Araştırma Makalesi
BibTex RIS Kaynak Göster

Kronik Obstrüktif Akciğer Hastalığı Olan Hastaların Fonksiyonel Performans ve Öz-Bakım Gücünün Belirlenmesi

Yıl 2023, Cilt: 12 Sayı: 2, 128 - 141, 14.12.2023
https://doi.org/10.46971/ausbid.1229932

Öz

Amaç: Araştırma, KOAH’lı bireylerin fonksiyonel performans ve öz-bakım gücünü ve ilişkili faktörleri belirlemek amacıyla tanımlayıcı olarak yapılmıştır. Örneklem ve Yöntem: Araştırma örneklemini, bir araştırma hastanesinin göğüs hastalıkları polikliniğinde ayaktan tedavi ve izlemi yapılan 128 KOAH’lı birey oluşturmuştur. Bulgular: Hastaların fonksiyonel performans puan ortalaması düşük (1.33±0.60), öz-bakım gücü puan ortalaması orta (92.3±22.5) olarak belirlenmiştir. Günlük yaşam aktivitelerinde yardıma ihtiyaç duyan, komorbiditesi olan, son altı ayda KOAH nedeniyle acil servise başvuran ve hastaneye yatışı olan, evde uzun süreli oksijen tedavisi kullanan hastaların fonksiyonel performans ve öz-bakım gücü puanları istatistiksel olarak anlamlı şekilde düşük bulunmuştur (p<0.05). Hastaların fonksiyonel performansı ve öz-bakım gücü ile hastalık evreleri ve dispne şiddetleri arasında negatif yönlü güçlü bir korelasyon bulunurken, FEV1 değeri pozitif yönlü bir korelasyon göstermiştir. KOAH’lı hastalarda fonksiyonel performans ile öz-bakım gücü arasında anlamlı, pozitif korelasyon olduğu belirlenmiştir. Sonuç: KOAH fonksiyonel performans ve öz-bakım gücünde düşmeye neden olur. Hemşirelik bakımını KOAH’lı hastaların fonksiyonel performans ve öz-bakım gücünü etkileyen önemli faktörlerden olan dispne şiddeti ve hastalık evresini dikkate alarak planlamaları önerilmektedir.

Proje Numarası

SBF-027

Kaynakça

  • Alahmari, A. D., Patel, A. R. C., Kowlessar, B. S., Mackay, A. J., Singh, R., Wedzicha, J. A., & Donaldson, G. C. (2014). Decline of daily activity in COPD patients with frequent and infrequent exacerbations. European Respiratory Journal, 42, 98. https://doi.org/10.1186/1471-2466-14-98
  • Arslan, Z., Ilgazli, A., Etiler, N., & Hamzaoǧlu, O. (2013). Prevalence of chronic obstructive pulmonary disease in Kocaeli: An industrialised city in Turkey. Balkan Medical Journal, 30(4), 387–393. https://doi.org/10.5152/balkanmedj.2013.8042
  • Bozkurt, N., Atalay, O., Kocyigit, F., Taskin, H., Yalman, A., & Bozkurt, A. (2020). The assessment of functional performance of COPD patients according to new gold classification. In CHEST Congress, Italy. American College of Chest Physicians. 157(6), A271. https://doi.org/10.1016/j.chest.2020.05.333
  • Bugajski, A., Szalacha, L., Rechenberg, K., Johnson, A., Beckie, T., & Morgan, H. (2022). Psychometric evaluation of the self-care in chronic obstructive pulmonary disease inventory in the United States. Heart and Lung, 51, 1–8. https://doi.org/10.1016/j.hrtlng.2021.07.004
  • Clari, M., Matarese, M., Alvaro, Ro., Piredda, M., & Grazia De Marinis, M. (2016). Measurement properties of instruments evaluating self-care and related concepts in people with chronic obstructive pulmonary disease: A systematic review. Heart and Lung: Journal of Acute and Critical Care, 45(5), 441–448. https://doi.org/10.1016/j.hrtlng.2016.06.006
  • Clari, M., Matarese, M., Ivziku, D., & De Marinis, M. G. (2017). Self-care of people with chronic obstructive pulmonary disease: A meta-synthesis. Patient, 10, 407–427. https://doi.org/10.1007/s40271-017-0218-z
  • Ding, B., Judge, D., Small, M., Bent-Ennakhil, N., & Siddiqui, S. (2018). Functional performance in patients with COPD: Association with treatment regimen, GOLD group, lung function, and symptom burden in a cross-sectional study. International Journal of COPD, 13, 2785–2796. https://doi.org/10.2147/COPD.S170391
  • Fletcher, C. M. (1952). The clinical diagnosis of pulmonary emphysema: An experimental study. Proceedings of the Royal Society of Medicine, 45(9), 577–584.
  • Gimeno-Santos, E., Frei, A., Steurer-Stey, C., De Batlle, J., Rabinovich, R. A., Raste, Y., Hopkinson, N. S., Polkey, M. I., Van Remoortel, H., Troosters, T., Kulich, K., Karlsson, N., Puhan, M. A., & Garcia- Aymerich, J. (2014). Determinants and outcomes of physical activity in patients with COPD: A systematic review. Thorax, 69, 731–739. https://doi.org/10.1136/thoraxjnl-2013-204763
  • GOLD. (2022). Global Strategy for the Diagnosis, Management, and Preventıon of Chronic Obstructive Pulmonary Disease. https://goldcopd.org/2023-gold-report-2/
  • Guo, A. M., Han, J. N., Kline Leidy, N., Wu, Z. L., Wang, P., & Lin, Y. X. (2011). Validation of the Chinese version of the functional performance inventory short form in patients with chronic obstructive pulmonary disease. Journal of Clinical Nursing, 20(11–12), 1613–1622. https://doi.org/10.1111/j.1365-2702.2010.03623.x
  • Kapella, M. C., Larson, J. L., Covey, M. K., & Alex, C. G. (2011). Functional performance in chronic obstructive pulmonary disease declines with time. Medicine and Science in Sports and Exercise, 43(2), 218–224. https://doi.org/10.1249/MSS.0b013e3181eb6024
  • Kaşıkçı, M. K., & Alberto, J. (2007). Family support, perceived self-efficacy and self-care behaviour of Turkish patients with chronic obstructive pulmonary disease. Journal of Clinical Nursing, 16(8), 1468–1478. https://doi.org/10.1111/j.1365-2702.2006.01782.x
  • Launois, C., Barbe, C., Bertin, E., Nardi, J., Perotin, J. M., Dury, S., Lebargy, F., & Deslee, G. (2012). The modified Medical Research Council scale for the assessment of dyspnea in daily living in obesity: A pilot study. BMC Pulmonary Medicine, 12(61), 1–7. https://doi.org/10.1186/1471-2466-12-61
  • Leidy, N. K. (1994). Functional status and the forward progress of merry-go-rounds: Toward a coherent analytical framework. Nursing Research, 43(4), 196–202.
  • Leidy, N. K., Hamilton, A., & Becker, K. (2012). Assessing patient report of function: Content validity of the functional performance inventory-short form (FPI-SF) in patients with chronic obstructive pulmonary disease (COPD). International Journal of COPD, 7, 543–554. https://doi.org/10.2147/COPD.S32032
  • López-López, L., Torres-Sánchez, I., Romero-Fernández, R., Granados-Santiago, M., Rodríguez-Torres, J., & Valenza, M. C. (2018). Impact of previous physical activity levels on symptomatology, functionality, and strength during an acute exacerbation in COPD patients. Healthcare (Switzerland), 6(4). https://doi.org/10.3390/healthcare6040139
  • Matarese, M., Clari, M., De Marinis, M. G., Barbaranelli, C., Ivziku, D., Piredda, M., & Riegel, B. (2020). The self-care in chronic obstructive pulmonary disease inventory: Development and psychometric evaluation. Evaluation and the Health Professions, 43(1), 50–62. https://doi.org/10.1177/0163278719856660
  • Mcnamara, R. J., Mckeough, Z. J., Mckenzie, D. K., & Alison, J. A. (2014). Physical comorbidities affect physical activity in chronic obstructive pulmonary disease : A prospective cohort study. Asian Pacific Society of Respirology, 19, 866–872. https://doi.org/10.1111/resp.12325
  • Melhem, O., Savage, E., Al Hmaimat, N., Lehane, E., & Fattah, H. A. (2021). Symptom burden and functional performance in patients with chronic obstructive pulmonary disease. Applied Nursing Research, 62, 151510. https://doi.org/10.1016/j.apnr.2021.151510
  • Nahcivan, N. (1993). The effect of Self-care Strength and Family Environment in Healthy Youth. İstanbul Üniversitesi.
  • O’Donnell, D. E., Milne, K. M., James, M. D., de Torres, J. P., & Neder, J. A. (2020). Dyspnea in COPD: New mechanistic insights and management implications. Advances in Therapy, 37, 41–60. https://doi.org/10.1007/s12325-019-01128-9
  • Örnek, T., Tor, M., Kıran, S., & Atalay, F. (2015). Prevalence of chronic obstructive pulmonary disease in Zonguldak province of Turkey. Tuberkuloz ve Toraks, 63(3), 170–177. https://doi.org/10.5578/tt.9582
  • Özkan, S., Durnaz, Z., Demir, T., & Gemicioğlu, B. (2007). Assessment of the functional performance and quality of life in patients with COPD and asthma. Solunum, 9(3), 158–166.
  • Park, S. K. (2017). Factors affecting self-care behavior in Koreans with COPD. Applied Nursing Research, 38, 29–37. https://doi.org/10.1016/j.apnr.2017.09.003
  • Park, S. K., Stotts, N. A., Douglas, M. K., Donesky-Cuenco, D. A., & Carrieri-Kohlman, V. (2012). Symptoms and functional performance in Korean immigrants with asthma or chronic obstructive pulmonary disease. Heart and Lung, 41(3), 226–237. https://doi.org/10.1016/j.hrtlng.2011.09.014
  • Pitta, F., Troosters, T., Probst, V. S., Spruit, M. A., Decramer, M., & Gosselink, R. (2006). Physical activity and hospitalization for exacerbation of COPD. Chest, 129(3), 536–544. https://doi.org/10.1378/chest.129.3.536
  • Pumar, M. I., Gray, C. R., Walsh, J. R., Yang, I. A., Rolls, T. A., & Ward, D. L. (2014). Anxiety and depression-Important psychological comorbidities of COPD. Journal of Thoracic Disease, 6(11), 1615–1631. https://doi.org/10.3978/j.issn.2072-1439.2014.09.28
  • Reishtein, J. L. (2005). Relationship between symptoms and functional performance in COPD. Research in Nursing and Health, 28(1), 39–47. https://doi.org/10.1002/nur.20054
  • Smith, M. C., & Wrobel, J. P. (2014). Epidemiology and clinical impact of major comorbidities in patients with COPD. International Journal of COPD, 9, 871–888. https://doi.org/10.2147/COPD.S49621
  • Timur, A., Balcı, E., & Durmuş, H. (2020). Prevalence of chronic obstructive pulmonary disease in individuals over 40 in central Kayseri. Erciyes Medical Journal, 42(3), 322–328. https://doi.org/10.14744/etd.2020.13245
  • Wang, K. Y., Sung, P. Y., Yang, S. T., Chiang, C. H., & Perng, W. C. (2012). Influence of family caregiver caring behavior on COPD patients’ self-care behavior in Taiwan. Respiratory Care, 57(2), 263–272. https://doi.org/10.4187/respcare.00986
  • Weldam, S. W. M., Lammers, J. W. J., Decates, R. L., & Schuurmans, M. J. (2013). Daily activities and health-related quality of life in patients with chronic obstructive pulmonary disease: Psychological determinants: A cross-sectional study. Health and Quality of Life Outcomes, 11(1), 1–8. https://doi.org/10.1186/1477-7525-11-190
  • Yeh, M. L., Chen, H. H., Liao, Y. C., & Liao, W. Y. (2004). Testing the functional status model in patients with chronic obstructive pulmonary disease. Journal of Advanced Nursing, 48(4), 342–350. https://doi.org/10.1111/j.1365-2648.2004.03203.x
  • Zeb, H., Younas, A., Ahmed, I., & Ali, A. (2020). Self-care experiences of Pakistani patients with COPD and the role of family in self-care: A phenomenological inquiry. Health and Social Care in the Community, 00, 1–10. https://doi.org/10.1111/hsc.13264
  • Zwerink, M., Pdlpm, V. D. V., Ga, Z., Em, M., Palen, J., Pa, F., & Effing, T. (2014). Self management for patients with chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 19(3), CD002990. https://doi.org/10.1002/14651858.CD002990.pub3

Determination of Functional Performance and Self-Care Agency in Patients with Chronic Obstructive Pulmonary Disease

Yıl 2023, Cilt: 12 Sayı: 2, 128 - 141, 14.12.2023
https://doi.org/10.46971/ausbid.1229932

Öz

Aim: This descriptive study was conducted to determine the functional performance and self-care agency levels of Chronic obstructive pulmonary disease (COPD) patients and associated factors. Subjects and Method: The sample of the study included 128 COPD patients who were being treated and followed up as outpatients at the pulmonology outpatient clinic of a research and training hospital. Results: The mean functional performance score of the patients was low (1.33±0.60), while their mean self-care agency score was moderate (92.3±22.5). Functional performance and self-care agency levels were found to be significantly lower among the patients who required help in their activities of daily living, those with comorbidities, those who presented to emergency services due to COPD in the last six months, those who were hospitalized, and those who were long-term users of oxygen treatment at home (p<0.05). While the functional performance and self-care agency levels of the patients were strongly and negatively correlated with their disease stages and dyspnea severity, these variables were positively correlated with their FEV1 values. A significant positive relationship was found between the functional performance and self-care agency levels of the patients. Conclusion: COPD causes a decrease in functional performance and self-care agency. It is also recommended that nursing care practices are planned by keeping in mind dyspnea severity and disease stage, which are among the significant factors that affect the functional performance and self-care agency of COPD patients.

Destekleyen Kurum

Scientific Research Project Fund of Cumhuriyet University

Proje Numarası

SBF-027

Kaynakça

  • Alahmari, A. D., Patel, A. R. C., Kowlessar, B. S., Mackay, A. J., Singh, R., Wedzicha, J. A., & Donaldson, G. C. (2014). Decline of daily activity in COPD patients with frequent and infrequent exacerbations. European Respiratory Journal, 42, 98. https://doi.org/10.1186/1471-2466-14-98
  • Arslan, Z., Ilgazli, A., Etiler, N., & Hamzaoǧlu, O. (2013). Prevalence of chronic obstructive pulmonary disease in Kocaeli: An industrialised city in Turkey. Balkan Medical Journal, 30(4), 387–393. https://doi.org/10.5152/balkanmedj.2013.8042
  • Bozkurt, N., Atalay, O., Kocyigit, F., Taskin, H., Yalman, A., & Bozkurt, A. (2020). The assessment of functional performance of COPD patients according to new gold classification. In CHEST Congress, Italy. American College of Chest Physicians. 157(6), A271. https://doi.org/10.1016/j.chest.2020.05.333
  • Bugajski, A., Szalacha, L., Rechenberg, K., Johnson, A., Beckie, T., & Morgan, H. (2022). Psychometric evaluation of the self-care in chronic obstructive pulmonary disease inventory in the United States. Heart and Lung, 51, 1–8. https://doi.org/10.1016/j.hrtlng.2021.07.004
  • Clari, M., Matarese, M., Alvaro, Ro., Piredda, M., & Grazia De Marinis, M. (2016). Measurement properties of instruments evaluating self-care and related concepts in people with chronic obstructive pulmonary disease: A systematic review. Heart and Lung: Journal of Acute and Critical Care, 45(5), 441–448. https://doi.org/10.1016/j.hrtlng.2016.06.006
  • Clari, M., Matarese, M., Ivziku, D., & De Marinis, M. G. (2017). Self-care of people with chronic obstructive pulmonary disease: A meta-synthesis. Patient, 10, 407–427. https://doi.org/10.1007/s40271-017-0218-z
  • Ding, B., Judge, D., Small, M., Bent-Ennakhil, N., & Siddiqui, S. (2018). Functional performance in patients with COPD: Association with treatment regimen, GOLD group, lung function, and symptom burden in a cross-sectional study. International Journal of COPD, 13, 2785–2796. https://doi.org/10.2147/COPD.S170391
  • Fletcher, C. M. (1952). The clinical diagnosis of pulmonary emphysema: An experimental study. Proceedings of the Royal Society of Medicine, 45(9), 577–584.
  • Gimeno-Santos, E., Frei, A., Steurer-Stey, C., De Batlle, J., Rabinovich, R. A., Raste, Y., Hopkinson, N. S., Polkey, M. I., Van Remoortel, H., Troosters, T., Kulich, K., Karlsson, N., Puhan, M. A., & Garcia- Aymerich, J. (2014). Determinants and outcomes of physical activity in patients with COPD: A systematic review. Thorax, 69, 731–739. https://doi.org/10.1136/thoraxjnl-2013-204763
  • GOLD. (2022). Global Strategy for the Diagnosis, Management, and Preventıon of Chronic Obstructive Pulmonary Disease. https://goldcopd.org/2023-gold-report-2/
  • Guo, A. M., Han, J. N., Kline Leidy, N., Wu, Z. L., Wang, P., & Lin, Y. X. (2011). Validation of the Chinese version of the functional performance inventory short form in patients with chronic obstructive pulmonary disease. Journal of Clinical Nursing, 20(11–12), 1613–1622. https://doi.org/10.1111/j.1365-2702.2010.03623.x
  • Kapella, M. C., Larson, J. L., Covey, M. K., & Alex, C. G. (2011). Functional performance in chronic obstructive pulmonary disease declines with time. Medicine and Science in Sports and Exercise, 43(2), 218–224. https://doi.org/10.1249/MSS.0b013e3181eb6024
  • Kaşıkçı, M. K., & Alberto, J. (2007). Family support, perceived self-efficacy and self-care behaviour of Turkish patients with chronic obstructive pulmonary disease. Journal of Clinical Nursing, 16(8), 1468–1478. https://doi.org/10.1111/j.1365-2702.2006.01782.x
  • Launois, C., Barbe, C., Bertin, E., Nardi, J., Perotin, J. M., Dury, S., Lebargy, F., & Deslee, G. (2012). The modified Medical Research Council scale for the assessment of dyspnea in daily living in obesity: A pilot study. BMC Pulmonary Medicine, 12(61), 1–7. https://doi.org/10.1186/1471-2466-12-61
  • Leidy, N. K. (1994). Functional status and the forward progress of merry-go-rounds: Toward a coherent analytical framework. Nursing Research, 43(4), 196–202.
  • Leidy, N. K., Hamilton, A., & Becker, K. (2012). Assessing patient report of function: Content validity of the functional performance inventory-short form (FPI-SF) in patients with chronic obstructive pulmonary disease (COPD). International Journal of COPD, 7, 543–554. https://doi.org/10.2147/COPD.S32032
  • López-López, L., Torres-Sánchez, I., Romero-Fernández, R., Granados-Santiago, M., Rodríguez-Torres, J., & Valenza, M. C. (2018). Impact of previous physical activity levels on symptomatology, functionality, and strength during an acute exacerbation in COPD patients. Healthcare (Switzerland), 6(4). https://doi.org/10.3390/healthcare6040139
  • Matarese, M., Clari, M., De Marinis, M. G., Barbaranelli, C., Ivziku, D., Piredda, M., & Riegel, B. (2020). The self-care in chronic obstructive pulmonary disease inventory: Development and psychometric evaluation. Evaluation and the Health Professions, 43(1), 50–62. https://doi.org/10.1177/0163278719856660
  • Mcnamara, R. J., Mckeough, Z. J., Mckenzie, D. K., & Alison, J. A. (2014). Physical comorbidities affect physical activity in chronic obstructive pulmonary disease : A prospective cohort study. Asian Pacific Society of Respirology, 19, 866–872. https://doi.org/10.1111/resp.12325
  • Melhem, O., Savage, E., Al Hmaimat, N., Lehane, E., & Fattah, H. A. (2021). Symptom burden and functional performance in patients with chronic obstructive pulmonary disease. Applied Nursing Research, 62, 151510. https://doi.org/10.1016/j.apnr.2021.151510
  • Nahcivan, N. (1993). The effect of Self-care Strength and Family Environment in Healthy Youth. İstanbul Üniversitesi.
  • O’Donnell, D. E., Milne, K. M., James, M. D., de Torres, J. P., & Neder, J. A. (2020). Dyspnea in COPD: New mechanistic insights and management implications. Advances in Therapy, 37, 41–60. https://doi.org/10.1007/s12325-019-01128-9
  • Örnek, T., Tor, M., Kıran, S., & Atalay, F. (2015). Prevalence of chronic obstructive pulmonary disease in Zonguldak province of Turkey. Tuberkuloz ve Toraks, 63(3), 170–177. https://doi.org/10.5578/tt.9582
  • Özkan, S., Durnaz, Z., Demir, T., & Gemicioğlu, B. (2007). Assessment of the functional performance and quality of life in patients with COPD and asthma. Solunum, 9(3), 158–166.
  • Park, S. K. (2017). Factors affecting self-care behavior in Koreans with COPD. Applied Nursing Research, 38, 29–37. https://doi.org/10.1016/j.apnr.2017.09.003
  • Park, S. K., Stotts, N. A., Douglas, M. K., Donesky-Cuenco, D. A., & Carrieri-Kohlman, V. (2012). Symptoms and functional performance in Korean immigrants with asthma or chronic obstructive pulmonary disease. Heart and Lung, 41(3), 226–237. https://doi.org/10.1016/j.hrtlng.2011.09.014
  • Pitta, F., Troosters, T., Probst, V. S., Spruit, M. A., Decramer, M., & Gosselink, R. (2006). Physical activity and hospitalization for exacerbation of COPD. Chest, 129(3), 536–544. https://doi.org/10.1378/chest.129.3.536
  • Pumar, M. I., Gray, C. R., Walsh, J. R., Yang, I. A., Rolls, T. A., & Ward, D. L. (2014). Anxiety and depression-Important psychological comorbidities of COPD. Journal of Thoracic Disease, 6(11), 1615–1631. https://doi.org/10.3978/j.issn.2072-1439.2014.09.28
  • Reishtein, J. L. (2005). Relationship between symptoms and functional performance in COPD. Research in Nursing and Health, 28(1), 39–47. https://doi.org/10.1002/nur.20054
  • Smith, M. C., & Wrobel, J. P. (2014). Epidemiology and clinical impact of major comorbidities in patients with COPD. International Journal of COPD, 9, 871–888. https://doi.org/10.2147/COPD.S49621
  • Timur, A., Balcı, E., & Durmuş, H. (2020). Prevalence of chronic obstructive pulmonary disease in individuals over 40 in central Kayseri. Erciyes Medical Journal, 42(3), 322–328. https://doi.org/10.14744/etd.2020.13245
  • Wang, K. Y., Sung, P. Y., Yang, S. T., Chiang, C. H., & Perng, W. C. (2012). Influence of family caregiver caring behavior on COPD patients’ self-care behavior in Taiwan. Respiratory Care, 57(2), 263–272. https://doi.org/10.4187/respcare.00986
  • Weldam, S. W. M., Lammers, J. W. J., Decates, R. L., & Schuurmans, M. J. (2013). Daily activities and health-related quality of life in patients with chronic obstructive pulmonary disease: Psychological determinants: A cross-sectional study. Health and Quality of Life Outcomes, 11(1), 1–8. https://doi.org/10.1186/1477-7525-11-190
  • Yeh, M. L., Chen, H. H., Liao, Y. C., & Liao, W. Y. (2004). Testing the functional status model in patients with chronic obstructive pulmonary disease. Journal of Advanced Nursing, 48(4), 342–350. https://doi.org/10.1111/j.1365-2648.2004.03203.x
  • Zeb, H., Younas, A., Ahmed, I., & Ali, A. (2020). Self-care experiences of Pakistani patients with COPD and the role of family in self-care: A phenomenological inquiry. Health and Social Care in the Community, 00, 1–10. https://doi.org/10.1111/hsc.13264
  • Zwerink, M., Pdlpm, V. D. V., Ga, Z., Em, M., Palen, J., Pa, F., & Effing, T. (2014). Self management for patients with chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, 19(3), CD002990. https://doi.org/10.1002/14651858.CD002990.pub3
Toplam 36 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Ufuk Demirel 0000-0002-8630-8203

Hatice Tel Aydın 0000-0002-1518-8080

Proje Numarası SBF-027
Erken Görünüm Tarihi 3 Aralık 2023
Yayımlanma Tarihi 14 Aralık 2023
Yayımlandığı Sayı Yıl 2023 Cilt: 12 Sayı: 2

Kaynak Göster

APA Demirel, U., & Tel Aydın, H. (2023). Determination of Functional Performance and Self-Care Agency in Patients with Chronic Obstructive Pulmonary Disease. Ankara Sağlık Bilimleri Dergisi, 12(2), 128-141. https://doi.org/10.46971/ausbid.1229932