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As the results of improvements and developments conducted on the areas of health, technology, education and social security in the world, the overall lifespan was extended, mortality rate was decreased and so many problems were emerged in association with the population ageing. One of these problems is currently incurable Alzheimer disease which is named to be a disease of elderly people. It has been estimated that the number of the Alzheimer patients are 46.8 million in the world and over 400.000 – 450.000 in Turkey. According to the data provided by the Turkish Statistical Institute, the mortality rate due to the Alzheimer disease was 2.9% in 2011 and increased to 4.3% in 2015. The disease causes cognitive, emotional and physical loses in patients and, as the diseases progresses, the dependency of patients increase. Different progresses at each patients, lack of psychological and behavioural symptoms as well as its being currently incurable make this disease difficult to distinguish from the others. It is a gospel truth that the Alzheimer disease will become more widespread in the forthcoming years and the care of Alzheimer disease is very difficult, abrasive and exhausting, and moreover, the responsibility of caregiver increases as the disease progresses. The aim of this study is to investigate the factors affecting the responsibilities of family members providing primary caregiving to Alzheimer patients. A quantitative research design was applied in this study. Sampling group of this study is constituted by 108 patient’s relative who have direct responsibility of caregiving to Alzheimer disease patients resident in the city of Sinop. “Caregiver Burden Inventory”, which was developed by Novak and Guest in 1989 and whose reliability and effectiveness for Turkish society realised by Küçükgüçlü in 2004, was applied in the scope of this research study. At the end of this research study, it was found that the most of the caregivers were women (74.1%), married (81.5%), at the ages of between 45 and 64 (64.8%) and the daughter of patient (43.5%), 50% of the caregivers had “a sense of family responsibility”, 67.6% needed help on “accompaniment”, 49.1% had health problems due to caregiving and finally 43.5% had psychiatric illnesses who declared health problems. It was determined that there was no statistically significant difference between the “Caregiver Burden Scale” and marital status, number of children, family structure, degree of relationship with the patient and whether receiving any payment while there was statistically significant difference between “Caregiver Burden Scale” and the age, sex, employment status, income status, duration of disease and daily caregiving period (hours).

06.03.2018 tarihli ve 30352 sayılı Resmi Gazetede yayımlanan “Yükseköğretim Kanunu İle Bazı Kanun Ve Kanun Hükmünde Kararnamelerde Değişiklik Yapılması Hakkında Kanun” ile 18.06.2018 tarihli “Lisansüstü Tezlerin Elektronik Ortamda Toplanması, Düzenlenmesi ve Erişime Açılmasına İlişkin Yönerge” gereğince tam metin erişime açılmıştır. Dünyada teknolojik ve bilimsel ilerlemeler ile birlikte ortalama yaşam süresi uzamakta, yaşlı nüfus oranı artmakta ve nüfusun demografik değişimi birçok sorunu da beraberinde getirmektedir. Bu sorunlardan biri ileri yaş hastalığı olarak bilinen Alzheimer hastalığıdır. Dünyada 46,8 milyon ülkemizde 600.000 Alzheimer hastası vardır. Yaşlı nüfus oranı ve ortalama yaşam süresinin artmasıyla birlikte ileriki yıllarda bu sayı daha da fazla artacaktır. Hastalığın yaygınlaşması ve giderek hasta sayısının artması beraberinde bakım sorununu da getirmiştir. Alzheimer hastalığı bireyde unutkanlık, davranış ve kişilik değişiklikleri, yer-zaman bilincinin kaybolması gibi yeti yitimlerine sebep olması, ilerleyici ve henüz tedavisinin bulunamamış olması nedeniyle diğer hastalıklardan farklı ve hem hasta hem bakım veren için yıpratıcı bir hastalıktır. Bu araştırma ile Alzheimer hastalarına bakım veren aile üyelerinin yaşadıkları güçlükleri belirlemek amaçlanmıştır. Araştırmanın örneklemini Sinop Atatürk Devlet Hastanesine başvuran 108 hasta yakını oluşturmaktadır. Elde edilen veriler SPSS paket programı ile analiz edilmiştir. Araştırma sonucunda: Bakım verenlerin çoğunlukla kadın(%74,1), evli(%81,5), orta yaş grubu(%64,8) ve hastanın kızı(%43,5) olduğu, %38,1'inin asgari ücret ve daha az gelire sahip olduğu, %61,2'sinin bakım vermekten kaynaklı olduğunu düşündüğü hastalığının olduğu, hastalığı olanların %43,5'inin psikiyatrik hastalık tanısı olduğu, %50'sinin hastasına "ailevi sorumluluk", %5,6'sının ise "sevgi bağı" duygusu ile bakım verdiği bulunmuştur. Alzheimer tanısı almış hastaların çoğunluğunun kadın(%65,7), 80 yaş ve üzeri (%62,6) ve Alzheimer dışında başka hastalığının olduğu(%68,6) saptanmıştır. Bakım verenler hastanın en çok ev işleri, ulaşım, kişisel temizlik, tedavi, ekonomik, giyim ve boşaltım ihtiyaçlarını karşılarken; en fazla refakat, hastanın fiziki bakımı ve ulaşım ihtiyaçlarında desteğe ihtiyaç duymaktadır. Bakım veren aile üyelerinin hastalığın doğasından kaynaklanan belirti ve bozukluklardan en fazla "öz bakımını sağlayamama", "kaygı-huzursuzluk sıkıntı hali", "idrar sorunu" ve "iletişimde bozulma" konularında güçlük çektikleri, bakım vermekten kaynaklı olarak en çok "eve bağımlı hale gelme", "sosyal hayata zaman ayıramama", "yorgun hissetme", "çabuk sinirlenme" ve "kendine zaman ayıramama" sorunları yaşadıkları bulunmuştur. Bakım verenlerin yaşı, cinsiyeti, çalışma ve gelir durumu, hastalığın evresi, süresi ve bakım verme süresi ile bakımveren yükü envanteri toplam ve alt puan ortalamaları arasında istatistiksel olarak anlamlı bir fark bulunurken(p0,05) Improvements and developments on technological and scientific areas expand the average lifespan, increase the rate of elderly age population and the demographic changes on population have brought many problems in the world. One of these problem is Alzheimer which is known as elder age health disease. There are 46,8 millions in the world, 600.000 Alzheimer patients in our country. It is expected that the rate of elder people and increasing of average lifespan will increase the number of these patients. By the increasing of elderly population and the average lifespan expectancy will further increase the rate in coming years. The spread of disease and the increasing number of patients have brought along the problem of caring. Alzheimer is different from other diseases because of the fact that it causes loss of memory, forgetfullness, behavioural and personality changes in individual and still progressive and treatment hasn't found yet. It is very devastating disease for both patient and the caregiver. In this study, it is aimed to determine the difficulties of family members who are responsible on caregiving to Alzheimer patients. The samples of the study consists of 108 patients relatives who were applied to Sinop Atatürk State Hospital. The obtained datas were analyzed with SPSS packege program. As a result of this study most of the caregivers are woman (74,1%), married (81,5%), middle-aged group (64,8%), and patient's daughter (43,5%), 38,1% with minimum wage or less income, 61,2% thinks they have disease depending on caregiving, 43,2% of them are diagnosed with psychiatic disease, 50% of them have family responsibility and 5,6% is caregiving with a sense of love bond. The majority of patients diagnosed with Alzheimer is woman (65,7%), 80 years and older ( 62,6%) and having other disease than Alzheimer (68,6%). The caregivers stated that patients are mostly in need of housework, transportation, personal hygiene, treatment, economics, clothing and excreation help while they are in need of escorting, physical care and transportation support. Caregiver family members have difficulties on "lack of selfcare", "distress disorder", "urinary problem" and "disorderance in communication" due to the symptons and disorders caused by the nature of disease while caring. However, there are some other difficultiescome out with the responsibility of caregiving like becoming "dependent at home", "no time for social life", "feeling tired", "quick irritation" and "no time for themselves". There is a statistically significant difference between caregivers age, gender, working and income status, stage of disease, duration and caregiving period with caregiver burden total inventory and average of sub-score point (p0,05).

The first aim of this study was to evaluate the degree of organophosphorus (OP) pesticides' exposure in viniculture and tobacco production workers via physical examination (neurology and general health aspect) and analysis of paraoxonase (PON1) and butyrylcholinesterase (BuChE) activities. The second aim was to investigate if PON1 polymorphism plays any role in long-term OP exposure. A total of 93 farmers who work as applicators in agriculture were studied. The data were evaluated according to agricultural type, and although the total exposure time was similar in both areas, BuChE and PON1 activities of farmers who work in tobacco production were lower. Overall, BuChE and PON1 activities showed a depletion in the farmer group compared to age-matched controls. When the farmers were categorized according to the number of their symptoms, the BuChE activities of farmers who had two or more symptoms were found to be depleted (n = 43, 2948 +/- 756) compared to farmers who had one or no symptoms (n = 37, 3356 +/- 659). Allele frequencies of patients and controls for positions 55 and 192 were similar to Turkish population data and there was no association between the allele polymorphism and symptoms/signs of long-term exposure. Our results indicate that there is an important inhibition of PON1 activity in chronic OP poisoning, and this together with BuChE activity might well be used as a reliable index of chronic exposure to OP.