Research Article
BibTex RIS Cite

Sleep Quality, Body Awareness and Neck Disability Differences Between Patients with Nonspecific Mechanic Neck Pain and Healthy Individuals: A Cross-sectional Study

Year 2023, Volume: 8 Issue: 1, 30 - 40, 01.04.2023
https://doi.org/10.25279/sak.1108857

Abstract

Introduction: Non-specific mechanical neck pain (NMNP) may cause decrease of work quality, sleep disturbance, disability in adults. There is still a need for studies in the literature on sleep quality, body awareness and neck disability in adults with nonspecific mechanical neck pain.
Aim: The study aimed to compare sleep quality, body awareness, and neck disability in adults with and without NMNP. Adults with non-specific mechanical neck pain (n=89) and age-matched asymptomatic controls (n=90) were included in this cross-sectional study. Body awareness, sleep quality, and neck disability were assessed using online questionnaires. Sleep quality was assessed using the Pittsburgh Sleep Quality Index, body awareness was assessed using the Body Awareness Questionnaire, and neck disability was evaluated with the Neck Bournemouth Questionnaire.
Results: Overall, 179 adults (mean age: 24.14±22.42 years) were divided into two groups of those with and without nonspecific mechanic neck pain. Females comprised 70.2% (n=125) of the sample. Sleep quality was better and neck disability was lower in participants without NMNP (p<0.05).
Conclusion: NMNP affects sleep quality and neck disability but not body awareness in adults. Adults can be oriented to postural exercise programs and rehabilitation for better sleep quality and improving neck disability.

References

  • Ağargün, M., Kara, H., Anlar, O. (1996). Pittsburgh uyku kalitesi indeksinin geçerliği ve güvenirliği. Journal of Turkish Psychiatry, 7 (2), 107-115.
  • Alfawaz, S., Lohman, E., Alameri, M., Daher, N., Jaber, H.,et al. (2020). Effect of adding stretching to standardized procedures on cervical range of motion, pain, and disability in patients with non-specific mechanical neck pain: A randomized clinical trial. Journal of Bodywork Movement Therapy, 24(3),50-58. https://doi.org/10.1016/j.jbmt.2020.02.020.
  • Asliyüce, Y.Ö., Gökmen, D., Ülger, Ö. (2019). Rasch analysis of the Neck Bournemouth Questionnaire: Turkish version, validity, and reliability study. Turkish Journal of Medical Science, 49 (6), 1760-1765. doi:10.3906/sag-1907-3.
  • Aydın, L.Z., Yiğitalp, G. (2021). The effect of reflexology on sleep quality and fatigue in postmenopausal women: A randomized control trial. European Journal of Integrative Medicine, 43: 101281. https://doi.org/10.1016/j.eujim.2020.101281.
  • Baskan, E., Yagci, N., Cavlak, U. (2021). Factors affecting body awareness in older adults with chronic musculoskeletal pain. Archives of Medical Science, 17 (4), 934-939. doi: 10.5114/aoms.2019.86614.
  • Bolton, J.E., Humphreys, B.K. (2002). The Bournemouth Questionnaire: a short-form outcome measure. II. Psychometric properties in neck pain patients. Journal of Manipulative and Physiological Therapeutics, 25 (3), 141-148. doi: 10.1067/ mmt.2002.123333
  • Brown, F. C., Buboltz Jr, W. C., Soper, B. (2002). Relationship of sleep hygiene awareness, sleep hygiene practices, and sleep quality in university students. Behavioral medicine, 28(1), 33-38. DOI: 10.1080/08964280209596396.
  • Buysse, D.J., Reynolds III, C. F., Monk, T. H., Berman, S. R., Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and Research. Psychiatry Research, 28 (2),193-213. https://doi.org/10.1016/0165-1781(89)90047-4.
  • Cheng, S. H., Shih, C. C., Lee, I. H., Hou, Y. W., Chen, K. C., Chen, K. T., Yang, K. Y., Yang, Y. C. (2012). A study on the sleep quality of incoming university students. Psychiatry Research, 197(3), 270-274. https://doi.org/10.1016/j.psychres.2011.08.011.
  • Celenay, S.T., Akbayrak, T., Kaya, D.O. (2016). A comparison of the effects of stabilization exercises plus manual therapy to those of stabilization exercises alone in patients with nonspecific mechanical neck pain: a randomized clinical trial. Journal of Orthopaedic Sports Physical Therapy, 46 (2):44-55. https://www.jospt.org/doi/10.2519/jospt.2016.5979.
  • Celenay, S.T., Mete, O., Sari, A., Kaya, D. O. (2021). Comparison of kinesio taping and classical massage in addition to cervical stabilization exercise in patients with chronic neck pain. Complementary Therapy in Clinical Practice, 43: 101381. https://doi.org/10.1016/j.ctcp.2021.101381.
  • Choudhary, S., Hussain, M. E., Moscovitch, A., Pandi-Perumal, S. R., Bahammam,A. S. (2021).Multimodal Physiotherapy Improves Pain, Functional Disability, Sleep Quality and Health Related Quality of Life in Chronic Mechanical Neck Pain Patients. International Journal of Health Science Research. 8 (3):138-148. Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates. ( p. 20-26) Hillsdale, New Jersey.
  • De Campos, T. F., Maher, C. G., Steffens, D., Fuller, J. T., Hancock, M. J. (2018). Exercise programs may be effective in preventing a new episode of neck pain: a systematic review and meta-analysis. Journal of Physiotherapy, 64(3),159-165. https://doi.org/10.1016/j.jphys.2018.05.003.
  • Erden, A., Altuğ, F., Cavlak, U. (2013). Sağlıklı kişilerde vücut farkındalık durumu ile ağrı, emosyonel durum ve yaşam kalitesi arasındaki ilişkinin incelenmesi. Kartal Eğitim ve Araştırma Hastanesi Tıp Dergisi, 24 (3),145-150. doi: 10.5505/jkartaltr.2013.20438.
  • Fatima, Y., Doi, S. A., Najman, J. M., Al Mamun, A. (2016). Exploring gender difference in sleep quality of young adults: findings from a large population study. Clinical medical research, 14(3-4), 138-144. doi:10.3121/cmr.2016.1338.
  • Faul, F., Erdfelder, E., Lang, G., Buchner, A. (2008). G* Power 3 (Version 3.0. 10) [Statistical analysis software]. Düsseldorf, Germany: Institut fur Experimentelle Psychologie.
  • Juan, W., L. Rui, Z. Wei-Wen. (2020). Chronic neck pain and depression: the mediating role of sleep quality and exercise. Psychiatrty, Health and Medicine. 25(8),1029-1035. https://doi.org/10.1080/13548506.2020.1724308.
  • Karaca, S., Bayar B. (2017). Turkish version of Body Awareness Questionnaire: Validity and reliability study. Journal of Turk Physiotherapy and Rehabilitation, 32 (1), 44-50. doi: 10.21653/tjpr.660186.
  • Landry, G.J., Best, J.R., Liu-Ambrose T. (2015). Measuring sleep quality in older adults: a comparison using subjective and objective methods. Frontiers Aging Neuroscience, 7(166),1-10. https://doi.org/10.3389/fnagi.2015.00166.
  • Lauche, R., Cramer, H., Hohmann, C., Choi, K. E., Rampp, T., Saha, F. J, Musial, F., Langhorst J., Dobos, G. (2012). The effect of traditional cupping on pain and mechanical thresholds in patients with chronic nonspecific neck pain: a randomised controlled pilot study. Evidence-Based Complementary Alternative Medicine, 2012,1-10. https://doi.org/10.1155/2012/429718.
  • Lauche, R., Wayne, P. M., Fehr, J., Stumpe, C., Dobos, G., Cramer, H. (2017). Does postural awareness contribute to exercise-induced improvements in neck pain intensity? A secondary analysis of a randomized controlled trial evaluating Tai Chi and neck exercises. Spine, 42 (16), 1195-1200. doi: 10.1097/BRS.0000000000002078.
  • Lohman, E., Pacheco, G.R., Gharibvand, L., Daher, N., Devore, K., Bains, G., AlAmeri, M., Berk, L. S. (2019). The immediate effects of cervical spine manipulation on pain and biochemical markers in females with acute non-specific mechanical neck pain: a randomized clinical trial. Journal of Manual and Manipulative Therapy, 27(4),186-196. https://doi.org/10.1080/10669817.2018.1553696.
  • Martin-Gomez, C., Sestelo-Diaz, R., Carrillo-Sanjuan, V., Navarro-Santana, M. J., Bardon-Romero, J., Plaza-Manzano, G. (2019). Motor control using cranio-cervical flexion exercises versus other treatments for non-specific chronic neck pain: A systematic review and meta-analysis. Musculoskeleteal Science and Practice, 42, 52-59. https://doi.org/10.1016/j.msksp.2019.04.010.
  • Muñoz-Muñoz, S., Muñoz-García, M. T., Alburquerque-Sendín, F., Arroyo-Morales, M., Fernández-de-las-Peñas, C. (2012). Myofascial trigger points, pain, disability, and sleep quality in individuals with mechanical neck pain. Journal of Manipulative and Physiological Therapy, 35(8), 608-613. https://doi.org/10.1016/j.jmpt.2012.09.003.
  • Pinto, J., van Zeller, M., Amorim, P., Pimentel, A., Dantas, P., Eusébio, E., Neves, A., Pipa, J., Clara, E. S., Santiago, T., Viana, P., Drummond, M. (2020). Sleep quality in times of Covid-19 pandemic. Sleep Medicine, 74,81-85. https://doi.org/10.1016/j.sleep.2020.07.012.
  • Sella, E., Carbone, E., Toffalini, E., Borella, E. (2021). Self-reported sleep quality and dysfunctional sleep-related beliefs in young and older adults: changes in times of COVID-19 lockdown. Sleep Medicine, 81, 127-135. https://doi.org/10.1016/j.sleep.2021.02.017.
  • Sertel, M., Şimşek, T., Yümin, E. (2021). The Effect of Body Awareness Therapy on Pain, Fatigue and Health-related Quality of Life in Female Patients with Tension-type Headaches and Migraine. West Indian Medical Journal, 69 (2),121-128. DOI: 10.7727/wimj.2015.304.
  • Shields, S.A., Mallory, M.E., Simon, A. (1989). The Body Awareness Questionnaire: reliability and validity. Journal of Personality Assessment, 53(4),802-815.
  • Ünlüer, N., Ateş, Y. (2021). An investigation of neck pain in older adults, and its relation with shoulder position sense and upper extremity function. Somatosensory and Motor Research, 38(4), 333-338. https://doi.org/10.1080/08990220.2021.1977266
  • Wunsch, K., Kasten, N., Fuchs, R. (2017). The effect of physical activity on sleep quality, well-being, and affect in academic stress periods. Nature Science Sleep, 9, 117-123. doi: 10.2147/NSS.S132078.
  • Wand, B.M., Parkitny, L., O’Connell, N. E., Luomajoki, H., McAuley, J. H., Thacker, M., Moseley, M. G. (2011). Cortical changes in chronic low back pain: current state of the art and implications for clinical practice. Manual Therapy, 16(1),15-20. https://doi.org/10.1016/j.math.2010.06.008.
  • Zhang, S., Yang, Y., Gu, M., Mao, S., Zhou, W.S. (2022). Effects of Low Back Pain Exercises on Pain Symptoms and Activities of Daily Living: A Systematic Review and Meta-Analysis. Perceptual and Motor Skills,129(1),63-89. doi:10.1177/00315125211059407.

Spesifik Olmayan Mekanik Boyun Ağrısı Olan Yetişkinler ve Sağlıklılarda Uyku Kalitesi, Vücut Farkındalık ve Boyun Özrünün Farkları: Kesitsel Bir Çalışma

Year 2023, Volume: 8 Issue: 1, 30 - 40, 01.04.2023
https://doi.org/10.25279/sak.1108857

Abstract

Giriş: Spesifik olmayan mekanik boyun ağrısı, yetişkinlerde iş kalitesinde azalma, uyku bozukluğu, özre neden olabilir. Spesifik olmayan mekanik boyun ağrısı olan erişkinlerde uyku kalitesi, beden farkındalığı ve boyun özürlülüğü ile ilgili literatürde halen çalışmalara ihtiyaç vardır.
Amaç: Bu çalışmada, spesifik olmayan mekanik boyun ağrısı ve boyun ağrısı olmayan yetişkinlerde uyku kalitesi, vücut farkındalığı ve boyun özrünü karşılaştırmayı amaçlandı.
Gereç ve Yöntemler: Spesifik olmayan mekanik boyun ağrısı olan yetişkinler (n=89) ve aynı yaştaki asemptomatik kontroller (n=90) bu kesitsel çalışmaya dahil edildi. Vücut farkındalığı, uyku kalitesi ve boyun özür durumu çevrimiçi anketler kullanılarak değerlendirildi. Uyku kalitesi Pittsburgh Uyku Kalitesi İndeksi ile, beden farkındalığı Beden Farkındalığı Anketi ile ve boyun özrü Boyun Bournemouth Anketi ile değerlendirildi.
Bulgular: Genel olarak, 179 yetişkin (ortalama yaş: 24.14±22.42 yıl) spesifik boyun ağrısı olanlar ve olmayanlar olarak iki gruba ayrıldı. Örneklemin %70.2'sini (n=125) kadınlar oluşturmuştur. Kontrollerde spesifik olmayan mekanik boyun ağrısı olanlara kıyasla uyku kalitesi daha iyi ve boyun özürlülüğü daha düşüktü (p<0.05).
Sonuç ve Öneriler: Spesifik olmayan mekanik boyun ağrısı olan yetişkinlerde uyku kalitesini ve boyun özrünü etkilediği ancak vücut farkındalığını etkilemediği görülmüştür. Yetişkinler, daha iyi uyku kalitesi ve boyun özrünü iyileştirmek için postural egzersiz programlarına ve rehabilitasyona yönlendirilebilir.

References

  • Ağargün, M., Kara, H., Anlar, O. (1996). Pittsburgh uyku kalitesi indeksinin geçerliği ve güvenirliği. Journal of Turkish Psychiatry, 7 (2), 107-115.
  • Alfawaz, S., Lohman, E., Alameri, M., Daher, N., Jaber, H.,et al. (2020). Effect of adding stretching to standardized procedures on cervical range of motion, pain, and disability in patients with non-specific mechanical neck pain: A randomized clinical trial. Journal of Bodywork Movement Therapy, 24(3),50-58. https://doi.org/10.1016/j.jbmt.2020.02.020.
  • Asliyüce, Y.Ö., Gökmen, D., Ülger, Ö. (2019). Rasch analysis of the Neck Bournemouth Questionnaire: Turkish version, validity, and reliability study. Turkish Journal of Medical Science, 49 (6), 1760-1765. doi:10.3906/sag-1907-3.
  • Aydın, L.Z., Yiğitalp, G. (2021). The effect of reflexology on sleep quality and fatigue in postmenopausal women: A randomized control trial. European Journal of Integrative Medicine, 43: 101281. https://doi.org/10.1016/j.eujim.2020.101281.
  • Baskan, E., Yagci, N., Cavlak, U. (2021). Factors affecting body awareness in older adults with chronic musculoskeletal pain. Archives of Medical Science, 17 (4), 934-939. doi: 10.5114/aoms.2019.86614.
  • Bolton, J.E., Humphreys, B.K. (2002). The Bournemouth Questionnaire: a short-form outcome measure. II. Psychometric properties in neck pain patients. Journal of Manipulative and Physiological Therapeutics, 25 (3), 141-148. doi: 10.1067/ mmt.2002.123333
  • Brown, F. C., Buboltz Jr, W. C., Soper, B. (2002). Relationship of sleep hygiene awareness, sleep hygiene practices, and sleep quality in university students. Behavioral medicine, 28(1), 33-38. DOI: 10.1080/08964280209596396.
  • Buysse, D.J., Reynolds III, C. F., Monk, T. H., Berman, S. R., Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and Research. Psychiatry Research, 28 (2),193-213. https://doi.org/10.1016/0165-1781(89)90047-4.
  • Cheng, S. H., Shih, C. C., Lee, I. H., Hou, Y. W., Chen, K. C., Chen, K. T., Yang, K. Y., Yang, Y. C. (2012). A study on the sleep quality of incoming university students. Psychiatry Research, 197(3), 270-274. https://doi.org/10.1016/j.psychres.2011.08.011.
  • Celenay, S.T., Akbayrak, T., Kaya, D.O. (2016). A comparison of the effects of stabilization exercises plus manual therapy to those of stabilization exercises alone in patients with nonspecific mechanical neck pain: a randomized clinical trial. Journal of Orthopaedic Sports Physical Therapy, 46 (2):44-55. https://www.jospt.org/doi/10.2519/jospt.2016.5979.
  • Celenay, S.T., Mete, O., Sari, A., Kaya, D. O. (2021). Comparison of kinesio taping and classical massage in addition to cervical stabilization exercise in patients with chronic neck pain. Complementary Therapy in Clinical Practice, 43: 101381. https://doi.org/10.1016/j.ctcp.2021.101381.
  • Choudhary, S., Hussain, M. E., Moscovitch, A., Pandi-Perumal, S. R., Bahammam,A. S. (2021).Multimodal Physiotherapy Improves Pain, Functional Disability, Sleep Quality and Health Related Quality of Life in Chronic Mechanical Neck Pain Patients. International Journal of Health Science Research. 8 (3):138-148. Cohen, J. (1988). Statistical power analysis for the behavioral sciences. Lawrence Erlbaum Associates. ( p. 20-26) Hillsdale, New Jersey.
  • De Campos, T. F., Maher, C. G., Steffens, D., Fuller, J. T., Hancock, M. J. (2018). Exercise programs may be effective in preventing a new episode of neck pain: a systematic review and meta-analysis. Journal of Physiotherapy, 64(3),159-165. https://doi.org/10.1016/j.jphys.2018.05.003.
  • Erden, A., Altuğ, F., Cavlak, U. (2013). Sağlıklı kişilerde vücut farkındalık durumu ile ağrı, emosyonel durum ve yaşam kalitesi arasındaki ilişkinin incelenmesi. Kartal Eğitim ve Araştırma Hastanesi Tıp Dergisi, 24 (3),145-150. doi: 10.5505/jkartaltr.2013.20438.
  • Fatima, Y., Doi, S. A., Najman, J. M., Al Mamun, A. (2016). Exploring gender difference in sleep quality of young adults: findings from a large population study. Clinical medical research, 14(3-4), 138-144. doi:10.3121/cmr.2016.1338.
  • Faul, F., Erdfelder, E., Lang, G., Buchner, A. (2008). G* Power 3 (Version 3.0. 10) [Statistical analysis software]. Düsseldorf, Germany: Institut fur Experimentelle Psychologie.
  • Juan, W., L. Rui, Z. Wei-Wen. (2020). Chronic neck pain and depression: the mediating role of sleep quality and exercise. Psychiatrty, Health and Medicine. 25(8),1029-1035. https://doi.org/10.1080/13548506.2020.1724308.
  • Karaca, S., Bayar B. (2017). Turkish version of Body Awareness Questionnaire: Validity and reliability study. Journal of Turk Physiotherapy and Rehabilitation, 32 (1), 44-50. doi: 10.21653/tjpr.660186.
  • Landry, G.J., Best, J.R., Liu-Ambrose T. (2015). Measuring sleep quality in older adults: a comparison using subjective and objective methods. Frontiers Aging Neuroscience, 7(166),1-10. https://doi.org/10.3389/fnagi.2015.00166.
  • Lauche, R., Cramer, H., Hohmann, C., Choi, K. E., Rampp, T., Saha, F. J, Musial, F., Langhorst J., Dobos, G. (2012). The effect of traditional cupping on pain and mechanical thresholds in patients with chronic nonspecific neck pain: a randomised controlled pilot study. Evidence-Based Complementary Alternative Medicine, 2012,1-10. https://doi.org/10.1155/2012/429718.
  • Lauche, R., Wayne, P. M., Fehr, J., Stumpe, C., Dobos, G., Cramer, H. (2017). Does postural awareness contribute to exercise-induced improvements in neck pain intensity? A secondary analysis of a randomized controlled trial evaluating Tai Chi and neck exercises. Spine, 42 (16), 1195-1200. doi: 10.1097/BRS.0000000000002078.
  • Lohman, E., Pacheco, G.R., Gharibvand, L., Daher, N., Devore, K., Bains, G., AlAmeri, M., Berk, L. S. (2019). The immediate effects of cervical spine manipulation on pain and biochemical markers in females with acute non-specific mechanical neck pain: a randomized clinical trial. Journal of Manual and Manipulative Therapy, 27(4),186-196. https://doi.org/10.1080/10669817.2018.1553696.
  • Martin-Gomez, C., Sestelo-Diaz, R., Carrillo-Sanjuan, V., Navarro-Santana, M. J., Bardon-Romero, J., Plaza-Manzano, G. (2019). Motor control using cranio-cervical flexion exercises versus other treatments for non-specific chronic neck pain: A systematic review and meta-analysis. Musculoskeleteal Science and Practice, 42, 52-59. https://doi.org/10.1016/j.msksp.2019.04.010.
  • Muñoz-Muñoz, S., Muñoz-García, M. T., Alburquerque-Sendín, F., Arroyo-Morales, M., Fernández-de-las-Peñas, C. (2012). Myofascial trigger points, pain, disability, and sleep quality in individuals with mechanical neck pain. Journal of Manipulative and Physiological Therapy, 35(8), 608-613. https://doi.org/10.1016/j.jmpt.2012.09.003.
  • Pinto, J., van Zeller, M., Amorim, P., Pimentel, A., Dantas, P., Eusébio, E., Neves, A., Pipa, J., Clara, E. S., Santiago, T., Viana, P., Drummond, M. (2020). Sleep quality in times of Covid-19 pandemic. Sleep Medicine, 74,81-85. https://doi.org/10.1016/j.sleep.2020.07.012.
  • Sella, E., Carbone, E., Toffalini, E., Borella, E. (2021). Self-reported sleep quality and dysfunctional sleep-related beliefs in young and older adults: changes in times of COVID-19 lockdown. Sleep Medicine, 81, 127-135. https://doi.org/10.1016/j.sleep.2021.02.017.
  • Sertel, M., Şimşek, T., Yümin, E. (2021). The Effect of Body Awareness Therapy on Pain, Fatigue and Health-related Quality of Life in Female Patients with Tension-type Headaches and Migraine. West Indian Medical Journal, 69 (2),121-128. DOI: 10.7727/wimj.2015.304.
  • Shields, S.A., Mallory, M.E., Simon, A. (1989). The Body Awareness Questionnaire: reliability and validity. Journal of Personality Assessment, 53(4),802-815.
  • Ünlüer, N., Ateş, Y. (2021). An investigation of neck pain in older adults, and its relation with shoulder position sense and upper extremity function. Somatosensory and Motor Research, 38(4), 333-338. https://doi.org/10.1080/08990220.2021.1977266
  • Wunsch, K., Kasten, N., Fuchs, R. (2017). The effect of physical activity on sleep quality, well-being, and affect in academic stress periods. Nature Science Sleep, 9, 117-123. doi: 10.2147/NSS.S132078.
  • Wand, B.M., Parkitny, L., O’Connell, N. E., Luomajoki, H., McAuley, J. H., Thacker, M., Moseley, M. G. (2011). Cortical changes in chronic low back pain: current state of the art and implications for clinical practice. Manual Therapy, 16(1),15-20. https://doi.org/10.1016/j.math.2010.06.008.
  • Zhang, S., Yang, Y., Gu, M., Mao, S., Zhou, W.S. (2022). Effects of Low Back Pain Exercises on Pain Symptoms and Activities of Daily Living: A Systematic Review and Meta-Analysis. Perceptual and Motor Skills,129(1),63-89. doi:10.1177/00315125211059407.
There are 32 citations in total.

Details

Primary Language English
Subjects Rehabilitation
Journal Section Original research articles
Authors

Tezel Yıldırım Şahan 0000-0002-4004-3713

Duygu Türker 0000-0003-2470-5737

Senem Demirdel 0000-0001-7395-8859

Publication Date April 1, 2023
Submission Date April 25, 2022
Acceptance Date October 28, 2022
Published in Issue Year 2023 Volume: 8 Issue: 1

Cite

APA Yıldırım Şahan, T., Türker, D., & Demirdel, S. (2023). Sleep Quality, Body Awareness and Neck Disability Differences Between Patients with Nonspecific Mechanic Neck Pain and Healthy Individuals: A Cross-sectional Study. Health Academy Kastamonu, 8(1), 30-40. https://doi.org/10.25279/sak.1108857

Health Academy Kastamonu is included in the class of 1-b journals (journals scanned in international indexes other than SCI, SSCI, SCI-expanded, ESCI) according to UAK associate professorship criteria. HEALTH ACADEMY KASTAMONU Journal cover is registered by the Turkish Patent Institute.