Health-related quality of life in different stages of breast cancer in Serbia.

OBJECTIVE: Breast cancer is the most commonly diagnosed malignant tumor worldwide, and Serbia ranks first in Europe in standardized breast cancer mortality rate. The aim of this research is to estimate health-related quality of life (HRQoL) and work productivity among patients in different stages of breast cancer in Serbia. SUBJECTS AND METHODS: A total of 175 breast cancer patients attending the breast cancer outpatient clinic at the Oncology Institute of Vojvodina between March 2022 and February 2023 were included in the study. Patients were divided into three mutually exclusive groups: (1) First year after primary breast cancer (Group P), (2) Second and following years after primary breast cancer or recurrence (Group S) and (3) Metastatic disease (Group M). The EQ-5D-3L self-classifier was used to estimate the HRQoL, using the EQ-5D-3L index value and visual analog scale (VAS) score. RESULTS: Мean EQ-5D-3L index value was 0.777 for Group P, and 0.768 for Group S. Patients with metastatic disease reported the lowest EQ-5D index value of 0.646 (p < 0.05). Pain/discomfort, as well as anxiety/depression, were the main drivers of the reduction in HRQoL. Patients in Group M also reported the lowest VAS score of 65.4. Furthermore, the highest percentage of women who sought leave or cited breast cancer as the reason for their early retirement were patients with metastatic disease. CONCLUSIONS: HRQoL was most impaired in Group M, and patients with metastatic disease were more likely to take sick leave or retire early due to breast cancer. Delaying or preventing metastatic recurrence could significantly benefit patients' productivity and HRQoL.

Burnout syndrome among employees in a clinical center in Montenegro during COVID-19.

OBJECTIVE: Burnout syndrome occurs as a result of the influence of stressors in the workplace. The chronic disproportion between the demands placed on the worker and the resources available to fulfill the demands makes a significant contribution to the development of this syndrome. The occurrence of burnout syndrome has been shown to occur in a wide range of jobs, and it is taking on epidemic proportions among healthcare workers. So far, there have been no large-scale studies dealing with burnout syndrome in healthcare workers in Montenegro. SUBJECTS AND METHODS: The research was conducted as a cross-sectional study. All full-time employees of the Clinical Center of Montenegro who participated in the treatment of patients with COVID-19 during 2020 and 2021 were included in the research. Questionnaires used in the research were: a general questionnaire for collecting socio-demographic data, a questionnaire for the assessment of burnout syndrome at work - Maslach Burnout Inventory and a COVID-19 stress scale. RESULTS: The prevalence of burnout syndrome was 16.8% among employees who were engaged around COVID-19 patients. Predictors of burnout syndrome identified were occupation (nurses/technicians have a 2.8 times higher chance of burnout syndrome than doctors as a reference category), confirmed COVID-19 infection (subjects with confirmed COVID-19 infection have more than 2 times higher chance for burnout syndrome), higher CSS scores (subjects with high CSS score have a 3% higher chance of developing burnout syndrome). CONCLUSIONS: In order to reduce losses due to reduced productivity of employees and prevent long-term detrimental consequences on the mental health of employees, evidence-based preventive measures are needed.

Quality of life and mental health of volunteers during COVID-19 pandemic: a cross-sectional survey in Serbia.

OBJECTIVE: There is a paucity of information on the COVID-19 pandemic's impact on young volunteers. Therefore, the aim of this survey was to examine the QoL and mental health of young volunteers of the Novi Sad Voluntary Service during the COVID-19 pandemic. PATIENTS AND METHODS: This cross-sectional prospective study included 255 members of the Novi Sad Voluntary Service, Serbia. The survey instrument probed into the respondents' demographic characteristics and was followed by the anonymous WHOQOL-BREF questionnaire that measured their quality of life during the COVID-19 pandemic and DASS-21 scale. All statistical analyses were carried out using IBM SPSS Statistics for Windows, vers. 24.0. RESULTS: The study sample consisted of 255 young volunteers (71.4% females, 28.6% males), 62.0% of whom were aged 18-25 years, and 52.2% were students. Lower Physical Capacity scores could be predicted by female gender (p < 0.01) and COVID-19 infection among friends (p < 0.05). Male gender (p < 0.05) and being employed (p < 0.05) predicted greater QoL in the Psychological domain. The only predictor of a lower QoL in the Social Relationships domain was the internet as the main COVID-19-related information source (p < 0.05). On the other hand, being female (p < 0.05) and having COVID-19-positive household members (p = 0.01) predicted lower environment domain scores. For the lower overall DASS-21 score, having COVID-19-positive household members was the only significant predictor (p < 0.01). CONCLUSIONS: Mental health support should pursue strategies to improve all domains of QoL, especially for vulnerable sub-groups of the population, such as young females and the unemployed. Bearing in mind the importance of public engagement and community support in pandemic circumstances, as well as generally in public health, these results are relevant for interventions far beyond the current pandemic.

Decade of lung cancer in Serbia: tobacco abuse and gender differences.

OBJECTIVE: Lung cancer (LC) is one of the most frequently diagnosed cancers and the leading cause of cancer mortality worldwide. The aim of this study was to get a comprehensive insight into the epidemiology of LC among patients in Vojvodina, the Northern Serbian region, during the ten-year period. PATIENTS AND METHODS: This retrospective study was performed using LC hospital registry data of the Institute for Pulmonary Diseases of Vojvodina (IPBV) from 2011 to 2020. All patients reported in the registry with a place of residence in Vojvodina were included in this study. The data used in this research were: date of diagnosis, gender, age at diagnosis, place of residence, smoking habits at diagnosis, the intensity of smoking (pack/years), ECOG performance (0-5), histological cancer type, TNM classification and disease stage. RESULTS: A total of 12,055 LC patients were included, 69.6% of whom were male. The percentage of female LC patients significantly increased, from 26.9% in 2011 to 35.9% in 2020 (p<0.001). Non-small cell lung cancer (NSCLC) was diagnosed in 80.8% of patients, while 15.4% of patients had small cell lung cancer (SCLC). The most common histological type was adenocarcinoma (41.9%), followed by squamous cell carcinoma (30.0%) and SCLC (15.4%). CONCLUSIONS: The number of diagnosed LC patients in the Northern Serbian region increased over the past decade and is significantly higher in females. There was a strong correlation between smoking habits and LC in both genders. Our results also indicate the importance of introducing and promoting LC screening programs for all risk populations, particularly current and ex-smokers of younger age.

The COVID-19 pandemic - related psychological distress and job burnout among Serbian pharmacy practitioners: a cross-sectional online study.

OBJECTIVE: The current COVID-19 pandemic has increased occupational stress for all healthcare providers, making job burnout one of the most common and largely unrecognized mental health issues among healthcare professionals. Besides physicians and nurses, pharmacy practitioners were "front-line" healthcare professionals with a critical and unique role in the public health crisis. Considering this, the aim of this study was to examine distress levels and the prevalence of job burnout among Serbian pharmacy practitioners in relation to the COVID-19 pandemic. SUBJECTS AND METHODS: This cross-sectional online study was conducted in April and May of 2020. A total of 176 pharmacy practitioners anonymously and voluntarily completed the two-section questionnaire, consisting of Copenhagen burnout inventory, CBI and 4DSQ Distress subscale. The two-section questionnaire was distributed online, among various social-media groups of pharmacy practitioners, as well as by personal contacts following the "snowball" sampling method. RESULTS: Results revealed moderately high burnout scores in our sample. The majority of the participants showed signs of personal-related job burnout, followed by work-related and client-related burnout. A strongly elevated distress level was obtained in almost two-thirds of study respondents. In addition, a significant and high correlation of all CBI subscales with distress was found, as well as medium correlations with sleep duration shortening as a mediator between distress and job burnout. CONCLUSIONS: Results of our study showed that job burnout significantly increased among pharmacy practitioners during the COVID-19 pandemic. Furthermore, we discovered that stress has an indirect impact on study participants' burnout via insufficient sleep.

Risk factors and clinical outcomes for intensive care unit patients with mul-tidrug-resistant Acinetobacter spp. bacteremia.

BACKGROUND: Multidrug-resistant (MDR) isolates of Acinetobacter spp. have been reported worldwide. This study aimed to analyze clinical features and outcomes of intensive care unit (ICU) patients with MDR Acinetobacter spp. bacteremia and to determine factors influencing survival by using 30-day mortality as the primary endpoint. METHODS: A case-control study included a total of 164 patients with MDR Acinetobacter spp. bacteremia hospitalized in ICUs in Vojvodina Province, Serbia, from January 2013 through March 2016. Medical records were reviewed, and patients' demographic and clinical characteristics were collected. Predictors of 30-day mortality were identified by logistic regression analysis.  Results: The overall 30-day mortality rate was 48.2 % (79 of 164 patients). Multivariate logistic regression analysis revealed that independent predictors of 30-day mortality were two or more co-morbidities, diabetes mellitus, and inappropriate use of antimicrobials.  Conclusion: Early implementation of appropriate antimicrobial therapy, particularly in critically ill ICU patients with MDR Acinetobacter spp. bacteremia, with two or more co-morbidities and diabetes mellitus, can be crucial for survival. HIPPOKRATIA 2020, 24(1): 21-26.