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THE INFLUENCE OF THE EDUCATION LEVEL OF MIDWIVES ON REDUCTION OF THE PERFORMANCE OF EPISIOTOMIES IN THE DEPARTMENT FOR WOMEN'S DISEASES AND CHILDBIRTH KBC ZAGREB
No full textUvod: Epiziotomija je kirurški zahvat koji se koristi tijekom porođaja kako bi se proširio vaginalni otvor i olakšao porod. Kroz povijest se praksa izvođenja epiziotomije značajno mijenjala, a posljednjih desetljeća raste trend restriktivne primjene, što je potkrijepljeno novim istraživanjima. Ovaj rad uspoređuje učestalost epiziotomija u Klinici za ženske bolesti i porode KBC-a Zagreb između razdoblja 2006.–2008. kada su u rađaonici radile isključivo primalje srednje stručne spreme i 2021.–2023. godine, kada su radile prvostupnice primaljstva u jednakom omjeru sa primaljama srednje stručne spreme.
Cilj: Cilj ovog istraživanja je analizirati razlike u učestalosti epiziotomija između dva promatrana razdoblja. Istraživanje se fokusira na učestalost epiziotomija s obzirom na različite čimbenike, kao što su paritet, gestacijska dob, način započetog poroda, porođajna masa novorođenčeta, Apgar ocjena te razdor međice III i IV stupnja.
Metode: Retrospektivno istraživanje obuhvaćalo je analizu podataka iz knjige protokola rađaonice Klinike za ženske bolesti i porode KBC-a Zagreb za razdoblja 2006.–2008. i 2021.–2023. godine. Statistička analiza provedena je korištenjem χ² testa za usporedbu razlika u učestalosti epiziotomija između dva razdoblja.
Rezultati: Rezultati pokazuju značajan pad u učestalosti epiziotomija između dva promatrana razdoblja. Učestalost epiziotomija smanjila se sa 69,87% u razdoblju 2006.–2008. na 13,30% u razdoblju 2021.–2023. Statistički značajna smanjenja zabilježena su kod prvorodilja, višerodilja, prijevremenih i terminskih porođaja, te kod novorođenčadi s različitim Apgar ocjenama. Nije zabilježen statistički značajan porast razdora međice III i IV stupnja.
Zaključak: Istraživanje potvrđuje značajno smanjenje učestalosti epiziotomija u suvremenoj medicinskoj praksi. Rezultati sugeriraju pozitivan utjecaj edukacije i restriktivnijih smjernica o primjeni epiziotomije. Blago povećanje razdora međice III i IV stupnja nije statistički značajno
ANXIETY AND DEPRESSION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE
No full textUvod: Anksioznost i depresivnost kod bolesnika s upalnim bolestima crijeva (UBC) u zadnjih nekoliko godina postala je tema istraživanja stručnjacima iz različitih područja. Poremećaji raspoloženja poput anksioznosti i depresivnosti česte su kod UBC-a. Žene su češće podložnije anksioznosti te se pokušalo istražiti jesu li jednako podložne i one oboljele od UBC-a. Povezanost aktivnosti i ozbiljnosti bolesti s aktivnošću UBC-a nerijetko se pokazuje pozitivna.
Cilj: Ispitati učestalost anksioznosti u odnosu na učestalost depresivnosti kod bolesnika s UBC-om. Ispitati postoje li spolne razlike u odnosu na učestalost povišenih razina anksioznosti i depresivnosti kod oboljelih od UBC-a. Ispitati postoji li povezanost anksioznosti i depresivnosti s aktivnošću UBC-a.
Ispitanici i metode: U istraživanju je sudjelovalo 60 ispitanika i to bolesnici s UBC-om koji se liječe u Kliničkom bolničkom centru Rijeka na Zavodu za gastroenterologiju. Ispitanici su ispunjavali upitnik koji je kombiniran od pitanja o sociodemografskim podacima, standardizirane Bolničke ljestvice anksioznosti i depresivnosti (engl. Hospital Anxiety and Depression Scale, HADS), zatim od indeksa za procjenu aktivnosti bolesti Partial Mayo Score (PMS) kod procjene ulceroznog kolitisa i Harvey-Bradshaw Index (HBI) kod procjene Crohnove bolesti.
Rezultati: Rezultati su pokazali da su žene značajno anksioznije u odnosu na muškarce, dok se kod depresivnosti ta razlika ne primjećuje. Što se tiče učestalosti poremećaja raspoloženja, anksioznost se pokazala zastupljenija u odnosu na depresivnost kod bolesnika s UBC-om. Kod ispitivanja povezanosti anksioznosti i depresivnosti s aktivnošću bolesti ne postoji korelacija između indeksa ozbiljnosti i aktivnosti bolesti i pojavnosti i težine simptoma anksioznosti. S druge strane prisutna je umjerena do dobra povezanost u tome dijelu što se tiče depresivnosti.
Zaključak: Anksioznost i depresivnost prateći su poremećaji raspoloženja kod bolesnika s UBC-om. Povezanost aktivnosti UBC-a s pojavnosti ova dva poremećaja raspoloženja neznatna je i za relevantnije rezultate potrebno je provesti istraživanje koje bi obuhvatilo veći broj ispitanika. U svakom slučaju, provedba sestrinskih intervencija iz područja mentalnog zdravlja budućnost je daljnjih istraživanja i implementacija različitih programa kod bolesnika s UBC-om.Introduction: Anxiety and depression in patients with inflammatory bowel disease (IBD) have become the subject of research by experts from various fields in recent years. Mood disorders such as anxiety and depression are common in IBD. Women are often more susceptible to anxiety, and attempts have been made to investigate whether women suffering from IBD are equally susceptible. The correlation between disease activity and severity with IBD activity is often positive.
Objective: To investigate the prevalence of anxiety in relation to the prevalence of depression in patients with IBD. To investigate whether there are gender differences in the frequency of elevated anxiety and depression scores in patients with IBD. To investigate whether there is a relationship between anxiety and depression and IBD activity.
Subjects and methods: The study involved 60 subjects, namely patients with IBD being treated at the Rijeka Clinical Hospital Center in the Department of Gastroenterology. Respondents completed a questionnaire that was combined with questions on sociodemographic data, the standardized Hospital Anxiety and Depression Scale (HADS), the Partial Mayo Score (PMS) disease activity index to assess of ulcerative colitis and the Harvey-Bradshaw Index (HBI) to assess Crohn's disease.
Results: The results show that women are significantly more anxious than men, while this difference is not noticeable for depression. Regarding the frequency of mood disorders, anxiety was found to be more common in patients with IBD than depression. When examining the relationship between anxiety and depression and disease activity, there is no correlation between the disease severity and activity index and the occurrence and severity of anxiety symptoms. On the other hand, there is a moderate to good correlation in the part concerning depression.
Conclusion: Anxiety and depression are concomitant mood disorders in patients with IBD. The association of IBD activities with the occurrence of these two mood disorders is insignificant. To obtain more meaningful results, studies need to be conducted that include a larger number of respondents. In any case, the implementation of nursing interventions in mental health is the future of further research and the implementation of various programmes in patients with IBD
FEAR OF CHILDBIRTH FOR WOMEN IN LABOR IN GENERAL HOSPITAL KARLOVAC: research
No full textUvod: Strah od poroda potpuno je normalan, kako za prvorotke, tako i za žene koje su već rodile. Porod je nepredvidljiv, često bolan i povezan sa rizikom da završi neugodno za majku i dijete. Većina žena uspijeva taj strah prebroditi, a kod nekolicine se javlja ekstremni strah ili neugoda koja u rijetkim slučajevima može prerasti u bolestan strah od poroda ili tokofobiju.
Cilj istraživanja: Cilj ovog istraživanja je istražiti i analizirati kako strah od poroda utječe na iskustvo poroda te procijeniti kako utječe na ostale opstetričke i sociodemografske varijable.
Materijali i metode: Istraživanje je provedeno u razdoblju od 01.06. do 31.07.2024. u OB Karlovac. Istraživanje se provodilo putem anonimnog anketnog upitnika licem u lice koji se sastojao od tri dijela. Prvi dio anketnog upitnika odnosio se na sociodemografske podatke, dok se glavni dio upitnika odnosio na ispitivanje strah od poroda, za što je korišten standardizirani upitnik „Wijma Delivery Expectancy/Experietue Questwnnaire (W-DEQ version A and B)“, autora Wijma, Wijma i Zar iz 1998. godine, odnosno njezina prevedena i prilagođena hrvatska verzija. U istraživanju je sudjelovalo 120 ispitanica.
Rezultati: U istraživanju je sudjelovalo 120 ispitanica. Najviše ispitanica, njih 55,0% ima srednju školu. Prema porodu po redu možemo vidjeti kako podjednaki broj ispitanica, odnosno njih 37,5% ima 1. ili 2. porod. Prema načinu dovršetka poroda 74,2% ispitanica navodi kako je porod dovršen vaginalno. Kod W-DEQ ukupno (inicijalno) 58,8% ispitanica iskazalo je da ima klinički značajan strah od porođaja. Kod W-DEQ ukupno 70,6% ispitanica imalo je klinički značajan strah od porođaja.
Zaključak: Na temelju provedenog istraživanja, promatrana pitanja može se uočiti kako p iznosi može se zaključiti kako ne postoji statistički značajna razlika u odgovorima ispitanica s obzirom na kategorije W-DEQ ukupno inicijalno i ukupno finialno. Možemo reći kako ispitanice podjedanko osjećaju strah prije i nakon poroda.Introduction: Fear of childbirth is completely normal, both for first-time mothers and for women who have already given birth. Childbirth is unpredictable, often painful and associated with the risk of ending unpleasantly for mother and child. Most women manage to overcome this fear, and a few experience extreme fear or discomfort, which in rare cases can develop into a morbid fear of childbirth or tokophobia.
Research goal: The goal of this research is to investigate and analyze how fear of childbirth affects the experience of childbirth and to assess how it affects other obstetric and sociodemographic variables.
Materials and methods: The research was conducted in the period from 01.06. until 31.07.2024. in OB Karlovac. The research was conducted through an anonymous, face-to-face questionnaire consisting of three parts. The first part of the questionnaire referred to sociodemographic data, while the main part of the questionnaire referred to the examination of fear of childbirth, for which the standardized questionnaire "Wijma Delivery Expectancy/Experietue Questwnnaire (W-DEQ version A and B)" was used, authored by Wijma, Wijma and Zar from 1998, i.e. its translated and adapted Croatian version. 120 respondents participated in the research.
Results: 120 respondents participated in the research. Most of the respondents, 55.0% of them, have high school education. According to the order of birth, we can see that an equal number of respondents, i.e. 37.5% of them, have the 1st or 2nd birth in order. According to the method of completion of childbirth, 74.2% of respondents stated that the delivery was completed vaginally. In the W-DEQ, a total of 58.8% of the respondents stated that they had a clinically significant fear of childbirth. In the W-DEQ, a total of 70.6% of respondents had a clinically significant fear of childbirth.
Conclusion: Based on the conducted research, and the significance values for all observed questions it can be said that there is no statistically significant difference in the answers of the respondents regarding the W-DEQ categories total initial and total final. We can say that the respondents feel fear equally before and after childbirth
Pulmonaly Hypertension and Cardiopulmonary Rehabilitation
No full textUvod: Pacijenti s plućnom hipertenzijom imaju smanjen funkcionalni kapacitet i kvalitetu života. Rezultati istraživanja u zadnjem desetljeću iskazala su benefit nadzirane i monitorirane kardiopulmonalne rehabilitacije. Mnoga istraživanja objavila su da je kardiopulmonalna rehabilitacija siguran postupak koja povećava funkcionalni kapacitet pacijentima i kvalitetu života.
Metode: Pregledni rad proveden je pretragom biomedicinske baze Medline (PubMed, PubMed Central), multidisciplinarne baze Scopus, Cochrane Database i Hrčak. Pretraživana je literatura od 2014. godine na dalje. Zadnji datum pretrage bio je 27.07.2024. 11 istraživanja uključeno je u pregledni rad. Podaci primarnih i sekundarnih ishoda izvučeni su iz 8 randomizirana kontrolirana istraživanja. Primarni ishodi su šest minutni test hoda, maksimalna snaga inspiratorne muskulature i kvaliteta života. Sekundarni ishodi su nalaz transezofagijskog ultrazvuka i biomarker srčanog popuštanja. Ukupan broj sudionika je 294, 153 pacijenata koji su provodili kardiopulmonalnu rehabilitaciju spram 141 pacijenata kontrolne grupe. Srednja dobna vrijednost je bila od 37 do 57 godina, većina sudionika je ženskog roda, plućne arterijske hipertenzije. Program kardiopulmonalne rehabilitacije je provedena u bolničkim i van bolničkim uvjetima, kontrolna skupina nije provodila vježbe. Najčešće je uključivala aerobne vježbe, vježbe snage i inspiratorno mišićni trening. Duljina trajanja programa bila je od 6 tjedana do 6 mjeseci.
Rezultati: Primarni ishodi: 6MWD mean promjena interventne grupe (n = 118) bila je +35 m, (24 - 49 m) vs. mean promjena kontrolne grupe (n = 106) - 21 m (- 23 - 15 m) 6 istraživanja, 224 sudionika; niske razine dokaza. Mean promjena Pimax u interventnoj grupi (n = 48) bila je +26,31 cmH2O (17,8 - 35cmH2O), mean promjena u kontrolnoj grupi (n = 43) bila je +4 cmH2O (3 – 5,41 cmH2O), 3 istraživanja, 91 sudionika; niske razine dokaza. HRQoL: QoL SF-36 mentalna komponenta (MCS), mean promjena interventne grupe (n = 89) bila je 4 bodova (3 - 5) vs. mean promjena u kontrolnoj grupi (n=79) bila je - 3,1 bodova. QoL SF-36 fizička komponenta (PCS), interventna grupa (n = 89) imala je povećanje za 6,85 bodova (4 – 9,7) vs. mean promjena u kontrolnoj grupi (n = 79) bila je 0,5 - 2 bodova, 4 istraživanja, 168 sudionika; razina dokaza umjerene izvjesnosti. NHP Mean promjena u interventnoj grupi (n = 14) bila je - 2,63 bodova vs. kontrolne (n = 15) mean promjena bila je 0,69 bodova, 1 istraživanje, 29 sudionika; umjerena razina dokaza. IPAQ Mean promjena interventne grupe (n
= 15) bila je 157 bodova vs. kontrolne grupe (n = 12), - 22,75 bodova i MLHFQ mean promjena interventnoj grupi bila je - 0,87 bodova vs. mean promjena u kontrolnoj grupi bila je - 2,91 bodova, 1 istraživanje, 27 sudionika; umjerena razina dokaza. Sekundarni ishodi: ultrazvuk srca (TTE) mean promjena RVSP interventne grupe (n=35) bila je 2,9 mmHg (- 12,05 – 17,92 mmHg) vs. kontrolne grupe (n = 35), - 5,7 mmHg, 3 istraživanja, 70 sudionika; niska razina dokaza. Mean promjena SPAP u interventnoj grupi (n=12) bila je – 4mmHg vs. kontrolne (n=12) bila je – 11mmHg i mean promjena LVEF(%), RVEF (%), LVEDD (mm), LVESD (mm) obiju skupina bile su bez značajne promjene, 1 istraživanje, 24 sudionika; niska razina dokaza. Mean promjena interventne grupe (n = 20), EF bila je + 17,74 (%), 1 istraživanje, 20 sudionika; niska razina dokaza. Mean promjena NT proBNP interventne grupe (n = 65) bila je - 38 pg/mL vs. mean promjena kontrolne (n = 57), + 104,5 pg/mL, 2 istraživanja, 122 sudionika; niska razina dokaza.
Zaključak: Kod pacijenata s plućnom hipertenzijom, nadzirana kardiopulmonalna rehabilitacija mogle bi povećati kapacitet vježbanja, snagu inspiratorne muskulature i poboljšati mentalnu i fizičku komponentu kvalitete života. Kardiopulmonalne vježbe na biciklu/traci mogle bi smanjiti vrijednosti RVSP (mmHg) kod pacijenata s plućnom hipertenzijom i povećati EF (%) s kroničnim zatajenjem srca. Kardiopulmonalne vježbe mogla bi smanjiti rezultat biomarkera srčanog popuštanja. Sigurnost dokaza je smanjena zbog nedosljednosti u podacima i pristranosti izvedbe. Potrebna su daljnja istraživanja koja bi zahvatila sve klasifikacije plućne hipertenzije, uzrokovane bolestima lijeve strane srca, bolesti pluća odnosno hipoksije i plućnu hipertenziju s više ozbiljnih oboljenja.Introduction: Patients with pulmonary hypertension have reduced functional capacity and quality of life. Research results in the last decades have shown the benefits of supervised and monitored cardiopulmonary rehabilitation. Many studies have reported that a cardiopulmonary rehabilitation is a safe procedure that increases patient functional capacity and quality of life.
Methods: The review was conducted by searching the biomedical database Medline (Pubmed, Pubmed Central), the multidisciplinary database Scopus, the Cochrane Database and Hrčak. 11 studies were included in the review. Data on primary and secondary outcomes were extracted from 8 randomised controlled trials. Primary outcomes were six minute walk test, maximal inspiratory power and quality of life. Secondary outcomes were transthoracic echocardiogram and N-terminal-pro brain natriuretic peptide. The total number of participants were 294, 153 patients who performed cardiopulmonary rehabilitation to 141 patients of control group. The mean age was from 37 to 57 years, most of participants were female, pulmonary arterial hypertension. The cardiopulmonary rehabilitation program was carried in-hospital and out hospital conditions, the control group did not perform exercises. It most often included aerobic exercises, strength exercises and inspiratory muscle training. The duration of the program was from 6 weeks to 6 months.
Results: Primary outcomes: 6MWD mean change in the intervention group (n = 118) + 35 m, (24 – 49 m) vs. mean change of the control group (n = 106) was -21 m (- 23 – 15 m) 6 studies, 224 participants; low level of evidence. Pimax mean change in the intervention group (n = 48) was + 26,31 cmH20 (17,8 - 35cmH20), the mean change in the control group (n = 43) was + 4cmH20 (3 - 5,41cmH20), 3 studies, 91 participants: low level of evidence. HRQoL: QoL SF-36 mental component (MCS), mean change of intervention group (n = 89) intervention group was 4 points (3 - 5) vs. mean change in the control group was - 3,1 point. QoL SF-36 physical component (PCS), intervention group (n = 89) was 6,85 points (4 - 9,7) vs. mean change in the control group (n = 79) was 0,5 -2 points, 4 studies, 168 participants: moderate certainty level of evidence. NHP The mean change in the intervention group (n = 14) was -2,63 points vs. the
control group (n = 15), the mean change was 0,69 points, 1 study, 29 participants; moderate level of evidence. IPAQ mean change in the intervention group (n = 15) was 157 mean change in the control group (n = 12) was – 22,75 points and MLHFQ mean change in the intervention group was -0,87 points vs. mean change in the control group was -2,91 points, 1 study, 27 participants; moderate level of evidence. Secondary outcomes: heart ultrasound (TTE) mean change in RVSP intervention group (n = 35) was 2,9 mmHg (- 12,05 – 17,92 mmHg) vs. control group (n = 35), - 5,7 mmHg, 3 studies, 70 participants; low level of evidence. Mean change SPAP in the intervention group (n= 12) was – 4 mmHg vs. control (n=12) – 11 mmHg and mean change mean LVEF (%), RVEF (%), LVEDD (mm), LVESD (mm) were for both groups without significant changes, 1 trial, 24 participants; low level of evidence. Mean change of the intervention group (n = 20). EF was + 17,74 (%), 1 study, 20 participants; low level of evidence. Mean change of NT proBNP intervention group (n = 65) was -38 pg/mL vs. mean change in the control (n = 57), + 104,5 pg/mL, 2 studies, 122 participants: low level of evidence.
Conclusion: In patients with pulmonary hypertension supervised cardiopulmonary rehabilitation could increase exercise capacity, inspiratory muscle strength and improve mental and physical components quality of life. Cardiopulmonary exercise trainig bike/tread could reduce RVSP (mmHg) values in patients with pulmonary hypertension, increase EF (%) in patients with chronic heart failure. Cardiopulmonary exercise trainig could reduce N-terminal-pro brain natriuretic peptide. The certainity of evidence is reduced due to data inconsistencies and performance bias. Further research is needed that would cover all classifications of pulmonary hypertension, caused by diseases of the left side of heart, lung diseases or hypoxia and pulmonary hypertension with more serious diseases
FREQUENCY OF RECURRENCE OF ANKLE SPRAIN IN FOOTBALL PLAYERS AFTER A FIRST ANKLE SPRAIN
No full textUvod: Nogomet je jedan od najpopularnijih sportova na svijetu, a zahtjevi osobito profesionalnog nogometa su izrazito veliki. Nogomet je intentivan sport s mnogo naglih promjena smjerova, puno trčanja i isto tako i mnogo duela. Veoma je dinamičan sport, a samim time i ozljede u nogometu nisu nepoznanica. Najučestalije ozljede u nogometu su ozljede stražnje lože i uganuća nožnoga zgloba. Cilj istraživanja: Glavni cilj istraživanja je prikazati ponavljaju li se uganuća nožnog zgloba kod nogometaša nakon prvotnoga uganuća dok su specifični ciljevi prikazati utjecaj prevencije na ponovno uganuće, te prikazati koji stupanj ozljede ligamenata najčešće nastupa nakon prvoga uganuća.
Ispitanici i metode: U ovome istraživanju sudjelovalo je 106 aktivnih nogometaša iz Primorsko.goranske županije muškog spola.Ispitanici koji nikada nisu imali uganuće nožnoga zgloba bili su isključeni iz daljnjega istraživanja. Anketa je sadržavala 11 pitanja zatvorenog tipa. Pitanjima se dolazilo do općih podataka o ispitanicima poput dobi, mase, koliko se dugo bave nogometom, koliko je prosječno trajanje treninga, te koliko treninga imaju tjedno. Zatim su odgovarali na specifična pitanja poput onoga jesu li provodili preventivne vježbe nakon prvoga uganuća, koliko dugo su ih provodili, jesu li imali ponovno uganuće, koliko je vremena prošlo od prvotnog uganuća, te koji je stupanj ozljede nastupio nakon prvoga uganuća.
Rezultati: Rezultati ovoga istraživanja su pokazali kako su se uganuća ponavljala u 61,1% ispitanika, odnosno 44 od 72 nogometaša je imalo ponavljano uganuće. Istraživanje je također pokazalo da je od 72 ispitanika koji su imali prvotno uganuće prevenciju radilo njih 46. Utvrđena je statistički značajna razlika između nogometaša koji su provodili vježbe prevencije i imali ponavljanu ozljedu i onih koji nisu. Od 72 ispitanika koji su imali prvotno uganuće njih 52 odnosno 75% imalo je prvi stupanj ozljede ligamenata (uganuće).
Zaključak: Ovim istraživanjem skrenula se pozornost na jednu od najčešćih ozljeda u nogometu. Također se pokazala i važnost prevencije i koliko veliku ulogu ima u sprječavanju ponovnoga ozljeđivanja. Isto tako samim time skreće se pozornost na fizioterapiju kao struku, pravilnu rehabilitaciju nakon ozljede i koliko veliki značaj ima u sport.Introduction: Soccer is one of the most popular sports in the world, and the demands of professional soccer in particular are extremely high. Soccer is an intensive sport with many sudden changes of direction, a lot of running and also a lot of duels. It is a very dynamic sport, and therefore injuries in football are not unknown. The most common injuries in soccer are back injuries and ankle sprains. Research goal: The main goal of the research is to show whether ankle sprains are repeated in soccer players after the initial sprain, while the specific goals are to show the impact of prevention on repeat sprains, and to show what degree of ligament injury most often occurs after the first sprain.
Subjects and methods: 106 active male soccer players from Primorje-Gorski County participated in this research. Subjects who never had an ankle sprain were excluded from further research. The survey contained 11 closed questions. The questions were used to obtain general information about the respondents, such as age, weight, how long they have been playing football, the average duration of training, and how many training sessions they have per week. They then answered specific questions such as whether they performed preventive exercises after the first sprain, how long they performed them, whether they had a repeat sprain, how long it had been since the original sprain, and what degree of injury occurred after the first sprain.
Results: The results of this study showed that sprains were repeated in 61.1% of respondents, that is, 44 out of 72 soccer players had repeated sprains. The research also showed that out of 72 subjects who had an initial sprain, 46 of them practiced prevention. A statistically significant difference was established between soccer players who performed prevention exercises and had a repeated injury and those who did not. Out of 72 respondents who had an initial sprain, 52 or 75% had the first degree of ligament injury (sprain).
Conclusion: This research drew attention to one of the most common injuries in football. It also showed the importance of prevention and how big a role it plays in preventing re-injury. It also draws attention to physiotherapy as a profession, proper rehabilitation after an injury and how important it is to sports
KNOWLEDGE AND ATTITUDE OF MIDWIFERY AND NURSING STUDENTS ABOUT BREASTFEEDING: research
No full textDojenje je tema o kojoj se najviše razgovara sa babinjačama. Bilo da se radi o primaljama u rodilištu odmah nakon poroda ili medicinskim sestrama koje rade u patronaži, uvijek se dolazi u doticaj s dojenjem, preporukama i dobrobitima tog načina prehrane novorođenčeta. U ovom istraživanju, glavni cilj je ispitati znanje i stavove redovnih studenata studija Primaljstva i Sestrinstva o dojenju. Podatci su prikupljeni online anketom izrađenom pomoću Google Forms alata 2024. godine među studentima studija Primaljstva i Sestrinstva na Fakultetu zdravstvenih studija Sveučilište u Rijeci.Breastfeeding is the most discussed topic with midwives. Whether it's midwives in the maternity ward immediately after birth or nurses working in community care, they always come into contact with breastfeeding, recommendations and the benefits of this way of feeding a newborn. In this research, the main goal is to examine the knowledge and attitudes of regular Midwifery and Nursing students about breastfeeding. The data was collected through an online survey created using the Google Forms tool in 2024 among Midwifery and Nursing students at the Faculty of Health Studies, University of Rijeka
Traumatic brain injury in the Clinical Hospital Center Rijeka
No full textUVOD: Traumatske ozljede mozga (TOM) su značajan javnozdravstveni problem. Uzroci ozljeda glave i mozga mogu biti različiti, od padova s visina i prometnih nezgoda do raznih sportskih ozljeda.
CILJ: Opći cilj istraživanja je procijeniti učestalost traumatskih ozljeda mozga u Kliničkom bolničkom centru Rijeka. Specifični ciljevi uključuju ispitivanje učestalosti traumatskih ozljeda mozga s obzirom na spol i dob ispitanika, procjenu učestalosti ozljeda prema mehanizmu nastanka te utvrđivanje stope smrtnosti uzrokovane traumatskim ozljedama mozga.
METODE: Podaci za istraživanje prikupljeni su retrospektivno iz medicinske dokumentacije i bolničkog informacijskog sustava (BIS) Kliničkog bolničkog centra Rijeka. U istraživanje je bilo uključeno 415 ispitanika, a prikupljeni podaci analizirani su korištenjem deskriptivne i diferencijalne statistike.
REZULTATI: Rezultati istraživanja pokazali su da je najčešći mehanizam ozljede kod pacijenata bio pad (62,9%). Ozljede uzrokovane udarcem predmetom činile su 12%, dok se 23,6% ozljeda dogodilo u prometnim nesrećama. Nadalje, 4% ozljeda nije imalo jasno utvrđen mehanizam. Prema dokumentaciji BIS-a KBC-a Rijeka, najčešća kategorija ozljeda bile su intrakranijalne ozljede glave (35,7%), zatim površinske ozljede glave (29,2%), dok su nepoznate ozljede činile 1%. Maksilofacijalne ozljede zabilježene su u 16% slučajeva, a otvorene rane glave u 17,3%.
Što se tiče ishoda liječenja, podaci pokazuju vrlo dobre rezultate jer je 93,3% pacijenata preživjelo traumatsku ozljedu mozga, dok je stopa smrtnosti bila iznimno niska, iznosivši 6%.
ZAKLJUČAK: Rezultati istraživanja ukazuju na potrebu razvijanja i implementiranja edukativnih programa koji bi povećali svijest o sigurnosti i prevenciji ozljeda, s posebnim naglaskom na promet, bilo da se radi o biciklistima ili vozačima automobila.INTRODUCTION: Traumatic brain injuries (TBI) are a significant public health problem. The causes of head and brain injuries can be different, from falls from heights and traffic accidents to various sports injuries.
OBJECTIVE: The general aim of the research is to assess the frequency of traumatic brain injuries in the Rijeka Clinical Hospital Center. Specific objectives include examining the frequency of traumatic brain injuries to the sex and age of the subjects, assessing the frequency of injuries according to the mechanism of their occurrence, and determining the mortality rate caused by traumatic brain injuries.
METHODS: Data for the research were collected retrospectively from medical records and the hospital information system (HIS) of the Rijeka Clinical Hospital Center. 415 respondents were included in the research, and the collected data were analyzed using descriptive and inferential statistics.
RESULTS: The research results showed that the most common mechanism of injury among patients was a fall (62.9%). Injuries caused by hitting an object accounted for 12%, while 23.6% of injuries occurred in traffic accidents. Furthermore, 4% of injuries did not have an established mechanism. According to the BIS documentation of KBC Rijeka, the most common category of injuries were intracranial head injuries (35.7%), followed by superficial head injuries (29.2%), while unknown injuries accounted for 1%. Maxillofacial injuries were recorded in 16% of cases, and open head wounds in 17.3%.
CONCLUSION: The research results point to the need to develop and implement educational programs that would increase awareness of safety and injury prevention, with a special emphasis on traffic, whether it's cyclists or car drivers
Differences in motor skill abilities of children with intellectual disabilities and children of the typical population
No full textUvod: Motoričke sposobnosti su latentne motoričke strukture koje su odgovorne za niz motoričkih reakcija te ih je moguće izmjeriti i opisati. Motoričke sposobnosti su brzina, snaga, ravnoteža, izdržljivost, preciznost, fleksibilnost, koordinacija i agilnost. Cilj istraživanja: Glavni cilj ovoga istraživanja bio je ispitati razliku između motoričkih sposobnosti djece s intelektualnim teškoćama i djece tipične populacije. Uz ispitivanje razlika između ispitivanih skupina u motoričkim sposobnostima, jedan od ciljeva je bio ispitati razliku u indeksu tjelesne mase između kontrolne i eksperimentalne skupine. Ispitanici i metode: U istraživanju je sudjelovalo 30 ispitanika. Eksperimentalna skupina sastojala se od 15 učenika s intelektualnim teškoćama polaznika OŠ Voštarnica, a kontrolna skupina od 15 učenika tipične populacije polaznika OŠ Benkovac. Ispitivala se motorička sposobnost ravnoteže pomoću testa stajanja na jednoj nozi, za mjerenje fleksibilnosti korišten je test pretklona trupa, za snagu test podizanja trupa iz ležećeg u sjedeći položaj, za koordinaciju test odbijanja lopte od zid, za brzinu test tapinga rukom. Pomoću testa skupljanja kovanica ispitala se fina motorika. Izmjereni su i zabilježeni podaci o visini i masi pojedinog ispitanika u svrhu računanja indeksa tjelesne mase.
Rezultati: Rezultati su potvrdili pet od sedam postavljenih hipoteza. Dokazano je da djeca s intelektualnim teškoćama postižu statistički značajno lošije rezultate u testovima za ispitivanje motorčkih sposobnosti. Postižu lošije rezultate u području ravnoteže, koordinacije, snage i brzine. Za motoričku sposobnost fleksibilnosti nije pronađena statistički značajna razlika između skupina. Osim toga dokazano je da djeca s intelektualnim teškoćama postižu lošije rezultate u testu za ispitivanje fine ručne motorike. Računanjem indeksa ITM dokazano je da djeca s intelektualnim teškoćama imaju veći ITM u odnosu na djecu tipične populacije. Zaključak: Ovaj rad je pokazao da djeca s intelektualnim teškoćama postižu lošije rezultate u testovima za mjerenje motoričkih sposobnosti u odnosu na djecu tipične populacije. Rezultati potvrđuju ranija istraživanja na ovu temu i upućuju na potrebu za daljnjim istraživanjima i oblikovanjem treninga i rehabilitacije za djecu i odrasle s intelektualnim teškoćama.Introduction: Motor skills are latent motor structures responsible for a range of motor reactions, which can be measured and described. Motor skills include speed, strength, balance, endurance, precision, flexibility, coordination, and agility. Research Objective: The main objective of this research was to examine the differences in motor skills between children with intellectual disabilities and children from the typical population. In addition to examining the differences between the groups in motor skills, another goal was to investigate the difference in body mass index (BMI) between the control and experimental groups.
Participants and Methods: A total of 30 participants were included in the study. The experimental group consisted of 15 students with intellectual disabilities attending Voštarnica Primary School, while the control group consisted of 15 students from the typical population attending Benkovac Primary School. Motor skills were assessed using various tests: balance was evaluated with the one-leg standing test, flexibility was measured with the trunk forward bend test, strength was assessed with the sit-up test, coordination with the ball bouncing off the wall test, and speed with the hand tapping test. Fine motor skills were evaluated with a coin-picking test. Additionally, height and weight data were recorded for each participant to calculate their body mass index.
Results: The results confirmed five out of the seven hypotheses. It was proven that children with intellectual disabilities achieve statistically significantly lower scores on motor skills tests. They perform worse in the areas of balance, coordination, strength, and speed. No statistically significant difference was found between the groups for flexibility. Additionally, it was shown that children with intellectual disabilities perform worse in fine motor skills tests. The calculation of BMI indicated that children with intellectual disabilities have a higher BMI compared to children from the typical population. Conclusion: This study demonstrated that children with intellectual disabilities achieve lower scores in motor skill tests compared to children from the typical population. The results support previous research on this topic and highlight the need for further studies and the development of training and rehabilitation programs for children and adults with intellectual disabilities
RETROSPECTIVE ANALYSIS OF THE USE OF OPIOID ANALGESICS DURING CHILDBIRTH AT THE RIJEKA GYNECOLOGY AND OBSTETRICS CLINIC IN THE PERIOD FROM JANUARY 1. 2018 UNTIL DECEMBER 31. IN 2022 : research
No full textBol je subjektivno, individualno iskustvo te je neizbježni dio poroda. Obezboljenje poroda se postiže s nefarmakološkim i farmakološkim metodama. U današnjoj anesteziji najpopularnija farmakološka metoda ublaženja boli tijekom poroda je epiduralna analgezija. Postojanjem kontraindikacija za epiduralnu analgeziju, bol se tijekom poroda može tretirati sustavnom primjenom analgetika.
Cilj istraživanja bio je analizirati ukupnu primjene opioidnih analgetika tijekom poroda u rodilja koje na Klinici za ginekologiju i porodništvo Kliničkog bolničkog centra (KBC) Rijeka u razdoblju od 1. siječnja 2018. do 31. prosinca 2022. te istražiti da li upotreba opioida tijekom poroda bila veća u prvorotki ili višerotki. U ovo istraživanje uključene su sve rodilje koje su boravile na Klinici za ginekologiju i porodništvo KBC Rijeka u petogodišnjem periodu. Analizirana je uporaba opioidnih analgetika i paritet. Statistička analiza je uključivala deskriptivnu statistiku i testove s razinom značajnosti p < 0,05.Rezultati pokazuju smanjenu primjenu opioidnih analgetika tijekom poroda u mjerenom petogodišnjem razdoblju, pri čemu je najveća uporaba zabilježena u 2018.godini (2,02%), a najmanja u 2021.godini (0,72%). Rezultat istraživanja je i da prvorotke imaju veći postotak korištenja opioidnih analgetika (67,4%) u odnosu na višerotkinje (32,6%). Zaključak: Na Klinici za ginekologiju i porodništvo KBC Rijeka odabir sustavne primjene opioidnih analgetika tijekom poroda je nizak te ukazuje na povećanu sklonost drugim metodama ublažavanja boli tijekom poroda. U budućnosti je potrebno još više istražiti sustavnu primjenu opioidnih analgetika.Pain is a subjective, individual experience and is an inevitable part of childbirth. Disability of childbirth is achieved with non-pharmacological and pharmacological methods. In today's anesthesia, the most popular pharmacological method of treatment pain during childbirth is epidural analgesia. With the existence of contraindications to epidural analgesia, pain during childbirth can be treated with the systematic use of analgesics. The aim of the study was to analyze the overall use of opioid analgesics during childbirth in mothers at the Clinic for Gynecology and Obstetrics of the Clinical Hospital Center (KBC) Rijeka in the period from January 1, 2018 to December 31, 2022, and to investigate whether the use of opioids during childbirth was higher in first-born or multi-breasted. This study included all mothers who stayed at the Clinic for Gynecology and Obstetrics, Clinical Hospital Centre Rijeka at this time. The following data were analyzed: the use of opioid analgesics and parity. Statistical analysis included descriptive statistics and tests with a statistical significance p < 0,05. The results show a decrease in the use of opioid analgesics during childbirth in a measured five-year period, with the highest use recorded in 2018 (2.02%) and the lowest in 2021 (0.72%). The result of the research is that first-born women have a higher percentage of opioid analgesic use (67.4%) compared to multi-horned women (32.6%). Conclusion: At the Department of Gynecology and Obstetrics, Clinical Hospital Centre Rijeka, the selection of systematic use of opioid analgesics during childbirth is low and indicates an increased tendency to other methods of pain relief during childbirth. In the future, it is necessary to investigate even more the systematic use of opioid analgesics
Levels of depression, anxiety and subjective happiness among health sciences students in Croatia: a multi-centric cross-sectional study
No full textBackground: Previous studies have shown that symptoms of depression and anxiety were highly prevalent among health sciences students. This may lead to other professional and personal difficulties and a decrease in individuals’ well-being. This study aimed to analyze levels of depression, anxiety and subjective happiness among health sciences students in Croatia. Methods: We conducted a cross-sectional study in 10 higher education institutions in Croatia during March 2023. Eligible participants were health sciences students. Participants filled out an online survey consisting of sociodemographic questions and validated scales for determining the levels of depression (9-question Patient Health Questionnaire, PHQ-9), anxiety (General Anxiety Disorder 7-item scale, GAD-7), and happiness (Subjective Happiness Scale, SHS). Results: Of 7460 invited students, 2137 students participated in the study (29% response rate). There were 41.4% of students that exhibited at least mild depressive symptoms, with 8% of students exhibiting moderately severe symptoms and 1.8% severe depressive symptoms. Mild anxiety was found in 36.8%, moderate anxiety in 23.9% and severe anxiety in 15.8% of students. The median SHS score was 19 (15.25–22). Women students had significantly higher levels of depression (p < 0.001) and anxiety (p < 0.001) than their men peers. Students in earlier study years showed higher levels of depression, anxiety and lower levels of subjective happiness compared to those in later study years. Students with lower self-assessed financial status had higher levels of depression (p < 0.001) and anxiety (p < 0.001). Students that failed an academic year had higher levels of depression (p < 0.001), but lower levels of anxiety (p = 0.005). Conclusion: In this study, we have shown that health sciences students exhibit high levels of depression and anxiety, at rates exceeding those in the general population reported in other studies. Our results may help educational institutions to put greater effort into the battle against mental health stigma, foster acceptance of mental health issues and encourage students to seek help when needed. Adequate mental health services are needed at universities to promote timely diagnosis and treatment of mental health problems