High quality of informed consent form is essential for adequate information transfer between physicians and patients. Current status of medical procedure consent forms in clinical practice in Croatia ...specifically in terms of the readability and the content is unknown. The aim of this study was to assess the readability and the content of informed consent forms for diagnostic and therapeutic procedures used with patients in Croatia.
52 informed consent forms from six Croatian hospitals on the secondary and tertiary health-care level were tested for reading difficulty using Simple Measure of Gobbledygook (SMOG) formula adjusted for Croatian language and for qualitative analysis of the content.
The averaged SMOG grade of analyzed informed consent forms was 13.25 (SD 1.59, range 10-19). Content analysis revealed that informed consent forms included description of risks in 96% of the cases, benefits in 81%, description of procedures in 78%, alternatives in 52%, risks and benefits of alternatives in 17% and risks and benefits of not receiving treatment or undergoing procedures in 13%.
Readability of evaluated informed consent forms is not appropriate for the general population in Croatia. The content of the forms failed to include in high proportion of the cases description of alternatives, risks and benefits of alternatives, as well as risks and benefits of not receiving treatments or undergoing procedures. Data obtained from this research could help in development and improvement of informed consent forms in Croatia especially now when Croatian hospitals are undergoing the process of accreditation.
Chronic neuropathic orofacial pain along with physical suffering can cause emotional, psychological and social difficulties, which significantly affects the quality of life of patients. Pain in the ...area of glossopharyngeal nerve innervation, especially chronic neuropathic, is relatively rare, but is significant because of the great suffering it causes to sufferers. It can be life threatening, due to the cardiac arrhythmia, syncope or convulsions it can cause. Drug treatment is often of limited effectiveness and can be fraught with side effects. It is necessary to look for the etiology of the underlying disease, and if possible, to take adequate causal treatment. This review article discusses the etiology, clinical features, differential diagnosis, and treatment modalities of neuropathic pain in the area of glossopharyngeal nerve innervation.
Schwannoma as an extracranial nerve sheath tumor rarely affects brachial plexus. Due to the fact that brachial plexus schwannomas are a rare entity and due to the brachial plexus anatomic complexity, ...schwannomas in this region present a challenge for surgeons. We present a case of a 49-year-old female patient with a slow growing painless mass in the right supraclavicular region that was diagnosed as schwannoma and operated at our department. The case is described to remind that in case of supraclavicular tumors, differential diagnosis should take brachial plexus tumors, i.e. schwannomas, in consideration. Extra caution is also required on fine needle aspiration procedures or biopsies of schwannomas due to the possible iatrogenic injury of the nerve and adjacent structures. On operative treatment of schwannoma, complete tumor resection should be achieved while preserving the nerve.
The aim of our study was to describe and interpret national trends in thyroid cancer in Croatian men and women during the 1988-2010 period, to better understand the incidence and mortality trends in ...comparison with other populations, and to determine the proportion of certain histologic subtypes of thyroid cancer and their impact on these trends. Using information from the Croatian National Cancer Registry and WHO Mortality Database, we estimated trends in the age-standardized incidence and mortality rates by joinpoint regression analysis. Thyroid cancer incidence increased in both women and men during the study period, with the estimated annual percent change (EAPC) of 6.4% and 5.5%, with no joinpoints identified. A significant decrease in mortality (EAPC-2.1%) was observed in women, while in men mortality rates decreased nonsignificantly (EAPC-1.3%). A statistically significant incidence increase was observed only for papillary carcinomas with annual incidence increase by 6.7% for women and 7.9% for men. During the study period, thyroid cancer showed an incidence increase in Croatia with persistent and steady decrease in mortality in women and statistically nonsignificant decrease in mortality in men. The increase in papillary carcinomas led to the thyroid cancer incidence increase and also affected the thyroid cancer mortality decrease in women. The trends observed are similar to those in other European countries and require additional analysis to determine all factors that have an effect on them.
Abstract
Conclusion: Head and neck cancer (HNC) incidence and mortality trends in men displayed a significant downward trend in Croatia during the study period. No significant changes of incidence ...and mortality trends were observed in women. Decreasing trends observed in men are similar to other European countries. Further decreases in HNC incidence and mortality could be achieved with more restrictive alcohol and tobacco control policies and adherence to national treatment guidelines. Objective: To describe and interpret trends in incidence and mortality of HNC in Croatia in the period 1988-2008. Methods: HNCs were defined as ICD-10 codes C00-C14, C32. Incidence data were obtained from the Croatian National Cancer Registry, while numbers of deaths were obtained from the WHO Mortality Databank. Joinpoint regression analysis of age-standardized rates (ASR, standard world population) and age-specific rates for 10-year age groups was used to estimate changes in trends of HNC incidence and mortality. Results: HNC incidence and mortality in men declined steadily during the study period (estimated annual percent change (EAPC) of -1.5% and -1.8%, respectively). The most prominent decreases of -5.7% annually for incidence and -9.3% for mortality were observed in the youngest age group, 30-39 years. A non-significant increase in incidence (EAPC 0.9%) and decrease in mortality (EAPC -1.3%) were observed in women.
Aim To investigate the prevalence of burnout syndrome among physicians of all specialties, including residents and non-specialists, on a national level in Croatia. Methods This cross-sectional study, ...conducted in October 2017, used anonymous online survey based on the Maslach Burnout Inventory Human Services Survey. The Croatian version of the inventory was assessed for acceptability, factorial validity, and reliability. Key dimensions of burnout--emotional exhaustion, depersonalization, and lack of personal accomplishment were assessed. Respondents scoring high for emotional exhaustion or depersonalization were defined as burned-out. Results The response rate was 18% (2557/14 427). Respondents' median age was 41 years (range 25-80), and 68% (1737/2557) were women. Good sampling adequacy and scale reliability were confirmed. Factorial validity suggested the presence of three overall factors, and no items were eliminated. Sixty-three percent of physicians were burned-out. High score on emotional exhaustion, depersonalization, and reduced personal accomplishment were found in 58%, 29%, and 52% of respondents, respectively. As many as 16% of the respondents simultaneously experienced high levels of all three burnout dimensions. Multivariate logistic regression analysis revealed that residents and physicians in tertiary or primary care were at an increased risk of burnout, while physicians working in institutes were at a decreased risk. Conclusion Active national measures are needed to reduce the high prevalence of burnout among Croatian physicians.
Highlights • Reliable and valid questionnaire was developed. • Contributes to the development of suitable measuring instrument for informed consent. • Assessed quality of the informed consent process ...in Croatia was reasonably high. • Four factors were analyzed and Written information was rated with the lowest score. • Provides patient related determinants of the quality of the informed consent process.
As Croatia makes the transition from one political system and type of economy to another, there are inevitable social and political changes that have a profound affect on the healthcare system. This ...article charts some of the progress of change with respect to patients' rights and informed consent.
Informed Consent in Croatia VUCEMILO, LUKA; BOROVECKI, ANA
Cambridge quarterly of healthcare ethics,
07/2014, Volume:
23, Issue:
3
Journal Article
Peer reviewed
As Croatia makes the transition from one political system and type of economy to another, there are inevitable social and political changes that have a profound affect on the healthcare system. This ...article charts some of the progress of change with respect to patients’ rights and informed consent.
To explore physician-patient communication practices during the process of obtaining informed consent in a hospital setting in Croatia.
Two hundred and fifty patients (response rate 78%) from five ...tertiary level hospitals in Zagreb, Croatia, anonymously filled in the questionnaire on informed consent and communication practices by Nemcekova et al in the period from April to December 2011.
Eighty five percent of patients received complete, understandable information, presented in a considerate manner. Patients in surgical departments received a higher level of information than those in internal medicine departments. Patients were informed about health risks of the proposed treatments (in 74% of cases) and procedures (76%), health consequences of refusing a medical intervention (69%), and other methods of treatment (46%). However, patients pointed out a number of problems in physician-patient communication.
Communication practices during informed consent-obtaining process in hospitals in Zagreb are based on a model of shared decision-making, but paternalistic physician-patient relationship is still present. Our results indicate that Croatia is undergoing a transition in the physician-patient relationship and communication.
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