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Multiple Sklerozlu Bireylerde Enerji Koruma ve Zaman Yönetimi Eğitiminin Yorgunluğa ve Okupasyonel Performansa Etkisi

Yıl 2021, Cilt: 9 Sayı: 3, 63 - 70, 20.12.2021
https://doi.org/10.30720/ered.930289

Öz

Amaç: Multiple Skleroz’da (MS) yorgunluk, bireyin rutin okupasyonlarını tamamlayamaması ile tanımlanan fiziksel ve mental enerji eksikliğidir. Bu çalışmanın amacı MS’de enerji koruma ve zaman yönetimi eğitiminin yorgunluğa ve oküpasyonel performansa etkisini incelemektir. Gereç ve Yöntem: Bireylere Yorgunluk Şiddet Ölçeği, Yorgunluk Etki Ölçeği (YEÖ), Kanada Aktivite Performansı Ölçümü uygulandı. Tüm bu değerlendirmeler eğitim öncesi ve sonrası olmak üzere 2 kez yapıldı. Bireylere toplam 10 seans enerji koruma ve zaman yönetimi eğitimi verildi. Sonuçlar: Çalışmaya yaş ortalaması 39,66±10,92 yıl olan 15 kişi dahil edildi. Eğitim öncesi ve sonrası bulgular karşılaştırıldığında bireylerin yorgunluk şiddeti (p=0.001) , yorgunluğun etkilediği bilişsel alan (p=0.001), sosyal alan (p=0.003), fiziksel alan (p=0.001) ve toplam YEÖ puanlarında (p=0.001) azalma görüldü. Bireylerin okupasyonel performans (p<0.001) ve memnuniyet (p<0.001) değerlerinde ise istatistiksel olarak anlamlı artış görüldü. Tartışma: Enerji koruma ve zaman yönetimi eğitiminin MS’li bireylerin yorgunluk, okupasyonel performans ve memnuniyet üzerine olumlu etkileri olduğu görülmüştür. Bu nedenle MS’de enerji koruma ve zaman yönetimi eğitiminin müdahale programlarına dahil edilmesi yararlı olacaktır. Daha büyük örneklem gruplarının dahil edildiği, kontrollü ve takipli çalışmalara ihtiyaç vardır.

Kaynakça

  • Armutlu, K., Keser, İ., Korkmaz, N., Akbıyık, D. İ., Sümbüloğlu, V., Güney, Z. ve ark. (2007). Psychometric study of Turkish version of Fatigue Impact Scale in multiple sclerosis patients. J Neurol Sci, 255(1–2), 64–68. https://doi.org/10.1016/j.jns.2007.01.073
  • Armutlu, K., Korkmaz, N. C., Keser, I., Sumbuloglu, V., Akbiyik, D. I., Guney, Z. ve ark. (2007). The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. Int J Rehabil Res, 30(1), 81–85. https://doi.org/10.1097/MRR.0b013e3280146ec4
  • Audulv, Å., Hutchinson, S., Warner, G., Kephart, G., Versnel, J., & Packer, T. L. (2021). Managing everyday life: Self-management strategies people use to live well with neurological conditions. Patient Educ Couns, 104(2), 413–421. https://doi.org/10.1016/j.pec.2020.07.025
  • Ayache, S. S., & Chalah, M. A. (2017). Fatigue in multiple sclerosis–insights into evaluation and management. Clin Neurophysiol, 47(2), 139–171. https://doi.org/10.1016/j.neucli.2017.02.004
  • Barin, L., Salmen, A., Disanto, G., Babačić, H., Calabrese, P., Chan, A. ve ark. (2018). The disease burden of multiple sclerosis from the individual and population perspective: which symptoms matter most? Mult Scler Relat Disord, 25, 112–121. https://doi.org/10.1016/j.msard.2018.07.013
  • Blikman, L. J. M., van Meeteren, J., Twisk, J. W. R., de Laat, F. A. J., de Groot, V., Beckerman, H. ve ark. (2019). Energy Conservation Management for People With Multiple Sclerosis–Related Fatigue: Who Benefits? Am J Occup Ther, 73(4), 7304205040p1-7304205040p9. https://doi.org/10.5014/ajot.2019.032474
  • Blikman, L. J. M., van Meeteren, J., Twisk, J. W. R., de Laat, F. A. J., de Groot, V., Beckerman, H. ve ark. (2017). Effectiveness of energy conservation management on fatigue and participation in multiple sclerosis: A randomized controlled trial. Mult Scler J, 23(11), 1527–1541. https://doi.org/10.1177/1352458517702751
  • Börü, Ü. T., Duman, A., Kulualp, A. Ş., Güler, N., Taşdemir, M., Yılmaz, Ü. ve ark. (2018). Multiple sclerosis prevalence study: The comparison of 3 coastal cities, located in the black sea and mediterranean regions of Turkey. Medicine (Baltimore), 97(42). https://doi.org/10.1097/MD.0000000000012856
  • Carswell, A., McColl, M. A., Baptiste, S., Law, M., Polatajko, H., & Pollock, N. (2004). The Canadian Occupational Performance Measure: a research and clinical literature review. Can J Occup Ther, 71(4), 210–222. https://doi.org/10.1177/000841740407100406
  • De-Bernardi-Ojuel, L., Torres-Collado, L., & García-de-la-Hera, M. (2021). Occupational therapy interventions in adults with multiple sclerosis or amyotrophic lateral sclerosis: a scoping review. Int J Environ Res Public Health, 18(4), 1432. https://doi.org/10.3390/ijerph18041432
  • de Heredia-Torres, M. P., Huertas-Hoyas, E., Sánchez-Camarero, C., Máximo-Bocanegra, N., Alegre-Ayala, J., Sanchez-Herrera-Baeza, P. ve ark. (2020). Occupational performance in multiple sclerosis and its relationship with quality of life and fatigue. Eur J Phys Rehabil Med, 56(2), 148–154. https://doi.org/10.23736/s1973-9087.20.05914-6
  • Fritz, C. O., Morris, P. E., & Richler, J. J. (2012). Effect size estimates: current use, calculations, and interpretation. J Exp Psychol Gen, 141(1), 2-18. https://doi.org/10.1037/a0024338
  • García Jalón, E. G., Lennon, S., Peoples, L., Murphy, S., & Lowe-Strong, A. (2013). Energy conservation for fatigue management in multiple sclerosis: a pilot randomized controlled trial. Clin Rehabil, 27(1), 63–74. https://doi.org/10.1177/0269215512446495
  • Gilmour, H., Ramage-Morin, P. L., & Wong, S. L. (2018). Multiple sclerosis: Prevalence and impact. Heal Reports, 29(1), 3–8.
  • Giovannoni, G., Butzkueven, H., Dhib-Jalbut, S., Hobart, J., Kobelt, G., Pepper, G. ve ark. (2016). Brain health: time matters in multiple sclerosis. Mult Scler Relat Disord, 9, S5–S48. https://doi.org/10.1016/j.msard.2016.07.003
  • Green, E., Huynh, A., Broussard, L., Zunker, B., Matthews, J., Hilton, C. L. ve ark. (2019). Systematic review of yoga and balance: effect on adults with neuromuscular impairment. Am J Occup Ther, 73(1), 7301205150p1-7301205150p11. https://doi.org/10.5014/ajot.2019.028944
  • Hyarat, S. Y., Subih, M., Rayan, A., Salami, I., & Harb, A. (2019). Health related quality of life among patients with multiple sclerosis: the role of psychosocial adjustment to illness. Arch Psychiatr Nurs, 33(1), 11–16. https://doi.org/10.1016/j.apnu.2018.08.006
  • Kalb, R., Brown, T. R., Coote, S., Costello, K., Dalgas, U., Garmon, E. ve ark. (2020). Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course. Mult Scler J, 26(12), 1459–1469. https://doi.org/10.1177/1352458520915629
  • Kidd, T., Carey, N., Mold, F., Westwood, S., Miklaucich, M., Konstantara, E. ve ark. (2017). A systematic review of the effectiveness of self-management interventions in people with multiple sclerosis at improving depression, anxiety and quality of life. PLoS One, 12(10), e0185931. https://doi.org/10.1371/journal.pone.0185931
  • Kos, D., Duportail, M., Meirte, J., Meeus, M., D’hooghe, M. B., Nagels, G. ve ark. (2016). The effectiveness of a self-management occupational therapy intervention on activity performance in individuals with multiple sclerosis-related fatigue: a randomized-controlled trial. Int J Rehabil Res, 39(3), 255–262. https://doi.org/10.1097/MRR.0000000000000178
  • Law, M. C., Baptiste, S., Carswell, A., McColl, M. A., Polatajko, H., & Pollock, N. (1998). Canadian Occupational Performance Measure: COPM. CAOT Publ. ACE.
  • O’Loughlin, E., Hourihan, S., Chataway, J., Playford, E. D., & Riazi, A. (2017). The experience of transitioning from relapsing remitting to secondary progressive multiple sclerosis: views of patients and health professionals. Disabil Rehabil, 39(18), 1821–1828. https://doi.org/10.1080/09638288.2016.1211760
  • Packer, T. L. (1995). Managing fatigue: a six-week course for energy conservation. Therapy Skill Builders. Tuscon, Ariz.
  • Patel, S., SirDeshpande, P., Desai, R., Desai, N., Mistry, H., Patel, N. ve ark. (2019). Thirty-day readmissions in multiple sclerosis: An age and gender-based US national retrospective analysis. Mult Scler Relat Disord, 31, 41–50. https://doi.org/10.1016/j.msard.2019.03.012
  • Quinn, É., & Hynes, S. M. (2020). Occupational therapy interventions for multiple sclerosis: A scoping review. Scand J Occup Ther, 28(5), 1–16. https://doi.org/10.1080/11038128.2020.1786160
  • Salomè, A., Sasso D’Elia, T., Franchini, G., Santilli, V., & Paolucci, T. (2019). Occupational therapy in fatigue management in multiple sclerosis: an umbrella review. Mult Scler Int, 2019, Article ID 2027947, 7 pages. https://doi.org/10.1155/2019/2027947
  • Torpil, B., Ekici-Çağlar, G., & Bumin, G. (2018). Reliability and validity of the Canadian Occupational Performance Measure in people with multiple sclerosis. J Exerc Ther Rehabil, 5(2), 68.
  • van den Akker, L. E., Beckerman, H., Collette, E. H., Eijssen, I. C. J. M., Dekker, J., & de Groot, V. (2016). Effectiveness of cognitive behavioral therapy for the treatment of fatigue in patients with multiple sclerosis: a systematic review and meta-analysis. J Psychosom Res, 90, 33–42. https://doi.org/10.1016/j.jpsychores.2016.09.002
  • van Zanten, J. V., Douglas, M. R., & Ntoumanis, N. (2021). Fatigue and fluctuations in physical and psychological wellbeing in people with multiple sclerosis: a longitudinal study. Mult Scler Relat Disord, 47, 102602. https://doi.org/10.1016/j.msard.2020.102602
  • Yu, C.-H., & Mathiowetz, V. (2014). Systematic review of occupational therapy–related interventions for people with multiple sclerosis: Part 1. Activity and participation. Am J Occup Ther, 68(1), 27–32. https://doi.org/10.5014/ajot.2014.008672

Effects of Energy Conservation and Time Management Training on Fatigue and Occupational Performance in Individuals with Multiple Sclerosis

Yıl 2021, Cilt: 9 Sayı: 3, 63 - 70, 20.12.2021
https://doi.org/10.30720/ered.930289

Öz

Purpose: Fatigue in Multiple Sclerosis (MS) is the lack of physical and mental energy, defined by the individual's inability to complete routine activities. The purpose of this study is to examine the effect of energy conservation and time-management training on fatigue and occupational performance with MS. Material and Methods: Fatigue Severity Scale, Fatigue Impact Scale (FIS) and Canadian Occupational Performance Measure were done before and after the training. Individuals received 10 sessions of energy conservation and time-management training. Results: 15 individuals with a mean age of 39.66±10.92 years were included in the study. When the scores of before and after the training were compared, decreases were seen in terms of the fatigue severity (p=0.001), cognitive domain affected by fatigue (p=0.001), social area (p=0.003), physical area (p=0.001) and in total FIS (p=0.001). There was a significant increase in occupational performance (p<0.001) and satisfaction (p<0.001) of individuals. Discussion: Energy conservation and time-management training have been found to have positive effects on fatigue and occupational performance in individuals with MS. So, it would be beneficial to include energy conservation and time-management training in intervention programs for MS. There is a need for controlled follow-up studies with larger sample groups

Kaynakça

  • Armutlu, K., Keser, İ., Korkmaz, N., Akbıyık, D. İ., Sümbüloğlu, V., Güney, Z. ve ark. (2007). Psychometric study of Turkish version of Fatigue Impact Scale in multiple sclerosis patients. J Neurol Sci, 255(1–2), 64–68. https://doi.org/10.1016/j.jns.2007.01.073
  • Armutlu, K., Korkmaz, N. C., Keser, I., Sumbuloglu, V., Akbiyik, D. I., Guney, Z. ve ark. (2007). The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. Int J Rehabil Res, 30(1), 81–85. https://doi.org/10.1097/MRR.0b013e3280146ec4
  • Audulv, Å., Hutchinson, S., Warner, G., Kephart, G., Versnel, J., & Packer, T. L. (2021). Managing everyday life: Self-management strategies people use to live well with neurological conditions. Patient Educ Couns, 104(2), 413–421. https://doi.org/10.1016/j.pec.2020.07.025
  • Ayache, S. S., & Chalah, M. A. (2017). Fatigue in multiple sclerosis–insights into evaluation and management. Clin Neurophysiol, 47(2), 139–171. https://doi.org/10.1016/j.neucli.2017.02.004
  • Barin, L., Salmen, A., Disanto, G., Babačić, H., Calabrese, P., Chan, A. ve ark. (2018). The disease burden of multiple sclerosis from the individual and population perspective: which symptoms matter most? Mult Scler Relat Disord, 25, 112–121. https://doi.org/10.1016/j.msard.2018.07.013
  • Blikman, L. J. M., van Meeteren, J., Twisk, J. W. R., de Laat, F. A. J., de Groot, V., Beckerman, H. ve ark. (2019). Energy Conservation Management for People With Multiple Sclerosis–Related Fatigue: Who Benefits? Am J Occup Ther, 73(4), 7304205040p1-7304205040p9. https://doi.org/10.5014/ajot.2019.032474
  • Blikman, L. J. M., van Meeteren, J., Twisk, J. W. R., de Laat, F. A. J., de Groot, V., Beckerman, H. ve ark. (2017). Effectiveness of energy conservation management on fatigue and participation in multiple sclerosis: A randomized controlled trial. Mult Scler J, 23(11), 1527–1541. https://doi.org/10.1177/1352458517702751
  • Börü, Ü. T., Duman, A., Kulualp, A. Ş., Güler, N., Taşdemir, M., Yılmaz, Ü. ve ark. (2018). Multiple sclerosis prevalence study: The comparison of 3 coastal cities, located in the black sea and mediterranean regions of Turkey. Medicine (Baltimore), 97(42). https://doi.org/10.1097/MD.0000000000012856
  • Carswell, A., McColl, M. A., Baptiste, S., Law, M., Polatajko, H., & Pollock, N. (2004). The Canadian Occupational Performance Measure: a research and clinical literature review. Can J Occup Ther, 71(4), 210–222. https://doi.org/10.1177/000841740407100406
  • De-Bernardi-Ojuel, L., Torres-Collado, L., & García-de-la-Hera, M. (2021). Occupational therapy interventions in adults with multiple sclerosis or amyotrophic lateral sclerosis: a scoping review. Int J Environ Res Public Health, 18(4), 1432. https://doi.org/10.3390/ijerph18041432
  • de Heredia-Torres, M. P., Huertas-Hoyas, E., Sánchez-Camarero, C., Máximo-Bocanegra, N., Alegre-Ayala, J., Sanchez-Herrera-Baeza, P. ve ark. (2020). Occupational performance in multiple sclerosis and its relationship with quality of life and fatigue. Eur J Phys Rehabil Med, 56(2), 148–154. https://doi.org/10.23736/s1973-9087.20.05914-6
  • Fritz, C. O., Morris, P. E., & Richler, J. J. (2012). Effect size estimates: current use, calculations, and interpretation. J Exp Psychol Gen, 141(1), 2-18. https://doi.org/10.1037/a0024338
  • García Jalón, E. G., Lennon, S., Peoples, L., Murphy, S., & Lowe-Strong, A. (2013). Energy conservation for fatigue management in multiple sclerosis: a pilot randomized controlled trial. Clin Rehabil, 27(1), 63–74. https://doi.org/10.1177/0269215512446495
  • Gilmour, H., Ramage-Morin, P. L., & Wong, S. L. (2018). Multiple sclerosis: Prevalence and impact. Heal Reports, 29(1), 3–8.
  • Giovannoni, G., Butzkueven, H., Dhib-Jalbut, S., Hobart, J., Kobelt, G., Pepper, G. ve ark. (2016). Brain health: time matters in multiple sclerosis. Mult Scler Relat Disord, 9, S5–S48. https://doi.org/10.1016/j.msard.2016.07.003
  • Green, E., Huynh, A., Broussard, L., Zunker, B., Matthews, J., Hilton, C. L. ve ark. (2019). Systematic review of yoga and balance: effect on adults with neuromuscular impairment. Am J Occup Ther, 73(1), 7301205150p1-7301205150p11. https://doi.org/10.5014/ajot.2019.028944
  • Hyarat, S. Y., Subih, M., Rayan, A., Salami, I., & Harb, A. (2019). Health related quality of life among patients with multiple sclerosis: the role of psychosocial adjustment to illness. Arch Psychiatr Nurs, 33(1), 11–16. https://doi.org/10.1016/j.apnu.2018.08.006
  • Kalb, R., Brown, T. R., Coote, S., Costello, K., Dalgas, U., Garmon, E. ve ark. (2020). Exercise and lifestyle physical activity recommendations for people with multiple sclerosis throughout the disease course. Mult Scler J, 26(12), 1459–1469. https://doi.org/10.1177/1352458520915629
  • Kidd, T., Carey, N., Mold, F., Westwood, S., Miklaucich, M., Konstantara, E. ve ark. (2017). A systematic review of the effectiveness of self-management interventions in people with multiple sclerosis at improving depression, anxiety and quality of life. PLoS One, 12(10), e0185931. https://doi.org/10.1371/journal.pone.0185931
  • Kos, D., Duportail, M., Meirte, J., Meeus, M., D’hooghe, M. B., Nagels, G. ve ark. (2016). The effectiveness of a self-management occupational therapy intervention on activity performance in individuals with multiple sclerosis-related fatigue: a randomized-controlled trial. Int J Rehabil Res, 39(3), 255–262. https://doi.org/10.1097/MRR.0000000000000178
  • Law, M. C., Baptiste, S., Carswell, A., McColl, M. A., Polatajko, H., & Pollock, N. (1998). Canadian Occupational Performance Measure: COPM. CAOT Publ. ACE.
  • O’Loughlin, E., Hourihan, S., Chataway, J., Playford, E. D., & Riazi, A. (2017). The experience of transitioning from relapsing remitting to secondary progressive multiple sclerosis: views of patients and health professionals. Disabil Rehabil, 39(18), 1821–1828. https://doi.org/10.1080/09638288.2016.1211760
  • Packer, T. L. (1995). Managing fatigue: a six-week course for energy conservation. Therapy Skill Builders. Tuscon, Ariz.
  • Patel, S., SirDeshpande, P., Desai, R., Desai, N., Mistry, H., Patel, N. ve ark. (2019). Thirty-day readmissions in multiple sclerosis: An age and gender-based US national retrospective analysis. Mult Scler Relat Disord, 31, 41–50. https://doi.org/10.1016/j.msard.2019.03.012
  • Quinn, É., & Hynes, S. M. (2020). Occupational therapy interventions for multiple sclerosis: A scoping review. Scand J Occup Ther, 28(5), 1–16. https://doi.org/10.1080/11038128.2020.1786160
  • Salomè, A., Sasso D’Elia, T., Franchini, G., Santilli, V., & Paolucci, T. (2019). Occupational therapy in fatigue management in multiple sclerosis: an umbrella review. Mult Scler Int, 2019, Article ID 2027947, 7 pages. https://doi.org/10.1155/2019/2027947
  • Torpil, B., Ekici-Çağlar, G., & Bumin, G. (2018). Reliability and validity of the Canadian Occupational Performance Measure in people with multiple sclerosis. J Exerc Ther Rehabil, 5(2), 68.
  • van den Akker, L. E., Beckerman, H., Collette, E. H., Eijssen, I. C. J. M., Dekker, J., & de Groot, V. (2016). Effectiveness of cognitive behavioral therapy for the treatment of fatigue in patients with multiple sclerosis: a systematic review and meta-analysis. J Psychosom Res, 90, 33–42. https://doi.org/10.1016/j.jpsychores.2016.09.002
  • van Zanten, J. V., Douglas, M. R., & Ntoumanis, N. (2021). Fatigue and fluctuations in physical and psychological wellbeing in people with multiple sclerosis: a longitudinal study. Mult Scler Relat Disord, 47, 102602. https://doi.org/10.1016/j.msard.2020.102602
  • Yu, C.-H., & Mathiowetz, V. (2014). Systematic review of occupational therapy–related interventions for people with multiple sclerosis: Part 1. Activity and participation. Am J Occup Ther, 68(1), 27–32. https://doi.org/10.5014/ajot.2014.008672
Toplam 30 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Rehabilitasyon
Bölüm Araştırma Makalesi
Yazarlar

Gamze Ekici 0000-0002-7423-178X

Ege Temizkan 0000-0002-8275-1777

Elif Pekşen 0000-0002-8041-7804

Yayımlanma Tarihi 20 Aralık 2021
Yayımlandığı Sayı Yıl 2021 Cilt: 9 Sayı: 3

Kaynak Göster

APA Ekici, G., Temizkan, E., & Pekşen, E. (2021). Multiple Sklerozlu Bireylerde Enerji Koruma ve Zaman Yönetimi Eğitiminin Yorgunluğa ve Okupasyonel Performansa Etkisi. Ergoterapi Ve Rehabilitasyon Dergisi, 9(3), 63-70. https://doi.org/10.30720/ered.930289
AMA Ekici G, Temizkan E, Pekşen E. Multiple Sklerozlu Bireylerde Enerji Koruma ve Zaman Yönetimi Eğitiminin Yorgunluğa ve Okupasyonel Performansa Etkisi. Ergoterapi ve Rehabilitasyon Dergisi. Aralık 2021;9(3):63-70. doi:10.30720/ered.930289
Chicago Ekici, Gamze, Ege Temizkan, ve Elif Pekşen. “Multiple Sklerozlu Bireylerde Enerji Koruma Ve Zaman Yönetimi Eğitiminin Yorgunluğa Ve Okupasyonel Performansa Etkisi”. Ergoterapi Ve Rehabilitasyon Dergisi 9, sy. 3 (Aralık 2021): 63-70. https://doi.org/10.30720/ered.930289.
EndNote Ekici G, Temizkan E, Pekşen E (01 Aralık 2021) Multiple Sklerozlu Bireylerde Enerji Koruma ve Zaman Yönetimi Eğitiminin Yorgunluğa ve Okupasyonel Performansa Etkisi. Ergoterapi ve Rehabilitasyon Dergisi 9 3 63–70.
IEEE G. Ekici, E. Temizkan, ve E. Pekşen, “Multiple Sklerozlu Bireylerde Enerji Koruma ve Zaman Yönetimi Eğitiminin Yorgunluğa ve Okupasyonel Performansa Etkisi”, Ergoterapi ve Rehabilitasyon Dergisi, c. 9, sy. 3, ss. 63–70, 2021, doi: 10.30720/ered.930289.
ISNAD Ekici, Gamze vd. “Multiple Sklerozlu Bireylerde Enerji Koruma Ve Zaman Yönetimi Eğitiminin Yorgunluğa Ve Okupasyonel Performansa Etkisi”. Ergoterapi ve Rehabilitasyon Dergisi 9/3 (Aralık 2021), 63-70. https://doi.org/10.30720/ered.930289.
JAMA Ekici G, Temizkan E, Pekşen E. Multiple Sklerozlu Bireylerde Enerji Koruma ve Zaman Yönetimi Eğitiminin Yorgunluğa ve Okupasyonel Performansa Etkisi. Ergoterapi ve Rehabilitasyon Dergisi. 2021;9:63–70.
MLA Ekici, Gamze vd. “Multiple Sklerozlu Bireylerde Enerji Koruma Ve Zaman Yönetimi Eğitiminin Yorgunluğa Ve Okupasyonel Performansa Etkisi”. Ergoterapi Ve Rehabilitasyon Dergisi, c. 9, sy. 3, 2021, ss. 63-70, doi:10.30720/ered.930289.
Vancouver Ekici G, Temizkan E, Pekşen E. Multiple Sklerozlu Bireylerde Enerji Koruma ve Zaman Yönetimi Eğitiminin Yorgunluğa ve Okupasyonel Performansa Etkisi. Ergoterapi ve Rehabilitasyon Dergisi. 2021;9(3):63-70.

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