Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
Karaciğer Hastalıklarının Yönetiminde Telesağlık Uygulamalarının Etkisi: Sistematik Derleme
The Effect of Telehealth Interventions in Management of Liver Diseases: Systematic Review
Ferya ÇELİKa, Hicran BEKTAŞa
aİç Hastalıkları Hemşireliği ABD, Akdeniz Üniversitesi Hemşirelik Fakültesi, Antalya, TÜRKİYE
Turkiye Klinikleri J Nurs Sci. 2019;11(3):295-304
doi: 10.5336/nurses.2018-64286
Article Language: TR
Full Text
ÖZET
 Amaç: Karaciğer hastalıklarının hemşirelik bakım sürecinde telesağlık uygulamaları kullanılmaktadır. Bu sistematik derlemenin amacı karaciğer hastalıklarının yönetiminde telesağlık uygulamalarının etkisini incelemektir. Gereç ve Yöntemler: 30 Temmuz-10 Ağustos 2018 tarihleri arasında Ulakbim Ulusal Veri Tabanı, Google Scholar, Scopus, PubMed, Cochrane Library, Science Direct, Web of Science, EBSCO Host, Medline, CINAHL veri tabanlarında ?karaciğer hastalığı, karaciğer sirozu, telesağlık, mobil uygulama, semptom yönetimi, yaşam kalitesi? anahtar kelimeleriyle tarama yapılmıştır. Tarama sonucunda 386 makaleye ulaşılmıştır. Örneklemini 18 yaş ve üzeri karaciğer hastalarının oluşturduğu, telesağlık uygulamalarının etkinliğinin değerlendirildiği, Türkçe veya İngilizce dilinde deneysel çalışmalar incelenmiştir. Tam metnine ulaşılan, dili İngilizce olan 14 deneysel çalışma bu sistematik derlemeye dâhil edilmiştir. Bulgular: Çalışmaların örneklem sayısı 19-38.753 arasında değişmektedir. Telesağlık uygulamalarının; siroz hastalarında komplikasyon gelişmesini, tekrarlı yatışları azalttığı, hepatik ensefalopatinin tanılanmasında etkili olduğu; hepatit olan bireylerde yaşam kalitesini, tedaviye uyumu artırdığı, antiviral tedavinin yan etkilerini azalttığı; nonalkolik karaciğer yağlanması olan bireylerde karaciğer enzim düzeylerinin normale dönmesine yardımcı olduğu, sağlıklı beslenme davranışını ve fiziksel aktivite öz etkililiğini artırdığı görülmüştür. Sonuç: Telesağlık uygulamaları karaciğer hastalıklarının yönetiminde etkilidir. Bireylerin semptomlarının erken dönemde saptanmasına ve uzaktan yönetilmesine yardımcı olmaktadır. Hemşireler, karaciğer hastalarının bakımında telesağlık uygulamalarını kullanarak sürekli ve uzaktan izlemle hastalık yönetimini sürdürülebilir hâle getirmelidir.

Anahtar Kelimeler: Hemşirelik; karaciğer hastalıkları; teletıp
ABSTRACT
 Objective: Telehealth interventions are used in the nursing care process of liver diseases. The aim of this systematic review is to examine the effect of telehealth interventions in the management of liver diseases. Material and Methods: Literature review has been done between 30 July-10 August 2018 in Ulakbim National Database, Google Scholar, Scopus, Pubmed, Cochrane Library, Science Direct, Web of Science, EBSCO Host, Medline, CINAHL? databases using the keywords ?Liver disease, cirrhosis, telehealth, smartphone application, symptom management, quality of life?. 386 articles were obtained in the database. Experimental studies in Turkish or English in which evaluating effect of telehealth interventions in management of liver disease were included in the study. 14 original full text studies in English were included in the systematic review. Results: The sample number of studies ranged between 19 and 38.753. Telehealth interventions have decreased complications, hospitalization and increased diagnose of hepatic encephalopathy in cirrhotic patients. It has increased quality of life, compliance of treatment, decreased side effects of anti-viral treatment in patients with hepatitis. It has been shown that it helps normalize liver enzyme levels and increases healthy eating behavior and physical activity self efficacy. Conclusion: Telehealth interventions are effective in the management of liver diseases. It helps the early detection and management of symptoms via remotely. Nurses should use of telehealth interventions in the care of liver patients and disease management sustainable through continuous and remote monitoring.

Keywords: Nursing; liver diseases; telemedicine
REFERENCES:
  1. Head BA, Schapmire TJ, Zheng Y. Telehealth in palliative care: a systematic review of patient-reported outcomes. J Hosp Palliat Nurs. 2017;19(2):130-9. [Crossref] 
  2. Yildirim O, Dogan RO, Kaya I, Kayikcioglu T. Health-monitoring system based tele-tip for elders. TIPTEKNO: In Medical Technologies National Congress; 2016. p.1-4. [Crossref] 
  3. Schwamm LH, Chumbler N, Brown E, Fonarow GC, Berube D, Nystrom K, et al. Recommendations for the implementation of telehealth in cardiovascular and stroke care: a policy statement from the American Heart Association. Circulation. 2017;135(7):e24-e44. [Crossref] 
  4. Siegel CA. Transforming gastroenterology care with telemedicine. Gastroenterology. 2017;152(5):958-63. [Crossref]  [PubMed] 
  5. Jenkins RL, White P. Telehealth advancing nursing practice. Nurs Outlook. 2001;49(2): 100-5. [Crossref]  [PubMed] 
  6. Bonvissuto K. Coming of age. Telemedicine is maturing. It can increase patient access--and maybe even your income. Med Econ. 2010;4(11):8714-8.
  7. McFarland LV, Raugi GJ, Reiber GE. Primary care provider and imaging technician satisfaction with a teledermatology project in rural Veterans Health Administration clinics. Telemed J E Health. 2013;19(11):815-25. [Crossref]  [PubMed] 
  8. Pazar B, Taştan S, İyigün E. [Roles of nurses in tle-health services]. Bakırköy Tıp Dergisi. 2015;11(1):1-4. [Crossref] 
  9. Orhan B, Bahçecik N. [Technology in diabetes and diabetic foot education-mobile education]. JAREN/Hemşirelik Akademik Araştırma Dergisi. 2017;3(2):101-8.
  10. Sayre GG, Haverhals LM, Ball S, Stevenson L, Battaglia C, Aron DC, et al. Adopting SCAN-ECHO: The providers' experiences. Healthc (Amst). 2017;5(1-2):29-33. [Crossref]  [PubMed] 
  11. Flores A, Ho CK, Asrani SK. Innovative care models in liver disease: the role of multidisciplinary teams. Curr Hepatol Rep. 2018;17(3): 193-9. [Crossref] 
  12. Çelik F, Bektaş H. [Liver cirrhosis and symptom management]. Uluslararası Hakemli Hemşirelik Araştırmaları Dergisi. 2017;10(27): 215-45.
  13. Verma M, Navarro V. Patient‐centered care: a new paradigm for chronic liver disease. Hepatology. 2015;62(4):988-90. [Crossref]  [PubMed] 
  14. Arora S, Kalishman S, Thornton K, Dion D, Murata G, Deming P, et al. Expanding access to hepatitis C virus treatment--Extension for Community Healthcare Outcomes (ECHO) project: disruptive innovation in specialty care. Hepatology. 2010;52(3):1124-33. [Crossref]  [PubMed]  [PMC] 
  15. Lorentz MM. Telenursing and home healthcare. The many facet of technology. Home Healthc Nurse. 2008;6(4):237-43. [Crossref]  [PubMed] 
  16. Akay B, Akyol AD. [Investigation of the effect of tele monitoring on the self care agency in patients with chronic heart failure]. Turk Soc Cardiol Turkish Journal of Cardiovascular Nursing. 2014;5(8):75-88. [Crossref] 
  17. Sevinç S. [Tele-monitoring in heart failure]. Kalp Yetersizliği Elektronik Haber Bülteni. 2015;7(4).
  18. Barlow J, Singh D, Bayer S, Curry R. A systematic review of the benefits of home telecare for frail elderly people and those with long-term conditions. J Telemed Telecare. 2007;13(4):172-9. [Crossref]  [PubMed] 
  19. Ekeland AG, Bowes A, Flottorp S. Effectiveness of telemedicine: a systematic review of reviews. Int J Med Inform. 2010;79(11):736-71. [Crossref]  [PubMed] 
  20. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4(1):1. [Crossref]  [PubMed]  [PMC] 
  21. The Joanna Briggs Institute. Chapter Eight; The Protocol design for reviews of Economic Evidence, Inclusion criteria. In The Joanna Briggs Institute Reviwers' Manual: 2014 edition. Australia: The Joanna Briggs Institute; 2014. p.88-91.
  22. Armijo‐Olivo S, Stiles CR, Hagen NA, Biondo PD, Cummings GG. Assessment of study quality for systematic reviews: a comparison of the Cochrane Collaboration Risk of Bias Tool and the Effective Public Health Practice Project Quality Assessment Tool: methodological research. J Eval Clin Pract. 2012;18 (1):12-8. [Crossref]  [PubMed] 
  23. Nahcivan N, Seçginli S. [How are the methodological quality of quantitative studies included in systematic review?]. Turkiye Klinikleri J Public Health Nurs-Special Topics. 2017;3(1): 10-9.
  24. Yiwen K, Hegney D, Drury V. A comprehensive systematic review of the nurses' perceptions of risk from exposure to emerging acute respiratory infectious diseases and the effectiveness of strategies used to facilitate healthy coping in acute hospital and community healthcare settings. JBI Libr Syst Rev. 2009;7(24 Suppl):1-27.
  25. Sümen A, Öncel S. [Development of sun protection behaviors in preschoolers: a systemeatic review]. Turkderm-Turk Arch Dermatol Venereology. 2018;52(2):56-63. [Crossref] 
  26. Silberbogen AK, Ulloa E, Mori DL, Brown K. A telehealth intervention for veterans on antiviral treatment for the hepatitis C virus. Psychol Serv. 2012;9(2):163-73. [Crossref]  [PubMed] 
  27. Beste LA, Glorioso TJ, Ho PM, Au DH, Kirsh SR, Todd-Stenberg J, et al. Telemedicine specialty support promotes hepatitis C treatment by primary care providers in the Department of Veterans Affairs. Am J Med. 2017;130(4): 432-8.e3. [Crossref]  [PubMed] 
  28. Bajaj JS, Heuman DM, Sterling RK, Sanyal AJ, Siddiqui M, Matherly S, et al. Validation of encephalApp, smartphone-based stroop test, for the diagnosis of covert hepatic encephalopathy. Clin Gastroenterol Hepatol. 2015;13(10):1828-35.e1. [Crossref]  [PubMed]  [PMC] 
  29. Bajaj JS, Frederick RT, Bass NM, Ghabril M, Coyne K, Margolis MK, et al. Overt hepatic encephalopathy: development of a novel clinician reported outcome tool and electronic caregiver diary. Metab Brain Dis. 2016;31(5): 1081-93. [Crossref]  [PubMed] 
  30. Ganapathy D, Acharya C, Lachar J, Patidar K, Sterling MB, Ignudo C, et al. The patient buddy app can potentially prevent hepatic encephalopathy‐related readmissions. Liver Int. 2017;37(12):1843-51. [Crossref]  [PubMed] 
  31. Ha P, Warner S, O'Neil P, Anderson P, Sievert W. Development of a smartphone application to enable remote monitoring in the outpatient management of cirrhotic ascites. Journal of the International Society for Telemedicine and eHealth. 2018;6(1):1-9. [Crossref] 
  32. Rossaro L, Tran TP, Ransibrahmanakul K, Rainwater JA, Csing G, Cole SL, Prosser CC, et al. Hepatitis C videoconferencing: the impact on continuing medical education for rural healthcare providers. Telemed J E Health. 2007;13(3):269-77. [Crossref]  [PubMed] 
  33. Dehghan Nayeri N, Asadi Noghabi AA, Molaee S. The effect of telephone consultation on the quality of life of patients receiving interferon therapy: a quasi-experimental study. Telemed J E Health. 2012;18(6):459-63. [Crossref]  [PubMed] 
  34. Scott JD, Unruh KT, Catlin MC, Merrill JO, Tauben DJ, Rosenblatt R, et al. Project ECHO: a model for complex, chronic care in the Pacific Northwest region of the United States. J Telemed Telecare. 2012;18(8):481-4. [Crossref]  [PubMed]  [PMC] 
  35. Chen WL, Chiu WT, Wu MS, Hsu MH, Tsai SH. Translational research of telecare for the treatment of hepatitis C. Biomed Res Int. 2014;2014:195097. [Crossref]  [PubMed]  [PMC] 
  36. Jeon JH. Evaluation of a smartphone application for self-care performance of patients with chronic hepatitis B: a randomized controlled trial. Appl Nurs Res. 2016;32:182-9. [Crossref]  [PubMed] 
  37. Rattay T, Dumont IP, Heinzow HS, Hutton DW. Cost-effectiveness of access expansion to treatment of hepatitis C virus infection through primary care providers. Gastroenterology. 2017;153(6):1531-43.e2. [Crossref]  [PubMed] 
  38. Fard SJ, Ghodsbin F, Kaviani MJ, Jahanbin I, Bagheri Z. The effect of follow up (telenursing) on liver enzymes in patients with nonalcoholic fatty liver disease: a randomized controlled clinical trial. Int J Community Based Nurs Midwifery. 2016;4(3):239-46.
  39. Javanmardifard S, Ghodsbin F, Kaviani MJ, Jahanbin I. The effect of telenursing on self-efficacy in patients with non-alcoholic fatty liver disease: a randomized controlled clinical trial. Gastroenterol Hepatol from Bed Bench. 2017;10(4):263-71.
  40. Liu X, Luo H, Zhang L, Leung FW, Liu Z, Wang X, et al. Telephone-based re-education on the day before colonoscopy improves the quality of bowel preparation and the polyp detection rate: a prospective, colonoscopist-blinded, randomised, controlled study. Gut. 2014;63(1):125-30. [Crossref]  [PubMed] 
  41. Lee SWH, Chan CKY, Chua SS, Chaiyakunapruk N. Comparative effectiveness of telemedicine strategies on type 2 diabetes management: a systematic review and network meta-analysis. Sci Rep. 2017;7(1): 12680. [Crossref]  [PubMed]  [PMC] 
  42. Chi NC, Demiris G. A systematic review of telehealth tools and interventions to support family caregivers. J Telemed Telecare. 2015;21(1):37-44. [Crossref]  [PubMed]  [PMC] 
  43. Jennett PA, Affleck Hall L, Hailey D, Ohinmaa A, Anderson C, Thomas R, et al. The socio-economic impact of telehealth: a systematic review. J Telemed Telecare. 2003;9(6):311-20. [Crossref]  [PubMed] 
  44. Cox A, Lucas G, Marcu A, Piano M, Grosvenor W, Mold F, et al. Cancer survivors' experience with telehealth: a systematic review and thematic synthesis. J Med Internet Res. 2017;19(1):e11. [Crossref]  [PubMed]  [PMC] 
  45. Angelidou D. Caring for the heart failure patient: contemporary nursing interventions. Hospital Chronicles. 2010;5(1):1-8.
  46. Akıncı AÇ, Zengin N, Buğu Y. [Heart failure and nursing care]. Yoğun Bakım Hemşireliği Dergisi. 2014;18(2):52-61.
  47. Clark RA, Inglis SC, McAlister FA, Cleland JG, Stewart S. Telemonitoring or structured telephone support programmes for patients with chronic heart failure: systematic review and meta-analysis. BMJ. 2007;334(7600):942. [Crossref]  [PubMed]  [PMC] 

.: 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