Coping Attitudes Research Articles

The relationship of coping skills with psychache in patients with depressive disorder.

Suicide is a leading cause of death and disability worldwide. Psychache (psychological pain) and diminished tolerance of psychaches are important risk factors for suicide. People experiencing psychaches of similar severity may not demonstrate the same levels of tolerance because of various coping skills. This study aimed to determine the relationship between psychache, tolerance for psychache, and coping skills in individuals with depression and healthy controls. We included 73 patients with depressive disorders without comorbid mental disorders and 65 healthy controls. We applied beck depression inventory, beck hopelessness scale, beck suicidal ideation scale, psychache scale, tolerance for mental pain scale (TMPS), and coping attitudes evaluation scale (COPE) to all participants. People with depression had significantly higher COPE dysfunction scores than those in the control group did. Patients who had previously attempted suicide attempt(s) previously had significantly higher beck hopelessness scale, beck depression inventory, COPE dysfunction, and psychache scale scores, and lower TMPS-10 scores than those who did not attempt suicide. Mediation analyses revealed that dysfunctional coping skills played a partial mediating role in the relationship between psychache and the TMPS. The study revealed that dysfunctional coping skills were related to suicidal ideation and previous suicide attempts. These findings suggest that improving coping skills could help reduce the severity of suicidal ideation.

Anxiety and Coping Attitudes in Medical School Students During the COVID-19 Pandemic

Aim: The coronavirus (COVID-19) pandemic process has affected individuals of all ages, from children to the elderly, both physically and mentally. This study aimed to determine the anxiety levels and coping attitudes of Medical Faculty students during the COVID-19 pandemic period. Material and Methods: A personal information form (containing questions about COVID-19), the State Trait Anxiety Inventory and the Coping Strategies Scale were applied online to the students (n=186) who volunteered to participate in the study, studying at the Faculty of Medicine. The scores of the scales were evaluated statistically. Results: The study included 186 participants consisting of 57% (n=106) females and 43% (n=80) males. A statistically significant positive correlation was found between trait anxiety scale score and emotion focused scale score (r=0.151 p=0.040). A statistically significant positive correlation was found between trait anxiety scale score and dysfunctional coping scale score (r=0.455 p<0.001). According to the simple linear regression analysis, a 1-unit increase in the trait anxiety scale score increased the dysfunctional coping scale score by 0.35 units. Conclusion: As seen in our study, an increase in anxiety levels leads to dysfunctional coping attitudes. Dysfunctional coping attitudes are among the reasons that lead people to mental illnesses. Therefore, goals should be determined to reduce the anxiety levels of future physicians and to increase their functional coping attitudes.

Investigation of Predictors of Psychological Resilience in Occupational Therapy Students in Terms of Different Variables

There is an increased number of publications concerning the mental health of occupational therapy students. The aim of this study is to investigate the predictors of psychological resilience in occupational therapy students in terms of different variables. Four scales measuring resilience, psychological flexibility, coping and coping attitudes were used in this study. Predictors of resilience were evaluated using multiple linear regression analysis with the backward elimination. It was determined that psychological resilience, psychological flexibility, and coping attitudes are interrelated concepts (p < 0.05). This is the first study to examine the predictors of the concept of resilience in occupational therapy students in terms of different variables. The results show that students’ psychological flexibility and positive coping behaviors need to be improved to develop psychological resilience.

Pediatri Hemşirelerinin Etkili Konuşma Becerileri ve Başa Çıkma Tutumları

Objective: This descriptive and cross sectional study was carried out to analyse the effective speaking skills and coping attitudes of pediatric nurses. Method: The population of the study consists of 251 nurses working in pediatric clinics of two hospitals in the eastern region of Turkey. The data in the study were collected with Descriptive Information Form, Effective Speech Skills Scale and Coping Attitudes Assessment Scale. Results: It was found that pediatric nurses had a mean effective speech scale total score of 50.96 ±16.92 and a mean coping scale total score of 157.75±26.69. Positive significant association was found between mean effective speech scale sub-dimension scores and total scores and between mean coping attitude scale sub-dimension scores and total scores. Conclusions: It was found that descriptive characteristics of pediatric nurses such as age, years of working as a nurse and weekly working hours were effective on their effective speech skills and coping attitudes. It was found that nurses used their coping attitudes effectively as their effective speech skills developed. Effective speech skills of pediatric nurses were moderate. When nurses are faced with stressful events, they use their coping attitudes effectively

Attitudes of Coping with Stress and Self-Care Agency Levels of Nursing Students

Attitudes of Coping with Stress and Self-Care Agency Levels of Nursing Students

Evaluation of cognitive insight, social functionality, and coping attitudes of patients diagnosed with schizophrenia being followed-up in a community mental health center

AimThis study was conducted to evaluate the cognitive insight, social functionality, and coping attitudes of patients diagnosed with schizophrenia being followed-up in a Community Mental Health Center (CMHC). Design and methodsThe population of this descriptive and relationship-seeking study comprised 170 schizophrenia patients followed-up in the CMHC. Study data were collected using the Information Form, the Beck Cognitive Insight Scale (BCIS), the Social Functioning Assessment Scale (SFAS), and the Coping Orientation of Problem Experience (COPE). FindingsA moderately significant positive correlation between cognitive insight and social functionality was determined. It was found that participants with high cognitive insight and social functionality used more problem- and emotion-focused coping methods. Application implicationsIt is thought that practices that improve cognitive insight and social functionality will contribute to the rehabilitation of patients with schizophrenia by supporting their coping skills.

Correlação entre sintomas de depressão, atitude e autocuidado em idosos com diabetes tipo 2

ABSTRACT Objectives: to correlate depressive symptoms, attitude, and self-care of elderly people with type 2 diabetes. Methods: study developed with 144 elderly people with diabetes; carried out in Family Health Units. A semi-structured instrument was used to obtain data on the sociodemographic profile; the Geriatric Depression Scale (15 items), the Questionário de Atitudes Psicológicas do Diabetes [Psychological Attitudes of Diabetes Questionnaire], and the Diabetes Self-Care Activities Questionnaire (DSCA) were also used. Results: it was identified that 24.3% of the participants presented depressive symptoms, and 93.8% presented negative attitudes of coping. A greater adherence to self-care activities related to the practice of medication was observed. In the correlation between the scales, a negative and inversely proportional correspondence was noted between depressive symptomatology and physical activity (p=0.010) and foot care (p=0.006), likewise between attitude and foot care (p=0.009). Conclusions: self-care in elderly people with diabetes mellitus is influenced by depressive symptoms and negative coping attitudes.

Anxiety, Depression and Coping Styles in Mothers of Children with Cow's Milk Protein Allergy

Objective: Cow’s milk protein allergy (CMPA) in the infant is shown to be associated with hightened anxiety in the parents. However, depression and coping styles were not studied in mothers of children with CMPA. The aim of the present study was to compare the anxiety, depression levels and coping styles between mothers of children with CMPA and control group. Materials and Methods: The study sample consisted of 41 subjects with CMPA and 41 subject without any chronical health problems, aged between 4 and 11 months. Anxiety, depression and coping styles of mothers were measured with Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI) and Coping Attitudes Rating Scale (COPE). Results: Depression and anxiety levels were significantly higher in the CMPA group according to the BDI and BAI (p&lt; 0.001). The mothers in the CMPA group used active emotional coping strategies less than control group (p=0.021). Total breastfeeding duration of the children in the CMPA group was significantly lower than the healthy controls (p=0.008). There was negative correlation between active emotional coping scores and the time of adding supplemental food to infant’s diet (r=-0.42, p=0.06). Children who had additional food allergies breastfed less than the children who had only CMPA (p=0.02). Conclusions: Mothers of the children with CMPA are under heightened risk for anxiety and depression. Children with CMPA may be at risk for shorter duration of breastfeeding. Anxious and depressed caregivers may be referred for psychological help since the first year of life is essential for healthy psychological development of the children.

Burnout, Anxiety and Coping Attitudes in Parents of Children with Autism Spectrum Disorder

Objective: In this study, the relationship between burnout level, anxiety and coping attitudes of parents with children diagnosed with autism spectrum disorder (ASD) was examined together with demographic variables. Methods: Relational model was used in the research. The research was conducted with the parents of 180 children diagnosed with ASD. Data were obtained using the Beck Anxiety Inventory (BAI), Maslach Burnout Inventory (MBI), and the Coping Attitudes Rating Scale (COPE). T Test, One Way Analysis of Variance (ANOVA) and Pearson correlation analysis were used in the analysis of the data. Results: In the research findings, it was observed that the burnout level of the parents differed according to the age groups of the autistic children, the number of siblings and the psychiatric disease history of the parents. In addition, it was observed that the anxiety level and coping methods of the parents differed significantly according to the psychiatric illness history of the parents. A strong positive correlation was found between parents' anxiety and burnout levels. A moderate positive relationship was also found between the emotional burnout levels of the parents and their coping levels. Conclusion: It was observed that the levels of anxiety and burnout were lower in parents who used the problem-focused coping method. In addition, it has been observed that parents overcome problems by using problem-focused coping methods and this situation affects their lives positively. In addition, it was observed that parents with high levels of anxiety and burnout used dysfunctional coping methods more.

Temporomandibular Disorders as a Risk Factor for Suicidal Behavior: A Systematic Review.

Temporomandibular disorders (TMD) are a group of common musculoskeletal dysfunctions that affect the temporomandibular joint or masticatory muscles and related structures or are expressed as a clinical combination of these two factors. The etiology of TMD is multifactorial and features related to anxiety, depression and mental disorders can contribute to the predisposition, onset and progression of TMD. The ability to adapt and develop coping attitudes was reduced in patients presenting with chronic pain, while suicidal behavior (suicidal ideation, suicide attempts, and suicide completion) was increased. The objective of this review was therefore to investigate suicidal behavior in relation to TMD. The review was performed according to the PRISMA 2020 guidelines. Six databases (PubMed, MEDLINE, EMBASE, Scopus, Ovid, and Google Scholar) were consulted through the use of keywords related to the review topic. The study is registered on PROSPERO (CRD42022320828). The preliminary systematic search of the literature yielded 267 records. Excluding duplicates, 15 were considered potentially relevant and kept for title and abstract analysis. Only six articles were considered admissible reporting a single exposure factor, TMD and a single outcome, suicidal behavior, although these were evaluated through different assessment tools. We found a low association of TMD with suicidal behavior in observational studies, with estimates partly provided [prevalence ratio (PR) from 1.26 to 1.35, 95% confidence intervals (CI) from 1.15 to 1.19 (lower) and from 1.37 to 1.54 (higher); and odds ratios (OR) from 1.54 to 2.56, 95% CI from 1.014 to 1.157 (lower) and 2.051 to 6.484 (higher)], a relevant sample size (n = 44,645), but a few studies included (n = 6). The results of the included studies showed that the prevalence data of suicidal behavior were more present in young adults with TMD, with a controversial association with gender. Suicidal behavior was also correlated and aggravated by the intensity of pain.

Fear of cancer recurrence and coping attitudes of breast cancer survivors

This study aimed to determine the fear of cancer recurrence levels and coping orientation of breast cancer survivors. This descriptive exploratory study was conducted using a web-based online survey. This article is written using the STROBE checklist. The study was completed with 204 women participants. Data were collected using the 'Demographic and Clinical Information Form', 'Fear of Cancer Recurrence Inventory (FCRI)' and 'Coping Orientation to Problems Experienced Inventory-Revised (COPE-R)'. FCRI total score average within the scope of the study was calculated as 42.00 ± 18.88. Women's COPE-R total score average is 80.62 ± 13.20. There was a positive correlation between FCRI total score and COPE-R (r = 0.183, p = 0.009). According to the results of multiple linear regression analysis, age, education level, CAM usage, getting psychological support and COPE-R subscales (accommodation, avoidance, self-punishment) were associated with FCRI total score. The fear of cancer recurrence experienced by breast cancer survivors was associated with their coping orientation. Determining the fear of cancer recurrence level and coping orientation of breast cancer survivors by healthcare professionals will guide the reduction of women's fear of cancer recurrence and further the development of adaptive coping orientation.

Determination of Death Anxiety and Coping Attitudes of Individuals with Myocardial Infarction

Determination of Death Anxiety and Coping Attitudes of Individuals with Myocardial Infarction

The determinants affecting the intention of urban residents to prepare for flood risk in China

Abstract. In the context of global warming and China's disaster response patterns, it is critical to understand how to promote the effectiveness of household flood protection measures among the public. In this study, we developed a comprehensive theoretical framework based on protection motivation theory (PMT) to identify the main determinants that influence urban residents' intention to prepare for flood risk. In addition to the fundamental factors in PMT, this framework also considered the influence of individual coping attitudes and social context. We selected urban residents in flood-prone areas of Henan Province as the study population as well as collected 857 valid questionnaires through an online survey. Firstly, the results showed that both threat perception and coping appraisal of flood risk are effective in increasing residents' intention to prepare. Secondly, negative risk-coping attitudes reduced people's intention to prepare. If people do not perceive preparedness actions as absolutely necessary, they will postpone them or shift their focus to public flood protection measures. In addition, analysis of affective pathways revealed that negative emotion (worry) was primarily influenced by perceptions of flood consequences and was not significantly related to perceptions of likelihood. The analysis of trust mechanisms showed that higher levels of trust in public flood protection reduced people's perceptions of flood risk, thereby hindering their intention to prepare for flood risk. Finally, we found that the positive influence of social norms on preparedness intentions makes it appropriate to focus on the power of social mobilization. The findings will provide theoretical references for government departments to design further policy measures to improve integrated flood risk management in China.

Contrasting the COVID-19 Effects on Tourism Safety Perceptions and Coping Behavior among Young People during Two Pandemic Waves: Evidence from Egypt

The aim of this study is to analyze the impact of COVID-19 on tourism safety perceptions, acceptance of restrictions, and the intention to change behavior during the COVID-19 pandemic among young people. Taking Egypt as a case study, a total of 386 respondents were surveyed in two different pandemic periods, with data being collected during the first wave, in April and May 2020, and during the second wave, in December 2020 and January 2021. Data was analyzed using partial least squares structural equation modelling (PLS-SEM) with multigroup analysis (MGA). Results reveal significant differences between the first and the second coronavirus waves regarding the effects of perceived risk. Findings point to the heightened potential of the youth market segment in the current context and suggest that youngsters’ adaptive coping responses evolved towards self-regulatory behavior. Based on the results, theoretical and practical implications are drawn. Conceptually, the study has contributed to the clarification of the desensitization process experienced by youth over time, in the post-pandemic tourism context. Additionally, the activities’ safety perceptions being examined per se enlightened the relationship between risk susceptibility, safety perceptions, and coping attitudes and behavior. Findings suggest that special attention should be paid to crowded group settings, such as youth events, advising that authorities and tourism services should target their communication to different population segments and use appropriate safety messaging according to the evolution of health crises.

The Relationship Between Coping Attitudes of Depression, Anxiety and Stress Experienced During Covid-19 Pandemic and Social Media Addiction

COVID-19 küresel sağlık krizinde bilgi boşluğu bireylerin korku düzeyini arttırmış, belirsizlik stres, anksiyete ve depresyon gibi psikolojik bozukluklara neden olmuştur. Pandemi sürecinde kolay erişilmesi, kitlesel kullanıma ve ihtiyaç duyulan etkileşime olanak tanıması sosyal medya kullanımını arttırmıştır. Bu çalışmanın amacı COVID-19 pandemi sürecinde zamanının çoğunu evde geçiren gençlerin sosyal medya bağımlılığı ile depresyon, anksiyete ve stresle ile başa çıkma tutumları arasındaki ilişkinin incelenmesidir. Çalışmada aynı zamanda başa çıkma tutumunun sosyal medya bağımlılığına etkisi değerlendirilmektedir. Araştırmanın evrenini Gaziantep Üniversitesi öğrencileri, örneklemini ise, amaçlı örneklem tekniği kullanılarak belirlenen 338 öğrenci oluşturmaktadır. Araştırma nicel araştırma deseninde tasarlanmış ve çevrimiçi anket yöntemi ile veriler toplanmıştır. Verilerin analizinde T-Testi, tek yönlü ANOVA, ilişkiyi ortaya koymada Pearson korelasyon ve bağımlı değişken üzerinde diğer değişkenlerini etkisini açıklayan çoklu regresyon analizi kullanılmıştır. Analiz sonucunda COVID-19 pandemi sürecinde sosyal medya bağımlılığının stres ve anksiyete ile pozitif yönde orta düzeyde, işlevsel başa çıkma ile pozitif yönde orta düzeyde ilişkili olduğu bulunmuştur. Araştırmada aynı zamanda stres ve anksiyete gibi olumsuz duygu durumunun ve işlevsel olmayan başa çıkmanın sosyal medya bağımlılığını pozitif ve anlamlı şekilde yordadığı sonucu elde edilmiştir. COVID-19 pandemi sürecinde gençlerin içinde bulundukları zor durumla başa çıkmada sosyal medyadan faydalandığı ve bunun da bağımlılık düzeyinin artmasına yol açabileceği görülmektedir.

No Progress Leads to Abandonment: The Research on Learning Problems of At-Risk Students in Junior High School

&lt;p&gt;高關懷學生有較高的學業適應問題，容易促發偏差行為甚至中輟。為了瞭解他們的學習困境，本研究從 第三空間理論探究他們自學校學習的認同特徵及形成，同時檢視不利於他們學習的學校制度特徵。研究 對象為十位有偏差行為的高關懷學生，選自北部一所升學型國中的三個多元班。研究方法採個別深度訪 談及非參與觀察法。訪談對象為學生、三位多元班主責教師與輔導組長。觀察的三個班別為農耕班、熱 舞班及導航班。以詮釋現象學取向進行資料分析。研究結果發現，他們的認同特徵是不讀書。認同形成 肇因於不懂所學，他們學習壓力相當大，混和許多負向情緒，於是成為課堂局外人，展現課堂偏差、翹 課甚至中輟。他們因應學習壓力的方式，混和逃避、放棄、抗拒、自然反應與偏差行為，不僅無助於改 善困境，反而在學校制度課程屬性、統一規範的課程進度、大班教學與考試範圍下，形成棄學的迴圈。 在課堂規範下，他們受管教而破壞師生關係，連帶討厭課堂。即使師生關係佳，仍不等於支持學習。也 因放棄學習而缺乏支持學習的同儕。當他們從學習轉向玩樂，提高回歸學習的難度，若交往涉及幫派的 同儕，不僅偏差行為加劇，更可能回頭抗拒家庭的管教。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;At-risk students have more problems of learning in schools that might lead to delinquent behaviors and drop-out. It is important to find out their difficulties in learning in schools and let at-risk students receive suitable schooling. The research purposes are to investigate the identity and their formation based on the third space theory. This approach could reflect the school systems which would obstruct learning of at-risk students from their coping attitudes. Ten at-risk students who had delinquent behaviors were chosen from three Multiple Classes in a junior high school in Taipei. The school has better high school entrance performance. Multiple Classes teaching various activities but academy are designed for delinquent students who are not able to stay in regular classroom to learn. Classes include gardening, dance and navigation related activites. Research methods are individual in-depth interview and non-participatory observation. Interviewees were students, one teacher from each of the three Multiple Classes and Section Chief of Counseling in school. Observation was conducted in each of three Multiple Classes using video recording and field diary. Data were analyzed by hermeneutic phenomenology approach. Interviews with student were the primary data, and interviews with teachers and class observation served as triangulation. After all cases were analyzed individually, cross cases analysis followed.&lt;/p&gt; &lt;p&gt;The results find the identity of at-risk students is to quit learning, and four students identified themselves as to playaround. Regarding identity formation, they bear huge pressure from learning with lots of negative emotions which results from not understanding what they are taught. These emotions led to their delinquency behaviors and marginalization in class, cut classes or even flunk out. Avoiding, giving up, resisting and spontaneous reaction were used by these students to cope with pressure in school. These attitudes relating to misbehaviors can not relieve their difficulties, but form a feedback loop that impeded student learning in the school systems. These school systems are academic curriculum, one-size-fits-all curriculum schedule and tests, and whole class instruction. The loop keeps them from learning, getting harder to follow up classes and even staying away from schools. Class delinquency of students often led to disciplinary actions which worsened teacher-student relationship and their attitude toward the teachers’ classes. Even the relationship is fair, it does not mean to support their learning. Additionally, at-risk students lack of classmates to support their learning after quit learning because common activities of classmates are about learning. If they escape from learning to play around, they spend more time on play and created a vicious circle of low school. Their parents are commonly unfamiliar with their friends frequently hanging on. If they have friends to do with gangsters, they would act more delinquent behaviors and even rebel against their family rules.&lt;/p&gt; &lt;p&gt;The contributions of this research are in two perspectives. From research approach perspective, this research adopts third space theory to explore at-risk students learning problems in school. It not only reveals huge pressure experiences by at-risk students in learning but also the school systems that are disadvantageous to their learning. The at-risk student is the title labelled from the authority of school system taking them as different. From practical perspective, the results depict extremely embarrassed situations of at-risk students in learning. Education policy makers and school administrators should adjust the systems to be more flexible and fit better students’ learning conditions. Teachers and consultants should be more sensitive to identifying their explicit delinquent behaviors and interpret such behaviors not as violating rules intentionally but as a warning of their learning difficulties and assist them to overcome.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

The Socioeconomic Gradient in Coping Attitudes Towards the COVID-19 Measures in Social Welfare Regimes in Europe

The Socioeconomic Gradient in Coping Attitudes Towards the COVID-19 Measures in Social Welfare Regimes in Europe

The socioeconomic gradient in coping attitudes towards the COVID-19 measures in social welfare regimes in Europe.

The socioeconomic gradient in coping attitudes towards the COVID-19 measures in social welfare regimes in Europe.

Doğuştan kalp hastalığı olan çocukların annelerinin baş etme tutumlarının depresyon düzeyleri ile ilişkisi

Aim: To reveal the coping attitudes of mothers of children who had undergone surgery to diagnose congenital heart diseases and the relationship between these attitudes and depression levels.&#x0D; Material and Methods: This study was a cross-sectional observational descriptive study conducted in a pediatric cardiovascular surgery clinic. The study included 32 mothers of pediatric patients who were surgically treated for congenital heart diseases. Participants were assessed with sociodemographic information form, Turkish versions of the coping orientation to problems experienced inventory (COPE), and the Beck depression inventory (BDI). &#x0D; Results: The median maternal age was 31.0 (range, 21-47) years. The median BDI score was 11 (range, 1-27), and the number of mothers with a BDI score of 17 and above was 13 (40.6%). Problem-focused coping was the most common problem-coping style used by 29 (90.6%) participants with a median score of 67.0 (range, 41.0-72.0). In addition, 10 (31.3%), 10 (31.3%), and 9 (28.1%) participants showed the highest scores for active coping, suppression of competing activities, and seeking instrumental social support subscales, respectively. There was a negative correlation between BDI score and active coping, restraint, seeking instrumental social support subscales, and problem-focused coping total scores.&#x0D; Conclusion: Our study revealed that most mothers of children with CHD used problem-focused coping more frequently. There was a negative correlation between the problem-focused coping attitude total score and the Beck Depression total scores. Interventions to target problem-focused coping could potentially protect mothers from depression.

Contact Disturbances, Self-Construal and Coping Attitudes of University Students

Bu çalışmanın temel amacı üniversite öğrencilerinde temas engelleri, benlik kurgusu ve başa çıkma tutumlarının çeşitli değişkenler açısından incelenmesidir. Bu araştırmada ilişkisel tarama yöntemi kullanılmış ve çalışma grubu uygun örnekleme yöntemiyle seçilmiştir. Çalışma grubunu bir devlet üniversitesinde öğrenim gören 760 üniversite öğrencisi oluşturmaktadır. Araştırmanın verileri Gestalt Temas Engelleri Ölçeği, İlişkisel-Bireyci-Toplulukçu Benlik Ölçeği ve Başa Çıkma Tutumlarını Değerlendirme Ölçeği ile elde edilmiştir. Araştırmada temas engelleri, benlik kurguları ve başa çıkma tutumları arasında anlamlı bir ilişki bulunduğu belirlenmiştir. Temas, bireysellik, ilişkisellik, başa çıkma tutum puanlarının cinsiyete göre anlamlı düzeyde farklılaştığı sonucuna varılmıştır. Tam temas, bireysellik ve ilişkisellik, sosyo-ekonomik düzeylere göre anlamlı farklılık göstermiştir. Bağımlı temas puanları sınıf düzeylerine göre anlamlı farklılık göstermiştir. Tam temas, temas sonrası, bireycilik ve başa çıkma tutum puanları açısından algılanan başarı düzeylerine göre anlamlı farklılıklar tespit edilmiştir.