General awareness of stroke in the Czech Republic.

OBJECTIVE: The main goal of the study was to find out the general public's awareness of stroke, the relations between the awareness of stroke and socio-demographic factors, and awareness of stroke and experience of stroke. METHODS: The combination of a non-standardized questionnaire on the stroke prevention and a standardized questionnaire on the identification of the general health literacy (HLSQ-16) was used. The sample was chosen using a quota choice. The sample structure corresponded with the composition of the Czech population with regard to regions, sex and age. These features were determined as representative. The sample consisted of 1,004 respondents. RESULTS: The general awareness of stroke is high in the Czech Republic. Most of the respondents (97.2%) stated that they had ever heard of stroke. This basic awareness is influenced by the sex and marital status of the respondents. Almost one half (42.2%) of the general public would welcome more information on stroke. Women showed significantly higher interest in the information than men. Significantly higher interest could be seen in elderly respondents while younger respondents said significantly more frequently that they were not interested in the information. Married respondents showed a significantly higher degree of awareness. Rural respondents expressed higher interest in the information. The interest in the information dropped with higher education. The interest was significantly influenced by the respondents' sex, place of residence, marital status, and education. Almost 1/4 (24.3%) of respondents mentioned stroke incidence in their families. Our study proved that this incidence significantly varied in dependence on the respondents' sex, age, marital status and education. Further questions were focused on the sources of information on stroke. The most important sources include internet, which was named by nearly one half (48.6%) of respondents, and it was found that women could use the sources of information more frequently than men. Women used all sources of information on stroke (internet, television, families, GPs) more than men. CONCLUSION: The Czech respondents' interest in stroke is significantly influenced by their sex, age, place of residence, marital status, and the respondents' education. The findings play a role in the focus on preventive activities in this area. It is necessary to implement the general public education not only in general practitioners' offices but also in mass media in order to improve the awareness of stroke.

Pharmacotherapy as major risk factor of falls - analysis of 12 months experience in hospitals in South Bohemia.

This study aimed to analyze the effect of fall risk-increasing drugs (FRIDs) and drug-related factors relative to falls through clinical pharmacy service in hospitalized patients, focusing on the relevance of clinical pharmacist evaluation in the context of physician assessment. A prospective study of inpatient falls was conducted in 2017 retrieving data from 4 hospitals in South Bohemia, Czech Republic. An online database was developed to collect patient and fall-related data, and fall evaluation records. Healthcare professionals classified the overall effect of drugs on falls using Likert scale. Univariate and multivariate correlations were performed with a significance level of p < 0.05. Out of the total 280 falls (mean age of patients 77.0 years), a mean of 2.8 diagnoses with fall-related risk, 8.8 drugs, and 4.1 FRIDs per fall were identified. Incidence of falls decreased quarterly (p < 0.001). Use of FRIDs were positively associated with increasing age (p = 0.007). Clinical pharmacists were more likely to identify pharmacotherapy as the relevant fall-related risk, compared to physicians evaluation (p < 0.001). An increasing total number of prescribed drugs as well as higher number of FRIDs increased the suspicion in both professionals in the context of drug-related causes of falls.

Assessing the awareness of Czechs, age 40+, on the link between lifestyle choices and risk factors for cardiovascular diseases.

OBJECTIVES: Cardiovascular diseases constitute the main cause of disability and premature death worldwide. Those diseases will continue to endanger health unless the public understands clearly and completely which risk factors contribute to the development of these diseases and what they can do to avoid these risks. This article assesses the understanding of risk factors that can lead to the development of heart and vessel diseases. METHODS: A non-standardized questionnaire was used for data collection. The respondents expressed their opinions on influenceable factors using a five-degree Likert scale. The research set included 1,992 respondents. Data were statistically analyzed using the SASD program, version 1.4.12. To calculate the level of dependence of the selected characteristics, the Wallis, and Spearman correlation coefficients were calculated. The goodness-of-fit χ2 was applied as well. RESULTS: The results show that 66.8% of respondents go walking for at least 30 minutes on 5 or more days per week. Respondents from lower age groups reported significantly more (p < 0.001) walking. The comparison of mean values showed that Czech citizens aged 40 or more years express the highest agreement with the statement that they could prevent heart and vessel diseases by modifying their eating habits. The results further showed that 25.8% of Czech citizens smoked and that men smoked significantly more (29.6%) than women (22.5%). More than one-half (60.1%) reported drinking alcohol occasionally; the remaining respondents reported drinking alcohol 3-4 times a month or more often. Men reported drinking beer significantly more often (p < 0.001) than women, while women reported drinking wine significantly more often (p < 0.001) than men. CONCLUSIONS: Respondents aged 40 or more years were aware of some, but not all, of the risk factors that can influence the development of cardiovascular diseases. They accepted that they could prevent heart and vessel diseases by modifying their eating habits, however, their opinions regarding exercise differed from professional recommendations. Two-thirds of the respondents stated that smoking could also influence heart and vessel diseases. The study suggests that primary care providers need to put more effort into educating their patients regarding steps that can be to influence their own health.

Clinical pharmacist involvement in fall management in a polymorbid geriatric patient with a history of recurrent falls.

Patient falls represent a significant burden on healthcare facilities, particularly by prolonging hospitalization and increasing the cost of subsequent healthcare. In most cases, fall is caused by a combination of several modifiable and unmodifiable risk factors. The pharmacotherapy, which is often unreasonably administered in relation to patient health condition and drug combination, belongs among the modifiable risk factors. In this case report, the potential effect of pharmacotherapy on the patient fall-related risk as well as clinical pharmacy service that can contribute to reducing the risk of falls by engaging of clinical pharmacist in a multidisciplinary team with focus on the risks of pharmacotherapy and their management are shown.

[New ways towards the improvement of the seniors health literacy]. / Nové cesty pro zlepsení zdravotní gramotnosti senioru.

The elderly population is one of the vulnerable groups due to their low health literacy. Health literacy represents a way of effective ensuring, comprehension and utilization of health information to be able to make the best possible decisions in the care of one's health. The presented systematic overview study was compiled using the analysis of 38 database publications. The goal was to find relevant resources concerning the relation between health literacy and compliance in the treatment of adult and elderly individuals. Another goal was to describe the influence of tools and the possibility of using e-health to improve the seniors' health literacy. The source analysis proves that limited health literacy correlates with the decrease of cognitive functions. Some studies show that health literacy directly correlates with the level of education and age. The elderly individuals who show higher health literacy observe their doctors' advice more frequently and are, moreover, active recipients of health care. One of the tools of how to improve health literacy is e-health technology using internet, mobile phones, tablets or other information media.Key words: health literacy, health care, patient, senior, compliance, e-health.

Retrospective analysis of falls in selected hospitals of the Czech Republic.

INTRODUCTION: Hospitals strive, over the long term, to reduce the incidence of falls of hospitalized patients. Falls are monitored, analyzed, and regularly evaluated and corrective and preventive actions are established based on the findings. To establish preventive actions, it is essential to determine the circumstances under which the patient fell and in what type of health care facility. OBJECTIVES: The goal of the study consisted in retrospectively analyzing falls in selected hospitals of the South Bohemian Region in 2014 and 2015. METHODS: Our retrospective analysis of 1101 patient falls was reported by the health care staff from 4 hospitals of the South Bohemian Region. The data from the reported incidents (i.e., falls) from individual hospitals were encoded and entered in a database using the SASD statistical program and subsequently subjected to statistical analysis. RESULTS: The highest frequency of falls was found on internal wards, 565 (51.3%) with the second highest frequency found on subsequent care wards, 267 (24.3%). The study showed that the risk of falls increases with patient age; more than 60% the hospitals, in the monitored period, involved patients over 70 years of age. Falls occurred most frequently in patient rooms and in bathrooms. Statistically significant relationships were identified between the type of ward and the time of the fall, between the type of the ward and the location of the fall, between patient age and the time of the fall, between patient age and the location of the fall, between the time of fall and the location of fall, and between the location of fall and the patient mobility before the fall. CONCLUSION: Intensive monitoring of patient falls and the circumstances under which the falls occurred are needed to fully understand the epidemiology of hospital falls.

Selected aspects of health literacy among seniors.

OBJECTIVES: This study aimed to map the selected indicators of health literacy in the senior population via a qualitative survey that focused specifically on its relationship with autonomy in the context of health literacy among seniors. METHODS: A qualitative survey focused on the selected indicators of health literacy of seniors living in the South Bohemian Region of the Czech Republic (R1-19). The snowball sampling method was intentionally selected. Completed interviews were transcribed and data was reduced, analyzed, and categorized. The identified categories were 1) information comprehension, 2) decision-making in healthcare, and 3) compliance with nonpharmacologic treatment. RESULTS: The 'information comprehension' category clearly shows that the seniors involved in this study rated the comprehensibility of information provided by medical professionals as being good. An especially positive finding was that seniors do seek information through the internet, print sources, or other media, even though, as one senior (80-year-old woman) said, comprehension of medical information is becoming "more and more complex". The 'decision-making in healthcare' category touched upon opinions regarding informed consent and opinions regarding seniors' own involvement in healthcare. Results from this category suggest that seniors accept informed consent as a routine necessity. Inhibition regarding personal involvement in healthcare was also apparent: "... I come from a family accustomed to not bothering the doctor unnecessarily, so I just stick out my arm..." The last category of 'compliance with nonpharmacologic treatment' clearly shows that respondents are informed regarding lifestyle modifications that would benefit their treatment, although, few respondents had achieved the desired lifestyle changes. CONCLUSION: Results of this qualitative research show clear health literacy limits among seniors. As shown in this study, age itself could also be a limiting factor of health literacy.

Risk management in inpatient units in the Czech Republic from the point of view of nurses in leadership positions.

OBJECTIVES: The goal of this study was to assess specific features of risk management from the point of view of nurses in leadership positions in inpatient units in Czech hospitals. METHODS: The study was performed using a quantitative research strategy, i.e., a questionnaire. The data sample was analyzed using SPSS v. 23.0. Pearson's chi-square and analysis of adjusted residues were used for identifying the existence associations of nominal and/or ordinal quantities. 315 nurses in leadership positions working in inpatient units of Czech hospitals were included in the sample. The sample was created using random selection by means of quotas. RESULTS: Based on the study results, statistically significant relations between the respondents' education and the utilization of methods to identify risks were identified. Furthermore, statistically significant relationships were found between a nurse's functional role within the system and regular analysis and evaluation of risks and between the type of the healthcare facility and the degree of patient involvement in risk management. CONCLUSION: The study found statistically significant correlations that can be used to increase the effectiveness of risk management in inpatient units of Czech hospitals. From this perspective, the fact that patient involvement in risk management was only reported by 37.8% of respondents seems to be the most notable problem.

Opinions regarding the effectiveness of non-pharmacological measures in prevention of cardiovascular disease in the Czech Republic.

OBJECTIVE: Cardiovascular diseases are the most common cause of deaths. Cardiovascular mortality is influenced by several factors that can be changed by our behaviour. The goal of this study was to survey the opinions of physicians and nurses on the topic of preventative cardiovascular risk factors. METHODS: The inquiry was carried out using a standardized structured interviewer-respondent interview (face-to-face). The final form of the interview was based on the results of a pre-investigation. The study was anonymous, participation was voluntary, and the actual interview did not contain any controversial ethical questions. To meet these goals, a non-standardized questionnaire for nurses and physicians was developed. The questions evaluated the interest, coping difficulties, and efficiency of multimodal interventions in practice. The study sample included 1000 physicians and 1000 nurses. The results were statistically evaluated. RESULTS: The survey of physician and nurse opinions showed that patients were primarily interested in interventions in the area of nutrition, weight loss, and coping with pharmacotherapy; however, the overall lack of interest in smoking cessation was a surprising result. Physicians and nurses viewed smoking cessation as the most difficult risk factors to influence, followed by nutrition changes, and weight loss. It was noteworthy that more than half of the interviewed physicians and nurses were of the opinion that behavioral interventions were only sometimes or rarely effective. CONCLUSION: The results of our study show that nurses and physicians largely agree on behavioral risk factors and how to influence them. Nurses and physicians in Czech health care generally agree that patients are interested in influencing the above risk factors, being least interested in exercise and smoking cessation. Nurses and physicians also consider smoking reduction and weight loss as particularly difficult risk factors to manage. Results from this study will contributed to the overall goal of preparing and implementing short-term and long-term interventions in preventive cardiology.

Areas of health-education of physicians and nurses in care for cardiac patients from the perspective of citizens of the Czech Republic.

OBJECTIVES: The goal of this article was to assess the delivery of patient health-education, relative to cardiovascular disease from the perspective of physicians and nurses, as well as from the perspective of citizens living in the Czech Republic. METHODS: The article is based on data acquired from the "Intervention procedures in preventive cardiology" grant project. To evaluate patient health education, non-standardized questionnaires intended for physicians (n = 1000) and nurses (n = 1000) were used. A combination of a non-standardized questionnaire and a standardized questionnaire (SF-36) was used to assess citizen (n = 1992) viewpoints. The actual investigation took place from April 1 to April 20, 2016 and was implemented over the entirety of the Czech Republic. Data were analyzed using the SASD v. 1.4.12 program. Both first and second degree sorting was used. The degree of dependence of selected characteristics was established based on the Chi-square test and the T-test. RESULTS: A bit more than half (53.1%) of the physicians indicated that nurses carried out patient education regarding influenceable risk factors associated with cardiovascular diseases, while 71.6% of nurses reported carrying out this duty. The overwhelming majority of physicians (97.1%) and nurses (92.3%) report informing patients about how to improve their health condition. Citizen respondents reported that topics such as nutrition, exercise, smoking cessation, stress reduction, and the drug side effects use were discussed with them more frequently by physicians than by nurses. Citizen respondents reported that nutrition was discussed most frequently with them, while the issue of smoking cessation was discussed the least frequently. CONCLUSION: Our analysis showed that physicians engage in patient education more frequently than nurses. At the same time, results suggest that a relatively significant number of physicians and nurses rarely or never educate regarding risk factors associated with cardiovascular diseases.

Risk Factors for Malnutrition in Seniors Aged 75+ Living in Home Environment in Selected Regions of the Czech Republic.

BACKGROUND AND AIM: Nutrition is an important social determinant of health that influences the ageing process. The aim of this study was to evaluate the nutritional condition of a group of seniors and identify the bio-psycho-social factors that increase the risk of malnutrition. METHODS: The research was conducted using a quantitative method. The standardised scales Mini Nutritional Assessment - Short Form (MNA-SF) and the Geriatric depression scale (GDS-5) were used to evaluate the nutritional condition and tendency towards depression of the tested group. This group consisted of seniors aged 75 and above living in home environment in the Ceské Budejovice region. The group was comprised of 320 seniors, 115 men (35.9%) and 205 women (64.1%), which corresponds to the composition of the population in the chosen region of the Czech Republic. Statistical data analysis was conducted using SASD 1.4.10 and SPSS 15.0 programs. Pearson's chi-squared test (Χ²) and Cramér's V were chosen for statistical testing. The significance level was set at 5%. RESULTS: The average BMI value of the seniors was 26.2 kg/m² (overweight). This value decreased with age. More than one third of the respondents were evaluated as being at risk of malnutrition (36.3%). Unintended weight loss was determined as the strongest risk factor of malnutrition. Seniors who had lowered their food intake stated unintended weight loss 10 times more often than respondents with no noticeable reduction in food intake. Seniors who showed signs of depression indicated weight loss three and a half times more often than respondents without depression. Meanwhile acute illness increased the risk by three times. Depression was found to be the cause and also the consequence of malnutrition. CONCLUSION: Despite the high prevalence of overweight and obesity, a large proportion of the respondents were running the risk of malnutrition. It was concluded that the strongest risk factors for malnutrition in the respondents were unintended weight loss, depression and lowered food intake. Compared to biological factors, social and economic factors were less significant in causing malnutrition in seniors.

Selected aspects of "safety culture" in hospitals of the Czech Republic.

THEORETICAL BACKGROUND: Patient safety is a strategic goal of managers of all health care facilities in the Czech Republic. The development of a safety culture in the facility helps to ensure high quality health care. GOAL OF THE SURVEY was to assess the safety culture with regard to patient safety and team cooperation. A partial goal was to confirm the hypothesis that team cooperation among health care staff significantly influences patient safety. METHODOLOGY: 772 nurses took part in a quantitative survey. The respondents were nurses working shifts in inpatient departments of hospitals in the Czech Republic. RESULTS: Patient safety was described as excellent by 17.5% of nurses. It is described as very good by 60.2% of nurses and described as acceptable by 20.5% nurses. 78% of respondents agreed with the statement that patient safety was never neglected at the expense of increased workload. More than 10% of nurses reported that there were problems with patient safety. 19.8% of respondents were reported that efforts to prevent errors were not practiced at their clinic, and, therefore, and only chance had prevent more errors from occurring. According to 64.9% of respondents, the staff on the wards supported each other and a similar number of respondents reported that they showed respect for each other (60.2%). Respondents reported that intra-ward support increased the degree of patient safety. CONCLUSION: Results from the survey show that team cooperation is a precondition for providing safe patient care, which cannot be underestimated and must be refined and improved through good hospital management.

Patient misidentification in nursing care.

GOAL: The goal of the study was to assess the opinions of nurses regarding patient safety associated with patient misidentification. The investigation was focused on actual patient misidentification as well as loss of patient materials (e.g., blood samples, X-rays, etc.). These are problems often associated with patient identification methods and/or confusing patients with the same surname assigned to the same ward. The risks of misidentification incidents pose a considerable threat to patient health especially when the confusion extends to the operating room. Our objective was to identify the potential causes of patient misidentification and offers solutions to correct the issue. METHODS: A survey as part of a sociological investigation was carried out through the use of questionnaires. The selected sample included, in accordance with the needs of the project and methodology of the Institute for Health Care Information and Statistics of the Czech Republic, registered nurses working shifts on inpatient wards. The study took place across the Czech Republic between Sept. 15 and 30, 2013. The sample consisted of 772 registered nurses. RESULTS: The potential for patient misidentification (PM) was described as negligible by 73.8% of respondents. Only 9.1% of nurses admitted problems associated with patient misidentification. Respondents reported that the greatest potential for patient misidentification was associated with patients having the same surname staying on the same ward. An absolute majority of nurses responded that patient identification wristbands were the most frequently used method to prevent PM. Over 90% (90.6%) of nurses reported that patient ID wristbands were used for all patients. Almost 80% (77.4%) reported the use of positive verbal identification in addition to ID wrist bands. Respondents reported (76.2%) that the most frequently used method to avoid PM in the operating room involved a review of patient documentation. Almost the same number of repondents (74.1%) reported the use of verbal confirmation as a method to avoid PM. Another mechanism included verification of the surgical procedure. ID wristbands and completion of an 'identification protocol' rank among other options mentioned most frequently by respondents. CONCLUSION: The study shows that registered nurses regard patient misidentification as a very rare and unlikely event. Nonetheless, statistics suggest otherwise and education, changes in protocols, and new technologies are needed to improve the precision of patient identification.

Prevention of patient falls in hospitals in the Czech Republic.

THEORY: The prevention of patient falls is one of the safety goals set forth by the Ministry of Health of the Czech Republic. GOAL: A sociological survey was carried out to (1) determine to what extent nurses identify the risk of patient falls at admission, (2) if the risk is reassessed and at what intervals, (3) what preventive measures were taken, and (4) in what way are patient falls reported. METHODOLOGY: A representative sample consisting of general nurses working shifts on inpatient wards at hospitals in the Czech Republic was surveyed. Altogether 772 nurses took part in the study. RESULTS: The survey showed that at admission, most nurses assessed the risk of falls (91.6%). Nonetheless, it should stand as a stark warning that nearly one fifth of the respondents (16.2%) did not reassess the risk of falls after admission! On the other hand, it can be perceived as a positive that most nurses (70.1%) use a multifaceted program of preventive measures for at risk patients and immediately reported fall events to the doctor in charge (71.4%). During statistical testing, the predication that a working atmosphere supporting a culture of patient safety would significantly decrease the probability of patient falls and increases the willingness of nurses to use preventive programs in daily practice. CONCLUSION: Results from the survey showed that a system to minimalize fall risks has been successfully introduced into the hospitals of the Czech Republic. The system is based on the recommendations of the Ministry of Health of the Czech Republic.

The importance of self-management in the prevention and treatment of excessive weight and obesity.

OBJECTIVES: The aim of this research into 'self-management' was to determine to what extent respondents were aware of their status as overweight or obese. For respondents who indicated that they were overweight or obese, the goal was to determine whether they tried to lose weight, what steps they took to control their, and what specific methods they used. METHODS: Information was collected using semi-structured interviews from May 31, 2014, to January 30, 2015. Data processing was performed using statistical analysis of the social data SASDM 01/04/10 software. The total study group consisted of 600 respondents, including 302 from the Roma minority, and 298 from the non-Roma majority population (control group). Respondents were selected specifically from South Bohemia Region of the Czech Republic. The sample from the Roma minority was constructed using the snowball method (Snowball Sampling). The control sample of non-Roma was selected through quota sampling. RESULTS: The results indicate that the respondents from both the Roma minority and the non-Roma control group generally recognized when they were overweight or obese, or they were aware of it to a much lesser extent than objective indicators revealed. More than two thirds of the respondents who admitted they were overweight or obese (N = 143) reported that they had suffered from overweight or obesity since they were young adults. Significantly more members of the majority population had tried to lose weight using self-management, whereas the level of effort was significantly less among members of the Roma minority (P = 0). Nevertheless, Roma respondents significantly more often reported (P < 0.01) that they had agreed on a specific weight loss plan with a doctor. CONCLUSION: The results of our research show that in the context of prevention, it is important to promote self-managed skills, habits and other characteristics that can play an important role in the prevention and treatment of obesity and overweight.

Evaluation of selected indicators of overweight and obesity of Roma minority in the region of South Bohemia.

OBJECTIVES: The objective of our correlation study was to compare selected indicators of overweight and obesity of Roma and non-Roma (majority) populations in the South Bohemia Region or the Czech Republic. METHODS: The following indicators were chosen for evaluation of overweight and obesity: body height and weight, waistline measurement, waist/height index, waist/hips index, BMI, total fat and blood pressure. 600 participants were examined and interviewed in total, including 302 Roma and 298 non-Roma participants. Each of the participants had a personal examination performed by a general nurse, under hygienic-epidemiological conditions. The criteria for inclusion of participants into the study were consent with examination and age greater than 18 years. RESULTS: The statistical analysis showed that, at a level of significance of p < 0.001, the following values differed between the Roma and non-Roma population of the South Bohemia Region: waist/height index, waistline, total fat, body mass index (BMI), systolic and diastolic blood pressure. Differences in the incidence of the waist/hips index were significant at p < 0.01. Correlations of incidence with indicators of overweight and obesity in Roma were registered in relation to both age and gender of participants. The results show that overweight and obesity indicators were recorded more frequently in Roma female respondents. Although the results are unique, the conclusions cannot be generalized for Roma throughout the Czech Republic. CONCLUSION: The conclusions of the above findings will be implemented in strategic materials for community planning in the South Bohemia Region. The goal will be to offer services aimed at supporting a healthy life style for Roma living in the South Bohemia Region of the Czech Republic.

The hospitalized patient as a partner in the survey on safe care in the Czech Republic.

OBJECTIVES: The study examined the extent to which patients in the Czech Republic are involved in decisions regarding their treatment and whether they are interested in ensuring safety during hospitalization. METHODS: Patients were interviewed to determine their perspectives regarding the previously stated objectives. The sample consisted of 514 patients who had been admitted to hospital for a minimum of three days. RESULTS: It is clear that patients in the Czech Republic are unaware of safety issues associated with provided care, but 52.2% of respondents expressed a desire to be more involved in decisions pertaining to their treatment. Widowed patients, as well as those hospitalized for more than six days, expressed less of a desire for such involvement. Half of the patients enrolled in the study stated that health care professionals had encouraged them to ask questions about their treatment. With regard to errors associated with surgical reversals, 58.3% of respondents stated that nursing staff had performed checkups to avoid confusion in surgery. Another patient safety issue is nosocomial infection acquired through improper hand-washing techniques of medical personnel. 73.5% of patients said they would not have the courage to ask medical staff (doctors or nurses) whether they had washed their hands prior to examination. CONCLUSION: Patients in the Czech Republic are unaware of the safety issues associated with provided care, but more than half expressed a desire to be more involved in decisions that pertain their treatment.

The nurse's role in preventive care in the field of community nursing.

OBJECTIVES: According to published reports from the WHO, health care is undergoing a transformation that reflects the increasing importance of community care based on social, group, and individual needs. Community health care is provided by multidisciplinary teams, with nurses occupying irreplaceable positions. Nurse competencies constitute significant potential in the area of community based preventive care as well as the more traditional roles in treatment and recovery. METHODS: Data was obtained from health care professionals and the public through a structured interview. The study population included 1,007 physicians, 1,005 nurses and 2,022 laypersons. Respondents were selected randomly with the aid of quotas. The parameters for the selection of health care workers (nurses and physicians) were constructed based on registration data from the Institute of Health Information and Statistics. Layperson selection was based on data from the Czech Statistical Office. The Statistical Analysis of Social Data program (version 1.4.4) was used to process the data, which was in the form of 1st and 2nd degree contingency tables. The dependence level was determined based on χ2 and other testing criteria (according to the character of the signs). RESULTS: The results show that respondents perceive the concept of a "community nurse" as a nurse working independently in local neighborhoods and communities. Results also showed that work in senior care, followed by home care, and care for chronically ill patients were the most preferred. A role for nurses in health care education centers was only supported by 13.1% of physicians, 13.8% of nurses, and 6.8% of laypersons. The results also reveal that community nursing is perceived by both health care professionals and laypersons as fieldwork (i.e. work not based in a hospital or clinic environment), yet, at the same time, it was perceived as work that dealt with people needing health care. The results also reflect the opinion that the establishment of an independent nurse in the workplace (in the form of preventive care) could lead to an increase in the quality of care for employees (65.7% of physicians and 70.8% of nurses), an improvement in workplace health education (33% of physicians and 34.7% of nurses) and would provide support for healthy work environments (31.4% of physicians and 30.4% of nurses). CONCLUSION: Our results lead us to conclude that the health care system in the Czech Republic needs to better utilize the potential of trained nurses in the field of community health care. Additionally, steps need to be taken to increase job opportunities and staffing for nurses wanting to work in community health and preventive care.

Quality of life in patients with chronic diseases.

OBJECTIVES: A quality of life assessment is of great importance for patients with chronic diseases, because problems caused by specific diseases impact specific areas of their lives. The goal of this work was to determine, in which areas select diseases (rheumatoid arthritis, Crohn's disease, ischemic disease of the lower extremities and chronic obstructive pulmonary disease) affect patients' quality of life. METHODS: The Czech version of the WHOQOL-100 instrument and specific standardized questionnaires for individual diseases: EuroQol, EQ-5D-5L, IBDQ, PAQ were used to assess quality of life. This paper presents the results of the WHOQOL-100 questionnaire. In total, 5 research samples were put together. The first sample consisted of 200 respondents with rheumatoid arthritis (RA); the second sample included 100 respondents with inflammatory bowel disease (IBD); the third sample was comprised of 404 respondents with ischemic disease of the lower extremities (IDLE); the fourth sample consisted of 449 respondents with chronic obstructive pulmonary disease (COPD); and the fifth sample was represented by 1,456 healthy respondents. The acquired data were then statistically analyzed. A statistical data analysis was performed in two steps. In the first step descriptive statistical analyses were performed in the SASD program (absolute and relative frequencies of respondents' answers, median values and variability characteristics). In the second step differences in means of the subjectively-perceived quality of life in patients with individual diseases and in control group were tested using the Mann-Whitney U test and the non-parametric Wilcoxon pair test. These analyses were computed in the SPSS (Statistical Package for the Social Sciences) program. RESULTS: The results show that a statistically significant difference in average domain score values was found between the healthy population and patients diagnosed with RA in the domains of "physical health", "level of independence", "environment", and "spirituality/religion/personal beliefs". A statistically significant difference was found in all domains for patients with IDLE and COPD. A statistically significant difference was found in four domains for patients with IBD, namely those of "physical health", "level of independence", "social relationships" and "spirituality/religion/personal beliefs". CONCLUSION: All therapeutic and nursing interventions that can contribute to improving QoL in poorly performing domains should be utilized.

Opinions of citizens of the Czech Republic on the role of nurses in primary care during the COVID-19 pandemic.

INTRODUCTION AND OBJECTIVE: In spite of the general current decrease in COVID-19 incidence, the epidemiological situation on the territory of the Czech Republic is still unfavourable. Nurses play an essential role in the fight against this disease. MATERIAL AND METHODS: A non-standardized questionnaire was used to discover the expectations regarding nursing care provided during the COVID-19 pandemic. The sample of respondents was constructed using quota selection. The sample consisted of 1,815 respondents. RESULTS: The study identified a significant correlation between the age of respondents and the method used to contact general practitioners (p < 0.001). The oldest respondents (65+) more likely contacted GPs by phone. Respondents with basic education used outpatient services more often before than during the pandemic (p < 0.05). The behaviour of nurses was considered as professional and accommodating. The oldest respondents (65+) reported nurses did not to make them feel rushed. Other age groups rated nurses more critically (p < 0.01). Respondents, especially women, described the psychological burden on nurses during the COVID-19 pandemic as demanding (p < 0.01). Women, more than men, reported that nurses lacked protective equipment during the pandemic (p < 0.05). The use of an online system was significantly influenced by respondent education (p 0.001). Respondents with lower education were less likely to welcome this option. CONCLUSIONS: Due to the persisting COVID-19 incidence on the territory of the Czech Republic, citizens` opinions of the position of nurse in primary care in the period of COVID- 19 pandemics need to be known.The behaviour of nurses was considered to be accommodating and satisfactory.