solidatrity Promotion Fund'' which was founded in 1986 , also known as ''FAK FUK FUND '', has emerged in response to the fact that being needed to develope news methods to cope with powerty. It's seen that the fund had not a serious function in 1980's, during the ANAP gowernment period and in 1990's and mostly used for different porposes .The function of this fund was started being used properly during Ecevit government period at the first time ,after 1999 earthquake and 2001 in a manner similar the systematic oureach practise , then during AKP government period, it gained more importance.In this study , Poverty in Turkey and the fight against poverty has been discussed more in the terms of institutions. The methods, solition of fighting gainst powerty and its effectiveness has been searched. This study consists of three chapters.İn first chapters ; has been focused on the concept, variety and measurement of poverty, in the second chapter; the institutions which fights the poverty in Turkey has been analysed, in the third chapter analyzing of poverty and institutions, organizations which fight against the poverty in Biga has been featured.