RESUMEN
AIM: The Covid-19 pandemic may be associated with an increase in mental disorders and mental distress. However, there are no representative studies testing the impact of stressors directly related to Covid-19. We aimed to determine whether Covid-19-related stressors were associated with mental disorders, depressive and anxiety symptoms in the second year of the pandemic. METHOD: This cross-sectional observational epidemiological survey was conducted from June to October 2021. We interviewed a representative sample of the adult population in Serbia (18-65 years) in the second year of the pandemic, at a time when large parts of the population had been affected by the pandemic in different ways. A multistage probabilistic household sampling of the adult population in 60 municipalities was used. Mental disorders were assessed by in-person interviews using the Mini International Neuropsychiatric Interview. Depressive and anxiety symptoms were measured by PHQ-9 and GAD-7 scales. Covid-19-related stressors (Sars-CoV-2 infection, the infection of a close relative, self-isolation and lack of protective equipment at work), as well as other stressors during the pandemic (not directly related to the risk of the infection), were measured. The associations with mental disorders, depressive and anxiety symptoms were explored through univariable and multivariable regression analyses. RESULTS: In total, 1203 individuals (mean age 43.7 ± 13.6 years, 48.7% male) were interviewed. Most respondents (67.8%) of the sample had already experienced Covid-19-related stressors (20.1% had Sars-CoV-2 infection; 43.2% had a close relative member who had Covid-19; 28.2% reported lack of appropriate protection; 27.5% had been quarantined) and about 50% had already been vaccinated. The prevalence of any mental disorder was 15.2% (95% CI 13.2-17.2): mood disorders 4.6%, anxiety disorders 4.3% and substance use disorders 8.0%. Mean PHQ-9 was 3.2 ± 3.8 and GAD-7 was 2.1 ± 3.1. In this study, one Covid-19 stressor, i.e. lack of protective equipment, was weakly associated with a greater frequency of anxiety disorders (p = 0.023), while the other stressors had significant associations with several groups of mental disorders and symptom levels. CONCLUSIONS: Our study did not provide any evidence that the prevalence of mental disorders exceeds the range of pre-pandemic data reported in the literature. Covid-related stressors, although frequently reported, did not dramatically influence the prevalence of mental disorders. The provision of the appropriate equipment at workplaces might lead to the reduction of anxiety disorders.
Asunto(s)
COVID-19 , Trastorno Depresivo , Trastornos Mentales , Adulto , Ansiedad/epidemiología , COVID-19/epidemiología , Estudios Transversales , Depresión/epidemiología , Trastorno Depresivo/epidemiología , Femenino , Humanos , Masculino , Trastornos Mentales/epidemiología , Persona de Mediana Edad , Pandemias , SARS-CoV-2 , Serbia/epidemiología , Encuestas y CuestionariosRESUMEN
OBJECTIVES: Previous research has shown that the COVID-19 Stress Scale (CSS), a measure assessing various dimensions of distress related to the COVID-19 pandemic, is associated with self-protective behaviours; however, it remains unknown whether this distress can be used to predict attitudes towards vaccination. The purpose of this study was to validate the Serbian CSS (Serbian-CSS) and to explore its predictive power over and above certain sociodemographic characteristics, individual difference variables (attitudes and personality) and general distress in relation to COVID-19 vaccine acceptance. STUDY DESIGN: An online cross-sectional study was conducted that targeted users of different social network groups at the beginning of the public COVID-19 vaccination programme in Serbia. METHODS: A large, online study sample (N = 3129) provided self-reported data on COVID-19-related distress, health and sociodemographic indicators, individual difference variables and attitudes towards vaccination. RESULTS: The Serbian-CSS is a valid and reliable instrument that assesses six dimensions of COVID-19 distress. The strongest predictors of vaccine acceptance were attitudes towards immigrants (adjusted odds ratio [AOR] = 0.36, 95% confidence interval [CI] 0.31, 0.41), followed by education (AOR = 1.51, 95% CI 1.27, 1.88) and prepandemic mental health issues (AOR = 1.61, 95% CI 1.30, 2.01). CONCLUSIONS: The level of distress measured by the CSS had a non-substantial contribution to vaccine acceptance, which is probably because of the mild level of distress that was observed at the time of assessment. Public health messaging that relies on the distribution of information is not sufficient to address strongly held beliefs against vaccination. The study provides a benchmark for future cross-cultural research regarding negative affective states associated with the COVID-19 pandemic.
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COVID-19 , Vacunas , Actitud , COVID-19/epidemiología , COVID-19/prevención & control , Vacunas contra la COVID-19/uso terapéutico , Estudios Transversales , Humanos , Pandemias , SARS-CoV-2 , Autoinforme , Serbia/epidemiología , VacunaciónRESUMEN
OBJECTIVES: Physical activity level decreases during young adulthood. As social media are nowadays widely used and are included into many people's daily routines, the interventions on these websites have the possibilities to be integrated into those routines without becoming a burden. The aim of this study was to assess physical activity level among first- and fifth-year medical students and social media intervention with the aim to improve physical activity among them. STUDY DESIGN: Prospective longitudinal study was conducted during October of 2016 at the Faculty of Medicine, University of Belgrade, Serbia. The study included 375 first- and fifth-year students. METHODS: At the baseline, students filled in the questionnaire and were asked to join a Facebook discussion group. The intervention consisted of motivation for physical activity through motivational pictures, texts, and discussions. The second assessment was carried out after one month. Based on the reported physical activity level, students were divided into groups: sufficient (>600 metabolic equivalent [MET]-minutes/week) and insufficient physical activity (≤600 MET-minutes/week). RESULTS: Total of 85.4% of students were sufficiently active at the baseline, whereas 90.4% were sufficiently active after one month. Multivariate logistic regression analysis showed that students who were part of the Facebook group (odds ratio [OR]: 3.51, 95% confidence interval [CI]: 1.46-8.43) and students who had sufficient physical activity at the baseline (OR: 5.44, 95% CI: 2.44-12.13) had a higher likelihood to be sufficiently active after one month. CONCLUSION: Social media are shown to be valuable in health-promoting interventions and can be used for interventions targeting lifestyle change among young adults.
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Ejercicio Físico/psicología , Promoción de la Salud/métodos , Medios de Comunicación Sociales , Estudiantes de Medicina/psicología , Femenino , Humanos , Estudios Longitudinales , Masculino , Motivación , Evaluación de Programas y Proyectos de Salud , Estudios Prospectivos , Serbia , Estudiantes de Medicina/estadística & datos numéricos , Encuestas y Cuestionarios , Adulto JovenRESUMEN
OBJECTIVE: The objective was to analyze possible inequalities by gender in the utilization of health services (general practitioner [GP] and hospital), among people with non-communicable diseases (NCDs) in the Republic of Serbia, with special reference to multimorbidity. In addition, we examined the prevalence patterns of NCDs by sociodemographic characteristics of the population. STUDY DESIGN: This study is a population-based, cross-sectional survey. METHODS: A secondary analysis from the 2013 Serbian National Health Survey included 13,765 adults aged ≥20 years. Multivariable logistic and linear regression analyses were performed to assess the association between NCDs and health care utilization. RESULTS: Multimorbidity was present in 30.2% of the total sample. An increased number of NCDs was associated with a higher utilization of both primary (odds ratio [OR] for having any GP visit is 3.17 in males and 3.14 in females; unstandardized coefficient [B] for number of GP visits is 0.33 for both gender) and secondary health care services (OR for having any hospitalization is 2.45 in males and 1.97 in females; B for number of overnight stays in hospital is 1.62 in males and 0.97 in females) in Serbia. CONCLUSIONS: Our study provided strong evidence that an increased number of NCDs was significantly associated with a higher utilization of health care services in Serbia. There is a need for wise, decisive, and integrated care interventions for effective management of NCDs and their risk factors. Further research is necessary with special emphasis on the role of the health system in satisfying needs of such patients.
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Disparidades en Atención de Salud , Multimorbilidad , Enfermedades no Transmisibles/epidemiología , Enfermedades no Transmisibles/terapia , Aceptación de la Atención de Salud/estadística & datos numéricos , Adulto , Anciano , Estudios Transversales , Femenino , Encuestas de Atención de la Salud , Humanos , Masculino , Persona de Mediana Edad , Serbia , Factores Sexuales , Adulto JovenRESUMEN
BACKGROUND: In times of austerity, the availability of econometric health knowledge assists policy-makers in understanding and balancing health expenditure with health care plans within fiscal constraints. The objective of this study is to explore whether the health workforce supply of the public health care sector, population number, and utilization of inpatient care significantly contribute to total health expenditure. METHODS: The dependent variable is the total health expenditure (THE) in Serbia from the years 2003 to 2011. The independent variables are the number of health workers employed in the public health care sector, population number, and inpatient care discharges per 100 population. The statistical analyses include the quadratic interpolation method, natural logarithm and differentiation, and multiple linear regression analyses. The level of significance is set at P < 0.05. RESULTS: The regression model captures 90 % of all variations of observed dependent variables (adjusted R square), and the model is significant (P < 0.001). Total health expenditure increased by 1.21 standard deviations, with an increase in health workforce growth rate by 1 standard deviation. Furthermore, this rate decreased by 1.12 standard deviations, with an increase in (negative) population growth rate by 1 standard deviation. Finally, the growth rate increased by 0.38 standard deviation, with an increase of the growth rate of inpatient care discharges per 100 population by 1 standard deviation (P < 0.001). CONCLUSIONS: Study results demonstrate that the government has been making an effort to control strongly health budget growth. Exploring causality relationships between health expenditure and health workforce is important for countries that are trying to consolidate their public health finances and achieve universal health coverage at the same time.
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Atención a la Salud , Gastos en Salud , Personal de Salud/economía , Fuerza Laboral en Salud/economía , Sector Público , Atención a la Salud/economía , Gobierno , Sector de Atención de Salud , Hospitalización/economía , Humanos , SerbiaRESUMEN
PURPOSE OF THE STUDY: The prevalence of vitamin D deficiency in pediatric populations is high. In the present study we analyzed associations between vitamin D therapy and pain, mobility, fatigue, and daily functioning in children with musculoskeletal/orthopedic conditions suffering from chronic and recurrent pain, but also diagnosed with vitamin D deficiency. MATERIAL AND METHODS: Children with different musculoskeletal/orthopedic conditions and vitamin D deficiency were prescribed to receive vitamin D over 6 months. Thirty-five children (18 males; age 10.48 ± 3.87 years) completed a 6-month follow-up. Self- and parent/proxy rating scales were used to evaluate pain, movement, fatigue, and daily functioning. RESULTS: At a six-month follow-up assessment involving child- and parent-reported scores, worst pain intensity significantly decreased (p ≤ 0.03) after vitamin D therapy, as well as functioning problems related to pain (p ≤ 0.01). The children reported better movement and balance with less fatigue. The parents reported better functioning in everyday activities of their children. CONCLUSION: This pilot study showed that vitamin D therapy possibly reduces pain intensity and improves mobility and daily functioning in children with musculoskeletal/orthopedic disorders, chronic recurrent pain, and vitamin D deficiency. Further follow-up and randomized studies are required in order to assess the validity of clinical recommendations.
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Dolor Musculoesquelético/diagnóstico , Dolor Musculoesquelético/tratamiento farmacológico , Dimensión del Dolor/efectos de los fármacos , Deficiencia de Vitamina D/diagnóstico , Deficiencia de Vitamina D/tratamiento farmacológico , Vitamina D/uso terapéutico , Adolescente , Niño , Fatiga/tratamiento farmacológico , Femenino , Estudios de Seguimiento , Humanos , Masculino , Enfermedades Musculoesqueléticas/diagnóstico , Enfermedades Musculoesqueléticas/tratamiento farmacológico , Dolor Musculoesquelético/sangre , Proyectos Piloto , Prevalencia , Vitamina D/análogos & derivados , Vitamina D/sangre , Deficiencia de Vitamina D/sangreRESUMEN
BACKGROUND: In a country with a poor economy and limited job opportunities, the outmigration of students is not commonly perceived as a problem but rather is perceived as a solution to the high unemployment facing young health professionals. OBJECTIVES: Study objectives were to identify the prevalence of intention to work abroad of nursing graduates to point to the predictors of intention to work abroad and predictors of having a firm plan to work in a foreign country. DESIGN: Descriptive study, a survey. SETTINGS: College and specialist nursing schools, Serbia. PARTICIPANTS: 719 nursing graduates from the 2012/2013 school year. METHODS: Voluntarily completed a questionnaire that was designed with regard to similar surveys administered in EU-candidate countries during the pre-accession period. Data were analysed with descriptive and multivariate regression analyses. RESULTS: Almost 70% (501) of respondents indicated an intention to work abroad. Of the nurses, 13% already had established a firm plan to work abroad. Single graduates and those with a friend or relative living abroad were more likely to consider working abroad than were their counterparts (odds ratios were 2.3 and 1.7, respectively). The likelihood of considering working abroad decreased by 29% when the individuals' financial situation was improved. Factors associated with having a firm plan were previous professional experience in a foreign country, having someone abroad and financial improvement (5.4 times, 4.8 times and 2 times greater likelihood, respectively). CONCLUSIONS: The high prevalence of intention to work abroad suggests the need to place the issue of the out-migration of nursing graduates on the policy agenda. College and specialty nursing graduates and health technicians are prepared to work abroad in search of a better quality of life, better working conditions and higher salaries.