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Aim To assess a psychosocial impact of the Coronavirus disease 2019 (COVID-19) on health care workers and to quantify the size of depression symptoms, anxiety and stress levels. Methods This cross-sectional study used an anonymous online survey questionnaire as a research instrument and it included 114 health workers of all profiles from the Sarajevo Canton employed in private and public institutions. The research was voluntary, non-commercial and all participants provided an oral informed consent. Depression, Anxiety and Stress Scale (DASS-21) questionnaire was used for assessing emotional status of depression, anxiety and stress. Results The mean age of participants was 40.5±8.44 years with male:female ratio of 0.28. Prevalence of depression was 46.5%, anxiety61.4%, and 36.9% stress. Age and gender had no effect on emotional status, but it was revealed that women achieved higher depression, anxiety and stress scores than men (without statistical significance). The most notable effect on the emotional state was found for direct or indirect contact with COVID-19 patients. Medical workers in direct contact with COVID-19 patients achieved greater depression (p=0.005), anxiety (p=0.001), stress (p=0.030) and total DASS-21 (p=0.003) scores. Conclusion High prevalence of health workers affected by various psychological ailments during the COVID-19 pandemic was found. This evidence underscores the need to address adverse effects of the pandemic on mental health of health care workers.

Amer Ovčina, E. Eminović, S. Izetbegovíc, Jasmina Marušić, Dželila Dedović, Nada Spasojević

Healthcare risk management began in the 1960s (USA, UK, Australia, New Zealand). It has traditionally been driven by insurance and lawsuits. Today, health risk management is widely accepted through development of appropriate standards and educational programs (1). Risk management within the organization should be recognized as an integral part of good management, or part of organizational culture. Risk management should be included in the organization’s philosophy, practices and business plans, and not treated as a separate program (2). RISK MANAGEMENT IN THE CLINICAL HEALTH CARE PROCESS

Amer Ovčina, Jasmina Marušić, A. Hajdarevic, Nada Spasojević, E. Eminović, Selveta Mušanović

Healthcare documentation or nursing documentation as often used in practice is the name of an indispensable part of a patient’s medical documentation, and documentation is an integral part of a nurse’s daily work. Documenting health care in the hospital means recording data on all procedures performed, during the entire health care process for the individual, all for the purpose of systematic monitoring, planning and evaluation of the quality of health care. Nursing documentation serves as a means of communication between the team and is of great importance for the quality and continuity of health care.

Aim: The aim of this study is to represent the prevalence of non-communicable diseases risks among patients of family medicine practices in the Federation of Bosnia and Herzegovina. Risks prevalence was obtained from an organized massive screening being performed by 100 family medicine teams in four cities of the Federation of B&H during 2013. Material and Methods: Our concept of “preventive treatment of a patient” included detecting and monitoring the following chronic non-communicable diseases risk factors: (a) hypertension; (b) obesity; (c) smoking; (d) physical inactivity; and (e) dyslipidemia; (f) diabetes mellitus. Our sample of examined patients was 46.638. Results: Highest risk prevalence within entire F B&H is observed for dyslipidemia (90.3%) and physical inactivity (64.7%). Lowest prevalence was found for blood sugar and hypertension at 19.2% and 21.6%, respectively. Smoking prevalence of the examined patients was 28.4%. Prevalence of the obesity as health risk (ITM > 30) was 25.5 %. It is of interest that statistically significant differences of individual risk prevalence among cities are evident. Risk distribution among cities ranked from highest to lowest prevalence, shows clearly that Sarajevo is leading in four risks compared to the other cities, while Zenica is ranked lowest for four risk factors. The examined population of the four cities can be ranked from lowest to highest prevalence of the examined risk factors as follows: Sarajevo, Mostar, Tuzla, and Zenica.

Aim: To determine the rural–urban differences in primary care practice, hospital inpatient care and total services. Methods: This cross-sectional study used data from Zenica-Doboj Canton in Federation of Bosnia and Herzegovina (FBiH). The overall sample size for the study was 1,995. Individual interviews were conducted in one randomly selected day of the week, except Monday and Friday, on the basis of EUROPEP (European Task Force on Patient Evaluations of General Practice Care) standardized questionnaire. Results: Out of total number (n=1 995), 47.9% was urban population and median of age was 42 years for both populations. The most of urban residents (81.4%) had finished high school or higher education compared with rural residents (58.5%) (p < 0.001). There are significant differences in employment status between rural and urban population (p < 0.001). Rural residents are more likely to travel more than 15 minutes to see their health facilities compared with urban residents (61.7% vs. 24.4%, respectively). Median of distance (kilometers) from residence location to the nearest hospital was statistically significantly higher in rural Me = 8.0 (5.0 do 14.5) km compared to urban population Me = 1.5 (1.0 to 3.0) km (p < 0.001). The rural population was more likely to buy drugs for medical treatment (p < 0.001) and parenteral injections in primary care practice (p < 0.001). Conclusion: There are significant differences in the overall health care assessment of rural populations as compared to urban populations.

Aim. To determine the influence of sociodemographic factors on patients´ satisfaction with health care system. Methods. In a cross-sectional study, 1,995 patients from 12 municipalities of Zenica-Doboj Canton were interviewed after a visit to the practice. Individual interviews were conducted and the questionnaire was made on the basis of EUROPEP (European Task Force on Patient Evaluations of General Practice Care) standardized questionnaire. Results: Out of the total number patients, 47.1% were females, 47.9% were from urban population and median of age was 42.0 years (IQR = 30.0 to 53.0 years). The rural population was more likely to buy drugs for medical treatment (p < 0.001) and parenteral injections in primary care practice (p < 0.001). Patients with lower level of education were more likely: to be ordered for physical examination (p = 0.001), to buy drugs for medical treatment (p = 0.001), to buy parenteral injections in primary care practice (p < 0.001); to pay unofficially to someone from medical staff (p < 0.001); to feel that they could be better treated (p = 0.032) and they had longer waiting for health service in primary care practice (p < 0.001). Older population had better assessment of secondary (p = 0.040) and tertiary health care practices (p = 0.034); needed more time is needed to reach health facilities (p = 0.016), longer waiting for health service in primary care practice (p < 0.001); more likely to have health problems in the past 12 months but they did not request medical treatment (p = 0.008); more likely to be ordered for physical examination (p < 0.001); more likely to buy drugs for medical treatment (p = 0.004); more likely to buy parenteral injections in primary care practice (p < 0.001). Conclusion: The following variables: gender, age, overall perception of health status and financial status appear to be predictors of patients´ satisfaction.

Pepic Esad, I. Hasanbegović, Jasmin Muanovic, Nada Spasojević, Dubur Amela, Dubur Alen

Introduction: Quality of life is a broad term that refers to the total well-being of the individual in terms of physical, psychological, emotional, mental, and social well-being, and which is in turn influenced by numerous factors including age, gender, socioeconomic status, risk factors in behavior, the environment, and the absence or presence of disease. Goal: The goal was to determine the presence of respiratory symptoms in smokers and to compare them with non-smokers as well as determine the relationship between quality of life with the frequency of respiratory symptoms from the aspect of gender, age, the environment in which they live, and the total monthly income of smokers compared to non-smokers. Material and Methods: The study was conducted on a sample of 600 subjects who were divided into two groups. The first group consisted of regular smokers (300 subjects) and the second group consisted of non-smokers. Former smokers were not included in the study. The survey questionnaire was designed on the basis of the following. A questionnaire to test the quality of life SF-36; Inventory of socioeconomic status EuroQoL; Basic respiratory symptoms were examined by MRC questionnaire (consisting of 9 questions). Results: The presence of respiratory symptoms was not associated with gender and the area of origin of the respondents, while the level of education, age, total monthly household income, and smoking status were directly related to the presence of respiratory symptoms, so that respondents with lower education levels, older ones, those with lower incomes, and smokers have more pronounced symptoms of respiratory problems. There is large negative impact of respiratory symptoms presence on respondent's quality of life. Conclusion: Smoking status were directly related to the presence of respiratory symptoms. There is large negative impact of respiratory symptoms presence on respondent's quality of life.

V. Šimunović, Milivoj Petković, S. Miscia, M. Petrovic, Robert Stallaerts, Werner Busselmaier, Michael Hebgen, A. Horsch et al.

Since its foundation in 1992, the Croatian Medical Journal (CMJ) has followed the strict standards of quality in the scientific publishing. However, the Journal has been aware that its specific position demands more than just following the already established rules. From the very beginning, the Journal declared an “author-helpful policy,” stating that “journal editors should have a major role in training authors in science communication, especially in smaller and developing scientific communities. Journal authors usually send scientifically acceptable but poorly prepared articles and it is a pity to lose valid data because of their poor presentation.” (1,2). In brief, the editors and editorial staff of the CMJ have been well aware that the skills of scientific reporting and publishing in our academic community are not developed and that valuable research results and valid data are being lost because of poor presentation. To be perfectly honest, ten years ago this statement looked like a nice promise, one of the many we in academic medicine learnt not to take too seriously.

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