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YENİDEN DÜZENLENMİŞ KİSTİK FİBROZİS ANKETİNİN İŞLEVSELLİK YETİYİTİMİ VE SAĞLIĞIN ULUSLARARASI SINIFLANDIRMASI KAPSAMINDA İLİŞKİLENDİRME SÜRECİ

Year 2024, Volume: 35 Issue: 2, 214 - 223, 27.08.2024

Nisa Akyazı , Seda Nur Kemer , Tuğba Dere , İzel Demirhan , Birol Önal , Sevil Bilgin

https://doi.org/10.21653/tjpr.1367384

Abstract

Amaç: Sağlık sonuç ölçümleri, “ilişkilendirme kuralları” olarak adlandırılan bir yöntem kullanılarak standart bir şekilde İşlevsellik, Yetiyitimi ve Sağlığın Uluslararası Sınıflandırması (ICF) ile ilişkilendirilmektedir. Bu çalışmanın amacı kistik fibroziste yaşam kalitesini değerlendirme amacı ile en sık kullanılan anket olan Yeniden Düzenlenmiş Kistik Fibrozis Anketi’nin (CFQ-R) çocuk (CFQ-R6-11, CFQ-R12-13), adölesan/erişkin (CFQ-R14+) ve ebeveyn (CFQ-Rebeveyn) formlarının ICF kapsamında ilişkilendirilmesidir.
Yöntem: CFQ-R çocuk (6-11 yaş ve 12-13 yaş), adölesan/erişkin (14+) ve ebeveyn formlarının her bir maddesi üç bağımsız araştırmacı tarafından Cieze’nin kurallarına göre ICF ile ilişkilendirildi. Araştırmacıların anlaşma derecesi kappa katsayısı kullanılarak hesaplandı.
Sonuçlar: CFQ-R ebeveyn formunun vücut işlevlerini %46 (n=26), etkinlikler ve katılımı %34 (n=19) ve çevresel faktörleri %11 (n=6) oranında içerdiği bulundu. CFQ-R6-11 formunun vücut işlevlerini %40 (n=19), etkinlikler ve katılımı %34 (n=16) ve çevresel faktörleri %19 (n=9) oranında içerdiği bulundu. CFQ-R 12-13 formunun vücut işlevlerini %40 (n=19), etkinlikler ve katılımı %34 (n=16) ve çevresel faktörleri %19 (n=9) oranında içerdiği bulundu. CFQ-R14+ formunun vücut işlevlerini %43 (n=29), etkinlikler ve katılımı %37 (n=25) ve çevresel faktörleri %7 (n=5) oranında içerdiği bulundu. Anketlerde CFQ-R ebeveyn için %9 (n=5), CFQ-R6-11 için %6 (n=3), CFQ-R 12-13 için %6 (n=3) ve CFQ-R14+ için %12 (n=8) oranında madde ICF kapsamında tanımlanamadı.
Tartışma: CFQ-R çocuk, adölesan/yetişkin ve ebeveyn formlarında vücut işlevleri, ICF ile en çok ilişkili kategoridir. Çevresel faktörler anketler kapsamında yetersiz bir şekilde tanımlanmaktadır. Bu içerik karşılaştırması her bir anketin içeriğini ve doğasını göstererek kişinin fonksiyonelliğinin kapsamı hakkında bilgi edinmeyi sağlar. Ayrıca, KF’yi bütüncül değerlendirmek için çevresel faktörlerin değerlendirildiği ölçütlere ihtiyaç olduğu söylenebilir.

Keywords

ICF İlişkilendirme Kuralları Kistik Fibrozis Yaşam Kalitesi

References

  • Gee L, Abbott J, Conway SP, Etherington C, Webb AK. Quality of life in cystic fibrosis: the impact of gender, general health perceptions and disease severity. J Cyst Fibros. 2003;2(4):206-13.
  • McLeod C, Wood J, Tong A, Schultz A, Norman R, Smith S, et al. The measurement properties of tests and tools used in cystic fibrosis studies: a systematic review. Eur Respir Rev. 2021;30(160).
  • Modaresi M, Roshanzamir Z, Shirzadi R. The Correlation of Health-Related Quality of Life with Cystic Fibrosis Severity Markers in Chest CT Scan and 6-Minute Walk Test: A Cross-Sectional Study. Indian J Pediatr. 2022;89(2):113-7.
  • Kabakçı E aGA. International classification of functioning, disability and health işlevsellik, yetiyitimi ve sağliğin uluslararasi siniflandırması. Ankara:Başbakanlık Özürlüler İdaresi Başkanlığı 12 May 2021.
  • Cieza A, Brockow T, Ewert T, Amman E, Kollerits B, Chatterji S, et al. Linking health-status measurements to the international classification of functioning, disability and health. J Rehabil Med. 2002;34(5):205-10.
  • Povlak S, Valdes K. Linking ICF components to outcome measures for hand osteoarthritis and rheumatoid arthritis: A systematic review. J Hand Ther. 2020;33(4):484-92.
  • Pereira GS, Corrêa FI, Elord Júlio C, Thonnard JL, Kossi O, Bouffioulx E, et al. Linking of concepts measured by SATIS-Stroke and the PM-Scale to the international classification of functioning, disability and health. Physiother Theory Pract. 2022;38(13):3055-71.
  • Tschiesner U, Rogers SN, Harréus U, Berghaus A, Cieza A. Content comparison of quality of life questionnaires used in head and neck cancer based on the international classification of functioning, disability and health: a systematic review. Eur Arch Otorhinolaryngol. 2008;265(6):627-37.
  • Gomes DC, Longo E, de Camargo OK, de Sousa Dantas D, Ferreira HN, Regalado IC, et al. Common content between quality of life questionnaires for children with cystic fibrosis and the International Classification of Functionality, Disability and Health. J Rehabil Med. 2019;51(8):582-6.
  • Modi AC, Quittner AL. Validation of a disease-specific measure of health-related quality of life for children with cystic fibrosis. J Pediatr Psychol. 2003;28(8):535-45.
  • Yuksel H, Yilmaz O, Dogru D, Karadag B, Unal F, Quittner AL. Reliability and validity of the Cystic Fibrosis Questionnaire-Revised for children and parents in Turkey: cross-sectional study. Qual Life Res. 2013;22(2):409-14.
  • Valdes K, Naughton N, Algar L. Linking ICF components to outcome measures for orthotic intervention for CMC OA: A systematic review. J Hand Ther. 2016;29(4):396-404.
  • Geyh S, Cieza A, Kollerits B, Grimby G, Stucki G. Content comparison of health-related quality of life measures used in stroke based on the international classification of functioning, disability and health (ICF): a systematic review. Qual Life Res. 2007;16(5):833-51.
  • Moshki M, Khajavi A, Vakilian F, Minaee S, Hashemizadeh H. The content comparison of health-related quality of life measures in heart failure based on the international classification of functioning, disability, and health: a systematic review. J Cardiovasc Thorac Res. 2019;11(3):167-75.
  • Yang C, Montgomery M. Dornase alfa for cystic fibrosis. Cochrane Database Syst Rev. 2021;3(3):Cd001127.
  • Kayani K, Mohammed R, Mohiaddin H. Cystic Fibrosis-Related Diabetes. Front Endocrinol (Lausanne). 2018;9:20.
  • Olesen HV, Drevinek P, Gulmans VA, Hatziagorou E, Jung A, Mei-Zahav M, et al. Cystic fibrosis related diabetes in Europe: Prevalence, risk factors and outcome; Olesen et al. J Cyst Fibros. 2020;19(2):321-7.
  • Rawo T, Tramś M, Michalski P, Sands D. Postural defects in children with cystic fibrosis - preliminary report. Dev Period Med. 2015;19(1):114-9.
  • Frayman KB, Kazmerski TM, Sawyer SM. A systematic review of the prevalence and impact of urinary incontinence in cystic fibrosis. Respirology. 2018;23(1):46-54.
  • Pitts-Tucker TJ, Miller MG, Littlewood JM. Finger clubbing in cystic fibrosis. Arch Dis Child. 1986;61(6):576-9.
  • Bagci R, Vardar-Yagli N, Saglam M, Calik Kutukcu E, Inal-Ince D, Sener F, et al. Body functions and structure, activity, and participation limitations of adult cystic fibrosis patients under the international classification of functioning, disability, and health framework. Physiother Theory Pract. 2022:1-11.
  • Gathercole K. Managing cystic fibrosis alongside children's schooling: Family, nurse and teacher perspectives. J Child Health Care. 2019;23(3):425-36.
  • Schlüter DK, Griffiths R, Akbari A, Taylor-Robinson D. Educational achievements of children aged 10-11 years with cystic fibrosis. A data linkage study in Wales. Int J Popul Data Sci. 2022;7(1):1725.
  • Groh JD, Dempster NR, Cole T, Hayes D, Jr. Navigating School Reentry in Lung Transplant Recipients With Cystic Fibrosis. Prog Transplant. 2020;30(3):278-80.
  • Grant JJ, McDade EJ, Zobell JT, Young DC. The indispensable role of pharmacy services and medication therapy management in cystic fibrosis. Pediatr Pulmonol. 2022;57 Suppl 1:S17-s39.
  • Szczesniak R, Rice JL, Brokamp C, Ryan P, Pestian T, Ni Y, et al. Influences of environmental exposures on individuals living with cystic fibrosis. Expert Rev Respir Med. 2020;14(7):737-48.
  • Hassanzad M, Farnia P, Farnia P, Arian M, Valinejadi A, Ghaffaripour H, et al. Assessment of Cystic Fibrosis Distribution Based on Air Pollution by Geographical Information System (GIS). Tanaffos. 2022;21(1):31-44.
  • Collaco JM, McGready J, Green DM, Naughton KM, Watson CP, Shields T, et al. Effect of temperature on cystic fibrosis lung disease and infections: a replicated cohort study. PLoS One. 2011;6(11):e27784.
  • Selb M, Escorpizo R, Kostanjsek N, Stucki G, Üstün B, Cieza A. A guide on how to develop an International Classification of Functioning, Disability and Health Core Set. Eur J Phys Rehabil Med. 2015;51(1):105-17.
  • Lage SM, Jácome C, Oliveira A, Araújo AG, Pereira DAG, Parreira VF. Validation of the International Classification of Functioning, Disability and Health Core Set for obstructive pulmonary diseases in the perspective of adults with asthma. Disabil Rehabil. 2020;42(1):86-92.
  • Glässel A, Finger ME, Cieza A, Treitler C, Coenen M, Escorpizo R. Vocational rehabilitation from the client's perspective using the International Classification of Functioning, Disability and Health (ICF) as a reference. J Occup Rehabil. 2011;21(2):167-78.

LINKING PROCESS OF THE REVISED CYSTIC FIBROSIS QUESTIONNAIRE WITHIN THE SCOPE OF THE INTERNATIONAL CLASSIFICATION OF FUNCTIONING, DISABILITY AND HEALTH

Year 2024, Volume: 35 Issue: 2, 214 - 223, 27.08.2024

Nisa Akyazı , Seda Nur Kemer , Tuğba Dere , İzel Demirhan , Birol Önal , Sevil Bilgin

https://doi.org/10.21653/tjpr.1367384

Abstract

Purpose: Health outcome measures are standardly linked with the International Classification of Functioning, Disability, and Health (ICF) using a method called "linking rules". This study aims to evaluate the Cystic Fibrosis Questionnaire-Revised (CFQ-R), which is the most commonly used questionnaire to evaluate the quality of life in cystic fibrosis, for children (CFQ-R6-11, CFQ-R12-13), adolescent/adult (CFQ-R14+) and parent (CFQ-Rparent) questionnaires are linked within the scope of ICF.
Methods: Each items of the CFO-R child (6-11,12-13), adolescent/adults (14+) and parents forms was linked with the ICF by three independent researchers according to Cieze’s rules. The researchers' degree of agreement was calculated using the kappa coefficient.
Results: The CFQ-Rparent form was found to include body functions 46% (n=26), activities and participation 34% (n=19), and environmental factors 11% (n=6). The CFQ-R6-11 form was found to include body functions in 40% (n=19), activities and participation in 34% (n=16), and environmental factors in 19% (n=9). It was found that the CFQ-R12-13 form included body functions in 40% (n=19), activities and participation in 34% (n=16), and environmental factors in 19% (n=9). The CFQ-R14+ form was found to include body functions 43% (n=29), activities and participation 37% (n=25) and environmental factors 7% (n=5).
Conclusion: In the CFQ-R child, adolescent/adult, and parent forms, body functions are the category most associated with the ICF. Environmental factors were inadequately identified within the questionnaires. This content comparison showed the content and nature of each questionnaire, providing insight into the scope of the individual's functionality. Additionally, it can be said that criteria that evaluate environmental factors are needed to evaluate CF holistically.

Keywords

ICF Linking Rules Cystic Fibrosis Quality of Life

References

  • Gee L, Abbott J, Conway SP, Etherington C, Webb AK. Quality of life in cystic fibrosis: the impact of gender, general health perceptions and disease severity. J Cyst Fibros. 2003;2(4):206-13.
  • McLeod C, Wood J, Tong A, Schultz A, Norman R, Smith S, et al. The measurement properties of tests and tools used in cystic fibrosis studies: a systematic review. Eur Respir Rev. 2021;30(160).
  • Modaresi M, Roshanzamir Z, Shirzadi R. The Correlation of Health-Related Quality of Life with Cystic Fibrosis Severity Markers in Chest CT Scan and 6-Minute Walk Test: A Cross-Sectional Study. Indian J Pediatr. 2022;89(2):113-7.
  • Kabakçı E aGA. International classification of functioning, disability and health işlevsellik, yetiyitimi ve sağliğin uluslararasi siniflandırması. Ankara:Başbakanlık Özürlüler İdaresi Başkanlığı 12 May 2021.
  • Cieza A, Brockow T, Ewert T, Amman E, Kollerits B, Chatterji S, et al. Linking health-status measurements to the international classification of functioning, disability and health. J Rehabil Med. 2002;34(5):205-10.
  • Povlak S, Valdes K. Linking ICF components to outcome measures for hand osteoarthritis and rheumatoid arthritis: A systematic review. J Hand Ther. 2020;33(4):484-92.
  • Pereira GS, Corrêa FI, Elord Júlio C, Thonnard JL, Kossi O, Bouffioulx E, et al. Linking of concepts measured by SATIS-Stroke and the PM-Scale to the international classification of functioning, disability and health. Physiother Theory Pract. 2022;38(13):3055-71.
  • Tschiesner U, Rogers SN, Harréus U, Berghaus A, Cieza A. Content comparison of quality of life questionnaires used in head and neck cancer based on the international classification of functioning, disability and health: a systematic review. Eur Arch Otorhinolaryngol. 2008;265(6):627-37.
  • Gomes DC, Longo E, de Camargo OK, de Sousa Dantas D, Ferreira HN, Regalado IC, et al. Common content between quality of life questionnaires for children with cystic fibrosis and the International Classification of Functionality, Disability and Health. J Rehabil Med. 2019;51(8):582-6.
  • Modi AC, Quittner AL. Validation of a disease-specific measure of health-related quality of life for children with cystic fibrosis. J Pediatr Psychol. 2003;28(8):535-45.
  • Yuksel H, Yilmaz O, Dogru D, Karadag B, Unal F, Quittner AL. Reliability and validity of the Cystic Fibrosis Questionnaire-Revised for children and parents in Turkey: cross-sectional study. Qual Life Res. 2013;22(2):409-14.
  • Valdes K, Naughton N, Algar L. Linking ICF components to outcome measures for orthotic intervention for CMC OA: A systematic review. J Hand Ther. 2016;29(4):396-404.
  • Geyh S, Cieza A, Kollerits B, Grimby G, Stucki G. Content comparison of health-related quality of life measures used in stroke based on the international classification of functioning, disability and health (ICF): a systematic review. Qual Life Res. 2007;16(5):833-51.
  • Moshki M, Khajavi A, Vakilian F, Minaee S, Hashemizadeh H. The content comparison of health-related quality of life measures in heart failure based on the international classification of functioning, disability, and health: a systematic review. J Cardiovasc Thorac Res. 2019;11(3):167-75.
  • Yang C, Montgomery M. Dornase alfa for cystic fibrosis. Cochrane Database Syst Rev. 2021;3(3):Cd001127.
  • Kayani K, Mohammed R, Mohiaddin H. Cystic Fibrosis-Related Diabetes. Front Endocrinol (Lausanne). 2018;9:20.
  • Olesen HV, Drevinek P, Gulmans VA, Hatziagorou E, Jung A, Mei-Zahav M, et al. Cystic fibrosis related diabetes in Europe: Prevalence, risk factors and outcome; Olesen et al. J Cyst Fibros. 2020;19(2):321-7.
  • Rawo T, Tramś M, Michalski P, Sands D. Postural defects in children with cystic fibrosis - preliminary report. Dev Period Med. 2015;19(1):114-9.
  • Frayman KB, Kazmerski TM, Sawyer SM. A systematic review of the prevalence and impact of urinary incontinence in cystic fibrosis. Respirology. 2018;23(1):46-54.
  • Pitts-Tucker TJ, Miller MG, Littlewood JM. Finger clubbing in cystic fibrosis. Arch Dis Child. 1986;61(6):576-9.
  • Bagci R, Vardar-Yagli N, Saglam M, Calik Kutukcu E, Inal-Ince D, Sener F, et al. Body functions and structure, activity, and participation limitations of adult cystic fibrosis patients under the international classification of functioning, disability, and health framework. Physiother Theory Pract. 2022:1-11.
  • Gathercole K. Managing cystic fibrosis alongside children's schooling: Family, nurse and teacher perspectives. J Child Health Care. 2019;23(3):425-36.
  • Schlüter DK, Griffiths R, Akbari A, Taylor-Robinson D. Educational achievements of children aged 10-11 years with cystic fibrosis. A data linkage study in Wales. Int J Popul Data Sci. 2022;7(1):1725.
  • Groh JD, Dempster NR, Cole T, Hayes D, Jr. Navigating School Reentry in Lung Transplant Recipients With Cystic Fibrosis. Prog Transplant. 2020;30(3):278-80.
  • Grant JJ, McDade EJ, Zobell JT, Young DC. The indispensable role of pharmacy services and medication therapy management in cystic fibrosis. Pediatr Pulmonol. 2022;57 Suppl 1:S17-s39.
  • Szczesniak R, Rice JL, Brokamp C, Ryan P, Pestian T, Ni Y, et al. Influences of environmental exposures on individuals living with cystic fibrosis. Expert Rev Respir Med. 2020;14(7):737-48.
  • Hassanzad M, Farnia P, Farnia P, Arian M, Valinejadi A, Ghaffaripour H, et al. Assessment of Cystic Fibrosis Distribution Based on Air Pollution by Geographical Information System (GIS). Tanaffos. 2022;21(1):31-44.
  • Collaco JM, McGready J, Green DM, Naughton KM, Watson CP, Shields T, et al. Effect of temperature on cystic fibrosis lung disease and infections: a replicated cohort study. PLoS One. 2011;6(11):e27784.
  • Selb M, Escorpizo R, Kostanjsek N, Stucki G, Üstün B, Cieza A. A guide on how to develop an International Classification of Functioning, Disability and Health Core Set. Eur J Phys Rehabil Med. 2015;51(1):105-17.
  • Lage SM, Jácome C, Oliveira A, Araújo AG, Pereira DAG, Parreira VF. Validation of the International Classification of Functioning, Disability and Health Core Set for obstructive pulmonary diseases in the perspective of adults with asthma. Disabil Rehabil. 2020;42(1):86-92.
  • Glässel A, Finger ME, Cieza A, Treitler C, Coenen M, Escorpizo R. Vocational rehabilitation from the client's perspective using the International Classification of Functioning, Disability and Health (ICF) as a reference. J Occup Rehabil. 2011;21(2):167-78.
There are 31 citations in total.

Details

Primary Language Turkish
Subjects Physiotherapy, Rehabilitation
Journal Section Araştırma Makaleleri
Authors

Nisa Akyazı 0000-0002-3150-3685

Seda Nur Kemer 0000-0002-0623-302X

Tuğba Dere 0000-0002-3048-9113

İzel Demirhan 0000-0002-0091-3868

Birol Önal 0000-0002-3540-7156

Sevil Bilgin 0000-0003-1597-1312

Publication Date August 27, 2024
Published in Issue Year 2024 Volume: 35 Issue: 2

Cite

APA Akyazı, N., Kemer, S. N., Dere, T., Demirhan, İ., et al. (2024). YENİDEN DÜZENLENMİŞ KİSTİK FİBROZİS ANKETİNİN İŞLEVSELLİK YETİYİTİMİ VE SAĞLIĞIN ULUSLARARASI SINIFLANDIRMASI KAPSAMINDA İLİŞKİLENDİRME SÜRECİ. Türk Fizyoterapi Ve Rehabilitasyon Dergisi, 35(2), 214-223. https://doi.org/10.21653/tjpr.1367384
AMA Akyazı N, Kemer SN, Dere T, Demirhan İ, Önal B, Bilgin S. YENİDEN DÜZENLENMİŞ KİSTİK FİBROZİS ANKETİNİN İŞLEVSELLİK YETİYİTİMİ VE SAĞLIĞIN ULUSLARARASI SINIFLANDIRMASI KAPSAMINDA İLİŞKİLENDİRME SÜRECİ. Turk J Physiother Rehabil. August 2024;35(2):214-223. doi:10.21653/tjpr.1367384
Chicago Akyazı, Nisa, Seda Nur Kemer, Tuğba Dere, İzel Demirhan, Birol Önal, and Sevil Bilgin. “YENİDEN DÜZENLENMİŞ KİSTİK FİBROZİS ANKETİNİN İŞLEVSELLİK YETİYİTİMİ VE SAĞLIĞIN ULUSLARARASI SINIFLANDIRMASI KAPSAMINDA İLİŞKİLENDİRME SÜRECİ”. Türk Fizyoterapi Ve Rehabilitasyon Dergisi 35, no. 2 (August 2024): 214-23. https://doi.org/10.21653/tjpr.1367384.
EndNote Akyazı N, Kemer SN, Dere T, Demirhan İ, Önal B, Bilgin S (August 1, 2024) YENİDEN DÜZENLENMİŞ KİSTİK FİBROZİS ANKETİNİN İŞLEVSELLİK YETİYİTİMİ VE SAĞLIĞIN ULUSLARARASI SINIFLANDIRMASI KAPSAMINDA İLİŞKİLENDİRME SÜRECİ. Türk Fizyoterapi ve Rehabilitasyon Dergisi 35 2 214–223.
IEEE N. Akyazı, S. N. Kemer, T. Dere, İ. Demirhan, B. Önal, and S. Bilgin, “YENİDEN DÜZENLENMİŞ KİSTİK FİBROZİS ANKETİNİN İŞLEVSELLİK YETİYİTİMİ VE SAĞLIĞIN ULUSLARARASI SINIFLANDIRMASI KAPSAMINDA İLİŞKİLENDİRME SÜRECİ”, Turk J Physiother Rehabil, vol. 35, no. 2, pp. 214–223, 2024, doi: 10.21653/tjpr.1367384.
ISNAD Akyazı, Nisa et al. “YENİDEN DÜZENLENMİŞ KİSTİK FİBROZİS ANKETİNİN İŞLEVSELLİK YETİYİTİMİ VE SAĞLIĞIN ULUSLARARASI SINIFLANDIRMASI KAPSAMINDA İLİŞKİLENDİRME SÜRECİ”. Türk Fizyoterapi ve Rehabilitasyon Dergisi 35/2 (August 2024), 214-223. https://doi.org/10.21653/tjpr.1367384.
JAMA Akyazı N, Kemer SN, Dere T, Demirhan İ, Önal B, Bilgin S. YENİDEN DÜZENLENMİŞ KİSTİK FİBROZİS ANKETİNİN İŞLEVSELLİK YETİYİTİMİ VE SAĞLIĞIN ULUSLARARASI SINIFLANDIRMASI KAPSAMINDA İLİŞKİLENDİRME SÜRECİ. Turk J Physiother Rehabil. 2024;35:214–223.
MLA Akyazı, Nisa et al. “YENİDEN DÜZENLENMİŞ KİSTİK FİBROZİS ANKETİNİN İŞLEVSELLİK YETİYİTİMİ VE SAĞLIĞIN ULUSLARARASI SINIFLANDIRMASI KAPSAMINDA İLİŞKİLENDİRME SÜRECİ”. Türk Fizyoterapi Ve Rehabilitasyon Dergisi, vol. 35, no. 2, 2024, pp. 214-23, doi:10.21653/tjpr.1367384.
Vancouver Akyazı N, Kemer SN, Dere T, Demirhan İ, Önal B, Bilgin S. YENİDEN DÜZENLENMİŞ KİSTİK FİBROZİS ANKETİNİN İŞLEVSELLİK YETİYİTİMİ VE SAĞLIĞIN ULUSLARARASI SINIFLANDIRMASI KAPSAMINDA İLİŞKİLENDİRME SÜRECİ. Turk J Physiother Rehabil. 2024;35(2):214-23.