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Planlı Sezaryen İçin Hastaneye Başvuran Gebelerin Koronavirüs Anksiyetesi ile Hastane Anksiyetesi Arasındaki İlişki

Year 2023, Volume: 9 Issue: 3, 89 - 99, 30.11.2023

Merve Coşkun Yasemin Uslu Seda Er Aslınur Çırçır

Abstract

Amaç: Çalışmada planlı sezaryen ameliyatı için hastaneye başvuran gebelerin koronavirüs anksiyetesi ile hastane anksiyetesi arasında ilişkiyi incelemek amacı ile planlandı.
Metod: Bu tanımlayıcı çalışma, İstanbul’da bulunan üç hastanede 142 gebe ile yapıldı. Veriler “Koronavirüs Anksiyete Ölçeği”, "Prenatal Distres Ölçeği” ve “Hastane Anksiyete Depresyon Ölçeği” kullanılarak toplandı.
Bulgular: Kadınların yaş ortalaması 32.14±4.25 yıl, gebelik süreleri ortalama 38.97±2.39 haftadır. Çalışmaya katılan gebelerin, koronavirüs anksiyetesi, prenatal distres, hastane anksiyetesi ve depresyon puanları arasında pozitif yönde orta düzeyde anlamlı ilişki saptandı (p<0.001; r=0.493; r=0.393; r=0.413).
Sonuç: Gebelerin, COVID-19 salgını sırasında kaygıları artırma eğilimindedir. Ailesinde COVID-19 tanısı alan, koruyucu ekipman kullanan, hastanede kendisine destek olacak yakınları bulunan kişilerde COVID-19 stresinin daha yüksek olduğu belirlendi. Koronovirüs anksiyetesindeki artış, hastane anksiyetesi ve prenatal distres düzeylerini arttırmaktadır.

Keywords

anksiyete koronavirus COVİD-19 sezaryen distress

Ethical Statement

Ethics committee approval and institutional permission were obtained before the research. Participants were informed about the research before starting data collection and informed consent was obtained from the participants.

References

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  • Aydemir, Ö., Güvenir, T., Küey, L., & Kültür, S. (1997). Validity and reliability of the Turkish version of Hospital Anxiety and Depression Scale. Turkish Journal of Psychiatry, 8(4), 280-287.
  • Aydın, R., Kızılkaya, T., Aytaç, S. H., & Taşlar, N. (2020). In COVID-19 Pandemic; social support requirements and midwifery approaches to women during pregnancy, childbirth and the postpartum period. Electronic Turkish Studies, 15(4), 679-690.
  • Becker, M., Weinberger, T., Chandy, A., & Schmukler, S. (2016). Depression during pregnancy and postpartum. Current Psychiatry Reports, 18(3), 1-9. https://doi.org/10.1007/s11920-016-0664-7
  • Brooks, S. K., Weston, D., & Greenberg, N. (2020). Psychological impact of infectious disease outbreaks on pregnant women: rapid evidence review. Public Health, 189, 26-36. https://doi.org/10.1101/2020.04.16.20068031
  • Chen, Y., Li, Z., Zhang, Y. Y., Zhao, W. H., & Yu, Z. Y. (2020a). Maternal health care management during the outbreak of coronavirus disease 2019. Journal of medical virology, 92(7), 731-739. https://doi.org/10.1002/jmv.25787 Chen, S., Zhuang, J., Chen, Q., & Tan, X. (2020b). Psychological investigation on pregnant women during the outbreak of COVID-19. Research Square, https://doi.org/10.21203/rs.3.rs-34763/v2
  • Craig, F., Gioia, M. C., Muggeo, V., Cajiao, J., Aloi, A., Martino, I., Tenuta, F., Cerasa, A., & Costabile, A. (2021). Effects of maternal psychological distress and perception of COVID-19 on prenatal attachment in a large sample of italian pregnant women. Journal of Affective Disorders, 295, 665–672. https://doi.org/10.1016/j. jad.2021.08.102
  • Davenport, M. H., McCurdy, A. P., Mottola, M. F., Skow, R. J., Meah, V. L., Poitras, V. J., Ruchat, S. M. et al. (2018). Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: a systematic review and meta-analysis. British Journal of Sports Medicine, 52(21), 1376-1385. http://dx.doi.org/10.1136/bjsports-2018-099697
  • Demir, E. T., & Kilic, F. (2020). Determination of the anxiety level in pregnant women who administer to the obstetrics clinic within the COVID-19 pandemia period. Selcuk Medical Journal, 36(4), 352-356. https://doi.org/10.30733/std.2020.01468
  • Dotters-Katz, S. K., & Hughes, B. L. 2020. Considerations for obstetric care during the COVID-19 pandemic. American Journal of Perinatology, 37,(08), 773-779. https://doi.org/10.1055/s-0040-1710051
  • Durankuş, F., & Aksu, E. (2020). Effects of the COVID-19 pandemic on anxiety and depressive symptoms in pregnant women: a preliminary study. The Journal of Maternal-Fetal & Neonatal Medicine, 35(2), 205-211
  • Effati-Daryani, F., Zarei, S., Mohammadi, A., Hemmati, E., Ghasemi Yngyknd, S., & Mirghafourvand, M. (2020). Depression, stress, anxiety and their predictors in Iranian pregnant women during the outbreak of COVID-19. BMC Psychology, 8(99), 1-10. https://doi.org/10.1186/s40359-020-00464-8
  • Evren, C., Evren, B., Dalbudak, E., Topcu, M., & Kutlu, N. (2020). Measuring anxiety related to COVID-19: a Turkish validation study of the Coronavirus Anxiety Scale. Death Studies, 1-7. https://doi.org/10.1080/07481187.2020.1774969
  • Holmes, E. A., O'Connor, R. C., Perry, V. H., Tracey, I., Wessely, S., Arseneault, L., Bullmore, E., et al. (2020). Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. The Lancet Psychiatry, 7(6), 547-560. https://doi.org/10.1016/S2215-0366(20)30168-1
  • Kahyaoglu Sut, H., & Kucukkaya, B. (2021). Anxiety, depression, and related factors in pregnant women during the COVID-19 pandemic in Turkey: A web-based cross-sectional study. Perspectives in psychiatric care, 57(2), 860–868. https://doi.org/10.1111/ppc.12627
  • Karaca, P. P., Koyucu, R. G., & Aksu, S. Ç. (2022). The relatıonshıp between pregnant women's anxıety levels about coronavırus and prenatal attachment. Archives of Psychiatric Nursing, 36, 78-84. https://doi.org/10.1016/j.apnu.2021.12.001
  • Lebel, C., MacKinnon, A., Bagshawe, M., Tomfohr-Madsen, L., & Giesbrecht, G. (2020). Elevated depression and anxiety among pregnant individuals during the COVID-19 pandemic. Journal of Affective Disorders, 277, 5-13. https://doi.org/10.1016/j.jad.2020.07.126
  • Lee, S. A. (2020). Coronavirus anxiety scale: a brief mental health screener for COVID-19 related anxiety. Death Studies, 1-9. 44(7), 393-401. https://doi.org/10.1080/07481187.2020.1748481
  • Liu, X., Chen, M., Wang, Y., Sun, L., Zhang, J., Shi, Y., Qi, H., et al. (2020). Prenatal anxiety and obstetric decisions among pregnant women in Wuhan and Chongqing during the COVID‐19 outbreak: a cross‐sectional study. BJOG: An International Journal of Obstetrics & Gynaecology, 127(10), 1229-1240. https://doi.org/10.1111/1471-0528.16381
  • Lu, R., Zhao, X., Li, J., Niu, P., Yang, B., Wu, H., Tan, W., et al. (2020). Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. The Lancet, 395(10224), 565-574. https://doi.org/10.1016/S0140-6736(20)30251-8
  • Moyer, C. A., Compton, S. D., Kaselitz, E., & Muzik, M. (2020). Pregnancy-related anxiety during COVID-19: a nationwide survey of 2740 pregnant women. Archives of Women's Mental Health, 23(6), 757–765. https://doi.org/10.1007/s00737-020-01073-5
  • Nanjundaswamy, M. H., Shiva, L., Desai, G., Ganjekar, S., Kishore, T., Ram, U., Satyanarayana, V., Thippeswamy, H., & Chandra, P. S. (2020). COVID-19-related anxiety and concerns expressed by pregnant and postpartum women-a survey among obstetricians. Archives of Women's Mental Health, 23(6), 787–790. https://doi.org/10.1007/s00737-020-01060-w
  • Nomura, R., Tavares, I., Ubinha, A. C., Costa, M. L., Opperman, M. L., Brock, M., Ruano, R., et al. (2021). Impact of the COVID-19 pandemic on maternal anxiety in Brazil. Journal of Clinical Medicine, 10(4), 620. https://doi.org/10.3390/jcm10040620
  • Rezaei, F., Masaeli, Z., & Atighechian, G. (2021). Information needs of pregnant women in the COVID-19 pandemic from experts’ point of view: a qualitative study. International Journal of Community Based Nursing and Midwifery, 9(2), 139-151. https://doi.org/10.30476/IJCBNM.2021.87447.1432
  • Sun, F., Zhu, J., Tao, H., Ma, Y., & Jin, W. (2021). A systematic review involving 11,187 participants evaluating the impact of COVID-19 on anxiety and depression in pregnant women. Journal of Psychosomatic Obstetrics & Gynecology, 42(2), 91-99. https://doi.org/10.1080/0167482X.2020.1857360
  • Taubman–Ben-Ari, O., Chasson, M., Abu Sharkia, S., & Weiss, E. (2020). Distress and anxiety associated with COVID-19 among Jewish and Arab pregnant women in Israel. Journal of Reproductive and İnfant Psychology, 38(3), 340-348. https://doi.org/10.1080/02646838.2020.1786037
  • Yali, A. M., & Lobel, M. (1999). Coping and distress in pregnancy: an investigation of medically high risk women. Journal of Psychosomatic Obstetrics & Gynecology, 20(1), 39-52. https://doi.org/10.3109/01674829909075575
  • Yüksel, F., Akın, S., & Durna, Z. (2011). The Turkish adaptation of the “Revised Prenatal Distress Questionnaire”: a reliability/validity and factor analysis study. Journal of Education and Research in Nursing, 8(3), 43-51. Zhang, Y., Muyiduli, X., Wang, S., Jiang, W., Wu, J., Li, M., Yu, Y., et al. (2018). Prevalence and relevant factors of anxiety and depression among pregnant women in a cohort study from south-east China. Journal of Reproductive and İnfant Psychology, 36(5), 519-529. https://doi.org/10.1080/02646838.2018.1492098
  • Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361-370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x

The Relationship Between Coronavirus Anxiety and Hospital Anxiety of Pregnant Women Applying to the Hospital for Planned Cesarean Section

Year 2023, Volume: 9 Issue: 3, 89 - 99, 30.11.2023

Merve Coşkun Yasemin Uslu Seda Er Aslınur Çırçır

Abstract

Objective: To determine examine the relationship between coronavirus anxiety and hospital anxiety of pregnant women who applied to the hospital for planned cesarean section.
Design: This was a prospective descriptive study.
Setting: This study was conducted in the three university hospitals in Istanbul.
Participants: Sample consisted of a total of 142 women who applied for planned cesarean section between the gestational weeks 36-39.
Methods: Data were collected using the “Coronavirus Anxiety Scale”, the “Prenatal Distress Questionnaire”, and the “Hospital Anxiety and Depression Scale”.
Results: The mean age of the women was 32.14±4.25 years and the average period of gestation was 38.97±2.39 weeks. A moderately positive significant correlation was found between the coronavirus anxiety, prenatal distress, and hospital anxiety and depression scores of the pregnant women who participated in the study (p<0.001; r=0.493; r=0.393; r=0.413).
Conclusions: Pregnant women tend to increase their anxiety during the COVID-19 pandemic. It was found that the COVID-19 stress was higher in those who were diagnosed with COVID-19 in their family, used protective equipment more, and had relatives who would support them in the hospital; whereas, their stress increased the levels of hospital anxiety and prenatal distress.

Keywords

anxiety distress coronavirus COVID‐19 cesarean section

References

  • REFERENCES Anikwe, C. C., Ogah, C. O., Anikwe, I. H., Ewah, R. L., Onwe, O. E., & Ikeoha1c, C. C. (2021). Coronavirus 2019 pandemic: assessment of the level of knowledge, attitude, and anxiety among pregnant women in ebonyi state, nigeria. Annals of Medical and Health Sciences Research, 11(3), 1267-1273.
  • Aydemir, Ö., Güvenir, T., Küey, L., & Kültür, S. (1997). Validity and reliability of the Turkish version of Hospital Anxiety and Depression Scale. Turkish Journal of Psychiatry, 8(4), 280-287.
  • Aydın, R., Kızılkaya, T., Aytaç, S. H., & Taşlar, N. (2020). In COVID-19 Pandemic; social support requirements and midwifery approaches to women during pregnancy, childbirth and the postpartum period. Electronic Turkish Studies, 15(4), 679-690.
  • Becker, M., Weinberger, T., Chandy, A., & Schmukler, S. (2016). Depression during pregnancy and postpartum. Current Psychiatry Reports, 18(3), 1-9. https://doi.org/10.1007/s11920-016-0664-7
  • Brooks, S. K., Weston, D., & Greenberg, N. (2020). Psychological impact of infectious disease outbreaks on pregnant women: rapid evidence review. Public Health, 189, 26-36. https://doi.org/10.1101/2020.04.16.20068031
  • Chen, Y., Li, Z., Zhang, Y. Y., Zhao, W. H., & Yu, Z. Y. (2020a). Maternal health care management during the outbreak of coronavirus disease 2019. Journal of medical virology, 92(7), 731-739. https://doi.org/10.1002/jmv.25787 Chen, S., Zhuang, J., Chen, Q., & Tan, X. (2020b). Psychological investigation on pregnant women during the outbreak of COVID-19. Research Square, https://doi.org/10.21203/rs.3.rs-34763/v2
  • Craig, F., Gioia, M. C., Muggeo, V., Cajiao, J., Aloi, A., Martino, I., Tenuta, F., Cerasa, A., & Costabile, A. (2021). Effects of maternal psychological distress and perception of COVID-19 on prenatal attachment in a large sample of italian pregnant women. Journal of Affective Disorders, 295, 665–672. https://doi.org/10.1016/j. jad.2021.08.102
  • Davenport, M. H., McCurdy, A. P., Mottola, M. F., Skow, R. J., Meah, V. L., Poitras, V. J., Ruchat, S. M. et al. (2018). Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: a systematic review and meta-analysis. British Journal of Sports Medicine, 52(21), 1376-1385. http://dx.doi.org/10.1136/bjsports-2018-099697
  • Demir, E. T., & Kilic, F. (2020). Determination of the anxiety level in pregnant women who administer to the obstetrics clinic within the COVID-19 pandemia period. Selcuk Medical Journal, 36(4), 352-356. https://doi.org/10.30733/std.2020.01468
  • Dotters-Katz, S. K., & Hughes, B. L. 2020. Considerations for obstetric care during the COVID-19 pandemic. American Journal of Perinatology, 37,(08), 773-779. https://doi.org/10.1055/s-0040-1710051
  • Durankuş, F., & Aksu, E. (2020). Effects of the COVID-19 pandemic on anxiety and depressive symptoms in pregnant women: a preliminary study. The Journal of Maternal-Fetal & Neonatal Medicine, 35(2), 205-211
  • Effati-Daryani, F., Zarei, S., Mohammadi, A., Hemmati, E., Ghasemi Yngyknd, S., & Mirghafourvand, M. (2020). Depression, stress, anxiety and their predictors in Iranian pregnant women during the outbreak of COVID-19. BMC Psychology, 8(99), 1-10. https://doi.org/10.1186/s40359-020-00464-8
  • Evren, C., Evren, B., Dalbudak, E., Topcu, M., & Kutlu, N. (2020). Measuring anxiety related to COVID-19: a Turkish validation study of the Coronavirus Anxiety Scale. Death Studies, 1-7. https://doi.org/10.1080/07481187.2020.1774969
  • Holmes, E. A., O'Connor, R. C., Perry, V. H., Tracey, I., Wessely, S., Arseneault, L., Bullmore, E., et al. (2020). Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. The Lancet Psychiatry, 7(6), 547-560. https://doi.org/10.1016/S2215-0366(20)30168-1
  • Kahyaoglu Sut, H., & Kucukkaya, B. (2021). Anxiety, depression, and related factors in pregnant women during the COVID-19 pandemic in Turkey: A web-based cross-sectional study. Perspectives in psychiatric care, 57(2), 860–868. https://doi.org/10.1111/ppc.12627
  • Karaca, P. P., Koyucu, R. G., & Aksu, S. Ç. (2022). The relatıonshıp between pregnant women's anxıety levels about coronavırus and prenatal attachment. Archives of Psychiatric Nursing, 36, 78-84. https://doi.org/10.1016/j.apnu.2021.12.001
  • Lebel, C., MacKinnon, A., Bagshawe, M., Tomfohr-Madsen, L., & Giesbrecht, G. (2020). Elevated depression and anxiety among pregnant individuals during the COVID-19 pandemic. Journal of Affective Disorders, 277, 5-13. https://doi.org/10.1016/j.jad.2020.07.126
  • Lee, S. A. (2020). Coronavirus anxiety scale: a brief mental health screener for COVID-19 related anxiety. Death Studies, 1-9. 44(7), 393-401. https://doi.org/10.1080/07481187.2020.1748481
  • Liu, X., Chen, M., Wang, Y., Sun, L., Zhang, J., Shi, Y., Qi, H., et al. (2020). Prenatal anxiety and obstetric decisions among pregnant women in Wuhan and Chongqing during the COVID‐19 outbreak: a cross‐sectional study. BJOG: An International Journal of Obstetrics & Gynaecology, 127(10), 1229-1240. https://doi.org/10.1111/1471-0528.16381
  • Lu, R., Zhao, X., Li, J., Niu, P., Yang, B., Wu, H., Tan, W., et al. (2020). Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. The Lancet, 395(10224), 565-574. https://doi.org/10.1016/S0140-6736(20)30251-8
  • Moyer, C. A., Compton, S. D., Kaselitz, E., & Muzik, M. (2020). Pregnancy-related anxiety during COVID-19: a nationwide survey of 2740 pregnant women. Archives of Women's Mental Health, 23(6), 757–765. https://doi.org/10.1007/s00737-020-01073-5
  • Nanjundaswamy, M. H., Shiva, L., Desai, G., Ganjekar, S., Kishore, T., Ram, U., Satyanarayana, V., Thippeswamy, H., & Chandra, P. S. (2020). COVID-19-related anxiety and concerns expressed by pregnant and postpartum women-a survey among obstetricians. Archives of Women's Mental Health, 23(6), 787–790. https://doi.org/10.1007/s00737-020-01060-w
  • Nomura, R., Tavares, I., Ubinha, A. C., Costa, M. L., Opperman, M. L., Brock, M., Ruano, R., et al. (2021). Impact of the COVID-19 pandemic on maternal anxiety in Brazil. Journal of Clinical Medicine, 10(4), 620. https://doi.org/10.3390/jcm10040620
  • Rezaei, F., Masaeli, Z., & Atighechian, G. (2021). Information needs of pregnant women in the COVID-19 pandemic from experts’ point of view: a qualitative study. International Journal of Community Based Nursing and Midwifery, 9(2), 139-151. https://doi.org/10.30476/IJCBNM.2021.87447.1432
  • Sun, F., Zhu, J., Tao, H., Ma, Y., & Jin, W. (2021). A systematic review involving 11,187 participants evaluating the impact of COVID-19 on anxiety and depression in pregnant women. Journal of Psychosomatic Obstetrics & Gynecology, 42(2), 91-99. https://doi.org/10.1080/0167482X.2020.1857360
  • Taubman–Ben-Ari, O., Chasson, M., Abu Sharkia, S., & Weiss, E. (2020). Distress and anxiety associated with COVID-19 among Jewish and Arab pregnant women in Israel. Journal of Reproductive and İnfant Psychology, 38(3), 340-348. https://doi.org/10.1080/02646838.2020.1786037
  • Yali, A. M., & Lobel, M. (1999). Coping and distress in pregnancy: an investigation of medically high risk women. Journal of Psychosomatic Obstetrics & Gynecology, 20(1), 39-52. https://doi.org/10.3109/01674829909075575
  • Yüksel, F., Akın, S., & Durna, Z. (2011). The Turkish adaptation of the “Revised Prenatal Distress Questionnaire”: a reliability/validity and factor analysis study. Journal of Education and Research in Nursing, 8(3), 43-51. Zhang, Y., Muyiduli, X., Wang, S., Jiang, W., Wu, J., Li, M., Yu, Y., et al. (2018). Prevalence and relevant factors of anxiety and depression among pregnant women in a cohort study from south-east China. Journal of Reproductive and İnfant Psychology, 36(5), 519-529. https://doi.org/10.1080/02646838.2018.1492098
  • Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361-370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x
There are 29 citations in total.

Details

Primary Language English
Subjects Obstetrics and Gynocology Nursing
Journal Section Araştırma Makele
Authors

Merve Coşkun 0000-0003-3811-5105

Yasemin Uslu 0000-0001-5727-3753

Seda Er 0000-0003-1984-8071

Aslınur Çırçır This is me 0000-0003-2424-7676

Publication Date November 30, 2023
Submission Date November 15, 2023
Acceptance Date November 29, 2023
Published in Issue Year 2023 Volume: 9 Issue: 3

Cite

APA Coşkun, M., Uslu, Y., Er, S., Çırçır, A. (2023). The Relationship Between Coronavirus Anxiety and Hospital Anxiety of Pregnant Women Applying to the Hospital for Planned Cesarean Section. Kadın Sağlığı Hemşireliği Dergisi, 9(3), 89-99.
AMA Coşkun M, Uslu Y, Er S, Çırçır A. The Relationship Between Coronavirus Anxiety and Hospital Anxiety of Pregnant Women Applying to the Hospital for Planned Cesarean Section. KASHED. November 2023;9(3):89-99.
Chicago Coşkun, Merve, Yasemin Uslu, Seda Er, and Aslınur Çırçır. “The Relationship Between Coronavirus Anxiety and Hospital Anxiety of Pregnant Women Applying to the Hospital for Planned Cesarean Section”. Kadın Sağlığı Hemşireliği Dergisi 9, no. 3 (November 2023): 89-99.
EndNote Coşkun M, Uslu Y, Er S, Çırçır A (November 1, 2023) The Relationship Between Coronavirus Anxiety and Hospital Anxiety of Pregnant Women Applying to the Hospital for Planned Cesarean Section. Kadın Sağlığı Hemşireliği Dergisi 9 3 89–99.
IEEE M. Coşkun, Y. Uslu, S. Er, and A. Çırçır, “The Relationship Between Coronavirus Anxiety and Hospital Anxiety of Pregnant Women Applying to the Hospital for Planned Cesarean Section”, KASHED, vol. 9, no. 3, pp. 89–99, 2023.
ISNAD Coşkun, Merve et al. “The Relationship Between Coronavirus Anxiety and Hospital Anxiety of Pregnant Women Applying to the Hospital for Planned Cesarean Section”. Kadın Sağlığı Hemşireliği Dergisi 9/3 (November 2023), 89-99.
JAMA Coşkun M, Uslu Y, Er S, Çırçır A. The Relationship Between Coronavirus Anxiety and Hospital Anxiety of Pregnant Women Applying to the Hospital for Planned Cesarean Section. KASHED. 2023;9:89–99.
MLA Coşkun, Merve et al. “The Relationship Between Coronavirus Anxiety and Hospital Anxiety of Pregnant Women Applying to the Hospital for Planned Cesarean Section”. Kadın Sağlığı Hemşireliği Dergisi, vol. 9, no. 3, 2023, pp. 89-99.
Vancouver Coşkun M, Uslu Y, Er S, Çırçır A. The Relationship Between Coronavirus Anxiety and Hospital Anxiety of Pregnant Women Applying to the Hospital for Planned Cesarean Section. KASHED. 2023;9(3):89-9.
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