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.

Background: Observational and experimental studies consistently show that physical activity supports improvements in both physical and mental health. Various exercise modalities have been proposed as intervention protocols, ranging from aerobic training to traditional Eastern relaxation practices that incorporate elements of physical movement. Objective: The aim of this article was to analyze and synthesize evidence on the impact of different forms of physical activity on psychological stress and related symptoms of anxiety and depression among healthcare workers. Methods: A focused PubMed search was conducted for studies published in the last five years addressing physical activity interventions targeting stress, anxiety, or depression in healthcare workers. Both randomized and non-randomized intervention studies, pilot trials, and relevant systematic reviews were included to provide a descriptive synthesis because of heterogeneity in interventions and outcomes. Results: A review of PubMed-indexed studies published in the past five years identified 7,475 articles exploring the relationship between physical activity and stress levels in diverse populations. Of these, 284 studies specifically examined healthcare workers, with 72 addressing these outcomes in the context of the COVID-19 pandemic. Interventions included aerobic exercises, yoga, tai chi, qigong, and other movement-based relaxation techniques, with considerable variation in session duration, frequency, and follow-up periods. Reported outcomes varied, but most studies demonstrated reductions in perceived stress and improvements in anxiety and depression symptoms. Several studies suggested that more intensive exercise protocols may be less effective, while shorter and lower-intensity interventions often produced stronger psychological benefits. Conclusion: Various forms of physical activity can effectively reduce stress and symptoms of anxiety and depression among healthcare workers. Interventions do not necessarily need to involve high-intensity or long-duration activity to achieve meaningful improvements. Short, low-intensity protocols may represent a feasible and beneficial resource for supporting the psychological well-being of healthcare professionals.

Objectives. The main objective was to assess the relationship between sociodemographic and occupational factors and stress levels among healthcare workers in family medicine in Bosnia and Herzegovina, using the PSS-10-BH scale. Materials and Methods. A cross-sectional study was conducted using the PSS-10-BH questionnaire distributed via Google Forms to primary care nurses and physicians between July and August 2022. Results. The study included 272 participants, with a mean age of 44.7 (±10.55), predominantly women (86.8%) and physicians (58.8%). The mean PSS-10-BH total score for the sample was 21.26 (±6.77) ranging from 3 to 36. The linear regression model indicated male gender and older age showed an association with slightly lower stress levels. Marital status and the number of children showed a slight positive association with stress levels. Occupation (B=-3.068, 95% CI: -5.442 to -0.694, P=0.012) was associated with stress, with physicians tending to report lower stress levels compared to nurses. Years of work experience (B=0.060, 95% CI: -0.190 to 0.309, P=0.636), and patient load (B=0.082, 95% CI: 0.027 to 0.137, P=0.004) were associated with higher stress levels. The results suggest that work-related variables are significant predictors of stress levels as measured by the PSS-10-BH scale in this sample of healthcare workers. The included predictors explain 10% of the variability in the outcome, indicating additional unidentified contributing factors. Conclusion. Occupational factors, particularly profession, work experience, and daily patient load, significantly influence stress levels in healthcare workers. Further research is needed to explore other potential influences and refine interventions aimed at managing stress in this population.

Objectives. The main objective of this paper was to examine the perceptions of family physicians on the use of primary health care in Bosnia and Herzegovina during the COVID-19 pandemic. Materials and Methods. A cross-sectional study was conducted using a short online questionnaire that was sent to primary care physicians in Bosnia and Herzegovina from April 20th, 2022, to May 20th, 2022. Results. The research sample consisted of 231 doctors of primary health care from Bosnia and Herzegovina, with an average age of 45 years and 85% women. About 70% of participants reported having COVID-19 at least once from March 2020 to March 2022. Participants had an average of 1,986 registered patients and approximately 50 encounters per day. The study revealed a high degree of reliability between test-retest measurements, with a single measure Intraclass correlation coefficient of 0.801, and internal consistency determined using Cronbach’s alpha of 0.89. Participants reported that the following health services were most affected during the COVID-19 pandemic: care for patients with chronic diseases, home visits, navigating the health system with patients making appointments with specialists, cancer screening, and preventive health services. The study also found statistically significant perceived differences in the use of these health services based on age, gender, postgraduate education in family medicine, participation in COVID-19 clinics, and personal history of Covid-19. Conclusion. There were significant disturbances to the use of primary health care during the COVID-19 pandemic. Future research could investigate patient outcomes compared to family physician perceptions.

Background: After the World Health Organization declared the outbreak of a new coronavirus on 30 January 2020 a public health emergency of international importance, health authorities in Bosnia and Herzegovinaas in other countries around the world, have ordered active surveillance, early detection, isolation and management, cases, contact monitoring and prevention of the spread of infection. Objective: The aim of this study was to describe and analyze of the organization of family medicine during COVID-19 pandemic in Canton Sarajevo with its positive and negative aspects. Methods: The case study design provided an ideal framework for systematic research into the organization of primary health care in Sarajevo Canton during the COVID-19 pandemic as it is an empirical study exploring a contemporary phenomenon within its real-life context when the boundaries between phenomenon and context are not clearly visible. Multiple sources of evidence are used. Data were collected in several different ways: analyzing policies, laws, regulations, decisions related to the COVID pandemic, insight into changes in the health information system, collecting data from reports, and through a group interview (Delphi exploratory) with eleven family medicine specialists. Results: Primary care was organized as two parallel systems with family medicine in the center. The first system was COVID-19 primary care and the second was regular care for non-COVID-19 patients. Family medicine physicians despite a numerus setbacks provide health care for 106346 COVID-19 cases. Discussion: Every principal (first contact access, person-centered care, comprehensiveness, continuity of care, community based, coordination of care, and holistic modeling) of family medicine was interrupted with consequences for patients and family physicians. Conclusion: Additional research is needed to examine all facets of the family medicine and primary health care response to the COVID-19 pandemic in Sarajevo Canton.

Background: Family medicine is defined as continuous, comprehensive medical care of the patient in the context of the family and the community. Continuous patient care includes prevention, diagnosis and treatment of acute and chronic diseases and palliative care. Caring for individuals during different diseases and stages in the life cycle, understanding the role of the family in disease and using community resources makes family medicine unique among medical disciplines. With the development of new technologies, there was a need for changes in the work and introduction of the Health Information System, in all areas of medicine, including family medicine. Objective: The objectives of this study are to analyze CHIS functions in family medicine, analyze CHIS data reports, complaints, and suggestions for improvement, and then, based on the results of these analyses, to offer recommendations for future development of the CHIS family medicine module. Methods: This article represents a qualitative, interpretative case study of the implementation of the CHIS in family medicine in Public Institution Health Centre of Sarajevo Canton conducted by a group of physicians using three primary data sources: medical experts’ analysis of the CHIS content, reports available in the CHIS about the number and type of services, analysis of written medical doctor and nurse complaints, and suggestions for improving the CHIS. Although qualitative data analysis predominated, quantitative data analysis was also employed. Results and Discussion: It is crucial that healthcare professionals who utilize HIS have the opportunity to provide feedback on the system and suggest modifications. The main results show that CHI is widely used in family medicine and that employees in this department provide purposeful suggestions to improve CHI, as well as that a good cooperation between the software company and the user exist. Experts in software should view these suggestions as useful information and adopt them to enhance the system so as to increase customer satisfaction and enhance the quality of health care. Health informatics as a separate scientific discipline began to be effective in academic institutions at the end of the 70’s by the presentation of actual accomplishments in this area in under and postgraduate education at biomedical faculties. The Central Health Information System (CHIS) in Sarajevo Canton was implemented in 2014 but was not fully integrated and was incompletely used at certain levels of health care. Conclusion: Thanks to the agility of the company rapid implementation of new software modules enabled the organizational transformation of the Sarajevo Canton health network.

Introduction: Diabetes and depression are two common and major non-communicable diseases with significant disease burdens worldwide. Aim: The aim of this study is to obtain the association among A1C levels and symptoms of depression in patients with type 2 diabetes in family medicine offices. Methods: This cross-sectional study was carried out between June 2016 and July 2017. We recruited 150 adults with type 2 diabetes from various family medicine offices. The study questionnaire had two parts; the first one for participants and the second one for family medicine physicians. Participants completed the part of the questionnaire with the PHQ-9 scale and questions regarding demographic data. Family medicine physicians completed the part of the questionnaire with questions concerning clinical data. A univariate and multivariate linear regression analysis was conducted to identify significant predictors of depressive symptoms revealed by the PHQ-9 score. Results: Multiple linear regression showed that the level of A1C was a significant predictor of the PHQ-9 score in all three models. Increases in the A1C level were followed by increases in depressive symptoms. Other significant predictors of a positive PHQ-9 score were smoking, level of education and income. Conclusion: The level of A1C as an indicator of glycemic control has been shown to have a significant association with the scores of the PHQ-9 questionnaire, which identifies the intensity of symptoms of depression. An increase in the level of A1C is followed by an increase in the intensity of symptoms of depression.

Introduction: Although during undergraduate study students have a high opinion of family medicine and often praise it, during postgraduate studies they show little interest in this medical specialty. Aim: The study aimed to examine the interest of public medical school students in family medicine as a career choice, to establish whether it changed during the study and if there was a difference in that regard among students studying at medical schools in Bosnia and Herzegovina. Hypotheses: students’ attitudes change with learning about the way a family doctor works. Methods: Descriptive cross-sectional survey. This manuscript presents a nationwide survey (63% response rate) of public medical school students in Bosnia and Herzegovina regarding their likelihood of selecting Family Medicine as a specialty. An anonymous questionnaire was distributed to all medical students on all six state universities in Bosnia and Herzegovina. Data basis of all doctors who have completed specialization programs were taken from ministries of health. Results: In the period from 01/01/08 to 12/31/18, only 8.4% of all completed specializations were family medicine doctors in Bosnia and Herzegovina. Interest in family medicine, as a future career, was shown by 31% of medical students, of which over 75% were female students. The largest interest in family medicine was shown by the sixth-year medical students, stating their extensive knowledge of medicine as a reason. Conclusion: Students’ interest in FM specialization is changing through the years of study. Unfortunately, it is not only the lack of interest, that is the cause of the small number of family medical specialities among students but also poor health policy, which should be subjected to actual reform.