It can be stated that quality is an integral part of our daily life. All people constantly insist on quality in certain areas of life, which indicates that quality can be found in all segments in which a person work. The main objective of this study is to examine the satisfaction of clients/users with the services of spa centers. The basic research methods used are: synthesis, analysis, induction and deduction, comparative and statistical methods. The collection of primary data was carried out through an online survey, which contains a standardized scale (SERVQUAL). The correlation analysis confirms the general objective, so it can be concluded that the Pearson coefficient is -0.158, from which it follows that there is a very weak negative correlation between these two variables. It is concluded that sociodemographic factors do not at all influence the attitude of respondents about the quality of service of spa resorts. But, Pearson coefficient indicates a high degree of correlation between respondents' satisfaction with the quality of service in sparesorts and other factors. There is a very high degree of correlation between respondents' satisfaction with service quality and other factors -81%, which have an impact on the respondents' satisfaction with thequality of service in the spa: the first contact in the spa, the reason for coming to the spa, the distance from home to the spa, travel time and the manner the therapy is introduced. Key words: Quality, safety of services, spa resorts, Bosnia and Herzegovina

Background: The COVID-19 pandemic has significantly affected people’s lifestyles, particularly influencing existing chronic conditions such as hypertension. It is estimated that 1.28 billion adults aged 30–79 worldwide have hypertension. In addition to its impact on blood pressure levels, the pandemic also affected the quality of life and mental health of hypertensive patients. Mental health among individuals with chronic diseases who have recovered from COVID-19 is an important and complex issue. Research indicates that these patients are at a considerably higher risk of developing anxiety, depression, and PTSD, as well as experiencing deterioration of their underlying conditions. Objective: The aim of this study was to analyze the impact of independent factors on the mental health score using the SF-36 questionnaire among hypertensive patients who recovered from COVID-19. Methods: A cross-sectional study was conducted in selected primary healthcare centers across four cantons in the Federation of Bosnia and Herzegovina (FBiH). The study included a total of 240 patients, randomly selected from those diagnosed with hypertension who had recovered from COVID-19 (experimental group, n = 120). The control group consisted of 120 participants who had recovered from COVID-19 but did not have hypertension. The European SF-36 questionnaire was used for longitudinal self-assessment of health status in patients with various chronic conditions. Results: The analysis of independent factors affecting mental health during the COVID-19 pandemic showed poorer mental health outcomes among older, single participants with higher educational attainment. In relation to COVID-19 treatment, patients who had been hospitalized or treated in Intensive Care Units and who experienced cardiac complications exhibited worse mental health scores. Conclusion: The findings of this study indicate a statistically significant higher likelihood of poorer mental health among hypertensive patients who had contracted COVID-19.

Introduction: The World Health Organization states that health care is a science and art that requires a lot of understanding and practical application of knowledge and skills that are specific and based on research derived from biological, social, and humanistic sciences, and management.Aim: The main goal of this study is to determine the extent to which nurses implement the health care process based on scientific and professional evidence and evidence from clinical practice. Materials and methods: The study is quantitative, descriptive, cross-sectional, and comparative. The author's questionnaire was created based on a review of professional and scientific literature and evidence from practice was used for the research.Results: Analysis of knowledge about the meaning of evidence-based health care shows that 140 (61.4%) respondents answered correctly to this question “Providing health care based on scientific research, professional literature, and good practice”. Almost 80% of respondents (181) correctly answered that evidence-based health care should be provided by nurse technicians of all levels of education who work in the health care process.Conclusion: The results of this research support the statement that nurses-technicians implement the health care process based on scientific and expert evidence, evidence from clinical practice, and this is supported by the fact that evidence-based health care is applied fully or partially by 221, or 96, 6%, of respondents.

Introduction: With the continuous aging of the population of Western societies, an increase is expected not only in the number of patients with diabetes but also in the number of patients with comorbidities. Population studies suggest that most patients with diabetes have at least one comorbidity. Comorbidities can profoundly impact a person’s ability to care for himself/herself and can present barriers to adherence to lifestyle changes and compliance with therapy. Methods: The research was conducted in the Public Institution Health Centre of Sarajevo Canton - Health Center Hadžići and Health Center Novi Grad. It included 161 patients diagnosed with diabetes; 96 women and 65 men.The respondents were between 18 and 65 years old (the upper age limit for the working population for both genders). The instruments for conducting the research were a questionnaire on the socio-demographic characteristics of the respondents and Ferrans and Powers index of quality of life, a version for diabetes. Results: The research included 43.48% of respondents with diabetes mellitus (DM) Type II, 31.06% with DM Type I, while even 25.46% of respondents did not know which type of diabetes they suffered from. There were no statistically significant differences in the Total Quality of Life Index (TQLI) (p=0.328) between respondents with different types of diabetes. The average TQLI value in the group with diabetes duration from 1 to 5 years was 22.07 +/- 5.10; in the group from 6 to10 years was 21.23 +/- 6.0; in the group from 11 to 20 years was 21.86 +/- 4.82; in the group from 21 to 30 years was 19.20 +/- 6.81; and in the group with diabetes duration >30 years, was 23.36 +/- 5.46. High blood pressure was present in 60.24% of respondents, followed by elevated blood fats in 51.55% of respondents, and heart/brain blood vessel diseases, in 43.48% of respondents. Neuropathies were present in 38.5%, visual impairment in 26.08%, and malignant diseases were present in a total of 14.28% of respondents. Conclusion: The average value of the quality of life of respondents with 1 comorbidity was 21.30; with 2 comorbidities 20.91; and with 3 comorbidities was 21.94. There was no statistically significant difference in the quality of life of diabetes patients about the presence of one, two, or more comorbidities (p=0.537). The presence of a greater number of comorbidities in patients with diabetes does not contribute to poor quality of life.

Introduction: Surgical intervention and anesthesia procedure lead to a series of hormonal changes in the organism, which is mainly attributed to catecholamine response to stress. Surgical intervention is resulting in significant changes in neuroendocrine regulation, metabolism and physiological functions, as part of the overall response to stress. Research aim: The aim of this study was to determine and evaluate the levels of hormones in patients undergoing transvesical prostatectomy under general or local anesthesia. Material and methods: The study included a total of 100 patients from the Clinic of Urology, Clinical Center of Sarajevo who underwent surgery by technique of transvesical prostatectomy (BPH) in which the indicators were set:: a) repeated urinary retention; b) calculosis and diverticulosis of the urinary bladder; c) urinary infection, d) repeated massive hamaturia and e) the distal obstruction that can lead to uremia. Results: General anesthesia may limit the perception of stimuli from injury, but does not eliminate the full response to noxious stimuli, even with deep anesthesia. All intravenous agents andvolatile anesthetics in normal doses have little effect on the endocrine and physiological functions. Neural blockade induced by regional anesthesia or local anesthetics have a direct impact on endocrine and metabolic response. Regional anesthesia with the present consciousness, but with sympathetic blockade caused a greater suppression of hormonal responses than the general balanced anesthesia. In our research we obtained: a) a significant increase in prolactin intraoperatively, for respondents under general anesthesia; b) a significant increase in TSH values intraoperatively for respondents under general anesthesia; c) a significant drop in T4 intraoperatively in patients with regional anesthetic technique; d) a significant increase in cortisol values 24 hours postoperatively in patients with regional anesthetic technique.