PAIN MANAGEMENT IN PATIENTS WITH CHRONIC WOUNDS

Uvod: Bol je čest simptom kod bolesnika s kroničnim ranama, te značajno utječe na kvalitetu života. Kontinuiranom procjenom boli, medicinska sestra će omogućiti pravovremeno terapijsko djelovanje. Metode: Provedeno je presječno istraživanje u OŽB Požega. Sudjelovali su punoljetni bolesnici s ranama koje nisu zacijelile duže od 8 tjedana. Obuhvaćeno je 60 bolesnika. Za procjenu boli je korištena Vizualno analogna skala u tri vremenske točke (kod prijema, pri previjanju rane i u mirovanju). Od statističkih testova korišten je Hi kvadrat test, MANOVA, te Bonferroni post hoc test. Rezultati: Utvrđeno kako postoji značajna statistička razlika u tri vremenska perioda mjerenja boli prema spolu ispitanika na način da su ispitanice značajno više procjenjivale razinu boli od ispitanika (p=0,008). Statistička značajna razlika je uočena u tri vremenska perioda mjerenja boli prema vrsti rane (p<0,001). Značajna razliku između razine boli kod prijema bolesnika i s ulkusom gdje procjenjuju bol značajno više od ispitanika s dekubitusom (p=0,031) i površinskim ranama/kontuzijama (p=0,006). Također ispitanici s gangrenom u istom vremenu mjerenja značajno višom procjenjuju bol od ispitanika s dekubitusom (p=0,002) i ispitanika s površinskim ranama/kontuzijama (p=0,006). Kod razine boli u mirovanju ispitanici s ulkusom značajno višom procjenjuju bol od ispitanika s površinskim ranama/kontuzijama (p=0,003). Postoji značajna statistička razlika u tri vremenska perioda mjerenja boli prema veličini rane, (p=0,025). Ispitanici s ranom manjom od 5x5 cm značajno manjom procjenjuju razinu boli od ispitanika s operativnim rezom (p=0,031), ranom veličine 10 x 10, (p=0,029) i ranama velikih površina (p=0,002). Zaključak: Doživljaj boli ovisi o doživljaju pojedinca i nije objektivno mjerljiv. Postoje velike osobne, kulturne i spolno uvjetovane razlike u izrazu boli. U rješavanju složenog zadatka upravljanja boli potrebno je izabrati model koji je kulturološki prihvatljiv i osjetljiv, kako bi se optimiziralo zadovoljstvo i ishod liječenja bolesnika.Introduction: Chronic wounds are considered a major public health problem and increases the suffering of the patient and significantly affects the quality of life. By continuous assessment of pain, the nurse will allow timely therapeutic action either by pharmacological or non-pharmacological methods. Methods: A cross-sectional survey was conducted from April to August 2019 at the General County Hospital Pozega. The study involved adult patients with wounds that did not heal for more than 8 weeks. 60 patients were enrolled. A visually analogous three-point time scale (at admission, wound dressing, and at rest) was used for pain assessment.From the statistical tests, the Hi square test MANOVA (Multivariate analysis of variance), and the Bonferroni post hoc test. Results: It was found that there was a significant statistical difference in the three time periods of pain measurement according to the gender of the subjects in such a way that the respondents significantly evaluated the pain level more than the respondents (p = 0.008). A statistically significant difference was observed in the three time periods of pain measurement according to the type of wound (p <0.001). a significant difference between pain levels at admission and ulcer where they rate pain significantly higher than subjects with decubitus (p = 0.031) and superficial wounds / contusions (p = 0.006). Also, subjects with gangrene at the same time of measurement had significantly higher pain scores than subjects with decubitus (p = 0.002) and subjects with superficial wounds / contusions (p = 0.006). At the level of pain during the dressing, subjects with superficial wounds / contusions had significantly lower pain scores than all other groups of subjects, subjects with ulcer (p = 0.009), subjects with decubitus (p = 0.022), and subjects with gangrene (p = 0.001). At resting pain level, subjects with ulcer had significantly higher pain scores than subjects with superficial wounds / contusions (p = 0.003). There was a significant statistical difference in the three time periods of pain measurement according to wound size, (p = 0.025). Subjects with a wound less than 5x5 cm significantly less rated pain level than subjects with an operative incision (p = 0.031), a size 10 x 10 wound (p = 0.029), and large area wounds (p = 0.002) Conclusion: The experience of pain depends on the experience of the individual and is not objectively measurable. There are major personal, cultural and gender-related differences in the expression of pain. In dealing with the complex task of pain management, it is necessary to choose a model that is culturally acceptable and sensitive, in order to optimize patient satisfaction and outcome

In vitro antimicrobial susceptibility of Ureaplasma urealyticum

Uvod. Ureaplazma urealyticum komenzal je donjeg urogenitalnoga trakta, te uzročnik spolno prenosivih bolesti. Antimikrobna rezistencija na tetracikline i makrolide je niska, a na kinolone visoka. Cilj. Određivanje i usporedba prevalencije i in vitro antimikrobne osjetljivosti U.urealyticum nađenih u urogenitalnim uzorcima žena reproduktivne dobi u razdoblju od lipnja 2005. do lipnja 2006. godine i u 2015. godini. Materijali i metode. U razdoblju od lipnja 2005. do lipnja 2006. godine evaluirana je in vitro antimikrobna osjetljivosti U. urealyticum urogenitalnih uzoraka 72 bolesnice s uretralnim sindromom, te su rezultati uspoređeni s podacima 181 izolata U. urealyticum dobivenih iz urogenitalnog trakta bolesnica s ginekološkom problematikom iz 2015. godine. Za identifikaciju U.urealyticum korišten je Mycoplasma IST 2 kit. In vitro antimikrobna osjetljivost izolata visoke koncentracije ≥ 104 CCU/ml određivana je metodom dilucije u bujonu na 7 antibiotika: doksiciklin, tetraciklin, azitromicin, eritromicin, klaritromicin, ciprofloksacin, ofloksacin. Rezultati. U razdoblju 2005./2006. godine prevalencija U. urealyticum u urogenitalnim uzorcima žena reproduktivne dobi iznosila je 28%, a 2015. 22,7%, (p = 0,516). Rezultati in vitro antimikrobne osjetljivosti U. urealyticum za 2005/2006. godinu i 2015. godinu bili su sljedeći: osjetljivost na doksiciklin 100% i 98,7%, na tetraciklin 100% i 98,7 %, na klaritromicin 93,7% i 89,5%, na eritromicin 90,3% i 85,6%, na azitromicin 87% i 81,2%, na ofloksacin 62% i 59,7%, na ciprofloksacin 40,3% i 28,9%. Bilježi se mala stopa rezistencije na doksiciklin i tetracikin (2,2%) i na makrolide (klaritromicin 6,3% i 10,5%; eritromicin 9,7% i 14,4%; azitromicin 13% i 18,8%), te viša na kinolone (ofloksacin 38% i 40,3%; ciprofloksacin 59% i 71,1%), a razlike u rezistencijama nisu bile statistički značajne. Zaključak. U našoj studiji nije registrirana statistički značajna razlika u prevalenciji U. urealyticum u žena reproduktivne dobi u promatranom vremenskom razdoblju u razmaku od deset godina. Rezultati in vitro antimikrobne osjetljivosti U. urealyticum pokazivali su trend porasta rezistencija, ali razlike u rezistencijama nisu bile statistički značajne. Unatoč visokoj osjetljivosti U. urealyticum na tetracikline i makrolide kao prvoj liniji terapije s obzirom na trend porasta rezistencije potrebno je kontinuirano praćenje antimikrobne osjetljivosti in vitro na lokalnoj razini radi adekvatnog izbora antimikrobika.Introduction. Ureaplasma urealyticum is the commensal of the lower genitourinary tract and causes sexually transmitted diseases. Antimicrobial resistance to tetracyclines and macrolides is low, and to quinolones high. Objective. To determine and compare the prevalence and in vitro antimicrobial susceptibility of U. urealyticum in urogenital samples of women of reproductive age in the period from June 2005 to June 2006 and in 2015. Materials and methods. In the period from June 2005 to June 2006 in vitro antimicrobial susceptibility of U. urealyticum from urogenital samples of 72 female patients with urethral syndrome were evaluated and the results were compared with 181 isolates of U. Urealyticum from the genitourinary tract of patients with gynaecological issues in year 2015. The U. urealyticum. Mycoplasma IST 2 kit was used for identification. Invitro antimicrobial susceptibility of the isolates high concentrations ≥ 104 CCU / ml was determined by the dilution method in broth to 7 antibiotics: doxycycline, tetracycline, azithromycin, erythromycin, clarythromycin, ciprofloxacin, ofloxacin. Results. In 2005/2006, the prevalence of U. urealyticum in women of reproductive age was 28% and 22.7% in 2015 (p = 0.516). The results in vitro antimicrobial susceptibility in the period from June 2005 to June 2006 and in 2015 were the following: sensitivity to doxycycline 100% and 97.8%, tetracycline 100% and 97.8%, clarithromycin 93.7% and 89.5%, erythromycin 90.3% and 85.6%, azithromycin 87% and 81.2%, ofloxacin 62 and 59.7%, ciprofloxacin 40.3% and 28.9%. Low rate of resistance to doxycycline and tetracyclines (2.2%) and the macrolides (clarithromycin 6.3% and 10.5%; erythromycin 9.7% and 14.4%; azithromycin 13% and 18.8%) and high to quinolones (ofloxacin 38% and 40.3%; ciprofloxacin 59% and 71.1%) was registered, and there were not statistically significant differences in resistance. Conclusion. In our study, statistically significant differences in the prevalence of U. urealyticum in women of reproductive age in were not registered in the observed period. The results in vitro antimicrobial susceptibility of U. urealyticum show a trend of increasing resistance but there were no statistically significant differences. Despite the high sensitivity of U. urealyticum to tetracyclines and macrolides as a first-line treatment, due to the trend of increasing resistance, it is necessary to continuously monitor in vitro antimicrobial susceptibility in the local region for the purpose of an adequate choice of antibiotics

MALNUTRITION IN ELDERLY

Cilj: Cilj istraživanja je bio ispitati koliki je rizik za pojavu pothranjenosti u osoba starije životne dobi smještenih u Dom za starije i nemoćne osobe. Nadalje, pokušala se dokazati ili opovrgnuti veza između pokretljivosti ispitanika i ukupnog rezultata testa. Metode: Metoda istraživanja je bio MNA upitnik (Mali prehrambeni upitnik) koji je mjerni instrument pothranjenosti posebno razvijen za osobe starije životne dobi, a sadrži 18 pitanja. Istraživanje je provedeno u Domu za starije i nemoćne osobe u Požegi (N = 100). Rezultati: Rezultati MNA upitnika su pokazali da je 25 od 100 ispitanika bilo pothranjeno (25%), 38 ispitanika je imalo rizik za razvoj pothranjenosti (38%), a 37 ispitanika je bilo dobro uhranjeno (37%). Statistički je dokazano da pokretljivost ispitanika utječe na rezultate MNA testa. Od 32 potpuno nepokretna ispitanika, njih 20 je bilo pothranjeno, 12 ih je imalo rizik za razvoj pothranjenosti, a niti jedan nepokretni ispitanik nije bio dobro uhranjen. Zaključak: Pothranjenost je česta u osoba starije životne dobi, bilo da žive sami u zajednici, u svojim obiteljima, domovima za starije i nemoćne osobe, ili da su hospitalizirane. U prepoznavanju, dijagnosticiranju i liječenju pothranjenosti potreban je multidisciplinaran pristup u koji trebaju biti uključeni liječnici, medicinske sestre, dijetetičari i ostali pružatelji zdravstvene skrbi. Zdravstveni djelatnici moraju razviti stav da je pravilna prehrana važan i neizostavan korak u liječenju i podizanju kvalitete života u starijih osoba, te tu spoznaju prenijeti oboljeloj osobi i njegovoj obitelji.Aim: The objective of the study was to examine the risk of malnutrition for older persons that had been placed in the residential care home for the older and disabled people. Furthermore, it tried to prove or disprovethe link between mobility of respondent sand total test results. Methods: The research method was MNA questionnaire (concise food habits questionnaire), a malnutrition measuring instrument specially developed for the older people that contains 18 questions. The studywasconductedinthe Home for theolderanddisabledpeoplein Požega, Croatia (N = 100). Results: Resultsof MNA questionnaire showe dthat 25 of 100 respondent ssuffered from malnutrition (25 %), 38 patients had a risk of developing malnutrition (38 %) and 37 subjects werewell-fed (37 %). It was statistically proventh at mobility of patients affectsthe results of the MNA test. Outof 32 completely immobile patients, 20 of the mwereunder weight, 12 oft hemhad a risk of malnutrition, andnot a single one immobile respondent was well-fed. Conclusion: Malnutrition is common among older people, whether they live alone, with their families, inresidential care homes for the older and disabled persons, or they are hospitalised. Recognition, diagnosis and treatment of malnutrition require a multidisciplinary approach that should include doctors, nurses, dieti- 8 Sažeci radova / Abstracts tiansan dotherhealthcare providers. Health care professionals need to develop the awareness that proper nutrition is an important and essential step in healing and transfer that knowledge to the patient and their family

RISKY BEHAVIOUR AND EXPOSURE TO NOISE AMONG ADOLESCENTS

Uvod: Adolescenti su, ovisno o interesima, odgoju, obrazovanju, navikama pod povećanim rizikom od utjecaja buke na njihovo zdravlje te psihički i fizički razvoj. Cilj rada: Istražiti rizično ponašanje i stavove adolescenata prema buci; istražiti u kojoj mjeri adolescenti prepoznaju simptome i znakove utjecaja buke na vlastito psihofizičko zdravlje. Ispitanici i metode rada: U istraživanje je uključeno 533 učenika Srednje škole Pakrac u dobi od 15 – 19 godina. Podaci su prikupljeni pomoću anketnog upitnika koji sadrži ukupno 32 pitanja/stava/tvrdnje. Korišteni su izvorno pisani programi za baze podataka te statistički paket SPSS. Rezultati: Učenici viših razreda (trećeg i četvrtog) pokazuju bolje poznavanje vrste buke koje mogu oštetiti sluh i slažu se s tvrdnjom da slušanje glasne glazbe može oštetiti sluh u odnosu na učenike prvog i drugog razreda. Stariji ispitanici smatraju da buka ima najveći negativan utjecaj za vrijeme odmora i opuštanja te da posljedica buke može biti tjeskoba, depresija i visok krvni tlak za razliku od mlađih učenika. Mlađi ispitanici oštećenje sluha bukom češće povezuju sa starijim osobama. Stariji ispitanici rjeđe slušaju glazbu više od jednog sata preko slušalica. Zaključak: Istraživanje je pokazalo da je rizično ponašanje adolescenata, nažalost, u skladu sa svjetskim trendovima. Na njega se može i mora utjecati i to kroz integrirane programe unutar osnovnog i srednjeg obrazovanja. Pravilnom edukacijom djece i roditelja o razini buke u okolini u kojoj žive, rade ili se zabavljaju te načinu na koji mogu utjecati na smanjenje buke, oštećenja sluha moguće je prevenirati, ili barem odgoditi.Introduction: Adolescents, depending on their interests, upbringing, education and habits, are under greater risk of noise influence which affects their health, as well as psychological and physical development. Aim of this work: To do some research based on risky behaviour and adolescents\u27 behaviour towards noise; to explore in which way adolescents recognize symptoms and signs of noise influence to their own psychological and physical health. Examinees and work methods: 533 students of High school Pakrac (age from 15 to 19) were included in this research. Information was collected through survey which consisted of 32 questions/ attitudes/ thesis. Data basis originally written programmes and statistical package SPSS were used Results: Students of higher grades (third and fourth grades) show better recognition of noise types which can damage hearing and they agree with a statement that listening to loud music can damage hearing, whereas students of first and second grades disagree. Older examinees believe that noise has the most negative influence during the period of leisure and relaxation. They also believe that anxiety, depression and high blood pressure can be the consequences of noise. Younger examinees disagree with these statements and they relate hearing damage by noise to older persons. Older examinees rarely use headphones to listen to music for more than one hour. Conclusion: The research showed that risky behaviour of adolescents is, unfortuantely, in accordance with the world trends. It can be and it has to be influenced by the integrated programmes within primary and secondary education. By regular education of both children and parents when it comes to noise level in their living, working or entertainment environment, and when it comes to the ways in which they can decrease the noise level, hearing damages can be prevented, or at least postponed

Antimicrobial susceptibility of the most common microorganisms isolated from blood

Cilj istraživanja bio je utvrditi učestalost i antimikrobnu osjetljivost najčešćih mikroorganizama izoliranih iz krvi na području Požeško-slavonske županije, te usporedba dobivenih rezultata s podacima iz Hrvatske i Europe. Materijali i metode: U ovom retrospektivnom istraživanju ukupno je obrađeno 2536 uzoraka krvi uzetih u razdoblju od 1. 1. 2015. do 31. 12. 2016. Uzorci krvi uzimani su na odjelima, u dvije bočice za hemokulturu (aerobnu i anaerobnu), po 10 ml krvi. Dječje hemokulture uzimane su u jednu bočicu, po 5 ml krvi. Bočice su zatim stavljene u Bact/Alert 3D aparat (BioMerieux, Marcy-l\u27Étoile, Francuska), gdje su inkubirane na 37°C kroz 7 dana. Identifikaciju poraslih mikroorganizama i antimikrobnu osjetljivost određivali smo pomoću Vitek 2 uređaja (BioMerieux, Marcy-l\u27Étoile, Francuska). Rezultati: Od 2536 uzoraka krvi, pozitivno je bilo njih 89 (3,5%). Gram-pozitivne bakterije (stafilokoki i streptokoki) činile su 77%, a gram-negativne (enterobakterije) 22%, dok je jedan izolat bio bio Candida albicans (1%). Statistički je značajno veća učestalost gram-pozitivnih mikroorganizama izoliranih iz krvi (p< 0,001). Najčešće izolirani mikroorganizmi su bili koagulaza negativni stafilokoki (KNS), 57%. Od gramnegativnih bakterija, najčešći izolat je bila Escherichia coli (E. coli), 13%. Rasprava: Antimikrobna osjetljivost E. coli je bila najveća na karbapeneme, treću i četvrtu generaciju cefalosporina , ko-amoksiklav i ciprofloxacin, a najmanja na amoxicillin, dok je osjetljivost na ko-trimoksazol i gentamicin umjerena. Zaključak: Vrlo niska prevalencija (3,5%) mikroorganizama izoliranih iz krvi ukazuje na nekritično uzimanje hemokultura. Najveći broj izolata su bili KNS (57%) koji se normalno nalaze na koži, stoga je prije vađenja krvi za hemokulturu, potrebno dobro dezinficirati kožu i pažljivo izvaditi krv kako se ne bi kontaminirala bakterijama s kože. Podaci o antimikrobnoj osjetljivosti uzročnika izoliranih iz krvi mogu poslužiti u planiranju empirijske terapije u liječenju sepse.The aim of this study was to determine the prevalence and antimicrobal susceptibility of the most common microorganisms isolated from the blood in the Pozega-Slavonia County and to compare it with data from Croatia and Europe. Materials and methods: In this retrospective study, we processed 2,536 blood samples taken from January 2015 to December 2016. Blood samples were taken in medical wards, in two vials for blood cultures (aerobic and anaerobic), 10 ml blood in each. Children\u27s blood cultures were taken into one vial, 5 ml of blood. Vials were incubated at 37°C for 7 days in the Bact/Alert 3D system (BioMerieux, Marcy-l\u27Étoile, France). Identification and antimicrobial testing were performed using commercially available automated Vitek 2 system (BioMerieux, Marcy-l\u27Étoile, France). Results: Out of the 2,536 submitted blood samples, 89 samples (3.5%) were positive for bacterial growth. Gram-positive bacteria (Staphylococcus spp and Streptococcus spp) were 77% and the gram-negative (Enterobacteriaceae) 22%, and one isolate was Candida albicans (1%). The most commonly isolated organisms were coagulase-negative staphylococci (KNS), 57%. Of the gram negative bacteria, the most common isolate was E. coli (13%). Discussion: Antimicrobial susceptibility of E. coli was the highest to carbapenems, third and fourth generation cephalosporins, co-amoxiclav and ciprofloxacin. Conclusion: Very low prevalence (3.5%) of microorganisms isolated from the blood indicates uncritical blood culture sampling. The most common isolates were KNS (57%), which are normally found on the skin, so before sampling blood cultures, it is essential to disinfect the skin and carefully take the blood sample. These resistance data can serve as a clinical tool in the prescription of empiric antimicrobial therapy

Risky Behavior and Exposure to Noise Among Adolescents

Aim: Adolescents are under greater risk of noise influence which affects their psychophysical health.The most common noise sources are too loud cinema halls, concerts, sports events, different outdoor events, street noise, and listening to music that is too loud on iPod and MP3 gadgets.The aim of this study was to investigate risk behaviors and attitudes among adolescents toward noise exposure; to explore how adolescents recognize symptoms and signs of noise influence to their own psychophysical health. Methods: The study included 533 high school students aged 15-19 years.The data were collected using a questionnaire that contained a total of 32 questions/ attitudes/ statements. SPSS statistical software was used for data processing. Results: Students in higher grades (third and fourth) show a better understanding of noise types that can damage hearing and they agree with the statement that listening to loud music can damage hearing, whereas students of first and second grades disagree.Younger students usually associate hearing loss withaging. Conclusion: The study showed that such risky behavior of adolescents is in accordance with global trends.It can be and it has to be influenced by integrated programs within primary and secondary education. By continuous education of both children and parents when it comes to noise level in their living, working or entertainment environment, and when it comes to the ways in which they can decrease the noise level, damage to hearing can be prevented, or at least postponed

HEALTH LITERACY WITH ADOLESCENTS

Uvod: Zdravstvena pismenost se definira kao osobna, kognitivna i društvena umijeća koja određuju sposobnost pojedinaca da dođu do, razumiju i koriste informacije kako bi unaprijedili i održavali zdravlje. Cilj: Utvrditi razinu zdravstvene pismenosti kod učenika završnih razreda srednje škole, utvrditi postoje li razlike u razini zdravstvene pismenosti s obzirom na školu koju pohađaju, utvrditi postoji li razlika u razini zdravstvene pismenosti s obzirom na spol. Metode: Istraživanje zdravstvene pismenosti provedeno je u učenika završnih razreda srednjih škola u Srednjoj školi Pakrac i Srednjoj školi Novska. U istraživanju zdravstvene pismenosti korišten je validirani hrvatski prijevod anketnog upitnika SAHLSA-50. Rezultati: Svega 4 (2,1%) ispitanika je zdravstveno nepismeno dok je visoku razinu zdravstvene pismenosti pokazalo 94 ispitanika (49%). Razina zdravstvene pismenosti je veća kod učenika gimnazije i zdravstvenih usmjerenja u odnosu na učenike građevinske škole (Hi kvadrat = 31,428, P = ,00). Testiranjem razlika u zdravstvenoj pismenosti s obzirom na spol utvrđeno je da nema razlike između muškaraca i žena (Mann-Whitneyev test, P= ,059). Zaključak: Prema rezultatima provedenog istraživanja, ispitanici pokazuju visoku razinu zdravstvene pismenosti. Uočena je razlika u razini zdravstvene pismenosti u različitim školama. Ujednačenost razine zdravstvene pismenosti moguće je postići dodatnim nastavnim satima iz zdravstvenog odgoja. Visokoobrazovane medicinske sestre, s kompetencijama koje posjeduju, trebale bi biti implementirane u kontinuirano provođenju nastave zdravstvenog odgoja tijekom osnovnoškolskog i srednjoškolskog obrazovanja. U Hrvatskoj ne postoji instrument mjerenja zdravstvene pismenosti prilagođen ovoj populaciji na čemu bi trebalo poraditi.Introduction: Health literacy is defined as personal, cognitive and social skills which determine individual\u27s ability to reach, understand and use the information in order to improve and preserve health. Aim: To define the level of health literacy with high school seniors, to define if there are any differences in the level of health literacy according to the school that they attend, to define if there is a difference in the level of health literacy according to the gender. Methods: Health literacy research was conducted between the seniors of High school Pakrac and Novska Valid Croatian translation of SAHLSA-50 questionnaire was used for the research of health literacy. Results: Out of total number, only 4 examinees (2,1%) are illiterate when it comes to health literacy, whereas high level of health literacy was shown by 94 examinees (49%). The level of health literacy is higher with the students of gymnasium and medical orientations, regarding the students of building school (Hi square = 31,428, P= ,00). Testing the differences in health literacy concerning the gender, it has been determined that there is no difference between men and women (Mann-Whitney test, P= ,059). Conclusion: Examinees show high level of health literacy. There has been perceived a difference between the level of health literacy in different schools. Homogeneity of the health literacy level is possible to be achieved by additional lessons in health education

HEALTH LITERACY WITH ADOLESCENTS

Uvod: Zdravstvena pismenost se definira kao osobna, kognitivna i društvena umijeća koja određuju sposobnost pojedinaca da dođu do, razumiju i koriste informacije kako bi unaprijedili i održavali zdravlje. Cilj: Utvrditi razinu zdravstvene pismenosti kod učenika završnih razreda srednje škole, utvrditi postoje li razlike u razini zdravstvene pismenosti s obzirom na školu koju pohađaju, utvrditi postoji li razlika u razini zdravstvene pismenosti s obzirom na spol. Metode: Istraživanje zdravstvene pismenosti provedeno je u učenika završnih razreda srednjih škola u Srednjoj školi Pakrac i Srednjoj školi Novska. U istraživanju zdravstvene pismenosti korišten je validirani hrvatski prijevod anketnog upitnika SAHLSA-50. Rezultati: Svega 4 (2,1%) ispitanika je zdravstveno nepismeno dok je visoku razinu zdravstvene pismenosti pokazalo 94 ispitanika (49%). Razina zdravstvene pismenosti je veća kod učenika gimnazije i zdravstvenih usmjerenja u odnosu na učenike građevinske škole (Hi kvadrat = 31,428, P = ,00). Testiranjem razlika u zdravstvenoj pismenosti s obzirom na spol utvrđeno je da nema razlike između muškaraca i žena (Mann-Whitneyev test, P= ,059). Zaključak: Prema rezultatima provedenog istraživanja, ispitanici pokazuju visoku razinu zdravstvene pismenosti. Uočena je razlika u razini zdravstvene pismenosti u različitim školama. Ujednačenost razine zdravstvene pismenosti moguće je postići dodatnim nastavnim satima iz zdravstvenog odgoja. Visokoobrazovane medicinske sestre, s kompetencijama koje posjeduju, trebale bi biti implementirane u kontinuirano provođenju nastave zdravstvenog odgoja tijekom osnovnoškolskog i srednjoškolskog obrazovanja. U Hrvatskoj ne postoji instrument mjerenja zdravstvene pismenosti prilagođen ovoj populaciji na čemu bi trebalo poraditi.Introduction: Health literacy is defined as personal, cognitive and social skills which determine individual\u27s ability to reach, understand and use the information in order to improve and preserve health. Aim: To define the level of health literacy with high school seniors, to define if there are any differences in the level of health literacy according to the school that they attend, to define if there is a difference in the level of health literacy according to the gender. Methods: Health literacy research was conducted between the seniors of High school Pakrac and Novska Valid Croatian translation of SAHLSA-50 questionnaire was used for the research of health literacy. Results: Out of total number, only 4 examinees (2,1%) are illiterate when it comes to health literacy, whereas high level of health literacy was shown by 94 examinees (49%). The level of health literacy is higher with the students of gymnasium and medical orientations, regarding the students of building school (Hi square = 31,428, P= ,00). Testing the differences in health literacy concerning the gender, it has been determined that there is no difference between men and women (Mann-Whitney test, P= ,059). Conclusion: Examinees show high level of health literacy. There has been perceived a difference between the level of health literacy in different schools. Homogeneity of the health literacy level is possible to be achieved by additional lessons in health education

PAIN MANAGEMENT IN PATIENTS WITH CHRONIC WOUNDS

Uvod: Bol je čest simptom kod bolesnika s kroničnim ranama, te značajno utječe na kvalitetu života. Kontinuiranom procjenom boli, medicinska sestra će omogućiti pravovremeno terapijsko djelovanje. Metode: Provedeno je presječno istraživanje u OŽB Požega. Sudjelovali su punoljetni bolesnici s ranama koje nisu zacijelile duže od 8 tjedana. Obuhvaćeno je 60 bolesnika. Za procjenu boli je korištena Vizualno analogna skala u tri vremenske točke (kod prijema, pri previjanju rane i u mirovanju). Od statističkih testova korišten je Hi kvadrat test, MANOVA, te Bonferroni post hoc test. Rezultati: Utvrđeno kako postoji značajna statistička razlika u tri vremenska perioda mjerenja boli prema spolu ispitanika na način da su ispitanice značajno više procjenjivale razinu boli od ispitanika (p=0,008). Statistička značajna razlika je uočena u tri vremenska perioda mjerenja boli prema vrsti rane (p<0,001). Značajna razliku između razine boli kod prijema bolesnika i s ulkusom gdje procjenjuju bol značajno više od ispitanika s dekubitusom (p=0,031) i površinskim ranama/kontuzijama (p=0,006). Također ispitanici s gangrenom u istom vremenu mjerenja značajno višom procjenjuju bol od ispitanika s dekubitusom (p=0,002) i ispitanika s površinskim ranama/kontuzijama (p=0,006). Kod razine boli u mirovanju ispitanici s ulkusom značajno višom procjenjuju bol od ispitanika s površinskim ranama/kontuzijama (p=0,003). Postoji značajna statistička razlika u tri vremenska perioda mjerenja boli prema veličini rane, (p=0,025). Ispitanici s ranom manjom od 5x5 cm značajno manjom procjenjuju razinu boli od ispitanika s operativnim rezom (p=0,031), ranom veličine 10 x 10, (p=0,029) i ranama velikih površina (p=0,002). Zaključak: Doživljaj boli ovisi o doživljaju pojedinca i nije objektivno mjerljiv. Postoje velike osobne, kulturne i spolno uvjetovane razlike u izrazu boli. U rješavanju složenog zadatka upravljanja boli potrebno je izabrati model koji je kulturološki prihvatljiv i osjetljiv, kako bi se optimiziralo zadovoljstvo i ishod liječenja bolesnika.Introduction: Chronic wounds are considered a major public health problem and increases the suffering of the patient and significantly affects the quality of life. By continuous assessment of pain, the nurse will allow timely therapeutic action either by pharmacological or non-pharmacological methods. Methods: A cross-sectional survey was conducted from April to August 2019 at the General County Hospital Pozega. The study involved adult patients with wounds that did not heal for more than 8 weeks. 60 patients were enrolled. A visually analogous three-point time scale (at admission, wound dressing, and at rest) was used for pain assessment.From the statistical tests, the Hi square test MANOVA (Multivariate analysis of variance), and the Bonferroni post hoc test. Results: It was found that there was a significant statistical difference in the three time periods of pain measurement according to the gender of the subjects in such a way that the respondents significantly evaluated the pain level more than the respondents (p = 0.008). A statistically significant difference was observed in the three time periods of pain measurement according to the type of wound (p <0.001). a significant difference between pain levels at admission and ulcer where they rate pain significantly higher than subjects with decubitus (p = 0.031) and superficial wounds / contusions (p = 0.006). Also, subjects with gangrene at the same time of measurement had significantly higher pain scores than subjects with decubitus (p = 0.002) and subjects with superficial wounds / contusions (p = 0.006). At the level of pain during the dressing, subjects with superficial wounds / contusions had significantly lower pain scores than all other groups of subjects, subjects with ulcer (p = 0.009), subjects with decubitus (p = 0.022), and subjects with gangrene (p = 0.001). At resting pain level, subjects with ulcer had significantly higher pain scores than subjects with superficial wounds / contusions (p = 0.003). There was a significant statistical difference in the three time periods of pain measurement according to wound size, (p = 0.025). Subjects with a wound less than 5x5 cm significantly less rated pain level than subjects with an operative incision (p = 0.031), a size 10 x 10 wound (p = 0.029), and large area wounds (p = 0.002) Conclusion: The experience of pain depends on the experience of the individual and is not objectively measurable. There are major personal, cultural and gender-related differences in the expression of pain. In dealing with the complex task of pain management, it is necessary to choose a model that is culturally acceptable and sensitive, in order to optimize patient satisfaction and outcome

ANTIBACTERIAL ACTIVITY OF CHESTNUT HONEY (Castanea sativa Mill.) AGAINST Helicobacter pylori AND CORRELATION TO ITS ANTIOXIDANT CAPACITY

One of the proven therapeutic properties of honey is its antimicrobial activity. The aim of this study was to examine the antimicrobial activity of chestnut honey against Helicobacter pylori and to evaluate a relationship between the content of phenols, antioxidant capacity and antimicrobial activity. The antimicrobial activity of honey was determined by the agar well diffusion method, and the inhibitory effect of different honey concentrations (20%, 50% and 75%) was evaluated. The phenolic content was determined by the Folin-Ciocalteu method while the total antioxidant capacity was determined by the FRAP assay. Water activity and hydrogen peroxide content were also determined. The results showed that the zones of inhibition of H. pylori ranged from eight to 21 mm depending on the sample and the concentration of honey, where the concentration of honey of 20% did not have inhibitory effect. The phenolic content ranged from 204.94 to 233.82 mg of GA/kg while FRAP values were between 392.71 and 441.53 μM Fe (II). The honey sample that showed the highest antimicrobial activity against H. pylori also had the highest total antioxidant capacity. However, the same correlation was not observed in the other analysed samples. Further research is needed to determine the contribution of individual components of honey to its antimicrobial activity