7091 research outputs found
Sort by
The importance of spirituality in palliative care
No full textDuhovnost je jedna od dimenzija osobe kojom se označava način na koji pojedinci doživljavaju, izražavaju ili traže svrhu, smisao i transcendenciju te način na koji su povezani sa samim sobom, drugima, prirodom i onim što je sveto. Veliku ulogu može imati kod bolesnika s progresivnim bolestima nepovoljne prognoze u kojima dolazi do temeljnih egzistencijalnih pitanja na koja se nastoje pronaći odgovori o smislu patnje, bolesti i života općenito. Mnoga znanstvena istraživanja potvrdila su postojanje pozitivnih učinaka duhovnosti kod bolesnika pa je duhovnost kao dio palijativne skrbi priznata od Svjetske zdravstvene organizacije. Pristup prema bolesnicima u palijativnoj skrbi kao i prema ostalima mora biti holistički obuhvaćajući tako svaku dimenziju bolesnika, fizičku, socijalnu, psihičku i duhovnu. Mnogi su već kroz povijest naglašavali važnosti duhovnosti u medicini i to ne samo filozofi ili teolozi, nego i liječnici. Duhovnost može imati terapijsko djelovanje utječući na cjelokupno stanje bolesnika i dolazi do boljeg prihvaćanja bolesti. Pružanje duhovne skrbi važan je dio u palijativnoj skrbi, posebno kod bolesnika koji su vjernici i izražavaju duhovne potrebe vezane za religiju. Iz tog razloga, u palijativnoj skrbi izrazito je bitna prisutnost duhovnika koji vršeći svoju službu pomaže bolesniku, njegovoj obitelji, ali i ostalim članovima tima palijativne skrbi. Za razliku od nekih drugih potreba, duhovne potrebe bolesnika nije tako lako prepoznati i zadovoljiti ih, samim time što su složenije i teže uočljive, a neke od njih su traženje životnog smisla, potreba za pomirenjem, potreba bolesnika da bude promatran kao osoba ili traženje odgovora na egzistencijalna pitanja. Osim duhovnika, tim palijativne skrbi čine i mnogi drugi stručnjaci koji zajedničkim radom moraju prepoznati bolesnikove potrebe i adekvatno ih zbrinuti. Kao jedan od članova tima, medicinska sestra ima važnu ulogu u zbrinjavanju bolesnikovih duhovnih potreba pristupajući svakom bolesniku individualno i holistički. Istražujući bolje duhovnu dimenziju bolesnika, postoji nekoliko metoda kako provoditi, odnosno kako pružati duhovnu skrb poput logoterapije, hagioterapije ili pregleda života.Spirituality is one of the dimensions of a person that indicates the way in which individuals experience, express or seek purpose, meaning and transcendence and the way in which they are connected to themselves, others, nature and what is sacred. It can play a big role in patients with progressive diseases with an unfavorable prognosis, in which fundamental existential questions arise, to which we try to find answers about the meaning of suffering, illness and life in general. Many scientific studies have confirmed the existence of positive effects of spirituality in patients, so spirituality as part of palliative care is recognized by the World Health Organization. The approach to patients in palliative care, as well as to others, must be holistic, thus encompassing every dimension of the patient, physical, social, psychological and spiritual. Throughout history, many have emphasized the importance of spirituality in medicine, not only philosophers or theologians, but also doctors. Spirituality can have a therapeutic effect by influencing the overall condition of the patient and leads to a better acceptance of the disease. Providing spiritual care is an important part of palliative care, especially for patients who are believers and express spiritual needs related to religion. For this reason, in palliative care, the presence of a clergyman is extremely important, who, performing his service, helps the patient, his family, and other members of the palliative care team. Unlike some other needs, the spiritual needs of the patient are not so easy to recognize and satisfy, precisely because they are more complex and difficult to observe, and some of them are the search for the meaning of life, the need for reconciliation, the patient's need to be seen as a person or the search for answers to existential questions. In addition to the clergy, the palliative team consists of numerous other specialists who, working together, must recognize the needs of the patient and take care of them adequately. As one of the team members, the nurse plays an important role in taking care of the patient's spiritual needs by approaching each patient individually and holistically. By better exploring the spiritual dimension of the patient, there are several methods of how to implement, that is, how to provide spiritual care, such as logotherapy, hagiotherapy or life review
Physiotherapy procedures for diastasis of the rectus abdominis muscle
No full textDijastaza m. rectus abdominisa definira se kao razdvajanje m. rectus abdominisa po sredini linee albe. Počinje se javljati u drugom tromjesečju trudnoće a najučestalija u trećem tromjesečju i može biti izražena i do šest mjeseci nakon porođaja. Najčešće je lokalizirana u području iznad pupka, dok je lokalizacija ispod pupka vrlo rijetka. Javlja se zbog povećanog intrabdominalnog tlaka, rasta samog ploda, povećane tjelesne težine kao i hormonskih promjena koje olakšavaju rastezanje trbušnog zida. Također, više plodna i višestruka trudnoća, starija dob trudnice i veći indeks tjelesne mase povećavaju rizik od razvoja dijastaze. Trudnoća je normalno fiziološko stanje žene u reproduktivnoj dobi života, i ima veliki utjecaj na njeno psihičko i fizičko zdravlje. Normalan proces je da se žene tijekom trudnoće udebljaju, a kod nekih taj višak dobivenih kilograma ostane i tijekom života. Stoga je važno trudnicu educirati o pravilnoj prehrani, tjelesnoj aktivnosti te pravilnom načinu izvođenja vježbi. U prevenciji nastanka dijastaze m. rectusa abdominisa jedan od načina učinkovitog pristupa je tjelovježba i briga o pravilnoj prehrani. Stoga je važno trudnicu poticati na tjelovježbu kako bi se očuvala normalna funkcija trbušnih mišića koji imaju ključnu ulogu u podržavanju trbušnih organa i održavanju stabilnosti trupa. Cilj rada je specificirati dijastazu ravnog trbušnog mišića, opisati vrste, metode procjene i samoprocjene kao i mogući fizioterapijski pristup za njen oporavak.Diastasis of the rectus abdominis is defined as the separation of the rectus abdominis in the middle of the linea alba. It begins to appear in the second trimester of pregnancy is most common in the third trimester, and can be expressed up to six months after childbirth. It is most often localized in the area above the navel, while localization below the navel is very rare. It is caused by increased intra-abdominal pressure, the growth of the fetus itself, increased body weight, as well as hormonal changes that facilitate the stretching of the abdominal wall. Also, more fertile and multiple pregnancies, older age of the pregnant woman, and higher body mass index increase the risk of developing diastasis. Pregnancy is a normal physiological condition of a woman of reproductive age, and it has a great impact on her mental and physical health. It is normal for women to gain weight during pregnancy, and for some, the excess weight remains for life. Therefore, it is important to educate a pregnant woman about proper nutrition, physical activity, and the proper way to perform exercises. In the prevention of diastasis of the rectus abdominis muscle, one of the effective approaches is exercise and proper nutrition. Therefore, it is important to encourage a pregnant woman to exercise to preserve the normal function of the abdominal muscles, which play a key role in supporting the abdominal organs and maintaining the stability of the trunk. The work aims to specify diastasis recti, to describe the types, assessment, and self-assessment methods, as well as a possible physiotherapy approach to its recovery
The incidence of infectious endocarditis before and during the COVID-19 pandemic
No full textPandemija bolesti COVID – 19 imala je velik utjecaj na globalno zdravlje postavljajući značajne izazove zdravstvenim sustavima širom svijeta. Infektivni endokarditis je ozbiljna infekcija koja zahvaća unutarnju ovojnicu srčanih klijetki i zalistaka. Obično je uzrokovana bakterijama ili gljivama, dok u kontekstu infekcije virusom SARS – CoV – 2 može nastati zbog izravne invazije virusa ili kao posljedica nereguliranog imunološkog odgovora ili uz izostanak postojećih čimbenika rizika. Infektivni endokarditis manifestira se širokim rasponom simptoma koji su često nalik na simptome uslijed bolesti COVID – 19, a oni uključuju stalnu vrućicu, zimicu, umor, bolove u mišićima i zglobovima, otežano disanje.
Istraživanje je planirano kao opservacijska studija koja će uključiti sve punoljetne bolesnike s dijagnozom dokazanog endokarditisa i virusom SARS – CoV – 2 infekcije u razdoblju od 1. siječnja 2018. do 1. ožujka 2023. godine na Klinici za bolesti srca i krvnih žila, Kliničkog bolničkog centra Zagreb. Glavni cilj istraživanja je bio istražiti i usporediti pojavnost endokarditisa u razdobljima prije i tijekom pandemije bolesti COVID – 19, dok je specifični cilj bio usporediti kliničke značajke i čimbenike rizika te usporediti postoji li statistički značajna razlika ili pozitivna korelacija u pojavnosti endokarditisa i osoba inficiranih virusom SARS – CoV – 2 uz ili bez prisutnost različitih komorbiditeta.
U istraživanje je bilo uključeno 93 bolesnika, od kojih je 24 (25,8 %) bilo prije pandemije bolesti COVID – 19, a tijekom pandemije bolesti COVID – 19 bilo je 69 bolesnika (74,2 %). Najčešći uzročnik u oba razdoblja bio je iz roda Staphylococcus. Svi bolesnici liječili su se antibiotskom terapijom, dok je za vrijeme pandemije bolesti COVID – 19 uz antibiotsko liječenje, njih 26,4 % zahtijevalo žurno kardiokirurško liječenje, smrtnih ishoda prije razdoblja pandemije nije bilo, a za vrijeme pandemije bilo 7 smrtnih ishoda (10,6 %). Svi bolesnici imali su opće simptome bolesti, prije razdoblja pandemije bolesti COVID – 19 5,4 % bolesnika imalo je neke od embolijskih incidenata te njih 34,4 % kardiovaskularne simptome, dok je za vrijeme pandemije bolesti COVID – 19, uz opće simptome bolesti, njih 37,5 % najviše imalo kardiovaskularne simptome. Najčešći komorbiditeti u oba razdoblja bili su kardiološke bolesti. Iako je više pacijenata oboljelo od endokarditisa tijekom razdoblja pandemije bolesti COVID – 19, istraživanje nije pokazalo kako su bolesnici tijekom razdoblja pandemije preboljeli i bolest COVID – 19.
Bolest COVID – 19 i endokarditis povezani su samim mehanizmom virusa bolesti COVID – 19 radi svoje prirode djelovanja. Uzrokujući snažnu upalnu reakciju, zahvaćeni organizam dovodi do sistemske upale i moguće citokinske oluje koja kao posljedica može oštetiti krvožilni endotel te time dovesti do disfunkcije endokarda. Također, bolest COVID – 19 uzrokuju koagulopatiju koja može biti predispozicija nastanku endokarditisa radi stvaranja tromba na srčanim zaliscima koji uz upalu prethode nastankom vegetacija na zaliscima. Radi sličnosti simptoma bolesti COVID – 19 i endokarditisa, često je moguća odgoda dijagnoze endokarditisa koja za posljedicu dovodi do niza komplikacija koje su povezane s težim slučajima endokarditisa i samog liječenja te ishoda bolesti što zahtjeva uspostavu uključivanja multidisciplinarnog tima u liječenje.The COVID – 19 pandemic has had a major impact on global health, posing significant challenges to healthcare systems around the world. Infective endocarditis is a serious infection that affects the lining of the heart's ventricles and valves. It is usually caused by bacteria or fungi, while in the context of infection with the SARS – CoV – 2 virus, it can occur due to direct invasion of the virus or as a result of an unregulated immune response or in the absence of existing risk factors. Infective endocarditis is manifested by wide range of symptoms that are often similar to symptoms due to the disease COVID – 19, and they include constant fever, chills, fatigue, pain in muscles and joints, difficulty breathing.
The research is planned as a observational study that will include all adult patients with a diagnosis of proven endocarditis and/or with SARS – CoV – 2 virus coinfection in the period from January 1., 2018. to March 1., 2023. at the Clinic for Heart and blood vessel diseases, Clinical Hospital Center Zagreb. The main goal of the research was to investigate and compare the incidence of endocarditis in the periods before and during the global pandemic of COVID – 19, while the specific goal was to compare clinical features and risk factors and to compare whether there is a statistically significant difference or positive correlation in the incidence of endocarditis and people infected with the SARS – CoV – 2 virus with or without the presence of various comorbidities.
In the study, 93 patients were included, of which 24 (25,8 %) were before the pandemic of COVID – 19 disease, and 69 patients (74,2 %) were during the pandemic. The most common causative agent in both periods was from the genus Staphylococcus. All patients were treated with antibiotic therapy, while during the pandemic, in addition to antibiotic treatment, due to complications of endocarditis, 26,4 % of them required urgent cardiosurgical treatment, there were no deaths before the pandemic period, and during the pandemic there were 7 fatal outcomes (10,6 %). All patients had general symptoms of the disease, before the period of the pandemic, 5,4 % of patients had some embolic incidents, and 34,4 % of them had cardiovascular symptoms, while during the COVID – 19 pandemic, in addition to the general symptoms of the disease, 37,5 % of them mostly had cardiovascular symptoms. The most common comorbidities in both periods were cardiac disease. Although more patients fell ill with endocarditis during the period of the COVID – 19 pandemic, the research did not show how the patients also recovered from the disease during the pandemic.
The disease COVID – 19 and endocarditis are linked by the very mechanism of the disease virus of COVID – 19 due to its nature of action. Causing a strong inflammatory reaction, the affected organism leads to systemic inflammation and a possible cytokine storm, which as a consequence can damage the vascular endothelium and thus lead to endocardial dysfunction. Also, the disease COVID – 19 causes coagulopathy, which can be a predisposition to the occurrence of endocarditis due to the formation of thrombus on the heart valves, which, along with inflammation precedes the appearance of vegetations on the valves. Due to the similarity of the symptoms of the disease COVID – 19 and endocarditis, it is often possible to delay the diagnosis of endocarditis, which as a result leads to a series of complications that are associated with more severe cases of endocarditis and the treatment itself and the outcome of the disease which requires the establishment of the involvement of a multidisciplinary team in the treatment
Triage process and adult life support
No full textObjedinjeni hitni bolnički prijam predstavlja središnje mjesto u bolničkoj zdravstvenoj ustanovi za hitnu procjenu, dijagnostiku i liječenje osoba. U njemu se osobe najčešće prvo susreću s medicinskim sestrama/tehničarima koji vrše procjenu hitnosti stanja odnosno proces trijaže.
Trijažna medicinska sestra/tehničar mora omogućiti da razina i kvaliteta trijažnog procesa budu proporcionalne s objektivnim kliničkim standardima, a ne administrativnim ili kadrovskim potrebama te je zbog toga važno poštivanje standardiziranih sustava trijaže. Hitnost se definira prema kliničkom stanju bolesnika i služi kako bi se procijenila brzina intervencije koja je
neophodna za ostvarenje optimalnog rezultata neovisno od ozbiljnosti i složenosti određene bolesti ili ozljede. Potrebno je istaknuti da trijažna medicinska sestra ne postavlja ili pretpostavlja medicinsku dijagnozu, već daje svoj odgovor odnosno trijažnu odluku na bolesnikove tegobe koje se donose na njegove prezentirajuće simptome. Poznavanje postupaka kardiopulmonalne reanimacije (KPR) te postupaka održavanja života i njezinih reevaluacija obveza i dužnost su svakog zdravstvenog djelatnika. Cilj ovog završnog rada je pobliže pojasniti ulogu trijažne medicinske sestre/tehničara u procesu trijaže (Australsko-azijska ljestvica trijaže, utvrđivanje glavne tegobe, utjecaj fizioloških parametara i ABCDE pristup, procjena boli, specifičnosti trijaže u određenim populacijama te dokumentiranje trijažnog procesa) i objasniti elemente održavanje života odraslih osoba odnosno osnovno održavanje života i napredno održavanje života.The unified hospital emergency department is the central point in the hospital health facility for the urgent assessment, diagnosis, and treatment of people. People usually first meet with nursing staff who assess the urgency of the illness, i.e. the triage process. The triage nurse must ensure that the level and quality of the triage process are proportional to objective clinical criteria and not to administrative or organizational requirements. Therefore, compliance with standardized
triage systems is important. Urgency is based on the patient's clinical condition. It determines the
speed of intervention required to achieve an optimal outcome and is independent of the severity and complexity of the disease or injury. It is important to note that the triage nurse does not make or accept a medical diagnosis, but rather gives her response or triage decisions to the patient's complaints, which are made based on his presenting symptoms. Knowledge of cardiopulmonary resuscitation (CPR) and life support procedures and their reassessment are the obligation and duty
of every healthcare professional. This final paper aims to clarify in more detail the role of the triage nurse/technician in the triage process (Australian-Asian triage scale, determination of the main complaint, influence of physiological parameters and the ABCDE approach, pain assessment, peculiarities of triage in certain population groups and documentation of the triage process) and the elements of adult life support, i.e. basic life support and advanced life support
Schroth method in the treatment of scoliosis
No full textKralježnica je pokretni koštani stup sastavljen od kralježaka povezanih zglobovima i ligamentima. Glavni je oslonac trupa, omogućuje pokretljivost, podršku glavi i gornjem dijelu trupa te stabilizaciju zdjelice. Također održava posturalno poravnanje i štiti kralježničnu moždinu. Kralježnica povezuje kosti glave, trupa i udova, a kralješci postaju veći i čvršći od glave prema zdjelici, prenoseći opterećenje na noge. Ima blagu fiziološku lordozu u vratnom i slabinskom dijelu te blagu stražnju fiziološku kifozu u prsnom i križnom dijelu, što osigurava prilagodbu za uspravno držanje. Pravilno držanje ovisi o snazi posturalnih mišića, pravilnom položaju anatomskih dijelova, pokretljivosti zglobova te vizualnim i kinestetičkim sposobnostima za ravnotežu i poravnanje tijela. Iako je osnovna postura nasljedna, može se modificirati kroz zanimanje, tjelesnu aktivnost, prehranu i životni stil. Deformacije kralježnice uključuju lordozu, kifozu i skoliozu. Lordoza je najmanje uobičajena deformacija, uzrokovana poremećenom stražnjom segmentacijom i prednjim rastom. Često se pojavljuje u kombinaciji sa skoliozom. Kifoza je abnormalna izbočenost kralježnice prema natrag, najčešće u torakalnom dijelu, pod kutom većim od 45°, što uzrokuje povijenost trupa prema naprijed. Skolioza je trodimenzionalna deformacija koja uključuje postranično savijanje i rotaciju kralježaka. Liječenje skolioze ovisi o veličini zakrivljenosti, dobi i zrelosti pacijenta te vremenu početka liječenja. Jedan od učinkovitih pristupa koji se koristi u fizioterapiji kod skolioze je Schroth trodimenzionalna metoda. Razvijena je u Njemačkoj prije jednog stoljeća od strane Katharine Schroth, koja je sama imala navedenu deformaciju, a kasnije metodu razvija i njezina kći i unuk.The spine is a movable bony column composed of vertebrae connected by joints and ligaments. It is the main support of the trunk, enables mobility, supports the head and the upper part of the trunk, and stabilizes the pelvis. It also maintains postural alignment and protects the spinal cord. The spine connects the bones of the head, trunk and limbs, and the vertebrae become larger and stronger from the head towards the pelvis, transferring the load to the legs. It has a slight physiological lordosis in the neck and lumbar region and a slight physiological posterior kyphosis in the chest and sacral region, which ensures adaptation for upright posture. Correct posture depends on the strength of the postural muscles, the correct position of the anatomical parts, the mobility of the joints, and the visual and kinesthetic abilities for balance and alignment of the body. Although the basic posture is hereditary, it can be modified through occupation, physical activity, diet and lifestyle. Spinal deformities include lordosis, kyphosis, and scoliosis. Lordosis is the least common deformity, caused by impaired posterior segmentation and anterior growth. It often appears in combination with scoliosis. Kyphosis is an abnormal protrusion of the spine backwards, most often in the thoracic part, at an angle greater than 45°, which causes the trunk to bend forward. Scoliosis is a three-dimensional deformity that involves lateral bending and rotation of the vertebrae. The treatment of scoliosis depends on the size of the curvature, the age and maturity of the patient and the time of the start of the treatment. One of the most effective approaches used in physiotherapy for scoliosis is the Schroth three-dimensional method. It was developed in Germany a century ago by Katharine Schroth, she had the above-mentioned deformity, and later the method was developed by her daughter and grandson
Opinions and attitudes of teachers of vocational subjects in the field of health care about the current method of education of general care nurses/medical technicians
No full textStrukovno obrazovanje medicinskih sestara i tehničara u Republici Hrvatskoj započinje na srednjoškolskoj razini. Kvalitetno obrazovanje trebalo bi omogućiti medicinskim sestrama i tehničarima da učinkovito odgovore na izazove modernog zdravstvenog sustava, unaprijede praksu i osiguraju visok standard zdravstvene njege i sigurnosti pacijenata. Kroz ovaj rad pružit će se uvid u povijesni pregled razvoja srednjoškolskog obrazovanja medicinskih sestara i tehničara u Republici Hrvatskoj, od osnutka prvih škola za medicinske sestre do današnjih dana, ističući ključne promjene obrazovnog sustava tokom vremena, od prilagodba potrebama tržišta rada do usklađivanja sa standardima Europske unije. Pregled postojećeg stanja opisuje trenutni sustav obrazovanja za medicinske sestre i tehničare opće njege u Republici Hrvatskoj, ističući pojedine segmente koji se kasnije propituju tokom samog istraživanja. Fokus je na strukovnom kurikulumu za stjecanje kvalifikacije medicinska sestra/tehničar opće njege, uvjetima upisa za navedeno zanimanje, trajanju obrazovanja, strukturi i organizaciji nastavnog plana i programa, izradi i obrani završnog rada, pitanju potrebe pripravničkog staža, izlaznim kompetencijama učenika, ali i ulozi nastavnika strukovnih predmeta iz područja zdravstvene njege. Kako bi se pružio širi kontekst, obrazovanje medicinskih sestara i tehničara opće njege u Republici Hrvatskoj uspoređeno je sa obrazovnim sustavima drugih zemalja Europske Unije. Ukratko se opisuju obrazovni sustavi Slovenije, Njemačke, Švedske i Ujedinjenog Kraljevstva te se ističu razlike i sličnosti u pristupu obrazovanju. Istraživački dio rada definira ciljeve i probleme istraživanja, postavlja hipoteze te opisuje ispitanike i metode korištene u istraživanju. Grafički prikazani rezultati istraživanja pružaju uvid u trenutne izazove i mogućnosti unapređenja obrazovnog sustava, a analiza prikupljenih rezultata istraživanja pruža zanimljiv uvid u mišljenja i stavove nastavnika strukovnih predmeta iz područja zdravstvene njege o trenutnom načinu obrazovanja medicinskih sestara i tehničara opće njege. Fokus same rasprave je na analizi dobivenih rezultata, uz predlaganje konkretnih mjera za poboljšanje kvalitete obrazovanja.Vocational education of nurses and technicians in the Republic of Croatia begins at the secondary school level. Quality education should enable nurses and technicians to effectively respond to the challenges of the modern healthcare system, improve practice, and ensure a high standard of healthcare and patient safety. Through this work, an insight into the historical development of the secondary education of nurses and technicians in the Republic of Croatia will be provided, from the establishment of the first schools for nurses to the present day, highlighting key changes in the educational system over time, from adaptation to the needs of the labor market to harmonization with standards of European Union. The overview of the current situation describes the current system of education for nurses and general care technicians in the Republic of Croatia, highlighting certain segments that are later questioned during the research itself. The focus is on the professional curriculum for obtaining the qualification nurse/general care technician, the conditions for enrollment in the mentioned profession, the duration of education, the structure and organization of the curriculum, the preparation and defense of the final thesis, the question of the need for an internship, the student's output competencies, but also the role teacher of vocational subjects in the field of health care. To provide a broader context, the education of nurses and general care technicians in the Republic of Croatia was compared with the educational systems of other European Union countries. The educational systems in Slovenia, Germany, Sweden, and United Kingdom are briefly described and the differences and similarities in the approach to education are highlighted. The research part of the work defines the objectives and problems of the research, sets hypotheses, and describes the respondents and the methods used in the research. The graphically presented research results provide an insight into the current challenges and opportunities to improve the education system, and the analysis of the collected research results provides an interesting insight into the opinions and attitudes of teachers of vocational subjects in the field of health care about the current way of educating nurses and general care technicians. The focus of the discussion itself is on the analysis of the obtained results, along with proposing concrete measures to improve the quality of education
Availability of physiotherapy after mastectomy
No full textKarcinom dojke najčešće je sijelo karcinoma u žena na području Republike Hrvatske, dok je na razini ostalih država svijeta, uključujući i muški spol, drugi najčešći po pojavnosti. Etiologija nastanka nije poznata, već se pojavnost prepisuje složenom međudjelovanju rizičnih čimbenika koji okružuju pojedinca. Simptomi ovise o tipu, podtipu te stadiju bolesti, dok ishod o što ranijem dijagnosticiranju. Samopregled, odnosno orijentacijski pregled učinkovita je metoda ranog prepoznavanja. U liječenju sudjeluje multidisciplinarni tim, a ono se sastoji od kirurškog liječenja te radioterapije, kemoterapije i/ili hormonalne terapije. Kirurško liječenje dijeli zahvate na poštedne te radikalne.
Cilj istraživanja usmjeren je na prikupljanje podataka o dostupnosti fizioterapije nakon operativnog zahvata mastektomije, o postoperativnim simptomima, razlici u kvaliteti života te o educiranosti oboljelih o mogućnostima opskrbe ortopedskim i drugim pomagalima.
Uzorak čine žene oboljele od karcinoma dojke liječene radikalnim operativnim zahvatom, te je u istraživanju sudjelovala 81 žena. Postoperativnu fizioterapiju provodilo je 39,5 % njih, te je najveći broj ispitanika započeo s provođenjem prvi postoperativni dan. Od terapijskih vježbi provodile su se vježbe disanja i cirkulacije, vježbe za povećanje opsega pokreta i snage mišića gornjih ekstremiteta. Po završetku hospitalizacije ukupno 33,3 % ispitanika upućeno je na daljnji proces fizioterapije. Najčešće izraženi postoperativni simptomi jesu smanjen opseg pokreta u području gornjih ekstremiteta, limfni edem, trnci u rukama, bol te umor. Period trajanja simptoma varirao je do 3 i više mjeseci, dok za 12,35 % ispitanika navedeni još traju. Razliku u kvaliteti života s obzirom na aktivnosti svakodnevnog života nema 7,4 % ispitanika, dok ostali imaju minimalnu do jaku. Za 13,6 % ispitanika mastektomija onemogućava izvođenje svakodnevnih aktivnosti. O mogućnostima opskrbe ortopedskim i drugim pomagalima u okviru edukacije od strane zdravstvenih djelatnika, educiranih je 54,3 %. Najčešće preporučena pomagala jesu postoperativni grudnjaci, silikonske dojke, kompresijski rukav za limfni edem te perika.Breast cancer is the most common type of cancer in women in the Republic of Croatia, while on a global scale, including males, it is the second most common in terms of incidence. The etiology of its occurence is not fully understood, but the incidence is attributed to a complex interplay of risk factors surrounding the indvidual. Symptoms depend on the type, subtype and stage of disease, while early diagnosis greatly influences the outcome of cancer treatment. Self-examination is an effective method of early diagnosis. Treatmen involves a surgical treatment, radiotherapy, chemotherapy, and/or hormonal therapy. Surgical treatmen includes both sparing or radical interventions.
The research aims to collect dana on the availability of physiotherapy after mastectomy, postoperative symptoms, differences in quality of life and level of awarness among patients about the options for orthopedic and other aids.
Sample includes women diagnosed with breast cancer and treated with mastectomy, with a total of 81 woman participating in the study. Postoperative physiotherapy was conducted for 39,5 % of them, with the majority starting on the first postoperative day. Therapeutic interventions included breathing and circulation exercises, then exercises to increase range of motion, and muscle strenghtening exercises. After hospitalization, a total of 33,3 % of participants were reffered for further physiotherapy. The most commonly reported symptoms were reduced range of motion in the upper extremities, lymphedema, tingling in the hands, pain and fatigue. The duration of symptoms varied up to 3 months or more, with 12,35 % of respondents still experiencing them. No difference in quality of live was reported in 7,4 % of respondents, while others reported minimal to severe impact. Regarding education about the options for the ortopedic and other aids, 54,3 % recieved such information. The most commonly recommended aids were postoperative bras, silicone breasts, compression sleeves and wigs
Analysis of affordable housing in the context of the Croatian real estate market and European practices
No full textU Europskoj uniji, modeli socijalnog stanovanja imaju izravan utjecaj na dinamiku i stabilnost tržišta nekretnina te predstavljaju ključne indikatore socio-ekonomske stabilnosti. Postoje značajne razlike u dostupnosti, pristupačnosti i kvaliteti socijalnog stanovanja. Zemlje poput Danske i Nizozemske mogu se pohvaliti naprednim i inkluzivnim sustavima socijalnog stanovanja, dok se druge bore s neučinkovitom birokracijom i neadekvatnom infrastrukturom. S druge strane, tržište nekretnina pokazuje trend rasta cijena, pri čemu su veliki gradovi diljem Europe suočeni s nedostatkom stanova i špekulativnom kupnjom, čime se pogoršava stambena kriza. Dok tržište nekretnina utječe na ekonomske trendove i investicijske prioritete, modeli socijalnog stanovanja često su odraz socijalnih vrijednosti i političkih odluka svake države članice. Ovaj specijalistički rad odnosi se na analizu socijalno priuštivog stanovanja u kontekstu hrvatskog tržišta nekretnina, u usporedbi s europskim praksama. Istražuje se kako različiti modeli socijalnog stanovanja utječu na dostupnost, cijene i kvalitetu stanovanja unutar Europske unije. S obzirom na rastuće cijene nekretnina i stambene izazove, koji postaju sve izraženiji, potreba za pristupačnim stambenim rješenjima nikada nije bila veća. Iako modeli socijalnog stanovanja variraju među državama članicama, zajednički cilj je omogućavanje pristupačnog smještaja za one kojima je to najpotrebnije, posebno u kontekstu sve intenzivnije globalne urbanizacije i demografskih promjena. Ovaj rad naglašava važnost razumijevanja tih dinamika za razvoj održivih stambenih politika koje će odgovoriti na sveprisutne izazove, osiguravajući da pristupačno stanovanje ostane ključni stup socijalne sigurnosti unutar Europske unije. U ovom radu definira se koncept socijalno priuštivog stanovanja i istražuje se tržište nekretnina, s fokusom na Republiku Hrvatsku u usporedbi s praksama unutar EU. Analizira se tržište nekretnina, razvoj stambenih strategija u Hrvatskoj, i prikaz modela socijalno priuštivog stanovanja u EU, uključujući povijest, kreditiranje, zakonodavstvo, i nacionalne politike. Također se pojašnjava razvoj stambenih strategija i primjene modela socijalno priuštivog stanovanja kako u Hrvatskoj, tako i u odabranim europskim zemljama.In the European Union, social housing models directly influence the dynamics and stability of the real estate market and are key indicators of socio-economic stability. There are significant differences in the availability, affordability, and quality of social housing. Countries like Denmark and the Netherlands can boast advanced and inclusive social housing systems, while others struggle with inefficient bureaucracy and inadequate infrastructure. On the other hand, the real estate market shows a trend of rising prices, with major cities across Europe facing a shortage of apartments and speculative buying, worsening the housing crisis. While the real estate market impacts economic trends and investment priorities, social housing models are often a reflection of the social values and political decisions of each member state. This specialist paper relates to the analysis of socially affordable housing in the context of the Croatian real estate market, compared to European practices. It explores how different social housing models affect availability, prices, and the quality of housing within the European Union. With rising real estate prices and housing challenges becoming more pronounced, the need for affordable housing solutions has never been greater. Although social housing models vary among member states, the common goal is to provide affordable accommodation for those most in need, especially in the context of increasing global urbanization and demographic changes. This paper highlights the importance of understanding these dynamics for developing sustainable housing policies that will address pervasive challenges, ensuring that affordable housing remains a key pillar of social security within the European Union. This paper defines the concept of socially affordable housing and explores the real estate market, focusing on the Republic of Croatia compared to practices within the EU. It includes an analysis of the real estate market, the development of housing strategies in Croatia, and a presentation of socially affordable housing models in the EU, including history, lending, legislation, and national policies. It also clarifies the development of housing strategies and the application of socially affordable housing models in Croatia and selected European countries
Correlation between the level of self-esteem and the development of anxiety, depression and/or stress
No full textMentalno zdravlje odnosi se na stanje dobrobiti u kojem je osoba sposobna ostvarivati svoje potencijale i nositi se sa raznim životnim stresovima. Povezano je sa subjektivnim osjećajem dobrobiti i sastavni je dio općega zdravlja. Samopoštovanje jedna od bitnih odrednica mentalnog zdravlja te o njemu ovisi kako će pojedinac reagirati na izazove koji su pred njega postavljeni i kako će se s njima nositi.
U ovom istraživanju ispitivala se povezanost mentalnih poremećaja sa razinom samopoštovanja. Tako je temeljna znanstvena pretpostavka (hipoteza) da je razina samopoštovanja povezana sa razvojem anksioznosti, depresije i/ili stresa. Metodologija istraživanja uključuje provedbu anketnog upitnika među pacijentima Dnevne bolnice Klinike za psihijatriju KB Dubrava te osobama koje nikada nisu bile uključene u niti jedan oblik psihijatrijskog tretmana. Rezultati istraživanja ukazuju na veći broj osoba sa niskim samopoštovanjem u skupini liječenih osoba nego u skupini neliječenih. Također, kod osoba sa niskom razinom samopoštovanja izraženiji su simptomi anksioznosti, depresije i/ili stresa nego kod osoba sa visokim samopoštovanjem.
Ovaj rad doprinosi razumijevanju odrednica mentalnog zdravlja te doprinosi boljem razumijevanju bolesti te samim time postiže pronalaženje najboljeg pristupa liječenju i prevenciji pojave navedenih psihičkih poremećaja kod zdravih pojedinaca.Mental health refers to a state of well-being in which a person is able to realize their potential and cope with various life stresses. It is related to the subjective feeling of well-being and is an integral part of overall health. Self-esteem plays a crucial role in mental health, and it influences how an individual will respond to challenges and how they will cope with them.
This study examined the connection between mental disorders and the level of self-esteem. The fundamental scientific hypothesis is that the level of self-esteem is related to the development of anxiety, depression, and/or stress. The research methodology includes the implementation of a survey questionnaire among patients of the Daily Hospital of the Psychiatric Clinic of Clinical Hospital Dubrava and individuals who have never been involved in any form of psychiatric treatment. The research results indicate a higher number of individuals with low self-esteem in the treated group compared to the untreated group. Additionally, individuals with low levels of self-esteem exhibit more pronounced symptoms of anxiety, depression, and/or stress than those with high self-esteem.
This work contributes to understanding the determinants of mental health and to better understanding of illnesses, thus achieving the best approach to treatment and prevention of the mentioned mental disorders in healthy individuals
Physical therapy after total knee arthroplasty
No full textUgradnja totalne endoproteze koljena odnosi se na zamjenu svih sastavnica zgloba koljena
protetskim nadomjestkom. Zglob koljena čini distalni kraj bedrene kosti zajedno s iverom i
proksimalnim krajem goljenične kosti. Za izvođenje pokreta u koljenu zadužena je bedrena ili
natkoljenična muskulatura. Biomehanika zgloba koljena uključuje opterećenja, položaje, pokrete
i sile koje utječu na njega. Oštećenja ili promjene u strukturama zgloba mogu dovesti do
poremećaja ravnoteže i ozljeda. Opterećenje na zglobu varira ovisno o položaju tijela, a mišićna
sila igra ključnu ulogu u održavanju ravnoteže i stabilnosti. Prva prava zamjena zgloba koljena
izvedena je 1880. godine, a bitan napredak dogodio se 1973. godine s predloženim prototipom
moderne proteze. Danas su u upotrebi različite vrste fiksacija za postavljanje proteze, uključujući
cementnu, bescementnu i hibridnu fiksaciju. Indikacije za ugradnju totalne endoproteze koljena
uključuju primarni i sekundarni osteoartritis, osteonekrozu, reumatoidni artritis i druge
degenerativne promjene koje uzrokuju bol i smanjenje funkcije koljena. Operacija se obično
izvodi kroz veliki otvoreni rez iznad zgloba koljena, a odluka o operaciji temelji se na težini boli
i stupnju onesposobljenosti pacijenta. Fizioterapijski pristup temelji se na modelu SOAP
(Subjective Objective Assessment Plan), koji obuhvaća subjektivni pregled, objektivni pregled,
analizu i plan. Preoperativna rehabilitacija priprema pacijenta za kirurški zahvat kako bi se
smanjila mogućnost postoperativnih komplikacija i ubrzao oporavak. Uključuje sveobuhvatan
pregled, edukaciju pacijenta i sudjelovanje u preoperativnom programu vježbanja.
Postoperativna rehabilitacija podijeljena je u faze koje uzimaju u obzir faze cijeljenja tkiva i
specifičnosti kirurškog zahvata. Uključuje kontinuirano pasivno pokretanje i terapijsko vježbanje
kako bi se smanjila bol, poboljšala pokretljivost i funkcionalnost te osigurao optimalan
oporavak. Terapijsko vježbanje ključna je komponenta rehabilitacije koja pruža sustavnu i
planiranu tjelovježbu za poboljšanje funkcije i kvalitete života pacijenta. Važno je pravovremeno
prepoznati komplikacije i intervenirati u slučajevima poput duboke venske tromboze i plućne
embolije.The implantation of total knee endoprosthesis refers to the replacement of all components of
the knee joint with a prosthetic replacement. The knee joint forms the distal end of the femur
along with the splinter and the proximal end of the tibia. The femoral or thigh musculature is in
charge of performing movements in the knee. The biomechanics of the knee joint involves loads,
positions, movements and forces that affect it. Damage or changes in the structures of the joint
can lead to disturbed balance and injury. The load on the joint varies depending on the position
of the body, and muscle force plays a key role in maintaining balance and stability. The first real
replacement of the knee joint was performed in 1880, and significant progress occurred in 1973
with a proposed prototype of a modern prosthesis. Today, various types of fixations are used for
the placement of dentures, including cement, cementless and hybrid fixation. Indications for this
procedure include primary and secondary osteoarthritis, osteonecrosis, rheumatoid arthritis and
other degenerative changes that cause pain and decrease in knee function. This operation is
usually performed through a large open incision above the knee joint, and the decision to
undergo surgery is based on the severity of the pain and the degree of disability of the patient.
The physiotherapy approach is based on the SOAP (Subjective Objective Assessment Plan)
model, which includes subjective review, objective review, analysis and plan. Preoperative
rehabilitation prepares the patient for surgery to reduce postoperative complications and speed
up recovery. It includes a comprehensive examination, patient education and participation in a
preoperative exercise program. Postoperative rehabilitation is divided into stages that take into
account the stages of tissue healing and the specifics of the surgical procedure. It includes
continuous passive start-up and therapeutic exercise to reduce pain, improve mobility and
functionality, and ensure optimal recovery. Therapeutic exercise is a key component of
rehabilitation that provides systematic and planned exercise to improve the function and quality
of life of the patient. It is important to recognize and intervene on the risks of complications such
as deep vein thrombosis and pulmonary embolism in a timely manner