RESUMO
BACKGROUND/OBJECTIVES: Multiple sclerosis is characterised by the manifestation of heterogeneous symptoms that affect daily functioning. Patients face physical impairment, psychological problems and socioeconomic changes. Depending on the form of the disease, they may have different needs, which are often unsatisfied and could be overcome by including palliative care in the treatment. Despite the above, not enough is known about this population's needs for palliative care. This cross-sectional study aimed to identify the need for palliative care and assess the functional dependence level in daily living activities in patients with multiple sclerosis. METHODS: The sample consisted of 120 patients from the Neurology Clinic of the University Clinical Center of Vojvodina, Serbia. The following research instruments were used: a General questionnaire, Sheffield Profile for Assessment and Referral for Care, Multiple Sclerosis Impact Scale and Barthel Index. RESULTS: The need for palliative care was expressed by 36.7% of patients, who expressed the most concern for the physical symptoms, independence and activity domains. Also, it was determined that the disease prevents patients from doing demanding physical tasks and that they are worried about multiple sclerosis. Almost a quarter of patients have had complete/severe dependence on other persons in performing daily activities. CONCLUSIONS: The most frequently reported physical symptoms by patients with MS were weakness, bladder problems, fatigue and different levels of dependence, while concerns related to sexual health, low mood and anxiety emerged as key challenges in the psychological domain. These findings underscore the importance of conducting needs assessments to guide the development of an appropriate palliative care model for MS patients.
RESUMO
Objectives: The aim of this paper is to assess the relationship between demographic and socioeconomic predictors and the unmet health needs of the older adult population in Serbia. Materials and methods: The study is part of the Population Health Survey of Serbia, which was conducted in the period from October to December 2019 by the Institute for Public Health of Serbia "Dr. Milan Jovanovic Batut" and the Ministry of Health of the Republic of Serbia. The research was conducted on a representative sample of Serbian residents in the form of a cross-sectional study. For the purposes of this research study, data on senior citizens, aged 65 and older, were used. Results: Multivariate regression analysis of demographic characteristics that showed statistical significance in the univariate model as a whole explains between 4.2% (Cox & Snell R Square) and 5.9% (Nagelkerke R Square) of the variance of unmet health needs and correctly classifies 66.3% cases. Statistically significant demographic predictors were the region where the respondents live, level of education, and material condition. The results of the research show that the most dominant predictors of the unmet health needs of the older adult population are related to socioeconomic inequalities, financial reasons, and predictors related to the inaccessibility of health care. Conclusion: The results suggest that individual socioeconomic predictors have a great influence on the emergence of unmet health needs of the older adult population in Serbia. Every third older adult resident did not receive the necessary health care, most often due to financial constraints.