rss_2.0Slovenian Journal of Public Health FeedSciendo RSS Feed for Slovenian Journal of Public Health Journal of Public Health 's Cover between quality of life indicators and cardiac status indicators in chemotherapy patients<abstract> <title style='display:none'>Abstract</title> <sec id="j_sjph-2021-0028_s_006"> <title style='display:none'>Aim</title> <p>With the aim of improving personalized treatment of patients on chemotherapy, the objective of the study was to assess the degree of association between selected Quality of life (QoL) indicators and both clinical and imaging cardiac status indicators when detecting deterioration in QoL of these patients.</p></sec> <sec id="j_sjph-2021-0028_s_007"> <title style='display:none'>Methods</title> <p>In a cohort clinical study in Hamburg, from August 2017 through October 2020, 59 cancer patients, aged 18-80 years, were evaluated before chemotherapy, and at several follow-ups, using EQ-5D and SF-36 QoL questionnaires, fast strain-encoded (fast-SENC) cardiac magnetic resonance (CMR), conventional CMR, and echocardiography, and further received a clinical and biomarker examination. Data was analyzed using survival analyses. A decline of more than 5% in each observed QoL metric value was defined as the observed event. Patient were separated into groups according to the presentation of cardiotoxicity as per its clinical definition, the establishment of the indication for cardioprotective therapy initiation, and by a worsening in the value of each observed imaging metric by more than 5% in the previous follow-up compared to the corresponding pre-chemotherapy baseline value.</p></sec> <sec id="j_sjph-2021-0028_s_008"> <title style='display:none'>Results</title> <p>Among clinical cardiac status indicators, the indication for cardioprotective therapy showed statistically good association with QoL scores (EQ-5D p=0.028; SF-36 physical component p=0.016; SF-36 mental component p=0.012). In terms of imaging metrics, the MyoHealth segmental myocardial strain score was the only one demonstrating consistently good QoL score association (EQ-5D p=0.005; SF-36 physical component p=0.056; SF-36 mental component p=0.002).</p></sec> <sec id="j_sjph-2021-0028_s_009"> <title style='display:none'>Conclusions</title> <p>Established fast-SENC CMR scores are capable of highlighting patients with reduced QoL, who require more frequent/optimal management.</p></sec> </abstract>ARTICLE2021-10-20T00:00:00.000+00:00E-learning as an effective method in the prevention of patient falls<abstract> <title style='display:none'>Abstract</title> <sec id="j_sjph-2021-0034_s_006"> <title style='display:none'>Objectives</title> <p>Patient falls deteriorate patients’ functional condition and quality of life, and increase their treatment costs. E-learning is considered an effective way to gain knowledge and competencies for quality and safety in nursing practice. The aim of the study is to evaluate the effectiveness of an e-learning course for nurses in preventing in-patient falls.</p></sec> <sec id="j_sjph-2021-0034_s_007"> <title style='display:none'>Methods</title> <p>The research design was mixed. In the first phase of the study, a five-year retrospective analysis of 2,280 in-patient falls was performed. Based on the analysis of risk factors for patient falls and group interviews with clinic managers an e-learning course was designed and completed by 250 nurses from five surgical and internal departments. The course’s effectiveness was evaluated based on the incidence of patient falls and the consequences of the falls before and after e-learning.</p></sec> <sec id="j_sjph-2021-0034_s_008"> <title style='display:none'>Results</title> <p>At surgical departments, there was a statistically significant decrease in patient fall indices after the implementation of the e-learning course (from 4.4 to 2.6 falls per 1,000 patients; p=0.022). On the contrary, in internal departments, this index increased in the monitored period (from 19.0 to 26.9 falls per 1,000 patients; p=0.001). In all departments, there was a decrease in the incidence of patient injuries caused by falls after the implementation of the e-learning course; in internal medicine, this decrease was statistically significant (from 54.5% to 33.3%; p=0.014).</p></sec> <sec id="j_sjph-2021-0034_s_009"> <title style='display:none'>Conclusions</title> <p>The study confirmed that e-learning forms of education for healthcare professionals have a positive effect in preventing patient falls.</p></sec></abstract>ARTICLE2021-10-20T00:00:00.000+00:00Self-reported sexually transmitted infections and healthcare in Slovenia: Findings from the second national survey of sexual lifestyles, attitudes and health, 2016-2017<abstract> <title style='display:none'>Abstract</title> <sec id="j_sjph-2021-0030_s_006"> <title style='display:none'>Introduction</title> <p>Objectives were to estimate the lifetime prevalence of self-reported sexually transmitted infections (STIs) and describe STIs healthcare.</p></sec> <sec id="j_sjph-2021-0030_s_007"> <title style='display:none'>Methods</title> <p>Data was collected in the period 2016-2017 from a probability sample of the general population, 18-49 years old, at respondents’ homes by a combination of face-to-face interviews and self-administration of more sensitive questions. Statistical methods for complex survey data were used to account for stratification, clustered sampling, and weighting.</p></sec> <sec id="j_sjph-2021-0030_s_008"> <title style='display:none'>Results</title> <p>Approximately every tenth sexually experienced individual reported to have had genitourinary symptoms suggestive of STIs, but only a minority of them reported to have had those respective STIs diagnosed. The proportion of sexually experienced individuals that reported to have ever been diagnosed with an STI (excluding trichomoniasis, pubic lice for men and women, and pelvic inflammatory disease, vaginal thrush, bacterial vaginosis for women) was 2.4% for men and 6.7% for women (p&lt;0.001). Independent risk factors associated with self-reported STIs in women included at least 10 lifetime sexual partners and having been forced into sex. The majority of the last STI episodes in women were treated by gynaecologists accessible at the primary healthcare level and in men by a dermatovenerologist, after referral by a general practitioner. Approximately half of STI patients were counselled for safer sex and majority reported to have notified their sexual contacts.</p></sec> <sec id="j_sjph-2021-0030_s_009"> <title style='display:none'>Conclusions</title> <p>Our estimates for lifetime prevalence of self-reported STIs in a probability sample of Slovenian sexually experienced men and women, 18-49 years old, indicate a substantial national burden of STIs. The results will inform national STI prevention and control policies and strategies.</p></sec> </abstract>ARTICLE2021-10-20T00:00:00.000+00:00Students in danger: Binge drinking behaviour and associated factors in Hungary<abstract> <title style='display:none'>Abstract</title> <sec id="j_sjph-2021-0033_s_006"> <title style='display:none'>Introduction</title> <p>Among young adults, high rates of binge drinking were observed in certain European countries. Binge drinking is associated with several health problems (unplanned pregnancy, HIV infections, problems with memory, and injuries). The aim of this questionnaire-based study was to measure the frequency of binge drinking and its association with sociodemographic, familial, lifestyle factors and school performance among secondary and university students (n=2449) in Csongrád County, Hungary.</p></sec> <sec id="j_sjph-2021-0033_s_007"> <title style='display:none'>Methods</title> <p>In this cross-sectional study the students’ sociodemographic data, parents’ educational and economic level, and students’ academic performance and self-reported use of tobacco, drugs, and alcohol were collected by a questionnaire. Descriptive statistics and multivariable binary logistic regression analyses were applied using SPSS 24.0 software.</p></sec> <sec id="j_sjph-2021-0033_s_008"> <title style='display:none'>Results</title> <p>Altogether 2449 Hungarian secondary school students and university students participated in the study. Nearly one-third of the students were classified as binge drinkers, significantly more male university students. Tobacco or illicit drug use resulted in higher odds of being a binge drinker in both subgroups. Poor school performance and binge drinking were significantly correlated especially among secondary school students.</p></sec> <sec id="j_sjph-2021-0033_s_009"> <title style='display:none'>Conclusions</title> <p>Targeting alcohol, tobacco, and illicit drug use together, including education, parent interventions, and public health policies, are crucial in the prevention of possible serious consequences.</p></sec></abstract>ARTICLE2021-10-20T00:00:00.000+00:00A questionnaire for rating health-related quality of life<abstract> <title style='display:none'>Abstract</title> <sec id="j_sjph-2021-0035_s_006"><title style='display:none'>Background</title> <p>Translations of instruments for measuring quality of life developed in certain, mostly more developed, parts of the world usually do not cover regionally specific aspects of health-related quality of life, even after transcultural validation. The aim of this study was to develop and validate a reliable questionnaire in Serbian, Croatian, Bosnian, and Montenegrin languages suitable for measuring health-related quality of life in adults.</p></sec> <sec id="j_sjph-2021-0035_s_007"><title style='display:none'>Methods</title> <p>The study was of a cross-sectional type, assessing the reliability and validity of a newly developed questionnaire for measuring health-related quality of life (HRQoL) in adults residing in western Balkan states (WB-HRQoL). It was conducted on a sample of 489 adults from Serbia, Croatia, Bosnia &amp; Herzegovina, and Montenegro, with a mean age of 52.2±14.4 years and a male/female ratio of 195/294 (39.9%/60.1%).</p></sec> <sec id="j_sjph-2021-0035_s_008"><title style='display:none'>Result</title> <p>The definitive version of the WB-HRQoL scale with 19 items showed very good reliability, with Cronbach’s alpha 0.905. The scale was temporally stable, and satisfactory results were obtained for divergent and convergent validity tests. Exploratory factorial analysis brought to the surface four domains of health-related quality of life, namely the physical, psychical, social, and environmental.</p></sec> <sec id="j_sjph-2021-0035_s_009"><title style='display:none'>Conclusion</title> <p>The WB-HRQoL scale is a reliable and valid generic instrument for measuring HRQoL that takes into account the cultural specifics of the western Balkan region.</p></sec> </abstract>ARTICLE2021-10-20T00:00:00.000+00:00Development dynamics of health and social infrastructure for the long-term care – The case of the Posavje region<abstract> <title style='display:none'>Abstract</title> <sec id="j_sjph-2021-0036_s_006"><title style='display:none'>Background and purpose</title> <p>The populations of rural areas across Europe, especially Slovenia, are ageing rapidly and the areas themselves are becoming depopulated. Therefore, this study aims to contribute to our understanding of the population dynamics and provide a method for forecasting housing and other long-term care needs.</p></sec> <sec id="j_sjph-2021-0036_s_007"><title style='display:none'>Method</title> <p>The surveys questioned those responsible for long-term care, the caretakers in institutional care, and current and potential homecare users in rural areas of Slovenia. We wanted to discover what they considered as crucial in the process of long-term care deinstitutionalization. Our 2020–2050 projections are based on the surveys conducted across 38 municipalities in the Eastern Slovenian region and an in-depth empirical study in Posavje. The results are embedded in the demographic projections and the multistate transition model of the declining functional capacities to forecast the needed housing facilities and human resources.</p></sec> <sec id="j_sjph-2021-0036_s_008"><title style='display:none'>Results</title> <p>The results are the time series of required capacities. Around 60% of respondents in Slovenian rural areas believe that even a better organization of homecare would not allow them to stay at home until death due to inadequately built housing and the absence of a continuous presence of caregivers. These findings were included in the projections. Therefore, community care in the network of Smart Silver Villages was proposed.</p></sec> <sec id="j_sjph-2021-0036_s_009"><title style='display:none'>Discussion</title> <p>Investments are needed to renovate the housing stock of older adults and construct sheltered, assisted living housing and specialized households in the community. Moreover, proper education and training of human resources would increase the output. In addition, financial solutions are advised to develop Smart Silver Villages.</p></sec></abstract>ARTICLE2021-10-20T00:00:00.000+00:00Working conditions and satisfaction with working conditions among Slovenian family medicine trainees: A cross-sectional study<abstract> <title style='display:none'>Abstract</title> <sec id="j_sjph-2021-0032_s_006"> <title style='display:none'>Introduction</title> <p>In order to achieve a high standard in training programmes for future family medicine specialists, it is essential to have good tutors with well-organised family medicine practices. Proper working conditions for young doctors are essential for their satisfaction and future professional development. The aim of our study was to check the current working conditions of family medicine trainees in the practical modular part of the training programme in Slovenia, and to determine their satisfaction with working conditions.</p></sec> <sec id="j_sjph-2021-0032_s_007"> <title style='display:none'>Methods</title> <p>A cross-sectional study was conducted. The data was collected through a questionnaire distributed to 105 family medicine trainees undergoing the practical modular part of their training programme.</p></sec> <sec id="j_sjph-2021-0032_s_008"> <title style='display:none'>Results</title> <p>The study showed that the following 7 out of 25 organisational and labour law factors are significantly associated with a trainee’s general satisfaction with working conditions: the location where work with patients takes place, the privacy of the premises, the accessibility of the main tutor, a constant patient population, suitable places for rest, paid out-of-hours substitutions, and appropriate pay grade.</p></sec> <sec id="j_sjph-2021-0032_s_009"> <title style='display:none'>Conclusion</title> <p>The results we obtained can be used to address certain aspects of trainees’ working conditions in Slovenia that need improvement. By determining which working conditions significantly affect a trainee’s satisfaction, we have the opportunity to modify these conditions and thereby improve the training programme. This could result in a less stressful and more efficient residency programme.</p></sec> </abstract>ARTICLE2021-10-20T00:00:00.000+00:00Habits of energy drink consumption among teens in Slovenia – Focus group findings<abstract> <title style='display:none'>Abstract</title> <sec id="j_sjph-2021-0031_s_006"> <title style='display:none'>Introduction</title> <p>Teachers in Slovenia have been noticing the increased consumption of energy drinks among pupils. Therefore, the purpose of this study was to investigate habits that contribute to the frequency of energy drink consumption.</p></sec> <sec id="j_sjph-2021-0031_s_007"> <title style='display:none'>Method</title> <p>36 teens participated in the study: elementary school pupils (6th and 8th grades), general upper secondary school pupils, and secondary technical school pupils (1st and 3rd year). In the course of the study 6 group interviews were held to help investigate young people’s habits and their reasons for energy drink purchase and consumption. Moreover, we investigated the influence of age on the consumption and knowledge about energy drink ingredients, as well as their influence on the body.</p></sec> <sec id="j_sjph-2021-0031_s_008"> <title style='display:none'>Results</title> <p>Interview analysis showed that energy drink consumers are predominantly secondary school pupils. Their choice most frequently depends on the price, their taste, or the brand. What influences elementary school pupils’ purchasing decisions are price, packaging, and advertisements, while secondary school pupils choose their drinks according to the lack of energy and how tired they feel. The predominant factors preventing energy drink consumption are health problems among family members and friends. Secondary school pupils know more about energy drink ingredients than elementary school pupils.</p></sec> <sec id="j_sjph-2021-0031_s_009"> <title style='display:none'>Conclusion</title> <p>On the basis of these findings, we will design a survey questionnaire for Slovenian teenagers and teachers, didactic material, and suggestions for improving educational programmes.</p></sec> </abstract>ARTICLE2021-10-20T00:00:00.000+00:00Frequency of four-dimensional oral health problems across dental fields – A comparative survey of Slovenian and international dentists<abstract> <title style='display:none'>Abstract</title> <sec id="j_sjph-2021-0029_s_006"> <title style='display:none'>Objectives</title> <p>To compare the frequency of patients’ oral health problems and prevention needs among Slovenian and international dentists with the aim to validate the four oral health-related quality of life (OHRQoL) dimensions across six clinical dental fields in all World Health Organization (WHO) regions.</p></sec> <sec id="j_sjph-2021-0029_s_007"> <title style='display:none'>Methods</title> <p>An anonymous electronic survey in the English language was designed using Qualtrics software. A probability sampling for Slovenia and a convenience sampling strategy for dentist recruitment was applied for 31 countries. Dentists engaged in six dental fields were asked to categorize their patients’ oral health problems and prevention needs into the four OHRQoL dimensions (Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact). Proportions of patients’ problems and prevention needs were calculated together with the significance of Slovenian and international dentists’ differences based on dental fields and WHO regions.</p></sec> <sec id="j_sjph-2021-0029_s_008"> <title style='display:none'>Results</title> <p>Dentists (n=1,580) from 32 countries completed the survey. There were 223 Slovenian dentists (females: 68%) with a mean age (SD) of 41 (10.6) years and 1,358 international dentists (females: 51%) with a mean age (SD) of 38 (10.4). Pain-related problems and prevention needs were the most prevalent among all six dental fields reported by dentists; Slovenian (37%) and 31 countries (45%). According to Cohen, differences between Slovenia, the broader European Region, and 31 countries were considered non-significant (&lt;0.1).</p></sec> <sec id="j_sjph-2021-0029_s_009"> <title style='display:none'>Conclusion</title> <p>According to the dentists’ responses, the frequency of patients’ oral health problems and prevention needs are proportionate between Slovenia and 31 countries, regionally and globally. The four OHRQoL dimensions can be considered universal across all dental fields.</p></sec> </abstract>ARTICLE2021-10-20T00:00:00.000+00:00The safety culture of the Ljubljana community health centre’s employees<abstract> <title style='display:none'>Abstract</title> <sec id="j_sjph-2021-0021_s_006"> <title style='display:none'>Introduction</title> <p>Patient safety is one of the key aspects of healthcare quality and a serious global public health concern. Patient safety culture is a part of the patient safety concept. In Slovenia, primary care is easily accessible, and for medical care, it serves as a gatekeeper to hospital care. For several years, the quality and safety at the primary healthcare level have been the focus of several studies. The present study aimed to assess patient safety culture among all employees of the Community Health Centre Ljubljana.</p></sec> <sec id="j_sjph-2021-0021_s_007"> <title style='display:none'>Methods</title> <p>We conducted a cross-sectional study in 2017 using the Slovene version of “Medical Office Survey on Patient Safety Culture” from the Agency for Healthcare Research and Quality. Mean percent positive scores on all items in each composite were calculated according to a user guide.</p></sec> <sec id="j_sjph-2021-0021_s_008"> <title style='display:none'>Results</title> <p>The final sample contained 1021 participants (67.8% response rate), of which 909 (89.0%) were women. The mean age of the sample was 43.0±11.0 years. The dimensions most highly rated by the respondents were: teamwork and patient care tracking/follow-up. The lowest scores came from leadership support for patients’ safety and work pressure and pace.</p></sec> <sec id="j_sjph-2021-0021_s_009"> <title style='display:none'>Conclusion</title> <p>Patient safety culture in the Community Health Centre Ljubljana is high, but there are certain areas of patient safety that need to be evaluated further and improved. Our study revealed differences between professions, indicating that a customized approach per profession group might contribute to the successful implementation of safety strategies. Patient safety culture should be studied at national levels.</p></sec> </abstract>ARTICLE2021-06-28T00:00:00.000+00:00Prevalence and incidence of frailty among community-dwelling older adults in Slovenia<abstract> <title style='display:none'>Abstract</title> <sec id="j_sjph-2021-0027_s_006"> <title style='display:none'>Introduction</title> <p>Frailty is recognized as one of the most important global health challenges as the population is aging. The aim of this study was to evaluate prevalence and incidence of frailty, and associated factors, among the population of older adults in Slovenia compared to other European countries.</p></sec> <sec id="j_sjph-2021-0027_s_007"> <title style='display:none'>Methods</title> <p>The prevalence and 4-year incidence of frailty among older adults (≥65 years) were evaluated using data from the Survey of Health, Ageing and Retirement in Europe (SHARE). Frailty was defined by the SHARE operationalization of Frailty phenotype. Multiple logistic regression model was used to explore factors associated with frailty.</p></sec> <sec id="j_sjph-2021-0027_s_008"> <title style='display:none'>Results</title> <p>Age-standardized prevalence (95% CI) of frailty and pre-frailty in Slovenia were 14.9% (13.3-16.5) and 42.5% (39.8-45.2), respectively. Factors (OR, 95% CI) associated with increased frailty in Slovenia included age (7584 years: 5.03 (3.08-8.22); ≥85 years 21.7 (10.6-44.7) vs. 65-74 years), self-rated health (fair: 4.58 (2.75-7.61), poor: 54.6 (28.1-105.9) vs. excellent/very good/good), number of chronic diseases (1.20 (1.03-1.40)), and polypharmacy (yes: 3.25 (1.93-5.48) vs. no). Female gender and lower education were significantly associated with pre-frailty, but not frailty, in the adjusted model. Independently of these characteristics, age-standardized prevalence of frailty varied among geographical regions. Age-standardized 4-year incidence of frailty and pre-frailty in Slovenia were 6.6% (3.0-10.1) and 40.2% (32.7-47.6), respectively.</p></sec> <sec id="j_sjph-2021-0027_s_009"> <title style='display:none'>Conclusion</title> <p>Among the Slovenian population of older adults aged 65 years and older, the age-standardized prevalence of frailty is 15% and 4-year incidence of frailty is 7%. Regional differences in Slovenia show the lowest prevalence in central Slovenian regions and the highest in northeastern Slovenian regions.</p></sec> </abstract>ARTICLE2021-06-28T00:00:00.000+00:00Primary care research – influencing and implementing into policy<abstract><title style='display:none'>Abstract</title><p>This editorial describes how research in primary health care can be used to influence policy. It draws on previous literature to give an example from the UK of how research in one part of primary care, the health-visiting service, has endeavoured to use evidence to influence policy and practice. The editorial considers frameworks for policy implementation such as Bardach’s eight phase approach and concepts that can inform policy implementation such as Lipsky’s Street-Level Bureaucrat approach.</p></abstract>ARTICLE2021-06-28T00:00:00.000+00:00Scaling-up an integrated care for patients with non-communicable diseases: An analysis of healthcare barriers and facilitators in Slovenia and Belgium<abstract> <title style='display:none'>Abstract</title> <sec id="j_sjph-2021-0023_s_006"> <title style='display:none'>Introduction</title> <p>Although the concept of integrated care for non-communicable diseases was introduced at the primary level to move from disease-centered to patient-centered care, it has only been partially implemented in European countries. The aim of this study was to identify and compare identified facilitators and barriers to scale-up this concept between Slovenia and Belgium.</p> </sec> <sec id="j_sjph-2021-0023_s_007"> <title style='display:none'>Methods</title> <p>This was a qualitative study. Fifteen focus groups and fifty-one semi-structured interviews were conducted with stakeholders at the micro, meso and macro levels. In addition, data from two previously published studies were used for the analysis. Data collection and analysis was initially conducted at country level. Finally, the data was evaluated by a cross-country team to assess similarities and differences between countries.</p> </sec> <sec id="j_sjph-2021-0023_s_008"> <title style='display:none'>Results</title> <p>Four topics were identified in the study: patient-centered care, teamwork, coordination of care and task delegation. Despite the different contexts, true teamwork and patient-centered care are limited in both countries by hierarchies and a very heavily skewed medical approach. The organization of primary healthcare in Slovenia probably facilitates the coordination of care, which is not the case in Belgium. The financing and organization of primary practices in Belgium was identified as a barrier to the implementation of task delegation between health professionals.</p> </sec> <sec id="j_sjph-2021-0023_s_009"> <title style='display:none'>Conclusions</title> <p>This study allowed formulating some important concepts for future healthcare for non-communicable diseases at the level of primary healthcare. The results could provide useful insights for other countries with similar health systems.</p></sec></abstract>ARTICLE2021-06-28T00:00:00.000+00:00Variation in perception of safety culture in out-of-hours family medicine service in Croatia<abstract> <title style='display:none'>Abstract</title> <sec id="j_sjph-2021-0022_s_006"> <title style='display:none'>Introduction</title> <p>The Safety Attitudes Questionnaire (SAQ) is among the most frequently cited tools for measuring safety culture in healthcare settings. Its ambulatory version was used in this study. The aim was to assess safety culture in out-of-hours (OOH) family medicine service and its variation across job positions, regions, and respondents’ demographic characteristic.</p></sec> <sec id="j_sjph-2021-0022_s_007"> <title style='display:none'>Methods</title> <p>A cross-sectional observational study was carried out targeting 358 health professionals working in the 29 largest Croatian healthcare centres providing out-of-hours family medicine service. The response rate was 51.7% (185 questionnaires). The questionnaire comprised 62 Likert items with 5 responses (fully disagree to fully agree). Scores of negatively worded items were reversed before analysis. Scores on the total scale and subscales were calculated as additive scores. The study included demographic data on gender, age, working experience, and job position. Repeated measurement analysis of variance was used to assess variation of Safety Attitudes Questionnaire – Ambulatory Version (SAQ-AV) sub-scales.</p></sec> <sec id="j_sjph-2021-0022_s_008"> <title style='display:none'>Results</title> <p>Nurses assessed safety culture higher than did physicians and residents. Teamwork climate had higher scores than Ambulatory process of care and Organizational climate. Stress recognition and Perceptions of workload had the lowest overall scores. Variation across gender, age, working experience, and region was not statistically significant.</p></sec> <sec id="j_sjph-2021-0022_s_009"> <title style='display:none'>Conclusions</title> <p>SAQ-AV can be used to identify areas for improvement in patient safety at OOH GPs. There is a need to improve staffing and support for OOH GP residents. Further research is needed in order to gain better understanding of factors influencing observed variations among job positions.</p></sec></abstract>ARTICLE2021-06-28T00:00:00.000+00:00Quality of life and health status in middle-aged presumed healthy Slovenian family practice attendees<abstract> <title style='display:none'>Abstract</title> <sec id="j_sjph-2021-0026_s_006"> <title style='display:none'>Background</title> <p>There is a gap in our knowledge of health-related quality of life (HRQoL) in a population presumed healthy, so this study aimed to assess the associations between HRQoL, demographics and clinical variables.</p> </sec> <sec id="j_sjph-2021-0026_s_007"> <title style='display:none'>Methods</title> <p>The participants were attendees, presumed healthy, at 40 pre-selected model family medicine practices (MFMPs), aged between 30 and 65 years and recruited during a preventive check-up in 2019. Each MFMP pragmatically invited 30 attendees to voluntarily participate. The EQ-5D questionnaire was administered as a measure of HRQoL; the independent variables were demographic characteristics, smoking, alcohol consumption, stress perception, physical activity, signs of depression, cardiovascular risk, body mass index, blood pressure values, and blood sugar and lipidogram laboratory test values. Ordinal logistic regression was used to calculate associations between self-assessed quality of life, demographics, and clinical variables, with P&lt;0.05 set as statistically significant.</p></sec> <sec id="j_sjph-2021-0026_s_008"> <title style='display:none'>Results</title> <p>Of 986 participants, 640 (64.9%) were women and 346 (35.1%) men, aged 42.7±8.6 years. The average values for the EQ-5D-3L were 0.91±0.15. In the multivariate model, a positive association between adequate physical activity (p=0.003), and a negative association between higher age (p&lt;0.001), female gender (p=0.009), signs of depression (p&lt;0.001), stress (p=0.013), and EQ-5D score were identified.</p></sec> <sec id="j_sjph-2021-0026_s_009"> <title style='display:none'>Conclusion</title> <p>Given that physical activity was shown to be positively associated with HRQoL, it is of the utmost importance for family physicians to motivate their middle-aged patients, especially women and those with signs of depression and excessive stress, to adopt a more rigorously physically active lifestyle.</p></sec></abstract>ARTICLE2021-06-28T00:00:00.000+00:00Informal care in the context of long-term health care for the elderly in Slovenia: A qualitative study<abstract> <title style='display:none'>Abstract</title> <sec id="j_sjph-2021-0024_s_006"> <title style='display:none'>Background</title> <p>Slovenia is an aging society. Social security expenditures for the elderly are rising steadily, and the majority of Slovenians are firmly convinced that the state must provide elder care. This situation means that informal caregivers face many challenges and problems in their altruistic mission.</p> </sec> <sec id="j_sjph-2021-0024_s_007"> <title style='display:none'>Objectives</title> <p>To explore the experiences and feelings of informal caregivers and to provide an understanding of how informal caregivers support the elderly and what challenges and difficulties they face in Slovenian society.</p></sec> <sec id="j_sjph-2021-0024_s_008"> <title style='display:none'>Methods</title> <p>The study is based on qualitative semi-structured interviews with 10 caregivers. In addition to descriptive statistics, we conducted a qualitative study using the qualitative content analysis method.</p></sec> <sec id="j_sjph-2021-0024_s_009"> <title style='display:none'>Results</title> <p>We identified four themes among health caregivers’ experiences with challenges and problems in providing long-term health care for the elderly. Caregivers pointed out that they are mostly left to themselves and their altruistic mission of giving informal long-term care to their elderly relatives and friends. Systemic regulation of the national public health care system is the source of many problems.</p> </sec> <sec id="j_sjph-2021-0024_s_010"> <title style='display:none'>Conclusion</title> <p>Other social systems determine and limit the position of informal caregivers in Slovenia. This qualitative study should be understood as useful stepping-stone to future research and real improvement in this area.</p> </sec> </abstract>ARTICLE2021-06-28T00:00:00.000+00:00Training in interprofessional learning and collaboration: An evaluation of the interprofessional education program in the scale-up phase in Antwerp (Belgium)<abstract> <title style='display:none'>Abstract</title> <sec id="j_sjph-2021-0025_s_006"> <title style='display:none'>Background</title> <p>Curricula are reviewed and adapted in response to a perceived need to improve interprofessional collaboration for the benefit of patient care. In 2005, the module Interprofessional Collaboration in Healthcare (IPCIHC) was developed by the Antwerp University Association (AUHA). The program was based upon a concept of five steps to IPCIHC. This educational module aims to help graduates obtain the competence of interprofessional collaborators in health care.</p> </sec> <sec id="j_sjph-2021-0025_s_007"> <title style='display:none'>Methods</title> <p>Over a span of 15 years, the IPCIHC module is evaluated annually by students and provided with feedback by the tutors and steering committee. Data up to 2014 were supplemented with data up to 2019. For the students the same evaluative one-group, post-test design was used to gather data using a structured questionnaire. The tutors’ and students’ feedback was thematically analyzed.</p> </sec> <sec id="j_sjph-2021-0025_s_008"> <title style='display:none'>Results</title> <p>Based upon the results and the contextual changing needs, the program was adjusted. Between 2005 and 2019, a total of 8616 evaluations were received (response rate: 78%). Eighty percent of the respondents indicated through the evaluations that they were convinced of the positive effect of the IPCIHC module on their interprofessional development. Over the years, two more disciplines enrolled into this program and also education programs form the Netherlands.</p> </sec> <sec id="j_sjph-2021-0025_s_009"> <title style='display:none'>Conclusions</title> <p>After 15 years, positive outcomes are showed, and future health professionals have a better understanding of interprofessional learning. Gathering feedback and annually evaluation helped to provide a targeted interprofessional program addressing contextual changes. The challenge remains to keep on educating future healthcare providers in interprofessional collaboration in order to achieve an increase in observable interprofessional behaviour towards other professional groups.</p></sec></abstract>ARTICLE2021-06-28T00:00:00.000+00:00Key Challenges in Modelling an Epidemic – What Have we Learned from the COVID-19 Epidemic so far<abstract><title style='display:none'>Abstract</title><p>Mathematical modelling can be useful for predicting how infectious diseases progress, enabling us to show the likely outcome of an epidemic and help inform public health interventions. Different modelling techniques have been used to predict and simulate the spread of COVID-19, but they have not always been useful for epidemiologists and decision-makers. To improve the reliability of the modelling results, it is very important to critically evaluate the data used and to check whether or not due regard has been paid to the different ways in which the disease spreads through the population. As building an epidemiological model that is reliable enough and suits the current epidemiological situation within a country or region, certain criteria must be met in the modelling process. It might be necessary to use a combination of two or more different types of models in order to cover all aspects of epidemic modelling. If we want epidemiological models to be a useful tool in combating the epidemic, we need to engage experts from epidemiology, data science and statistics.</p></abstract>ARTICLE2020-06-25T00:00:00.000+00:00Optimisation of Heart Failure Management in Nursing Homes Using Point-of-Care Ultrasonography: Harmonious Trial Rationale and Design<abstract><title style='display:none'>Abstract</title><sec><title style='display:none'>Introduction</title><p>Heart failure is common in the nursing home population and presents many diagnostic and therapeutic challenges. Point-of-care ultrasonography is a bedside method that can be used to assess volume status more reliably than clinical examination. This trial was conceived to test whether point-of-care ultrasonography-guided management improves heart failure outcomes among nursing home residents.</p></sec><sec><title style='display:none'>Methods</title><p>Nursing home residents with heart failure will be enrolled in a multi-centre, prospective, randomised controlled trial. Residents will first be screened for heart failure. Patients with heart failure will be randomised in 1:1 fashion into two groups. Nursing home physicians will adjust diuretic therapy according to volume status for six months. Point-of-care ultrasonography will be used in the test group and clinical examination in the control group. The primary endpoint will be heart failure deterioration, defined as a composite of any of the following four events: the need for an intravenous diuretic application, the need for an emergency service intervention, the need for unplanned hospitalisation for non-injury causes, or death from whatever cause.</p></sec><sec><title style='display:none'>Expected results</title><p>The expected prevalence of heart failure among nursing home residents is above 10%. Point-of-care ultrasonography-guided heart failure management will reduce the number of deteriorations of heart failure in the nursing home population.</p></sec><sec><title style='display:none'>Conclusion</title><p>This study will explore the usefulness of point-of-care ultrasonography for heart failure management in the nursing home population.</p></sec></abstract>ARTICLE2020-06-25T00:00:00.000+00:00Slovenian Cross-Cultural Adaptation and Validation of Health-Related Quality of Life Measures for Chronic Otitis Media (COMQ-12), Vertigo (DHI, NVI) and TINNITUS (THI)<abstract><title style='display:none'>Abstract</title><sec><title style='display:none'>Purpose</title><p>To provide physicians and patients with the tools needed to evaluate patients’ problems and health-related quality of life by cross-culturally adapting and validating the Chronic Otitis Media Questionnaire 12 (COMQ-12), the Dizziness Handicap Inventory (DHI), the Neuropsychological Vertigo Inventory (NVI) and the Tinnitus Handicap Inventory (THI).</p></sec><sec><title style='display:none'>Materials and methods</title><p>COMQ-12, DHI, NVI and THI were translated into the Slovenian language and completed by patients treated at our department for chronic otitis media, vertigo or tinnitus. The control group for each questionnaire consisted of healthy volunteers. Internal consistency, test-retest reliability, discriminant validity, diagnostic accuracy and cut-off value were determined for each questionnaire.</p></sec><sec><title style='display:none'>Results</title><p>Test-retest reliability was excellent for DHI (ICC A=0.946) and NVI (p=0.315, ICC A=0.975), good to excellent for COMQ-12 (p=0.680, ICC A=0.858) and satisfactory for THI (p=0.120). Discriminant validity was confirmed for each questionnaire (p&gt;0.05) using the Mann-Whitney U test (COMQ-12, DHI, THI) or the Welch t-test (NVI). COMQ-12 had acceptable (α=0.796) and DHI (α=0.910), NVI (α=0.950) and THI (α=0.924) perfect internal consistency. COMQ-12 and DHI had excellent, NVI acceptable and THI perfect diagnostic accuracy (AUC=0.987, AUC=0.999, AUC=0.781 and AUC=1.000 respectively). Cut-off values determined by Youden’s index were 7, 7, 9 and 56 for COMQ-12, THI, DHI and NVI, respectively.</p></sec><sec><title style='display:none'>Conclusion</title><p>Slovenian COMQ-12, DHI, NVI and THI are a valid and accurate tool for the diagnosis and measurement of health-related quality of life in patients with chronic otitis media, vertigo and tinnitus. They could aid general practitioners, occupational health specialists, neurologists and otorhinolaryngologists.</p></sec></abstract>ARTICLE2020-06-25T00:00:00.000+00:00en-us-1