Publications by authors named "Vanja Erčulj"

15 Publications

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How health care professionals confront and solve ethical dilemmas - a tale of two countries: Slovenia and Croatia.

Croat Med J 2021 Apr;62(2):120-129

Ana Borovečki, Andrija Štampar School of Public Health, Rockfellerova 4, 10000 Zagreb, Croatia,

Aim: To assess the differences in the way how Slovenian and Croatian health care professionals (HCPs) confront ethical dilemmas and perceive the role of hospital ethics committees (HECs).

Methods: This cross-sectional, survey-based study involved HCPs from three Slovenian and five Croatian university medical centers (UMC). The final sample sizes were 308 (244 or 79.2% women) for Slovenia and 485 (398 or 82.1% women) for Croatia.

Results: Compared with Croatian physicians, Slovenian physicians reported a higher share of ethical dilemmas regarding waiting periods for diagnostics or treatment, suboptimal working conditions due to interpersonal relationships in the ward, and end-of-life treatment withdrawal, and a lower share regarding access to palliative care and patient information protection. Compared with Croatian nurses, Slovenian nurses reported a lower share of ethical dilemmas regarding the distribution of limited resources, recognizing the patient's best interests, and access to palliative care. Compared with Croatian other HCPs, Slovenian other HCPs reported a lower burden of ethical dilemmas regarding waiting periods for diagnostics or treatment, distribution of limited resources, and access to palliative care. When encountering an ethical dilemma, all HCPs in both countries would first consult their colleagues. Slovenian and Croatian HCPs recognized the importance of the HECs to a similar extent, but viewed their role differently.

Conclusion: Croatian and Slovenian HCPs are confronted with different ethical dilemmas and perceive the role of HECs differently.
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April 2021

Serum hepcidin and ferritin as markers of iron deficiency in premature infants born at less than 32 weeks of gestation: prospective observational study.

Minerva Pediatr (Torino) 2021 Apr 23. Epub 2021 Apr 23.

Neonatology Section, Department of Perinatology, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, Ljubljana, Slovenia.

Background: Preterm infants born at less than 32 weeks of gestation are at higher risk of low total iron stores (iron deficiency). Serum ferritin is used as a valid total iron stores and iron deficiency biomarker, usually as a combination of ferritin and red blood cell counts.

Methods: Serum hepcidin and ferritin values and red blood cell counts were obtained from 37 of 40 included premature infants born at less than 32 weeks of gestation at risk of iron deficiency. The first sample was obtained in the first week of life, and the second at transfer from the Neonatal intensive care unit to the maternity ward, when serum ferritin level below 25 μg/L has been defined as very low total iron stores (iron deficiency).

Results: Ferritin median levels decreased from a median value of 152 μg/L at the first measurement to 54 μg/L at the second measurement. Hepcidin median levels also decreased from 30.1 μg/L to 2.1 μg/L. We found a positive and statistically significant correlation between levels of ferritin and hepcidin at both measurements (r = 0.57; p < 0.001 and r = 0.72; p < 0.001, respectively). Compared to serum hepcidin, ferritin at the first measurement has not statistically significant higher power in predicting children with iron deficiency before discharge from the hospital.

Conclusions: We found a correlation between ferritin and hepcidin levels. Nevertheless, hepcidin does not have a worse power in predicting children with iron deficiency compared to ferritin.
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http://dx.doi.org/10.23736/S2724-5276.21.06264-9DOI Listing
April 2021

The Role of Online Social Support in Patients Undergoing Infertility Treatment - A Comparison of Pregnant and Non-pregnant Members.

Health Commun 2021 Apr 15:1-7. Epub 2021 Apr 15.

Department of Social Informatics and Methodology, Faculty of Social Sciences, University of Ljubljana.

The role of social support in the online setting is explored in this study. For this purpose, the posts of infertility treatment patients participating in an infertility treatment online support group between 2002 and 2016 were retrieved. Members who contributed at least 100 words were divided into two groups according to the treatment outcome they reported (pregnancy). The association between the length of group membership, type of support provided, intensity of interaction, active support seeking, overall sentiment and the amount of sadness, anxiety and anger words and the treatment outcome was examined. The findings suggest that online social, in particular emotional, support acts as a buffer between the stressor and the treatment outcome. The expression of anger and initiating of communication by new members diminish this relationship.
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http://dx.doi.org/10.1080/10410236.2021.1915517DOI Listing
April 2021

Mistreatment by Patients: An Analysis of the Patient-related Social Stressors among Slovenian Healthcare Workers.

Zdr Varst 2021 Jun 18;60(2):90-96. Epub 2021 Mar 18.

University of Maribor, Faculty of Criminal Justice and Security, Mladinska 9, 2000 Maribor, Slovenia.

Introduction: Healthcare workers (HCWs) are often exposed to mistreatment by patients, which has negative effects on both staff and institutions. To take appropriate action to help HCWs in this context, patient-related social stressors (PSS) should be explored. The purpose of the research was to identify the most pronounced patient behaviour contributing to the social stress (SS) of HCWs, and compare PSS between different HCWs and different types of healthcare institutions.

Methods: 750 HCWs from Slovenian public health centres and hospitals participated in the online survey. Although the non-probability sampling was used, the sample was representative according to gender and HCW type (doctors, nurses and other HCWs).

Results: The results show that the most pronounced patient behaviour contributing to the SS of HCWs are attitudes and behaviour of patients that are challenging in terms of what is - from the HCWs' point of view - considered as acceptable and reasonable (disproportionate patient expectations), and unpleasant, humourless, and hostile patients. HCWs in primary institutions meet less verbally aggressive and unpleasant patients than in tertiary ones. Although among all HCWs less educated ones are more exposed to inappropriate behaviour, doctors are those HCWs who experience more inappropriate behaviour.

Conclusion: Managers should enable HCWs to get comprehensive patient service training, oriented towards improving relationship management and patient-HCW relationships.
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http://dx.doi.org/10.2478/sjph-2021-0014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8015656PMC
June 2021

The Impact of Financial and Non-Financial Work Incentives on the Safety Behavior of Heavy Truck Drivers.

Int J Environ Res Public Health 2021 03 9;18(5). Epub 2021 Mar 9.

Faculty of Criminal Justice and Security, University of Maribor, Kotnikova ulica 8, 1000 Ljubljana, Slovenia.

The goal of the research is to determine how compensation affects the safety behavior of truck drivers and consequently the frequency of traffic accidents. For this purpose, a survey was conducted on a sample of 220 truck drivers in international road transport in the EU, where the results of the Structural Equation Model (SEM) show that in the current state of the transport sector, financial and non-financial incentives have a positive impact on the work and safety behavior of drivers. Financial incentives also have an impact on drivers' increased perception of their driving ability, while moving violations continue to have a major impact on the number of accidents. The proposed improvements enable decision-makers at the highest level to adopt legal solutions to help manage the issues that have been affecting the industry from a work, social and safety point of view for the past several years. The results of the research therefore represent an important guideline for improvements to the legislature as well as in the systematization of truck driver compensation within companies.
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http://dx.doi.org/10.3390/ijerph18052759DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7967259PMC
March 2021

Systemic azithromycin as an adjunct to scaling and root planing in patients with stage III/IV periodontitis: 12-month results of a randomized controlled clinical trial.

Clin Oral Investig 2021 Mar 30. Epub 2021 Mar 30.

Department of Oral Medicine and Periodontology, Faculty of Medicine, University of Ljubljana, Hrvatski trg 6, 1000, Ljubljana, Slovenia.

Objectives: To determine whether azithromycin (AZI) as an adjunct to scaling and root planing (SRP), when compared to placebo, decreases the number of sites demonstrating pocket depth (PD) ≥ 5 mm and bleeding on probing (BOP) 12 months post-treatment in stage III/IV periodontitis patients.

Materials And Methods: In a double-blind randomized parallel-arm placebo-controlled trial, 40 stage III/IV periodontitis patients received steps 1 and 2 of periodontal treatment in two sessions within 7 days. Patients then received systemic antibiotic therapy (n = 20; AZI 500 mg/day, 3 days) or placebo (n = 20). Additional instrumentation of residual diseased sites (DS) - sites with PD ≥ 5 mm and BOP - was performed at the 3-, 6- and 9-month follow-ups. The primary outcome variable was the number of DS at the 12-month re-evaluation. Using a multivariate multilevel logistic regression model, the effects of gender, age, antibiotic therapy, presence of Porphyromonas gingivalis or Aggregatibacter actinomycetemcomitans, smoking, tooth being a molar and interdental location were evaluated.

Results: The number of DS after 12 months was similar in the test (median (Me) = 4, interquartile range (IQR) = 0-6) and control (Me = 3, IQR = 1-6.5) groups. Both groups showed substantial but equivalent improvements in periodontal parameters, with no intergroup differences at initially shallow or deep sites. The logistic regression showed a lower odds ratio (OR) for the healing of DS on molars (OR = 0.29; p < 0.001) and in smokers (OR = 0.36; p = 0.048).

Conclusion: Stage III/IV periodontitis patients showed significant but comparable improvements in periodontal parameters and the number of residual DS at the 12-month revaluation regardless of treatment type. This may have been the result of the additional instrumentation received by patients at residual DS in both treatment groups.

Clinical Relevance: Treatment with AZI + SRP provided no additional benefits after 12 months in terms of periodontal parameters or the number of persisting sites with PD ≥ 5 mm + BOP as compared to SRP plus placebo.

Trial Registration: EUDRA-CT: 2015-004306-42; https://www.clinicaltrialsregister.eu/ctr-search/trial/2015-004306-42/SI , registered 17. 12. 2015.
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http://dx.doi.org/10.1007/s00784-021-03906-8DOI Listing
March 2021

The first nationwide study on facing and solving ethical dilemmas among healthcare professionals in Slovenia.

PLoS One 2020 14;15(7):e0235509. Epub 2020 Jul 14.

Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia.

Background: Healthcare professionals (HCPs), patients and families are often faced with ethical dilemmas. The role of healthcare ethics committees (HECs) is to offer support in these situations.

Aim: The primary objective was to study how often HCPs encounter ethical dilemmas. The secondary objective was to identify the main types of ethical dilemmas encountered and how HCPs solve them.

Subjects And Methods: We conducted a cross-sectional, survey-based study among HCPs in 14 Slovenian hospitals. A questionnaire was designed and validated by HCPs who were selected by proportional stratified sampling. Data collection took place between April 2015 and April 2016.

Results: The final sample size was n = 485 (385 or 79.4%, female). The response rates for HCPs working in secondary and tertiary level institutions were 45% and 51%, respectively. Three hundred and forty (70.4%) of 485 HCPs (very) frequently encountered ethical dilemmas. Frequent ethical dilemmas were waiting periods for diagnostics or treatment, suboptimal working conditions due to poor interpersonal relations on the ward, preserving patients' dignity, and relations between HCPs and patients. Physicians and nurses working in secondary level institutions, compared to their colleagues working in tertiary level institutions, more frequently encountered ethical dilemmas with respect to preserving patients' dignity, protecting patients' information, and relations between HCPs and patients. In terms of solutions, all HCPs most frequently discussed ethical dilemmas with co-workers (colleagues), and with the head of the department. According to HCPs, the most important role of HECs is staff education, followed by improving communication, and reviewing difficult ethical cases.

Conclusions: Waiting periods for diagnostics and treatment and suboptimal working conditions due to poor interpersonal relations are considered to be among the most important ethical issues by HCPs in Slovenian hospitals. The most important role of HECs is staff education, improving communication, and reviewing difficult ethical cases.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0235509PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7360038PMC
September 2020

A Cross-sectional Study Among Healthcare and Non-healthcare Students in Slovenia and Croatia About Do-not Resuscitate Decision-making.

Zdr Varst 2019 Sep 26;58(3):139-147. Epub 2019 Jun 26.

University Medical Centre Ljubljana, Division of Obstetrics and Gynecology Department of Perinatology, Neonatal Intensive Care Unit, Šlajmerjeva ulica 3, 1000 Ljubljana, Slovenia.

Objective: To survey university students on their views concerning the respect for autonomy of patients and the best interest of patients in relation to the withholding of resuscitation.

Methods: A cross-sectional survey among university students of medicine, nursing, philosophy, law and theology of the first and the final study years at the University of Ljubljana and the University of Zagreb was conducted during the academic year of 2016/2017. A questionnaire constructed by Janiver et al. presenting clinical case vignettes was used.

Results: The survey response rates for students in Ljubljana and Zagreb were 45.4% (512 students) and 37.9% (812 students), respectively. The results of our research show statistically significant differences in do-not resuscitate decisions in different cases between medical and non-medical students in both countries. Male and religious students in both countries have lower odds of respecting relatives' wishes for the withholding of resuscitation (odds ratio 0.49-0.54; 95% confidence interval). All students agreed that they would first resuscitate children if they had to prioritize among patients.

Conclusions: Our study clearly shows that gender, religious beliefs, and type of study are important factors associated with the decisions pertaining to the respect for autonomy, patient's best interest, and initiation or withholding of resuscitation.
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http://dx.doi.org/10.2478/sjph-2019-0018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6598388PMC
September 2019

Lack of correlation between reduced outpatient consumption of macrolides and macrolide resistance of invasive Streptococcus pneumoniae isolates in Slovenia during 1997-2017.

J Glob Antimicrob Resist 2019 03 1;16:242-248. Epub 2018 Nov 1.

University Medical Centre Ljubljana, Department of Infectious Diseases, Japljeva 2, 1525 Ljubljana, Slovenia.

Objectives: The objective of this study was to investigate the correlation between decreased national consumption of macrolides and resistance of invasive Streptococcus pneumoniae isolates in Slovenia during 1997-2017.

Methods: A total of 4241 invasive S. pneumoniae isolates were collected in Slovenia from 1997 to 2017. The presence of erm(B), mef(E), mef(A) and erm(TR) genes was determined by PCR in 612 erythromycin-resistant isolates. Selected isolates carrying the mef(A) gene were further examined by pulsed-field gel electrophoresis (PFGE). Multilocus sequence typing (MLST) was performed for 161 erythromycin-resistant isolates from 2004 to 2009.

Results: Consumption of macrolides decreased by 42.5% between 1997 and 2017, and by 57.0% from the highest consumption during 1999 to 2017. Resistance of S. pneumoniae increased by 120.7% in the same period, from 5.8% in 1997 to 12.8% in 2017. The most prevalent serotypes among macrolide-resistant isolates were 14 (54.9%), 19A (9.0%), 19F (8.3%), 6B (7.2%), 6A (5.2%) and 9V (19; 3.0%). The most prevalent determinant of macrolide resistance in the observed period was erm(B) (43.0%; 263/612), followed by mef(A) (36.3%; 222/612) and mef(E) (14.9%; 91/612). During the study period, an increasing trend in serotype 14, mef(A)-carrying isolates was observed, with a peak in 2011 (P<0.001); 63/71 isolates (88.7%) with the mef(A) gene were clonally related and were related to the international England-9 clonal cluster.

Conclusions: The reason for the observed increase in macrolide resistance among invasive S. pneumoniae in Slovenia despite decreased macrolide consumption was spread of the England-9 clonal cluster.
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http://dx.doi.org/10.1016/j.jgar.2018.10.022DOI Listing
March 2019

Corporate Volunteering: Relationship to Job Resources and Work Engagement.

Front Psychol 2018 4;9:1884. Epub 2018 Oct 4.

Faculty of Criminal Justice and Security, University of Maribor, Maribor, Slovenia.

Employers are increasingly including volunteer activities in their social responsibility programs. At companies at which this is done in a planned manner, we can speak of the development of a corporate volunteering, which correlates with numerous positive psychological outcomes at both the individual and the organizational level. The aim of the study was to investigate the relationship between the corporate volunteering programs and job characteristics, connected with work engagement. In our study we were interested in identifying the role of the corporate volunteering in the evaluation of job resources and work engagement. The study included 274 employees from 15 Slovenian companies, of whom 62% participate in their organizations' volunteer activities. They filled out the Job demands and resources questionnaire, the Utrecht Work Engagement Scale (UWES-17) and a scale for measuring the corporate volunteering climate. The results indicate that the carrying out of volunteer activities correlates with the perception of the corporate volunteering climate. Employees whose employers implement volunteering programs are more engaged and report higher levels of both autonomy and support from their co-workers and supervisors. Theoretical and practical implications are discussed.
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http://dx.doi.org/10.3389/fpsyg.2018.01884DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6180289PMC
October 2018

Risk factors for bronchiolitis severity: A retrospective review of patients admitted to the university hospital from central region of Slovenia.

Influenza Other Respir Viruses 2018 11 9;12(6):765-771. Epub 2018 Aug 9.

Chair of Pediatrics, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.

Aim: Study's objective was to identify risk factors associated with bronchiolitis severity.

Methods: A retrospective chart review of all children <2 years old diagnosed with bronchiolitis at the University Medical Centre Ljubljana between May 2014 and April 2015, who were treated as outpatients (paediatric emergency department, PED group) or as inpatients in the standard hospital setting (WARD group) or in the paediatric intensive care unit (PICU group). Detection of respiratory viruses in nasopharyngeal swab was accomplished by RT-PCR. Severity was assessed by Wang Respiratory Score and hospitalization longer than 24 hours.

Results: The study included 761 children. The three most frequently detected viruses were respiratory syncytial virus (RSV), human rhinovirus (hRV) and human bocavirus (hBoV) (57.5%, 272/473; 25.6%, 121/473; 18.4%, 87/473). Patient groups differed in Wang Respiratory Score for the severity of bronchiolitis (P < 0.001). No differences regarding the causative viruses were found. There was a lower proportion of children with the presence of more than one virus in PICU group compared to other two groups (P = 0.017). The three groups significantly differed in age, birthweight, comorbidities, bronchodilator treatment and antibiotic usage. However, multiple regression analysis revealed that younger age and the use of antibiotics were associated with bronchiolitis severity defined as hospitalization for >24 hours.

Conclusions: Respiratory syncytial virus, hRV and hBoV were the most frequently detected viruses. The majority of patients admitted to the PICU had only one virus detected. Younger age and the use of antibiotics were associated with bronchiolitis severity.
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http://dx.doi.org/10.1111/irv.12587DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6185887PMC
November 2018

Socio-Economic Characteristics in Notified Erythema Migrans Patients.

Zdr Varst 2015 Dec 25;54(4):267-73. Epub 2015 Sep 25.

RO SIGMA, Topniška 45, 1000 Ljubljana, Slovenia.

Background: Lyme borreliosis disease results from infection by members of the Borrelia burgdorferi sensu lato complex. The most common clinical presentation of Lyme borreliosis is erythema migrans (EM). To gain knowledge of the epidemiological parameters and the risk factors of EM in Slovenia, a survey has been carried out in 2010.

Methods: A short anonymous and self-administrated questionnaire was sent to 4917 notified EM patients in 2010, aiming to collect epidemiological data and assess socio-economic determinants in patients with EM.

Results: Three thousand and five (61%) patients with EM returned completed questionnaires. One thousand and nine hundred twenty-nine (74%) patients noted the tick where the EM developed. The tick bite was most often located on the legs in adults and in the head/neck area in children. The time that elapsed before the tick has been removed increased significantly with age. The attached tick was most frequently overlooked in preschool children. Nearly 70% of patients believed that they contracted the infection with borrelia near home. Infection away from their permanent residence was more often the case in those with a higher level of education and in 15-49 age groups. Compared to the Slovenian general population over 14 years of age, those with a higher level of education, the unemployed and farmers were overrepresented among the EM patients.

Conclusions: The risk of Lyme borreliosis is widespread in Slovenia, with some areas more affected then others. Determinants of exposure to infected ticks are different, and depend on the socio-economic status and demographic characteristics.
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http://dx.doi.org/10.1515/sjph-2015-0035DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4820204PMC
December 2015

Prevention of post-herpetic neuralgia using transcutaneous electrical nerve stimulation.

Wien Klin Wochenschr 2015 May 4;127(9-10):369-74. Epub 2014 Dec 4.

Zdravstveni dom Kranj, Gosposvetska ulica 10, 4000, Kranj, Slovenia,

Background: Post-herpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ) and is difficult to treat. The role of antiviral agents and nonpharmacologic procedures in preventing PHN is not entirely clear. Recent retrospective study showed that transcutaneous electrical nerve stimulation (TENS) may completely prevent PHN. The aim of our study was to identify predictors for PHN and evaluate the treatment with antiviral agents and TENS.

Methods: We conducted a multicenter prospective, randomized intervention study in patients with a new onset of HZ. Immunocompromised patients were excluded. Patients were randomly assigned to four groups (TENS, Antiviral agents, TENS and Antiviral agents, and Control Group). At the inclusion, the following criteria were recorded: age, gender, duration of pain before the onset of the rash, the number of efflorescence, the intensity of pain, and the analgesic prescribed. During the follow-up, we recorded a spontaneous pain sensation, pain intensity, and presence of allodynia, hyperalgesia, or paraesthesia.

Results: With each additional year of age, the odds for the presence of PHN with unchanged values of other predictors increase (odds ratio (OR) = 1.03 [1.01; 1.05], p = 0.001). The same is true for the initial intensity of the pain (OR = 1.25 [1.09; 1.43], p = 0.002). The odds for acute and subacute herpetic neuralgia are greater than for PHN. The odds for subacute herpetic neuralgia are the lowest in the group treated with TENS (OR = 0.15 [0.05; 0.47], p = 0.001).

Conclusions: PHN cannot be completely prevented. TENS as a single therapy was found the most successful among the tested treatments in reducing the incidence of subacute herpetic neuralgia.
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http://dx.doi.org/10.1007/s00508-014-0669-3DOI Listing
May 2015

Early detection of influenza like illness through medication sales.

Cent Eur J Public Health 2012 Jun;20(2):156-62

Centre for Communicable Diseases, National Institute of Public Health, Ljubljana, Slovenia.

Monitoring sales of medications is a potential candidate for an early signal of a seasonal influenza epidemic. To test this theory, the data from a traditional, consultation-oriented influenza surveillance system were compared to medication sales and a predictive model was developed. Weekly influenza-like incidence rates from the National Influenza Sentinel Surveillance System were compared to sales of seven groups of medications (nasal decongestants, medicines for sore throat (MST), antitussives, mucolytics, analgo-antipyretics, non-steroidal anti-inflamatory drugs (NSAIDs), betalactam antibiotics, and macrolide antibiotics) to determine the correlation of medication sales with the sentinel surveillance system - and therefore their predictive power. Poisson regression and regression tree approaches were used in the statistical analyses. The fact that NSAIDs do not exhibit any seasonality and that prescription of antibiotics requires a visit to the doctor's office makes the two medication groups inappropriate for predictive purposes. The influenza-like illness (ILI) curve is the best matched by the mucolytics and antitussives sales curves. Distinct seasonality is also observed with MST and decongestants. The model including these four medication groups performed best in prediction of ILI incidence rate using the Poisson regression model. Sales of antitussives proved to be the best single predictive variable for regression tree model. Sales of medication groups included in the model were demonstrated to have a predictive potential for early detection of influenza season. The quantitative information on medication sales proves to be a useful supplementary system, complementing the traditional consultation-oriented surveillance system.
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http://dx.doi.org/10.21101/cejph.a3735DOI Listing
June 2012

Knowledge and attitudes on pandemic and seasonal influenza vaccination among Slovenian physicians and dentists.

Eur J Public Health 2013 Feb 24;23(1):92-7. Epub 2012 Feb 24.

Centre for Communicable Diseases, National Institute of Public Health, Ljubljana, Slovenia.

Background: The aim of our study was to determine vaccination coverage among Slovenian physicians and dentists and assess their knowledge and attitudes regarding the pandemic and seasonal influenza vaccine.

Methods: In February 2010, an anonymous, self-administered questionnaire was developed and sent to all practising physicians and dentists in Slovenia.

Results: Out of 7092 physicians/dentists, 1718 (24%) completed the questionnaire and 41.7% of the respondents were vaccinated against pandemic and seasonal influenza, while 58.3% of the study participants decided not to adhere to the recommendation: 15.6% received the pandemic vaccine only, 10.1% the seasonal vaccine only and 32.4% were not vaccinated at all. Acceptance of the pandemic and seasonal influenza vaccine was determined by higher age, being an internal medical trainee or specialist, working in a hospital, performing any kind of vaccination and having a chronic disease. Unvaccinated participants were more often working in out-patient clinics, were without a specialty, were dentists and were not performing any vaccinations. Those who declined vaccination believed that they did not need to be vaccinated, had safety concerns and were afraid of side effects. Physicians/dentists vaccinated against pandemic and seasonal influenza had better knowledge and a more positive attitude towards the issue compared with their non-vaccinated colleagues.

Conclusions: Education on the efficacy and safety of vaccines should be one of the priority public health measures taken to improve knowledge and eliminate misconceptions and attitudinal barriers regarding immunization in physicians and dentists.
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http://dx.doi.org/10.1093/eurpub/cks006DOI Listing
February 2013