Turkiye Klinikleri Journal of Nursing Sciences

.: ORIGINAL RESEARCH
Effect on Nurses' Care Behaviors of Burnout at the COVID-19 Pandemic: Descriptive Cross-Sectional Study
COVID-19 Pandemisinde Tükenmişliğin Hemşirelerin Bakım Davranışları Üzerine Etkisi: Tanımlayıcı Kesitsel Araştırma
Şenay TAKMAKa , Sümeyye ARSLANb , Fatma YURTSEVENc
aDepartment of Nursing, Kütahya University of Health Sciences Faculty of Health Sciences, Kütahya, Türkiye
bDepartment of Nursing, Pamukkale University Faculty of Health Sciences, Denizli, Türkiye
cClinic of Gastroenterology Surgery, Denizli State Hospital, Denizli, Türkiye
Turkiye Klinikleri J Nurs Sci. 2023;15(4):1067-76
doi: 10.5336/nurses.2023-96445
Article Language: EN
Full Text
ABSTRACT
 Objective: This study was to determine the burnout levels and care behaviors of nurses during the coronavirus disease-2019 pandemic and to evaluate the effects of nurses' sociodemographic characteristics, pandemic process, and burnout on care behaviors. Material and Methods: The study was cross-sectional design and the sample consisted of 150 nurses working at a state hospital. Data were collected between April and May 2021 with Maslach Burnout Inventory and Caring Behaviors Inventory-24 scales. Independent samples t-test, MannWhitney U test, Kruskal-Wallis variance analysis, Pearson correlation test and multiple linear regression analysis were used in data analysis. Results: Approximately one in three nurses experienced high levels of emotional exhaustion (30%), whereas 34.7% of the nurses experienced moderate burnout in terms of personal achievement. Nurses had a high perception of care behaviors and the mean score was 5.05±0.57. Highest care behavior scores were obtained in the knowledge and skill subdimension (5.46±0.58) and the lowest scores were obtained in the positive connectedness sub-dimension (4.94±0.70). Emotional exhaustion, depersonalization, personal achievement, and working in the pandemic ward had a significant effect on care behaviors. Depersonalization negatively affected care behaviors, whereas personal achievement, emotional exhaustion and working in the pandemic ward increased care behaviors. Conclusion: In this study, unlike the literature, almost all of the nurses experience moderate and high levels of personal achievement burnout. Caring behavior was negatively affected by depersonalization. Nursing curriculum and health policies should prepare nurses for possible crises and psychosocial support for nurses should be increased.

Keywords: Burnout; caring behaviors; COVID-19; nurses; pandemic
ÖZET
 Amaç: Bu çalışma, koronavirüs hastalığı-2019 pandemisi sırasında hemşirelerin tükenmişlik düzeylerini, bakım davranışlarını belirlemek ve hemşirelerin sosyodemografik özellikleri, pandemi süreci ile tükenmişliğin bakım davranışları üzerindeki etkilerini değerlendirmek amacıyla yapılmıştır. Gereç ve Yöntemler: Çalışma kesitsel desende olup, örneklemini bir devlet hastanesinde çalışan 150 hemşire oluşturmuştur. Veriler Nisan-Mayıs 2021 tarihleri arasında Maslach Tükenmişlik Envanteri ve Bakım Davranışları Envanteri-24 ölçekleri ile toplanmıştır. Verilerin analizinde bağımsız örneklem t-testi, MannWhitney U testi, Kruskal-Wallis varyans analizi, Pearson korelasyon testi ve çoklu doğrusal regresyon analizi uygulanmıştır. Bulgular: Yaklaşık her üç hemşireden biri yüksek düzeyde duygusal tükenme yaşarken (%30), hemşirelerin %34,7'si kişisel başarı açısından orta düzeyde tükenmişlik yaşamaktadır. Hemşirelerin bakım davranışları algısı yüksek olup puan ortalaması 5,05±0,57'dir. En yüksek bakım davranışı puanları bilgi ve beceri alt boyutunda (5,46±0,58), en düşük puanlar ise olumlu bağlılık alt boyutunda (4,94±0,70) elde edilmiştir. Duygusal tükenme, duyarsızlaşma, kişisel başarı ve pandemi servisinde çalışmanın bakım davranışları üzerinde anlamlı bir etkisi vardır. Duyarsızlaşma bakım davranışlarını olumsuz yönde etkilerken, kişisel başarı, duygusal tükenme ve pandemi servisinde çalışma bakım davranışlarını artırmıştır. Sonuç: Bu çalışmada literatürden farklı olarak hemşirelerin neredeyse tamamı orta ve yüksek düzeyde kişisel başarı tükenmişliği yaşamaktadır. Bakım verme davranışı duyarsızlaşmadan olumsuz etkilenmiştir. Hemşirelik müfredatı ve sağlık politikaları hemşireleri olası krizlere hazırlamalı ve hemşirelere yönelik psikososyal destek artırılmalıdır.

Anahtar Kelimeler: Tükenmişlik; bakım davranışı; COVID-19; hemşireler; pandemi
REFERENCES:
  1. Morse JM, Solberg SM, Neander WL, Bottorff JL, Johnson JL. Concepts of caring and caring as a concept. In: Smith MC, Turkel MC, Wolf ZR, eds. Caring in Nursing Classics an Essential Resource (E-Book). 1st ed. Springer Publishing Company; 2013. p.19-31. [Crossref] 
  2. Wolf ZR. The caring concept and nurse identified caring behaviors. Top Clin Nurs. 1986;8(2):84-93. [PubMed] 
  3. Davoodi A, Azarsa T, Shahbazpour M, Sokhanvar Z, Ghahramanian A. Relationship between quality of work life and caring behaviors among emergency nurses. Int J Work Heal Manag. 2020;13(6):687-701. [Crossref] 
  4. Putra KR, Andayani T, Ningrum EH. Job satisfaction and caring behavior among nurses in a military hospital: a cross-sectional study. J Public Health Res. 2021;10(2):2212. [Crossref]  [PubMed]  [PMC] 
  5. Miguel-Puga JA, Cooper-Bribiesca D, Avelar-Garnica FJ, Sanchez-Hurtado LA, Colin-Martínez T, Espinosa-Poblano E, et al. Burnout, depersonalization, and anxiety contribute to post-traumatic stress in frontline health workers at COVID-19 patient care, a follow-up study. Brain Behav. 2021;11(3):e02007. [Crossref]  [PubMed]  [PMC] 
  6. Maslach C, Leiter MP. Early predictors of job burnout and engagement. J Appl Psychol. 2008;93(3):498-512. [Crossref]  [PubMed] 
  7. Chen R, Sun C, Chen JJ, Jen HJ, Kang XL, Kao CC, et al. A Large-scale survey on trauma, burnout, and posttraumatic growth among nurses during the COVID-19 pandemic. Int J Ment Health Nurs. 2021;30(1):102-16. [Crossref]  [PubMed]  [PMC] 
  8. Galanis P, Vraka I, Fragkou D, Bilali A, Kaitelidou D. Nurses' burnout and associated risk factors during the COVID-19 pandemic: a systematic review and meta-analysis. J Adv Nurs. 2021;77(8):3286-302. [Crossref]  [PubMed]  [PMC] 
  9. Woo T, Ho R, Tang A, Tam W. Global prevalence of burnout symptoms among nurses: a systematic review and meta-analysis. J Psychiatr Res. 2020;123:9-20. [Crossref]  [PubMed] 
  10. Ma Y, Faraz NA, Ahmed F, Iqbal MK, Saeed U, Mughal MF, et al. Curbing nurses' burnout during COVID-19: the roles of servant leadership and psychological safety. J Nurs Manag. 2021;29(8):2383-91. [Crossref]  [PubMed]  [PMC] 
  11. Leyva EWA, Peralta AB, Tejero LMS, Santos MA. Global perpectives of caring: an integrative review. Int J Hum Caring. 2015;19(4):7-29. [Crossref] 
  12. Halbesleben JR, Wakefield BJ, Wakefield DS, Cooper LB. Nurse burnout and patient safety outcomes: nurse safety perception versus reporting behavior. West J Nurs Res. 2008;30(5):560-77. [Crossref]  [PubMed] 
  13. Kakemam E, Chegini Z, Rouhi A, Ahmadi F, Majidi S. Burnout and its relationship to self-reported quality of patient care and adverse events during COVID-19: a cross-sectional online survey among nurses. J Nurs Manag. 2021;29(7):1974-82. [Crossref]  [PubMed]  [PMC] 
  14. Lasalvia A, Amaddeo F, Porru S, Carta A, Tardivo S, Bovo C, et al. Levels of burn-out among healthcare workers during the COVID-19 pandemic and their associated factors: a cross-sectional study in a tertiary hospital of a highly burdened area of north-east Italy. BMJ Open. 2021;11(1):e045127. [Crossref]  [PubMed]  [PMC] 
  15. Efıl S, Turen S, Yıldız Ayvaz M, Bulbul E, Yenı T. Burnout levels and care behaviours in intensive care nurses: a cross-sectional, multicentre study. Intensive Crit Care Nurs. 2022;71:103246. [Crossref]  [PubMed] 
  16. Inocian EP, Cruz JP, Saeed Alshehry A, Alshamlani Y, Ignacio EH, Tumala RB. Professional quality of life and caring behaviours among clinical nurses during the COVID-19 pandemic. J Clin Nurs. 2021:10.1111/jocn.15937. [Crossref]  [PubMed]  [PMC] 
  17. Shen A, Wang Y, Qiang W. A multicenter investigation of caring behaviors and burnout among oncology nurses in China. Cancer Nurs. 2020;43(5):E246-E53. [Crossref]  [PubMed] 
  18. Matsuo T, Kobayashi D, Taki F, Sakamoto F, Uehara Y, Mori N, et al. Prevalence of health care worker burnout during the coronavirus disease 2019 (COVID-19) Pandemic in Japan. JAMA Netw Open. 2020;3(8):e2017271. [Crossref]  [PubMed]  [PMC] 
  19. Maslach C, Jackson S, Leiter M. The Maslach Burnout Inventory manual. In: Zalaquett CP, Wood RJ, eds. Evaluating Stress: A Book of Resources. Vol. 3. 1st ed. Lanham, Maryland: Scarecrow Press; 1997. p.191-218.
  20. Ergin C. Doktor ve Hemşirelerde Tükenmişlik ve Maslach Tükenmişlik Ölçeğinin uyarlanması. Bayraktar İ, Dağ R, editörler. VII. Ulusal Psikoloji Kongresi Bilimsel Çalışmaları. Ankara: Türk Psikologlar Derneği Yayını; 1993.
  21. Ergin C. Maslach Tükenmişlik Ölçeğinin Türkiye sağlık personeli normları [Turkish health personel norms for Maslach Burnout Inventory]. 3P Derg. 1996;4(1):28-33. [Link] 
  22. Wu Y, Larrabee JH, Putman HP. Caring Behaviors Inventory: a reduction of the 42-item instrument. Nurs Res. 2006;55(1):18-25. [Crossref]  [PubMed] 
  23. Kurşun Ş, Kanan N. Bakım Davranışları Ölçeği-24'ün Türkçe formunun geçerlik ve güvenirlik çalışması [Validity and reliability study of the Turkish version of Caring Behaviors Inventory-24]. Anadolu Hemşirelik ve Sağlık Bilim Derg. 2012;15(4):229-35. [Link] 
  24. Murat M, Köse S, Savaşer S. Determination of stress, depression and burnout levels of front-line nurses during the COVID-19 pandemic. Int J Ment Health Nurs. 2021;30(2):533-43. [Crossref]  [PubMed]  [PMC] 
  25. Topçu I, Türkmen E, Badır A, Göktepe N, Miral M, Albayrak S, et al Relationship between nurses' practice environments and nursing outcomes in Turkey. Int Nurs Rev. 2016;63(2):242-9. [Crossref]  [PubMed] 
  26. Kelly LA, Gee PM, Butler RJ. Impact of nurse burnout on organizational and position turnover. Nurs Outlook. 2021;69(1):96-102. [Crossref]  [PubMed]  [PMC] 
  27. Roslan NS, Yusoff MSB, Razak AA, Morgan K. Burnout prevalence and its associated factors among malaysian healthcare workers during COVID-19 pandemic: an embedded mixed-method study. Healthcare (Basel). 2021;9(1):90. [Crossref]  [PubMed]  [PMC] 
  28. Dos Santos MA, Pereira FH, DE Souza Caliari J, Oliveira HC, Ceolim MF, Andrechuk CRS. Sleep and professional burnout in nurses, nursing technicians, and nursing assistants during the COVID-19 pandemic. J Nurs Res. 2022;30(4):e218. [Crossref]  [PubMed]  [PMC] 
  29. Akansel N, Watson R, Vatansever N, Özdemir A. Nurses' perceptions of caring activities in nursing. Nurs Open. 2020;8(1):506-16. [Crossref]  [PubMed]  [PMC] 
  30. Romero-Martín M, Gómez-Salgado J, Robles-Romero JM, Jiménez-Picón N, Gómez-Urquiza JL, Ponce-Blandón JA. Systematic review of the nature of nursing care described by using the Caring Behaviours Inventory. J Clin Nurs. 2019;28(21-22):3734-46. [Crossref]  [PubMed] 
  31. Hajibabaee F, Salisu WJ, Akhlaghi E, Farahani MA, Dehi MMN, Haghani S. The relationship between moral sensitivity and caring behavior among nurses in Iran during COVID-19 pandemic. BMC Nurs. 2022;21(1):58. [Crossref]  [PubMed]  [PMC] 
  32. Chana N, Kennedy P, Chessell ZJ. Nursing staffs' emotional well-being and caring behaviours. J Clin Nurs. 2015;24(19-20):2835-48. [Crossref]  [PubMed] 
  33. Foster K, Roche M, Giandinoto JA, Furness T. Workplace stressors, psychological well-being, resilience, and caring behaviours of mental health nurses: a descriptive correlational study. Int J Ment Health Nurs. 2020;29(1):56-68. [Crossref]  [PubMed] 
  34. Oluma A, Abadiga M. Caring behavior and associated factors among nurses working in Jimma University specialized hospital, Oromia, Southwest Ethiopia, 2019. BMC Nurs. 2020;19:19. [Crossref]  [PubMed]  [PMC] 
  35. Putra KR, Sutadi H, Setyowati S, Hariyati RTS. The impact of nurse manager caring behaviors and work environment on burnout syndrome among nurses. Kontakt. 2021;23(2):90-6. [Crossref] 

.: 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