Araştırma Makalesi
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Attitudes of Nurses and Nursing Students Towards Vital Signs: A Comparatıve Study

Yıl 2024, , 575 - 590, 15.10.2024
https://doi.org/10.46483/jnef.1347139

Öz

Background: Monitoring of vital signs is an important nursing evaluation that contributes to the early detection of changes in the clinical status of patients.

Aim: The aim of this study to compare the current practices and attitudes of nurses and nursing students towards monitoring vital signs.

Method: This descriptive study was conducted with nurses (n= 350) working in a training and research hospital and students (n= 344) studying in the nursing department of faculty of health sciences. Study data were obtained with Nurse Information Form, Student Information Form, and Vital Signs Scale (V-Scale).

Results: It was determined that 80.9% of the nurses participating in the study and 82.6% of the nursing students were female, and their mean age was 30.09 ± 7.23 and 21.09 ± 1.38, respectively. The total attitude score towards monitoring vital signs was 60.54 ± 7.26 for nurses and 52.94 ± 7.04 for nursing students (p <0.001). Nurses’ V-Scale total and sub-dimension mean scores were found to be significantly higher than those of nursing students (p < .001).

Conclusion: The findings of the study showed that nurses and nursing students attach importance to the monitoring of vital signs, but the attitudes of nurses are significantly more positive when compared to nursing students. To more positive attitudes towards vital signs, it is recommended to organize educational interventions aimed at interpreting vital signs and improving clinical decision-making skills.

Kaynakça

  • Alshehry, A. S., Cruz, J. P., Bashtawi, M. A., Almutairi, K. O., Tumala, R. B. (2021). Nursing students’ knowled-ge, competence and attitudes towards vital signs monitoring during clinical practice. Journal of Clinical Nur-sing, 30(5-6), 664–675.
  • Andrews, T., Waterman, H. (2005). Packaging: a grounded theory of how to report physiological deterioration effectively. Journal of Advanced Nursing, 52(5), 473-481.
  • Ansell, H., Meyer, A., Thompson, S. (2014). Why don’t nurses consistently take patient respiratory rates? British Journal of Nursing, 23(8), 414-418.
  • Baştürk, S. ve Taştepe, M. (2013). Evren ve Örneklem. Savaş Baştürk (Ed.), Bilimsel Araştırma Yöntemleri içinde (ss. 129–159). Ankara: Vize Yayıncılık.
  • Bellomo, R., Ackerman, M., Bailey, M., Beale, R., Clancy, G., Danesh, V., …… Tangkau, P. (2012). A controlled trial of electronic automated advisory vital signs monitoring in general hospital wards. Critical Care Medicine, 40(8), 2349-2361.
  • Brekke, I.J., Puntervoll, L.H., Pedersen, P.B., Kellett, J., Brabrand, M. (2019). The value of vital sign trends in predicting and monitoring clinical deterioration: A systematic review. PLoS ONE, 14(1), e0210875.
  • Burchill, C. N., Polomano, R. (2016). Certification in emergency nursing associated with vital signs attitudes and practices. International Emergency Nursing, 27, 17–23.
  • Burchill, C., Anderson, B., O’Connor, P. C. (2015). Exploration of nurse practices and attitudes related to pos-toperative vital signs. MEDSURG Nursing, 24(4), 249-255.
  • Candel, B. G. J., Duijzer, R., Gaakeer, M. I., ter Avest, E., Sir, Ö., Lameijer, H., … de Groot, B. (2022). The asso-ciation between vital signs and clinical outcomes in emergency department patients of different age catego-ries. Emergency Medicine Journal, 39(12), 903–911.
  • Cardona-Morrell, M., Prgomet, M., Lake, R., Nicholson, M., Harrison, R., Long, J., … Hillman, K. (2016a). Vital signs monitoring and nurse–patient interaction: A qualitative observational study of hospital practice. Inter-national Journal of Nursing Studies, 56, 9–16
  • Cardona-Morrell, M., Prgomet, M., Turner, R. M., Nicholson, M., & Hillman, K. (2016b). Effectiveness of con-tinuous or intermittent vital signs monitoring in preventing adverse events on general wards: a systematic review and meta-analysis. International Journal of Clinical Practice, 70(10), 806-824.
  • Chua, W. L., Mackey, S., Ng, E. K. C., Liaw, S. Y. (2013). Front line nurses’ experiences with deteriorating ward patients: a qualitative study. International Nursing Review, 60(4), 501-509.
  • Churpek, M. M., Adhikari, R., Edelson, D. P. (2016). The value of vital sign trends for detecting clinical deteri-oration on the wards. Resuscitation, 102, 1-5.
  • Dall’Ora, C., Griffiths, P., Hope, J., Briggs, J., Jeremy, J., Gerry, S., Redfern, O. C. (2021). How long do nursing staff take to measure and record patients’ vital signs observations in hospital? A time-and-motion study. In-ternational Journal of Nursing Studies, 118:103921.
  • Dall’Ora, C., Griffiths, P., Hope, J., Barker, H., Smith, G.B. (2020). What is the nursing time and workload in-volved in taking and recording patients’ vital signs? A systematic review. Journal of Clinical Nursing, 29 (13-14):2053-2068.
  • Duruk, N., Kalaycı, F. (2021). Hemşirelik öğrencilerinin kan basıncı ölçümü hakkındaki bilgileri uygulamalarını etkiler mi? Hemşirelik Bilimi Dergisi, 4(1), 18-25.
  • Eddahchouri, Y., Peelen, R. V., Koeneman, M., Touw, H. R. W., van Goor, H. ve Bredie, S. J. H. (2022). Effect of continuous wireless vital sign monitoring on unplanned ICU admissions and rapid response team calls: a be-fore-and-after study. British Journal of Anaesthesia, 128(5), 857-863.
  • Elliott, M., Endacott, R. (2022). The clinical neglect of vital signs’ assessment: an emerging patient safety is-sue? Contemporary Nurse, 58(4), 249-252.
  • Ertuğ, N. (2018). Evaluating the validity and reliability of the V-Scale instrument (Turkish version) used to de-termine nurses’ attitudes towards vital sign monitoring. International Journal of Nursing Practice, 24(3), 5-9.
  • Gawronski, O., Biagioli, V., Dall’oglio, I., Cecchetti, C., Ferro, F., Tiozzo, E., … Rocco, G. (2022). Attitudes and practices towards vital signs monitoring on paediatric wards: Cross-validation of the Ped-V scale. Journal of Pediatric Nursing, 65, 98-107.
  • Gül, Ş., Çelik, G.H.T., Arslan, S., Basit, G. (2019). Hemşirelik esasları dersi klinik uygulaması sırasında gerçek-leştirilen temel hemşirelik uygulamalarının değerlendirilmesi: retrospektif bir çalışma. Sağlık ve Toplum, 29(1), 54-64.
  • Gülnar, E., Doğan Yılmaz, E., ve Özveren, H. (2020). Hemşirelerin yaşam bulgularına ı̇li̇şki̇n tutum ve uygu-lamalarını beli̇rlenmesi̇. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, 22(3), 377–385.
  • Hemşirelik Yönetmeliğinde Değişiklik Yapılmasına Dair Yönetmelik (2011). Erişim Adresi https://www.resmigazete.gov.tr/eskiler/2011/04/20110419-5.htm
  • Kaba, A., Beran, T.N. (2016). Impact of peer pressure on accuracy of reporting vital signs: An interprofessio-nal comparison between nursing and medical students. Journal of Interprofessional Care, 30:1, 116-122.
  • Kaba, A., Beran, T. N., White, D. (2016). Accuracy of interpreting vital signs in simulation: An empirical study of conformity between medical and nursing students. Journal of Interprofessional Education & Practice, 3, 9-18.
  • Kamio, T., Kajiwara, A., Iizuka, Y., Shiotsuka, J., Sanui, M. (2018). Frequency of vital sign measurement among intubated patients in the general ward and nurses’ attitudes toward vital sign measurement. Journal of Mul-tidisciplinary Healthcare, 11, 575–581.
  • Leonard, M. M., Kyriacos, U. (2015). Student nurses’ recognition of early signs of abnormal vital sign recor-dings. Nurse Education Today, 35(9), e11–e18.
  • Massey, D., Chaboyer, W., Aitken, L. (2014). Nurses’ perceptions of accessing a Medical Emergency Team: A qualitative study. Australian Critical Care, 27(3), 133-138.
  • Massey, D., Chaboyer, W., Anderson, V. (2017). What factors influence ward nurses’ recognition of and res-ponse to patient deterioration? An integrative review of the literatüre. Nursing Open, 4(1), 6-23.
  • Mok, W., Wang, W., Cooper, S., Ang, E. N. K., Liaw, S. Y. (2015a). Attitudes towards vital signs monitoring in the detection of clinical deterioration: scale development and survey of ward nurses. International Journal for Quality in Health Care, 27(3), 207-213.
  • Mok, W.Q., Wang, W., Liaw, S.Y. (2015b). Vital signs monitoring to detect patient deterioration: An integrative literature review. International Journal of Nursing Practice, 21(2), 91-98.
  • Özsaban, A., Turan, N., Beki, Ç., Aşti, T. (2022). The relationship between nurses’ attitudes toward vital signs monitoring and emotional ıntelligence levels. Genel Tıp Dergisi, 32(6), 652-657.
  • Pereira, F.G.F., Frota, N.M., da Silva, D.V., de Sousa, L.M.O., de Almeida, J.C., Cysne Filho, F.M.S. (208). Evalu-ation of an application program for the teaching of vital signs. Revista Mineira de Enfermagem, 21:e-1034
  • Pozam, M., Khorshid, L. ve Sarı, D. (2022). Hemşirelerin Yaşamsal Bulguların İzlenmesine Yönelik Tutumlarının Belirlenmesi: Tanımlayıcı Araştırma. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi, 14(2), 398-406.
  • Prgomet, M., Cardona-Morrell, M., Nicholson, M., Lake, R., Long, J., Westbrook, J., ….. Hillman, K. (2016). Vital signs monitoring on general wards: clinical staff perceptions of current practices and the planned intro-duction of continuous monitoring technology. International Journal for Quality in Health Care, 28(4), 515-21.
  • Redfern, O. C., Griffiths, P., Maruotti, A., Recio Saucedo, A., & Smith, G. B. (2019). The association between nurse staffing levels and the timeliness of vital signs monitoring: A retrospective observational study in the UK. BMJ Open, 9(9), 1-8.
  • Sarı, H.Y., Yöntem, S.Ç., Demir, D., Karaoğlan, N., Başkurt, S.Ş., ve Çimen, S. (2013). Pediatri hemşirelerinin yaşam bulgularına yönelik bilgi ve tutumları. Hemşirelikte Eğitim ve Araştırma Dergisi, 10(1): 38-44.
  • Schell, K., Lyons, D.L. (2022). Staff knowledge of orthostatic vital signs measurement. Nursing Research, 52(8), 55-61.
  • Sun, L., Joshi, M., Khan, S. N., Ashrafian, H., Darzi, A. (2020). Clinical impact of multi-parameter continuous non-invasive monitoring in hospital wards: a systematic review and meta-analysis. Journal of the Royal Soci-ety of Medicine, 113(6), 217-224.

Hemşirelerin ve Hemşirelik Öğrencilerinin Yaşamsal Bulgulara Yönelik Tutumları: Karşılaştırmalı Bir Çalışma

Yıl 2024, , 575 - 590, 15.10.2024
https://doi.org/10.46483/jnef.1347139

Öz

Giriş: Yaşamsal bulguların izlemi, hastaların klinik durumlarındaki değişimlerin erken dönemde saptanabilmesine katkı sağlayan önemli bir hemşirelik değerlendirmesidir.

Amaç: Bu çalışmanın amacı; hemşirelerin ve hemşirelik öğrencilerinin yaşamsal bulguların izlenmesine yönelik mevcut uygulamalarını ve tutumlarını karşılaştırmaktır.

Yöntem: Tanımlayıcı tipteki bu araştırma, bir eğitim ve araştırma hastanesinde çalışan hemşireler (n= 350) ile bir sağlık bilimleri fakültesinin hemşirelik bölümünde öğrenim gören öğrencilerle (n= 344) yürütüldü. Çalışma verileri Hemşire Bilgi Formu, Öğrenci Bilgi Formu ve Yaşam Bulguları Ölçeği ile elde edildi.

Bulgular: Araştırmaya katılan hemşirelerin %80.9’unun, hemşirelik öğrencilerinin ise %82.6’sının kadın, yaş ortalamalarının ise sırasıyla 30.09 ± 7.23 ve 21.09 ± 1.38 olduğu saptandı. Yaşamsal bulguların takibine yönelik toplam tutum puanı hemşireler için 60.54 ± 7.26, hemşirelik öğrencileri için 52.94 ± 7.04 olarak bulundu. Hemşirelerin Yaşam Bulguları Ölçeği toplam ve alt boyut puan ortalamalarının hemşirelik öğrencilerinden anlamlı olarak daha yüksek olduğu saptandı (p < .001).

Sonuç: Araştırmadan elde edilen bulgular, hemşirelerin ve hemşirelik öğrencilerinin yaşamsal bulguların takibine önem verdiklerini, ancak hemşirelik öğrencileri ile kıyaslandığında hemşirelerin tutumlarının anlamlı olarak daha olumlu olduğunu gösterdi. Yaşamsal bulgulara yönelik daha olumlu tutum için, yaşamsal bulguları yorumlamayı ve klinik karar verme becerilerini geliştirmeyi amaçlayan eğitim müdahalelerinin düzenlenmesi önerilir.

Kaynakça

  • Alshehry, A. S., Cruz, J. P., Bashtawi, M. A., Almutairi, K. O., Tumala, R. B. (2021). Nursing students’ knowled-ge, competence and attitudes towards vital signs monitoring during clinical practice. Journal of Clinical Nur-sing, 30(5-6), 664–675.
  • Andrews, T., Waterman, H. (2005). Packaging: a grounded theory of how to report physiological deterioration effectively. Journal of Advanced Nursing, 52(5), 473-481.
  • Ansell, H., Meyer, A., Thompson, S. (2014). Why don’t nurses consistently take patient respiratory rates? British Journal of Nursing, 23(8), 414-418.
  • Baştürk, S. ve Taştepe, M. (2013). Evren ve Örneklem. Savaş Baştürk (Ed.), Bilimsel Araştırma Yöntemleri içinde (ss. 129–159). Ankara: Vize Yayıncılık.
  • Bellomo, R., Ackerman, M., Bailey, M., Beale, R., Clancy, G., Danesh, V., …… Tangkau, P. (2012). A controlled trial of electronic automated advisory vital signs monitoring in general hospital wards. Critical Care Medicine, 40(8), 2349-2361.
  • Brekke, I.J., Puntervoll, L.H., Pedersen, P.B., Kellett, J., Brabrand, M. (2019). The value of vital sign trends in predicting and monitoring clinical deterioration: A systematic review. PLoS ONE, 14(1), e0210875.
  • Burchill, C. N., Polomano, R. (2016). Certification in emergency nursing associated with vital signs attitudes and practices. International Emergency Nursing, 27, 17–23.
  • Burchill, C., Anderson, B., O’Connor, P. C. (2015). Exploration of nurse practices and attitudes related to pos-toperative vital signs. MEDSURG Nursing, 24(4), 249-255.
  • Candel, B. G. J., Duijzer, R., Gaakeer, M. I., ter Avest, E., Sir, Ö., Lameijer, H., … de Groot, B. (2022). The asso-ciation between vital signs and clinical outcomes in emergency department patients of different age catego-ries. Emergency Medicine Journal, 39(12), 903–911.
  • Cardona-Morrell, M., Prgomet, M., Lake, R., Nicholson, M., Harrison, R., Long, J., … Hillman, K. (2016a). Vital signs monitoring and nurse–patient interaction: A qualitative observational study of hospital practice. Inter-national Journal of Nursing Studies, 56, 9–16
  • Cardona-Morrell, M., Prgomet, M., Turner, R. M., Nicholson, M., & Hillman, K. (2016b). Effectiveness of con-tinuous or intermittent vital signs monitoring in preventing adverse events on general wards: a systematic review and meta-analysis. International Journal of Clinical Practice, 70(10), 806-824.
  • Chua, W. L., Mackey, S., Ng, E. K. C., Liaw, S. Y. (2013). Front line nurses’ experiences with deteriorating ward patients: a qualitative study. International Nursing Review, 60(4), 501-509.
  • Churpek, M. M., Adhikari, R., Edelson, D. P. (2016). The value of vital sign trends for detecting clinical deteri-oration on the wards. Resuscitation, 102, 1-5.
  • Dall’Ora, C., Griffiths, P., Hope, J., Briggs, J., Jeremy, J., Gerry, S., Redfern, O. C. (2021). How long do nursing staff take to measure and record patients’ vital signs observations in hospital? A time-and-motion study. In-ternational Journal of Nursing Studies, 118:103921.
  • Dall’Ora, C., Griffiths, P., Hope, J., Barker, H., Smith, G.B. (2020). What is the nursing time and workload in-volved in taking and recording patients’ vital signs? A systematic review. Journal of Clinical Nursing, 29 (13-14):2053-2068.
  • Duruk, N., Kalaycı, F. (2021). Hemşirelik öğrencilerinin kan basıncı ölçümü hakkındaki bilgileri uygulamalarını etkiler mi? Hemşirelik Bilimi Dergisi, 4(1), 18-25.
  • Eddahchouri, Y., Peelen, R. V., Koeneman, M., Touw, H. R. W., van Goor, H. ve Bredie, S. J. H. (2022). Effect of continuous wireless vital sign monitoring on unplanned ICU admissions and rapid response team calls: a be-fore-and-after study. British Journal of Anaesthesia, 128(5), 857-863.
  • Elliott, M., Endacott, R. (2022). The clinical neglect of vital signs’ assessment: an emerging patient safety is-sue? Contemporary Nurse, 58(4), 249-252.
  • Ertuğ, N. (2018). Evaluating the validity and reliability of the V-Scale instrument (Turkish version) used to de-termine nurses’ attitudes towards vital sign monitoring. International Journal of Nursing Practice, 24(3), 5-9.
  • Gawronski, O., Biagioli, V., Dall’oglio, I., Cecchetti, C., Ferro, F., Tiozzo, E., … Rocco, G. (2022). Attitudes and practices towards vital signs monitoring on paediatric wards: Cross-validation of the Ped-V scale. Journal of Pediatric Nursing, 65, 98-107.
  • Gül, Ş., Çelik, G.H.T., Arslan, S., Basit, G. (2019). Hemşirelik esasları dersi klinik uygulaması sırasında gerçek-leştirilen temel hemşirelik uygulamalarının değerlendirilmesi: retrospektif bir çalışma. Sağlık ve Toplum, 29(1), 54-64.
  • Gülnar, E., Doğan Yılmaz, E., ve Özveren, H. (2020). Hemşirelerin yaşam bulgularına ı̇li̇şki̇n tutum ve uygu-lamalarını beli̇rlenmesi̇. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi, 22(3), 377–385.
  • Hemşirelik Yönetmeliğinde Değişiklik Yapılmasına Dair Yönetmelik (2011). Erişim Adresi https://www.resmigazete.gov.tr/eskiler/2011/04/20110419-5.htm
  • Kaba, A., Beran, T.N. (2016). Impact of peer pressure on accuracy of reporting vital signs: An interprofessio-nal comparison between nursing and medical students. Journal of Interprofessional Care, 30:1, 116-122.
  • Kaba, A., Beran, T. N., White, D. (2016). Accuracy of interpreting vital signs in simulation: An empirical study of conformity between medical and nursing students. Journal of Interprofessional Education & Practice, 3, 9-18.
  • Kamio, T., Kajiwara, A., Iizuka, Y., Shiotsuka, J., Sanui, M. (2018). Frequency of vital sign measurement among intubated patients in the general ward and nurses’ attitudes toward vital sign measurement. Journal of Mul-tidisciplinary Healthcare, 11, 575–581.
  • Leonard, M. M., Kyriacos, U. (2015). Student nurses’ recognition of early signs of abnormal vital sign recor-dings. Nurse Education Today, 35(9), e11–e18.
  • Massey, D., Chaboyer, W., Aitken, L. (2014). Nurses’ perceptions of accessing a Medical Emergency Team: A qualitative study. Australian Critical Care, 27(3), 133-138.
  • Massey, D., Chaboyer, W., Anderson, V. (2017). What factors influence ward nurses’ recognition of and res-ponse to patient deterioration? An integrative review of the literatüre. Nursing Open, 4(1), 6-23.
  • Mok, W., Wang, W., Cooper, S., Ang, E. N. K., Liaw, S. Y. (2015a). Attitudes towards vital signs monitoring in the detection of clinical deterioration: scale development and survey of ward nurses. International Journal for Quality in Health Care, 27(3), 207-213.
  • Mok, W.Q., Wang, W., Liaw, S.Y. (2015b). Vital signs monitoring to detect patient deterioration: An integrative literature review. International Journal of Nursing Practice, 21(2), 91-98.
  • Özsaban, A., Turan, N., Beki, Ç., Aşti, T. (2022). The relationship between nurses’ attitudes toward vital signs monitoring and emotional ıntelligence levels. Genel Tıp Dergisi, 32(6), 652-657.
  • Pereira, F.G.F., Frota, N.M., da Silva, D.V., de Sousa, L.M.O., de Almeida, J.C., Cysne Filho, F.M.S. (208). Evalu-ation of an application program for the teaching of vital signs. Revista Mineira de Enfermagem, 21:e-1034
  • Pozam, M., Khorshid, L. ve Sarı, D. (2022). Hemşirelerin Yaşamsal Bulguların İzlenmesine Yönelik Tutumlarının Belirlenmesi: Tanımlayıcı Araştırma. Türkiye Klinikleri Hemşirelik Bilimleri Dergisi, 14(2), 398-406.
  • Prgomet, M., Cardona-Morrell, M., Nicholson, M., Lake, R., Long, J., Westbrook, J., ….. Hillman, K. (2016). Vital signs monitoring on general wards: clinical staff perceptions of current practices and the planned intro-duction of continuous monitoring technology. International Journal for Quality in Health Care, 28(4), 515-21.
  • Redfern, O. C., Griffiths, P., Maruotti, A., Recio Saucedo, A., & Smith, G. B. (2019). The association between nurse staffing levels and the timeliness of vital signs monitoring: A retrospective observational study in the UK. BMJ Open, 9(9), 1-8.
  • Sarı, H.Y., Yöntem, S.Ç., Demir, D., Karaoğlan, N., Başkurt, S.Ş., ve Çimen, S. (2013). Pediatri hemşirelerinin yaşam bulgularına yönelik bilgi ve tutumları. Hemşirelikte Eğitim ve Araştırma Dergisi, 10(1): 38-44.
  • Schell, K., Lyons, D.L. (2022). Staff knowledge of orthostatic vital signs measurement. Nursing Research, 52(8), 55-61.
  • Sun, L., Joshi, M., Khan, S. N., Ashrafian, H., Darzi, A. (2020). Clinical impact of multi-parameter continuous non-invasive monitoring in hospital wards: a systematic review and meta-analysis. Journal of the Royal Soci-ety of Medicine, 113(6), 217-224.
Toplam 39 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Hemşirelik Esasları
Bölüm Araştırma Makalesi
Yazarlar

Öznur Gürlek Kısacık 0000-0002-1317-3141

Azize Özdaş Gündoğan 0000-0001-7186-3792

Esra Yılmaz 0009-0009-9582-5913

Erken Görünüm Tarihi 15 Ekim 2024
Yayımlanma Tarihi 15 Ekim 2024
Yayımlandığı Sayı Yıl 2024

Kaynak Göster

APA Gürlek Kısacık, Ö., Özdaş Gündoğan, A., & Yılmaz, E. (2024). Hemşirelerin ve Hemşirelik Öğrencilerinin Yaşamsal Bulgulara Yönelik Tutumları: Karşılaştırmalı Bir Çalışma. Etkili Hemşirelik Dergisi, 17(4), 575-590. https://doi.org/10.46483/jnef.1347139

Etkili Hemşirelik Dergisi ULAKBİM Türk Tıp Dizini, Türk Medline, Türkiye Atıf Dizini, Şubat 2021 tarihinden beri EBSCO Host ve 26 Ekim 2021 tarihinden itibaren DOAJ ve 18 Ocak 2022 tarihinden beri Index Copernicus, 14 Kasım 2022 tarihinden beri SCOPUS tarafından indekslenmektedir.

Dokuz Eylül Üniversitesi Yayınevi Web Sitesi
https://kutuphane.deu.edu.tr/yayinevi/

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https://dergipark.org.tr/tr/pub/jnef/contacts

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