Systematic Reviews and Meta Analysis
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The Psychological and Social Impacts of COVID -19 on Nursing Students: A Systematic Review

Year 2024, Volume: 7 Issue: 2, 162 - 173, 23.08.2024
https://doi.org/10.54189/hbd.1319638

Abstract

In this study, it is aimed to examine the psychological and social effects of the COVID-19 pandemic process on nursing students by making a literature review. In the research, electronic databases were searched using the keywords "Nursing Students, COVID-19, Psychological Impact, Social Impact, Nursing Students, COVID-19, Psychological Effect, Social Effect" between 2019 and 2023. As a result of the search, 562 studies were found and 25 articles were included in the study. In the studies, it was determined that students between the ages of 18-25 experienced moderate and severe anxiety, depression, stress, fatigue, burnout, fear and loneliness. In addition, the situations experienced; It has been determined that it may be related to factors such as gender, age, class, country, level of knowledge, social isolation, economic instability, future anxiety, disease status, difficulty in distance education, fear of contagion, adequacy of protective equipment, insufficient social support, family structure.

References

  • Akman Ö, Yıldırım D, Sarıkaya A. (2020). The effect of COVID-19 pandemic on nursing students’ anxiety levels. IGUSABDER, 12, 379-397.
  • Alexis J, Labrague LJ, Falguare CC. (2021). Fear of COVID-19, poor quality of sleep, irritability, and intention to quit school among nursing students: A cross-sectional study. Perspective in Psychiatric Care, 4,1-8.
  • Alsolais A, Alguwez N, Alotaibi KA, Algarni AS, Almoki M, Alsolamai F, et al. (2021). Risk perceptions, fear, depression, anxiety, stress and coping among Saudi nursing students during the COVID-19 pandemic. Journal of Mental Health, 30(2),194-201.
  • Aşkın R, Bozkurt Y, Zeybek Z. (2019). COVID-19 pandemisi: Psikolojik etkileri ve terapötik müdahaleler. İstanbul Ticaret Üniversitesi Sosyal Bilimler Dergisi, 37,304-318.
  • Aslan H, Pekince H. (2021). Nursing students views on the COVID-19 pandemic and their perceived stress levels. Perspective in Psychiatric Care, 57,695-701. doi:10.1111/ppc.12597.
  • Bai W, Xi H, Zhu Q, Ji M, Zhang H, Yang BX, et al. (2021). Network analysis of anxiety and depressive symptoms among nursing students during the COVID-19 pandemic. Journal of Affective Disorders, 294,753-760.
  • Bvumbwe T, Mtshali N. (2018). Nursing education challenges and solutions in Sub Saharan Africa: An integrative review. Bvumbwe and Mtshali BMC Nursing, 17,3.
  • Cabarkapa S, Nadjidai S, Murgier J, Ng C. (2020). The psychological impact of COVID-19 and other viral epidemics on frontline healthcare workers and ways to address it: A rapid systematic review. Brain. Behavior, & Immunity – Health, 8,2-10.
  • Carolan C, Davies CL, Crookes P, McGhee S, Roxburgh M. (2020). COVID 19: Disruptive impacts and transformative opportunities in undergraduate nurse education. Nurse Education in Practice, 46,102807.
  • Çelik AS, Pasinlioğlu T, Kocabeyoğlu T, Çetin S. (2013). Hemşirelik mesleğinin toplumdaki imajının belirlenmesi. Florence Nightingale Hemşirelik Dergisi, 21(3),147-153.
  • Comparcini D, Tomietto M, Cicolini G, Dickens GL, Mthimunya K, Marcelli S, et al. (2022). Pre-registration nursing students' anxiety and academic concerns after the second wave of COVID-19 pandemic in Italy: A cross-sectional study. Nurse Education Today, 118, 105520. doi:10.1016/j.nedt.2022.105520.
  • Çürük G, Özgül E, Karadağ S. (2023) Hemşirelik öğrencilerinde COVİD-19'un korku, kaygı ve uyku üzerine etkisi. Ir J Med Sci, 1138,2. doi:10.1007/s11845-023-03308-7.
  • Demirezen E, Bağış A. (2021). Covıd-19 pandemi sürecinde ebelik eğitimi ve öğrenci kaygısı. Ebelik ve Sağlık Bilimleri Dergisi, 4(3), 254-259.
  • Dewart G, Corcoran L, Thirsk L, Petrovic K. (2020). Nursing education in a pandemic: Academic challenges in response to COVID-19. Nurse Education Today, 92,104471.
  • Gallego-gomez JI, Campillo-Cano M, Carrion-Martinez A, Balanza S, Rodríguez-González-Moro MT, Simonelli-Munoz AJ, et al. (2020).The COVID-19 pandemic and its impact on homebound nursing students. International Journal of Environmental Research and Public Health, 17,2-12.
  • Hasuike M, Hara Y, Mori HM, Ideguchi N, Shirai F, Yoshimura Y, et al. (2021). Influence of new coronavirus pandemic on behavior and awareness of young nurses and nursing students in Japan. BMC Nursing, 23(237), 2-10.
  • Hee Kim J, Park H. (2019). Effects of smartphone-based mobile learning in nursing education: A systematic review and meta-analysis. Asian Nursing Research, 13(1), 20-29.
  • Jones K, Hein LC, James L. (2021). A nursing leadership practicum in the time of COVID-19: A Southeastern University experience. Nurse Lead, 19(2), 145-147.
  • Kaçan Yüksel C, Özdemir A, Ünal E. (2021). COVID-19 salgını sürecinde hemşirelik öğrencilerinin uyku düzenleri, psikoljik durumları ve egzersiz yapma durumlarının incelenmesi. İnönü Üniversitesi Sağlık Hizmetleri MYO Dergisi, 9(3), 1044-1065.
  • Karakayalı Ay C, Benli TE. (2021). Sağlık bilimleri ve hemşirelik öğrencilerinin COVID-19 tükenmişlik düzeyi ve etkileyen faktörlerin belirlenmesi. Samsun Sağlık Bilimleri Dergisi, 6(3), 655-670.
  • Kehyanan V, Yasin M, Khraim F, Masaba A, Abed Alah M. (2023). Fear and stress related to COVID-19 and associated factors among undergraduate nursing students in Qatar. Applied Nursing Research, 73, 151727.
  • Kupcewicz E, Mikla M, Kaducakova H, Grochans E. (2022). Loneliness and satisfaction with life among nursing students in Poland, Spain and Slovakia during the COVID-19 pandemic. Int J Environ Res Public Health, 19(5), 2929.
  • Li D, Zou L, Zhang Z, Zhang P, Zhang J, Fu W, et al. (2021). The psychological effect of COVID-19 on home–quarantined nursing student in China. Frontiers Psychiatry, 12, 1-8. doi:10.3389/fpsyt.2021.652296.
  • Lopez FE, Sanchez EM, Valiente FJ, Padilla JS, Navarro VS, Marino Godey MA. (2021). Psychological discomfort in nursing degree students as a consequence of the COVID-19 pandemic. Journal of Clinical Medicine, 10, 1-11.
  • Luo M, Guo L, Yu M, Jiang W, Wange H. (2020). The psychological and mental impact of coronavirus disease 2019 (COVID 19) on medical staff and general public: A systematic review and metaanalysis. Psychiatry Research, 291,113190.
  • Morin KH. (2020). Nursing education after COVID-19: Same or different?. Journal Clinical Nursing, 29, 3117-3119.
  • Nehir S, Tavşanlı NG. (2021). COVID-19 pandemisinin hemşire ve ebe öğrencilerin korku ve kontrol algısı üzerindeki etkisi. Medical Science, 16(2),141-150.
  • Nodine PM, Arbet J, Jenkins A, Rosenthal L, Carrington S, Purcell SK, et al. (2021). Graduate nursing student stressors during the COVID-19 pandemic. Journal of Professional Nursing, 37(4), 721-728.
  • Nurhidayati T, Rahayu DA, Alfiyanti D. (2019). Nursing students coping for burnout and fatigue online learning during coronavirus disease 2019 pandemic. Macedonian Journal of Medical Science, 9(4), 92-96.
  • Okuyan CB, Karasu F, Polat F. (2020). COVID-19’un hemşirelik öğrencilerinin sağlık kaygısı düzeyleri üzerine etkisi. Van Sağlık Bilimleri Dergisi, 13, 45-52.
  • Patelarou A, Mechili EA, Galanis P, Sfakianaki MZ, Konstantihidis Sİ, Soliaj A, et al. (2021). Nursing students, mental health status during COVID-19 quarantine: Evidence from three European countries. Journal of Mental Health, 30(2), 162-169.
  • Polat Ö, Coşkun F. (2020). COVID-19 salgınında sağlık çalışanlarının kişisel koruyucu ekipman kullanımları ile depresyon, anksiyete, stres düzeyleri arasındaki ilişkinin belirlenmesi. Batı Karadeniz Tıp Dergisi, 4(2), 51-58.
  • Sabancı B. (2021). Uzaktan eğitim sisteminin öğrenci motivasyonu: Türkiye’de yapılan çalışmalar üzerine bir derleme. Türkiye Mesleki ve Sosyal Bilimler Dergisi, 3(6),148-162.
  • Şanlı D, Uyanık G, Ünsal Avdal E. (2021). COVID-19 pandemi sürecinde dünyada hemşirelik eğitimi. İzmir Kâtip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 6(1), 55-63.
  • Savitsky B, Findling Y, Ereli A, Hendel T. (2020). Anxiety and coping strategies among nursing students during the COVID-19 pandemic. Nurse Education in Practice, 46, 2-6.
  • Sharif F, Masoumi SA. (2005). Qualitative study of nursing student experiences of clinical practice. BMC Nursing, 4(6), 1-7.
  • Sveinsdottir H, Flygenring BG, Svavarsdottir MH, Thorsteinnson HS, Kristofersson GK, Bernharosdottir J, et al. (2021). Predictors of university nursing students burnout at the time of the COVID-19 pandemic: A cross sectional study. Nurse Education Today, 106, 2-8.
  • Tanji F, Kadama Y. (2021). Prevelance of psychological distress and associated factors in nursing students during the COVID-19 pandemic: A cross sectional study. International Journal of Environmental Research and Public Health, 18, 2-10.
  • Taş AS, Köktürk Dalcalı B. (2021). COVID-19 pandemisi döneminde hemşirelik öğrencilerinde mesleki güdülenme. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 12(2), 418-424. doi:10.31067/acusaglik.851946.
  • Thomas LMK. (2022). Stress and depression in undergraduate students during the COVID-19 pandemic: Nursing students compared to undergraduate students in non-nursing majors. Journal of Professional Nursing, 38, 89-96.
  • Turan N, Kaya H, Özsaban A, Özdemir Aydın G, Özçelik K, Güneş E. (2019). Hemşirelik öğrencilerinin empati ve tükenmişlik düzeyleri arasındaki ilişkinin incelenmesi. FNJN Florence Nightingale Journal of Nursing, 27(2), 119-132.
  • Villarroya SR, Ortage L, Lavedon A, Masot O, Burjales-Matti MO, Bollester-Ferrando D, et al. (2021). The influence of COVID-19 on the mental health of final years nursing students compering the situation before and during the pandemic. International Journalof Mental Health Nursing, 30, 668-700.
  • Yanık D, Yeşilçınar İ. (2021). COVID-19 pandemi sürecinde yaşanan sosyal izolasyonun hemşirelik öğrencileri üzerindeki etkileri: Niteliksel araştırma. Sağlık Akademisyenleri Dergisi, 8(2), 103-112.
  • Zengin D, Uzsen H, Ardahan S, Yılmaz HB. (2023). COVID-19 korku düzeyinin hemşirelik öğrencilerinin e-öğrenmeye yönelik tutumlarına etkisi, Uluslararası Çevre Sağlığı Araştırmaları Dergisi,10(3), 282-290. doi:10.1080/09603123.2023.2182409.

COVID-19’un Hemşirelik Öğrencileri Üzerindeki Psikolojik ve Sosyal Etkileri: Sistematik Derleme

Year 2024, Volume: 7 Issue: 2, 162 - 173, 23.08.2024
https://doi.org/10.54189/hbd.1319638

Abstract

Bu araştırmada, COVID-19 pandemi sürecinin hemşirelik öğrencileri üzerinde oluşturduğu psikolojik ve sosyal etkilerinin, literatür taraması yapılarak incelenmesi amaçlanmıştır. Araştırmada, 2019 ve 2023 tarihleri arasında elektronik veri tabanları “Hemşirelik öğrencileri, COVID-19, Psikolojik etki, Sosyal etki, Nursing students, COVID-19, Psychological effect, Social effect” anahtar sözcükleri kullanılarak taranmıştır. Tarama sonucunda 562 çalışmaya ulaşılmış olup 25 makale çalışmaya dahil edilmiştir. Çalışmalarda, yaş aralığı 18-25 arasında olan öğrencilerin anksiyete, depresyon, stres, yorgunluk, tükenmişlik, korku ve yalnızlığı orta ve ciddi derecede deneyimledikleri belirlenmiştir. Ayrıca deneyimlenen durumların; cinsiyet, yaş, sınıf, ülke, bilgi düzeyi, sosyal izolasyon, ekonomik istikrarsızlık, gelecek kaygısı, hastalık durumu, uzaktan eğitim zorluğu, hastalık bulaşma korkusu, koruyucu ekipmanların yetersizliği, yetersiz sosyal destek, aile yapısı gibi faktörlerle ilişkili olabileceği saptanmıştır.

References

  • Akman Ö, Yıldırım D, Sarıkaya A. (2020). The effect of COVID-19 pandemic on nursing students’ anxiety levels. IGUSABDER, 12, 379-397.
  • Alexis J, Labrague LJ, Falguare CC. (2021). Fear of COVID-19, poor quality of sleep, irritability, and intention to quit school among nursing students: A cross-sectional study. Perspective in Psychiatric Care, 4,1-8.
  • Alsolais A, Alguwez N, Alotaibi KA, Algarni AS, Almoki M, Alsolamai F, et al. (2021). Risk perceptions, fear, depression, anxiety, stress and coping among Saudi nursing students during the COVID-19 pandemic. Journal of Mental Health, 30(2),194-201.
  • Aşkın R, Bozkurt Y, Zeybek Z. (2019). COVID-19 pandemisi: Psikolojik etkileri ve terapötik müdahaleler. İstanbul Ticaret Üniversitesi Sosyal Bilimler Dergisi, 37,304-318.
  • Aslan H, Pekince H. (2021). Nursing students views on the COVID-19 pandemic and their perceived stress levels. Perspective in Psychiatric Care, 57,695-701. doi:10.1111/ppc.12597.
  • Bai W, Xi H, Zhu Q, Ji M, Zhang H, Yang BX, et al. (2021). Network analysis of anxiety and depressive symptoms among nursing students during the COVID-19 pandemic. Journal of Affective Disorders, 294,753-760.
  • Bvumbwe T, Mtshali N. (2018). Nursing education challenges and solutions in Sub Saharan Africa: An integrative review. Bvumbwe and Mtshali BMC Nursing, 17,3.
  • Cabarkapa S, Nadjidai S, Murgier J, Ng C. (2020). The psychological impact of COVID-19 and other viral epidemics on frontline healthcare workers and ways to address it: A rapid systematic review. Brain. Behavior, & Immunity – Health, 8,2-10.
  • Carolan C, Davies CL, Crookes P, McGhee S, Roxburgh M. (2020). COVID 19: Disruptive impacts and transformative opportunities in undergraduate nurse education. Nurse Education in Practice, 46,102807.
  • Çelik AS, Pasinlioğlu T, Kocabeyoğlu T, Çetin S. (2013). Hemşirelik mesleğinin toplumdaki imajının belirlenmesi. Florence Nightingale Hemşirelik Dergisi, 21(3),147-153.
  • Comparcini D, Tomietto M, Cicolini G, Dickens GL, Mthimunya K, Marcelli S, et al. (2022). Pre-registration nursing students' anxiety and academic concerns after the second wave of COVID-19 pandemic in Italy: A cross-sectional study. Nurse Education Today, 118, 105520. doi:10.1016/j.nedt.2022.105520.
  • Çürük G, Özgül E, Karadağ S. (2023) Hemşirelik öğrencilerinde COVİD-19'un korku, kaygı ve uyku üzerine etkisi. Ir J Med Sci, 1138,2. doi:10.1007/s11845-023-03308-7.
  • Demirezen E, Bağış A. (2021). Covıd-19 pandemi sürecinde ebelik eğitimi ve öğrenci kaygısı. Ebelik ve Sağlık Bilimleri Dergisi, 4(3), 254-259.
  • Dewart G, Corcoran L, Thirsk L, Petrovic K. (2020). Nursing education in a pandemic: Academic challenges in response to COVID-19. Nurse Education Today, 92,104471.
  • Gallego-gomez JI, Campillo-Cano M, Carrion-Martinez A, Balanza S, Rodríguez-González-Moro MT, Simonelli-Munoz AJ, et al. (2020).The COVID-19 pandemic and its impact on homebound nursing students. International Journal of Environmental Research and Public Health, 17,2-12.
  • Hasuike M, Hara Y, Mori HM, Ideguchi N, Shirai F, Yoshimura Y, et al. (2021). Influence of new coronavirus pandemic on behavior and awareness of young nurses and nursing students in Japan. BMC Nursing, 23(237), 2-10.
  • Hee Kim J, Park H. (2019). Effects of smartphone-based mobile learning in nursing education: A systematic review and meta-analysis. Asian Nursing Research, 13(1), 20-29.
  • Jones K, Hein LC, James L. (2021). A nursing leadership practicum in the time of COVID-19: A Southeastern University experience. Nurse Lead, 19(2), 145-147.
  • Kaçan Yüksel C, Özdemir A, Ünal E. (2021). COVID-19 salgını sürecinde hemşirelik öğrencilerinin uyku düzenleri, psikoljik durumları ve egzersiz yapma durumlarının incelenmesi. İnönü Üniversitesi Sağlık Hizmetleri MYO Dergisi, 9(3), 1044-1065.
  • Karakayalı Ay C, Benli TE. (2021). Sağlık bilimleri ve hemşirelik öğrencilerinin COVID-19 tükenmişlik düzeyi ve etkileyen faktörlerin belirlenmesi. Samsun Sağlık Bilimleri Dergisi, 6(3), 655-670.
  • Kehyanan V, Yasin M, Khraim F, Masaba A, Abed Alah M. (2023). Fear and stress related to COVID-19 and associated factors among undergraduate nursing students in Qatar. Applied Nursing Research, 73, 151727.
  • Kupcewicz E, Mikla M, Kaducakova H, Grochans E. (2022). Loneliness and satisfaction with life among nursing students in Poland, Spain and Slovakia during the COVID-19 pandemic. Int J Environ Res Public Health, 19(5), 2929.
  • Li D, Zou L, Zhang Z, Zhang P, Zhang J, Fu W, et al. (2021). The psychological effect of COVID-19 on home–quarantined nursing student in China. Frontiers Psychiatry, 12, 1-8. doi:10.3389/fpsyt.2021.652296.
  • Lopez FE, Sanchez EM, Valiente FJ, Padilla JS, Navarro VS, Marino Godey MA. (2021). Psychological discomfort in nursing degree students as a consequence of the COVID-19 pandemic. Journal of Clinical Medicine, 10, 1-11.
  • Luo M, Guo L, Yu M, Jiang W, Wange H. (2020). The psychological and mental impact of coronavirus disease 2019 (COVID 19) on medical staff and general public: A systematic review and metaanalysis. Psychiatry Research, 291,113190.
  • Morin KH. (2020). Nursing education after COVID-19: Same or different?. Journal Clinical Nursing, 29, 3117-3119.
  • Nehir S, Tavşanlı NG. (2021). COVID-19 pandemisinin hemşire ve ebe öğrencilerin korku ve kontrol algısı üzerindeki etkisi. Medical Science, 16(2),141-150.
  • Nodine PM, Arbet J, Jenkins A, Rosenthal L, Carrington S, Purcell SK, et al. (2021). Graduate nursing student stressors during the COVID-19 pandemic. Journal of Professional Nursing, 37(4), 721-728.
  • Nurhidayati T, Rahayu DA, Alfiyanti D. (2019). Nursing students coping for burnout and fatigue online learning during coronavirus disease 2019 pandemic. Macedonian Journal of Medical Science, 9(4), 92-96.
  • Okuyan CB, Karasu F, Polat F. (2020). COVID-19’un hemşirelik öğrencilerinin sağlık kaygısı düzeyleri üzerine etkisi. Van Sağlık Bilimleri Dergisi, 13, 45-52.
  • Patelarou A, Mechili EA, Galanis P, Sfakianaki MZ, Konstantihidis Sİ, Soliaj A, et al. (2021). Nursing students, mental health status during COVID-19 quarantine: Evidence from three European countries. Journal of Mental Health, 30(2), 162-169.
  • Polat Ö, Coşkun F. (2020). COVID-19 salgınında sağlık çalışanlarının kişisel koruyucu ekipman kullanımları ile depresyon, anksiyete, stres düzeyleri arasındaki ilişkinin belirlenmesi. Batı Karadeniz Tıp Dergisi, 4(2), 51-58.
  • Sabancı B. (2021). Uzaktan eğitim sisteminin öğrenci motivasyonu: Türkiye’de yapılan çalışmalar üzerine bir derleme. Türkiye Mesleki ve Sosyal Bilimler Dergisi, 3(6),148-162.
  • Şanlı D, Uyanık G, Ünsal Avdal E. (2021). COVID-19 pandemi sürecinde dünyada hemşirelik eğitimi. İzmir Kâtip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi, 6(1), 55-63.
  • Savitsky B, Findling Y, Ereli A, Hendel T. (2020). Anxiety and coping strategies among nursing students during the COVID-19 pandemic. Nurse Education in Practice, 46, 2-6.
  • Sharif F, Masoumi SA. (2005). Qualitative study of nursing student experiences of clinical practice. BMC Nursing, 4(6), 1-7.
  • Sveinsdottir H, Flygenring BG, Svavarsdottir MH, Thorsteinnson HS, Kristofersson GK, Bernharosdottir J, et al. (2021). Predictors of university nursing students burnout at the time of the COVID-19 pandemic: A cross sectional study. Nurse Education Today, 106, 2-8.
  • Tanji F, Kadama Y. (2021). Prevelance of psychological distress and associated factors in nursing students during the COVID-19 pandemic: A cross sectional study. International Journal of Environmental Research and Public Health, 18, 2-10.
  • Taş AS, Köktürk Dalcalı B. (2021). COVID-19 pandemisi döneminde hemşirelik öğrencilerinde mesleki güdülenme. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 12(2), 418-424. doi:10.31067/acusaglik.851946.
  • Thomas LMK. (2022). Stress and depression in undergraduate students during the COVID-19 pandemic: Nursing students compared to undergraduate students in non-nursing majors. Journal of Professional Nursing, 38, 89-96.
  • Turan N, Kaya H, Özsaban A, Özdemir Aydın G, Özçelik K, Güneş E. (2019). Hemşirelik öğrencilerinin empati ve tükenmişlik düzeyleri arasındaki ilişkinin incelenmesi. FNJN Florence Nightingale Journal of Nursing, 27(2), 119-132.
  • Villarroya SR, Ortage L, Lavedon A, Masot O, Burjales-Matti MO, Bollester-Ferrando D, et al. (2021). The influence of COVID-19 on the mental health of final years nursing students compering the situation before and during the pandemic. International Journalof Mental Health Nursing, 30, 668-700.
  • Yanık D, Yeşilçınar İ. (2021). COVID-19 pandemi sürecinde yaşanan sosyal izolasyonun hemşirelik öğrencileri üzerindeki etkileri: Niteliksel araştırma. Sağlık Akademisyenleri Dergisi, 8(2), 103-112.
  • Zengin D, Uzsen H, Ardahan S, Yılmaz HB. (2023). COVID-19 korku düzeyinin hemşirelik öğrencilerinin e-öğrenmeye yönelik tutumlarına etkisi, Uluslararası Çevre Sağlığı Araştırmaları Dergisi,10(3), 282-290. doi:10.1080/09603123.2023.2182409.
There are 44 citations in total.

Details

Primary Language Turkish
Subjects Fundamentals of Nursing
Journal Section Research Articles
Authors

Serpil Özmen 0000-0002-1415-0822

Publication Date August 23, 2024
Submission Date July 6, 2023
Published in Issue Year 2024 Volume: 7 Issue: 2

Cite

APA Özmen, S. (2024). COVID-19’un Hemşirelik Öğrencileri Üzerindeki Psikolojik ve Sosyal Etkileri: Sistematik Derleme. Hemşirelik Bilimi Dergisi, 7(2), 162-173. https://doi.org/10.54189/hbd.1319638