Araştırma Makalesi
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Doğum Yapan ve Yapmayan Kadınlarda Premenstrual Sendrom ve Mental İyi Oluş Arasındaki İlişkinin İncelenmesi

Yıl 2023, , 290 - 298, 01.09.2023
https://doi.org/10.38108/ouhcd.1122220

Öz

Amaç: Bu araştırma doğum yapan ve yapmayan kadınlarda premenstrual sendrom ve mental iyi oluş arasındaki ilişkinin incelenmesi amacıyla yapılmıştır.
Yöntem: Tanımlayıcı, kesitsel ve karşılaştırmalı tipteki araştırma Ocak 2020-Haziran 2020 tarihleri arasında Türkiye’deki bir üniversitede öğrenim gören kadın hemşirelik bölümü öğrencileri ve aynı üniversitede görev yapan akademik ve idari personelde yürütülmüştür. Araştırma verileri katılımcı tanıtım formu, Premenstrual Sendrom Ölçeği ve Warwick-Edinburgh Mental İyi Oluş Ölçeği kullanılarak elde edilmiştir. Araştırma 123 doğum yapan ve 127 doğum yapmayan 250 kadınla gerçekleştirilmiştir.
Bulgular: Araştırmaya dahil edilen kadınlardan doğum yapan ve yapmayanların prementrual sendrom yaşama durumları arasında istatistiksel olarak anlamlı fark bulunmuştur (p<0.05). Doğum yapan ve yapmayan kadınların Warwick-Edinburgh Mental İyi Oluş ve Premenstrual Sendrom Ölçeği puanları açısından istatistiksel olarak anlamlı fark bulunmuştur (p<0.05). Doğum yapan ve yapmayan kadınların Premenstrual Sendrom Ölçeği puanları arttıkça Mental İyi Oluş puanlarının azaldığı bulunmuştur(p<0.05).
Sonuç: Araştırmaya dahil edilen kadınlardan doğum yapanlarda premenstrual sendrom görülme oranın daha düşük olduğu, premenstrual sendrom şiddeti ve premenstrual sendroma bağlı diğer problemleri doğum yapmayan kadınlara göre daha az yaşadıkları bulunmuştur.

Destekleyen Kurum

Bulunmamaktadır.

Proje Numarası

Yoktur.

Teşekkür

Çalışmaya katılan katılımcılara teşekkür ederiz.

Kaynakça

  • Abdi F, Ozgoli G, Rahnemaie F. S. (2019). A systematic review of the role of vitamin D and calcium in premenstrual syndrome. Obstetrics and Gynecology Science, 62(2), 73–86. https://doi.org/10.5468/ ogs.2019.62.2.73
  • Acikgoz A, Dayi A, Binbay T. (2017). Prevalence of premenstrual syndrome and its relationship to depressive symptoms in first-year university students. In Saudi Medical Journal 38(11), 1125–1131. https://doi.org/10.15537/smj.2017.11.20526
  • ACOG. (2000). ACOG Committee on Practice Bulletins-Gynecology, ACOG practice bulletin: No 15: premenstrual syndrome. Obstetrics & Gynecology, 95(4), 1–9. https://www.acog.org/store/products /patient-education/pamphlets/gynecologic-problems/premenstrual-syndrome
  • Akbarzadeh M, Heydari N, Abootalebi M, Ghodrati F. (2017). Correlation between Mental Health and Premenstrual Syndrome in Students of Shiraz University of Medical Sciences. Journal of Health Sciences and Surveillance System, 5(4), 176–179.
  • Aksoy Derya Y, Çolak C, Tetik BK, Yılmaz AN, Özşahin Z. (2020). Female students by using artificial neural network model. The Journal of Cognitive Systems, 5(2), 88–93.
  • Alimoradi B, Nejat H. (2018). Early Maladaptive schemas and Premenstrual syndrome in mothers with postpartum depression. Preventive Care In Nursing and Midwifery Journal, 8(1), 43–48. https://doi.org/10.29252/pcnm.8.1.43
  • Amiel Castro RT, Pataky EA, Ehlert U. (2019). Associations between premenstrual syndrome and postpartum depression: A systematic literature review. Biological Psychology, 147, 107612. https://doi.org/10.1016/j.biopsycho.2018.10.014
  • Arafa AE, Senosy SA, Helmy HK, Mohamed AA. (2018). Prevalence and patterns of dysmenorrhea and premenstrual syndrome among Egyptian girls (12–25 years). Middle East Fertility Society Journal, 23(4), 486–490. https://doi.org/10.1016/j.mefs.2018 .01.007
  • Bakır N, Balcı Yangın H. (2019). Üniversite öğrencilerinde premenstrual sendrom ve sağlıklı yaşam biçimi davranışları arasındaki ilişki. Yaşam Becerileri Psikoloji Dergisi, 3, 39–51. https://doi.org/10.31461/ybpd.538946
  • Bakır N, Irmak Vural P, Körpe G. (2021). The effects of emotional freedom techniques on coping with premenstrual syndrome: A randomized control trial. In Perspectives in Psychiatric Care. 1-10. https://doi.org/10.1111/ppc.12957
  • Bakır N, Kızılkaya Beji N. (2021). Üniversite öğrenci̇leri̇nde premenstrual sendrom prevelansi ve etki̇leyen faktörler. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi, 9(1), 264–277. https://doi.org/10.33715/inonusaglik.835785
  • Cao S, Jones M, ToothL, Mishra G. (2021). Does premenstrual syndrome before pregnancy increase the risk of postpartum depression? Findings from the Australian Longitudinal Study on Women’s Health. Journal of Affective Disorders, 279, 143–148. https://doi.org/10.1016/j.jad.2020.09.130
  • Chumpalova P, Iakimova R, Stoimenova-Popova M, Aptalidis D, Pandova M, Stoyanova M, Fountoulakis KN. (2020). Prevalence and clinical picture of premenstrual syndrome in females from Bulgaria. Annals of General Psychiatry, 19(1), 1–7. https://doi.org/10.1186/s12991-019-0255-1
  • da Silva EA, Pires DA. (2021). Prevalence of premenstrual syndrome and its psychological effects among university students who participate and do not participate in resistance training. Revista Brasileira de Ciencias Do Esporte, 43, e007420. https://doi.org/ 10.1590/rbce.43.e007420
  • Dilbaz B, Aksan A. (2021). Premenstrual syndrome, a common but underrated entity: Review of the clinical literature. Journal of the Turkish German Gynecology Association, 22(2), 139–148. https://doi.org/ 10.4274/jtgga.galenos.2021.2020.0133.
  • Dönmez S, Gümüşsoy S. (2019). Hemşirelik öğrencilerinde premenstrual sendromun ve etkileyen faktörlerin incelenmesi. Kocaeli Medical Journal., 8(2), 38–45.
  • Erbaş N, Altunbaş N. (2021). Bazı değişkenlere göre bir lisedeki kız öğrencilerde premenstrual sendrom şiddetinin ve algılanan stres düzeyinin belirlenmesi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 12(2), 479–486.
  • Erbil N, Yücesoy H. (2021). Premenstrual syndrome prevalence in Turkey: a systematic review and meta-analysis. Psychology, Health and Medicine, 8,1-11. https://doi.org/10.1080/13548506.2021.2013509
  • Gao M, Zhang H, Gao Z, Cheng X, Sun Y, Qiao M, Gao D. (2022). Global and regional prevalence and burden for premenstrual syndrome and premenstrual dysphoric disorder A study protocol for systematic review and meta-analysis. Medicine (United States), 101(1), 1–4. https://doi.org/10.1097/MD.000000000 0028528
  • Gençdoğan B. (2006). Premenstruel sendrom için yeni bir ölçek. Türkiye’de Psikiyatri Dergisi, 8(2), 81–87.
  • Işik H, Ergöl Ş, Aynioğlu Ö, Şahbaz A, Kuzu A, Uzun M. (2016). Premenstrual syndrome and life quality in Turkish health science students. Turkish Journal of Medical Sciences, 46(3), 695–701. https://doi.org/ 10.3906/sag-1504-140
  • Izadi-Mazidi M, Amiri S. (2019). Personality characteristics in female students with premenstrual dysphoric disorder and premenstrual syndrome. Advances in Nursing and Midwifery, 28(3), 40–45. https://doi.org/10.29252/anm-280307
  • Jang HJ, Sung MH. (2018). Impact of menstrual attitudes, premenstrual syndrome, and stress response on quality of life among nursing students. Korean Journal of Women Health Nursing, 24(4), 346–354. https://doi.org/10.4069/kjwhn.2018.24.4.346
  • Kaewrudee S, Kietpeerakool C, Pattanittum P, Lumbiganon P. (2018). Vitamin or mineral supplements for premenstrual syndrome. Cochrane Database of Systematic Reviews, (1), CD012933. https://doi.org/10.1002/14651858.CD012933
  • Kahyaoglu Sut H, Mestogullari E. (2016). Effect of premenstrual syndrome on work-related quality of life in Turkish nurses. Safety and Health at Work, 7(1), 78–82. https://doi.org/10.1016/j.shaw.2015.09.001
  • Keldal G. (2015). Warwick-Edinburgh Mental İyi Oluş Ölçeği’nin Türkçe Formu: Geçerlik ve güvenirlik çalışması. The Journal of Happiness & Well-Being, 3(1), 103–115.
  • Kleinstäuber M, Schmelzer, K, Ditzen, B, Andersson, G, Hiller, W, Weise C. (2016). Psychosocial profile of women with premenstrual syndrome and healthy controls: A comparative study. International Journal of Behavioral Medicine, 23(6), 752–763. https:// doi.org/10.1007/s12529-016-9564-9
  • Moradifili B, Ghiasvand R, Pourmasoumi M, Feizi A, Shahdadian F, Shahshahan Z. (2020). Dietary patterns are associated with premenstrual syndrome: Evidence from a case-control study. In Public Health Nutrition, 23(5),833–842. https://doi.org/10.1017/S136898001 9002192
  • Nam SJ, Cha C. (2020). Effects of a social-media-based support on premenstrual syndrome and physical activity among female university students in South Korea. In Journal of Psychosomatic Obstetrics and Gynecology 41(1),47–53. https://doi.org/10.1080/ 0167482X.2018.1559811
  • Özkan S, Koç G. (2020). Kadınlarda premenstrual sendrom yaşanmasını etkileyen sosyal ve kültürel faktörler. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi, 7(2), 180–185. https://doi.org/10.31125/ hunhemsire.763193
  • Sahu R, Lal Barnwal S, Vishvakarma S. (2022). Prevalence and severity of premenstrual syndrome among young females in Chhattisgarh, India. Asian Pacific Journal of Health Sciences, January, 2–8. https://doi.org/10.21276/apjhs.2022.9.1.34
  • Saka S, Okuyucu T. (2020). Genç kadınlarda premenstrual sendromun yorgunluk ve uyku kalitesi üzerine etkisi. Haliç Üniversitesi Sağlık Bilimleri Dergisi, 3(1), 33–40.
  • Tennant R, Hiller L, Fishwick R, Platt S, Josep, S, Weich S, Parkinson J, Secker J, Stewart-Brown S. (2007). The Warwick-Edinburgh mental well-being scale (WEMWBS): Development and UK validation. Health and Quality of Life Outcomes, 5(1), 50–63.
  • Victor FF, Souza AI, Barreiros CDT, Barros JLN, De Silva FACD, Ferreira ALCG. (2019). Quality of life among university students with premenstrual syndrome. Revista Brasileira de Ginecologia e Obstetricia, 41(5), 312–317. https://doi.org/10.1055 /s-0039-1688709
  • Yang Q, Sjölander A, Li Y, Viktorin A, Bertone-Johnson ER, Ye W, Fang F, Valdimarsdóttir UA, Lu D. (2021). Clinical indications of premenstrual disorders and subsequent risk of injury: a population-based cohort study in Sweden. BMC Medicine, 19(1), 1–12. https://doi.org/10.1186/s12916-021-01989-4
  • Yorulmaz DS, Karadeniz H. (2021). Premenstrual sendrom yaşayan üniversite öğrencilerinin yakınmalarını azaltmaya yönelik kültürel uygulamaları. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi, 9(2), 755–769. https://doi.org/10.33715/inonusaglik.833166

Relationship Between Premenstrual Syndrome and Mental Well-Being in Women who Gave and did not Give Birth

Yıl 2023, , 290 - 298, 01.09.2023
https://doi.org/10.38108/ouhcd.1122220

Öz

Objective: This study was conducted to examine the relationship between premenstrual syndrome and mental well-being in women who gave birth and those who did not.
Methods: A descriptive, cross-sectional, comparative designed research was conducted with female Nursing Department students studying at a university in Turkey and academic and administrative staff working at the same university between January-June, 2020. Research data were collected using participant identification form, Premenstrual Syndrome, and Warwick-Edinburgh Mental Well-Being Scales. One hundred twenty-three women who gave birth and 127 women who did not give birth were included in the research.
Results: In the study, a statistically significant difference was found between the premenstrual syndrome status of women who gave birth and those who did not (p<0.05). A statistically significant difference was found in terms of the Warwick-Edinburgh Mental Well-Being Scale and Premenstrual Syndrome Scale scores of women who gave birth and those who did not (p<0.05). As the Premenstrual Syndrome Scale scores of the women who gave birth and did not give birth, their Warwick-Edinburgh Mental Well-Being Scale scores decreased (p<0.05).
Conclusion: According to the women’s results, included in our study, found that the incidence of premenstrual syndrome was lower in women who gave birth, and they experienced premenstrual syndrome severity and other premenstrual syndrome-related problems less than in women who did not give birth.

Proje Numarası

Yoktur.

Kaynakça

  • Abdi F, Ozgoli G, Rahnemaie F. S. (2019). A systematic review of the role of vitamin D and calcium in premenstrual syndrome. Obstetrics and Gynecology Science, 62(2), 73–86. https://doi.org/10.5468/ ogs.2019.62.2.73
  • Acikgoz A, Dayi A, Binbay T. (2017). Prevalence of premenstrual syndrome and its relationship to depressive symptoms in first-year university students. In Saudi Medical Journal 38(11), 1125–1131. https://doi.org/10.15537/smj.2017.11.20526
  • ACOG. (2000). ACOG Committee on Practice Bulletins-Gynecology, ACOG practice bulletin: No 15: premenstrual syndrome. Obstetrics & Gynecology, 95(4), 1–9. https://www.acog.org/store/products /patient-education/pamphlets/gynecologic-problems/premenstrual-syndrome
  • Akbarzadeh M, Heydari N, Abootalebi M, Ghodrati F. (2017). Correlation between Mental Health and Premenstrual Syndrome in Students of Shiraz University of Medical Sciences. Journal of Health Sciences and Surveillance System, 5(4), 176–179.
  • Aksoy Derya Y, Çolak C, Tetik BK, Yılmaz AN, Özşahin Z. (2020). Female students by using artificial neural network model. The Journal of Cognitive Systems, 5(2), 88–93.
  • Alimoradi B, Nejat H. (2018). Early Maladaptive schemas and Premenstrual syndrome in mothers with postpartum depression. Preventive Care In Nursing and Midwifery Journal, 8(1), 43–48. https://doi.org/10.29252/pcnm.8.1.43
  • Amiel Castro RT, Pataky EA, Ehlert U. (2019). Associations between premenstrual syndrome and postpartum depression: A systematic literature review. Biological Psychology, 147, 107612. https://doi.org/10.1016/j.biopsycho.2018.10.014
  • Arafa AE, Senosy SA, Helmy HK, Mohamed AA. (2018). Prevalence and patterns of dysmenorrhea and premenstrual syndrome among Egyptian girls (12–25 years). Middle East Fertility Society Journal, 23(4), 486–490. https://doi.org/10.1016/j.mefs.2018 .01.007
  • Bakır N, Balcı Yangın H. (2019). Üniversite öğrencilerinde premenstrual sendrom ve sağlıklı yaşam biçimi davranışları arasındaki ilişki. Yaşam Becerileri Psikoloji Dergisi, 3, 39–51. https://doi.org/10.31461/ybpd.538946
  • Bakır N, Irmak Vural P, Körpe G. (2021). The effects of emotional freedom techniques on coping with premenstrual syndrome: A randomized control trial. In Perspectives in Psychiatric Care. 1-10. https://doi.org/10.1111/ppc.12957
  • Bakır N, Kızılkaya Beji N. (2021). Üniversite öğrenci̇leri̇nde premenstrual sendrom prevelansi ve etki̇leyen faktörler. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi, 9(1), 264–277. https://doi.org/10.33715/inonusaglik.835785
  • Cao S, Jones M, ToothL, Mishra G. (2021). Does premenstrual syndrome before pregnancy increase the risk of postpartum depression? Findings from the Australian Longitudinal Study on Women’s Health. Journal of Affective Disorders, 279, 143–148. https://doi.org/10.1016/j.jad.2020.09.130
  • Chumpalova P, Iakimova R, Stoimenova-Popova M, Aptalidis D, Pandova M, Stoyanova M, Fountoulakis KN. (2020). Prevalence and clinical picture of premenstrual syndrome in females from Bulgaria. Annals of General Psychiatry, 19(1), 1–7. https://doi.org/10.1186/s12991-019-0255-1
  • da Silva EA, Pires DA. (2021). Prevalence of premenstrual syndrome and its psychological effects among university students who participate and do not participate in resistance training. Revista Brasileira de Ciencias Do Esporte, 43, e007420. https://doi.org/ 10.1590/rbce.43.e007420
  • Dilbaz B, Aksan A. (2021). Premenstrual syndrome, a common but underrated entity: Review of the clinical literature. Journal of the Turkish German Gynecology Association, 22(2), 139–148. https://doi.org/ 10.4274/jtgga.galenos.2021.2020.0133.
  • Dönmez S, Gümüşsoy S. (2019). Hemşirelik öğrencilerinde premenstrual sendromun ve etkileyen faktörlerin incelenmesi. Kocaeli Medical Journal., 8(2), 38–45.
  • Erbaş N, Altunbaş N. (2021). Bazı değişkenlere göre bir lisedeki kız öğrencilerde premenstrual sendrom şiddetinin ve algılanan stres düzeyinin belirlenmesi. Acıbadem Üniversitesi Sağlık Bilimleri Dergisi, 12(2), 479–486.
  • Erbil N, Yücesoy H. (2021). Premenstrual syndrome prevalence in Turkey: a systematic review and meta-analysis. Psychology, Health and Medicine, 8,1-11. https://doi.org/10.1080/13548506.2021.2013509
  • Gao M, Zhang H, Gao Z, Cheng X, Sun Y, Qiao M, Gao D. (2022). Global and regional prevalence and burden for premenstrual syndrome and premenstrual dysphoric disorder A study protocol for systematic review and meta-analysis. Medicine (United States), 101(1), 1–4. https://doi.org/10.1097/MD.000000000 0028528
  • Gençdoğan B. (2006). Premenstruel sendrom için yeni bir ölçek. Türkiye’de Psikiyatri Dergisi, 8(2), 81–87.
  • Işik H, Ergöl Ş, Aynioğlu Ö, Şahbaz A, Kuzu A, Uzun M. (2016). Premenstrual syndrome and life quality in Turkish health science students. Turkish Journal of Medical Sciences, 46(3), 695–701. https://doi.org/ 10.3906/sag-1504-140
  • Izadi-Mazidi M, Amiri S. (2019). Personality characteristics in female students with premenstrual dysphoric disorder and premenstrual syndrome. Advances in Nursing and Midwifery, 28(3), 40–45. https://doi.org/10.29252/anm-280307
  • Jang HJ, Sung MH. (2018). Impact of menstrual attitudes, premenstrual syndrome, and stress response on quality of life among nursing students. Korean Journal of Women Health Nursing, 24(4), 346–354. https://doi.org/10.4069/kjwhn.2018.24.4.346
  • Kaewrudee S, Kietpeerakool C, Pattanittum P, Lumbiganon P. (2018). Vitamin or mineral supplements for premenstrual syndrome. Cochrane Database of Systematic Reviews, (1), CD012933. https://doi.org/10.1002/14651858.CD012933
  • Kahyaoglu Sut H, Mestogullari E. (2016). Effect of premenstrual syndrome on work-related quality of life in Turkish nurses. Safety and Health at Work, 7(1), 78–82. https://doi.org/10.1016/j.shaw.2015.09.001
  • Keldal G. (2015). Warwick-Edinburgh Mental İyi Oluş Ölçeği’nin Türkçe Formu: Geçerlik ve güvenirlik çalışması. The Journal of Happiness & Well-Being, 3(1), 103–115.
  • Kleinstäuber M, Schmelzer, K, Ditzen, B, Andersson, G, Hiller, W, Weise C. (2016). Psychosocial profile of women with premenstrual syndrome and healthy controls: A comparative study. International Journal of Behavioral Medicine, 23(6), 752–763. https:// doi.org/10.1007/s12529-016-9564-9
  • Moradifili B, Ghiasvand R, Pourmasoumi M, Feizi A, Shahdadian F, Shahshahan Z. (2020). Dietary patterns are associated with premenstrual syndrome: Evidence from a case-control study. In Public Health Nutrition, 23(5),833–842. https://doi.org/10.1017/S136898001 9002192
  • Nam SJ, Cha C. (2020). Effects of a social-media-based support on premenstrual syndrome and physical activity among female university students in South Korea. In Journal of Psychosomatic Obstetrics and Gynecology 41(1),47–53. https://doi.org/10.1080/ 0167482X.2018.1559811
  • Özkan S, Koç G. (2020). Kadınlarda premenstrual sendrom yaşanmasını etkileyen sosyal ve kültürel faktörler. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi, 7(2), 180–185. https://doi.org/10.31125/ hunhemsire.763193
  • Sahu R, Lal Barnwal S, Vishvakarma S. (2022). Prevalence and severity of premenstrual syndrome among young females in Chhattisgarh, India. Asian Pacific Journal of Health Sciences, January, 2–8. https://doi.org/10.21276/apjhs.2022.9.1.34
  • Saka S, Okuyucu T. (2020). Genç kadınlarda premenstrual sendromun yorgunluk ve uyku kalitesi üzerine etkisi. Haliç Üniversitesi Sağlık Bilimleri Dergisi, 3(1), 33–40.
  • Tennant R, Hiller L, Fishwick R, Platt S, Josep, S, Weich S, Parkinson J, Secker J, Stewart-Brown S. (2007). The Warwick-Edinburgh mental well-being scale (WEMWBS): Development and UK validation. Health and Quality of Life Outcomes, 5(1), 50–63.
  • Victor FF, Souza AI, Barreiros CDT, Barros JLN, De Silva FACD, Ferreira ALCG. (2019). Quality of life among university students with premenstrual syndrome. Revista Brasileira de Ginecologia e Obstetricia, 41(5), 312–317. https://doi.org/10.1055 /s-0039-1688709
  • Yang Q, Sjölander A, Li Y, Viktorin A, Bertone-Johnson ER, Ye W, Fang F, Valdimarsdóttir UA, Lu D. (2021). Clinical indications of premenstrual disorders and subsequent risk of injury: a population-based cohort study in Sweden. BMC Medicine, 19(1), 1–12. https://doi.org/10.1186/s12916-021-01989-4
  • Yorulmaz DS, Karadeniz H. (2021). Premenstrual sendrom yaşayan üniversite öğrencilerinin yakınmalarını azaltmaya yönelik kültürel uygulamaları. İnönü Üniversitesi Sağlık Hizmetleri Meslek Yüksek Okulu Dergisi, 9(2), 755–769. https://doi.org/10.33715/inonusaglik.833166
Toplam 36 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Hemşirelik
Bölüm Araştırma
Yazarlar

İlknur Yeşilçınar 0000-0003-2864-4935

Derya Yanık 0000-0001-8004-6786

Proje Numarası Yoktur.
Erken Görünüm Tarihi 1 Eylül 2023
Yayımlanma Tarihi 1 Eylül 2023
Gönderilme Tarihi 27 Mayıs 2022
Yayımlandığı Sayı Yıl 2023

Kaynak Göster

APA Yeşilçınar, İ., & Yanık, D. (2023). Doğum Yapan ve Yapmayan Kadınlarda Premenstrual Sendrom ve Mental İyi Oluş Arasındaki İlişkinin İncelenmesi. Ordu Üniversitesi Hemşirelik Çalışmaları Dergisi, 6(2), 290-298. https://doi.org/10.38108/ouhcd.1122220