Ognjen Brborović

Psychiatric disorders and aggression in the printed media: is there a link? a central European perspective

BackgroundA content analysis was used to describe the association between psychiatric disorders and aggression in the printed media in the Czech Republic and Slovakia.MethodsArticles were chosen from the most widely read daily newspapers and magazines in both countries during five one-week periods in 2007. A coding manual was developed and a content analysis was performed. Aggressive behavior was assessed by two separate categories - the role of the mentally ill person in the violent act (perpetrator/victim) and the type of aggressive act (homicide, suicide).ResultsA total of 375 articles were analyzed. Main findings: 1) The proportion of articles depicting psychiatric disorders together with either self- or other-directed aggressive behavior is 31.2%; 2) Homicide was most frequently mentioned in the context of psychotic disorders and schizophrenia, while affective disorders were most frequently associated with both completed suicides and homicides; 3) Eating disorders and anxiety disorders were seldom associated with any kind of aggressive behavior, including self-harm; 4) The vast majority of articles presented mentally ill people as perpetrators, and these articles were more often coded as stigmatizing. 5) Articles with aggressive behavior mentioned on the cover are roughly as frequent as those with aggressive behavior in the later sections of the media (36.7% vs. 30.7%).ConclusionsThe results are similar to the findings in countries with longer histories of consistent advocacy for improved depiction of mental illness in the media. However, we have shown that persons with mental illness are still over-portrayed as perpetrators of violent crimes, especially homicides.

Development of a Croatian version of the US Hospital Survey on Patient Safety Culture questionnaire: dimensionality and psychometric properties

Background The Hospital Survey on Patient Safety Culture (HSOPSC), originally developed in the USA, is used worldwide to assess patient safety culture in hospitals. A limited number of studies have provided data on psychometric properties outside of the US healthcare system. Our aim was to determine if all 12 dimensions of the US HSOPSC were applicable, valid and reliable to Croatian healthcare workers. Methods The study was conducted from September 2010 to April 2011. Questions were translated into Croatian and then translated back into English. The questionnaires (ie, the Croatian translation of the US HSOPSC) were distributed in unmarked envelopes along with a consent form to all the doctors and nurses in four Croatian hospitals. The responses were analysed using explorative factor analyses, reliability testing, and confirmatory factor analyses. Results The study included 561 healthcare workers in four Croatian hospitals—a response rate of 32.69%. Our results are similar to the original US sample, but with some differences: 11 dimensions with acceptable reliability scores were identified by exploratory factor analysis compared with the original 12 in the US sample; five of 12 dimensions had a Cronbachs α higher than 0.7, suggesting a reasonable fit to the original US HSOPSC; the dimensions ‘Staffing’ and ‘Organisational learning—continuous improvement’ were found to have a Cronbachs α <0.6. The use of confirmatory factor analysis confirmed a good fit to the original US model. Conclusions Results show that the Croatian translation of the US HSOPSC is compatible in 11 of the original 12 dimensions. Results suggest that for the purposes of research in Croatia, the dimensions ‘Staffing’, ‘Communication openness’, and ‘Organisational learning—continuous improvement’ should be revised. For example, the use of question A7 (‘We use more agency/temporary staff than is best for patient care’) in the context of European healthcare systems should be adapted or removed for the Croatian version of the US HSOPSC questionnaire.

Are nurse presenteeism and patient safety culture associated: a cross-sectional study

Abstract Working as a nurse involves great dedication and sacrifice: working night shifts, working overtime, and coming to work sick. The last is also known as presenteeism. Research has shown that poor nurse performance can affect both caregiver’s and patient’s safety. The aim of this cross-sectional study was to investigate whether nurse presenteeism affected patient safety culture and to look deeper into the characteristics of nurse presenteeism and patient safety culture in Croatia. The study was conducted in one general hospital in Croatia over April and May 2012 and specifically targeted medical nurses as one of the largest groups of healthcare professionals. They were asked to fill two questionnaires: the six-item Stanford Presenteeism Scale (SPS-6) and the Hospital Survey on Patient Safety Culture (HSOPSC). We found no association between presenteeism and patient safety culture. Overall positive perception of safety was our sample’s strength, but other dimensions were positively rated by less than 65 % of participants. The lowest positive response concerned “nonpunitive response to error”, which is consistent with previous studies. Presenteeist nurses did not differ in their characteristics from nurses without presenteeism (gender, age, years of experience, working hours, contact with patients and patient safety grades). Our future research will have to include a broader healthcare population for us to be able to identify weak spots and suggest improvements toward high-quality and cost-effective health care. Sažetak Zanimanje medicinske sestre uključuje veliku predanost i požrtvovnost: medicinske sestre rade noćne smjene, rade prekovremeno i dolaze na posao i kada su bolesne. Naziv za ovu zadnju pojavu je prezentizam. Neka su istraživanja pokazala da smanjena radna sposobnost medicinskih sestara zbog bolesti može ugroziti sigurnost pružatelja zdravstvene usluge i bolesnika. Cilj ovog presječnog istraživanja bio je ispitati obilježja prezentizma i kulture bolesničke sigurnosti u medicinskih sestara u Hrvatskoj te utječe li njihov prezentizam na kulturu bolesničke sigurnosti. Istraživanje je provedeno u jednoj općoj bolnici u Hrvatskoj tijekom travnja i svibnja 2012., i bilo je posebno ciljano prema medicinskim sestrama s obzirom na to da čine jednu od najvećih skupina zdravstvenih djelatnika. Ispitanici su zamoljeni da ispune dva upitnika: Stanfordsku ljestvicu prezentizma (SPS-6) i Upitnik o kulturi bolesničke sigurnosti u bolnici (HSOPSC). Nije nađena povezanost između prezentizma i kulture bolesničke sigurnosti. Najveći broj pozitivnih odgovora imala je dimenzija “Opća percepcija bolesničke sigurnosti”; ostale dimenzije imale su pozitivne odgovore ispod 65 %. Najmanji broj pozitivnih ocjena imala je dimenzija “Nekažnjavajući pristup neželjenom događaju”, što je u skladu s prethodnim istraživanjima. U pogledu spola, dobi, godina iskustva, radnih sati, kontakata s bolesnicima i njihove sigurnosti, medicinske sestre s prezentizmom nisu se nimalo razlikovale od medicinskih sestara bez prezentizma.

Development of the PICMIN (picture of mental illness in newspapers): instrument to assess mental illness stigma in print media

PurposeThe aim of this paper is to report on the development and applicability of a standardised and objective measure of stigma of mental illness in print media. Picture of mental illness in newspapers (PICMIN) instrument consists of eleven descriptive and five analytical categories. It is intended to allow comparison among countries and different studies over time.MethodsThe research team conducted a three-phase study to develop the instrument based on the principles of content analysis and test its inter-coder reliability (ICR). In the first phase, keyword search and ICR assessment was performed on articles from Croatia (75), Czech Republic (203), and Slovakia (172). The second phase consisted of instrument revision and training, along with ICR reassessment on 40 articles from USA and UK. In the third, main phase articles from Croatia (238), Czech Republic (226), and Slovakia (158) were analysed with the final version of the PICMIN instrument.ResultsAcross three countries, ICR was found acceptable to assess mental illness representations related to stigma in print media. Print media representations of the mental illness in Croatia, Czech Republic, and Slovakia significantly differed in the type of media distribution, whether headline of the article was positioned on the media cover, in the use of a sensationalistic style of writing, in the association of aggressive behaviour with persons with mental illness and in the distribution of the global impression of the headline.ConclusionsPICMIN instrument allows comparison among countries and different studies over time.

Evaluation of Croatian model of polycentric health planning and decision making.

OBJECTIVE To determine the progress in the development and implementation of health policies on a county level resulting from the learning-by-doing training provided through the County Public Health Capacity Building Program started in 2001 in Croatia. METHODS Modular training using management tools, public health theory and practice, and SMDPs Healthy Plan-it tool, followed by the self-evaluation of the progress made by county teams in health needs assessment and health policy development, implementation, and assurance. Fifteen county teams consisting of politicians, executive officers, public health professionals, and community members. RESULTS Twelve of 15 county teams completed the program. The teams made progress in the evaluated areas, although to a different extent, which did not depend on the amount of time they had or the governance experience. The differences in improvement depended on the differences in the strength of political, executive, and professional components of the teams. Teams with a strong political and/or executive component, but weak public health professional and community components made major improvements in policy development and/or assurance function, but performed less well in the health needs assessment and constituency building. The reversed was also true. CONCLUSION Learning-by-doing training program improved public health practices on a county level in Croatia.

Public health capacity building in southeastern europe: a partnership between the open society institute and the us centers for disease control and prevention

The political disintegration of former Yugoslavia inaugurated in 1991 resulted in the decentralization of health systems in the federations successor nation-states. Efforts by the Open Society Institute improved public health planning and management needs consequent to health sector changes. Beginning in Croatia in 2001, the Institute developed ongoing collaborations between Andrija Stampar School of Public Health and the US Centers for Disease Control and Prevention. In 2003 and 2004, it expanded its project to include the republics of Macedonia and of Serbia and Montenegro.

Antecedents and associations of sickness presenteeism and sickness absenteeism in nurses: A systematic review

AIMS This study comprehensively analysed and systemized the elements associated with nursing sickness presenteeism (SP) and sickness absenteeism (SA). BACKGROUND Both behaviours represent a real challenge to nursing departments because they can increase costs, cause health care adverse events, and impact the quality of health care. DESIGN The systematic review of cohort studies was designed to be consistent with the PRISMA guidelines. DATA SOURCES PubMed, ProQuest, and Emerald were systematically searched for peer-reviewed articles published from the 1950s to December 2016. REVIEW METHODS Cohort studies were included (12 SA and 1 SP) in the review if they examined the association between one or more exposures and SP and/or SA in nurses. The methodological quality of the included studies was assessed using the Newcastle-Ottawa Scale. RESULTS Twenty-three antecedents were associated with SA and grouped as work and organizational, mental and physical health, and demographic; 3 antecedents were associated with SP (job demands, burnout, and exhaustion). Exhaustion (fatigue) and job demands were associated with SA and SP. Depersonalization was an outcome of SP over time. CONCLUSION The ability to predict presenteeism and absenteeism in nursing is useful to constrain costs and ensure that quality care is delivered.

Patient safety culture shapes presenteeism and absenteeism: a cross-sectional study among Croatian healthcare workers

Abstract Healthcare workers have high rates of injuries and illnesses at the workplace, and both their absence from work due to illness (absenteeism) or working ill (presenteeism) can compromise patient safety and the quality of health care delivered. Following this premise, we wanted to determine whether presenteeism and absenteeism were associated with patient safety culture (PSC) and in what way. Our sample consisted of 595 Croatian healthcare workers (150 physicians and 445 nurses) who answered the short-form WHO Health and Work Performance Questionnaire and the Hospital Survey on Patient Safety Culture. The results have confirmed the association with both presenteeism and absenteeism in several PSC dimensions, but not as we expected based on the premise from which we started. Opposite to our expectations, lower job performance (as a measure of presenteeism) was associated with higher PSC instead of lower PSC. Absenteeism, in turn, was associated with lower PSC, just as we expected. These findings suggest that it is the PSC that shapes presenteeist and absenteeist behaviour and not the other way around. High PSC leads to presenteeism, and low PSC to absenteeism. We also believe that the presenteeism questionnaires should be adjusted to health care and better define what lower performance means both quantitatively and qualitatively in a hospital setting

2442 – How media influence stigma towards psychiatric disorders

Media are considered to be the publics primary source of information regarding mental illness. Evidence suggests that media representations of people with psychiatric disorders are frequently negative and contribute to their stigmatization. On the other hand, media can play an important role in reducing this stigmatisation by providing adequate information about this topic. An example of an use of a standardised and objective measurement of the stigma of mental illness in print media using clearly operationalized definitions will be shawn. The Picture of Mental Illness in newspapers (PICMIN) instrument is based on the principles of content analysis and used in an analysis of the coverage on mental health/illness issues in Czech, Croatian, and Slovak print media. Some of the most interesting findings based on the analysis include; a similarly high level of stigmatizing articles across countries, clearly exceeding the ones with destigmatizing statements; overrepresentation of schizophrenia and eating disorders and underrepresentation of anxiety disorders and dementia when comparing the correlation of their actual rate in the populations; the proportion of articles depicting mental disorders together with aggressive deeds being as high as onethird of all articles; homicide being most frequently mentioned in the context of psychotic disorders, while affective disorders being most frequently associated with completed suicides, etc. As the influences of the media and the stigma of psychiatric disorders are heterogeneous, activities that should tighten the mental health together with media professionals should be initiated in an ultimate effort to improve media coverage of mental illness issues.

PW01-203 - Predictors of stigmatizing and destigmatizing articles on mental illness in the printed media: a central European perspective

Objectives Many studies describing print media representations of mental illnesses have showed that these depictions are frequently negative and contribute to consequent stigmatization of people with mental illness. The main objective of this international study was to identify predictors of stigmatizing and nonstigmatizing articles on mental illness in Czech Republic, Croatia and Slovakia. Methods The study sample comprised all articles pertaining to the topic of mental illness (N=450) chosen from 6 most widely read newspapers and magazines identified during five weeklong periods in 2007. The presence of stigmatization and destigmatization statements was coded and articles were grouped in positive, neutral, mixed and negative clusters. Negative/positive ratio (NPR) was used to assess the predictor value of different features of the article regarding stigmatization. Results 61.8% of articles contained some stigmatizing statements towards persons with mental illness. The highest NPR was found in articles published in tabloids (6.8), on the front page (3.7) and in the articles where psychotic disorder was mentioned (7.4) and mentally ill person figured as a source of information (1.8). Lowest NPR was found in magazines (0.6), articles in later sections (1.7) that mentioned eating disorders (0.3) and scientific surveys (0.1). Conclusions There is a high level of stigmatizing statements in the studied articles. As the strongest predictors of stigmatizing content we have identified articles that are published in tabloids and articles with reference to psychosis. Contrary to this, eating disorders had the least stigmatizing depiction as well as articles containing scientific data.