Birinci basamakta yapılan otoskopik kulak muayenelerinin, kulak burun boğaz uzman görüşleriyle değerlendirilmesi
Küçük Resim Yok
Tarih
2026
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Aile hekimi, kişiye yönelik koruyucu sağlık hizmetleri ile birinci basamak teşhis, tedavi ve rehabilite edici sağlık hizmetlerini, yaş, cinsiyet ve hastalık ayrımı yapmaksızın, her kişiye kapsamlı ve devamlı olarak belirli bir mekânda vermekle yükümlü olan tabip veya uzman tabiptir. Aile hekimleri hastalarının kulak muayenelerini yaparken otoskop kullanmaktadırlar. Bu çalışmanın amacı, birinci basamakta aile hekimleri tarafından yapılan otoskopik kulak muayenelerinin tanısal doğruluğunu, Kulak Burun Boğaz (KBB) uzman hekimi değerlendirmesi ile karşılaştırmak ve hekimler arası uyumu belirlemektir. Gereç-Yöntem: Çalışma, 20.01.2025 - 31.05.2025 tarihleri arasında Düzce ilinde bulunan Aile Sağlığı Merkezleri'ne başvuran 105 hasta ile yapılmıştır. Hastalar önce aile hekimlerinde, sonra Düzce Üniversitesi Araştırma ve Uygulama Hastanesi Kulak Burun Boğaz polikliniğinde muayene olmuşlardır. Çalışmaya özel hazırlanan muayene formlarına bulgular kayıt edilmiştir. Sonrasında hekimlerin elde ettiği bulgular istatistiksel olarak karşılaştırılmıştır. Bulgular: Aile hekimlerinin yaşı (p=0,428), mesleki tecrübeleri (p=0,428), aile hekimliği süreleri (p=0,474), kullanılan otoskop tipi (p=0,961) ve otoskop markasının (p=0,913) KBB hekimi ile uyumda anlamlı etkisi olmadığı saptanmıştır. Timpan zar hiperemisi, timpan zar perforasyonu, buşon, dış kulak yolu (DKY)'nda akıntıda (sırasıyla p=0,019, p<0,001, p<0,001, p<0,001) KBB hekimiyle uyumda istatistiksel olarak anlamlı fark bulunmuştur. Timpan zar matlaşması, timpan zarda bombeleşme ve DKY hiperemisinde (sırasıyla p=0,777, p=0,108, p=0,713) KBB hekimiyle uyumda istatistiksel olarak anlamlı fark saptanmamıştır. Sonuç: Aile hekimlerinin otoskopik becerilerinin geliştirilmesine yönelik adımlar atılmalıdır. Bu anlamda hekimlerin tıp fakültesindeki eğitimleri sırasında KBB stajlarında daha aktif rol almalarını sağlamak, mezuniyet sonrası sürekli mesleki gelişim eğitimleri planlamak ve aile hekimliği uzmanlık eğitiminde KBB rotasyonu yapmaya teşvik etmek faydalı olacaktır.
Objective: A family physician is a medical doctor or specialist responsible for providing comprehensive and continuous preventive, diagnostic, therapeutic, and rehabilitative primary health care services to individuals of all ages and sexes without disease discrimination, within a defined setting. Family physicians use otoscopy during routine ear examinations. The aim of this study was to evaluate the diagnostic accuracy of otoscopic ear examinations performed by family physicians in primary care by comparing their findings with those of an Ear, Nose and Throat (ENT) specialist and to determine the inter-physician agreement. Materials and Methods: The study was conducted with 105 patients who applied to Family Health Centers in Düzce province between January 20, 2025, and May 31, 2025. The patients were first examined by family physicians and subsequently at the Ear, Nose, Throat (ENT) outpatient clinic of Düzce University Research and Application Hospital. Findings were recorded on examination forms specifically prepared for the study. Following this, the findings obtained by the physicians were statistically compared. Results: No statistically significant association was found between agreement with the ENT specialist and the family physicians' age (p=0,428), years of professional experience (p=0,428), duration of practice in family medicine (p=0,474), type of otoscope used (p=0,961), or otoscope brand (p=0,913). A statistically significant difference in agreement was observed for tympanic membrane hyperemia, tympanic membrane perforation, cerumen impaction, and external auditory canal discharge (p=0,019, p<,001, p<0,001, p<0,001, respectively). No statistically significant difference in agreement was found for tympanic membrane opacity, tympanic membrane bulging, or external auditory canal hyperemia (p=0,777, p=0,108, p=0,713, respectively). Conclusion: Measures should be taken to improve the otoscopic skills of family physicians. These may include increasing active participation during ENT clerkships in medical school, planning structured continuing professional development programs after graduation, and incorporating structured ENT rotations into family medicine residency training.
Objective: A family physician is a medical doctor or specialist responsible for providing comprehensive and continuous preventive, diagnostic, therapeutic, and rehabilitative primary health care services to individuals of all ages and sexes without disease discrimination, within a defined setting. Family physicians use otoscopy during routine ear examinations. The aim of this study was to evaluate the diagnostic accuracy of otoscopic ear examinations performed by family physicians in primary care by comparing their findings with those of an Ear, Nose and Throat (ENT) specialist and to determine the inter-physician agreement. Materials and Methods: The study was conducted with 105 patients who applied to Family Health Centers in Düzce province between January 20, 2025, and May 31, 2025. The patients were first examined by family physicians and subsequently at the Ear, Nose, Throat (ENT) outpatient clinic of Düzce University Research and Application Hospital. Findings were recorded on examination forms specifically prepared for the study. Following this, the findings obtained by the physicians were statistically compared. Results: No statistically significant association was found between agreement with the ENT specialist and the family physicians' age (p=0,428), years of professional experience (p=0,428), duration of practice in family medicine (p=0,474), type of otoscope used (p=0,961), or otoscope brand (p=0,913). A statistically significant difference in agreement was observed for tympanic membrane hyperemia, tympanic membrane perforation, cerumen impaction, and external auditory canal discharge (p=0,019, p<,001, p<0,001, p<0,001, respectively). No statistically significant difference in agreement was found for tympanic membrane opacity, tympanic membrane bulging, or external auditory canal hyperemia (p=0,777, p=0,108, p=0,713, respectively). Conclusion: Measures should be taken to improve the otoscopic skills of family physicians. These may include increasing active participation during ENT clerkships in medical school, planning structured continuing professional development programs after graduation, and incorporating structured ENT rotations into family medicine residency training.
Açıklama
Anahtar Kelimeler
Aile Hekimliği, Kulak Burun ve Boğaz
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
İştar, S. (2026). Birinci Basamakta Yapılan Otoskopik Kulak Muayenelerinin, Kulak Burun Boğaz Uzman Görüşleriyle Değerlendirilmesi (Tez No. 1009533) [Tıpta Uzmanlık Tezi, Düzce Üniversitesi].
