Prevalence of adverse childhood experiences (ACE) in the Czech Republic.

A cross-sectional survey was undertaken to estimate the prevalence of child maltreatment and adverse childhood experiences in the Czech Republic, as data on these is scarce. The survey was conducted among 1760 randomly selected students from five Czech universities. Participants filled in the adverse childhood experiences survey instrument. The results showed that the prevalence of child maltreatment and other adverse childhood experiences is high: emotional abuse was reported by 20.7%, physical abuse by 17.1%, sexual abuse by 6.4%, and physical neglect by 8.0%. Household dysfunction was also high, with household street drug use reported by 4.9%, alcohol misuse by 15.3%, mental disorder by 13.4%, parental violence by 22.1% and parental separation by 23%. Thirty-eight per cent had not experienced any adverse childhood experience, while 9.9% reported experiencing four or more types of adverse childhood experiences. There was a significant association between adverse childhood experiences and health-harming behaviours such as suicide attempt, drug use, risky sexual behaviour and tobacco use. The findings suggest that there is a need to invest in prevention programmes.

Medical and salutogenic approaches and their integration in taking prenatal and postnatal care of immigrants.

OBJECTIVES: To compile a proposal of the system of taking complex prenatal, perinatal and postnatal care of pregnant immigrants in the Czech Republic with taking into account medical and salutogenic approaches. MATERIAL AND METHODS: The research was implemented by the form of a controlled interview and was based on a questionnaire comprising 50 questions focused on the evaluation of taking the prenatal, natal and postnatal care of immigrants. The data were accumulated among immigrants from Vietnam, Mongolia and Ukraine. RESULTS: It is possible to conclusively state that no principal dissatisfaction with taking care of pregnant women in the Czech Republic compared to native countries was demonstrated. There is a difference in a more considerable participation of midwives in the prenatal and natal care compared to the native countries. Failures in taking care of mothers-immigrants in the Czech Republic are considered to be the poor communication, particularly in association with the language barrier, limited possibilities of the participation of family members in the delivery and persisting unsuitable behaviour of certain healthcare professionals. CONCLUSION: In the Czech Republic, the medical care is at a higher level compared to native countries. For the improvement of the salutogenic attitude, it is necessary to take into consideration certain results and provide their application to practice.

Medical and salutogenic approaches and their integration in taking prenatal and postnatal care of Czech women.

OBJECTIVE: To compile a proposal of the system of taking complex prenatal, perinatal and postnatal care of pregnant women and their children in the Czech Republic with taking into account medical and salutogenic approaches. MATERIAL AND METHODS: A questionnaire was prepared comprising questions for mothers and making it possible to exactly use specified data from their healthcare documentation. The method thus consisted of a secondary data analysis and subsequent contact with mothers. This was implemented in the form a qualitative and narrative interview. The study included 541 women from five Czech regions. RESULTS: In this group, there was a high level of the preventive care with persisting preference of prenatal consulting rooms conducted by physicians. Most deliveries occurred in institutions in the presence of physicians. In the groups evaluated, there were, however, no significant differences. In spite of this, the evaluation of delivering women indicated that there is a high level of the perinatal care in terms of the medical approach. However, the salutogenic care calls for increasing the active participation of midwives in the prenatal, perinatal and postnatal care and extension and intensification of activities particularly in the psychosocial area. CONCLUSION: In the group monitored, there were no significant correlations of determined perinatal interventions with the method and result of the delivery and condition of the mother and newborn. It is to mention that the medical perinatal care is at a high level.