Dementia is a growing public health problem, particularly in low- and middle-income countries. Bosnia and Herzegovina (BiH), as a post-conflict LMIC with a complex administrative structure, currently lacks national guidelines, epidemiological data, and systematic approaches for dementia care. This study investigates healthcare workers’ attitudes toward dementia care and identifies both obstacles and practical opportunities for improving practice within BiH’s unique healthcare system. A qualitative cross-sectional study was conducted in primary healthcare settings across Bosnia and Herzegovina, with 25 participants, including family medicine doctors (n = 10), nurses (n = 10), and psychologists (n = 5). The data were analyzed using thematic analysis guided by the Consolidated Framework for Implementation Research (CFIR). Dementia care in BiH is predominantly reactive, with healthcare professionals typically responding only after families have expressed concerns. Participants reported inconsistent use of cognitive screening tools (e.g. MMSE, MoCA), largely due to insufficient training, lack of clear national guidelines, and varying institutional practices. Many clinicians felt unprepared and unsupported in managing dementia cases. Cultural stigma and widespread misperceptions of dementia as a normal part of aging contribute to delays in diagnosis and reduce the likelihood that families will seek help early. These barriers are exacerbated by a lack of national prevalence data and fragmented care pathways. The findings of this study indicate the need to change the approach to dementia care in BiH through concrete and realistic measures within the existing systemic frameworks. Practice-based guidelines, culturally adapted tools for early detection, reactivation of community-based care, accessible education, a pragmatic approach to prevention, and local initiatives for awareness-raising and multidisciplinary care are recommended.

AIMS The aim of this study was to estimate cutoff values of mid-upper arm circumference (MUAC) and calf circumference (CC) for reduced muscle mass and analyze their accuracy in identifying malnutrition among individuals of 65 years of age or older in Bosnia and Herzegovina. MATERIALS AND METHODS The study is a secondary analysis dataset assessing nutritional risk and malnutrition among 446 community-dwellers and nursing home residents in Bosnia and Herzegovina. Malnutrition assessment included phenotypic criterions (weight loss, low body mass index, and reduced muscle mass) and etiologic criterions (inadequate food intake, disease-related inflammation, or albumin levels) according to recommendations of the Global Leadership Initiative on Malnutrition (GLIM). Receiver operating curves were used to calculate MUAC and CC's cutoff values as compared to the Mini Nutritional Assessment (MNA). RESULTS The optimal cutoff value for MUAC in men was 24 cm (AUC = 0.910, sensitivity 100%, specificity 77%), and in women 23 cm (AUC = 0.792, sensitivity 64%, specificity 83%). Optimal cutoff value of CC in men was 31 cm (AUC = 0.818, sensitivity 100%, specificity 67%) and in women 29 cm (AUC = 0.882, sensitivity 86%, specificity 74%). Two hundred fifty nine elderly individuals were categorized as malnourished/at risk for malnutrition per MNA. The prevalence of malnutrition based on GLIM criteria ranged from 19% to 30%. CONCLUSIONS The study suggested that MUAC and CC may be used as the alternative indicators of muscle mass when other assessment methods are unavailable. Future validation and reliability studies for GLIM using anthropometric parameters as a proxy of reduced muscle mass are needed.

Psychological care involves caring for the patient's psychological needs using a range of skills such as listening, perceiving, communicating, and empathizing, with the ultimate res of alleviating human suffering. The nurse spends the most time with the psychiatric patient; she is with the patient from his admission to the hospital, during his stay, until he leaves the hospital. Observing the patient's behavior, she determines problems in health care. In order for a nurse to solve this problem, she must be educated, experienced in her professional vocation, and have a good knowledge of the healthcare process, because that is the only way she can make an appropriate plan and choose the most appropriate interventions. In addition to knowing the process of health care, a nurse must also be extremely patient and possess certain communication skills due to the nature of the illnesses of patients suffering from psychiatric disorders. Therapeutic communication is actually the core and essence of all interactions between a nurse and a patient. It is often stated that it is the nurse who takes care of the psychiatric patient and who has the most face-to-face contact with patients. The nurse deals with the total personality of the psychiatric patient, and therefore she applies models that make the assessment of the patient's needs the basis of health care. The main goal of this scientific review is to investigate and analyze the role of psychiatric nursing as an indispensable element in nursing practice, explore its importance for improving the quality of health care and patient well-being, and provide guidelines for the integration of psychiatric nursing in nursing practice.

Objective. Aging is characterized by the loss of abilities in the psychological and physical sense. Detailed assessment of cognitive status may enable early identification of high-risk patients who are candidates for dementia. The aim of this research was to examine the cognitive status of elderly people over 65 years of age living in the community and potential risk factors that contribute to the onset of dementia. Methods. The research was designed according to the principle of a cross-sectional study. The research used a general questionnaire, subjective and objective assessment of respondents, Mini Kog assessment. The ch2 square test was used for statistical tests. The usual value of p<0.05 was taken as the level of statistical significance. Results. Females (80.2%) had better cognitive status than males (84.6%) (ch2 =0.189; p=0.664). Respondents with the lowest level of education (primary school) had a worse cognitive status (23.5%) compared to 13.3% of respondents with an intermediate level of education (ch2 =9.139; p=0.010). 8.8% of respondents who socialize with friends had a good cognitive score compared to 0% of respondents with a good cognitive score who do not socialize with friends (ch2 =18.243; p=0.000), also, the cognitive status was worse in those respondents who used different aids (75%) versus 17% of those who do not use different aids for their functional mobility (ch2 =8.832; p=0.003). Conclusion. Dementia is present in a high percentage among elderly people. The level of education and the use of aids are potential risk factors for the onset of dementia.

Objective. Long-term care represents a series of health and social care services that are provided at home or in an institutional environment to people with reduced functional capacity (reduced physical and/or cognitive abilities) who need support in performing daily activities, and who depend on the help of others for a long time period. The goal of the research was to examine the quality of life of users with long-term health care, with a special focus on comparing the quality of life between people placed institutionally and outside of the institution. Methods. The research was designed according to the principle of a cross-sectional study. In the research, a general questionnaire and a scale for assessing the quality of life Short Form 36 Health Survey (SF-36) were used. Among the statistical tests, the ch2 square test was used. The usual value of p<0.05 was taken as the level of statistical significance. Results. Subjects who were institutionalized had statistically significantly lower values of domains and summary scores of quality of life compared to subjects whose health care took place outside of institutions, whereby the difference was observed in physical functioning (p<0.001), social functioning (p=0.003) and mental health summary score (p=0.015). Conclusion. Users of long-term health care placed in an institution had significantly worse physical functioning, a higher level of limitations due to physical problems, worse general health, a lower level of social functioning, as well as mental health.

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.

Introduction: Diabetes mellitus (DM) is a global public health problem. It is a complex illness which affects on the medical, psychological and social aspects of life. The aims of this research were to determine the subjective sense quality of life of patients with diabetes mellitus, to determine whether or not there are differences in the quality of life of patients with diabetes mellitus compared to sex, age and place of residence, as well as to determine factors the quality of life of patients with DM. Material and methods: The study was conducted as a crosssectional study of the population of persons with (DM). The sample consisted of 100 respondents, who in the observed period were treated at the Department of Internal Medicine of the University Hospital in Foča. A combined questionnaire consisting of 40 questions was used. The questions in the questionnaire were related to socio-demographic characteristics, hobbies, support of family and friends of patients, eating habits, as well as the presence of comorbidities. The HolmesRahe Stress Scale and the Subjective Assessment of Well-Being Scale (SVB Life Satisfaction Scale) were also included in the questionnaire. Results: Among the respondents there were 48 (48%) men and 52 (52%) women. Respondents rated their satisfaction with the quality of life, with an average score of 6.68 ± 1.72. Younger respondents have significantly better quality of life (7.09 ± 1.91) compared to the older group of subjects 6.35 ± 1.50. Also, respondents who living in the city are significantly satisfied with their quality of life (6.95 ± 1.80) compared to respondents who lives in the countryside (6.14 ± 1.45). Respondents with secondary education (30%) are significantly satisfied with their quality of life compared to respondents without primary school (13%), with elementary school (3%) or with higher education (12%). Conclusion: People with diabetes their own quality of life estimates with satisfactory grades.

Introduction. According to the data of the World Health Organization (WHO), mental illnesses are on the rise. The World Health Report estimates that today about 1 billion people suffer from mental and behavioral disorders or psychosocial problems such as those related to alcohol and drug abuse. Stigmatization of the mentally ill is one of the burning social problems of those people, and the attitudes and behavior of nurses/technicians significantly affect the self-stigmatization of patients, and thus their condition and recovery. The main aim of this study was to assess attitudes of nurses and nursing students towards patients with mental illnesses. Method. The research conducted is a cross-sectional study. The study covered two countries, Bosnia and Herzegovina and Serbia. In June and July 2018, 200 nurses and nursing students from the second to the fourth year of study were surveyed. Data were collected with original anonymous questionnaires, which was made for the purpose of this research. Results. Seventy percent of nurses believe that people with mental illness are discriminated against in our society, while there are statistically significant differences between respondents in relation to demographic characteristics (ch2 = 10.217; p = 0.037). Nurses working in psychiatric wards show a lower level of stigmatization compared to nurses working in other wards (ch2 = 25.553; p = 0.001). Nursing students have more negative attitudes towards mentally ill people compared to nurses (ch2 = 13.471; p = 0.009). Nurses from Serbia show a higher level of tolerance towards people with mental disabilities compared to nurses from Bosnia and Herzegovina (ch2 = 16.115; p = 0.003). Conclusion. The results of the research show that stigmatization of patients with mental illness still exists among health professionals. Undergraduate and continuing medical education of nurses should include more content related to access to the patient with mental disorders, communication skills in psychiatry, mental health promotion and prevention of stigmatization.

Introduction. A specific characteristic of the elderly is brittleness or fragility, and due to its prevalence, fragility needs to be understood as a public health priority. The aim of the study was to examine the association of functional and anthropometric parameters with fragility in persons over 65 years of age. Method. The study was designed as a cross-sectional study and included 446 elderly people. As research instruments, a general questionnaire was used to assess the functional status of the Tinetti test and, of anthropometric parameters, the circumference of the upper arm and the circumference of the middle part of the lower leg. We used the ch2 test and Pearson's correlation analysis as statistical tests. Results. Females had poorer functional status, walking, and balance compared to males (ch2 = 4.125; p <0.127). It was observed males subjects had higher values of upper arm circumference (26.96 ± 3.44) compared to females, while females had higher values of the middle circumference of the lower leg (32.66 ± 6.29). Analyzing the correlation of anthropometric measurements with the total score of the Tinetti test and in relation to subjects' gender, it was noticed there is a correlation analysis between the parameters. Conclusion. A high percentage of people over the age of 65 have poor functional status, as well as lower values of anthropometric markers, suggesting that they may be potential risk factors for the fragility in the elderly.