Društvo za kvalitetu - Hrvatska udruga medicinskih sestara - 4. konferencija: „Osnaživanje sestrinstva – motivacija za rad u Jedinici za kvalitetu“

Motivacija je važan čimbenik poboljšanja stupnja kvalitete zaposlenika u sustavu zdravstva. Danas postoji dvojba koja se iskazuje pitanjem: Ako je stupanj nezadovoljstva zaposlenika u zdravstvenom sustavu Republike Hrvatske [RH] sve viši [smanjenje stečenih prava, ukidanje radnog mjesta visoke stručne spreme (VSS) zdravstvenog radnika], može li se povećati stupanj motivacije? Današnji je profesionalni status medicinskih sestara/tehničara u zdravstvenom sustavu RH nezadovoljavajući. S ciljem informiranja i podizanja svijesti o statusu i složenosti poslova medicinskih sestara/tehničara u Jedinici za kvalitetu, dana 12. lipnja 2014. u Kliničkoj bolnici [KB] Merkur u Zagrebu održana je 4. konferencija Društva za kvalitetu pod nazivom „Osnaživanje sestrinstva – motivacija za rad u Jedinici za kvalitetu“

The clinical and predictive value of C-reactive protein/albumin ratio in critically ill and mechanically ventilated adult patients

Introduction: CPR/albumin ratio represents a new biomarker that integrates two laboratory-tested acute phase reactants: a positive one (C-reactive protein) and a negative one (albumin), and which can be used as an indicator of the severity, progression and outcome of various illnesses, including critical illnesses. In this retrospective study, we investigated the impact of the CRP/albumin ratio on the clinical characteristics and outcome of the treatment of critically ill and mechanically ventilated adult patients. Patients and methods: This retrospective study included 100 critically ill patients (65 % males and 35 % females; median age of 67) treated at the medical intensive care unit (ICU) which required the use of invasive mechanical ventilation. The primary diagnoses upon admission to the intensive care unit were: sepsis and septic shock (39 %), acute heart failure or worsening chronic heart failure (20 %), exacerbation of chronic obstructive pulmonary disease (16 %), pneumonia (11 %), acute kidney injury or the exacerbation of chronic kidney disease (7 %) and other conditions (7 %). Results: Correlation analysis showed a significant moderate positive correlation between CRP/albumin ratio and the duration of mechanical ventilation measured in hours (r = 0.48, p = 0.001) and the time spent in the intensive care unit, measured in days (r = 0.44, p = 0.001). The median of the CRP/albumin ratio was 58.77 and the patients in the above-the-median group had a higher SOFA score. In terms of the outcomes, it has been determined that the surviving patients (56 %) had a significantly lower CRP/albumin ratio compared to those that had not survived (44 %), which correlates with their SOFA scores as well. In the group of survivors, the correlation between the ratio of CRP/albumin and the SOFA score is positive and statistically significant (r = 0.29, p = 0.03), in the group non-survivoris (r= 0.45, p = 0.003.) Conclusion: Based on the results of our study, the CRP/albumin ratio has proved to be a good predictor of clinical characteristics and outcomes of critically ill and mechanically ventilated patients

Blízký východ - nové hřiště pro hegemonické soupeření

Throughout history, the relationship between the Islamic Republic of Iran and the Kingdom of Saudi Arabia has been dynamic and complex. These two Middle Eastern superpowers went from being allies to being enemies that are fighting for hegemony in the region after the Iranian Revolution. Ideological and religious reasons are usually used to explain the shift in their relationship.However,the complexity oftheirrelationship can notonly be described by them.This thesis aims to analyse changes that occurred in the relationship between Iran and Saudi Arabia through the lens of the role that leadership played in their relationship,focusing on the impact that public support has on decisions brought by leadership. Already existing literature that relates to this research is mainly focusing on democratic countries. Therefore,this thesis aims to show that public opinion is vital for the non-democratic Middle Eastern leadership of Iran and Saudi Arabia, as well. It will determine leadership decisions related to their mutual relationship, as well as relations they have with other foreign powers, such as the United States and Russia.1 Abstract Historicky byl vztah mezi Íránskou islámskou republikou a Saúdskou Arábií dynamický a komplexní. Tyto dvě blízkovýchodní velmoci se vyvinuly ze spojenců do nepřátel, kteří spolu po Iránské revoluci bojují o následovnictví v regionu. Ideologické a náboženské důvody jsou obvykle využity k vysvětlení vývoje jejich vzájemných vztahů. Avšak, složitost jejich vztahů, nelze vysvětlit těmito důvody. Tato diplomová práce se zaměřuje na analýzu změn, které se údály mezi Íránem a Saúdskou Arábií skrz objektiv toho, jakou roli sehrály vůdčí schopnosti v jejich vztahu, se zaměřením na dopad, který má veřejná podpora na rozhodnutí učiněná vůdci. Již publikovaná literatura, která se vztahuje k tématu toho výzkumu, se zaměřuje hlavně na demokratické země. Z tohoto důvodu je tato práce zaměřena na prokázání toho, že věřejné mínění je nezbytné také pro nedemokratické blízkovýchodní vůdce Iránů a Saudské Arábie.To předurčí vůdcovská rozhodnutí související s jejich vzájemnými vztahy, stejně jako mají se zahraničními mocnostmi jako např. Spojenými státy americkými a Ruskem.Katedra bezpečnostních studiíDepartment of Security StudiesFaculty of Social SciencesFakulta sociálních vě

Middle East - a new playground for hegemonic rivalry

Throughout history, the relationship between the Islamic Republic of Iran and the Kingdom of Saudi Arabia has been dynamic and complex. These two Middle Eastern superpowers went from being allies to being enemies that are fighting for hegemony in the region after the Iranian Revolution. Ideological and religious reasons are usually used to explain the shift in their relationship.However,the complexity oftheirrelationship can notonly be described by them.This thesis aims to analyse changes that occurred in the relationship between Iran and Saudi Arabia through the lens of the role that leadership played in their relationship,focusing on the impact that public support has on decisions brought by leadership. Already existing literature that relates to this research is mainly focusing on democratic countries. Therefore,this thesis aims to show that public opinion is vital for the non-democratic Middle Eastern leadership of Iran and Saudi Arabia, as well. It will determine leadership decisions related to their mutual relationship, as well as relations they have with other foreign powers, such as the United States and Russia

The correlation between stressors in the workplace and the ability of emotional regulation and control in health professionals in hospitals

Cilj istraživanja: Glavni je cilj doktorskog rada bio ispitati emocionalnu regulaciju i kontrolu (ERIK) i vrste stresora na radnom mjestu zdravstvenih djelatnika u bolnici, utvrditi povezanost i utjecaj stresora na sposobnost ERIK-a. Cilj je bio utvrditi doprinos ERIK-a na razvoj stresa zdravstvenih djelatnika. Nacrt studije: presječno istraživanje. Ispitanici i metode: U istraživanje su bila uključena 203 zdravstvena djelatnika zaposlena u KBC Osijek na stacionarnim odjelima. Instrumenti ispitivanja bili su validirani standardizirani upitnici: upitnik o stresorima na radnom mjestu bolničkih zdravstvenih djelatnika koji je uključivao i pitanja o općim obilježjima ispitanika te upitnik ERIK. Rezultati: Skala doživljenog stresa i skala ERIK značajno su povezane u svim domenama osim u domeni smjenski rad koja nije značajno povezana s domenama pamćenje emocionalno saturiranih sadržaja i efekt emocija i raspoloženja. Sve su veze pozitivne i slabe (Rho < 0,5). Ukupna skala doživljenog stresa viša je ako je više ocijenjena i skala ERIK, odnosno, što je niži ERIK, to je više izražen doživljeni stres (Rho = 0,308). Ispitanici koji su izloženiji stresu na radnom mjestu imaju značajno manje izraženo pamćenje emocionalno saturiranih sadržaja (P = 0,01) te ukupnu skalu ERIK (P = 0,04). Ispitanici koji imaju jače izraženo pamćenje emocionalno saturiranih sadržaja imaju veću vjerojatnost (omjer izgleda 1,18 (95 %) s rasponom pouzdanosti od 1,07 do 1,30) za jače doživljeni stres. Model je u cijelosti statistički značajan i objašnjava 11,2 % varijance prisutnog jače doživljenog stresa i točno klasificira 72,4 % slučaja. Rezultat regresijske analize prikazuje predikciju jače doživljenog stresa kod pamćenja emocionalno saturiranih sadržaja i kao model objašnjava 8,8 % promjene ukupno doživljenog stresa. Zaključak: Rezultatima ovog istraživanja potvrđena je hipoteza da su stresori na radnom mjestu povezani s ERIK-om i pridonose razvoju sposobnosti ERIK-a kod zdravstvenih djelatnika u bolničkim ustanovama. Potvrđen je i doprinos sposobnosti ERIK-a na razvoj stresa među zdravstvenim djelatnicima. Naime, zdravstveni djelatnici koji su imali bolju sposobnost ERIK-a bili su pod manjim utjecajem stresora na radnom mjestu u odnosu na one pod većim utjecajem.Aim: The main goal of the doctoral thesis is to examine emotional regulation and control (ERC), as well as types of stressors in the workplace of health workers, i.e. a medical institution, and to determine the correlation and impact of stressors on the ability of ERC The aim is to determine the contribution of the ERC ability to the development of stress in healthcare workers. Design: cross-sectional survey Participants and methods: The research was based on the participation of 203 health workers employed at the University Hospital Center Osijek in Croatia, in inpatient departments. The research instruments were standardized validated questionnaires, i.e. the Questionnaire on stressors in the workplace of hospital health workers, and the Emotional Regulation and Control Questionnaire. Results: The scale of experienced stress and the ERC scale are related significantly in all the domains, including the total scales, with the exception of the domain Shift work, which is not significantly related to the domain Recollection of emotionally saturated memories, nor the domain Effect of emotions and mood. All the correlations are positive and weak (Rho < 0.5). The total scale of experienced stress is higher if the ERC scale is rated higher, that is, the lower the regulation and control, the more pronounced the experienced stress (Rho = 0.308). Participants who are more exposed to stress in their workplace have significantly less recollection of emotionally saturated memories (P = 0.01) and the overall ERaC scale (P = 0.04). Participants who have a stronger recollection of emotionally saturated memories have a higher chance (odds ratio 1.18; 95% confidence interval 1.07 to 1.30) of experiencing stronger stress. The model is statistically significant in its entirety and explains 11.2% of the variance in the presence of stronger experienced stress, and accurately classifies 72.4% of the cases. The results of the regression analysis clearly show that the recollection of emotionally saturated memories is significant in the prediction of higher quantities of experienced stress among healthcare workers, and as a model, it accounts for 8.8% of the difference in the total experienced stress. Conclusion: The results of this study confirmed the hypothesis that workplace stressors are related to ERC, as well as that they contribute to the development of the ability of ERCin the hospital’s healthcare workers. Healthcare workers who have a better ability of emotion regulation were less influenced by workplace stressors than the employees whose such ability is lower

The correlation between stressors in the workplace and the ability of emotional regulation and control in health professionals in hospitals

Cilj istraživanja: Glavni je cilj doktorskog rada bio ispitati emocionalnu regulaciju i kontrolu (ERIK) i vrste stresora na radnom mjestu zdravstvenih djelatnika u bolnici, utvrditi povezanost i utjecaj stresora na sposobnost ERIK-a. Cilj je bio utvrditi doprinos ERIK-a na razvoj stresa zdravstvenih djelatnika. Nacrt studije: presječno istraživanje. Ispitanici i metode: U istraživanje su bila uključena 203 zdravstvena djelatnika zaposlena u KBC Osijek na stacionarnim odjelima. Instrumenti ispitivanja bili su validirani standardizirani upitnici: upitnik o stresorima na radnom mjestu bolničkih zdravstvenih djelatnika koji je uključivao i pitanja o općim obilježjima ispitanika te upitnik ERIK. Rezultati: Skala doživljenog stresa i skala ERIK značajno su povezane u svim domenama osim u domeni smjenski rad koja nije značajno povezana s domenama pamćenje emocionalno saturiranih sadržaja i efekt emocija i raspoloženja. Sve su veze pozitivne i slabe (Rho < 0,5). Ukupna skala doživljenog stresa viša je ako je više ocijenjena i skala ERIK, odnosno, što je niži ERIK, to je više izražen doživljeni stres (Rho = 0,308). Ispitanici koji su izloženiji stresu na radnom mjestu imaju značajno manje izraženo pamćenje emocionalno saturiranih sadržaja (P = 0,01) te ukupnu skalu ERIK (P = 0,04). Ispitanici koji imaju jače izraženo pamćenje emocionalno saturiranih sadržaja imaju veću vjerojatnost (omjer izgleda 1,18 (95 %) s rasponom pouzdanosti od 1,07 do 1,30) za jače doživljeni stres. Model je u cijelosti statistički značajan i objašnjava 11,2 % varijance prisutnog jače doživljenog stresa i točno klasificira 72,4 % slučaja. Rezultat regresijske analize prikazuje predikciju jače doživljenog stresa kod pamćenja emocionalno saturiranih sadržaja i kao model objašnjava 8,8 % promjene ukupno doživljenog stresa. Zaključak: Rezultatima ovog istraživanja potvrđena je hipoteza da su stresori na radnom mjestu povezani s ERIK-om i pridonose razvoju sposobnosti ERIK-a kod zdravstvenih djelatnika u bolničkim ustanovama. Potvrđen je i doprinos sposobnosti ERIK-a na razvoj stresa među zdravstvenim djelatnicima. Naime, zdravstveni djelatnici koji su imali bolju sposobnost ERIK-a bili su pod manjim utjecajem stresora na radnom mjestu u odnosu na one pod većim utjecajem.Aim: The main goal of the doctoral thesis is to examine emotional regulation and control (ERC), as well as types of stressors in the workplace of health workers, i.e. a medical institution, and to determine the correlation and impact of stressors on the ability of ERC The aim is to determine the contribution of the ERC ability to the development of stress in healthcare workers. Design: cross-sectional survey Participants and methods: The research was based on the participation of 203 health workers employed at the University Hospital Center Osijek in Croatia, in inpatient departments. The research instruments were standardized validated questionnaires, i.e. the Questionnaire on stressors in the workplace of hospital health workers, and the Emotional Regulation and Control Questionnaire. Results: The scale of experienced stress and the ERC scale are related significantly in all the domains, including the total scales, with the exception of the domain Shift work, which is not significantly related to the domain Recollection of emotionally saturated memories, nor the domain Effect of emotions and mood. All the correlations are positive and weak (Rho < 0.5). The total scale of experienced stress is higher if the ERC scale is rated higher, that is, the lower the regulation and control, the more pronounced the experienced stress (Rho = 0.308). Participants who are more exposed to stress in their workplace have significantly less recollection of emotionally saturated memories (P = 0.01) and the overall ERaC scale (P = 0.04). Participants who have a stronger recollection of emotionally saturated memories have a higher chance (odds ratio 1.18; 95% confidence interval 1.07 to 1.30) of experiencing stronger stress. The model is statistically significant in its entirety and explains 11.2% of the variance in the presence of stronger experienced stress, and accurately classifies 72.4% of the cases. The results of the regression analysis clearly show that the recollection of emotionally saturated memories is significant in the prediction of higher quantities of experienced stress among healthcare workers, and as a model, it accounts for 8.8% of the difference in the total experienced stress. Conclusion: The results of this study confirmed the hypothesis that workplace stressors are related to ERC, as well as that they contribute to the development of the ability of ERCin the hospital’s healthcare workers. Healthcare workers who have a better ability of emotion regulation were less influenced by workplace stressors than the employees whose such ability is lower

Nurses’ Assessments Versus Patients’ Self-Assessments of Postoperative Pain: Knowledge and Skills of Nurses for Effective Pain Management

Postoperative pain is the most common form of acute pain. Nurses contribute to effective pain management with their knowledge and skills. The aims of this research were to examine differences between nurses’ assessments and patients’ self-assessments of postoperative pain, differences in the mentioned (self) assessments with respect to characteristics of both groups of respondents, and the correlation between the NRS and the VRS scale. The study included 103 nurses employed at a hospital and 103 patients treated in the surgical departments after the surgical procedures. Data were collected using the standardized Numerical rating scale (NRS) and Verbal rating score (VRS). The median of patients’ self-assessments of pain intensity on the NRS scale was 4, while the nursing assessment of patients’ pain was 3, with no significant difference (p = 0.083). No significant differences were found on the VRS scale between nurse assessments and patient self-assessments of current pain intensity. The pain was described as moderate by 35% of participants, including 35.9% nurses and 35% patients. Significant positive correlations were recorded between values on the VRS and NRS scales for nurses (Rho = 0.812; p p < 0.001). The results of this study may have implications for the improvement of postoperative pain management protocols, with regular use of pain assessment scales and individualization of analgesic prescriptions