Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
Tip 2 Diyabetli Yaşlılarda Kırılganlık ve Öz-Etkililik Düzeyinin Belirlenmesi: Tanımlayıcı Araştırma
Level of Frailty and Self-Efficacy in Elderly Individuals with Type 2 Diabetes: Descriptive Research
Sinem KURTOĞLUa, Bahar İNKAYAb
aBolu Abant İzzet Baysal Üniversitesi Sağlık Bilimleri Fakültesi, İç Hastalıkları Hemşireliği ABD, Bolu, Türkiye
bAnkara Yıldırım Beyazıt Üniversitesi Sağlık Bilimleri Fakültesi, İç Hastalıkları Hemşireliği ABD, Ankara, Türkiye
Turkiye Klinikleri J Nurs Sci. 2022;14(3):825-34
doi: 10.5336/nurses.2021-86451
Article Language: TR
Full Text
ÖZET
 Amaç: Bu çalışma, Tip 2 diyabetli yaşlılarda kırılganlık ve özetkililik düzeyinin belirlenmesi amacıyla yapıldı. Gereç ve Yöntemler: Araştırmanın evrenini Dörtdivan Aile Sağlığı Merkezine başvuran Tip 2 diyabetli yaşlılar oluşturdu, örneklemini ise dahil edilme kriterlerine uyan, gönüllü katılım sağlayan 138 diyabetli yaşlı oluşturdu. Veriler yüz yüze görüşme yöntemi ile topladı. Verilerin analizinde tanımlayıcı istatistikler, Mann-Whitney U, Kruskal-Wallis H, bağımsız örneklem testti ve ANOVA testleri kullanıldı. Bulgular: Katılımcıların yaş ortalaması 70,36±5,42 ve %48,6'sı 9 yıl ve üzeri süredir diyabet hastasıdır. Katılımcıların %23,9'unun görünüşte incinebilir, %16,7'si hafif kırılgan, %8,7'sinin de şiddetli kırılgan olduğu saptandı. Edmonton Kırılganlık Ölçeği puan ortalaması 5,80±3,31 olarak bulundu. Öz Yeterlilik Ölçeği puan ortalaması 60,01±17,22 olarak saptandı ve diyabetli yaşlıların %52,2'sinin Öz Yeterlilik Ölçeği puan ortalamasından yüksek puan aldığı görüldü. Diyabetli yaşlı bireylerde Öz Yeterlilik Ölçeği alt boyutları ve Edmonton Kırılganlık Ölçeği arasında negatif yönde istatistiksel olarak anlamlı bir ilişki bulundu (p<0,05). Yaş ve hemoglobin A1C düzeyi arttıkça kırılganlığın arttığı, öz-etkililiğin azaldığı görüldü. Sonuç: Yaşam kalitesini önemli düzeyde olumsuz etkileyen kırılganlığın önlenmesi ve azaltılması öz-etkililiğin artırılması ile mümkündür. Bu bağlamda, sağlık profesyonelleri arasında farkındalığın artırılması, özellikle riskli grupta olan diyabetli yaşlıların kırılganlık ve öz-etkililik yönünden değerlendirilmesi, her yaşlının diyabet yönetimini kendi kendine gerçekleştirebilmesi adına öz-etkililiğini artıracak uygulamalarla kırılganlık ve öz-etkililiğin bakım sürecine dâhil edilmesi önerilmektedir.

Anahtar Kelimeler: Diabetes mellitus; hemşirelik; kırılganlık; öz yeterlik; yaşlı
ABSTRACT
 Objective: This study was conducted to determine frailty and self-efficacy levels in the elderly with Type 2 diabetes. Material and Methods: The population of the study consisted of elderly people with Type 2 diabetes who applied to Dörtdivan Family Health Center, and the sample consisted of 138 elderly diabetics who met the inclusion criteria and participated voluntarily. Data were collected by face-to-face interview method. Descriptive statistics, Mann-Whitney U, Kruskal-Wallis H, independent sample t-test and ANOVA tests were used in the analysis of the data. Results: The mean age of the participants was 70.36±5.42 years and 48.6% of them had diabetes for 9 years or more. It was determined that 23,9% of the participants were apparently vulnerable, 16,7% were mild frail, and 8.7% were severely frail. Edmonton Frailty Scale mean score was found to be 5.80±3.31. The mean score of the Self-Efficacy Scale was determined as 60.01±17.22, and it was seen that 52.2% of the elderly with diabetes got a higher score than the mean score of the Self-Efficacy Scale. A statistically significant correlation was found between the sub-dimensions of the Self-Efficacy Scale and the Frailty Scale in elderly individuals with diabetes (p<0.05). It was observed that frailty increased and self-efficacy decreased as age and hemoglobin A1C level increased. Conclusion: Prevention and reduction of frailty, which negatively affects quality of life, is possible by increasing self-efficacy. In this context, it is recommended to raise awareness among health professionals, to evaluate especially the elderly with diabetes, who are in the risk group, in terms of frailty and self-efficacy, and to include frailty and selfefficacy in the care process with practices that will increase the self-efficacy of each elderly person in order to manage diabetes by himself.

Keywords: Diabetes mellitus; nursing; frailty; self efficacy; aged
REFERENCES:
  1. International Diabetes Federation [Internet]. [Cited: January 1, 2022]. IDF Diabetes Atlas 10th. Available from: [Link] 
  2. Türk Diyabet Cemiyeti [İnternet]. Copyright 2020 © [Erişim tarihi: 15 Şubat 2020]. Turdep-2 Sonuçlarının Özeti. Erişim linki: [Link] 
  3. Kitiş Y. Diyabet ve hemşirelik bakımı. Bilgili N, Kitiş Y, editörler. Yaşlılık ve Yaşlı Sağlığı. 1. Baskı. Ankara: Vize Yayıncılık; 2017. p.241-63.
  4. Kulmala J, Nykänen I, Hartikainen S. Frailty as a predictor of all-cause mortality in older men and women. Geriatr Gerontol Int. 2014;14(4):899-905. [Crossref]  [PubMed] 
  5. Le Maguet P, Roquilly A, Lasocki S, Asehnoune K, Carise E, Saint Martin M, et al. Prevalence and impact of frailty on mortality in elderly ICU patients: a prospective, multicenter, observational study. Intensive Care Med. 2014;40(5):674-82. [Crossref]  [PubMed] 
  6. Hewitt J, Moug SJ, Middleton M, Chakrabarti M, Stechman MJ, McCarthy K; Older Persons Surgical Outcomes Collaboration. Prevalence of frailty and its association with mortality in general surgery. Am J Surg. 2015;209(2):254-9. [Crossref]  [PubMed] 
  7. WHO Clinical Consortium on Healthy Ageing Topic Focus: Frailty and İntrinsic Capacity Report of Consortium Meeting 1-2 December 2016 in Geneva, Switzerland. Erişim tarihi: 7 Haziran 2019. [Link] 
  8. Wada T, Matsumoto H, Hagino H. Customized exercise programs implemented by physical therapists improve exercise-related self-efficacy and promote behavioral changes in elderly individuals without regular exercise: a randomized controlled trial. BMC Public Health. 2019;19(1):917. [Crossref]  [PubMed]  [PMC] 
  9. Beckerle CM, Lavin MA. Association of self-efficacy and self-care with glycemic control in diabetes. Diabetes Spectrum. 201326(3):172-8. [Crossref] 
  10. Ahmad Sharoni SK, Mohd Razi MN, Abdul Rashid NF, Mahmood YE. Self-efficacy of foot care behaviour of elderly patients with diabetes. Malays Fam Physician. 2017;12(2):2-8. [PubMed]  [PMC] 
  11. Hladek M. Self-efficacy and its associations with sweat pro-inflammatory cytokine interleukin-6 and pre-frailty/frailty among older adults with chronic disease [Doctoral thesis]. Baltimore: John Hopkins University; 2018. [Erişim tarihi: 7 Haziran 2019]. [Link] 
  12. Yanase T, Yanagita I, Muta K, Nawata H. Frailty in elderly diabetes patients. Endocr J. 2018;65(1):1-11. [Crossref]  [PubMed] 
  13. Gao J, Wang J, Zheng P, Haardörfer R, Kegler MC, Zhu Y, et al. Effects of self-care, self-efficacy, social support on glycemic control in adults with type 2 diabetes. BMC Fam Pract. 2013;14:66. [Crossref]  [PubMed]  [PMC] 
  14. Aygör HE, Fadıloğlu Ç, Şahin S, Aykar FŞ, Akçiçek F. Validation of edmonton frail scale into elderly Turkish population. Archives of Gerontology and Geriatrics, 2018;76:133-7. [Crossref]  [PubMed] 
  15. Usluoğlu H. Diyabetik hastaların öz yeterlilikleri ile öz bakım aktiviteleri arasındaki İlişki [Yüksek lisans tezi]. Gaziantep: Gaziantep Üniversitesi; 2018. Erişim tarihi: 01.08.2019 [Link] 
  16. Usta Yeşilbalkan Ö. Tip 2 diyabetli hastaların kendi kendine bakımlarındaki öz yeterlilikleri ve öz yeterliliklerini etkileyen faktörlerin incelenmesi [Yüksek lisans tezi]. İzmir: Ege Üniversitesi; 2001. [Yükseköğretim Kurulu Başkanlığı Tez Merkezi] Erişim tarihi: 01.08.19. [Link] 
  17. Bijl JV, Poelgeest-Eeltink AV, Shortridge-Baggett L. The psychometric properties of the diabetes management self-efficacy scale for patients with type 2 diabetes mellitus. J Adv Nurs. 1999;30(2):352-9. [Crossref]  [PubMed] 
  18. Karslı Z. 65 yaş üzeri diyabeti olan ve olmayan bireylerde kırılganlığın değerlendirilmesi [Uzmanlık tezi]. İzmir: İzmir Kâtip Çelebi Üniversitesi; 2018. [Yükseköğretim Kurulu Başkanlığı Tez Merkezi] Erişim tarihi: 01.08.2019 [Link] 
  19. Liccini A, Malmstrom TK. Frailty and sarcopenia as predictors of adverse health outcomes in persons with diabetes mellitus. J Am Med Dir Assoc. 2016;17(9):846-51. [Crossref]  [PubMed] 
  20. Yang L, Jiang Y, Xu S, Bao L, Parker D, Xu X, et al. Evaluation of frailty status among older people living in urban communities by Edmonton Frail Scale in Wuhu, China: a cross-sectional study. Contemp Nurse. 2018;54(6):630-9. [Crossref]  [PubMed] 
  21. Silva AP, Pureza DY, Landre CB. Frailty syndrome in elderly patients with type 2 diabetes mellitus. Acta Paul Enferm. 2015;28(6):503-9. [Crossref] 
  22. Aguayo GA, Hulman A, Vaillant MT, Donneau AF, Schritz A, Stranges S, et al. Prospective association among diabetes diagnosis, HbA1c, glycemia, and frailty trajectories in an elderly population. Diabetes Care. 2019;42(10):1903-11. [Crossref]  [PubMed] 
  23. Yanagita I, Fujihara Y, Eda T, Tajima M, Yonemura K, Kawajiri T, et al. Low glycated hemoglobin level is associated with severity of frailty in Japanese elderly diabetes patients. J Diabetes Investig. 2018;9(2):419-25. [Crossref]  [PubMed]  [PMC] 
  24. Arslan B. Tip-2 diyabetli hastalarda öz yeterlilik düzeyinin yaşam kalitesine etkisi [Yüksek Lisans tezi]. Samsun: Ondokuz Mayıs Üniversitesi; 2019. [Yükseköğretim Kurulu Başkanlığı Tez Merkezi] Erişim tarihi; 01.08.19 [Link] 
  25. Dehghan H, Charkazi A, Kouchaki GM, Zadeh BP, Dehghan BA, Matlabi M, et al. General self-efficacy and diabetes management self-efficacy of diabetic patients referred to diabetes clinic of Aq Qala, North of Iran. J Diabetes Metab Disord. 2017;16:8. [Crossref]  [PubMed]  [PMC] 
  26. Şireci E, Yılmaz Karabulutlu E. Tip 2 diabetes mellituslu hastaların hastalıklarını kabullenme ve kendi bakımlarındaki öz yeterlilik düzeylerinin belirlenmesi. Journal of Anatolia Nursing and Health Sciences. 2017;20(1):48-55. [Link] 
  27. Kılıç M. Tip 2 diyabetli bireylerin öz-etkililik düzeyleri ve sağlık kontrol odağı ile ilişkisi [Yüksek lisans tezi]. Konya: Selçuk Üniversitesi; 2016. Erişim tarihi: 01.08.19 [Link] 
  28. Tharek Z, Ramli AS, Whitford DL, Ismail Z, Mohd Zulkifli M, Ahmad Sharoni SK, et al. Relationship between self-efficacy, self-care behaviour and glycaemic control among patients with type 2 diabetes mellitus in the Malaysian primary care setting. BMC Fam Pract. 2018;19(1):39. [Crossref]  [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