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YOĞUN BAKIMDA PALYATİF BAKIMIN GEREKLİLİĞİ

Year 2017, Volume: 18 Issue: 2, 78 - 84, 17.04.2017

Sibel Eyigör Hilal Yeşil

https://doi.org/10.18229/kocatepetip.344628

Abstract

ÖZ

Yaşlanan popülasyon ve yaşam süresinin artmasını sağlayan teknolojiler nedeniyle ciddi veya yaşamı tehdit edici hastalıklara sahip bireylerin sayısı giderek artmaktadır. Bu hastalıklar sırasında yaşam kalitesini arttırmak için artan bir şekilde palyatif bakım programları geliştirilmektedir. Palyatif bakımda hizmet, deneyimli ve eğitimli sağlık personeli ve gönüllülerden oluşan bir ekip tarafından sunulmakta ve her ülkenin kendi koşulları içerisinde; hastane ortamında, birinci basamak sağlık alanlarında, ev ortamında ve son dönem evleri veya hospislerde verilmektedir. Yoğun bakım üniteleri, kritik hastaların hızlı ve hayat kurtarıcı müdahaleler aldığı özgün bakım ortamlarıdır. Fizik tedavi ve rehabilitasyon programları gelişmiş ülkelerde pek çok hastanede yoğun bakım ünitelerine entegre olmuş bir bölüm olarak yer almaktadır. Yoğun bakım ünitelerinde hastaların ihtiyaçları ve komplikasyonları göz önünde bulundurulduğunda, bu hastaların yaşam kalitelerinin iyileştirilmesinin önemi akılda tutulması geren bir durum olmalıdır. Fizik tedavi ve rehabilitasyon programları ile hastalardaki optimum respiratuar ve sirkulatuar fonksiyonun sürdürülmesi, kas atrofisi ve kas kısalmasının, eklem kontraktürlerinin önlenmesi, ağrının kontrol edilmesi ve giderilmesi, fonksiyonun ve bağımsızlığın optimize hale getirilmesi, hastaların eğitimi ve bakıcının katılımı hedeflenmektedir. Fizik tedavi ve rehabilitasyon uzmanları, fizyoterapistler ve iş-uğraşı terapistleri multidisipliner palyatif bakım ekibi içerisinde hastaların mobilitesinin, bağımsızlığının ve yaşam kalitesinin arttırılmasına yardımcı olmak için birlikte çalışmaktadırlar. Maalesef palyatif bakım kaynaklarının dağıtımı sırasında fizyoterapi ve rehabilitasyon olasılıklarının yüksek oranda göz ardı edilmekte olduğu ve gerekli kaynak aktarımının yeterince yapılmadığı gözlenmektedir. Biz bu yazımızda palyatif bakımın önemli bir bileşeni olan rehabilitasyonun, yoğun bakım ünitesindeki rolünü, gerekliliğini ve sağladığı faydanın vurgulanması amaçlamaktayız.

Keywords

Palyatif bakım rehabilitasyon yoğun bakım ünitesi egzersiz palyatif bakım takımı

References

  • REFERENCES
  • Hartjes TM. Making the Case for Palliative Care in Critical Care. Crit Care Nurs Clin North Am. 2015;27(3):289-95
  • Friedman DL, Hilden JM, Powaski K. Issues and challenges in palliative care for children with cancer. Curr Oncol Rep. 2004;6:431-37
  • Mularski RA, Puntillo K, Varkey B, et al. Pain management within the palliative and end-of-life care experience in the ICU. Chest. 2009; 135:1360-69
  • Nelson JE, Azoulay E, Curtis JR, et al. Palliative care in the ICU. J Palliat Med. 2012;15: 168-74
  • Selecky PA, Eliasson CA, Hall RI, et al. Palliative and end-of-life care for patients with cardiopulmonary diseases: American College of Chest Physicians position statement. American College of Chest Physicians. Chest. 2005;128:3599-610
  • Truog RD, Campbell ML, Curtis JR, et al. Recommendations for end-of-life care in the intensive care unit: a consensus statement by the American College [corrected] of Critical Care Medicine. Crit Care Med. 2008;36: 953-63
  • Puntillo K, Nelson JE, Weissman D, et al. Palliative care in the ICU: relief of pain, dyspnea, and thirst--a report from the IPAL-ICU Advisory Board. Intensive Care Med. 2014;40: 235-48
  • Clarke EB, Curtis JR, Luce JM, et al. Robert Wood Johnson Foundation Critical Care End-Of-Life Peer Workgroup Members. Quality indicators for end-of-life care in the intensive care unit. Crit Care Med. 2003;31: 2255-62
  • Lau BD, Aslakson RA, Wilson RF, et al. Methods for improving the quality of palliative care delivery: a systematic review. Am J Hosp Palliat Care. 2014 ;31:202-10
  • Nelson JE, Curtis JR, Mulkerin C, et al. Choosing and using screening criteria for palliative care consultation in the ICU: a report from the Improving Palliative Care in the ICU (IPAL-ICU) Advisory Board. Crit Care Med. 2013;41: 2318-27
  • Braiteh F, El Osta B, Palmer JL, et al. Characteristics, findings, and outcomes of palliative care inpatient consultations at a comprehensive cancer center . J Palliat Med. 2007;10: 948-55.
  • Center to Advance Palliative Care . www.capc.org. Access date: 22.04.2017
  • Eyigor S. Fifth-Year Medical Students’ Knowledge of Palliative Care and Their Views on the Subject. Journal of Palliative Medicine. 2013; 16: 941-4683
  • Stiller K. Physiotherapy in intensive care: Towards an evidence-based practice. Chest 2000;118: 1801-13
  • Denehy L, Berney S. Physiotherapy in intensive care unit. Physical Therapy Reviews 2006;11: 49-56
  • Marciniak CM, Sliwa JA, Spill G, et al. Functional outcome following rehabilitation of the cancer patient. Arch Phys Med Rehabil. 1996;77: 54-57
  • Sabers SR, Kokal JE, Girardi JC, et al. Evaluation of consultation-based rehabilitation for hospitalized cancer patients with functional impairment Mayo Clin Proc. 1999;74:855-61
  • Cole RP, Scialla SJ, Bednarz L. Functional recovery in cancer rehabilitation. Arch Phys Med Rehabil. 2000 ; 81:623-7
  • Montagnini M, Lodhi M, Born W. The utilization of physical therapy in a palliative care unit. J Palliat Med. 2003;6:11–17
  • Yurdalan SU. Yoğun Bakım Ünitelerinde Güncel Fizyoterapi Yaklaşımları MÜSBED 2011;1: 196-201
  • Kasven-Gonzalez N, Souverain R, Miale S. Improving quality of life through rehabilitation in palliative care: case report. Palliat Support Care. 2010;8:359-369
  • Frost M. The role of physical, occupational, and speech therapy in hospice: patient empowerment. Am J Hosp Palliat Care. 2001;18:397-402
  • Javier NS, Montagnini ML. Rehabilitation of the hospice and palliative care patient. J Palliat Med. 2011;14:638-48
  • Byrnes MC, Schuerer DJ, Schallom ME, et al. Implementation of a mandatory checklist of protocols and objectives improves compliance with a wide range of evidence-based intensive care unit practices. Crit Care Med. 2009;37:2775-81
  • Gosselink R, Needham D, Hermans G. ICU-based rehabilitation and its appropriate metrics. Curr Opin Crit Care. 2012;18:533-9
  • Zanni JM, Korupolu R, Fan E, et al. Rehabilitation therapy and outcomes in acute respiratory failure: an observational pilot project. J Crit Care. 2010 Jun;25:254-62
  • Needham DM, Wang W, Desai SV et al. Intensive care unit exposures for long-term outcomes research: development and description of exposures for 150 patients with acute lung injury. J Crit Care. 2007;22:275-84
  • Winkelman C, Higgins PA, Chen YJ. Activity in the chronically critically ill. Dimens Crit Care Nurs. 2005;24:281-90
  • Kanach FA, Brown LM, Campbell RR. The role of rehabilitation in palliative care services. Am J Phys Med Rehabil. 2014;93:342-5
  • Dahlin Y, Heiwe S. Patients’ experiences of physical therapy within palliative cancer care. J Palliat Care. 2009;25:12-20
  • Lowe SS, Watanabe SM, Courneya KS. Physical activity as a supportive care intervention in palliative cancer patients: a systematic review. J Support Oncol. 2009;7:27-34
  • Reticker AL, Nici L, ZuWallack R. Pulmonary rehabilitation and palliative care in COPD: Two sides of the same coin?.Chron Respir Dis. 2012;9:107-16
  • Khandelwal N, Benkeser DC, Coe NB, Curtis JR. Potential Influence of Advance Care Planning and Palliative Care Consultation on ICU Costs for Patients With Chronic and Serious Illness. Crit Care Med. 2016;44(8):1474-81
  • 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
  • Bourdin G, Barbier J, Burle JF, et al. The feasibility of early physical activity in intensive care unit patients: a prospective observational one-center study. Respir Care. 2010;55:400-7
  • Hanekom S, Gosselink R, Dean E, et al. The development of a clinical management algorithm for early physical activity and mobilization of critically ill patients: synthesis of evidence and expert opinion and its translation into practice. Clin Rehabil. 2011;25:771-87
  • Pohlman MC, Schweickert WD, Pohlman AS, et al. Feasibility of physical and occupational therapy beginning from initiation of mechanical ventilation. Crit Care Med. 2010;38:2089-94
  • Kumar SP, Jim A. Physical therapy in palliative care: from symptom control to quality of life: a critical review. Indian J Palliat Care. 2010;16:138-46
  • Morris PE, Goad A, Thompson C, et al. Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Crit Care Med. 2008;36:2238-43
  • Kasotakis G, Schmidt U, Perry D, et al. The surgical intensive care unit optimal mobility score predicts mortality and length of stay. Crit Care Med. 2012 ;40:1122-8
  • Needham DM, Korupolu R. Rehabilitation quality improvement in an intensive care unit setting: implementation of a quality improvement model. Top Stroke Rehabil. 2010;17:271-81
  • Yoshioka H. Rehabilitation for the terminal cancer patient. Am J Phys Med Rehabil. 1994;73:199-206
  • Savcı S. Yoğun Bakım Ünitesinde Göğüs Fizyoterapisi. Yoğun Bakım Dergisi 2001; 1: 33-40
  • Stiller K, Philips A. Safety aspects of mobilising acutely ill patientes. Physioth Theory and Pract. 2003; 19: 239-57
  • Needham DM, Truong AD, Fan E. Technology to enhance physical rehabilitation of critically ill patients. Crit Care Med. 2009;37: 436-4184
  • Burtin C, Clerckx B, Robbeets C, et al. Early exercise in critically ill patients enhances short-term functional recovery. Crit Care Med. 2009;37:2499-505
  • Mahoney FI, Barthel DW. Functional Valuation: The Barthel Index. Md State Med J. 1965;14:61-5
  • Keith RA, Granger CV, Hamilton BB, Sherwin FS. The functional independence measure: a new tool for rehabilitation. Adv Clin Rehabil. 1987;1: 6-18
  • Katz S, Ford AB, Moskowitz RW, et al. Studies Of Illness in The Aged. The Index Of Adl: A Standardized Measure of Biological And Psychosocial Function. JAMA. 1963;(21):914-9
  • Sommers J, Engelbert RH, Dettling- Ihnenfeldt D, Gosselink R et al. Physiotherapy in the intensive care unit: an evidence- based, expert driven, practical statement and rehabilitation recommendations. Clin Rehabil 2015;29(11):1051-63
  • Kurtoğlu DK, Tastekin N, Birtane M, Tabakoğlu E, Sut N. Effectiveness of Neuromuscular Electrical Stimulation on Auxiliary Respiratory Muscles in Patients with Chronic Obstructive Pulmonary Disease Treated in the Intensive Care Unit. Turk J Phys Med Rehab 2015;61:12-7
  • Ciesla ND. Chest physical therapy for patients in the intensive care unit. Phys Ther 1996;76: 609-25
  • Polat MG. Yoğun Bakımda Fizyoterapi Uygulamaları. Yoğun Bakım Dergisi 2007; 7: 357-61
  • Martin AD, Smith BK, Davenport PD, et al. Inspiratory muscle strength training improves weaning outcome in failure to wean patients: a randomized trial. Crit Care. 2011;15:R84
  • Cader SA, Vale RG, Castro JC, et al. Inspiratory muscle training improves maximal inspiratory pressure and may assist weaning in older intubated patients: a randomised trial. J Physiother. 2010;56:171-7
  • Mularski RA, Puntillo K, Varkey B, et al. Pain Management Within the Palliative and End-of-Life Care Experience in the ICU. Chest 2009; 135:1360–9
  • Gelinas C. Management of pain in cardiac surgery ICU patients: have we improved over time? Intensive Crit Care Nurs. 2007; 23: 298–303
  • Lorenz KA, Lynn J, Dy SM, Shugarman L, et al. Evidence for Improving Palliative Care at the End of Life: A Systematic Review. Annals of Internal Medicine; 2008;148:147-159
  • Charlton JE (ed): Core Curriculum for Professional Education in Pain. Seattle, WA: IASP Press, 2005

Year 2017, Volume: 18 Issue: 2, 78 - 84, 17.04.2017

Sibel Eyigör Hilal Yeşil

https://doi.org/10.18229/kocatepetip.344628

Abstract

References

  • REFERENCES
  • Hartjes TM. Making the Case for Palliative Care in Critical Care. Crit Care Nurs Clin North Am. 2015;27(3):289-95
  • Friedman DL, Hilden JM, Powaski K. Issues and challenges in palliative care for children with cancer. Curr Oncol Rep. 2004;6:431-37
  • Mularski RA, Puntillo K, Varkey B, et al. Pain management within the palliative and end-of-life care experience in the ICU. Chest. 2009; 135:1360-69
  • Nelson JE, Azoulay E, Curtis JR, et al. Palliative care in the ICU. J Palliat Med. 2012;15: 168-74
  • Selecky PA, Eliasson CA, Hall RI, et al. Palliative and end-of-life care for patients with cardiopulmonary diseases: American College of Chest Physicians position statement. American College of Chest Physicians. Chest. 2005;128:3599-610
  • Truog RD, Campbell ML, Curtis JR, et al. Recommendations for end-of-life care in the intensive care unit: a consensus statement by the American College [corrected] of Critical Care Medicine. Crit Care Med. 2008;36: 953-63
  • Puntillo K, Nelson JE, Weissman D, et al. Palliative care in the ICU: relief of pain, dyspnea, and thirst--a report from the IPAL-ICU Advisory Board. Intensive Care Med. 2014;40: 235-48
  • Clarke EB, Curtis JR, Luce JM, et al. Robert Wood Johnson Foundation Critical Care End-Of-Life Peer Workgroup Members. Quality indicators for end-of-life care in the intensive care unit. Crit Care Med. 2003;31: 2255-62
  • Lau BD, Aslakson RA, Wilson RF, et al. Methods for improving the quality of palliative care delivery: a systematic review. Am J Hosp Palliat Care. 2014 ;31:202-10
  • Nelson JE, Curtis JR, Mulkerin C, et al. Choosing and using screening criteria for palliative care consultation in the ICU: a report from the Improving Palliative Care in the ICU (IPAL-ICU) Advisory Board. Crit Care Med. 2013;41: 2318-27
  • Braiteh F, El Osta B, Palmer JL, et al. Characteristics, findings, and outcomes of palliative care inpatient consultations at a comprehensive cancer center . J Palliat Med. 2007;10: 948-55.
  • Center to Advance Palliative Care . www.capc.org. Access date: 22.04.2017
  • Eyigor S. Fifth-Year Medical Students’ Knowledge of Palliative Care and Their Views on the Subject. Journal of Palliative Medicine. 2013; 16: 941-4683
  • Stiller K. Physiotherapy in intensive care: Towards an evidence-based practice. Chest 2000;118: 1801-13
  • Denehy L, Berney S. Physiotherapy in intensive care unit. Physical Therapy Reviews 2006;11: 49-56
  • Marciniak CM, Sliwa JA, Spill G, et al. Functional outcome following rehabilitation of the cancer patient. Arch Phys Med Rehabil. 1996;77: 54-57
  • Sabers SR, Kokal JE, Girardi JC, et al. Evaluation of consultation-based rehabilitation for hospitalized cancer patients with functional impairment Mayo Clin Proc. 1999;74:855-61
  • Cole RP, Scialla SJ, Bednarz L. Functional recovery in cancer rehabilitation. Arch Phys Med Rehabil. 2000 ; 81:623-7
  • Montagnini M, Lodhi M, Born W. The utilization of physical therapy in a palliative care unit. J Palliat Med. 2003;6:11–17
  • Yurdalan SU. Yoğun Bakım Ünitelerinde Güncel Fizyoterapi Yaklaşımları MÜSBED 2011;1: 196-201
  • Kasven-Gonzalez N, Souverain R, Miale S. Improving quality of life through rehabilitation in palliative care: case report. Palliat Support Care. 2010;8:359-369
  • Frost M. The role of physical, occupational, and speech therapy in hospice: patient empowerment. Am J Hosp Palliat Care. 2001;18:397-402
  • Javier NS, Montagnini ML. Rehabilitation of the hospice and palliative care patient. J Palliat Med. 2011;14:638-48
  • Byrnes MC, Schuerer DJ, Schallom ME, et al. Implementation of a mandatory checklist of protocols and objectives improves compliance with a wide range of evidence-based intensive care unit practices. Crit Care Med. 2009;37:2775-81
  • Gosselink R, Needham D, Hermans G. ICU-based rehabilitation and its appropriate metrics. Curr Opin Crit Care. 2012;18:533-9
  • Zanni JM, Korupolu R, Fan E, et al. Rehabilitation therapy and outcomes in acute respiratory failure: an observational pilot project. J Crit Care. 2010 Jun;25:254-62
  • Needham DM, Wang W, Desai SV et al. Intensive care unit exposures for long-term outcomes research: development and description of exposures for 150 patients with acute lung injury. J Crit Care. 2007;22:275-84
  • Winkelman C, Higgins PA, Chen YJ. Activity in the chronically critically ill. Dimens Crit Care Nurs. 2005;24:281-90
  • Kanach FA, Brown LM, Campbell RR. The role of rehabilitation in palliative care services. Am J Phys Med Rehabil. 2014;93:342-5
  • Dahlin Y, Heiwe S. Patients’ experiences of physical therapy within palliative cancer care. J Palliat Care. 2009;25:12-20
  • Lowe SS, Watanabe SM, Courneya KS. Physical activity as a supportive care intervention in palliative cancer patients: a systematic review. J Support Oncol. 2009;7:27-34
  • Reticker AL, Nici L, ZuWallack R. Pulmonary rehabilitation and palliative care in COPD: Two sides of the same coin?.Chron Respir Dis. 2012;9:107-16
  • Khandelwal N, Benkeser DC, Coe NB, Curtis JR. Potential Influence of Advance Care Planning and Palliative Care Consultation on ICU Costs for Patients With Chronic and Serious Illness. Crit Care Med. 2016;44(8):1474-81
  • 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
  • Bourdin G, Barbier J, Burle JF, et al. The feasibility of early physical activity in intensive care unit patients: a prospective observational one-center study. Respir Care. 2010;55:400-7
  • Hanekom S, Gosselink R, Dean E, et al. The development of a clinical management algorithm for early physical activity and mobilization of critically ill patients: synthesis of evidence and expert opinion and its translation into practice. Clin Rehabil. 2011;25:771-87
  • Pohlman MC, Schweickert WD, Pohlman AS, et al. Feasibility of physical and occupational therapy beginning from initiation of mechanical ventilation. Crit Care Med. 2010;38:2089-94
  • Kumar SP, Jim A. Physical therapy in palliative care: from symptom control to quality of life: a critical review. Indian J Palliat Care. 2010;16:138-46
  • Morris PE, Goad A, Thompson C, et al. Early intensive care unit mobility therapy in the treatment of acute respiratory failure. Crit Care Med. 2008;36:2238-43
  • Kasotakis G, Schmidt U, Perry D, et al. The surgical intensive care unit optimal mobility score predicts mortality and length of stay. Crit Care Med. 2012 ;40:1122-8
  • Needham DM, Korupolu R. Rehabilitation quality improvement in an intensive care unit setting: implementation of a quality improvement model. Top Stroke Rehabil. 2010;17:271-81
  • Yoshioka H. Rehabilitation for the terminal cancer patient. Am J Phys Med Rehabil. 1994;73:199-206
  • Savcı S. Yoğun Bakım Ünitesinde Göğüs Fizyoterapisi. Yoğun Bakım Dergisi 2001; 1: 33-40
  • Stiller K, Philips A. Safety aspects of mobilising acutely ill patientes. Physioth Theory and Pract. 2003; 19: 239-57
  • Needham DM, Truong AD, Fan E. Technology to enhance physical rehabilitation of critically ill patients. Crit Care Med. 2009;37: 436-4184
  • Burtin C, Clerckx B, Robbeets C, et al. Early exercise in critically ill patients enhances short-term functional recovery. Crit Care Med. 2009;37:2499-505
  • Mahoney FI, Barthel DW. Functional Valuation: The Barthel Index. Md State Med J. 1965;14:61-5
  • Keith RA, Granger CV, Hamilton BB, Sherwin FS. The functional independence measure: a new tool for rehabilitation. Adv Clin Rehabil. 1987;1: 6-18
  • Katz S, Ford AB, Moskowitz RW, et al. Studies Of Illness in The Aged. The Index Of Adl: A Standardized Measure of Biological And Psychosocial Function. JAMA. 1963;(21):914-9
  • Sommers J, Engelbert RH, Dettling- Ihnenfeldt D, Gosselink R et al. Physiotherapy in the intensive care unit: an evidence- based, expert driven, practical statement and rehabilitation recommendations. Clin Rehabil 2015;29(11):1051-63
  • Kurtoğlu DK, Tastekin N, Birtane M, Tabakoğlu E, Sut N. Effectiveness of Neuromuscular Electrical Stimulation on Auxiliary Respiratory Muscles in Patients with Chronic Obstructive Pulmonary Disease Treated in the Intensive Care Unit. Turk J Phys Med Rehab 2015;61:12-7
  • Ciesla ND. Chest physical therapy for patients in the intensive care unit. Phys Ther 1996;76: 609-25
  • Polat MG. Yoğun Bakımda Fizyoterapi Uygulamaları. Yoğun Bakım Dergisi 2007; 7: 357-61
  • Martin AD, Smith BK, Davenport PD, et al. Inspiratory muscle strength training improves weaning outcome in failure to wean patients: a randomized trial. Crit Care. 2011;15:R84
  • Cader SA, Vale RG, Castro JC, et al. Inspiratory muscle training improves maximal inspiratory pressure and may assist weaning in older intubated patients: a randomised trial. J Physiother. 2010;56:171-7
  • Mularski RA, Puntillo K, Varkey B, et al. Pain Management Within the Palliative and End-of-Life Care Experience in the ICU. Chest 2009; 135:1360–9
  • Gelinas C. Management of pain in cardiac surgery ICU patients: have we improved over time? Intensive Crit Care Nurs. 2007; 23: 298–303
  • Lorenz KA, Lynn J, Dy SM, Shugarman L, et al. Evidence for Improving Palliative Care at the End of Life: A Systematic Review. Annals of Internal Medicine; 2008;148:147-159
  • Charlton JE (ed): Core Curriculum for Professional Education in Pain. Seattle, WA: IASP Press, 2005
There are 60 citations in total.

Details

Subjects Health Care Administration
Journal Section Review
Authors

Sibel Eyigör This is me

Hilal Yeşil

Publication Date April 17, 2017
Acceptance Date March 13, 2017
Published in Issue Year 2017 Volume: 18 Issue: 2

Cite

APA Eyigör, S., & Yeşil, H. (2017). YOĞUN BAKIMDA PALYATİF BAKIMIN GEREKLİLİĞİ. Kocatepe Tıp Dergisi, 18(2), 78-84. https://doi.org/10.18229/kocatepetip.344628
AMA Eyigör S, Yeşil H. YOĞUN BAKIMDA PALYATİF BAKIMIN GEREKLİLİĞİ. KTD. April 2017;18(2):78-84. doi:10.18229/kocatepetip.344628
Chicago Eyigör, Sibel, and Hilal Yeşil. “YOĞUN BAKIMDA PALYATİF BAKIMIN GEREKLİLİĞİ”. Kocatepe Tıp Dergisi 18, no. 2 (April 2017): 78-84. https://doi.org/10.18229/kocatepetip.344628.
EndNote Eyigör S, Yeşil H (April 1, 2017) YOĞUN BAKIMDA PALYATİF BAKIMIN GEREKLİLİĞİ. Kocatepe Tıp Dergisi 18 2 78–84.
IEEE S. Eyigör and H. Yeşil, “YOĞUN BAKIMDA PALYATİF BAKIMIN GEREKLİLİĞİ”, KTD, vol. 18, no. 2, pp. 78–84, 2017, doi: 10.18229/kocatepetip.344628.
ISNAD Eyigör, Sibel - Yeşil, Hilal. “YOĞUN BAKIMDA PALYATİF BAKIMIN GEREKLİLİĞİ”. Kocatepe Tıp Dergisi 18/2 (April 2017), 78-84. https://doi.org/10.18229/kocatepetip.344628.
JAMA Eyigör S, Yeşil H. YOĞUN BAKIMDA PALYATİF BAKIMIN GEREKLİLİĞİ. KTD. 2017;18:78–84.
MLA Eyigör, Sibel and Hilal Yeşil. “YOĞUN BAKIMDA PALYATİF BAKIMIN GEREKLİLİĞİ”. Kocatepe Tıp Dergisi, vol. 18, no. 2, 2017, pp. 78-84, doi:10.18229/kocatepetip.344628.
Vancouver Eyigör S, Yeşil H. YOĞUN BAKIMDA PALYATİF BAKIMIN GEREKLİLİĞİ. KTD. 2017;18(2):78-84.

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