Research Article
BibTex RIS Cite

FARKLI VÜCUT KÜTLE İNDEKSİNE SAHİP BİREYLERİN NAZALANS SKORLARININ İNCELENMESİ

Year 2020, , 173 - 181, 30.12.2020
https://doi.org/10.47115/jshs.755305

Abstract

Amaç: Bu çalışmanın amacı akustik değerlendirme bataryalarından biri olan nazometre ölçüm parametreleriyle, Vücut Kütle İndeksi (VKİ) arasındaki ilişkinin incelenmesidir.
Gereç ve Yöntem: 18-25 yaş arası sağlıklı sese sahip 94 kadın katılımcı, zayıf (n=20), normal (n=30), fazla kilolu (n=20) ve obez (n=24) olmak üzere 4 VKİ grubuna ayrılmıştır. Ölçümler NASOMETER-II Model 6400 ile gerçekleştirilmiş olup değerlendirme ve kayıt sırasında katılımcılara oral ve nazal metinler okutulmuştur. İncelenen parametreler ise sırasıyla; minimum, maksimum ve ortalama nazalans skordur.
Bulgular: VKİ fark etmeksizin nazal cümledeki nazalans skorları, oral cümledekinden daha yüksektir (p<0,05). Oral cümle okunurken nazometre ile ölçülen değerler VKİ’ne göre incelendiğinde, anlamlı fark sadece ortalama ve maksimum nazalans skor parametrelerindeki normal ve fazla kilolu bireyler arasında mevcuttur (p<0,05). Gruplara göre ortalama nazalans skor parametresine ait ortalama değerler sırasıyla normal (14,23±7,00) ve fazla kilolu (9,45±6,32) iken; maksimum nazalans skor parametresi için ise için normal (75,43±23,08) ve fazla kilolu (46,85±28,36) şeklindedir. Nazal cümlede ise ortalama, minimum ve maksimum nazalans skor parametrelerinin hiçbiri VKİ’ye göre anlamlı farklılık göstermemiştir (p>0,05).
Sonuç: Ölçüm sonucunda VKİ’nin iki uç değeri olan zayıf ve obez grubun, oral ve nazal cümleler sırasında nazometre değerlerinde anlamlı bir farklılık bulunamamıştır. Bunun nedeni olarak ise uç VKİ gruplarında nazalans skorlarındaki değişimi inhibe edecek bir fizyolojik kompansasyon mekanizmasının olduğu düşünülmektedir.

Thanks

Yazım sürecindeki katkılarından ötürü Sayın Prof. Dr. Ahmet Konrot’a, Dr. Ceki Paltura’ya ve Dr. Öğretim Üyesi Burak Öztürk’e ek olarak veri toplama aşamasındaki yardımlarından ötürü Dkt. Emine Nerse’ye katkılarından dolayı teşekkür ederiz.

References

  • Anderson, R. T. (1996). Nasometric values for normal Spanish-speaking females: a preliminary report. The Cleft palate-craniofacial journal, 33(4), 333-336.
  • Birkent, H., Erol, U., Ciyiltepe, M., Eadie, T. L., Durmaz, A., & Tosun, F. (2009). Relationship between nasal cavity volume changes and nasalance. The Journal of Laryngology & Otology, 123(4), 407-411.
  • Brunnegård, K., & van Doorn, J. (2009). Normative data on nasalance scores for Swedish as measured on the Nasometer: influence of dialect, gender, and age. Clinical Linguistics & Phonetics, 23(1), 58-69.
  • Crouse, U., & Laine‐Alava, M. T. (1999). Effects of age, body mass index, and gender on nasal airflow rate and pressures. The Laryngoscope, 109(9), 1503-1508.
  • Demir, N., Sanli, A., Demir, G., Erdogan, B. A., Yilmaz, H. B., & Paksoy, M. (2015). The evaluation of relationship between body mass index and nasal geometry using objective and subjective methods. Journal of Craniofacial Surgery, 26(6), 1861-1864.
  • D'haeseleer, E., Depypere, H., Claeys, S., & Lierde, K. M. V. (2011). Nasal resonance in middle-aged women: a multiparameter approach. Annals of Otology, Rhinology & Laryngology, 120(9), 575-580.
  • Haapanen, M. L. (1991). Nasalance scores in normal Finnish speech. Folia Phoniatrica et Logopaedica, 43(4), 197-203.
  • Hamdan, A. L. H., Al Barazi, R., Khneizer, G., Turfe, Z., Sinno, S., Ashkar, J., & Tabri, D. (2013). Formant frequency in relation to body mass composition. Journal of Voice, 27(5), 567-571.
  • Hilberg, O. A. C. D. L. O. F., Jackson, A. C., Swift, D. L., & Pedersen, O. F. (1989). Acoustic rhinometry: evaluation of nasal cavity geometry by acoustic reflection. Journal of applied physiology, 66(1), 295-303.
  • Hirschberg, J., Bók, S., Juhász, M., Trenovszki, Z., Votisky, P., & Hirschberg, A. (2006). Adaptation of nasometry to Hungarian language and experiences with its clinical application. International journal of pediatric otorhinolaryngology, 70(5), 785-798.
  • Hoit, J. D., Watson, P. J., Hixon, K. E., McMahon, P., & Johnson, C. L. (1994). Age and velopharyngeal function during speech production. Journal of Speech, Language, and Hearing Research, 37(2), 295-302.
  • Jones, B. (1994). The pharynx. Disorders of function. Radiologic Clinics of North America, 32(6), 1103-1115.
  • Karakoc, O., Akcam, T., Birkent, H., Arslan, H. H., & Gerek, M. (2013). Nasalance scores for normal-speaking Turkish population. Journal of craniofacial surgery, 24(2), 520-522.
  • Kavanagh, M. L. (1994). Nasometric values for three dialectal groups within the Atlantic provinces of Canada. J. Speech. Lang. Path. Audiol., 18, 7-13.
  • Keck, T., Wiesmiller, K., Lindemann, J., & Rozsasi, A. (2006). Acoustic rhinometry in nasal provocation test in perennial allergic rhinitis. European Archives of Oto-Rhino-Laryngology and Head & Neck, 263(10), 910-916.
  • Kienstra, M. A., Gassner, H. G., Sherris, D. A., & Kern, E. B. (2005). Effects of the nasal muscles on the nasal airway. American journal of rhinology, 19(4), 375-381. Laine, M. T., & Warren, D. W. (1995). Perceptual and respiratory responses to added nasal airway resistance loads in older adults. The Laryngoscope, 105(4), 425-428.
  • Litzaw, L. L., & Dalston, R. M. (1992). The effect of gender upon nasalance scores among normal adult speakers. Journal of communication disorders, 25(1), 55-64. Mayo, R., Floyd, L. A., Warren, D. W., Dalston, R. M., & Mayo, C. M. (1996). Nasalance and nasal area values: cross-racial study. The Cleft palate-craniofacial journal, 33(2), 143-149.
  • Mezzanotte WS, Tangel DJ , White DP. Waking genioglossal electromyogram in sleep apnea patients versus normal controls (a neuromuscular compensatory mechanism). The Journal of clinical investigation. 1992;89(5): 1571-1579.
  • Millqvist, E., & Bende, M. (1998). Reference values for acoustic rhinometry in subjects without nasal symptoms. American journal of rhinology, 12(5), 341-344.
  • Min, Y. G., & Jang, Y. J. (1995). Measurements of cross‐sectional area of the nasal cavity by acoustic rhinometry and CT scanning. The Laryngoscope, 105(7), 757-759.
  • Mishima, K., Sugii, A., Yamada, T., Imura, H., & Sugahara, T. (2008). Dialectal and gender differences in nasalance scores in a Japanese population. Journal of Cranio-Maxillofacial Surgery, 36(1), 8-10.
  • Nichols, A. C. (1999). Nasalance statistics for two Mexican populations. The Cleft palate-craniofacial journal, 36(1), 57-63.
  • Nishio, M., & Niimi, S. (2008). Changes in speaking fundamental frequency characteristics with aging. Folia phoniatrica et logopaedica, 60(3), 120-127.
  • Numminen, J., Ahtinen III, M., Huhtala, H., Laranne, J., & Rautiainen, M. (2002). Correlation between rhinometric measurement methods in healthy young adults. American journal of rhinology, 16(4), 203-208.
  • Oğuzhan O. Türkçe İçin Normal Nazalans Değerlerinin Saptanması [Tıpta Uzmanlık Tezi]. Kahramanmaraş: Sütçü İmam Üniversitesi Kulak Burun Boğaz Hastalıkları Anabilim Dalı; 2013.
  • Pegoraro-Krook, M. I., Dutka-Souza, J. C., Williams, W. N., Teles Magalhães, L. C., Rossetto, P. C., & Riski, J. E. (2006). Effect of nasal decongestion on nasalance measures. The Cleft palate-craniofacial journal, 43(3), 289-294.
  • Prathanee, B., Thanaviratananich, S., Pongjunyakul, A., & Rengpatanakij, K. (2003). Nasalance scores for speech in normal Thai children. Scandinavian journal of plastic and reconstructive surgery and hand surgery, 37(6), 351-355.
  • Raza, M. T., & Wang, D. Y. (2012). Is nasal cavity geometry associated with body mass index, height and weight?. Indian Journal of Otolaryngology and Head & Neck Surgery, 64(3), 266-269.
  • Sarac, E. T., Kayikci, M. E. K., & Ozkan, S. (2011). Nasality evaluation of Turkish phonemes in vowel-consonant combinations. International journal of pediatric otorhinolaryngology, 75(7), 894-898.
  • Seaver, E. J., Dalston, R. M., Leeper, H. A., & Adams, L. E. (1991). A study of nasometric values for normal nasal resonance. Journal of Speech, Language, and Hearing Research, 34(4), 715-721.
  • Souza, L. B. R. D., Periera, R. M., Santos, M. M. D., & Godoy, C. M. D. A. (2014). Frequência fundamental, tempo máximo de fonação e queixas vocais em mulheres com obesidade mórbida. ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), 27(1), 43-46.
  • Thompson, A. E. (1978). Nasal air flow during normal speech production.
  • Ünal–Logacev, Ö., Kummer, A. W., Çetin, C., & Topbaş, S. (2020). Nasometric evaluation of resonance disorders: A norm study In Turkish. International Journal of Pediatric Otorhinolaryngology, 131, 109888.
  • Van Doorn, J., & Purcell, A. (1998). Nasalance levels in the speech of normal Australian children. The Cleft palate-craniofacial journal, 35(4), 287-292.
  • Van Lierde, K. M., Wuyts, F. L., Bodt, M. D., & Van Cauwenberge, P. (2003). Age‐related patterns of nasal resonance in normal Flemish children and young adults. Scandinavian journal of plastic and reconstructive surgery and hand surgery, 37(6), 344-350.
  • Van Lierde, K. M., Wuyts, F. L., De Bodt, M., & Van Cauwenberge, P. (2001). Nasometric values for normal nasal resonance in the speech of young Flemish adults. The Cleft palate-craniofacial journal, 38(2), 112-118.
  • Watterson, T., York, S. L., & McFarlane, S. C. (1994). Effects of vocal loudness on nasalance measures. Journal of communication disorders, 27(3), 257-262.
  • Whitehill, T. L. (2001). Nasalance measures in Cantonese-speaking women. The Cleft palate-craniofacial journal, 38(2), 119-125.
  • Williams, R. G., Eccles, R., & Hutchings, H. (1990). The relationship between nasalance and nasal resistance to airflow. Acta oto-laryngologica, 110(5-6), 443-449.

Analysis of The Nasalance Score By Different Body Mass Index

Year 2020, , 173 - 181, 30.12.2020
https://doi.org/10.47115/jshs.755305

Abstract

Objective: The aim of this study is to examine the relationship between nasometer measurement parameters, one of the acoustic evaluation batteries, and Body Mass Index (BMI).
Material and Method: 94 female participants with healthy voices between the ages of 18-25 were divided into 4 BMI groups, namely weak (n=20), normal (n=30), overweight (n=20) and obese (n=24). Measurements were made with the NASOMETER-II Model 6400, and oral and nasal texts were read to the participants during the evaluation and registration. Analyzed parameters are minimum, maximum and average nasalance score.
Results: Regardless of the BMI, all values measured by the nasometer when reading the nasal sentence are higher than the reading when reading the oral sentence (p<0.05). When reading the oral sentence, when the values measured by the nasometer were examined according to the BMI, the significant difference was only for the mean and maximum nasal score (p> 0.05). While the mean (14.23 ± 7.00), overweight (9.45 ± 6.32) for the average nasal score; normal (75.43 ± 23.08), overweight (46.85 ± 28.36) for maximum accident score. In the nasal sentence, none of the mean, minimum, and maximum nasal scores showed any significant difference compared to BMI (p> 0.05).
Conclusion: As a result of the measurement, no significant difference was found in the nasometer values of the weak and obese group, which are two extreme values of BMI, during oral and nasal sentences. The reason for this is thought to be a physiological compensation mechanism that will inhibit the change in nasalance scores in the extreme BMI groups.

References

  • Anderson, R. T. (1996). Nasometric values for normal Spanish-speaking females: a preliminary report. The Cleft palate-craniofacial journal, 33(4), 333-336.
  • Birkent, H., Erol, U., Ciyiltepe, M., Eadie, T. L., Durmaz, A., & Tosun, F. (2009). Relationship between nasal cavity volume changes and nasalance. The Journal of Laryngology & Otology, 123(4), 407-411.
  • Brunnegård, K., & van Doorn, J. (2009). Normative data on nasalance scores for Swedish as measured on the Nasometer: influence of dialect, gender, and age. Clinical Linguistics & Phonetics, 23(1), 58-69.
  • Crouse, U., & Laine‐Alava, M. T. (1999). Effects of age, body mass index, and gender on nasal airflow rate and pressures. The Laryngoscope, 109(9), 1503-1508.
  • Demir, N., Sanli, A., Demir, G., Erdogan, B. A., Yilmaz, H. B., & Paksoy, M. (2015). The evaluation of relationship between body mass index and nasal geometry using objective and subjective methods. Journal of Craniofacial Surgery, 26(6), 1861-1864.
  • D'haeseleer, E., Depypere, H., Claeys, S., & Lierde, K. M. V. (2011). Nasal resonance in middle-aged women: a multiparameter approach. Annals of Otology, Rhinology & Laryngology, 120(9), 575-580.
  • Haapanen, M. L. (1991). Nasalance scores in normal Finnish speech. Folia Phoniatrica et Logopaedica, 43(4), 197-203.
  • Hamdan, A. L. H., Al Barazi, R., Khneizer, G., Turfe, Z., Sinno, S., Ashkar, J., & Tabri, D. (2013). Formant frequency in relation to body mass composition. Journal of Voice, 27(5), 567-571.
  • Hilberg, O. A. C. D. L. O. F., Jackson, A. C., Swift, D. L., & Pedersen, O. F. (1989). Acoustic rhinometry: evaluation of nasal cavity geometry by acoustic reflection. Journal of applied physiology, 66(1), 295-303.
  • Hirschberg, J., Bók, S., Juhász, M., Trenovszki, Z., Votisky, P., & Hirschberg, A. (2006). Adaptation of nasometry to Hungarian language and experiences with its clinical application. International journal of pediatric otorhinolaryngology, 70(5), 785-798.
  • Hoit, J. D., Watson, P. J., Hixon, K. E., McMahon, P., & Johnson, C. L. (1994). Age and velopharyngeal function during speech production. Journal of Speech, Language, and Hearing Research, 37(2), 295-302.
  • Jones, B. (1994). The pharynx. Disorders of function. Radiologic Clinics of North America, 32(6), 1103-1115.
  • Karakoc, O., Akcam, T., Birkent, H., Arslan, H. H., & Gerek, M. (2013). Nasalance scores for normal-speaking Turkish population. Journal of craniofacial surgery, 24(2), 520-522.
  • Kavanagh, M. L. (1994). Nasometric values for three dialectal groups within the Atlantic provinces of Canada. J. Speech. Lang. Path. Audiol., 18, 7-13.
  • Keck, T., Wiesmiller, K., Lindemann, J., & Rozsasi, A. (2006). Acoustic rhinometry in nasal provocation test in perennial allergic rhinitis. European Archives of Oto-Rhino-Laryngology and Head & Neck, 263(10), 910-916.
  • Kienstra, M. A., Gassner, H. G., Sherris, D. A., & Kern, E. B. (2005). Effects of the nasal muscles on the nasal airway. American journal of rhinology, 19(4), 375-381. Laine, M. T., & Warren, D. W. (1995). Perceptual and respiratory responses to added nasal airway resistance loads in older adults. The Laryngoscope, 105(4), 425-428.
  • Litzaw, L. L., & Dalston, R. M. (1992). The effect of gender upon nasalance scores among normal adult speakers. Journal of communication disorders, 25(1), 55-64. Mayo, R., Floyd, L. A., Warren, D. W., Dalston, R. M., & Mayo, C. M. (1996). Nasalance and nasal area values: cross-racial study. The Cleft palate-craniofacial journal, 33(2), 143-149.
  • Mezzanotte WS, Tangel DJ , White DP. Waking genioglossal electromyogram in sleep apnea patients versus normal controls (a neuromuscular compensatory mechanism). The Journal of clinical investigation. 1992;89(5): 1571-1579.
  • Millqvist, E., & Bende, M. (1998). Reference values for acoustic rhinometry in subjects without nasal symptoms. American journal of rhinology, 12(5), 341-344.
  • Min, Y. G., & Jang, Y. J. (1995). Measurements of cross‐sectional area of the nasal cavity by acoustic rhinometry and CT scanning. The Laryngoscope, 105(7), 757-759.
  • Mishima, K., Sugii, A., Yamada, T., Imura, H., & Sugahara, T. (2008). Dialectal and gender differences in nasalance scores in a Japanese population. Journal of Cranio-Maxillofacial Surgery, 36(1), 8-10.
  • Nichols, A. C. (1999). Nasalance statistics for two Mexican populations. The Cleft palate-craniofacial journal, 36(1), 57-63.
  • Nishio, M., & Niimi, S. (2008). Changes in speaking fundamental frequency characteristics with aging. Folia phoniatrica et logopaedica, 60(3), 120-127.
  • Numminen, J., Ahtinen III, M., Huhtala, H., Laranne, J., & Rautiainen, M. (2002). Correlation between rhinometric measurement methods in healthy young adults. American journal of rhinology, 16(4), 203-208.
  • Oğuzhan O. Türkçe İçin Normal Nazalans Değerlerinin Saptanması [Tıpta Uzmanlık Tezi]. Kahramanmaraş: Sütçü İmam Üniversitesi Kulak Burun Boğaz Hastalıkları Anabilim Dalı; 2013.
  • Pegoraro-Krook, M. I., Dutka-Souza, J. C., Williams, W. N., Teles Magalhães, L. C., Rossetto, P. C., & Riski, J. E. (2006). Effect of nasal decongestion on nasalance measures. The Cleft palate-craniofacial journal, 43(3), 289-294.
  • Prathanee, B., Thanaviratananich, S., Pongjunyakul, A., & Rengpatanakij, K. (2003). Nasalance scores for speech in normal Thai children. Scandinavian journal of plastic and reconstructive surgery and hand surgery, 37(6), 351-355.
  • Raza, M. T., & Wang, D. Y. (2012). Is nasal cavity geometry associated with body mass index, height and weight?. Indian Journal of Otolaryngology and Head & Neck Surgery, 64(3), 266-269.
  • Sarac, E. T., Kayikci, M. E. K., & Ozkan, S. (2011). Nasality evaluation of Turkish phonemes in vowel-consonant combinations. International journal of pediatric otorhinolaryngology, 75(7), 894-898.
  • Seaver, E. J., Dalston, R. M., Leeper, H. A., & Adams, L. E. (1991). A study of nasometric values for normal nasal resonance. Journal of Speech, Language, and Hearing Research, 34(4), 715-721.
  • Souza, L. B. R. D., Periera, R. M., Santos, M. M. D., & Godoy, C. M. D. A. (2014). Frequência fundamental, tempo máximo de fonação e queixas vocais em mulheres com obesidade mórbida. ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo), 27(1), 43-46.
  • Thompson, A. E. (1978). Nasal air flow during normal speech production.
  • Ünal–Logacev, Ö., Kummer, A. W., Çetin, C., & Topbaş, S. (2020). Nasometric evaluation of resonance disorders: A norm study In Turkish. International Journal of Pediatric Otorhinolaryngology, 131, 109888.
  • Van Doorn, J., & Purcell, A. (1998). Nasalance levels in the speech of normal Australian children. The Cleft palate-craniofacial journal, 35(4), 287-292.
  • Van Lierde, K. M., Wuyts, F. L., Bodt, M. D., & Van Cauwenberge, P. (2003). Age‐related patterns of nasal resonance in normal Flemish children and young adults. Scandinavian journal of plastic and reconstructive surgery and hand surgery, 37(6), 344-350.
  • Van Lierde, K. M., Wuyts, F. L., De Bodt, M., & Van Cauwenberge, P. (2001). Nasometric values for normal nasal resonance in the speech of young Flemish adults. The Cleft palate-craniofacial journal, 38(2), 112-118.
  • Watterson, T., York, S. L., & McFarlane, S. C. (1994). Effects of vocal loudness on nasalance measures. Journal of communication disorders, 27(3), 257-262.
  • Whitehill, T. L. (2001). Nasalance measures in Cantonese-speaking women. The Cleft palate-craniofacial journal, 38(2), 119-125.
  • Williams, R. G., Eccles, R., & Hutchings, H. (1990). The relationship between nasalance and nasal resistance to airflow. Acta oto-laryngologica, 110(5-6), 443-449.
There are 39 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original Research
Authors

Göksu Yılmaz 0000-0001-6123-8395

Tuğba Kaya

Mehmet Emrah Cangi 0000-0001-8149-3254

Publication Date December 30, 2020
Submission Date June 23, 2020
Published in Issue Year 2020

Cite

APA Yılmaz, G., Kaya, T., & Cangi, M. E. (2020). FARKLI VÜCUT KÜTLE İNDEKSİNE SAHİP BİREYLERİN NAZALANS SKORLARININ İNCELENMESİ. Samsun Sağlık Bilimleri Dergisi, 5(2), 173-181. https://doi.org/10.47115/jshs.755305
AMA Yılmaz G, Kaya T, Cangi ME. FARKLI VÜCUT KÜTLE İNDEKSİNE SAHİP BİREYLERİN NAZALANS SKORLARININ İNCELENMESİ. JSHS. December 2020;5(2):173-181. doi:10.47115/jshs.755305
Chicago Yılmaz, Göksu, Tuğba Kaya, and Mehmet Emrah Cangi. “FARKLI VÜCUT KÜTLE İNDEKSİNE SAHİP BİREYLERİN NAZALANS SKORLARININ İNCELENMESİ”. Samsun Sağlık Bilimleri Dergisi 5, no. 2 (December 2020): 173-81. https://doi.org/10.47115/jshs.755305.
EndNote Yılmaz G, Kaya T, Cangi ME (December 1, 2020) FARKLI VÜCUT KÜTLE İNDEKSİNE SAHİP BİREYLERİN NAZALANS SKORLARININ İNCELENMESİ. Samsun Sağlık Bilimleri Dergisi 5 2 173–181.
IEEE G. Yılmaz, T. Kaya, and M. E. Cangi, “FARKLI VÜCUT KÜTLE İNDEKSİNE SAHİP BİREYLERİN NAZALANS SKORLARININ İNCELENMESİ”, JSHS, vol. 5, no. 2, pp. 173–181, 2020, doi: 10.47115/jshs.755305.
ISNAD Yılmaz, Göksu et al. “FARKLI VÜCUT KÜTLE İNDEKSİNE SAHİP BİREYLERİN NAZALANS SKORLARININ İNCELENMESİ”. Samsun Sağlık Bilimleri Dergisi 5/2 (December 2020), 173-181. https://doi.org/10.47115/jshs.755305.
JAMA Yılmaz G, Kaya T, Cangi ME. FARKLI VÜCUT KÜTLE İNDEKSİNE SAHİP BİREYLERİN NAZALANS SKORLARININ İNCELENMESİ. JSHS. 2020;5:173–181.
MLA Yılmaz, Göksu et al. “FARKLI VÜCUT KÜTLE İNDEKSİNE SAHİP BİREYLERİN NAZALANS SKORLARININ İNCELENMESİ”. Samsun Sağlık Bilimleri Dergisi, vol. 5, no. 2, 2020, pp. 173-81, doi:10.47115/jshs.755305.
Vancouver Yılmaz G, Kaya T, Cangi ME. FARKLI VÜCUT KÜTLE İNDEKSİNE SAHİP BİREYLERİN NAZALANS SKORLARININ İNCELENMESİ. JSHS. 2020;5(2):173-81.

Samsun Sağlık Bilimleri Dergisi CC BY-NC 4.0 lisansına sahiptir.