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PANDEMİ DÖNEMİNDE ANNELERİN EMZİRMEYE İLİŞKİN YAŞADIKLARI SORUNLAR, BAŞVURDUKLARI KAYNAKLAR VE BİLGİ GEREKSİNİMLERİ Skip to content Yıl 2024, Cilt: 25 Sayı: 2, 150 – 159, 29.04.2024
Dilek Bilgiç , Büşra Çap , Hülya Özberk
https://doi.org/10.18229/kocatepetip.1288593
Öz OBJECTIVE: In this study, it was aimed to examine the problems that mothers experienced with breastfeeding during the COVID-19 pandemic, their information sources and information needs for problems. MATERIAL AND METHODS: Descriptive study was conducted with 112 breastfeeding mothers at the a Family Health Center in between September and October 2021. The data were collected using the “Personal Information Form”, “Questionnaire Revealing Information Requirements of Mothers Regarding Breastfeeding During the COVID-19 Pandemic Period” and “Breastfeeding Experience Scale (BES)”. RESULTS: The total mean score of the BES of Mothers was 32.37±9.05. The sub-dimension of mechanical, process, and breast-related concerns during the pandemic period was higher than other dimensions. Mothers mostly consulted nurses (31.3%) and family/friends (28.5%) for breastfeeding problems. During the pandemic, it was determined that 49.1% of the mothers had higher than average knowledge scores about breast milk and its benefits, 54.5% of the mothers about the benefits of breastfeeding and breastfeeding technique, and 52.6% of them had a higher level of knowledge about breastfeeding. As the mothers’ knowledge about breast milk and its benefits decreased, concerns about the breastfeeding process increased (r=-0.243, p=0.010). As the level of knowledge about the benefits of breastfeeding and the breastfeeding technique decreased, breast concerns increased (r= -0.180, p = 0.016). Also, as the level of knowledge about breastfeeding decreased during the pandemic, mothers’ concerns about milk insufficiency (r=-0.258, p=0.006) and social concerns (r = -0.218, p = 0.021) increased (p< 0.05). CONCLUSIONS: During the pandemic, there was a greater increase in mothers’ mechanical concerns, process concerns, and breast-related concerns related to breastfeeding. As mothers’ knowledge of breastfeeding decreases, breastfeeding problems are increasing. Mothers have consulted with nurses the most about breastfeeding problems during the pandemic. For this reason, nurses should evaluate the breastfeeding process, identify problems, and provide education and breastfeeding support for the problems.
Anahtar Kelimeler Information needs, COVID-19 pandemic, Breastfeeding problems, Nursing.
Proje Numarası Çalışma proje değildir.
Kaynakça 1. Turrentine M, Ramirez M, Monga M, et al. Rapid deplopment of a drive-through prenatal care model in response to the coronavirus disease 2019 (COVID-19) pandemic. Obstet Gynecol. 2020;136(1):29-32. 2. Cheema R, Partridge E, Kair LR, et al. Protecting breastfeeding during the COVID-19 pandemic. Am J Perinatol. 2023;40(3):260-66. 3. Gokcay G, Keskindermirci G. Breastmilk and COVID-19. J Ist Faculty Med. 2020;83(3):286-90. 4. Nalbantoğlu A, Nalbanoğlu B, Gökçay G. COVID-19 Enfeksiyonu seyrinde annelerin emzirme ve anne sütü hakkında bilgi ve tutumları. Namık Kemal Tıp Dergisi. 2020;8(3):314-20. 5. Öncel MY, Akın IM, Kanburoglu MK, et al. Neo-COVID Study Group. A multicenter study on epidemiological and clinical characteristics of 125 newborns born to women infected with COVID-19 by Turkish Neonatal Society. Eur J Pediatr. 2021;180(3):733-42. 6. Karaçam Z, Sağlık M. 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Emziren Annelerin emzirme bilgilerinin kaynaklarının incelenmesi: instagram örneği-emziren annelerin emzirme bilgilerinin kaynaklarının incelenmesi: Instagram örneği. Mehmet Akif Ersoy Üniversitesi Sosyal Bilimler Enstitüsü Dergisi. 2019;9(22):389-403. 12. Royal College of Obstetricians and Gynaecologists (RCOG). 2020; Coronavirus (COVID-19) infection in pregnancy.https://www.rcog.org.uk/globalassets/documents/guidelines/coronavirus-covid-19-virus- ifection-in-pregnancy-2020-03-09.pdf. Erişim Tarihi: 15.01.2023. 13. Uyanık, G. Emzirme Sorunlarını Değerlendirme Ölçeğinin (ESDÖ) Türkçe Geçerlilik ve Güvenilirlik Çalışması. (2019). Ege Üniversitesi (Yüksek Lisans Tezi). 14. World Health Organization (WHO). 2020; Breastfeeding and COVID-19. https://www.who.int/newsroom/commentaries/detail/breastfeeding-and-covid-19.Erişim Tarihi: 15.01.2023. 15. United Nations International Children's Emergency Fund (UNICEF). 2020; Breastfeeding safely during the COVID-19 Pandemic. https://www.unicef.org/coronavirus/breastfeeding-safely-during-covid-19- pandemic. Erişim Tarihi: 15.01.2023. 16. Academy of Breastfeeding Medicine (ABM). 2020; ABM Statement on Coronavirus 2019 (COVID19). Retrieved May 18, 2020, from https://www.bfmed. org/abm-statement-coronavirus. Erişim Tarihi: 15.01.2023. 17. Abuidhail J, Mrayan L, Jaradat D. Evaluating effects of prenatal web-based breastfeeding education for pregnant mothers in their third trimester of pregnancy: Prospective randomized control trial. Midwifery. 2019;69:143–49. 18. Araban M, Karimian Z, Kakolaki ZK, et al. Randomize controlled trial of a prenatal breastfeeding self-efficacy intervention in Primiparous women in Iran. J Obstet Gynecol Neonatal Nurs. 2018;47(2):173-83. 19. Selvi Y, Desdicioğlu R, Eray Karataş İ. Antenatal dönemde verilen emzirme eğitiminin emzirme bilgi düzeyine ve Emzirme Öz Yeterlilik Ölçeğine etkisinin değerlendirilmesi. Ankara Med J. 2021;21(1):12-21. 20. Şimşek A, Balkan E, Çalışkan E, Genç Koyucu R. Annelerin emzirme öyküleri ve emzirme davranışlarının incelenmesi: Bir Türkiye örneği. Ebelik ve Sağlık Bilimleri Dergisi. 2021;4(3):222-31. 21. Güner Çevik Ü, İnan B. COVID-19 Pandemi sürecinde annelerin bebek besleme tutumları ve bu tutumları etkileyen faktörler: Facebook, Instagram Örneği. Turkish Journal of Family Medicine and Primary Care. 2022;16(2):357-66. 22. Nazik F, Doğan Yüksekol Ö, Baltacı N, Ulucan M. Gebe kadınların doğum öncesi bakım alma durumu ve COVID-19 pandemisinin etkisi. TOGÜ Sağlık Bilimleri Dergisi. 2022;2(2):111-22. 23. United Nations International Children's Emergency Fund (UNICEF). The state of the World’s Children 2019. Children, food and nutrition: Growing well in a changing world. UNICEF, New York, 2019; 1-258. https://www.unicef.org/reports/state-of-worlds-children-2019. Erişim Tarihi: 15.01.2023. 24. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. 2018; Türkiye Nüfus ve Sağlık Araştırması. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, T.C. Cumhurbaşkanlığı Strateji ve Bütçe Başkanlığı ve TÜBİTAK, Ankara, Türkiye. 2019;143-146.http://www.hips.hacettepe.edu.tr/tr/2018_tnsa_analiz_ve_rapor-56. Erişim tarihi 22.01.2023. 25. Holand B L, de Oliveira Agostini C, Pacheco M, et al. Association between breastfeeding and complementary feeding in pre-pandemic and pandemic COVID-19 times: Maternar cohort study. Jornal de Pediatria. 2022;98(5):496–503. 26. Gallego-Rodríguez I, Strivens-Vilchez H, Agea-Cano I, et al. Breastfeeding experiences during the COVID-19 pandemic in Spain: A qualitative study. International Breastfeeding Journal. 2022;17(1):1-12. 27. Durmuş A, Öztaş HG. COVID-19 tanısı almış veya temaslı annelerin emzirme ile ilgili bilgi düzeyleri ve emzirme öz yeterliliğine etkisi. Kırşehir Ahi Evran Üniversitesi Sağlık Bilimleri Dergisi. 2022;6(1):14-21. 28. Sakalidis VS, Rea A, Perrella SL, et al. Longitudinal changes in wellbeing amongst breastfeeding women in Australia and New Zealand during the COVID-19 pandemic. Eur J Pediatr. 2022;181(10):3753-66. 29. Oggero MK, Wardell DW. Changes in breastfeeding exclusivity and satisfaction during the COVID-19 Pandemic. Journal of Human Lactation. 2022;38(3):433-42. 30. Durmazoğlu G, Tokat MA, Okumuş H. COVID-19 pandemi sürecinde emziren annelere ve emzirme hemşirelerine insan bakım kuramı temelli yaklaşım. DEUHFED. 2022;15(4):568-81.
PANDEMİ DÖNEMİNDE ANNELERİN EMZİRMEYE İLİŞKİN YAŞADIKLARI SORUNLAR, BAŞVURDUKLARI KAYNAKLAR VE BİLGİ GEREKSİNİMLERİ Yıl 2024, Cilt: 25 Sayı: 2, 150 – 159, 29.04.2024
Dilek Bilgiç , Büşra Çap , Hülya Özberk
https://doi.org/10.18229/kocatepetip.1288593
Öz AMAÇ: Bu araştırmada, COVID-19 pandemisinde annelerin emzirmeye ilişkin yaşadıkları sorunlar, sorunlara yönelik bilgi kaynakları ve bilgi gereksinimlerinin incelemesi amaçlanmıştır. GEREÇ VE YÖNTEM: Tanımlayıcı bu araştırma, bir Aile Sağlık Merkezinde, Eylül – Ekim 2021 tarihlerinde 112 emziren anne ile yapılmıştır. Veriler “Kişisel Bilgi Formu”, “COVID-19 Pandemi Döneminde Annelerin Emzirmeye İlişkin Bilgi Gereksinimlerini Ortaya Çıkaran Soru Formu” ve “Emzirme Sorunlarını Değerlendirme Ölçeği” kullanılarak toplanmıştır. BULGULAR: Annelerin Emzirme Sorunlarını Değerlendirme Ölçeği toplam puan ortalaması 32,37±9,05’dir. Annelerin pandemi döneminde emzirmeyle ilişkili olarak mekanik endişeleri, sürece ait endişeleri ve memeyle ilişkili endişelerinin daha fazla olduğu saptanmıştır. Anneler emzirme sorunlarında en fazla hemşirelere (%31,3) ve aile/arkadaşlarına (%28,5) başvurmuştur. Pandemide, annelerin %49,1’inin anne sütü ve yararlarına, %54,5’inin emzirmenin yararları ve emzirme tekniğine ve %52,6’sının pandemi döneminde emzirmeye ilişkin bilgi puanlarının ortalamanın üstünde olduğu belirlenmiştir. Annelerin anne sütü ve yararlarına ilişkin bilgileri azaldıkça emzirme sürecine ait endişeleri artmıştır (r= -0.243, p = 0.010). Emzirmenin yararları ve emzirme tekniğine ilişkin bilgileri azaldıkça, memeye ait endişeleri artmıştır (r=-0.180, p = 0.016). Ayrıca, pandemi döneminde emzirmeye ilişkin bilgi düzeyleri azaldıkça, annelerin süt yetersizliğine ait endişeleri (r=-0.258, p = 0.006) ve sosyal endişeleri (r=-0.218, p = 0.021) artmıştır (p< 0,05). SONUÇ: Pandemi döneminde annelerin emzirmeyle ilişkili olarak mekanik endişelerinde, sürece ait endişelerinde ve memeyle ilişkili endişelerinde daha fazla artış olmuştur. Annelerin emzirmeye ait bilgi düzeyleri azaldıkça emzirme sorunları artmaktadır. Pandemi sürecinde emzirme sorunları için en fazla hemşirelere başvurulmuştur. Bu nedenle hemşireler emzirme sürecini değerlendirerek sorunları saptamalı, sorunlara yönelik eğitim ve emzirme desteği sağlamalıdırlar.
Anahtar Kelimeler Bilgi gereksinimi, COVID-19 pandemisi, Emzirme sorunları, Hemşirelik.
Destekleyen Kurum Bulunmamaktadır.
Proje Numarası Çalışma proje değildir.
Teşekkür Bulunmamaktadır.
Kaynakça 1. Turrentine M, Ramirez M, Monga M, et al. Rapid deplopment of a drive-through prenatal care model in response to the coronavirus disease 2019 (COVID-19) pandemic. Obstet Gynecol. 2020;136(1):29-32. 2. Cheema R, Partridge E, Kair LR, et al. Protecting breastfeeding during the COVID-19 pandemic. Am J Perinatol. 2023;40(3):260-66. 3. Gokcay G, Keskindermirci G. Breastmilk and COVID-19. J Ist Faculty Med. 2020;83(3):286-90. 4. Nalbantoğlu A, Nalbanoğlu B, Gökçay G. COVID-19 Enfeksiyonu seyrinde annelerin emzirme ve anne sütü hakkında bilgi ve tutumları. Namık Kemal Tıp Dergisi. 2020;8(3):314-20. 5. Öncel MY, Akın IM, Kanburoglu MK, et al. Neo-COVID Study Group. A multicenter study on epidemiological and clinical characteristics of 125 newborns born to women infected with COVID-19 by Turkish Neonatal Society. Eur J Pediatr. 2021;180(3):733-42. 6. Karaçam Z, Sağlık M. Breastfeeding problems and interventions performed on problems: Systematic review based on studies made in Turkey. Turk Pediatri Ars. 2018;53(3):134-48. 7. Brown A, Shenker N. Experiences of breastfeeding during COVID‐19: Lessons for future practical and emotional support. Matern Child Nutr. 2021;17(1):e13088. 8. Zanardo V, Tortora D, Guerrini P, et al. Infant feeding initiation practices in the context of COVID-19 lockdown. Early Hum Dev. 2021;152:105286. 9. Ceulemans M, Verbakel JY, Van Calsteren K, et al. SARS-CoV-2 ınfections and ımpact of the COVID-19 pandemic in pregnancy and breastfeeding: Results from an observational study in primary care in Belgium. Int J Environ Res Public Health. 2020:17(18);6766. 10. Vazquez-Vazquez A, Dib S, Rougeaux E, et al. The impact of the COVID-19 lockdown on the experiences and feeding practices of new mothers in the UK: Preliminary data from the COVID-19 New Mum Study. Appetite. 2021;1;156:104985. 11. Demirtaş ZG, Çelik R. Emziren Annelerin emzirme bilgilerinin kaynaklarının incelenmesi: instagram örneği-emziren annelerin emzirme bilgilerinin kaynaklarının incelenmesi: Instagram örneği. Mehmet Akif Ersoy Üniversitesi Sosyal Bilimler Enstitüsü Dergisi. 2019;9(22):389-403. 12. Royal College of Obstetricians and Gynaecologists (RCOG). 2020; Coronavirus (COVID-19) infection in pregnancy.https://www.rcog.org.uk/globalassets/documents/guidelines/coronavirus-covid-19-virus- ifection-in-pregnancy-2020-03-09.pdf. Erişim Tarihi: 15.01.2023. 13. Uyanık, G. Emzirme Sorunlarını Değerlendirme Ölçeğinin (ESDÖ) Türkçe Geçerlilik ve Güvenilirlik Çalışması. (2019). Ege Üniversitesi (Yüksek Lisans Tezi). 14. World Health Organization (WHO). 2020; Breastfeeding and COVID-19. https://www.who.int/newsroom/commentaries/detail/breastfeeding-and-covid-19.Erişim Tarihi: 15.01.2023. 15. United Nations International Children's Emergency Fund (UNICEF). 2020; Breastfeeding safely during the COVID-19 Pandemic. https://www.unicef.org/coronavirus/breastfeeding-safely-during-covid-19- pandemic. Erişim Tarihi: 15.01.2023. 16. Academy of Breastfeeding Medicine (ABM). 2020; ABM Statement on Coronavirus 2019 (COVID19). Retrieved May 18, 2020, from https://www.bfmed. org/abm-statement-coronavirus. Erişim Tarihi: 15.01.2023. 17. Abuidhail J, Mrayan L, Jaradat D. Evaluating effects of prenatal web-based breastfeeding education for pregnant mothers in their third trimester of pregnancy: Prospective randomized control trial. Midwifery. 2019;69:143–49. 18. Araban M, Karimian Z, Kakolaki ZK, et al. Randomize controlled trial of a prenatal breastfeeding self-efficacy intervention in Primiparous women in Iran. J Obstet Gynecol Neonatal Nurs. 2018;47(2):173-83. 19. Selvi Y, Desdicioğlu R, Eray Karataş İ. Antenatal dönemde verilen emzirme eğitiminin emzirme bilgi düzeyine ve Emzirme Öz Yeterlilik Ölçeğine etkisinin değerlendirilmesi. Ankara Med J. 2021;21(1):12-21. 20. Şimşek A, Balkan E, Çalışkan E, Genç Koyucu R. Annelerin emzirme öyküleri ve emzirme davranışlarının incelenmesi: Bir Türkiye örneği. Ebelik ve Sağlık Bilimleri Dergisi. 2021;4(3):222-31. 21. Güner Çevik Ü, İnan B. COVID-19 Pandemi sürecinde annelerin bebek besleme tutumları ve bu tutumları etkileyen faktörler: Facebook, Instagram Örneği. Turkish Journal of Family Medicine and Primary Care. 2022;16(2):357-66. 22. Nazik F, Doğan Yüksekol Ö, Baltacı N, Ulucan M. Gebe kadınların doğum öncesi bakım alma durumu ve COVID-19 pandemisinin etkisi. TOGÜ Sağlık Bilimleri Dergisi. 2022;2(2):111-22. 23. United Nations International Children's Emergency Fund (UNICEF). The state of the World’s Children 2019. Children, food and nutrition: Growing well in a changing world. UNICEF, New York, 2019; 1-258. https://www.unicef.org/reports/state-of-worlds-children-2019. Erişim Tarihi: 15.01.2023. 24. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü. 2018; Türkiye Nüfus ve Sağlık Araştırması. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, T.C. Cumhurbaşkanlığı Strateji ve Bütçe Başkanlığı ve TÜBİTAK, Ankara, Türkiye. 2019;143-146.http://www.hips.hacettepe.edu.tr/tr/2018_tnsa_analiz_ve_rapor-56. Erişim tarihi 22.01.2023. 25. Holand B L, de Oliveira Agostini C, Pacheco M, et al. Association between breastfeeding and complementary feeding in pre-pandemic and pandemic COVID-19 times: Maternar cohort study. Jornal de Pediatria. 2022;98(5):496–503. 26. Gallego-Rodríguez I, Strivens-Vilchez H, Agea-Cano I, et al. Breastfeeding experiences during the COVID-19 pandemic in Spain: A qualitative study. International Breastfeeding Journal. 2022;17(1):1-12. 27. Durmuş A, Öztaş HG. COVID-19 tanısı almış veya temaslı annelerin emzirme ile ilgili bilgi düzeyleri ve emzirme öz yeterliliğine etkisi. Kırşehir Ahi Evran Üniversitesi Sağlık Bilimleri Dergisi. 2022;6(1):14-21. 28. Sakalidis VS, Rea A, Perrella SL, et al. Longitudinal changes in wellbeing amongst breastfeeding women in Australia and New Zealand during the COVID-19 pandemic. Eur J Pediatr. 2022;181(10):3753-66. 29. Oggero MK, Wardell DW. Changes in breastfeeding exclusivity and satisfaction during the COVID-19 Pandemic. Journal of Human Lactation. 2022;38(3):433-42. 30. Durmazoğlu G, Tokat MA, Okumuş H. COVID-19 pandemi sürecinde emziren annelere ve emzirme hemşirelerine insan bakım kuramı temelli yaklaşım. DEUHFED. 2022;15(4):568-81. Toplam 33 adet kaynakça vardır.
Ayrıntılar Birincil Dil Türkçe Konular Klinik Tıp Bilimleri Bölüm Makaleler-Araştırma Yazıları Yazarlar Dilek Bilgiç DOKUZ EYLÜL ÜNİVERSİTESİ 0000-0001-9569-8875 Türkiye
Büşra Çap DOKUZ EYLÜL ÜNİVERSİTESİ 0000-0003-4611-0283 Türkiye
Hülya Özberk Dokuz Eylül Üniversitesi 0000-0002-0902-7037 Türkiye
Proje Numarası Çalışma proje değildir. Yayımlanma Tarihi 29 Nisan 2024 Kabul Tarihi 25 Temmuz 2023 Yayımlandığı Sayı Yıl 2024 Cilt: 25 Sayı: 2
Kaynak Göster APA Bilgiç, D., Çap, B., & Özberk, H. (2024). PANDEMİ DÖNEMİNDE ANNELERİN EMZİRMEYE İLİŞKİN YAŞADIKLARI SORUNLAR, BAŞVURDUKLARI KAYNAKLAR VE BİLGİ GEREKSİNİMLERİ. Kocatepe Tıp Dergisi, 25(2), 150-159. https://doi.org/10.18229/kocatepetip.1288593 AMA Bilgiç D, Çap B, Özberk H. PANDEMİ DÖNEMİNDE ANNELERİN EMZİRMEYE İLİŞKİN YAŞADIKLARI SORUNLAR, BAŞVURDUKLARI KAYNAKLAR VE BİLGİ GEREKSİNİMLERİ. KTD. Nisan 2024;25(2):150-159. doi:10.18229/kocatepetip.1288593 Chicago Bilgiç, Dilek, Büşra Çap, ve Hülya Özberk. “PANDEMİ DÖNEMİNDE ANNELERİN EMZİRMEYE İLİŞKİN YAŞADIKLARI SORUNLAR, BAŞVURDUKLARI KAYNAKLAR VE BİLGİ GEREKSİNİMLERİ”. Kocatepe Tıp Dergisi 25, sy. 2 (Nisan 2024): 150-59. https://doi.org/10.18229/kocatepetip.1288593. EndNote Bilgiç D, Çap B, Özberk H (01 Nisan 2024) PANDEMİ DÖNEMİNDE ANNELERİN EMZİRMEYE İLİŞKİN YAŞADIKLARI SORUNLAR, BAŞVURDUKLARI KAYNAKLAR VE BİLGİ GEREKSİNİMLERİ. Kocatepe Tıp Dergisi 25 2 150–159. IEEE D. Bilgiç, B. Çap, ve H. Özberk, “PANDEMİ DÖNEMİNDE ANNELERİN EMZİRMEYE İLİŞKİN YAŞADIKLARI SORUNLAR, BAŞVURDUKLARI KAYNAKLAR VE BİLGİ GEREKSİNİMLERİ”, KTD , c. 25, sy. 2, ss. 150–159, 2024, doi: 10.18229/kocatepetip.1288593. ISNAD Bilgiç, Dilek vd. “PANDEMİ DÖNEMİNDE ANNELERİN EMZİRMEYE İLİŞKİN YAŞADIKLARI SORUNLAR, BAŞVURDUKLARI KAYNAKLAR VE BİLGİ GEREKSİNİMLERİ”. Kocatepe Tıp Dergisi 25/2 (Nisan 2024), 150-159. https://doi.org/10.18229/kocatepetip.1288593. JAMA Bilgiç D, Çap B, Özberk H. PANDEMİ DÖNEMİNDE ANNELERİN EMZİRMEYE İLİŞKİN YAŞADIKLARI SORUNLAR, BAŞVURDUKLARI KAYNAKLAR VE BİLGİ GEREKSİNİMLERİ. KTD . 2024;25:150–159. MLA Bilgiç, Dilek vd. “PANDEMİ DÖNEMİNDE ANNELERİN EMZİRMEYE İLİŞKİN YAŞADIKLARI SORUNLAR, BAŞVURDUKLARI KAYNAKLAR VE BİLGİ GEREKSİNİMLERİ”. Kocatepe Tıp Dergisi, c. 25, sy. 2, 2024, ss. 150-9, doi:10.18229/kocatepetip.1288593. Vancouver Bilgiç D, Çap B, Özberk H. PANDEMİ DÖNEMİNDE ANNELERİN EMZİRMEYE İLİŞKİN YAŞADIKLARI SORUNLAR, BAŞVURDUKLARI KAYNAKLAR VE BİLGİ GEREKSİNİMLERİ. KTD. 2024;25(2):150-9.
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