Araştırma Makalesi
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Hipertansiyon Hastası Olan Bireylerin Depresyon, Anksiyete ve Stres Düzeylerinin Yaşam Kalitesi Üzerine Etkisi

Yıl 2023, Cilt: 3 Sayı: 2, 181 - 187, 11.08.2023
https://doi.org/10.58252/artukluder.1288377

Öz

Giriş: Bu araştırma; hipertansiyonu olan kişilerin depresyon anksiyete stres düzeylerinin yaşam kalitesi üzerine etkisini belirlemek amacıyla planlandı.
Yöntem: Araştırma Samsun İl Sağlık Müdürlüğü’ne bağlı bir ilçe devlet hastanesinde acile başvuran hipertansiyon hastaları ile yapıldı. Araştırma çalışmaya katılmaya gönüllü olan 161 hasta ile gerçekleştirildi. Çalışma tanımlayıcı tipte yürütüldü. Veriler Tanımlayıcı Anket Formu, SF-12 Yaşam Kalitesi Ölçeği kısa formu, Depresyon, Anksiyete, Stres Ölçeği (DASS-21) kullanılarak yüz yüze anket formuyla toplandı.
Bulgular: Çalışmaya katılan hastaların yaş ortalaması 62.3±14.3, depresyon puan ortalaması 9.1±4.4, anksiyete puan ortalaması 7.8±4.3, stres puan ortalaması 9.8±4.0, Fiziksel Bileşen Özet Puanı (FBÖ-12) puan ortalaması 39.7±9.1, Mental Bileşen Özet Puanı (MBÖ-12) puan ortalaması 38.3±8.9 saptandı. Cinsiyet grupları ile karşılaştırıldığında depresyon ve anksiyete seviyesinin kadınlarda erkeklerden daha fazla olduğu, yaşam kalitesinin erkeklerde daha iyi olduğu bulundu. Yaş ortalaması arttıkça depresyon, anksiyete, stres oranının arttığı, yaşam kalitesinin azaldığı görüldü.
Sonuç: Bu çalışmada; depresyon ve anksiyete düzeyinin kadınlarda daha fazla, evli çiftlerde daha düşük olduğu, eğitim düzeyinin yüksek olmasının depresyon, anksiyete, stres ve yaşam kalitesi üzerinde olumlu yönde etkili olduğu, kronik hastalığı olmayan ve egzersiz yapan bireylerde depresyon, anksiyete, stres seviyelerinin düşük olduğu, yaşam kalitesinin yüksek olduğu belirlendi.

Kaynakça

  • Wang Z, Chen Z, Zhang L, Wang X, Hao G, Zhang Z, et al. Status of Hypertension in China. Circulation. 2018;137(22):2344-56. doi: 10.1161/CIRCULATIONAHA.117.032380
  • Group SR. A Randomized trial of intensive versus standard blood-pressure control. New England Journal of Medicine. 2015;373(22):2103-16. doi: 10.1056/NEJMoa1511939
  • Aslan H, Uysal Z. Hipertansiyon hastalarının özellikleri ile sürekli kaygi ve baş etme becerileri arasındaki ilişki. Mustafa Kemal Üniversitesi Tıp Dergisi. 2018; 9(34): 68-80.
  • Shahimi NH, Lim R, Mat S, Goh C-H, Tan MP, Lim E. Association between mental illness and blood pressure variability: A systematic review. BioMedical Engineering OnLine. 2022;21(1):19. doi: 10.1186/s12938-022-00985-w
  • Ang CW, Tan MM, Bärnighausen T, Reininghaus U, Reidpath D, Su TT. Mental distress along the cascade of care in managing hypertension. Scientific Reports. 2022;12(1): 15910. doi: 10.1038/s41598-022-20020-1
  • Organization WH. Decade of Healthy Ageing 2020–2030: Plan of Action. Geneva: World Health Organization. Date: 08.08.2022. Available from: https://www.who.int/initiatives/decade-of-healthy-ageing
  • Chantakeeree C, Sormunen M, Estola M, Jullamate P, Turunen H. Factors affecting quality of life among older adults with hypertension in urban and rural areas in Thailand: A cross-sectional study. The International Journal of Aging and Human Development. 2022;95(2):222-44. doi: 10.1177/00914150211050880
  • Pogosova N, Boytsov S, De Bacquer D, Sokolova O, Ausheva A, Kursakov A, et al. Factors associated with anxiety and depressive symptoms in 2775 patients with arterial hypertension and coronary heart disease: results from the cometa multicenter study. Global Heart. 2021;16(1). 73. doi: 10.5334/gh.1017
  • Berntson J, Patel JS, Stewart JC. Number of recent stressful life events and incident cardiovascular disease: moderation by lifetime depressive disorder. Journal of Psychosomatic Research. 2017;99:149-54. doi: 10.1016/j.jpsychores.2017.06.008
  • Rawlings GH, Thompson AR, Armstrong I, Novakova B, Beail N. Coping styles associated with depression, health anxiety and health-related quality of life in pulmonary hypertension: cross-sectional analysis. BMJ Open. 2022;12(8):e062564. doi: 10.1136/bmjopen-2022-062564
  • Erci B, Elibol M, Aktürk. Hipertansiyon hastalarının tedaviye uyumunu ve yaşam kalitesini etkileyen faktörlerin incelenmesi. ÜJFNHD. 2018;26(2):79-92. doi: 10.26650/FNJN427146
  • Emre N, Edı̇rne T, Özşahı̇n A, Çoban N, Yanik A. The relationship between adherence to medication and quality of life and health perception in hypertensive patients. Turkish Journal of Family Medicine and Primary Care. 2020;14(39):436-442. doi: 10.21763/tjfmpc.725974
  • Hanssen TA, Subbotina A, Miroslawska A, Solbu MD, Steigen TK. Quality of life following renal sympathetic denervation in treatment-resistant hypertensive patients: a two-year follow-up study. Scandinavian Cardiovascular Journal. 2022;56(1):174-179. doi: 10.1080/14017431.2022.2084562
  • Trevisol DJ, Moreira LB, Fuchs FD, Fuchs SC. Health-related quality of life is worse in individuals with hypertension under drug treatment: results of population-based study. Journal of Human Hypertension. 2012;26(6):374-380. doi: 10.1038/jhh.2011.48
  • Sariçam H. The psychometric properties of Turkish version of Depression Anxiety Stress Scale-21 (DASS-21) in health control and clinical samples. Journal of Cognitive Behavioral Psychotherapy and Research. 2018;7(1):19-30.
  • Soylu C, Kütük B. SF-12 yaşam kalitesi ölçeği’nin türkçe formunun güvenirlik ve geçerlik çalışması. Türk Psikiyatri Dergisi. 2022;33(2):108-17.
  • Ware J, Kosinski M, Keller S. SF-12: How to Score the SF-12 physical and mental health summary scales. 1998. Date: 08.08.2022. Available from: https://www.researchgate.net/publication/242636950_SF-12_How_to_Score_the_SF-12_Physical_and_Mental_Health_Summary_Scales
  • Loke WH, Ching SM. Prevalence and factors associated with psychological distress among adult patients with hypertension in a primary care clinic: A cross-sectional study. Malaysian Family Physician. 2022;17(2):89-98. doi: 10.51866/oa.131
  • Saleem F, Hassali MA, Shafie AA. A cross-sectional assessment of health-related quality of life (HRQoL) among hypertensive patients in Pakistan. Health Expectations. 2014;17(3):388-395. doi: 10.1111/j.1369-7625.2012.00765.x
  • Boima V, K. Yeboah A, A. Kretchy I, Koduah A, Agyabeng K, Yorke E. Health-related quality of life and its demographic, clinical and psychosocial determinants among male patients with hypertension in a Ghanaian tertiary hospital. Ghana Medical Journal. 2022;56(1):5-14. doi: 10.4314/gmj.v56i1.2
  • Sang S, Kang N, Liao W, Wu X, Hu Z, Liu X, et al. The influencing factors of health-related quality of life among rural hypertensive individuals: A cross-sectional study. Health and Quality of Life Outcomes. 2021;19(1):244. doi: 10.1186/s12955-021-01879-6
  • Chen L, Bai C, Zheng Y, Wei L, Han C, Yuan N, et al. The association between sleep architecture, quality of life, and hypertension in patients with obstructive sleep apnea. Sleep and Breathing. 2023;27(1):191-203. doi: 10.1007/s11325-022-02589-z
  • Eghbali M, Akbari M, Seify K, Fakhrolmobasheri M, Heidarpour M, Roohafza H, et al. Evaluation of psychological distress, self-care, and medication adherence in association with hypertension control. International Journal of Hypertension. 2022; 2022:1-7. doi: 10.1155/2022/7802792
  • Mannan A, Akter KM, Akter F, Chy NUHA, Alam N, Pinky SD, et al. Association between comorbidity and health-related quality of life in a hypertensive population: a hospital-based study in Bangladesh. BMC Public Health. 2022;22(1): 181. doi: 10.1186/s12889-022-12562-w
  • Tusa BS, Geremew BM, Tefera MA. Heath related quality of life and associated factors among adults with and without diabetes in Adama city East Shewa, Ethiopia 2019; using generalized structural equation modeling. Health and Quality of Life Outcomes. 2020;18(1):83. doi: 10.1186/s12955-020-01337-9
  • Choi M-J, Park YG, Kim YH, Cho KH, Nam GE. Association between type of exercise and health-related quality of life in adults without activity limitations: A nationwide cross-sectional study. BMC Public Health. 2020;20(1): 599. doi: 10.1186/s12889-020-08699-1
  • Han JH, Park HS, Shin CI, Chang HM, Yun KE, Cho SH, et al. Metabolic syndrome and quality of life (QOL) using generalised and obesity-specific QOL scales. International Journal of Clinical Practice. 2009;63(5):735-41. doi: 10.1111/j.1742-1241.2009.02021.x
  • Hatami H, Deihim T, Amiri P, Cheraghi L, Azizi F. Association between metabolic syndrome and health-related quality of life among individuals with normal and impaired glucose regulation: findings from tehran lipid and glucose study. Archives of Iranian medicine. 2016;19(8):577-83.
  • Foster H, Polz P, Mair F, Gill J, O'Donnell CA. Understanding the influence of socioeconomic status on the association between combinations of lifestyle factors and adverse health outcomes: A systematic review protocol. BMJ Open. 2021;11(5):e042212. doi: 10.1136/bmjopen-2020-042212
  • Roohafza HR, Afshar H, Keshteli AH, Mohammadi N, Feizi A, Taslimi M, et al. What's the role of perceived social support and coping styles in depression and anxiety? Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences. 2014;19(10):944-949.
  • Lawton E, Brymer E, Clough P, Denovan A. The Relationship between the physical activity environment, nature relatedness, anxiety, and the psychological well-being benefits of regular exercisers. Frontiers in Psychology. 2017;8. 1058. doi: 10.3389/fpsyg.2017.01058
  • Lopes S, Félix G, Mesquita-Bastos J, Figueiredo D, Oliveira J, Ribeiro F. Determinants of exercise adherence and maintenance among patients with hypertension: A narrative review. Reviews in Cardiovascular Medicine. 2021;22(4):1271-1278. doi: 10.31083/j.rcm2204134
  • Baghai T, Varallo-Bedarida G, Born C, Häfner S, Schüle C, Eser D, et al. Classical risk factors and inflammatory biomarkers: one of the missing biological links between cardiovascular disease and major depressive disorder. International Journal of Molecular Sciences. 2018;19(6):1740. doi: 10.3390/ijms19061740

The Effects of Depression, Anxiety and Stress Levels on Quality of Life of Individuals with Hypertension

Yıl 2023, Cilt: 3 Sayı: 2, 181 - 187, 11.08.2023
https://doi.org/10.58252/artukluder.1288377

Öz

Introduction: This study was planned to determine the effects of depression, anxiety and stress levels of individuals with hypertension on their quality of life.
Methods: This descriptive study was conducted with 161 hypertension patients who presented to the emergency department of a district state hospital affiliated to Samsun Provincial Health Directorate and volunteered to participate in the study. Data were collected with the Descriptive Information Form, SF-12 (Quality of Life Scale Short Form), and Depression, Anxiety, Stress Scale (DASS-21) through face-to-face interviews.
Results: The mean age of the patients participating in the study was 62.3±14.3 years. The mean scores they obtained from the depression, anxiety and stress sub-dimensions of the DASS-21 were 9.1±4.4, 7.8±4.3 and 9.8±4.0, respectively. The mean scores they obtained from the Physical Component Summary-12 (PCS-12) and Mental Component Summary-12 (MCS-12) of the SF-12 were 39.7±9.1 and 38.3±8.9, respectively. While the depression and anxiety levels were higher in the female participants, the level of the quality of life was higher in the male participants.
As the participants’ age increased, their depression, anxiety and stress levels increased, and the quality-of-life levels decreased. In the participants who exercised while depression, anxiety and stress levels were lower, the level of quality of life was higher.
Conclusion: In this study, depression and anxiety levels are higher in women and lower in married couples. Higher education level has a positive effect on depression, anxiety, stress and quality of life. Individuals who do not have chronic diseases and exercise have low levels of depression, anxiety, and stress.

Kaynakça

  • Wang Z, Chen Z, Zhang L, Wang X, Hao G, Zhang Z, et al. Status of Hypertension in China. Circulation. 2018;137(22):2344-56. doi: 10.1161/CIRCULATIONAHA.117.032380
  • Group SR. A Randomized trial of intensive versus standard blood-pressure control. New England Journal of Medicine. 2015;373(22):2103-16. doi: 10.1056/NEJMoa1511939
  • Aslan H, Uysal Z. Hipertansiyon hastalarının özellikleri ile sürekli kaygi ve baş etme becerileri arasındaki ilişki. Mustafa Kemal Üniversitesi Tıp Dergisi. 2018; 9(34): 68-80.
  • Shahimi NH, Lim R, Mat S, Goh C-H, Tan MP, Lim E. Association between mental illness and blood pressure variability: A systematic review. BioMedical Engineering OnLine. 2022;21(1):19. doi: 10.1186/s12938-022-00985-w
  • Ang CW, Tan MM, Bärnighausen T, Reininghaus U, Reidpath D, Su TT. Mental distress along the cascade of care in managing hypertension. Scientific Reports. 2022;12(1): 15910. doi: 10.1038/s41598-022-20020-1
  • Organization WH. Decade of Healthy Ageing 2020–2030: Plan of Action. Geneva: World Health Organization. Date: 08.08.2022. Available from: https://www.who.int/initiatives/decade-of-healthy-ageing
  • Chantakeeree C, Sormunen M, Estola M, Jullamate P, Turunen H. Factors affecting quality of life among older adults with hypertension in urban and rural areas in Thailand: A cross-sectional study. The International Journal of Aging and Human Development. 2022;95(2):222-44. doi: 10.1177/00914150211050880
  • Pogosova N, Boytsov S, De Bacquer D, Sokolova O, Ausheva A, Kursakov A, et al. Factors associated with anxiety and depressive symptoms in 2775 patients with arterial hypertension and coronary heart disease: results from the cometa multicenter study. Global Heart. 2021;16(1). 73. doi: 10.5334/gh.1017
  • Berntson J, Patel JS, Stewart JC. Number of recent stressful life events and incident cardiovascular disease: moderation by lifetime depressive disorder. Journal of Psychosomatic Research. 2017;99:149-54. doi: 10.1016/j.jpsychores.2017.06.008
  • Rawlings GH, Thompson AR, Armstrong I, Novakova B, Beail N. Coping styles associated with depression, health anxiety and health-related quality of life in pulmonary hypertension: cross-sectional analysis. BMJ Open. 2022;12(8):e062564. doi: 10.1136/bmjopen-2022-062564
  • Erci B, Elibol M, Aktürk. Hipertansiyon hastalarının tedaviye uyumunu ve yaşam kalitesini etkileyen faktörlerin incelenmesi. ÜJFNHD. 2018;26(2):79-92. doi: 10.26650/FNJN427146
  • Emre N, Edı̇rne T, Özşahı̇n A, Çoban N, Yanik A. The relationship between adherence to medication and quality of life and health perception in hypertensive patients. Turkish Journal of Family Medicine and Primary Care. 2020;14(39):436-442. doi: 10.21763/tjfmpc.725974
  • Hanssen TA, Subbotina A, Miroslawska A, Solbu MD, Steigen TK. Quality of life following renal sympathetic denervation in treatment-resistant hypertensive patients: a two-year follow-up study. Scandinavian Cardiovascular Journal. 2022;56(1):174-179. doi: 10.1080/14017431.2022.2084562
  • Trevisol DJ, Moreira LB, Fuchs FD, Fuchs SC. Health-related quality of life is worse in individuals with hypertension under drug treatment: results of population-based study. Journal of Human Hypertension. 2012;26(6):374-380. doi: 10.1038/jhh.2011.48
  • Sariçam H. The psychometric properties of Turkish version of Depression Anxiety Stress Scale-21 (DASS-21) in health control and clinical samples. Journal of Cognitive Behavioral Psychotherapy and Research. 2018;7(1):19-30.
  • Soylu C, Kütük B. SF-12 yaşam kalitesi ölçeği’nin türkçe formunun güvenirlik ve geçerlik çalışması. Türk Psikiyatri Dergisi. 2022;33(2):108-17.
  • Ware J, Kosinski M, Keller S. SF-12: How to Score the SF-12 physical and mental health summary scales. 1998. Date: 08.08.2022. Available from: https://www.researchgate.net/publication/242636950_SF-12_How_to_Score_the_SF-12_Physical_and_Mental_Health_Summary_Scales
  • Loke WH, Ching SM. Prevalence and factors associated with psychological distress among adult patients with hypertension in a primary care clinic: A cross-sectional study. Malaysian Family Physician. 2022;17(2):89-98. doi: 10.51866/oa.131
  • Saleem F, Hassali MA, Shafie AA. A cross-sectional assessment of health-related quality of life (HRQoL) among hypertensive patients in Pakistan. Health Expectations. 2014;17(3):388-395. doi: 10.1111/j.1369-7625.2012.00765.x
  • Boima V, K. Yeboah A, A. Kretchy I, Koduah A, Agyabeng K, Yorke E. Health-related quality of life and its demographic, clinical and psychosocial determinants among male patients with hypertension in a Ghanaian tertiary hospital. Ghana Medical Journal. 2022;56(1):5-14. doi: 10.4314/gmj.v56i1.2
  • Sang S, Kang N, Liao W, Wu X, Hu Z, Liu X, et al. The influencing factors of health-related quality of life among rural hypertensive individuals: A cross-sectional study. Health and Quality of Life Outcomes. 2021;19(1):244. doi: 10.1186/s12955-021-01879-6
  • Chen L, Bai C, Zheng Y, Wei L, Han C, Yuan N, et al. The association between sleep architecture, quality of life, and hypertension in patients with obstructive sleep apnea. Sleep and Breathing. 2023;27(1):191-203. doi: 10.1007/s11325-022-02589-z
  • Eghbali M, Akbari M, Seify K, Fakhrolmobasheri M, Heidarpour M, Roohafza H, et al. Evaluation of psychological distress, self-care, and medication adherence in association with hypertension control. International Journal of Hypertension. 2022; 2022:1-7. doi: 10.1155/2022/7802792
  • Mannan A, Akter KM, Akter F, Chy NUHA, Alam N, Pinky SD, et al. Association between comorbidity and health-related quality of life in a hypertensive population: a hospital-based study in Bangladesh. BMC Public Health. 2022;22(1): 181. doi: 10.1186/s12889-022-12562-w
  • Tusa BS, Geremew BM, Tefera MA. Heath related quality of life and associated factors among adults with and without diabetes in Adama city East Shewa, Ethiopia 2019; using generalized structural equation modeling. Health and Quality of Life Outcomes. 2020;18(1):83. doi: 10.1186/s12955-020-01337-9
  • Choi M-J, Park YG, Kim YH, Cho KH, Nam GE. Association between type of exercise and health-related quality of life in adults without activity limitations: A nationwide cross-sectional study. BMC Public Health. 2020;20(1): 599. doi: 10.1186/s12889-020-08699-1
  • Han JH, Park HS, Shin CI, Chang HM, Yun KE, Cho SH, et al. Metabolic syndrome and quality of life (QOL) using generalised and obesity-specific QOL scales. International Journal of Clinical Practice. 2009;63(5):735-41. doi: 10.1111/j.1742-1241.2009.02021.x
  • Hatami H, Deihim T, Amiri P, Cheraghi L, Azizi F. Association between metabolic syndrome and health-related quality of life among individuals with normal and impaired glucose regulation: findings from tehran lipid and glucose study. Archives of Iranian medicine. 2016;19(8):577-83.
  • Foster H, Polz P, Mair F, Gill J, O'Donnell CA. Understanding the influence of socioeconomic status on the association between combinations of lifestyle factors and adverse health outcomes: A systematic review protocol. BMJ Open. 2021;11(5):e042212. doi: 10.1136/bmjopen-2020-042212
  • Roohafza HR, Afshar H, Keshteli AH, Mohammadi N, Feizi A, Taslimi M, et al. What's the role of perceived social support and coping styles in depression and anxiety? Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences. 2014;19(10):944-949.
  • Lawton E, Brymer E, Clough P, Denovan A. The Relationship between the physical activity environment, nature relatedness, anxiety, and the psychological well-being benefits of regular exercisers. Frontiers in Psychology. 2017;8. 1058. doi: 10.3389/fpsyg.2017.01058
  • Lopes S, Félix G, Mesquita-Bastos J, Figueiredo D, Oliveira J, Ribeiro F. Determinants of exercise adherence and maintenance among patients with hypertension: A narrative review. Reviews in Cardiovascular Medicine. 2021;22(4):1271-1278. doi: 10.31083/j.rcm2204134
  • Baghai T, Varallo-Bedarida G, Born C, Häfner S, Schüle C, Eser D, et al. Classical risk factors and inflammatory biomarkers: one of the missing biological links between cardiovascular disease and major depressive disorder. International Journal of Molecular Sciences. 2018;19(6):1740. doi: 10.3390/ijms19061740
Toplam 33 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Hemşirelik
Bölüm Araştırma Makaleleri
Yazarlar

Yasemin Özyer Güvener 0000-0002-2706-8107

Eda Altaş 0000-0001-5904-4807

Erken Görünüm Tarihi 19 Haziran 2023
Yayımlanma Tarihi 11 Ağustos 2023
Gönderilme Tarihi 27 Nisan 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 3 Sayı: 2

Kaynak Göster

APA Özyer Güvener, Y., & Altaş, E. (2023). The Effects of Depression, Anxiety and Stress Levels on Quality of Life of Individuals with Hypertension. Artuklu International Journal of Health Sciences, 3(2), 181-187. https://doi.org/10.58252/artukluder.1288377
AMA Özyer Güvener Y, Altaş E. The Effects of Depression, Anxiety and Stress Levels on Quality of Life of Individuals with Hypertension. Artuklu International Journal of Health Sciences. Ağustos 2023;3(2):181-187. doi:10.58252/artukluder.1288377
Chicago Özyer Güvener, Yasemin, ve Eda Altaş. “The Effects of Depression, Anxiety and Stress Levels on Quality of Life of Individuals With Hypertension”. Artuklu International Journal of Health Sciences 3, sy. 2 (Ağustos 2023): 181-87. https://doi.org/10.58252/artukluder.1288377.
EndNote Özyer Güvener Y, Altaş E (01 Ağustos 2023) The Effects of Depression, Anxiety and Stress Levels on Quality of Life of Individuals with Hypertension. Artuklu International Journal of Health Sciences 3 2 181–187.
IEEE Y. Özyer Güvener ve E. Altaş, “The Effects of Depression, Anxiety and Stress Levels on Quality of Life of Individuals with Hypertension”, Artuklu International Journal of Health Sciences, c. 3, sy. 2, ss. 181–187, 2023, doi: 10.58252/artukluder.1288377.
ISNAD Özyer Güvener, Yasemin - Altaş, Eda. “The Effects of Depression, Anxiety and Stress Levels on Quality of Life of Individuals With Hypertension”. Artuklu International Journal of Health Sciences 3/2 (Ağustos 2023), 181-187. https://doi.org/10.58252/artukluder.1288377.
JAMA Özyer Güvener Y, Altaş E. The Effects of Depression, Anxiety and Stress Levels on Quality of Life of Individuals with Hypertension. Artuklu International Journal of Health Sciences. 2023;3:181–187.
MLA Özyer Güvener, Yasemin ve Eda Altaş. “The Effects of Depression, Anxiety and Stress Levels on Quality of Life of Individuals With Hypertension”. Artuklu International Journal of Health Sciences, c. 3, sy. 2, 2023, ss. 181-7, doi:10.58252/artukluder.1288377.
Vancouver Özyer Güvener Y, Altaş E. The Effects of Depression, Anxiety and Stress Levels on Quality of Life of Individuals with Hypertension. Artuklu International Journal of Health Sciences. 2023;3(2):181-7.

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