Zdravstveno Varstvo最新文献

Background and purpose: The populations of rural areas across Europe, especially Slovenia, are ageing rapidly and the areas themselves are becoming depopulated. Therefore, this study aims to contribute to our understanding of the population dynamics and provide a method for forecasting housing and other long-term care needs.

Method: The surveys questioned those responsible for long-term care, the caretakers in institutional care, and current and potential homecare users in rural areas of Slovenia. We wanted to discover what they considered as crucial in the process of long-term care deinstitutionalization. Our 2020-2050 projections are based on the surveys conducted across 38 municipalities in the Eastern Slovenian region and an in-depth empirical study in Posavje. The results are embedded in the demographic projections and the multistate transition model of the declining functional capacities to forecast the needed housing facilities and human resources.

Results: The results are the time series of required capacities. Around 60% of respondents in Slovenian rural areas believe that even a better organization of homecare would not allow them to stay at home until death due to inadequately built housing and the absence of a continuous presence of caregivers. These findings were included in the projections. Therefore, community care in the network of Smart Silver Villages was proposed.

Discussion: Investments are needed to renovate the housing stock of older adults and construct sheltered, assisted living housing and specialized households in the community. Moreover, proper education and training of human resources would increase the output. In addition, financial solutions are advised to develop Smart Silver Villages.

Background: Translations of instruments for measuring quality of life developed in certain, mostly more developed, parts of the world usually do not cover regionally specific aspects of health-related quality of life, even after transcultural validation. The aim of this study was to develop and validate a reliable questionnaire in Serbian, Croatian, Bosnian, and Montenegrin languages suitable for measuring health-related quality of life in adults.

Methods: The study was of a cross-sectional type, assessing the reliability and validity of a newly developed questionnaire for measuring health-related quality of life (HRQoL) in adults residing in western Balkan states (WB-HRQoL). It was conducted on a sample of 489 adults from Serbia, Croatia, Bosnia & Herzegovina, and Montenegro, with a mean age of 52.2±14.4 years and a male/female ratio of 195/294 (39.9%/60.1%).

Result: The definitive version of the WB-HRQoL scale with 19 items showed very good reliability, with Cronbach's alpha 0.905. The scale was temporally stable, and satisfactory results were obtained for divergent and convergent validity tests. Exploratory factorial analysis brought to the surface four domains of health-related quality of life, namely the physical, psychical, social, and environmental.

Conclusion: The WB-HRQoL scale is a reliable and valid generic instrument for measuring HRQoL that takes into account the cultural specifics of the western Balkan region.

Introduction: Among young adults, high rates of binge drinking were observed in certain European countries. Binge drinking is associated with several health problems (unplanned pregnancy, HIV infections, problems with memory, and injuries). The aim of this questionnaire-based study was to measure the frequency of binge drinking and its association with sociodemographic, familial, lifestyle factors and school performance among secondary and university students (n=2449) in Csongrád County, Hungary.

Methods: In this cross-sectional study the students' sociodemographic data, parents' educational and economic level, and students' academic performance and self-reported use of tobacco, drugs, and alcohol were collected by a questionnaire. Descriptive statistics and multivariable binary logistic regression analyses were applied using SPSS 24.0 software.

Results: Altogether 2449 Hungarian secondary school students and university students participated in the study. Nearly one-third of the students were classified as binge drinkers, significantly more male university students. Tobacco or illicit drug use resulted in higher odds of being a binge drinker in both subgroups. Poor school performance and binge drinking were significantly correlated especially among secondary school students.

Conclusions: Targeting alcohol, tobacco, and illicit drug use together, including education, parent interventions, and public health policies, are crucial in the prevention of possible serious consequences.

Objectives: Patient falls deteriorate patients' functional condition and quality of life, and increase their treatment costs. E-learning is considered an effective way to gain knowledge and competencies for quality and safety in nursing practice. The aim of the study is to evaluate the effectiveness of an e-learning course for nurses in preventing in-patient falls.

Methods: The research design was mixed. In the first phase of the study, a five-year retrospective analysis of 2,280 in-patient falls was performed. Based on the analysis of risk factors for patient falls and group interviews with clinic managers an e-learning course was designed and completed by 250 nurses from five surgical and internal departments. The course's effectiveness was evaluated based on the incidence of patient falls and the consequences of the falls before and after e-learning.

Results: At surgical departments, there was a statistically significant decrease in patient fall indices after the implementation of the e-learning course (from 4.4 to 2.6 falls per 1,000 patients; p=0.022). On the contrary, in internal departments, this index increased in the monitored period (from 19.0 to 26.9 falls per 1,000 patients; p=0.001). In all departments, there was a decrease in the incidence of patient injuries caused by falls after the implementation of the e-learning course; in internal medicine, this decrease was statistically significant (from 54.5% to 33.3%; p=0.014).

Conclusions: The study confirmed that e-learning forms of education for healthcare professionals have a positive effect in preventing patient falls.

Introduction: In order to achieve a high standard in training programmes for future family medicine specialists, it is essential to have good tutors with well-organised family medicine practices. Proper working conditions for young doctors are essential for their satisfaction and future professional development. The aim of our study was to check the current working conditions of family medicine trainees in the practical modular part of the training programme in Slovenia, and to determine their satisfaction with working conditions.

Methods: A cross-sectional study was conducted. The data was collected through a questionnaire distributed to 105 family medicine trainees undergoing the practical modular part of their training programme.

Results: The study showed that the following 7 out of 25 organisational and labour law factors are significantly associated with a trainee's general satisfaction with working conditions: the location where work with patients takes place, the privacy of the premises, the accessibility of the main tutor, a constant patient population, suitable places for rest, paid out-of-hours substitutions, and appropriate pay grade.

Conclusion: The results we obtained can be used to address certain aspects of trainees' working conditions in Slovenia that need improvement. By determining which working conditions significantly affect a trainee's satisfaction, we have the opportunity to modify these conditions and thereby improve the training programme. This could result in a less stressful and more efficient residency programme.

Introduction: Objectives were to estimate the lifetime prevalence of self-reported sexually transmitted infections (STIs) and describe STIs healthcare.

Methods: Data was collected in the period 2016-2017 from a probability sample of the general population, 18-49 years old, at respondents' homes by a combination of face-to-face interviews and self-administration of more sensitive questions. Statistical methods for complex survey data were used to account for stratification, clustered sampling, and weighting.

Results: Approximately every tenth sexually experienced individual reported to have had genitourinary symptoms suggestive of STIs, but only a minority of them reported to have had those respective STIs diagnosed. The proportion of sexually experienced individuals that reported to have ever been diagnosed with an STI (excluding trichomoniasis, pubic lice for men and women, and pelvic inflammatory disease, vaginal thrush, bacterial vaginosis for women) was 2.4% for men and 6.7% for women (p<0.001). Independent risk factors associated with self-reported STIs in women included at least 10 lifetime sexual partners and having been forced into sex. The majority of the last STI episodes in women were treated by gynaecologists accessible at the primary healthcare level and in men by a dermatovenerologist, after referral by a general practitioner. Approximately half of STI patients were counselled for safer sex and majority reported to have notified their sexual contacts.

Conclusions: Our estimates for lifetime prevalence of self-reported STIs in a probability sample of Slovenian sexually experienced men and women, 18-49 years old, indicate a substantial national burden of STIs. The results will inform national STI prevention and control policies and strategies.

Introduction: Teachers in Slovenia have been noticing the increased consumption of energy drinks among pupils. Therefore, the purpose of this study was to investigate habits that contribute to the frequency of energy drink consumption.

Method: 36 teens participated in the study: elementary school pupils (6th and 8th grades), general upper secondary school pupils, and secondary technical school pupils (1st and 3rd year). In the course of the study 6 group interviews were held to help investigate young people's habits and their reasons for energy drink purchase and consumption. Moreover, we investigated the influence of age on the consumption and knowledge about energy drink ingredients, as well as their influence on the body.

Results: Interview analysis showed that energy drink consumers are predominantly secondary school pupils. Their choice most frequently depends on the price, their taste, or the brand. What influences elementary school pupils' purchasing decisions are price, packaging, and advertisements, while secondary school pupils choose their drinks according to the lack of energy and how tired they feel. The predominant factors preventing energy drink consumption are health problems among family members and friends. Secondary school pupils know more about energy drink ingredients than elementary school pupils.

Conclusion: On the basis of these findings, we will design a survey questionnaire for Slovenian teenagers and teachers, didactic material, and suggestions for improving educational programmes.

Aim: With the aim of improving personalized treatment of patients on chemotherapy, the objective of the study was to assess the degree of association between selected Quality of life (QoL) indicators and both clinical and imaging cardiac status indicators when detecting deterioration in QoL of these patients.

Methods: In a cohort clinical study in Hamburg, from August 2017 through October 2020, 59 cancer patients, aged 18-80 years, were evaluated before chemotherapy, and at several follow-ups, using EQ-5D and SF-36 QoL questionnaires, fast strain-encoded (fast-SENC) cardiac magnetic resonance (CMR), conventional CMR, and echocardiography, and further received a clinical and biomarker examination. Data was analyzed using survival analyses. A decline of more than 5% in each observed QoL metric value was defined as the observed event. Patient were separated into groups according to the presentation of cardiotoxicity as per its clinical definition, the establishment of the indication for cardioprotective therapy initiation, and by a worsening in the value of each observed imaging metric by more than 5% in the previous follow-up compared to the corresponding pre-chemotherapy baseline value.

Results: Among clinical cardiac status indicators, the indication for cardioprotective therapy showed statistically good association with QoL scores (EQ-5D p=0.028; SF-36 physical component p=0.016; SF-36 mental component p=0.012). In terms of imaging metrics, the MyoHealth segmental myocardial strain score was the only one demonstrating consistently good QoL score association (EQ-5D p=0.005; SF-36 physical component p=0.056; SF-36 mental component p=0.002).

Conclusions: Established fast-SENC CMR scores are capable of highlighting patients with reduced QoL, who require more frequent/optimal management.

This editorial describes how research in primary health care can be used to influence policy. It draws on previous literature to give an example from the UK of how research in one part of primary care, the health-visiting service, has endeavoured to use evidence to influence policy and practice. The editorial considers frameworks for policy implementation such as Bardach's eight phase approach and concepts that can inform policy implementation such as Lipsky's Street-Level Bureaucrat approach.

Background: Slovenia is an aging society. Social security expenditures for the elderly are rising steadily, and the majority of Slovenians are firmly convinced that the state must provide elder care. This situation means that informal caregivers face many challenges and problems in their altruistic mission.

Objectives: To explore the experiences and feelings of informal caregivers and to provide an understanding of how informal caregivers support the elderly and what challenges and difficulties they face in Slovenian society.

Methods: The study is based on qualitative semi-structured interviews with 10 caregivers. In addition to descriptive statistics, we conducted a qualitative study using the qualitative content analysis method.

Results: We identified four themes among health caregivers' experiences with challenges and problems in providing long-term health care for the elderly. Caregivers pointed out that they are mostly left to themselves and their altruistic mission of giving informal long-term care to their elderly relatives and friends. Systemic regulation of the national public health care system is the source of many problems.

Conclusion: Other social systems determine and limit the position of informal caregivers in Slovenia. This qualitative study should be understood as useful stepping-stone to future research and real improvement in this area.