Pub Date : 2023-06-22DOI: 10.3889/oamjms.2023.11713
Mia Šimičić, Stana Pačarić, Dragica Pavlović, Marko Babić, Nikolina Farčić, Nika Srb
BACKGROUND: Stigma and negative attitudes can affect the quality of life of the mentally ill and people with substance use disorders. Nurses’ personal attitudes toward mental illness and substance abuse affect the care they provide. AIM: The aim of the study was to examine the attitudes of nurses toward mental illness and substance abuse. MATERIALS AND METHODS: This was a cross-sectional study conducted in March and April 2022 at the Neuropsychiatric Hospital among nurses. The survey was filled out by 100 nurses, 43 (43%) male and 57 (57%) female nurses. The survey consisted of a revised scale for measuring attitudes toward psychiatric patients, the scale of knowledge on psychiatric patients, and the social distance scale. The statistical analysis was performed using MedCalc® Statistical Software version 20.218. RESULTS: Compared to male nurses, female nurses are significantly more afraid of mental patients (χ2 test, p = 0.01), and estimate that they are aggressive and dangerous for the environment (Fisher’s exact test, p = 0.001). Compared to female nurses, male nurses change the way that they communicate significantly more with mentally ill people (χ2 test, p = 0.01, they are especially kind to mentally ill people, so as not to cause unwanted reactions (χ2 test, p < 0.001). CONCLUSION: Nurses’ attitudes toward mentally ill people are negative, and there is a difference according to gender. Most nurses estimate that mentally ill patients are aggressive and dangerous to the environment and cannot fully feel understanding toward them.
{"title":"Nurses’ Attitudes and Stigma about Mental Illness and Substance Abuse","authors":"Mia Šimičić, Stana Pačarić, Dragica Pavlović, Marko Babić, Nikolina Farčić, Nika Srb","doi":"10.3889/oamjms.2023.11713","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11713","url":null,"abstract":"BACKGROUND: Stigma and negative attitudes can affect the quality of life of the mentally ill and people with substance use disorders. Nurses’ personal attitudes toward mental illness and substance abuse affect the care they provide. AIM: The aim of the study was to examine the attitudes of nurses toward mental illness and substance abuse. MATERIALS AND METHODS: This was a cross-sectional study conducted in March and April 2022 at the Neuropsychiatric Hospital among nurses. The survey was filled out by 100 nurses, 43 (43%) male and 57 (57%) female nurses. The survey consisted of a revised scale for measuring attitudes toward psychiatric patients, the scale of knowledge on psychiatric patients, and the social distance scale. The statistical analysis was performed using MedCalc® Statistical Software version 20.218. RESULTS: Compared to male nurses, female nurses are significantly more afraid of mental patients (χ2 test, p = 0.01), and estimate that they are aggressive and dangerous for the environment (Fisher’s exact test, p = 0.001). Compared to female nurses, male nurses change the way that they communicate significantly more with mentally ill people (χ2 test, p = 0.01, they are especially kind to mentally ill people, so as not to cause unwanted reactions (χ2 test, p < 0.001). CONCLUSION: Nurses’ attitudes toward mentally ill people are negative, and there is a difference according to gender. Most nurses estimate that mentally ill patients are aggressive and dangerous to the environment and cannot fully feel understanding toward them.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136287082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-20DOI: 10.3889/oamjms.2023.11460
B. Ameen, Sanaa Hassan Abdulsahibb
BACKGROUND: The industry is one of the Kurdistan region’s largest and most influential sectors. The number of workers in industrial factories increased by an average of 61.4% in 2019 compared to 2018. However, industrial workers are exposed to numerous risks in the workplace, which may have adverse effects on their health and increase the incidence of diseases among workers. AIM: The aim of this study is to identify patterns of morbidity among industrial workers in Sulaymaniyah industries, as well as to find the relationship between disease patterns and some of the sociodemographic data of the study sample. METHODS: A worker-based and cross-sectional study was conducted among ten large-scale industries. The ten participating factories have over 900-line workers. Three hundred were selected using Epi Info™ software. The correct number of employees per factory was determined using a proportionate method, and then the employees were chosen on purpose. The workers were interviewed using a developed questionnaire. The data were analyzed using descriptive and inferential statistics methods (Chi-square test). RESULTS: Morbidity was noticed among 55.3% of participating workers. About 32.3% of the workers were found to be overweight, making it the most common health condition. Obesity came in second at 8%, then musculoskeletal problems at 3.7%. About 2.7% had vision problems. Younger age groups, who had worked in the industry for fewer years, showed lower percentages of morbidity patterns among them. CONCLUSION: Industry workers must be aware of occupational health and safety measures to protect themselves from workplace hazards and reduce disease incidence.
{"title":"The Morbidity Patterns among Industrial Workers in Sulaymaniyah Governorate, Iraqi Kurdistan-Region: A Cross-sectional Study","authors":"B. Ameen, Sanaa Hassan Abdulsahibb","doi":"10.3889/oamjms.2023.11460","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11460","url":null,"abstract":"BACKGROUND: The industry is one of the Kurdistan region’s largest and most influential sectors. The number of workers in industrial factories increased by an average of 61.4% in 2019 compared to 2018. However, industrial workers are exposed to numerous risks in the workplace, which may have adverse effects on their health and increase the incidence of diseases among workers.\u0000AIM: The aim of this study is to identify patterns of morbidity among industrial workers in Sulaymaniyah industries, as well as to find the relationship between disease patterns and some of the sociodemographic data of the study sample.\u0000METHODS: A worker-based and cross-sectional study was conducted among ten large-scale industries. The ten participating factories have over 900-line workers. Three hundred were selected using Epi Info™ software. The correct number of employees per factory was determined using a proportionate method, and then the employees were chosen on purpose. The workers were interviewed using a developed questionnaire. The data were analyzed using descriptive and inferential statistics methods (Chi-square test).\u0000RESULTS: Morbidity was noticed among 55.3% of participating workers. About 32.3% of the workers were found to be overweight, making it the most common health condition. Obesity came in second at 8%, then musculoskeletal problems at 3.7%. About 2.7% had vision problems. Younger age groups, who had worked in the industry for fewer years, showed lower percentages of morbidity patterns among them.\u0000CONCLUSION: Industry workers must be aware of occupational health and safety measures to protect themselves from workplace hazards and reduce disease incidence.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48432294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-11DOI: 10.3889/oamjms.2023.11684
Suparmi Suparmi, Tin Afifah, Siti Masitoh, Oktarina Oktarina, Ning Sulistiyowati, Esti Nugraheny, Yunefit Ulfa, Muhammad Agus Mikrajab, Yuni Purwatiningsih, Sinta Dewi Lestyoningrum, Made Diah Permata Laksmi, Laila Mahmudah
BACKGROUND: Inadequate antenatal care (ANC) has been identified as a risk factor for poor pregnancy outcomes in low-income nations. The World Health Organization recommends adequate ANC for a minimum of eight visits. While universal health coverage has been implemented since 2014, Indonesia as fourth largest populous country encounters challenge on socioeconomic disparities. AIM: This study aims to explore the socioeconomic difference of adequate ANC in Indonesia. METHODS: Data from the Indonesia Demographic and Health Survey 2017 was used for the analysis and includes 15,313 mothers age 15–49 who had a last live birth in the 5 years preceding the survey. Multivariate logistic regression was employed to assess correlation between socioeconomic status and adequate ANC. RESULTS: About 20.8% of mothers had adequate ANC and the proportion ranging between 11.4% in the poorest group and 34.5% in the richest group. Poorest (adjusted odds ratio [AOR]: 0.68; 95% CI: 0.54–0.86) and poorer (AOR 0.79; 95% CI: 0.64–0.97) mothers are less likely to have adequate ANC compared to the richest mothers. In addition, mothers who lived in Java-Bali region, had better knowledge on danger sign of pregnancy, exposed to internet every day, health insurance ownerships, and having ANC at health facilities were more likely to have adequate ANC. CONCLUSION: Socioeconomic status was significantly associated with adequate ANC, where inequality was profound among poor mothers. Therefore, specific intervention to expand universal health coverage for poor mothers is essential to reduce socioeconomic disparities.
{"title":"Socioeconomic Difference and Adequate Antenatal Care in Indonesia: Evidence from a Nationwide Household Survey","authors":"Suparmi Suparmi, Tin Afifah, Siti Masitoh, Oktarina Oktarina, Ning Sulistiyowati, Esti Nugraheny, Yunefit Ulfa, Muhammad Agus Mikrajab, Yuni Purwatiningsih, Sinta Dewi Lestyoningrum, Made Diah Permata Laksmi, Laila Mahmudah","doi":"10.3889/oamjms.2023.11684","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11684","url":null,"abstract":"BACKGROUND: Inadequate antenatal care (ANC) has been identified as a risk factor for poor pregnancy outcomes in low-income nations. The World Health Organization recommends adequate ANC for a minimum of eight visits. While universal health coverage has been implemented since 2014, Indonesia as fourth largest populous country encounters challenge on socioeconomic disparities. AIM: This study aims to explore the socioeconomic difference of adequate ANC in Indonesia. METHODS: Data from the Indonesia Demographic and Health Survey 2017 was used for the analysis and includes 15,313 mothers age 15–49 who had a last live birth in the 5 years preceding the survey. Multivariate logistic regression was employed to assess correlation between socioeconomic status and adequate ANC. RESULTS: About 20.8% of mothers had adequate ANC and the proportion ranging between 11.4% in the poorest group and 34.5% in the richest group. Poorest (adjusted odds ratio [AOR]: 0.68; 95% CI: 0.54–0.86) and poorer (AOR 0.79; 95% CI: 0.64–0.97) mothers are less likely to have adequate ANC compared to the richest mothers. In addition, mothers who lived in Java-Bali region, had better knowledge on danger sign of pregnancy, exposed to internet every day, health insurance ownerships, and having ANC at health facilities were more likely to have adequate ANC. CONCLUSION: Socioeconomic status was significantly associated with adequate ANC, where inequality was profound among poor mothers. Therefore, specific intervention to expand universal health coverage for poor mothers is essential to reduce socioeconomic disparities.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135006110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-07DOI: 10.3889/oamjms.2023.11640
Helmizar Helmizar, Sri Rahma Sari, Utami Ariyasra, Andani Eka Putra
BACKGROUND: Dadih is an Indonesian traditional fermented buffalo milk produced and consumed by the secretory immunoglobulin A (sIgA) level and nutritional status of infants aged 4–10 months. AIM: This study aims to assess the effect of dadih and zinc supplementation given to pregnant mothers for 6 months on fecal. MATERIALS AND METHODS: A prospective randomized controlled trial was conducted in two districts on 138 pregnant mothers for 6 months, randomly assigned into three groups, namely, control, dadih, combination of dadih and zinc groups. Then, the combination of groups was supplemented to expecting mothers, respectively, 6 times a week during 6 months. Anthropometric measurement and fecal sIgA of infants were assessed. RESULTS: The prevalence of nutritional status of infants who mothers were supplemented during pregnancy with dadih, dadih and zinc, and, normal diet, respectively, are 10% stunting, 5.0% underweight, and 5.0% wasting infants; and 22.5% stunted, 20.0% underweight, and 5.0% wasting infants were found in expecting mothers supplemented with it and without any supplementation (control group). The percentage of stunting in 8 months and older infants tended to reduce: 28.57%, 31.25%, and 11.76%. Their mothers were supplemented with all groups. CONCLUSION: Dadih and zinc are potential for improving nutritional status of the newborn. In addition, the two types of supplementation are recommended to pregnant mothers, to reduce the prevalence of stunting. Potential probiotic contained in Dadih which consumed in adequate amounts can help the absorption of nutrients and increase immunity of mothers and infants amounts confer a health benefit. Acceleration and growth of infants to achieve optimal growth and development should be carried out before they are under two years old.
{"title":"Immune Response and Nutritional Status of Infants’ Birth after Supplementation with Dadih and Zinc during Pregnancy: A Prospective Intervention Study","authors":"Helmizar Helmizar, Sri Rahma Sari, Utami Ariyasra, Andani Eka Putra","doi":"10.3889/oamjms.2023.11640","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11640","url":null,"abstract":"BACKGROUND: Dadih is an Indonesian traditional fermented buffalo milk produced and consumed by the secretory immunoglobulin A (sIgA) level and nutritional status of infants aged 4–10 months. AIM: This study aims to assess the effect of dadih and zinc supplementation given to pregnant mothers for 6 months on fecal. MATERIALS AND METHODS: A prospective randomized controlled trial was conducted in two districts on 138 pregnant mothers for 6 months, randomly assigned into three groups, namely, control, dadih, combination of dadih and zinc groups. Then, the combination of groups was supplemented to expecting mothers, respectively, 6 times a week during 6 months. Anthropometric measurement and fecal sIgA of infants were assessed. RESULTS: The prevalence of nutritional status of infants who mothers were supplemented during pregnancy with dadih, dadih and zinc, and, normal diet, respectively, are 10% stunting, 5.0% underweight, and 5.0% wasting infants; and 22.5% stunted, 20.0% underweight, and 5.0% wasting infants were found in expecting mothers supplemented with it and without any supplementation (control group). The percentage of stunting in 8 months and older infants tended to reduce: 28.57%, 31.25%, and 11.76%. Their mothers were supplemented with all groups. CONCLUSION: Dadih and zinc are potential for improving nutritional status of the newborn. In addition, the two types of supplementation are recommended to pregnant mothers, to reduce the prevalence of stunting. Potential probiotic contained in Dadih which consumed in adequate amounts can help the absorption of nutrients and increase immunity of mothers and infants amounts confer a health benefit. Acceleration and growth of infants to achieve optimal growth and development should be carried out before they are under two years old.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135493739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-06-04DOI: 10.3889/oamjms.2023.11690
Y. A. A. Gayatri, Putu Juni Wulandari
BACKGROUND: Tuberculosis is the major opportunistic infection and the leading cause of death among the HIV population worldwide. Indonesia is included among the countries seriously affected by both TB and HIV. HIV increases the lifetime risk of TB infection. One of the parameters related to TB infection in HIV patients is the level of sCD14, which is part of monocytes and macrophages and can bind to lipoarabinomannan in Mycobacterium tuberculosis. METHODS: This study uses cross-sectional analysis. The research subjects were determined by the purposive consecutive method at the Sanglah Hospital, Bali, in 2021–2022. The sCD14 level was measured by the ELISA method. The diagnosis of active tuberculosis was confirmed by examining patient specimens using the molecular rapid test method RT-PCR GeneXpert MTB/RIF. RESULTS: There were 60 subjects with HIV infection, consisting of 42 (70%) men and 18 (30%) women. The mean age was 39.13 ± 11.734 years. The median body mass index was 18.8 (16.3–23.4), clinical stage 1–2 was 17 (28.3%), and stage 3–4 was 43 (71.7%). A total of 46 (76.7%) people had other opportunistic infections besides TB. The cut-off point for sCD14 levels was 2900 ng/mL. Subjects with active TB infection were 18 (30%) people and 42 (70%) people without TB. The results of bivariate analysis using the Chi-Square test found a significant relationship between sCD14 levels and active tuberculosis infection in HIV patients (p < 0.001). Multivariate analysis with logistic regression showed that high sCD14 levels were independently associated with active tuberculosis infection in HIV patients (AOR 13.64; 95% CI: 2.89–64.42; p = 0.001), while other confounding factors were not significantly associated with active tuberculosis infection in HIV patients. CONCLUSION: sCD14 levels are associated with active tuberculosis infection in HIV patients.
{"title":"Association Between Soluble Cluster of Differentiation 14 Levels and Active Tuberculosis Infection in Human Immunodeficiency Virus Patients","authors":"Y. A. A. Gayatri, Putu Juni Wulandari","doi":"10.3889/oamjms.2023.11690","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11690","url":null,"abstract":"BACKGROUND: Tuberculosis is the major opportunistic infection and the leading cause of death among the HIV population worldwide. Indonesia is included among the countries seriously affected by both TB and HIV. HIV increases the lifetime risk of TB infection. One of the parameters related to TB infection in HIV patients is the level of sCD14, which is part of monocytes and macrophages and can bind to lipoarabinomannan in Mycobacterium tuberculosis. METHODS: This study uses cross-sectional analysis. The research subjects were determined by the purposive consecutive method at the Sanglah Hospital, Bali, in 2021–2022. The sCD14 level was measured by the ELISA method. The diagnosis of active tuberculosis was confirmed by examining patient specimens using the molecular rapid test method RT-PCR GeneXpert MTB/RIF. RESULTS: There were 60 subjects with HIV infection, consisting of 42 (70%) men and 18 (30%) women. The mean age was 39.13 ± 11.734 years. The median body mass index was 18.8 (16.3–23.4), clinical stage 1–2 was 17 (28.3%), and stage 3–4 was 43 (71.7%). A total of 46 (76.7%) people had other opportunistic infections besides TB. The cut-off point for sCD14 levels was 2900 ng/mL. Subjects with active TB infection were 18 (30%) people and 42 (70%) people without TB. The results of bivariate analysis using the Chi-Square test found a significant relationship between sCD14 levels and active tuberculosis infection in HIV patients (p < 0.001). Multivariate analysis with logistic regression showed that high sCD14 levels were independently associated with active tuberculosis infection in HIV patients (AOR 13.64; 95% CI: 2.89–64.42; p = 0.001), while other confounding factors were not significantly associated with active tuberculosis infection in HIV patients. CONCLUSION: sCD14 levels are associated with active tuberculosis infection in HIV patients.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134973708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-28DOI: 10.3889/oamjms.2023.11653
Jasmina Starc, Tanja Regina Fabjan
BACKGROUND: Absenteeism and fluctuation of nursing staff negatively affect the quality of care, increase the costs of health-care facilities, and increase the workload of the remaining nursing staff. To identify which measures can be effective in retaining care staff in the profession and reducing their sickness absence, we need to continuously monitor the organizational climate and update the organizational culture of health-care facilities. In this way, we can identify and mitigate the causes of absenteeism and fluctuation in a timely manner, while at the same time creating working conditions that enable care staff to meet their personal needs, expectations, and goals, leading to a productive working environment and thus to quality healthcare. AIM: The aim of this study was to identify and analyze the causes and determinants of absenteeism and fluctuation and to define the consequences of absenteeism and fluctuation in healthcare settings. METHODS: We used a quantitative method. Data were collected with questionnaires and analyzed with Pearson Chi-square test, Kolmogorov–Smirnov test, Shapiro–Wilkov test, and Mann–Whitney U test using Statistical Package for the Social Sciences 24.0. RESULTS: A survey of nursing staff (n = 178) showed that, apart from annual leave, sickness is the most common reason for absenteeism, but there are no statistically significant differences by gender (χ2 = 2.695; sig. = 0.610). Respondents state that they are absent because they are aware that their own health is an important value (x̄ = 4.0) and that they try to maintain their health as much as possible (x̄ = A good half of them (54%) believe that absenteeism leads to a loss of control at work. The most important influences on turnover are stressful situations (91%), unpleasant situations (83%), and monthly income (73%). Aboput 35% are thinking about changing jobs, with men thinking about it more (R = 72.92) than women (R=64.19) . About 69% are satisfied with their job security, but more so for those aged 46 and over (R = 66.85) than those under 45 (R = 64.79) . CONCLUSION: The priority for health organizations should not be to prevent absenteeism, but to create the conditions to ensure that sickness absence does not occur at all or to the minimum extent possible. Sustained success in improving retention of nursing staff in the profession and thus reducing fluctuation depends on a number of measures such as appropriate financial and non-financial incentives, “family friendly” policies, opportunities for professional development, access to training, productive working conditions, job mobility, and responsive leadership. Particular emphasis should be placed on occupational safety training and the provision of organized seminars and courses on healthy lifestyles. Prolonged overworking of nursing staff puts their mental, physical, and social health at risk, resulting in staff leaving for other jobs.
背景:护理人员的缺勤和波动会对护理质量产生负面影响，增加卫生保健设施的成本，并增加剩余护理人员的工作量。为了确定哪些措施可以有效地留住专业护理人员并减少他们因病缺勤，我们需要不断监测组织气氛并更新保健设施的组织文化。通过这种方式，我们可以及时确定和减轻缺勤和波动的原因，同时创造工作条件，使护理人员能够满足他们的个人需求、期望和目标，从而创造一个富有成效的工作环境，从而提供高质量的医疗保健。目的:本研究的目的是确定和分析缺勤和波动的原因和决定因素，并确定医疗机构缺勤和波动的后果。方法:采用定量方法。采用问卷调查的方式收集数据，采用Pearson Chi-square检验、Kolmogorov-Smirnov检验、Shapiro-Wilkov检验和Mann-Whitney U检验，采用Statistical Package for the Social Sciences 24.0进行分析。结果:对178名护理人员的调查显示，除年假外，疾病是最常见的缺勤原因，但性别差异无统计学意义(χ2 = 2.695;Sig = 0.610)。受访者表示，他们缺勤是因为他们意识到自己的健康是一项重要价值(x ā = 4.0)，并尽可能保持健康(x ā = 54%)，其中一半以上的人认为缺勤会导致工作失控。最重要的离职影响因素是压力(91%)、不愉快(83%)和月收入(73%)。约35%的人在考虑换工作，其中男性(R= 72.92)比女性(R=64.19)考虑得更多。大约69%的人对自己的工作保障感到满意，但46岁及以上的人(R = 66.85)比45岁以下的人(R = 64.79)更满意。结论:卫生组织的优先事项不应是防止缺勤，而应创造条件，确保根本不发生缺勤或尽可能减少缺勤。要想持续成功地提高护理人员的留任率，从而减少波动，取决于一系列措施，如适当的财政和非财政激励措施、"家庭友好"政策、专业发展机会、获得培训的机会、富有成效的工作条件、工作流动性和负责任的领导。应特别强调职业安全培训和提供有组织的关于健康生活方式的研讨会和课程。护理人员的长期过度工作使他们的精神、身体和社会健康处于危险之中，导致工作人员离职从事其他工作。
{"title":"Absenteeism and Fluctuation of Nursing Staff in Health-care Settings","authors":"Jasmina Starc, Tanja Regina Fabjan","doi":"10.3889/oamjms.2023.11653","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11653","url":null,"abstract":"BACKGROUND: Absenteeism and fluctuation of nursing staff negatively affect the quality of care, increase the costs of health-care facilities, and increase the workload of the remaining nursing staff. To identify which measures can be effective in retaining care staff in the profession and reducing their sickness absence, we need to continuously monitor the organizational climate and update the organizational culture of health-care facilities. In this way, we can identify and mitigate the causes of absenteeism and fluctuation in a timely manner, while at the same time creating working conditions that enable care staff to meet their personal needs, expectations, and goals, leading to a productive working environment and thus to quality healthcare. AIM: The aim of this study was to identify and analyze the causes and determinants of absenteeism and fluctuation and to define the consequences of absenteeism and fluctuation in healthcare settings. METHODS: We used a quantitative method. Data were collected with questionnaires and analyzed with Pearson Chi-square test, Kolmogorov–Smirnov test, Shapiro–Wilkov test, and Mann–Whitney U test using Statistical Package for the Social Sciences 24.0. RESULTS: A survey of nursing staff (n = 178) showed that, apart from annual leave, sickness is the most common reason for absenteeism, but there are no statistically significant differences by gender (χ2 = 2.695; sig. = 0.610). Respondents state that they are absent because they are aware that their own health is an important value (x̄ = 4.0) and that they try to maintain their health as much as possible (x̄ = A good half of them (54%) believe that absenteeism leads to a loss of control at work. The most important influences on turnover are stressful situations (91%), unpleasant situations (83%), and monthly income (73%). Aboput 35% are thinking about changing jobs, with men thinking about it more (R = 72.92) than women (R=64.19) . About 69% are satisfied with their job security, but more so for those aged 46 and over (R = 66.85) than those under 45 (R = 64.79) . CONCLUSION: The priority for health organizations should not be to prevent absenteeism, but to create the conditions to ensure that sickness absence does not occur at all or to the minimum extent possible. Sustained success in improving retention of nursing staff in the profession and thus reducing fluctuation depends on a number of measures such as appropriate financial and non-financial incentives, “family friendly” policies, opportunities for professional development, access to training, productive working conditions, job mobility, and responsive leadership. Particular emphasis should be placed on occupational safety training and the provision of organized seminars and courses on healthy lifestyles. Prolonged overworking of nursing staff puts their mental, physical, and social health at risk, resulting in staff leaving for other jobs.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"560 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135895567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-28DOI: 10.3889/oamjms.2023.11654
Jasmina Starc, Tanja Regina Fabjan
BACKGROUND: Affiliation and presenteeism have a profound impact on organizational performance, individual health worker performance and health, and clinical performance, which in turn affects patient outcomes. AIM: The aim of this study was to identify organizational affiliation and to analyze the causes and determinants of presenteeism among nursing staff in health-care settings. METHODS: We used a descriptive-empirical method. Data were obtained by survey technique. Health professionals (n = 178) at primary, secondary, and tertiary health-care levels participated in the survey, 91% of whom were women and 9% men. More than half of the respondents (51%) are registered nurses/nursing technicians, 46% are paramedical nurses/nursing technicians, and 4% have a master’s degree in various health and nursing disciplines. RESULTS: The results showed that nursing staff show the greatest organizational loyalty in the way that they are always willing to help colleagues and managers and that they believe in the successful development of their healthcare institution. They are aware that they act irresponsibly toward other colleagues and patients when they come to work sick, but they were present at work despite their reduced ability to perform their job, because they do not want their colleagues to be overwhelmed by them and, despite having a health problem, they were able to complete the difficult tasks of their job, even though it took them more time and energy to do so. CONCLUSION: Employee adherence influences the quality of patient care, the work environment, and the reputation of the healthcare institution. Presenteeism is an undesirable behavior that receives too little attention from employers. It is a risk for the organization, for patients – service users as well as for health-care providers who are less effective in their work.
{"title":"Employee Affiliation and Presenteeism in Health-care Settings","authors":"Jasmina Starc, Tanja Regina Fabjan","doi":"10.3889/oamjms.2023.11654","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11654","url":null,"abstract":"BACKGROUND: Affiliation and presenteeism have a profound impact on organizational performance, individual health worker performance and health, and clinical performance, which in turn affects patient outcomes. AIM: The aim of this study was to identify organizational affiliation and to analyze the causes and determinants of presenteeism among nursing staff in health-care settings. METHODS: We used a descriptive-empirical method. Data were obtained by survey technique. Health professionals (n = 178) at primary, secondary, and tertiary health-care levels participated in the survey, 91% of whom were women and 9% men. More than half of the respondents (51%) are registered nurses/nursing technicians, 46% are paramedical nurses/nursing technicians, and 4% have a master’s degree in various health and nursing disciplines. RESULTS: The results showed that nursing staff show the greatest organizational loyalty in the way that they are always willing to help colleagues and managers and that they believe in the successful development of their healthcare institution. They are aware that they act irresponsibly toward other colleagues and patients when they come to work sick, but they were present at work despite their reduced ability to perform their job, because they do not want their colleagues to be overwhelmed by them and, despite having a health problem, they were able to complete the difficult tasks of their job, even though it took them more time and energy to do so. CONCLUSION: Employee adherence influences the quality of patient care, the work environment, and the reputation of the healthcare institution. Presenteeism is an undesirable behavior that receives too little attention from employers. It is a risk for the organization, for patients – service users as well as for health-care providers who are less effective in their work.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135895566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-28DOI: 10.3889/oamjms.2023.11619
Michelle Husin, Dewi Sutriani, Mahalini, Gusti Ngurah, Made Suwarba, Ni Putu, Siadi Purniti, I. B. Subanada, Ksenija Bogoeva-Kostovska
AIM: The objective of the study is to describe neurologic manifestation in children with coronavirus disease-2019 (COVID-19) at Prof. Dr. I.G.N.G Ngoerah Hospital. METHODS: This was a retrospective descriptive study using the medical record with a total sampling of children with confirmed COVID-19 that manifests neurologic symptoms. Exclusion criteria were pre-existing neurologic comorbidities and incomplete medical records. RESULTS: From March 2020 to December 2021, from 308 children with confirmed cases of COVID-19, 106 had neurologic symptoms, 17 were excluded (16 pre-existing comorbidities, and 1 incomplete medical record), and total samples were 89 (28.8%) from inpatient and outpatient. Most children were male (57.3%) with a median age of 13 years. Most symptoms found were anosmia (73%), followed by a decrease in consciousness (19.1%) and seizure (10.1%). Children with anosmia median age were 14 years. There were 84 (94.3%) children with specific neurological symptoms (encephalopathy, seizures, and anosmia) and 5 (5.7%) with non-specific neurological symptoms (headache). CONCLUSION: There were 28.8% confirmed cases of COVID-19 with a neurologic manifestation, and most symptoms found were anosmia (73%).
{"title":"Neurologic Manifestation in Children with Coronavirus Disease 2019 at Prof. Dr. I.G.N.G Ngoerah Tertiary Hospital","authors":"Michelle Husin, Dewi Sutriani, Mahalini, Gusti Ngurah, Made Suwarba, Ni Putu, Siadi Purniti, I. B. Subanada, Ksenija Bogoeva-Kostovska","doi":"10.3889/oamjms.2023.11619","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11619","url":null,"abstract":"AIM: The objective of the study is to describe neurologic manifestation in children with coronavirus disease-2019 (COVID-19) at Prof. Dr. I.G.N.G Ngoerah Hospital.\u0000METHODS: This was a retrospective descriptive study using the medical record with a total sampling of children with confirmed COVID-19 that manifests neurologic symptoms. Exclusion criteria were pre-existing neurologic comorbidities and incomplete medical records.\u0000RESULTS: From March 2020 to December 2021, from 308 children with confirmed cases of COVID-19, 106 had neurologic symptoms, 17 were excluded (16 pre-existing comorbidities, and 1 incomplete medical record), and total samples were 89 (28.8%) from inpatient and outpatient. Most children were male (57.3%) with a median age of 13 years. Most symptoms found were anosmia (73%), followed by a decrease in consciousness (19.1%) and seizure (10.1%). Children with anosmia median age were 14 years. There were 84 (94.3%) children with specific neurological symptoms (encephalopathy, seizures, and anosmia) and 5 (5.7%) with non-specific neurological symptoms (headache).\u0000CONCLUSION: There were 28.8% confirmed cases of COVID-19 with a neurologic manifestation, and most symptoms found were anosmia (73%).","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42881512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-26DOI: 10.3889/oamjms.2023.11685
Mohab Mohamed, Ahmed Noaman, Islam Nour, Hesham Abdel-Hady
AIM: The objective is to assess the effect of the application of a nasal injury prevention bundle on the incidence and severity of nasal-continuous positive airway pressure (nCPAP)-related nasal injuries in preterm infants. METHODS: We conducted a prospective controlled before-after study in a preterm neonate, <37 weeks gestation, who required nCPAP in the neonatal intensive care unit, at Mansoura University Children’s Hospital, between September 2018 through October 2019. After 2 months of nursing staff training, a nasal trauma prevention bundle was implemented. The nursing intervention bundle comprised nasal barrier dressing, regular focused checking for evolving nasal skin injury, and proper application of the CPAP device. nCPAP-related nasal injuries per 1000 days and grading of nasal injury severity were the primary outcomes. Time to onset of nasal injury after initiation of CPAP; duration of nCPAP use, duration of oxygen dependency; incidence of pneumothorax, broncho-pulmonary dysplasia; intraventricular hemorrhage; periventricular leukomalacia; late-onset sepsis; length of hospital stay; and in-hospital mortality were the secondary outcomes. RESULTS: Data from 62 preterm neonates were analyzed (31 in each group). The nasal trauma prevention bundle of care was associated with reduced nasal injury incidence per 1000 nCPAP-days (140 vs. 148.94, p = 0.03) with improved nasal injury severity staging (p = 0.003) compared to the pre-bundle era. Nasal injury developed earlier in the control group (1 [1–1] vs. 2 [1–3] days, p = 0.002) compared to the intervention group. No statistically significant differences were reported between groups regarding any of the other secondary outcomes. Longer duration of CPAP use (p = 0.009) and lack of bundle application (0.03) were the independent risk factors associated with nCPAP-related nasal injuries in preterm neonates. CONCLUSION: The implementation of a bundle of nursing interventions is associated with a substantially improved incidence and severity of nasal injuries in preterm infants receiving nCPAP.
{"title":"Impact of a Nursing Intervention Bundle of Care on Nasal-CPAP-Related Nasal Injuries in Preterm Infants: A Quality Improvement Initiative","authors":"Mohab Mohamed, Ahmed Noaman, Islam Nour, Hesham Abdel-Hady","doi":"10.3889/oamjms.2023.11685","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11685","url":null,"abstract":"AIM: The objective is to assess the effect of the application of a nasal injury prevention bundle on the incidence and severity of nasal-continuous positive airway pressure (nCPAP)-related nasal injuries in preterm infants. METHODS: We conducted a prospective controlled before-after study in a preterm neonate, <37 weeks gestation, who required nCPAP in the neonatal intensive care unit, at Mansoura University Children’s Hospital, between September 2018 through October 2019. After 2 months of nursing staff training, a nasal trauma prevention bundle was implemented. The nursing intervention bundle comprised nasal barrier dressing, regular focused checking for evolving nasal skin injury, and proper application of the CPAP device. nCPAP-related nasal injuries per 1000 days and grading of nasal injury severity were the primary outcomes. Time to onset of nasal injury after initiation of CPAP; duration of nCPAP use, duration of oxygen dependency; incidence of pneumothorax, broncho-pulmonary dysplasia; intraventricular hemorrhage; periventricular leukomalacia; late-onset sepsis; length of hospital stay; and in-hospital mortality were the secondary outcomes. RESULTS: Data from 62 preterm neonates were analyzed (31 in each group). The nasal trauma prevention bundle of care was associated with reduced nasal injury incidence per 1000 nCPAP-days (140 vs. 148.94, p = 0.03) with improved nasal injury severity staging (p = 0.003) compared to the pre-bundle era. Nasal injury developed earlier in the control group (1 [1–1] vs. 2 [1–3] days, p = 0.002) compared to the intervention group. No statistically significant differences were reported between groups regarding any of the other secondary outcomes. Longer duration of CPAP use (p = 0.009) and lack of bundle application (0.03) were the independent risk factors associated with nCPAP-related nasal injuries in preterm neonates. CONCLUSION: The implementation of a bundle of nursing interventions is associated with a substantially improved incidence and severity of nasal injuries in preterm infants receiving nCPAP.","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134974768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-26DOI: 10.3889/oamjms.2023.11687
Gde Sastra Winata, William Alexander Setiawan, Putu Bagus Mulyana Yoga, Wayan Agus Surya Pradnyana, Stanly Kamardi, Putu Agung Satvika Pradnyadevi
BACKGROUND: Patients with early-stage cervical cancer (ESCC) after radical hysterectomy surgery usually need additional adjuvant treatment, but it depends on the presence or absence of certain risk factors. Factors, such as large tumor size, deep stromal invasion, and lymphovascular space involvement, are classified as intermediate risks. Therefore, postoperative adjuvant concurrent chemo-radiotherapy (CRT) or radiotherapy (RT) is recommended for ESCC with risk factors. However, it remains controversial whether CRT is superior to RT as an adjuvant regimen for postoperative with risk factors. METHODS: A systematic search was performed within PubMed, Cochrane, Science Direct, and Google Scholar databases to research the outcome between CRT and RT in ESCC. Three reviewers independently reviewed titles, abstracts, and full article text to identify studies meeting inclusion and exclusion criteria. If there are any discrepancies, it will be resolved by discussion. In this analysis, the Newcastle–Ottawa scale was used to assess the risk of bias of non-randomized studies. We used review manager 5.4 to calculate the result of 95% CI for the outcomes using odds ratio (OR), random effect model was also used if there is heterogeneity. The primary endpoints of interest are recurrence-free survival (RFS) and overall survival (OS). RESULTS: A total of 14 studies included in qualitative synthesis and meta-analysis with a total of 5.294 patients were identified. Patients who had RT after radical hysterectomy was found to significantly have a more favorable RFS rate with OR 0.57 95% CI (0.38–0.84), p = 0.005; I2 = 63%. Nine studies were found comparing the OS between adjuvant RT and adjuvant CRT in a patient with ESCC with intermediate risk, the result is quite similar favoring adjuvant RT with significantly better OS outcome OR 0.69 95% CI (0.54–0.87), p = 0.002; I2 =34%. 1.526 had hematologic toxicities, 797 were RT and 729 had CRT. The study showed RT had better outcomes with lesser toxicities (OR 0.11, 95% CI [0.03–0.44] p = 0.002; I2 = 91%). Non-hematological toxicity, with a total of 1.463 patients, 799 were RT and 664 had CRT. Random models were used due to heterogeneity. RT is significantly associated with lesser non- hematologic toxicities with OR 0.34, 95% CI (0.18–0.66) p = 0.001; I2 = 65%. DISCUSSION: During the last two decades, there were significant changes in practice to cure uterine cervical cancer. Based on the consistent results generated in several previous randomized controlled trials, cisplatin-based CCRT has become the standard treatment for advanced cervical cancer. A randomized prospective studies by Sedlis et al., randomized FIGO IB patients without residual tumor or involved lymph nodes but with two or more intermediate-risk factors later named the “Sedlis criteria” to receive observation or RT following radical surgery. Adjuvant RT led to a reduction of recurrence rates at the cost of an approximately 4% higher rate of grade 3/4 adverse
背景:早期宫颈癌(ESCC)根治性子宫切除术后患者通常需要额外的辅助治疗，但这取决于某些危险因素的存在与否。肿瘤大、间质浸润深、淋巴血管间隙受累等因素被归为中度危险。因此，对于有危险因素的ESCC，建议术后辅助同步放化疗(CRT)或放疗(RT)。然而，对于有危险因素的术后辅助方案，CRT是否优于RT仍存在争议。方法:在PubMed、Cochrane、Science Direct和Google Scholar数据库中进行系统检索，研究ESCC中CRT和RT的疗效。三位审稿人独立审查标题、摘要和全文，以确定符合纳入和排除标准的研究。如有异议，将通过协商解决。在本分析中，纽卡斯尔-渥太华量表用于评估非随机研究的偏倚风险。我们使用review manager 5.4对结果使用比值比(odds ratio, OR)计算95% CI的结果，如果存在异质性也使用随机效应模型。主要研究终点为无复发生存期(RFS)和总生存期(OS)。结果:定性综合meta分析共纳入14项研究，共纳入患者5.294例。根治性子宫切除术后接受RT治疗的患者有更有利的RFS率，OR为0.57 95% CI (0.38-0.84)， p = 0.005;I2 = 63%。9项研究比较了辅助RT和辅助CRT对中度危险ESCC患者的OS，结果非常相似，支持辅助RT的OS结果明显更好OR 0.69 95% CI (0.54-0.87)， p = 0.002;I2 = 34%。血液学毒性1.526例，放疗797例，CRT 729例。研究显示，RT治疗效果更好，毒性更小(OR 0.11, 95% CI [0.03-0.44] p = 0.002;I2 = 91%)。非血液学毒性，共1463例，其中放疗799例，CRT 664例。由于异质性，采用随机模型。RT与较小的非血液学毒性显著相关，OR为0.34,95% CI (0.18-0.66) p = 0.001;I2 = 65%。讨论:在过去的二十年中，治疗子宫颈癌的实践发生了重大变化。基于之前几项随机对照试验的一致结果，以顺铂为基础的CCRT已成为晚期宫颈癌的标准治疗。Sedlis等人的一项随机前瞻性研究，随机选择无肿瘤残留或淋巴结受累者但存在两种或两种以上中间危险因素的FIGO IB患者，并将其命名为“Sedlis标准”，在根治性手术后接受观察或RT。辅助放疗降低了复发率，但代价是3/4级不良事件发生率增加了约4%。OS没有增加，但长期RFS有所改善。另一方面，一项研究发现，随着化疗的增加，RFS和OS明显改善，特别是在临床期IA2, IB和IIA伴有准性侵袭，肿瘤残留和/或淋巴结受累的患者中。本研究发现，在RFS和OS中，RT具有更好的结果，并且RT具有较小的血液学毒性和非血液学毒性。毕竟，考虑不良事件和长期幸存者的生活质量是谨慎的。结论:辅助放疗在RFS和OS中具有更好的疗效。CRT常伴有较大的血液学和非血液学毒性。建议进一步进行高质量的随机临床试验，以更大的样本量比较辅助CRT与RT的疗效和毒性。
{"title":"Adjuvant Therapy in Early-Stage Cervical Cancer Patients with Intermediate-Risk Factors, Comparing Between Chemotherapy and Radiotherapy: A Systematic Review and Meta-Analysis","authors":"Gde Sastra Winata, William Alexander Setiawan, Putu Bagus Mulyana Yoga, Wayan Agus Surya Pradnyana, Stanly Kamardi, Putu Agung Satvika Pradnyadevi","doi":"10.3889/oamjms.2023.11687","DOIUrl":"https://doi.org/10.3889/oamjms.2023.11687","url":null,"abstract":"BACKGROUND: Patients with early-stage cervical cancer (ESCC) after radical hysterectomy surgery usually need additional adjuvant treatment, but it depends on the presence or absence of certain risk factors. Factors, such as large tumor size, deep stromal invasion, and lymphovascular space involvement, are classified as intermediate risks. Therefore, postoperative adjuvant concurrent chemo-radiotherapy (CRT) or radiotherapy (RT) is recommended for ESCC with risk factors. However, it remains controversial whether CRT is superior to RT as an adjuvant regimen for postoperative with risk factors. METHODS: A systematic search was performed within PubMed, Cochrane, Science Direct, and Google Scholar databases to research the outcome between CRT and RT in ESCC. Three reviewers independently reviewed titles, abstracts, and full article text to identify studies meeting inclusion and exclusion criteria. If there are any discrepancies, it will be resolved by discussion. In this analysis, the Newcastle–Ottawa scale was used to assess the risk of bias of non-randomized studies. We used review manager 5.4 to calculate the result of 95% CI for the outcomes using odds ratio (OR), random effect model was also used if there is heterogeneity. The primary endpoints of interest are recurrence-free survival (RFS) and overall survival (OS). RESULTS: A total of 14 studies included in qualitative synthesis and meta-analysis with a total of 5.294 patients were identified. Patients who had RT after radical hysterectomy was found to significantly have a more favorable RFS rate with OR 0.57 95% CI (0.38–0.84), p = 0.005; I2 = 63%. Nine studies were found comparing the OS between adjuvant RT and adjuvant CRT in a patient with ESCC with intermediate risk, the result is quite similar favoring adjuvant RT with significantly better OS outcome OR 0.69 95% CI (0.54–0.87), p = 0.002; I2 =34%. 1.526 had hematologic toxicities, 797 were RT and 729 had CRT. The study showed RT had better outcomes with lesser toxicities (OR 0.11, 95% CI [0.03–0.44] p = 0.002; I2 = 91%). Non-hematological toxicity, with a total of 1.463 patients, 799 were RT and 664 had CRT. Random models were used due to heterogeneity. RT is significantly associated with lesser non- hematologic toxicities with OR 0.34, 95% CI (0.18–0.66) p = 0.001; I2 = 65%. DISCUSSION: During the last two decades, there were significant changes in practice to cure uterine cervical cancer. Based on the consistent results generated in several previous randomized controlled trials, cisplatin-based CCRT has become the standard treatment for advanced cervical cancer. A randomized prospective studies by Sedlis et al., randomized FIGO IB patients without residual tumor or involved lymph nodes but with two or more intermediate-risk factors later named the “Sedlis criteria” to receive observation or RT following radical surgery. Adjuvant RT led to a reduction of recurrence rates at the cost of an approximately 4% higher rate of grade 3/4 adverse","PeriodicalId":19562,"journal":{"name":"Open Access Macedonian Journal of Medical Sciences","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134974371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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