Aleksandra Jovic-Vranes

Functional health literacy among primary health-care patients: data from the Belgrade pilot study

BACKGROUND Over the last decade, health literacy has become a vibrant area of research. Our objective was to evaluate health literacy and its association with socio-demographic variables, self-perception of health and the presence of chronic conditions in primary health-care patients. METHODS A cross-sectional study among 120 patients was conducted in two primary health-care centers. The test of functional health literacy in adults, a 50-item reading comprehension and 17-item numerical ability test (score, 0-100) were administered. Chi-square test and logistic regression analyses were applied. RESULTS Inadequate and marginal health literacy existed in 43 participants (41.0%), and adequate health literacy was present in 62 participants (59.0%). Functional health literacy was significantly different by location, gender, age, marital status, employment, education, material status, self-perception of health and presence of chronic conditions. Based on the multivariate analysis, health literacy was significantly associated with the participants age (odds ratio [OR], 4.86; 95% confidence interval [CI], 2.41-9.80; P = 0.000), level of education (OR, 4.48; 95% CI, 1.73-11.57; P = 0.002) and chronic conditions (OR, 1.90; 95% CI, 1.16-3.11; P = 0.010). CONCLUSION These results provide evidence that limitations in functional health literacy are widespread among primary health-care patients and encourage efforts for further monitoring. Low health literacy may impair a patients understanding of health messages and limit their ability to attend to their medical problems.

Safety Practice and Professional Exposure to Blood and Blood-Containing Materials in Serbian Health Care Workers

Safety Practice and Professional Exposure to Blood and Blood‐Containing Materials in Serbian Health Care Workers: Aleksandra Jovic‐Vranes, et al. Institute of Social Medicine, Medical School University of Belgrade, Servia and Montenegro—Safety practice is an important element of workplace safety and quality of health care. To investigate the safety practice and professional exposure to blood and blood‐containing materials during a one‐year period among Health Care Workers (HCWs) in Serbia. Cross‐sectional study of 1559 Serbian HCWs using a self‐administered questionnaire. Mantel‐Haenszel statistics and multiple logistic regression analysis were used in statistical analysis. Fifty‐nine percent (921) of HCWs had skin contact with patients blood, followed by 51% (791) with needle stick injuries, 38% (599) with cuts from sharp instruments, and 34% with contact of eye and other mucosa with patients blood. Nurses reported professional exposure more often than others. Safety practices consisted of using appropriate barriers (gloves, mask, glasses) in all procedures with patients and were used by 58%, 23%, and 4% of HCWs, respectively. Doctors protected themselves more regularly than others. Hospital protocols for post exposure prophylaxis and safety disposal of medical waste are not common in Serbian health care settings. Safety practices in use were having hospital guidelines for safety practice in hospitals [odds ratio (OR)=1.58, 95% confidence interval (CI)=1.14–2.19], carrying out some form of intervention with risks of infection (OR=3.76, 95% CI=2.57–5.51), and HCWs aware of the professional risk of acquiring infection (OR=1.48, 95% CI=1.28–1.79). This study indicates that emphasis on work practice, attire, disposal systems and education strategies, should be employed to reduce professional exposure to blood and blood containing materials among HCWs in Serbia.

Health literacy in a population of primary health-care patients in Belgrade, Serbia

ObjectiveOur objective was to evaluate the health literacy and its association with sociodemographic variables, the self-perception of health and the presence of chronic conditions in primary health-care patients.MethodsA cluster survey was conducted. A total of 1,500 patients were enrolled. Functional health literacy was measured by the Serbian version of the Short Test of Functional Health Literacy in Adults. Chi-square testing and multilevel logistic regression analyses were applied.ResultsWe found that health literacy was inadequate and marginal in 436 (32%) and 195 participants (14.4%), respectively, and adequate in 730 participants (53.6%). A better health literacy score was present among the following participants: younger, employed, and those with a high level of education, a good self-perception of health, a good socioeconomic status and no chronic conditions. If, on multilevel analysis, the primary health center and individual variables were included, the probability for adequate health literacy was higher among younger, employed, higher educated and those with no chronic conditions.ConclusionsPrimary health-care patients do not have the literacy skills necessary to function adequately in the health-care environment.

Evaluation of a health literacy screening tool in primary care patients: evidence from Serbia

Improving health literacy skills is important for patient comprehension of health-related topics and their ability to attend to their medical problems. Promoting health literacy is a pivotal policy for maintaining and promoting health. The objective of the present study was to translate the Test of Functional Health Literacy in Adults (TOFHLA; long and short versions) into Serbian and evaluate the translated and cross-culturally adapted questionnaires in Serbian primary care patients. The translated TOFHLA questionnaires were administered to 120 patients. Additionally, a self-completed questionnaire was used. Both descriptive and inferential statistics were measured. The mean score for the TOFHLA was 73.49 (median, 78; SD = 17.94; range, 0-100) and the mean score for the Short Test of Functional Health Literacy in Adults (STOFHLA) was 29.28 (median, 32; SD = 6.16; range, 0-36). Sex, age, education, self-perceived health and presence of any chronic disease were associated with health literacy scores. The internal consistency (Cronbachs alpha) was 0.73 for the TOFHLA numeracy subset, 0.95 for reading comprehension, 0.94 for the TOFHLA and 0.90 for the STOFHLA. The Pearson correlation between the TOFHLA and STOFHLA was 0.89. The area under the curve of these two tests was 0.79 (95% CI, 0.602-0.817). The Serbian translated versions of the TOHFLA questionnaires offer valid measures of functional health literacy. There were no differences between the reliability and validity of the short and long TOFHLA forms.

Education for public health in Europe and its global outreach

Introduction At the present time, higher education institutions dealing with education for public health in Europe and beyond are faced with a complex and comprehensive task of responding to global health challenges. Review Literature reviews in public health and global health and exploration of internet presentations of regional and global organisations dealing with education for public health were the main methods employed in the work presented in this paper. Higher academic institutions are searching for appropriate strategies in competences-based education, which will increase the global attractiveness of their academic programmes and courses for continuous professional development. Academic professionals are taking advantage of blended learning and new web technologies. In Europe and beyond they are opening up debates about the scope of public health and global health. Nevertheless, global health is bringing revitalisation of public health education, which is recognised as one of the core components by many other academic institutions involved in global health work. More than ever, higher academic institutions for public health are recognising the importance of institutional partnerships with various organisations and efficient modes of cooperation in regional and global networks. Networking in a global setting is bringing new opportunities, but also opening debates about global harmonisation of competence-based education to achieve functional knowledge, increase mobility of public health professionals, better employability and affordable performance. Conclusions As public health opportunities and threats are increasingly global, higher education institutions in Europe and in other regions have to look beyond national boundaries and participate in networks for education, research and practice.Introduction At the present time, higher education institutions dealing with education for public health in Europe and beyond are faced with a complex and comprehensive task of responding to global health challenges. Review Literature reviews in public health and global health and exploration of internet presentations of regional and global organisations dealing with education for public health were the main methods employed in the work presented in this paper. Higher academic institutions are searching for appropriate strategies in competences-based education, which will increase the global attractiveness of their academic programmes and courses for continuous professional development. Academic professionals are taking advantage of blended learning and new web technologies. In Europe and beyond they are opening up debates about the scope of public health and global health. Nevertheless, global health is bringing revitalisation of public health education, which is recognised as one of the core components by many other academic institutions involved in global health work. More than ever, higher academic institutions for public health are recognising the importance of institutional partnerships with various organisations and efficient modes of cooperation in regional and global networks. Networking in a global setting is bringing new opportunities, but also opening debates about global harmonisation of competence-based education to achieve functional knowledge, increase mobility of public health professionals, better employability and affordable performance. Conclusions As public health opportunities and threats are increasingly global, higher education institutions in Europe and in other regions have to look beyond national boundaries and participate in networks for education, research and practice.

Which women patients have better health literacy in Serbia

OBJECTIVE To evaluate health literacy among female primary care patients and the possible factors which contribute to better health literacy. METHODS A cross-sectional study was conducted among 824 female primary health care patients. Functional health literacy was measured by the Serbian version of the Short Test of Functional Health Literacy in Adults (STOFHLA). Chi-square testing and logistic regression analyses were applied. RESULTS We found that inadequate or marginal health literacy was present in 363 participants (44.1%) and adequate health literacy was present in 461 participants (55.9%). Functional health literacy was significantly different by age, marital status, employment, education, material status, self-perception of health, and health status. Based on multivariate analysis, health literacy was significantly associated with participant age, employment status, level of education, and perception of health. CONCLUSION Better health literacy existed among younger, employed participants with a higher education and better self-perception of health. PRACTICE IMPLICATIONS Strengthening the knowledge and evidence base for measuring and assessing health literacy are action points for health strategies to decrease the ill effects of low health literacy.

Job satisfaction in Serbian health care workers who work with disabled patients

The study was undertaken to assess job satisfaction among health care workers (HCWs) who work with disabled patients and to identify the factors that contribute to their job satisfaction. This was a cross-sectional study conducted at nine rehabilitation centers in Serbia. The study sample consisted of doctors, nurses, physiotherapists, and other HCWs (social workers, work and speech therapists, and psychologists). A self-administrated questionnaire was distributed to 170 HCWs. Chi square testing and multivariate logistic regression analyses were applied. The response rate was 97.1% (165/170). Overall job satisfaction was reported by 22.4% of the respondents and was associated with hospital politics (odds ratio [OR], 4.16; 95% confidence interval [CI], 1.13–15.30], personal relationships (OR, 13.96; 95% CI, 4.07–47.92) and the feeling of being able to provide a good quality of care (OR, 5.24; 95% CI, 1.62–16.99). Profession, age, and gender did not affect job satisfaction. In conclusion, the results show very low job satisfaction among HCWs. Improving contributing factors may lead to higher job satisfaction and a better quality of health care.

Adolescent substance abuse, the importance of family, school and peers: data from the health behaviour in school children

Summary.Objectives: To determine the possible factors associated with adolescent substance use in a country having recently experienced war.Methods: The survey applied the World Health Organization research protocol for cross-national survey – HBSC: a cross-sectional study among 1540 15-year old adolescents in Belgrade was conducted. The research instrument was a self-administered questionnaire.Results: Substance abuse is associated with living in a single parent family, living in a family without support, having a poor commitment to school, displaying aggressive behaviour, and spending a lot of time with friends.Conclusions: Factors associated with adolescent substance use include social background, family, school and peers. Such associations could help to focus on better measures to eliminate or reduce the risk of substance use.Zusammenfassung.Missbrauch von Substanzen bei Jugendlichen, Bedeutung von Familie, Schule und peers: Angaben aus BelgradFragestellung: Ziel der Forschung ist, Faktoren zu bestimmen, die für den Substanzmissbrauch bei Jugendlichen mitverantwortlich sind.Methoden: Die Forschung ist ein Teil des Projektes „Gesundheitliches Verhalten bei Schulkindern“, das gemäss dem Protokoll der WHO für internationale komparative Studien, bei 1540 Jugendlichen in Belgrad durchgeführt wurde. Es wurde ein Fragebogen benutzt, der von den Befragten selbst ausgefüllt wurde. Die Ergebnisse sind mit Methoden der deskriptiven Statistik analysiert worden, d.h. mittels Chi2-Tests sowie der logistischen Regression.Ergebnisse: Die Ergebnisse deuten darauf hin, dass der Substanzmissbrauch mit folgenden Faktoren in Zusammenhang steht: „Leben in einer Familie mit nur einem Elternteil“, „Leben in einer Familie ohne Unterstützung“, „einem sehr niedrigen Engagement für die Schule“, „leichter Kommunikation mit Freunden des anderen Geschlechts“, „mit agressivem Verhalten“ sowie „dem Verbringen eines grossen Teils seiner Freizeit mit den Gleichaltrigen“.Schlussfolgerung: Es besteht ein Zusammenhang zwischen dem Substanzenmissbrauch bei Jugendlichen und den verschiedenen sozialen Verhältnissen wie Familie, Schule und Gleichaltrige. Die Erkennung dieses Zusammenhangs wird uns die Fokussierung auf die Massnahmen ermöglichen, die den Expositionseffekt zum Risiko beseitigen, reduzieren oder auf irgendeine Weise schwächer machen können.Résumé.L’abus de substances chez les adolescents l’importance de la famille, de l’école et des pairs (Health Behaviour in School Children – Belgrade)Objectifs: Déterminer les facteurs pouvant provoquer un abus de substances chez les adolescents dans un pays ayant souffert récemment de la guerre.Méthodes: Le projet Health Behaviour in School Children a été réalisé parmi 1540 adolescents à Belgrade selon le protocole de l’OMS, avec un questionnaire auto-administré.Résultats: L’abus de substances est en lien avec la présence d’une structure familiale monoparentale ou avec l’absence de soutien familial, avec un comportement agressif, avec un investissement scolaire limité de même qu’avec le temps passé auprès des pairs.Conclusions: Les facteurs en lien avec l’abus de substances chez les adolescents à Belgrade sont d’origine sociale comme par exemple la famille, l’école, les pairs. La mise en évidence de ces facteurs pourrait contribuer à améliorer les mesures prises pour éliminer ou réduire le risque d’abus de substances.

Self-perceived health and psychological well-being among Serbian schoolchildren and adolescents: data from National Health Survey

The purpose was to determinate possible factors associated with psychosocial health through self-perceived health and psychological well-being among Serbian schoolchildren and adolescents. A cross-sectional study. The study is based on the 2006 National Health Survey of the population of Serbia. A total of 2,721 schoolchildren and adolescents were included. Face-to-face questionnaire and self-administered questionnaire were used for collection of data. For the assessment of psychosocial health we created two indicators (varibles): Self perceived health (using the categorical principal components), and Psychological well-being (using reliability analisys). Data were analyzed using descriptive statistics, Pearson’s correlation coeficient and categorical regression. Self-perceived health was found to have a positive association with gender, age, objective and subjective socioeconomic status. Psychological well-being was associated with gender, age, social support, objective and subjective socioeconomic status. Age group was strongly associated with self-perceived health and psychological well-being. Older respondents and female perceived their health to be better than others. Male and respondents in age group 7–11 had higher levels of psychological well-being. Results show that both demographic and socioeconomic variables have an important influence on schoolchildren and adolescent self-perceived health and psychological well-being.

Knowledge, attitudes and practices towards blood-borne pathogens in healthcare workers in Banja Luka, Bosnia and Herzegovina

Exposure to blood borne pathogens poses a serious risk to healthcare workers (HCWs). This study was undertaken to investigate knowledge, attitudes and practices among HCWs towards blood borne pathogens. We carried out a cross sectional KAP (Knowledge, Attitudes and Practice) study, using self-administered questionnaire. The study population consisted of 127(23.6%) physicians, and 410 (76.4%) nurses and laboratory technicians. Factor analysis and conditional multiple logistic regression were used in statistical analysis. We found that the knowledge of the epidemiological characteristics of blood-borne infection, the risk of acquisition and available preventative measures among HCWs is insufficient. Doctors were more knowledgeable about the transmissibility of blood borne pathogens regarding sexual transmission after percutaneous exposure (odds ratio) OR=2.71; 95% (confidence interval) CI=1.51–4.84, OR=2.45; 95% CI=1.21–4.96), respectively. Nurses reported professional exposure to patient’s blood more often than doctors (OR=0.90; 95% CI=0.84–0.96). Negative attitudes towards HIV positive patients were also noted. Less than half of HCWs used appropriate barriers (gloves, mask, and glasses) to protect them regularly. The compulsory preventive measures implied by the results of this study are continuous education, immunization against Hepatitis B, implementing Standard Precautions, as well as the development of written guidelines on the prevention of blood-borne infections.