Opportunities to strengthen resilience of health care workers regarding patient safety

BACKGROUND: The COVID-19 pandemic endangered the quality of health care and the safety of patients and health care workers (HCWs). This provided challenges for HCWs' resilience and for hospital management and probably increased risks for patient safety incidents (PSI). HCWs may also have experienced psychological consequences as second victims of PSI, but evidence on this is lacking. Therefore, we mapped HCWs' experiences with PSI during the second wave of COVID-19, the associations of these experiences with the hospital management of patient safety culture and HCWs' interests in receiving further training.METHODS: We obtained data from 193 HCWs working at the COVID-related departments of one large hospital in eastern Slovakia via a questionnaire developed in direct collaboration with them. We measured PSI experiences as various HCWs' experiences with near miss and adverse events and the hospital management of patient safety culture using indicators such as risk of recurrence, open disclosure and second victim experiences. For analysis, we used logistic regression models adjusted for age and gender of the HCWs.RESULTS: One-third of the hospital HCWs had experienced PSI; these were more likely to expect adverse events to recur (odds ratio, OR = 2.7-3.5). Regarding the hospital management of patient safety culture, the HCWs' experiencing openly disclosed PSI was associated with one negative outcome, i.e. conflicts among colleagues (OR = 2.8), and one positive outcome, i.e. patients' acceptance of their explanation and apologies (OR = 2.3). We found no associations for any other essential domains after disclosure. PSI experiences were strongly associated with psychological indicators of second victimhood, such as sadness, irritability, anxiety and depression (OR = 2.2-4.3), while providing support was not. The majority of the HCWs would like to participate in the suggested trainings (83.4%).CONCLUSION: HCWs with PSI experiences reported poor hospital management of the patient safety culture, which might reflect they missed the opportunities to strengthen their resilience, especially during the COVID-19 pandemic.</p

Appropriate Employment for Segregated Roma:Mechanisms in a Public-Private Partnership Project

Our earlier article showed that increased employability of segregated Roma may improve their well-being and health. To achieve that, appropriate employment based on a public-private partnership could be the key. For optimal design of such a partnership, we need insight into its potential mechanisms. Evidence on this is lacking, however. This paper builds on the previously published article by focusing on mechanisms for achieving better health. Therefore, our aim was to identify the potential mechanisms by which a public-private Roma employment project could increase employability. We investigated a Roma employment project called Equality of Opportunity established by a private company, U.S. Steel Kosice in eastern Slovakia. We conducted a multi-perspective qualitative study to obtain key stakeholders' perspectives on the potential mechanisms of a public-private Roma employment project in terms of increased employability. We found three types of mechanisms. The first type regarded formal job mechanisms, such as an appropriate employment and salary offer and a bottom-up approach in capacity building. The second type involved sustainability mechanisms, such as the personal profile of project and work-shift coordinators, the continuous offer of training and cooperation with relevant stakeholders (municipalities, community centers, etc.). The third type was cultural mechanisms, such as personal contact with project participants, attention to less-voiced groups like children, the motivation of project participants, a counter-value reciprocity approach and respect for the specifics of Roma history. Our findings imply that policymakers could consider public-private partnerships for increasing the employability of segregated Roma, as they have the potential to address a wider range of social needs simultaneously

Family Socioeconomic Status and Adolescent School Satisfaction:Does Schoolwork Support Affect This Association?

BACKGROUND: The aim of this study is to explore the association of family socioeconomic status (SES) and internal and external schoolwork support with adolescents’ school satisfaction and whether schoolwork support modifies these associations. METHODS: Data come from the cross-sectional Health Behavior in School-aged Children study collected in 2018 from Slovak 15-year-olds (N = 1127; 52.7% boys). SES was measured by Family Affluence Scale (low; middle; high). School satisfaction was measured via school engagement and attitudes toward education. Schoolwork support was measured regarding two groups of sources inside and outside the family, separately. Logistic regression models were used to explore the associations of SES and schoolwork support with school satisfaction as well as the moderating effect of schoolwork support. RESULTS: Adolescents with low SES were more likely to feel indifferent toward school and education (odds ratios/95%-confidence interval: 1.77/1.26–2.49), and similarly, adolescents who did not have schoolwork support inside or outside the family (1.38/1.02–1.87, and 1.50/1.01–2.22, respectively). Schoolwork support moderated the associations of SES with school satisfaction. Adolescents with low and middle SES without support inside or outside the family were more likely to feel indifferent than satisfied (2.72/1.21–6.10; 3.00/1.27–7.06; and 2.86/1.05–7.80; 6.04/1.72–21.24, respectively). CONCLUSION: Adolescents from low and middle SES without schoolwork support inside or outside the family are more likely to feel indifferent toward school and education

The Impact of Pandemic Management on the Quality of Life of Slovak Dentists

Pandemic management increases the burden on healthcare workers to provide care and also affects their personal lives, with dentists being at particular risk. Therefore, we aim to describe the quality of life (QoL) and limitations experienced due to pandemic management-related measures (PanMan), as well as to assess the association of PanMan with QoL during the first lockdown after the coronavirus outbreak. We obtained data from 500 dentists (33.2% males, M/SD = 43.8) registered with the Slovak Chamber of Dentists using an online questionnaire. We categorized PanMan as the availability of personal protective equipment (PPE) and the ability to implement anti-pandemic measures, information overload, pandemic-related limitations and QoL in terms of their impact on family life and activities, housekeeping, relationships with relatives, financial situation and mental well-being. PanMan mainly affected financial situation, mental well-being and housekeeping. Factors contributing most towards the worsening of QoL were information overload (odds ratio/95% confidence interval, OR/CI: 5.79/2.64-12.71) and several pandemic-related limitations. These consisted of (OR/CI): a lack of PPE (5.17/2.48-10.77), infection risks in the work environment (3.06/1.57-5.95), obligatory safety measures (3.02/1.47-6.21), lack of staff (2.85/1.30-6.25) and client concerns (3.56/1.70-7.49). Pandemic management has led to a considerable worsening of dentists' QoL

Body image, body composition and environment:do they affect adolescents' physical activity?

BACKGROUND: Most adolescents are less physically active than recommended, despite the strong effort of various stakeholders to promote physical activity (PA). Body image and body composition may play an important role not only in directly facilitating adolescents' PA but also in enabling environment-related factors. As evidence is lacking, we aimed to assess the associations of adolescents' PA with body-related and environment-related factors, whether this differs by age and gender, and whether these factors interact. METHODS: We used data on 888 11- to 15-year-old adolescents (mean age = 13.5, 56% boys) from the Health Behaviour in School-aged Children study conducted in 2018 in Slovakia. We used multinomial logistic regression analysis to assess the association of adolescents' PA with body-related factors (body image, body composition) and environment-related factors (PA-promoting environment, less leisure constraints), taking into account age and gender. RESULTS: Adolescents who perceived their body as not too fat were more likely to be physically very active rather than inactive [odds ratios (ORs)/95% confidence interval (CI) 2.15/1.44-3.22], and similarly those who were not overweight/obese (3.24/2.09-5.01) and perceived less leisure constraints (1.74/1.44-2.11). In older adolescents and in girls, the association of adolescents' PA with body composition and environment-related factors was stronger. The association of adolescents' PA with perceiving less leisure constraints was stronger among adolescents who did not perceive their body as too fat (OR/95% CI 1.98/1.26-3.14), and for those who were not overweight/obese (OR/95% CI 1.62/1.01-2.57). CONCLUSION: Adolescents' PA is associated with both body-related and environment-related factors. These associations are stronger in girls and older adolescents, if co-occurring

School is (not) calling:the associations of gender, family affluence, disruptions in the social context and learning difficulties with school satisfaction among adolescents in Slovakia

Objectives Education is an important tool to reduce health inequalities. Several factors influence the educational trajectory of children, with school satisfaction being one of them. The aim was to explore how learning difficulties, a disrupted social context and family affluence relate to school satisfaction. Methods We used data from the 2018 Slovak cross-sectional Health Behaviour in School-aged Children-study (age 15 years;N = 913; 50.3% boys). School satisfaction was categorized as liking school and caring about education (satisfied), disliking school but caring about education or vice versa (inconsistent), and disliking school and not caring about education (indifferent). We explored the association of learning difficulties, disrupted social context and family affluence with school satisfaction using multinomial logistic regression. Results Boys, and children having learning difficulties, or disruption in the social context and living in low affluence family were significantly less likely to be satisfied at school. Conclusions The key is to create a stimulating and encouraging environment at school, where children successfully learn functional literacy and feel well. The more satisfaction pupils get from school, the more likely is a favourable educational trajectory for them

Increased Employment for Segregated Roma May Improve Their Health:Outcomes of a Public-Private Partnership Project

Increasing employment opportunities for segregated Roma might prevent major economic losses and improve their health. Involvement of the private sector in Roma employment, on top of intensified governmental actions, is likely to be a key to sustainable improvement, but evidence on this is scarce. Our aim was to determine the potential outcomes of such a partnership regarding increased employability and the resulting improved well-being and health. We therefore investigated a Roma employment project called Equality of Opportunity, run since 2002 by a private company, U.S. Steel Kosice, in eastern Slovakia. We conducted a multi-perspective qualitative study to obtain the perspectives of key stakeholders on the outcomes of this project. We found that they expected the employability of segregated Roma to increase in particular via improvements in their work ethic and working habits, education, skills acquisition, self-confidence, courage and social inclusion. They further expected as the main health effects of increased employability an improvement in Roma well-being and health via a stable income, better housing, crime reduction, improved hygienic standards, access to prevention and improved mental resilience. Social policies regarding segregated Roma could thus be best directed at increasing employment and at these topics in particular to increase their effects on Roma health.</p

Adolescents exposed to discrimination:are they more prone to excessive internet use?

BACKGROUND: The Internet may serve as a suitable environment for discriminated adolescents as they may consider the online space as the place where they have possibility to build social ties they are missing in their offline life or manage their self-presentation. Therefore, our aim was to explore the association between different types of discrimination by peers (because of gender, physical appearance, culture/skin color/language, unfavorable family situation) and excessive Internet use (EIU), and whether gender moderates this association. METHODS: We used data from a representative sample of 6,462 Slovak adolescents (mean age: 13.00, 49.6% boys) from the HBSC study conducted in 2018. Data were collected through online self-reported questionnaires. We assessed the association between various types of discrimination by peers and EIU using linear regression, and the role of gender as potential moderator. RESULTS: Discrimination because of physical appearance was most prevalent (18.0%). Adolescents exposed to discrimination by peers reported higher levels of EIU. We found an interaction of gender on the association of discrimination because unfavorable family situation with EIU. Boys who experienced this type of discrimination were at higher risk of EIU compared to girls. CONCLUSION: Discriminated adolescents are more likely to use the Internet excessively, with some associations being stronger for boys than for girls. Prevention strategies focused on raising adolescent awareness of the risks and benefits of the Internet should target discriminated adolescents, especially boys, as they seem to be the vulnerable group