Turkiye Klinikleri Journal of Medical Sciences

.: ORIGINAL RESEARCH
Compliance with General Rules and Periodically Differences During the COVID-19 Pandemic in Türkiye: A Cross-Sectional Study
Türkiye'de COVID-19 Pandemi Sürecinde Genel Kurallara Uyum ve Dönemsel Farklılıklar: Bir Kesitsel Çalışma
İbrahim ŞAHİNa, Özlem TOLUKa,b, Fisun KASKIR KESİNa,c, Arda UZUNOĞLUa, Ayşegül YABACI TAKb, İlker ERCANd
aDepartment of Biostatistics, Bursa Uludag University Institute of Health Sciences, Bursa, Türkiye
bDepartment of Biostatistics, Bezmialem Vakıf University Faculty of Medicine, İstanbul, Türkiye
cProgram of Social Security, Düzce University Vocational School of Social Sciences, Düzce, Türkiye
dDepartment of Biostatistics, Bursa Uludag University Faculty of Medicine, Bursa, Türkiye
Turkiye Klinikleri J Med Sci. 2022;42(4):297-310
doi: 10.5336/medsci.2022-91461
Article Language: EN
Full Text
ABSTRACT
 Objective: The aim of this research is to investigate the compliance of the society with the general 14 rules of the Ministry of Health and the generally accepted hygiene rules recommended in the literature during the coronavirus disease-2019 (COVID-19) pandemic process. In line with the purpose, behavioral differences related to demographic characteristics and pandemic periods were also evaluated. Material and Methods: The study was conducted in August 2021 and snowball sampling technique was used. A questionnaire of 23 questions was applied to participants, in which compliance with the hygiene rules, including demographic questions, was investigated. The study included 1,069 participants between the ages of 18 and 65, living in Türkiye, using smartphones. Results: In our study, when the results of the compliance with the measures are examined, the compliance has decreased in almost all the other periods compared to the first period of the pandemic. In general, females pay more attention to complying with hygiene rules than males. It has been observed that those who have had COVID-19 disease pay less attention to participating in public areas than those who have not had COVID-19 disease. Conclusion: Social distancing, avoidance of mass events, hygiene, etc., are the most critical measures in slowing the spread of coronavirus. For this reason, it should not be forgotten that non-compliance with the rules will lead to an increase in cases. In terms of the 'normalization' steps taken during the pandemic process, analyzing the compliance rate with the hygiene rules seems very important in guiding future studies.

Keywords: COVID-19; public health; compliance; Türkiye
ÖZET
 Amaç: Çalışmamızın amacı, koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] pandemi sürecinde Sağlık Bakanlığının genel 14 kuralına ve literatürde önerilen genel kabul görmüş hijyen kurallarına toplumun uyumunu araştırmaktır. Amaç doğrultusunda ayrıca demografik özelliklere ve pandemi dönemlerine ilişkin davranış farklılıkları değerlendirilmiştir. Gereç ve Yöntemler: Çalışmamız, Ağustos 2021 tarihinde gerçekleştirilmiş olup, kartopu örnekleme tekniği kullanılmıştır. Katılımcılara demografik sorular da dâhil olmak üzere hijyen kurallarına uygunluğunun araştırıldığı 23 soruluk anket uygulanmıştır. Araştırma, Türkiye'de yaşayan ve akıllı telefon kullanan 18-65 yaş aralığında 1.069 katılımcı ile gerçekleştirilmiştir. Bulgular: Çalışmamızda, tedbirlere uyum sonuçları incelendiğinde, pandeminin ilk dönemine göre hemen hemen diğer tüm dönemlerde uyum azalmıştır. Genel olarak kadınlar hijyen kurallarına uymaya erkeklere göre daha fazla dikkat etmektedir. COVID-19 hastalığı geçirenlerin toplu alanlara katılım göstermede COVID-19 hastalığı geçirmeyenlere göre daha az dikkat ettiği gözlenmiştir. Sonuç: Sosyal mesafeye uyum, toplu etkinliklerden kaçınma, hijyen vb. davranışlar koronavirüsün yayılmasını yavaşlatmada en kritik önlemlerdir. Bu nedenle kurallara uyulmadığı durumda vaka sayınının artışına sebep olacağı unutulmamalıdır. Pandemi sürecinde atılan 'normalleşme' adımları açısından kurallara uyum oranının analiz edilmesi ve bundan sonraki çalışmalara yön vermesi açısından oldukça önemlidir.

Anahtar Kelimeler: COVID-19; halk sağlığı; uyum; Türkiye
REFERENCES:
  1. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497-506. [Crossref]  [PubMed]  [PMC] 
  2. World Health Organization [Internet]. © 2022 WHO. [Cited: January 5, 2020]. Pneumonia of unknown cause-China. Available from: [Link] 
  3. World Health Organization [Internet]. © 2021 WHO. [Cited: September 28, 2021]. Weekly epidemiological update on COVID-19-Edition 59. Available from: [Link] 
  4. Republic of Turkey Ministry of Health [Internet]. Covid-19 Information Platform. Access Date: September 30, 2021. Available from: [Link] 
  5. Chan JF, Yuan S, Kok KH, To KK, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395(10223):514-23. [Crossref]  [PubMed]  [PMC] 
  6. Republic of Turkey Ministry of Health Directorate General of Public Health. COVID-19 (SARS-CoV-2 INFECTION) GUIDE.2020. Available from: [Link] 
  7. Sanche S, Lin YT, Xu C, Romero-Severson E, Hengartner N, Ke R. High contagiousness and rapid spread of severe acute respiratory syndrome coronavirus 2. Emerg Infect Dis. 2020;26(7):1470-7. [Crossref]  [PubMed]  [PMC] 
  8. Wilder-Smith A, Freedman DO. Isolation, quarantine, social distancing and community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak. J Travel Med. 2020;27(2):taaa020. [Crossref]  [PubMed]  [PMC] 
  9. Wiese AD, Everson J, Grijalva CG. Social distancing measures: evidence of interruption of seasonal influenza activity and early lessons of the SARS-CoV-2 pandemic. Clin Infect Dis. 2021;73(1):e141-3. [Crossref]  [PubMed]  [PMC] 
  10. Republic of Turkey Ministry of Health. 14 Rules Aganist The Risk Of New Coronavirus. 2020. Available from: [Link] 
  11. Marroquín B, Vine V, Morgan R. Mental health during the COVID-19 pandemic: Effects of stay-at-home policies, social distancing behavior, and social resources. Psychiatry Res. 2020;293:113419. [Crossref]  [PubMed]  [PMC] 
  12. Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. Gen Psychiatr. 2020;33(2):e100213. [Crossref]  [PubMed]  [PMC] 
  13. Goodman LA. Snowball sampling. Annals of Mathematical Statistics. 1961;32(1):148-70. [Crossref] 
  14. Guidry JPD, O?Donnell NH, Austin LL, Coman IA, Adams J, Perrin PB. Stay socially distant and wash your hands: using the health belief model to determine intent for COVID-19 preventive behaviors at the beginning of the pandemic. Health Educ Behav. 2021;48(4):424-33. [Crossref]  [PubMed] 
  15. Júnior A, Dula J, Mahumane S, Koole O, Enosse S, Fodjo JNS, et al. Adherence to COVID-19 preventive measures in mozambique: two consecutive online surveys. Int J Environ Res Public Health. 2021;18(3):1091. [Crossref]  [PubMed]  [PMC] 
  16. Ditekemena JD, Nkamba DM, Muhindo HM, Siewe JNF, Luhata C, Van den Bergh R, et al. Factors associated with adherence to COVID-19 prevention measures in the Democratic Republic of the Congo (DRC): results of an online survey. BMJ Open. 2021;11(1):e043356. [Crossref]  [PubMed]  [PMC] 
  17. Shewasinad Yehualashet S, Asefa KK, Mekonnen AG, Gemeda BN, Shiferaw WS, Aynalem YA, et al. Predictors of adherence to COVID-19 prevention measure among communities in North Shoa Zone, Ethiopia based on health belief model: a cross-sectional study. PLoS One. 2021;16(1):e0246006. [Crossref]  [PubMed]  [PMC] 
  18. Makhni S, Umscheid CA, Soo J, Chu V, Bartlett A, Landon E, et al. Hand hygiene compliance rate during the COVID-19 pandemic. JAMA Intern Med. 2021;181(7):1006-8. [Crossref]  [PubMed]  [PMC] 
  19. Qeadan F, Akofua Mensah N, Tingey B, Bern R, Rees T, Talboys S, et al. What protective health measures are Americans taking in response to COVID-19? Results from the COVID impact survey. Int J Environ Res Public Health. 2020;17(17):6295. [Crossref]  [PubMed]  [PMC] 
  20. Sirin H, Ketrez G, Ahmadi AA, Arslan A, Altunel E, Gunes IS, et al. Community approach towards COVID-19 in Turkey: one month after the first confirmed case. Turkish Bull Hyg Exp Biol. 2020;77(4):381-98. [Crossref] 
  21. Zhou Q, Lai X, Zhang X, Tan L. Compliance measurement and observed influencing factors of hand hygiene based on COVID-19 guidelines in China. Am J Infect Control. 2020;48(9):1074-9. [Crossref]  [PubMed]  [PMC] 
  22. Singh A, Ahuja R. Knowledge, attitude, and practice of general public towards COVID-19 in India: an online cross-sectional study. Int J Innov Res Sci Eng Technol. 2020;09(06):5005-12. [Crossref] 

.: Up To Date

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com