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Kovačević I, Majerić Kogler V, Krikšić V, Ilić B, Friganović A, Ozimec Vulinec Š, Pavić J, Milošević M, Kovačević P, Petek D. Non-Medical Factors Associated with the Outcome of Treatment of Chronic Non-Malignant Pain: A Cross-Sectional Study. Int J Environ Res Public Health 2022; 19:2881. [PMID: 35270575 PMCID: PMC8910574 DOI: 10.3390/ijerph19052881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/25/2022] [Accepted: 02/28/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Chronic pain is a global public health issue with increasing prevalence. Chronic pain causes sleep disorder, reactive anxiety, and depression, impairs the quality of life; it burdens the individual and society as a whole. The aim of this study was to examine non-medical factors related to the outcome of the treatment of chronic non-malignant pain. METHODS A cross-sectional study with two groups of patients was conducted using a questionnaire with biological, psychological, and social characteristics of patients. Since this study was cross-sectional, it was not possible to determine whether some factors were the cause or the consequence of unsuccessful treatment outcome, which is at the same time one of the disadvantages of cross-sectional studies. RESULTS The poor outcome of the treatment of chronic non-malignant pain in a multivariate binary logistic regression model was statistically significantly associated with the lower quality of life (OR = 0.95 (95% CI: 0.91-0.99; p = 0.009), and higher depression level OR = 1.08 (95% CI: 1.02-1.14; p = 0.009). The outcome of the treatment was not directly related to social support measured by the multivariate binary logistic regression model (OR = 1.04, 95% CI: 0.95-1.15, p = 0.395), but solitary life (without partner) was (OR = 2.16 (95% CI: 1.03-4.53; p = 0.043). CONCLUSION The typical patient with a poor pain management outcome is retired, presents depressive behavior; their pain disturbs general activity and sleeping. Moreover, they have a physically disturbed quality of life and require self-treatment due to the inaccessibility of doctors and therapies. The principle of treatment of patients with chronic, non-malignant pain should take into account a biopsychosocial approach with individually adjusted procedures.
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Affiliation(s)
- Irena Kovačević
- Department of Nursing, University of Applied Health Sciences, Mlinarska 38, 10000 Zagreb, Croatia; (V.K.); (B.I.); (A.F.); (Š.O.V.); (J.P.)
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, 1000 Ljubljana, Slovenia;
| | | | - Valentina Krikšić
- Department of Nursing, University of Applied Health Sciences, Mlinarska 38, 10000 Zagreb, Croatia; (V.K.); (B.I.); (A.F.); (Š.O.V.); (J.P.)
- Institution for Home Healthcare Domnius, 10000 Zagreb, Croatia
| | - Boris Ilić
- Department of Nursing, University of Applied Health Sciences, Mlinarska 38, 10000 Zagreb, Croatia; (V.K.); (B.I.); (A.F.); (Š.O.V.); (J.P.)
| | - Adriano Friganović
- Department of Nursing, University of Applied Health Sciences, Mlinarska 38, 10000 Zagreb, Croatia; (V.K.); (B.I.); (A.F.); (Š.O.V.); (J.P.)
- Department of Anaesthesiology and Intensive Medicine, University Hospital Centre Zagreb, Kišpaticeva 12, 10000 Zagreb, Croatia
| | - Štefanija Ozimec Vulinec
- Department of Nursing, University of Applied Health Sciences, Mlinarska 38, 10000 Zagreb, Croatia; (V.K.); (B.I.); (A.F.); (Š.O.V.); (J.P.)
| | - Jadranka Pavić
- Department of Nursing, University of Applied Health Sciences, Mlinarska 38, 10000 Zagreb, Croatia; (V.K.); (B.I.); (A.F.); (Š.O.V.); (J.P.)
| | - Milan Milošević
- Andrija Štampar School of Public Health, University of Zagreb School of Medicine, 10000 Zagreb, Croatia;
| | - Petra Kovačević
- Department of Rheumatology, Physical and Rehabilitation Medicine, University Hospital Centre “Sestre Milosrdnice”, 10000 Zagreb, Croatia;
| | - Davorina Petek
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, 1000 Ljubljana, Slovenia;
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Žagar M, Rotar Pavlič D, Švab I, Maksuti A, Ilić B, Smrekar M, Kovačević I. Through health workers' eyes: a qualitative study of health service provision for migrants at Schengen border. Int J Equity Health 2019; 18:117. [PMID: 31357991 PMCID: PMC6664722 DOI: 10.1186/s12939-019-1022-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 07/21/2019] [Indexed: 12/05/2022] Open
Abstract
Background Croatia and Slovenia were the transit countries on the Balkan route for migrants and refugees from Middle East countries in 2015 and 2016. They had to optimize health care delivery in the special circumstances in refugee camps and transit centres. Little is known about health care provision in border camps where a large number of migrants stay for only couple of hours. Previous studies emphasize that language barriers and cultural differences play a central part in the relationship between health workers and migrants inside the transit zone. The aim of the study was to identify specific characteristics of health care provision experienced by primary healthcare providers in order to prepare solutions on how to organise health care in refugee settings. Methods Twelve thematic interviews were conducted in the middle of the most intense migration movements to the North-West Europe between November and December 2015 with health workers from Croatia and Slovenia. Interview transcripts were read, coded, reviewed, and labelled. We used qualitative content analysis. Results Four themes about the health service provision for refugees at Schengen border were identified. The circumstance when mutual understanding is poor and the consultation not successful, cultural differences represent a central barrier. Participants highlighted that the importance of respecting human dignity is crucial for the provision of basic medical care for migrants in transit. Conclusion Successful overcoming language barriers, respecting cultural differences, humanity, susceptibility to social deprivation and traumatic experiences are the key factors important for organisation of health care in transit centers and camps. This article gives some useful tips for healthcare workers and policy makers who are participating in health services provision for migrants and other refugees. Health workers should be prepared to work in special working conditions with a lack of resources. Their work would require timely planning and reflection on the organization of more transit camps. Trial registration Ethical Committee of the Republic of Slovenia approved the study as a project number 112/02/16.
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Affiliation(s)
- Mateja Žagar
- Medical faculty, Department of family medicine, Poljanski nasip 58, 1000, Ljubljana, Slovenia.
| | - Danica Rotar Pavlič
- Medical faculty, Department of family medicine, Poljanski nasip 58, 1000, Ljubljana, Slovenia
| | - Igor Švab
- Medical faculty, Department of family medicine, Poljanski nasip 58, 1000, Ljubljana, Slovenia
| | - Alem Maksuti
- Medical faculty, Department of family medicine, Poljanski nasip 58, 1000, Ljubljana, Slovenia
| | - Boris Ilić
- University of Applied Health Sciences Zagreb, Mlinarska cesta 38, 10 000, Zagreb, Croatia
| | - Martina Smrekar
- University of Applied Health Sciences Zagreb, Mlinarska cesta 38, 10 000, Zagreb, Croatia
| | - Irena Kovačević
- University of Applied Health Sciences Zagreb, Mlinarska cesta 38, 10 000, Zagreb, Croatia
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Friganović A, Kovačević I, Ilić B, Žulec M, Krikšić V, Grgas Bile C. Healthy Settings in Hospital - How to Prevent Burnout Syndrome in Nurses: Literature Review. Acta Clin Croat 2019; 56:292-298. [PMID: 29485797 DOI: 10.20471/acc.2017.56.02.13] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Healthy settings involve a holistic and multidisciplinary method that integrates actions towards risk factors. In hospital settings, a high level of stress can lead to depression, anxiety, decreased job satisfaction and lower loyalty to the organization. Burnout syndrome can be defined as physical, psychological and emotional exhaustion, depersonalization, and low sense of personal accomplishment. The aim of this literature review was to make systematic literature analysis to provide scientific evidence for the consequences of constant exposure to high levels of stress and for the methods to be used to prevent burnout syndrome among health care workers. The Medline database was searched to identify relevant studies and articles published during the last 15 years. The key words used in this survey were burnout syndrome, prevention, nurses, and healthy settings. The 6 eligible studies were included in literature review. Evidence showed nurses to be exposed to stress and to have symptoms of burnout syndrome. As a result of burnout syndrome, chronic fatigue and reduced working capacity occur, thus raising the risk of adverse events. In conclusion, the occurrence of burnout syndrome is a major problem for hospitals and healthcare system. Action plan for hospital burnout syndrome prevention would greatly reduce the incidence and improve the quality of health care.
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Affiliation(s)
- Adriano Friganović
- Department of Nursing, University of Applied Health Sciences; Clinical Department of Anesthesiology, Resuscitation and Intensive Care, Zagreb
| | - Irena Kovačević
- Department of Nursing, University of Applied Health Sciences
| | - Boris Ilić
- Department of Nursing, University of Applied Health Sciences
| | - Mirna Žulec
- Department of Nursing, Technical College, Bjelovar
| | | | - Cecilija Grgas Bile
- Quality Control Department, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
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Ilić B, Švab V, Sedić B, Kovačević I, Friganović A, Jurić E. Mental Health in Domesticated Immigrant Population - a Systematic Review. Psychiatr Danub 2018; 29:273-281. [PMID: 28949308 DOI: 10.24869/psyd.2017.273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
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.
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Affiliation(s)
- Boris Ilić
- Department of Nursing, University of Applied Health Sciences, Mlinarska cesta 38, HR-10000 Zagreb, Croatia,
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Alma LJ, De Groot CJM, De Menezes RX, Hermes W, Hordijk PL, Kovačević I. Endothelial dysfunction as a long-term effect of late onset hypertensive pregnancy disorders: High BMI is key. Eur J Obstet Gynecol Reprod Biol 2018; 225:62-69. [PMID: 29677687 DOI: 10.1016/j.ejogrb.2018.04.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 04/04/2018] [Accepted: 04/05/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Hypertensive disorders during pregnancy increase cardiovascular risk later in life by 2 to 9-fold. Endothelial activation is one of the underlying mechanisms of cardiovascular risk. Therefore, we decided to investigate endothelial activation in primiparous women, 2.5 years after a hypertensive pregnancy disorder. STUDY DESIGN Plasma samples were taken from women 2.5 years after gestational hypertension (GH) or late onset preeclampsia (cases) and from women 2.5 years after a normotensive pregnancy (controls). We studied the effects of patient plasma on the endothelial barrier function of primary human umbilical vein endothelial cells (HUVECs) using Electric Cell-Substrate Impedance Sensing (ECIS) and we measured levels of endothelial activation markers soluble intercellular adhesion molecule 1 (sICAM-1) and soluble endothelial selectin (sE-selectin) in the plasma samples of patients. RESULTS Plasma from primiparous women with a history of late onset preeclampsia disrupted the endothelial barrier more than plasma from women with a history of GH. Endothelial resistance was reduced by 22% in samples taken after preeclampsia, 16% after normotensive pregnancy and 3% after GH (p ≤ 0.0001 GH versus preeclampsia and p = 0.0003 versus normotensive pregnancy). We did not find differences in the levels of soluble endothelial activation markers (sICAM-1 p = 0.326 and sE-selectin p = 0.978). However, the BMI ≥25 showed a strong correlation with increased levels of sICAM-1 (p = 0.046) and sE-selectin (p = 0.002). CONCLUSION Our results indicate that GH and late onset preeclampsia are distinct disease entities with a different pathogenic mechanism underlying their cardiovascular risk. Furthermore, this study supports the hypothesis that these two diseases are early manifestations of cardiovascular vulnerability due to an unfavorable risk profile, and that obesity plays a main role. Our results suggest that this high-risk female population would be eligible for preventive care.
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Affiliation(s)
- L J Alma
- Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, The Netherlands; Department of Physiology, VU University Medical Center, Amsterdam, The Netherlands
| | - C J M De Groot
- Department of Obstetrics and Gynecology, VU University Medical Center, Amsterdam, The Netherlands
| | - R X De Menezes
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - W Hermes
- Department of Obstetrics and Gynecology, Haaglanden Medical Center, The Hague, The Netherlands
| | - P L Hordijk
- Department of Physiology, VU University Medical Center, Amsterdam, The Netherlands
| | - I Kovačević
- Department of Physiology, VU University Medical Center, Amsterdam, The Netherlands.
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Kovačević I, Kogler VM, Turković TM, Dunkić LF, Ivanec Ž, Petek D. Self-care of chronic musculoskeletal pain - experiences and attitudes of patients and health care providers. BMC Musculoskelet Disord 2018. [PMID: 29514616 PMCID: PMC5842573 DOI: 10.1186/s12891-018-1997-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-care is often the first choice for people with chronic musculoskeletal pain. Self-care includes the use of non-prescription medications with no doctor's supervision, as well as the use of other modern and traditional treatment methods with no consultation of the health care provider. Self-care may have positive effects on the successful outcome of a multidisciplinary approach to treatment. The aim of this study was to investigate the experiences and attitudes of patients and health care providers to the self-care of chronic musculoskeletal pain. METHODS Qualitative Phenomenological study, where the data were collected by the method of an audio-taped interview in 15 patients at the outpatient clinic for pain management and in 20 health care providers involved in the treatment of those patients. The interviews were transcribed verbatim and analyzed by principles of Interpretative Thematic Analysis. RESULTS Topics identified in patients: a) positive aspects of self-care, b) a need for pain self-care, c) social aspects of pain self-care. Topics identified in health care providers: a) aspects of self-care, b) a need for self-care c) risks of self-care. Most of patients have positive attitude to self-care and this is the first step to pain management and to care for itself. The most frequent factors influencing decision about the self-care are heavy pain, unavailability of the doctor, long awaiting time for the therapy, or ineffectiveness of methods of conventional medicine. The health care providers believe that self-care of chronic musculoskeletal pain may be a patient's contribution to clinical treatment. However, good awareness of methods used is important in this context, to avoid adverse effects of self-care. CONCLUSION Patients understand the self-care of musculoskeletal pain as an individually adjusted treatment and believe in its effectiveness. Health care providers support self-care as an adjunction to clinical management only, and think that self-care of musculoskeletal pain acts as a placebo, with a short-lived effect on chronic musculoskeletal pain.
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Affiliation(s)
- Irena Kovačević
- University of Applied Health Sciences, Mlinarska 38, 10 000, Zagreb, Croatia.
| | | | | | - Lidija Fumić Dunkić
- Sisters of Charity University Hospital Centre, Vinogradska cesta 29, Zagreb, Croatia
| | - Željko Ivanec
- Sisters of Charity University Hospital Centre, Vinogradska cesta 29, Zagreb, Croatia
| | - Davorina Petek
- Department of Family Medicine, Faculty of Medicine, University of Ljubljana, Poljanski nasip 58, 1000, Ljubljana, Slovenia
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Vučurević G, Marinković S, Puškaš L, Kovačević I, Tanasković S, Radak D, Ilić A. Anatomy and radiology of the variations of aortic arch branches in 1,266 patients. Folia Morphol (Warsz) 2013; 72:113-22. [DOI: 10.5603/fm.2013.0019] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Accepted: 06/03/2013] [Indexed: 11/25/2022]
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Kovačević-Pavićević D, Radosavljević A, Ilić A, Kovačević I, Djurković-Djaković O. Clinical pattern of ocular toxoplasmosis treated in a referral centre in Serbia. Eye (Lond) 2012; 26:723-8. [PMID: 22361847 DOI: 10.1038/eye.2012.20] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To analyze the clinical pattern of ocular toxoplasmosis (OT) in a referral centre in Serbia. PATIENTS AND METHODS The medical records of consecutive patients admitted for OT to the single referral centre for uveitis in Serbia between 2006 and 2010 were retrospectively analyzed. OT was diagnosed on the basis of typical fundus lesions and positive serology for Toxoplasma. RESULTS In a total of 457 uveitis patients, OT was the third leading cause, with 59 patients (12.9%). Most OT cases (73%) were monocular. An active primary retinal lesion was observed in 36% and recurrent OT in 64% patients. Localization of lesions was central/paracentral (44%), juxtapapillar (27%), peripheral (19%), and multifocal (10%). Other ocular manifestations of inflammation included vitritis (44%), anterior uveitis (19%), and retinal vasculitis (10%). Complications included choroidal neovascularization in two and exudative retinal detachment with cataract, glaucoma, and cystoid macular oedema in one patient each. The detection of Toxoplasma-specific IgM antibodies in a single patient indicates a low rate of OT concomitant with acute infection. After treatment, the mean best-corrected visual acuity (BCVA) increased significantly. However, 14 (24%) patients ended up legally blind in the affected eye, of which 2 (3%) with bilateral blindness, all with a very poor BCVA (0.047 ± 0.055) at presentation. Visual impairment and treatment outcome were both associated with central localization of lesions (P<0.0001 and P=0.006, respectively). CONCLUSION OT is a significant cause of posterior uveitis in Serbia. Patients should be aware of the recurring nature of OT and react immediately if symptoms occur.
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Affiliation(s)
- D Kovačević-Pavićević
- Uveitis Department, Clinic for Eye Diseases, Clinical Centre of Serbia, Belgrade, Serbia
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