članek osvetljuje vlogo lokalne skupnosti pri razvoju skupnostne skrbi na področju duševnega zdravja, kot jo vidijo tri skupine deležnikov: občinski uslužbenci (uslužbenci lokalnih ...skupnosti/upravnih subjektov), izvajalci v mreži programov in storitev za duševno zdravje ter uporabniki teh storitev. Gre za presečno študijo primera zdravstvene regije Novo mesto s kombinacijo kvantitativnih in kvalitativnih metod, s cilji oceniti sedanje stanje skrbi in ugotoviti, ali obstajajo razlike v razumevanju vloge lokalnih skupnosti pri razvoju skupnostne skrbi za duševno zdravje. Ugotovitve raziskave nakazujejo nekatere priložnosti za izboljšanje procesov skupnostne skrbi.
The contribution's aim is highlighting the differences in understanding non-governmental organizations' (NGOs) role in the mental health area within the public support network for patients with ...mental health problems from various viewpoints, in order to achieve progress in supporting patients with mental health problems in local communities.
Qualitative data gathered as a part of a cross-sectional study of NGOs in the support network for patients with mental health problems in two Slovenian health regions (56 local communities), carried out in 2013 and 2014, were used. Qualitative analysis of interviews, focus groups and answers to an open survey question was performed.
There are differences in understanding NGOs' role in the support network for patients with mental health problems, which stem from the roles of stakeholders (local community officials, experts, care providers, and patients) within this system and their experience.
The actual differences need to be addressed and overcome in order to provide integrated community care. The importance of knowing the current state of NGOs in their life cycle and the socio-chronological context of the local community support network is evident.
Objectives. Health-related quality of life (HRQoL) measures a patient’s subjective experience of his or her health status. We aimed to show how the presence of chronic diseases and satisfaction with ...family physicians (FPs) were associated with the HRQoL of a Roma population.
Methods. A cross-sectional study was carried out in May 2011 on a representative sample of 650 Roma living in Prekmurje, Slovenia. The EQ-5D questionnaire was used for measuring the HRQoL of the Roma. Demographical data, 12 groups of diseases diagnosed in the last 12 months and satisfaction with FPs were included in the questionnaire.
Results. The response rate was 88.3% (574), of which 56.4% were female, and the average age of the participants had a mean value of 40.2±12.7 years. The presence of cardiovascular problems with risk factors for them or presence of musculoskeletal disorders were strongly associated with the presence of pain (Cramer’s V = 0.40 and 0.46 respectively).There was a strong association between the presence of mental disorders and anxiety and depression (Cramer´s V = 0.58). The average satisfaction with the family physician was 3.9 (mean±1.10) on a five-point Likert scale. There was no significant association between HRQoL and satisfaction with the family physician.
Conclusions. Roma with chronic mental health problems had the lowest HRQoL in the Roma population. More attention should be paid to this subgroup of Roma in family medicine, and interventions should be provided. High satisfaction with their FPs is not associated with the observed quality of life variables
Uvod. Z zdravjem povezana kakovost življenja (HRQoL) je odraz pacientove subjektivne ocene lastnega zdravstvenega stanja. V naši raziskavi smo skušali ugotoviti, kakšen je vpliv nekaterih kroničnih bolezni in zadovoljstva z izbranim zdravnikom na HRQoL med romskim prebivalstvom.
Metode. Maja 2011 smo izvedli presečno raziskavo v reprezentativnem vzorcu 650 pomurskih Romov. HRQoL smo merili z vprašalnikom EQ-5D; vključili smo še demografske podatke, zadovoljstvo z izbranim družinskim zdravnikom in 12 bolezenskih stanj, ki so bila diagnosticirana v zadnjih 12 mesecih.
Rezultati. Odzivnost je bila 88,3-odstotna (574), 56,4 % je bilo žensk in povprečna starost sodelujočih je bila 40,2 +/- 12,7 leta. Nizek HRQoL v skupini s srčno-žilnimi boleznimi z dejavniki tveganja zanje in kostnomišičnimi boleznimi je bil močno povezan s prisotnostjo bolečine (Cramer z V = 0,40 in 0,46). V skupini z duševnimi težavami pa je bila močna povezava nizkega HRQoL s prisotnimi znaki anksioznosti in depresije (Cramer z V = 0,58). Povprečno zadovoljstvo z zdravnikom družinske medicine je bilo 3,9 (mediana +/- 1,10) na pettočkovni Likertovi lestvici. Ni bilo statistične povezave med HRQoL in zadovoljstvom z zdravnikom družinske medicine.
Zaključki. Romi s prisotnostjo duševnih težav imajo najnižji HRQoL v romskem prebivalstvu. Več pozornosti bi v družinski medicini morali posvetiti tej podskupini Romov. Zadovoljstvo z zdravnikom družinske medicine ni povezano z opazovanimi spremenljivkami kakovosti življenja
Ravnovesje med ceno in učinkovitostjo dela je najbolje optimizirati s primerno mešanico strokovnih profilov in izkušenj. V članku sta predstavljeni matematični enačbi za izračun potreb za različne ...duševne motnje ter potreb po osebju za ustrezno obravnavo določene duševne motnje. Teoretično bi lahko vse oblike zdravljenja opravil pedopsihiater, kar pa bi, zaradi dražjega izobraževanja in plačevanja zdravnikov, po nepotrebnem dvignilo ceno storitvam. Ena od rešitev bi bil kompromis, kjer bi pomemeben delež otrok, ki ne potrebujejo terapije z zdravili, spremljalo nezdravniško osebje. Zagotovo pa bi bilo potrebno razdeliti delo v tri kategorije: na primere, ko naj pedopsihiatrija prevzame vodilno vlogo, primere, ko naj preostale ustanove prevzamejo vodilno vlogo ter primere, pri katerih naj bo pristop od vsega začetka večslojen. S krepitvijo interesa staršev in ostalih svojcev ter s spodbujanjem k organiziranju skupin za samopomoč, bo tudi pedopsihiatrija dolgoročno pridobila. Predstavljeni podatki in razmišljanja v članku naj bodo izziv za razpravo med vsemi udeleženimi pri morebitnem prilagajanju ali celo preoblikovanju pedopsihiatričnih storitev v Sloveniji.
The balance between cost and work effectiveness is best optimised with an appropriate mix of profiles and experiences. The article presents mathematical equations and calculations of requirements for a given mental disorder and requirements per personnel for all mental disorders. In theory, all forms of treatment could be performed by a pedopsychiatrist, but this would unnecessarily raise the price of services due to the more expensive education and payment of doctors. One solution would be a compromise, where a significant part of the children who do not need drug therapy can be monitored by non-medical personnel. It would surely be necessary to divide the work into three categories: into cases where pedopsychiatry takes a leading role, cases where the remaining institutions take the lead, and cases where the approach should be multilayered from the very beginning. Pedopsychiatry will also gain in the long-term by reinforcing the interest of parents and other relatives, and by encouraging the organisation of self-help groups. The data and thoughts presented in this article should be a challenge for debate among all parties involved in any adaptation or even transformation of pedopsychiatric services in Slovenia.
The influence of education on differences in depressive symptoms between men and women in Slovenia Background: This paper discusses depressive symptoms among men and women in Slovenia and their ...relationship to various socioeconomic factors, and education in particular. Methods: The analysis is based on the European Social Survey Round 3 (ESS-3) from 2006, for the Slovene population (n = 1,282). Depressive symptoms, as a dependent variable, are measured using an 8-item version of the Centre for Epidemiological Studies - Depression (CES-D 8) scale. Independent variables included in the research model are: gender, age, education, income, marital and employment status and the presence of a child under the age of 12 in the household. Using mean comparisons of depression symptoms and regression analyses, the paper presents gender differences in depression levels and factors that influence it. Results: Education contributes to lower depression levels in both genders; however, its influence is substantially higher among women. Depression symptoms are closely related to education. Lower educated women show a significantly higher score in depression symptoms than lower educated men. However, higher educated women show better mental health than higher educated men. Different sociodemographic factors influence the levels of depression symptoms differently between genders. The impact of housework as an employment status thus significantly influences higher levels of depression only among men. Similar indications for age, widowhood and the absence of partnership. In contrast, the influence of work disability on depression is only significant for women. Conclusion: The influence of socioeconomic and cultural factors on depression symptoms is greater for women than men. PUBLICATION ABSTRACT
The article will outline the logic, parameters, and methodology of an attempt at mainstreaming ethnicity within EMILIA, an EU 6th FP multi-sites project focused on mental health and social inclusion ...over two years. Led by two social work researchers within a large multi-disciplinary group consisting of eight sites spread across Southern, Central and Northern Europe, alongside mainstreaming gender, we will look at the findings of the baseline audit, the ensuing action plans and the changes which followed. Examining the process and its outcomes for mainstreaming across the different sites and the services they provide for people experiencing mental health problems highlights the impact of country-specific policies on disclosure of information pertaining to ethnicity as well as country and site policies and practices pertaining to recognising the existence of ethnic inequality and tackling it. Issues underlying formal mainstreaming staff and users' training will be explored. The role of social work within a multi-disciplinary group will also be looked at, and the lessons for European social work will be outlined. The lessons pertain in part to the impact of the wide ranging variation in background, scope and focus on the role social work values, knowledge and skills can play in the intersection between mental health, parameters of social inclusion and mainstreaming ethnicity.
This paper provides a discussion about the relevance of medical terminology within the social work context. The authors use the example of dual diagnoses to argue for less stigmatised attitudes ...toward people who become, in the process of help, labelled as people with dual diagnoses. It sets out that using medical terminology in the field of social work is more often a strategy to exclude people from the system of help than as a moment of providing adequate help. It is concluded that social workers do not need the knowledge about diagnoses - knowing the diagnosis is important only as information that illustrates users' specific experience and perception of reality, the available resources and obstacles that people face in their everyday life. The planning of a social work intervention should be based on an operational definition of everyday life, e.g. how people live through the day, what are the important and valued roles they play in life, what are their wishes and needs.
Medicinska sestra, ki opravlja holistično zdravstveno nego, poskuša ugotoviti vse bolnikove potrebe, vključno z duhovnimi. Samo z razvojem zavesti in vpogleda v duhovno dimenzijo bo medicinska sestra ...sposobna razumeti, raziskati in ponuditi duhovno oporo bolniku. Pri tem so bistvene njene komunikacijske sposobnosti, toplina, empatija in skrben človeški odnos.
Avtorica v prispevku razmišlja o vseživljenjskem izobraževanju ter njegovemu vplivu na kakovost človekovega življenja. S pomočjo izobraževanja lahko pri ljudeh dosežemo drugačen pogled na zdravje, ...vzpostavimo drugačen odnos do njega, predvsem pa ozavestimo dejstvo, da smo sami odgovorni za lastno zdravje in dobro počutje. Večina duševnih bolezni je posledica daljših psihičnih obremenitev in ker v psihiatriji prav tako velja načelo bolje preprečevati kakor zdraviti, je še toliko bolj razumljiva velika vloga vzgoje in izobraževanja, pri čemer bi morali dati poudarek predvsem na vzgojo čustev, vzgojo k odpornosti do porabniške družbe, k zdravi storilnostni motivaciji, na vzgojo za uravnoteženo in zdravo življenje.
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