The possible role of machine learning in detection of increased cardiovascular risk patients - KSC MR Study (design).

Introduction: Currently, just a few major parameters are used for cardiovascular (CV) risk quantification to identify many of the high-risk subjects; however, they leave a lot of them with an underestimated level of CV risk which does not reflect the reality. Material and methods: The submitted study design of the Kosice Selective Coronarography Multiple Risk (KSC MR) Study will use computer analysis of coronary angiography results of admitted patients along with broad patients' characteristics based on questionnaires, physical findings, laboratory and many other examinations. Results: Obtained data will undergo machine learning protocols with the aim of developing algorithms which will include all available parameters and accurately calculate the probability of coronary artery disease. Conclusions: The KSC MR study results, if positive, could establisha base for development of proper software for revealing high-risk patients, as well as patients with suggested positive coronary angiography findings, based on the principles of personalised medicine.

Advanced Practice Nursing in Cardiology: The Slovak Perspective for the Role Development and Implementation.

BACKGROUND: Cardiovascular diseases (CVDs) are the number one cause of death globally. Most can be prevented by addressing behavioral risk factors, where advanced practice nurses- clinical specialists in cardiovascular nursing play a fundamental role. This modern and effective role is based on advanced activities, knowledge, skills, and experience in a specialized field, which can make a significant contribution to solving the problems of these civilization diseases. The aim of this work is to explore the self-perception of advanced-practice nurses (APNs) working in cardiology and vascular medicine departments within the context of advanced-practice nursing. METHODS: This quantitative exploratory study included 103 APNs working in cardiology and vascular diseases departments of specialized hospitals in Slovakia. A validated instrument was used. RESULTS: The overall perception was at the level of 68.01%. The highest-rated domain was the outcomes for patients/clients, and subdomains were meeting the needs, education of healthcare workers, and quality in relation to management. There was a significant difference found among hospitals with a better scoring of specialized institutions. CONCLUSION: There have been promising advances due to the current legislation in Slovakia defining APNs and specialists' competencies. However, the practice in nursing for CVD patients remains fragmented, uncategorized and less valued by stakeholders and the public. According to the results, nurses have the potential and preparedness for this role in the context of their knowledge and skills in general. The Authors conclude that there is a need of such specialization of APNs in Slovakia.

Spirituality as a Mediator Between Depressive Symptoms and Subjective Well-being in Older Adults.

As the population is aging, strategies for helping older people to maintain and promote good health and well-being are needed. This study aims to assess whether depressive symptomatology and spirituality are associated with subjective well-being in older adults when controlled for sociodemographic variables. Furthermore, the mediating role of spirituality in the association between depressive symptomatology and subjective well-being was examined. A total of 250 participants (mean age 75.91 ± 7.60) in this cross-sectional study completed the Daily Spiritual Experience Scale, the Zung's Self-rating Depression Scale, and the Personal Wellbeing Index. Multiple linear regression and mediation analyses were used to analyze the data. Subjective well-being was negatively associated with depressive symptoms and positively associated with spiritual experiences. The indirect effect of depressive symptomatology on subjective well-being via spirituality was 28.7%. The enhancement of spirituality seems to represent one of the relevant interventional strategies in prevention and treatment of depressive symptoms and well-being improvement.

Self-Reported Cultural Competence of Nurses Providing Nursing Care in Slovakia.

PURPOSE: The goals of this study were to determine and evaluate the perception of cultural competence of nurses in the Slovak healthcare system, identify factors that influence their perception, and ascertain opportunities to improve nurses' cultural competence. DESIGN: Cross-sectional nonexperimental study. METHODS: Nurses from Slovakia were surveyed in this cross-sectional study using the standardized Cultural Competency Assessment (CCA) questionnaire. Statistical analysis was conducted using SPSS version 22 (IBM Corp., Armonk, NY, USA). RESULTS: In total, 267 nurses responded. Only 28% perceived themselves as very culturally competent to care for people from other cultures. Over 68% received no diversity training. Age (p < .011) and prior diversity training (p < .006) were significantly associated with culturally competent behavior (CCB). A significant relationship (r = 0.17; p < .015) was also confirmed between the self-reported CCA and CCB. CONCLUSIONS: Culturally competent care is a professional imperative. The ability to deliver high-quality, culturally congruent care may be enhanced by cultural diversity education and training. Further research is needed to identify other influences on cultural competency and the impact on patient care and outcomes. CLINICAL RELEVANCE: There is a need for nurses to enhance their knowledge and skills related to cultural competency, awareness, sensitivity, and behaviors. Education and training contribute to nurses' ability to provide high-quality, culturally competent nursing care to patients from different cultures, and may possibly contribute to decreased health disparities.

Anxiety and depression in Slovak patients with rheumatoid arthritis.

BACKGROUND: Rheumatoid arthritis (RA) is significantly associated with psychiatric morbidity. Mental health conditions are often unrecognized and untreated in primary care. AIMS: To assess prevalence of anxiety and depression and their impact on arthritis pain and functional disability in Slovak patients with rheumatoid arthritis. METHODS: Anxiety was assessed by the Beck Anxiety Inventory (BAI), depression by the Zung self-rating depression scale (SDS), pain by the visual analog scale (VAS) and functional disability by the health assessment questionnaire - disability index (HAQ-DI) in 142 patients with rheumatoid arthritis. Spearman's rho was calculated to assess relations between variables. Stepwise linear regression analysis was used to assess impact of anxiety and depression on arthritis pain and functional disability. RESULTS: High prevalence of anxiety and depression was observed in arthritis patients. Anxiety and depression were significant predictors of arthritis pain and functional disability. Sex, education, marital status, disease duration and comorbidity had no impact on arthritis pain and functional disability. CONCLUSION: These findings support the notions that psychological negative affect can influence subjective perception of arthritis pain and disability. The regular screening of anxiety and depression and the psychological approaches can be useful for managing arthritis patients.