Year 2018, Volume 34, Issue 3, Pages 103 - 118 2018-12-25

PALYATİF BAKIMDA KANSER REHABİLİTASYONU VE HEMŞİRELİK YÖNETİMİ

Gönül Düzgün [1] , AYFER KARADAKOVAN [2]

103 191

Başlık:PALYATİF BAKIMDA KANSER REHABİLİTASYONU VE HEMŞİRELİK YÖNETİMİ

Özet:Günümüzde kanserin tanı  tedavisindeki gelişmeler, gittikçe daha fazla sayıda kanserli hastanın daha uzun yaşamasını sağlamaktadır. 1960’lardan beri rehabilitasyon; miyokardiyal enfeksiyon, inme, baş ve spinal kord yaralanmaları, amputasyonla birlikte diğer fiziksel/nörolojik yetersizlikten muzdarip hastalar için bakım programlarının önemli bir parçası olarak kabul edilmiştir.

Kansere bağlı kötü prognoz sonucu temel tedavilerin ön plana çıkması nedeniyle rehabilitasyona yeterli ilgi gösterilmemektedir. Ancak palyatif bakım felsefesi hastanın yaşam kalitesinin iyileştirilmesi, temel yaşam aktivitelerini sürdürmesi, semptom kontrolü ve fiziksel fonksiyonları sürdürmesine destek sağlanmayı amaçlandığı için rehabilitasyon hizmetinin önemi de dikkat çekmektedir.

Palyatif Bakım Geliştirme Merkezi konsensüs raporunda, hastane ortamında bakım değerlendirmesine ihtiyaç duyan hastaların belirlenmesine yardımcı olmak için birincil tetikleyici kriterlerin ana hatları verilmektedir. Böylelikle hastaların palyatif bakıma yatışları sırasında hangi riskleri barındırdığı ve alınabilecek önlemleri planlamada yardımcı olması amaçlanmıştır.

Kanser hastalarında rehabilitasyon tedavisine uyumunu azaltan ve tedaviyi bırakmasına neden olan en önemli faktörler terapiye ilgi eksikliği, tıbbi komplikasyonlar, zaman ve yoğunluk egzersiz programlarının uzun olması, hastalığın evresi ve ulaşım sorunlarıdır. Egzersiz programının yoğunluğu ve uzunluğu, özellikle son dönem kanser hastaları söz konusu olduğunda, hastayı yormayacak ya da sıkmayacak şekilde ayarlanmalıdır.

Hemşirelerin kanıta dayalı uygulamaların geliştirilmeleri, hasta odaklı daha kapsamlı araştırmalar yapmaları ve palyatif bakım hastalarının yaşam kalitelerini arttırmaya yönelik çalışmalar içinde aktif bulunmaları önerilmektedir. 

Anahtar kelimeler:   Palyatif Bakım, Kanser, Rehabilitasyon, Hemşirelik

Destekleyen kurumlar:

Kaynakça:1.        Adamsen L, Quist M, Midtgaard J, Andersen C, Møller T, Knutsen L, et al. The effect of a multidimen-sional exercise intervention on physical capacity, well-being and quality of life in cancer patients undergoing chemotherapy. Support Care Cancer 2006; 14: 116- 27.

2.        Akdemir, N., Akkuş, Y. Rehabilitasyon ve hemşirelik. Hacettepe Üniversitesi Hemşirelik Yüksekokulu Dergisi, 2006;13(1), 82–91.

3.        Andersen C, Adamsen L, Moeller T, Midtgaard J, Quist M, Tveteraas A, et al. The effect of a multidimensional exercise programme on symptoms and side-effects in cancer patients undergoing chemotherapy-the use of semi-structured diaries. Eur J Oncol Nurs 2006; 10: 247-62.

4.        Barawid E, Covarrubias N, Tribuzio B, Liao S. The benefits of rehabilitation for palliative care patients. Am J Hosp Palliat Care. 2015; 32(1):34-43.

5.        Brown WJ, Ford JH, Burton NW, Marshall AL, Dobson AJ. et al. Prospective study of physical activity and depressive symptoms in middle-aged women. Am J Prev Med 2005; 29: 265-72

6.        Cheville A. Cancer Rehabilitation. In: Physical Medicine & Rehabilitation, Ed: Braddom RL, Saunders Company, Third Edition, 2007; 1369-98

7.        Cheville AL, Kollasch J, Vandenberg J, Shen T, Grothey A, Gamble G, et al. A home-based exercise program to improve function, fatigue, and sleep quality in patients with Stage IV lung and colorectal cancer: a randomized controlled trial, J Pain Symptom Manage. 2013; 45 (5): 811-21

8.        Clemens KE, Jaspers B, Klaschik E, Nieland P. Evaluation of the clinical effectiveness of physiotherapeutic management of lymphoedema in palliative care patients. Jpn J Clin Oncol. 2010; 40 (11): 1068-72.

9.        Corsonello A, Scarlata S, Pedone C, Bustacchini S, Fusco S, Zito A, et al. Treating COPD in older and oldest old patients. Curr Pharm Des. 2015; 21 (13): 1672-89

10.      Curtis EB, Krech R, Walsh TD.. Common symptoms in patients with advanced cancer. J Palliat Care. 1991; 7 : 25-29

11.      Dietz JH. Rehabilitation oncology. John Wiley & Sons Inc, New York. 1981

12.      Escalante CP, Meyers C, Reuben JM, Wang X, Qiao W, Manzullo E, Alvarez RH, Morrow PK, Gonzalez-Angulo AM, Wang XS, Mendoza T, Liu W, Holmes H, Hwang J, Pisters K, Overman M, Cleeland C. A randomized, double-blind, 2-period, placebocontrolled crossover trial of a sustained-release methylphenidate in the treatment of fatigue in cancer patients. Cancer J 2014:20(1):8–14. doi: 10.1097/PPO.0000000000000018

13.      Eyigor S, Akdeniz S. Is exercise ignored in palliative cancer patients? World J Clin Oncol. 2014; 5(3):554-9

14.      Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol.2011; 12 : 489-495.

15.      Guo Y, Shin KY, Hainley S, Bruera E, Palmer JL. Inpatient rehabilitation improved functional status in asthenic patients with solid and hematologic malignancies. Am J Phys Med Rehabil. 2011; 90 (4): 265-71. 

16.      Institute of Medicine (2001) Crossing the quality chasm: a new health system for the 21st century. National Academy Press. https://www.iom.edu/Reports/2001/Crossing-the-Quality-ChasmA-New-Health-System-for-the-21st-Century.aspx Erişim Tarihi; 20.07.2018

17.      Javier NS, Montagnini ML, Rehabilitation of the hospice and palliative care patient, J Palliat Med. 2011; 14 (5): 638-48.

18.      Jensen W, Baumann FT, Stein A, Bloch W, Bokemeyer C, de Wit M, et al. Exercise training in patients with advanced gastrointestinal cancer undergoing palliative chemotherapy: a pilot study. Support Care Cancer. 2014; 22 (7): 1797-806

19.      Johansson B, Wentzel AP, Andrell P, Mannheimer C, Ronnback L. Methylphenidate reduces mental fatigue and improves processing speed in persons suffered a traumatic brain injury. Brain Inj 2015:1–8. doi:10.3109/02699052.2015.1004747

20.      Kanser İstatistikleri http://kanser.gov.tr/Dosya/2017Haberler/2017_4_subat.pdf Erişim Tarihi; 16.07.2018

21.      Kubler Ross E. On Death and Dying. New York, NY, Scribner, 1969

22.      Lehmann JF, DeLisa JA, Warren CG, deLateur BJ, Bryant PL, Nicholson CG, Cancer rehabilitation: assessment of need, development, and evaluation of a model of care. 1978; 59 : 410-419.

23.      Maddocks M, Mockett S, Wilcock A. Is exercise an acceptable and prac-tical practical therapy for people with or cured of cancer? A systematic review. Cancer Treat Rev 2009; 35: 383-90.

24.      Martinsen EW. Physical activity for mental health. Tidsskr Nor Laegeforen 2000; 120: 3054-6. 29.

25.      Molinaro J, Kleinfeld M, Lebed S. Physical therapy and dance in the surgical management of breast cancer. Phys Ther 1986;66:967-9.

26.      Narayanan V, Koshy C. Fatigue in cancer: a review of literature.. Hint ndian J Palliat Care 2009; 15 : 19-25

27.      Oldervoll LM, Kaasa S, Hjermstad MJ, Lund JA, Loge JH, et al. Physical exercise results in the improved subjective well-being of a few or is effective rehabilitation for all cancer patients? Eur J Cancer 2004; 40: 951-62.

28.      Oldervoll LM, Loge JH, Lydersen S, Paltiel H, Asp MB, Nygaard UV, et al. Physical exercise for cancer patients with advanced disease: a randomized controlled trial. Oncologist. 2011; 16 (11): 1649-57

29.      Osborne TR, Ramsenthaler C, Wolf-Linder S, Schey SA, Siegert RJ, Edmonds PM, et al. Understanding what matters most to people with multiple myeloma: a qualitative study of views on quality of life. BMC Cancer. 2014; 14 (1): 496.

30.      Palacio A, Calmels P, Genty M, Le-Quang B, Beuret-Blanquart F. Onkoloji ve fizikî tıp ve rehabilitasyon. Ann Phys Rehabil Med. 2009; 52 : 568-578

31.      Porock D, Kristjanson LJ, Tinnelly K, Duke T, Blight J. An exercise intervention for advanced cancer patients experiencing fatigue: a pilot study. J Palliat Care. 2000 Autumn;16(3):30-6

32.      Radbruch L, Strasser F, Elsner F, Gonçalves JF, Løge J, Kaasa S, Nauck F, Stone P. Fatigue in palliative care patients -- an EAPC approach, Palliat Med. 2008; 22 : 13-32

33.      Sami MB, Faruqui R, The effectiveness of dopamine agonists for treatment of neuropsychiatric symptoms post brain injury and stroke. Acta Neuropsychiatr 2015:1–11. doi:10.1017/neu.2015.17

34.      Silver JK, Raj VS, Fu JB, Wisotzky EM, Smith SR, Kirch RA, Cancer rehabilitation and palliative care: critical components in the delivery of high-quality oncology services, Support Care Cancer, 2015;23(12):3633-43.

35.      Stene GB, Helbostad JL, Balstad TR, Riphagen II, Kaasa S, Oldervoll LM. Effect of physical exercise on muscle mass and strength in cancer patients during treatment--a systematic review. Crit Rev Oncol Hematol. 2013; 88 : 573-593.

36.      Stout NL, Binkley JM, Schmitz KH, Andrews K, Hayes SC, Campbell KL, McNeely ML, Soballe PW, Berger AM, Cheville AL, Fabian C, Gerber LH, Harris SR, Johansson K, Pusic AL, Prosnitz RG, Smith RA . A prospective surveillance model for rehabilitation for women with breast cancer. Cancer 2012:118(8 Suppl):2191–2200. doi:10.1002/cncr.27476

37.      Taşpınar Ö , Aydın T, Akcakaya A, Kanser Rehabilitasyonunda Palyatif Yaklaşımın Yeri ve Önemi, Bezmialem Science, 2014; 1: 31-37

38.      Van Weert E, Hoekstra-Weebers J, Otter R, Postema K, Sanderman R, van der Schans C. Cancer-related fatigue: predictors and effects of rehabilitation. Oncologist. 2006; 11 : 184-196

39.      von Haehling S, Anker SD Cachexia as a major underestimated and unmet medical need: facts and numbers. J Cachexia Sarcopenia Muscle.  2010; 1 : 1-5

40.      Weissman DE, Meier DE, Identifying patients in need of a palliative care assessment in the hospital setting: aconsensusreport from the center to advance palliative care. J Palliat Med 2011;14(1):17– 23. doi:10.1089/jpm.2010.0347

41.      Wells, M., Macbride, S Rehabilitation and Survivorship. In: Nursing Patients with Cancer Principles and Practice. Eds: Kearney N, Richardson A, 1 th ed, Elsevier, 2006;799-819.

42.      Who definition of palliative care World Health Organization. http://www.who.int/cancer/palliative/definition/en/2015. Erişim Tarihi: 22.07.2018

43.      WHO, Search results, http://www.who.int/mediacentre/factsheets/fs297/en/, erişim tarihi: 16.07.2018

Palyatif Bakım, Kanser, Rehabilitasyon, Hemşirelik
  • Adamsen L, Quist M, Midtgaard J, Andersen C, Møller T, Knutsen L, et al. The effect of a multidimen-sional exercise intervention on physical capacity, well-being and quality of life in cancer patients undergoing chemotherapy. Support Care Cancer 2006; 14: 116- 27. Akdemir, N., Akkuş, Y. Rehabilitasyon ve hemşirelik. Hacettepe Üniversitesi Hemşirelik Yüksekokulu Dergisi, 2006;13(1), 82–91. Andersen C, Adamsen L, Moeller T, Midtgaard J, Quist M, Tveteraas A, et al. The effect of a multidimensional exercise programme on symptoms and side-effects in cancer patients undergoing chemotherapy-the use of semi-structured diaries. Eur J Oncol Nurs 2006; 10: 247-62.
  • Barawid E, Covarrubias N, Tribuzio B, Liao S. The benefits of rehabilitation for palliative care patients. Am J Hosp Palliat Care. 2015; 32(1):34-43.
  • Brown WJ, Ford JH, Burton NW, Marshall AL, Dobson AJ. et al. Prospective study of physical activity and depressive symptoms in middle-aged women. Am J Prev Med 2005; 29: 265-72
  • Cheville A. Cancer Rehabilitation. In: Physical Medicine & Rehabilitation, Ed: Braddom RL, Saunders Company, Third Edition, 2007; 1369-98
  • Cheville AL, Kollasch J, Vandenberg J, Shen T, Grothey A, Gamble G, et al. A home-based exercise program to improve function, fatigue, and sleep quality in patients with Stage IV lung and colorectal cancer: a randomized controlled trial, J Pain Symptom Manage. 2013; 45 (5): 811-21
  • Clemens KE, Jaspers B, Klaschik E, Nieland P. Evaluation of the clinical effectiveness of physiotherapeutic management of lymphoedema in palliative care patients. Jpn J Clin Oncol. 2010; 40 (11): 1068-72.
  • Corsonello A, Scarlata S, Pedone C, Bustacchini S, Fusco S, Zito A, et al. Treating COPD in older and oldest old patients. Curr Pharm Des. 2015; 21 (13): 1672-89
  • Curtis EB, Krech R, Walsh TD.. Common symptoms in patients with advanced cancer. J Palliat Care. 1991; 7 : 25-29
  • Dietz JH. Rehabilitation oncology. John Wiley & Sons Inc, New York. 1981
  • Escalante CP, Meyers C, Reuben JM, Wang X, Qiao W, Manzullo E, Alvarez RH, Morrow PK, Gonzalez-Angulo AM, Wang XS, Mendoza T, Liu W, Holmes H, Hwang J, Pisters K, Overman M, Cleeland C. A randomized, double-blind, 2-period, placebocontrolled crossover trial of a sustained-release methylphenidate in the treatment of fatigue in cancer patients. Cancer J 2014:20(1):8–14. doi: 10.1097/PPO.0000000000000018
  • Eyigor S, Akdeniz S. Is exercise ignored in palliative cancer patients? World J Clin Oncol. 2014; 5(3):554-9
  • Fearon K, Strasser F, Anker SD, Bosaeus I, Bruera E, Fainsinger RL, Jatoi A, Loprinzi C, MacDonald N, Mantovani G, et al. Definition and classification of cancer cachexia: an international consensus. Lancet Oncol.2011; 12 : 489-495.
  • Guo Y, Shin KY, Hainley S, Bruera E, Palmer JL. Inpatient rehabilitation improved functional status in asthenic patients with solid and hematologic malignancies. Am J Phys Med Rehabil. 2011; 90 (4): 265-71.
  • Institute of Medicine (2001) Crossing the quality chasm: a new health system for the 21st century. National Academy Press. https://www.iom.edu/Reports/2001/Crossing-the-Quality-ChasmA-New-Health-System-for-the-21st-Century.aspx Erişim Tarihi; 20.07.2018
  • Javier NS, Montagnini ML, Rehabilitation of the hospice and palliative care patient, J Palliat Med. 2011; 14 (5): 638-48.
  • Jensen W, Baumann FT, Stein A, Bloch W, Bokemeyer C, de Wit M, et al. Exercise training in patients with advanced gastrointestinal cancer undergoing palliative chemotherapy: a pilot study. Support Care Cancer. 2014; 22 (7): 1797-806
  • Johansson B, Wentzel AP, Andrell P, Mannheimer C, Ronnback L. Methylphenidate reduces mental fatigue and improves processing speed in persons suffered a traumatic brain injury. Brain Inj 2015:1–8. doi:10.3109/02699052.2015.1004747
  • Kanser İstatistikleri http://kanser.gov.tr/Dosya/2017Haberler/2017_4_subat.pdf Erişim Tarihi; 16.07.2018
  • Kubler Ross E. On Death and Dying. New York, NY, Scribner, 1969
  • Lehmann JF, DeLisa JA, Warren CG, deLateur BJ, Bryant PL, Nicholson CG, Cancer rehabilitation: assessment of need, development, and evaluation of a model of care. 1978; 59 : 410-419.
  • Maddocks M, Mockett S, Wilcock A. Is exercise an acceptable and prac-tical practical therapy for people with or cured of cancer? A systematic review. Cancer Treat Rev 2009; 35: 383-90.
  • Martinsen EW. Physical activity for mental health. Tidsskr Nor Laegeforen 2000; 120: 3054-6. 29. Molinaro J, Kleinfeld M, Lebed S. Physical therapy and dance in the surgical management of breast cancer. Phys Ther 1986;66:967-9.
  • Narayanan V, Koshy C. Fatigue in cancer: a review of literature.. Hint ndian J Palliat Care 2009; 15 : 19-25
  • Oldervoll LM, Kaasa S, Hjermstad MJ, Lund JA, Loge JH, et al. Physical exercise results in the improved subjective well-being of a few or is effective rehabilitation for all cancer patients? Eur J Cancer 2004; 40: 951-62.
  • Oldervoll LM, Loge JH, Lydersen S, Paltiel H, Asp MB, Nygaard UV, et al. Physical exercise for cancer patients with advanced disease: a randomized controlled trial. Oncologist. 2011; 16 (11): 1649-57
  • Osborne TR, Ramsenthaler C, Wolf-Linder S, Schey SA, Siegert RJ, Edmonds PM, et al. Understanding what matters most to people with multiple myeloma: a qualitative study of views on quality of life. BMC Cancer. 2014; 14 (1): 496.
  • Palacio A, Calmels P, Genty M, Le-Quang B, Beuret-Blanquart F. Onkoloji ve fizikî tıp ve rehabilitasyon. Ann Phys Rehabil Med. 2009; 52 : 568-578
  • Porock D, Kristjanson LJ, Tinnelly K, Duke T, Blight J. An exercise intervention for advanced cancer patients experiencing fatigue: a pilot study. J Palliat Care. 2000 Autumn;16(3):30-6Radbruch L, Strasser F, Elsner F, Gonçalves JF, Løge J, Kaasa S, Nauck F, Stone P. Fatigue in palliative care patients -- an EAPC approach, Palliat Med. 2008; 22 : 13-32Sami MB, Faruqui R, The effectiveness of dopamine agonists for treatment of neuropsychiatric symptoms post brain injury and stroke. Acta Neuropsychiatr 2015:1–11. doi:10.1017/neu.2015.17
  • Silver JK, Raj VS, Fu JB, Wisotzky EM, Smith SR, Kirch RA, Cancer rehabilitation and palliative care: critical components in the delivery of high-quality oncology services, Support Care Cancer, 2015;23(12):3633-43.
  • Stene GB, Helbostad JL, Balstad TR, Riphagen II, Kaasa S, Oldervoll LM. Effect of physical exercise on muscle mass and strength in cancer patients during treatment--a systematic review. Crit Rev Oncol Hematol. 2013; 88 : 573-593.
  • Stout NL, Binkley JM, Schmitz KH, Andrews K, Hayes SC, Campbell KL, McNeely ML, Soballe PW, Berger AM, Cheville AL, Fabian C, Gerber LH, Harris SR, Johansson K, Pusic AL, Prosnitz RG, Smith RA . A prospective surveillance model for rehabilitation for women with breast cancer. Cancer 2012:118(8 Suppl):2191–2200. doi:10.1002/cncr.27476
  • Taşpınar Ö , Aydın T, Akcakaya A, Kanser Rehabilitasyonunda Palyatif Yaklaşımın Yeri ve Önemi, Bezmialem Science, 2014; 1: 31-37
  • Van Weert E, Hoekstra-Weebers J, Otter R, Postema K, Sanderman R, van der Schans C. Cancer-related fatigue: predictors and effects of rehabilitation. Oncologist. 2006; 11 : 184-196
  • von Haehling S, Anker SD Cachexia as a major underestimated and unmet medical need: facts and numbers. J Cachexia Sarcopenia Muscle. 2010; 1 : 1-5Weissman DE, Meier DE, Identifying patients in need of a palliative care assessment in the hospital setting: aconsensusreport from the center to advance palliative care. J Palliat Med 2011;14(1):17– 23. doi:10.1089/jpm.2010.0347
  • Wells, M., Macbride, S Rehabilitation and Survivorship. In: Nursing Patients with Cancer Principles and Practice. Eds: Kearney N, Richardson A, 1 th ed, Elsevier, 2006;799-819. Who definition of palliative care World Health Organization. http://www.who.int/cancer/palliative/definition/en/2015. Erişim Tarihi: 22.07.2018
  • WHO, Search results, http://www.who.int/mediacentre/factsheets/fs297/en/, erişim tarihi: 16.07.2018
Primary Language tr
Subjects Health Care Sciences and Services
Journal Section Derlemeler
Authors

Orcid: 0000-0003-3584-8354
Author: Gönül Düzgün (Primary Author)
Institution: SAĞLIK BİLİMLERİ ÜNİVERSİTESİ TEPECİK EĞİTİM VE ARAŞTIRMA HASTANESİ
Country: Turkey


Orcid: 0000-0002-7225-6860
Author: AYFER KARADAKOVAN
Institution: EGE ÜNİVERSİTESİ, HEMŞİRELİK FAKÜLTESİ, HEMŞİRELİK BÖLÜMÜ, İÇ HASTALIKLARI HEMŞİRELİĞİ ANABİLİM DALI
Country: Turkey


Bibtex @review { egehemsire448833, journal = {Ege Üniversitesi Hemşirelik Fakültesi Dergisi}, issn = {2147-3463}, address = {Ege University}, year = {2018}, volume = {34}, pages = {103 - 118}, doi = {}, title = {PALYATİF BAKIMDA KANSER REHABİLİTASYONU VE HEMŞİRELİK YÖNETİMİ}, key = {cite}, author = {Düzgün, Gönül and KARADAKOVAN, AYFER} }
APA Düzgün, G , KARADAKOVAN, A . (2018). PALYATİF BAKIMDA KANSER REHABİLİTASYONU VE HEMŞİRELİK YÖNETİMİ. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 34 (3), 103-118. Retrieved from http://dergipark.org.tr/egehemsire/issue/41598/448833
MLA Düzgün, G , KARADAKOVAN, A . "PALYATİF BAKIMDA KANSER REHABİLİTASYONU VE HEMŞİRELİK YÖNETİMİ". Ege Üniversitesi Hemşirelik Fakültesi Dergisi 34 (2018): 103-118 <http://dergipark.org.tr/egehemsire/issue/41598/448833>
Chicago Düzgün, G , KARADAKOVAN, A . "PALYATİF BAKIMDA KANSER REHABİLİTASYONU VE HEMŞİRELİK YÖNETİMİ". Ege Üniversitesi Hemşirelik Fakültesi Dergisi 34 (2018): 103-118
RIS TY - JOUR T1 - PALYATİF BAKIMDA KANSER REHABİLİTASYONU VE HEMŞİRELİK YÖNETİMİ AU - Gönül Düzgün , AYFER KARADAKOVAN Y1 - 2018 PY - 2018 N1 - DO - T2 - Ege Üniversitesi Hemşirelik Fakültesi Dergisi JF - Journal JO - JOR SP - 103 EP - 118 VL - 34 IS - 3 SN - 2147-3463- M3 - UR - Y2 - 2018 ER -
EndNote %0 Journal of Ege University Nursing Faculty PALYATİF BAKIMDA KANSER REHABİLİTASYONU VE HEMŞİRELİK YÖNETİMİ %A Gönül Düzgün , AYFER KARADAKOVAN %T PALYATİF BAKIMDA KANSER REHABİLİTASYONU VE HEMŞİRELİK YÖNETİMİ %D 2018 %J Ege Üniversitesi Hemşirelik Fakültesi Dergisi %P 2147-3463- %V 34 %N 3 %R %U
ISNAD Düzgün, Gönül , KARADAKOVAN, AYFER . "PALYATİF BAKIMDA KANSER REHABİLİTASYONU VE HEMŞİRELİK YÖNETİMİ". Ege Üniversitesi Hemşirelik Fakültesi Dergisi 34 / 3 (December 2018): 103-118.