Research Article
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Fatigue and depression in mothers caring for children with spina bifida: Examining the role of child's functionality

Year 2024, Volume: 41 Issue: 1, 47 - 52, 29.03.2024

Pelin Güneş Beyzanur Dikmen Hoşbaş Berna Karamancıoğlu Turgay Altunalan

Abstract

Spina bifida (SB) has a significant impact on factors such as stress, depression and fatigue in mothers. The purpose of this study was to examine the relationship between depression and fatigue in mothers of children diagnosed with SB and the functional status of their children. The research was conducted with 75 children (53.3% girls; 46.7% boys) with SB (5.3% meningocele, 94.7% myelomeningocele) aged between 1 and 16 years (mean 6.34 ± SD 3.64) and their mothers aged between 22 and 55 years (mean 33.76 ± SD 7.06). Functional levels of the children were assessed using the Gross Motor Function Classification System (GMFCS), and depression and fatigue levels of the mothers were assessed using the Beck Depression Inventory and the Fatigue Impact Scale, respectively. No significant correlation was found between maternal fatigue and depression levels and GMFCS levels in children with SB (p>0.05). However, 25.33% of the mothers had minimal, 64% mild, 8% moderate and 2.67% severe depression. It was found that 6.67% of the mothers had some, 45.33% moderate, 44% significant and 4% very significant problems with fatigue. Moderate to severe fatigue is reported by approximately 9 out of 10 parents of children with SB, whereas moderate to severe depression is reported by approximately 1 out of 10. Rehabilitation practices for children with SB should include psychological support for their mothers, regardless of their functional status.

Keywords

Caregiver depression fatigue functionality spina bifida

Ethical Statement

The participants were fully informed about the study and voluntarily agreed to participate. The study protocol was approved by the Üsküdar University Non-Interventional Research Ethics Committee on 26/04/2022 with decision number 61351342. The study adhered to the World Medical Association's Declaration of Helsinki.

Supporting Institution

There is no supporting organisation.

Thanks

The authors are grateful to the children with Spina Bifida and their mothers who participated in the study.

References

  • Blencowe H, Kancherla V, Moorthie S, Darlison MW, Modell B. Estimates of global and regional prevalence of neural tube defects for 2015: a systematic analysis. Annals of the new York Academy of Sciences. 2018;1414(1):31-46.
  • Detrait ER, George TM, Etchevers HC, Gilbert JR, Vekemans M, Speer MC. Human neural tube defects: developmental biology, epidemiology, and genetics. Neurotoxicology and teratology. 2005;27(3):515-24.
  • Tunçbilek E. Türkiye’deki yüksek nöral tüp defekti sıklığı ve önlemek için yapılabilecekler. Çocuk sağlığı ve hastalıkları dergisi. 2004;47(2):79-84.
  • Malm-Buatsi E, Aston CE, Ryan J, Tao Y, Palmer BW, Kropp BP, et al. Mental health and parenting characteristics of caregivers of children with spina bifida. Journal of Pediatric Urology. 2015;11(2):65. e1-. e7.
  • Ravi KS, Hassan SB, Pasi R, Mittra S, Kumar R. Neural tube defects: Different types and brief review of neurulation process and its clinical implication. Journal of Family Medicine and Primary Care. 2021;10(12):4383.
  • Stucki G, Cieza A, Ewert T, Kostanjsek N, Chatterji S, Ustun TB. Application of the International Classification of Functioning, Disability and Health (ICF) in clinical practice. Disability and rehabilitation. 2002;24(5):281-2.
  • Singhal B, Mathew K. Factors affecting mortality and morbidity in adult spina bifida. European Journal of Pediatric Surgery. 1999;9(S 1):31-2.
  • Kanaheswari Y, Razak N, Chandran V, Ong L. Predictors of parenting stress in mothers of children with spina bifida. Spinal Cord. 2011;49(3):376-80.
  • Davis BE, Daley CM, Shurtleff DB, Duguay S, Seidel K, Loeser JD, et al. Long-term survival of individuals with myelomeningocele. Pediatric neurosurgery. 2005;41(4):186-91.
  • Betz CL, Smith KA, Kysh L, Roland M, Van Speybroeck A, Castillo P, et al. Psychosocial outcomes for adults with spina bifida: a scoping review protocol. JBI Evidence Synthesis. 2020;18(5):1135-43.
  • Thompson Jr RJ, Gustafson KE. Adaptation to chronic childhood illness: American Psychological Association; 1996. Grosse SD, Flores AL, Ouyang L, Robbins JM, Tilford JM. Impact of spina bifida on parental caregivers: findings from a survey of Arkansas families. Journal of child and family studies. 2009;18:574-81.
  • Ammerman RT, Kane VR, Slomka GT, Reigel DH, Franzen MD, Gadow KD. Psychiatric symptomatology and family functioning in children and adolescents with spina bifida. Journal of Clinical Psychology in Medical Settings. 1998;5:449-65.
  • Holmbeck GN, Coakley RM, Hommeyer JS, Shapera WE, Westhoven VC. Observed and perceived dyadic and systemic functioning in families of preadolescents with spina bifida. Journal of Pediatric Psychology. 2002;27(2):177-89.
  • Chaney JM, Mullins LL, Frank RG, Peterson L, Mace LD, Kashani JH, et al. Transactional patterns of child, mother, and father adjustment in insulin-dependent diabetes meelitus: A prospective study. Journal of pediatric psychology. 1997;22(2):229-44.
  • Holmbeck GN, Gorey-Ferguson L, Hudson T, Sefeldt T, Shapera W, Turner T, et al. Maternal, paternal, and marital functioning in families of preadolescents with spina bifida. Journal of Pediatric Psychology. 1997;22(2):167-81. Vermaes IP, Janssens JM, Bosman AM, Gerris JR. Parents' psychological adjustment in families of children with spina bifida: a meta-analysis. BMC pediatrics. 2005;5:1-13.
  • Ong LC, Norshireen NA, Chandran V. A comparison of parenting stress between mothers of children with spina bifida and able-bodied controls. Developmental Neurorehabilitation. 2011;14(1):22-8.
  • Vermaes IP, Janssens J, Mullaart R, Vinck A, Gerris J. Parents' personality and parenting stress in families of children with spina bifida. Child: care, health and development. 2008;34(5):665-74.
  • Friedman D, Holmbeck GN, Jandasek B, Zukerman J, Abad M. Parent functioning in families of preadolescents with spina bifida: longitudinal implications for child adjustment. Journal of Family Psychology. 2004;18(4):609.
  • Macias MM, Saylor CF, Rowe BP, Bell NL. Age-related parenting stress differences in mothers of children with spina bifida. Psychological reports. 2003;93(3_suppl):1223-32.
  • Carr J, Pearson A, Halliwell M. The effect of disability on family life. Zeitschrift für Kinderchirurgie. 1983;38(S 2):103-6. Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Gross motor function classification system for cerebral palsy. Dev Med Child Neurol. 1997;39(4):214-23.
  • Russell DJ, Avery LM, Rosenbaum PL, Raina PS, Walter SD, Palisano RJ. Improved scaling of the gross motor function measure for children with cerebral palsy: evidence of reliability and validity. Physical therapy. 2000;80(9):873-85.
  • Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP. Investigation of the timed 'up & go'test in children. Developmental medicine and child neurology. 2005;47(8):518-24.
  • El Ö, Baydar M, Berk H, Peker Ö, Koşay C, Demiral Y. Interobserver reliability of the Turkish version of the expanded and revised gross motor function classification system. Disability and rehabilitation. 2012;34(12):1030-3.
  • Fisk JD, Ritvo PG, Ross L, Haase DA, Marrie TJ, Schlech WF. Measuring the functional impact of fatigue: initial validation of the fatigue impact scale. Clinical Infectious Diseases. 1994;18(Supplement_1):S79-S83.
  • Frith J, Newton J. Fatigue impact scale. Occupational medicine. 2010;60(2):159-. Armutlu K, Korkmaz NC, Keser I, Sumbuloglu V, Akbiyik DI, Guney Z, et al. The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. International Journal of Rehabilitation Research. 2007;30(1):81-5.
  • Beck AT, Ward C, Mendelson M, Mock J, Erbaugh J. Beck depression inventory (BDI). Arch Gen Psychiatry. 1961;4(6):561-71.
  • Hisli N. Validity and reliability of the Beck Depression Inventory for university students. Psikoloji dergisi. 1989;7:3-13. Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation. Anesthesia & analgesia. 2018;126(5):1763-8.
  • Unsal-Delialioglu S, Kaya K, Ozel S, Gorgulu G. Depression in mothers of children with cerebral palsy and related factors in Turkey: a controlled study. International Journal of Rehabilitation Research. 2009;32(3):199-204.
  • Garip Y, Ozel S, Tuncer OB, Kilinc G, Seckin F, Arasil T. Fatigue in the mothers of children with cerebral palsy. Disability and rehabilitation. 2017;39(8):757-62.
  • Leão LL, Zhang L, Sousa PL, Mendoza-Sassi R, Chadha R, Lovatel R, et al. High prevalence of depression amongst mothers of children with asthma. Journal of Asthma. 2009;46(4):388-91.
  • Durat G, Atmaca GD, Ünsal A, Kama N. Özel gereksinimi olan çocukların ailelerinde umutsuzluk ve depresyon. Osmangazi Tıp Dergisi. 2017;39(3):49-57.
  • Özcanarslan F, Karataş H, AYDIN D. Şanlıurfa ilinde engelli çocuğa sahip Annelerin depresyon durumlarinin belirlenmesi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2014;11(2):75-82.
  • Sawin KJ, Thompson NM. The experience of finding an effective bowel management program for children with spina bifida: The parent's perspective. Journal of Pediatric Nursing. 2009;24(4):280-91.
  • Ulus Y, Tander B, Akyol Y, Ulus A, Tander B, Bilgici A, et al. Functional disability of children with spina bifida: its impact on parents' psychological status and family functioning. Developmental Neurorehabilitation. 2012;15(5):322-8.
  • Ridosh MM, Sawin KJ, Klein-Tasman BP, Holmbeck GN. Depressive symptoms in parents of children with spina bifida: A review of the literature. Comprehensive Child and Adolescent Nursing. 2017;40(2):71-110.
  • Tew B, Laurence K. Some sources of stress found in mothers of spina bifida children. Journal of Epidemiology & Community Health. 1975;29(1):27-30.
  • Wiegner S, Donders J. Predictors of parental distress after congenital disabilities. Journal of Developmental and Behavioral Pediatrics. 2000.
  • Heiman T. Parents of children with disabilities: Resilience, coping, and future expectations. Journal of developmental and physical disabilities. 2002;14:159-71.
  • Khayatzadeh MM, Rostami HR, Amirsalari S, Karimloo M. Investigation of quality of life in mothers of children with cerebral palsy in Iran: association with socio-economic status, marital satisfaction and fatigue. Disability and rehabilitation. 2013;35(10):803-8.
  • Giallo R, Wood CE, Jellett R, Porter R. Fatigue, wellbeing and parental self-efficacy in mothers of children with an autism spectrum disorder. Autism. 2013;17(4):465-80.
  • Albayrak I, Biber A, Çalışkan A, Levendoglu F. Assessment of pain, care burden, depression level, sleep quality, fatigue and quality of life in the mothers of children with cerebral palsy. Journal of Child Health Care. 2019;23(3):483-94.
  • Goldbeck L, Hölling I, Schlack R, West C, Besier T. The impact of an inpatient family-oriented rehabilitation program on parent-reported psychological symptoms of chronically ill children. Klinische Pädiatrie. 2011;223(02):79-84.
  • Ozaras N. Spina bifida and rehabilitation. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi-Turkish Journal of Physical Medicine and Rehabilitation. 2015;61(1).

Year 2024, Volume: 41 Issue: 1, 47 - 52, 29.03.2024

Pelin Güneş Beyzanur Dikmen Hoşbaş Berna Karamancıoğlu Turgay Altunalan

Abstract

References

  • Blencowe H, Kancherla V, Moorthie S, Darlison MW, Modell B. Estimates of global and regional prevalence of neural tube defects for 2015: a systematic analysis. Annals of the new York Academy of Sciences. 2018;1414(1):31-46.
  • Detrait ER, George TM, Etchevers HC, Gilbert JR, Vekemans M, Speer MC. Human neural tube defects: developmental biology, epidemiology, and genetics. Neurotoxicology and teratology. 2005;27(3):515-24.
  • Tunçbilek E. Türkiye’deki yüksek nöral tüp defekti sıklığı ve önlemek için yapılabilecekler. Çocuk sağlığı ve hastalıkları dergisi. 2004;47(2):79-84.
  • Malm-Buatsi E, Aston CE, Ryan J, Tao Y, Palmer BW, Kropp BP, et al. Mental health and parenting characteristics of caregivers of children with spina bifida. Journal of Pediatric Urology. 2015;11(2):65. e1-. e7.
  • Ravi KS, Hassan SB, Pasi R, Mittra S, Kumar R. Neural tube defects: Different types and brief review of neurulation process and its clinical implication. Journal of Family Medicine and Primary Care. 2021;10(12):4383.
  • Stucki G, Cieza A, Ewert T, Kostanjsek N, Chatterji S, Ustun TB. Application of the International Classification of Functioning, Disability and Health (ICF) in clinical practice. Disability and rehabilitation. 2002;24(5):281-2.
  • Singhal B, Mathew K. Factors affecting mortality and morbidity in adult spina bifida. European Journal of Pediatric Surgery. 1999;9(S 1):31-2.
  • Kanaheswari Y, Razak N, Chandran V, Ong L. Predictors of parenting stress in mothers of children with spina bifida. Spinal Cord. 2011;49(3):376-80.
  • Davis BE, Daley CM, Shurtleff DB, Duguay S, Seidel K, Loeser JD, et al. Long-term survival of individuals with myelomeningocele. Pediatric neurosurgery. 2005;41(4):186-91.
  • Betz CL, Smith KA, Kysh L, Roland M, Van Speybroeck A, Castillo P, et al. Psychosocial outcomes for adults with spina bifida: a scoping review protocol. JBI Evidence Synthesis. 2020;18(5):1135-43.
  • Thompson Jr RJ, Gustafson KE. Adaptation to chronic childhood illness: American Psychological Association; 1996. Grosse SD, Flores AL, Ouyang L, Robbins JM, Tilford JM. Impact of spina bifida on parental caregivers: findings from a survey of Arkansas families. Journal of child and family studies. 2009;18:574-81.
  • Ammerman RT, Kane VR, Slomka GT, Reigel DH, Franzen MD, Gadow KD. Psychiatric symptomatology and family functioning in children and adolescents with spina bifida. Journal of Clinical Psychology in Medical Settings. 1998;5:449-65.
  • Holmbeck GN, Coakley RM, Hommeyer JS, Shapera WE, Westhoven VC. Observed and perceived dyadic and systemic functioning in families of preadolescents with spina bifida. Journal of Pediatric Psychology. 2002;27(2):177-89.
  • Chaney JM, Mullins LL, Frank RG, Peterson L, Mace LD, Kashani JH, et al. Transactional patterns of child, mother, and father adjustment in insulin-dependent diabetes meelitus: A prospective study. Journal of pediatric psychology. 1997;22(2):229-44.
  • Holmbeck GN, Gorey-Ferguson L, Hudson T, Sefeldt T, Shapera W, Turner T, et al. Maternal, paternal, and marital functioning in families of preadolescents with spina bifida. Journal of Pediatric Psychology. 1997;22(2):167-81. Vermaes IP, Janssens JM, Bosman AM, Gerris JR. Parents' psychological adjustment in families of children with spina bifida: a meta-analysis. BMC pediatrics. 2005;5:1-13.
  • Ong LC, Norshireen NA, Chandran V. A comparison of parenting stress between mothers of children with spina bifida and able-bodied controls. Developmental Neurorehabilitation. 2011;14(1):22-8.
  • Vermaes IP, Janssens J, Mullaart R, Vinck A, Gerris J. Parents' personality and parenting stress in families of children with spina bifida. Child: care, health and development. 2008;34(5):665-74.
  • Friedman D, Holmbeck GN, Jandasek B, Zukerman J, Abad M. Parent functioning in families of preadolescents with spina bifida: longitudinal implications for child adjustment. Journal of Family Psychology. 2004;18(4):609.
  • Macias MM, Saylor CF, Rowe BP, Bell NL. Age-related parenting stress differences in mothers of children with spina bifida. Psychological reports. 2003;93(3_suppl):1223-32.
  • Carr J, Pearson A, Halliwell M. The effect of disability on family life. Zeitschrift für Kinderchirurgie. 1983;38(S 2):103-6. Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Gross motor function classification system for cerebral palsy. Dev Med Child Neurol. 1997;39(4):214-23.
  • Russell DJ, Avery LM, Rosenbaum PL, Raina PS, Walter SD, Palisano RJ. Improved scaling of the gross motor function measure for children with cerebral palsy: evidence of reliability and validity. Physical therapy. 2000;80(9):873-85.
  • Williams EN, Carroll SG, Reddihough DS, Phillips BA, Galea MP. Investigation of the timed 'up & go'test in children. Developmental medicine and child neurology. 2005;47(8):518-24.
  • El Ö, Baydar M, Berk H, Peker Ö, Koşay C, Demiral Y. Interobserver reliability of the Turkish version of the expanded and revised gross motor function classification system. Disability and rehabilitation. 2012;34(12):1030-3.
  • Fisk JD, Ritvo PG, Ross L, Haase DA, Marrie TJ, Schlech WF. Measuring the functional impact of fatigue: initial validation of the fatigue impact scale. Clinical Infectious Diseases. 1994;18(Supplement_1):S79-S83.
  • Frith J, Newton J. Fatigue impact scale. Occupational medicine. 2010;60(2):159-. Armutlu K, Korkmaz NC, Keser I, Sumbuloglu V, Akbiyik DI, Guney Z, et al. The validity and reliability of the Fatigue Severity Scale in Turkish multiple sclerosis patients. International Journal of Rehabilitation Research. 2007;30(1):81-5.
  • Beck AT, Ward C, Mendelson M, Mock J, Erbaugh J. Beck depression inventory (BDI). Arch Gen Psychiatry. 1961;4(6):561-71.
  • Hisli N. Validity and reliability of the Beck Depression Inventory for university students. Psikoloji dergisi. 1989;7:3-13. Schober P, Boer C, Schwarte LA. Correlation coefficients: appropriate use and interpretation. Anesthesia & analgesia. 2018;126(5):1763-8.
  • Unsal-Delialioglu S, Kaya K, Ozel S, Gorgulu G. Depression in mothers of children with cerebral palsy and related factors in Turkey: a controlled study. International Journal of Rehabilitation Research. 2009;32(3):199-204.
  • Garip Y, Ozel S, Tuncer OB, Kilinc G, Seckin F, Arasil T. Fatigue in the mothers of children with cerebral palsy. Disability and rehabilitation. 2017;39(8):757-62.
  • Leão LL, Zhang L, Sousa PL, Mendoza-Sassi R, Chadha R, Lovatel R, et al. High prevalence of depression amongst mothers of children with asthma. Journal of Asthma. 2009;46(4):388-91.
  • Durat G, Atmaca GD, Ünsal A, Kama N. Özel gereksinimi olan çocukların ailelerinde umutsuzluk ve depresyon. Osmangazi Tıp Dergisi. 2017;39(3):49-57.
  • Özcanarslan F, Karataş H, AYDIN D. Şanlıurfa ilinde engelli çocuğa sahip Annelerin depresyon durumlarinin belirlenmesi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2014;11(2):75-82.
  • Sawin KJ, Thompson NM. The experience of finding an effective bowel management program for children with spina bifida: The parent's perspective. Journal of Pediatric Nursing. 2009;24(4):280-91.
  • Ulus Y, Tander B, Akyol Y, Ulus A, Tander B, Bilgici A, et al. Functional disability of children with spina bifida: its impact on parents' psychological status and family functioning. Developmental Neurorehabilitation. 2012;15(5):322-8.
  • Ridosh MM, Sawin KJ, Klein-Tasman BP, Holmbeck GN. Depressive symptoms in parents of children with spina bifida: A review of the literature. Comprehensive Child and Adolescent Nursing. 2017;40(2):71-110.
  • Tew B, Laurence K. Some sources of stress found in mothers of spina bifida children. Journal of Epidemiology & Community Health. 1975;29(1):27-30.
  • Wiegner S, Donders J. Predictors of parental distress after congenital disabilities. Journal of Developmental and Behavioral Pediatrics. 2000.
  • Heiman T. Parents of children with disabilities: Resilience, coping, and future expectations. Journal of developmental and physical disabilities. 2002;14:159-71.
  • Khayatzadeh MM, Rostami HR, Amirsalari S, Karimloo M. Investigation of quality of life in mothers of children with cerebral palsy in Iran: association with socio-economic status, marital satisfaction and fatigue. Disability and rehabilitation. 2013;35(10):803-8.
  • Giallo R, Wood CE, Jellett R, Porter R. Fatigue, wellbeing and parental self-efficacy in mothers of children with an autism spectrum disorder. Autism. 2013;17(4):465-80.
  • Albayrak I, Biber A, Çalışkan A, Levendoglu F. Assessment of pain, care burden, depression level, sleep quality, fatigue and quality of life in the mothers of children with cerebral palsy. Journal of Child Health Care. 2019;23(3):483-94.
  • Goldbeck L, Hölling I, Schlack R, West C, Besier T. The impact of an inpatient family-oriented rehabilitation program on parent-reported psychological symptoms of chronically ill children. Klinische Pädiatrie. 2011;223(02):79-84.
  • Ozaras N. Spina bifida and rehabilitation. Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi-Turkish Journal of Physical Medicine and Rehabilitation. 2015;61(1).
There are 43 citations in total.

Details

Primary Language English
Subjects Health Services and Systems (Other)
Journal Section Research Article
Authors

Pelin Güneş 0009-0004-5723-311X

Beyzanur Dikmen Hoşbaş 0000-0003-2494-480X

Berna Karamancıoğlu 0000-0003-2561-4618

Turgay Altunalan 0000-0002-6970-0959

Publication Date March 29, 2024
Submission Date September 15, 2023
Acceptance Date March 18, 2024
Published in Issue Year 2024 Volume: 41 Issue: 1

Cite

APA Güneş, P., Dikmen Hoşbaş, B., Karamancıoğlu, B., Altunalan, T. (2024). Fatigue and depression in mothers caring for children with spina bifida: Examining the role of child’s functionality. Journal of Experimental and Clinical Medicine, 41(1), 47-52.
AMA Güneş P, Dikmen Hoşbaş B, Karamancıoğlu B, Altunalan T. Fatigue and depression in mothers caring for children with spina bifida: Examining the role of child’s functionality. J. Exp. Clin. Med. March 2024;41(1):47-52.
Chicago Güneş, Pelin, Beyzanur Dikmen Hoşbaş, Berna Karamancıoğlu, and Turgay Altunalan. “Fatigue and Depression in Mothers Caring for Children With Spina Bifida: Examining the Role of child’s Functionality”. Journal of Experimental and Clinical Medicine 41, no. 1 (March 2024): 47-52.
EndNote Güneş P, Dikmen Hoşbaş B, Karamancıoğlu B, Altunalan T (March 1, 2024) Fatigue and depression in mothers caring for children with spina bifida: Examining the role of child’s functionality. Journal of Experimental and Clinical Medicine 41 1 47–52.
IEEE P. Güneş, B. Dikmen Hoşbaş, B. Karamancıoğlu, and T. Altunalan, “Fatigue and depression in mothers caring for children with spina bifida: Examining the role of child’s functionality”, J. Exp. Clin. Med., vol. 41, no. 1, pp. 47–52, 2024.
ISNAD Güneş, Pelin et al. “Fatigue and Depression in Mothers Caring for Children With Spina Bifida: Examining the Role of child’s Functionality”. Journal of Experimental and Clinical Medicine 41/1 (March 2024), 47-52.
JAMA Güneş P, Dikmen Hoşbaş B, Karamancıoğlu B, Altunalan T. Fatigue and depression in mothers caring for children with spina bifida: Examining the role of child’s functionality. J. Exp. Clin. Med. 2024;41:47–52.
MLA Güneş, Pelin et al. “Fatigue and Depression in Mothers Caring for Children With Spina Bifida: Examining the Role of child’s Functionality”. Journal of Experimental and Clinical Medicine, vol. 41, no. 1, 2024, pp. 47-52.
Vancouver Güneş P, Dikmen Hoşbaş B, Karamancıoğlu B, Altunalan T. Fatigue and depression in mothers caring for children with spina bifida: Examining the role of child’s functionality. J. Exp. Clin. Med. 2024;41(1):47-52.
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