Mental illnesses in Primorsko-goranska County from 1995 to 2009

Cilj: U ovom radu prikazana je zastupljenost mentalnih bolesti u Primorsko-goranskoj županiji (PGŽ) na temelju statističkih podataka. Mortalitet je prikazan u razdoblju od 1995. do 2009., a morbiditet od 1996. do 2009. godine. Metode: Korišteni su podaci iz Zdravstveno-statističkog ljetopisa Nastavnog zavoda za javno zdravstvo PGŽ-a. Dobiveni podaci prikazani su kao apsolutni i relativni brojevi uz prikazivanje mjera učestalosti s usporedbom podataka iz svjetske literature. Rezultati: Mortalitet uzrokovan mentalnim bolestima pokazao je porast u promatranom vremenskom periodu. Jednadžba linearnog trenda broja umrlih pokazala je statističku značajnost (P < 0,001). Morbiditet uzrokovan mentalnim bolestima pokazao je porast od 1999. do 2009. s najviše oboljelih u skupini s dijagnozom neurotskih i somatoformnih poremećaja i poremećaja izazvanih stresom. Jednadžba linearnog trenda broja oboljelih nije pokazala statističku značajnost (P = 0,068). Rasprava i zaključak: Podaci za PGŽ pokazali su kako mortalitet, odnosno morbiditet uzrokovan mentalnim bolestima ne spada u vodeće uzroke smrti, odnosno bolesti. Porast apsolutnog broja oboljelih od 1999. do 2009. i porast broja umrlih pokazali su kako je problem mentalnog zdravlja sve zastupljeniji u populaciji. Na području mentalnog zdravlja potrebno je uložiti velike napore, edukaciju i rad na svim razinama u svrhu poboljšanja položaja mentalnog zdravlja za sve.Aim: In this study was shown the representation of mental illnesses in Primorskogoranska County (PGC) based on the statistical data. Mortality was shown in the period from 1995 to 2009, and the morbidity from 1996 to 2009. Methods: The data used were from the Health-statistical yearbook of the Institute of public health PGC. Given data were represented as absolute and relative numbers showing the measures of occurrence by comparing them with the data from the world literature. Results: Mortality caused by mental illnesses showed an increase in the observed period. The linear trend analysis of number of deaths showed statistical significance (P < 0.001). Mortality caused by mental illnesses showed an increase from 1999 to 2009 with most patients in the diagnostic group of neurotic and somatoform disorders caused by stress. The linear trend analysis of number of ill people did not show statistical significant (P = 0.068). Discussion and conclusion: Data for PGC showed that the mortality and morbidity caused by mental illnesses are not among the leading causes of deaths and diseases. Increase in the absolute number of ill patients from 1999 to 2009 and an increase in the number of deaths showed that the problem of mental health is more represent in the population. In the field of mental health there is need for lot of effort, education, and work at all levels in order to improve the position of mental health for all

Rabies and rabies postexposure prophylaxis in the Primorje-Gorski Kotar County from 1986 to 2021

Cilj: Prikazati karakteristike antirabične zaštite koja se provodi u antirabičnoj ambulanti Epidemiološkog odjela Rijeka Nastavnog zavoda za javno zdravstvo Primorsko-goranske županije u razdoblju od 1986. do 2021. godine. Ispitanici i metode: U istraživanju su korišteni podatci antirabičnih anketa koje su dio godišnjeg izvješća koje se dostavlja Referentnom centru Ministarstva zdravstva za bjesnoću. Osobe koje su obrađivane i koje su primile antirabičnu zaštitu (imunoprofilaksu – postekspozicijsko cijepljenje protiv bjesnoće s humanim antirabičnim imunoglobulinom ili bez njega) najvećim su udjelom stanovnici Primorsko-goranske županije, odnosno grada Rijeke. Rezultati: U antirabičnoj ambulanti od 1986. do 2021. godine utvrđen je trend smanjivanja broja pregledanih osoba (y= -6,9+304, R2=0,78; p<0,05), s 263 na 50 osoba. Broj osoba koje su primile antirabičnu zaštitu u promatranome se periodu povećao (y=0,95+19, R2=0,24; p<0,05). U navedenome vremenskom razdoblju pregledano je 7.678 osoba, od kojih je 1.318 (17,2%) primilo imunoprofilaksu. Imunizirano je 42,3% (558/1.318) osoba ženskoga spola i 57,7% osoba muškoga spola (760/1.318). Najveći broj osoba imuniziran je zbog ozljede, ogrebotine, kontakta od nepoznate, uginule, odlutale, ubijene ili divlje životinje (N=1005) (grupa C) te zbog ozljede, ogrebotine i kontakta sa životinjom pozitivnom na bjesnoću (N=155) (grupa A). Osobe su najčešće imunizirane zbog ozljede, ogrebotine i kontakta sa psom (752/1318; 61,4%). Godine 2011. zabilježena je posljednja osoba koja je imunizirana zbog kontakta s dokazano bijesnom životinjom. Zaključak: U 35 godina rada antirabične ambulante na području grada Rijeke nije zabilježena bjesnoća u ljudi, što se pripisuje učinkovitim mjerama antirabične zaštite. Multidisciplinarni pristup pokazao se najučinkovitijim u smanjenju pobola od bjesnoće u životinja te posljedično sprječavanju pojave bjesnoće u ljudi na području Primorsko-goranske županije i Republike Hrvatske. Međutim, neizostavno mjesto u prevenciji bjesnoće u ljudi i dalje ima antirabična imunoprofilaksa.Aim: To present the characteristics of rabies preventive measures at the Antirabies Clinic at the Epidemiological Department of the Teaching Institute for Public Health Rijeka, Primorje-Gorski Kotar County, in the period from 1986 to 2021. Respondents and methods: In this study, data from anti-rabies surveys included in the annual reports submitted to the Ministry of Health Rabies Reference Center were used. Persons who received antirabies protection (immunoprophylaxis – vaccination against rabies with or without human rabies immunoglobulin) were mostly residents of the Primorje-Gorski Kotar County, dominantly from the city of Rijeka and its surroundings. Results: In the period from 1986 to 2021, a decreasing trend in the number of examined persons at the Antirabies Clinic was determined (y=–6.9+304, R2=0.78; p<0.05), from 263 to 50 persons. During the study period the number of people who received protection against rabies increased (y=0.95+19, R2=0.24; p<0.05).In this period 7678 persons were examined, out of which 1318 received immunoprophylaxis(17.2%). A total of 42.3% of females(558/1318) and 57.7% of males (760/1318) were immunized. Most people were vaccinated because of scratches, contacts from unknown, dead, stray, killed or wild animals (N=1005) (group C), or because of scratches and contacts with an animal tested positive for rabies (N=155) (group A). People were most often treated with antirabies treatment due to scratches or contact with a dog (752/1318; 57.1%). In 2011, the last person to receive antirabies treatment due to the contact with an animal tested positive for rabies was recorded. Conclusion: In 35 years of operation of the Antirabies Clinic in Rijeka, no rabies cases have been recorded in humans, which can be attributed to effective antirabies protection measures. The multidisciplinary approach has proven to be the most effective in reducing the incidence of rabies in animals and consequently preventing the occurrence of rabies in humans from the Primorje-Gorski Kotar County and the Republic of Croatia. However, human anti-rabies immunoprophylaxis still plays an indispensable role in the prevention of rabies

Projekt „Europsko radno mjesto i alkohol“

Prevencija konzumacije alkohola povezana s radnim mjestom predstavlja važan okvir za prevenciju alkoholom uzrokovanih poremećaja u sveukupnoj populaciji. S ciljem kreiranja preporuka za intervencije u prevenciji konzumacije alkohola na radnom mjestu, te time i prevencije alkoholom uzrokovanih poremećaja u radnika, pod pokroviteljstvom Europske unije u protekle tri godine (2011.-2013.), u 15 zemalja EU proveden je projekt Europsko radno mjesto i alkohol (EWA). Europska komisija, u sklopu Drugog programa akcije zajednice u području zdravstva, sufinancirala je provođenje projekta s 510.000 Eura. Koordinator projekta u Hrvatskoj bio je Zavod za javno zdravstvo Zagrebačke županije, a suradne ustanove Hrvatski zavod za zaštitu zdravlja i sigurnost na radu, Ministarstvo zdravlja i Neuropsihijatrijska bolnica ”Dr I. Barbot” u Popovači.

Projekt „Europsko radno mjesto i alkohol“

Prevencija konzumacije alkohola povezana s radnim mjestom predstavlja važan okvir za prevenciju alkoholom uzrokovanih poremećaja u sveukupnoj populaciji. S ciljem kreiranja preporuka za intervencije u prevenciji konzumacije alkohola na radnom mjestu, te time i prevencije alkoholom uzrokovanih poremećaja u radnika, pod pokroviteljstvom Europske unije u protekle tri godine (2011.-2013.), u 15 zemalja EU proveden je projekt Europsko radno mjesto i alkohol (EWA). Europska komisija, u sklopu Drugog programa akcije zajednice u području zdravstva, sufinancirala je provođenje projekta s 510.000 Eura. Koordinator projekta u Hrvatskoj bio je Zavod za javno zdravstvo Zagrebačke županije, a suradne ustanove Hrvatski zavod za zaštitu zdravlja i sigurnost na radu, Ministarstvo zdravlja i Neuropsihijatrijska bolnica ”Dr I. Barbot” u Popovači.

The Influence of Low Amperage Electric Current on Various Bacterial Species in Seawater

Mikroorganizmima kontaminirana morska voda mogući je izvor infekcije za čovjeka ili izravno ili konzumacijom hrane iz mora. Konvencionalne metode za dezinfekciju vode za piće nisu primjenjive za morski okoliš. U našem istraživanju ispitivali smo učinak istosmjerne električne struje niske jakosti na različite ubikvitarne, a ujedno i potencijalno patogene bakterijske vrste: Staphylococcus epidermidis, Klebsiella pneumoniae i Escerichia coli. Utjecaj istosmjerne struje niske jakosti promatran je pri 4,9 A i 24 V u pripremljenoj standardiziranoj otopini morske vode. Broj svih tretiranih bakterijskih vrsta reduciran je na približno 102 CFU/mL u prvih pet sekunda. Najosjetljivija na djelovanje električne struje je vrsta S. epidermidis; ona je u potpunosti eliminirana nakon deset sekunda. K. pneumoniae je najotpornija pa se potpun letalni učinak ostvaruje nakon dvadeset sekunda električnog tretmana. Zaključno, rezultati su pokazali da je tretman električnom strujom niske jakosti pogodan za učinkovitu i brzu eliminaciju bakterija u morskoj vodi.According to literature data low amperage electric current is an alternative method for water disinfection. In our study we wanted to examine its effect on various bacterial species: Staphylococcus epidermidis, Klebsiella pneumoniae and Escherichia coli. We used device for the generation of low amperage direct electric current. The lethal effect of low amperage direct electric current on bacteria was monitored in standardized seawater suspension with 4,9 A and 24 V. Staphylococcus epidermidis was shown to be the most sensitive species tested. The lethal effect was achieved after 10 seconds of treatment. The most resistant bacterial species on electric treatment was Klebsiella pneumoniae for which the lethal effect was accomplished after 20 seconds. Our results indicate that the low amperage electric field treatment is effective for rapid inactivation of bacteria in seawater

Mortality Characteristics of Two Populations in the Northern Mediterranean (Croatia) in the Period 1960–2012: An Ecological Study

In the second half of the 20th century, the town of Bakar (Primorje-Gorski Kotar County, Croatia), where a coking plant was operational 1978–1994, experienced intensive industrialisation. The town of Mali Lošinj (Primorje-Gorski Kotar County, Croatia) in this period based its economy on non-industrial sectors. The study goal was comparing mortality characteristics of these populations in the northern Mediterranean for 1960–2012. An ecological study design was used. Data were analysed for 1960–2012 for the deceased with recorded place of residence in the study area. Data on the deceased for 1960–1993 were taken from death reports, for 1994–2012 from digital archives of the Teaching Institute of Public Health, Primorje-Gorski Kotar County. Data on causes of death for 1960–1994 were recoded to the three-digit code of underlying cause of death according to the International Classification of Diseases (ICD–10). Among studied populations significant difference was found among the causes of deaths coded within ICD–10 chapters: neoplasms (particularly stomach carcinoma), mental and behavioural disorders and diseases of the respiratory system (particularly chronic obstructive pulmonary disease, (COPD)). Increase in mortality from neoplasms, increase in respiratory diseases for the area exposed to industrial pollution, also stomach carcinoma and COPD particularly in the town Bakar require further research

Predictors of burnout syndrome and depression among physicians : doctoral thesis

Cilj istraživanja: Glavni cilj predloženog istraživanja je određivanje prediktora sindroma profesionalnoga sagorijevanja i depresivnosti u liječnika. Sporedni ciljevi su izrada prediktivnog modela za određivanje povezanosti između percipiranog stresa na radnom mjestu i pojave sindroma profesionalnoga sagorijevanja i depresivnosti u liječnika KBC-a Rijeka. Utvrđivanje najznačajnijh stresora koje ispitanici percipiraju na radnom mjestu. Određivanje prevalencije depresivnosti i sindroma profesionalnog sagorijevanja liječnika u KBC Rijeka te uspoređivanje prema socio-demografskim karakteristikama, određenim specijalizacijama i grupama specijalizacija. Ispitanici i metode: Istraživanje je provedeno u Kliničkom bolničkom centru Rijeka. U istraživanju je sudjelovalo 286 ispitanika, od planiranih 469 ispitanika, što čini odaziv od 62,3%. Ispitanici su bili podijeljeni tri podskupine: kirurška, nekirurška i dijagnostička grupa. Prema tipu epidemiološkog istraživanja riječ je o presječnom istraživanju. Korišteni su: Upitnik o socio-demografskim pitanjima i radnim karakteristikama, Upitnik o stresorima na radnom mjestu zdravstvenih djelatnika (OSAQ), Upitnik izgaranja na poslu (MBI-HSS), Beckov inventar depresije (BDI-II). Za utvrđivanje povezanosti između stresora na radnom mjestu s depresivnosti i sindromom sagorijevanja korišteni su Spearmanova korelacija i logistička regresija. Rezultati: Petina ispitanika percipira sve ispitivane faktore (stresore) na radnom mjestu stresnim. Najznačajniji stresori su se pokazali oni iz skupine F1- Organizacija rada i financije. Udio visokog stupnja emocionalnog iscrpljenja je 43,6%, depersonalizacije 33,5%, a gubitka doživljaja osobnog postignuća je 49,1%. Visok udio na svim podljestvicama sindroma profesionalnog sagorijevanja ima 15,7% ispitanika. Prevalencija umjerene i teške depresivnosti je 12,2%. Između kirurške, nekirurške i dijagnostičke grupe nije ustanovljena statistički značajna razlika u depresivnosti i podljestvicama MBI. Sociodemografske varijable se nisu pokazale kao značajni prediktori sindroma profesionalnog sagorijevanja za razliku od stresora na radnom mjestu. Zaključak: Visoki udjeli na podljestvicama sindroma profesionalnog izgaranja u usporedbi s rezultatima iz sličnih studija ukazuju da se rezultati u našem istraživanju nalaze na gornjoj granici raspona vrijednosti, dok rezultati za depresiju ukazuju da se nakon prilagodbe bodovanja, ne razlikuju u odnosu na podatke iz sličnih istraživanja. Usmjerene intervencije na radnom mjestu bi trebale biti dio strategije reorganizacije zdravstvenog sustava s ciljem povećanje kvalitete pružene usluge i podizanja standarda mentalnog zdravlja među liječnicima.Objectives: The main objective of the present study was to determine predictors of burnout syndrome and depression among physicians. Secondary objectives were making predictive models to determine the association between perceived stress in the workplace and the occurrence of burnout syndrome and depression among physicians in KBC Rijeka. Identify the major stressors that respondents perceived at their workplace. To determine the prevalence of depression and burnout syndrome among doctors in the KBC Rijeka and compare them according to socio-demographic characteristics, certain specialties and specialty groups. Patients and Methods: The study was conducted at the Clinical Hospital Center Rijeka. The study included 286 respondents, of a total of 469, which makes response rate of 62.3%. The subjects were divided into three groups: non-surgical, surgical and diagnostic groups. According to the type of epidemiological research it is a cross-sectional study. Socio-demographic and work-related characteristics questionnaire, Occupational Stress Assessment Questionnaire (OSAQ), Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and Beck Depression Inventory II (BDI-II) were used. Sperman correlation and logistic regression were calculated to rank association between stressors at work with depression and burnout. Results: A fifth of respondents perceived all factors (stressors) on workplace as stressful. The most significant stressors have been shown to those in the group F1 Work Organization and Finance. High levels of emotional exhaustion were 43.6%, depersonalization 33.5%, and lack of personal accomplishment 49.1%. The prevalence of moderate and severe depression was 12.2%. There was no statistical difference in surgical, nonsurgical and diagnostic groups in depression and all domains of MBI-HSS. Socio-demographic variables were not significant predictors of burnout and depression unlike stressors in the workplace. Conclusion: High levels of burnout domain compared to overall results from similar studies from other countries, placed the resultas in our sample on the higher end of the range, while results for depression after adjustment with lower cutoff point would be similar to those usually found in research literature. Targeted interventions in the workplace should be part of a strategy of reorganization of the health care system with the aim of increasing the quality of services provided and to raise the standards of mental health among physicians

Mental illnesses in Primorsko-goranska County from 1995 to 2009

Cilj: U ovom radu prikazana je zastupljenost mentalnih bolesti u Primorsko-goranskoj županiji (PGŽ) na temelju statističkih podataka. Mortalitet je prikazan u razdoblju od 1995. do 2009., a morbiditet od 1996. do 2009. godine. Metode: Korišteni su podaci iz Zdravstveno-statističkog ljetopisa Nastavnog zavoda za javno zdravstvo PGŽ-a. Dobiveni podaci prikazani su kao apsolutni i relativni brojevi uz prikazivanje mjera učestalosti s usporedbom podataka iz svjetske literature. Rezultati: Mortalitet uzrokovan mentalnim bolestima pokazao je porast u promatranom vremenskom periodu. Jednadžba linearnog trenda broja umrlih pokazala je statističku značajnost (P < 0,001). Morbiditet uzrokovan mentalnim bolestima pokazao je porast od 1999. do 2009. s najviše oboljelih u skupini s dijagnozom neurotskih i somatoformnih poremećaja i poremećaja izazvanih stresom. Jednadžba linearnog trenda broja oboljelih nije pokazala statističku značajnost (P = 0,068). Rasprava i zaključak: Podaci za PGŽ pokazali su kako mortalitet, odnosno morbiditet uzrokovan mentalnim bolestima ne spada u vodeće uzroke smrti, odnosno bolesti. Porast apsolutnog broja oboljelih od 1999. do 2009. i porast broja umrlih pokazali su kako je problem mentalnog zdravlja sve zastupljeniji u populaciji. Na području mentalnog zdravlja potrebno je uložiti velike napore, edukaciju i rad na svim razinama u svrhu poboljšanja položaja mentalnog zdravlja za sve.Aim: In this study was shown the representation of mental illnesses in Primorskogoranska County (PGC) based on the statistical data. Mortality was shown in the period from 1995 to 2009, and the morbidity from 1996 to 2009. Methods: The data used were from the Health-statistical yearbook of the Institute of public health PGC. Given data were represented as absolute and relative numbers showing the measures of occurrence by comparing them with the data from the world literature. Results: Mortality caused by mental illnesses showed an increase in the observed period. The linear trend analysis of number of deaths showed statistical significance (P < 0.001). Mortality caused by mental illnesses showed an increase from 1999 to 2009 with most patients in the diagnostic group of neurotic and somatoform disorders caused by stress. The linear trend analysis of number of ill people did not show statistical significant (P = 0.068). Discussion and conclusion: Data for PGC showed that the mortality and morbidity caused by mental illnesses are not among the leading causes of deaths and diseases. Increase in the absolute number of ill patients from 1999 to 2009 and an increase in the number of deaths showed that the problem of mental health is more represent in the population. In the field of mental health there is need for lot of effort, education, and work at all levels in order to improve the position of mental health for all

Predictors of burnout syndrome and depression among physicians : doctoral thesis

Cilj istraživanja: Glavni cilj predloženog istraživanja je određivanje prediktora sindroma profesionalnoga sagorijevanja i depresivnosti u liječnika. Sporedni ciljevi su izrada prediktivnog modela za određivanje povezanosti između percipiranog stresa na radnom mjestu i pojave sindroma profesionalnoga sagorijevanja i depresivnosti u liječnika KBC-a Rijeka. Utvrđivanje najznačajnijh stresora koje ispitanici percipiraju na radnom mjestu. Određivanje prevalencije depresivnosti i sindroma profesionalnog sagorijevanja liječnika u KBC Rijeka te uspoređivanje prema socio-demografskim karakteristikama, određenim specijalizacijama i grupama specijalizacija. Ispitanici i metode: Istraživanje je provedeno u Kliničkom bolničkom centru Rijeka. U istraživanju je sudjelovalo 286 ispitanika, od planiranih 469 ispitanika, što čini odaziv od 62,3%. Ispitanici su bili podijeljeni tri podskupine: kirurška, nekirurška i dijagnostička grupa. Prema tipu epidemiološkog istraživanja riječ je o presječnom istraživanju. Korišteni su: Upitnik o socio-demografskim pitanjima i radnim karakteristikama, Upitnik o stresorima na radnom mjestu zdravstvenih djelatnika (OSAQ), Upitnik izgaranja na poslu (MBI-HSS), Beckov inventar depresije (BDI-II). Za utvrđivanje povezanosti između stresora na radnom mjestu s depresivnosti i sindromom sagorijevanja korišteni su Spearmanova korelacija i logistička regresija. Rezultati: Petina ispitanika percipira sve ispitivane faktore (stresore) na radnom mjestu stresnim. Najznačajniji stresori su se pokazali oni iz skupine F1- Organizacija rada i financije. Udio visokog stupnja emocionalnog iscrpljenja je 43,6%, depersonalizacije 33,5%, a gubitka doživljaja osobnog postignuća je 49,1%. Visok udio na svim podljestvicama sindroma profesionalnog sagorijevanja ima 15,7% ispitanika. Prevalencija umjerene i teške depresivnosti je 12,2%. Između kirurške, nekirurške i dijagnostičke grupe nije ustanovljena statistički značajna razlika u depresivnosti i podljestvicama MBI. Sociodemografske varijable se nisu pokazale kao značajni prediktori sindroma profesionalnog sagorijevanja za razliku od stresora na radnom mjestu. Zaključak: Visoki udjeli na podljestvicama sindroma profesionalnog izgaranja u usporedbi s rezultatima iz sličnih studija ukazuju da se rezultati u našem istraživanju nalaze na gornjoj granici raspona vrijednosti, dok rezultati za depresiju ukazuju da se nakon prilagodbe bodovanja, ne razlikuju u odnosu na podatke iz sličnih istraživanja. Usmjerene intervencije na radnom mjestu bi trebale biti dio strategije reorganizacije zdravstvenog sustava s ciljem povećanje kvalitete pružene usluge i podizanja standarda mentalnog zdravlja među liječnicima.Objectives: The main objective of the present study was to determine predictors of burnout syndrome and depression among physicians. Secondary objectives were making predictive models to determine the association between perceived stress in the workplace and the occurrence of burnout syndrome and depression among physicians in KBC Rijeka. Identify the major stressors that respondents perceived at their workplace. To determine the prevalence of depression and burnout syndrome among doctors in the KBC Rijeka and compare them according to socio-demographic characteristics, certain specialties and specialty groups. Patients and Methods: The study was conducted at the Clinical Hospital Center Rijeka. The study included 286 respondents, of a total of 469, which makes response rate of 62.3%. The subjects were divided into three groups: non-surgical, surgical and diagnostic groups. According to the type of epidemiological research it is a cross-sectional study. Socio-demographic and work-related characteristics questionnaire, Occupational Stress Assessment Questionnaire (OSAQ), Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and Beck Depression Inventory II (BDI-II) were used. Sperman correlation and logistic regression were calculated to rank association between stressors at work with depression and burnout. Results: A fifth of respondents perceived all factors (stressors) on workplace as stressful. The most significant stressors have been shown to those in the group F1 Work Organization and Finance. High levels of emotional exhaustion were 43.6%, depersonalization 33.5%, and lack of personal accomplishment 49.1%. The prevalence of moderate and severe depression was 12.2%. There was no statistical difference in surgical, nonsurgical and diagnostic groups in depression and all domains of MBI-HSS. Socio-demographic variables were not significant predictors of burnout and depression unlike stressors in the workplace. Conclusion: High levels of burnout domain compared to overall results from similar studies from other countries, placed the resultas in our sample on the higher end of the range, while results for depression after adjustment with lower cutoff point would be similar to those usually found in research literature. Targeted interventions in the workplace should be part of a strategy of reorganization of the health care system with the aim of increasing the quality of services provided and to raise the standards of mental health among physicians

STRESS, DEPRESSION AND BURNOUT AMONG HOSPITAL PHYSICIANS IN RIJEKA, CROATIA

Background: Six years of recent ongoing economic and structural crisis in Croatia have brought to a significant decrease of socioeconomic standard in our country, and had an important impact on the health care system. In this background we examined the prevalence of depression and burnout and their association with work stressors. Subjects and methods: Cross sectional survey was conducted with self reported questionnaires in 459 hospital physicians in Rijeka, Croatia. Physicians were divided into three groups: surgical, nonsurgical and diagnostic group. Socio-demographic and work-related characteristics questionnaire, Occupational Stress Assessment Questionnaire (OSAQ), Maslach Burnout Inventory- Human Services Survey (MBI-HSS) and Beck Depression Inventory II (BDI-II) were used. Sperman correlation and logistic regression were calculated to rank association between stressors at work with depression and burnout syndrome. Results: Response rate was 62.3%, (286/459). Every fifth doctor experienced all examined stressors in the workplace as stressful. The prevalence of moderate and severe depression was 12.2%. High levels of emotional exhaustion were 43.6%, depersonalization 33.5%, and lack of personal accomplishment 49.1%. There was no statistical difference in surgical, nonsurgical and diagnostic groups in depression and all domains of MBI-HSS. Almost all stressors were correlated with depression and burnout syndrome. Most of the perceived stressors were significant predictors of burnout syndrome and depression. Conclusions: High levels of burnout domain compared to overall results from similar studies from other countries, placed the results in our sample on the higher end of the range, while results for depression after adjustment with lower cutoff point would be similar to those usually found in research literature. Our study showed that burnout is highly prevalent among Croatian physicians. Target interventions at the workplace should be considered as one of the strategies to reduce negative impact of work stress on physicians’ mental health