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The Relationship Between the Health Transformation Program and Health Expenditures: Evidence From an Autoregressive Distributed Lag Testing Approach
(Elsevier, 2023) Ilgun, Gulnur; Konca, Murat; Sönmez, Seda
Objectives: As health expenditure increases every year, countries try to provide accessible health services to society and try to protect individuals from the expenses they cannot overcome by investigating the reason for this increase. Especially with the arrangements made in the health systems in developing countries such as Turkey, it has been tried to take the control of dramatic increases in health expenditure. Based on this issue, in this study, we aimed to evaluate the effect of income per capita, annual inflation, and health reform called as Health Transformation Program on the health expenditure per capita in Turkey.Methods: This study reflected the effects of income, inflation, and the reform on the total health expenditure through the autoregressive distributed lag. This study covered the years between 1985 and 2016 for Turkey.Results: As a result of this study, there was a positive relationship between health expenditure and income and a negative relationship with the reform (P , .05).Conclusion: According to the results of this study, it is suggested that health expenditures can be kept under control with improvements such as encouraging individuals to use more primary healthcare services than curative health services and increasing the quality of service without compromising the equity in financing.
The impact of pandemic fatigue on anxiety and quality of life in patients attending physical medicine and rehabilitation clinics
(Kashan Univ Medical Sciences, 2024) Çapar, Haşim; Çakmak, Cuma; Türken, Askeri; Kar, Ahmet; Kurt, Mehmet Emin
Objectives: The current study aims to investigate the impact of pandemic fatigue on anxiety and quality of life in patients visiting physical therapy and rehabilitation outpatient clinics. Methods: A cross-sectional study was conducted involving 303 patients over the age of 18 who had not previously contracted COVID19. These patients sought treatment at the Physical Medicine and Rehabilitation outpatient clinic for musculoskeletal disorders and reported experiencing symptoms of pandemic fatigue for at least one month. Results: A low-level positive significant relationship was identified between COVID-19 anxiety and pandemic fatigue. Additionally, perceived health status demonstrated a low-level negative significant relationship with both behavioral fatigues, a sub-dimension of pandemic fatigue, and COVID-19 anxiety. Furthermore, a significant effect of COVID-19 anxiety on pandemic fatigue was observed, as well as a reciprocal significant effect of pandemic fatigue on COVID-19 anxiety. Conclusion: The findings provide empirical evidence for policymakers, decision-makers, and clinicians studying pandemic fatigue and anxiety. It is recommended that stakeholders develop their plans and programs based on this evidence and draw appropriate conclusions from these findings.
The Granger Causality Between Health Expenditure and Gross Domestic Product in OECD Countries
(Sage Publications India Pvt Ltd, 2022) İlgün, Gülnur; Konca, Murat; Sönmez, Seda
The aim of this study is to reflect the causality relationship between the exchange ratio in gross domestic product (dGDP) and health expenditures per capita (HEPC) among OECD countries based on purchasing power parity in dollars through Granger causality test. Within this perspective, HEPC data of 26 OECD member countries between the years 1992 and 2014 and GDP exchange ratio between the periods 1992-1993 and 2014-2015 were analysed. As a result of the analysis, the relation between the exchange ratio in GDP and HEPC is unilateral in 9 countries and bilateral in 2 countries while there has not been any relation in 15 countries. There are strong relations between the revenues of countries and their health expenditures. The results from this study is considered to lead the health policy makers and planners in taking administrative decisions.
The effect of digital storytelling on nursing students' compliance with isolation precautions and their knowledge levels: A randomized controlled trial
(Wiley, 2024) Bayram, Şule Bıyık; Gülnar, Emel; Çalışkan, Nurcan; Torun Kılıç, Çiğdem
Background: Digital storytelling is a teaching tool that can help nursing students master the curriculum and improve their skills. This study investigated the effect of digital storytelling on nursing students' knowledge levels and compliance with isolation precautions. Methodology: A pretest-posttest open-label randomized controlled trial. This study was conducted in the nursing department of the faculty of health sciences of a university in T & uuml;rkiye. The sample consisted of 109 fourth-year nursing students divided into experimental (n = 66) and control (n = 43) groups. Data were collected using a Demographic Characteristics Questionnaire (DCQ), the Isolation Knowledge Test (IKT), the Questionnaire of Students' Opinions on Digital Storytelling (QSODS) and the Scale of Compliance with Isolation Precautions (SCIP). The experimental group participated a digital storytelling activity, whilst the control group received an education based on the curriculum. The data were analysed using the Mann-Whitney U test, the Wilcoxon test, analysis of variance (ANOVA), and the Spearman correlation test. Results and Conclusions: The experimental group had significantly higher posttest IKT and SCIP scores than the control group (p < 0.05). Both groups had lower IKT and SCIP scores 2 months after the experiment. However, the change was much smaller in the experimental group. Digital storytelling helped the experimental group participants learn about isolation precautions and how to comply with them. Digital storytelling also promotes learning retention. In conclusion, digital tools are effective in distance learning.
Prioritization of the policies and practices applied in Turkey to fight against covid-19 through AHP technique
(Univ Sao Paulo, Fac Saude Publica, 2021) Yetim, Birol; Sönmez, Seda; Konca, Murat; İlgün, Gülnur
Concerns about covid-19 become deeper globally. Due to these concerns, all countries, international health institutions, health authorities and health care professionals in the world take several measures through policies or practices to control and handle covid-19 pandemic. For example; different types of policies in the fight against covid-19 have been launched in Turkey. Therefore, in this study, we sought to determine how policies and practices against covid-19 were prioritized by health care professionals and other segments of society via AHP method. We observed that the order of importance of health care professionals and other segments of the society regarding the policies and practices used in combating the covid-19 outbreak was quite similar between the groups. The covid-19 test policy was revealed as the most important one of both groups. However, social welfare programs have more significance than economic measures for society, while health care professionals are more concerned with economic measures. With this study, we intend to provide evidence-based information to decision-makers in combating the pandemic.
Benchmarking countries' technical efficiency using AHP-based weighted slack-based measurement (W-SBM): A cross-national perspective
(Elsevier Sci Ltd, 2023) Yetim, Birol; Sönmez, Seda; Konca, Murat; İlgün, Gülnur
Objectives: The objective of the research is to assess the technical efficiency of national health systems in OECD member countries and to provide ideas to improve the efficiency of health systems in countries that have been identified as having a lower degree of efficiency as a result of the findings.Methods: The technical efficiency scores were calculated using one of the data envelopment analyses (DEA), the Weighted Slack-Based Measure (W-SBM). The Analytic Hierarchy Process was used to establish the aforementioned weights (AHP). Weights are calculated separately for both input and output variables.Results: The technical efficiency of the relevant countries' health systems is around 0.79, according to the data, and just 13 (36.1%) of the 36 countries have a fairly efficient health system.Conclusions: The outcomes of the study were supposed to aid health policymakers and management in improving system efficiency. In addition, since the number of studies examining the health systems of OECD countries with the W-SBM method is limited, it is thought that this study will make an important contribution to the literature.
A phenomenological study of nurses' experiences with maternal guilt in Turkey
(Wiley, 2021) Karakaya, Pınar Öke; Sönmez, Seda; Aşık, Elif
Aim: This study aims to describe nurses' views on what it is like to be a working mother in Turkey. Background: Most mothers are in the workforce but continue to fulfil their traditional roles at home. This emerges as an important factor causing mothers to try to find a balance between work and home. Method: For this purpose, a semi-structured form was used in face-to-face interviews conducted with 17 participants. A phenomenological design was preferred in this qualitative study. Results: The findings obtained from the study revealed the six themes of `the sense of inadequacy/helplessness, the sense of responsibility, the strong desire to have a positive effect, gender role stereotypes, the choice between achieving a successful career and being a good mother, but with a sense of depletion'. Conclusion: The results obtained from the study of nurses in Turkey have shed light on how policies should be developed to eliminate work-life barriers in realizing the roles of motherhood. Implications for Nursing Management: The study results will guide nurse managers in taking the steps needed to incorporate arrangements that will result in balanced conduct of work and home for nurses.
The cost of one unit blood transfusion components and cost-effectiveness analysis results of transfusion improvement program
(Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2021) İndelen, Cenk; Kizmaz, Yecim Uygun; Kar, Ahmet; Shander, Aryeh; Kirali, Kaan
Background: This study aims to analyze the cost of the entire transfusion process in Turkey including evaluation of the cost of transfusion from the perspective of hospital management and determination of savings achieved with the transfusion improvement program. Methods: Invoices, labor, material costs were calculated with micro-costing method, while general production expenses were calculated with gross costing method between January 2018 and December 2019. Unit costs for each blood product were calculated separately by collecting unit acquisition costs, material costs, labor costs, and general production expenses and, then, distributed into six different blood products as follows: erythrocyte suspension, fresh frozen plasma, pooled platelet, apheresis platelet, cryoprecipitate, fresh whole blood. The total costs for 2018 and 2019 were calculated and the savings achieved were estimated. The Turkish Lira was converted into the United States Dollar ($) currency using the purchasing power parity. Results: In 2018/2019, the blood component transfusion cost was $240.90/251.18 for erythrocyte suspension, $120.00/128.67 for fresh frozen plasma, $313.50/322.19 for pooled platelet, $314.24/325.73 for apheresis platelet, $104.95/113.99 for cryoprecipitate, and $189.91/209.09 for fresh whole blood. The total transfusion cost was $6,224,208.33 in 2108 and $5,308,148.43 in 2019. As a result of the transfusion improvement program launched in 2019, the amount of blood components decreased by 23.24%, compared to the previous year, and a saving of $916,059.9 was achieved. Conclusion: The transfusion is a burden for both the hospital management systems and the country's economy. To accurately calculate and manage this economic burden is important for sustainable healthcare services.
Trust in the Healthcare System and Social Coronavirus Anxiety; A Study in the Turkish Society
(Dokuz Eylul Univ Inst Health Sciences, 2022) Saygılı, Meltem; Tekin, Rukiye Numanoğlu
Purpose: The aim of this research is to determine the level of trust in the healthcare system and coronavirus anxiety of the Turkish society during the COVID-19 pandemic. Methods: To obtain the data; Multidimensional Trust in Health-Care Systems Scale (MTHCSS) and Coronavirus Anxiety Scale (CAS) were used. The research was carried out with 1185 people living in Turkey between August and September 2020, using an online questionnaire. Two-Sample Independent TTest, One-Way Analysis of Variance (ANOVA) and correlation analysis were used in the analysis of the data. Results: It was determined that the mean scale scores of the participants the MTHCSS was high (59.06 +/- 13.76) and the mean score of the CAS was (1.86 +/- 3.30) low. Analyses carried out; showed that there are significant statistical differences between gender, presence of chronic disease, working status and compliance with the measures taken, trust in the healthcare system and coronavirus anxiety (p< 0.05). In Addition, the correlation analysis performed showed that there is a weak negative relationship between trust in the healthcare system and social coronavirus anxiety. Conclusion: The results showed that the Turkish society trusts their healthcare system. This makes think that the struggle given under the pandemic conditions is well managed by the Turkish healthcare system.
Assessment of cost-effectiveness of surgical clipping and endovascular coil methods in the treatment of unruptured cerebral aneurysms
(Dokuz Eylul Univ Inst Health Sciences, 2022) Kar, Ahmet; Şahin, İsmet; Şahin, Bayram
Purpose: The study aims to assess the cost-effectiveness of endovascular coiling and surgical clipping in the treatment of unruptured cerebral aneurysms. Material and methods: Patients with ICD 10 167.1 and treated with one of the two treatment methods performed at the Hacettepe University Hospitals between January 2013 and December 2015 were included in the study. The cost data in the study were obtained by analyzing patient invoices through the automation program of the university hospital. The effectiveness and treatment costs were assessed using the Markov model with the Social Security Institution's (SSI) perspective. To generate the cost input in the model, the lifetime costs obtained based on the expert's opinions were added to the amounts received from patient invoices. Results: The study results were presented as the incremental cost-effectiveness ratio (ICER). When 3% reduction rate was applied to the costs and effectiveness data, the Quality Adjusted Life Years (QALY) was calculated as 4.39 and 1.84 for the coiling and clipping methods, respectively. Lifetime costs were 66463.40$ and 7900.27$ for the coiling and clipping methods, respectively. The incremental cost-effectiveness rate of endovascular coiling method was 22965.93. Conclusion: The endovascular coiling method was found to be cost-effective because the ICER score of the process is below the threshold.
E-profesyonelizm Kavramı ve Sağlık Alanına Yansımaları
(2020) Öke, Pınar; Yılmaz, Necla
Etik kurallara uymak ve profesyonel davranmak her meslek için önemlidir. Bu sebeple her meslek kendine özgü etik kodlar ve profesyonel davranış kalıpları geliştirmiştir. Bu davranış kalıpları sayesinde kişilerin mesleki sınırlarını daha iyi bildiği ve oluşturulan standartlar sayesinde bu sınırlara uyum sağlamada zorlanmadığı söylenebilir. Dijital çağ olarak nitelenen günümüzde ise yeni etik sorunlar doğmuştur. Sağlık alanı, bu gibi sorunların en çok yaşandığı alanlardan biridir. Bu çalışmada dijitalleşme, çevrimiçi ortamlar, etik ilkeler ve etik ihlaller perspektifinden e-profesyonelizm kavramının sağlık alanına yansımalarını değerlendirmek, ayrıca sağlık sektörüne ilişkin İnternet’teki haberlerin e-profesyonelizm ile ilgili yönlerini ele almak hedeflenmiştir. Bu doğrultuda konu ile ilgili literatür taranmış, e-profesyonelizm ile ilişkilendirilebilecek etik ihlallere dair haberler derlenmiş ve yorumlanmıştır. E-profesyonelizm kavramının sağlık alanına yönelik önemine vurgu yapmak ve ilgili literatüre katkıda bulunmak amaçlanmıştır.
Emergency department visits following discharge: Implications for healthcare management
(ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2020) Kaya, Sidika; Guven, Gulay Sain; Teles, Mesut; Aydan, Seda; Kar, Ahmet; Bahcecioglu, A. Begum; Senturk, Esra Firat
Objective: This study aimed to reveal the frequency of emergency department (ED) visits within 7 and 30 days after discharge and to identify the factors affecting these ED visits. Methods: A total of 1570 patients discharged from the internal medicine wards of a university hospital in Turkey within 1 year were included in this prospective cohort study. Multiple logistic regression analyses were used to identify the factors affecting ED visits. Results: Of the patients, 1.3% visited the ED within the first 7 days after discharge and 5.2% within 30 days. Multivariable analyses showed that the probability of an ED visit within 30 days was 1.83 (95% CI 1.09-3.08; p = 0.023) times higher for male patients and 2.15 (95% CI 1.00-4.60; p = 0.049) times higher for patients with intensive care unit (ICU) stay before discharge. The probability of an ED visit increased by 1.25 (95% CI 1.11-1.42, p < 0.001) times for every 1-point increase in the comorbidity score. The costs of ED visits within 0-7 days were lower than the costs within 8-30 days (p = 0.001). Conclusion: Innovative approaches targeting discharge planning and postdischarge care for patients with high comorbidity scores and ICU use during index hospitalization could reduce ED visits within 30 days after discharge.
Quality of Work Life and Burnout in Healthcare Workers in Turkey
(SAGE PUBLICATIONS INDIA PVT LTD, 2020) Saygılı, Meltem; Avcı, Keziban; Sönmez, Seda
Quality of work life (QWL) is important to healthcare organisations that aim to increase patient and employee satisfaction and produce quality healthcare services. The literature lacks research investigating the relationship between QWL and burnout among in healthcare professionals. The purpose of this study is to determine healthcare workers' QWL and burnout levels and to investigate whether there is a correlation them. The research population consisted of all healthcare workers serving in a public hospital in Ankara. The study did not make a sample selection but tried to access the entire population; a total of 328 usable surveys were obtained. 'Quality of Work Life Scale' and 'Maslach Burnout Inventory' scales were used for this research. A correlation analysis was performed to determine the correlation between healthcare workers' QWL and burnout levels. The analysis results showed that healthcare workers had 'good' perceived QWL and 'moderate' level of burnout. Additionally, there was a statistically significant but weak correlation between healthcare workers' levels of QWL and burnout (rho = 0.184; p = 0.0008). Results can be used by healthcare managers to implement appropriate initiatives to improve QWL and reduce burnout of healthcare workers.
The Effect of COVID-19 Pandemic on the Turkish Society
(MODESTUM LTD, 2020) Bostan, Sedat; Erdem, Ramazan; Ozturk, Yunus Emre; Kilic, Taskin; Yilmaz, Ali
Pandemics leave significant marks on the memories of societies with their permanent impacts. Going beyond a cause of disease or death, they can have consequences in many aspects, psychological, social and economic ones being in the first place. The Covid-19 outbreak, which first emerged in China and has spread to the whole world as of the first months of 2020, has the potential to constitute a breaking the course of history, as well. Turkey is located on the transit point between Asia and Europe with its geographical position, and thus, received its share from the outbreak of Covid-19, which spreads through social contact. The first official case was recorded on 11 March 2020, and then the virus spread rapidly. This study aims to assess the attitude of the public towards Covid19 at times when the impact of the disease reached maximum. To this end, data were collected from 1586 people with different socio-demographic features through Covid-19 Pandemic Community Scale. The impact of the pandemic on the society was measured in three dimensions as Sensitivity to Pandemic, Protection against Pandemic and Social Trust. The research results showed that the people had high levels of sensitivity to the pandemic, exerted the maximum effort for protection and social trust was above the average although it fell behind the other dimensions. As a consequence, it can be concluded that Covid-19 has had a significant impact on the Turkish people.
The impact of work alienation on organizational health: A field study in health sector
(Routledge Journals, Taylor & Francis Ltd, 2019) Ozer, Ozlem; Ugurluoglu, Ozgur; Saygili, Meltem; Songur, Cuma
This study aims to examine the impact of work alienation on organizational health. The implementation of the research is conducted on the nurses and physicians working in a public hospital and the data collected from 388 people are evaluated. As a result of the analyses carried out, work alienation's subdimensions and correlations with organizational health are moderate in the negative direction and the subdimensions of perception of work alienation explain the 21.5% of total variance on organizational health. When the test results of regression coefficient significance in the regression model are analyzed, increasing levels of powerlessness and self-estrangement of the participants decrease the perception of organizational health statistics. Order of relative importance predictor variables on the organizational health level is such as powerlessness, self-estrangement, and meaninglessness.
An evaluation of the cost-effectiveness of the different palliative care models available to cancer patients in Turkey
(Wiley, 2019) Saygili, Meltem; Celik, Yusuf
Background Three different models are commonly used to provide palliative care services to cancer patients in Turkey: comprehensive palliative care center (CPCC), hospital inpatient services (HIS) and home healthcare (HHC). Objectives The purpose of this study was to evaluate the cost-effectiveness of three alternative palliative care models for cancer patients. Methods The study included a total of 160 patients diagnosed with cancer (CPCC:60, HIS:59, HHC:41). The patients' quality of life and their levels of satisfaction were used as the indicators of effectiveness, while direct and indirect costs incurred by service providers, patients and relatives were considered in estimating the costs of alternative models. The cost and effectiveness of the alternatives compared the "patient perspective" and "societal perspective" separately. Results From a societal perspective, palliative care services provided the HIS model was found to be more cost-effective than the CPCC model. From a patient perspective, HHC was found to be more cost-effective compared to the other two models. Conclusions This study has the potential to provide substantial evidence to health managers and decision-makers with respect to health planning and the formulation of social security policies in Turkey.
Determining Breast Cancer Treatment Costs Using the Top Down Cost Approach
(Aves, 2019) Tekin, Rukiye Numanoglu; Saygili, Meltem
Objective: Breast cancer is the most common type of cancer among women in Turkey, with approximately 15.000 breast cancer diagnoses each year. In this study, our goal was to determine annual direct medical costs of all breast cancer patients in Turkey with top down cost approach. Materials and Methods: Data regarding patients who have been diagnosed with breast cancer and received health services from any hospital in Turkey in 2014 were used for the purpose of the study. Data were obtained from the MEDULA System for a total of 126.664 patient. Treatment of costs of patients were calculated based on types of patient admissions (inpatient/outpatient/intensive care) and costs of drugs and medical equipment. Indirect costs and out of pocket costs were not included. Results: Total medical costs of 126,664 patients was calculated as $116.792.107,9, with an average treatment cost per patient of $922,1. Based on types of patient admission, intensive care treatment had the highest average cost with $2.916.5. In metastatic breast cancer patients, average annual treatment cost per patient is $2.326,6, which is 2.8 times higher compared to non-metastatic breast cancer patients. Conclusion: In order to ensure effective resource allocation at micro and macro level, healthcare administrators have to learn costs of diseases with high incidence such as breast cancer. Results obtained from studies on disease costs calculated using the top down cost approach provide data on actual health services use and therefore are seen as important tools for healthcare administrators in terms of effective resource allocation.
An Evidence-Based Approach to Outcome Measurement in Oral and Dental Health Services: Oral Health-Related Quality of Life and Oral Health Impact
(Wiley, 2019) Top, Mehmet; Sonmez, Seda; Aslan, Huseyin
Purpose The purpose of this study was to examine the Oral Health-Related Quality of Life (OHRQOL) and Oral Health Impact Profile (OHIP) of oral and dental health patients in terms of gender, educational status, and the reason for coming to the oral health center. Also, we investigated the relationships between OHRQOL and OHIP. Methods This cross-sectional study was conducted and planned for dental patients in Turkey. OHRQOL-United Kingdom (OHRQOL-UK) and OHIP-14 were used for data collection. Descriptive statistics, correlation analysis, student t-tests, and ANOVA were used for data analyses. Results Of 527 respondents, 62.8% were female, and 37.2% were male. One-hundred-forty-one (26.8%) participants were illiterate. Three-hundred-fifty-four (67.20%) dental patients had an elementary school degree. Only 32 (6.10%) participants graduated from college and bachelor programs. For dimensions of the OHIP-14 and OHRQOL-UK, we detected statistically significant differences in personal characteristics. We found that gender, marital status, age, education status, and reasons for coming to the hospital have a significant impact on OHRQOL and OHIP. Linking Evidence to Action These results are expected to provide important evidence-based information to health managers and decision-makers in health planning and reimbursement policies. Clinicians and health managers should use OHIP, quality of life (QOL), and evidence-based practice to determine individual treatments and approaches to improve oral health. QOL is an outcome indicator in healthcare services and evidence-based practice. Measurements of evidence-based health outcomes in national health systems can be made, and global comparisons and policies in oral and dental health can be developed.
An Evaluation Of Abuse And Neglect In Elderly With The Hwalek-Sengstock Elder Abuse Screening Test
(Gunes Kitabevi Ltd Sti, 2018) Sahin, Hande; Erkal, Sibel
Introduction: The participants in this study, which was conducted to evaluate abuse and neglect in the elderly using the Hwalek-Sengstock Elder Abuse Screening Test, comprised older adults aged 65 and over, residing in Etimesgut, Ankara. Materials and Method: The study employed the Hwalek-Sengstock Elder Abuse Screening Test as the data collection instrument. In addition to standard deviation and arithmetic mean, the t-test was used for data comparisons between two groups, and analysis of variance was conducted when analyzing more than two groups. Results: The abuse and neglect status of the participants displayed significant differences with respect to educational attainment, monthly income, number of children, other household members, ownership of residence, and social security (p < 0.05). Conclusion: The elderly experience serious health problems because of physical, psychological, sexual, and economic violence and neglect.
Parent expectations towards participation to extracurricular sport activity of high school students
(Kharkiv State Acad Design & Arts, 2018) Yilmaz, A.
Purpose: Extracurricular activities are the activities that are carried out inside and outside of the school after the class depending upon a plan and program, and that contain the traits designed for the various purposes. This activities are important for adolescents in terms of discovery the skills, interests and strengths, and creating a chance to get to know themselves. Besides, the activities provide to strengthen the relationships with persons in school, and to build up academic success and moral life factors. This study aims to determine the expectations of parents from the extracurricular sportive activities. Material: In research, interwoven single case study design, one of the qualitative research approaches, was used. Easy accessible sample was benefited for the selection of study group. Parents of 14 students studying in different high schools in the city center of Kirikkale in 2014-2015 academic years were included in the research. Data were obtained from the semi-structured interview form and applied a content analysis. Results: As a result of the obtained findings, it was figured out that expectations of parents from the extracurricular sportive activities are generally the contributions of activities on children to spend a quality leisure time. 5 categories were obtained as a result of analysis. These categories are "being a healthy individual", "keeping away from the harmful habits", "socializing", "keeping away from the bad circle of friends", "providing skill development" and "providing being an intellectual individual". Conclusions: As a result, parental opinions revealed that extracurricular sportive activities are important in terms of children spending a quality leisure time. Parents' expectations from these activities are also in this direction.

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