The Commitment to Excellence: Understanding Nurses' Perspectives on Continuous Professional Development.

Continuous Professional Development (CPD) is essential for nurses to maintain up-to-date knowledge and skills in the evolving healthcare sector. This study explores nurses' attitudes toward CPD, its necessity, and the challenges encountered. The aim is to examine nurses' perspectives on CPD, focusing on their participation and motivation, in relation to their workplace, workplace function, and form of work. A cross-sectional study design was employed with 151 nurses from University Hospital Centre Split, Croatia. Data were collected using the "Professional Development of Nurses questionnaire (Q-PDN)" and analyzed using descriptive statistical methods, the Kolmogorov-Smirnov test, Pearson's correlation, ANOVA test, and t-test. The average level of participation in CPD activities was 4.27 (±0.63), indicating a positive inclination towards CPD. The study identified a statistically significant difference in activities related to CPD (t = 2.12; p = 0.036) among employees of surgical and intensive care units compared to other departments, where a higher level of engagement was present among employees of other departments. Notably, nurses without managerial roles showed 0.16 points higher participation in CPD activities compared to their managerial counterparts, though this was not statistically significant (t = 0.92; p = 0.357). Nurses in managerial roles valued CPD for professional development more highly, with a significant difference (t = 2.77; p = 0.006). Full-time nurses demonstrated a higher perception of the importance of personal professional development compared to part-time nurses, with a significant difference (F = 2.88; p = 0.038). The study reveals a strong commitment to CPD among nurses, with variations based on workplace roles and schedules. It underscores the need for role-specific and adaptable CPD programs to meet diverse needs and enhance professional competence in the nursing workforce.

Differences in Resilience, Self-Stigma and Mental Health Recovery between Patients with Schizophrenia and Depression.

INTRODUCTION: There is growing evidence that resilience is a key factor for prevention of mental disorder. Low resilience levels were found in individuals at clinical high risk to psychosis and schizophrenia. Higher level of resilience was associated with better functioning, less severe negative, anxiety and depressive symptoms. Low level of self stigma is associated with recovery from schizophrenia. Aim of this paper was to determine whether resilience and self-stigma are significant predictors of mental health recovery in patients diagnosed with schizophrenia and depression treated in a rehabilitation-oriented program. SUBJECTS AND METHODS: 51 patients diagnosed with psychoses and 53 patients with depression treated in day hospital participated in this study. Internalized Stigma of Mental Illness Scale (ISMI), The Boston University Empowerment Scale (BUES), Perceived Devaluation and Discrimination (PDD) Scale, Mental Health Recovery Measure (MHRM) and Resilience questionnaire were used. RESULTS: Self-stigma positively correlates with PDD (r=0.44; p=0.000), and negatively with BUES (r=-0.78; p=0.000), resilience (r=-0.51; p=0.000) and with recovery (r=-0.59; p=0.000) in two groups. In addition, a higher PDD score indicates poorer levels of empowerment (r=-0.42; p=0.000), resilience (r=-0.35; p=0.000) and recovery (r=-0.44; p=0.000). Mental health empowerment, resilience and recovery all correlate significantly and positively with each other. Cross-group comparison results show the best results for patients with schizophrenia. Sociodemographic factors do not affect resilience, self-stigma nor recovery. CONCLUSION: Self-stigma and resilience are connected with moderate correlation. Research supports the need for interventions that prevent self-stigma and increase resilience in the treatment of schizophrenia patients.

Stress and burnout syndrome and their associations with coping and job satisfaction in critical care nurses: a literature review.

BACKGROUND: Burnout is usually defined as a prolonged response to chronic emotional and interpersonal stressors, characterrized by emotional exhaustion, depersonalization and lack of social accomplishment. Coping mechanisms and job satisfaction are associated with the incidence of burnout symptoms in a work context. SUBJECTS AND METHODS: The aim of this paper was to make a systematic analysis of the literature related to nurses' stress and the incidence of burnout syndrome in intensive care nurses, and also to determine the research into associations between coping mechanisms and job satisfaction on one side, and burnout on the other side. Appropriate databases (Scopus, PubMed) were searched with the aim of finding relevant studies and articles published in the last 15 years. The keywords were burnout, coping mechanisms, job satisfaction, nurses, and intensive care. Two independent reviewers carried out a selection of the studies. RESULTS: The literature review found 786 studies about burnout and its association with different variables. Twenty-nine original research papers were discovered in this review process. Open questions still remain concerning burnout and the associations between the considered variables. We also found that studies using a qualitative approach, which could provide better insight into the investigation of burnout, was insufficient in this area. CONCLUSION: Burnout syndrome is serious problem for healthcare systems and affects almost all profiles of healthcare workers. Although burnout is an evidence-based public health problem, there is still no systematic approach to prevention. Prevention activities to reduce stress and the incidence of burnout should be provided for nurses, especially those in very demanding posts.

Impact of Differences in Economic Development and Socioeconomic Stability on Benzodiazepine Exposure between the Three Balkans Countries.

INTRODUCTION: Anxiety disorders are among the most common mental disorders. Benzodiazepines belong to the group of anxiolytic sedatives and the most prescribed drugs in the world. The aim in ours study was to evaluate the differences in the exposure of the population to benzodiazepines (in period from 2014-2018) between Serbia, Slovenia and Croatia, the three countries of the Southwestern Balkans with varying degrees of socioeconomic development. STUDY DESIGN: A academic investigator initiated, pharmacoepidemiological difference-in-difference time series analysis of population exposure to benzodiazepines between the three, geographically close Balkans countries (Slovenia, Serbia, Croatia) with varying degrees of socioeconomic development has been carried out. Study was conducted as academic investigator initiated, in a retrospective manner on monthly basis international data set from January 2014 to December 2018. RESULTS: At the annual level, during the study period from January 2014 to December 2018, compared to Slovenia, Serbia and Croatia had higher DIDs, from 5 fold (Croatia) to 6 fold (Serbia), for all benzodiazepines in total. By analyzing the differences-in-difference, we have shown that influence of both time (month) and country on DIDs is significant as well as their mutual interaction (the country x month) for all benzodiazepines in total. CONCLUSION: Serbia and Croatia must implement explicit measures of reducing benzodiazepine prescription in health primary care based on evidence-based recommendations in the indications where general medicine practitioners/family doctors most commonly prescribe these medicines. Without providing a realistic supplement/alternative to benzodiazepines such as increasing the availability of psychotherapy and improving the structure of psychiatric professionals in healthcare settings, implicit measures are not recommended for reducing prescription, implementing accountability measures for prolonged prescription of benzodiazepines, and in particular for "masked" somatic diseases. All this comes to the fore by raising economic development and socioeconomic stability.

Mental Health in Domesticated Immigrant Population - a Systematic Review.

BACKGROUND: Migration is a process during which a person moves from one cultural setting to another in order to settle for a longer period of time or permanently. The number of immigrants in the world has more than doubled since 1975, with majority of migrants living in Europe today. Migration is now being increasingly recognized as a risk factor for multiple mental-health related issues, such as schizophrenia, psychosis, anxiety disorders and others. AIM: The aim of this study was to collect, systematically review and analyze relevant articles pertaining to the mental health of second-or-higher generations of domesticated immigrant population, as well as to determine common socio-cultural predisposition factors leading to the development of mental illness among the mentioned population. METHODS: Systematic search of relevant and peer-reviewed electronic database ScienceDirect was performed to identify studies related to mental health and healthcare in before-mentioned immigrant population. Study selection was performed by two independent reviewers, following the agreed specific inclusion and exclusion criteria. RESULTS: 2 036 records were identified through initial database search, out of which 5 studies were included in this review, after the selection process. CONCLUSION: The most consistent clinical finding is an increase in the rate of diagnosis of schizophrenia and related psychoses among migrants when compared to the host population, however the relationship between migration and psychotic disorders remains unexplained. So far, biological factors, such as cannabis use or obstetric complications, have failed to account for the risk of schizophrenia among migrant groups. Socio-environmental factors are now being looked upon as potential contributing factors for psychotic disorders in migrants.

Changes in values of cholesterol and tryglicerides after weight loss during treatment with aripiprazole in a patient with schizophrenia - Case report.

Metabolic syndrome can contribute to significant morbidity and premature mortality and should be accounted for in the treatment of mental disorders. Patients with schizophrenia are at risk of undetected somatic comorbidity. Patients with schizophrenia have metabolically unfavorable body composition, comprising abdominal obesity, high fat percentage and low muscle mass, leading to increased risk of metabolic and cardiovascular diseases. Smoking, poor diet, reduced physical activity and alcohol or drug abuse are prevalent in people with schizophrenia and contribute to the overall cardiovascular disease risk. Side effects of antipsychotics may cause diagnostic problems in deciding regarding the origin of particular symptoms (somatic illness vs. side effects) during treatment of psychotic disorders. Bearing in mind frequent comorbidity between of psychotic and somatic disorders, early recognition of such comorbidity is important, as well as the selection of antipsychotics. The aim of this article is to report a case of changes in values of cholesterol and tryglicerides after weight loss, during treatment with aripiprazole in a patient with schizophrenia. This case report emphasizes the importance of regular monitoring of values of cholesterol and tryglicerides during treatment with antipsychotics.

Side effects of treatment with benzodiazepines.

BACKGROUND: The use of benzodiazepine anxiolytics and hypnotics continues to excite controversy. Views differ from expert to expert and from country to country as to the extent of the problem, or even whether long-term benzodiazepine use actually constitutes a problem. Although as a class benzodiazepines act rapidly and are well tolerated, their use presents clinical issues such as dependence, rebound anxiety, memory impairment, and discontinuation syndrome. The aim of this article is to review literature regarding different side effects associated with treatment with benzodiazepines - effects on cognition, treatment with benzodiazepines during pregnancy, dependence on benzodiazepines and risk of falling. CONTENT ANALYSIS OF LITERATURE: Literature research included structured searches of Medline and other publications on the subject of treatment with benzodiazepines, particularly effects on cognition, risk of falls, benzodiazepine dependence and treatment with benzodiazepines during pregnancy. CONCLUSION: Results of investigations have revealed different side effects associated with treatment with benzodiazepines. Previous investigations showed that treatment with benzodiazepines may induce anterograde amnesia. Also, previous studies confirmed occurrence of physical dependence in high percentage of patients in long term treatment with benzodiazepines at therapeutic dosages. Some investigation suggested higher risk of oral cleft, the floppy infant syndrome, or marked neonatal withdrawal symptoms when using benzodiazepines during pregnany. Investigations have shown increased risk of falling in elderly persons taking benzodiazepines.

Update of suicide trends in croatia 1966-2002.

OBJECTIVE: To analyze trend the suicide rates in Croatia during the pre-war period of socialistic Yugoslavia (1966-1990), war period in the former Yugoslavia (1991-1995) and the post-war period of Croatian independence and democratization (1996-2002). METHOD: Using official suicide statistics, this study examined suicide rates in Croatia over a 36-year span (1966 to 2002) as a function of gender, age, marital status, time, war and social changes. Suicide rates were displayed graphically and compared with some neighbouring countries (Slovenia, SCG, Hungary and Italy). RESULTS: During the period of socialistic Yugoslavia, suicide rate in Croatia was constantly increasing with small variations. During the war time suicides with firearms were significantly increased. Since 1993 (the period of independence and democratization) there has been a trend of evident decrease in total suicide rate. CONCLUSION: This study demonstrated that Croatia has still had high suicide rates with declining trend since 1993, probably related to democratization, more national, religious and cultural rights, better availability of SSRIs and systemic campaign for education of general practitioners for early recognition and treatment of depressive disorders.

Suicides in croatia 1993-2001: regional differences.

OBJECTIVE: With regard to historical, economical, cultural, climate and probably genetic diversity of the Republic of Croatia, it is to be expected to find significant regional differences in suicide rates. The aim of this paper is to describe the specific regional characteristics of suicide rates in Croatia and compare it with that in neighbour countries like Slovenia, Hungary and Italy. METHOD: Using official suicide statistics, this study examined suicide rate in Croatia over a 8-years span (1993-2001) as the function of age, gender, employment and marital status and geographical regions. RESULTS: Our results demonstrated: a). higher suicide rate in the Continental part (21.96) in comparison with the Mediterranean part (15.42) of Croatia as well as lower suicide rate in the South (10.91) compared to the North (22.28) of Mediterranean Croatia; b). higher suicide male/female ratio in the Continental (3.49) than in the Mediterranean (2.36) Croatia as well as in the North (2.77) than in the South (1.94) of Mediterranean Croatia; c). bigger percentage of suicide in younger age (15-24 years) in the South (11.58%) than in the North (3.97%) of Mediterranean Croatia; d). lowest rate of homicide and lowest divorce rate were found in the South of Mediterranean Croatia with lowest suicide rates. CONCLUSION: This study showed significant regional differences in suicide rates accros the Republic of Croatia. With its south Mediterranean part, Croatia share the same low rate with Mediterranean neighbour Italy, while with its west-north continental part Croatia with high suicide rate is similar to its neighbours Slovenia and Hungary.