Rationale and Aim
At the beginning of the COVID‐19 pandemic in March 2020, the Serbian government instituted a 24‐h curfew for people aged ≥65 years for 2 months. The aim of this study was to examine ...the experiences and perceptions of curfew for older people in Serbia 15 months after the curfew had ended.
Methods
In‐depth interviews were carried out with 23 older adults from urban areas in Serbia. We identified the first three participants, while others were selected using the snowballing method. The interviews were audio‐recorded, transcribed and data were analyzed according to guidelines for qualitative studies.
Results
Six topics emerged: (1) perception of the curfew announcement; (2) attitude toward the curfew; (3) organization of daily living; (4) mood; (5) frustrations/limitations and 6) making sense of the curfew 15 months after. Older people in this study overall remember not feeling disturbed by the curfew because they perceived it as prevention, especially because this population group is considered to have the highest rate of mortality from COVID‐19. Some people remember being extremely frustrated because of the restrictions and considered them unnecessary. Most people remembered that the lack of social interactions and lack of physical activity were the most difficult to cope with.
Conclusions
Although challenging and bothersome, the majority of older people in this study accepted the curfew as an appropriate measure to avoid catching the virus and combat the COVID‐19 pandemic.
The aim of our study was to examine the position of vaccinated people regarding the proposal for mandatory and seasonal vaccination against COVID-19 in Serbia. A cross-sectional study was conducted ...in a sample of people who came to receive a third dose of COVID-19 at the Institute of Public Health of Serbia in September and October 2021. Data were collected by means of a sociodemographic questionnaire. The study sample comprised 366 vaccinated adults. Factors associated with the belief that vaccination against COVID-19 should become mandatory were being married, being informed about COVID-19 from TV programmes and medical journals, trust in health professionals, and having friends affected by COVID-19. In addition to these predictors, factors associated with the belief that COVID-19 vaccination should become seasonal were being older, consistently wearing facemasks, and not being employed. The results of this study highlight that trust in information delivery, evidence-based data, and healthcare providers may be a major driver of mandatory and seasonal vaccine uptake. A careful assessment of the epidemiological situation, the capacity of the health system, and the risk–benefit ratio is needed in order to introduce seasonal and/or mandatory vaccination against COVID-19.
In prominent international documents and professional position papers, confidentiality was recognized as a necessary condition for effective reproductive healthcare of adolescents. Although legally ...guaranteed, it is questionable if the right to confidentiality of adolescents is respected in healthcare practice in Serbia.
To assess primary care physicians' perspectives on the legal right of minors to confidentiality in sexual and reproductive healthcare, as well as their experiences in practice.
Qualitative, semi-structured face-to-face interviews with 12 primary care pediatricians and gynecologists at several municipalities of the city of Belgrade were performed. Interview transcripts were analyzed using qualitative content analysis method.
Most interviewees were aware of their legal obligations and support the general idea of granting adolescents the right to confidentiality. They recognized that the lack of confidentiality assurances prevents adolescents' access to sensitive care. However, physicians expressed concerns regarding medical situations when parents should be notified, which was reflected in their inconsistent respect of said right in actual practice. Several organizational obstacles were emphasized by interviewees, including insufficient number of physicians, time constraints, poor access to gynecological services and vague definitions of legal provisions.
If the aim is for adolescents' right to confidentiality to be consistently respected in practice, primary care physicians need to be systematically educated about legal provisions and given comprehensive clinical guidelines. The general positive attitude towards confidentiality expressed by the primary care physicians implies that a possibility exists to engage them as main advocates for improvements in access to the necessary health care.
Abstract
Background
Introduction of vaccines against COVID-19 has not encountered expected acceptance. The uptake of COVID-19 vaccines in Western Balkans countries is lagging behind the European ...Union average. The aim of our study was to assess the intention to get vaccinated against COVID-19 in the population of unvaccinated adult citizens of five Western Balkans countries, and to explore factors that influence the vaccination intention.
Methods
Cross-sectional study was conducted in the period from July to October 2021. The questionnaire was shared through online social media. Intention to get vaccinated against COVID-19 was measured by a single item assessing the likelihood of getting vaccinated on a 5-points Likert scale. Linear regressions were conducted with socio-demographic characteristics, presence of chronic diseases and attitudes towards COVID-19 vaccination as independent factors.
Results
The largest proportion of unvaccinated respondents willing to get vaccinated in the future was observed in Montenegro and Albania (40.4% in each country), while in the Serbian sample, the willingness to get vaccinated was the lowest (22.6%). Socio-demographic characteristics were not significantly associated with the intention to get vaccinated against COVID-19 in most of the countries. In Albania, Bosnia and Herzegovina, North Macedonia and Serbia the strongest determinant of COVID-19 vaccination intention was the higher sense of social responsibility.
Conclusions
Vaccination interventions and campaigns aiming to improve the COVID-19 vaccine uptake should be focussed on specific set of factors in each country, appealing to social responsibility as most prevalent determinant of vaccination intention in Western Balkans.
Few countries provided multiple COVID-19 vaccines for their citizens right from the start of mass immunization. In Serbia, four vaccines were available. Circumstances in which people had several ...options to choose from are unique. The purpose of this study was to identify motivators behind COVID-19 vaccination and the choice of COVID-19 vaccine among people who were immunized against COVID-19. Qualitative interviews with 35 vaccinated people aged > 18 years were conducted in May 2021 at the Institute of Public Health of Serbia, a reference institution for vaccination. Interviews were audio-recorded, transcribed and data were analyzed using qualitative content analysis. Four topics emerged: 1) Decision to receive COVID-19 vaccine; 2) Sources of information about the vaccine; 3) Choice of the COVID-19 vaccine and 4) Anti-vaccination sentiment around the vaccinated people. Participants were classified in two groups: those who were determined to receive the vaccine and those who were hesitant. People who were hesitant decided to receive the vaccine after reviewing the information collected from various sources, especially physicians. Although some participants accepted any vaccine regardless of their characteristics, there were others who had explicit preferences. These preferences stemmed mainly from their beliefs about particular vaccine's efficacy and safety, COVID-19 status (previous infection), living or lifestyle circumstances (residence or travel abroad), doctor's recommendation (underlying health status) or trust in expertise of that particular manufacturer's country of origin. Opting for appropriate vaccine was motivated by reasons specific to various individuals, which enabled them to make choices in line with their preferences and values.
Allowing competent children to exercise their right to consent relies largely on healthcare practitioners’ own understanding and attitudes regarding the maturity and decision-making capacity of minor ...patients, particularly in circumstances when professional guidelines for practice do not exist. The aim of this study was to explore Serbian primary care physicians’ a) views and experiences regarding decision-making capacity of adolescents, b) experiences with adolescents’ parents regarding their children’s right to give autonomous consent and c) views on their own role in adolescents’ healthcare. Qualitative semi-structured interviews were conducted in person with twelve pediatricians and gynecologists at eight primary health care institutions at Belgrade (Serbia) from March to May 2016. Qualitative content analysis was used to identify categories in the data. Participants agreed that decision-making capacity is reached at an individual pace, making it difficult to set age boundaries for consent. However, they noted that adolescents’ decision-making capacity can be enhanced by providing appropriate support, by both physicians and parents. Participants described witnessing overprotective behavior in parents, yet highlighted that physicians are well placed to help parents understand the importance of letting their adolescent children participate in decision-making. Since participation in decision-making is considered to be in the best interest of minors, primary care physicians can be important agents in strengthening adolescents’ positions as decision-makers in healthcare. In addition, healthcare workers would benefit from additional training in skills to enhance communication with both adolescents and parents.
Highlights
Adolescents need to be encouraged and assisted in the development of their decisional capacity and autonomy.
Parents need to be educated on the importance of adolescents’ right to participation in health care decision-making.
Cultural values and inter-familial relations need to be taken into account when deciding on the level of children’s autonomy.
Primary care physicians would benefit from additional training in adolescent medicine and skills for communication with both adolescents and parents.
Objectives
Confidential counseling is a critical condition of the healthcare quality in adolescent medicine. This study aimed at assessing knowledge, attitudes and practice of primary healthcare ...pediatricians and gynecologists regarding adolescents’ rights to confidentiality.
Methods
A cross-sectional study was conducted in a sample of 152 pediatricians and gynecologists who are employed at 13 primary healthcare centers in Belgrade, Serbia, in 2017–2018. Data were collected by a self-administered questionnaire purposefully constructed for this study. The questionnaire examined knowledge and attitudes toward adolescents’ right to confidentiality as well as whether participating physicians practice confidential health care with adolescents.
Results
Physicians scored 4 out of 7 on a knowledge scale, but they overall supported adolescents’ right to confidential health care (average attitude score was 71 out of 95). On average, physicians scored 21 out of 30 on practice of confidentiality scale. Multivariate analysis showed that better knowledge and stronger positive attitudes toward duty of confidentiality were associated with consistent practice of confidential health care.
Conclusions
Knowledge about adolescents’ rights to confidentiality and attitudes toward keeping adolescents’ information confidential influence the practice of providing confidential services.
The lower rates of COVID-19 vaccination in Western Balkans countries could be partially explained by societal distrust of its citizens, jeopardizing the sustainability of COVID-19 vaccination ...programs. The aim of the study was to determine the level and predictors of societal trust in five countries of the region. Using an online questionnaire, data were obtained from 1157 respondents from Albania, Bosnia and Herzegovina, Montenegro, North Macedonia, and Serbia. The instrument included a socio-demographic questionnaire, a measure of vaccination behavior, and a scale measuring societal trust. Being a significant determinant of the COVID-19 vaccination behavior in all countries, societal trust considerably varied from country to country (F (24, 4002) = 7.574, p < 0.001). It was highest in North Macedonia (Mean = 3.74, SD = 0.99), and lowest in Albania (Mean = 3.21, SD = 1.03). Younger, female, less religious, and higher educated tended to have more pronounced societal trust in Serbia. In North Macedonia, younger age and lower health literacy predicted societal trust, while in Bosnia and Herzegovina, educational level was the single predictor. In Montenegro and Albania, higher societal trust was significantly predicted by lower health literacy only. The results provide evidence that the determinants of societal trust in Western Balkans vary across countries, indicating the need for different approaches in communication campaigns.
With growing opportunities for medical doctors to work either in academia and industry, research ethics education for health sciences research, meaning research which includes humans and animals ...and/or their tissues and cells with the goal to understand underlying mechanisms of disease occurrence and disease treatment, is of paramount importance, especially in regions, such as Serbia, where comprehensive research ethics curricula for physician researchers are lacking. This article addresses the spectrum of research ethics topics that were identified through analysis of the existing research ethics curricula in medical schools, international organizations, Serbian legislative codes and the PubMed database applying the key search terms:
ethics
,
research
,
biomedical
,
education
,
curriculum
,
program
,
course
and their combinations. Selected topics were classified in eight syllabi based on their similarity: #1 Responsible conduct of research, #2 Justice in human subjects research, #3 Research on human subjects, #4 Vulnerable population groups, #5 Conflict of interest, #6 Research on animals, #7 Research on genes, cells and embryos, and #8 Organization of research ethics. Justifications for each syllabus are discussed based on empirical evidence and local context. Higher education authorities could use this framework to strengthen, adjust or refine research ethics education for physician researchers in Serbia.
Financial reimbursements after receiving the coronavirus disease 2019 (COVID-19) vaccine have been criticized in the literature. This strategy has been described as payment to receive the vaccines, ...undue inducement, and unethical. We are aware that healthcare workers who work in primary healthcare, prevention, and public health may encounter similar reasons from people who refuse vaccination against COVID-19. For this reason, we are compelled to clarify these claims and provide arguments for all healthcare workers who might be challenged by such reasoning. In this critical review, we discuss why the claims against financial incentives that have been presented in the literature are erroneous.
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