Introduction: Health literacy enables adolescents to access, understand, and evaluate health information, act on it in a relevant and competent way, make decisions, and take measures that promote health in different contexts of everyday life. The study aimed to assess adolescents' health and e-health literacy levels, evaluate the differences in adolescents' health literacy to sociodemographic characteristics and health determinants, and determine their relationship. Material and methods: The study was designed as an observational, analytical, comparative, and cross-sectional survey of secondary vocational schools and gymnasium pupils. The sample consisted of a total of N = 456 adolescents. The following research instruments were used: The Health Literacy Measure for Adolescents (HELMA), the e-Health Literacy Assessment Scale (e-HEALS) and a general questionnaire for obtaining sociodemographic data and data on health determinants created for this research. Results: The desired health literacy level was reached by 61.6% of adolescents, and 38.4% were at limited health literacy. A high level of e-health literacy was established in the majority of adolescents. Adolescents showed the highest level of health literacy in understanding health information and communicating about it, and the lowest level was in the domain of calculations. The difference in the level of health literacy was determined by age, school performance and mother's education, as well as by health determinants. The health literacy level and e-health literacy among adolescents are strongly positively correlated. Conclusion: Considering that more than one-third of adolescents have limited health literacy and the impact of health literacy on disease prevention, self-care and quality of life, it is necessary to work on raising the level of health literacy among adolescents through educational interventions.
Cyclosporine or cyclosporine A is an immunosuppressive medicine used after solid organ transplantation -heart, lungs, liver, pancreas, kidney and bone marrow - to prevent organ transplant rejection and to ensure proper functioning of the transplanted organ or bone marrow. It is used in the treatment of a wide range of autoimmune diseases in various branches of medicine -hematology, ophthalmology, dermatology, nephrology, rheumatology and gastroenterology. The discovery of cyclosporine and decades of its use have led to a revolution in transplant medicine. It can be administered intravenously, orally -capsules and oral solutions, intraocularly and by inhalation. Given the successful administration of cyclosporine is the most important factor in effectual therapeutic effect, the nurse must successfully perform all the stages of the administration of oral forms of this drug, which are: medicine storage, preparation for medicine administration, medicine administration, waste disposal and providing education of the patient and family members. During the performance of all these stages, ac-cording to the health care protocol, the nurse must demonstrate dexterity, skill, confidence and a professional attitude towards the patient, while respecting all ethical principles. A successful administration of cyclosporine requires a team approach involving the doctor, nurse, patient and family members, continual professional training, keeping pace with innovations in this field and constant work on improving communication skills.
Introduction: End-stage renal disease is a terminal illness with a glomerular filtration rate of less than 15 mL/min. when must start one of the methods of renal replacement therapy: hemodialysis, peritoneal dialysis or kidney transplantation. Peritoneal dialysis is based on the processes of diffusion and osmosis, while the transport of substances takes place through the peritoneal membrane. The advantages of peritoneal dialysis compared to hemodialysis include longer-term preservation of residual renal function, preservation of blood vessels and a better quality of life for the patient. Complications of peritoneal dialysis can be infectious, metabolic and mechanical. Encapsulating peritoneal sclerosis (EPS) is a life-threatening complication of peritoneal dialysis (PD) treatment. The incidence of EPS is variable between 0.7 and 3.7%, while it increases with the length of PD treatment (0.7-6.4% after 5 years to as much as 17.2% after 15 years). The diagnosis of EPS is based on clinical symptoms. and signs as well as specific, but not pathognomonic, radiological and pathohistological findings. Features of IPS on computed tomography (CT) images are thickening and calcification of the peritoneal membrane, thickening of the intestinal wall, narrowing and dilatation of the in-testine, as well as "trapped" fluid collections. Case report: A 60-year-old patient, who has been treated with peritoneal dialysis for 4 years, was hospitalized due to severe gastrointestinal complaints. Due to clinical findings a peritoneal equilibration test was performed, which determined that it was a moderately fast transporter. Based on the findings of the computed tomography, the diagnosis was confirmed. Treatment is started tamoxifen and prednisone was started, the response to therapy was positive. Despite the control of sclerosing peritonitis, death occurred because of cardiac decompensation. Conclusion: Early diagnosis is necessary to start specific treatment in a timely manner and, if possible, preserve peritoneal dialysis as a treatment method and patient survival.
Introduction: Physical restraint is a frequently debated procedure due to controversial ethical and legal issues related to patient autonomy and dignity. This study aimed to assess the level of knowledge, attitudes and practice of nurses regarding the use of physical restraint measures on patients and to determine whether there is a difference between the level of knowledge, attitudes and practice of nurses regarding the use of physical restraint measures to their sociodemographic and professional characteristics. Material and methods: This study was conducted as a cross-sectional study at three healthcare institutions of different medical care levels (n = 253). Instruments used in this research included a questionnaire to assess knowledge, attitude, intention, and practice and a sociodemographic questionnaire. Descriptive and inferential statistics were used for statistical analysis of the data, and statistical significance was determined at p < 0.05. Results: Nurses have a moderate level of knowledge, a positive attitude, and good practice in applying measures of physical restraint of patients. A significant difference in the level of knowledge regarding the application of measures of physical restraint of patients was determined by the age of the nurses, as well as that nurses with a positive attitude towards the application of measures of physical restraint of patients have a better practice. Conclusion: By implementing an appropriate educational pro-gram, which is certainly mandatory for all employees in the health sector, and creating a guide for the proper use of measures for physical restraint of patients, it is possible to influence the improvement of the quality of care and treatment of patients.
Malignant diseases represent a significant public health problem worldwide. Annually, over two million new cases are registered worldwide and over 4000 new cases in Serbia. The modern way of life characterized by sedentary behavior and improper diet have significant impact on the risk of disease, recurrence and survival. The role of nutrition is important in the prevention of malignant diseases. Fruits and vegetables (dietary fiber, vitamin C and E), omega-3 fatty acids have a protective effect by reducing oxidative stress and chronic inflammation. On the other hand, a high intake of sugar, saturated fatty acids, red and processed meat and alcohol are potential risk factors, increasing the level of circulating endogenous estrogen, insulin-like growth factor and cytokines. In the prevention of malignant diseases, the Mediterranean diet stands out, which shows the most significant effects in reducing the frequency and improving the survival of patients with malignant diseases.
Quality of life is a construct that often engages the research community. Examining this construct is of particular importance for individuals with disabilities, chronic illnesses, as well as those with various impairments and disorders. Investigating the quality of life in the population of children and adolescents with spina bifida is particularly significant due to the wide range of challenges these individuals face. This study aims to review relevant literature to identify key factors influencing the quality of life of children and adolescents with spina bifida, with the goal of gaining a deeper understanding of their overall experiences and quality of life. Data from the literature were collected using the PubMed and Google Scholar databases. Literature search, analysis, and comparison of results within the research were conducted based on keywords: spina bifida, myelomeningocele, quality of life, health-related quality of life, children, and adolescents. Based on the review of research results, it can be concluded that the quality of life of children and adolescents with spina bifida is significantly compromised across various dimensions of this construct, and the combined presence of different factors significantly influences the quality of life of this population.
Introduction: Inadequate nutrition, excessive use of alcohol and tobacco can significantly increase the risk of chronic mass non-communicable diseases, which are responsible for more than two-thirds of deaths in the adult population globally. The aim of this paper is to analyze the risk factors for chronic non-communicable diseases among employees in higher education. Material and methods: The research was conducted in the form of a cross-sectional study during May 2022. The surveyed population consists of 31 employees of the College of Vocational Studies in Subotica. The research instrument consists of a survey questionnaire created for research purposes. The data analysis was performed using the statistical package SPSS 20. The methods of descriptive statistical analysis, cross-tabulation analysis were applied, and the parametric ch2 test was used to confirm the correlation. Results: A third of the employees have been diagnosed with a chronic disease, most often hypertension and hypercholesterolemia. More than half (58%) of employees eat breakfast, 87% eat lunch and 52% eat dinner regularly. About 60% of employees consume fruits and vegetables at least 5-6 days a week, significantly more often employees over 45. Almost half (42%) of employees consume sweets at least 5-7 days a week, or more often. A quarter (24%) of employees consume alcoholic beverages on a weekly basis. Conclusion: The results of the study show that among employees in higher education there are inadequate eating habits that can increase the risk of chronic mass non-communicable diseases.
Introduction: Hospitalized patients have an increased risk of developing infections caused by Clostridioides difficile. Due to the changing epidemiology of C. difficile, it is necessary to educate nurses about the implementation of prevention measures, but also about the criteria for obtaining a quality sample of feces in order to establish an etiological diagnosis in a timely manner. The aim of the study was to assess gaps and flaws in C. difficile infection (CDI) prevention policies and practices, and to determine whether a nurses knowledge about early identification and isolation of CDI patients improved after education. Methods: The research was conducted in a quasi-experimental study at the University Clinical Center of the Republka Srpska (UKC RS) in the period from May 2020 to December 2021 on a sample of 60 nurses. A survey questionnaire Centers for Disease Control and Prevention (CDC) was used as a research instrument and it was intended for the assessment of knowledge, attitudes and understanding about procedures for the prevention of infection with C. difficile. The applied strategy to prevent hospital CDI was based on the introduction of the concept of "package of care", which was based on scientific evidence. For the education of nurses, interactive educational modules were used that contained detailed prevention measures CDI in hospital conditions in accordance with the guidelines. Before and after the education, the participants completed a knowledge test about C. difficile and prevention CDI.The study was approved by the Ethics Committee of the UKC RS. Results: Only 5 (8.3%) respondents stated that they were informed about CDI prevention during the visit of a nurse from the infection control team. Most of the shortcomings during the assessment of CDI prevention at the observed clinics were related to the practice of sending feces samples for laboratory testing for C. difficile. Nurses showed highly statistically significant (p<0.001) better knowledge about the importance of early identification of C. difficile and isolation of CDI patients in the post-education test. Conclusions: The implementation of a CDI prevention protocol intended for nurses can be one of the algorithms that will precisely identify C. difficile, and thus successfully implement CDI prevention measures.
Aging implies a process during which changes occur in the function of all organic systems in the human body. For a detailed assessment of the health status of an elderly person, a comprehensive geriatric assessment (CGA) is recommended. CGA is defined as a multidisciplinary diagnostic and therapeutic approach that enables the identification of medical, psychosocial and functional limitations of an elderly person, all with the aim of developing a coordinated plan to improve the health of the elderly person. The aim of this review was to point out the significance, comprehensiveness, applicability and prognostic significance of geriatric assessment based on data from recent literature and by searching available electronic databases. Studies were collected from the electronic databases MEDLINE (via Ovid), Pubmed, COBSON database and Google Scholar database, as well as by manual search of relevant studies cited in the references of key articles. The search for papers as a whole is limited to the English language. All studies that used a comprehensive geriatric assessment in their methodology, in elderly people over 65 years of age, were included. CGA is very important for the elderly, for their families, health systems of countries, health professionals as well as the social community. Interventions resulting from a CGA are one way to improve the performance of activities of daily living in elderly patients. CGA has numerous advantages in practice, it is comprehensive, applicable, economically relatively acceptable and as such can be routinely implemented at different levels of health care. CGA has a high prognostic significance for the early detection of multimodal problems in the geriatric population.
Congenital heart defects are the most common chronic congenital anomalies in childhood. They occur as a consequence of the action of genetic and multifactorial factors. Feasibility is present in both sexes, regardless of the economic situation of the country. They lead to structural and functional changes in the heart muscle, thus interfering with its normal functioning. The most effective method of treating and solving the problem of heart defects is surgery. By being exposed to an invasive procedure, they encounter numerous postoperative risks, and it is necessary to provide maximum care and support. The formation of a care team, the application of the health care process, ensures adequate conditions during the stay in the tertiary level health institution. This paper presents all the necessary segments of nursing care, in children with a diagnosis of congenital heart defect. The segments arise from the process of health care. Professional action is based on independent and interdependent nursing interventions. Key words: congenital heart defect, cardiac intensive care, nursing diagnoses of heart defects in children, postoperative care of heart defects.
Introduction: The COVID-19 pandemic has increased the symptoms of significant psychological burdens for the entire population. However, little is known about the psychological effect of COVID-19 on healthcare students. Objective: The research aimed to determine whether and to what degree healthcare students exhibit signs and symptoms of anxiety and depression during the second year of the pandemic. Material and methods: The study was conducted as an online cross-sectional study, by surveying 133 healthcare students of the Faculty of Medicine. The questionnaire for the assessment of anxiety (General Anxiety Disorder - GAD-7) and the questionnaire for the assessment of depression (Patient Health Questionnaire - PHQ-9) were used as research instruments. Descriptive and inferential statistical methods were used for statistical data processing, and statistical significance was determined at the p≤ 0.05 level. Results: The highest percentage of students showed minimal symptoms of depression (40.6%), i.e. symptoms of minimal anxiety (45.1%), while the total average score of the GAD-7 questionnaire was 6.35±5.27(SD), and the average value of the total PHQ-9 score was 7.42±5.59(SD). Conclusion: The COVID-19 pandemic had an impact on healthcare students, who during the second year of the pandemic showed mild depression and mild anxiety.
Introduction: Diabetes is a significant public health problem. In Serbia, 12% of the population suffers dominantly from type 2 diabetes, the development of which is associated with an inadequate diet and lack of physical activity. The treatment of patients involves the application of diet therapy in combination with medical treatment. The aim of this paper is to evaluate the differences in anthropometric and biochemical parameters in patients with type 2 diabetes after the counseling work. Respondents and methods: The research was conducted as a retrospective evaluation study through the analysis of medical records of users of the Nutrition Counseling Service of the Public Health Institute of Subotica. The sample included 34 patients with type 2 diabetes, mostly women (71%). Results: The average body weight of the patients was 87.6 kg, waist circumference 105 cm, the average glycemima was 7.14 mmol/l, and the blood pressure level was 140/84 mmHg. After counseling, at the first control measurement 2-4 months after the first examination, the patients lost an average of 3 kg, the waist circumference decreased by an average of 2 cm, and the percentage of fat in the body decreased by 1.6%. There was a decrease in glycemia by 0.6 mmol/l and systolic blood pressure by 5 mmHg. Although the second control examination was attended by a much smaller number of patients, based on the results, it was observed that the average values of the observed parameters were significantly lower compared to the initial values (body mass decreased by 1 kg, waist circumference by 4 cm, glycemia level by an additional 1 mmol/l). Conclusion: Based on the results of the research, it can be concluded that after the counseling work, there was a significant improvement in the nutritional status and glycemia in patients with type 2 diabetes.
Anxiety represents the behavioral, emotional and cognitive response of the person on experience if potential or future danger. Pathological anxiety occurs when this reaction is unreasonable, that is it is not proportionate to the stress or challenge, and it leads to intense fear, nervousness and impaired functioning. Anxiety can occur in any period of life. Adolescence is a turbulent developmental period that increases the risk of young people to develop numerous mental disorders. Numerous predictors determinate the development of anxiety in adolescents. Prevention of anxiety disorders in adolescents is a public health priority, therefore it is necessary to identify risk factors and implement activities to suppress these factors.
The diagnosis of sarcoidosis-associated pulmonary hypertension is a challenge, because there are signs and symptoms, such as dyspnea, dizziness, and chest pain that are nonspecific and may exist in both diseases. Right heart catheterization is the gold standard for the diagnosis of pulmonary hypertension. However, this is an invasive procedure, so it is reserved for patients with a high probability of the presence of pulmonary hypertension. Current guidelines for the diagnosis of pulmonary hypertension recommend transthoracic echocardiography for the screening method. Adequate treatment of underlying diseases and comorbidities is important in order to prevent disease progression, disability, and shortened patient survival. Specific therapy for SAPH is not routinely recommended.
Introduction: Unintentional falls are the leading cause of traumatic injuries, without fatal consequences, with significant morbidity in the population of children and adolescents. Goal: The main goal of this research was to analyze the manner of falling in relation to age and gender, and to assess the type of injury and the anatomical region of the body affected by the injury sustained during a fall in patients ≤19 years of age treated in the emergency medical services in the Republic of Srpska. Material and methods: A cross-section study with retrospective analysis of the national e-database WebMedic from 11 emergency medical services between January 2018 and December 2020 was conducted. Research included patients with diagnosis of unintentional injury caused by a fall, aged ≤19 years. Descriptive statistics and the Chi-square test were used for comparisons between groups. Results: During the observed period, 857 cases of unintentional falls were identified, where 87.5% were referred for hospitalization. The group of children aged 0 to 9 years (55.7%) was more often treated for falls (p<0.001), and boys were affected 6.7 times more often than girls (p<0.001). Falls from the same level caused different types of injuries depending on the age and gender of the children (p<0.001). According to the type of injury, superficial injuries (36.8%) and open wounds (29.4%) were most often identified, and the most frequently affected body region was the head (52.0%). Conclusion: The group of children up to the age of nine and males were more often affected by superficial injuries and open wounds, with head injuries being predominant in all age groups. These results could indicate the necessity of creating programs with targeted prevention.
The acceptance of the postulate that people's health is the general interest of human society and also its basic resource for development represents the shift in the focus of the health care system and the society from disease and treatment to health promotion and preservation, healthy lifestyles affirmation and to development of a healthy environment. The promotion of health is becoming the key area for public healthcare actions, and thus a key element of nursing practice. Through the presentation and comparison of the current concept of health promotion based on the bio-psycho-social model and the basic postulates of the Life Course Theory, the author implies the necessity of expanding the existing frames in health promotion theory and the significance of implementation of Life Course Theory into the nursing curriculum, giving at the same time basic guidelines for its practical application within the health promotion activities of the nurses.
Introduction: Infertility is a very important medical and social problem that affects increasing number of couples. Taking into account the specifics of the problem, impact on the partnership and social interactions, treatment of infertility can have significant negative impacts on the quality of life in women during the in-vitrofertilization procedure (IVF). Main goal: To determine the quality of life of women during the IVF process in relation to general life satisfaction, physical and mental health, as well as to determine the satisfaction of patients with health services during the IVF process. Material and methods: The research was conducted as a descriptive cross-sectional study lasting 4 months. The survey was conducted online, the sample consisted of 150 respondents currently in the IVF process. The Fertility quality of life tool questionnaire - FertiQol - was used as a data collection tool. Results: The largest number of respondents are in good general physical condition (61.5%) and are satisfied with the general quality of their life (67.7%). Significant statistical differences were proved between the score Core Quality of life and the score Quality of life in the treatment domain (p<0,001). These results show that the respondents' core quality of life is statistically significantly higher than the quality of life associated with in vitro fertilization. Conclusion: The research confirmed that patients entering the IVF process are satisfied with the overall quality of life, but have a lower quality of life compared to their core, which is directly related to the lack of necessary information that is not available at the optimal time and/or presented in an adequate way, as well as the level of communication with health professionals that needs to be improved.
Introduction: During the COVID-19 pandemic, teaching in higher education institutions took place online, or combined. This way of teaching was a challenge for both teachers and students. Aim: The aim of the research is to examine the attitudes and experiences of medical students about online teaching. Methods: The research was conducted as a descriptive study. The research instrument is a specially designed questionnaire that assesses student attitudes and experiences with online teaching. The study included 103 students of medical courses, Healthcare and Pharmacy, at the Academy of Vocational Studies Šabac, Department of Medical and Business-Technological Studies in June 2022. Results: The majority of students were in the age category of 19-30 years, female, from the Health Care study program. The students expressed their agreement with the statements about the regularity of online classes at the Department, as well as the way of informing about obligations during online classes. The negative attitude of the students was that online teaching is not a better form of teaching than traditional teaching, as well as that online teaching is suitable for practical exercises. The overall quality of organizing online classes at the Department of Medical and Business-Technological Studies was rated four by most students. Conclusion: In the conditions of the fight against the COVID-19 pandemic, classes are organized well, but in the future, if necessary, classes should be combined. The obtained results will serve to improve the teaching process at the Department.
The coronavirus pandemic caused unprecedented changes in all spheres of life. Education has completely shifted from the dominantly traditional to the digital framework. With that, nurse educators in higher education also started applying different models of innovative digital technologies. For example, the recreational escape room (ER) game, which has gained global popularity in the last decade, has inspired nurse educators to apply it in an educational setting. According to the definition, ER is a game in which a team of players discovers clues solves puzzles and performs tasks in one or more rooms to achieve a specific goal in a limited time, usually "room escape". In educational ER, all problems, challenges and activities are called a puzzle, while the term room means the space in which it is realized. Therefore, educational ER can be on-site and online. ER has found its place in the learning environment because it brings time-limited authentic situations from the natural professional environment. To successfully complete the mission and "escape from the room", students, in addition to engagement that encourages critical thinking, intensively communicate and cooperate with each other. This paper presents the application of online educational ER in the subject Fundamentals of Nursing.
