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Introduction: Family history (FH) is an important part of the patients' medical history during preventive management at model family medicine practices (MFMP). It currently includes a one (or two) generational inquiry, predominately in terms of cardiovascular diseases, arterial hypertension, and diabetes, but not of other diseases with a probable genetic aetiology. Beside family history, no application-based algorithm is available to determine the risk level for specific chronic diseases in Slovenia. Methods: A web application-based algorithm aimed at determining the risk level for selected monogenic and polygenic diseases will be developed. The data will be collected in MFMP; approximately 40 overall with a sample including healthy preventive examination attendees (approximately 1,000). Demographic data, a threegenerational FH, a medical history of acquired and congenital risk factors for the selected diseases, and other important clinical factors will be documented. Results: The results will be validated by a clinical genetic approach based on family pedigrees and the nextgeneration genetic sequencing method. After the risk of genetic diseases in the Slovenian population has been determined, clinical pathways for acting according to the assessed risk level will be prepared. Conclusion: By means of a public health tool providing an assessment of family predisposition, a contribution to the effective identification of people at increased risk of the selected monogenic and polygenic diseases is expected, lessening a significant public health burden.

Introduction: Therapeutic alliance is a term most commonly associated with psychotherapeutic treatment, but recently its use has become increasingly significant in the other fields of medicine. An increasing amount of evidence implies that the quality of the therapeutic alliance between the doctor and patient substantially affects treatment outcomes. A European consensus chose the Working Alliance Inventory - Short Revised (WAI-SR) scale as the most efficient for European primary care. This paper presents the process of establishing the semantic and cultural equivalence of the two WAI-SR scales in Slovene. Method: As a part of a larger international project, a group of four experts translated the two WAI SR scales (physician and patient versions) from English into Slovene. Twenty-six Slovenian family medicine doctors participated in the process of obtaining semantic, idiomatic, experiential and conceptual equivalence in translation using a Delphi consensus procedure. Afterward, a cultural equivalence was made to adapt the translations within the national context. Results: Agreement on translation was achieved after two Delphi rounds. The back-translation and cultural equivalence were accomplished without major problems, with some minor additional linguistic corrections. Conclusion: A Slovene version of the WAI-SR scale was successfully adapted and is available for further scale validation and research on therapeutic alliance.

Background: Burnout is usually defined as a prolonged response to chronic emotional and interpersonal stressors, characterrized by emotional exhaustion, depersonalization and lack of social accomplishment. Coping mechanisms and job satisfaction are associated with the incidence of burnout symptoms in a work context. Subjects and methods: The aim of this paper was to make a systematic analysis of the literature related to nurses’ stress and the incidence of burnout syndrome in intensive care nurses, and also to determine the research into associations between coping mechanisms and job satisfaction on one side, and burnout on the other side. Appropriate databases (Scopus, PubMed) were searched with the aim of finding relevant studies and articles published in the last 15 years. The keywords were burnout, coping mechanisms, job satisfaction, nurses, and intensive care. Two independent reviewers carried out a selection of the studies. Results: The literature review found 786 studies about burnout and its association with different variables. Twenty-nine original research papers were discovered in this review process. Open questions still remain concerning burnout and the associations between the considered variables. We also found that studies using a qualitative approach, which could provide better insight into the investigation of burnout, was insufficient in this area. Conclusion: Burnout syndrome is serious problem for healthcare systems and affects almost all profiles of healthcare workers. Although burnout is an evidence-based public health problem, there is still no systematic approach to prevention. Prevention activities to reduce stress and the incidence of burnout should be provided for nurses, especially those in very demanding posts.

Background: Study aimed to assess the burnout prevalence and level of empathic attitude in family medicine doctors (FMDs) and its associations with demographic factors, working conditions and physician health, using the Jefferson Scale of Empathy % Health Professional version (JSE-HP). Methods: Slovenian FMDs (n=316, response rate 56%) completed an online socio-demographic questionnaire, with questions on working conditions, physician health, and the Slovenian versions of the Maslach Burnout Inventory (MBI) and the JSE-HP. Univariate and multivariate analyses were used, applying linear regression to calculate associations between demographic variables, factors of empathy and burnout dimensions, P

Introduction: Medically unexplained symptoms (MUS) are very common in family medicine, despite being a poorly-defined clinical entity. This study aimed to evaluate the effect of an educational intervention (EI) on self-rated quality of life, treatment satisfaction, and the family physician-patient relationship in patients with MUS. Methods: In a multi-centre longitudinal intervention study, which was performed between 2012 and 2014, patients were asked to rate their quality of life, assess their depression, anxiety, stress and somatisation, complete the Hypochondriasis Index, the Medical Interview Satisfaction Scale and the Patient Enablement Instrument for assessing the physician-patient relationship, before and after the EI. Results: The mean values before and after the intervention showed that after the EI, patients with MUS gave a lower (total) mean rating of their health issues and a higher rating of their quality of life, and they also had a more positive opinion of their relationship with the physician (p

Background: Burnout as a distinct work-related syndrome is established by the combination of high scores for emotional exhaustion (EE) and depersonalisation(D), and a low score for personal accomplishment (PA). The aim of the study was to assess the prevalence of burnout among Slovenian family medicine trainees and the influence of the socio-demographic characteristics on burnout assessment. Methods: The study included 127 family medicine trainees in a modular part of the residency in the study year 2008/09. A self-administered questionnaire addressed the socio-demographic variables (age, gender, marital status, and years of practice and labour details - number of patients per day, number of night shifts per month) the second part consisted of the Slovenian version of the Maslach Burnout Inventory. Results: The responses were received from 117 trainees (92 % response rate). In terms of burnout, 45.9 % respondents scored high for EE, 43.1 % for high D, and 45.9 % for low P, with 18.3 % scoring high burnout in all three dimensions, 27.5 % in two dimensions, 24.8 % in one dimension and only 29.4% id not score high for burnout in any dimension at al. A high EE wassignificantly associated with frequent work in the emergency unit (four times per month) and age a higher D was associated only with frequent work inthe emergency unit (four times per month), whereas a low PA was not associated with any of the variables studied. Conclusions: The prevalence of burnout syndrome among family medicine trainees is high and consistent with data from other studies among the physicians worldwide using the same instrument. Family medicine trainees are at risk of burnout regardless of their demographic characteristics. Increased workload affects EE and D. Izhodišča: Izgorelost je sindrom, ki je vezan na delovno okolje. Najbolj so mu izpostavljeni tisti poklici, ki se ukvarjajo z dejavnostmi, s katerimi pomagajo ljudem. O izgorelosti govorimo ob visoki čustveni izčrpanosti in visoki depersonalizaciji ter nizki osebni izpolnitvi. Z raziskavo smo želeli ugotoviti prevalenco izgorelosti med specializanti družinske medicine v Sloveniji in opredeliti povezavo med izgorelostjo in socialno-demografskimi spremenljivkami ter delovnimi obremenitvami. Metode: V raziskavo je bilo vključenih 127 specializantov družinske medicine, ki so v študijskem letu 2008/09 opravljali modularni del specializacije iz družinske medicine. Vprašalnik je vključeval vprašanja o socialno-demografskih spremenljivkah (spol, starost, zakonski stan, delovna doba, delovni pogoji ter obremenitve) ter slovensko različico vprašalnika izgorelosti MBI po Maslachovi, s katerim merimo vse tri dimenzije izgorelosti. Rezultati: Od 127 razdeljenih vprašalnikov smo dobili 117 vrnjenih (92 % odziv). Med specializanti družinske medicine jih je bilo 45,9 % visoko čustveno izčrpanih, pri 43,1 % smo zasledili visoko depersonalizacijo, pri 45,9 % pa nizko osebno izpolnitev. Visoko izgorelih v vseh treh dimenzijah je bilo 18,3 % specializantov, v dveh dimenzijah 27,5 %, v eni dimenziji 24,8 %, le 29,4 % pa ni bilo izgorelih v nobeni od treh dimenzij. Na visoko čustveno izčrpanost je statistično pomembno vplivalo pogosto (tedensko) dežurstvo in višja starost zdravnika. Na visoko depersonalizacijo je statistično pomembno vplivalo le pogosto (tedensko) dežurstvo. Nismo ugotovili statistično pomembnih vplivov na nizko osebno izpolnitev. Zaključki: Prevalenca izgorelosti med specializanti družinske medicine v Sloveniji je visoka in primerljiva s prevalenco izgorelosti v različnih tujih študijah med zdravniki. Specializanti družinske medicine so ne glede na demografske značilnosti dovzetni za pojav izgorelosti.

Introduction: Trust is crucial in forming a good relationship between a patient and a doctor, where both persons believe that they are benevolent, competent and willing to act in their best interest. This research examines factors associated with patient trust in their general practitioner (GP). Method: Every third patient at the General Practice in Pernica was asked to participate in a voluntary, anonymous survey. 464 questionnaires (92.8 % response rate) were filled in. The questionnaire consisted of patient demographic data, the Trust in Physician Scale (Cronbach alpha = 0.795), and the Humanistic Behaviours Questionnaire (Cronbach alpha = 0.965). The research sample was described with frequency and percentage distribution, average values and standard deviation. Factor analysis was implemented. Using linear regression modelling, the connection between patient demographic data, patient health status and patient's cooperation with the GP, along with factors describing trust in physician, was analysed. Factors of physician behaviour were included in the linear regression as independent variables. Results: Positive past experience with the GP (beta = 0.20, p < 0.001), greater care and involvement in treatment (beta = 0.28, p < 0.001), and greater benevolence (beta = 0.32, p < 0.001) were positively correlated with the competence of the GP. A lower degree of benevolence (beta = -0.28, p < 0.001) was associated with greater distrust. Discussion: Physician behavior was statistically associated with patient trust. With appropriate interventions we could improve patients' trust in their physician and thus influence a better treatment outcome, continuity of care, better cooperation and most importantly, patient satisfaction.

Background: In addition to clinical knowledge, communication skills and sovereign decision making, a good doctor is also expected to posses professional values, including the ability to establish empathic relationships with patients. The purpose of the study was to identify the reasons that lead students to choose the study of dental medicine/medicine, and determine the level of emphaty in relation to the choice of study in the first year students of the Faculty of Medicine in Ljubljana. Methods: For the needs of the research we developed a questionnaire, which included basic data on students, their reasons for choosing the study of medicine or dental medicine and the Jefferson scale of empathy-version for students (JSE-S version with a modified scale with 16 arguments). The questionnaire was forwarded to all 227 first-year students in the academic year 2014/15 at the completion of the Communication course. Results: The study involved a total of 216 (response 95.2 %) students; 158 medical students and 58 students of dental medicine. Among the reasons for enrollment to the Medical Faculty, the highest proportion of medical students indicated a desire to help people (85.3 %), a desire to improve human health (78.8 %) and a desire to work with people (64.7 %); 28.8 % of the medical students chose the argument "because employment is guarantee", while 14.1 % of medical students believed the argument "because it is well paid" was the reason to choose the study of medicine. The students of dental medicine most often choose the following answers: a desire to help people (87.9 %), a desire to improve human health (74.1 %), followed by a desire to work with people (65.5 %). The argument "because employment is guaranteed" convinced 50 % of the students, and the argument "because the pay is good" convinced 46.6 %. Three claims were significantly associated with self-assessment of empathic stance: the arguments "because I want to help people" (91.08 +- 10.65 vs. 86.61 +- 12.56; p = 0.037) and "because I want to work with people" (91.82 +- 10.18 vs. 87.90 +- 12.11; p = 0.012) were associated with a greater self-assessmentwhile the argument "because the pay is good" (91.36 +- 11.41 vs. 87.29 +- 9.01; p = 0.023) was associated with a lower self-assessment of empathic stance. Conclusion: Students who want to help people have higher level of self-assessment of empathic stance. The task of a medical faculty is to ensure that students whose choice of study is based on their humanist values are encouraged to have those values further developed and put into practice during their study.

Namen: Namen prispevka je na podlagi analize mnenj identificirati prepričanja in stališča zdravnikov družinske medicine (ZDM) o pristopih k prepoznavanju in zdravljenju medicinsko nepojasnjenih stanj (MNS). Metode: Uporabljene so bile kvalitativne in kvantitativne metode raziskovanja; namenski vzorec za izvedbo je predstavljalo pet fokusnih skupin (Maribor in Ljubljana) v obdobju od julija do septembra 2011. Ugotovitve so bile kot vprašanja uporabljene v kvantitativnem delu raziskave s slučajnostnim vzorčenjem (N = 90), povabljeni pa so bili ZDM iz celotne Slovenije (januar - marec 2012). Za analizo kvalitativnega materiala in proces kodiranja smo uporabili računalniško orodje ATLAS.ti 7, kvantitativne podatke smo statistično obdelali s statističnim programskim paketom SPSS 21.0. Rezultati: V procesu kodiranja smo oblikovali 64 kod in jih razvrstili v osem kategorij. V kvantitativnem delu se je odzvalo 63 (70 %) povabljenih ZDM, ki so poudarili preprečevanje in zdravljenje bolnikov z MNS (84,1 %; n = 53), pomen dobre komunikacije z bolnikom v 77,8 % (n = 49), medtem ko je bilo 93,7 % (n = 59) ZDM mnenja, da jih bolniki z MNS izčrpajo, utrudijo in frustrirajo. Kot potencialne vzroke za MNS so ZDM opisali težave v bolnikovi interakciji z okolico (100 % , n = 63), pretekle in sedanje stresne dogodke (96,8 %, n = 61) ter skrite psihiatrične bolezni (68,3 %, n = 43). Kvaliteto obravnave bolnikov z MNS bi v največji meri izboljšalo izobraževanje s področja osnovnih psihoterapevtskih tehnik in na temo pristopa k težavnemu bolniku (95,2 %, n = 60) ter s področja veščin komuniciranja (95,2 %, n = 60). Zaključek: Ugotovili smo, da slovenski ZDM namenjajo velik poudarek preprečevanju in zdravljenju bolnikov z MNS, hkrati pa jih ti bolniki izčrpajo, utrudijo in frustrirajo

Introduction: Internet use is important for health education, patient support,professional medical education and healthcare quality. Medical information is amongst the most important information on the internet. Aim: The aim of the research was an analysis of modern information sources, especially the websites and email of the Institute of Public Health of Ljubljana (IPH Lj). Methods: Using statistical analysis of the website, its' "behaviour" online was evaluated in detail. This was done, with a tool for presenting statistical data - Google Analytics. We reviewed how IPH Lj provides information to users online: general information about the activitiesof the Institute at www.zzv-lj.si, and information on travel medicine at www.zdravinapot.si.

Background: Burnout as a distinct work-related syndrome is established by the combination of high scores for emotional exhaustion (EE) and depersonalisation(D), and a low score for personal accomplishment (PA). The aim of the study was to assess the prevalence of burnout among Slovenian family medicine trainees and the influence of the socio-demographic characteristics on burnout assessment. Methods: The study included 127 family medicine trainees in a modular part of the residency in the study year 2008/09. A self-administered questionnaire addressed the socio-demographic variables (age, gender, marital status, and years of practice and labour details - number of patients per day, number of night shifts per month); the second part consisted of the Slovenian version of the Maslach Burnout Inventory. Results: The responses were received from 117 trainees (92 % response rate). In terms of burnout, 45.9 % respondents scored high for EE, 43.1 % for high D, and 45.9 % for low P, with 18.3 % scoring high burnout in all three dimensions, 27.5 % in two dimensions, 24.8 % in one dimension and only 29.4% id not score high for burnout in any dimension at al. A high EE wassignificantly associated with frequent work in the emergency unit (four times per month) and age; a higher D was associated only with frequent work inthe emergency unit (four times per month), whereas a low PA was not associated with any of the variables studied. Conclusions: The prevalence of burnout syndrome among family medicine trainees is high and consistent with data from other studies among the physicians worldwide using the same instrument. Family medicine trainees are at risk of burnout regardless of their demographic characteristics. Increased workload affects EE and D.

Presented in the article are the clinical practice and the roles and competences of anaesthesia providers, two paths in anaesthesia practice worldwide, and the impact of anaesthesia provider credentials on patient outcomes. The requirements for anaesthetic nurses, and a restructuring of the areas of responsibility between healthcare professionals are to be expected, due to the reorganization of healthcare services in many countries; therefore the issues of professional conflict between nurse anesthetists and anaesthesiologists, nurses' aspirations and self-assessment, and the possibilities of turnover in nurses are raised. A reflection is made on nurse militancy with reference to professionalism, and the commitment to service, patriarchal practices and gendered subordination, and the confrontation with healthcare restructuring. Special emphasis on research in nursing profession, as the most needed basis for professional identity, career structure and pathways, as well as professional role modification, is offered as a contribution to establishing an active nursing research culture and evidence-based practice promotion. The countries anticipating a shortfall in the supply of anaesthesiologists are to examine working models from other countries that currently work with fewer physicians and more nurse anaesthetists. The nurse anaesthesia professionals should be well prepared and competent to respond to new challenges in the future.

"Violent crime investigations are often faced with the need to bridge a shortage of information. Th is can, to an extent, be neutralized by the use of the profi ling of unknown perpetrators of criminal off ences and by polygraph examination (the credibility assessment) (Selič, Juratovec, 2004)."(...)

Background: This study explored how adequately the additive and mediational models could explain the relationships between personality traits and coping behavior in predicting burnout syndrome in professional soldiers of the Slovene Army. The additive model suggests that personality and coping are independent, unique contributors to maladjustment outcomes. The mediational model, on the other hand, suggests that personality factors predispose people to use particular coping strategies that tend to be less effective for adjustment. Methods: A total of 390 soldiers (87% response rate) completed theEysenck Personality Questionnaire, the Ways of Coping Questionnaire and theMaslach Burnout Inventory. Results: The structural equation modeling confirmed an adequate fit only of the additive model. As hypothesized, emotional exhaustion was positively associated with neuroticism and emotionoriented coping. Depersonalization was positively associated with psychoticism, and personal accomplishment was positively associated with extraversion and problem-oriented coping, and inversely with neuroticism and emotion-oriented coping. Conclusions: To reduce burnout in the Slovenian Army,it may be of great benefit to provide training of effective stress-copingmechanisms, and create peer support groups among soldiers. Such intervention should be especially beneficial for soldiers with a vulnerable personality structure (high neuroticism and psychoticism and low extraversion).

Introduction: Mobbing in the workplace is defined as any systematic maltreatment of employees against a colleague (horizontal mobbing), a subordinate (downward mobbing) or a superior (upward mobbing). Employees in health care sector are often faced with mobbing due to unclearly defined tasksand expectations and the extant health care vertical hierarchical organizational structure. The aim of research is to establish the prevalence and nature of mobbing events among physicians and nurses, addressing the extent to which demographic issues are pertinent to the workplace mobbing. Methods: Translated and adopted the Leymann Inventory of Psychological Terrorization questionnaire was used, including questions about the respondentsć demographics, psychosomatic implications of mobbing, sick leave, length of work experience, and educational status of perpetrators. Of the 200 questionnaires distributed, 161 were returned (response rate = 80.5 %). Participating in the study were 84 (52.2 %) physicians (every second) and 77 (47.8 %) nurses (every eighth) who had been employed in the Celje General Hospital for more than six months, representing a systematic sample. The participation was voluntary and anonymity assured. Results: The incidence of exposure to mobbing among physicians and nurses was high (60.1 %) but comparable to the results of other studies. A higher percentage of nurses (71.4 %) as compared to physicians (51.2 %) were exposed to mobbing (p = 0,009). In both cases, the perpetrators were mainly superiors and most frequent mobbing behavior towards victims was prohibiting of communication. Discussion and conclusions: As a result of mobbing, the victims from both healthcare groups developed different psychological and physical health problems. Hospital executives should therefore adopt zero-tolerance policy towards workplace mobbing, take effective preventive measures to eliminate mobbing behaviour and apply appropriate sanctions to perpetrators.

Background: By 2015, mental illness will become the greatest healthcare burdenin the world. Within the community, people with depression are most often treated by family doctors. Treatment for depression also includes psychiatric specialists, with varying cooperation between the primary care provider and the psychiatrist. This studyćs goal was to define cooperation between family doctors and psychiatric specialists when treating patients withdepression. Methods: In 2009 six focus groups were held that included general practitioners. The data were analyzed using qualitative methods. Results: Seventeen topics and related categories were developed for the study.One of these related to the cooperation between primary care providers and psychiatric specialists. Family doctors see psychiatrists as responsible for working with more challenging patients and as intermediaries in evaluatingsick leave and assessing ability to work. Psychiatrists offer familydoctors support in the education process and in terms of supervision. Numerous factors influence referral from primary to secondary level, includingpatientsć and doctorsć personal characteristics. Conclusions: Achieving the goals of treating patients with depression requires not only expertise, organization at the primary care level, and a method of communication between patients and doctors, but also cooperation between primary care providers and psychiatric specialists. This ought to take place in compliance with professional criteria and not as a result of the patientćs condition and pressure from the patient. Representatives of both specializations should establish ways to work together and clarify the issue of information exchange and (in)appropriate referrals for obtaining opinions regarding sick leave and disability-based retirement.

Problem: The main objectives of this study were to identify differences in thepsychosocial status of military personnel who had and who had no traumatic event experience, and to screen for potential mental health vulnerability related to post-traumatic stress. Methods: 390 military personnel were included in the study, with 103 of them reporting traumatic event experience. The Mini-International Neuropsychiatric Interview Screening for Post-TraumaticStress Disorder, the CAGE instrument, the Eysenck Personality Scales, the Folkman-Lazarus Ways of Coping Questionnaire, the Rosenberg Self-Esteem scale and self-evaluative questions about important relationships were administered. Results: The respondents who reported traumatic event experience (TEE) also reported a significantly higher frequency of other stressful events, a significantly more frequent past history of depression (16.5 % of respondents with TEE and 6.2 % of respondents without TEE) and significantly higher risky alcohol drinking; the latter, however, is not higher than the estimate for the total Slovenian population (10.7 % of respondents with TEE and 2.7 % of participants without TEE). Respondents with TEE smoke less frequently than respondents who reported no TEE (46.6 % vs. 60.1 %), and more often rely on self in stressful situations. There was no significant difference between the respondents with reported TEE and those without TEE in their personality traits, coping styles, and self-esteem, or inthe majority of job- and family-related factors. No difference was found between male and female personnel as concerns intra-personal factors and in stress- related behaviour. Conclusions: Intra-personal factors (personality, coping styles, and self-esteem) of military personnel indicate good personal potential for resilience. Stress-related substance (ab)use, especially smokingrates well above the Slovenian average, need further attention. (Abstract truncated at 2000 characters)

Problem: The study addresses basic personality traits with soldiers who reportlower bio-psycho-social-wellbeing and burnout and therefore perform poorer working effectiveness and motivation. Perception of one''s health and physical well-being may be used as a measure of one''s health condition and consequently a predictor of higher mortality and greater need for health services. Used diagnostic strategy conceptualizes health as a bio-psycho-social well-being and provides broader insight on interdependence among stress, burnout and organizational climate. Method: Self-rated health questionnaire, Eysenck''s personality scales (EPQ-Revised), Folkman-Lazarus Ways of coping questionnaire and Maslach Burnout inventory were administered. Responses of 390 persons were analyzed. Participants were divided into three groups - healthy (SK1-Z), less healthy (by sick leave criteria, injuries were not included; SK2-B) and persons on missions abroad. Members of the third group meet all health criteria and are exposed to special working conditions, since serving abroad. Data was analyzed by statistical package SPSS (v 17.0, SPSS Inc.): performed were t-test, Mann-Whitney''s test, Kruskal-Wallis'' test, Factor analysis (PC-analysis, Kaiser''s normalization) and correlation coefficients. Results: Interpretation is based upon presumption about veracity of responses; nevertheless the possibility of denial is mentioned. Assuming sincere responses, one distinctive key factor burnout is identified. The highest burnout scores have soldiers serving missions and the lowest healthy group (depersonalization: ?2=21,756; p=0,000; reduced personal accomplishment: ?2=7,088; p=0,029; emotional exhaustion: ?2=6,316; p=0,043). Differences between healthy and less healthy persons are explained by personality traits (such as psychosomatic prone personality, neuroticism and psychoticism). Persons serving missions abroad are cynical, macho and distrustful. Burnout (cynicism, lower personal accomplishment) is a symptom ofdestroyed bio-psycho-social well-being and may develop into absenteeism or quitting the job. Conclusion: A redefinition of selection process for admission in the Slovenian Armed Forces is proposed, to test the basic personality traits and release candidates who exceed values for neuroticism and psychoticism, which could reduce the use of less appropriate coping strategies, depersonalization and emotional fatigue and increase work efficiency. Learning interpersonal skills and using protective strategies (noncompetitive physical activities, hobbies) may reduce the functioning of non-changeable (stable) working conditions and requirements. Necessary emotions-focused coping within macho subculture could be achieved by strengthening group cohesion and quality of relationships, thereby creating social support within the collective. Problem: Študija odgovarja na vprašanje, katere osebnostne lastnosti izstopajopri vojakih, ki poročajo o slabšem bio-psiho-socialnem blagostanju, dosegajo višje vrednosti izgorevanja in so posledično manj učinkoviti pri deluin manj motivirani za delo. Občutenje lastnega zdravja je okvirno merilo za zdravstveno stanje posameznika, slaba samoocena zdravja pa je napovedni dejavnik povečane umrljivosti in večje potrebe po zdravstvenih storitvah. Uporabljena diagnostična strategija operacionalizira koncept zdravja, kje bio-psiho-socialno blagostanje, na eni strani ter prinaša možnost za nove ugotovitve o povezanosti stresa in izgorevanja, (samoocen) zdravja in organizacijskega ozračja na drugi strani. Metoda: Študija je potekala med letoma 2006 in 2008. Uporabili smo vprašalnik za samooceno zdravstvenega stanja, Eysenckove osebnostne lestvice, Folkman-Lazarusovo lestvico Načini spoprijemanja s stresom in lestvico izgorevanja Maslachove. Analizirali smo odgovore 390 pripadnikov Slovenske vojske, ki smo jih razdelili v skupino zdravih (SK1-Z), manj zdravih (po merilu bolniške odsotnosti zaradi bolezni; SK2-B) in skupino udeležencev njihovih misij. Ti izpolnjujejo vsa merila zdravja (na eni strani), so pa izpostavljeni posebnim delovnim obremenitvam (delo v tujini). Za obdelavo podatkov smo uporabili statistični paket SPSS (v 17.0, SPSS inc.): izvedli smo t-test, Mann-Whitneyev test, Kruskal-Wallisov test, faktorsko analizo (PC-analiza, rotacija Varimax, Kaiserjeva normalizacija) in korelacijske izračune. Rezultati: Rezultate razlagamo na osnovi predpostavke, da so udeleženci odgovarjali verodostojno, opozorimo pa tudi na možnost zanikanja in/ali odpora. Ključni dejavnik razlikovanja med skupinami je izgorelost, pri kateri najvišje vrednosti dosegajo vojaki na misijah, najnižje pa skupina zdravih vojakov (razosebljenje: ?2=21,756; p=0,000; delovna neučinkovitost: ?2=7,088; p=0,029; čustvena izčrpanost: ?2=6,316; p=0,043). Razlike med SK1-Z in SK2-B pojasnjujemo z osebnostnimi značilnostmi (zaprtost/odprtost mišljenja, nevrotičnost) in t.i. psihosomatskonaravnanostjo. Za udeležence misij so značilni cinizem, mačizem in nezaupanje. Izgorelost (cinizem, nizka delovna učinkovitost) je znak izčrpanega/okvarjenega bio-psiho-socialnega blagostanja, ki lahko vodi v absentizem ali zapustitev poklica/dela. Zaključek: Predlagamo spremembo oz. dopolnitev izbirnega postopka za sprejem v Slovensko vojsko s testom temeljnih osebnostnih lastnosti ter izločanje kandidatov, ki presegajo normirane vrednosti za nevrotičnost in psihotičnost, kar bi lahko zmanjšalo uporabo manj ustreznih strategij spoprijemanja s stresom, depresonalizacijo in čustveno izčrpanost ter povečalo delovno učinkovitost. Učenje veščin v medosebnih odnosih in prevzemanje varovalnih strategij (netekmovalne fizične dejavnosti, konjički) lahko ublaži delovanje nespremenljivih delovnih pogojevin zahtev. Potrebno usmerjenost na čustva ob siceršnji mačistični subkulturi bi bilo mogoče doseči s krepitvijo skupinske povezanosti in kakovosti odnosov v enotah, s čimer bi oblikovali socialno podporo znotraj kolektiva.

With this survey we wanted to explore the willingness of the patients to convey their experience of abuse in the family and to study the differences inpatient reports and doctors' observations on domestic violence. A cross-sectional study on.f'amily violence included 27 Slovenian family practitioners, who screened each fifth consecutive patient in the period of 14days. 1103 patients were surveyed. We identified the frequency of the violence (as reported by the patients to a trustworthy person, i, e. their family physician), the readiness of the victims of violence to seek help, the sensitivity of the physicians to this topic and their qualifications/aptitude for immediate help/intervention. 30% of involved persons confirmed experience of physical and/orpsychical violence and with every fifth person physician didnothing despite being asked ,for help. Every fourth answer to the question "What would you do if a victim of violence would come to you for help" is direction to psychiatrist. That probably reflects perception of doctors' profession and their competence. 1/10 of persons sought medical help because of being exposed to violence. Physicians offered support and conversation to victims in 1/3 of cases, 1/10 of victims got sick-leave and hospitalization. 1/5 of them were sent to psychiatrist and for 1/20 physician prescribed antidepressants. In every ninth case physicians noticed police and social service. In 1/5 of cases the physician did nothing. The study showed that investigation of medical files and evaluations of physicians about possible factors, which increase the possibility of persons being exposed to violence are not so useful. Physicians are not equipped well enough to give needed helpand support to persons exposed to violence in the family. Physicians do not feel that they are the right ones who should in their practice help victims of violence.

Background: Domestic violence has considerable impact on the health status of patients. The purpose of this survey was to explore the willingness of the patients to convey their experience of abuse in the family, and to compare patient reports and doctors' observations on domestic violence. Methods: A cross-sectional study on family violence included 27 Slovenian family practitioners, who screened each fifth consecutive patient (totally 1,103 patients) over a period of 14 days. The study investigated the frequency of violence episodes (as reported by the patients to a trustworthy person, i.e. their family physician), the readiness of the victims to seek help, the sensitivity of the physicians to this issue, and their qualifications/aptitudefor immediate help/intervention. Results: Exposure to both physical and psychological violence was reported by 141 (12.78 %) patients, physical violence alone by 65 (5.89 %), psychological violence aloneby 120 (10.88 %), whereas 777 (70.44 %) patients denied exposure to any kind of family violence. Conclusions: The exposure of a victim to psychological and/or physical violence in the family is very likely to be recognized by the family physician. However, such patients very rarely seek help from their family doctor. Physicians identified 164 and failed to identify 162 of the 326 self-reported victims of domestic violence. The results show that physicians need additional knowledge and guidelines in the field. Izvleček Izhodišče: Družinsko nasilje vpliva na zdravje bolnikov. Z raziskavosmo želeli posneti stanje pripravljenosti bolnikov za razkrivanje morebitnih izkušenj telesnega in/ali psihičnega nasilja v družini in preveritirazlike o poročanjih bolnikov in opažanjih zdravnikov o nasilju v družini. Metode: V presečni raziskavi je sodelovalo 27 zdravnikov družinske medicine v Sloveniji, ki so 14 dni presejali vsakega petega bolnika. Zajeli smo 1103 bolnike. Identificirali smo pogostost nasilja, povzročitelje nasilja,pripravljenost oseb z izkušnjo nasilja za iskanje pomoči, občutljivostzdravnikov za to problematiko in opremljenost zdravnikov za nudenje pomoči. Rezultati: 141 (12,78 %) bolnikov je bilo izpostavljenih telesnemu in duševnemu nasilju, 65 (5,89 %) samo telesnemu in 120 (10,88 %) samo duševnemu nasilju, 777 (70,44 %) jih o izkušnji nasilja v družini ni poročalo. Sklepi: Če je bolnik žrtev telesnega in duševnega nasilja, je verjetno, da jo kot osebo z izkušnjo nasilja prepozna tudi zdravnik družinske medicine, vendar bolniki, izpostavljeni nasilju v družini, v večini primerov ne iščejo pomoči pri zdravniku. Po lastni oceni je bilo 326 oseb izpostavljenih nasilju. Zdravniki so jih prepoznali 164, ostalih 162 pa ne. Izrezultatov je razvidno, da zdravniki potrebujejo dodatna znanja in usmeritves tega področja.