Burnout and job satisfaction of healthcare workers in Slovenian nursing homes in rural areas during the COVID-19 pandemic.

INTRODUCTION AND OBJECTIVE: Since there is no study on burnout and job satisfaction in Slovenian nursing homes during the COVID-19 pandemic, this study aims to analyse job satisfaction and burnout levels of healthcare professionals working in Slovenian nursing homes in rural areas during the COVID-19 pandemic, and make a comparison with the results of the same services in 2013. MATERIAL AND METHODS: The study is based on a cross-organisational and descriptive quantitative study conducted in spring 2013 (n = 556) and spring 2020 at the peak of the pandemic in Eastern Europe (n = 781) to identify the relationships and the changes in the satisfaction and burnout levels of healthcare professionals working in Slovenian nursing homes in rural areas, and on a qualitative study conducted in 2020, to identify in-depth relationships and changes in both studies during the COVID-19 pandemic. RESULTS: An increase in burnout syndromes between 2013 - 2020 was observed. The respondents experienced intensified emotional exhaustion and lack of personal accomplishment during the COVID-19 pandemic; however, depersonalisation did not differ statistically over the years. During the pandemic crisis, healthcare workers were less satisfied with their job than in spring 2013. Their job satisfaction was related to satisfaction with the work of nursing homes and with the work of state institutions and politicians who directly affected their working conditions and recognition in society. CONCLUSIONS: The COVID-19 pandemic significantly exacerbated already existing burnout syndromes of nursing homes healthcare workers in Slovenian rural areas. Job satisfaction proved to be a relevant predictor of burnout syndrome. A negative correlation was observed between job satisfaction in 2020 and emotional exhaustion and personal accomplishment in 2013 and 2020.

Lifestyle and perceived health in subjects with chronic bronchitis or emphysema: a cross-sectional study.

BACKGROUND: The study aim was to compare lifestyle behaviors, body mass index (BMI) and perceived health in subjects with and without chronic bronchitis or emphysema, and to explore if these comparisons differed between demographic subgroups. METHODS: A stratified two-stage sample of the population of Serbia was used; 14.522 adults aged ≥ 20 years were interviewed. RESULTS: Compared with controls, respondents with chronic bronchitis or emphysema reported a 23% increased likelihood of eating fresh vegetables every day (CI 1.02-1.48), 58% increased likelihood of currently smoking (CI 1.32-1.88) and more likely to perceive their health as very bad or bad (OR 4.67, CI 3.64-5.98). After stratification for sex, education, and type of settlement, smoking was significantly associated with chronic bronchitis or emphysema in all subgroups except males. The increased likelihood of very bad or bad perceived health in respondents with chronic bronchitis or emphysema was significant in all subgroups, and was highest for respondents ≤ 65 years of age (adjusted OR 6.51; CI 4.87-8.72) and lowest for respondents > 65 years of age (adjusted OR 3.25; CI 2.12-4.97). CONCLUSION: Efforts to enhance perceived health and healthy lifestyle behaviors in subjects with chronic bronchitis or emphysema are necessary. Special attention should be paid to smoking cessation in almost all demographic subgroups.

Kinetics of C-reactive protein, interleukin-6 and -10, and phospholipase A2-II in severely traumatized septic patients.

BACKGROUND/AIM: Injury-induced anergy is one of the key factors contributing to trauma victims' high susceptibility to sepsis. This group of patients is mostly of young age and it is therefore essential to be able to predict as accurately as possible the development of septic complications, so appropriate treatment could be provided. The aim of this study was to assess kinetics of interleukin (IL)-6 and -10, phospholipase A2-II and C-reactive protein (CRP) in severely traumatized patients and explore the possibilities for early detection of potentially septic patients. METHODS: This prospective study included 65 traumatized patients with injury severity score (ISS) > 18, requiring treatment at surgical intensive care units, divided into two groups: 24 patients without sepsis and 41 patients with sepsis. C-reactive protein, IL-6 and -10 and phospholipase A2 group II, were determined within the first 24 hours, and on the second, third and seventh day of hospitalization. RESULTS: Mean values of IL-6 and phospholipase A2-II in the patients with and without sepsis did not show a statistically significant difference on any assessed time points. In the septic patients with ISS 29-35 and > 35 on the days two and seven a statistically significantly lower level of IL-10 was found, compared with those without sepsis and with the same ISS. C-reactive protein levels were significantly higher in septic patients with ISS 18-28 on the first day. On the second, third and seventh day CRP levels were significantly lower in the groups of septic patients with ISS 29-35 and > 35, than in those with the same ISS but without sepsis. CONCLUSION: Mean levels of CRP on the first day after the injury may be useful predictor of sepsis development in traumatized patients with ISS score 18-28. Mean levels of CRP on the days two, three and seven after the injury may be a useful predictor of sepsis development in traumatized patients with ISS score more than 28. Mean levels of IL-10 on the second and seventh day after the injury may be a useful predictor of sepsis development in traumatized patients with ISS score > 28.

[Damage control surgery--our experience].

Damage control surgery represents widely implemented technique of treatment of seriously injured patients all over the world. In medical facilities with large number of seriously injured patients, type of injuries often imposes method of damage control surgery as ultimate way in treating such patients. In Emergency center from 2005-2009. 895 patients had been operated because of the trauma to the abdomen and thorax. Method of damage control surgery had been implented on 41 patients (4.6% of all operated patients). 18 patients died, and 30 seriously injured patients that hadn't been treated according to this method had died in operating room. Likewise, 11 non-trauma patients were treated according to the principles of damage control surgery because of uncontrolled bleeding. The greatest challenge today is defining criteria for choosing right patients for damage control surgery.

Prevalence of chronic diseases according to socioeconomic status measured by wealth index: health survey in Serbia.

AIM: To examine socioeconomic inequalities in the prevalence of chronic diseases in Serbia, using the data from 2006 national health survey. METHOD: A stratified sample of 7673 households was selected and 14522 household members older than 20 years were interviewed (response rate 80.5%). Wealth index was used as a measure of socioeconomic status. Standardized morbidity prevalence ratios were computed using the poorest category as reference. Odds ratios for the prevalence of the selected chronic diseases and their 95% confidence intervals were calculated by multivariate logistic analysis adjusted for age, education, smoking status, and body mass index. RESULTS: Hypertension was the most prevalent disease in all socioeconomic categories; standardized morbidity prevalence ratios were higher in richer men (151.3 in the richest) and lower in richer women (86.1 in the richest). Rheumatism/arthritis was the second most prevalent disease in both sexes, with the highest prevalence in the poorest group; the pattern remained the same after standardization (standardized morbidity prevalence ratio in the richest: 86.4 in men and 74.0 in women). The prevalence of hyperlipidemia was associated with wealth index in both men and women and was highest in the richest group; the pattern remained the same after standardization (standardized morbidity prevalence ratio in the richest: 275.9 in men and 138.4 in women). Logistic regression models showed that higher wealth index was associated with higher prevalence of hypertension, hyperlipidemia, and allergy, while lower wealth index was associated with higher prevalence of rheumatism/arthritis. CONCLUSION: There were considerable socioeconomic inequalities in the prevalence of chronic diseases in Serbia. These results indicate an opportunity to reduce inequalities and show a need for further investigation on the determinants of chronic diseases.