Turkiye Klinikleri Journal of Nursing Sciences

.: REVIEW
Kronik Hastalıkların Yönetiminde Kronik Bakım Modeline Temellendirilmiş Girişimlerin Etkinliği: Geleneksel Derleme
Effectiveness of Interventions Based on the Chronic Care Model in the Management of Chronic Diseases: Traditional Review
Simge KALAVa, Hicran BEKTAŞa
aAkdeniz Üniversitesi Hemşirelik Fakültesi, İç Hastalıkları Hemşireliği ABD, Antalya, TÜRKİYE
Turkiye Klinikleri J Nurs Sci. 2021;13(2):435-51
doi: 10.5336/nurses.2020-77108
Article Language: TR
Full Text
ÖZET
Kronik hastalıkların yönetiminde, sağlık profesyonellerinin bakım modellerinden yararlanması önemlidir. Kronik Bakım Modeli kanıta dayalı sağlık sistemi değişikliklerinin sunulmasına imkân verebilmekte ve kronik hastalığı olan bireylerin birçok gereksinimini karşılayabilmektedir. Kronik Bakım Modeli'nin diabetes mellitus, kardiyovasküler hastalıklar, inme, kronik obstrüktif akciğer hastalığı ve kronik böbrek hastalığı gibi kronik hastalıkların yönetiminde kullanıldığı ve başarılı sonuçlar elde edildiği belirtilmektedir. Modelin bileşenleri kapsamında hemşirelerin bireysel/grup eğitimi, öz yönetim programları, danışmanlık, tarama, vaka yöneticiliği, hasta katılımlı taburculuk planlaması, ev ziyaretleri, telefonla izlem, kardiyak rehabilitasyon programı, poliklinik izlemi, ayakta tedavi programı, kanıta dayalı protokol kapsamında uygulanan geçiş bakımı gibi girişimler uyguladıkları görülmektedir. Kronik Bakım Modeline dayalı girişimler kronik hastalıkların yönetiminde etkili olabilmektedir. Modele ait iki veya daha fazla bileşenin uygulanması durumunda acil başvurularında ve tekrarlı yatışlarda azalma olabilmekte, öz etkililik ve öz yönetim becerisi artabilmektedir. Kronik Bakım Modeline temellendirilen girişimlerin etkisine yönelik çalışmaların yapılması, girişimlerin sağlık sistemine yerleştirilmesi ve sağlık profesyonelleri tarafından uygulanması, sonuçların sürekli olarak değerlendirilmesi ile kronik hastalık yönetiminin ve yaşam kalitesinin olumlu yönde iyileştirilebileceği düşünülmektedir. Bu derlemenin amacı, kronik hastalıkların yönetiminde Kronik Bakım Modeline temellendirilmiş girişimlerin etkinliğini incelemektir.

Anahtar Kelimeler: Modeller, hemşirelik; kronik hastalık
ABSTRACT
It is important for health professionals to benefit from care models in the management of chronic diseases.The Chronic Care Model can enable the presentation of evidence-based health system changes and meet many needs of individuals with chronic diseases.The Chronic Care Model is used in the management of chronic diseases such as diabetes mellitus, cardiovascular diseases, stroke, chronic obstructive pulmonary disease and chronic kidney disease and successful results are obtained.Within the scope of the model, the following interventions including individual/group training, self-management programs, counseling, screening, case management, patient participation discharge planning, home visits, telephone monitoring, cardiac rehabilitation program, outpatient clinic monitoring, outpatient treatment program and transition care initiatives are implemented by nurses under the evidence-based protocol. Interventions based on the Chronic Care Model can be effective in the management of chronic diseases. If two or more components of the model are applied, emergency applications and repeated hospitalizations may decrease, and self efficacy and self-management skills may increase.Chronic disease management and quality of life may be improved positively by health professionals through carrying out studies on the effect of interventions based on the Chronic Care Model, placing the interventions in the health system,implementing them by health professionals, evaluating the results continuously.The purpose of this review is to examine the effectiveness of interventions based on the Chronic Care Model in the management of chronic diseases.

Keywords: Models, nursing; chronic disease
REFERENCES:
  1. Stellefson M, Dipnarine K, Stopka C. The chronic care model and diabetes management in US primary care settings: a systematic review. Prev Chronic Dis. 2013;10:E26. [Crossref] [PubMed] [PMC] 
  2. Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A. Improving chronic illness care: translating evidence into action. Health Aff (Millwood). 2001;20(6):64-78. [Crossref] [PubMed] 
  3. Drewes HW, Steuten LM, Lemmens LC, Baan CA, Boshuizen HC, Elissen AM, et al. The effectiveness of chronic care management for heart failure: meta-regression analyses to explain the heterogeneity in outcomes. Health Serv Res. 2012;47(5):1926-59. [Crossref] [PubMed] [PMC] 
  4. Epping-Jordan JE, Pruitt SD, Bengoa R, Wagner EH. Improving the quality of health care for chronic conditions. Qual Saf Health Care. 2004;13(4):299-305. [Crossref] [PubMed] [PMC] 
  5. İncirkuş K, Nahcivan NÖ. Kronik Hastalık Yönetimi İçin Bir Rehber: Kronik Bakım Modeli [A guide for chronic disease management: the Chronic Care Model]. F.N. Hem. Derg. 2015;23(1):66-75. [Crossref] 
  6. Grover A, Joshi A. An overview of chronic disease models: a systematic literature review. Glob J Health Sci. 2014;7(2):210-27. [Crossref] [PubMed] [PMC] 
  7. Stuckey HL, Adelman AM, Gabbay RA. Improving care by delivering the ChronicCare Model for diabetes. Diabetes Manage. 2011;1(1):37-52. [Crossref] 
  8. Koolen EH, van der Wees PJ, Westert GP, Dekhuijzen R, Heijdra YF, van 't Hul AJ. The COPDnet integrated care model. Int J Chron Obstruct Pulmon Dis. 2018;13:2225-35. [Crossref] [PubMed] [PMC] 
  9. Kacaroğlu Vicdan A, Gülseven Karabacak B. Hemşirelik modellerinden: Roy adaptasyon modeli [Models of nursing: Roy adaptation model]. ACU Sağlık Bil Derg. 2014(4):255-9.
  10. Baykara ZG, Çalışkan N, Öztürk D, Karadağ A. Hemşirelikte teori ve model kullanımı: Nitel bir çalışma [The use of nursing theories and models: a qualitative study]. Cukurova Med J. 2019;44(Suppl 1):281-9. [Crossref] 
  11. McDonald K, Ledwidge M, Cahill J, Quigley P, Maurer B, Travers B, et al. Heart failure management: multidisciplinary care has intrinsic benefit above the optimization of medical care. J Card Fail. 2002;8(3):142-8. [Crossref] [PubMed] 
  12. GESICA Investigators. Randomised trial of telephone intervention in chronic heart failure: DIAL trial. BMJ. 2005;331(7514):425. [Crossref] [PubMed] [PMC] 
  13. Glasgow RE, Orleans CT, Wagner EH. Does the chronic care model serve also as a template for improving prevention? Milbank Q. 2001;79(4):579-612, iv-v. [Crossref] [PubMed] [PMC] 
  14. Hung DY, Rundall TG, Tallia AF, Cohen DJ, Halpin HA, Crabtree BF. Rethinking prevention in primary care: applying the chronic care model to address health risk behaviors. Milbank Q. 2007;85(1):69-91. [Crossref] [PubMed] [PMC] 
  15. Sobnath DD, Philip N, Kayyali R, Nabhani-Gebara S,Pierscionek B,Vaes AW et al. Features of a mobile supportappforpatients withchronicobstructivepulmonarydisease: literatüre reviewandcurrentapplications.JMIR Mhealth Uhealth. 2017;5(2):17. [Crossref] [PubMed] [PMC] 
  16. Clini E, Castaniere I, Tonelli R. Lookingfor aChronicCare Model in COPD patients. EurRespir J. 2018;51(1):1702087. [Crossref] [PubMed] 
  17. Baptista DR, Wiens A, Pontarolo R, Regis L, Reis WCT, Correr CJ. The Chronic Care Model fortype 2 diabetes: a systematicreview. Diabetology&Metabolic Syndrome. 2016;8:7. [Crossref] [PubMed] [PMC] 
  18. Benedetti R, Flock B, Pedersen S, Ahern M. Improved clinical outcomes for fee-for-service physician practices participating in a diabetes care collaborative. Jt Comm J Qual Saf. 2004;30(4):187-94. [Crossref] [PubMed] 
  19. Siminerio LM, Piatt G, Zgibor JC. Implementing the chronic care model for improvements in diabetes care and education in a rural primary care practice. Diabetes Educ. 2005;31(2):225-34. [Crossref] [PubMed] 
  20. Siminerio LM, Piatt GA, Emerson S, Ruppert K, Saul M, Solano F, et al. Deploying the chronic care model to implement and sustain diabetes self-management training programs. Diabetes Educ. 2006;32(2):253-60. [Crossref] [PubMed] 
  21. Liebman J, Heffernan D, Sarvela P. Establishing diabetes self-management in a community health center serving low-income Latinos. Diabetes Educ. 2007;33 Suppl 6:132S-8S. [Crossref] [PubMed] 
  22. Schillinger D, Handley M, Wang F, Hammer H. Effects of self-management support on structure, process, and outcomes among vulnerable patients with diabetes: a three-arm practical clinical trial. Diabetes Care. 2009;32(4):559-66. [Crossref] [PubMed] [PMC] 
  23. Piatt GA, Anderson RM, Brooks MM, Songer T, Siminerio LM, Korytkowski MM, et al. 3-year follow-up of clinical and behavioral improvements following a multifaceted diabetes care intervention: results of a randomized controlled trial. Diabetes Educ. 2010;36(2):301-9. [Crossref] [PubMed] 
  24. Piatt GA, Songer TJ, Brooks MM, Anderson RM, Simmons D, Orchard TJ, et al. Impact of patient level factors on the improvement of the ABCs of diabetes. Patient Educ Couns. 2011;82(2):266-70. [Crossref] [PubMed] 
  25. Khan MA, Evans AT, Shah S. Caring for uninsured patients with diabetes: designing and evaluating a novel chronic care model for diabetes care. J Eval Clin Pract. 2010;16(4):700-6. [Crossref] [PubMed] 
  26. Bodenheimer T, Lorig K, Holman H, Grumbach K. Patient self-management of chronic disease in primary care. JAMA. 2002;288(19):2469-75. [Crossref] [PubMed] 
  27. West DS, DiLillo V, Bursac Z, Gore SA, Greene PG. Motivational interviewing improves weight loss in women with type 2 diabetes. Diabetes Care. 2007;30(5):1081-7. [Crossref] [PubMed] 
  28. Stuckey HL, Dellasega C, Graber NJ, Mauger DT, Lendel I, Gabbay RA. Diabetes nurse case management and motivational interviewing for change (DYNAMIC): study design and baseline characteristics in the Chronic Care Model for type 2 diabetes. Contemp Clin Trials. 2009;30(4):366-74. [Crossref] [PubMed] [PMC] 
  29. Piatt GA, Orchard TJ, Emerson S, Simmons D, Songer TJ, Brooks MM, et al. Translating the chronic care model into the community: results from a randomized controlled trial of a multifaceted diabetes care intervention. Diabetes Care. 2006;29(4):811-7. [Crossref] [PubMed] 
  30. Norris SL, Engelgau MM, Narayan KM. Effectiveness of self-management training in type 2 diabetes: a systematic review of randomized controlled trials. Diabetes Care. 2001;24(3):561-87. [Crossref] [PubMed] 
  31. Khan L, Mincemoyer S, Gabbay RA. Diabetes registries: where we are and where are we headed? Diabetes Technol Ther. 2009;11(4):255-62. [Crossref] [PubMed] 
  32. Azar M, Gabbay R. Web-based management of diabetes through glucose uploads: has the time come for telemedicine? Diabetes Res Clin Pract. 2009;83(1):9-17. [Crossref] [PubMed] 
  33. Klug C, Toobert DJ, Fogerty M. Healthy Changes for living with diabetes: an evidence-based community diabetes self-management program. Diabetes Educ. 2008;34(6):1053-61. [Crossref] [PubMed] [PMC] 
  34. Tudor-Locke C, Lauzon N, Myers AM, Bell RC, Chan CB, McCargar L, et al. Effectiveness of the first step program delivered by professionals versus peers. J Phys Act Health. 2009;6(4):456-62. [Crossref] [PubMed] 
  35. Noh JH, Cho YJ, Nam HW, Kim JH, Kim DJ, Yoo HS, et al. Web-based comprehensive information system for self-management of diabetes mellitus. Diabetes Technol Ther. 2010;12(5):333-7. [Crossref] [PubMed] 
  36. Lyles CR, Harris LT, Le T, Flowers J, Tufano J, Britt D, et al. Qualitative evaluation of a mobile phone and web-based collaborative care intervention for patients with type 2 diabetes. Diabetes Technol Ther. 2011;13(5):563-9. [Crossref] [PubMed] 
  37. Conway N, Adamson KA, Cunningham SG, Emslie Smith A, Nyberg P, Smith BH, et al. Decision Support for Diabetes in Scotland: Implementation and Evaluation of a Clinical Decision Support System. J Diabetes Sci Technol. 2018;12(2):381-8. [Crossref] [PubMed] [PMC] 
  38. Arslan S, Öztunç G. The Effects of a Walking Exercise Program on Fatigue in the Person with COPD. Rehabil Nurs. 2016;41(6):303-312. [Crossref] [PubMed] 
  39. Kaptein AA, Fischer MJ, Scharloo M. Self-management in patients with COPD: theoretical context, content, outcomes, and integration into clinical care. Int J Chron Obstruct Pulmon Dis. 2014;9:907-17. [Crossref] [PubMed] [PMC] 
  40. Adams SG, Smith PK, Allan PF, Anzueto A, Pugh JA, Cornell JE. Systematic review of the chronic care model in chronic obstructive pulmonary disease prevention and management. Arch Intern Med. 2007;167(6):551-61. [Crossref] [PubMed] 
  41. Fromer L. Implementing chronic care for COPD: planned visits, care coordination, and patient empowerment for improved outcomes. Int J Chron Obstruct Pulmon Dis. 2011;6:605-14. [Crossref] [PubMed] [PMC] 
  42. Effing TW, Bourbeau J, Vercoulen J, Apter AJ, Coultas D, Meek P, et al. Self-management programmes for COPD: moving forward. Chron Respir Dis. 2012;9(1):27-35. [Crossref] [PubMed] 
  43. Jiang Y, Liu F, Guo J, Sun P, Chen Z, Li J, et al. Evaluating an Intervention Program Using WeChat for Patients With Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial. J Med Internet Res. 2020;22(4):e17089. [Crossref] [PubMed] [PMC] 
  44. Ivers N, Jamtvedt G, Flottorp S, Young JM, Odgaard-Jensen J, French SD, et al. (2012). Audit and feedback: Effects on professional practice and healthcare outcomes. [Crossref] [PubMed] 
  45. Francesconi P, Ballo P, Profili F, Policardo L, Roti L, Zuppiroli A. Chronic Care Model for the Management of Patients with Heart Failure in Primary Care. Health Serv Insights. 2019 Aug 19;12:1178632919866200. [Crossref] [PubMed] [PMC] 
  46. Zarrinkoub R, Wettermark B, Wändell P, Mejhert M, Szulkin R, Ljunggren G, et al. The epidemiology of heart failure, based on data for 2.1 million inhabitants in Sweden. Eur J Heart Fail. 2013;15(9):995-1002. [Crossref] [PubMed] 
  47. McAlister FA, Lawson FM, Teo KK, Armstrong PW. A systematic review of randomized trials of disease management programs in heart failure. Am J Med. 2001;110(5):378-84. [Crossref] [PubMed] 
  48. Gonseth J, Guallar-Castillón P, Banegas JR, Rodríguez-Artalejo F. The effectiveness of disease management programmes in reducing hospital re-admission in older patients with heart failure: a systematic review and meta-analysis of published reports. Eur Heart J. 2004;25(18):1570-95. [Crossref] [PubMed] 
  49. Gwadry-Sridhar FH, Flintoft V, Lee DS, Lee H, Guyatt GH. A systematic review and meta-analysis of studies comparing readmission rates and mortality rates in patients with heart failure. Arch Intern Med. 2004;164(21):2315-20. [Crossref] [PubMed] 
  50. Phillips CO, Wright SM, Kern DE, Singa RM, Shepperd S, Rubin HR. Comprehensive discharge planning with postdischarge support for older patients with congestive heart failure: a meta-analysis. JAMA. 2004;291(11):1358-67. Erratum in: JAMA. 2004 Sep 1;292(9):1022. [Crossref] [PubMed] 
  51. Roccaforte R, Demers C, Baldassarre F, Teo KK, Yusuf S. Effectiveness of comprehensive disease management programmes in improving clinical outcomes in heart failure patients. A meta-analysis. Eur J Heart Fail. 2005;7(7):1133-44. Erratum in: Eur J Heart Fail. 2006;8(2):223-4. [Crossref] [PubMed] 
  52. Taylor S, Bestall J, Cotter S, Falshaw M, Hood S, Parsons S, Wood L, Underwood M. Clinical service organisation for heart failure. Cochrane Database Syst Rev. 2005;(2):CD002752. Update in: Cochrane Database Syst Rev. 2012;9:CD002752. [PubMed] [PMC] 
  53. Göhler A, Januzzi JL, Worrell SS, Osterziel KJ, Gazelle GS, Dietz R, et al. A systematic meta-analysis of the efficacy and heterogeneity of disease management programs in congestive heart failure. J Card Fail. 2006;12(7):554-67. [Crossref] [PubMed] 
  54. Costantini O, Huck K, Carlson MD, Boyd K, Buchter CM, Raiz P, et al. Impact of a guideline-based disease management team on outcomes of hospitalized patients with congestive heart failure. Arch Intern Med. 2001;161(2):177-82. [Crossref] [PubMed] 
  55. Akosah KO, Schaper AM, Havlik P, Barnhart S, Devine S. Improving care for patients with chronic heart failure in the community: the importance of a disease management program. Chest. 2002;122(3):906-12. [Crossref] [PubMed] 
  56. Ansari M, Shlipak MG, Heidenreich PA, Van Ostaeyen D, Pohl EC, Browner WS, et al. Improving guideline adherence: a randomized trial evaluating strategies to increase beta-blocker use in heart failure. Circulation. 2003;107(22):2799-804. [Crossref] [PubMed] 
  57. Benatar D, Bondmass M, Ghitelman J, Avitall B. Outcomes of chronic heart failure. Arch Intern Med. 2003;163(3):347-52. [Crossref] [PubMed] 
  58. Atienza F, Anguita M, Martinez-Alzamora N, Osca J, Ojeda S, Almenar L, et al; PRICE Study Group. Multicenter randomized trial of a comprehensive hospital discharge and outpatient heart failure management program. Eur J Heart Fail. 2004;6(5):643-52. [Crossref] [PubMed] 
  59. Naylor MD, Brooten DA, Campbell RL, Maislin G, McCauley KM, Schwartz JS. Transitional care of older adults hospitalized with heart failure: a randomized, controlled trial. J Am Geriatr Soc. 2004;52(5):675-84. Erratum in: J Am Geriatr Soc. 2004;52(7):1228. [Crossref] [PubMed] 
  60. Austin J, Williams R, Ross L, Moseley L, Hutchison S. Randomised controlled trial of cardiac rehabilitation in elderly patients with heart failure. Eur J Heart Fail. 2005;7(3):411-7. [Crossref] [PubMed] 
  61. Dhamoon MS, Sciacca RR, Rundek T, Sacco RL, Elkind MS. Recurrent stroke and cardiac risks after first ischemic stroke: the Northern Manhattan Study. Neurology. 2006;66(5):641-6. [Crossref] [PubMed] 
  62. O'Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P, et al; INTERSTROKE investigators. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet. 2010;376(9735):112-23. [Crossref] [PubMed] 
  63. Wolf TJ, Baum CM, Lee D, Hammel J. The Development of the Improving Participation after Stroke Self-Management Program (IPASS): An Exploratory Randomized Clinical Study. Top Stroke Rehabil. 2016;23(4):284-92. [Crossref] [PubMed] [PMC] 
  64. Allen K, Hazelett S, Jarjoura D, Hua K, Wright K, Weinhardt J, et al. A randomized trial testing the superiority of a postdischarge care management model for stroke survivors. J Stroke Cerebrovasc Dis. 2009;18(6):443-52. [Crossref] [PubMed] [PMC] 
  65. Towfighi A, Cheng EM, Ayala-Rivera M, McCreath H, Sanossian N, Dutta T, et al. Randomized controlled trial of a coordinated care intervention to improve risk factor control after stroke or transient ischemic attack in the safety net: Secondary stroke prevention by Uniting Community and Chronic care model teams Early to End Disparities (SUCCEED). BMC Neurol. 2017;17(1):24. [Crossref] [PubMed] [PMC] 
  66. Cheng EM, Cunningham WE, Towfighi A, Sanossian N, Bryg RJ, Anderson TL, et al. Efficacy of a Chronic Care-Based Intervention on Secondary Stroke Prevention Among Vulnerable Stroke Survivors: A Randomized Controlled Trial. Circ Cardiovasc Qual Outcomes. 2018;11(1):e003228. [Crossref] [PubMed] [PMC] 
  67. Varol E, Karaca-Sivrikaya S. Kronik böbrek yetmezliğinde yaşam kalitesi ve hemşirelik [Quality of life in chronic renal failure and nursing]. J DU Health Sci Inst. 2018;8(2):89-96. [Link] 
  68. Llewellyn S. The Chronic Care Model, Kidney Disease, and Primary Care: A Scoping Review. Nephrol Nurs J. 2019;46(3):301-328. [PubMed] 
  69. Ong SW, Jassal SV, Porter E, Logan AG, Miller JA. Using an electronic self-management tool to support patients with chronic kidney disease (CKD): A CKD clinic self-care model. Semin Dial. 2013;26(2):195-202. [Crossref] [PubMed] 
  70. Pang J, Grill A, Bhatt M, Woodward GL, Brimble S. Evaluation of a mentorship program to support chronic kidney disease care. Can Fam Physician. 2016;62(8):e441-7. [PubMed] [PMC] 
  71. Pefanis A, Botlero R, Langham RG, Nelson CL. eMAP:CKD: electronic diagnosis and management assistance to primary care in chronic kidney disease. Nephrol Dial Transplant. 2018;33(1):121-8. [PubMed] [PMC] 
  72. Bhardwaja B, Carroll NM, Raebel MA, Chester EA, Korner EJ, Rocho BE, et al. Improving prescribing safety in patients with renal insufficiency in the ambulatory setting: the Drug Renal Alert Pharmacy (DRAP) program. Pharmacotherapy. 2011;31(4):346-56. [Crossref] [PubMed] 
  73. Blakeman T, Blickem C, Kennedy A, Reeves D, Bower P, Gaffney H, et al. Effect of information and telephone-guided access to community support for people with chronic kidney disease: Randomised controlled trial. PLoS One. 2014;9(10):e109135. [Crossref] [PubMed] [PMC] 
  74. Walker RC, Marshall MR, Polaschek NR. A prospective clinical trial of specialist renal nursing in the primary care setting to prevent progression of chronic kidney: a quality improvement report. BMC Fam Pract. 2014;15:155. [Crossref] [PubMed] [PMC] 
  75. Jiamjariyapon T, Ingsathit A, Pongpirul K, Vipattawat K, Kanchanakorn S, Saetie A, et al. Effectiveness of Integrated Care on Delaying Progression of stage 3-4 Chronic Kidney Disease in Rural Communities of Thailand (ESCORT study): a cluster randomized controlled trial. BMC Nephrol. 2017;18(1):83. [Crossref] [PubMed] [PMC] 

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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