Introduction This study explored the complex relationship between anxiety, depression, compassion fatigue, and satisfaction among long-term care (LTC) workers following the COVID-19 pandemic. In addition, the study assessed psychometric properties of the Professional Quality of Life (ProQOL) scale, to ensure a reliable and valid instrument for identifying compassion fatigue and satisfaction in the Serbian healthcare system. Methods A cross-sectional study was conducted across LTC facilities in the Republic of Serbia. A ProQOL was administered to physicians, nurses, and aids, to measure compassion fatigue (including burnout and secondary traumatic stress) and compassion satisfaction. The following standardized instruments were also distributed: Secondary Traumatic Stress Scale (STSS), Depression Anxiety and Stress Scale 21 (DASS-21) and 12-Item Short-Form Health 36 Survey (SF-12). Results A total of 300 LTC workers participated, mostly women (86.3%), with an average age of 45.4 ± 10.5 years and a median work experience of 15 years (range: 1 to 42 years). The study reported a significant presence of anxiety and depression symptoms (53.3% and 43.3%, respectively), with LTC workers experiencing moderate levels of compassion fatigue, as indicated by burnout (58.3%) and stress (57.3%) subscales, and moderate or high levels of compassion satisfaction (49.0% and 50.0%, respectively). The study demonstrated that anxiety impacts depression both directly and indirectly (p<0.05). Specifically, burnout and compassion satisfaction mediated the positive effect of anxiety on depression, indicating that increased anxiety led to higher burnout and lower compassion satisfaction, which resulted in greater depression (p<0.05). The three-factor structure of the ProQOL was validated (IFI, TLI, and CFI were above the cut-off of ≥0.95, and the RMSEA was below the suggested value of ≤ 0.06). The Cronbach α of the three subscales was above 0.8, indicating good scale reliability. Conclusion This study contributes to the broader literature on LTC workers wellbeing by examining the complex interplay between professional quality of life, anxiety, and depression. The findings should guide decision-makers in developing targeted interventions and policies that promote the psychological resilience and well-being of LTC workers, thereby enhancing both individual and organizational outcomes in the healthcare sector.

ABSTRACT Introduction The aim of the study was to assess the seroprevalence of SARS‐CoV‐2 in the Republika Srpska, Bosnia and Herzegovina, after five waves of COVID‐19 and 1 year after introduction of vaccination to better understand the true extent of the COVID‐19 pandemic in the population of the Republika Srpska and role of vaccination in achieving herd immunity. Methods The population‐based study was conducted from December 2021 to February 2022 in a group of 4463 individuals in the Republika Srpska. Total anti–SARS‐CoV‐2 antibodies were determined in serum specimens using the Wantai total antibody ELISA assay. Quantitative analysis, using Kantaro IgG assays, was performed in subsamples (1273 specimens) to asses and compare levels of IgG among vaccinated, recovered and participants with hybrid immunity. To adjust for age and gender distribution in sample, poststratification method is applied. Results The overall cumulative seroprevalence was 94.6% (95% CI = 93.9–95.3). Significantly higher seroprevalence rates were observed among vaccinated 97.8% (95% CI = 97.3–98.4) comparing to unvaccinated participants (89.5%, 95% CI = 88.0–91.0). Seroprevalence increases with the number of received doses. Among various professions, the highest seroprevalence was found in the service industry (98.1%), education (98.0%) and healthcare (96.9%). We found that 2.2% of vaccinated and 3.6% of participants with SARS‐CoV‐2 positivity during 2021 had no detectable IgG antibodies. Both seroprevalence (98.6%) and antibody titres (1094.4 AU/mL) were significantly higher among people with hybrid immunity. Conclusion Our findings reveal a 2.3‐fold increase in seroprevalence of SARS‐CoV‐2 antibodies due to infection and vaccination, comparing to the first study performed 1 year earlier. This study provides better understanding of the SARS‐CoV‐2 transmission and highlights the important role of the vaccination in achieving the population immunity. Periodically conducted population‐based seroprevalence studies are important to understand temporal trends and assess surveillance system performance and public compliance with vaccination policies.

Background Research involves the systematic collection and analysis of data to enhance understanding of a particular phenomenon. Participation in medical research is crucial for advancing healthcare practices. However, there has been limited focus on understanding the factors that motivate medical students to engage in research. Additionally, in the era of e-learning, the easy accessibility of online resources has contributed to a widespread ‘copy-paste culture’ among digital-native students, which is recognized in academia as plagiarism. Existing studies suggest that a contributing factor to the increasing prevalence of plagiarism is students’ limited understanding of this act. The purpose of this study was to assess medical students’ attitudes toward research and plagiarism, and to evaluate the psychometric properties of the Attitudes Toward Research (ATR) and Attitudes Toward Plagiarism (ATP) questionnaires. Methods This was a multicenter study conducted among medical undergraduate and postgraduate students attending the three medical universities who were involved in research. Students’ attitudes toward research and plagiarism were assessed using the ATR and ATP questionnaires. The research instruments underwent translation and cultural adaptation in accordance with internationally accepted methodology. The psychometric properties of the ATR and ATP, including validity and reliability, were assessed. Confirmatory factor analysis was used to test the model’s fit to the data. Results The ATR and ATP questionnaires were completed by 793 medical students who were involved in research (647 undergraduates and 146 PhD students). Cronbach’s alpha coefficients of 0.917 and 0.822 indicated excellent and good scale reliability for the ATR and ATP questionnaires, respectively. The five-and three- factor structures of ATR and ATP have been validated with maximum likelihood confirmatory analysis, and the results demonstrated an adequate level of model fit (TLI = 0.930, CFI = 0.942 and TLI = 0.924, CFI = 0.943, respectively). Medical students showed a high degree of positive attitudes toward research and favorable scores across all three domains of attitudes toward plagiarism. In multivariate regression models, age was found to be positively associated with favorable attitudes of research usefulness, positive attitudes, relevance to life subscales and total ATR scale (p < 0.001), while PhD study level was related to research anxiety (p < 0.001) and favorable attitudes across all three ATP domains (p < 0.001). Conclusion Medical students who were involved in research showed a high degree of favorable attitudes toward research and plagiarism. Adjusting medical school curricula to include research courses would broaden the students’ interest in scientific research and maximize their impact on the full preservation of research ethics and integrity. Supplementary Information The online version contains supplementary material available at 10.1186/s13010-024-00161-z.

Background: The COVID-19 pandemic has had a significant impact on the global economy and public health, disrupting various aspects of daily life. Apart from its direct effects on physical health, it has also significantly affected the overall quality of life and mental health. This study employed a path analysis to explore the complex association among multiple factors associated with quality of life, anxiety, and depression in the general population of the Republic of Srpska during the pandemic’s second year. Method: A cross-sectional study was conducted on a nationally representative sample (n = 1382) of the general population (adults aged 20+) during the second year of the COVID-19 pandemic in the Republic of Srpska, Bosnia, and Herzegovina. Assessment tools included the DASS-21 scale for depression, anxiety, and stress, along with the Brief COPE scale, Quality of Life Scale (QOLS), and Oslo Social Support Scale (OSSS-3). Sociodemographic factors and comorbidities were also assessed. Structural equation modeling was used to identify the direct and indirect links of various characteristics to quality of life, anxiety, and depression. Results: This study revealed a considerable prevalence of anxiety and depression symptoms (27.5% and 20.9%, respectively), with quality of life playing a significant mediating role. The constructed path model accounted for 33.1% of moderate to severe depression and 79.5% of anxiety. Negative coping was directly linked to anxiety and indirectly to depression via anxiety, while the absence of positive coping had both direct and indirect paths (through quality of life) on depression. Among variables that directly affected depression, anxiety had the highest effect. However, the bidirectional paths between anxiety and depression were also suggested by the model. Conclusions: Pandemic response strategies should be modified to effectively reduce the adverse effects on public mental health. Further research is necessary to assess the long-term effects of the pandemic on mental health and to analyze the contributing factors of anxiety and depression in the post-COVID period.

Introduction: Metacognition, which refers to the ability to oversee and regulate one's cognitive activities, plays a crucial role in medical education. Evaluating metacognitive awareness is particularly important for university students, as it impacts their learning strategies and academic performance. The objective of this study was to examine the psychometric characteristics of the Serbian adaptation of the Metacognitive Awareness Inventory (MAI), with an emphasis on its construct validity and internal consistency. Materials and methods: This was a cross-sectional study conducted at the Faculty of Medicine University of Belgrade, on third-year medical students during October 2024. The psychometric properties of the Serbian version of the MAI were evaluated by assessing its factorial structure and internal consistency. The MAI consists of 52 items, comprising two primary components: 'Knowledge of Cognition' and 'Regulation of Cognition'. The subcomponent of "knowledge of cognition" were categorized into declarative knowledge, procedural knowledge, and conditional knowledge, whereas "regulation of cognition" subcomponent were classified into planning, information management strategies, comprehension monitoring, debugging, and evaluation. Results: A total of 426 medical students were included in the study. The mean age of the respondents was 21.3 ± 1.4 years, and the majority were females (68.5%). The mean score of the scale was 199.0. The internal consistency analysis of the Serbian version of the MAI questionnaire yielded a Cronbach's a of 0.94, and a McDonald's o of 0.95 for the entire scale, which indicates excellent scale reliability. The Serbian version of the MAI questionnaire was validated using confirmatory factor analysis, supporting both the hypothesized eight-factor and two-factor structures. The eight-factor model showed good fit indices (IFI = 0.908, CFI = 0.905, RMSEA = 0.042), with statistically significant factor loadings (p < 0.05). Similarly, the two-factor model demonstrated adequate fit (IFI = 0.921, CFI = 0.918, RMSEA = 0.039), with all loadings also significant (p < 0.05). Conclusion: The present study revealed the Serbian version of MAI as reliable and valid tool for identifying medical students' metaconginive awareness.

<p><strong>Introduction. </strong>Frailty is common in elderly persons and carries a high risk of poor health outcomes, including increased mortality, institutionalization, falls, and hospitalization. The aim of the work was to determine the risk factors for frailty in elderly persons.</p> <p><strong>Methods. </strong>The research was conducted in Bijeljina and Foča, in the period from February to June 2022, and was approved by the Ethics Committee of the Faculty of Medicine in Foča. A total of 243 respondents over the age of 65 took part in the research. When it comes to the instruments, the sociodemographic questionnaire, the EQ-5D-5L health questionnaire, the general sarcopenia rapid screening questionnaire SARC-F and the Kessler scale for the assessment of psychological distress were used.</p> <p><strong>Results.</strong> There were 43.6% of males and 56.4% of females participating in the research. One quarter (25%) of respondents evaluated their health as weak. Sarcopenia was identified in 28% of respondents, while 18.1% had a moderate and 11.9% a serious disorder in the field of psychological distress.</p> <p><strong>Conclusion. </strong>The presence of psychological distress and sarcopenia in a high percentage, as well as weak health status in the people over 65, is evident, which represents potential risk factors for frailty.</p>

Abstract Surgical treatment and formation of a stoma can be lifesaving for colorectal cancer patients. However, the quality of life is often impaired in patients with stoma. The goal of this study is to determine the quality of life of patients with stoma and cancer, and the relationship between the quality of life and characteristics of these patients. The study was conducted from 2018 to 2020 and included a total of 64 patients of both sexes with colorectal cancer and temporary or permanent stoma. The European Organization for Research and Treatment of Cancer with Quality of Life Questionnaire (EORTC QLQC29-30) and the anonymous WHO Quality of Life Questionnaire SF-36 were used for self-assessment of quality of life. Our study included 39 (61.0%) men and 25 (39.0%) women. 24 patients (37.5%) had colostomy, 14 patients (21.9%) had ileostomy, and 26 patients (40.6%) underwent surgery for resection of colorectal cancer without stoma. A significant number of women were in the group of patients with a permanent stoma (p = 0.01). There was no statistically significant difference in the assessment of general health (p = 0.680) and quality of life (p = 0.721) during the past month in relation to gender. Patients without a stoma rated their general health better compared to those with stoma and the difference reached statistical significance (p = 0.035). There was no statistically significant difference in the assessment of quality of life between the group of patients with stoma and without stoma, as well as between the patients of different age groups. Patients with stoma rated their general health as worse, but not their quality of life.

The aim of the study was to assess the seroprevalence of SARS-CoV-2 in the Republic of Srpska, Bosnia and Herzegovina, and to analyse the knowledge, attitudes and practices of the population toward COVID-19. This population-based study was conducted in a group of 1,855 randomly selected individuals from all municipalities from 1 December 2020 to 15 January 2021. All individuals were asked to sign a consent form and to fill in a questionnaire, following which a blood samples were collected. Total anti-SARS-CoV-2 antibodies were determined in serum specimens using the total Ab ELISA assay. The overall seroprevalence rate was 40.3%. Subjects aged <65 years were 2.06 times more likely to be seropositive than those aged ≥65, and 30% of seropositive individuals presented no COVID-19 symptoms. The household members of seropositive individuals were 2.24 times more likely to develop COVID-19 symptoms than the household members of seronegative individuals. More than 95% of respondents believe that preventive measures are very important to control the infection transmission. Majority of respondents wear the masks properly, maintain the required physical distance whenever possible and wash hands with soap. Nearly 50% of individuals were of the opinion that the vaccine could prevent the infection. This study showed that an overall SARS-CoV-2 seropositivity rate by the middle of January 2021 was very high. Attitudes and practices regarding the COVID-19 indicate that additional efforts should be taken in order to improve the health education with a focus on preventive measures and vaccination.