Klinik Araştırma
BibTex RIS Kaynak Göster

Yatan Çocuk ve Ergen Psikiyatri Hastalarının Klinik Özellikleri ile Bakım Verenlerin Kaygı, Umutsuzluk, Bakım Yükü ve Tükenmişlik Düzeyleri Arasındaki İlişkinin Değerlendirilmesi

Yıl 2025, Cilt: 47 Sayı: 4, 606 - 613, 18.06.2025
https://doi.org/10.20515/otd.1625419

Öz

Bu çalışmanın amacı, üçüncü basamak bir psikiyatri servisinde yatan çocuk ve ergenlerin bakımverenlerinin stres, tükenmişlik, bakım yükü ve umutsuzluk düzeylerini değerlendirmek ve bu faktörlerle hastaların yaş, semptom şiddeti, işlevsellik ve hastalık süresi gibi değişkenler arasındaki ilişkileri incelemektir. Bu çalışmaya erken başlangıçlı şizofreni (n=20), bipolar bozukluk (n=17), depresif bozukluk (n=27) ve dikkat eksikliği ve hiperaktivite bozukluğu (n=13), tanıları konmuş 77 çocuk ve ergen ile bu hastaların bakım verenlerini kapsamaktadır. Klinik semptomlar, Çocuklar için Global Değerlendirme Ölçeği ve Klinik Global İzlenim ölçeği ile değerlendirilmiştir. Bakım verenler, Bakım Verenin Stres Ölçeği, Zarith Bakım Yükü Ölçeği, Maslach - Tükenmişlik Ölçeği, Beck Umutsuzluk Ölçeği, Beck Anksiyete Ölçeği kullanılarak stres, tükenmişlik, bakım yükü ve umutsuzluk düzeyleri ölçülmüştür. Çalışmaya katılan hasta grubunun yaş ortalaması 15,6±2,8 olup 40’ı (%51,9) erkek, 37’i (%48,1) kızdı. Bakım verenlerin %26’sı stres düzeyi yüksek, %32,5’inin anksiyete düzeyi orta-şiddetli bulunmuştur. Bakım verenlerin tükenmişlik düzeyi orta-yüksek, bakım yükü düzeyi orta şiddette, umutsuzluk düzeyi hafif şiddette şeklindeydi. Bakım verenlerin %70,1’i bakım yükü yaşadığını ifade etmiştir. Bakım yükü açısından tanılar arasında istatistiksel olarak anlamlı fark bulunmamıştır (p=0,774). Tükenmişlik ve bakım yükü ölçekleri arasında pozitif korelasyon saptanmış (r: 0.623, p<0,001), ancak hastaların yaş, işlevsellik ve semptom şiddeti ile bu ölçekler arasında anlamlı ilişki bulunamamıştır. Bulgular, psikiyatrik hastalığı olan çocuk ve ergenlerin ebeveynlerinin stres ve bakım yükünü azaltmaya yönelik destekleyici müdahalelere ihtiyaç olduğunu göstermektedir. Bu tür müdahalelerin, ebeveynlerin yaşam kalitesini artırabileceği ve tedavi süreçlerini olumlu yönde etkileyebileceği düşünülmektedir.

Kaynakça

  • 1. Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):617-27.
  • 2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders 5ed2013.
  • 3. Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A. Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry. 2003;60(8):837-44.
  • 4. Alfonso BJMS-P. Impacts of Informal Caregiving on Caregiver Employment, Health, and Family. Population Ageing. 2015(8):113-45.
  • 5. Ikeda T, Nagai T, Kato-Nishimura K, Mohri I, Taniike M. Sleep problems in physically disabled children and burden on caregivers. Brain Dev. 2012;34(3):223-9.
  • 6. Karambelas GJ, Filia K, Byrne LK, Allott KA, Jayasinghe A, Cotton SM. A systematic review comparing caregiver burden and psychological functioning in caregivers of individuals with schizophrenia spectrum disorders and bipolar disorders. BMC Psychiatry. 2022;22(1):422.
  • 7. Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Ustun TB. Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatry. 2007;20(4):359-64.
  • 8. Shim R, Szilagyi M, Perrin JM. Epidemic Rates of Child and Adolescent Mental Health Disorders Require an Urgent Response. Pediatrics. 2022;149(5).
  • 9. Wong DF, Lam AY, Chan SK, Chan SF. Quality of life of caregivers with relatives suffering from mental illness in Hong Kong: roles of caregiver characteristics, caregiving burdens, and satisfaction with psychiatric services. Health Qual Life Outcomes. 2012;10:15.
  • 10. Semke CA, Garbacz SA, Kwon K, Sheridan SM, Woods KE. Family involvement for children with disruptive behaviors: the role of parenting stress and motivational beliefs. J Sch Psychol. 2010;48(4):293-312.
  • 11. Adelman RD, Tmanova LL, Delgado D, Dion S, Lachs MS. Caregiver burden: a clinical review. JAMA. 2014;311(10):1052-60.
  • 12. Benderix Y, Nordstrom B, Sivberg B. Parents' experience of having a child with autism and learning disabilities living in a group home: a case study. Autism. 2006;10(6):629-41.
  • 13. Benson PR, Karlof KL. Anger, stress proliferation, and depressed mood among parents of children with ASD: a longitudinal replication. J Autism Dev Disord. 2009;39(2):350-62.
  • 14. Falk NH, Norris K, Quinn MG. The factors predicting stress, anxiety and depression in the parents of children with autism. J Autism Dev Disord. 2014;44(12):3185-203.
  • 15. Keitel MA, Parisi M, Whitney JL, Stack LF. Salient stressors for mothers of children and adolescents with anorexia nervosa. Eat Disord. 2010;18(5):435-44.
  • 16. Machado Junior SB, Celestino MI, Serra JP, Caron J, Ponde MP. Risk and protective factors for symptoms of anxiety and depression in parents of children with autism spectrum disorder. Dev Neurorehabil. 2016;19(3):146-53.
  • 17. Masefield SC, Prady SL, Sheldon TA, Small N, Jarvis S, Pickett KE. The Caregiver Health Effects of Caring for Young Children with Developmental Disabilities: A Meta-analysis. Matern Child Health J. 2020;24(5):561-74.
  • 18. Montes G, Halterman JS. Psychological functioning and coping among mothers of children with autism: a population-based study. Pediatrics. 2007;119(5):e1040-6.
  • 19. Shorey S, Pereira TL. Experiences of fathers caring for children with neurodevelopmental disorders: A meta-synthesis. Fam Process. 2023;62(2):754-74.
  • 20. Sowden E, Robinson D, Lovell K, Bee P, Fulwood A, Lidbetter N, et al. Understanding the support needs of parents of children with obsessive-compulsive disorder: a qualitative descriptive study in the UK. BMC Psychiatry. 2023;23(1):309.
  • 21. Weiss MJ. Harrdiness and social support as predictors of stress in mothers of typical children, children with autism, and children with mental retardation. Autism. 2002;6(1):115-30.
  • 22. Benazzi F. Bipolar II disorder : epidemiology, diagnosis and management. CNS Drugs. 2007;21(9):727-40.
  • 23. Fonseca A, Nazare B, Canavarro MC. Parental psychological distress and quality of life after a prenatal or postnatal diagnosis of congenital anomaly: a controlled comparison study with parents of healthy infants. Disabil Health J. 2012;5(2):67-74.
  • 24. Wu MS, Lewin, A. B., Murphy, T. K., Geffken, G. R., & Storch, E. A. . Phenomenological considerations of family accommodation: Related clinical characteristics and family factors in pediatric obsessive–compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders. 2014;3(3):228–35.
  • 25. Pinquart M. Parenting stress in caregivers of children with chronic physical condition-A meta-analysis. Stress Health. 2018;34(2):197-207.
  • 26. Yang R, Zhou H, Liu J, Wang Y, Zhang Y, Wang Y, et al. Psychometric properties of the Caregiver Strain Questionnaire among Chinese parents of children with ADHD or ASD. Gen Psychiatr. 2021;34(2):e100246.
  • 27. Dada MU, Okewole NO, Ogun OC, Bello-Mojeed MA. Factors associated with caregiver burden in a child and adolescent psychiatric facility in Lagos, Nigeria: a descriptive cross sectional study. BMC Pediatr. 2011;11:110.
  • 28. Mayberry LS, Heflinger CA. How Caregivers Make Meaning of Child Mental Health Problems: Toward Understanding Caregiver Strain and Help Seeking. Fam Soc. 2013;94(2):105-13.
  • 29. Molebatsi K, Ndetei DM, Opondo PR. Caregiver burden and correlates among caregivers of children and adolescents with psychiatric morbidity: a descriptive cross sectional study. J Child Adolesc Ment Health. 2017;29(2):117-27.
  • 30. Shaffer D, Gould MS, Brasic J, Ambrosini P, Fisher P, Bird H, et al. A children's global assessment scale (CGAS). Arch Gen Psychiatry. 1983;40(11):1228-31.
  • 31. Uğur Ö. Onkoloji hastasına evde bakım verenlerin bakım yükünün incelenmesi. Doktora tezi. 2006.
  • 32. İnci F, Erdem M. Bakım verme yükü ölçeğinin Türkçe’ ye uyarlanması geçerlilik ve güvenilirliği. Journal of Anatolia Nursing and Health Sciences. 2010;11:85-9.
  • 33. Duygun T, Sezgin N. Zihinsel engelli ye sağlıklı çocuk annelerinde stres belirtileri, stresle başa çıkma tarzları ve algılanan sosyal desteğin tükenmişlik düzeyine olan etkisi. Türk Psikoloji Dergisi. 2003;18(52):37-52.
  • 34. Durak A, & Palabıyıkoğlu, R. . Beck Umutsuzluk ölçeği geçerlilik çalişmasi. Kriz dergisi.2(2):311-9.
  • 35. Beck AT, Epstein, N., Brown, G., Steer, R.A. . An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol. 1988;56:893-7.
  • 36. Cham CQ, Ibrahim N, Siau CS, Kalaman CR, Ho MC, Yahya AN, et al. Caregiver Burden among Caregivers of Patients with Mental Illness: A Systematic Review and Meta-Analysis. Healthcare (Basel). 2022;10(12).
  • 37. Collins R.N. KN. Prevalence of Depression and Burden among Informal Care-Givers of People with Dementia: A Meta-Analysis. Ageing Soc. 2020;40:2355–92.
  • 38. Rezaei H, Niksima SH, Ghanei Gheshlagh R. Burden of Care in Caregivers of Iranian patients with chronic disorders: a systematic review and meta-analysis. Health Qual Life Outcomes. 2020;18(1):261.
  • 39. Tanna KJ. Evaluation of burden felt by caregivers of patients with schizophrenia and bipolar disorder. Ind Psychiatry J. 2021;30(2):299-304.
  • 40. van Wijngaarden B, Koeter M, Knapp M, Tansella M, Thornicroft G, Vazquez-Barquero JL, et al. Caring for people with depression or with schizophrenia: are the consequences different? Psychiatry Res. 2009;169(1):62-9.
  • 41. Cousino MK, Hazen RA. Parenting stress among caregivers of children with chronic illness: a systematic review. J Pediatr Psychol. 2013;38(8):809-28.
  • 42. Pisula E, Porebowicz-Dorsmann A. Family functioning, parenting stress and quality of life in mothers and fathers of Polish children with high functioning autism or Asperger syndrome. PLoS One. 2017;12(10):e0186536.
  • 43. van der Lee J, Bakker TJ, Duivenvoorden HJ, Droes RM. Multivariate models of subjective caregiver burden in dementia: a systematic review. Ageing Res Rev. 2014;15:76-93.
  • 44. Kostak MA, Avci G. Hopelessness and depression levels of parents of children with cancer. Asian Pac J Cancer Prev. 2013;14(11):6833-8.
  • 45. Farmer AY, & Lee, S. K. The Effects of Parenting Stress, Perceived Mastery, and Maternal Depression on Parent-Child Interaction. Journal of Social Service Research. 2011;37(5):516-25

Evaluation of the Relationship Between Clinical Characteristics of Inpatient Child and Adolescent Psychiatry Patients and the Anxiety, Hopelessness, Caregiver Burden, and Burnout Levels of Their Caregivers

Yıl 2025, Cilt: 47 Sayı: 4, 606 - 613, 18.06.2025
https://doi.org/10.20515/otd.1625419

Öz

This study aims to evaluate the stress, burnout, caregiving burden, and hopelessness levels of caregivers of children and adolescents hospitalized in a tertiary psychiatric ward and to examine the relationships between these factors and variables such as the patient’s age, symptom severity, functionality, and duration of illness. This study included 77 children and adolescents diagnosed with early-onset schizophrenia (n=20), bipolar disorder (n=17), depressive disorder (n=27) and attention deficit and hyperactivity disorder (n=13), along with their caregivers. Clinical symptoms were assessed using the Children’s Global Assessment Scale and the Clinical Global Impressions Scale. Caregivers were evaluated for stress, burnout, caregiver burden, and hopelessness levels using the Caregiver Strain Index, Zarit Burden Interview, Maslach Burnout Inventory, Beck Hopelessness Scale, and Beck Anxiety Inventory. The mean age of the patient group was 15.6 ± 2.8 years, with 40 (51.9%) being male and 37 (48.1%) female. Among caregivers, 26% had high stress levels, and 32.5% had moderate-to-severe anxiety levels. Caregivers' burnout levels were moderate-to-high, caregiving burden levels were moderate, and hopelessness levels were mild. A total of 70.1% of caregivers reported experiencing caregiver burden. No statistically significant differences were found in caregiver burden across diagnostic groups (p=0.774). A positive correlation was identified between burnout and caregiver burden (r: 0.623, p<0.001); however, no significant associations were found between these scales and patients’ age, functionality, or symptom severity. The findings indicate a need for supportive interventions to reduce the stress and caregiving burden of parents of children and adolescents with psychiatric disorders. Such interventions may enhance the quality of life for caregivers and positively influence treatment processes.

Kaynakça

  • 1. Kessler RC, Chiu WT, Demler O, Merikangas KR, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):617-27.
  • 2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders 5ed2013.
  • 3. Costello EJ, Mustillo S, Erkanli A, Keeler G, Angold A. Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry. 2003;60(8):837-44.
  • 4. Alfonso BJMS-P. Impacts of Informal Caregiving on Caregiver Employment, Health, and Family. Population Ageing. 2015(8):113-45.
  • 5. Ikeda T, Nagai T, Kato-Nishimura K, Mohri I, Taniike M. Sleep problems in physically disabled children and burden on caregivers. Brain Dev. 2012;34(3):223-9.
  • 6. Karambelas GJ, Filia K, Byrne LK, Allott KA, Jayasinghe A, Cotton SM. A systematic review comparing caregiver burden and psychological functioning in caregivers of individuals with schizophrenia spectrum disorders and bipolar disorders. BMC Psychiatry. 2022;22(1):422.
  • 7. Kessler RC, Amminger GP, Aguilar-Gaxiola S, Alonso J, Lee S, Ustun TB. Age of onset of mental disorders: a review of recent literature. Curr Opin Psychiatry. 2007;20(4):359-64.
  • 8. Shim R, Szilagyi M, Perrin JM. Epidemic Rates of Child and Adolescent Mental Health Disorders Require an Urgent Response. Pediatrics. 2022;149(5).
  • 9. Wong DF, Lam AY, Chan SK, Chan SF. Quality of life of caregivers with relatives suffering from mental illness in Hong Kong: roles of caregiver characteristics, caregiving burdens, and satisfaction with psychiatric services. Health Qual Life Outcomes. 2012;10:15.
  • 10. Semke CA, Garbacz SA, Kwon K, Sheridan SM, Woods KE. Family involvement for children with disruptive behaviors: the role of parenting stress and motivational beliefs. J Sch Psychol. 2010;48(4):293-312.
  • 11. Adelman RD, Tmanova LL, Delgado D, Dion S, Lachs MS. Caregiver burden: a clinical review. JAMA. 2014;311(10):1052-60.
  • 12. Benderix Y, Nordstrom B, Sivberg B. Parents' experience of having a child with autism and learning disabilities living in a group home: a case study. Autism. 2006;10(6):629-41.
  • 13. Benson PR, Karlof KL. Anger, stress proliferation, and depressed mood among parents of children with ASD: a longitudinal replication. J Autism Dev Disord. 2009;39(2):350-62.
  • 14. Falk NH, Norris K, Quinn MG. The factors predicting stress, anxiety and depression in the parents of children with autism. J Autism Dev Disord. 2014;44(12):3185-203.
  • 15. Keitel MA, Parisi M, Whitney JL, Stack LF. Salient stressors for mothers of children and adolescents with anorexia nervosa. Eat Disord. 2010;18(5):435-44.
  • 16. Machado Junior SB, Celestino MI, Serra JP, Caron J, Ponde MP. Risk and protective factors for symptoms of anxiety and depression in parents of children with autism spectrum disorder. Dev Neurorehabil. 2016;19(3):146-53.
  • 17. Masefield SC, Prady SL, Sheldon TA, Small N, Jarvis S, Pickett KE. The Caregiver Health Effects of Caring for Young Children with Developmental Disabilities: A Meta-analysis. Matern Child Health J. 2020;24(5):561-74.
  • 18. Montes G, Halterman JS. Psychological functioning and coping among mothers of children with autism: a population-based study. Pediatrics. 2007;119(5):e1040-6.
  • 19. Shorey S, Pereira TL. Experiences of fathers caring for children with neurodevelopmental disorders: A meta-synthesis. Fam Process. 2023;62(2):754-74.
  • 20. Sowden E, Robinson D, Lovell K, Bee P, Fulwood A, Lidbetter N, et al. Understanding the support needs of parents of children with obsessive-compulsive disorder: a qualitative descriptive study in the UK. BMC Psychiatry. 2023;23(1):309.
  • 21. Weiss MJ. Harrdiness and social support as predictors of stress in mothers of typical children, children with autism, and children with mental retardation. Autism. 2002;6(1):115-30.
  • 22. Benazzi F. Bipolar II disorder : epidemiology, diagnosis and management. CNS Drugs. 2007;21(9):727-40.
  • 23. Fonseca A, Nazare B, Canavarro MC. Parental psychological distress and quality of life after a prenatal or postnatal diagnosis of congenital anomaly: a controlled comparison study with parents of healthy infants. Disabil Health J. 2012;5(2):67-74.
  • 24. Wu MS, Lewin, A. B., Murphy, T. K., Geffken, G. R., & Storch, E. A. . Phenomenological considerations of family accommodation: Related clinical characteristics and family factors in pediatric obsessive–compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders. 2014;3(3):228–35.
  • 25. Pinquart M. Parenting stress in caregivers of children with chronic physical condition-A meta-analysis. Stress Health. 2018;34(2):197-207.
  • 26. Yang R, Zhou H, Liu J, Wang Y, Zhang Y, Wang Y, et al. Psychometric properties of the Caregiver Strain Questionnaire among Chinese parents of children with ADHD or ASD. Gen Psychiatr. 2021;34(2):e100246.
  • 27. Dada MU, Okewole NO, Ogun OC, Bello-Mojeed MA. Factors associated with caregiver burden in a child and adolescent psychiatric facility in Lagos, Nigeria: a descriptive cross sectional study. BMC Pediatr. 2011;11:110.
  • 28. Mayberry LS, Heflinger CA. How Caregivers Make Meaning of Child Mental Health Problems: Toward Understanding Caregiver Strain and Help Seeking. Fam Soc. 2013;94(2):105-13.
  • 29. Molebatsi K, Ndetei DM, Opondo PR. Caregiver burden and correlates among caregivers of children and adolescents with psychiatric morbidity: a descriptive cross sectional study. J Child Adolesc Ment Health. 2017;29(2):117-27.
  • 30. Shaffer D, Gould MS, Brasic J, Ambrosini P, Fisher P, Bird H, et al. A children's global assessment scale (CGAS). Arch Gen Psychiatry. 1983;40(11):1228-31.
  • 31. Uğur Ö. Onkoloji hastasına evde bakım verenlerin bakım yükünün incelenmesi. Doktora tezi. 2006.
  • 32. İnci F, Erdem M. Bakım verme yükü ölçeğinin Türkçe’ ye uyarlanması geçerlilik ve güvenilirliği. Journal of Anatolia Nursing and Health Sciences. 2010;11:85-9.
  • 33. Duygun T, Sezgin N. Zihinsel engelli ye sağlıklı çocuk annelerinde stres belirtileri, stresle başa çıkma tarzları ve algılanan sosyal desteğin tükenmişlik düzeyine olan etkisi. Türk Psikoloji Dergisi. 2003;18(52):37-52.
  • 34. Durak A, & Palabıyıkoğlu, R. . Beck Umutsuzluk ölçeği geçerlilik çalişmasi. Kriz dergisi.2(2):311-9.
  • 35. Beck AT, Epstein, N., Brown, G., Steer, R.A. . An inventory for measuring clinical anxiety: Psychometric properties. J Consult Clin Psychol. 1988;56:893-7.
  • 36. Cham CQ, Ibrahim N, Siau CS, Kalaman CR, Ho MC, Yahya AN, et al. Caregiver Burden among Caregivers of Patients with Mental Illness: A Systematic Review and Meta-Analysis. Healthcare (Basel). 2022;10(12).
  • 37. Collins R.N. KN. Prevalence of Depression and Burden among Informal Care-Givers of People with Dementia: A Meta-Analysis. Ageing Soc. 2020;40:2355–92.
  • 38. Rezaei H, Niksima SH, Ghanei Gheshlagh R. Burden of Care in Caregivers of Iranian patients with chronic disorders: a systematic review and meta-analysis. Health Qual Life Outcomes. 2020;18(1):261.
  • 39. Tanna KJ. Evaluation of burden felt by caregivers of patients with schizophrenia and bipolar disorder. Ind Psychiatry J. 2021;30(2):299-304.
  • 40. van Wijngaarden B, Koeter M, Knapp M, Tansella M, Thornicroft G, Vazquez-Barquero JL, et al. Caring for people with depression or with schizophrenia: are the consequences different? Psychiatry Res. 2009;169(1):62-9.
  • 41. Cousino MK, Hazen RA. Parenting stress among caregivers of children with chronic illness: a systematic review. J Pediatr Psychol. 2013;38(8):809-28.
  • 42. Pisula E, Porebowicz-Dorsmann A. Family functioning, parenting stress and quality of life in mothers and fathers of Polish children with high functioning autism or Asperger syndrome. PLoS One. 2017;12(10):e0186536.
  • 43. van der Lee J, Bakker TJ, Duivenvoorden HJ, Droes RM. Multivariate models of subjective caregiver burden in dementia: a systematic review. Ageing Res Rev. 2014;15:76-93.
  • 44. Kostak MA, Avci G. Hopelessness and depression levels of parents of children with cancer. Asian Pac J Cancer Prev. 2013;14(11):6833-8.
  • 45. Farmer AY, & Lee, S. K. The Effects of Parenting Stress, Perceived Mastery, and Maternal Depression on Parent-Child Interaction. Journal of Social Service Research. 2011;37(5):516-25
Toplam 45 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Yeşim Sağlam 0000-0002-9492-8584

Nurbahar Birsen 0009-0007-6503-5780

Gül Karaçetin 0000-0002-9109-6559

Yayımlanma Tarihi 18 Haziran 2025
Gönderilme Tarihi 23 Ocak 2025
Kabul Tarihi 26 Mayıs 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 47 Sayı: 4

Kaynak Göster

Vancouver Sağlam Y, Birsen N, Karaçetin G. Yatan Çocuk ve Ergen Psikiyatri Hastalarının Klinik Özellikleri ile Bakım Verenlerin Kaygı, Umutsuzluk, Bakım Yükü ve Tükenmişlik Düzeyleri Arasındaki İlişkinin Değerlendirilmesi. Osmangazi Tıp Dergisi. 2025;47(4):606-13.


13299        13308       13306       13305    13307  1330126978