Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
COVID-19 Salgınının Sağlık Çalışanlarında İkincil Travmatik Strese ve Uyku Kalitesi Üzerine Etkisi
The Effect of COVID-19 Outbreak on Secondary Traumatic Stress and Sleep Quality in Healthcare Workers
Ezgi DEMİRTÜRK SELÇUKa, Birsel Canan DEMİRBAĞb
aErzincan Binali Yıldırım Üniversitesi Sağlık Hizmetleri Meslek Yüksekokulu, Erzincan, TÜRKİYE
bKaradeniz Teknik Üniversitesi Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü, Halk Sağlığı Hemşireliği ABD, Trabzon, TÜRKİYE
Turkiye Klinikleri J Nurs Sci. 2021;13(3):533-43
doi: 10.5336/nurses.2020-79415
Article Language: TR
Full Text
ÖZET
 Amaç: Bu araştırmanın amacı, sağlık çalışanlarında koronavirüs salgınının ikincil travmatik stres ve uyku kalitesiyle ilişkisini incelemektir. Gereç ve Yöntemler: Tanımlayıcı olarak planlanan bu araştırmanın evrenini, Türkiye'deki 1, 2 ve 3. basamak sağlık hizmetlerinde görev yapan sağlık çalışanları oluşturmuştur. Araştırmada, kartopu örneklem seçim yöntemi kullanılmış ve araştırmaya katılmayı gönüllü olarak kabul eden sağlık çalışanları araştırma kapsamına alınmıştır. Veriler, kişisel bilgi formu, İkincil Travmatik Stres Ölçeği ve Pittsburgh Uyku Kalitesi İndeksi kullanılarak toplanmıştır. Verilerin tanımlayıcı istatistikleri frekans, yüzde, ortalama, standart sapma, medyan, minimum, maksimum olarak verilmiştir. İstatistiksel karşılaştırmalar için ANOVA, Kruskal-Wallis, Mann-Whitney U testi ve Spearman korelasyon analizi kullanılmıştır. Araştırmadan elde edilen veriler, SPSS (Statistical Package for Social Science) 22.0 istatistik programıyla analiz edilmiştir. Bulgular: Çalışmaya katılan sağlık çalışanların %45,2'si 31-40 yaşında, %77,6'sı kadın, %61,1'i lisans mezunu, %76,2'si hemşire/ebe, %64,4'ü evli, %43,9'unun çocuğu yok, %65'i eşi ve çocuklarıyla birlikte yaşamaktadır. Sağlık çalışanlarının %39,6'sı koronavirüs hastalığı-2019 [coronavirus disease-2019] (COVID-19)] testi pozitif çıkan hastaya bakım vermiş ve %9,2'sine COVID-19 tanısı konulmuştur. Sağlık çalışanlarının Pittsburgh Uyku Kalitesi İndeksi toplam puan ortalamalarının 8,84±3,58 olduğu saptanmıştır. Araştırmada çalışanların ikincil travmatik stres ölçeği puan ortalaması 45,01±15,51 olarak bulunmuştur. Sonuç: Bu çalışmayla bu grubun, uykusuzluk ve ikincil travmatik streslerinin yüksek olduğu tespit edilmiştir. Çalışmanın sonuçları doğrultusunda pandemi döneminde sağlık çalışanlarının çalışma saatlerinin planlanmasının çok dikkatli yapılması ve sirkülasyon yöntemiyle COVID-19 hastalarına bakmaları önerilebilinir.

Anahtar Kelimeler: COVID-19; uyku; stres bozuklukları; post travmatik
ABSTRACT
 Objective: The aim of this study is to examine the relationship between the coronavirus epidemic and secondary traumatic stress and sleep quality in healthcare workers. Material and Methods: The universe of this descriptive and cross-sectional study; in Turkey the primary care, health care workers who were working in secondary and tertiary health care services has joined. The snowball sampling method was used in the study, and healthcare workers who voluntarily accepted to participate in the study were included in the study. The data were collected using a personal information form, Secondary Traumatic Stress Scale, and Pittsburgh Sleep Quality Index (PSQI). Descriptive statistics of the data are given as frequency, percentage, mean, standard deviation, median, minimum, maximum. ANOVA, Kruskal-Wallis, Mann-Whitney U test and Spearman correlation analysis were used for statistical comparisons. The data obtained from the research were analyzed with SPSS (Statistical Package for Social Science) 22.0 statistics program. Results: Health workers participating in the study was 45.2% are 31-40 years old, 77.6% are women, 61.1% are undergraduate, 76.2% are nurses/midwives, 64.4% are married, 43.9% have no children, 65% are with their spouses and children live together. 39.6% of the healthcare professionals provided care to the patient who had a positive coronavirus disease-2019 (COVID-19) test, and 9.2% were diagnosed with COVID-19. It was determined that the PSQI total score mean of healthcare workers was 8.84±3.58. The secondary traumatic stress scale mean score of the employees in the study was found to be 45.01±15.51. Conclusion: The pandemic period causes psychological and physical disorders in healthcare workers. This study found that this group had high levels of insomnia and secondary traumatic stress. Considering that employees with this condition may make much more mistakes and experience burnout, it may be recommended to plan their working hours very carefully in line with the results of this study and to take care of COVID-19 patients with the circulation method.

Keywords: COVID-19; sleep; stress disorders; post-traumatic
REFERENCES:
  1. Lai CC, Wang CY, Wang YH, Hsueh SC, Ko WC, Hsueh PR. Global epidemiology of coronavirus disease 2019 (COVID-19): disease incidence, daily cumulative index, mortality, and their association with country healthcare resources and economic status. Int J Antimicrob Agents. 2020;55(4):105946. [Crossref] [PubMed] [PMC] 
  2. Park SE. Epidemiology, virology, and clinical features of severe acute respiratory syndrome -coronavirus-2 (SARS-CoV-2; coronavirus disease-19). Clin Exp Pediatr. 2020;63(4):119-24. [Crossref] [PubMed] [PMC] 
  3. Özlü A, Öztaş D. Yeni corona pandemisi (COVID-19) ile mücadelede geçmişten ders çıkarmak. [Learning lessons from the past in combating the novel coronavirus (COVID-19) pandemic]. Ankara Med J. 2020;20(2):468-81. [Crossref] 
  4. Adams JG, Walls RM. Supporting the health care workforce during the COVID-19 global epidemic. JAMA. 2020;21;323(15):1439-40. [Crossref] [PubMed] 
  5. Wu KK, Chan SK, Ma TM. Posttraumatic stress, anxiety, and depression in survivors of severe acute respiratory syndrome (SARS). J Trauma Stress. 2005;18(1):39-42. [Crossref] [PubMed] [PMC] 
  6. Atkinson P, French J, Lang E, McColl T, Mazurik L. Just the facts: protecting frontline clinicians during the COVID-19 pandemic. CJEM. 2020;22(4):435-9. [Crossref] [PubMed] [PMC] 
  7. Wu KK, Chan SK, Ma TM. Posttraumatic stress after SARS. Emerg Infect Dis. 2005;11(8):1297-300. [Crossref] [PubMed] [PMC] 
  8. Aysan E, Karaköse S, Zaybak A, Günay İsmailoğlu E. Üniversite öğrencilerinde uyku kalitesini etkileyen faktörler. [Sleep quality among undregraduate students and influencing factors]. Dokuz Eylül Üniversitesi Hemşirelik Yüksekokulu Elektronik Dergisi. 2014;7(3):193-8. [Link] 
  9. Lange T, Dimitrov S, Born J. Effects of sleep and circadian rhythm on the human immune system. Ann N Y Acad Sci. 2010;1193:48-59. [Crossref] [PubMed] 
  10. Akdemir N, Özdemir L. Dinlenme-Uyku ve Düzensizliklerinde Hemşirelik Bakımı. Akdemir N, Birol L, editör. İç Hastalıkları ve Hemşirelik Bakımı. 4. Baskı. Ankara: Akademisyen Kitabevi; 2018. p.129-39.
  11. Çetinol T, Özvurmaz S. Hemşirelerde uyku kalitesi ve ilişkili faktörler. [Sleep quality and related factors in nurses]. Medical Sciences. 2018;13(4):80-9. [Link] 
  12. Benbir G, Karadeniz D. Uyku ile ilişkili solunum bozuklukları: obstrüktif uyku apne sendromu. [Sleep related breathing disorders: obstructive sleep apnea syndrome]. Turkiye Klinikleri J Neurol-Special Topics. 2010;3(3):27-40. [Link] 
  13. Kara N. Gazete kuryelerinde uyku kalitesinin ruhsal belirtiler ve yaşam kalitesi üzerine etkisi. [Effect of sleep quality on psychiatric symptoms and life quality in newspaper couriers]. Arch Neuropsychiatr. 2016;53:102-7. [Crossref] [PubMed] [PMC] 
  14. Xiao H, Zhang Y, Kong D, Li S, Yang N. The effects of social support on sleep quality of medical staff treating patients with coronavirus disease-2019 (COVID-19) in january and february 2020 in China. Med Sci Monit. 2020;5;26:e923549. [Crossref] [PubMed] [PMC] 
  15. Çolak B, Şişmanlar ŞG, Karakaya I, Etiler N, Biçer Ü. Çocuk cinsel istismarı olgularını değerlendiren meslek gruplarında dolaylı travmatizasyon. [Vicarious traumatization in professionals working with sexually abused children]. Anadolu Psikiyatri Dergisi. 2012;13(1):51-8.
  16. Beck CT. Secondary traumatic stress in nurses: a systematic review. Arch Psychiatr Nurs. 2011;25(1):1-10. [Crossref] [PubMed] 
  17. Karakaş SA, Gönültaş N, Okanlı A. Vardiyalı çalışan hemşirelerde uyku kalitesi. [The quality of sleep of nurses who works shift workers]. Erciyes Üniversitesi Sağlık Bilimleri Fakültesi Dergisi. 2017;4(1):17-26. [Link] 
  18. Günaydın N. Bir devlet hastanesinde çalışan hemşirelerin uyku kalitesi ve genel ruhsal durumlarına etkisi. [The quality of sleep and effects on general mental health nurses who works in a state hospital]. Journal of Psychiatric Nursing. 2014;5(1):33-40. [Crossref] 
  19. Şentürk S. Yoğun bakım hemşirelerinin tükenmişlik düzeyleri ile uyku kalitesi arasındaki ilişkinin incelenmesi. [Evaluation of the relationship between burnout levels and sleep quality in the intensive care unit nurses]. Bozok Med J. 2014;4(3):48-56. [Link] 
  20. Bride BE, Robinson MM, Yegidis BL, Figley CR. Development and validation of the secondary traumatic stress scale. Research on Social Work Practice. 2004;14(1):27-35. [Crossref] 
  21. Yıldırım G, Kıdak LB, Yurdabakan İ. İkincil travmatik stres ölçeği: bir uyarlama çalışması. [Secondary traumatic stress scale: an adaptation study]. Anadolu Psikiyatri Dergisi. 2018;19(1):45-51. [Crossref] 
  22. Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213. [Crossref] [PubMed] 
  23. Yücel Ağargün M, Kara H, Anlar Ö. Pittsburgh uyku kalitesi indeksinin geçerliği ve güvenirliği. [The validity and reliability of the Pittsburgh sleep quality index]. Türk Psikiyatri Dergisi. 1996;7(2):107-15. [Link] 
  24. Alpar R. Uzaklık ve benzerlik ölçüleri. Uygulamalı Çok Değişkenli İstatistiksel Yöntemler. 5. baskı. Ankara: Detay Yayıncılık; 2017. p.153-73. [Link] 
  25. Özdemir C. Erciyes üniversitesi tıp fakültesi hastanelerinde çalışan hekim dışı sağlık personelindeuyku kalitesi ve ilişkili faktörler. [Sleep quality and associated factors among non-physician health personnel working in Erciyes university medical faculty hospitals]. Journal of Health Sciences. 2014;23(2):66. [Link] 
  26. Dong H, Zhang Q, Sun Z, Sang F, Xu Y. Sleep disturbances among Chinese clinical nurses in general hospitals and its influencing factors. BMC Psychiatry. 2017;3;17(1):241. [Crossref] [PubMed] [PMC] 
  27. Kara B, Tenekeci EG. Sleep quality and associated factors in older Turkish adults with hypertension: a pilot study. J Transcult Nurs. 2017;28(3):296-305. [Crossref] [PubMed] 
  28. Shim J, Kang SW. Behavioral factors related to sleep quality and duration in adults. J Lifestyle Med. 2017;7(1):18-26. [Crossref] [PubMed] [PMC] 
  29. Arslan M. Aydemir İ. Sağlık çalışanlarının uyku kalitesi ve fiziksel aktivite durumlarının beden kitle [The relationship between sleep quality and physical activity status of health personnel with their body mass index]. Turkiye Klinikleri J Health Sci. 2020;5(1):1-9. [Crossref] 
  30. Restauri N, Sheridan AD. Burnout and posttraumatic stress disorder in the coronavirus disease-2019 (COVID-19) pandemic: intersection, impact, and interventions. J Am Coll Radiol. 2020;17(7):921-6. [Crossref] [PubMed] [PMC] 
  31. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open. 2020;2;3(3):e203976. [Crossref] [PubMed] [PMC] 
  32. Lerias D, Byrne MK. Vicarious traumatization: symptoms and predictors. Stress Health. 2003:19(3):129-38. [Crossref] 
  33. Zara A, İçöz JF. Türkiye'de ruh sağlığı alanında travma mağdurlarıyla çalışanlarda ikincil travmatik stres. [Secondary traumatic stress in mental health workers in Turkey]. Klinik Psikiyatri Dergisi. 2015;18(1):15-23. [Link] 
  34. Arslan S, Özer N. Yoğun bakım hastalarının duyusal girdi sorunlarında tamamlayıcı istatistikler. [Complementary treatments for the sensory input problems of ıntensive care patients]. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi. 2010;13(2):68-75. [Link] 

.: Up To Date

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com