Turkiye Klinikleri Journal of Health Sciences

.: ORIGINAL RESEARCH
Determining the Symptoms During Chemotherapy and Learning Needs Among Breast Cancer Patients: A Descriptive Study
Meme Kanserli Hastaların Kemoterapi Esnasında Yaşadığı Semptomlar ve Öğrenim Gereksinimlerinin Belirlenmesi: Tanımlayıcı Bir Araştırma
Hilal TÜRKBEN POLATa, Emine KAPLAN SERİNb
aDepartment of Nursing, Necmettin Erbakan University Seydişehir Kamil Akkanat Faculty of Health Sciences, Konya, Türkiye
bDepartment of Nursing, Gaziantep University Faculty of Health Sciences, Gaziantep, Türkiye
Turkiye Klinikleri J Health Sci. 2022;7(4):1105-111
doi: 10.5336/healthsci.2021-87518
Article Language: EN
Full Text
ABSTRACT
 Objective: This study was conducted to determine the learning needs and disease-related symptoms in women with breast cancer undergoing chemotherapy. Material and Methods: This study was conducted with descriptive and correlational design. The population of the study was composed of female patients with breast cancer who undergoing chemotherapy in the Necmettin Erbakan University Meram Medical Faculty Oncology Hospital Medical Oncology Clinic inpatient unit. The sample of the study was 88 female patients who undergoing chemotherapy with breast cancer who met the inclusion criteria and volunttee to participate in the study. 'Patient Information Form', 'Edmonton Symptom Assessment Scale' and 'Patient Learning Needs Scale' were used as the data collection tool. Results: Patients experienced mostly fatigue (7.62±2.96), depression (6.50±3.41), and anxiety (6.32±3.75). Patients had very significant learning needs. The average Patient Learning Needs Scale score was 181.05±36.53. As disease stage of the patients increased, their Patient Learning Needs Scale score also increased (r=0.221, p=0.039). Conclusion: Training programs should be organized to meet the learning needs of patients. Meeting the learning needs is important for the control of symptoms developing due to chemotherapy, for the patients to have more compliance to the treatment and to increase their life expectancy.

Keywords: Breast neoplasms; drug therapy; nursing; patient education as topic
ÖZET
 Amaç: Bu araştırma, meme kanserli kemoterapi uygulanan kadınlarda hastalığa bağlı semptomların ve öğrenim gereksinimlerinin belirlenmesi amacıyla gerçekleştirildi. Gereç ve Yöntemler: Bu araştırma, tanımlayıcı ve ilişki arayan desende yapıldı. Araştırmanın evrenini Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi Onkoloji Hastanesi Tıbbi Onkoloji Kliniğinde yatarak kemoterapi uygulanan meme kanserli kadın hastalar oluşturdu. Araştırmanın örneklemini ise araştırmaya katılmak isteyen ve dâhil olma kriterlerine uyan meme kanserli kemoterapi uygulanan 88 kadın hasta oluşturdu. Veri toplama aracı olarak 'Hasta Bilgi Formu', 'Edmonton Semptom Değerlendirme Ölçeği' ve 'Hasta Öğrenme İhtiyaçları Ölçeği' kullanıldı. Bulgular: Hastalar çoğunlukla yorgunluk (7,62±2,96), depresyon (6,50±3,41) ve anksiyete (6,32±3,75) yaşamaktaydı. Hastaların çok önemli düzeyde öğrenme gereksinimleri tespit edildi. Ortalama Hasta Öğrenme Gereksinimleri Ölçeği puanı 181,05±36,53 idi. Hastaların hastalık evresi arttıkça Hasta Öğrenme Gereksinimleri Ölçeği puanı da arttı (r=0,221, p=0,039). Sonuç: Hastaların öğrenim gereksinimlerinin karşılanması için eğitim programları düzenlenmelidir. Öğrenim gereksinimlerinin karşılanması kemoterapiye bağlı gelişen semptomların kontrolü, hastaların tedaviye daha fazla uyum sağlayabilmesi ve yaşam süresinin artırılması için önemlidir.

Anahtar Kelimeler: Meme neoplazileri; ilaç tedavisi; hemşirelik; konu olarak hasta eğitimi
REFERENCES:
  1. Özkan M, Akın S. Kanserli hastalarda yorgunluğun fonksiyonel yaşam kalitesi üzerindeki etkisinin değerlendirilmesi [Evaluation of the effect of fatigue on functional quality of life in cancer patients]. Florence Nightingale Journal of Nursing. 2017;25(3):177-92. [Crossref] 
  2. Turkey Global Cancer Observatory. Globocan 2020. Cited: April 3, 2022. Available from [Link] 
  3. ECIS [Internet]. [Cited: April 1, 2022]. European Cancer Information System: European Commission. Available from: [Link] 
  4. Wilkes GM. Chemoterapy: principles od adminstration. In: Yarbro CH, Wujcik D, Gobel BH, eds. Cancer Nursing Principles and Practice. 7th ed. Sudbury, Massachusetts: Jones and Barlett Publishers; 2011. p.390-457.
  5. Mohamed NE, Pisipati S, Lee CT, Goltz HH, Latini DM, Gilbert FS, et al. Unmet informational and supportive care needs of patients following cystectomy for bladder cancer based on age, sex, and treatment choices. Urol Oncol. 2016;34(12):531.e7-531.e14. [Crossref]  [PubMed] 
  6. Yeşilbalkan ÖU. Yorgunluk. Can G, editör. Onkoloji Hemşireliği. 1. Baskı. İstanbul: Nobel Tıp Kitapevleri; 2014. p.335-47.
  7. Bastable SB. Nurse as Educator: Principles of Teaching and Learning for Nursing Practice. 5th ed. Burlington, Massachusetts: Jones & Bartlett Learning; 2017.
  8. Tariman JD, Doorenbos A, Schepp KG, Singhal S, Berry DL. Information needs priorities in patients diagnosed with cancer: a systematic review. J Adv Pract Oncol. 2014;2014(5):115-22. [Crossref]  [PubMed]  [PMC] 
  9. Kemp E, Koczwara B, Butow P, Turner J, Girgis A, Schofield P, et al. Online information and support needs of women with advanced breast cancer: a qualitative analysis. Support Care Cancer. 2018;26(10):3489-96. [Crossref]  [PubMed] 
  10. McRoy S, Rastegar-Mojarad M, Wang Y, Ruddy KJ, Haddad TC, Liu H. Assessing unmet information needs of breast cancer survivors: exploratory study of online health forums using text classification and retrieval. JMIR Cancer. 2018;4(1):e10. [Crossref]  [PubMed]  [PMC] 
  11. Lei CP, Har YC, Abdullah KL. Informational needs of breast cancer patients on chemotherapy: differences between patients' and nurses' perceptions. Asian Pac J Cancer Prev. 2011;12(3):797-802. [PubMed] 
  12. Sharif F, Abshorshori N, Tahmasebi S, Hazrati M, Zare N, Masoumi S. The effect of peer-led education on the life quality of mastectomy patients referred to breast cancer-clinics in Shiraz, Iran 2009. Health Qual Life Outcomes. 2010;8:74. [Crossref]  [PubMed]  [PMC] 
  13. Aslan Ö, Vural H, Kömürcü Ş, Özet A. Kemoterapi alan kanser hastalarına verilen eğitimin kemoterapi semptomlarına etkisi [The effect of training given to cancer patients taking chemotherapy on chemotherapy symptoms]. C.Ü. Hemşirelik Yüksekokulu Dergisi. 2006;10(1):15-28.
  14. Saygılı M, Çelik Y. Kanser tanılı hastalarda palyatif bakım hizmetlerinin etkisinin değerlendirilmesi: semptom düzeyi ve bakım memnuniyeti açısından bir karşılaştırma [An evaluation of palliative care service effect in patients with cancer diagnosis: comparison in terms of the symptom level and care satisfaction]. Ağrı. 2020;32(2):61-71. [PubMed] 
  15. Faul F, Erdfelder E, Buchner A, Lang AG. Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses. Behav Res Methods. 2009;41(4):1149-60. [Crossref]  [PubMed] 
  16. Bruera E, Kuehn N, Miller MJ, Selmser P, Macmillan K. The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care. 1991;7(2):6-9. [Crossref]  [PubMed] 
  17. Sadırlı SK, Ünsar S. Kanserli Hastalarda Edmonton Semptom Tanılama Ölçeği (ESTÖ): Türkçe geçerlilik ve güvenirlik çalışması [Edmonton Symptom Assessment Scale (ESAS) in Patients with Cancer: The Turkish study of validity and reliability]. Fırat Sağlık Hizmetleri Dergisi. 2009;4(11):79-95.
  18. Bubela N, Galloway S, McCay E, McKibbon A, Nagle L, Pringle D, et al. The Patient Learning Needs Scale: reliability and validity. J Adv Nurs. 1990;15(10):1181-7. [Crossref]  [PubMed] 
  19. Çatal E, Dicle A. Hasta Öğrenim Gereksinimleri Ölçeği'nin Türkiye'de geçerlik ve güvenirlik çalışması [The validity and reliability study of the Patient Learning Needs Scale in Turkey]. Dokuz Eylül Üniversitesi Hemşirelik Yüksekokulu Dergisi. 2008;1(1):19-32. [Link] 
  20. Davis LE, Bubis LD, Mahar AL, Li Q, Sussman J, Moody L, et al. Patient-reported symptoms after breast cancer diagnosis and treatment: a retrospective cohort study. Eur J Cancer. 2018;101:1-11. [Crossref]  [PubMed] 
  21. Cuthbert CA, Boyne DJ, Yuan X, Hemmelgarn BR, Cheung WY. Patient-reported symptom burden and supportive care needs at cancer diagnosis: a retrospective cohort study. Support Care Cancer. 2020;28(12):5889-99. [Crossref]  [PubMed] 
  22. Bubis LD, Davis L, Mahar A, Barbera L, Li Q, Moody L, et al. Symptom burden in the first year after cancer diagnosis: an analysis of patient-reported outcomes. J Clin Oncol. 2018;36(11):1103-11. [Crossref]  [PubMed] 
  23. Enright K, Grunfeld E, Yun L, Moineddin R, Ghannam M, Dent S, et al. Population-based assessment of emergency room visits and hospitalizations among women receiving adjuvant chemotherapy for early breast cancer. J Oncol Pract. 2015;11(2):126-32. [Crossref]  [PubMed] 
  24. Fiorentino L, Rissling M, Liu L, Ancoli-Israel S. The symptom cluster of sleep, fatigue and depressive symptoms in breast cancer patients: severity of the problem and treatment options. Drug Discov Today Dis Models. 2011;8(4):167-73. [Crossref]  [PubMed]  [PMC] 
  25. Runowicz CD, Leach CR, Henry NL, Henry KS, Mackey HT, Cowens-Alvarado RL, et al. American Cancer Society/American Society of Clinical Oncology Breast Cancer Survivorship Care Guideline. J Clin Oncol. 2016;34(6):611-35. [Crossref]  [PubMed] 
  26. Ferrante JM, Chen PH, Kim S. The effect of patient navigation on time to diagnosis, anxiety, and satisfaction in urban minority women with abnormal mammograms: a randomized controlled trial. J Urban Health. 2008;85(1):114-24. [Crossref]  [PubMed]  [PMC] 
  27. Kav S, Tokdemir G, Tasdemir R, Yalili A, Dinc D. Patients with cancer and their relatives beliefs, information needs and information-seeking behavior about cancer and treatment. Asian Pac J Cancer Prev. 2012;13(12):6027-32. [Crossref]  [PubMed] 
  28. Çalışkan T, Duran S, Karadaş A, Ergün S, Tekir Ö. Kanser hastalarının yaşam kalitesi ve sosyal destek düzeylerinin değerlendirilmesi [Assessment the levels of life quality and social support of the cancer patients]. KÜ Tıp Fak Dergisi. 2015;17(1):27-36. [Crossref] 
  29. Carpenter CCJ, Griggs RC, Loscalzo J, eds. Çavuşoğlu H, Akın S, Alican İ, Direskeneli GS, çeviri editörleri. Cecil Essentials of Medicine. 8. Baskı. İstanbul: Nobel Kitapevi; 2015. p.485-512.
  30. Findik UY. The Information needs of women who have undergone breast cancer surgery in the west of Turkey. J Cancer Educ. 2017;32(3):432-7. [Crossref]  [PubMed] 
  31. Kimiafar K, Sarbaz M, Shahid Sales S, Esmaeili M, Javame Ghazvini Z. Breast cancer patients' information needs and information-seeking behavior in a developing country. Breast. 2016;28:156-60. [Crossref]  [PubMed] 
  32. Cheng KK, Darshini Devi R, Wong WH, Koh C. Perceived symptoms and the supportive care needs of breast cancer survivors six months to five years post-treatment period. Eur J Oncol Nurs. 2014;18(1):3-9. [Crossref]  [PubMed] 
  33. Demark-Wahnefried W, Platz EA, Ligibel JA, Blair CK, Courneya KS, Meyerhardt JA, et al. The role of obesity in cancer survival and recurrence. Cancer Epidemiol Biomarkers Prev. 2012;21(8):1244-59. [PubMed]  [PMC] 
  34. Chan DSM, Vieira AR, Aune D, Bandera EV, Greenwood DC, McTiernan A, et al. Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies. Ann Oncol. 2014;25(10):1901-14. [Crossref]  [PubMed]  [PMC] 
  35. Beaver K, Twomey M, Witham G, Foy S, Luker KA. Meeting the information needs of women with breast cancer: piloting a nurse-led intervention. Eur J Oncol Nurs. 2006;10(5):378-90. [Crossref]  [PubMed] 

.: Up To Date

Login

 Forgot your password?

 New Registration  

Contact

Ortadoğu Reklam Tanıtım Yayıncılık Turizm Eğitim İnşaat Sanayi ve Ticaret A.Ş.

.: Address

Turkocagi Caddesi No:30 06520 Balgat / ANKARA
Phone: +90 312 286 56 56
Fax: +90 312 220 04 70
E-mail: info@turkiyeklinikleri.com

.: Manuscript Editing Department

Phone: +90 312 286 56 56/ 2
E-mail: yaziisleri@turkiyeklinikleri.com

.: English Language Redaction

Phone: +90 312 286 56 56/ 145
E-mail: tkyayindestek@turkiyeklinikleri.com

.: Marketing Sales-Project Department

Phone: +90 312 286 56 56/ 142
E-mail: reklam@turkiyeklinikleri.com

.: Subscription and Public Relations Department

Phone: +90 312 286 56 56/ 118
E-mail: abone@turkiyeklinikleri.com

.: Customer Services

Phone: +90 312 286 56 56/ 118
E-mail: satisdestek@turkiyeklinikleri.com

1. TERMS OF USE

1.1. To use the web pages with http://www.turkiyeklinikleri.com domain name or the websites reached through the sub domain names attached to the domain name (They will be collectively referred as "SITE"), please read the conditions below. If you do not accept these terms, please cease to use the "SITE." "SITE" owner reserves the right to change the information on the website, forms, contents, the "SITE," "SITE" terms of use anytime they want.

1.2. The owner of the "SITE" is Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. (From now on it is going to be referred as "Turkiye Klinikleri", shortly) and it resides at Turkocagi cad. No:30, 06520 Balgat Ankara. The services in the "SITE" are provided by "Turkiye Klinikleri."

1.3. Anyone accessing the "SITE" with or without a fee whether they are a natural person or a legal identity is considered to agree these terms of use. In this contract hereby, "Turkiye Klinikleri" may change the stated terms anytime. These changes will be published in the "SITE" periodically and they will be valid when they are published. Any natural person or legal identity benefiting from and reaching to the "SITE" are considered to be agreed to any change on hereby contract terms done by "Turkiye Klinikleri."

1.4. The "Terms of Use" hereby is published in the website with the last change on March 30th 2014 and the "SITE" is activated by enabling the access to everyone. The "Terms of Use" hereby is also a part of the any "USER Contract" was and/or will be done with the users using "Turkiye Klinikleri" services with or without a fee an inseparable.

2. DEFINITIONS

2.1. "SITE": A website offering different kind of services and context with a certain frame determined by "Turkiye Klinikleri" and it is accessible on-line on http://www.turkiyeklinikleri.com domain name and/or subdomains connected to the domain name.

2.2. USER: A natural person or a legal identity accessing to the "SITE" through online settings.

2.3. LINK: A link enabling to access to another website through the "SITE", the files, the context or through another website to the "SITE", the files and the context.

2.4. CONTEXT: Any visual, literary and auditory images published in the "Turkiye Klinikleri", "SITE" and/or any website or any accessible information, file, picture, number/figures, price, etc.

2.5. "USER CONTRACT": An electronically signed contract between a natural or a legal identity benefiting from special services "Turkiye Klinikleri" will provide and "Turkiye Klinikleri".

3. SCOPE OF THE SERVICES

3.1. "Turkiye Klinikleri" is completely free to determine the scope and quality of the services via the "SITE".

3.2. To benefit the services of "Turkiye Klinikleri" "SITE", the "USER" must deliver the features that will be specified by "Turkiye Klinikleri". "Turkiye Klinikleri" may change this necessity any time single-sided.

3.3. Not for a limited number, the services "Turkiye Klinikleri" will provide through the "SITE" for a certain price or for free are;

- Providing scientific articles, books and informative publications for health industry.

- Providing structural, statistical and editorial support to article preparation stage for scientific journals.

4. GENERAL PROVISIONS

4.1. "Turkiye Klinikleri" is completely free to determine which of the services and contents provided in the "SITE" will be charged.

4.2. People benefiting from the services provided by "Turkiye Klinikleri" and using the website can use the "SITE" only according to the law and only for personal reasons. Users have the criminal and civil liability for every process and action they take in the "SITE". Every USER agrees, declares and undertakes that they will not proceed by any function or action infringement of rights of "Turkiye Klinikleri"s and/or other third parties', they are the exclusive right holder on usage, processing, storage, made public and revealing any written, visual or auditory information reported to Turkiye Klinikleri" and/or "SITE" to the third parties. "USER" agrees and undertakes that s/he will not duplicate, copy, distribute, process, the pictures, text, visual and auditory images, video clips, files, databases, catalogs and lists within the "SITE", s/he will not be using these actions or with other ways to compete with "Turkiye Klinikleri", directly or indirectly.

4.3. The services provided and the context published within the "SITE" by third parties is not under the responsibility of "Turkiye Klinikleri", institutions collaborated with "Turkiye Klinikleri", "Turkiye Klinikleri" employee and directors, "Turkiye Klinikleri" authorized salespeople. Commitment to accuracy and legality of the published information, context, visual and auditory images provided by any third party are under the full responsibility of the third party. "Turkiye Klinikleri" does not promise and guarantee the safety, accuracy and legality of the services and context provided by a third party.

4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com