Background
Croatia and Slovenia were the transit countries on the Balkan route for migrants and refugees from Middle East countries in 2015 and 2016. They had to optimize health care delivery in the special circumstances in refugee camps and transit centres. Little is known about health care provision in border camps where a large number of migrants stay for only couple of hours. Previous studies emphasize that language barriers and cultural differences play a central part in the relationship between health workers and migrants inside the transit zone. The aim of the study was to identify specific characteristics of health care provision experienced by primary healthcare providers in order to prepare solutions on how to organise health care in refugee settings.
Methods
Twelve thematic interviews were conducted in the middle of the most intense migration movements to the North-West Europe between November and December 2015 with health workers from Croatia and Slovenia. Interview transcripts were read, coded, reviewed, and labelled. We used qualitative content analysis.
Results
Four themes about the health service provision for refugees at Schengen border were identified. The circumstance when mutual understanding is poor and the consultation not successful, cultural differences represent a central barrier. Participants highlighted that the importance of respecting human dignity is crucial for the provision of basic medical care for migrants in transit.
Conclusion
Successful overcoming language barriers, respecting cultural differences, humanity, susceptibility to social deprivation and traumatic experiences are the key factors important for organisation of health care in transit centers and camps. This article gives some useful tips for healthcare workers and policy makers who are participating in health services provision for migrants and other refugees. Health workers should be prepared to work in special working conditions with a lack of resources. Their work would require timely planning and reflection on the organization of more transit camps.
Trial registration
Ethical Committee of the Republic of Slovenia approved the study as a project number 112/02/16.
Introduction
Aimed at preparing the basis for planning evidence-based public health measures for preservation/ improvement of nurses’ work ability (WA), the objective was to assess the relationship between WA and sense of coherence (SOC).
Methods
A cross-sectional study was conducted in 2018 among 713 nurses in Croatia. The association between poor WA index (PWAI) and SOC score (SOCS), adjusted for possible confounders, was determined by binary logistic regression analysis.
Results
The results of univariate logistic regression analysis showed a statistically significant negative association between SOCS and PWAI (OR=0.977, 95% CI 0.968 – 0.986, p<0.001). The results of multivariate logistic analysis showed an even stronger statistically significant negative association between SOCS and PWAI (OR=0.966, 95% CI 0.954 – 0.977, p<0.001) when adjusted for confounders.
Conclusions
The present study suggested SOC as an important health promoting resource of nurses which might offer protection regarding work-related stress. Weak SOC could be an important explanatory factor of poor WA. Accordingly, improving SOC by implementing health promotion measures in nurses’ workplace could be an important way to increase the WA among nurses.
AimTo assess the psychometric properties of the Croatian version of a Work Ability Index Questionnaire (WAIQ-CRO) in the population of nurses by using a specific methodological approach.MethodsA cross-sectional survey was conducted in a sample of 711 Croatian nurses in 2018 in Zagreb, Croatia. The instrument’s internal consistency was assessed by using Cronbach’s alpha coefficient (α). The factor structure was verified by confirmatory (CFA) and exploratory factor analysis (EFA), with the assumption of a single-factor structure. To ensure the equality of importance of items in the assessment, the item-specific scores were transformed.ResultsThe internal consistency of the instrument was satisfactory (α=0.71). CFA showed poor first model (Model-1) compatibility data (p<0.001, CFI=0.85, GFI=0.93, RMSEA=0.13). The modificated indexes suggested the introduction of correlation parameters residual variances of results from WAIQ-CRO Item-1 and Item-2. After introducing these covariances, the index model assentation (Model-2) showed desirable assentation measures (p<0.001, CFI=0.95, GFI=0.97, RMSEA=0.08). Comparison showed better compatibility of Model-2 (p<0.001). The implementation of EFA has identified three factors. Replication of this model in CFA resulted in relatively good model assentation approaches with data (p<0.001, CFI=0.96, GFI=0.98, RMSEA=0.07). Comparison of this model (Model-3) with Model-2 showed a significantly better compatibility of Model-3 (p<0.001).ConclusionThe WAIQ-CRO proved to be a reliable and valid instrument which can be used in research among Croatian nurses. The results suggest that it would be better to consider a three-factor structure than a single-factor structure, as a three-factor structure can direct decision-makers to which segment to locate interventions.
studenti slažu se da pacijenti uglavnom imaju pozitivna i podijeljena mišljenja o medicinskim sestrama. Uočena je razlika u odgovorima medicinskih sestara i studenta s obzirom na njihova mišljenja o tome što društvo i liječ-nici misle o medicinskim sestrama. Studenti, za razliku od zaposlenih medicinskih sestara, navode da smatraju da društvo i liječnici imaju pozitivnija mišljenja o sestrama. Dio studenata smatra da društvo ima stereotipna mišljenja o medicinskim sestrama.Rezultati istraživanja ukazuju da na razvoj profesionalnog identiteta i percepcije o sestrinstvu značajan utjecaj imaju mediji, okolina i edukacija. Mišljenja studenata sestrinstva u znatnoj su mjeri usklađena s mišljenjima zaposlenih medicinskih sestara, što može ukazivati na lakše uklapanje na radno mjesto po završetku studija.
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