Clinical hypnosis and female sexual dysfunction

Female sexual function comprises variable and multi-layered conditions that incorporate complex interactions of physiological, psychological, and interpersonal components. Despite the progress in understanding the neurobiology of sexual response, the definition of normal sexual response in women remains unresolved. Normal female sexual function differs from individual to individual and depends on the culture, ideology, beliefs, and other factors. Methods: We used a case report, the purpose of which is to justify further investigation into the effectiveness of hypnosis for the treatment of cervical pain during penetration, as well as orgasm disorder. Results: An orgasm was reached by masturbation performed on her by her partner, but without an orgasm by penile-vaginal penetration. The frequency of sexual intercourse has increased (3-4 times/week) in comparison to prior to therapy (once/ 2 months). Orgasm does not occur by self- and by partner masturbation every time, but sporadicallyhowever, more frequently than before therapy. Success has been achieved with the orgasm by penile-vaginal penetration. Conclusions: Hypnotherapy may be a promising co-intervention or intervention per se for both physical and psychological symptoms. The results of hypnotherapy demonstrate that symptoms were significantly alleviated and, consequently, the quality of life improved. Symptoms of pain during sexual intercourse were not eliminated, but the patient had achieved significant control over those symptoms

Seksualna funkcija u žena i tvrdnje semantičke diferencijalne skale

Background: The purpose of the study was to evaluate the correlations between demographic variables and claims from the Female Sexual Function Index (FSFI), and questions from Semantic Differential Items of Female Sexual Function (SDIFSF). Data were collected through an online survey. Methods: Based on the Kolmogorov-Smirnov and Shapiro-Wilk test on six claims of FSFI, a non-parametric statistical analysis with the Spearman correlation coefficient and χ2-test were used. Statistical significance was set at p<0.05 Results: The sample consisted solely of female participants, aged from 18 to 89 years. Most of the participants (n=287; 66.9%) were in a relationships (but not married), were still students (n=178; 41.5%) and were Catholic (n=267; 62.2%). Conclusions: The youngest participants expressed the highest level of satisfaction after sexual intercourse and mostly take the initiative for sexual intercourse. However, they mostly experienced pain after sexual intercourse. Married participants had the highest level of experiencing an orgasm (in any way), were pleasantly aroused during and had feelings of satisfaction after sexual intercourse. The higher the level of education, the more positive effects were present during (experiencing an orgasm, lubrication) and feelings of satisfaction after sexual intercourse. However, at the same time, participants felt pain during and after sexual intercourse, were concerned whether their partners like them, and were concerned about not being mentally present (e.g. daydreaming or fantasising about being with someone else) during sexual intercourse. Participants with one sexual partner in the previous year experienced an orgasm during and felt satisfied after sexual intercourse but felt pain during sexual intercourse. With the increasing number of sexual partners, lubrication increased, as did pleasant arousal during sexual intercourse, and a feeling of satisfaction. Furthermore, pain was present during and after sexual intercourse.Svrha istraživanja bila je procijeniti korelacije između demografskih varijabli i tvrdnji iz Indeksa ženske seksualne funkcije i pitanja iz Semantičke diferencijalne skale ženske seksualne funkcije. Podaci su prikupljeni putem online ankete. Metode: Na temelju testiranja šest tvrdnji Indeksa ženske seksualne funkcije Kolmogorov-Smirnovljevim i Shapiro-Wilkovim testom primijenjena je neparametarska statistička analiza sa Spearmanovim koeficijentom korelacije i hi-kvadrat testom. Statistička razina značajnosti postavljena je na p < 0,05. Rezultati: Uzorak se sastojao od isključivo ženskih sudionika u dobi od 18 do 89 godina. Većina sudionica (n = 287, 66,9%) bila je u vezi (ali nisu bile udane), još uvijek su pohađale fakultet (n = 178; 41,5%) i bile su pripadnice katoličke vjeroispovijesti (n = 267, 62,2%). Zaključak: Najmlađe sudionice iskazale su najvišu razinu zadovoljstva nakon spolnog odnosa i one uglavnom poduzimaju inicijativu za stupanje u spolni odnos. Međutim, one su uglavnom doživjele bol nakon spolnog odnosa. Udane sudionice najčešće su postizale orgazam (na bilo koji način), bile su uzbuđene tijekom spolnog odnosa i osjećale zadovoljstvo nakon njega. Viša razina obrazovanja pozitivnije utječe na sam spolni odnos (postizanje orgazma, lubrikacija) i osjećaj užitka nakon spolnog odnosa. Međutim, istodobno, sudionice su osjećale bol tijekom i nakon spolnog odnosa, bile su zabrinute sviđaju li se svojim partnerima te su bile zabrinute zbog toga što nisu bili mentalno prisutne (npr. sanjarenje ili maštanje o tome da su s nekim drugim) tijekom spolnog odnosa. Sudionice s jednim seksualnim partnerom u prethodnoj godini doživjele su orgazam i osjećale zadovoljstvo nakon spolnog odnosa, ali su osjećale bol tijekom spolnog odnosa. S porastom broja seksualnih partnera pojačala se lubrikacija, kao i uzbuđenje tijekom spolnog odnosa te osjećaj zadovoljstva. Nadalje, bol je bila prisutna tijekom i nakon spolnog odnosa

Zdravstvene organizacije i odlučivanje: stil rukovođenja za rast i razvoj

Background: Change management has become a key instrument in every organization and is crucial for their survival since changes have become unavoidable. The manner in which changes are introduced in everyday practice is an important component of change management. Managing change involves thoughtful planning and implementation, as well as the involvement of employees. Success is based on an appropriate managerial approach since management styles have a direct impact on the introduction of change by transforming employee attitudes. The aim of the study was to examine the impact of different leadership styles onthe success of introducing changes. Methods: We used a quantitative methodology. The instrument used was a validated questionnaire with closed questions. Four Slovenian healthcare centers were included in the study. Results: The success of the introduced changes statistically positively correlates with the transformational leadership (p < 0.05), and negatively correlates with the Laissez-faire leadership (p < 0.05). The assessed effectiveness of leadership styles positively correlates with the transformational, transactional, and Laissez-faire leadership (p < 0.05). However, within the assessed effectiveness of leadership styles, and the satisfaction with the introduced changes the strong link was observed in transformational leadership. Conclusions: Over the past decades, the emphasis on change has proven to be a key feature of organizational success. Changes are introduced and based on a proper management style, which has a direct impact on the working environment.Uvod: Upravljanje promjenama postalo je ključni instrument u svakoj organizaciji i presudan je za njihov opstanak jer su promjene postale neizbježne. Način na koji se promjene uvode u svakodnevnu praksu važna je komponenta upravljanja promjenama. Upravljanje promjenama uključuje promišljeno planiranje i provedbu, kao i uključivanje zaposlenika. Uspjeh se temelji na odgovarajućem pristupu upravljanju, budući da stilovi vodstva izravno utječu na uvođenje promjena transformiranjem stavova zaposlenika. Cilj istraživanja bio je ispitati utjecaj različitih stilova vodstva na uspjeh uvođenja promjena. Metode: Primijenjena je kvantitativna metodologija. Instrument istraživanja bio je validirani upitnik s pitanjima zatvorenog tipa. Četiri slovenska doma zdravlja bila su uključena u istraživanje. Rezultati: Uspjeh uvedenih promjena statistički pozitivno korelira s transformacijskim stilom vodstva (p < 0,05), a negativno s laissez-faire stilom vodstva (p < 0,05). Procjena učinkovitosti stilova vodstva pozitivno korelira s transformacijskim, transakcijskim i laissez-faire stilom vodstva (p < 0,05). Međutim, jaka veza zabilježena je između transformacijskog stila vodstva i procijenjene učinkovitosti stilova vodstva i zadovoljstva uvedenim promjenama. Zaključak: Tijekom proteklih desetljeća naglasak na promjeni pokazao se kao ključna značajka organizacijskog uspjeha. Promjene se uvode i temelje se na odgovarajućem stilu upravljanja koji ima izravan utjecaj na radno okruženje

Profesionalizacija u lancu zdravstvene zaštite

Background: Several elements influence the process of professionalization. The focus is on the process of professionalization in the healthcare chain. A special emphasis proportion was given to the field of nursing and its gradual transition to the profession. During the transition process endogenous and exogenous environment act as elements which should be identified. Methods: Data were analysed using quantitative and qualitative methodology. A quantitative part involved descriptive statistics, contingency analysis and ordinary least squares and multivariate linear regression with and without control variables, both based on indexation. The qualitative part consisted of the analysis of the data collected through open-ended questions and semi-structured interview. An adjusted questionnaire was designed. Results: Attributes into the process of professionalization are present in nursing professionals aged more than 51 years with more than 26 years of working experience, employed at primary level of healthcare. The acquisition of new knowledge represents the contribution to their human capital and contemporaneously raises their expert power as well. Lifelong learning, nursing professional autonomy and specific knowledge in nursing as an endogenous and exogenous factors indicate statistically significant positive impact. The analysis identified that ethics in nursing had only marginal statistically significant positive impact in the process of nursing professionalization. Conclusions: The identification of endogenous and exogenous elements allows additional planning as well as research into the practice and quality of care in general.Uvod: Nekoliko čimbenika utječe na proces profesionalizacije. Rad se fokusira na proces profesionalizacije u lancu zdravstvene zaštite. Poseban naglasak stavljen je na sestrinstvo i profesionalizaciju sestrinstva kao struke. Tijekom procesa tranzicije postoje određeni endogeni i egzogeni elementi koje je potrebno identificirati. Metode: U analizi podataka korištena je kvantitativna i kvalitativna metodologija. U kvantitativnom dijelu analize korištena je deskriptivna statistika, analiza kontingencije, metoda najmanjih kvadrata i multivarijatna linearna regresija sa i bez kontrolnih varijabli, oboje temeljenih na indeksaciji. Kvalitativni dio se sastojao od analize podataka prikupljenih putem otvorenih pitanja i polu-strukturiranog intervjua. Za potrebe istraživanja izrađen je i posebno prilagođen upitnik. Rezultati: Značajke procesa profesionalizacije prisutne su kod profesionalaca u području sestrinstva starijih od 51 godina, s više od 26 godina radnog iskustva, i zaposlenih na primarnoj razini zdravstvene zaštite. Stjecanje novih znanja predstavlja doprinos njihovom ljudskom kapitalu te istovremeno podiže razinu njihovog stručnog znanja. Cjeloživotno učenje, autonomija sestrinskih profesionalaca i specifična znanja u sestrinstvu kao endogeni i egzogeni čimbenici ukazuju na statistički značajan pozitivan utjecaj. Analiza je utvrdila da etika u sestrinstvu ima samo marginalan statistički značajan pozitivan utjecaj u procesu profesionalizacije sestrinstva. Zaključak: Identifikacija endogenih i egzogenih čimbenika omogućuje dodatno planiranje i istraživanje prakse i kvalitete zdravstvene zaštite

Program zdravstvenega izobraževanja sladkornih bolnikov

Sestavek obravnava zdravstveni izobraževalni program za sladkorne bolnike v dispanzerju za sladkorne bolnike. Osnovni pogoj realizacije ciljev zdravstvenega izobraževalnega programa sladkornih bolnikov je, da morajo tovrstni programi temeljiti na andragoški didaktiki in na načelih vzgojno-izobraževalnega dela z odraslimi. V študiji je bila uporabljena deskriptivna kavzalna neeksperimentalna metoda – študija primera, ki je trajala od oktobra 2001 do januarja 2002

Utjecaj liječenja simptoma donjeg mokraćnog sustava uzrokovanih dobroćudnim povećanjem prostate na erektilnu funkciju

Background: Benign prostatic enlargement is the most common benign disease in men. The main cause for the emergence of benign prostatic enlargement is sexual hormone testosterone. Under the influence of enzyme 5-alpha reductase testosterone turns into active dihydrotestosterone, which is then combined with receptors and causes the growth of the prostate. Benign prostatic enlargement can cause the lower urinary tract symptoms. One of the treatment options of lower urinary tract symptoms due to benign prostatic enlargement is the treatment with medicaments – inhibitors 5-alpha reductase. Like any other medicament, this one can also have unpleasant side effects, between others reduced erectile function and reduced libido. Methods: We used the International Index of Erectile Function (IIEF-5), Quality of Erection Questionnaire (QEQ), and demographic data. Results: Men with benign prostatic enlargement have problems with keeping an erection even before starting the therapy with medicaments. After the therapy with inhibitors 5-alpha reductase the results of the research show that on the erectile function scale, there are no significant differences between the first and second measurement, but on the erectile dysfunction scale expected differences occur – the functionality decreases. We also noticed that the independent variables of age and employment status have influence on the result of medicament treatment in the way that older participants in the study have more issues with erectile function than younger ones. Secondly, the men in retirement have more problem than employed men. There were no noticeable connections between the level of completed education and the profession of the participants. Conclusions: The results of the research were expected, according to the previously consulted literature, where the side effects of treatment with medicaments inhibitors 5-alpha reductase were already mentioned. The effects that the treatment has on erectile function are that the function deteriorates, that is why it is important that we seek doctor assistance immediately after it occurs. The disease mainly manifests itself in older generation of men and it has a negative effect on erectile function already at the very beginning. Before starting the treatment the patients would need to be informed about the side effects of the medicament treatment and they should be presented other possibilities of treatment without side effects for erectile function.Uvod: Dobroćudno povećanje prostate je najčešća dobroćudna bolest u muškaraca. Glavni uzročnik pojave dobroćudnog povećanja prostate je muški spolni hormon testosteron. Pod utjecajem enzima 5-alfa reduktaze testosteron se pretvara u aktivni dihidrotestosteron, koji se tada kombinira s receptorima i uzrokuje rast prostate. Dobroćudno povećanje prostate može uzrokovati simptome u donjem mokraćnom sustavu. Jedna od mogućnosti liječenja simptoma donjeg dijela mokraćnog sustava uslijed dobroćudnog povećanja prostate je liječenje lijekovima - inhibitorima 5-alfa reduktaze. Kao i bilo koji drugi lijek, i ovaj može imati neugodne nuspojave, između ostalih smanjenu erektilnu funkciju i smanjeni libido. Metode: Koristili smo međunarodni indeks erektilne funkcije (IIEF-5), upitnik o kvaliteti erekcije (QEQ) i demografske podatke. Rezultati: Muškarci s benignim povećanjem prostate imaju problema s održavanjem erekcije, čak i prije nego što započnu terapiju lijekovima. Nakon terapije inhibitorom 5-alfa reduktaze rezultati istraživanja pokazuju da na ljestvici erektilne funkcije nema značajnih razlika između prvog i drugog mjerenja, ali na ljestvici erektilne disfunkcije dolazi do očekivanih razlika - funkcionalnost opada. Također smo primijetili da nezavisne varijable dobi i zaposlenja imaju utjecaj na rezultat liječenja lijekovima na način da stariji sudionici u istraživanju imaju više problema s erektilnom funkcijom od mlađih muškaraca. Zatim, muškarci u mirovini imaju više problema nego muškarci koji su zaposleni. Nisu bile uočljive veze između završene razine obrazovanja i profesije sudionika. Zaključci: Rezultati istraživanja bili su očekivani, prema prethodno konzultiranoj literaturi, gdje su već spomenute nuspojave liječenja inhibitorima 5-alfa reduktaze. Učinak koji tretman ima na erektilnu funkciju je pogoršanje funkcije, zato je važno potražiti pomoć liječnika odmah nakon što se pojavi. Bolest se uglavnom očituje kod starije generacije muškaraca i negativno utječe na erektilnu funkciju već u samom početku. Prije početka liječenja, pacijente bi trebalo informirati o nuspojavama liječenja lijekovima i treba im predstaviti druge mogućnosti liječenja bez nuspojava za erektilnu funkciju

Assessment of physical activity in elderly people using a PASE questionnaire in accordance with the selected MKB-10 disease category

Practising a sitting way of life in elderly people can result in a lowered level of physical activity with an increased risk of developing cardiovascular diseases. The aim of this research is to ascertain the level of physical activity in elderly people and in which group they belong according to the selected MKB-10 disease category using a PASE questionnaire as a measuring instrument. Participants (N = 100) that can partake in physical activity on their own or with assistance were included in this study. They were distributed into three groups categorized by the International Classification of Diseases and related medical issues (MKB-10). The first group consisted of people with musculoskeletal disorders (N = 34), the second included cardiovascular diseases (N = 35) and the third included participants with neurological disorders (N = 31). The PASE questionnaire was used in order to evaluate the level of physical activity. The results of this research confirm that most elderly people practise a sitting way of life with a low level of physical activity and an increased BMI index in all observed groups. According to the results of this study, there was no statistically significant difference between the three observed groups in regards to physical activity, BMI and sitting activity. In further research, it is needed to design measuring instruments for assessing the level of physical activity in elderly people that would enable defining limiting factors for including people of this age group in physical activity

Pridobivanje in razvoj znanstvenega in strokovnega človeškega kapitala v zdravstveni negi: študija primera

Namen članka je prikazati praktično aplikacijo teoretičnega koncepta pridobivanja in razvoja znanstvenega in strokovnega človeškega kapitala profesionalcev zdravstvene nege. Leta 2005 smo v Ortopedski bolnišnici Valdoltra opravili študijo primera, kjer smo testirali teoretični model konverzije človeškega kapitala. Raziskavo, v kateri je sodelovalo 29 višje, visokostrokovno in/ali univerzitetno izobraženih profesionalcev zdravstvene nege, smo izvedli z anketnim vprašalnikom. Za testiranje teoretičnega modela je bila uporabljena korelacijska analiza. Rezultati: anketiranci razumejo vseživljenjsko učenje kot nadgradnjo osnovnega znanstvenega in strokovnega znanja v povezavi s prakso. Raziskava je tudi pokazala, da vseživljenjsko učenje pripomore k sprejemanju novih zahtevnejših delovnih zadolžitev ter služi za pospešeno pridobivanje in razvijanje novega osebnostnega in organizacijskega znanja. Zaključek: »aktivacija« profesionalcev zdravstvene nege v procesu vseživljenjskega učenja prikazuje pozitivno korelacijo med vseživljenjskim učenjem in indikatorji uspešnega pridobivanja in razvijanja znanstvenega in strokovnega človeškega kapitala. Študija primera prikazuje profesionalce zdravstvene nege kot so-ustvarjalce intelektualnega kapitala zdravstvene organizacije

Seksualna funkcija i disfunkcija žene: nacionalno istraživanje učestalosti u Sloveniji

The purpose of the current study was to evaluate the prevalence of female sexual dysfunction in Slovenia. We aimed to explore the prevalence itself, comparison among demographic groups and potential correlations. Data were collected based on the validated standardized Female Sexual Function Index (FSFI) (N=605). Most participants had sexual intercourse with one partner (n=523), and the majority of sexual relationships were heterosexual (n=584). University educated subjects had the highest claims of arousal, followed by those with master/doctoral degrees and college educated ones. The lowest level was expressed by subjects with elementary school. The youngest subjects (18-23 years) expressed the highest levels of desire and arousal, followed by the 24-29 age group. The 42-47 age group reported higher levels of lubrication and orgasm. The claim of satisfaction was highest in the 24-29 age group, while the pain was highest in the 42-47 age group. Strong correlation was found between the claims of desire and arousal (r=0.585), arousal and lubrication (r=0.879), lubrication and pain (r=0.856), orgasm and lubrication (r=0.856), satisfaction and orgasm (r=0.782), and pain and arousal (r=0.776) (p<0.001). We identified a 31% prevalence of female sexual dysfunction in Slovenia.Cilj ovoga istraživanja bio je procijeniti učestalost seksualne disfunkcije kod žena u Sloveniji. Ispitivala se učestalost disfunkcije s usporedbom demografskih skupina i moguće korelacije. Podaci su prikupljani pomoću potvrđenog standardiziranog Indeksa seksualne funkcije žene (N=605). Većina sudionica u istraživanju imala je seksualni odnos s jednim partnerom (n=523) i većina seksualnih odnosa bila je heteroseksualna (n=584). Najveće zahtjeve za uzbuđivanje imale su osobe s fakultetskim obrazovanjem, a nakon njih one s magisterijem i doktoratom te osobe s višom školom. Najnižu razinu izrazile su osobe s osnovnom školom. Najmlađa dobna skupina (18-23 godine) izrazila je najviše razine želje i uzbuđenja, a nakon nje dobna skupina od 24-29 godina. Dobna skupina od 42-47 godina izrazila je najviše razine lubrikacije i orgazma. Zahtjev zadovoljavanja bio je najviši u skupini od 24-29 godina, dok je bolnost bila najviša u skupini od 42-47 godina. Utvrđena je snažna korelacija između zahtjeva želje i uzbuđivanja (r=0,585), uzbuđivanja i lubrikacije (r=0,879), lubrikacije i boli (r=0,856), orgazma i lubrikacije (r=0,856), zadovoljenja i orgazma (r=0,782) te boli i uzbuđivanja (r=0,776). Utvrđena je učestalost seksualne disfunkcije kod žena u Sloveniji od 31%

Darivanje organa: iskustvo u održavanju moždano mrtvog donora na životu

Background: Brain death is an irreversible biological event, and is the permanent cessation of functions of the brain and brainstem. Transplantation has become an established method of treatment of many, near-terminal patients. Methods: The sample consisted of three groups: doctors, registered nurses, and nursing assistants. The research was carried out in the Intensive Care Unit of the University Medical Centre Ljubljana, Department of An- aesthesiology and Surgical Intensive Therapy Department and at the Clinical Department of Vascular Neurology and Intensive Neurological Therapy. Data were collected using a questionnaire and semi-structured interviews. Results: Women experience more stress when working with brain-dead donors than men do. We conclude that the work with a brain-dead organ donor represents a specific situation and has little in common with the factors that affect the overall satisfaction of health-care professionals. Healthcare professionals who are undecided about the donation of their own organs are against organ donation in general. It has been shown that there is a lack of education and communication on the maintenance of brain-dead donors. Conclusions: Work with brain-dead donors is almost routine work in intensive care units. Some healthcare professionals perceive a brain-dead organ donor like any other patient, but within a defined protocol.Pozadina: Moždana je smrt nepovratni biološki događaj koji podrazumijeva stalni prekid funkcija mozga i moždanog debla. Postupak transplantacije postao je uspješna metoda liječenja mnogih pacijenata s terminalnim stanjima bolesti. Metodologija: Uzorak se sastojao od tri skupine: liječnika, registriranih medicinskih sestara i njegovatelja. Istraživanje je provedeno u jedinici intenzivne skrbi Sveučilišnog kliničkog centra u Ljubljani, na Odjelu za anesteziologiju i intenzivno kirurško liječenje te na Odjelu za vaskularnu neurologiju i intenzivno neurološko liječenje. Podaci su prikupljeni putem upitnika i polustrukturiranih intervjua. Rezultati: U slučaju rada s moždano mrtvim donorima, stres utječe više na žene nego na muškarce. Zaključujemo da rad s moždano mrtvim donorom organa predstavlja specifičnu situaciju i nema mnogo zajedničkog s čimbenicima koji utječu na ukupno zadovoljstvo zdravstvenih djelatnika. Zdravstveni djelatnici koji su neodlučni oko darivanja vlastitih organa općenito su protiv darivanja organa. Utvrđeno je da postoji nedostatak obrazovanja i komunikacije o održavanju moždano mrtvih donora na životu. Zaključci: Rad s moždano mrtvim donorima gotovo je rutinski posao u jedinicama intenzivne skrbi. Neki zdravstveni djelatnici percipiraju moždano mrtve donore kao i sve ostale pacijente, ali unutar definiranog protokola