Majda Pahor

STRESS BURDEN IN WOMEN IN REPRODUCTIVE AGE IN SLOVENIA – SOME CAUSES AND CONSEQUENCES

Background Stress is one of basic risk factors influencing different health states, including reproductive health of women. The study was aimed at measuring the level of stress in different groups of women in order to identify high-risk groups for stress and relate them to birth rate dynamics in Slovenia. Methods The data originate from the national health behaviour database in adults aged 25–64. Data collected in 2001 were used. The sample size was 15,379. Among them there were 4,942 women in reproductive age (25–49 years). The response rate of the mailed questionnaire in this group was 68 %, with 3,181 questionnaires being eligible for analysis. Binary multiple logistic regression was used to determine the impact of age, education, type of work, marital status, self-assessed social class, and type of residence community on the prevalence of frequent perception of stress. Results The overall prevalence of frequent perception of stress was 29.7 %. The highest odds ratios (OR) for stress were registered in women in age group 40–44 (OR 40–44 vs 25–29 = 1.35, p = 0.048), with the lowest (OR uncompleted primary vs primary = 1.73, p = 0.038) and the highest education levels (OR college vs primary = 1.76, p = 0.008; OR university vs primary = 1.80, p = 0.006), employed in industry as heavy workers (OR heavy workers in industry vs housekeepers/students = 1.76, p = 0.010), divorced (OR divorced vs consensual union = 1.72, p = 0.013), self-classified in the lowest social classes (OR lower vs upper-middle = 3.25, p < 0.001; OR labour vs upper-middle = 1.57, p = 0.011); and residents of suburban communities (OR suburban vs rural = 1.27, p = 0.029). Conclusions Public health activities to reduce stress burden among women in reproductive age in Slovenia (e.g. changes of legislation, changes of workplace behaviour) should be focused on women with lowest education and of lowest social class, especially working in heavy industry, and on employed women with highest education.

The role of non-governmental organizations in the mental health area: differences in understanding.

Abstract Introduction The contribution’s aim is highlighting the differences in understanding non-governmental organizations’ (NGOs) role in the mental health area within the public support network for patients with mental health problems from various viewpoints, in order to achieve progress in supporting patients with mental health problems in local communities. Methods Qualitative data gathered as a part of a cross-sectional study of NGOs in the support network for patients with mental health problems in two Slovenian health regions (56 local communities), carried out in 2013 and 2014, were used. Qualitative analysis of interviews, focus groups and answers to an open survey question was performed. Results There are differences in understanding NGOs’ role in the support network for patients with mental health problems, which stem from the roles of stakeholders (local community officials, experts, care providers, and patients) within this system and their experience. Discussion and conclusion The actual differences need to be addressed and overcome in order to provide integrated community care. The importance of knowing the current state of NGOs in their life cycle and the socio-chronological context of the local community support network is evident.

User involvement in Slovenian healthcare

PURPOSE The purpose of this paper is to report on current developments in user involvement in healthcare in Slovenia and to explore the issue from the macro-, mezzo- and micro-levels. DESIGN/METHODOLOGY/APPROACH User involvement is first contextualised within history of the organisation of healthcare system, from its socialist past through to its post-transitional developments. Second, user involvement is tracked through an analysis of healthcare policies and legislation as well as at its institutional and organisational levels. Finally, user involvement practices are illustrated from the perspective of individual patients. A descriptive and exploratory case study design was employed, including a literature review, document analysis and qualitative thematic analysis of nine in-depth and four semi-structured interviews. FINDINGS The findings reveal a complex and at times ambivalent picture in which user involvement is still not firmly embedded into the healthcare system, despite being generally accepted. ORIGINALITY/VALUE No systematic qualitative research of patient involvement in Slovenia has previously been published. This research will establish a basis for further investigations of the topic.

Rhetorical skills as a component of midwifery care

OBJECTIVE this article argues that rhetorical skills are an important quality factor of midwifery care. In particular, it aims to identify and discuss the relevance of three classical means of persuasion: ethos, pathos and logos. DESIGN secondary analysis, rhetorical analysis of semi-structured interviews. SETTING Slovenia. Interviews were carried out predominantly in 2006. Data refer to childbirths in 2005 and 2006. PARTICIPANTS four women with recent experience of childbirth. FINDINGS analysis identified the presence of all three means of persuasion in the interaction between midwives and women. Focusing on midwives, the quality of their awareness and command of rhetorical skills remains questionable. In particular, women experienced lack of a rational account of the situation and decisions made by health-care professionals involved in maternity care. KEY CONCLUSIONS acknowledging professional ethics, awareness and good command of all three means of persuasion [but above all, argumentative persuasion (logos)] is an integral component of midwifery care. It can contribute to collaborative relations between midwives and women, and thus promote women-centred midwifery care. IMPLICATIONS FOR PRACTICE knowledge of the three classical rhetorical means of persuasion should be integrated into professional midwifery curricula.

Focus Group in Community Mental Health Research: Need for Adaption

The article presents an analysis of the use of focus groups in researching community mental health users, starting with the reasons for using them, their implementation in mental health service users’ research, and the adaptations of focus group use when researching the experiences of users. Based on personal research experience and a review of scientific publications in the Google Scholar, Web of Science, ProQuest, EBSCOhost, and Scopus databases, 20 articles published between 2010 and 2016 were selected for targeted content analysis. A checklist for reporting on the use of focus groups with community mental health service users, aiming to improve the comparability, verifiability and validity was developed. Adaptations of the implementation of focus groups in relation to participants’ characteristics were suggested. Focus groups are not only useful as a scientific research technique, but also for ensuring service users’ participation in decision-making in community mental health and evaluating the quality of the mental health system and services .

Double Vulnerability: Older Women and Health in Slovenia

Demographic trends in Slovenia follow the same pattern as in other developed countries: for the last twenty years they have showed birth rates decreased by almost 50 per cent, and a constantly increasing number of older citizens (Jakos, 2002). At the moment, there are 14.6 % of people above 65 (Selb-Semerl et al, 2004) and according to a demographic projection, it is expected that older people will represent approximately 16.5 % of the total population in 2020 (Jakos, 1999). This trend is reported to be on the rapid increase – in the year 2040 the calculations for Slovenia predict 30% of the population to be older people than 65 years of age (Hvalic Touzery, 2005). With respect to gender there is a noticeable misbalance especially in the oldest old stage of life, the majority of the old people being women.