Klinik Araştırma
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İkincil Travmatik Stres: Ebeler Ne Kadar Dayanıklıdır? Etkileyen Faktörler Nelerdir?

Yıl 2023, Cilt: 3 Sayı: 1, 61 - 74, 31.01.2023

Öz

Amaç: Ebeler, travmatik doğumlara tanık olma açısından ikincil travmatik stres yaşama riski taşıyan önemli bir gruptur. Bu çalışmada, ebelerin ikincil travmatik stres deneyimlerinin belirlenmesi, psikolojik dayanıklılık düzeyleri ve diğer bazı faktörlerle ilişkisinin ortaya konulması amaçlanmıştır.
Yöntem: Kesitsel ve tanımlayıcı özellikte bir çalışmadır. Çalışma grubu 502 ebeden oluşmuştur. Verileri toplamak için Kişisel Bilgi Formu, İkincil Travmatik Stres Ölçeği ve Yetişkinler için Dayanıklılık Ölçeği olmak üzere üç ayrı form kullanılmıştır.
Bulgular: Çalışmamızda ebelerin ikincil travmatik stres toplam puanı yüksek, dayanıklılık ölçeği toplam puanı ise düşük düzeyde tespit edilmiştir (sırasıyla 53,10 17,97; 135,52 32,06). Ebelerin yaşı, eğitim düzeyi, medeni durumu, mesleğini sevme durumları, çalışma süresi, mesleki gelecekleri hakkındaki düşüncelerine ve psikososyal hizmet içi eğitim alma durumuna göre ikincil travmatik stres ve psikolojik dayanıklılık ölçeği puanları açısından istatistiksel olarak anlamlı farklılık tespit edilmiştir (p<0,05). İkincil travmatik stres ölçeği ile psikolojik dayanıklılık ölçeği puanları arasında negatif yönde, yüksek derecede ve istatistiksel olarak anlamlı bir ilişki tespit edildi (r=-0,752; p=0,000).
Sonuç: Çalışmamızda daha genç, düşük eğitim seviyesine sahip, bekâr, mesleğini sevmeyen, mesleki deneyimi az olan, mesleğinden istifa etmek isteyen, psikososyal hizmet içi eğitim almayan ebelerin ikincil travmalardan etkilenme konusunda daha fazla risk altında olduğu bulunmuştur. Ebelerin psikolojik dayanıklılığın artmasıyla, ikincil travmatik stresin azaldığı tespit edilmiştir. Bu bulgu, psikolojik dayanıklılığın arttırılması yoluyla ebelerin ikincil travmanın olumsuz etkilerine karşı korunabileceğini göstermesi bakımından önem taşımaktadır. Ayrıca bu çalışma, ebelik stresini azaltmayı ve başa çıkma mekanizmalarını iyileştirmeyi amaçlayan müdahaleler geliştirmeye ışık tutabilir.

Kaynakça

  • 1. Kâhil A, Palabıyıkoğlu NR. Secondary traumatic stress. Current Approaches in Psychiatry. 2018;10(1):59-70 doi: 10.18863/pgy.
  • 2. Leinweber J, Rowe HJ. The costs of being with the woman: secondary traumatic stress in midwifery. Midwifery. 2010;26(1):76-87. org/10.1016/j.midw.2008.04.003.
  • 3. Cohen R, Leykin D, Golan-Hadari D, Lahad M. Exposure to traumatic events at work, posttraumatic symptoms and professional quality of life among midwives. Midwifery. 2017;50:1-8 https://doi.org/10.1016/j.midw.2017.03.009.
  • 4. Kerkman T, Dijksman LM, Baas MA, Evers R, Van Pampus MG, Stramrood CA. Traumatic experiences and the midwifery profession: a cross‐sectional study among dutch midwives. Journal of Midwifery & Women's Health. 2019;64:435-42. https://doi.org/10.1111/jmwh.12946
  • 5. Cheung T, Fong TK. Bressington D. COVID‐19 under the SARS cloud: mental health nursing during the pandemic in hong kong. Journal of Psychiatr Mental Health Nursing. 2020. doi.org/10.1111/jpm.12639
  • 6. Ghasempour, M., & Purabdollah, M. Necessity of attention to mental health of the front line nurses against COVID-19: a forgotten requirement. International Journal of Community Based Nursing & Midwifery. 2020. http://ijcbnm.sums.ac.ir/article_46528_1ee7785829ae046c2d3d41573dc2380d
  • 7. Toohill J, Fenwick J, Sidebotham M, Gamble J, Creedy DK. Trauma and fear in Australian midwives. Women and Birth. 2019;32(1);64-71. https://doi.org/10.1016/j.wombi.2018.04.003.
  • 8. Pezaro S, Clyne W, Turner A, Fulton EA, Gerada C. Midwives overboard! Inside their hearts are breaking, their makeup may be flaking but their smile still stays on. Women and Birth. 2016;29(3):e59-e66. https://doi.org/10.1016/j.wombi.2015.10.006.
  • 9. Rice H, Warland J. Bearing witness: Midwives experiences of witnessing traumatic birth. Midwifery. 2013;(29)9:1056-63. https://doi.org/10.1016/j.midw.2012.12.003.
  • 10. Oe M, Ishida T, Favrod C, Martin-Soelch C, Horsch A. Burnout, psychological symptoms, and secondary traumatic stress among midwives working on perinatal wards: a cross-cultural study between japan and switzerland. front. Psychiatry. 2018;9:387. doi: 10.3389/fpsyt.2018.00387
  • 11. Halperin O, Goldblatt H, Noble A, Raz I, Zvulunov I. Liebergall Wischnitzer M. Stressful childbirth situations: a qualitative study of midwives. Journal of Midwifery & Women's Health. 2011;56:388-94. https://doi.org/10.1111/j.1542-2011.2011.00030.x
  • 12. Patterson J. Traumatised midwives; traumatised women. AIMS Journal. 2019;30(4). ISSN:2516-5852.
  • 13. Çankaya S, Erkal-Aksoy Y, Dereli-Yılmaz S. Traumatic birth experiences of midwives: A qualitative study. Authorea. 2020;22. DOI: 10.22541/au.159015243.35248716/v2
  • 14. Townsend SM, Campbell R. Organizational correlates of secondary traumatic stress and burnout among sexual assault nurse examiners. Journal of Forensic Nursing. 2009;(5):97-106. DOI:10.1111/j.1939-3938.2009.01040.x
  • 15. Deniz-Pak M, Özcan E, İçağasıoğlu Çoban A. Acil servis çalışanlarının ikincil travmatik stres düzeyi ve psikolojik Dayanıklılığı. Uluslararası Sosyal Araştırmalar Dergisi. 2017;10:(52).
  • 16. Kılıç C, İnci F. Acil tıp çalışanlarında travmatik stres: yaş ve eğitimin koruyucu etkisi, Türk Psikiyatri Dergisi. 2015;26(4):236-41.
  • 17. Aydın R, Kızılkaya T, Hancıoğlu-Aytaç S, Taşlar N. COVID-19 pandemisinde gebelik, doğum ve doğum sonu dönemde kadınların sosyal destek gereksinimi ve ebelik yaklaşımları. Turkish Studies. 2020;15:(4), 679-90. https://dx.doi.org/10.29228/TurkishStudies.44489
  • 18. Killian K. Helping till it hurts? A multimethod study of compassion fatigue, burnout, and self-care in clinicians working with trauma survivors. Traumatology: 2008;14:32-44. doi:10.1177/1534765608319083
  • 19. Salston M, Figley CR. Secondary traumatic stress effects of working with survivors of criminal victimization. Journal of Traumatic Stress. 2003;16(2):167-74. https://doi.org/10.1023/A:1022899207206
  • 20. Skovholt TM. The counselor’s resilient self. Turkish Psychological Counseling and Guidance Journal. 2012;4(38):137-46.org.tr/en/pub/tpdrd/issue/21458/229822
  • 21. Whitfield N, Kanter D. Helpers in distress: preventing secondary trauma. Reclaiming Children and Youth. 2014;22:59-61.
  • 22. Newman A, Ucbasaran D, Zhu F. Hirst G. Psychological capital: a review and synthesis. Journal of Organizational Behavior 2014;35:120-38. https://doi.org/10.1002/job.1916 23. Hunter B, Warren L. Midwives׳ experiences of workplace resilience, Midwifery. 2014(30)8: 926-34. https://doi.org/10.1016/j.midw.2014.03.010.
  • 24. Traynor M. Critical resilience for nurses: an evidence-based guide to survival and change in the modern NHS. 2017. New York: Routledge
  • 25. Webb L. Resilience: How to cope when everything around you keeps changing. United Kingdom: John Wiley & Sons, Incorporated. 2013.
  • 26. Yörük S, Güler D. The relationship between psychological resilience, burnout, stress, and sociodemographic factors with depression in nurses and midwives during the COVID‐19 pandemic: A cross‐sectional study in Turkey. Perspect Psychiatr Care. 2021;57:390‐ 398. https://doi.org/10.1111/ppc.12659
  • 27. Bride BE, Robinson MM, Yegidis B, Figley CR. Development and validation of the secondary traumatic stress scale. Research on Social Work Practice. 2004;14(1):27-35. doi:10.1177/1049731503254106336495
  • 28. Kâhil A. Travmatik yaşantıları olan bireylere yardım davranışında bulunan profesyonel ve gönüllülerin ikincil travmatik stres düzeylerinin incelenmesi, [Master’s Thesis]. Ufuk Üniversitesi/Sosyal Bilimleri Enstitüsü; 2016.
  • 29. Friborg O, Hjemdal O, Rosenvinge JH, Martinussen M. A new rating scale for adult resilience:What are the central protective resources behind ealthy adjustment? International Journal of Nursing Studies. 2008:975-8.
  • 30. Basım N, Çetin F. Yetişkinler için psikolojik dayanıklılık ölçeğinin güvenilirlik ve geçerlilik çalışması. Türk Psikiyatri Dergisi.2011;104-114.doi: 10.1111/jmwh.12221
  • 31. Beck CT, Logiudice J, Gable RK. A mixed-methods study of secondary traumatic stress in certified nurse-midwives: shaken belief in the birth Process. J Midwifery Womens Health. 2015;60(1):16-23.
  • 32. Creedy DK, Gamble JA. Third of midwives who have experienced traumatic perinatal events have symptoms of post-traumatic stress disorder. Evidence-Based Nursing. 2016;19:44. http://dx.doi.org/10.1136/eb-2015-102095
  • 33. Kim HJ, Choi H. Emergency nurses’ professional quality of life: compassion satisfaction, burnout, and secondary traumatic stress. Journal of Korean Academy of Nursing Administration: 2012:18(3);320-8.
  • 34. Kaya R. Riskli birimlerde çalışan hemşirelerin psikolojik dayanıklılık düzeyleri ve spiritüel iyi oluşlarının belirlenmesi. [Master’s Thesis]. İstanbul Okan Üniversitesi/Sağlık Bilimleri Enstitüsü; 2019.
  • 35. Çam O, Büyükbayram A. Hemşirelerde psikolojik dayanıklılık ve etkileyen faktörler. Psikiyatri Hemşireliği Dergisi. 2017:8(2);118-26.
  • 36. Adıgüzel O, Tanrıverdi H, Özkan D. Mesleki profesyonellik ve bir meslek mensupları olarak hemşireler örneği. Yönetim Bilimleri Dergisi. 2011;9(2):235.
  • 37. Taş S. Düzce üniversitesi araştırma ve uygulama hastanesi hemşirelerinde psikolojik dayanıklılık, depresyon ve algılanan stresin değerlendirilmesi. [Master’s Thesis]. Düzce Üniversitesi/Sağlık Bilimleri Enstitüsü; 2013.
  • 38. Bektaş M, Özben Ş. Evli bireylerin psikolojik dayanıklılık düzeylerinin bazı sosyo-demografik değişkenler açısından incelenmesi, Celal Bayar Üniversitesi Sosyal Bilimler Dergisi. 2016;12-18.
  • 39. Foureur M, Besley K, Burton G, Yu N, Crisp J. Enhancing the resilience of nurses and midwives: Pilot of a mindfulnessbased program for increased health, sense of coherence and decreased depression, anxiety and stress, Contemporary Nurse. 2013;45:1,114-125. doi: 10.5172/conu.2013.45.1.114
  • 40. Chesak S. Integration and impact of stress management and resiliency training (smart) in a nurse residency program: A feasibility study. Theses and Dissertations. 2013:347. https://dc.uwm.edu/etd/347
  • 41. Wahlberg A, Andreen-Sachs M, Johannesson K, Hallberg G, Jonsson M, Skoog-Svanberg A, Högberg U. Post‐traumatic stress symptoms in Swedish obstetricians and midwives after severe obstetric events: a cross‐sectional retrospective survey. BJOG. 2017;124:1264-71. doi: 10.1111/1471-0528.14259

Secondary Traumatic Stress: How Resilient are Midwives? What are the Influencing Factors?

Yıl 2023, Cilt: 3 Sayı: 1, 61 - 74, 31.01.2023

Öz

Aims: Midwives are an important group at risk for experiencing secondary traumatic stress in terms of witnessing traumatic births. This study aimed to determine the secondary traumatic stress experiences of midwives and to reveal their relationship with psychological resilience levels and some other factors.
Method: A cross-sectional and descriptive design was used in the study. The study group consisted of 502 midwives. Three separate forms were used to collect the data, namely, a personal information form, the Secondary Traumatic Stress Scale, and the Resilience Scale for Adults.
Results: In the study, the mean score of the midwives from the secondary traumatic stress scale was found to be high, and their mean scores from the psychological resilience scale was low (53.10 ± 17.97; 135.52 ± 32.06, respectively). A statistically significant difference was found in terms of the secondary traumatic stress and psychological resilience scale scores according to midwives’ age, education level, marital status, love of profession, working years, thoughts about professional future, and the status of receiving psychosocial in-service training (p <0.05). A negative, high, and statistically significant correlation was found between the scores of the secondary traumatic stress scale and the psychological resilience scale (r = -0.752; p = 0.000)
Conclusion: In our study, it was found that midwives who were younger, had a low educational level, were single, did not like their job, had little professional experience, wanted to resign from their job, had not received psychosocial in-service training were at higher risk for experiencing secondary trauma. Secondary traumatic stress was found to decrease as the psychological resilience of midwives increased. This finding is important in terms of showing that midwives can be protected against the negative effects of secondary trauma by increasing their psychological resilience. In addition, this study may shed light on developing interventions aimed at reducing midwifery stress and improving coping mechanisms.

Kaynakça

  • 1. Kâhil A, Palabıyıkoğlu NR. Secondary traumatic stress. Current Approaches in Psychiatry. 2018;10(1):59-70 doi: 10.18863/pgy.
  • 2. Leinweber J, Rowe HJ. The costs of being with the woman: secondary traumatic stress in midwifery. Midwifery. 2010;26(1):76-87. org/10.1016/j.midw.2008.04.003.
  • 3. Cohen R, Leykin D, Golan-Hadari D, Lahad M. Exposure to traumatic events at work, posttraumatic symptoms and professional quality of life among midwives. Midwifery. 2017;50:1-8 https://doi.org/10.1016/j.midw.2017.03.009.
  • 4. Kerkman T, Dijksman LM, Baas MA, Evers R, Van Pampus MG, Stramrood CA. Traumatic experiences and the midwifery profession: a cross‐sectional study among dutch midwives. Journal of Midwifery & Women's Health. 2019;64:435-42. https://doi.org/10.1111/jmwh.12946
  • 5. Cheung T, Fong TK. Bressington D. COVID‐19 under the SARS cloud: mental health nursing during the pandemic in hong kong. Journal of Psychiatr Mental Health Nursing. 2020. doi.org/10.1111/jpm.12639
  • 6. Ghasempour, M., & Purabdollah, M. Necessity of attention to mental health of the front line nurses against COVID-19: a forgotten requirement. International Journal of Community Based Nursing & Midwifery. 2020. http://ijcbnm.sums.ac.ir/article_46528_1ee7785829ae046c2d3d41573dc2380d
  • 7. Toohill J, Fenwick J, Sidebotham M, Gamble J, Creedy DK. Trauma and fear in Australian midwives. Women and Birth. 2019;32(1);64-71. https://doi.org/10.1016/j.wombi.2018.04.003.
  • 8. Pezaro S, Clyne W, Turner A, Fulton EA, Gerada C. Midwives overboard! Inside their hearts are breaking, their makeup may be flaking but their smile still stays on. Women and Birth. 2016;29(3):e59-e66. https://doi.org/10.1016/j.wombi.2015.10.006.
  • 9. Rice H, Warland J. Bearing witness: Midwives experiences of witnessing traumatic birth. Midwifery. 2013;(29)9:1056-63. https://doi.org/10.1016/j.midw.2012.12.003.
  • 10. Oe M, Ishida T, Favrod C, Martin-Soelch C, Horsch A. Burnout, psychological symptoms, and secondary traumatic stress among midwives working on perinatal wards: a cross-cultural study between japan and switzerland. front. Psychiatry. 2018;9:387. doi: 10.3389/fpsyt.2018.00387
  • 11. Halperin O, Goldblatt H, Noble A, Raz I, Zvulunov I. Liebergall Wischnitzer M. Stressful childbirth situations: a qualitative study of midwives. Journal of Midwifery & Women's Health. 2011;56:388-94. https://doi.org/10.1111/j.1542-2011.2011.00030.x
  • 12. Patterson J. Traumatised midwives; traumatised women. AIMS Journal. 2019;30(4). ISSN:2516-5852.
  • 13. Çankaya S, Erkal-Aksoy Y, Dereli-Yılmaz S. Traumatic birth experiences of midwives: A qualitative study. Authorea. 2020;22. DOI: 10.22541/au.159015243.35248716/v2
  • 14. Townsend SM, Campbell R. Organizational correlates of secondary traumatic stress and burnout among sexual assault nurse examiners. Journal of Forensic Nursing. 2009;(5):97-106. DOI:10.1111/j.1939-3938.2009.01040.x
  • 15. Deniz-Pak M, Özcan E, İçağasıoğlu Çoban A. Acil servis çalışanlarının ikincil travmatik stres düzeyi ve psikolojik Dayanıklılığı. Uluslararası Sosyal Araştırmalar Dergisi. 2017;10:(52).
  • 16. Kılıç C, İnci F. Acil tıp çalışanlarında travmatik stres: yaş ve eğitimin koruyucu etkisi, Türk Psikiyatri Dergisi. 2015;26(4):236-41.
  • 17. Aydın R, Kızılkaya T, Hancıoğlu-Aytaç S, Taşlar N. COVID-19 pandemisinde gebelik, doğum ve doğum sonu dönemde kadınların sosyal destek gereksinimi ve ebelik yaklaşımları. Turkish Studies. 2020;15:(4), 679-90. https://dx.doi.org/10.29228/TurkishStudies.44489
  • 18. Killian K. Helping till it hurts? A multimethod study of compassion fatigue, burnout, and self-care in clinicians working with trauma survivors. Traumatology: 2008;14:32-44. doi:10.1177/1534765608319083
  • 19. Salston M, Figley CR. Secondary traumatic stress effects of working with survivors of criminal victimization. Journal of Traumatic Stress. 2003;16(2):167-74. https://doi.org/10.1023/A:1022899207206
  • 20. Skovholt TM. The counselor’s resilient self. Turkish Psychological Counseling and Guidance Journal. 2012;4(38):137-46.org.tr/en/pub/tpdrd/issue/21458/229822
  • 21. Whitfield N, Kanter D. Helpers in distress: preventing secondary trauma. Reclaiming Children and Youth. 2014;22:59-61.
  • 22. Newman A, Ucbasaran D, Zhu F. Hirst G. Psychological capital: a review and synthesis. Journal of Organizational Behavior 2014;35:120-38. https://doi.org/10.1002/job.1916 23. Hunter B, Warren L. Midwives׳ experiences of workplace resilience, Midwifery. 2014(30)8: 926-34. https://doi.org/10.1016/j.midw.2014.03.010.
  • 24. Traynor M. Critical resilience for nurses: an evidence-based guide to survival and change in the modern NHS. 2017. New York: Routledge
  • 25. Webb L. Resilience: How to cope when everything around you keeps changing. United Kingdom: John Wiley & Sons, Incorporated. 2013.
  • 26. Yörük S, Güler D. The relationship between psychological resilience, burnout, stress, and sociodemographic factors with depression in nurses and midwives during the COVID‐19 pandemic: A cross‐sectional study in Turkey. Perspect Psychiatr Care. 2021;57:390‐ 398. https://doi.org/10.1111/ppc.12659
  • 27. Bride BE, Robinson MM, Yegidis B, Figley CR. Development and validation of the secondary traumatic stress scale. Research on Social Work Practice. 2004;14(1):27-35. doi:10.1177/1049731503254106336495
  • 28. Kâhil A. Travmatik yaşantıları olan bireylere yardım davranışında bulunan profesyonel ve gönüllülerin ikincil travmatik stres düzeylerinin incelenmesi, [Master’s Thesis]. Ufuk Üniversitesi/Sosyal Bilimleri Enstitüsü; 2016.
  • 29. Friborg O, Hjemdal O, Rosenvinge JH, Martinussen M. A new rating scale for adult resilience:What are the central protective resources behind ealthy adjustment? International Journal of Nursing Studies. 2008:975-8.
  • 30. Basım N, Çetin F. Yetişkinler için psikolojik dayanıklılık ölçeğinin güvenilirlik ve geçerlilik çalışması. Türk Psikiyatri Dergisi.2011;104-114.doi: 10.1111/jmwh.12221
  • 31. Beck CT, Logiudice J, Gable RK. A mixed-methods study of secondary traumatic stress in certified nurse-midwives: shaken belief in the birth Process. J Midwifery Womens Health. 2015;60(1):16-23.
  • 32. Creedy DK, Gamble JA. Third of midwives who have experienced traumatic perinatal events have symptoms of post-traumatic stress disorder. Evidence-Based Nursing. 2016;19:44. http://dx.doi.org/10.1136/eb-2015-102095
  • 33. Kim HJ, Choi H. Emergency nurses’ professional quality of life: compassion satisfaction, burnout, and secondary traumatic stress. Journal of Korean Academy of Nursing Administration: 2012:18(3);320-8.
  • 34. Kaya R. Riskli birimlerde çalışan hemşirelerin psikolojik dayanıklılık düzeyleri ve spiritüel iyi oluşlarının belirlenmesi. [Master’s Thesis]. İstanbul Okan Üniversitesi/Sağlık Bilimleri Enstitüsü; 2019.
  • 35. Çam O, Büyükbayram A. Hemşirelerde psikolojik dayanıklılık ve etkileyen faktörler. Psikiyatri Hemşireliği Dergisi. 2017:8(2);118-26.
  • 36. Adıgüzel O, Tanrıverdi H, Özkan D. Mesleki profesyonellik ve bir meslek mensupları olarak hemşireler örneği. Yönetim Bilimleri Dergisi. 2011;9(2):235.
  • 37. Taş S. Düzce üniversitesi araştırma ve uygulama hastanesi hemşirelerinde psikolojik dayanıklılık, depresyon ve algılanan stresin değerlendirilmesi. [Master’s Thesis]. Düzce Üniversitesi/Sağlık Bilimleri Enstitüsü; 2013.
  • 38. Bektaş M, Özben Ş. Evli bireylerin psikolojik dayanıklılık düzeylerinin bazı sosyo-demografik değişkenler açısından incelenmesi, Celal Bayar Üniversitesi Sosyal Bilimler Dergisi. 2016;12-18.
  • 39. Foureur M, Besley K, Burton G, Yu N, Crisp J. Enhancing the resilience of nurses and midwives: Pilot of a mindfulnessbased program for increased health, sense of coherence and decreased depression, anxiety and stress, Contemporary Nurse. 2013;45:1,114-125. doi: 10.5172/conu.2013.45.1.114
  • 40. Chesak S. Integration and impact of stress management and resiliency training (smart) in a nurse residency program: A feasibility study. Theses and Dissertations. 2013:347. https://dc.uwm.edu/etd/347
  • 41. Wahlberg A, Andreen-Sachs M, Johannesson K, Hallberg G, Jonsson M, Skoog-Svanberg A, Högberg U. Post‐traumatic stress symptoms in Swedish obstetricians and midwives after severe obstetric events: a cross‐sectional retrospective survey. BJOG. 2017;124:1264-71. doi: 10.1111/1471-0528.14259
Toplam 40 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Birinci Basamak Sağlık Hizmetleri
Bölüm Araştırma Makaleleri
Yazarlar

Elif Dağlı 0000-0002-4608-8904

Nilüfer Topkara 0000-0001-7646-3456

Yayımlanma Tarihi 31 Ocak 2023
Gönderilme Tarihi 29 Ekim 2022
Yayımlandığı Sayı Yıl 2023 Cilt: 3 Sayı: 1

Kaynak Göster

Vancouver Dağlı E, Topkara N. Secondary Traumatic Stress: How Resilient are Midwives? What are the Influencing Factors?. TOGÜ Sağlık Bilimleri Dergisi. 2023;3(1):61-74.