Turkiye Klinikleri Cardiovascular Sciences

.: ORIGINAL RESEARCH
Kalp-Damar Cerrahi Hastalarının Anksiyete Düzeyleri: Baş Etme Yöntemleri, Öz-Etkililik Düzeyi ve Sosyal Destek Mekanizmalarının İncelenmesi: Tanımlayıcı ve İlişki Arayıcı Araştırma
Anxiety Levels of Cardiovascular Surgery Patients: Investigation of Coping Methods, Self-Efficacy Level and Social Support Mechanisms: Descriptive and Relational Research
Özlem KÖSEOĞLU ÖRNEKa, Hatice Nurhan GÜNAYDINb, Nurcan KOLAÇc, Burak AÇIKGÖZd, Ali Aycan KAVALAe, Saygın TÜRKYILMAZe
aInstitute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Almanya
bTozkoparan Uhud Aile Sağlığı Merkezi, İstanbul, Türkiye
cMarmara Üniversitesi Sağlık Bilimleri Fakültesi, Hemşirelik Bölümü, İstanbul, Türkiye
dLyckeby Health Central. Källevägen Karlskrona, İsviçre
eBakırköy Dr. Sadi Konuk Eğitim ve Araştırma Hastanesi, Kalp ve Damar Cerrahisi Kliniği, İstanbul, Türkiye
Turkiye Klinikleri J Cardiovasc Sci. 2022;34(2):35-45
doi: 10.5336/cardiosci.2022-88726
Article Language: TR
Full Text
ÖZET
 Amaç: Kalp hastalıkları, insan hayatını etkileyen önemli bir hastalık grubudur. Kronik hastalıklara bağlı dünyadaki ölümlerin büyük çoğunluğu kalp-damar hastalıklarından kaynaklanmaktadır. Bu çalışmanın amacı, kardiyovasküler hastalık nedeniyle cerrahi servise yatırılan hastaların kaygı, öz yeterlik, algılanan sosyal destek düzeyi ve baş etme profillerini incelemektir. Gereç ve Yöntemler: Araştırmanın verileri, İstanbul Avrupa Yakası'nda yer alan bir eğitim ve araştırma hastanesinin kalp-damar cerrahisi servisinde tedavi gören hastalardan oluşmaktadır. Veri toplama aracı olarak Beck Anksiyete Ölçeği, Öz-Etkililik/Yeterlilik Ölçeği, Çok Boyutlu Algılanan Sosyal Destek Ölçeği, Kısa Baş Etme Yöntemleri Ölçeği ve kısa tanımlayıcı özellikler formundan oluşmaktadır. Veriler Kasım 2017 ile Mayıs 2018 arasında toplanmıştır. Bulgular: Araştırma yaş ortalaması 49,03±12,83 (minimum: 21-maksimum: 82 yıl) olan 170 hastadan oluşmaktadır. Hastaların %12'sinde 'şiddetli' anksiyete saptandı. Hastaların algıladıkları sosyal destek düzeylerinin ekonomik durumlarına, taburculuk sonrası bakım aldıkları yere ve destek aldıkları kişilerin yakınlığına göre farklılaştığı görüldü (p<0,05). Sağlık profesyonellerinin kurdukları iletişimin kalitesine göre kaygı ve algılanan sosyal destek düzeylerinin farklılaştığı bulundu (p<0,05). Pearson'ın analizine göre hastaların anksiyete düzeyleri ile algıladıkları sosyal düzey arasında negatif yönlü bir ilişki olduğu bulundu (r=-0,191, p<0,05). Hastaların öz yeterlik düzeyleri ile algılanan sosyal destek arasında pozitif ilişki bulundu (p=0,000). Sonuç: Kalp hastalarının psikolojik sağlık sorunlarından biri olan anksiyetenin kontrolü ve hastalık süreciyle etkin bir şekilde baş etmede; algılanan sosyal desteğin, öz yeterlik düzeylerinin, baş etme yöntemlerinin, taburculuk sonrası evde bakım sürecinde birincil yakın desteğin, hekim, hemşire gibi sağlık profesyonelleri ile açık ve kaliteli iletişimin etkili olduğu görülmektedir. Hastaların evde bakım hizmetlerini kapsayacak şekilde psikososyal destek mekanizmalarının taburculuk öncesinde değerlendirilerek, profesyonel yardım almasının sağlanması önemli görünmektedir.

Anahtar Kelimeler: Kalp cerrahi süreci; sosyal destek; anksiyete; öz yeterlik; taburculuk
ABSTRACT
 Objective: Heart diseases are an important group of diseases that affect human life. It is the first cause of death in the world. The aim of this study is to examine the anxiety, self-efficacy, perceived social support level and coping profiles of patients admitted to the surgical service for cardiovascular disease. Material and Methods: The data of the study consists of patients who were treated in the cardiovascular surgery service of a training and research hospital located on the European side of İstanbul. It consists of Beck Anxiety Scale, Self-Efficacy Scale, Multidimensional Scale of Perceived Social Support, Brief Coping Profiles Scale and short descriptive characateristics form as data collection instruments. Data were collected between November 2017 and May 2018. Results: The study consisted of 170 patients with a mean age of 49.03±12.83 (minimum: 21-maximum: 82 years). 'Severe' anxiety was detected in 12% of the patients. It was observed that the perceived social support levels of the patients differed according to their economic status, the place where they received care after discharge, and the closeness of the people they received support from (p<0.05). It was found that the levels of anxiety and perceived social support differed according to the quality of communication established by health professionals (p<0.05). According to Pearson's analysis; a negative correlation was found between the anxiety levels of the patients and their perceived social level (r=-0.191, p<0.05). A positive correlation was found between patients' self-efficacy levels and perceived social support (p=0.000). Conclusion: In controlling anxiety, which is one of the psychological health problems of heart patients, and effectively coping with the disease process; it is seen that perceived social support, self-efficacy levels, coping methods, primary close support in the post-discharge home care process, open and quality communication with health professionals such as physicians and nurses are effective. It seems important to ensure that patients receive professional support before discharge by evaluating psychosocial support mechanisms, including home care services.

Keywords: Cardiac surgical procedures; social support; anxiety; self efficacy; discharge
REFERENCES:
  1. World Health Organisation [Internet]. © 2022 WHO [Cited: 10.04.2022]. Cardiovascular diseases (CVDs). Available from: [Link] 
  2. Türkiye İstatistik Kurumu [İnternet]. [Erişim tarihi: 10.04.2022]. Ölüm Nedeni İstatistikleri, 2018. Erişim linki: [Link] 
  3. Wang T, Chen L, Yang T, Huang P, Wang L, Zhao L, et al. Congenital heart disease and risk of cardiovascular disease: a meta-analysis of cohort studies. J Am Heart Assoc. 2019;8(10):e012030. [Crossref]  [PubMed]  [PMC] 
  4. Xia PF, Pan XF, Chen C, Wang Y, Ye Y, Pan A. Dietary intakes of eggs and cholesterol in relation to all-cause and heart disease mortality: a prospective cohort study. J Am Heart Assoc. 2020;9(10):e015743. [Crossref]  [PubMed]  [PMC] 
  5. Lee IM, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT; Lancet Physical Activity Series Working Group. Effect of physical inactivity on major non-communicable diseases worldwide: an analysis of burden of disease and life expectancy. Lancet. 2012;380(9838):219-29. [Crossref]  [PubMed]  [PMC] 
  6. Yusuf S, Joseph P, Rangarajan S, Islam S, Mente A, Hystad P, et al. Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet. 2020;395(10226):795-808. Erratum in: Lancet. 2020;395(10226):784. [Crossref]  [PubMed]  [PMC] 
  7. Miller MR, Newby DE. Air pollution and cardiovascular disease: car sick. Cardiovasc Res. 2020;116(2):279-94. [PubMed] 
  8. Ohlsson A, Eckerdal N, Lindahl B, Hanning M, Westerling R. Non-employment and low educational level as risk factors for inequitable treatment and mortality in heart failure: a population-based cohort study of register data. BMC Public Health. 2021;21(1):1040. [Crossref]  [PubMed]  [PMC] 
  9. Bucciarelli V, Nasi M, Bianco F, Seferovic J, Ivkovic V, Gallina S, et al. Depression pandemic and cardiovascular risk in the COVID-19 era and long COVID syndrome: Gender makes a difference. Trends Cardiovasc Med. 2022;32(1):12-7. [Crossref]  [PubMed]  [PMC] 
  10. Magnusson Hanson LL, Rod NH, Vahtera J, Virtanen M, Ferrie J, Shipley M, et al. Job insecurity and risk of coronary heart disease: Mediation analyses of health behaviors, sleep problems, physiological and psychological factors. Psychoneuroendocrinology. 2020;118:104706. [Crossref]  [PubMed] 
  11. Koseoglu Ornek O, Waibel J, Wullinger P, Weinmann T. Precarious employment and migrant workers' mental health: a systematic review of quantitative and qualitative studies. Scand J Work Environ Health. 2022:4019. [Crossref]  [PubMed] 
  12. Ornek OK, Weinmann T, Waibel J, Radon K. Precarious employment and migrant workers' mental health: a protocol for a systematic review of observational studies. Syst Rev. 2020;9(1):50. [Crossref]  [PubMed]  [PMC] 
  13. Shah N, Kelly AM, Cox N, Wong C, Soon K. Myocardial infarction in the "young": risk factors, presentation, management and prognosis. Heart Lung Circ. 2016;25(10):955-60. [Crossref]  [PubMed] 
  14. Chauvet-Gelinier JC, Bonin B. Stress, anxiety and depression in heart disease patients: A major challenge for cardiac rehabilitation. Ann Phys Rehabil Med. 2017;60(1):6-12. [Crossref]  [PubMed] 
  15. Tan J, Wang Y. Social integration, social support, and all-cause, cardiovascular disease and cause-specific mortality: a prospective cohort study. Int J Environ Res Public Health. 2019;16(9):1498. [Crossref]  [PubMed]  [PMC] 
  16. Svensson T, Inoue M, Sawada N, Yamagishi K, Charvat H, Saito I, et al. Coping strategies and risk of cardiovascular disease incidence and mortality: the Japan Public Health Center-based prospective Study. Eur Heart J. 2016;37(11):890-9. [Crossref]  [PubMed] 
  17. Mszar R, Buscher S, McCann D, Taylor HL. Self-efficacy, perceived barriers to care, and health-promoting behaviors among franco-americans across cardiovascular risk factors: a cross-sectional study. Am J Health Promot. 2021;35(5):703-7. [Crossref]  [PubMed] 
  18. Eşlik M, Çetinkaya A. Self-efficacy perceptions in coping of the patients' post-coronary artery bypass graft surgery. J. Cardiovasc. Nurs. 2019;10(22):41-9. [Crossref] 
  19. Kim MY, Johnson JL, Sawatzky R. Relationship between types of social support, coping strategies, and psychological distress in individuals living with congenital heart disease. J Cardiovasc Nurs. 2019;34(1):76-84. [Crossref]  [PubMed] 
  20. Kim SH, Hwang SY, Shin JH, Lim YH. Self-care and related factors associated with left ventricular systolic function in patients under follow-up after myocardial infarction. Eur J Cardiovasc Nurs. 2021;20(1):5-13. [Crossref]  [PubMed] 
  21. Köseoğlu Örnek Ö, Kürklü A. Üniversite öğrencilerinin sağlıklı yaşam biçimi davranışları, öz etkililik-yeterlilik düzeyleri ve etkileyen faktörler [Healthy lifestyle behaviours, levels of self efficacy among university students and affected factors]. Turkiye Klinikleri J Nurs Sci. 2017;9(3):207-17. [Crossref] 
  22. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988;56(6):893-7. [Crossref]  [PubMed] 
  23. Ulusoy M, Sahin NH, Erkmen H. Turkish version of the Beck Anxiety Inventory: Psychometric properties. J. Cogn. Psychother. 1998;12:163. [Link] 
  24. Sherer M, Adams CH. Construct validation of the self-efficacy scale. Psychol. Rep. 1983;53(3):899-902. [Crossref] 
  25. Gözüm S, Aksayan S. Öz-etkı̇lı̇lı̇k yeterlı̇k ölçeğı̇nı̇n Türkçe formunun güvenı̇lı̇rlı̇k ve geçerlı̇lı̇ğı̇ [The reliability and validity of Turkish form of the self-efficacy scale]. Atatürk Üniv. Hemşirelik Yüksekoukul Derg. 1999;2(1):21-34. [Link] 
  26. Zimmet GD, Dahlem NW, Zimmet SG, Farley GK. The multidimensional scale of perceived social support. J. Pers. Assess. 1998;52(1):30-41. [Crossref] 
  27. Eker D, Arkar H, Yaldız H. Çok boyutlu algılanan sosyal destek ölçeğinin gözden geçirilmiş formunun faktör yapısı, geçerlik ve güvenirliği [Factorial structure, validity, and reliability of revised form of the multidimensional scale of perceived social support]. Türk Psikiyatr. Dergisi. 2001;12(1):17-25. [Link] 
  28. Kageyama T, Kobayashi T, Kawashima M, Kanamaru Y. [Development of the Brief Scales for Coping Profile (BSCP) for workers: basic information about its reliability and validity]. Sangyo Eiseigaku Zasshi. 2004;46(4):103-14. Japanese. [Crossref]  [PubMed] 
  29. Ornek OK, Temel GY. Reliability and validity of the Turkish version of the brief scales for coping Profile in textile workers. Nővér. 2018;31(2):1-40. [Crossref] 
  30. Nguyen Q, Uminski K, Hiebert BM, Tangri N, Arora RC. Midterm outcomes after postoperative delirium on cognition and mood in patients after cardiac surgery. J Thorac Cardiovasc Surg. 2018;155(2):660-7.e2. [Crossref]  [PubMed] 
  31. Graven LJ, Gordon G, Keltner JG, Abbott L, Bahorski J. Efficacy of a social support and problem-solving intervention on heart failure self-care: A pilot study. Patient Educ Couns. 2018;101(2):266-75. Erratum in: Patient Educ Couns. 2019;102(8):1575-1576. [Crossref]  [PubMed] 
  32. Kelly S, Martin S, Kuhn I, Cowan A, Brayne C, Lafortune L. Barriers and facilitators to the uptake and maintenance of healthy behaviours by people at mid-life: a rapid systematic review. PLoS One. 2016;11(1):e0145074. [Crossref]  [PubMed]  [PMC] 
  33. Matley FAI, Davies EL. Resisting temptation: alcohol specific self-efficacy mediates the impacts of compensatory health beliefs and behaviours on alcohol consumption. Psychol Health Med. 2018;23(3):259-69. [Crossref]  [PubMed] 
  34. Arslan S, Gürsoy A. Hastaların hemşirelik bakım memnuniyetleri: cerrahi hastaları örneği [Nursing care satisfaction of patients: surgical patients example]. Ordu Üniversitesi Hemşirelik Çalışmaları Derg. 2021;4(1):21-8. [Crossref] 
  35. Sidar A, Dedeli Ö, Işkesen AI. The relationship between anxiety, pain distress and pain severity before and after open heart surgery in patients [Açık kalp cerrahisi öncesi ve sonrası hastaların kaygı ve ağrı distresi: ağrı düzeyi ile ilişkisinin incelenmesi]. J. Med. Surg. Intensive Care Med. 2013;4:1-8. [Link] 
  36. Heydarikhayat N, Ashktorab T, Rohani C, Zayeri F. Effect of post-hospital discharge follow-up on health status in patients with burn injuries: a randomized clinical trial. Int J Community Based Nurs Midwifery. 2018;6(4):293-304. [PubMed]  [PMC] 

.: Up To Date

.: Process List

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