The experience of labor pain is a complex process that represents the interaction of the nociceptive stimulus within the physiologic process with a series of psychological factors. The aim of this ...study was to investigate the relation between the choice of epidural analgesia as a form of pain management and psychological state of woman in labor; moreover, whether the women in labor with a higher level of anxiety have a more intensive experience of pain during labor and therefore decide on epidural analgesia. Pain was evaluated by the visual analog scale, while the sensory and affective pain components were evaluated by the McGill Pain Questionnaire, and anxiety as a trait was measured with the State-Trait Anxiety Inventory-form X. Women in labor with a higher level of anxiety had a significantly increased affective component of pain, but did not significantly more frequently decide on labor with epidural analgesia. The women having chosen epidural analgesia experienced more intense pain during delivery before epidural analgesia, with the sensory component of pain being less pronounced in the women in labor without epidural analgesia, while there was no difference in the affective component of pain. Key words: Epidural analgesia; Delivery; Pain; Anxiety Dozivljaj boli u porodaju je slozen proces koji predstavlja interakciju nociceptivnog stimulansa u okviru fizioloskog procesa s nizom psiholoskih cimbenika. U ovom istrazivanju se ispitivala povezanost izmedu izbora epiduralne analgezije kao oblika obezboljivanja porodaja i psihickog stanja rodilje, odnosno imaju li rodilje veceg stupnja anksioznosti intenzivniji dozivljaj boli tijekom porodaja te se shodno tome odlucuju na porodaj s epiduralnom analgezijom. Bolje procjenjivana vizualnom analognom ljestvicom (VAS), a pojedine komponente boli, senzorna i afektivna komponenta boli, mjerene su upitnikom McGill Pain Quesstionnaire, dok je anksioznost kao osobina mjerena instrumentom State-Trait Anxiety Inventory-form X. Rodilje visega stupnja anksioznosti su u znacajnijoj mjeri imale izrazeniju anksioznu komponentu boli, ali se nisu u vecoj mjeri odlucivale na porodaj s epiduralnom analgezijom. Rodilje koje su izabrale porodaj s epiduralnom analgezijom su intenzivnije dozivljavale bol tijekom porodaja prije epiduralne analgezije i kod njih je senzorna komponenta boli u manjoj mjeri prisutna u odnosu na rodilje koje su radale bez epiduralne analgezije, dok kod afektivne komponente boli nije bilo razlike. Kljucne rijeci: Epiduralna analgezija; Porodaj; Bol; Anksioznost
To explore differences in self-perceived health as an indicator of health status and mortality, in six isolated populations from Croatian islands and to compare the results with control from general ...Croatian population obtained through the National Health Survey.
Health-related quality of life was measured using the Short Form Health Status Questionnaire (SF-36). The questionnaire was administered to 600 participants, inhabitants of 6 villages: Rab, Barbat, Lopar, and Supetarska Draga on island Rab, and Komiza and Vis, on island Vis, and to control group of 600 participants from the general Croatian population matched by age and gender to islanders.
The islanders scored higher than controls on 3 out of 8 health dimensions, physical functioning (80.1+/-22.4 vs 73.2+/-24.8, P<0.001), vitality (61.0+/-20.3 vs 55.7+/-19.9, P<0.001), and pain (70.1+/-28.0 vs 65.9+/-26.5, P=0.008). Social functioning of islanders was significantly lower than in control group (73.4+/-18.6 vs 77.6+/-23.4, P=0.001). There was also a significant variation in health status among the islanders according to the isolation level, with the largest differences in general health perception and mental health. High isolation group reported the lowest score of all groups on mental health (P=0.018), physical functioning (P=0.045), general health (P=0.001), and vitality dimension (P=0.027).
Inhabitants of Croatian islands in general showed better health-related functioning on the most of the health dimensions than general population. Islanders scored lower than controls only on social functioning which can be explained by their geographical isolation and small population. Low mental health score of islanders in the highly isolated group should be taken in account in planning health services for islands.
The aim of this study was to compare the self-perceived quality of life between inactive people and people who cycle regularly and thus explore the relation between this type of physical activity and ...personal wellbeing. The study included 108 persons who used a bicycle three or more times a week for longer than half an hour per day, as a means of transport or recreation, and 100 persons, as a control group, who were physically active less than three times a week or took up no activity at all. The cyclists showed a higher quality of life than the controls in the overall personal wellbeing index (PWI) as well as in the domain of “health”. Another statistically important difference was observed between the groups in changes in health, where 16.7% of cyclists claimed to be of much better health than a year ago, as did only 2% of inactive respondents. A difference was also observed in the segment of health deterioration relative to a year ago where 30% of inactive participants reported their health worsened as compared to a year ago, as did only 8% of cyclists. While 4% of inactive respondents felt their health deteriorated drastically, no cyclist thought likewise. Our results suggest that cycling may be a mode of physical activity that is positively related to life satisfaction.
To assess self-perceived health of parents of children with autism spectrum disorders (ASD) in comparison with those of parents of non-disabled children.
A total of 350 parents participated in the ...study: 178 parents of children with ASD (71% response rate) and 172 parents of non-disabled children matched by age, education, and place of living. Parents' self-perceived health was assessed using the Croatian version of the health status questionnaire SF-36, while socio-demographic information, chronic medical conditions, and needs were assessed by a general questionnaire.
For all dimensions of health, except physical health, parents of children with ASD had significantly poorer self-perceived health and reported significantly more deteriorated health in the last year than the control group (P<0.001). They also reported more psychological disorders (11% vs 4.3%), which was the largest difference in specified chronic medical conditions. Hundred twenty six (71%) parents of children with ASD thought that enhancing different policy measures (economic, social, educational) could advance their and their children's health and well-being.
Parents of children with ASD had poorer health than the control group in all components, except physical health. Because parents are the main providers of support for children with ASD, preserving parents' good health and well-being is a precondition for an optimal care for children. Therefore, current system for treating children with ASD in Croatia should also include permanent improvement of parents' health and well-being.
To provide population norms and evaluate metric characteristics of the Croatian version of SF-36 Health Survey, an internationally used instrument for assessing subjective health.
The questionnaire ...was administered to a representative sample of Croatian adult population (n=9070). Three standard techniques were used in data analysis: reliability tests, descriptive statistics, and factor analysis. The population norms were presented in two standard forms--the SF-36 Health Profile and percentile values for different age groups of men and women.
The Croatian version of the SF-36 had generally acceptable metric characteristics including its construct validity. The internal consistency of the SF-36 scales ranged from 0.78 to 0.94. Pearson bivariate correlations showed moderate associations between SF-36 scales, and factor analysis provided one latent dimension underlying all SF-36 scales which explained 63.3% of the score variance. Less favorable results were obtained concerning its discriminative validity. All SF-36 scales showed negative asymmetry of score distributions, and some had high floor and ceiling effects--skewness estimations ranged from -0.12 to -0.91, with the highest floor effect of 30% and ceiling effect of 63%.
Presented population norms for the Croatian version of SF-36 Health Survey showed that SF-36 may be used as a valid and reliable instrument in research in subjective health of Croatian population.
The objective of this study was to examine prevalence of cardiovascular (CV) risk factors and presence of cardiovascular diseases (CVD) in people with low subjective quality of life (SQoL) in ...comparison with group of people with normal SQoL. A total of 9070 participants, 2890 men and 6180 women completed a questionnaire. SQoL was assessed with single item question on satisfaction with life as a whole, and data on risk behaviors and diagnosed CVD were obtained through self-reports. Biomedical measures were administrated by public health nurse at participant's home. Results have shown that people with low SQoL have significantly more CV risk factors, and have higher prevalence of obesity and physical inactivity, all irrespective to age group. The most pronounced difference in prevalence of CV risks was found in an age group 35 to 64 years of age where people with low SQoL have significantly higher prevalence of all measured risk behaviors, and physical conditions. Participants with low SQoL perceive their general health poorer, and experience negative and depressive feelings more frequently than those with normal SQoL, in all three age groups (p < 0.001). Implications of the results have been discussed. Low SQoL was recognized as a psychological state that represents potential risk factor for the CV health. Prospective studies are needed to allow causal inferences to be drawn.
The aim of this study was to analyze gender and age differences in physical inactivity in Croatia and physical inactivity pattern changes during the five-year period. The study is based on the data ...obtained from the Croatian Adult Health Cohort Study which was carried out in 2003 and 2008. The prevalence of physical inactivity in 2008 was 37.7%, 36.8% in men and 38.1% in women. In both study waves the prevalence was increasing with age in both men and women. The prevalence is statistically significantly higher in subjects older than 64 years than in younger age groups. The incidence of physical inactivity in the five-year period in total was 29.9%, 27.2% in men and 31.1% in women. The increase in prevalence of physical inactivity despite the number of preventive activities carried out periodically emphasizes the need for systematic and comprehensive approach in increasing the number of regularly physically active individuals.
The aim of this paper was to investigate the socio-demographic characteristics of heavy smokers in comparison to group the characteristics of light smokers and non-smokers. Data used for this study ...was collected within the Croatian Adult Health Survey (CAHS). The results show a significant gender differences in the prevalence of heavy smoking, with higher prevalence among men in all age groups. Highest prevalence of heavy smoking was found in people 35 to 64 years of age, irrespective to gender. According to analyzed socio-demographic characteristics men with low education and income who changed place of living have higher prevalence of heavy smoking. Pattern was different in women smokers. Majority of women smokers were light smokers. In women with better than average household economic status there were more smokers than non-smokers, with notable high proportion of heavy smokers in age 18 to 34 years and light smokers in age group 35 to 64. While planning future interventions at the population level, we must consider all of these characteristics and links between them, and engage all segments of society.
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