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Investigation of the Effects of the COVID-19 Pandemic on Physiotherapy and Rehabilitation Students

Yıl 2022, , 1411 - 1418, 22.12.2022
https://doi.org/10.37989/gumussagbil.960399

Öz

In our study, we aimed to evaluate the stress, anxiety, learning anxiety, sense of school belonging, physical activity levels and musculoskeletal system effects of physiotherapy and rehabilitation students with the COVID-19 pandemic. Material and Method: The study included 450 university students (364 girls, 86 boys) on the basis of volunteering. Generalized Anxiety Disorder-7, Perceived Stress Scale, International Physical Activity Survey Short Form, Visual Analog Scale were applied to the students. Pain localization, positions/activities that increase pain during the day, students' learning anxiety and feelings of belonging to the school were questioned with open-ended questions. The data were evaluated using the Mann-Whitney U test and Spearman's correlation analysis and the significance level (p<0.05). Results: In our study, anxiety level was found to be mild and stress level was found to be high, especially in favor of female students (p=0.000, p=0.001). A statistically significant difference was obtained in the total duration of physical activity of male students compared to female students (p=0.009). The students responded that they experienced the most pain in the spine and that the position that increased the pain was sitting for a long time. A statistically significant difference in learning anxiety was found in female students compared to male students (p=0.004). Conclusions: This study shows that covid-19 quarantine causes higher stress and anxiety among college students, and a decrease in physical activity levels. It provides data that the high stress level felt by the students develop learning anxiety and that distance education affects the musculoskeletal system negatively.

Kaynakça

  • 1. World Health Organization. (2020). “Coronavirus Disease (COVID19) Pandemic”. Erişim adresi: https://www.who.int/emergencies/diseases/novel-coronavirus-2019 (Erişim Tarihi:22.11.2022).
  • 2. Rodriguez-Morales, A.J, Cardona-Ospina, J.A, Gutiérrez-Ocampo, E, Villamizar-Peña, R, Holguin-Rivera, Y, Escalera-Antezana, J.P, ..., and Sah, R. (2020). “Clinical, Laboratory and Imaging Features of COVID-19: A Systematic Review and Meta-Analysis”. Travel Medicine and Infectious Disease, 34, 101623.
  • 3. Xie, M. and Chen, Q. (2020). “Insight Into 2019 Novel Coronavirus–an Updated Interim Review and Lessons From SARS-Cov and MERS-Cov”. Int J Infect Dis, 94, 119–124.
  • 4. Olaimat, A.N, Aolymat, I, Elsahoryi, N, Shahbaz, H.M. and Holley, R.A. (2020). “Attitudes, Anxiety, and Behavioral Practices Regarding COVID-19 Among University Students in Jordan: A Cross-Sectional Study.” The American Journal of Tropical Medicine and Hygiene, 103 (3), 1177-1183.
  • 5. Brooks, S.K, Webster, R.K, Smith, L.E, Woodland, L, Wessely, S, Greenberg, N. and Rubin, G.J. (2020). “The Psychological Impact of Quarantine and How to Reduce It: Rapid Review of The Evidence”. The Lancet, 395 (10227), 912-920.
  • 6. Rubin, G.J. and Wessely, S. (2020). “The Psychological Effects of Quarantining a City”, BMJ, 368.
  • 7. Zhang, N, Hu, W. and Wang, K. (2020). “Research on the Coping Methods of College Students to 2019-Ncov”. 4th International Conference on Culture, Education and Economic Development of Modern Society (ICCESE 2020), (1278-1280), Atlantis Press.
  • 8. Liang, L, Ren, H, Cao, R, Hu, Y, Qin, Z, Li, C. and Mei, S. (2020). “The Effect of COVID-19 on Youth Mental Health”. Psychiatric Quarterly, 91 (3), 841-852.
  • 9. Zhou, S.J, Zhang, L.G, Wang, L.L, Guo, Z.C, Wang, J.Q, Chen, J.C. and Chen, J.X. (2020). “Prevalence and Socio-Demographic Correlates of Psychological Health Problems in Chinese Adolescents During the Outbreak of COVID-19”. European Child and Adolescent Psychiatry, 29, 749-758.
  • 10. Sahu, P. (2020). “Closure of Universities Due to Coronavirus Disease 2019 (COVID-19): Impact on Education and Mental Health of Students and Academic Staff”. Cureus, 12 (4), E7541.
  • 11. Santos, L.M.D. (2020). “The Relationship Between The COVID-19 Pandemic and Nursing Students’ Sense of Belonging: The Experiences and Nursing Education Management of Pre-Service Nursing Professionals”. International Journal of Environmental Research and Public Health, 17 (16), 5848.
  • 12. Barkley, J.E, Lepp, A, Glickman, E, Farnell, G, Beiting, J, Wiet, R. and Dowdell, B. (2020). “The Acute Effects of The COVID-19 Pandemic on Physical Activity and Sedentary Behavior in University Students and Employees”. International Journal of Exercise Science, 13 (5), 1326.
  • 13. Srivastav, A.K, Sharma, N. and Samuel, A.J. (2020). “Impact of Coronavirus Disease-19 (COVID-19) Lockdown on Physical Activity and Energy Expenditure Among Physiotherapy Professionals and Students Using Web-Based Open E-Survey Sent Through Whatsapp, Facebook and Instagram Messengers”. Clinical Epidemiology and Global Health, 9, 78-84.
  • 14. Romero-Blanco, C, Rodríguez-Almagro, J, Onieva-Zafra, M. D, Parra-Fernández, M.L, Prado-Laguna, M.D.C. and Hernández-Martínez, A. (2020). “Physical Activity and Sedentary Lifestyle İn University Students: Changes During Confinement Due to The Covid-19 Pandemic”. International Journal of Environmental Research and Public Health, 17 (18), 6567.
  • 15. Leirós-Rodríguez, R, Rodríguez-Nogueira, Ó, Pinto-Carral, A, Álvarez-Álvarez, M, Galán-Martín, M.Á, Montero-Cuadrado, F. and Benítez-Andrades, J.A. (2020). “Musculoskeletal Pain and Non-Classroom Teaching in Times of The COVID-19 Pandemic: Analysis of The Impact on Students From Two Spanish Universities”. Journal of Clinical Medicine, 9 (12), 4053.
  • 16. Konkan, R, Şenormancı, Ö, Güçlü, O, Aydın, E. ve Sungur, M.Z. (2013). “Yaygın Anksiyete Bozukluğu-7 (YAB-7) Testi Türkçe Uyarlaması, Geçerlik ve Güvenirliği”. Noropsikiyatri Arşivi, 50 (1), 53-59.
  • 17. Eskin, M, Harlak, H, Demirkıran, F. ve Dereboy, Ç. (2013). “Algılanan Stres Ölçeğinin Türkçeye Uyarlanması: Güvenirlik ve Geçerlik Analizi”. New Symposium Journal, 51 (3), 132-140.
  • 18. Savcı, S, Öztürk, M, Arıkan, H, İnal-İnce, D. ve Tokgözoğlu, L. (2006). “Physical Activity Levels oof University Students”. Turkish Cardiology Society Archive, 34, 166-172. 19. Price, D.D, Mcgrath, P.A, Rafii, A. and Buckingham, B. (1983). “The Validation of Visualanalogue Scales as Ratio Scale Measures For Chronic and Experimental Pain”. Pain, 17, 45-56.
  • 20. Son, C, Hegde, S, Smith, A, Wang, X. and Sasangohar, F. (2020). “Effects of COVID-19 on College Students’ Mental Health in The United States: Interview Survey Study”. Journal of Medical Internet Research, 22 (9), E21279.
  • 21. Cao, W, Fang, Z, Hou, G, Han, M, Xu, X, Dong, J. and Zheng, J. (2020). “The Psychological İmpact of The COVID-19 Epidemic on College Students in China”. Psychiatry Research, 287, 112934.
  • 22. Wang, Y, Di, Y, Ye, J. and Wei, W. (2020). “Study on The Public Psychological States and Its Related Factors During The Outbreak of Coronavirus Disease 2019 (COVID-19) in Some Regions of China”. Psychol. Health Med, 22, 1–10.
  • 23. Ahmed, M.Z, Ahmed, O, Aibao, Z, Hanbin, S, Siyu, L. and Ahmad, A. (2020). “Epidemic of COVID-19 in China and Associated Psychological Problems”. Asian J. Psychiatr, 51, 102092.
  • 24. Ozkul, C.O. (2020). “Quality of Life and Related Factors in University Students During The Coronavirus Disease 2019 Pandemic”. Journal of Exercise Therapy and Rehabilitation, 7 (3), 267-276.
  • 25. Elmer, T, Mepham, K. And Stadtfeld, C. (2020). “Students Under Lockdown: Assessing Change in Students’social Networks and Mental Health During The COVID-19 Crisis”. Plos One. 15, E0236337.
  • 26. Odriozola-González, P, Planchuelo-Gómez, Á, Irurtia, M.J. and De Luis-Garcia, R. (2020). “Psychological Effects of The COVID-19 Outbreak and Lockdown Among Students and Workers of A Spanish University”. Psychiatry Res. 290, 113108.
  • 27. Balanzá–Martínez, V, Atienza–Carbonell, B, Kapczinski, F. and De Boni, R.B. (2020). “Lifestyle Behaviours During The COVID‐19–Time to Connect”. Acta Psychiatrica Scandinavica, 141 (5), 399.
  • 28. Ammar, A, Brach, M, Trabelsi, K, Chtourou, H, Boukhris, O. and Masmoudi, L. (2020). “Effects of COVID-19 Home Confinement on Eating Behaviour and Physical Activity: Results of The ECLB-COVID19 International Online Survey”. Nutrients, 12 (6), 1583.
  • 29. Kargün, M, Togo, O.T, Biner, M. ve Pala, A. (2016). “Üniversite Öğrencilerinin Fiziksel Aktivite Düzeylerinin İncelenmesi”. Marmara Üniversitesi Spor Bilimleri Dergisi, 1 (1), 61-72.
  • 30. Huéscar Hernández, E, Andrés Fabra, J.A. and Moreno Murcia, J.A. (2020). “Effect of Autonomy Support and Dialogic Learning on School Children’s Physical Activity and Sport”. Scandinavian Journal of Psychology, 61 (3), 402-409.

COVID-19 Pandemisinin Fizyoterapi ve Rehabilitasyon Öğrencilerindeki Etkilerinin İncelenmesi

Yıl 2022, , 1411 - 1418, 22.12.2022
https://doi.org/10.37989/gumussagbil.960399

Öz

Çalışmamızda COVID-19 pandemisi ile fizyoterapi ve rehabilitasyon öğrencilerinin stres, anksiyete, öğrenme kaygısı, okula aidiyet duygusu, fiziksel aktivite düzeyleri ve kas iskelet sistemi etkilenimlerinin değerlendirilmesi amaçlanmıştır. Materyal-Metod: Çalışmaya gönüllük esası ile 450 üniversite öğrencisi (364 kız, 86 erkek) dahil edildi. Öğrencilere çevrimiçi olarak Yaygın Anksiyete Bozukluğu-7, Algılanan Stres Ölçeği, Uluslararası Fiziksel Aktivite Anketi Kısa Form, Görsel Analog Skala uygulandı. Aynı zamanda ağrı lokalizasyonu, gün içinde ağrıyı arttıran pozisyonlar/aktiviteler, öğrencilerin öğrenme kaygısı ve okula aidiyet hissetme durumları açık uçlu sorular ile sorgulandı. Veriler SPSS 20.0 programında Mann-Whitney U testi ile Spearman’s korelasyon analizi kullanılarak ve anlamlılık düzeyi (p<0,05) üzerinden değerlendirildi. Bulgular: Çalışmamızda özellikle kız öğrenciler lehine kaygı düzeyi hafif, stres düzeyi yüksek bulunmuştur (p=0,000, p=0,001). Erkek öğrencilerin toplam fiziksel aktivite sürelerinde kız öğrencilere göre istatistiksel olarak anlamlı farklılık elde edildi (p=0,009). Öğrenciler en çok ağrıyı omurgada yaşadıklarını ve ağrıyı artıran pozisyonun uzun süre oturmak olduğunu iletti. Kız öğrencilerde erkek öğrencilere göre öğrenme kaygısı açısından istatistiksel olarak anlamlı fark bulundu (p=0,004). Sonuç: Bu çalışma, COVID-19 karantinasının, üniversite öğrencileri arasında daha yüksek stres ve anksiyeteye ve fiziksel aktivite seviyesinde düşüşe sebep olduğunu göstermektedir. Aynı zamanda öğrencilerin hissettiği yüksek stres düzeyinin öğrenme kaygısı geliştirmesine ve uzaktan eğitimin kas iskelet sistemini olumsuz etkilediğine dair veriler sunmaktadır.

Kaynakça

  • 1. World Health Organization. (2020). “Coronavirus Disease (COVID19) Pandemic”. Erişim adresi: https://www.who.int/emergencies/diseases/novel-coronavirus-2019 (Erişim Tarihi:22.11.2022).
  • 2. Rodriguez-Morales, A.J, Cardona-Ospina, J.A, Gutiérrez-Ocampo, E, Villamizar-Peña, R, Holguin-Rivera, Y, Escalera-Antezana, J.P, ..., and Sah, R. (2020). “Clinical, Laboratory and Imaging Features of COVID-19: A Systematic Review and Meta-Analysis”. Travel Medicine and Infectious Disease, 34, 101623.
  • 3. Xie, M. and Chen, Q. (2020). “Insight Into 2019 Novel Coronavirus–an Updated Interim Review and Lessons From SARS-Cov and MERS-Cov”. Int J Infect Dis, 94, 119–124.
  • 4. Olaimat, A.N, Aolymat, I, Elsahoryi, N, Shahbaz, H.M. and Holley, R.A. (2020). “Attitudes, Anxiety, and Behavioral Practices Regarding COVID-19 Among University Students in Jordan: A Cross-Sectional Study.” The American Journal of Tropical Medicine and Hygiene, 103 (3), 1177-1183.
  • 5. Brooks, S.K, Webster, R.K, Smith, L.E, Woodland, L, Wessely, S, Greenberg, N. and Rubin, G.J. (2020). “The Psychological Impact of Quarantine and How to Reduce It: Rapid Review of The Evidence”. The Lancet, 395 (10227), 912-920.
  • 6. Rubin, G.J. and Wessely, S. (2020). “The Psychological Effects of Quarantining a City”, BMJ, 368.
  • 7. Zhang, N, Hu, W. and Wang, K. (2020). “Research on the Coping Methods of College Students to 2019-Ncov”. 4th International Conference on Culture, Education and Economic Development of Modern Society (ICCESE 2020), (1278-1280), Atlantis Press.
  • 8. Liang, L, Ren, H, Cao, R, Hu, Y, Qin, Z, Li, C. and Mei, S. (2020). “The Effect of COVID-19 on Youth Mental Health”. Psychiatric Quarterly, 91 (3), 841-852.
  • 9. Zhou, S.J, Zhang, L.G, Wang, L.L, Guo, Z.C, Wang, J.Q, Chen, J.C. and Chen, J.X. (2020). “Prevalence and Socio-Demographic Correlates of Psychological Health Problems in Chinese Adolescents During the Outbreak of COVID-19”. European Child and Adolescent Psychiatry, 29, 749-758.
  • 10. Sahu, P. (2020). “Closure of Universities Due to Coronavirus Disease 2019 (COVID-19): Impact on Education and Mental Health of Students and Academic Staff”. Cureus, 12 (4), E7541.
  • 11. Santos, L.M.D. (2020). “The Relationship Between The COVID-19 Pandemic and Nursing Students’ Sense of Belonging: The Experiences and Nursing Education Management of Pre-Service Nursing Professionals”. International Journal of Environmental Research and Public Health, 17 (16), 5848.
  • 12. Barkley, J.E, Lepp, A, Glickman, E, Farnell, G, Beiting, J, Wiet, R. and Dowdell, B. (2020). “The Acute Effects of The COVID-19 Pandemic on Physical Activity and Sedentary Behavior in University Students and Employees”. International Journal of Exercise Science, 13 (5), 1326.
  • 13. Srivastav, A.K, Sharma, N. and Samuel, A.J. (2020). “Impact of Coronavirus Disease-19 (COVID-19) Lockdown on Physical Activity and Energy Expenditure Among Physiotherapy Professionals and Students Using Web-Based Open E-Survey Sent Through Whatsapp, Facebook and Instagram Messengers”. Clinical Epidemiology and Global Health, 9, 78-84.
  • 14. Romero-Blanco, C, Rodríguez-Almagro, J, Onieva-Zafra, M. D, Parra-Fernández, M.L, Prado-Laguna, M.D.C. and Hernández-Martínez, A. (2020). “Physical Activity and Sedentary Lifestyle İn University Students: Changes During Confinement Due to The Covid-19 Pandemic”. International Journal of Environmental Research and Public Health, 17 (18), 6567.
  • 15. Leirós-Rodríguez, R, Rodríguez-Nogueira, Ó, Pinto-Carral, A, Álvarez-Álvarez, M, Galán-Martín, M.Á, Montero-Cuadrado, F. and Benítez-Andrades, J.A. (2020). “Musculoskeletal Pain and Non-Classroom Teaching in Times of The COVID-19 Pandemic: Analysis of The Impact on Students From Two Spanish Universities”. Journal of Clinical Medicine, 9 (12), 4053.
  • 16. Konkan, R, Şenormancı, Ö, Güçlü, O, Aydın, E. ve Sungur, M.Z. (2013). “Yaygın Anksiyete Bozukluğu-7 (YAB-7) Testi Türkçe Uyarlaması, Geçerlik ve Güvenirliği”. Noropsikiyatri Arşivi, 50 (1), 53-59.
  • 17. Eskin, M, Harlak, H, Demirkıran, F. ve Dereboy, Ç. (2013). “Algılanan Stres Ölçeğinin Türkçeye Uyarlanması: Güvenirlik ve Geçerlik Analizi”. New Symposium Journal, 51 (3), 132-140.
  • 18. Savcı, S, Öztürk, M, Arıkan, H, İnal-İnce, D. ve Tokgözoğlu, L. (2006). “Physical Activity Levels oof University Students”. Turkish Cardiology Society Archive, 34, 166-172. 19. Price, D.D, Mcgrath, P.A, Rafii, A. and Buckingham, B. (1983). “The Validation of Visualanalogue Scales as Ratio Scale Measures For Chronic and Experimental Pain”. Pain, 17, 45-56.
  • 20. Son, C, Hegde, S, Smith, A, Wang, X. and Sasangohar, F. (2020). “Effects of COVID-19 on College Students’ Mental Health in The United States: Interview Survey Study”. Journal of Medical Internet Research, 22 (9), E21279.
  • 21. Cao, W, Fang, Z, Hou, G, Han, M, Xu, X, Dong, J. and Zheng, J. (2020). “The Psychological İmpact of The COVID-19 Epidemic on College Students in China”. Psychiatry Research, 287, 112934.
  • 22. Wang, Y, Di, Y, Ye, J. and Wei, W. (2020). “Study on The Public Psychological States and Its Related Factors During The Outbreak of Coronavirus Disease 2019 (COVID-19) in Some Regions of China”. Psychol. Health Med, 22, 1–10.
  • 23. Ahmed, M.Z, Ahmed, O, Aibao, Z, Hanbin, S, Siyu, L. and Ahmad, A. (2020). “Epidemic of COVID-19 in China and Associated Psychological Problems”. Asian J. Psychiatr, 51, 102092.
  • 24. Ozkul, C.O. (2020). “Quality of Life and Related Factors in University Students During The Coronavirus Disease 2019 Pandemic”. Journal of Exercise Therapy and Rehabilitation, 7 (3), 267-276.
  • 25. Elmer, T, Mepham, K. And Stadtfeld, C. (2020). “Students Under Lockdown: Assessing Change in Students’social Networks and Mental Health During The COVID-19 Crisis”. Plos One. 15, E0236337.
  • 26. Odriozola-González, P, Planchuelo-Gómez, Á, Irurtia, M.J. and De Luis-Garcia, R. (2020). “Psychological Effects of The COVID-19 Outbreak and Lockdown Among Students and Workers of A Spanish University”. Psychiatry Res. 290, 113108.
  • 27. Balanzá–Martínez, V, Atienza–Carbonell, B, Kapczinski, F. and De Boni, R.B. (2020). “Lifestyle Behaviours During The COVID‐19–Time to Connect”. Acta Psychiatrica Scandinavica, 141 (5), 399.
  • 28. Ammar, A, Brach, M, Trabelsi, K, Chtourou, H, Boukhris, O. and Masmoudi, L. (2020). “Effects of COVID-19 Home Confinement on Eating Behaviour and Physical Activity: Results of The ECLB-COVID19 International Online Survey”. Nutrients, 12 (6), 1583.
  • 29. Kargün, M, Togo, O.T, Biner, M. ve Pala, A. (2016). “Üniversite Öğrencilerinin Fiziksel Aktivite Düzeylerinin İncelenmesi”. Marmara Üniversitesi Spor Bilimleri Dergisi, 1 (1), 61-72.
  • 30. Huéscar Hernández, E, Andrés Fabra, J.A. and Moreno Murcia, J.A. (2020). “Effect of Autonomy Support and Dialogic Learning on School Children’s Physical Activity and Sport”. Scandinavian Journal of Psychology, 61 (3), 402-409.
Toplam 29 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Gülay Aras Bayram 0000-0002-5592-7546

Pınar Kaya Ciddi 0000-0002-7611-0527

Yayımlanma Tarihi 22 Aralık 2022
Yayımlandığı Sayı Yıl 2022

Kaynak Göster

APA Aras Bayram, G., & Kaya Ciddi, P. (2022). COVID-19 Pandemisinin Fizyoterapi ve Rehabilitasyon Öğrencilerindeki Etkilerinin İncelenmesi. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, 11(4), 1411-1418. https://doi.org/10.37989/gumussagbil.960399
AMA Aras Bayram G, Kaya Ciddi P. COVID-19 Pandemisinin Fizyoterapi ve Rehabilitasyon Öğrencilerindeki Etkilerinin İncelenmesi. Gümüşhane Sağlık Bilimleri Dergisi. Aralık 2022;11(4):1411-1418. doi:10.37989/gumussagbil.960399
Chicago Aras Bayram, Gülay, ve Pınar Kaya Ciddi. “COVID-19 Pandemisinin Fizyoterapi Ve Rehabilitasyon Öğrencilerindeki Etkilerinin İncelenmesi”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 11, sy. 4 (Aralık 2022): 1411-18. https://doi.org/10.37989/gumussagbil.960399.
EndNote Aras Bayram G, Kaya Ciddi P (01 Aralık 2022) COVID-19 Pandemisinin Fizyoterapi ve Rehabilitasyon Öğrencilerindeki Etkilerinin İncelenmesi. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 11 4 1411–1418.
IEEE G. Aras Bayram ve P. Kaya Ciddi, “COVID-19 Pandemisinin Fizyoterapi ve Rehabilitasyon Öğrencilerindeki Etkilerinin İncelenmesi”, Gümüşhane Sağlık Bilimleri Dergisi, c. 11, sy. 4, ss. 1411–1418, 2022, doi: 10.37989/gumussagbil.960399.
ISNAD Aras Bayram, Gülay - Kaya Ciddi, Pınar. “COVID-19 Pandemisinin Fizyoterapi Ve Rehabilitasyon Öğrencilerindeki Etkilerinin İncelenmesi”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi 11/4 (Aralık 2022), 1411-1418. https://doi.org/10.37989/gumussagbil.960399.
JAMA Aras Bayram G, Kaya Ciddi P. COVID-19 Pandemisinin Fizyoterapi ve Rehabilitasyon Öğrencilerindeki Etkilerinin İncelenmesi. Gümüşhane Sağlık Bilimleri Dergisi. 2022;11:1411–1418.
MLA Aras Bayram, Gülay ve Pınar Kaya Ciddi. “COVID-19 Pandemisinin Fizyoterapi Ve Rehabilitasyon Öğrencilerindeki Etkilerinin İncelenmesi”. Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi, c. 11, sy. 4, 2022, ss. 1411-8, doi:10.37989/gumussagbil.960399.
Vancouver Aras Bayram G, Kaya Ciddi P. COVID-19 Pandemisinin Fizyoterapi ve Rehabilitasyon Öğrencilerindeki Etkilerinin İncelenmesi. Gümüşhane Sağlık Bilimleri Dergisi. 2022;11(4):1411-8.