Construct validity of the perceived stress scale (PSS-10) in a sample of health professionals in family medicine in Bosnia and Herzegovina.

Background: The 10-item Perceived Stress Scale (PSS-10) has not been translated into Bosnian, nor has a study been conducted employing a sample of family medicine physicians and nurses to examine the instrument's reliability, validity, and factorial structure. Thus, the goal of this study was to investigate the reliability and construct validity of the Bosnian version of the PSS-10 among family medicine professionals. Study design: Cross-sectional descriptive study provided among healthcare professionals in family medicine, using Google forms questionnaire (PSS-10) in Bosnian language. Methods: Translation of PSS-10 in Bosnian is performed according to the proposed set of standardized guidelines. The questionnaire was sent on the email addresses of family physicians and nurses in whole Bosnia and Herzegovina. The collected data were subjected to reliability testing, exploratory and confirmatory factor analysis, which tested three alternative plausible models suggested by the extant literature: single factor, correlated two-factor and bifactor. Results: A total of 272 out of 440 (RR = 61.3) nurses and physician working in family medicine in Bosnia and Herzegovina completed the PSS-10 Bosnia and Herzegovina version (BH). Participants were aged 25 to 69, with a mean age of 44.7 (±10.55). Most participants were women (86.8%) and physicians (58.8%) with specialisation in family medicine (43%). The overall Cronbach's alpha was 0.87 and the test-retest reliability coefficient was 0.88. Exploratory Factor Analysis yielded 2 factors with eigenvalues of 4.77 and 1.35, accounting for 61.2% of variance. Factor 1 consisted of 6 items representing ''perceived distress'', whereas Factor 2 consisted of 4 items representing ''perceived coping''. The Confirmatory factor analysis indicated a very good fit of this bifactor model to this sample. Conclusions: Our results implies that the PSS-10-BH, as a bifactor model with good reliability and validity, may accurately measure the stress levels of family medicine physicians and nurses.

Family Physicians' Perceptions of Primary Health Care Use in Bosnia and Herzegovina during the Covid-19 Pandemic, a Cross-sectional Study.

OBJECTIVES: The main objective of this paper was to examine the perceptions of family physicians on the use of primary health care in Bosnia and Herzegovina during the COVID-19 pandemic. MATERIALS AND METHODS: A cross-sectional study was conducted using a short online questionnaire that was sent to primary care physicians in Bosnia and Herzegovina from April 20th, 2022, to May 20th, 2022. RESULTS: The research sample consisted of 231 doctors of primary health care from Bosnia and Herzegovina, with an average age of 45 years and 85% women. About 70% of participants reported having COVID-19 at least once from March 2020 to March 2022. Participants had an average of 1,986 registered patients and approximately 50 encounters per day. The study revealed a high degree of reliability between test-retest measurements, with a single measure Intraclass correlation coefficient of 0.801, and internal consistency determined using Cronbach's alpha of 0.89. Participants reported that the following health services were most affected during the COVID-19 pandemic: care for patients with chronic diseases, home visits, navigating the health system with patients making appointments with specialists, cancer screening, and preventive health services. The study also found statistically significant perceived differences in the use of these health services based on age, gender, postgraduate education in family medicine, participation in COVID-19 clinics, and personal history of Covid-19. CONCLUSION: There were significant disturbances to the use of primary health care during the COVID-19 pandemic. Future research could investigate patient outcomes compared to family physician perceptions.

Family Medicine Practice During COVID-19 Pandemic in Canton Sarajevo: Positive and Negative Aspects.

Background: After the World Health Organization declared the outbreak of a new coronavirus on 30 January 2020 a public health emergency of international importance, health authorities in Bosnia and Herzegovinaas in other countries around the world, have ordered active surveillance, early detection, isolation and management, cases, contact monitoring and prevention of the spread of infection. Objective: The aim of this study was to describe and analyze of the organization of family medicine during COVID-19 pandemic in Canton Sarajevo with its positive and negative aspects. Methods: The case study design provided an ideal framework for systematic research into the organization of primary health care in Sarajevo Canton during the COVID-19 pandemic as it is an empirical study exploring a contemporary phenomenon within its real-life context when the boundaries between phenomenon and context are not clearly visible. Multiple sources of evidence are used. Data were collected in several different ways: analyzing policies, laws, regulations, decisions related to the COVID pandemic, insight into changes in the health information system, collecting data from reports, and through a group interview (Delphi exploratory) with eleven family medicine specialists. Results: Primary care was organized as two parallel systems with family medicine in the center. The first system was COVID-19 primary care and the second was regular care for non-COVID-19 patients. Family medicine physicians despite a numerus setbacks provide health care for 106346 COVID-19 cases. Discussion: Every principal (first contact access, person-centered care, comprehensiveness, continuity of care, community based, coordination of care, and holistic modeling) of family medicine was interrupted with consequences for patients and family physicians. Conclusion: Additional research is needed to examine all facets of the family medicine and primary health care response to the COVID-19 pandemic in Sarajevo Canton.

The Association among Glycemic Control and Depression Symptoms in Patients with Type 2 Diabetes.

INTRODUCTION: Diabetes and depression are two common and major non-communicable diseases with significant disease burdens worldwide. AIM: The aim of this study is to obtain the association among A1C levels and symptoms of depression in patients with type 2 diabetes in family medicine offices. METHODS: This cross-sectional study was carried out between June 2016 and July 2017. We recruited 150 adults with type 2 diabetes from various family medicine offices. The study questionnaire had two parts; the first one for participants and the second one for family medicine physicians. Participants completed the part of the questionnaire with the PHQ-9 scale and questions regarding demographic data. Family medicine physicians completed the part of the questionnaire with questions concerning clinical data. A univariate and multivariate linear regression analysis was conducted to identify significant predictors of depressive symptoms revealed by the PHQ-9 score. RESULTS: Multiple linear regression showed that the level of A1C was a significant predictor of the PHQ-9 score in all three models. Increases in the A1C level were followed by increases in depressive symptoms. Other significant predictors of a positive PHQ-9 score were smoking, level of education and income. CONCLUSION: The level of A1C as an indicator of glycemic control has been shown to have a significant association with the scores of the PHQ-9 questionnaire, which identifies the intensity of symptoms of depression. An increase in the level of A1C is followed by an increase in the intensity of symptoms of depression.

Frequency and Forms of Workplace Violence in Primary Health Care.

INTRODUCTION: Violence at work has become an alarming problem worldwide. The real size of the problem is unknown because of underreporting. The aim of the survey was to estimate the prevalence of workplace violence (WPV) among primary health care professionals in the Public Institution Health Center of Sarajevo Canton (HCSC), Bosnia and Herzegovina, and determine possible association with demographic and work-related characteristics of participants. AIM: The aim of the survey was to estimate the prevalence of workplace violence (WPV) among Primary health care professionals in the Public Institution Health Center of Sarajevo Canton (HCSC), Bosnia and Herzegovina, and determine possible association with demographic and work-related characteristics of participants. METHODS: A cross-sectional study was conducted between March and May 2017. The sample consisted of medical professionals employed at HCSC. The data were collected by a questionnaire with 42 questions divided into 7 blocks of topic. Descriptive statistics were used to describe the sample. Binary logistic regression analysis was used to test the association between the occurrence of violence and independent variables (gender, age, years of work experience and office setting). RESULTS: A total of 558 out of 983 health professionals employed in Primary health care were involved in this survey. The overall prevalence of WPV was 90.3%, with 498 (89.2%) exposed to verbal violence and 417 (74.7%) exposed to indirect physical violence. Binary logistic regression analysis indicated that the following demographic and work-related characteristics were positively significantly associated with WPV: women were associated with verbal violence [Odd ratio (OR) 1.91, 95% confidence interval (CI) 1.06, 1.47] and stalking [OR= 2.06, 95% CI (1.04, 4.08)]. Office setting (urban) was significantly positively associated with indirect physical violence [OR= 1.59, 95% CI (1.03, 2.47)]. CONCLUSION: Almost all health professionals in Sarajevo primary health care were subjected to different types of WPV. There is a need for intervention to provide safer workplace environment. Professional, administrative, legal support and protection of health professionals by the health authorities and institution management is urgently required.

Frequency of Depression and its Correlation with Quality of Life of Patients with Oral Cavity Cancer.

INTRODUCTION: the effects of malignant tumors of oral cavity may be reflected through mental, physical, social and emotional well-being and quality of life of patients. Those suffering from malignancies show a large degree of psychological problems (fear, anxiety, depression, panic disorders, phobias) both at the time of diagnosis and during the treatment. AIM: to determine a level of depression in patients with oral cavity cancer and to link quality of life and level of depression of patients with oral cavity cancer. PATIENTS AND METHODS: The study was conducted at the Clinic of Maxillofacial Surgery of the Clinical Center University of Sarajevo (CCUS) in the period from July to late October 2015, through a survey of patients with verified oral cavity cancer, questionnaire related to socio-demographic characteristics of the patients, the University of Washington Quality of Life Questionnaire (UW-QOL), and the Beck Depression Inventory (BDI). RESULTS: Majority of patients from our study, specifically 50 (56%) of them, did not suffer from depression, 8 (9%) respondents suffered from mild depression, 14 (16%) respondents had moderate depression, whereas 17 (19%) of them had severe depression. CONCLUSION: quality of life and level of depression of patients with oral cavity cancer are in negative and almost linear correlation. The worse the evaluation results of one's physical or socio-emotional health, the higher degree of depression.

Quality of Life of Patients with Oral Cavity Cancer.

INTRODUCTION: In recent years the quality of life of patients is very important in monitoring the treatment and therapeutic procedure success. It has become a significant factor in assessing the therapeutic procedure accomplishment, and for the first time the patient alone can access the success of the respective therapy. Cancer of the oral cavity is one of the most common cancers of the head and neck, and is one of the ten most common causes of death in the world. In the majority of cases, cancer of the oral cavity is detected in an advanced stage when therapeutic options are reduced, and the prognosis is much worse. Cancer of the oral cavity is 10 times more common in men. Assessment of quality of life should be an indicator of the multidisciplinary treatment success and it should point to areas in which the affected person requires support. AIM OF THE STUDY: To examine the quality of life of patients with oral cavity cancer. MATERIALS AND METHODS: The study was conducted at the Clinic of Maxillofacial Surgery of the Clinical Center University of Sarajevo (CCUS), through a survey on patients with verified oral cavity cancer, questionnaire related to socio-demographic characteristics of the patients and the University of Washington Quality of Life Questionnaire (UW-QOL). The results were included in the database and statistically processed in the SPSS program, 19.0 version for Windows. Afterwards, the results were thoroughly analyzed and documented, presented in absolute numbers and statistical values using statistical indicators in simple and understandable tables and figures. RESULTS: The study results showed that out of the total score of 100, the median value of quality of life of patients with oral cavity cancer, for the physical health component in the definition of quality was M=69.75 ±29.12 and for social-emotional health M=65.11 ± 27.47. CONCLUSION: This could be considered as satisfactory quality of life, in the sphere above half of the rating scale, although both values significantly deviate from the UW-QOL scale norm. Physical and socio-emotional health components are in a strong positive correlation, R2=0.750, p=0.0001.