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The Effect of Lifestyle Behaviour to Women’s Fertility

Yıl 2016, Cilt: 6 Sayı: 3, 190 - 196, 16.01.2017

Öz

The development of a health-promoting lifestyle has an important role in preventing infertility and bringing fertility rates to the ideal level. Smoking, body mass index lower than 18.5 kg/m2- higher than 25 kg/m2, exercise level, alcohol consumption, caffeine consumption and stress were shown the negative affects to follicle development, ovulation and causing to failure the success rate of both fertilization and assisted reproduction techniques. Nurses have important tasks to identification of health risk behaviors and to plan and change of these behaviors. Therefore, the nurses should inform the infertile couple about the effect of healthy lifestyle to the reproductive health and encourage them about the healthpromoting lifestyle. In this review the aim is to discuss the effect of lifestyle behaviour to women’s fertility.

Kaynakça

  • Homan G, Norman R. Couples perception regarding how lifestyle mightaffect fertility: results of a pilot study. Australian Journal of Advanced Nursing. 2009; 26(4): 77-87.
  • McLean M, Wellons MF. Optimizing natural fertility: the role of lifestyle modification. Obstetrics & Gynecology Clinics of North America. 2012; 39(4): 465-77.
  • Grainger DA, Tjaden BL. Assisted reproductive technologies. In: Goldman MB, Hatch MC editors. Women and Health. San Diego: Academic Press; 2000.
  • Frey KA, Patel KS. Initial evaluation and management of infertility by the primary care physician. Mayo Clinic Proceedings. 2004; 79(11): 1439–43.
  • HealthyPeople.gov [Internet]. U.S. Department of Health and Human Services. [Cited: 2016 February 20]. Available from: http://healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=26.
  • Anderson K, Nisenblat V, Norman R. Lifestyle factors in people seeking infertility treatment a review. Australian and New Zealand Journal of Obstetrics Gynaecology. 2010: 50(1): 8–20.
  • Anderson K, Norman RJ, Middleton P. Preconception lifestyle advice for people with subfertility. Cochrane Database of Systematic Reviews. 2010: (4); CD008189. Doi: 10.1002/14651858.CD008189.pub2.
  • Klonoff-Cohen H. Female and male lifestyle habits and IVF: what is known and unknown. Human Reproduction Update. 2005; 11(2): 179–203.
  • Homan GF, Davies M, Norman R. The impact of lifestyle factors on reproductive performance in the general population and thoseundergoing infertility treatment: a review. Human Reproduction Update. 2007; 13(3): 209–23.
  • Practice Committee of American Society for Reproductive Medicine. Smoking and infertility. Fertility and Sterility. 2008; 90(5 Suppl): 254–59.
  • World Health Organization (WHO). Obesity: Preventing and managing the global epidemic. Technical Report Series. Geneva (Switzerland): [Updated: 2000; Cited: 2016 January 5]. Available from: http://www.who.int/nutrition/publications/obesity/WHO_TRS_894/en/.
  • Kelly-Weeder S, O'Connor A. Modifiable risk factors for impaired fertility in women: what nurse practitioners need to know. Journal of the American Association of Nurse Practitioners. 2006; 18(6): 268-76.
  • Centers for Disease Control and Prevention. Women and smoking: A report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. 2001; 5-17.
  • Sadeu JC, Foster WG. Cigarette smoke condensate exposure delays follicular developmentand function in a stage-dependent manner. Fertility and Sterility. 2011; 95(7): 2410–17.
  • Fuentes A, Muñoz A, Barnhart K, Argüello B, Díaz M, Pommer R. Recent cigarette smoking and assisted reproductive technologies outcome. Fertility and Sterility. 2010; 93(1): 89–95.
  • Soares SR, Simon C, Remohi J, Pellicer A. Cigarette smoking affects uterine receptiveness. Human Reproduction. 2007; 22(2): 543–7.
  • Shiloh H, Lahav-Baratz S, Koifman M. The impact of cigarette smoking on zona pellucida thickness of oocytes and embryos prior to transfer into the uterine cavity. Human Reproduction. 2004; 19(1): 157–9.
  • Benedict MD, Missmer SA, Vahratian A, Berry KF, Vitonis AF, Cramer DW et al. Secondhand tobacco smoke exposure is associated with increased risk of failed implantation and reduced IVF success. Human Reproduction. 2011; 26(9): 2525–31.
  • Zenzes MT. Smoking and reproduction: gene damage to human gametes and embryos. Human Reproduction Update. 2000; 6(2): 122–31.
  • Ganesan S, Bhattacharya P, Keating AF. 7,12-Dimethylbenz[a]anthracene exposure induces the DNA repair response in neonatal rat ovaries. Toxicology and Applied Pharmacology. 2013; 272(3): 690–6.
  • Neal MS, Zhu J, Holloway AC, Foster WG. Follicle growth is inhibited by benzo-[a]-pyrene, at concentrations representative of human exposure, in an isolated rat follicle culture assay. Human Reproduction. 2007; 22(4): 961–7.
  • Wu SC, Liu M. In vitro assessment of reproductive toxicity of cigarette smoke and deleterious consequences of maternal exposure to its constituents. Biological Research. 2012; 45(2): 101–9.
  • Lambert-Messerlian GM, Harlow BL. The influence of depression, body mass index, and smoking on serum inhibin B levels in late reproductive-aged women. Journal of Clinical Endocrinology and Metabolism. 2006; 91(4): 1496–500.
  • Kummer V. Mašková J, Zralý Z, Faldyna M. Ovarian disorders in immature rats after postnatal exposure to environmental polycyclic aromatic hydrocarbons. Journal of Applied Toxicology. 2013;33(2): 90–9.
  • El-Nemr A, Al-Shawaf T, Sabatini L, Wilson C, Lower AM, Grudzinskas JG. Effect of smoking on ovarian reserve and ovarian stimulation in in-vitro fertilization and embryo transfer. Human Reproduction. 1998; 13(8): 2192–8.
  • Hayatbakhsh MR, Clavarino A, Williams GM, Sina M, Najman JM. Cigarette smoking and age of menopause: a large prospective study. Maturitas. 2012; 72(4): 346–52.
  • Windham GC, Fenster L, Swan SH. Moderate maternal and paternal alcohol consumption and the risk of spontaneous abortion. Epidemiology. 1992; 3(4): 364–70.
  • Claman P. Men at risk: Occupation and male infertility. Fertility and Sterility. 2004; 81(2): 19–26.
  • Chang SH, Kim CS, Lee KS, Kim H, Yim S., Lim YJ, et al. Premenopausal factors influencing premature ovarian failure and early menopause. Maturitas. 2007; 58(1):19-30.
  • Mikkelsen TF, Graff-Iversen S, Sundby J, Bjertness E. Early menopause, association with tobacco smoking, coffee consumption and other lifestyle factors: a cross-sectional study. BMC Public Health. 2007;7(7): 149.
  • Younglai EV, Holloway AC, Foster WG. Environmental and occupational factors affecting fertility and IVF success. Human Reproduction Update. 2005; 11(1): 43–57.
  • Lintsen AM, Pasker-de Jong PC, de Boer EJ, Burger CW, Jansen CA, Braat DD, et al. Effects of subfertility cause, smoking and body weight on the success rate of IVF. Human Reproduction. 2005; 20(7): 1867–75.
  • Lumley J, Chamberlain C, Dowswell T, Oliver S, Oakley L, Watson L. Interventions for promoting smoking cessation during pregnancy. Cochrane Database of Systematic Reviews. 2009; 8(3): CD001055. doi: 10.1002/14651858.CD001055.pub3.
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Kadınlarda Yaşam Biçim Davranışlarının Fertilite Üzerine Etkisi

Yıl 2016, Cilt: 6 Sayı: 3, 190 - 196, 16.01.2017

Öz

Sağlıklı yaşam biçimi davranışlarının geliştirilmesi infertilitenin önlenmesi ve fertilite yeteneğinin ideal düzeye ulaşmasında önemli yere sahiptir. Sigara içme, vücut kitle indeksinin 18.5 kg/m2'den az - 25 kg/m2'den fazla olması, egzersiz yapma durumu, alkol tüketimi, kafein tüketimi ve stresin; folikül gelişimi, ovulasyon ve fertilizasyon üzerine olumsuz etkilerinin yanısıra infertiliteye ve yardımcı üreme tekniklerinin başarısızlıkla sonuçlanmasına da neden olduğu gösterilmiştir. Hemşireler; sağlık risk davranışlarının belirlenmesi ve davranış değiştirmeye yönelik girişimlerin planlanarak uygulanmasında, önemli görevlere sahiptirler. Bu nedenle hemşireler infertil çiftleri; sağlıklı yaşam biçiminin üreme sağlığı üzerine etkisi konusunda bilgilendirmeli ve sağlıklı yaşam biçimi davranışları konusunda motive etmelidirler. Bu derlemede amaç literatür ışığında kadınlarda yaşam biçimi davranışlarının fertilite üzerine olumsuz etkilerini açıklamaktır.

Kaynakça

  • Homan G, Norman R. Couples perception regarding how lifestyle mightaffect fertility: results of a pilot study. Australian Journal of Advanced Nursing. 2009; 26(4): 77-87.
  • McLean M, Wellons MF. Optimizing natural fertility: the role of lifestyle modification. Obstetrics & Gynecology Clinics of North America. 2012; 39(4): 465-77.
  • Grainger DA, Tjaden BL. Assisted reproductive technologies. In: Goldman MB, Hatch MC editors. Women and Health. San Diego: Academic Press; 2000.
  • Frey KA, Patel KS. Initial evaluation and management of infertility by the primary care physician. Mayo Clinic Proceedings. 2004; 79(11): 1439–43.
  • HealthyPeople.gov [Internet]. U.S. Department of Health and Human Services. [Cited: 2016 February 20]. Available from: http://healthypeople.gov/2020/topicsobjectives2020/objectiveslist.aspx?topicId=26.
  • Anderson K, Nisenblat V, Norman R. Lifestyle factors in people seeking infertility treatment a review. Australian and New Zealand Journal of Obstetrics Gynaecology. 2010: 50(1): 8–20.
  • Anderson K, Norman RJ, Middleton P. Preconception lifestyle advice for people with subfertility. Cochrane Database of Systematic Reviews. 2010: (4); CD008189. Doi: 10.1002/14651858.CD008189.pub2.
  • Klonoff-Cohen H. Female and male lifestyle habits and IVF: what is known and unknown. Human Reproduction Update. 2005; 11(2): 179–203.
  • Homan GF, Davies M, Norman R. The impact of lifestyle factors on reproductive performance in the general population and thoseundergoing infertility treatment: a review. Human Reproduction Update. 2007; 13(3): 209–23.
  • Practice Committee of American Society for Reproductive Medicine. Smoking and infertility. Fertility and Sterility. 2008; 90(5 Suppl): 254–59.
  • World Health Organization (WHO). Obesity: Preventing and managing the global epidemic. Technical Report Series. Geneva (Switzerland): [Updated: 2000; Cited: 2016 January 5]. Available from: http://www.who.int/nutrition/publications/obesity/WHO_TRS_894/en/.
  • Kelly-Weeder S, O'Connor A. Modifiable risk factors for impaired fertility in women: what nurse practitioners need to know. Journal of the American Association of Nurse Practitioners. 2006; 18(6): 268-76.
  • Centers for Disease Control and Prevention. Women and smoking: A report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. 2001; 5-17.
  • Sadeu JC, Foster WG. Cigarette smoke condensate exposure delays follicular developmentand function in a stage-dependent manner. Fertility and Sterility. 2011; 95(7): 2410–17.
  • Fuentes A, Muñoz A, Barnhart K, Argüello B, Díaz M, Pommer R. Recent cigarette smoking and assisted reproductive technologies outcome. Fertility and Sterility. 2010; 93(1): 89–95.
  • Soares SR, Simon C, Remohi J, Pellicer A. Cigarette smoking affects uterine receptiveness. Human Reproduction. 2007; 22(2): 543–7.
  • Shiloh H, Lahav-Baratz S, Koifman M. The impact of cigarette smoking on zona pellucida thickness of oocytes and embryos prior to transfer into the uterine cavity. Human Reproduction. 2004; 19(1): 157–9.
  • Benedict MD, Missmer SA, Vahratian A, Berry KF, Vitonis AF, Cramer DW et al. Secondhand tobacco smoke exposure is associated with increased risk of failed implantation and reduced IVF success. Human Reproduction. 2011; 26(9): 2525–31.
  • Zenzes MT. Smoking and reproduction: gene damage to human gametes and embryos. Human Reproduction Update. 2000; 6(2): 122–31.
  • Ganesan S, Bhattacharya P, Keating AF. 7,12-Dimethylbenz[a]anthracene exposure induces the DNA repair response in neonatal rat ovaries. Toxicology and Applied Pharmacology. 2013; 272(3): 690–6.
  • Neal MS, Zhu J, Holloway AC, Foster WG. Follicle growth is inhibited by benzo-[a]-pyrene, at concentrations representative of human exposure, in an isolated rat follicle culture assay. Human Reproduction. 2007; 22(4): 961–7.
  • Wu SC, Liu M. In vitro assessment of reproductive toxicity of cigarette smoke and deleterious consequences of maternal exposure to its constituents. Biological Research. 2012; 45(2): 101–9.
  • Lambert-Messerlian GM, Harlow BL. The influence of depression, body mass index, and smoking on serum inhibin B levels in late reproductive-aged women. Journal of Clinical Endocrinology and Metabolism. 2006; 91(4): 1496–500.
  • Kummer V. Mašková J, Zralý Z, Faldyna M. Ovarian disorders in immature rats after postnatal exposure to environmental polycyclic aromatic hydrocarbons. Journal of Applied Toxicology. 2013;33(2): 90–9.
  • El-Nemr A, Al-Shawaf T, Sabatini L, Wilson C, Lower AM, Grudzinskas JG. Effect of smoking on ovarian reserve and ovarian stimulation in in-vitro fertilization and embryo transfer. Human Reproduction. 1998; 13(8): 2192–8.
  • Hayatbakhsh MR, Clavarino A, Williams GM, Sina M, Najman JM. Cigarette smoking and age of menopause: a large prospective study. Maturitas. 2012; 72(4): 346–52.
  • Windham GC, Fenster L, Swan SH. Moderate maternal and paternal alcohol consumption and the risk of spontaneous abortion. Epidemiology. 1992; 3(4): 364–70.
  • Claman P. Men at risk: Occupation and male infertility. Fertility and Sterility. 2004; 81(2): 19–26.
  • Chang SH, Kim CS, Lee KS, Kim H, Yim S., Lim YJ, et al. Premenopausal factors influencing premature ovarian failure and early menopause. Maturitas. 2007; 58(1):19-30.
  • Mikkelsen TF, Graff-Iversen S, Sundby J, Bjertness E. Early menopause, association with tobacco smoking, coffee consumption and other lifestyle factors: a cross-sectional study. BMC Public Health. 2007;7(7): 149.
  • Younglai EV, Holloway AC, Foster WG. Environmental and occupational factors affecting fertility and IVF success. Human Reproduction Update. 2005; 11(1): 43–57.
  • Lintsen AM, Pasker-de Jong PC, de Boer EJ, Burger CW, Jansen CA, Braat DD, et al. Effects of subfertility cause, smoking and body weight on the success rate of IVF. Human Reproduction. 2005; 20(7): 1867–75.
  • Lumley J, Chamberlain C, Dowswell T, Oliver S, Oakley L, Watson L. Interventions for promoting smoking cessation during pregnancy. Cochrane Database of Systematic Reviews. 2009; 8(3): CD001055. doi: 10.1002/14651858.CD001055.pub3.
  • Augood C, Duckitt K, Templeton AA. Smoking and female infertility: a systematic review and metaanalysis. Human Reproduction. 1998; 13(6): 1532–9.
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  • Lipson SF, Ellison PT. Comparison of salivary steroid profiles in naturally occurring conception and nonconception cycles. Human Reproduction. 1996; 111(10): 2090–6.
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  • Domar AD, Dreher H. Healing mind, healthy woman: using the mind-body connection to manage stress and take control of your life. USA: Dell Publishing; 1996.
  • Gill J. The effects of moderate alcohol consumption on female hormone levels and reproductive function. Alcohol. 2000; 35(5): 417–23.
  • Eggert J, Theobald H, Engfeldt P. Effects of alcohol consumption on female fertility during an 18-year period. Fertility and Sterility. 2004; 81(2): 379–83.
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  • Vals K, Kiivet RA, Leinsalu M. Alcohol consumption, smoking and overweight as a burden forhealth care services utilization: A cross-sectional study in Estonia. BMC Public Health. 2013; 13: 772.
  • Mukherjee RA, Hollins S, Abou-Saleh MT, Turk J. Low level alcohol consumption and the fetus. BMJ. 2005; 330(7488): 375–6.
  • Hakim RB, Gray RH, Zacur H. Alcohol and caffeine consumption and decreased fertility. Fertility and Sterility. 1998; 70(4): 632–7.
  • Mutsaerts MA, Groen H, Huiting HG, Kuchenbecker WK, Sauer PJ, Land JA, et al. The influence of maternal and paternal factors on timeto pregnancy–a dutch population-based birth-cohort study: the GECKO dren the study. Human Reproduction. 2012;27(2): 583–93.
  • Rasch V. Cigarette, alcohol, and caffeine consumption: Risk factors forspontaneous abortion. Acta Obstetricia et Gynecologica Scandinavica. 2003; 82(2): 182–8.
  • Guerrini I, Jackson S, Keaney F. Pregnancy and alcohol misuse. British Medical Journal. 2009; 338: 845.
  • Gilmore IT. Excessive drinking in young women: not just a ‘‘lifestyle disease’’. British Medical Journal. 2008; 336(7650): 952–3.
  • Bolumar F, Olsen J, Rebagliato M, Bisanti L. Caffeine intake and delayed conception: a European multicenter study on infertility and sub fecundity. American Journal of Epidemiology. 1997; 145(4): 324–34.
  • Stanton CK, Gray RH. Effects of Caffeine Consumption on Delayed Conception. American Journal of Epidemiology. 1995; 142(12): 1322–9.
  • Wilcox A, Weinberg C, Baird D. Caffeinated beverages and decreased fertility. Lancet. 1988; 2(8626-8627): 1453-6.
  • Nawrot P, Jordan S, Eastwood J, Rotstein J, Hugenholtz A, Feeley M. Effects of caffeine on human health. Food Additives & Contaminants. 2003; 20(1): 1–30.
  • Klonoff-Cohen H, Bleha J, Lam-Kruglick PA. A prospective studyof the effects of female and male caffeine consumption on the reproductive endpoints of IVF and gamete intra-Fallopian transfer. Human Reproduction. 2002; 17(7): 1746–54.
  • Lucero J, Harlow BL, Barbieri RL, Sluss P, Cramer DW. Early follicular phase hormone levels in relation to patterns of alcohol, tobacco, and coffee use. Fertility and Sterility. 2001; 76(4): 723–9.
  • Grodstein F, Goldman MB, Ryan L, Cramer DW. Relation of female infertility to consumption of caffeinated beverages. American Journal of Epidemiology. 1993; 137(12): 1353–60.
  • Cnattingius S, Signorello LB, Anneren G, Clausson B, Ekbom A, Ljunger E, et al. Caffeine intake and the risk of first-trimester spontaneous abortion. The New England Journal of Medicine. 2000; 343(25): 1839–45.
  • Knight CA, Knight I, Mitchell DC, Zepp JE. Beverage caffeine intake in US consumers and subpopulations of interest: estimates from the Share of Intake Panel survey. Food and Chemical Toxicology. 2004; 42(12): 1923–30.
  • Higdon J, Frei B. Coffee and health: a review of recent human research. Critical Reviews Food Science&Nutrition. 2006; 46(2): 101–23.
  • Thiering P, Beaurepaire J, Jones M, Saunders D, Tennant C. Mood state as a predictor of treatment outcome after in vitro fertilization/embryo transfer technology (IVF/ET). Journal of Psychosomatic Research. 1993; 37(5): 481-91.
  • Facchinetti F, Matteo ML, Artini GP, Volpe A, Genazzani AR. An increased vulnerability to stress is associated with a poor outcome of in vitro fertilization-embryo transfer treatment. Fertility and Sterility. 1997; 67(2): 309-14.
  • Demyttenaere K, Bonte L, Gheldof M, Vervaeke M, Meuleman C, Vanderschuerem D, et al. Coping style and depression level influence outcome in in vitro fertilization. Fertility and Sterility. 1998; 69(6): 1026-33.
  • Klonoff-Cohen H, Chu E, Natarajan L, Sieber W. A prospective study of stress among women undergoing in vitro fertilization or gamete intrafallopian transfer. Fertility and Sterility. 2001; 76(4): 675-87.
  • Smeenk JM, Verhaak CM, Eugster A, van Minnen A, Zielhuis GA, Braat DD. The effect of anxiety and depression on the outcome of in-vitro fertilization. Human Reproduction. 2001; 16(7): 1420-3.
  • Terzioglu F. Investigation into effectiveness of counseling on assisted reproductive techniques in Turkey. Journal of Psychosomatic Obstetrics & Gynecology. 2001; 22(3): 133-41.
  • Domar AD, Clapp D, Slawsby EA, Dusek J, Kessel B, Freizinger M. Impact of group psychological interventions on pregnancy rates in infertile women. Fertility and Sterility. 2000; 73(4): 805–11.
  • Olivius C, Friden B, Borg G, Bergh C. Why do couples discontinue in vitro fertilization treatment? A cohort study. Fertility and Sterility. 2004; 81(2): 258–61.
  • Rajkhowa M, McConnell A, Thomas GE. Reasons for discontinuation of IVF treatment: a questionnaire study. Human Reproduction. 2006; 21(2): 358–63.
  • Louis GM, Lum KJ, Sundaram R, Chen Z, Kim S, Lynch CD et al. Stress reduces conception probabilities across the fertile window: Evidence in support of relaxation. Fertility and Sterility. 2011; 95(7): 2184–9.
  • Erol S, Erdoğan S. Sağlık davranışlarını geliştirmek ve değiştirmek için transteoretik modelin kullanılması. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi. 2007; 10(2): 86-94.
  • Damrosch S. General strategies for motivating people to change their behavior, Nursing Clinics of North America. 1991; 26(1): 833-43.
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  • Orem DE. Nursing concepts of practice. 4th ed. St Louis: Mosby Year Book; 1991.
  • Pender NJ. Health promotion and nursing practice. 2nd ed. USA: Appleton&Lange; 1987.
  • Spellbring AM. Nursing’s Role in Health Promotion. Nursing Clinics of North America. 1991; 26(4): 805-13.
  • Gökkoca Z. Sağlık eğitimi açısından temel ilkeler. Sürekli Tıp Eğitim Dergisi. 2001; 10(10): 371-74.
  • Güngör İ, Kızılkaya Beji N. İnfertilite hemşireliği. Kızılkaya Beji N, Editör. İnfertil çiftlerde sağlıklı yaşam biçimi davranışları geliştirme ve hemşirenin rolü. İstanbul: Acar Basım; 2009. s. 163-76.
  • Jose-Miller AB, Boyden JW, Frey KA. Infertility. American Family Physician. 2007; 75(6): 849-56.
  • Quaas A, Dokras A. Diagnosis and treatment of unexplained infertility. Reviews in Obstetric & Gynecology. 2008; 1(2): 69–76.
  • Lowdermilk DL, Perry ES. Maternity Nursing. 7th ed. Elsevier: Mosby; 2006. p. 160-70.
  • Balen AH, Rutherford AJ. Management of infertility. British Medical Journal. 2007; 335(7620): 608-11.
  • Ayaz S, Tezcan S, Akıncı F. Hemşirelik yüksekokulu öğrencilerinin sağlığı geliştirme davranışları. Cumhuriyet Üniversitesi Hemşirelik Yüksek Okulu Dergisi. 2005; 9(2): 2634.
  • Bahar Z, Bayık A. Sağlığın geliştirilmesi ve sağlık eğitimi. LEMON Hemşirelikte Eğitim Materyali. Bölüm 5. Ankara: Sağlık Bakanlığı Yayın no:605:23; 1998.
  • Eser, E. Temel sağlık hizmetleri ve sağlığın geliştirilmesi. l. Ulusal Sağlığı Geliştirme ve Sağlık Eğitimi Kongresi; 2006; Muğla. Kongre Özet Kitabı;2006.
  • Oran TN, Turgay SA. Hemşirelik öğrencilerinin sağlık davranışları. Ege Üniversitesi Hemşirelik Yüksek Okulu Dergisi. 2006; 22(1): 281-91.
  • Özcan A. Hasta hakları ve hemşirelik. Hacettepe Üniversitesi Hemşirelik Yüksek Okulu Dergisi. 1997; 4(2): 79-87.
  • Birol L. Hemşirelik süreci. 4. Baskı. İzmir: Bozyaka Matbaacılık; 2000.
Toplam 104 adet kaynakça vardır.

Ayrıntılar

Konular Sağlık Kurumları Yönetimi
Bölüm Derlemeler
Yazarlar

Yeliz Kaya

Nezihe Kızılkaya Beji Bu kişi benim

Yunus Aydın Bu kişi benim

Hikmet Hassa Bu kişi benim

Yayımlanma Tarihi 16 Ocak 2017
Gönderilme Tarihi 1 Mart 2016
Yayımlandığı Sayı Yıl 2016 Cilt: 6 Sayı: 3

Kaynak Göster

APA Kaya, Y., Kızılkaya Beji, N., Aydın, Y., Hassa, H. (2017). Kadınlarda Yaşam Biçim Davranışlarının Fertilite Üzerine Etkisi. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, 6(3), 190-196.
AMA Kaya Y, Kızılkaya Beji N, Aydın Y, Hassa H. Kadınlarda Yaşam Biçim Davranışlarının Fertilite Üzerine Etkisi. DÜ Sağlık Bil Enst Derg. Ocak 2017;6(3):190-196.
Chicago Kaya, Yeliz, Nezihe Kızılkaya Beji, Yunus Aydın, ve Hikmet Hassa. “Kadınlarda Yaşam Biçim Davranışlarının Fertilite Üzerine Etkisi”. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 6, sy. 3 (Ocak 2017): 190-96.
EndNote Kaya Y, Kızılkaya Beji N, Aydın Y, Hassa H (01 Ocak 2017) Kadınlarda Yaşam Biçim Davranışlarının Fertilite Üzerine Etkisi. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 6 3 190–196.
IEEE Y. Kaya, N. Kızılkaya Beji, Y. Aydın, ve H. Hassa, “Kadınlarda Yaşam Biçim Davranışlarının Fertilite Üzerine Etkisi”, DÜ Sağlık Bil Enst Derg, c. 6, sy. 3, ss. 190–196, 2017.
ISNAD Kaya, Yeliz vd. “Kadınlarda Yaşam Biçim Davranışlarının Fertilite Üzerine Etkisi”. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi 6/3 (Ocak 2017), 190-196.
JAMA Kaya Y, Kızılkaya Beji N, Aydın Y, Hassa H. Kadınlarda Yaşam Biçim Davranışlarının Fertilite Üzerine Etkisi. DÜ Sağlık Bil Enst Derg. 2017;6:190–196.
MLA Kaya, Yeliz vd. “Kadınlarda Yaşam Biçim Davranışlarının Fertilite Üzerine Etkisi”. Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi, c. 6, sy. 3, 2017, ss. 190-6.
Vancouver Kaya Y, Kızılkaya Beji N, Aydın Y, Hassa H. Kadınlarda Yaşam Biçim Davranışlarının Fertilite Üzerine Etkisi. DÜ Sağlık Bil Enst Derg. 2017;6(3):190-6.