In the Federation of Bosnia and Herzegovina, the prevalence and incidence of breast cancer has been increasing, and the national programme of early prevention, administered locally, is sporadic and ...without quality assurance. While many factors may influence women's decision to adopt prevention-oriented behaviours regarding breast cancer, this study has emphasised the importance of sociodemographic factors, psychological factors and mental wellbeing.
Participants in the study were all patients who, during one year, were admitted for the first time for diagnosis and treatment in the biggest Clinical hospitals of the Herzegovina-Neretva region Patients were divided into two groups based on their TNM classification: "early stage" and "late stage". Three instruments were used in this study: an individual questionnaire about demographic and socioeconomic characteristics of the woman, the Multidimensional Health Locus of Control scales, and the Hamilton Depression Rating Scale.
The majority of patients diagnosed with advanced disease were admitted to hospital in the late/advanced stages of the disease. Multi-variant analysis showed that the most statistically significant positive predictor for early admittance in hospital is living with family and marital status while religiosity has a negative predictive value. The results indicate that 59.7% of respondents do not have depression, while the remainder do have some degree of depression. There was no statistically significant difference in the degree of depression between women who were diagnosed and treated early and those who were not. The employment status of the respondents was the only significant factor related to degree of depression.
Although health locus of control and depression are not statistically significant predictors of early hospital treatment, the recommendation is that further studies focus on the implementation of MHLC and HDRS scales within the community. This could be useful in planning appropriate and specific interventions, not only because of early diagnosis, but also to ensure good mental health and resilient behaviour.
Working as a nurse involves great dedication and sacrifice: working night shifts, working overtime, and coming to work sick. The last is also known as presenteeism. Research has shown that poor nurse ...performance can affect both caregiver’s and patient’s safety. The aim of this cross-sectional study was to investigate whether nurse presenteeism affected patient safety culture and to look deeper into the characteristics of nurse presenteeism and patient safety culture in Croatia. The study was conducted in one general hospital in Croatia over April and May 2012 and specifically targeted medical nurses as one of the largest groups of healthcare professionals. They were asked to fill two questionnaires: the six-item Stanford Presenteeism Scale (SPS-6) and the Hospital Survey on Patient Safety Culture (HSOPSC). We found no association between presenteeism and patient safety culture. Overall positive perception of safety was our sample’s strength, but other dimensions were positively rated by less than 65 % of participants. The lowest positive response concerned “nonpunitive response to error”, which is consistent with previous studies. Presenteeist nurses did not differ in their characteristics from nurses without presenteeism (gender, age, years of experience, working hours, contact with patients and patient safety grades). Our future research will have to include a broader healthcare population for us to be able to identify weak spots and suggest improvements toward high-quality and cost-effective health care.
Zanimanje medicinske sestre uključuje veliku predanost i požrtvovnost: medicinske sestre rade noćne smjene, rade prekovremeno i dolaze na posao i kada su bolesne. Naziv za ovu zadnju pojavu je prezentizam. Neka su istraživanja pokazala da smanjena radna sposobnost medicinskih sestara zbog bolesti može ugroziti sigurnost pružatelja zdravstvene usluge i bolesnika. Cilj ovog presječnog istraživanja bio je ispitati obilježja prezentizma i kulture bolesničke sigurnosti u medicinskih sestara u Hrvatskoj te utječe li njihov prezentizam na kulturu bolesničke sigurnosti. Istraživanje je provedeno u jednoj općoj bolnici u Hrvatskoj tijekom travnja i svibnja 2012., i bilo je posebno ciljano prema medicinskim sestrama s obzirom na to da čine jednu od najvećih skupina zdravstvenih djelatnika. Ispitanici su zamoljeni da ispune dva upitnika: Stanfordsku ljestvicu prezentizma (SPS-6) i Upitnik o kulturi bolesničke sigurnosti u bolnici (HSOPSC). Nije nađena povezanost između prezentizma i kulture bolesničke sigurnosti. Najveći broj pozitivnih odgovora imala je dimenzija “Opća percepcija bolesničke sigurnosti”; ostale dimenzije imale su pozitivne odgovore ispod 65 %. Najmanji broj pozitivnih ocjena imala je dimenzija “Nekažnjavajući pristup neželjenom događaju”, što je u skladu s prethodnim istraživanjima. U pogledu spola, dobi, godina iskustva, radnih sati, kontakata s bolesnicima i njihove sigurnosti, medicinske sestre s prezentizmom nisu se nimalo razlikovale od medicinskih sestara bez prezentizma.
War in Bosnia and Herzegovina lasted from 1991 to 1995 and resulted in profound consequences marked by the large number of victims, increase in the diseases and disorders prevalence, that were not ...common before it occurred. The effects it had on health status of the entire population was reflected through many negative demographic trends, increasing prevalence of chronic diseases and the spread of a number of unhealthy behavioral patterns and a lot of migrations. All this presents a problem for institutions of health system which are attempting to control these negative influences especially during the transition period, marked by the direct adverse consequences of the 1991-1995 war. The present paper presents a summation of various sources which are attempting to provide a synthetic overview and provide basic information in relation to the health status of the population, and also to provide a baseline evaluation for deployment of public health interventions.
Generalised obesity is increasing in prevalence globally, however trends in abdominal obesity are less well known. In 2003, 1,999 women of childbearing age participated in the Croatian Adult Health ...Survey, of whom 598 (29.9%) participated in the second cycle in 2008. For 2008, the prevalence of abdominal obesity using the International Diabetes Federation (IDF) criterion (waist circumference > or = 80 cm) was estimated at 70.3% (95% CI 61.8% to 75.7%), whereas the prevalence of abdominal obesity using the National Cholesterol Education Program, Adult Treatment Panel III (NCEP ATP III) criterion (waist circumference > or = 88 cm) was estimated at 48.6% (42.6% to 54.7%). The preceding five-year cumulative incidence was 54.3% (44.5% to 64.2%) and 35.2% (28.0% to 42.4%) using the IDF and NCEP ATP III criteria, respectively. The burden of abdominal obesity is high and rapidly increasing in Croatian women of childbearing age, the key population subgroup for obesity control.
To analyse the early stage breast cancer tumour size distribution as an important prognostic factor among the female patients within our local geographic region of Herzegovina.
This cross-sectional ...retrospective study included 379 patients who were treated in 2017 at the Oncology Clinic, University Clinical Hospital Mostar. The patients were divided into two groups based on their primary tumour size: early (≤2 cm) and late (>2 cm) stage groups.
The number of patients tested for advanced stage tumours surpassing 2 cm was statistically higher (χ
=106,325; p<0.001). 39.32% (N=149) of the patients presented with tumours ≤2 cm (T1) and 52.24% (N=198) of the total number of the patients presented with tumours >2 cm but ≤5 cm in greatest dimension (T2). The patients' knowledge about breast cancer, availability and adherence of mammography did not show any statistically significant difference with regard to tumour size, while the number of patients with smaller tumours who indicated that they underwent regular mammography was statistically significantly higher (χ
=13,629; p<0.003).
Our data shows that in our region, more women with a diagnosis of breast cancer presented with a larger tumor size. Although there was no statistically significant difference with regard to prior knowledge about breast cancer and availability to mammography, this may be due to a small sample size. Our region does not have a screening mammogram program and this data suggests that the implementation of such a program may improve adherence to existing mammography guidelines which might capture tumors at a smaller size and hence an earlier stage.
Aim: Throughout 2004-2010, the series of 6 books entitled “Handbooks for Teachers, Researchers and Health Professionals” were published within the frame of the public health network established in ...South Eastern Europe (SEE), covering the total of 249 teaching modules. The aim of the study was to assess the use and exchange of these modules between the authors. Methods: Out of 148 identified authors, 106 took part in the cross-sectional study carried out from July to November 2011 (response rate: 71.6%). The primary endpoints were the utilization (use and/or exchange) of the modules in general, the percentage of utilized modules from all volumes, the percentages of utilized modules of each volume separately, and the percentage of utilized modules from all the volumes at different levels of the educational process. Non-parametric statistical methods were used for analysis (e.g. Mann-Whitney and Friedman tests). Results: Module utilization was reported by 80/106 participants (75.5%). The median value of the percentage of utilized modules from all the volumes was 4.8, being much higher among full-time university staff (9.2; p=0.008) and authors/editors (14.7; p=0.010). The respondents most frequently utilized Volume 1 (median value: 7.7) and Volume 6 (median value: 4.2) modules (p=0.002) as part of undergraduate (median value: 1.4) and postgraduate vocational (median value: 1.4) study programmes (p<0.001). Conclusion: The level of module utilization within the group of their authors is good. However, this is only partial information and not representative of the entire target population of SEE public health teachers.
Namen: V okviru javnozdravstvene mreže za jugovzhodno Evropo (JVE) je bila v obdobju 2004-2010 objavljena serija šestih knjig z naslovom Priročniki za učitelje, raziskovalce in zdravstvene delavce. Skupno je bilo objavljenih 249 učnih modulov. Namen študije je bil oceniti uporabo in izmenjavo modulov med avtorji. Metode: V presečni raziskavi, ki je bila izvedena v obdobju julij-november 2011, je sodelovalo 106 od 148 vabljenih avtorjev (71,6-odstotna odzivnost). Glavni opazovani pojavi so bili: uporaba/izmenjava modulov na splošno, odstotek uporabljanih/izmenjanih modulov iz vseh knjig, odstotek uporabljanih/izmenjanih modulov za vsako knjigo posebej in odstotek uporabljanih/izmenjanih modulov iz vseh knjig na različnih stopnjah izobraževalnega procesa. Za analizo smo uporabili neparametrične statistične metode (Mann Whitney in Friedmanov test). Rezultati: 80/106 udeležencev (75,5 %) je poročalo, da uporabljajo/izmenjujejo module. Med njimi je bila mediana odstotka uporabljanih/izmenjanih modulov iz vseh knjig 4,8. Le-ta je bila precej višja med polno zaposlenim univerzitetnim osebjem (9,2: p = 0,008) in avtorji/uredniki (14,7; p = 0,010). Ti anketiranci najpogosteje uporabljajo/izmenjujejo module prve (mediana: 7,7) in šeste knjige (mediana: 4,2) (p = 0,002). Najpogosteje jih uporabljajo na dodiplomskih (mediana: 1,4) in podiplomskih strokovnih študijskih programih (mediana: 1,4) (p < 0,001). Zaključki: Uporaba modulov v skupini njihovih avtorjev je dobra, vendar pa je to le delna informacija o uporabi modulov v ciljni populaciji učiteljev javnega zdravja v JVE.
Objective of this paper is to estimate interim risk factors (INTF) proportions and changes within 5-years of groups with at least one risk health behavior (BEHF) in CroHort population. Results show ...that CroHort 2008 group has higher proportions of excess abdominal fat and overweight. Men older than 65 without any BEHF have smaller proportions of INTF in 2008 than in 2003. Proportion of people with high blood pressure is smaller in 2008 for all groups except for young women who show increase. Analysis of middle age group shows significant increase in all INTF in women smokers while men smokers have the highest increase in abdominal fat. Physical inactivity in women is associated with increase of all INTF, while men have decrease in overweight INTF. Alcohol intake has protective effect on middle aged men, except for increase in waist circumference. Women show constant increase in all INTF with heavy alcohol intake.
Psychological distress (PD) is being increasingly recognized as a risk factor for cardiovascular diseases (CVD). Our aim was to recognize an association of PD and CVD in the Croatian adult ...population. We also explored association's strength obtainable as relative risk of PD on three levels; cardiovascular risk behaviors, conditions and diseases. This study used Croatian Adult Health Survey 2003 (CAHS 2003) data (N = 9,070). PD status was measured by the five-item Mental Health Scale of the Short Form questionnaire (SF-36) hence one distinguished subgroup consisted of population with PD and other without PD. Prevalence of cardiovascular risk behaviors, cardiovascular risk conditions and self-reported cardiovascular diseases within each subgroup were calculated using bootstrap method. Women had higher prevalence of PD in general population. Among distressed population women had higher prevalence of body mass index over 30, metabolic syndrome and angina pectoris. Men with PD had higher prevalence of high blood pressure and myocardial infarction with contradictory lower prevalence of angina pectoris then myocardial infarction. Physical inactivity was proven to be a risk behavior determinant with most impact on mental health. All CVD are consistently associated with higher prevalence and relative risks for PD both in men and women.
The purpose of this study was to develop and examine the psychometric properties of the Croatian version of the Duke Religion Index (DUREL-hr) and to examine religiousness trends among different ...years medical students. Our results demonstrated high internal consistency (coefficient alpha ranging from 0.883 for the total scale to 0.9398 for the intrinsic subscale) of DUREL-hr as well as students' religiousness results comparable to other studies on the religiousness of the youth in Croatia. DUREL-hr is a reliable and valid instrument suitable to use in Croatian language. Authors encourage studies on the relationship of religiousness and health in Croatia.
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