Research Article
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Disaster Preparedness of Generation Y Nurses and Related Factors

Year 2025, Volume: 5 Issue: 1, 24 - 37, 30.04.2025
https://doi.org/10.56061/fbujohs.1395036

Abstract

Generation Y nurses constitute the majority of hospital staff. Therefore, it is important to determine the influencing factors by understanding their core competencies in the event of a disaster. The purpose of this study is to determine the core competencies of Generation Y nurses in disaster situations and to compare their personal and professional characteristics and experiences in disaster situations. The study was designed as a descriptive cross-sectional study with an online survey that included demographic information and the Nurses’ Perceptions of Disaster Core Competencies Scale and conducted with 408 participants. The mean score of Generation Y nurses on the NPDCC was 151.18±30.11, and according to the subscales, they scored the highest on infectious diseases and outbreaks (6.04±3.04) and the lowest on nuclear accident preparedness (3.21±2.26). Educational level and the institution in which they work were found to be statistically significant differences in overall NPDCC in comparisons by nurses’ personal and professional characteristics, with postgraduates and nurses working in a university hospital scoring higher (p<.01). However, the marital status, position and unit variables did not cause a statistically significant difference in the overall NPDCC score (p>.05). It is recommended that disaster core competency training programmes take into account generational differences.

Ethical Statement

Ethical approval was obtained from the Ethics Committee of Social and Humanities Research of Istanbul University-Cerrahpaşa in order to conduct the research (Date: 16.03.2020 Number: 74555795-050.01.04).

Supporting Institution

Authors did not accept any funding from public or private facilities for performing this study.

Thanks

We are thankful to the nurses who participated to this study.

References

  • Adıgüzel, O., Batur, H.Z., & Ekşili, N. (2014). Generation's changing side and the newly arisen work style after Y-generation: Mobile collars. Suleyman Demirel University Journal of Social Sciences Institute, 1(19), 165-182.
  • Akdemir, A., Konakay, G., Demirkaya, H., et al. (2013). The investigation of relationship between organizational an investigation of expectations of career perception and change, and leadership style of generation Y. Muğla Sıtkı Koçman University Faculty of Economics and Administrative Sciences Journal of Economics and Management Research, 2(2), 11-44.
  • Alan, H., Taskiran Eskici, G., Tiryaki Sen, H., & Eskin Bacaksiz, F. (2022) Nurses’ disaster core competencies and resilience during the COVID-19 pandemic: A cross-sectional study from Turkey. J Nurs Manag., 30, 622–632. https://doi.org/10.1111/jonm.13552
  • Alzahrani, F., & Kyratsis, Y. (2017). Emergency nurse disaster preparedness during mass gatherings: A cross-sectional survey of emergency nurses’ perceptions in hospitals in Mecca, Saudi Arabia. BMJ Open, 7(4), 1–9. https://doi.org/10.1136/bmjopen-2016-013563
  • Aydın, Ç.G., & Başol, O. (2014). X and Y generation: Is there a change in the meaning of work?. Electronic Journal of Vocational Colleges, 1-15.
  • Azadi, A., Sahebi, A., & Tavan, H. (2018). The attitudes, knowledge and performance of Ilam nurses regarding disaster preparedness. Health in Emergencies and Disasters Quarterly, 3(2), 105–112. https://doi.org/10.29252/nrip.hdq.3.2.105
  • Basal, A.A., & Ahmed, R.E. (2018). Perception of nurses’ regarding role, preparedness and management skills during hospital disasters. International Journal of Novel Research in Healthcare and Nursing, 5(1), 151–161. https://doi.org/10.13140/RG.2.2.31584.58886.
  • Başoğlu, M., & Durmaz Edeer, A. (2017). Comparison of generation X and Y nurses and student nurses’ individual innovativeness awareness. Gümüşhane University Journal of Health Sciences, 6(4),77-84.
  • Celik, F. (2010). Disaster preparedness status of nurses working at Turkish Red Crescent. Unpublished master's thesis, Istanbul University Institute of Health Sciences, Istanbul.
  • Chegini, Z., Arab-Zozani, M., Kakemam, E., Lotfi, M., Nobakht, A., & Karkan, H.A. (2022). Disaster preparedness and core competencies among emergency nurses: A cross-sectional study. Nursing Open, 9(2), 1294–1302, https://doi.org/10.1002/nop2.1172
  • Chicca, J., & Shellenbarger, T. (2018). Generation Z: Approaches and teaching–learning practices for nursing professional development practitioners. Journal for Nurses in Professional Development, 34(5), 250-256. https://doi.org/10.1097/NND.0000000000000478
  • Disaster and Emergency Management Presidency. Disaster management and natural disaster statistics in Turkey (2021). Accessed: 19.08.2022, https://www.afad.gov.tr/afet-istatistikleri
  • Durgut, U., & Yildiz, T. (2022). Adaptation of the competencies for disaster nursing management questionnaire: Turkish version. Disaster Medicine and Public Health Preparedness, 16(4), 1496-1502. https://doi.org/10.1017/dmp.2021.160
  • Far, S.S., Marzaleh, M.A., Shokrpour, N., & Ravangard, R. (2020). Nurses’ knowledge, attitude, and performance about disaster management: A case of Iran. The Open Public Health Journal, 13(1). https://doi.org/10.2174/1874944502013010441
  • Firouzkouhi, M., Kako, M., Abdollahimohammad, A., Balouchi, A., & Farzi, J. (2021). Nurses' roles in nursing disaster model: A systematic scoping review. Iranian Journal of Public Health, 50(5), 879– 887. https://doi.org/10.18502/ijph.v50i5.6105
  • Gutierrez, A.P., Candela, L.L., & Carver, L. (2012). The structural relationships between organizational commitment, global job satisfaction, developmental experiences, work values, organizational support, and person-organization fit among nursing faculty. Journal of Advanced Nursing, 68(7), 1601-1614. https://doi.org/10.1111/j.1365-2648.2012.05990.x
  • Hahn, J.A. (2011). Managing multiple generations: Scenarios from the workplace. Nursing Forum, 46(3): 119-127. https://doi.org/10.1111/j.1744-6198.2011.00223.x
  • Hamouda, G.M. (2018). A comparative study to assess nurses’ perceptions toward the disaster management process in Alexandria and Jeddah cities, IOSR J. Nurs. Health Sci., 7(5), 21–30. https://doi.org/10.9790/1959-0705122130
  • Hasan, M.K., Younos, T.B., & Farid, Z. (2021). Nurses' knowledge, skills and preparedness for disaster management of a Megapolis: Implications for nursing disaster education. Nurse Education Today. 107, 105-122. https://doi.org/10.1016/j.nedt.2021.105122
  • Hutchinson, D., Brown, J., & Longworth, K. (2012). Attracting and maintaining the Y generation in nursing: A literature review. Journal of Nursing Managemen, 20, 444-450. doi:10.1111/j.1365-2834.2011.01203.x
  • International Federation of Red Cross and Red Crescent (IFRC) 2015 Word Disasters Report. Accessed: 19.08.2021, http://ifrc-media.org/interactive/world-disasters-report-2015/
  • International Federation of Red Cross and Red Crescent (IFRC). 2020. Word Disasters Report. Accessed: 19.08.2022, https://www.ifrc.org/sites/default/files/2021-05/20201116_WorldDisasters_Full.pdf
  • Iytemur, A., & Yesil, S.T. (2020). Examining the opinions of nurses working in a university hospital about hospital disaster and emergency plans. Journal of Hacettepe University Faculty of Nursing. 2020;7(2):138-148. Jeong, S., & Lee, O. (2020). Correlations between emergency code awareness and disaster nursing competencies among clinical nurses: A cross-sectional study. J. Nurs. Manag, 28(6), 1326–1334. https://doi.org/10.1111/jonm.13086
  • Kalanlar, B. (2018). Effects of disaster nursing education on nursing students’ knowledge and preparedness for disasters. International Journal of Disaster Risk Reduction, 28, 475-480. https://doi.org/10.1016/j.ijdrr.2017.12.008
  • Labrague, L.J., Hammad, K., Gloe, D.S., et al. (2018). Disaster preparedness among nurses: A systematic review of literature. Int. Nurs. Rev., 65(1), 41–53. https://doi.org/10.1111/inr.12369.
  • Labrague, L.J., Yboa, B.C., McEnroe–Petitte, D.M., Lobrino, L.R., & Brennan, M.G.B. (2016). Disaster preparedness in Philippine nurses. Journal of nursing scholarship, 48(1), 98-105. https://doi.org/10.1111/jnu.12186
  • Lam, R.P.K., Balsari, S., Hung, K.K.C., et al. (2018). How do doctors and nurses in emergency departments in Hong Kong view their disaster? A cross-sectional territory wide online survey. Disaster Med. Public Health Prep., 12(3), 329–336. https://doi.org/10.1017/dmp.2017
  • Maleki, L., Moghadamnia, M.T., Porshikhian, M., & Kazemnejad, E. (2018). Evaluatıon of the factors predicting nurses’ attitude to phase of preparedness to respond to disasters. Revista Latinoamericana de Hipertension, 13 (6): 538–543.
  • Martono, M., Satino, S., Nursalam, N., Efendi, F., & Bushy, A. (2019). Indonesian nurses’ perception of disaster management preparedness. Chin. J. Traumatol, 22(1), 41–46. https://doi.org/10.1016/j.cjtee.2018.09.002. Özyer, Y., & Dinçer, S. (2020). Psychological first-aid roles of nurses in disasters. Journal of Social Sciences, 7, 198-206. https://doi.org/10.21733/ibad.650795
  • Park, H.Y., & Kim, J.S. (2017). Factors influencing disaster nursing core competencies of emergency nurses. Applied Nursing Research, 37,1-5. . https://doi.org/10.1016/j.apnr.2017.06.004
  • Piper, L.E. (2012). Generation Y in healthcare: Leading millennials in an era of reform. Frontiers of Health Services Management, 29(1), 16-28. https://doi.org/10.1097/01974520-201207000-00003
  • Rickes, P.S. (2016). Generation in flux: How Gen Z will continue to transform higher education space. Planning for Higher Education Journal, 44(4), 21–45.
  • Rizqillah, A.F., & Suna, J. (2018). Indonesian emergency nurses’ preparedness to respond to disaster: A descriptive survey. Australas Emerg Care, 21(2), 64–68. https://doi.org/10.1016/j.auec.2018.04.001
  • Sangkala, M, & Gerdtz, M. (2018). Disaster preparedness and learning needs among community health nurse coordinators in South Sulawesi Indonesia, Australas. Emerg. Nurs. J., 21, 23–30. https://doi.org/10.1016/j.auec.2017.11.002.
  • Seyedin, H., Dolatabadi, Z.A., & Rajabifard, F. (2015). Emergency nurses’ requirements for disaster preparedness, Trauma Mon, 20 (4), e29033. https://doi.org/10.5812/traumamon.29033.
  • Sherman, R.O. (2015). Recruiting and retaining generation Y perioperative nurses. AORN Journal, 101(1), 138-143. https://doi.org/10.1016/j.aorn.
  • Taşkiran, G., & Baykal, U. (2017). Disasters and nurses’ preparedness for disasters in Turkey: Literature review. Journal of Health and Nursing Management, 4(2), 79-88. https://doi.org/ 10.5222/SHYD.2017.079
  • Taskiran, G., & Baykal, U. (2019). Nurses’ disaster preparedness and core competencies in Turkey: A descriptive correlational design. International Nursing Review, 66(2), 165–175. https://doi.org/10.1111/inr.12501
  • Tzeng, W.C., Feng, H.P., Cheng, W.T., et al. (2016). Readiness of hospital nurses for disaster response in Taiwan: A cross-sectional study. Nurse, Educ. Today, 47, 37–42. https://doi.org/10.1016/j.nedt.2016.02.025
  • Usher, K., Mills, J., West, C., et al. (2015). Cross-Sectional survey of the disaster preparedness of nurses across the Asia-Pacific Region. Nurs. Health Sci. 17 (4), 434–443. https://doi.org/10.1111/nhs.12211
  • World Health Organization (WHO); International Council of Nursing (ICN) (2009) ICN Framework of Disaster Nursing Competencies. World Health Organization, Geneva, Switzerland
  • Zeren, F. (2019). Preparedness to disasters of nurses who works at Bezmialem Foundation University hospitals. Unpublished master's thesis, Bezmialem Foundation University Institute of Health Sciences, Istanbul.

Y Kuşağı Hemşirelerin Afetlere Hazırlık Durumu ve İlgili Faktörler

Year 2025, Volume: 5 Issue: 1, 24 - 37, 30.04.2025
https://doi.org/10.56061/fbujohs.1395036

Abstract

Y kuşağı hemşireler hastanelerdeki en büyük insan işgücünü oluşturmaktadır. Bu nedenle afet temel yetkinliklerini anlayarak etkileyen faktörlerin belirlenmesi önemlidir. Bu çalışmanın amacı, Y kuşağı hemşirelerinin afet temel yeterliliklerini belirlemek, kişisel, mesleki ve afet deneyimi özelliklerini karşılaştırmaktır.
Araştırma, demografik bilgileri içeren çevrimiçi bir anket ve Hemşirelerin Afet Temel Yeterlik Algıları Ölçeği kullanılarak kesitsel, tanımlayıcı ve korelasyonel bir çalışma olarak tasarlandı. Araştırma 408 katılımcıyla gerçekleştirildi. Y kuşağı hemşirelerin NPDCC puan ortalaması 151,18 ± 30,11 oldu. Alt ölçeklere göre en yüksek puanı bulaşıcı hastalıklar ve salgınlardan (6,04±3,04), en düşük puanı ise nükleer kazalara hazırlıktan (3,21±2,26) aldılar. Afet temel yeterliliklerine ilişkin eğitim programlarının nesiller arası farklılıkları dikkate alması önerilir.

References

  • Adıgüzel, O., Batur, H.Z., & Ekşili, N. (2014). Generation's changing side and the newly arisen work style after Y-generation: Mobile collars. Suleyman Demirel University Journal of Social Sciences Institute, 1(19), 165-182.
  • Akdemir, A., Konakay, G., Demirkaya, H., et al. (2013). The investigation of relationship between organizational an investigation of expectations of career perception and change, and leadership style of generation Y. Muğla Sıtkı Koçman University Faculty of Economics and Administrative Sciences Journal of Economics and Management Research, 2(2), 11-44.
  • Alan, H., Taskiran Eskici, G., Tiryaki Sen, H., & Eskin Bacaksiz, F. (2022) Nurses’ disaster core competencies and resilience during the COVID-19 pandemic: A cross-sectional study from Turkey. J Nurs Manag., 30, 622–632. https://doi.org/10.1111/jonm.13552
  • Alzahrani, F., & Kyratsis, Y. (2017). Emergency nurse disaster preparedness during mass gatherings: A cross-sectional survey of emergency nurses’ perceptions in hospitals in Mecca, Saudi Arabia. BMJ Open, 7(4), 1–9. https://doi.org/10.1136/bmjopen-2016-013563
  • Aydın, Ç.G., & Başol, O. (2014). X and Y generation: Is there a change in the meaning of work?. Electronic Journal of Vocational Colleges, 1-15.
  • Azadi, A., Sahebi, A., & Tavan, H. (2018). The attitudes, knowledge and performance of Ilam nurses regarding disaster preparedness. Health in Emergencies and Disasters Quarterly, 3(2), 105–112. https://doi.org/10.29252/nrip.hdq.3.2.105
  • Basal, A.A., & Ahmed, R.E. (2018). Perception of nurses’ regarding role, preparedness and management skills during hospital disasters. International Journal of Novel Research in Healthcare and Nursing, 5(1), 151–161. https://doi.org/10.13140/RG.2.2.31584.58886.
  • Başoğlu, M., & Durmaz Edeer, A. (2017). Comparison of generation X and Y nurses and student nurses’ individual innovativeness awareness. Gümüşhane University Journal of Health Sciences, 6(4),77-84.
  • Celik, F. (2010). Disaster preparedness status of nurses working at Turkish Red Crescent. Unpublished master's thesis, Istanbul University Institute of Health Sciences, Istanbul.
  • Chegini, Z., Arab-Zozani, M., Kakemam, E., Lotfi, M., Nobakht, A., & Karkan, H.A. (2022). Disaster preparedness and core competencies among emergency nurses: A cross-sectional study. Nursing Open, 9(2), 1294–1302, https://doi.org/10.1002/nop2.1172
  • Chicca, J., & Shellenbarger, T. (2018). Generation Z: Approaches and teaching–learning practices for nursing professional development practitioners. Journal for Nurses in Professional Development, 34(5), 250-256. https://doi.org/10.1097/NND.0000000000000478
  • Disaster and Emergency Management Presidency. Disaster management and natural disaster statistics in Turkey (2021). Accessed: 19.08.2022, https://www.afad.gov.tr/afet-istatistikleri
  • Durgut, U., & Yildiz, T. (2022). Adaptation of the competencies for disaster nursing management questionnaire: Turkish version. Disaster Medicine and Public Health Preparedness, 16(4), 1496-1502. https://doi.org/10.1017/dmp.2021.160
  • Far, S.S., Marzaleh, M.A., Shokrpour, N., & Ravangard, R. (2020). Nurses’ knowledge, attitude, and performance about disaster management: A case of Iran. The Open Public Health Journal, 13(1). https://doi.org/10.2174/1874944502013010441
  • Firouzkouhi, M., Kako, M., Abdollahimohammad, A., Balouchi, A., & Farzi, J. (2021). Nurses' roles in nursing disaster model: A systematic scoping review. Iranian Journal of Public Health, 50(5), 879– 887. https://doi.org/10.18502/ijph.v50i5.6105
  • Gutierrez, A.P., Candela, L.L., & Carver, L. (2012). The structural relationships between organizational commitment, global job satisfaction, developmental experiences, work values, organizational support, and person-organization fit among nursing faculty. Journal of Advanced Nursing, 68(7), 1601-1614. https://doi.org/10.1111/j.1365-2648.2012.05990.x
  • Hahn, J.A. (2011). Managing multiple generations: Scenarios from the workplace. Nursing Forum, 46(3): 119-127. https://doi.org/10.1111/j.1744-6198.2011.00223.x
  • Hamouda, G.M. (2018). A comparative study to assess nurses’ perceptions toward the disaster management process in Alexandria and Jeddah cities, IOSR J. Nurs. Health Sci., 7(5), 21–30. https://doi.org/10.9790/1959-0705122130
  • Hasan, M.K., Younos, T.B., & Farid, Z. (2021). Nurses' knowledge, skills and preparedness for disaster management of a Megapolis: Implications for nursing disaster education. Nurse Education Today. 107, 105-122. https://doi.org/10.1016/j.nedt.2021.105122
  • Hutchinson, D., Brown, J., & Longworth, K. (2012). Attracting and maintaining the Y generation in nursing: A literature review. Journal of Nursing Managemen, 20, 444-450. doi:10.1111/j.1365-2834.2011.01203.x
  • International Federation of Red Cross and Red Crescent (IFRC) 2015 Word Disasters Report. Accessed: 19.08.2021, http://ifrc-media.org/interactive/world-disasters-report-2015/
  • International Federation of Red Cross and Red Crescent (IFRC). 2020. Word Disasters Report. Accessed: 19.08.2022, https://www.ifrc.org/sites/default/files/2021-05/20201116_WorldDisasters_Full.pdf
  • Iytemur, A., & Yesil, S.T. (2020). Examining the opinions of nurses working in a university hospital about hospital disaster and emergency plans. Journal of Hacettepe University Faculty of Nursing. 2020;7(2):138-148. Jeong, S., & Lee, O. (2020). Correlations between emergency code awareness and disaster nursing competencies among clinical nurses: A cross-sectional study. J. Nurs. Manag, 28(6), 1326–1334. https://doi.org/10.1111/jonm.13086
  • Kalanlar, B. (2018). Effects of disaster nursing education on nursing students’ knowledge and preparedness for disasters. International Journal of Disaster Risk Reduction, 28, 475-480. https://doi.org/10.1016/j.ijdrr.2017.12.008
  • Labrague, L.J., Hammad, K., Gloe, D.S., et al. (2018). Disaster preparedness among nurses: A systematic review of literature. Int. Nurs. Rev., 65(1), 41–53. https://doi.org/10.1111/inr.12369.
  • Labrague, L.J., Yboa, B.C., McEnroe–Petitte, D.M., Lobrino, L.R., & Brennan, M.G.B. (2016). Disaster preparedness in Philippine nurses. Journal of nursing scholarship, 48(1), 98-105. https://doi.org/10.1111/jnu.12186
  • Lam, R.P.K., Balsari, S., Hung, K.K.C., et al. (2018). How do doctors and nurses in emergency departments in Hong Kong view their disaster? A cross-sectional territory wide online survey. Disaster Med. Public Health Prep., 12(3), 329–336. https://doi.org/10.1017/dmp.2017
  • Maleki, L., Moghadamnia, M.T., Porshikhian, M., & Kazemnejad, E. (2018). Evaluatıon of the factors predicting nurses’ attitude to phase of preparedness to respond to disasters. Revista Latinoamericana de Hipertension, 13 (6): 538–543.
  • Martono, M., Satino, S., Nursalam, N., Efendi, F., & Bushy, A. (2019). Indonesian nurses’ perception of disaster management preparedness. Chin. J. Traumatol, 22(1), 41–46. https://doi.org/10.1016/j.cjtee.2018.09.002. Özyer, Y., & Dinçer, S. (2020). Psychological first-aid roles of nurses in disasters. Journal of Social Sciences, 7, 198-206. https://doi.org/10.21733/ibad.650795
  • Park, H.Y., & Kim, J.S. (2017). Factors influencing disaster nursing core competencies of emergency nurses. Applied Nursing Research, 37,1-5. . https://doi.org/10.1016/j.apnr.2017.06.004
  • Piper, L.E. (2012). Generation Y in healthcare: Leading millennials in an era of reform. Frontiers of Health Services Management, 29(1), 16-28. https://doi.org/10.1097/01974520-201207000-00003
  • Rickes, P.S. (2016). Generation in flux: How Gen Z will continue to transform higher education space. Planning for Higher Education Journal, 44(4), 21–45.
  • Rizqillah, A.F., & Suna, J. (2018). Indonesian emergency nurses’ preparedness to respond to disaster: A descriptive survey. Australas Emerg Care, 21(2), 64–68. https://doi.org/10.1016/j.auec.2018.04.001
  • Sangkala, M, & Gerdtz, M. (2018). Disaster preparedness and learning needs among community health nurse coordinators in South Sulawesi Indonesia, Australas. Emerg. Nurs. J., 21, 23–30. https://doi.org/10.1016/j.auec.2017.11.002.
  • Seyedin, H., Dolatabadi, Z.A., & Rajabifard, F. (2015). Emergency nurses’ requirements for disaster preparedness, Trauma Mon, 20 (4), e29033. https://doi.org/10.5812/traumamon.29033.
  • Sherman, R.O. (2015). Recruiting and retaining generation Y perioperative nurses. AORN Journal, 101(1), 138-143. https://doi.org/10.1016/j.aorn.
  • Taşkiran, G., & Baykal, U. (2017). Disasters and nurses’ preparedness for disasters in Turkey: Literature review. Journal of Health and Nursing Management, 4(2), 79-88. https://doi.org/ 10.5222/SHYD.2017.079
  • Taskiran, G., & Baykal, U. (2019). Nurses’ disaster preparedness and core competencies in Turkey: A descriptive correlational design. International Nursing Review, 66(2), 165–175. https://doi.org/10.1111/inr.12501
  • Tzeng, W.C., Feng, H.P., Cheng, W.T., et al. (2016). Readiness of hospital nurses for disaster response in Taiwan: A cross-sectional study. Nurse, Educ. Today, 47, 37–42. https://doi.org/10.1016/j.nedt.2016.02.025
  • Usher, K., Mills, J., West, C., et al. (2015). Cross-Sectional survey of the disaster preparedness of nurses across the Asia-Pacific Region. Nurs. Health Sci. 17 (4), 434–443. https://doi.org/10.1111/nhs.12211
  • World Health Organization (WHO); International Council of Nursing (ICN) (2009) ICN Framework of Disaster Nursing Competencies. World Health Organization, Geneva, Switzerland
  • Zeren, F. (2019). Preparedness to disasters of nurses who works at Bezmialem Foundation University hospitals. Unpublished master's thesis, Bezmialem Foundation University Institute of Health Sciences, Istanbul.
There are 42 citations in total.

Details

Primary Language English
Subjects Nursing Management
Journal Section Research Articles
Authors

Yunus Şimşek 0000-0003-3920-322X

Handan Alan 0000-0001-7414-2288

Publication Date April 30, 2025
Submission Date November 23, 2023
Acceptance Date April 4, 2024
Published in Issue Year 2025 Volume: 5 Issue: 1

Cite

APA Şimşek, Y., & Alan, H. (2025). Disaster Preparedness of Generation Y Nurses and Related Factors. Fenerbahçe University Journal of Health Sciences, 5(1), 24-37. https://doi.org/10.56061/fbujohs.1395036