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Vsak dan kompleksnejša obravnava pacientov z vse večjim številom kroničnih obolenj/stanj zahteva vključevanje vse večjega števila strokovnjakov različnih zdravstvenih in nezdravstvenih področij. Vse pogosteje v obravnavi pacientov sodelujejo različni zdravniki specialisti, medicinke sestre, fizioterapevti, dietetiki, farmacevti, psihologi in drugi strokovnjaki. Izveden je bil pregled literature, s katerim smo želeli ugotoviti, kako se povezujejo in sodelujejo različni zdravstveni delavci na vseh ravneh zdravstvenega varstva. Ključna besedna zveza za iskalni niz je bila kombinacija znanja in spretnosti (»skill mix«), postavljeni pa so bili tudi vključitveni kriteriji. Potek raziskave je prikazan v PRIZMA diagramu. Na podlagi pregleda izbranih virov smo oblikovali štiri vsebinske kategorije: »skill mix« v bolnišničnem okolju, »skill mix« v institucionalnem varstvu in skrbi za starejše odrasle, »skill mix« na primarni zdravstveni ravni ter »skill mix« v času pandemije covida-19. Timsko delo, ki zajema prenos/kombinacijo znanj in spretnosti, postaja velik izziv za zdravstveni sistem. Na podlagi ugotovitev sklepamo, da lahko prinese revolucionarne spremembe v oskrbi pacientov na vseh ravneh zdravstvenega in socialnega varstva. Ključni elementi za uspeh so sodelovanje, spoštovanje znanj in spretnosti vseh vključenih in dobra organizacija v času uvajanja sprememb.

Varnostna kultura je produkt individualnih in kolektivnih vrednot ter vedenjskih vzorcev, ki določajo vključenost in upravljanje zaposlenih. Cilj raziskave je bil ugotoviti, kako medicinske sestre razumejo varnostno kulturo in raziskati, kakšno raven varnostne kulture zaznavajo. Raziskava je bila izvedena s pomočjo kvalitativne metode raziskovanja in metode analiziranja pogojev. Podatke smo pridobili z intervjuvanjem treh diplomiranih medicinskih sester, ki imajo vsaj eno leto izkušenj z negovanjem bolnikov na bolnišničnem oddelku. Ugotovili smo, da je varnostna kultura okolje, ki vpliva na varnost bolnikov, odvisna pa je od značajskih lastnosti zdravstvenih delavcev in od vodstva same ustanove. Izkazalo se je, da poleg pomanjkljive izobrazbe tudi delovno okolje, čustveno stanje, delo v izmenah in utrujenost, pomanjkanje nadzora nad kompleksnimi in negotovimi delovnimi pogoji ter delovna obremenjenost medicinskih sester vplivajo na varnost bolnikov. Vsaka zdravstvena ustanova bi morala razviti in izboljšati raven varnostne kulture. Za doseganje tega cilja so potrebne določene spremembe, npr. izobraževanje, osredotočeno na varnostno kulturo, osebna rast vsakegazdravstvenega delavca, sprejemanje odgovornosti in proaktivno vedenje znotraj tima. Pomembna je tudi raba modernih stilov vodenja, upravljanje sprememb in participativno odločanje.

BACKGROUND: The research is based on the concept of health literacy. This is the “sixth vital sign” to navigating the healthcare system and raising self-efficacy in the field of healthcare. AIM: The study aim was to present the health literacy of the elderly in the Savinja statistical region in Slovenia. METHODS: The study was based on a non-experimental quantitative research approach. The study included 199 elderly people aged 65 and more, without the presence of dementia. The data were collected using the Health Literacy and Montreal Cognitive Assessment questionnaire. We used a non-random, convenience sampling. RESULTS: We established that in the study population, 64.8 % of the population was below the level of acceptable general health literacy, whereas only 3.5 % of this population had an excellent level of health literacy. Statistically significant differences in the level of health literacy are shown in the field of healthcare treatment in older adults living with their families (F = 5,198; p ˂ 0,001). Respondents who engaged in activities in day care centres also had a higher level of health literacy (t = 3,738; p < 0,001). People with low health literacy, who use health services more frequently, should be given access to health education, based on individual presentation of contents, supported by andragogical knowledge. CONCLUSION: The health literacy of older adults is the basis for their greater care for their own health and a better quality of life.

BACKGROUND: Physical activity, healthy diet and avoiding risk factors are essential for a healthy lifestyle of older adults and for their life satisfaction. AIM: The aim of the research was to determine the connection between lifestyle and life satisfaction of older adults in relation to the living environment (home environment, institutional environment). METHODS: The research was based on a non-experimental quantitative research approach. We used the Oldwellactive standardised questionnaire to obtain lifestyle data and the SWLS scale to determine life satisfaction. The study included 656 older adults with an average age of 78.2 years who lived in a domestic (n = 380) and institutional environment (276). RESULTS: Older adults living in the home environment rate their lifestyle higher (AV = 2.38, SD = 0.77) than those in the institutional environment (AV = 2.31, SD = 0.88), the difference is not statistically significant p = 0.304). Eating habits with regard to the location of residence showed statistically significant differences in the consumption of meat, fish and fish products and milk and dairy products (p

Aims: This study aimed to identify mentors’ cultural competence profiles at mentoring culturally and linguistically diverse nursing students in clinical practice and explore associating factors. Background: Globalization has had a significant impact on healthcare, increasing the diversity of healthcare workforces and the number of culturally and linguistically diverse nursing students in clinical practice. The cultural competence of mentors is important to secure students’ safe and successful learning. The mentor role in clinical practice contributes toward enabling and ensuring students’ high-quality and goal-oriented development of competence. Design: This study implemented a cross-sectional design with a final sample of 270 clinical practice mentors from Finland, Lithuania, Spain and Slovenia. Methods: The data were collected using an online survey including the Mentors’ Cultural Competence Instrument, Mentors’ Competence Instrument and background questions during 2020- 2021. The data were analyzed using a K-mean cluster algorithm to identify mentors’ competency profiles. Results: Three significantly differing mentor competency profiles (Profile A 42%, Profile B 41%, Profile C 17%) were identified in this study. The cultural competence of the mentors in clinical practice varied between intermediate and high levels. Mentors rated their cultural competence as best in the area of cultural sensitivity and awareness, whereas the lowest scored area was cultural interaction and safety. Conclusions: This study showed that the cultural competence of mentors in clinical practice varied and was influenced by mentors’ work experience, age, job title and frequency of mentoring. This study provides new knowledge that could help to develop cultural competence operating models and education to enhance the cultural competence of healthcare professionals.

Aim: Research utilization is at the core of evidence-based practice. The aim of the study was to describe Slovenian nursing students’ competence in research utilization (attitudes, knowledge, and skills) on graduation, and the support they received in learning research utilization during clinical practice. Design: A descriptive, cross-sectional study design. Methods: The participants were graduating Slovenian bachelor-level nursing students (n = 220). Data were collected using the Competence in Research Utilization instrument, and analyzed statistically. Results: Students’ attitudes to research utilization were positive, but their knowledge was rather limited. Skills were self-assessed as above moderate. The majority of the students had received support in learning research utilization during their most recent clinical practice period. The support received was related to students’ attitudes and skills. Conclusion: Educational institutions should pay attention to improving nursing students’ competence in research utilization, especially regarding their knowledge. Further research is needed to explore the most effective pedagogical strategies, including clinical practice, to improve students’ competence in research utilization and to gain a better understanding of multidimensional research utilization competence assessment.

Aims: This study aimed to explore mentoring competence in nursing student mentors during clinical practice by identifying different mentor profiles and connections between different competence areas among five European countries and Japan. Methods: The study implemented a cross-sectional design in Finland, Italy, Lithuania, Slovenia, Spain, and Japan during 2016 and 2019. In total, 6208 mentors were invited, and 1862 participated from 58 healthcare organizations. The data were collected with a survey questionnaire by including background question items with the Mentor Competence Instrument. K-clustering and structural equation modeling were used for data analysis. Results: Four mentor profiles, A (43%), B (30%), C (18%), and D (9%), were identified according to the seven mentoring competence areas with high statistical significance (p 3.50) was observed among Finnish, Lithuanian, and Slovenian mentors with university education in nursing, older ages, more work experience, and previous education in mentoring. Lower competence (mean

The aim of the study is the analysis of educational needs of European intensive care nurses (ICNs) with regard to multicultural care. A mixed-method multinational study was performed among 591 ICNs coming from 15 European countries. An online survey was utilised with three research tools: participants’ sociodemographic details, Healthcare Provider Cultural Competence Instrument, and a tool to assess the educational needs of ICU nurses with respect to multicultural care. The highest mean values in self-assessment of preparation of ICU nurses to provide multicultural nursing care and their educational needs in this regard were detected in the case of nurses coming from Southern Europe (M = 4.09; SD = 0.43). With higher age, nurses recorded higher educational needs in the scope of multicultural care (r = 0.138; p = 0.001). In addition, speaking other languages significantly correlated with higher educational needs related to care of patients coming from different cultures (Z = −4.346; p < 0.001) as well as previous education on multicultural nursing care (Z = −2.530; p = 0.011). Experiences of difficult situations when caring for culturally diverse patients in ICU were classified into categories: ‘treatment procedures and general nursing care’, ‘family visiting’, ‘gender issues’, ‘communication challenges’, and ‘consequences of difficult experiences’. The educational needs of intensive care nurses in caring for culturally diverse patients are closely related to experiencing difficult situations when working with such patients and their families.

Aims: To describe the mentoring competence of clinical practice nurse mentors and identify different mentor profiles. Design: Cross-sectional research design, secondary analysis. Methods: An international, cross-sectional study design was performed in five European countries. A total of 1 604 mentors from 33 healthcare organizations participated in the study between 2016–2019. The Mentors' Competence Instrument (MCI), which includes seven sub-dimensions and 44 items, was used to collect data. K-means cluster and binary regression analyses were performed to detect mentor profiles and determine how various factors affect competence, respectively. Results: The K-means cluster analysis identified three distinct profiles: A (n = 926); B (n = 566); and C (n = 85). The profiles showed significantly different values (p < .001) across all seven areas of mentoring competence. In comparison with the other profiles, nurses in profile A were older, had more work experience and were more probably to have completed mentoring-specific training. We would like to acknowledge European Commission, Erasmus+and KA2: Strategic partnership for providing funding for the project Quality mentorship for developing competent nursing students (QualMent).

Duhovnost je večdimenzionalni koncept, ki usmerja človekovo življenje, se s starostjo krepi in vpliva na kakovost življenja. Z raziskavo smo želeli ugotoviti, kakšen je vpliv duhovnosti na kakovost življenja in ali molitev vpliva na preprečevanje osamljenosti starih ljudi v domačem in v institucionalnem okolju. Raziskava temelji na kvantitativni metodi, v raziskavo smo zajeli 656 starih ljudi v domačem in v institucionalnem okolju. Za pridobivanje podatkov o kakovosti življenja smo uporabili standardizirani vprašalnik Svetovne zdravstvene organizacije WHOQOL-BREF, za pridobivanje podatkov o osamljenosti pa Oldwellactive (A self-rated welness profile for the assessment of wellbeing and wellness activity in older people). Ugotovili smo, da se stari ljudje ne počutijo osamljeno in da so nekoliko bolj osamljeni v institucionalnem okolju (PV=3,71) kakor v domačem okolju (PV=3,90). Molijo tisti, ki so pogosteje osamljeni in ki niže ocenjujejo kakovost življenja. Molitev ne vpliva na preprečevanje osamljenosti. Duhovni dejavnik je za stare ljudi najpomembnejši dejavnik, ki vpliva na njihovo kakovost življenja.

Background: Mentoring in clinical settings is an important factor in the development of nursing students' professional knowledge and competences, but more knowledge of mentors' current and required competences is needed to improve nursing students' clinical learning. Objectives: This study aimed to develop and test an evidence-based model of mentoring nursing students in clinical practice. Design: An international cross-sectional survey coordinated in five European countries: Finland, Italy, Lithuania, Slovenia and Spain. Methods: Mentors, 4980 registered nurses working in both primary and specialist healthcare organizations, were invited to participate in the study during 2016–2019. The final sample consisted of 1360 mentors (mean age 41.9 ± 11). Data were collected with background questions and the Mentor Competence Instrument. The instrument was psychometrically validated then the data were used to construct a Structural Equation Model (SEM) with Full Imputation Maximum Likelihood (FIML) estimation. Results: All of six hypotheses were verified. In summary: mentors' characteristics related to their motivation and reflection are positively related to mentoring practices in the workplace, which (together with constructive feedback) are positively related to and foster goal-orientation in students' clinical learning and student-centered evaluation. All parameters in the SEM model were significant and the model's fit indexes were verified (RMSEA = 0.055; SRMR = 0.083; CFI = 0.914, TLI = 0.909). Conclusion: Our evidence-based modeling confirms the research hypotheses about mentorship, and identifies focal competences for designing mentors' education to improve students' clinical learning and establish a common European mentoring model. Mentorship is important for both healthcare organizations and educational systems to enhance students' clinical competences, professional growth and commitment to the nursing profession and organizational environments. We would like to acknowledge European Commission, Erasmus+, KA2: Strategic partnership for providing funding for the project Quality mentorship for developing competent nursing students (QualMent).

Introduction: With aging, the incidence of chronic diseases among elderly increases, as about 88% of them have at least one chronic condition, with 50% having at least two. The presence of these diseases influences their self-image and self-esteem. This study aimed to identify the effects of chronic diseases on self-esteem and self-image in the group of elderly people. Methods: A quantitative research design using a structured questionnaire was employed, where Rosenberg questionnaire with an adapted measurement scale was used for evaluating self-esteem, while Marsh’s adjusted Multidimensional self-concept scale was used for assessing self-image. Results: The survey involved 51 respondents: 25.5% were male, and 74.5% were female, the average age of the respondents was 77.0 years. 60.8 % of them reported high blood pressure, 31.4% rheumatism, 25.5% osteoporosis and 23.5% diabetes. “Rheumatism” was statistically significantly associated with two elements of self-esteem: the “athletic self-esteem” and “inclusion”, whereas the claim for self-assessment “I can do things as good the majority of other people” was associated to the incidence of “diabetes”. Conclusions: The results of our study indicate that rheumatism, as a most common chronic disease among this population, has a significant impact on some elements of self-image and self-esteem. Further research should focus on the concepts of self-esteem and self-image of this population.

Aim: In our research we wanted to propose a holistic model of palliative care from the perspective of nurses. Additionally, we compared the presence of specific aspects of palliative care (psychological, physical, social and spiritual) in hospitals and the community/home environment. Design: A quantitative cross-sectional study was used. Methods: The sample consisted of 127 nurses (92 hospital nurses, 35 community nurses). The proposed model was tested using a specific method of structural equation modeling (SEM) known as partial least squares (PLS). Results: Our research confirmed that physical aspects are influenced both by psychological and spiritual aspects, whereas social aspects have only an indirect influence. We detected a statistically significant difference between the hospital and the community environment regarding the impact of psychological aspects on social aspects, and of psychological aspects on physical aspects. Conclusion: Our research highlighted the professional shortcomings of the holistic approach in palliative care as it stands, especially in the community care setting, where it is necessary to ensure in-depth knowledge and skills, and practice within each holistic domain to provide quality treatment to palliative patients. Keywords: holistic model, home environment, hospital setting, palliative care.

Introduction. Holism has been poorly researched in the field of health and social gerontology. The old man is a whole, therefore he needs a holistic treatment. It means that we consider his bio-psycho-social and spiritual needs. The purpose of the research is to determine the relationship of a psychological holistic factor with life satisfaction in old age. Material and methods. For the needs of the research work, a quantitative research method was used. A simple random sample was selected from the statistical set. The survey included 1064 elderly people in Slovenia (65 years and over) in ten statistical regions living in the domestic (n=532) and institutional (n=532). Environment. Sample realization was 61.6 % (656 correct questionnaires). According to demographic data, the survey involved 470 (71.6%) women and 186 (28.4%) men. The average age of the respondent was 78.2 years. The data was analyzed with the R MICE package. The analysis of causal effects and conditional associations advanced statistical methods, i.e. propensity score methods, and a questionnaire as a structured measurement instrument were used. Results. Obtained research results imply a scientific contribution in the field of quality management of people in old age and their life quality. On the basis of statistical calculations, the hypothesis that the psychological holistic factor (R2=0.21) is related to life satisfaction in old age is confirmed. We proved that indexes: social networks (R2=0.176), positive emotions (R2=0.366), loneliness (R2=0.151), cognitive abilities (R2=0.162) studied within a psychological holistic factor affect life satisfaction. Discussion and conclusion. Research confirmed that within the psychological factor, the most intimately related to life satisfaction is the emotional index, followed by the index of social networks, cognitive abilities and the last index of loneliness. For the holistic treatment of old man, in which the psychological factor is the only one of the four holistic factors, both structural and process changes are required for achievement of better outcomes, in our case, higher levels of satisfaction with life in old age.

OBJECTIVES: To determine the level of cultural competence of European critical care nurses.DESIGN: A multi-country survey performed in 2017 as a part of the European project Multicultural Care in European Intensive Care Units.METHOD: Online survey of critical care nurses in 15 European countries (n = 591) using the Healthcare Provider Cultural Competence Instrument consisting of 49 items divided into five subscales: awareness and sensitivity, behaviour, patient-centred orientation, practice orientation and self-assessment. Descriptive and correlational analyses were performed.RESULTS: Critical care nurses scored highest for 'awareness and sensitivity' (M = 5.09, SD = 0.76), and lowest for 'patient-centred communication' (M = 3.26, SD = 0.94). Nurses from northern and southern Europe scored higher across all subsets of the cultural competence instrument (all subsets, p < 0.001) than nurses from central Europe. Speaking other languages significantly correlated with higher scores in all subscales (all > 0.05) except 'practice orientation'. Previous education on multicultural nursing significantly correlated with higher scores in all subscales (all > 0.01) except patient-centred communication; and visits to other countries was negatively correlated with all subscales (all, p > 0.001) except patient-centred communication.CONCLUSION: Being exposed to cultural diversity in different ways, like living in a multicultural country, speaking a second language and visiting other countries may influence development of cultural competence. Therefore, programmes which facilitate multicultural clinical practice are strongly recommended in nursing education.

Background The physical factor (health literacy, health status, functional ability to perform daily basic and instrumental activities and risk factors) is linked to life satisfaction in older age. The aim of this study is to establish the correlation between the physical holistic factor and life satisfaction in older age. Material and Methods The quantitative research method was used. In order to sample the data, the authors chose a simple random sample. The designed questionnaire was filled in by 1064 older persons aged ≥ 65 years, living in social care institutions/nursing homes for older persons or in the home environment. The number of correctly completed survey questionnaires was 656. In order to measure life satisfaction, the Satisfaction with Life Scale was used. Within the physical factor, 4 indexes were formed. In order to be able to show the desired influences or links between the physical factor and life satisfaction, the authors used propensity score methods. Results The individual indexes within the physical factor are linked to life satisfaction to a varying degree: health literacy (R 2 = 0.137), health status (R 2 = 0.047), the functional ability to perform daily basic and instrumental activities (R 2 = 0.015), and risk factors (R 2 = 0.001). The physical holistic factor is linked to life satisfaction in older age (R 2 = 0.05). Conclusions With this research, the authors have proven that the older persons with high levels of health literacy, a good health status without chronic diseases, who are independent in performing daily basic and instrumental activities, and do not have any risk factors present, are more satisfied with their lives. Med Pr. 2019;70(5):535–43

Introduction. Man is a unique, unrepeatable whole in space and time and that is why he requires a holistic treatment, taking into account physical, psychological, social and spiritual factors. The balanced factors can ensure human well-being and his quality of life. Integrated treatment is especially important for patients in palliative care, which was the basic starting point of our research. In our research we wanted to establish whether the patients in palliative care are treated holistically from the perspective of the nurses and where are the specific aspects of palliative care (psychological, physical, social and spiritual) more visible - in the hospitals or in the home environment. Material and methods. The questionnaire survey was based on the empirical quantitative methodology; a descriptive causal non-experimental method was used. The number of the included sample was 127 nurses (92 hospital nurses, 35 community nurses). To test the differences between the groups (hospital, community nursing), the single factor analysis of variance was used. All the research participants were ensured anonymity and they had the right to withdraw from the study before or during the questionnaire completion. Results. The physical aspect of the treatment was statistically significantly higher assessed by nurses in a hospital setting (̅χ =3.83; s=1.012; p=0.042). The psychological and spiritual aspects were higher assessed in community nursing setting and social aspect in hospital setting. Conclusions. Our research has highlighted the shortcomings of the holistic approach in palliative care. Nurses need in-depth knowledge and skills as well as practice within each holistic domain to perform quality treatment of palliative patients.

Background: The assessment of nursing students’ nursing competence is a matter of concern worldwide and the complexity of assessing students’ clinical competence has challenged educators for decades. It has been recognized that there is inconsistency among assessment methods and tools between countries and institutions. Objective: To identify the current best evidence on the assessment of nursing students’ competence in clinical practice. Design: Systematic review of reviews. Data sources: The electronic databases CINAHL, PubMed, Eric, Medic and the JBI Database of Systematic Reviews and Implementation Reports were searched in autumn 2018. Review methods: Two researchers independently assessed the eligibility of the studies by title, abstract and full-text, and then assessed the methodological quality of the included studies. Analysis of study findings was conducted using the thematic synthesis approach. Results: Six reviews were included following critical appraisal. Assessment tools used to assess students’ nursing competence commonly focus on the domains of professional attributes, ethical practices, communication and interpersonal relationships, nursing processes, critical thinking and reason. Clinical learning environments and mentoring provide important support structures and guide the learning of students. The availability of assessment tools and criteria along with providing individualized feedback and time for reflection strengthen the objectivity and reliability of assessment. Conclusions: There continues to be a need to develop consistent and systematic approaches in assessment, and to use reliable and valid instruments in assessment. Mentors find assessment of students’ competence to be particularly challenging and emphasize the importance of clear assessment criteria, support from nurse educators and further education on assessment. Further development in feedback practices and providing students with opportunities for reflection are important in supporting the continuous learning process of students. We would like to acknowledge European Commission, Erasmus +, KA2: Strategic partnership for providing funding for the project Quality mentorship for developing competent nursing students (QualMent).