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İnfertilitede Anne Olma: Kuramsal Bir Analiz

Yıl 2018, Cilt: 10 Sayı: 4, 506 - 521, 30.12.2018
https://doi.org/10.18863/pgy.382342

Öz

İnfertilite nedeniyle bir bebeğe sahip olabilmek için çiftler çoğunlukla yardımcı üreme tedavilerine başvurmaktadır. Gebelik gerçekleştiği durumlarda, çiftler için gebeliğin anlamı mutlu ve keyifli bir süreç olsa da, infertilite tanısı ve tedavilerinin getirdiği yükle birlikte zorlu bir sürece dönüşebilmektedir. Özellikle kadınlar bu süreçte gebeliği kabullenememe, bebeğini kaybetme korkusu, bebeğin sağlığı konusunda endişelenme, belirsizlik gibi duygular yaşayabilmektedirler. İnfertilite tedavisi sonrası gebe kalan kadınların spontan gebeler arasında göz ardı edilebildiği bilinmektedir. Uluslararası literatürde niteliksel çalışmalarda yardımcı üreme tedavileri ile gebe kalan kadınların gebeliğe ve doğum sonu döneme kolayca uyum sağlamadığını göstermektedir. Bu derleme ile, infertilite tedavisi sonrası gebe kalan kadınların anne olma sürecinki deneyimleri kuramsal olarak incelenmiş ve analiz edilmiştir.

Kaynakça

  • Ak G (2001) İnfertil çiftlerin depresyon durumları ve başa çıkma yollarının incelenmesi (Yüksek lisans tezi). İzmir, Dokuz Eylül Üniversitesi.
  • Aktürk FS (2006) Türk toplumunun yardımcı üreme tekniklerine bakışı (Yüksek lisans tezi). Afyon, Kocatepe Üniversitesi.
  • Allan HT, Finnerty G (2007) The practice gap in the care of women following successful infertility treatments: unasked research questions in midwifery and nursing. Hum Fertil (Camb), 10:99–104.
  • Aşçı Ö, Kızılkaya Beji N (2012) İnfertilite danışmanlığı. Florence Nightingale Hemşirelik Dergisi, 20:154-159.
  • Ataman H (2007) Doğal ve infertilite tedavisi sonucu oluşan gebeliklerde psiko sosyal bakım gereksinimleri (Yüksek lisans tezi). İstanbul, Marmara Üniversitesi.
  • Baor L, Soskolne V (2010) Mothers of IVF and spontaneously conceived twins: a comparison of prenatal maternal expectations, coping resources and maternal stress. Hum Reprod, 25:1490-1496.
  • Beauvoir S (1970) Kadın Genç Kızlık Çağı (Çeviri Ed. O Asena). İstanbul, Payel Yayınevi.
  • Bergart AM (2000) The experience of women in unsuccessful infertility treatment: what do patients need when medical ıntervention fails. Soc Work Health Care, 30:45-69.
  • Boivin J, Appleton TC, Batens P, Baron J, Bitzer J, Corrigan E et al. (2001) Guidelines for counseling in fertility: outline version. Hum Reprod, 16:1301-1304.
  • Boz I, Okumus H (2017) The “everything about the existence” experiences of Turkish women with infertility: solicited diaries in qualitative research. J Nurs Res, 25:268–275.
  • Campbell A (2003) Cutting out motherhood: childfree, sterilised women. In Gender, Identity and Reproduction: Social Perspectives (Eds S Earle, G Letherby):191-204. London, Palgrave Macmillan.
  • Chen CJ, Chen YC, Sung HC, Kuo PC, Wang CH (2011) Perinatal attachment in naturally pregnant and infertility-treated pregnant women in Taiwan. J Adv Nurs, 67:2200-2208.
  • Covington NS, Burns LH (2006) Infertility Counseling: A Comprehensive Handbook for Clinicians, 2nd ed. New York, Cambridge University Press.
  • Çavuşoğlu İ (2015) İnfertilite tedavileri sonrasi gebe kalan kadinlarin yaşam kalitesi ve depresyon durumlarinin incelenmesi (Yüksek lisans tezi). İstanbul, Haliç Üniversitesi.
  • Çinar İÖ, Öztürk A (2014) The effect of planned baby care education given to primiparous mothers on maternal attachment and self-confidence levels. Health Care Women Int, 35:320-333.
  • Darwiche J, Maillard F, Germond M, Favez N, Lancastle D, Roten Y et al. (2013) The transition of care from fertility specialists to obstetricians: maternal adjustment and postpartum depressive symptoms. Womens Health (Lond), 9:109-118.
  • Dunnington RM, Glazer G (1991) Maternal identity and early mothering behavior in previously infertile and never infertile women. J Obstet Gynecol Neonatal Nurs, 20:309-318.
  • Dornelles LM, MacCallum F, Lopes RC, Piccinini CA, Passos EP (2014) “Living each week as unique”:Maternal fears in assisted reproductive technology pregnancies. Midwifery, 30:e115-e120.
  • Dornelles LM, MacCallum F, Lopes RC, Piccinini CA, Passos EP (2016) The experience of pregnancy resulting from Assisted Reproductive Technology (ART) treatment: a qualitative Brazilian study. Women Birth, 29:123-127.
  • French LR, Sharp DJ, Turner KM (2015) Antenatal needs of couples following fertility treatment: a qualitative study in primary care. Br J Gen Pract, 65:e570-577.
  • Gambadauro P, Iliadis S, Bränn E, Skalkidou A (2017) Conception by means of in vitro fertilization is not associated with maternal depressive symptoms during pregnancy or postpartum. Fertil Steril, 108:325-332.
  • Gourounti K (2016) Psychological stress and adjustment in pregnancy following assisted reproductive technology and spontaneous conception: a systematic review. Women Health, 56:98-118.
  • HaCohen N, Amir D, Wiseman H (2018) Women's narratives of crisis and change: Transitioning from infertility to pregnancy.. J Health Psychol, 23:720-730.
  • Hammarberg K, Fisher JR, Wynter KH (2008) Psychological and social aspects of pregnancy, childbirth and early parenting after assisted conception: a systematic review. Hum Reprod Update, 14: 395-414.
  • Hjelmstedt A, Widström AM, Collins A (2006) Psychological correlates of prenatal attachment in women who conceived after in vitro fertilization and women who conceived naturally. Birth, 33:303-310.
  • Kaylı D (2011) Kadın Bedeni ve Özgürleşme. İzmir, İlya Yayınevi.
  • Kılıç M, Ejder Apay S, Kizilkaya Beji N (2011) İnfertilite ve kültür. Florence Nightingale Hemşirelik Dergisi, 19:109-115.
  • Koç E, Kızılkaya Beji N (2016) Başarılı infertilite tedavisi sonrası gebelerin yaşadığı problemler ve danışmanlık. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 6: 201-206.
  • Kuo PC, Bowers B, Chen YC, Chen CH, Tzeng YL, Lee MS (2013) Maternal-foetal attachment during early pregnancy in Taiwanese women pregnant by in vitro fertilization. J Adv Nurs, 69:2502-2513.
  • Kuş C (2008) İnfertilite durumunda kadınların yaşam kalitesi ve algıladıkları sosyal desteğin belirlenmesi (Yüksek lisans tezi). İstanbul, Marmara Üniversitesi.
  • Ladores S, Aroian K (2015) The early postpartum experience of previously infertile mothers. J Obstet Gynecol Neonatal Nurs, 44:370-379.
  • Lin Y, Tsai Y, Lai P (2012) The experience of Taiwanese women achieving post-infertility pregnancy through assisted reproductive treatment. Fam J Alex Va, 21:189-197.
  • Maher JM, Saugeres L (2007) To be or not to be a mother? Women negotiating cultural representations of mothering. J Sociol (Melb), 43:5-21.
  • Meighan M (2018) Ramona T. Mercer: Maternal role attainment-becoming a mother. In Nursing Theorists and Their Work, 9th ed. (Ed: M Aldlisgood):432-446. St. Louis , Elsevier.
  • Mercer RT, Walker LO (2006) A review of nursing interventions to foster becoming a mother. J Obstet Gynecol Neonatal Nurs, 35:568-582.
  • Mercer RT (2004) Becoming a mother versus maternal role attainment. J Nurs Scholarsh, 36:226-232.
  • Nelson A (2003) Transition to motherhood. J Obstet Gynecol Neonatal Nurs, 32:465-477.
  • Obeidat H, Hamlan A, Callister L (2014) Missing motherhood: Jordanian women’s experiences with infertility. Advances in Psychiatry, 2014:241075.
  • Olshansky EF (1995) Pregnancy after infertility: An overview of the research. Course XII: ART Parents and Children. American Society for Reproductive Medicine. Seattle, October 7-8;5-13.
  • Ozkan H, Polat S (2011) Maternal identity development education on maternity role attainment and my baby perception of primiparas. Asian Nurs Res (Korean Soc Nurs Sci), 5:108-117.
  • Prinds C, Hvidt NC, Mogensen O, Buus N (2014) Making existential meaning in transition to motherhood--a scoping review. Midwifery, 30:733-741.
  • Porter M, Bhattacharya S (2008) Helping themselves to get pregnant: a qualitative longitudinal study on the information-seeking behaviour of infertile couples. Hum Reprod, 23:567-572.
  • Ranjbar F, Behboodi-Moghadam Z, Borimnejad L, Ghaffari SR, Akhondi MM (2015a) Experiences of infertile women seeking assisted pregnancy in Iran: a qualitative study. J Reprod Infertil, 16:221-228.
  • Ranjbar F, Akhondi MM, Borimnejad L, Ghaffari SR, Behboodi-Moghadam Z (2015b) Paradox of modern pregnancy: a phenomenological study of women’s lived experiences from assisted pregnancy. Journal of Pregnancy, 2015:543210.
  • Redshaw M, Hockley C, Davidson LL (2007) A qualitative study of the experience of treatment for infertility among women who successfully became pregnant. Hum Reprod, 22:295-304.
  • Rubin R (1984) Maternal Identity and The Maternal Experience, New York, Springer.
  • Saffee CL (1999) Maternal Identity in Previously Infertile and Never Infertile Women (Masters theses). Michigan, Grand Valley State University.
  • Sarı T (2014) Öznelik kapasitesi bağlamında biyolojik annelik: üremeye yardımcı teknolojileri kullanan kadınların deneyimleri (Yüksek lisans tezi). Aydın, Adnan Menderes Üniversitesi.
  • Şahinoğlu S, Buken NO (2010) Gender, infertility, motherhood, and assisted reproductive technology (ART) in Turkey. Hum Reprod Genet Ethics, 16:218-232.
  • Smorti M., Smorti A (2012) Transition to parenthood in infertile couples. Procedia Soc Behav Sci, 46:527-531.
  • Upadhyay S (2008) Pseudocyesis. J Nepal Med Assoc, 47:147-150.
  • Verhaak CM, Smeenk JMJ, Evers AWM, Kremer JAM, Kraaimaat FW, Braat DDM (2007) Women’s emotional adjusment to IVF: a systematic review of 25 years of research. Human Reprod Update, 13:27–36.
  • Wang L, Lee T (2004) Assisted pregnancy after infertility: Taiwanese women’s experience. J Med Sci, 24249-256.
  • Warmelink JC, Adema W, Pranger A, Cock PD (2016) Client perspectives of midwifery care in the transition from subfertility to parenthood: a qualitative study in the Netherlands. J Psychosom Obstet Gynaecol, 37:12-20.
  • Watkins KJ, Baldo TD (2004) The infertility experience: biopsychosocial effects and suggestions for counselors. J Couns Dev, 82:394–402.
  • Wıelgoś M, Szymusik I (2014) Pregnancy in women after infertility treatment. Archives of Perinatal Medicine, 20:73-77.
  • Yanıkkerem E, Kavlak O, Sevil Ü (2008) İnfertil çiftlerin yaşadıkları sorunlar ve hemşirelik. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi, 11:112-121.
  • Younger M, Hollins-Martin C, Choucri L (2015) Individualised care for women with assisted conception pregnancies and midwifery practice implications: an analysis of the existing research and current practice. Midwifery, 31:265–270.

Becoming a Mother after Infertility: A Theoretical Analysis

Yıl 2018, Cilt: 10 Sayı: 4, 506 - 521, 30.12.2018
https://doi.org/10.18863/pgy.382342

Öz

IIn order to have a baby due to infertility, couples often resort to assisted reproduction therapy. In cases of pregnancy, even if the meaning of pregnancy is a happy and enjoyable process for these couples, the burden of infertility diagnosis and treatments can turn into a challenging process. Especially women can experience emotions such as not accepting pregnancy, fear of losing their baby, worrying about their health, uncertainty. It is known that pregnant women after infertility treatment can be ignored among spontaneous pregnancies. In qualitative studies at international literature, pregnant women with assisted reproductive treatments do not easily adjust to gestation and postpartum period. With this review, the experiences of the mother who became pregnant after infertility treatment were reviewed and analyzed theoretically.

Kaynakça

  • Ak G (2001) İnfertil çiftlerin depresyon durumları ve başa çıkma yollarının incelenmesi (Yüksek lisans tezi). İzmir, Dokuz Eylül Üniversitesi.
  • Aktürk FS (2006) Türk toplumunun yardımcı üreme tekniklerine bakışı (Yüksek lisans tezi). Afyon, Kocatepe Üniversitesi.
  • Allan HT, Finnerty G (2007) The practice gap in the care of women following successful infertility treatments: unasked research questions in midwifery and nursing. Hum Fertil (Camb), 10:99–104.
  • Aşçı Ö, Kızılkaya Beji N (2012) İnfertilite danışmanlığı. Florence Nightingale Hemşirelik Dergisi, 20:154-159.
  • Ataman H (2007) Doğal ve infertilite tedavisi sonucu oluşan gebeliklerde psiko sosyal bakım gereksinimleri (Yüksek lisans tezi). İstanbul, Marmara Üniversitesi.
  • Baor L, Soskolne V (2010) Mothers of IVF and spontaneously conceived twins: a comparison of prenatal maternal expectations, coping resources and maternal stress. Hum Reprod, 25:1490-1496.
  • Beauvoir S (1970) Kadın Genç Kızlık Çağı (Çeviri Ed. O Asena). İstanbul, Payel Yayınevi.
  • Bergart AM (2000) The experience of women in unsuccessful infertility treatment: what do patients need when medical ıntervention fails. Soc Work Health Care, 30:45-69.
  • Boivin J, Appleton TC, Batens P, Baron J, Bitzer J, Corrigan E et al. (2001) Guidelines for counseling in fertility: outline version. Hum Reprod, 16:1301-1304.
  • Boz I, Okumus H (2017) The “everything about the existence” experiences of Turkish women with infertility: solicited diaries in qualitative research. J Nurs Res, 25:268–275.
  • Campbell A (2003) Cutting out motherhood: childfree, sterilised women. In Gender, Identity and Reproduction: Social Perspectives (Eds S Earle, G Letherby):191-204. London, Palgrave Macmillan.
  • Chen CJ, Chen YC, Sung HC, Kuo PC, Wang CH (2011) Perinatal attachment in naturally pregnant and infertility-treated pregnant women in Taiwan. J Adv Nurs, 67:2200-2208.
  • Covington NS, Burns LH (2006) Infertility Counseling: A Comprehensive Handbook for Clinicians, 2nd ed. New York, Cambridge University Press.
  • Çavuşoğlu İ (2015) İnfertilite tedavileri sonrasi gebe kalan kadinlarin yaşam kalitesi ve depresyon durumlarinin incelenmesi (Yüksek lisans tezi). İstanbul, Haliç Üniversitesi.
  • Çinar İÖ, Öztürk A (2014) The effect of planned baby care education given to primiparous mothers on maternal attachment and self-confidence levels. Health Care Women Int, 35:320-333.
  • Darwiche J, Maillard F, Germond M, Favez N, Lancastle D, Roten Y et al. (2013) The transition of care from fertility specialists to obstetricians: maternal adjustment and postpartum depressive symptoms. Womens Health (Lond), 9:109-118.
  • Dunnington RM, Glazer G (1991) Maternal identity and early mothering behavior in previously infertile and never infertile women. J Obstet Gynecol Neonatal Nurs, 20:309-318.
  • Dornelles LM, MacCallum F, Lopes RC, Piccinini CA, Passos EP (2014) “Living each week as unique”:Maternal fears in assisted reproductive technology pregnancies. Midwifery, 30:e115-e120.
  • Dornelles LM, MacCallum F, Lopes RC, Piccinini CA, Passos EP (2016) The experience of pregnancy resulting from Assisted Reproductive Technology (ART) treatment: a qualitative Brazilian study. Women Birth, 29:123-127.
  • French LR, Sharp DJ, Turner KM (2015) Antenatal needs of couples following fertility treatment: a qualitative study in primary care. Br J Gen Pract, 65:e570-577.
  • Gambadauro P, Iliadis S, Bränn E, Skalkidou A (2017) Conception by means of in vitro fertilization is not associated with maternal depressive symptoms during pregnancy or postpartum. Fertil Steril, 108:325-332.
  • Gourounti K (2016) Psychological stress and adjustment in pregnancy following assisted reproductive technology and spontaneous conception: a systematic review. Women Health, 56:98-118.
  • HaCohen N, Amir D, Wiseman H (2018) Women's narratives of crisis and change: Transitioning from infertility to pregnancy.. J Health Psychol, 23:720-730.
  • Hammarberg K, Fisher JR, Wynter KH (2008) Psychological and social aspects of pregnancy, childbirth and early parenting after assisted conception: a systematic review. Hum Reprod Update, 14: 395-414.
  • Hjelmstedt A, Widström AM, Collins A (2006) Psychological correlates of prenatal attachment in women who conceived after in vitro fertilization and women who conceived naturally. Birth, 33:303-310.
  • Kaylı D (2011) Kadın Bedeni ve Özgürleşme. İzmir, İlya Yayınevi.
  • Kılıç M, Ejder Apay S, Kizilkaya Beji N (2011) İnfertilite ve kültür. Florence Nightingale Hemşirelik Dergisi, 19:109-115.
  • Koç E, Kızılkaya Beji N (2016) Başarılı infertilite tedavisi sonrası gebelerin yaşadığı problemler ve danışmanlık. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 6: 201-206.
  • Kuo PC, Bowers B, Chen YC, Chen CH, Tzeng YL, Lee MS (2013) Maternal-foetal attachment during early pregnancy in Taiwanese women pregnant by in vitro fertilization. J Adv Nurs, 69:2502-2513.
  • Kuş C (2008) İnfertilite durumunda kadınların yaşam kalitesi ve algıladıkları sosyal desteğin belirlenmesi (Yüksek lisans tezi). İstanbul, Marmara Üniversitesi.
  • Ladores S, Aroian K (2015) The early postpartum experience of previously infertile mothers. J Obstet Gynecol Neonatal Nurs, 44:370-379.
  • Lin Y, Tsai Y, Lai P (2012) The experience of Taiwanese women achieving post-infertility pregnancy through assisted reproductive treatment. Fam J Alex Va, 21:189-197.
  • Maher JM, Saugeres L (2007) To be or not to be a mother? Women negotiating cultural representations of mothering. J Sociol (Melb), 43:5-21.
  • Meighan M (2018) Ramona T. Mercer: Maternal role attainment-becoming a mother. In Nursing Theorists and Their Work, 9th ed. (Ed: M Aldlisgood):432-446. St. Louis , Elsevier.
  • Mercer RT, Walker LO (2006) A review of nursing interventions to foster becoming a mother. J Obstet Gynecol Neonatal Nurs, 35:568-582.
  • Mercer RT (2004) Becoming a mother versus maternal role attainment. J Nurs Scholarsh, 36:226-232.
  • Nelson A (2003) Transition to motherhood. J Obstet Gynecol Neonatal Nurs, 32:465-477.
  • Obeidat H, Hamlan A, Callister L (2014) Missing motherhood: Jordanian women’s experiences with infertility. Advances in Psychiatry, 2014:241075.
  • Olshansky EF (1995) Pregnancy after infertility: An overview of the research. Course XII: ART Parents and Children. American Society for Reproductive Medicine. Seattle, October 7-8;5-13.
  • Ozkan H, Polat S (2011) Maternal identity development education on maternity role attainment and my baby perception of primiparas. Asian Nurs Res (Korean Soc Nurs Sci), 5:108-117.
  • Prinds C, Hvidt NC, Mogensen O, Buus N (2014) Making existential meaning in transition to motherhood--a scoping review. Midwifery, 30:733-741.
  • Porter M, Bhattacharya S (2008) Helping themselves to get pregnant: a qualitative longitudinal study on the information-seeking behaviour of infertile couples. Hum Reprod, 23:567-572.
  • Ranjbar F, Behboodi-Moghadam Z, Borimnejad L, Ghaffari SR, Akhondi MM (2015a) Experiences of infertile women seeking assisted pregnancy in Iran: a qualitative study. J Reprod Infertil, 16:221-228.
  • Ranjbar F, Akhondi MM, Borimnejad L, Ghaffari SR, Behboodi-Moghadam Z (2015b) Paradox of modern pregnancy: a phenomenological study of women’s lived experiences from assisted pregnancy. Journal of Pregnancy, 2015:543210.
  • Redshaw M, Hockley C, Davidson LL (2007) A qualitative study of the experience of treatment for infertility among women who successfully became pregnant. Hum Reprod, 22:295-304.
  • Rubin R (1984) Maternal Identity and The Maternal Experience, New York, Springer.
  • Saffee CL (1999) Maternal Identity in Previously Infertile and Never Infertile Women (Masters theses). Michigan, Grand Valley State University.
  • Sarı T (2014) Öznelik kapasitesi bağlamında biyolojik annelik: üremeye yardımcı teknolojileri kullanan kadınların deneyimleri (Yüksek lisans tezi). Aydın, Adnan Menderes Üniversitesi.
  • Şahinoğlu S, Buken NO (2010) Gender, infertility, motherhood, and assisted reproductive technology (ART) in Turkey. Hum Reprod Genet Ethics, 16:218-232.
  • Smorti M., Smorti A (2012) Transition to parenthood in infertile couples. Procedia Soc Behav Sci, 46:527-531.
  • Upadhyay S (2008) Pseudocyesis. J Nepal Med Assoc, 47:147-150.
  • Verhaak CM, Smeenk JMJ, Evers AWM, Kremer JAM, Kraaimaat FW, Braat DDM (2007) Women’s emotional adjusment to IVF: a systematic review of 25 years of research. Human Reprod Update, 13:27–36.
  • Wang L, Lee T (2004) Assisted pregnancy after infertility: Taiwanese women’s experience. J Med Sci, 24249-256.
  • Warmelink JC, Adema W, Pranger A, Cock PD (2016) Client perspectives of midwifery care in the transition from subfertility to parenthood: a qualitative study in the Netherlands. J Psychosom Obstet Gynaecol, 37:12-20.
  • Watkins KJ, Baldo TD (2004) The infertility experience: biopsychosocial effects and suggestions for counselors. J Couns Dev, 82:394–402.
  • Wıelgoś M, Szymusik I (2014) Pregnancy in women after infertility treatment. Archives of Perinatal Medicine, 20:73-77.
  • Yanıkkerem E, Kavlak O, Sevil Ü (2008) İnfertil çiftlerin yaşadıkları sorunlar ve hemşirelik. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi, 11:112-121.
  • Younger M, Hollins-Martin C, Choucri L (2015) Individualised care for women with assisted conception pregnancies and midwifery practice implications: an analysis of the existing research and current practice. Midwifery, 31:265–270.
Toplam 58 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Klinik Psikoloji, Psikolojide Davranış-Kişilik Değerlendirmesi
Bölüm Derleme
Yazarlar

İlkay Boz 0000-0002-3529-9351

Elif Özçetin Bu kişi benim 0000-0001-7490-5361

Gamze Teskereci 0000-0003-0298-9716

Yayımlanma Tarihi 30 Aralık 2018
Kabul Tarihi 12 Şubat 2018
Yayımlandığı Sayı Yıl 2018 Cilt: 10 Sayı: 4

Kaynak Göster

AMA Boz İ, Özçetin E, Teskereci G. İnfertilitede Anne Olma: Kuramsal Bir Analiz. Psikiyatride Güncel Yaklaşımlar. Aralık 2018;10(4):506-521. doi:10.18863/pgy.382342

Cited By









Sosyal Medyada Annelik
Turkish Journal of Family Medicine and Primary Care
https://doi.org/10.21763/tjfmpc.1004604








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Psikiyatride Güncel Yaklaşımlar Creative Commons Atıf-Gayriticari-Türetilemez 4.0 Uluslararası Lisansı ile lisanslanmıştır.