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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.
RESUMO
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.
