<p><strong>Objective. </strong>To investigate the level and causes of stress and the risk of onset of burnout syndrome among physicians employed at the Primary Health Care Centre, Banja Luka.</p><p><strong>Subjects and Methods. </strong>Between March 1, 2018, and May 31, 2018 all physicians from the Primary Health Care Centre, Banja Luka were offered the following questionnaires to fill in: a socio-demographic questionnaire, a questionnaire for self-assessment of the level of stress and the Maslach Burnout Inventory for assessment of the risk of burnout syndrome. <strong>Results. </strong>Out of 211 physicians, 85.8% were female. A high level of stress was found in 77.7% of the subjects. Older doctors had higher levels of emotional exhaustion compared to younger doctors with a shorter length of service (r=0.236, P=0.01). Emotional exhaustion was significantly correlated with a high level of depersonalization, a low level of personal accomplishment and a high level of stress (r=0.380, r=-0.174 and r=0.574, P=0.01, P=0.04 and P&lt;0.01, respectively). Depersonalization correlated with a low level of personal accomplishment and stress (r=-0.347 and r=0.283, P&lt;0.01 and P=0.01, respectively), while the level of personal accomplishment was in a negative correlation with stress (r=-0.281, P=0.01). A high stress level was associated with a high degree of emotional exhaustion (OR 56.543; 95% CI 11.35-213.09; P&lt;0.001) as well as lack of personal accomplishment (OR 0.155; 95% CI 0.04-0.50; P=0.003).</p><p><strong>Conclusion. </strong>A high level of stress was associated with older age, female gender, as well as with a high degree of emotional exhaustion and a lack of personal accomplishment. Preventive measures are warranted.</p>

Introduction: Elderly persons have higher risk for falls, compared to younger population. Although no single risk factor causes all falls, a great deal of risk factors to which an individual is exposed, i.e. osteoporosis, lack of physical activity, impaired vision, usage of drugs, living settings etc, can be treated.Objective: To investigate the risk for falls in elderly patients treated in Family medicine teaching center (ECPM), Primary Health Care Center Banja Luka.Method: This prospective study was conducted in June 2012. The study included 150 patients aged 65 years and older. Patients were chosen randomly. In study were included patients who have visited their family doctors on every of Mondays in June 2012. The Tinetti Gait and Balance Instrument was used to asses the risk for falls. Patients were examined to asses gait and balance according to Tinetti questionnaire, and supplementary questionnaire was created to record data about age, sex, chronic diseases and drugs that patients take.Results: The study included 91 (60.7%) female and 59 (39.3%) male patients. The average age of patients was 74.71 years. 77 (51.3%) were aged 65 to 75 years and 73 (48.7%) were more than 75 years old. Results of Tinetti Gait and Balance Instrument showed that the risk for falls was high in 55 (36.7%), moderate in 31 (20.7%) and low in 64 (42.7%) patients.Conclusion: Approximately, one third of investigated patients had high risk for falls, what indicates that family doctors should be more involved in fall prevention in elderly and in constant educating of older adults and their families.

AbstractThe work of physicians in primary health care is essential in prevention and early detection of health risk factors. To determine the incidence of depression among patients in family medicine clinics, as well as the correlation between depression, risk factors and NCDs, and to determine correlation between depression (PHQ-9 score) and the level of physical activity. The pilot study was conducted from January to March 2010 on 100 patients using the Patient Health Questionnaire (PHQ-9) and the International Physical Activity Questionnaire (IPAQ). The family doctor randomly interviewed and measured patients’ weight, height, blood pressure, fasting blood glucose and cholesterol and noted the presence of earlier diagnosed non-communicable diseases. The data for 92 patients were processed according to PHQ-9 and IPAQ guidelines. Out of 92 patients, 59 (64,1%) had PHQ-9 score ≤ 4 which suggests the absence of depression. The PHQ-9 score median was within normal limits, therefore, treatment was not required and there was no difference in PHQ-9 score median between patients with respect to age and sex. The level of physical activity was moderate in 39,1%, heavy in 35,9% and walking as physical activity in 25,0% of patients. Correlation coefficient between PHQ-9 score and MET score (r=−0,241) was statistically significant (p<0,05), as well as between PHQ -9 score and anxiety (r=0,27; p<0,01). Most studies show a correlation between depression and physical activity. It is essential to promote physical activity in order to prevent anxiety, depression and non-communicable diseases.

<p><strong>Objective</strong>. The aim of our study was to investigate the predictors of morbidity (age, gender, smoking habits, obesity and the presence of chronic diseases) and COVID-19 outcomes.</p><p><strong>Subjects and Methods</strong>. The research was an observational descriptive study, conducted at The Family Medicine Education Center, The Primary Health Care Center, Banja Luka, in the period from 26th June to 31st December 2020. During the research period, seven family medicine teams followed their patients with COVID-19, and recorded possible predictors for morbidity and their influence on the disease outcome.</p><p><strong>Results</strong>. The study included 934 patients, 46.90% of whom were male. The majority of subjects were non-smokers and overweight. Diabetes was found in 5.57% patients, hypertension in 29.44%, chronic respiratory diseases in 5.25%, cancer in 4.39% patients. In the observed sample, 29.23% subjects contracted pneumonia, 18.52% were hospitalized, while 19 (2.03%) patients with severe clinical features had a fatal outcome. Multivariable regression analysis showed a high risk of pneumonia in male patients [OR=2.45, 95% CI (1.73-3.46)], elderly [OR= 1.07, 95% CI (1.06-1.09)] and obese patients with Body Mass Index ≥30.0 kg/m2 [OR=2.55, 95% CI (1.73-3.77)]. Male gender [OR=2.19, 95% CI (1.11-4.31)], older age [OR=1.08, 95% CI (1.05-1.11)] and hypertension [OR=2.51, 95% CI (1.06-5.91)] were the most important predictors for the development of severe clinical features in COVID 19. The statistically significant predictors of mortality were male gender [OR=7.16, 95% CI (1.56-32.86)] and older age [OR=1.12, 95% CI (1.06-1.18].</p><p><strong> Conclusion</strong>. Being familiar with the predictors of morbidity and poor outcome in COVID-19 is helpful for carrying out preventive measures, early diagnosis and treatment of risk groups of patients.</p>

Lack of physical activity is associated with the causes of illness, death and incapacitation. To determine the level of physical activity and the presence of depression, and level of correlation between physical activity and the appearance of depression in patients. In clinic family medicine, with pilot study, in the first half of 2010 years, through the Interview with 141 patients, completed the questionnaires: International Physical Activity Questionnaire (IPAQ) and Patient Health Questionnaire (PHQ-9). The data were processed according to the instructions for questionnaires for PHQ-9 and IPAQ. The tested patients were aged 18-69 years, median 44 years (± 14.3). Of the total number of respondents 104 (73.76%) had values of PHQ-9 score ≤ 4. The largest number of respondents during the week 73 (51.77%) had moderate 23 (16.31%) low and 45 (31.91%), vigorous physical activity. Low levels of physical activity is present in people with depression PHQ-9 score of ≥ 5, which require treatment, as compared to subjects whose PHQ-9 score for depression ≤ 4 but no statistically significant difference p>0.05 (χ²=2.477; df=2). With increasing physical activity in patients with PHQ-9 score ≤ 4, increases are the value of the correlation is R2 = 0.85. And vice versa in patients whose PHQ-9 score above 5, with increasing PHQ-9 score reduces the variables for physical activity (R2 = 0.90). Moderate physical activity is associated with a reduction of depression. Physical activity in all age groups is essential for the promotion of health.