Zdravstveno Varstvo最新文献

Introduction: Higher nursing workload increases the odds of patient deaths, as the work environment has a significant effect on patient outcomes. The aim of the study was to explore the relation between patient outcomes and nurses' working conditions in hospitals.

Methods: Administrative data on discharges of surgical patients for the year 2019 in eight general hospitals and two university medical centres in Slovenia were collected to determine in-hospital mortality within 30 days of admission. The RN4CAST survey questionnaire was used to gather data from nurses in these hospitals, with 1,010 nurses participating. Data was collected at the beginning of 2020. The number of nurses per shift and the nurse-to-patient ratio per shift were calculated. Univariate, bivariate and multivariate statistical methods were used to analyse the data.

Results: The 30-day in-hospital mortality for surgical patients was 1.00% in the hospitals sampled and ranged from 0.27% to 1.62%. The odds ratio for staffing suggests that each increase of one patient per RN is associated with a 6% increase in the likelihood of a patient dying within 30 days of admission. The mean patient-to-RN ratio was 15.56 (SD=2.50) and varied from 10.29 to 19.39. Four of the 13 tasks checked were not performed on patients during the last shift.

Conclusion: The results are not encouraging, with an extremely critical shortage of RNs and thus a high RN workload. The number of patients per RN is the highest in Europe and also higher than in some non-European countries, and represents an extreme risk to the quality of nursing and healthcare as a whole. The recommendation for acute non-emergency internal medicine and surgery departments is four patients per RN per shift.

Introduction: Type 2 diabetes (T2D) and arterial hypertension (AH) are among the greatest challenges facing health systems worldwide and require comprehensive patient-centred care. The key to successful management in chronic patients is self-management support, which was found to be only weakly implemented in Slovenia. The aim of the study is to develop an evidence-based model of peer support for people with T2D and AH at the primary healthcare level in Slovenia, which could represent a potential solution for upgrading integrated care for these patients.

Methods: A prospective interventional, mixed-methods pilot study will begin by recruiting approximately 40 eligible people with T2D and AH through purposive sampling. The participants will receive structured training, led by a specialist nurse, to become trained peer supporters. Each will voluntarily share their knowledge and experience at monthly group meetings with up to 10 people with T2D and AH over a three-month period in the local community. Data will be collected through interviews and focus groups and questionnaires about socio-demographic and clinical data, knowledge about T2D and AH, participants' quality of life, level of empowerment and acceptability of the intervention.

Expected results: The study will provide an evidence-based model for integrating peer support into the local community. It is expected that the intervention will prove feasible and acceptable with educational, psychosocial and behavioural benefits.

Conclusion: Peer support through empowerment of people with T2D and AH, family members and other informal caregivers in the local community could scale-up the integrated care continuum and contribute to sustainability of the healthcare system.

Introduction: The completeness and timeliness of the pertussis questionnaire-based enhanced surveillance system (ESS) among infants and reported pertussis data within the electronic nationwide notification system (NNS) in the years 2015, 2017 and 2019 were evaluated in a pilot study.

Methods: The completeness of the variables for demographic characteristics, date of symptom onset, hospitalisation and vaccination status were assessed in both systems. Timeliness of reporting in the NNS was analysed as the interval between symptom onset and a) the date of first specimen collection (diagnostic delay), and b) the date of the Regional Public Health Authority receiving notification (notification delay).

Results: A total of 121 confirmed pertussis cases were reported to the NNS in the study years, while in the ESS a total of 104 confirmed cases were reported in infants. In both systems most cases were in the age group of one completed month of life (20% versus 23%) and males (55% versus 55%). The majority of cases were hospitalised (81% versus 85%) and unvaccinated (77% versus 78%). Within the NNS, the first dose of vaccine was reported in 13 cases, the second dose in 11, and third dose in three cases. Within the NNS, 100% completeness of following variables was found: symptom onset, week and region of reporting, age, gender and place of isolation. Median diagnostic delay was nine days. Median notification delay was 18 days.

Conclusions: Data completeness was high in the NNS, except for lack of vaccination data in those eligible by age. Efforts to improve the completeness of laboratory-related variables and timeliness are essential. Based on the study results, the project of improving the ESS for infants will continue with regular evaluation.

Introduction: The purpose of the research was to analyse the injuries of primary school children in the framework of organised sports activities at school and in clubs or associations, and in leisure time without professional guidance.

Methods: We surveyed 631 participants, of which there were 282 boys and 349 girls from eight Slovenian primary schools. Frequencies were calculated and a Chi-square test was performed.

Results: In physical education (PE) at school, 32% of the participants were injured in one school year, and there were no statistically significant differences in the number of injuries according to sex (p=0.18) and age (p=0.12). Most injuries were recorded in the lower extremities (50%), in the form of wounds. The participants were injured less often in PE at school than in a club or association, and more often than in their leisure time. The participants were absent from PE classes for longer after an injury in a club or association than in PE, while no significant differences in absences after injury were found. At school, the participants were most often injured in ball games, boys in football (43%) and girls in volleyball (19%). In activities in a club or association, we recorded the most injuries in boys in martial arts (18%) and dance for girls (19%). In their leisure time, boys suffered the most injuries from football (26%) and cycling, while girls suffered the most from running and rollerblading.

Conclusion: In the last ten years, the number of injuries in PE has increased in Slovenia. Based on the obtained results, we propose measures to reduce injuries and thus encourage more sports activities among children and adolescents, while ensuring their safety.

Introduction: Binge eating is the most common form of disordered eating associated with obesity, reduced quality of life, and medical and psychological comorbidities. It therefore affects the well-being of individuals. This underscores the fact that it is a serious public health problem. The study aimed to investigate binge eating and anxiety across gender, age and body mass index in a large population sample of adults in Slovenia.

Methods: A total of 3,310 adult volunteers participated in this cross-sectional study. Questionnaires, including a binge eating and anxiety scale and an eating behaviour questionnaire, were completed by 1,487 subjects (90.9% female, ages 18 to 69).

Results: The frequency of reported binge eating was 29.9%, with 9.8% of participants reporting severe binge eating, and the presence of overweight and obesity was high (41.8%). BMI was associated with this problematic eating, and explained 5.4% of the variation in binge eating. Importantly, anxiety was the most important factor related to binge eating, with younger participants and women reporting significantly more anxiety.

Conclusion: The high presence of binge eating, obesity and anxiety in the Slovenian population-based sample is worrying. Anxiety is clearly an important factor in understanding the relationship between negative affect and binge eating, as it accounts for a greater proportion of the variance in binge eating symptoms than BMI. Particularly concerning was the fact that the youngest participants showed the greatest anxiety. Targeting anxious adolescents and females is important from a health perspective because it can impact the physical and mental health of the population in the long term.

Introduction: Spending one's last days and dying at home is a common wish of people with a life-limiting illness. Home-based palliative care is essentially organised at the primary level to meet the needs of palliative patients and their carers. The aim of this study was to identify the characteristics of home-based palliative care, focusing on those who identify palliative patients, what their needs are and how this affects their length of life and site of death.

Methods: This retrospective cohort study analysed routinely collected notes of patients enrolled in home-based palliative care between 2015 and 2021. Palliative care was provided by a primary health care team in a predominantly rural area.

Results: This study included 107 palliative patients, aged 71±11.4 years, 94% of whom had cancer. They were enrolled in palliative care by their primary care team or by hospital staff. The enrolment by hospital staff (3%) resulted in significantly shorter survival (p=0.008). Patients lived an average of 66 days, and 65% of patients died at home. Home-based palliative care was found to respond to both basic and complex palliative medical needs, but was weaker in addressing socio-economic, psychological or spiritual issues.

Conclusion: This exemplary primary-level palliative team provided home-based palliative care that has improved over the years in terms of all the observed quality indicators: early enrolment, the proportion of patients dying at home and the ability to address needs. Specialised mobile palliative teams, hospitals and other palliative care settings complement home-based palliative care.

Introduction: The aim of this study was to translate the Cardiac Depression Scale into the Slovenian language and test its validity and reliability on Slovenian patients with heart disease.

Methods: A total of 272 patients with heart disease who underwent elective coronary angiography at Celje General Hospital participated in this study. We used the Slovenian Cardiac Depression Scale (S-CDS), the Spielberger State Anxiety Inventory (STAI-S), and the Center for Epidemiologic Studies Depression Scale-20 (CES-D) to collect data. An exploratory and confirmatory factor analysis, internal consistency, test-retest reliability, and concurrent validity were performed.

Results: Cronbach's alpha for the total scale was 0.92 and the test-retest reliability was 0.71. Exploratory factor analysis confirmed six factors, accounting for 61% of the total variance. The confirmatory factor analysis indicated that a two- and one-factor solution had acceptable goodness-of-fit measures. However, we kept a more parsimonious one-factor method, given a high correlation between the two factors and the theoretical background in previous studies. Concurrent validation against the CES-D and the STAI-S showed moderate to strong correlations.

Conclusions: The S-CDS is a reliable and valid instrument for screening for depression in Slovenian patients with heart disease.

Renaissance is the term used for the societal movement that marked the end of the Middle Ages. With the development of science came the rediscovery of the works and values of ancient scholars. This brought enormous development in all areas of society, including education. Man became the measure of all things, humanism became important again, and there was a blossoming of science and art. The 'renaissance of family medicine' took place approximately 50 years ago as a response to over-technical (even inhumane) medicine. Family medicine focused on the patient and was, as such, rediscovered and developed as a scientific discipline. In 2022 Wonca Europe launched a new document that set out the core values of family medicine, initiating a discussion about the 'new' renaissance of family medicine. The idea implies that, due to the changes brought about by rapid technical advances and recent global events, family medicine will develop further. However, the really intriguing question is whether these rapid and dramatic changes will actually result in a new renaissance of family medicine or whether they will result in its decline.

Introduction: The composition of the human gut microbiota, which can also be regulated by the consumption of probiotics, has a significant impact on host health. The main source of probiotics can be foods such as fermented foods, yogurts, fermented drinks and/or probiotic supplements. While parents play a critical role in ensuring the well-being of their children, this cross-sectional study is focused on parents' perspectives regarding the use of probiotics in the preschool period.

Methods: The self-administered online survey consisted of 24 questions arranged across two thematic sections. The final data analysis included 102 parents (96% F; 4% M), aged between 22 and 47. Their children were aged up to 6 years.

Results: The majority (52%) of the parents were familiar with the term 'probiotics' and 86.3% were including probiotics in their children's diet at the time of the survey. The main source was probiotic food (36.3%), of which yoghurt was the most commonly consumed (87.2%). The inclusion of probiotic supplements in a child's diet was positively correlated with parents' consumption and level of knowledge about the term 'probiotics'. Digestive tract-related disorders were the most frequently reported motive for the initial introduction of probiotics into children's diet.

Conclusions: Based on our study results, parents are familiar with probiotics and include them in their children's diet. However, an attempt should be made to close the gaps in parents' knowledge that our research identified. Further studies are needed to determine the recommended amount of probiotic foods, as well as strategies to educate parents about the benefits of including probiotic foods in their children's diet.