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Romatoid Artrit Hastalarının Tamamlayıcı ve Destekleyici Tıp Kullanım Durumlarının Uyku ve Yaşam Kalitesine Etkisi: Kesitsel Bir Çalışma

Yıl 2025, Cilt: 6 Sayı: 3, 366 - 377, 04.12.2025

Öz

Giriş: Romatoid Artrit (RA), bireylerde ağrı, eklemlerde şişlik ve fonksiyon kaybına neden olabilir. RA hastalarında uyku ve yaşam kalitesi açısından Tamamlayıcı ve Destekleyici Tıp (TAT) kullanımını inceleyen yayınlanmış bir çalışma bulunmamaktadır.
Amaç: Bu çalışmada RA'lı hastaların kullandığı yöntemleri ve TAT yöntemlerinin uyku ve yaşam kalitesine olan etkilerini belirlemek için yapıldı.
Yöntem: Bu araştırma kesitsel olarak yapıldı. Çalışmaya 190 RA'lı hasta dahil edildi. Veriler hasta bilgi formu, Romatoid Artrit için Yaşam Kalitesi Ölçeği ve Pittsburgh Uyku Kalitesi İndeksi kullanılarak toplandı. TAT kullanan ve kullanmayanların demografik, sosyoekonomik, hastalık ve tedavi özellikleri belirlendi.
Bulgular: Hastaların %60,5 en az bir tür TAT kullandığını bildirirken, %39.5 TAT kullanmadığını belirtti. TAT kullananlar ve TAT kullanmayanlar arasında yaş, cinsiyet, eğitim düzeyi, medeni durum ve gelir düzeyi açısından istatistiksel olarak anlamlı bir fark yoktu. TAT kullanım yaklaşımları ve nedenleri hastanın beklenti ve seçimine, hastanın sosyokültürel geçmişine ve dini özelliklerine göre farklılık göstermektedir. Bu çalışmada TAT kullanan RA'lı hastaların yaşam kalitesi puan ortalaması ve uyku kalitesi puan ortalamasının yüksek olduğu görüldü.
Sonuç: Bu araştırmada TAT kullanım oranının yüksek olduğu belirlendi. Hastaların düzenli olarak sağlık kontrollerini yaptırdıkları ve ilaç tedavisinin yanı sıra TAT yöntemlerini de kullandıkları saptandı. TAT kullanan hastalar bu konuda doktor veya hemşirelerine bilgi vermediklerini, faydalı olduğunu düşündükleri için TAT yöntemlerini kullandıklarını belirttiler. Sağlık çalışanlarının, hastaların kullandıkları TAT yöntemlerini sorgulamaları ve uyku düzenleri ve yaşam kalitelerinin değerlendirmeleri önerildi.

Etik Beyan

Before starting the study, approval from the non-invasive research ethics committee of the Kafkas University Faculty of Health Sciences (date: 28/02/2022 and number: 81829502.903/21) and written permission from the hospitals where the study was conducted were obtained. The participants were informed about the purpose and method of the study and that participation was entirely voluntary, and written consent was obtained. The research was conducted in accordance with the Principles of the Declaration of Helsinki.

Kaynakça

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  • 2. Kooshki A, Forouzan R, Rakhshani MH, Mohammadi M. Effect of topical application of nigella sativa oil and oral acetaminophen on pain in elderly with knee osteoarthritis: A crossover clinical trial. Electron Physician. 2016;8(11):3193-3197. doi: 10.19082/3193. eCollection 2016 Nov.
  • 3. Sadeghi A, Tabatabaiee M, Mousavi MA, Mousavi SN, Abdollahi Sabet S, Jalili N. Dietary Pattern or Weight Loss: Which One Is More Important to Reduce Disease Activity Score in Patients with Rheumatoid Arthritis? A Randomized Feeding Trial. Int J Clin Pract 2022;2022:6004916. doi: 10.1155/2022/6004916.
  • 4. Grega ML, Shalz JT, Rosenfeld RM, et al. American College of Lifestyle Medicine Expert Consensus Statement: Lifestyle Medicine for Optimal Outcomes in Primary Care. Am J Lifestyle Med 2023: 25;18(2):269-293. doi: 10.1177/15598276231202970.
  • 5. Smolen J, Aletaha D, Mclnees I, Rheumatoid arthritis. Lancet. 2016;388:2013–2038. doi:10.1016/S0140-6736(16)30173-8.
  • 6. Yang L, Sibbritt D, Adams J. A critical review of complementary an alternative medicine use among people with arthritis: a focus upon prevalence, cost, user profiles, motivation, decision-making, perceived benefits and communication. Rheumatol Int. 2017;37:337–351. doi:10.1007/s00296-016- 3616-y.
  • 7. Macfarlane GJ, El-Metwally A, De Silva V, Ernst E, Dowds GL, Moots RJ. Evidence for the efficacy of complementary and alternative medicines in the management of rheumatoid arthritis: A systematic reviwe. Rheumatology. 2011;50(9):1672-1683. doi:10.1093/rheumatology/ker119.
  • 8. Institute of Medicine (U.S.), editor. Complementary and alternative medicine in the United States. Washington, DC: National Academies Press; 2005.
  • 9. World Health Organization. WHO global report on traditional and complementary medicine, 2019.
  • 10. National Center for Complementary and Integrative Health (2020) Complementary, alternative, or integrative health: what’s in a name? NCCIH. https://nccih.nih.gov/health/integrative-health.
  • 11. Michalsen A. The role of Complementary and Alternative Medicine (CAM) in Rheumatology. It´s time to integrative medicine. J Rheumatol. 2013;40:547–549. doi:10.3899/jrheum.130107.
  • 12. Efthimiou P, Kukar M, Mackenzie CR. 2010. Complementary and alternative medicine in rheumatoid. HSS J. 2010;Feb;6(1):108-11. doi: 10.1007/s11420-009-9133-8.
  • 13. Ünal E, Arın G, Karaca BN, et al. Development of a quality of life measurement for rheumatic patients: item pool construction. Journal of Exercise Therapy and Rehabilitation. 2017;4(2):67-75.
  • 14. Buysee DJ, Reynolds CF, Monk TF, et al. The Pittsburgh sleep quality index: A new instrument for psychiatric practise and research. Psychiatry Res. 1989;28:193–213. doi: 10.1016/0165-1781(89)90047-4.
  • 15. Ağargün MY. Kara H. Anlar Ö. The validity and reliability of the Pittsburgh sleep quality index. Turk Psik Derg. 1996:107–115.
  • 16. Lahiri M, Santosa A, Teoh LK, et al. Use of complementary and alternative medicines is associated with delay to initiation of disease-modifying anti-rheumatic drug therapy in early inflammatory arthritis. Int J Rheum Dis. 2017;20:567–75. doi: 10.1111/1756-185X.13091.
  • 17. Phang JK, Kwan YH, Goh H, et al. Complementary and alternative medicine for rheumatic diseases: a systematic review of randomized controlled trials. Complement Ther Med. 2018;37:143–57. doi:10.1016/j.ctim.2018. 03.003
  • 18. Kısa İ, Ok E, Er F. The effect of Balneotherapy on pain, depression symptoms, sleep and quality of life in patients with osteoarthritis. J Tradit Complem Med. 2020;3(1):27-33. doi:10.5336/jtracom.2019-72308.
  • 19. Roberts JA, Mandl LA. Complementary and Alternative Medicine Use in Psoriatic Arthritis Patients: a Review. Current Rheumatology Reports. 2020:22;81. doi:10.1007/s11926-020-00956-x.
  • 20. Baig S, Direnzo D. Complementary and alternative medicine use in rheumatoid arthritis. Curr Rheumatol Rep. 2020;22 (10): 61. doi: 10.1007/s11926-020-00938-z.
  • 21. Singh JA, Saag KG, Bridges SL, et al. 2015 American college of rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol. 2016 Jan;68(1):1-26. doi: 10.1002/art.39480.
  • 22. Lahiri M, Santosa A, Teoh LK, et al. Use of complementary and alternative medicines is associated with delay to initiation of disease-modifying anti-rheumatic drug therapy in early inflammatory arthritis. Int J Rheum Dis. 2017;20(5):567-575. doi: 10.1111/1756-185X.13091.
  • 23. Tharakan CS, Ungcharoen N, Sabu J, Moorthy A. Complementary and alternative medicine in rheumatology: a survey of its use for common rheumatological conditions among multi-ethnic patients in Leicestershire. Ann Rheum Dis. 2019;78(supplement2):A621. doi:10.1136/annrheumdis-2019-eular.6493.
  • 24. Koçyiğit BF, Sagtaganov Z, Yessirkepov M, Akyol A. Assessment of complementary and alternative medicine methods in the management of ankylosing spondylitis, rheumatoid arthritis, and fbromyalgia syndrome. Rheumatol Int. 2023 Apr;43(4):617-625. doi: 10.1007/s00296-022-05267-1.
  • 25. James PB, Wardle J, Steel A, Adams J. Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review. BMJ Glob Health. 2018;31;3(5):e000895. doi: 10.1136/bmjgh-2018-000895.
  • 26. Altan L, Korkmaz N, Dizdar M, Yurtkuran M. Efect of Pilates training on people with ankylosing spondylitis. Rheumatol Int. 2012; 32:2093–2099. doi:10.1007/s00296-011-1932-9
  • 27. Ulusoy H, Güçer TK, Aksu M, Arslan Ş, Habiboğlu A. The use of complementary and alternative medicine in Turkish patients with rheumatic diseases. Turk J Rheumatol. 2012;27(1):31-37 doi: 10.5606/tjr.2012.004
  • 28. Abramoff B, Caldera FE. Osteoarthritis: Pathology, diagnosis, and treatment options. Med. Clin. North. Am. 2020;104 (2):293–311. doi:10.1016/j. mcna.2019
  • 29. Patterson SL, Ruvalcaba D, Issa A, Rai K, Katz P, Koenig CJ. Experiences with complementary and ıntegrative health among people with rheumatoid arthritis and systemic lupus erythematosus: a qualitative study. J Reumatol. 2025;52(8):758-769. doi: 10.3899/jrheum.2024-1218.
  • 30. Klingberg E, Wallerstedt SM, Torstenson T, Håwi G, Forsblad-d’Elia H. The use of complementary and alternative medicine in outpatients with inflammatory rheumatic diseases in Sweden. Scand J Rheumatol. 2009;38(6):472-480. doi: 10.3109/03009740902994280.
  • 31. Lee MS, Lee MS, Yang CY, et al. Use of complementary and alternative medicine by rheumatoid arthritis patients in Korea. Clin Rheumatol. 2008;27(1):29-33. doi: 10.1007/s10067-007-0646-6.
  • 32. Kılıç KN, Soylar P. Investigation of attitudes, reasons and satisfaction levels of individuals who apply to traditional and complementary medicine practices. J Tradit Complem Med. 2019;2(3):97-105. doi:10.5336/jtracom.2019-71531
  • 33. Talhaoğlu D. Traditional anad complementary treatment practices. Journal of Integrative and Anadolian Medicine. 2021;3(1):16-29. doi: 10.53445/batd.945893.
  • 34. Dikici A, Ulaşlı AM, Çevik H, Eroğlu S, Solak Ö, Dündar Ü. The use of complementary and alternative medicine in patients with degenerative osteoarthritis. Euras J Fam Med. 2015;4(3):126-130.
  • 35. de Cabo R, Mattson MP. Effects of intermittent fasting on health, aging, and disease. N Engl J Med. 2019;381:2541. doi:10.1056/NEJMra1905136.
  • 36. Caballero-Herna´ndez CI, Gonza´lez-Cha´vez SA, UrendaQuezada A, et al. Prevalence of complementary and alternative medicine despite limited perceived efficacy in patients with rheumatic diseases in Mexico: Cross-sectional study. Plos One. 2021;28(16):9; e0257319. doi:10.1371/journal.pone.0257319.
  • 37. Almuhareb AM, Alhawassi TM, Alghamdi AA, et al. Prevalence of complementary and alternative medicine use among rheumatoid arthritis patients in Saudi Arabia. Saudi Pharm J. 2019; 7(7):939-944. doi: 10.1016/j.jsps.2019.07.002.
  • 38.Baig S, Direnzo DD. Complementary and alternative medicine use in rheumatoid arthritis. Curr Rheumatol Rep. 2020;22(10):61. doi: 10.1007/s11926-020-00938-z.
  • 39. Hauser W, Ablin J, Perrot S, Fitzcharles MA. Management of fibromyalgia: Practical guides from recent evidence-based guidelines. Pol Arch Intern Med 2017; 127:47–56. doi: 10.20452/pamw.3877
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The Effect of Complementary and Supportive Medicine Practices on Sleep and Quality of Life in Patients with Rheumatoid Arthritis: A Cross-Sectional Study

Yıl 2025, Cilt: 6 Sayı: 3, 366 - 377, 04.12.2025

Öz

Introduction: Rheumatoid Arthritis (RA) is an autoimmune inflammatory rheumatic disease of unknown etiology with a chronic course involving multiple joints and systems. RA may induce pain, swelling in the joints, and loss of function in individuals. there has been no published study to date that examined the use of CAM in RA patients in terms of sleep and quality of life.
Objective: This study aimed to determine the CAM (Complementary and Supportive Medicine) methods used by patients with RA (Rheumatoid Arthritis) and the effects of CAM methods on sleep and quality of life.
Material and methods: This research was conducted cross-sectionally. 190 patients with RA were included in the study. Data were collected using a patient information form, the Quality-of-Life Measurement for Rheumatoid Arthritis, and the Pittsburgh Sleep Quality Index. The demographic, socioeconomic, disease, and treatment characteristics of CAM and non-CAM users were determined.
Results: Demographic, socioeconomic, disease and treatment characteristics of CAM users and users were determined. While 60.5% of the patients stated that they used at least one type of CAM, 39.5% stated that they did not use CAM. There was no significant difference between CAM users and non-CAM users in terms of age, gender, education level, marital status and income status. CAM use approaches and reasons differ according to the expectation and choice of patient, patient’s sociocultural background, and religious properties. In this study, it was observed that RA patients using TAT had high average quality of life scores and high average sleep quality scores.
Conclusions: The results of this study showed a high rate of CAM use. Moreover, patients attended regular check-ups and used CAM methods together with drug treatment. Patients who used CAM did not inform their doctor or nurse about this issue, and they used CAM methods because they thought that they were beneficial. Healthcare professionals are advised to ask patients about the TAT methods they use and to assess their sleep patterns and quality of life.

Etik Beyan

Before starting the study, approval from the non-invasive research ethics committee of the Kafkas University Faculty of Health Sciences (date: 28/02/2022 and number: 81829502.903/21) and written permission from the hospitals where the study was conducted were obtained. The participants were informed about the purpose and method of the study and that participation was entirely voluntary, and written consent was obtained. The research was conducted in accordance with the Principles of the Declaration of Helsinki.

Kaynakça

  • 1. Andriacchi TP, Griffin TM, Loeser RF, et al. Bridging disciplines as a pathway to finding new solutions for osteoarthritis a collaborative program presented at the 2019 orthopedic research society and the osteoarthritis research society international. Osteoarthr Cartil Open. 2020;2(1):1-7. doi:10.1016/j.ocarto.2020.100026.
  • 2. Kooshki A, Forouzan R, Rakhshani MH, Mohammadi M. Effect of topical application of nigella sativa oil and oral acetaminophen on pain in elderly with knee osteoarthritis: A crossover clinical trial. Electron Physician. 2016;8(11):3193-3197. doi: 10.19082/3193. eCollection 2016 Nov.
  • 3. Sadeghi A, Tabatabaiee M, Mousavi MA, Mousavi SN, Abdollahi Sabet S, Jalili N. Dietary Pattern or Weight Loss: Which One Is More Important to Reduce Disease Activity Score in Patients with Rheumatoid Arthritis? A Randomized Feeding Trial. Int J Clin Pract 2022;2022:6004916. doi: 10.1155/2022/6004916.
  • 4. Grega ML, Shalz JT, Rosenfeld RM, et al. American College of Lifestyle Medicine Expert Consensus Statement: Lifestyle Medicine for Optimal Outcomes in Primary Care. Am J Lifestyle Med 2023: 25;18(2):269-293. doi: 10.1177/15598276231202970.
  • 5. Smolen J, Aletaha D, Mclnees I, Rheumatoid arthritis. Lancet. 2016;388:2013–2038. doi:10.1016/S0140-6736(16)30173-8.
  • 6. Yang L, Sibbritt D, Adams J. A critical review of complementary an alternative medicine use among people with arthritis: a focus upon prevalence, cost, user profiles, motivation, decision-making, perceived benefits and communication. Rheumatol Int. 2017;37:337–351. doi:10.1007/s00296-016- 3616-y.
  • 7. Macfarlane GJ, El-Metwally A, De Silva V, Ernst E, Dowds GL, Moots RJ. Evidence for the efficacy of complementary and alternative medicines in the management of rheumatoid arthritis: A systematic reviwe. Rheumatology. 2011;50(9):1672-1683. doi:10.1093/rheumatology/ker119.
  • 8. Institute of Medicine (U.S.), editor. Complementary and alternative medicine in the United States. Washington, DC: National Academies Press; 2005.
  • 9. World Health Organization. WHO global report on traditional and complementary medicine, 2019.
  • 10. National Center for Complementary and Integrative Health (2020) Complementary, alternative, or integrative health: what’s in a name? NCCIH. https://nccih.nih.gov/health/integrative-health.
  • 11. Michalsen A. The role of Complementary and Alternative Medicine (CAM) in Rheumatology. It´s time to integrative medicine. J Rheumatol. 2013;40:547–549. doi:10.3899/jrheum.130107.
  • 12. Efthimiou P, Kukar M, Mackenzie CR. 2010. Complementary and alternative medicine in rheumatoid. HSS J. 2010;Feb;6(1):108-11. doi: 10.1007/s11420-009-9133-8.
  • 13. Ünal E, Arın G, Karaca BN, et al. Development of a quality of life measurement for rheumatic patients: item pool construction. Journal of Exercise Therapy and Rehabilitation. 2017;4(2):67-75.
  • 14. Buysee DJ, Reynolds CF, Monk TF, et al. The Pittsburgh sleep quality index: A new instrument for psychiatric practise and research. Psychiatry Res. 1989;28:193–213. doi: 10.1016/0165-1781(89)90047-4.
  • 15. Ağargün MY. Kara H. Anlar Ö. The validity and reliability of the Pittsburgh sleep quality index. Turk Psik Derg. 1996:107–115.
  • 16. Lahiri M, Santosa A, Teoh LK, et al. Use of complementary and alternative medicines is associated with delay to initiation of disease-modifying anti-rheumatic drug therapy in early inflammatory arthritis. Int J Rheum Dis. 2017;20:567–75. doi: 10.1111/1756-185X.13091.
  • 17. Phang JK, Kwan YH, Goh H, et al. Complementary and alternative medicine for rheumatic diseases: a systematic review of randomized controlled trials. Complement Ther Med. 2018;37:143–57. doi:10.1016/j.ctim.2018. 03.003
  • 18. Kısa İ, Ok E, Er F. The effect of Balneotherapy on pain, depression symptoms, sleep and quality of life in patients with osteoarthritis. J Tradit Complem Med. 2020;3(1):27-33. doi:10.5336/jtracom.2019-72308.
  • 19. Roberts JA, Mandl LA. Complementary and Alternative Medicine Use in Psoriatic Arthritis Patients: a Review. Current Rheumatology Reports. 2020:22;81. doi:10.1007/s11926-020-00956-x.
  • 20. Baig S, Direnzo D. Complementary and alternative medicine use in rheumatoid arthritis. Curr Rheumatol Rep. 2020;22 (10): 61. doi: 10.1007/s11926-020-00938-z.
  • 21. Singh JA, Saag KG, Bridges SL, et al. 2015 American college of rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol. 2016 Jan;68(1):1-26. doi: 10.1002/art.39480.
  • 22. Lahiri M, Santosa A, Teoh LK, et al. Use of complementary and alternative medicines is associated with delay to initiation of disease-modifying anti-rheumatic drug therapy in early inflammatory arthritis. Int J Rheum Dis. 2017;20(5):567-575. doi: 10.1111/1756-185X.13091.
  • 23. Tharakan CS, Ungcharoen N, Sabu J, Moorthy A. Complementary and alternative medicine in rheumatology: a survey of its use for common rheumatological conditions among multi-ethnic patients in Leicestershire. Ann Rheum Dis. 2019;78(supplement2):A621. doi:10.1136/annrheumdis-2019-eular.6493.
  • 24. Koçyiğit BF, Sagtaganov Z, Yessirkepov M, Akyol A. Assessment of complementary and alternative medicine methods in the management of ankylosing spondylitis, rheumatoid arthritis, and fbromyalgia syndrome. Rheumatol Int. 2023 Apr;43(4):617-625. doi: 10.1007/s00296-022-05267-1.
  • 25. James PB, Wardle J, Steel A, Adams J. Traditional, complementary and alternative medicine use in Sub-Saharan Africa: a systematic review. BMJ Glob Health. 2018;31;3(5):e000895. doi: 10.1136/bmjgh-2018-000895.
  • 26. Altan L, Korkmaz N, Dizdar M, Yurtkuran M. Efect of Pilates training on people with ankylosing spondylitis. Rheumatol Int. 2012; 32:2093–2099. doi:10.1007/s00296-011-1932-9
  • 27. Ulusoy H, Güçer TK, Aksu M, Arslan Ş, Habiboğlu A. The use of complementary and alternative medicine in Turkish patients with rheumatic diseases. Turk J Rheumatol. 2012;27(1):31-37 doi: 10.5606/tjr.2012.004
  • 28. Abramoff B, Caldera FE. Osteoarthritis: Pathology, diagnosis, and treatment options. Med. Clin. North. Am. 2020;104 (2):293–311. doi:10.1016/j. mcna.2019
  • 29. Patterson SL, Ruvalcaba D, Issa A, Rai K, Katz P, Koenig CJ. Experiences with complementary and ıntegrative health among people with rheumatoid arthritis and systemic lupus erythematosus: a qualitative study. J Reumatol. 2025;52(8):758-769. doi: 10.3899/jrheum.2024-1218.
  • 30. Klingberg E, Wallerstedt SM, Torstenson T, Håwi G, Forsblad-d’Elia H. The use of complementary and alternative medicine in outpatients with inflammatory rheumatic diseases in Sweden. Scand J Rheumatol. 2009;38(6):472-480. doi: 10.3109/03009740902994280.
  • 31. Lee MS, Lee MS, Yang CY, et al. Use of complementary and alternative medicine by rheumatoid arthritis patients in Korea. Clin Rheumatol. 2008;27(1):29-33. doi: 10.1007/s10067-007-0646-6.
  • 32. Kılıç KN, Soylar P. Investigation of attitudes, reasons and satisfaction levels of individuals who apply to traditional and complementary medicine practices. J Tradit Complem Med. 2019;2(3):97-105. doi:10.5336/jtracom.2019-71531
  • 33. Talhaoğlu D. Traditional anad complementary treatment practices. Journal of Integrative and Anadolian Medicine. 2021;3(1):16-29. doi: 10.53445/batd.945893.
  • 34. Dikici A, Ulaşlı AM, Çevik H, Eroğlu S, Solak Ö, Dündar Ü. The use of complementary and alternative medicine in patients with degenerative osteoarthritis. Euras J Fam Med. 2015;4(3):126-130.
  • 35. de Cabo R, Mattson MP. Effects of intermittent fasting on health, aging, and disease. N Engl J Med. 2019;381:2541. doi:10.1056/NEJMra1905136.
  • 36. Caballero-Herna´ndez CI, Gonza´lez-Cha´vez SA, UrendaQuezada A, et al. Prevalence of complementary and alternative medicine despite limited perceived efficacy in patients with rheumatic diseases in Mexico: Cross-sectional study. Plos One. 2021;28(16):9; e0257319. doi:10.1371/journal.pone.0257319.
  • 37. Almuhareb AM, Alhawassi TM, Alghamdi AA, et al. Prevalence of complementary and alternative medicine use among rheumatoid arthritis patients in Saudi Arabia. Saudi Pharm J. 2019; 7(7):939-944. doi: 10.1016/j.jsps.2019.07.002.
  • 38.Baig S, Direnzo DD. Complementary and alternative medicine use in rheumatoid arthritis. Curr Rheumatol Rep. 2020;22(10):61. doi: 10.1007/s11926-020-00938-z.
  • 39. Hauser W, Ablin J, Perrot S, Fitzcharles MA. Management of fibromyalgia: Practical guides from recent evidence-based guidelines. Pol Arch Intern Med 2017; 127:47–56. doi: 10.20452/pamw.3877
  • 40. Prasad K, Sharma V, Lackore K, Jenkins SM, Prasad A, Sood A. Use of complementary therapies in cardiovascular disease. Am J Cardiol. 2013;111(3):339-45. doi: 10.1016/j.amjcard.2012.10.010.
  • 41. Hawk C, Whalen W, Farabaugh RJ, Daniels CJ, Minkalis AL, Taylor DN, et al. Best Practices for Chiropractic Management of Patients with Chronic Musculoskeletal Pain: A Clinical Practice Guideline. J Altern Complement Med. 2020;26(10):884-901. doi: 10.1089/acm.2020.0181.
  • 42. Contreras-Ya´ñez I, Cabrera-Vanegas A, Robledo-Torres A, et al. Association of significant risk perception with the use of complementary and alternative medicine: A cross-sectional study in Hispanic patients with rheumatoid arthritis. PLoS One. 2020;15(8):1-18. doi:10.1371/journal.pone.0237504
  • 43. Solak Ö, Ulaşlı AM, Çevik H, et al. Application of complementary and alternative medicine methods in rheumatic diseases. Kocatepe Medical Journal. 2015; 16:116-121.
  • 44. Ulusoy H, Güçer TK, Aksu M, et al. The use of complementary and alternative medicine in Turkish patients with rheumatic diseases. Turk J Rheumatol 2012;27(1):31-7. doi: 10.5606/tjr.2012.004.
  • 45. Al-Zahim AA, Al-Malki NY, Al-Abdulkarim FM, et al. Use of alternative medicine by Saudi liver disease patients attending a tertiary care center: prevalence and attitudes. Saudi J Gastroenterol. 2023;19(2):75–80 doi:10.4103/1319-3767.108477.
  • 46. Mohammad Y, Al-Ahmari A, Al-Dashash F, et al. Pattern of traditional medicine use by adult Saudi patients with neurological disorders. BMC Compl Altern Med. 2015;1:15:102. doi: 10.1186/s12906-015-0623-6.
  • 47. Han M, Sung YK, Cho SK, et al. Factors Associated with the use of complementary and alternative medicine for Korean patients with rheumatoid arthritis. J Rheumatol. 2015;42: 2075–2081. doi:10.3899/jrheum.141447
  • 48. Yao L, Guyatt GH, Djulbegovic B. Can we trust strong recommendations based on low quality evidence? BMJ. 2021;375:n2833. doi: 10.1136/bmj.n2833.
  • 49. Gouda W, Mokhtar M, Elazab SA et al. Sleep disorders in patients with rheumatoid arthritis: association with quality of life, fatigue, depression levels, functional disability, disease duration, and activity: a multicentre cross-sectional study. J Int Med Res. 2023; 51(10): 03000605231204477. doi: 10.1177/03000605231204477.
  • 50. Kiper S, Sunal N. Evaluation of sleep quality in rheumatoid arthritis patients. The Medical Journal of Kocatepe. 2009;10:33-39.
  • 51.  Zhang X, Xia J, Jiang Y, Pisetsky DS, Smolen JS, Mu R. 2023 International Consensus Guidance for the use of Tripterygium Wilfordii Hook F in the treatment of active rheumatoid arthritis. J Autoimmun. 2024;142:103148. doi: 10.1016/j.jaut.2023.103148.
  • 52. Palominos PE, Gasparin AA, Pamplona Bueno de Andrade N, et al. Fears and beliefs of people living with rheumatoid arthritis: a systematic literature review. Adv Rheumatol. 2018; 58:1(1). doi:10.1186/s42358-018-0001-4.
Toplam 52 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Dahili Hastalıklar Hemşireliği
Bölüm Araştırma Makalesi
Yazarlar

Zümrüt Şahin 0000-0001-7141-273X

Yunus Demirel

Gönderilme Tarihi 26 Temmuz 2024
Kabul Tarihi 30 Kasım 2025
Yayımlanma Tarihi 4 Aralık 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 6 Sayı: 3

Kaynak Göster

APA Şahin, Z., & Demirel, Y. (2025). The Effect of Complementary and Supportive Medicine Practices on Sleep and Quality of Life in Patients with Rheumatoid Arthritis: A Cross-Sectional Study. YOBÜ Sağlık Bilimleri Fakültesi Dergisi, 6(3), 366-377.
AMA Şahin Z, Demirel Y. The Effect of Complementary and Supportive Medicine Practices on Sleep and Quality of Life in Patients with Rheumatoid Arthritis: A Cross-Sectional Study. YOBÜ Sağlık Bilimleri Fakültesi Dergisi. Aralık 2025;6(3):366-377.
Chicago Şahin, Zümrüt, ve Yunus Demirel. “The Effect of Complementary and Supportive Medicine Practices on Sleep and Quality of Life in Patients with Rheumatoid Arthritis: A Cross-Sectional Study”. YOBÜ Sağlık Bilimleri Fakültesi Dergisi 6, sy. 3 (Aralık 2025): 366-77.
EndNote Şahin Z, Demirel Y (01 Aralık 2025) The Effect of Complementary and Supportive Medicine Practices on Sleep and Quality of Life in Patients with Rheumatoid Arthritis: A Cross-Sectional Study. YOBÜ Sağlık Bilimleri Fakültesi Dergisi 6 3 366–377.
IEEE Z. Şahin ve Y. Demirel, “The Effect of Complementary and Supportive Medicine Practices on Sleep and Quality of Life in Patients with Rheumatoid Arthritis: A Cross-Sectional Study”, YOBÜ Sağlık Bilimleri Fakültesi Dergisi, c. 6, sy. 3, ss. 366–377, 2025.
ISNAD Şahin, Zümrüt - Demirel, Yunus. “The Effect of Complementary and Supportive Medicine Practices on Sleep and Quality of Life in Patients with Rheumatoid Arthritis: A Cross-Sectional Study”. YOBÜ Sağlık Bilimleri Fakültesi Dergisi 6/3 (Aralık2025), 366-377.
JAMA Şahin Z, Demirel Y. The Effect of Complementary and Supportive Medicine Practices on Sleep and Quality of Life in Patients with Rheumatoid Arthritis: A Cross-Sectional Study. YOBÜ Sağlık Bilimleri Fakültesi Dergisi. 2025;6:366–377.
MLA Şahin, Zümrüt ve Yunus Demirel. “The Effect of Complementary and Supportive Medicine Practices on Sleep and Quality of Life in Patients with Rheumatoid Arthritis: A Cross-Sectional Study”. YOBÜ Sağlık Bilimleri Fakültesi Dergisi, c. 6, sy. 3, 2025, ss. 366-77.
Vancouver Şahin Z, Demirel Y. The Effect of Complementary and Supportive Medicine Practices on Sleep and Quality of Life in Patients with Rheumatoid Arthritis: A Cross-Sectional Study. YOBÜ Sağlık Bilimleri Fakültesi Dergisi. 2025;6(3):366-77.