Research Article
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The Relationship between Maternal Attachment and Fear of COVID-19 in Mothers who Gave Birth During the Pandemic Period

Year 2023, , 102 - 112, 01.08.2023
https://doi.org/10.31125/hunhemsire.1333824

Abstract

Aim: It was aimed to examine the relationship between maternal attachment and fear of COVID-19 in mothers who gave birth during the pandemic period.
Material and Methods: The data of this descriptive study were collected using a Personal Information Form, Maternal Attachment Scale, and COVID-19 Fear Scale. The study sample consisted of mothers with babies between 0-6 months.
Results: It was observed that there was a strong negative correlation between Maternal Attachment and COVID-19 Fear Scale scores of the mothers. It was determined that the mean Maternal Attachment Scale score of the mothers who had COVID-19 positivity during pregnancy, had COVID-19 positivity in the family members, and did not take their baby to have heel blood sample removed due to the risk of COVID-19 transmission were statistically significantly lower than the other mothers.
Conclusions: This study data showed that mothers fearing COVID-19 had a weak maternal attachment. In addition, according to the results of this study, it can be said that the fear of COVID-19 negatively affects the mother-infant union.

References

  • National Institutes of Health (NIH). National Institutes of Health (NIH) COVID-19. [İnternet]. 2020. [Erişim Tarihi: 22.07.2021]. Erişim adresi: https://covid19.nih.gov/.
  • WHO. Coronavirus disease (COVID-19) pandemic. [İnternet]. 2020. [Erişim Tarihi: 22.07.2021]. Erişim adresi: https://www.who.int/news-room/feature-stories/ten-threats-to-global-health-in-2019.
  • Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD. How will country-based mitigation measures influence the course of the COVID-19 epidemic?. Lancet. 2020;395(10228):931-4.
  • Chen P, Mao L, Nassis GP, Harmer P, Ainsworth BE, Li F. Coronavirus disease (COVID-19): The need to maintain regular physical activity while taking precautions. J Sport Health Sci. 2020;9(2):103-4.
  • Gujski M, Humeniuk E, Bojar I. Current State of Knowledge About SARS-CoV-2 and COVID-19 Disease in Pregnant Women. Med Sci Monit. 2020;26:e924725.
  • Li N, Han L, Peng M, Lv Y, Ouyang Y, Liu K, et al. Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: A case-control study. Clin Infect Dis. 2020;71(36):2035–2041.
  • Korucu AE, Şahan FU, Terzioğlu F. Perinatal dönemde Koronavirüs Hastalığı 2019 yönetimi. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2020;11(4):475-485.
  • Schwartz DA, Graham AL. Potential maternal and infant outcomes from coronavirus 2019-nCoV (SARS-CoV-2) infecting pregnant women: lessons from SARS, MERS, and other human coronavirus infections. Viruses. 2020;12(2):194.
  • Uytenbogaardt A. Does COVID-19 affect pregnant women?. Br J Midwifery. 2020;28(4):209.
  • Liu J, Han P., Wu J, Gong J, Tian D. Positive rate of RT-PCR detection of SARS-CoV-2 infection in 4880 cases from one hospital in Wuhan, China, from Jan to Feb 2020. J Infect Public Health. 2020;505:172-5.
  • Kınık E, Özcan H. Maternal bağlanmayı etkileyen faktörler ve primiparlarda maternal bağlanma durumu. Sağlık Profesyonelleri Araştırma Dergisi. 2020;2(1):47-53.
  • Bilgin Z, Alpar ŞE. Kadınların maternal bağlanma algısı ve anneliğe ilişkin görüşleri. Sağlık Bilimleri ve Meslekleri Dergisi. 2018;5(1):6-15.
  • Aydın R, Kızılkaya T, Hancıoğlu Aytaç S, Taşlar N. COVID-19 pandemisinde; gebelik, doğum ve doğum sonu dönemde kadınların sosyal destek gereksinimi ve ebelik yaklaşımları. Turkish Psychological Counseling and Guidance Journal. 2020;15(4):679-90.
  • Chua MSQ, Lee JCS, Sulaiman S, Tan HK. From the frontline of COVID-19-How prepared are we as obstetricians: a commentary. BJOG. 2020;127(7):786-8.
  • Çuvadar A, Özcan H, Arıkan MG, Ateş S. COVID-19 tanılı gebede postpartum kaygı düzeyi̇. Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi. 2020;3(3):297-301.
  • Muller ME, Mercer RT. Development of the Prenatal Attachment Inventory. West J Nurs Res. 1993;15(2):199-215.
  • Kavlak O, Şirin A. Maternal Bağlanma Ölçeği’nin Türk toplumuna uyarlanması. Uluslararası İnsan Bilimleri Dergisi. 2009;6(1):188-202.
  • Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, & Pakpour AH. The Fear of COVID-19 Scale: Development and initial validation. Int J Ment Health Addict. 2020;20(3):1537-45.
  • Bakioğlu F, Korkmaz O, & Ercan H. Fear of COVID-19 and positivity: Mediating role of intolerance of uncertainty, depression, anxiety, and stress. Int J Ment Health Addict. 2021;19:2369-82.
  • Oskovi-Kaplan ZA, Buyuk GN, Ozgu-Erdinc AS, Keskin HL, Ozbas A, Tekin OM. The effect of COVID-19 pandemic and social restrictions on depression rates and maternal attachment in immediat epostpartum women: A preliminary study. Psychiatr Q. 2021;92(2):675-82.
  • Zanardo V, Manghina V, Giliberti L, Vettore M, Severino L, Straface G. Psychological impact of COVID-19 quarantine measures in north eastern Italy on mothers in the immediate postpartum period. Int J Gynaecol Obstet. 2020;150(2):184-8.
  • Collin J, Byström E, Carnahan A, Ahrne M. Public health agency of Sweden's brief report: Pregnant and postpartum women with severe acute respiratory syndrome Coronavirus 2 infection in intensive care in Sweden. Acta Obstet Gynecol Scand. 2020;99(7):819-22.
  • Dashraath P, Wong J, Lim M, Lim LM, Li S, Biswas A, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol. 2020;222(6):521-31.
  • Mayopoulos G. A, Ein-Dor T, Dishy GA, Nandru R, Chan SJ, Hanley LE, et al. COVID-19 is associated with traumatic child birth and subsequent mother-infant bonding problems. J Affect Disord. 2021;282(2021):122-5.
  • Balkaya NA. Postpartum dönemde annelerin bakım gereksinimleri ve ebe – hemşirenin rolü. Cumhuriyet Üniversitesi Hemşirelik Yüksekokulu Dergisi. 2002;6(2):42-93.
  • Eroğlu K. Evde bakım hizmetlerinin doğum sonu erken taburcu edilen yenidoğanlarda görülen komplikasyonlar üzerine etkisi. Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Dergisi. 2009;16(1):25-38.
  • Jafree SR, Momina A, Muazzam A, Wajid R, Calib G. Factors affecting delivery health service satisfaction of women and fear of COVID− 19: Implications for maternal and child health in Pakistan. Matern Child Health J. 2021;25(6):881-91.
  • Uzun A, Öztürk GZ, Bozkurt Z, Çavuşoğlu M. Investigating of fear of COVID-19 after pregnancy and Association with breastfeeding. Journal of Ideas in Health. 2021;4(1):327-33.
  • Ostacoli L, Cosma S, Bevilacqua F, Berchialla P, Bovetti M, Carosso AR, et al. Psychosocial factors associated with postpartum psychological distress during the COVID-19 pandemic: A cross-sectional study. BMC Pregnancy Childbirth. 2020;20(1):1-8.
  • Haktanir A, Seki T, Dilmaç B. Adaptation and evaluation of Turkish version of the fear of COVID-19 scale. Death Studies. (in press). 2020. doi: 10.1080/07481187.2020.1773026.
  • Cerda AA, García LY. Factors explaining the fear of being infected with COVID‐19. Health Expect. 2022;25(2):506-12.
  • Helmy HK., Elbastawes YS, Ahmed SI. Fear and anxiety impacts of the COVID-19 among primigravida versus multigravida pregnant women. Assiut Scientific Nursing Journal. 2020;8(23):75-85.
  • 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.
  • Sheen K, Slade P. Examining the content and moderators of women's fears forgiving birth: A meta-synthesis. J Clin Nurs. 2018;27(13–14):2523-35.
  • Mahboubeh H, Abbas E, Nourossadat K. Persian translation of the pregnancy experience scale (PES)–brief version: Confirmatory factor analysis. Pakistan Journal of Medical and Health Sciences. 2018;12(1):503-508.
  • Fakari FR, Simbar M. Coronavirus pandemic and worries during pregnancy; a letter to Editor. Arch Acad Emerg Med. 2020;8(1):e21.
  • Holditch-Davis D, Santos H, Levy J, White-Traut R, O'Shea TM, Geraldo V, et al. Patterns of psychological distress in mothers of preterm infants. Infant Behav Dev. 2015;(41):154-63.
  • Salehi L, Rahimzadeh M, Molaei E, Zaheri H, & Esmaelzadeh‐Saeieh S. The relationship among fear and anxiety of COVID‐19, pregnancy experience, and mental health disorder in pregnant women: A structural equation model. Brain Behav. 2020;10(11):e01835.
  • Colizzi M, Bortoletto R, Silvestri M, Mondini F, Puttini E, Cainelli C, et al. Medically unexplained symptoms in the times of COVID-19 pandemic: A case-report. Brain Behav Immun Health. 2020;5(2020):100073.
  • Cheema R, Partridge E, Kair LR, Kuhn-Riordon KM, Silva AI, Bettinelli ME, et al. Protecting breastfeeding during the COVID-19 pandemic. Am J Perinatol. 2023;40(3):260-6.
  • Hull N, Kam RL, Gribble KD. Providing breastfeeding support during the COVID-19 pandemic: Concerns of mothers who contacted the Australian Breastfeeding Association. Breastfeeding Review. 2020;28(3):25-35.
  • Çankaya S, Yılmaz SD, Can R, Kodaz ND. Postpartum depresyonun maternal bağlanma üzerine etkisi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2017;4:232-40.
  • Durualp E, Kaytez N, Girgin BA. An analysis of the relation between marital satisfaction and maternal bonding. Anadolu Psikiyatri Dergisi. 2017;18(2):129-38.
  • Kokanalı D, Ayhan S, Devran A, Kokanalı MK, Taşçı Y. Effect of cesarean section on postpartum depression and maternal attachment. Journal of Contemporary Medicine. 2018;0(0):148-52.
  • Unal D, Çak ET. Anne Bebek İlişkisi ve Sağlıklı Bağlanma. Turkiye Klinikleri Journal Child Psychiatry-Special Topics. 2018;4(1):1-4.
  • Sahin B, Karabekiroğlu K. Bebek ruh sağlığında erken müdahale programları. Turkiye Klinikleri Journal Child Psychiatry-Special Topics. 2018;4(1):69-76.
  • Tonkuş MB, Muslu SN. Maternal attachment and related factors. Journal of Medical Sciences. 2021;2(2):32-40.
  • Ruma UR. Association of mother-child attachment with maternal mental health in early years [PhD thesis], Dakka: Brac University; 2020.

Pandemi Döneminde Doğum Yapan Annelerde Maternal Bağlanma ve COVID-19 Korkusu Arasındaki İlişki

Year 2023, , 102 - 112, 01.08.2023
https://doi.org/10.31125/hunhemsire.1333824

Abstract

Amaç: Pandemi döneminde doğum yapan annelerde maternal bağlanma ve COVID-19 korkusu arasındaki ilişkinin incelenmesi amaçlanmıştır.
Gereç ve Yöntem: Tanımlayıcı nitelikte olan bu çalışmanın verileri Kişisel Bilgi Formu, Maternal Bağlanma Ölçeği ve COVID-19 Korkusu Ölçeği kullanılarak toplanmıştır. Araştırmanın örneklemini 0-6 ay arasında bebeğe sahip anneler oluşturmuştur.
Bulgular: Annelerin Maternal Bağlanma ve COVID-19 Korkusu Ölçeği puanları arasında negatif yönlü güçlü bir ilişki olduğu görülmüştür. Gebelikte COVID-19 pozitifliği olan, ailesindeki bireylerde COVID-19 pozitifliği olan ve bebeğini COVID-19 bulaşma riski nedeniyle topuk kanı aldırmaya götürmeyen annelerin Maternal Bağlanma Ölçeği puan ortalamalarının diğer annelere göre istatistiksel olarak anlamlı düzeyde daha düşük olduğu belirlenmiştir.
Sonuç: Bu çalışma verileri COVID-19 korkusu yaşayan annelerin maternal bağlanmalarının zayıf olduğunu göstermiştir. Ayrıca bu çalışma sonucuna göre COVID-19 korkusunun anne-bebek birlikteliğini olumsuz etkilediği söylenebilir.

References

  • National Institutes of Health (NIH). National Institutes of Health (NIH) COVID-19. [İnternet]. 2020. [Erişim Tarihi: 22.07.2021]. Erişim adresi: https://covid19.nih.gov/.
  • WHO. Coronavirus disease (COVID-19) pandemic. [İnternet]. 2020. [Erişim Tarihi: 22.07.2021]. Erişim adresi: https://www.who.int/news-room/feature-stories/ten-threats-to-global-health-in-2019.
  • Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD. How will country-based mitigation measures influence the course of the COVID-19 epidemic?. Lancet. 2020;395(10228):931-4.
  • Chen P, Mao L, Nassis GP, Harmer P, Ainsworth BE, Li F. Coronavirus disease (COVID-19): The need to maintain regular physical activity while taking precautions. J Sport Health Sci. 2020;9(2):103-4.
  • Gujski M, Humeniuk E, Bojar I. Current State of Knowledge About SARS-CoV-2 and COVID-19 Disease in Pregnant Women. Med Sci Monit. 2020;26:e924725.
  • Li N, Han L, Peng M, Lv Y, Ouyang Y, Liu K, et al. Maternal and neonatal outcomes of pregnant women with COVID-19 pneumonia: A case-control study. Clin Infect Dis. 2020;71(36):2035–2041.
  • Korucu AE, Şahan FU, Terzioğlu F. Perinatal dönemde Koronavirüs Hastalığı 2019 yönetimi. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2020;11(4):475-485.
  • Schwartz DA, Graham AL. Potential maternal and infant outcomes from coronavirus 2019-nCoV (SARS-CoV-2) infecting pregnant women: lessons from SARS, MERS, and other human coronavirus infections. Viruses. 2020;12(2):194.
  • Uytenbogaardt A. Does COVID-19 affect pregnant women?. Br J Midwifery. 2020;28(4):209.
  • Liu J, Han P., Wu J, Gong J, Tian D. Positive rate of RT-PCR detection of SARS-CoV-2 infection in 4880 cases from one hospital in Wuhan, China, from Jan to Feb 2020. J Infect Public Health. 2020;505:172-5.
  • Kınık E, Özcan H. Maternal bağlanmayı etkileyen faktörler ve primiparlarda maternal bağlanma durumu. Sağlık Profesyonelleri Araştırma Dergisi. 2020;2(1):47-53.
  • Bilgin Z, Alpar ŞE. Kadınların maternal bağlanma algısı ve anneliğe ilişkin görüşleri. Sağlık Bilimleri ve Meslekleri Dergisi. 2018;5(1):6-15.
  • Aydın R, Kızılkaya T, Hancıoğlu Aytaç S, Taşlar N. COVID-19 pandemisinde; gebelik, doğum ve doğum sonu dönemde kadınların sosyal destek gereksinimi ve ebelik yaklaşımları. Turkish Psychological Counseling and Guidance Journal. 2020;15(4):679-90.
  • Chua MSQ, Lee JCS, Sulaiman S, Tan HK. From the frontline of COVID-19-How prepared are we as obstetricians: a commentary. BJOG. 2020;127(7):786-8.
  • Çuvadar A, Özcan H, Arıkan MG, Ateş S. COVID-19 tanılı gebede postpartum kaygı düzeyi̇. Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi. 2020;3(3):297-301.
  • Muller ME, Mercer RT. Development of the Prenatal Attachment Inventory. West J Nurs Res. 1993;15(2):199-215.
  • Kavlak O, Şirin A. Maternal Bağlanma Ölçeği’nin Türk toplumuna uyarlanması. Uluslararası İnsan Bilimleri Dergisi. 2009;6(1):188-202.
  • Ahorsu DK, Lin CY, Imani V, Saffari M, Griffiths MD, & Pakpour AH. The Fear of COVID-19 Scale: Development and initial validation. Int J Ment Health Addict. 2020;20(3):1537-45.
  • Bakioğlu F, Korkmaz O, & Ercan H. Fear of COVID-19 and positivity: Mediating role of intolerance of uncertainty, depression, anxiety, and stress. Int J Ment Health Addict. 2021;19:2369-82.
  • Oskovi-Kaplan ZA, Buyuk GN, Ozgu-Erdinc AS, Keskin HL, Ozbas A, Tekin OM. The effect of COVID-19 pandemic and social restrictions on depression rates and maternal attachment in immediat epostpartum women: A preliminary study. Psychiatr Q. 2021;92(2):675-82.
  • Zanardo V, Manghina V, Giliberti L, Vettore M, Severino L, Straface G. Psychological impact of COVID-19 quarantine measures in north eastern Italy on mothers in the immediate postpartum period. Int J Gynaecol Obstet. 2020;150(2):184-8.
  • Collin J, Byström E, Carnahan A, Ahrne M. Public health agency of Sweden's brief report: Pregnant and postpartum women with severe acute respiratory syndrome Coronavirus 2 infection in intensive care in Sweden. Acta Obstet Gynecol Scand. 2020;99(7):819-22.
  • Dashraath P, Wong J, Lim M, Lim LM, Li S, Biswas A, et al. Coronavirus disease 2019 (COVID-19) pandemic and pregnancy. Am J Obstet Gynecol. 2020;222(6):521-31.
  • Mayopoulos G. A, Ein-Dor T, Dishy GA, Nandru R, Chan SJ, Hanley LE, et al. COVID-19 is associated with traumatic child birth and subsequent mother-infant bonding problems. J Affect Disord. 2021;282(2021):122-5.
  • Balkaya NA. Postpartum dönemde annelerin bakım gereksinimleri ve ebe – hemşirenin rolü. Cumhuriyet Üniversitesi Hemşirelik Yüksekokulu Dergisi. 2002;6(2):42-93.
  • Eroğlu K. Evde bakım hizmetlerinin doğum sonu erken taburcu edilen yenidoğanlarda görülen komplikasyonlar üzerine etkisi. Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Dergisi. 2009;16(1):25-38.
  • Jafree SR, Momina A, Muazzam A, Wajid R, Calib G. Factors affecting delivery health service satisfaction of women and fear of COVID− 19: Implications for maternal and child health in Pakistan. Matern Child Health J. 2021;25(6):881-91.
  • Uzun A, Öztürk GZ, Bozkurt Z, Çavuşoğlu M. Investigating of fear of COVID-19 after pregnancy and Association with breastfeeding. Journal of Ideas in Health. 2021;4(1):327-33.
  • Ostacoli L, Cosma S, Bevilacqua F, Berchialla P, Bovetti M, Carosso AR, et al. Psychosocial factors associated with postpartum psychological distress during the COVID-19 pandemic: A cross-sectional study. BMC Pregnancy Childbirth. 2020;20(1):1-8.
  • Haktanir A, Seki T, Dilmaç B. Adaptation and evaluation of Turkish version of the fear of COVID-19 scale. Death Studies. (in press). 2020. doi: 10.1080/07481187.2020.1773026.
  • Cerda AA, García LY. Factors explaining the fear of being infected with COVID‐19. Health Expect. 2022;25(2):506-12.
  • Helmy HK., Elbastawes YS, Ahmed SI. Fear and anxiety impacts of the COVID-19 among primigravida versus multigravida pregnant women. Assiut Scientific Nursing Journal. 2020;8(23):75-85.
  • 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.
  • Sheen K, Slade P. Examining the content and moderators of women's fears forgiving birth: A meta-synthesis. J Clin Nurs. 2018;27(13–14):2523-35.
  • Mahboubeh H, Abbas E, Nourossadat K. Persian translation of the pregnancy experience scale (PES)–brief version: Confirmatory factor analysis. Pakistan Journal of Medical and Health Sciences. 2018;12(1):503-508.
  • Fakari FR, Simbar M. Coronavirus pandemic and worries during pregnancy; a letter to Editor. Arch Acad Emerg Med. 2020;8(1):e21.
  • Holditch-Davis D, Santos H, Levy J, White-Traut R, O'Shea TM, Geraldo V, et al. Patterns of psychological distress in mothers of preterm infants. Infant Behav Dev. 2015;(41):154-63.
  • Salehi L, Rahimzadeh M, Molaei E, Zaheri H, & Esmaelzadeh‐Saeieh S. The relationship among fear and anxiety of COVID‐19, pregnancy experience, and mental health disorder in pregnant women: A structural equation model. Brain Behav. 2020;10(11):e01835.
  • Colizzi M, Bortoletto R, Silvestri M, Mondini F, Puttini E, Cainelli C, et al. Medically unexplained symptoms in the times of COVID-19 pandemic: A case-report. Brain Behav Immun Health. 2020;5(2020):100073.
  • Cheema R, Partridge E, Kair LR, Kuhn-Riordon KM, Silva AI, Bettinelli ME, et al. Protecting breastfeeding during the COVID-19 pandemic. Am J Perinatol. 2023;40(3):260-6.
  • Hull N, Kam RL, Gribble KD. Providing breastfeeding support during the COVID-19 pandemic: Concerns of mothers who contacted the Australian Breastfeeding Association. Breastfeeding Review. 2020;28(3):25-35.
  • Çankaya S, Yılmaz SD, Can R, Kodaz ND. Postpartum depresyonun maternal bağlanma üzerine etkisi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi. 2017;4:232-40.
  • Durualp E, Kaytez N, Girgin BA. An analysis of the relation between marital satisfaction and maternal bonding. Anadolu Psikiyatri Dergisi. 2017;18(2):129-38.
  • Kokanalı D, Ayhan S, Devran A, Kokanalı MK, Taşçı Y. Effect of cesarean section on postpartum depression and maternal attachment. Journal of Contemporary Medicine. 2018;0(0):148-52.
  • Unal D, Çak ET. Anne Bebek İlişkisi ve Sağlıklı Bağlanma. Turkiye Klinikleri Journal Child Psychiatry-Special Topics. 2018;4(1):1-4.
  • Sahin B, Karabekiroğlu K. Bebek ruh sağlığında erken müdahale programları. Turkiye Klinikleri Journal Child Psychiatry-Special Topics. 2018;4(1):69-76.
  • Tonkuş MB, Muslu SN. Maternal attachment and related factors. Journal of Medical Sciences. 2021;2(2):32-40.
  • Ruma UR. Association of mother-child attachment with maternal mental health in early years [PhD thesis], Dakka: Brac University; 2020.
There are 48 citations in total.

Details

Primary Language Turkish
Subjects Pediatric Health and Illnesses Nursing
Journal Section Research Article
Authors

Melike Yavaş Çelik This is me 0000-0002-1155-1022

Ebru Öztürk Çopur This is me 0000-0003-1843-3499

Publication Date August 1, 2023
Submission Date August 13, 2021
Published in Issue Year 2023

Cite

Vancouver Yavaş Çelik M, Öztürk Çopur E. Pandemi Döneminde Doğum Yapan Annelerde Maternal Bağlanma ve COVID-19 Korkusu Arasındaki İlişki. HUHEMFAD. 2023;10(2):102-1.