Review
BibTex RIS Cite

Müzik Terapi ve Alzheimer

Year 2023, Volume: 2 Issue: 3, 99 - 110, 29.12.2023
https://doi.org/10.61830/balkansbd.1364344

Abstract

Bu derleme, müzik terapisini tanımlamak ve Alzheimer hastalarında farmakoterapi ile birlikte müzik terapisinin önemini vurgulamak amacıyla yazılmıştır. Demanslı kişilerin müzikten hoşlandıkları ve sözlü iletişim artık mümkün olmadığında bile yanıt verme yeteneklerini korudukları bilinmektedir. Müzik, hasta ve bakıcısının başka türlü mevcut olmayacak bir bağı paylaşmasına yardımcı olabilir. Hastalığın tedavi sürecinde farmakolojik tedaviye ek olarak uygulanan müzik terapisinin hastaların bilişsel yeteneklerinin korunması ve davranışsal semptomların kontrolü üzerinde olumlu etkileri olduğu gösterilmiştir.

References

  • 1. Eftychios A, Nektarios S, NikoletamG. Alzheimer Disease and musictherapy: an ınteresting therapeutic challenge and proposal. Advances in Alzheimer’s Disease.2021;10(01):1-18. DOI: 10.4236/aad.2021.101001
  • 2. García-Navarro EB, Buzón-Pérez A, Cabillas-Romero M. Effect of music therapy as a non-pharmacological measure applied to Alzheimer’s disease patients: A systematic review. Nurs. Rep.2022;12(4):775-790. DOI: 10.3390/nursrep12040076
  • 3. Lane CA, Hardy J, Schott JM. Alzheimer’s disease. EAN.2018;25(1):59-70. doi: 10.1111/ene.13439
  • 4. Türkiye İstatistik Kurumu Haber Bülteni. 2023. İstatistiklerle Yaşlılar, 2022. Sayı: 49667. [Erişim tarihi: 18.08.2023] Erişim adresi: https://data.tuik.gov.tr/Bulten/Index?p=%C4%B0statistiklerle- Ya%C5%9Fl%C4%B1lar-2022-49667&dil=1
  • 5. Dı̇ lek F, Ünal A, Ünsar S. İleri evre demans hastasında hemşirelik bakımı: Olgu sunumu. HSP. 2017; 4(2):130-130. DOI: 10.17681/hspdergisi. 281474
  • 6. Güçer Öz Y, Göktaş Z. Alzheimer hastalığında antosiyaninlerin önemi. YIU Saglik Bil Derg. 2023; 4(1):13-16. doi:10.51261/yiu.2023.00058
  • 7. Yılmaz B, Can ÜK. Türkiye’de müzik terapi uygulamalarında kullanılan müzikler. OPUS .2019; 1:1. DOI: 10.26466/opus.584795
  • 8. Matziorinis AM, Koelsch S. The promise of music therapy for Alzheimer’s disease: A review. Ann NY Acad Sci. 2022;1516(1):11-17.DOİ:10.1111/nyas.14864
  • 9. World Alzheimer Report 2021. [Erişim tarihi: 08.08.2023]. Erişim adresi: https://www.alzint.org/u/World-Alzheimer-Report-2021.pdf .
  • 10. Yu-Ching Tasai. Research on AI music therapy nursing careto improve depression and brain activation. Dementia.2023; 4(1):1-24.
  • 11. Flo BK, Matziorinis AM, Skouras S, Sudmann TT. Gold C, Koelsch S. Study protocol for the Alzheimer and music therapy study: An RCT to compare the efficacy of music therapy and physical activity on brain plasticity, depressive symptoms, and cognitive decline, in a population with and at risk for Alzheimer’s disease. PLOS ONE.2022;17(6):e0270682. doi: 10.1371/journal.pone.0270682
  • 12. Popa LC, Manea MC, Velcea D, Șalapa I, Manea M, Ciobanu AM. Impact of Alzheimer’s dementia on caregivers and quality ımprovement through art and music therapy. Healthcare 2021; 9(6):698. doi:10.3390/healthcare9060698 13. Aydın AC. Alzheimer Disease and Dementia. J Lit Pharm Sci.2020;9(2):125-136. DOI:10.5336/pharmsci.2019-71813
  • 14. Alıcılar HE, Çalışkan D. Alzheimer hastalığı ve korunma stratejileri. STED. 2021. DOI:10.17942/sted.888837
  • 15. Çınar Fİ, Erbay F, Yıldırım E, Özer Küçük E, Demirtaş A. Ayla DEMİRTAŞ. Demansta bilişsel aktiviteyi artırıcı yöntemler ve bakımda teknolojinin kullanımı. HUHEMFAD-JOHUFON. 2022; 9(3):308-315.
  • 16. Parnetti L, Chipi E, Salvadori N, D’Andrea K, Eusebi P. Prevalence and risk of progression of preclinical Alzheimer’s disease stages: A systematic review and meta-analysis. Alzheimer’s Research & Therapy.2019; 11(1):7. https://doi.org/10.1186/s13195-018-0459-7
  • 17. Corbo I, Marselli G, Di Ciero V, Casagrande M. The Protective Role of Cognitive Reserve in Mild Cognitive Impairment: A Systematic Review. J. Clin. Med. 2023;12(5):1759. Doi:10.3390/jcm12051759
  • 18. Henneges C, Reed C, Chen YF, Dell’Agnello G, Lebrec J. Describing the Sequence of Cognitive Decline in Alzheimer’s Disease Patients: Results from an Observational Study. Journal of Alzheimer’s Disease. 2016;52(3):1065-1080. DOI:10.3233/JAD-150852
  • 19. Tahami Monfared AA, Byrnes MJ, White LA, Zhang Q. Alzheimer’s Disease: Epidemiology and Clinical Progression. Neurol Ther.2022;11(2):553-569. Doi:10.1007/s40120-022-00338-8
  • 20. Yavlal F, Aydın Güngör H. Clinical Findings in Dementia. Nucl Med Semin. 2016;2(3):134-138. DOI:10.4274/nts.2016.018
  • 21. Bando H. Perspectives of the relationship among the presence of music, well-being and happiness. Global J Arts Social Sci. 2021;3(3):1-3. Doi:10.36266/GJASS/153
  • 22. Karamızrak N. Ses ve Müziğin Organları İyileştirici Etkisi. Koşuyolu Heart Journal. 2014; 17(1):54-57. Doi:10.4274/khj.4775
  • 23. Kurap Öcebe D, Kolcu M, Uzun K. Müzik terapi ve yaşlı sağlığı. SBÜHD 2019; 1(2):112-115. 24. Word Federation of Music Therapy, About WFMT. [Erişim tarihi: 08.08.2023]. Erişim adresi: www.wfmt.info/about. 25. Geleneksel ve Tamamlayıcı Tıp Uygulamaları Yönetmeliği. 2014. [Erişim tarihi: 12.08.2023]. Erişim adresi: https://www.resmigazete.gov.tr/eskiler/2014/10/20141027-3.htm. 26. Müzikterapi Uygulaması Hakkında Bilgilendirme, 2017. [Erişim tarihi: 10.08.2023]. Erişim adresi: https://shgmgetatdb.saglik.gov.tr/TR,24681/muzikterapi-uygulamasihakkinda- bilgilendirme.html.
  • 27. Müzikterapi Sertifikalı Eğitim Programı Standartları Hakkında Duyuru,2020. [Erişim tarihi: 10.08.2023]. Erişim adresi: https://shgm.saglik.gov.tr/TR,12741/muzikterapi-sertifikali-egitimprogrami- standartlari-hakkinda-duyuru.html,%202016.
  • 28. Değer TB. Demans ve Alzheimer’da müzik terapinin etkisi ve Türkiye’deki mevcut durum. Sosyal Politika ve Sosyal Hizmet Çalışmaları Dergisi 2022; 3(2):267-280. 29. Mishra R, Florez-Perdomo WA, Shrivatava A, Chouksey P, Raj S, Moscote-Salazar LR, Rahman MM, Sutar R, Agrawal A. Role of music therapy in traumatic brain ınjury: A systematic review and metaanalysis. World Neurosurgery.2021;146:197-204. DOI: 10.1016/j.wneu.2020.10.130 30. Chatterjee D, Hegde S, Thaut M. Neural plasticity: The substratum of music-based interventions in neurorehabilitation. NeuroRehabilitation. 2021;48(2):155-166. doi:10.3233/NRE-208011 31. Cramer SC, Sur M, Dobkin BH, Berin C, Sanger TD, Trojanowski JQ, Rumsey JM, Hicks R, Cameron J, et al., Harnessing neuroplasticity for clinical applications. Brain. 2011;134(6):1591-1609. doi:10.1093/brain/awr039
  • 32. James CE, Altenmüller E, Kliegel M, Krüger THC, Van De Ville D, Worschech F, et al. Train the brain with music (TBM): Brain plasticity and cognitive benefits induced by musical training in elderly people in Germany and Switzerland, a study protocol for an RCT comparing musical instrumental practice to sensitization to music. BMC Geriatrics. 2020; 20(1):418. doi:10.1186/s12877-020-01761-y
  • 33. Pasqualitto F, Panin F, Maidhof C, Thompson N, Fachner J. Neuroplastic Changes in Addiction Memory—How Music Therapy and Music-Based Intervention May Reduce Craving: A Narrative Review. Brain Sciences. 2023;13(2):259. doi:10.3390/brainsci13020259
  • 34. Odell-Miller, H. Embedding Music and Music Therapy in Care Pathways for People with Dementia in the 21st Century—A position paper. Music & Science. 2021;4. doi:10.1177/20592043211020424 35. Hsieh S, Hornberger M, Piguet O, Hodges JR. Brain correlates of musical and facial emotion recognition: Evidence from the dementias. Neuropsychologia. 2012;50(8):1814-1822. doi:10.1016/j.neuropsychologia.2012.04.006 36. Torun Ş. Müziğin beynimizdeki yolculuğu. Osmangazi Tıp Dergisi. 2016; 38(1):66-70. 37. Honing H, Ten Cate C, Peretz I, Trehub SE. Without it no music: Cognition, biology and evolution of musicality. Philosophical Transactions B.2015;370(1664). DOI:10.1098/rstb.2014.0088 38. Shirsat A, Jha R K, Verma P. Music therapy in the treatment of dementia: A review article. Cureus. 2023. DOI:org/10.7759/cureus.36954
  • 39. Hale D, Marshall K. Dementia and Music Therapy. Home Healthcare Now. 2020; 38(2):105. doi:10.1097/NHH.0000000000000859 40. Satoh M, Yuba T, Tabei K, Okubo Y, Kida H, Sakuma H, Tomimoto H. Music Therapy Using Singing Training Improves Psychomotor Speed in Patients with Alzheimer’s Disease: A Neuropsychological and fMRI Study. Dement Geriatr Cogn Disord Extra.2015;5(3):296- 308. DOI:10.1159/000436960
  • 41. Jacobsen JH, Stelzer J, Fritz TH, Chételat G, La Joie R, Turner R. Why musical memory can be preserved in advanced Alzheimer’s disease. Brain.2015;138(8):2438-2450. doi:10.1093/brain/awv135 42. Orti JER, García-Pardo MP, Benlloch M, Drehmer E., Platero JL, Salazar A, et al. Music Therapy Decreases Sadness and Increases Happiness in Alzheimer Patients: A Pilot Study. Neuropsychiatry.2019; 9(1):2013-2020.
  • 43. Orti JER, García-Pardo MP, Iranzo CC, Madrigal JJC, Castillo SS, Rochina MJ, Gascó VJ. P. Does Music Therapy Improve Anxiety and Depression in Alzheimer’s Patients? JACM.2018; 24(1):33-36. DOI:10.1089/acm.2016.0346
  • 44. Gomez Gallego, M, Gomez Garcia, J. Music therapy and Alzheimer’s disease: Cognitive, psychological, and behavioural effects. Neurología. 2017;32(5):300-308. doi:10.1016/j.nrleng.2015.12.001 45. Ruiz-Muelle A, Lopez-Rodriguez MM. Dance for People with Alzheimer’s Disease: A Systematic Review. Current Alzheimer Research.2019;16(10):919-933. DOI:10.2174/1567205016666190725151614
  • 46. Thomas P, Chandes G, Hazif-Thomas C. Efficacité de la musicothérapie sur la résilience dans la maladie d’Alzheimer. NPG. 2017;17(101):299-306. Doi: 10.1016/j.npg.2017.05.005

MUSIC THERAPY AND ALZHEIMER

Year 2023, Volume: 2 Issue: 3, 99 - 110, 29.12.2023
https://doi.org/10.61830/balkansbd.1364344

Abstract

This review is written to define music therapy and emphasize the importance of music therapy in combination with pharmacotherapy in Alzheimer's disease patients. People with dementia are known to enjoy music and retain their ability to respond even when verbal communication is no longer possible. Music can help the patient and caregiver to share a bond that would not otherwise exist. Music therapy in addition to pharmacological treatment has been shown to have positive effects on the maintenance of cognitive abilities and control of behavioral symptoms.

References

  • 1. Eftychios A, Nektarios S, NikoletamG. Alzheimer Disease and musictherapy: an ınteresting therapeutic challenge and proposal. Advances in Alzheimer’s Disease.2021;10(01):1-18. DOI: 10.4236/aad.2021.101001
  • 2. García-Navarro EB, Buzón-Pérez A, Cabillas-Romero M. Effect of music therapy as a non-pharmacological measure applied to Alzheimer’s disease patients: A systematic review. Nurs. Rep.2022;12(4):775-790. DOI: 10.3390/nursrep12040076
  • 3. Lane CA, Hardy J, Schott JM. Alzheimer’s disease. EAN.2018;25(1):59-70. doi: 10.1111/ene.13439
  • 4. Türkiye İstatistik Kurumu Haber Bülteni. 2023. İstatistiklerle Yaşlılar, 2022. Sayı: 49667. [Erişim tarihi: 18.08.2023] Erişim adresi: https://data.tuik.gov.tr/Bulten/Index?p=%C4%B0statistiklerle- Ya%C5%9Fl%C4%B1lar-2022-49667&dil=1
  • 5. Dı̇ lek F, Ünal A, Ünsar S. İleri evre demans hastasında hemşirelik bakımı: Olgu sunumu. HSP. 2017; 4(2):130-130. DOI: 10.17681/hspdergisi. 281474
  • 6. Güçer Öz Y, Göktaş Z. Alzheimer hastalığında antosiyaninlerin önemi. YIU Saglik Bil Derg. 2023; 4(1):13-16. doi:10.51261/yiu.2023.00058
  • 7. Yılmaz B, Can ÜK. Türkiye’de müzik terapi uygulamalarında kullanılan müzikler. OPUS .2019; 1:1. DOI: 10.26466/opus.584795
  • 8. Matziorinis AM, Koelsch S. The promise of music therapy for Alzheimer’s disease: A review. Ann NY Acad Sci. 2022;1516(1):11-17.DOİ:10.1111/nyas.14864
  • 9. World Alzheimer Report 2021. [Erişim tarihi: 08.08.2023]. Erişim adresi: https://www.alzint.org/u/World-Alzheimer-Report-2021.pdf .
  • 10. Yu-Ching Tasai. Research on AI music therapy nursing careto improve depression and brain activation. Dementia.2023; 4(1):1-24.
  • 11. Flo BK, Matziorinis AM, Skouras S, Sudmann TT. Gold C, Koelsch S. Study protocol for the Alzheimer and music therapy study: An RCT to compare the efficacy of music therapy and physical activity on brain plasticity, depressive symptoms, and cognitive decline, in a population with and at risk for Alzheimer’s disease. PLOS ONE.2022;17(6):e0270682. doi: 10.1371/journal.pone.0270682
  • 12. Popa LC, Manea MC, Velcea D, Șalapa I, Manea M, Ciobanu AM. Impact of Alzheimer’s dementia on caregivers and quality ımprovement through art and music therapy. Healthcare 2021; 9(6):698. doi:10.3390/healthcare9060698 13. Aydın AC. Alzheimer Disease and Dementia. J Lit Pharm Sci.2020;9(2):125-136. DOI:10.5336/pharmsci.2019-71813
  • 14. Alıcılar HE, Çalışkan D. Alzheimer hastalığı ve korunma stratejileri. STED. 2021. DOI:10.17942/sted.888837
  • 15. Çınar Fİ, Erbay F, Yıldırım E, Özer Küçük E, Demirtaş A. Ayla DEMİRTAŞ. Demansta bilişsel aktiviteyi artırıcı yöntemler ve bakımda teknolojinin kullanımı. HUHEMFAD-JOHUFON. 2022; 9(3):308-315.
  • 16. Parnetti L, Chipi E, Salvadori N, D’Andrea K, Eusebi P. Prevalence and risk of progression of preclinical Alzheimer’s disease stages: A systematic review and meta-analysis. Alzheimer’s Research & Therapy.2019; 11(1):7. https://doi.org/10.1186/s13195-018-0459-7
  • 17. Corbo I, Marselli G, Di Ciero V, Casagrande M. The Protective Role of Cognitive Reserve in Mild Cognitive Impairment: A Systematic Review. J. Clin. Med. 2023;12(5):1759. Doi:10.3390/jcm12051759
  • 18. Henneges C, Reed C, Chen YF, Dell’Agnello G, Lebrec J. Describing the Sequence of Cognitive Decline in Alzheimer’s Disease Patients: Results from an Observational Study. Journal of Alzheimer’s Disease. 2016;52(3):1065-1080. DOI:10.3233/JAD-150852
  • 19. Tahami Monfared AA, Byrnes MJ, White LA, Zhang Q. Alzheimer’s Disease: Epidemiology and Clinical Progression. Neurol Ther.2022;11(2):553-569. Doi:10.1007/s40120-022-00338-8
  • 20. Yavlal F, Aydın Güngör H. Clinical Findings in Dementia. Nucl Med Semin. 2016;2(3):134-138. DOI:10.4274/nts.2016.018
  • 21. Bando H. Perspectives of the relationship among the presence of music, well-being and happiness. Global J Arts Social Sci. 2021;3(3):1-3. Doi:10.36266/GJASS/153
  • 22. Karamızrak N. Ses ve Müziğin Organları İyileştirici Etkisi. Koşuyolu Heart Journal. 2014; 17(1):54-57. Doi:10.4274/khj.4775
  • 23. Kurap Öcebe D, Kolcu M, Uzun K. Müzik terapi ve yaşlı sağlığı. SBÜHD 2019; 1(2):112-115. 24. Word Federation of Music Therapy, About WFMT. [Erişim tarihi: 08.08.2023]. Erişim adresi: www.wfmt.info/about. 25. Geleneksel ve Tamamlayıcı Tıp Uygulamaları Yönetmeliği. 2014. [Erişim tarihi: 12.08.2023]. Erişim adresi: https://www.resmigazete.gov.tr/eskiler/2014/10/20141027-3.htm. 26. Müzikterapi Uygulaması Hakkında Bilgilendirme, 2017. [Erişim tarihi: 10.08.2023]. Erişim adresi: https://shgmgetatdb.saglik.gov.tr/TR,24681/muzikterapi-uygulamasihakkinda- bilgilendirme.html.
  • 27. Müzikterapi Sertifikalı Eğitim Programı Standartları Hakkında Duyuru,2020. [Erişim tarihi: 10.08.2023]. Erişim adresi: https://shgm.saglik.gov.tr/TR,12741/muzikterapi-sertifikali-egitimprogrami- standartlari-hakkinda-duyuru.html,%202016.
  • 28. Değer TB. Demans ve Alzheimer’da müzik terapinin etkisi ve Türkiye’deki mevcut durum. Sosyal Politika ve Sosyal Hizmet Çalışmaları Dergisi 2022; 3(2):267-280. 29. Mishra R, Florez-Perdomo WA, Shrivatava A, Chouksey P, Raj S, Moscote-Salazar LR, Rahman MM, Sutar R, Agrawal A. Role of music therapy in traumatic brain ınjury: A systematic review and metaanalysis. World Neurosurgery.2021;146:197-204. DOI: 10.1016/j.wneu.2020.10.130 30. Chatterjee D, Hegde S, Thaut M. Neural plasticity: The substratum of music-based interventions in neurorehabilitation. NeuroRehabilitation. 2021;48(2):155-166. doi:10.3233/NRE-208011 31. Cramer SC, Sur M, Dobkin BH, Berin C, Sanger TD, Trojanowski JQ, Rumsey JM, Hicks R, Cameron J, et al., Harnessing neuroplasticity for clinical applications. Brain. 2011;134(6):1591-1609. doi:10.1093/brain/awr039
  • 32. James CE, Altenmüller E, Kliegel M, Krüger THC, Van De Ville D, Worschech F, et al. Train the brain with music (TBM): Brain plasticity and cognitive benefits induced by musical training in elderly people in Germany and Switzerland, a study protocol for an RCT comparing musical instrumental practice to sensitization to music. BMC Geriatrics. 2020; 20(1):418. doi:10.1186/s12877-020-01761-y
  • 33. Pasqualitto F, Panin F, Maidhof C, Thompson N, Fachner J. Neuroplastic Changes in Addiction Memory—How Music Therapy and Music-Based Intervention May Reduce Craving: A Narrative Review. Brain Sciences. 2023;13(2):259. doi:10.3390/brainsci13020259
  • 34. Odell-Miller, H. Embedding Music and Music Therapy in Care Pathways for People with Dementia in the 21st Century—A position paper. Music & Science. 2021;4. doi:10.1177/20592043211020424 35. Hsieh S, Hornberger M, Piguet O, Hodges JR. Brain correlates of musical and facial emotion recognition: Evidence from the dementias. Neuropsychologia. 2012;50(8):1814-1822. doi:10.1016/j.neuropsychologia.2012.04.006 36. Torun Ş. Müziğin beynimizdeki yolculuğu. Osmangazi Tıp Dergisi. 2016; 38(1):66-70. 37. Honing H, Ten Cate C, Peretz I, Trehub SE. Without it no music: Cognition, biology and evolution of musicality. Philosophical Transactions B.2015;370(1664). DOI:10.1098/rstb.2014.0088 38. Shirsat A, Jha R K, Verma P. Music therapy in the treatment of dementia: A review article. Cureus. 2023. DOI:org/10.7759/cureus.36954
  • 39. Hale D, Marshall K. Dementia and Music Therapy. Home Healthcare Now. 2020; 38(2):105. doi:10.1097/NHH.0000000000000859 40. Satoh M, Yuba T, Tabei K, Okubo Y, Kida H, Sakuma H, Tomimoto H. Music Therapy Using Singing Training Improves Psychomotor Speed in Patients with Alzheimer’s Disease: A Neuropsychological and fMRI Study. Dement Geriatr Cogn Disord Extra.2015;5(3):296- 308. DOI:10.1159/000436960
  • 41. Jacobsen JH, Stelzer J, Fritz TH, Chételat G, La Joie R, Turner R. Why musical memory can be preserved in advanced Alzheimer’s disease. Brain.2015;138(8):2438-2450. doi:10.1093/brain/awv135 42. Orti JER, García-Pardo MP, Benlloch M, Drehmer E., Platero JL, Salazar A, et al. Music Therapy Decreases Sadness and Increases Happiness in Alzheimer Patients: A Pilot Study. Neuropsychiatry.2019; 9(1):2013-2020.
  • 43. Orti JER, García-Pardo MP, Iranzo CC, Madrigal JJC, Castillo SS, Rochina MJ, Gascó VJ. P. Does Music Therapy Improve Anxiety and Depression in Alzheimer’s Patients? JACM.2018; 24(1):33-36. DOI:10.1089/acm.2016.0346
  • 44. Gomez Gallego, M, Gomez Garcia, J. Music therapy and Alzheimer’s disease: Cognitive, psychological, and behavioural effects. Neurología. 2017;32(5):300-308. doi:10.1016/j.nrleng.2015.12.001 45. Ruiz-Muelle A, Lopez-Rodriguez MM. Dance for People with Alzheimer’s Disease: A Systematic Review. Current Alzheimer Research.2019;16(10):919-933. DOI:10.2174/1567205016666190725151614
  • 46. Thomas P, Chandes G, Hazif-Thomas C. Efficacité de la musicothérapie sur la résilience dans la maladie d’Alzheimer. NPG. 2017;17(101):299-306. Doi: 10.1016/j.npg.2017.05.005
There are 32 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Reviews
Authors

Filiz Dilek 0000-0002-0245-0713

Aysun Ünal 0000-0002-7702-8437

Publication Date December 29, 2023
Published in Issue Year 2023 Volume: 2 Issue: 3

Cite

Vancouver Dilek F, Ünal A. Müzik Terapi ve Alzheimer. Balkan Health Sci J. 2023;2(3):99-110.

 CC BY-NC 4.0cc.svg?ref=chooser-v1by.svg?ref=chooser-v1nc.svg?ref=chooser-v1

Balkan Sağlık Bilimleri Dergisi Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı ile lisanslanmıştır.