Register      Login
Journal of Primary Health Care Journal of Primary Health Care Society
Journal of The Royal New Zealand College of General Practitioners
RESEARCH ARTICLE (Open Access)

‘Stepchildren of the Ministry’: an examination of the difficulties endured by family physicians in Istanbul during the course of the COVID-19 pandemic

Yeşim Yasin https://orcid.org/0000-0002-3188-3999 1 * , Seray Başak Bozkurt 1 , Cansu Yıldırım 1 , Atakan Arzak 1 , Hakan Döndürür 1 , Adar Eken 1 , Ismail Jan Kara 1
+ Author Affiliations
- Author Affiliations

1 Department of Public Health, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Icerenkoy mah. Kayisdagi cad. No: 32, 34684 Atasehir-Istanbul, Turkey.

* Correspondence to: yesim.yasin@acibadem.edu.tr

Journal of Primary Health Care 14(1) 57-63 https://doi.org/10.1071/HC21141
Published: 30 March 2022

© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution 4.0 International License (CC BY)

Abstract

Introduction: Efforts to contain the SARS-CoV-2 virus would fall short without strong primary health care.

Aim: In this study, we aimed to understand family physicians’ experiences of coronavirus disease 2019 (COVID-19) in Istanbul, focusing on their coping strategies in order to draw lessons for the future management of pandemics.

Methods: Twelve community-based physicians working in Istanbul participated in semi-structured interviews between January and May 2021. Purposive sampling was used to ensure a range of physicians’ characteristics. Individual interviews were conducted with each participant on an online platform. Participants were asked 26 open-ended questions. Phenomenological analysis was performed to describe experiences of physicians.

Results: The physical conditions of participants’ health centres were insufficient to provide service safely during the COVID-19 pandemic. Most physicians were uncomfortable about the quality and quantity of personal protective equipment received from the Ministry of Health and took additional measures themselves. Vaccine supply was thought to be insufficient and there were problems with the associated software. Many family physicians highlighted the inadequate communication from the Ministry. Insufficient knowledge about the disease caused anxiety and fear for the physicians and hindered their performance at the beginning of the pandemic. Physicians who live with their families were more anxious than those who did not.

Discussion: Despite challenges, routine procedures have mostly been continued, but newly added responsibilities during the COVID-19 pandemic have had significant impact on physicians’ lives.

Keywords: ambulatory care, COVID‐19, family health centres, family physicians, general practitioners, Istanbul, pandemic, primary health care, qualitative research, vaccines.


References

[1]  Saatçi E. COVID-19 Pandemisi ve sağlık çalışanları: Yaşatmak mı yaşamak mı? [The COVID-19 pandemic and healthcare workers: to survive or keep people alive?]. Türk Aile Hek Derg 2020; 24 153–166. [In Turkish]

[2]  Huston P, Campbell J, Russell G, et al. COVID-19 and primary care in six countries. BJGP Open 2020; 4 bjgpopen20X101128
COVID-19 and primary care in six countries.Crossref | GoogleScholarGoogle Scholar | 32900708PubMed |

[3]  WHO Regional Office for Europe. Turkey’s Response to COVID-19: First Impressions. WHO; 2020. [cited 2021 July 24]. Available from: https://apps.who.int/iris/bitstream/handle/10665/335803/WHO-EURO-2020-1168-40914-55408-eng.pdf

[4]  Acar H, Gökseven Y, Öztürk GZ, Arıca Z. COVID-19 in primary healthcare. Ank Med J 2020; 20 444–467.
COVID-19 in primary healthcare.Crossref | GoogleScholarGoogle Scholar |

[5]  Sahin MK, Sahin G. Family medicine departments and healthcare centres during COVID-19 pandemic in Turkey. Eur J Gen Pract 2020; 26 102–103.
Family medicine departments and healthcare centres during COVID-19 pandemic in Turkey.Crossref | GoogleScholarGoogle Scholar | 32674624PubMed |

[6]  Anadolu Ajansı. Kovid-19 nedeniyle evde izolasyona ‘aile hekimi’ takibi [Family physicians follow those who are isolated in home due to COVID-19]. 2020. [cited 2021 March 9]. Available from: https://www.aa.com.tr/tr/koronavirus/kovid-19-nedeniyle-evde-izolasyona-aile-hekimi-takibi/1771379 [In Turkish]

[7]  TTB. Aile Hekimliği Pandemi Anketi [Family Physicians Pandemic Survey], January 2021. [cited 2021 April 5]. Available from: https://www.ttb.org.tr/kollar/_ahek/haber_goster.php?Guid=2bc75636-6173-11eb-a370-4722d3be3ffd [In Turkish]

[8]  TTB. Aile Hekimliği Pandemi Anketi [Family Physicians Pandemic Survey], February 2021. [cited 2021 April 5]. Available from: https://www.ttb.org.tr/kollar/_ahek/haber_goster.php?Guid=a7e658c8-7840-11eb-88b2-b02bc55b7849 [In Turkish]

[9]  TTB. Aile Hekimliği Pandemi Anketi [Family Physicians Pandemic Survey], December 2020. [cited 2021 April 5]. Available from: https://www.ttb.org.tr/375yid6 [In Turkish]

[10]  TTB. Aile Hekimliği Pandemi Anketi [Family Physicians Pandemic Survey], April 2021. [cited 2021 April 5]. Available from: https://www.ttb.org.tr/kollar/_ahek/haber_goster.php?Guid=724ba4e8-a36a-11eb-ae7d-85666df1736a [In Turkish]

[11]  TTB. Birinci Basamak’ta COVID-19 Pandemisine İlişkin Durum Araştırması [Situational research of the COVID-19 pandemic in primary care], August 2020. [cited 2021 April 5]. Available from: https://www.istabip.org.tr/koronavirus/Haberler/6024/ttb-birinci-basamak-ta-COVID-19-pandemisine-iliskin-durum-arastirmasi-nin-sonuclarini-acikladi-birinci-basamak-pandemi-surecinin-disina-atildi [In Turkish]

[12]  Güler S, Topuz İ, Ulusoy F. COVID-19 Pandemisinde Aile Sağlığı Merkezi Çalışanlarının Deneyimleri. [Experiences of family healthcare workers in the COVID-19 pandemic]. Halk Sağ Hem Derg 2020; 2 143–151. [In Turkish]

[13]  Taş BG, Özceylan G, Öztürk GZ, et al. Evaluation of job strain of family physicians in COVID-19 pandemic period - an example from Turkey. J Community Health 2021; 46 777–785.
Evaluation of job strain of family physicians in COVID-19 pandemic period - an example from Turkey.Crossref | GoogleScholarGoogle Scholar | 33188617PubMed |

[14]  Kavas BN, Develi A. Çalışma Yaşamındaki Sorunlar Bağlamında COVID-19 Pandemisinin Kadın Sağlık Çalışanları Üzerindeki Etkisi [The impact of the COVID-19 pandemic on female health workers in the context of problems in working life]. Int Anatolian Soc Sci J 2020; 4 84–112. [In Turkish]

[15]  Wright B, Fraher E, Holder MG, et al. Will Community Health Centers survive COVID-19? J Rural Health 2021; 37 235–238.
Will Community Health Centers survive COVID-19?Crossref | GoogleScholarGoogle Scholar | 32415879PubMed |

[16]  Damian AJ, Gonzalez M, Oo M, Anderson D. A national study of Community Health Centers’ readiness to address COVID-19. J Am Board Fam Med 2021; 34 S85–94.
A national study of Community Health Centers’ readiness to address COVID-19.Crossref | GoogleScholarGoogle Scholar | 33622823PubMed |

[17]  Lotta G, Coelho VSP, Brage E. How COVID-19 has affected frontline workers in Brazil: a comparative analysis of nurses and community health workers. J Comp Pol Anal 2021; 23 63–73.
How COVID-19 has affected frontline workers in Brazil: a comparative analysis of nurses and community health workers.Crossref | GoogleScholarGoogle Scholar |

[18]  Kearon J, Risdon C. The role of primary care in a pandemic: reflections during the COVID-19 pandemic in Canada. J Primary Care Community Health 2020; 11 215013272096287
The role of primary care in a pandemic: reflections during the COVID-19 pandemic in Canada.Crossref | GoogleScholarGoogle Scholar |

[19]  Polat Ö, Coşkun F. COVID-19 Salgınında Sağlık Çalışanlarının Kişisel Koruyucu Ekipman Kullanımları ile Depresyon, Anksiyete, Stres Düzeyleri Arasındaki İlişkinin Belirlenmesi [Determining the relationship between personal protective equipment uses of medical healthcare workers and depression, anxiety and stress levels in the COVID‐19 pandemic]. Med J West Black Sea 2020; 4 51–58. [In Turkish]
COVID-19 Salgınında Sağlık Çalışanlarının Kişisel Koruyucu Ekipman Kullanımları ile Depresyon, Anksiyete, Stres Düzeyleri Arasındaki İlişkinin Belirlenmesi [Determining the relationship between personal protective equipment uses of medical healthcare workers and depression, anxiety and stress levels in the COVID‐19 pandemic].Crossref | GoogleScholarGoogle Scholar |

[20]  Karahan S, Agadayi E, Yilmaz IG. Problems experienced by family physicians in Sivas during the pandemic period and its relationship with COVID-19 fear. Eurasian J Family Med 2021; 10 74–83.
Problems experienced by family physicians in Sivas during the pandemic period and its relationship with COVID-19 fear.Crossref | GoogleScholarGoogle Scholar |

[21]  Buonsenso D, Cinicola B, Kallon MN, Iodice F. Child healthcare and immunizations in Sub-Saharan Africa during the COVID-19 pandemic. Front Pediatr 2020; 8 517
Child healthcare and immunizations in Sub-Saharan Africa during the COVID-19 pandemic.Crossref | GoogleScholarGoogle Scholar | 32850565PubMed |

[22]  Hamouche S. COVID-19 and employees’ mental health: stressors, moderators, and agenda for organizational actions. Emerald Open Research 2020; 2 15
COVID-19 and employees’ mental health: stressors, moderators, and agenda for organizational actions.Crossref | GoogleScholarGoogle Scholar |

[23]  Şahin MK, Aker S, Şahin G, Karabekiroğlu A. Prevalence of depression, anxiety, distress and insomnia and related factors in healthcare workers during COVID-19 pandemic in Turkey. J Community Health 2020; 45 1168–1177.
Prevalence of depression, anxiety, distress and insomnia and related factors in healthcare workers during COVID-19 pandemic in Turkey.Crossref | GoogleScholarGoogle Scholar | 32915381PubMed |