İnfertilite sonrası gebelikte algılanan gelişimsel stresin öz bakım gücüne etkisi
Year 2023,
Volume: 4 Issue: 3, 93 - 98, 31.12.2023
Dilek Öcalan
,
Yeliz Çakır Koçak
,
Nursel Alp Dal
,
Zehra Baykal Akmeşe
,
Hafize Öztürk Can
,
Ümran Sevil
,
Semra Gün
Abstract
Amaç: Araştırmanın amacı, infertilite tedavisi sonrası gerçekleşen gebeliklerde algılanan gelişimsel stresin öz bakım gücüne etkisini belirlemektir.
Yöntem: Kesitsel tipte yapılan çalışmada, infertilite tedavisi alarak gebe kalan 90 kadın araştırmaya katılmıştır. Araştırmada Birey Tanıtım Formu, Algılanan Stres Ölçeği ve Öz Bakım Gücü Ölçeği kullanılmıştır.
Bulgular: Gebelerin yaş ortalaması 30.76±4.29, gebelik haftası ortalaması 13.61±11.71, alınan infertilite tedavi sayısı ortalaması 2.17±1.44, toplam gebelik sayısı ortalaması 1.26±0.55’dir. Kadınların %95.6’sının primer infertilite tanısının olduğu, kadınların %70’inin herhangi bir işte çalışmadığı, %44.4’ünün ilköğretim mezunu olduğu ve %64.4’ünün gelirinin giderine eşit olduğu saptanmıştır. Algılanan Stres Ölçeği toplam puan ortalaması 25.73±5.36, Öz Bakım Gücü Ölçeği toplam puan ortalaması 104.60±15.25’dir. Algılanan Stres Ölçeği toplam puanları ile Öz Bakım Gücü Ölçeği toplam puanları arasında negatif yönlü anlamlı ilişki vardır (r=-0.385, p=0.000).
Sonuçlar: İnfertilite tedavisi sonrası gebelerin algıladıkları gelişimsel stres ve öz bakım gücü orta düzeydedir. Kadınların algıladıkları stres düzeyi arttıkça, öz bakım gücü düzeyi azalmaktadır. İnfertilite tedavisi sonrası gebelerin algıladıkları stresi azaltmak, öz bakım gücünü arttırmak için, destekleyici ve bütüncül bir bakım yaklaşımı önerilmektedir.
References
- Aimagambetova, G., Issanov, A., Terzic, S., Bapayeva, G., Ukybassova, T., Baikoshkarova, S., ... & Terzic, M. (2020). The effect of psychological distress on IVF Outcomes: Reality or Speculations? PLOS ONE, 15(12), e0242024. https://doi.org/10.1371/journal.pone.0242024
- Alkın, E. D., & Beydağ, K. D. (2020). Üç ve üzeri gebeliği olan kadınların algıladıkları stres düzeyi ve kendilerini algılama düzeyi ilişkisi. Journal of Psychiatric Nursing, 11(3), 228-238. https://doi.org/10.14744/phd.2020.72621
- Arabin, B., Hellmeyer, L., Maul, J., & Metz, G. A. S. (2021). Awareness of maternal stress, consequences for the offspring and the need for early interventions to increase stress resilience. Journal of Perinatal Medicine, 49(8), 979–989. https://doi.org/10.1515/jpm-2021-0323
- Phogat, N. K., Quaintance, C. C., Laborde, A., King, L., Gotlib, I. H., Gaudilliere, B., ... & Dhabhar, F. S. (2023). Deleterious and protective psychosocial and stress-related factors predict risk of spontaneous preterm birth. American Journal of Perinatology, 40, 74-88. https://doi.org/10.1055/s-0041-1729162
- Centers for Disease Control and Prevention [CDC]. (2023). Infertility FAQs. Centers for Disease Control and Prevention. https://www.cdc.gov/reproductivehealth/infertility (Erişim tarihi: 15.03.2023)
- Erci, B. (2006). Reliability and validity of the Turkish version of Perceived Stres Scale. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi, 9(1), 58-64.
- Ergun, S. (2022). The relationship between caregiver burden and self-care agency of pregnant women with 0–6-year-old children. Nursing Open, 9(2), 1052-1059. https://doi.org/10.1002/nop2.1142
- Faul, F., Erdfelder, E., Lang, A. G.,& Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175-191.
- Frazier, T., Hogue, C. J. R., Bonney, E. A., Yount, K. M., & Pearce, B. D. (2018). Weathering the Storm; A review of pre-pregnancy stress and risk of spontaneous abortion. Psychoneuroendocrinology, 92, 142-154.
- Gokler, M. E., Unsal, A.,& Arslantas, D. (2014). The prevalence of infertility and loneliness among women aged 18-49 years who are living in semi-rural areas In Western Turkey. International Journal of Fertility and Sterility, 8(2), 155.
- Golshani, F., Hasanpour, S., Mirghafourvand, M., & Esmaeilpour, K. (2021). Effect of cognitivebehavioral therapybased counseling on perceived stress in pregnant women with history of primary infertility: A Controlled Randomized Clinical Trial. BMC Psychiatry, 21, 278. https://doi.org/10.1186/s12888-021-03283-2
- Hu, L., Du, J., Lv, H., Zhao, J., Chen, M., Wang, Y., ... & Hu, Z. (2018). Influencing factors of pregnancy loss and survival probability of clinical pregnancies conceived through assisted reproductive technology. Reproductive Biology and Endocrinology, 16(1), 1-12. https://doi.org/10.1186/s12958-018-0390-6
- Isaacs, N. Z., & Andipatin, M. G. (2020). A systematic review regarding women’s emotional and psychological experiences of high-risk pregnancies. BMC Psychology, 8, 1-11. https://doi.org/10.1186/s40359-020-00410-8
- Karaca Saydam, B., Demirel Bozkurt, Ö., Pelik Hadımlı, A., Öztürk Can, H., & Soğukpınar, N. (2007). Riskli gebelerde öz-bakım gücünün sağlıklı yaşam biçimi davranışlarına etkisinin incelenmesi. Perinatoloji Dergisi, 15(3), 131-139.
- Karataş Baran, G., Şahin, S., Öztaş, D., Demir, P., & Raziye, R. (2020). Gebelerin algılanan stres düzeylerinin ve stres nedenlerinin değerlendirilmesi. Cukurova Medical Journal, 45(1), 170-180. https://doi.org/10.17826/cumj.633534
- Kavlak, O., Çetinkaya, E., Kazankaya, F., Mısırlı, S., & Aksakal, B. İ. (2021). İnfertilite tedavisi sonrası gebe kalan kadınlarda prenatal bağlanma. STED, 30(1), 25-31. https://doi.org/10.17942/sted.422876
- Koendjbiharie, A. P., Hindori-Mohangoo, A. D., Zijlmans, W. C., Shankar, A., Abdoel Wahid, F. Z., Covert, H. H., ... & Drury, S. S. (2022). Sociodemographic influences on perceived stress during pregnancy: Results from The CCREOH Environmental Epidemiologic Study, Suriname. Women, 2(2), 121-134. https://doi.org/10.3390/women2020014
- Liang, S., Chen, Y., Wang, Q., Chen, H., Cui, C., Xu, X., ... & Zhang, C. (2021). Prevalence and associated factors of infertility among 20–49 year old women in Henan Province, China. Reproductive Health, 18(1), 1-13. https://doi.org/10.1186/s12978-021-01298-2
- Maharlouei, N., Morshed Behbahani, B., Doryanizadeh, L., & Kazemi M. (2021). Prevalence and pattern of infertility in Iran: A systematic review and meta-analysis study. Women’s Health Bulletin, 8(2), 63-71. https://doi.org/10.30476/whb.2021.89924.1102
- Nahcivan, N. (1993). Sağlıklı gençlerde öz bakım gücü ve aile ortamının etkisi. İstanbul Üniversitesi [Yayınlanmamış Doktora Tezi], İstanbul.
- Nguyen, L. D., Nguyen, L. H., Ninh, L. T., Nguyen, H. T. T., Nguyen, A. D., Vu, L. G., ... & Ho, R. C. (2022). Women’s holistic self-care behaviors during pregnancy and associations with psychological well-being: implications for maternal care facilities. BMC Pregnancy and Childbirth, 22(1), 631. https://doi.org/10.1186/s12884-022-04961-z
- Okuducu, N. Y., & Yorulmaz, H. (2020). İnfertilite tanısı konmuş kadınlarda yaşam kalitesi. İstanbul Kanuni Sultan Süleyman Tıp Dergisi, 12(1), 13-20. https://doi.org/10.5222/iksstd.2020.76093
- Özcan, H., Sahan, Ö., Günay, M., & Şimşek, H. (2022). Self-Care agency in pregnancy. Clinical and Experimental Health Sciences, 12, 787-792. https://doi.org/10.33808/clinexphealthsci.780534
- Ozdemir, K., Sahin, S., Sevimli Guler, D., & Unsal, A. (2022). Headache and distress during pregnancy. International Journal of Gynecology & Obstetrics, 157(3), 686-693.
- Öztürk Can, H., Baykal Akmeşe, Z., Çakır Koçak, Y., Öcalan, D., Alp Dal, N., & Sevil, Ü. (2019). Factors affecting perceived stress and self-care agency pregnant women. Journal of Health, Medicine and Nursing, 59, 46-54.
- Pınar, Ş. E., Arslan, Ş., Polat, K., Çiftçi, D., Cesur, B.,& Dağlar, G. (2014). Gebelerde uyku kalitesi ile algılanan stres arasındaki ilişkinin incelenmesi. Dokuz Eylül Üniversitesi Hemşirelik Yüksekokulu Elektronik Dergisi, 7, 171-177.
- Rezaeian, S. M., Abedian, Z., Roodsari, R. L., Mazloom, S. R.,& Dadgar, S. (2017). The relationship of prenatal self-care behaviors with stress, anxiety and depression in women at risk of preterm delivery. The Iranian Journal of Obstetrics, Gynecology and Infertility, 20(3), 68-76. https://doi.org/10.22038/IJOGI.2017.8874
- Rooney, K. L., & Domar, A. D. (2018). The relationship between stress and infertility. Dialogues in Clinical Neuroscience, 20(1), 41-47. https://doi.org/10.31887/DCNS.2018.20.1/klrooney
- Sanders, J. N., Simonsen, S. E., Porucznik, C. A., Hammoud, A. O., Smith, K. R., & Stanford, J. B. (2022). Fertility treatments and the risk of preterm birth among women with subfertility: A Linked-Data Retrospective Cohort Study. Reprodutive Health, 19(1), 1-10. https://doi.org/10.1186/s12978-022-01363-4
- Sis Çelik, A., & Atasever İ. (2020). Gebelerde algılanan stres düzeylerinin ve etkileyen faktörlerin belirlenmesi. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 23(2), 267-276. https://doi.org/10.17049/ataunihem.622304
- Tendais, I., & Figueiredo, B. (2016). Parents' anxiety and depression symptoms after successful infertility treatment and spontaneous conception: does singleton/twin pregnancy matter?. Human Reproduction, 31(10), 2303-2312.
- Türkiye Nüfus ve Sağlık Araştırmaları [TNSA]. (2018). Erişim Adresi: http://www.sck.gov.tr/wp-content/uploads/2020/08/TNSA2018_ana_Rapor.pdf (Erişim Tarihi: 20.02.2023)
- Traylor, C. S., Johnson, J. D., Kimmel, M. C., & Manuck, T. A. (2020). Effects of psychological stress on adverse pregnancy outcomes and nonpharmacologic approaches for reduction: An Expert Review. American Journal of Obstetric and Gynecology MFM, 2(4), 100229. https://doi.org/10.1016/j.ajogmf.2020. 100229
- Türkiye İstatistik Kurumu [TUİK]. (2021). Türkiye İstatistik Kurumu, Erişim Adresi: https://data.tuik.gov.tr/Bulten/Index?p=Dunya-Nufus-Gunu-2021-37250 (Erişim tarihi: 20.03.2023)
- Van den Bergh, B. R., van den Heuvel, M. I., Lahti, M., Braeken, M., de Rooij, S. R., Entringer, S., ... & Schwab, M. (2020). Prenatal developmental origins of behavior and mental health: the influence of maternal stress in pregnancy. Neuroscience and Biobehavioral Reviews, 117, 26-64. https://doi.org/10.1016/j.neubiorev.2017.07.0 03
- World Health Organization [WHO] (2021). Erişim Adresi: https://www.who.int/health-topics/infertility#tab=tab_1 (Erişim tarihi: 29.01.2021)
- Yehia, D. B. M., Malak, M. Z., Al-Thwabih, N. N., Awad, R. R., Al-Ajouri, E. S., Darwish, S. S., & Hamad, A. S. (2020). Psychosocial factors correlate with fatigue among pregnant women in Jordan. Perspectives in Psychiatric Care, 56, 46-53. https://doi.org/10.1111/ppc.12372
- Yılmaz, S. D., & Beji, N. K. (2010). Gebelikte öz bakım gücünün değerlendirilmesi. Genel Tıp Dergisi, 20(4), 137-142.
- Zhou, F. J., Cai, Y. N., & Dong, Y. Z. (2019). Stress increases the risk of pregnancy failure in couples undergoing IVF. Stress, 22(4), 414-420. https://doi.org/10.1080/10253890.2019.1584181.
The effect of perceived developmental stress on self-care strength in after infertility pregnancy
Year 2023,
Volume: 4 Issue: 3, 93 - 98, 31.12.2023
Dilek Öcalan
,
Yeliz Çakır Koçak
,
Nursel Alp Dal
,
Zehra Baykal Akmeşe
,
Hafize Öztürk Can
,
Ümran Sevil
,
Semra Gün
Abstract
Aim: The aim of the study is to determine the effect of perceived developmental stress on self-care power in pregnancies after infertility treatment.
Methods: In this cross-sectional study, 90 women who became pregnant after receiving infertility treatment participated in the study. In the study, Individual Identification Form, Perceived Stress Scale and Self-Care Strength Scale were used.
Results: The mean age of the pregnant women was 30.76±4.29, the mean week of gestation was 13.61±11.71, the mean number of infertility treatments received was 2.17±1.44, the mean total number of pregnancies was 1.26±0.55. It was determined that 95.6% of the women had a diagnosis of primary infertility, 70% of the women did not work in any job, 44.4% of them were primary school graduates and 64.4% of them had income equal to their expenses. The total mean score of the Perceived Stress Scale was 25.73±5.36, and the total mean score of the Self-Care Scale was 104.60±15.25. There is a significant negative correlation between the Perceived Stress Scale total scores and the Self Care Strength Scale total scores (r=-0.385, p=0.000).
Conclusion: Perceived developmental stress and self-care power of pregnant women after infertility treatment are moderate. As the perceived stress level of women increases, the level of self-care power decreases. A supportive and holistic care approach is recommended in order to reduce the perceived stress of pregnant women after infertility treatment and to increase their self-care power.
References
- Aimagambetova, G., Issanov, A., Terzic, S., Bapayeva, G., Ukybassova, T., Baikoshkarova, S., ... & Terzic, M. (2020). The effect of psychological distress on IVF Outcomes: Reality or Speculations? PLOS ONE, 15(12), e0242024. https://doi.org/10.1371/journal.pone.0242024
- Alkın, E. D., & Beydağ, K. D. (2020). Üç ve üzeri gebeliği olan kadınların algıladıkları stres düzeyi ve kendilerini algılama düzeyi ilişkisi. Journal of Psychiatric Nursing, 11(3), 228-238. https://doi.org/10.14744/phd.2020.72621
- Arabin, B., Hellmeyer, L., Maul, J., & Metz, G. A. S. (2021). Awareness of maternal stress, consequences for the offspring and the need for early interventions to increase stress resilience. Journal of Perinatal Medicine, 49(8), 979–989. https://doi.org/10.1515/jpm-2021-0323
- Phogat, N. K., Quaintance, C. C., Laborde, A., King, L., Gotlib, I. H., Gaudilliere, B., ... & Dhabhar, F. S. (2023). Deleterious and protective psychosocial and stress-related factors predict risk of spontaneous preterm birth. American Journal of Perinatology, 40, 74-88. https://doi.org/10.1055/s-0041-1729162
- Centers for Disease Control and Prevention [CDC]. (2023). Infertility FAQs. Centers for Disease Control and Prevention. https://www.cdc.gov/reproductivehealth/infertility (Erişim tarihi: 15.03.2023)
- Erci, B. (2006). Reliability and validity of the Turkish version of Perceived Stres Scale. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi, 9(1), 58-64.
- Ergun, S. (2022). The relationship between caregiver burden and self-care agency of pregnant women with 0–6-year-old children. Nursing Open, 9(2), 1052-1059. https://doi.org/10.1002/nop2.1142
- Faul, F., Erdfelder, E., Lang, A. G.,& Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175-191.
- Frazier, T., Hogue, C. J. R., Bonney, E. A., Yount, K. M., & Pearce, B. D. (2018). Weathering the Storm; A review of pre-pregnancy stress and risk of spontaneous abortion. Psychoneuroendocrinology, 92, 142-154.
- Gokler, M. E., Unsal, A.,& Arslantas, D. (2014). The prevalence of infertility and loneliness among women aged 18-49 years who are living in semi-rural areas In Western Turkey. International Journal of Fertility and Sterility, 8(2), 155.
- Golshani, F., Hasanpour, S., Mirghafourvand, M., & Esmaeilpour, K. (2021). Effect of cognitivebehavioral therapybased counseling on perceived stress in pregnant women with history of primary infertility: A Controlled Randomized Clinical Trial. BMC Psychiatry, 21, 278. https://doi.org/10.1186/s12888-021-03283-2
- Hu, L., Du, J., Lv, H., Zhao, J., Chen, M., Wang, Y., ... & Hu, Z. (2018). Influencing factors of pregnancy loss and survival probability of clinical pregnancies conceived through assisted reproductive technology. Reproductive Biology and Endocrinology, 16(1), 1-12. https://doi.org/10.1186/s12958-018-0390-6
- Isaacs, N. Z., & Andipatin, M. G. (2020). A systematic review regarding women’s emotional and psychological experiences of high-risk pregnancies. BMC Psychology, 8, 1-11. https://doi.org/10.1186/s40359-020-00410-8
- Karaca Saydam, B., Demirel Bozkurt, Ö., Pelik Hadımlı, A., Öztürk Can, H., & Soğukpınar, N. (2007). Riskli gebelerde öz-bakım gücünün sağlıklı yaşam biçimi davranışlarına etkisinin incelenmesi. Perinatoloji Dergisi, 15(3), 131-139.
- Karataş Baran, G., Şahin, S., Öztaş, D., Demir, P., & Raziye, R. (2020). Gebelerin algılanan stres düzeylerinin ve stres nedenlerinin değerlendirilmesi. Cukurova Medical Journal, 45(1), 170-180. https://doi.org/10.17826/cumj.633534
- Kavlak, O., Çetinkaya, E., Kazankaya, F., Mısırlı, S., & Aksakal, B. İ. (2021). İnfertilite tedavisi sonrası gebe kalan kadınlarda prenatal bağlanma. STED, 30(1), 25-31. https://doi.org/10.17942/sted.422876
- Koendjbiharie, A. P., Hindori-Mohangoo, A. D., Zijlmans, W. C., Shankar, A., Abdoel Wahid, F. Z., Covert, H. H., ... & Drury, S. S. (2022). Sociodemographic influences on perceived stress during pregnancy: Results from The CCREOH Environmental Epidemiologic Study, Suriname. Women, 2(2), 121-134. https://doi.org/10.3390/women2020014
- Liang, S., Chen, Y., Wang, Q., Chen, H., Cui, C., Xu, X., ... & Zhang, C. (2021). Prevalence and associated factors of infertility among 20–49 year old women in Henan Province, China. Reproductive Health, 18(1), 1-13. https://doi.org/10.1186/s12978-021-01298-2
- Maharlouei, N., Morshed Behbahani, B., Doryanizadeh, L., & Kazemi M. (2021). Prevalence and pattern of infertility in Iran: A systematic review and meta-analysis study. Women’s Health Bulletin, 8(2), 63-71. https://doi.org/10.30476/whb.2021.89924.1102
- Nahcivan, N. (1993). Sağlıklı gençlerde öz bakım gücü ve aile ortamının etkisi. İstanbul Üniversitesi [Yayınlanmamış Doktora Tezi], İstanbul.
- Nguyen, L. D., Nguyen, L. H., Ninh, L. T., Nguyen, H. T. T., Nguyen, A. D., Vu, L. G., ... & Ho, R. C. (2022). Women’s holistic self-care behaviors during pregnancy and associations with psychological well-being: implications for maternal care facilities. BMC Pregnancy and Childbirth, 22(1), 631. https://doi.org/10.1186/s12884-022-04961-z
- Okuducu, N. Y., & Yorulmaz, H. (2020). İnfertilite tanısı konmuş kadınlarda yaşam kalitesi. İstanbul Kanuni Sultan Süleyman Tıp Dergisi, 12(1), 13-20. https://doi.org/10.5222/iksstd.2020.76093
- Özcan, H., Sahan, Ö., Günay, M., & Şimşek, H. (2022). Self-Care agency in pregnancy. Clinical and Experimental Health Sciences, 12, 787-792. https://doi.org/10.33808/clinexphealthsci.780534
- Ozdemir, K., Sahin, S., Sevimli Guler, D., & Unsal, A. (2022). Headache and distress during pregnancy. International Journal of Gynecology & Obstetrics, 157(3), 686-693.
- Öztürk Can, H., Baykal Akmeşe, Z., Çakır Koçak, Y., Öcalan, D., Alp Dal, N., & Sevil, Ü. (2019). Factors affecting perceived stress and self-care agency pregnant women. Journal of Health, Medicine and Nursing, 59, 46-54.
- Pınar, Ş. E., Arslan, Ş., Polat, K., Çiftçi, D., Cesur, B.,& Dağlar, G. (2014). Gebelerde uyku kalitesi ile algılanan stres arasındaki ilişkinin incelenmesi. Dokuz Eylül Üniversitesi Hemşirelik Yüksekokulu Elektronik Dergisi, 7, 171-177.
- Rezaeian, S. M., Abedian, Z., Roodsari, R. L., Mazloom, S. R.,& Dadgar, S. (2017). The relationship of prenatal self-care behaviors with stress, anxiety and depression in women at risk of preterm delivery. The Iranian Journal of Obstetrics, Gynecology and Infertility, 20(3), 68-76. https://doi.org/10.22038/IJOGI.2017.8874
- Rooney, K. L., & Domar, A. D. (2018). The relationship between stress and infertility. Dialogues in Clinical Neuroscience, 20(1), 41-47. https://doi.org/10.31887/DCNS.2018.20.1/klrooney
- Sanders, J. N., Simonsen, S. E., Porucznik, C. A., Hammoud, A. O., Smith, K. R., & Stanford, J. B. (2022). Fertility treatments and the risk of preterm birth among women with subfertility: A Linked-Data Retrospective Cohort Study. Reprodutive Health, 19(1), 1-10. https://doi.org/10.1186/s12978-022-01363-4
- Sis Çelik, A., & Atasever İ. (2020). Gebelerde algılanan stres düzeylerinin ve etkileyen faktörlerin belirlenmesi. Anadolu Hemşirelik ve Sağlık Bilimleri Dergisi, 23(2), 267-276. https://doi.org/10.17049/ataunihem.622304
- Tendais, I., & Figueiredo, B. (2016). Parents' anxiety and depression symptoms after successful infertility treatment and spontaneous conception: does singleton/twin pregnancy matter?. Human Reproduction, 31(10), 2303-2312.
- Türkiye Nüfus ve Sağlık Araştırmaları [TNSA]. (2018). Erişim Adresi: http://www.sck.gov.tr/wp-content/uploads/2020/08/TNSA2018_ana_Rapor.pdf (Erişim Tarihi: 20.02.2023)
- Traylor, C. S., Johnson, J. D., Kimmel, M. C., & Manuck, T. A. (2020). Effects of psychological stress on adverse pregnancy outcomes and nonpharmacologic approaches for reduction: An Expert Review. American Journal of Obstetric and Gynecology MFM, 2(4), 100229. https://doi.org/10.1016/j.ajogmf.2020. 100229
- Türkiye İstatistik Kurumu [TUİK]. (2021). Türkiye İstatistik Kurumu, Erişim Adresi: https://data.tuik.gov.tr/Bulten/Index?p=Dunya-Nufus-Gunu-2021-37250 (Erişim tarihi: 20.03.2023)
- Van den Bergh, B. R., van den Heuvel, M. I., Lahti, M., Braeken, M., de Rooij, S. R., Entringer, S., ... & Schwab, M. (2020). Prenatal developmental origins of behavior and mental health: the influence of maternal stress in pregnancy. Neuroscience and Biobehavioral Reviews, 117, 26-64. https://doi.org/10.1016/j.neubiorev.2017.07.0 03
- World Health Organization [WHO] (2021). Erişim Adresi: https://www.who.int/health-topics/infertility#tab=tab_1 (Erişim tarihi: 29.01.2021)
- Yehia, D. B. M., Malak, M. Z., Al-Thwabih, N. N., Awad, R. R., Al-Ajouri, E. S., Darwish, S. S., & Hamad, A. S. (2020). Psychosocial factors correlate with fatigue among pregnant women in Jordan. Perspectives in Psychiatric Care, 56, 46-53. https://doi.org/10.1111/ppc.12372
- Yılmaz, S. D., & Beji, N. K. (2010). Gebelikte öz bakım gücünün değerlendirilmesi. Genel Tıp Dergisi, 20(4), 137-142.
- Zhou, F. J., Cai, Y. N., & Dong, Y. Z. (2019). Stress increases the risk of pregnancy failure in couples undergoing IVF. Stress, 22(4), 414-420. https://doi.org/10.1080/10253890.2019.1584181.