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Samooskrba pacientov vključuje aktivno skrb za samega sebe v času zdravja in bolezni. Koncept samooskrbe v slovenskem prostoru ni enotno opredeljen in je redko raziskovalna tematika. Narejena je bila analiza koncepta samooskrbe po Walkerju in Avantu za slovenski prostor. Analiza je temeljila na pregledu slovenske strokovne in znanstvene literature. Koncept samooskrbe vključuje aktivno skrb za samega sebe, aktivnosti, usmerjene v doseganje optimalnega zdravja in dobrega počutja, ter kontinuirano izvajanje. Predhodniki samooskrbe so motiviranost in informiranost, zdravstvena pismenost in zdravstvena vzgojenost. Posledice samooskrbe so boljša kakovost življenja in večje zadovoljstvo z življenjem, boljše sprejemanje zdravljenja, manjša obremenitev zdravstva ter boljša kakovost zdravstvene obravnave. Nadaljnje raziskovanje oz. nadgradnja konceptualnega modela samooskrbe bi bila smiselna v smeri oblikovanja specifičnih negovalnih intervencij za spodbujanje samooskrbe med pacienti v raz-ličnih življenjskih obdobjih in pristopov k njihovemu izvajanju. Self-care includes actively caring for oneself in times of health and illness. The concept of self-care is not uniformly defined in Slovenia and is a rare research topic. A concept analysis of selfcare according to Walker and Avant was conducted for the Slovenian context. For this purpose, a review of Slovenian professional and scientific literature was conducted. The concept of self-care includes the following attributes: active self-care, activities to achieve optimal health and well-being, which are carried out continuously. The antecedents of selfcare are motivation and information, health literacy and health education, so that the patient has the necessary knowledge and skills and can implement them independently. The results of self-care are better quality of life and life satisfaction, better acceptance of treatment, reduced burden on healthcare systems and better quality of healthcare services. Further research and upgrading of the conceptual model of self-care would be useful to develop specific nursing interventions to promote self-care in patients at different stages of life and approaches for their implementation.

Population ageing together with the greater prevalence of multimorbidity add to the need for and complexity of healthcare services. This makes it important to encourage and empower patients with chronic diseases to take care of themselves. An associated goal of such efforts is to significantly reduce the burden on healthcare systems and positively impact patients' health outcomes and quality of life. The paper presents a multi-criteria decision model for assessing the health and self-care of patients with chronic diseases in the home environment. The model is based on the DEX methodology and was tested on ten cases. The model assists with the timely recognition of relevant symptoms and signs in decision-making about health and self-care. It can be used to promote patients taking on an active role with respect to caring for their health and well-being. The model could be integrated into self-care processes. It might also serve as a basis for an interprofessional approach to supporting older patients with chronic diseases living as fully and independently as possible in the environment in which they feel most comfortable.

Raziskovalno vprašanje (RV): Kakšne so možnosti za integracijo procesov dolgotrajne oskrbe in kakšne so posledice za oskrbo starejših oseb v domačem okolju? Namen: Raziskati možnosti za izboljšanje kakovosti in uspešnosti dolgotrajne oskrbe v domačem okolju z osredinjenostjo na prejemnika storitev. Cilj je analizirati obstoječe procese teh storitev, ki jih izvajajo formalni izvajalci. Prav tako na osnovi popisa procesov in analize oblikovati predloge za integracijo procesov ter podati hipotetično oceno učinkovitosti prenovljenega procesa. Metoda: Narejen je predlog modela prenovljenega procesa dolgotrajne oskrbe z uporabo eEPC pristopa k modeliranju procesov. Rezultati: Narejen je popis procesov za pomoč na domu in patronažno varstvo. Oblikovan je predlog prenovljenega procesa dolgotrajne oskrbe oseb v domačem okolju, ki vključuje tudi nekatere ključne usmeritve novega zakona na področju dolgotrajne oskrbe. Z integracijo in prenovo procesov se je zmanjšalo število začetnih in zaključnih dogodkov in dogodkov v procesu, število aktivnosti in odločitev. Ocena finančnega učinka integracije procesov oskrbe je narejena hipotetičnem primeru. Stroški oskrbe bi bili nižji skoraj za 20 %, število delovnih ur formalnih izvajalcev pa bi se zmanjšalo za 7 ur na mesec. Organizacija: Z integracijo storitev oskrbe oseb v domačem okolju in prenovo procesov je možno dosegati višjo kakovost storitev, optimizacijo kadrovskih virov in večjo stroškovno učinkovitost. Družba: S sistematičnim proučevanjem procesov dolgotrajne oskrbe, integracije in optimizacije se lahko zagotavlja kakovostna in kontinuirana oskrba, ki podpira samostojnost posameznika pri skrbi zase. To lahko pozitivno vpliva na kakovost življenja prejemnikov oskrbe in laičnih oskrbovalcev. Prenovljen proces lahko pozitivno vpliva na družbene izdatke. Originalnost: Po našem najboljšem vedenju do sedaj ni bil narejen popis procesov v patronažnem varstvu ali v pomoči na domu. Z implementacijo Zakona o dolgotrajni oskrbi v domačem okolju se bo lahko predlog procesa dolgotrajne oskrbe preverjal in smiselno dopolnjeval. Omejitve/nadaljnje raziskovanje: Model še ni preizkušen v praksi. S testiranjem in uporabo se bodo lahko razkrile pomanjkljivosti prenovljenega procesa. Njegovo kontinuirano nadgrajevanje, osnovano tudi na raziskovanju posameznih elementov modela procesa, bo lahko zagotavljalo dolgoročno uspešnost modela procesa. Za to je pomembno nadaljnje proučevanje dejanskih finančnih in drugih učinkov predlaganega modela procesa prek strukturnih kazalnikov učinkovitosti prenove procesa. Research Question (RQ): What are the possibilities for the integration of long-term care processes, and what are their implications for the care of older adults in their home environment? Purpose: The purpose is to identify opportunities to improve the quality and effectiveness of longterm care in the home environment through providing person-centred services. The aim is to analyse existing processes performed by formal caregivers. Based on the process inventory and analysis, opportunities for process integration will be created, and a hypothetical evaluation of the efficiency of the new process will be made. Method: An inventory of processes was taken, and a proposal for an integrated long-term care process model was developed using the eEPC approach to process modelling. Results: An inventory of home help and community health care processes was developed. A proposal for an integrated process of long-term care for people in their home environment was drafted, including some important orientations of the new law in the field of long-term care in Slovenia. With the integration of the processes, there has been a decrease in the number of initial and final events and events in the process, the number of activities and decisions. The evaluation of the financial impact of the integration of care processes is estimated based on a hypothetical case. The cost of care would decrease by almost 20% and the number of working hours of formal providers would decrease by 7 hours per month. Organization: By integrating care services in the home environment and process renovation, it is possible to achieve higher quality of services, optimization of human resources, and greater cost efficiency. Society: With a systematical approach to the research of care processes, integration, and optimization, it is possible to provide high-quality and continuous care that supports the independence of individuals in caring for themselves. This can have a positive impact on the quality of life of care recipients and their lay caregivers. This may also have a positive impact on social spending. Originality: To the best our knowledge, no inventory of community health nursing or home care processes has been conducted yet. With the implementation of the Long Term Care Act in home settings in Slovenia, the proposal for the care process will be able to be verified and may be improved in the future. Limitations/Future Research: The model has not been tested in practice. Its testing and use may reveal the shortcomings of the process model. Its continuous improvement, based in part on the exploration of individual elements of the process model, will ensure the long-term success of the model. It will also be useful to explore the actual financial and other implications of the proposed process model through structural indicators of the effectiveness of process renovation.

Ventilator-associated pneumonia is a hospital-acquired infection of the lungs occurring in mechanically ventilated patients. An active risk management approach can prevent the occurrence of the disease and promote positive organizational changes, subsequently decreasing mortality and hospitalization costs. Using scientific and clinical practice knowledge, a risk evaluation model was developed to identify patients more at risk of developing the disease. For this purpose, a Decision Expert qualitative multi-criteria decision method was used, in which alternatives are evaluated according to predetermined hierarchically arranged criteria. Characteristics of each evaluated alternative are described by the members of an interdisciplinary expert team and are represented by the values of the basic criteria. Values of hierarchically higher aggregated criteria are computed in an upwards fashion according to utility functions, which are defined as simple logical rules. This method is integrated into a software solution, DEXi. The approach is applicable to vastly diverse decision problems and has been successfully used before for health-related decision support. The designed model was tested using actual clinical data. Evaluations of alternatives that most distinctly demonstrated the functionality of the evaluation model were selected and are presented in the results. The evaluation model is intended to assist a holistic evaluation of the risk of developing ventilator-associated pneumonia, by considering patient-related risk factors and the use of preventive measures. The model incorporates nursing-specific data that have hitherto been poorly utilized in preventing ventilator-associated pneumonia and promotes the active engagement of nurses in confronting this interdisciplinary healthcare problem, which has gained more prominence with the onset of COVID-19 disease.

Uvod: Vest je večdimenzionalni koncept, zaradi katerega se medicinska sestra more zavedati manj kakovostne oskrbe bolnika in lastnih omejitev. Delovanje v nasprotju z lastno vestjo lahko vodi v izgorelost. Namen raziskave je bil prikazati povezanost bremena vesti in izgorelosti med zaposlenimi v intenzivni zdravstveni negi.Metode: Izvedena je bila presečna raziskava na priložnostnem vzorcu 46 medicinskih sester. Uporabljen je bil vprašalnik Stress of Conscience (slovensko »Slaba vest«). Vprašalnik je pokazal visoko notranjo skladnost (Cronbach α = 0,875). Podatki so bili zbrani v decembru 2017 in obdelani s programsko opremo IBM SPSS Statistics 23. Analizirani so bili z opisno in bivariatno statistiko. Uporabljeni so bili Fisherjev natančni test, T-test dveh neodvisnih vzorcev oziroma Mann-Whitneyev U-test ter enosmerna ANOVA.Rezultati: Starost in spol statistično značilno vplivata na breme vesti (p = 0,048 za starost oziroma p = 0,005 za spol). Statistično značilnih vplivov spola, starosti, trajanja zaposlitve ali izobrazbe na prisotnost števila simptomov izgorelosti raziskava ni pokazala. Z izgorelostjo je najbolj povezan (r = 0,503, p < 0,001) vpliv delovnega okolja na zasebno življenje.Diskusija in zaključek: Slaba vest je prisotna med medicinskimi sestrami v enotah intenzivne nege in terapije. Medicinskim sestram povzročajo slabo vest številni dejavniki. Raziskava je pokazala, da večje breme vesti povečuje število simptomov izgorelosti. Nadaljnje raziskovalno delo je smiselno usmeriti v zmanjševanje bremena vesti in izgorelosti.

Noncommunicable diseases (NCDs) bring new challenges for the healthcare sector, demanding a paradigm shift on healthcare deliverance. In this sense, information and communication technologies (ICTs) are being more and more used, implying a change in educational programs of nursing schools. The application of ICTs in healthcare is often linked with concepts like ‘patient engagement’ or ‘patient empowerment’, implying an active participation of the patient in the therapeutic process. Although coaching in a context where NCDs are present is well studies, nursing curricula seems to lack consistent content for future nurses. This study aims to develop a tool to explore nursing student’s perceived easiness of use and perceived utility of potential ICTs in the coaching of people with chronic diseases. The scale’s items list (n = 45) emerged from a recent study published in the nursing students’ digital competencies area. The scale was developed based on the Technology Acceptance Model (TAM) and other conceptual models. The scale was reviewed and discussed by a panel of experts and then translated into four languages (Portuguese, Slovenian, Flemish, and Finnish). The scale was applied to undergraduate nursing students from five universities from Portugal, Finland, Belgium and Slovenia. A total of 874 students were enrolled, with a mean age of 22.38 years (SD = 5.49), being 621 (71.1%) females. The most significant dimensions were Professional Performance, Relationship and Patient Empowerment. DTS-NCD constitutes a good tool to explore nursing student’s perceptions relating the use of ICTs.

Introduction: The importance of community health nursing is increasing due to the development of primary healthcare, illness prevention and making healthcare a part of an integrated care for patients and their families within local communities. The aim of the research was to establish the purpose of the research conducted by community nursing providers and the main issues and problems faced in the field of community nursing in Slovenia. Methods: A systematic literature review was performed by collecting scientific and professional literature from the COBIB.SI bibliographic/catalog database from January to May 2017. The literature was searched by the root of the Slovenian keyword patronaž*. The initial criteria for thematic content analysis were met by 144 references. 45 were included on the empirical data list. The PRISMA method was used to present the review and to decide on the usefulness of the references included in the research. Results: The literature review found the following research areas in community nursing care in Slovenia: improvement of quality, safety and condition at work, patient empowerment and integrated and holistic patient treatment. Publication accessibility issues and the quality of research plans and research methods have been identified. During the last three years of the period studied the dominant source of information in the research have been community nurses themselves. Discussion and conclusion: Targeted action, increased interest and knowledge of community health nurses related to research are necessary. In order to better identify their role in primary health care activities and strengthen interdisciplinary research at the micro, mezzo and macro level of the health care system, it is necessary to introduce more complex research plans.

Health documentation is a prerequisite for good and sustainable health and social care. It is especially important for patient involvement and their empowerment. A transition from paper to e-documentation together with the electronic patient record should be based on thorough knowledge of the current state of documentation and its usages. The main objective of this paper was to analyse which documents and work methods of documenting processes within nursing are being used within different environments. Furthermore, what are the main reasons for their discrepancies from theoretical approaches and best practices. The analysis is based on a survey carried out on all three levels of healthcare. The survey questionnaire consisted of 12 questions to which responded 286 nursing teams from community health centres, hospitals and retirement homes in Slovenia. The results point to diversity in documenting as well as lack of interoperability. This is reflected in a great number of different documents. All phases of the nursing process were being documented in only 31.8 % of cases. The main reasons for this can be attributed to work organisation, different definitions of data-set requirements and inadequate knowledge by nurses. Survey results pointed out a need for the renewal of nursing documentation towards a more uniform system based on contemporary health technologies.

Long-term care is more efficient and effective when it involves the active participation of the empowered patient and informal caregivers. To achieve this, it is necessary to guide the patient and informal caregivers through the systematic process of self-care. Well-documented observations and assessments are fundamental to plan further interventions of the interdisciplinary team. A systematic literature review revealed that the self-care process and the support of information technology are focused on just one chronic disease. Defined self-care process has a positive impact on the functionality and satisfaction of patients with comorbidity and on their caregivers. The model of the patient's self-care process should be an integral part of the long-term care.

Introduction: The development of computer technology showed the possibility of its use in physical therapy for children with cerebral palsy. Because these technologies have existed for a relatively short time only a few professional and scientific works have been published in the field. Previous studies used published computer programs such as video games as a computer-driven tool in physiotherapy. The appearance of sensors tracking movement developed for game consoles that are widely used today (Microsoft Xbox, Nintedo Wii) pointed to the possibility of interaction with the computer without standard computer peripherals such as a mouse or a keyboard. In Croatia, a computer system has been developed for computer-aided training of children with cerebral palsy named PeTh (Personal Therapist). It is based on Microsoft's Kinect motion sensor and an original Croatian developed computer program for use with a sensor. Methods: The purpose of this research was the valorisation of implementing this computer- driven aid in physical therapy for children with cerebral palsy. The research was carried out on six male children aged 9-15 years with cerebral palsy who reside in the day hospital school department of the Special Hospital for Children with neurodevelopmental disorders. The subjects exercised three times a week for a period of 30 days with a break over the weekend. In addition to the therapy, they also underwent therapy according to the Bobath concept three times a week for 60 min, which was their continuing treatment. Results: This study has shown improvement on the GMFM test of motor abilities for each respondent. Body scheme awareness also improved as well as the quality of the use of upper extremities. There was also a higher degree of respondents’ improved attention focus compared to other therapies they had attended. Results indicate a large potential of this computer- driven tool for the treatment of children with cerebral palsy. Discussion and conclusions: The review of recent studies has shown that they mostly deal with the analysis of virtually powered aids for children with cerebral palsy, which are based on motion sensors for commercial computer games. A program that provides a high level of personalization for each subject has been used in this research and the results have shown a recovery of body parts by means of a feedback system with a computer system for all subjects during exercise because the subjects monitored visual and voice instructions from the screen and independently corrected the position of the bodywork to which they were warned by the system. It may therefore, be assumed that this kind of exercise improves the octo-motor coordination and that was not studied by previous studies. You et al. have found that the use of virtual computing aids leads to neuroplastic changes and reorganization in the cerebral cortex, which improves the activities of the everyday life of children with unilateral cerebral palsy. By implementing this system of associated heart rate monitor sensors, comparisons could be made with the research conducted by Robert et al. who investigated the increase in cardiac rhythm while playing video games in children with cerebral palsy in relation to the control group of children without cerebral palsy. In conclusion, it is necessary to carry out further research on a larger sample in order to prove its effectiveness further, as well as target motor and sensory aspects in children with cerebral palsy. However, children with cerebral palsy generally lead 8 an inactive lifestyle. For this reason, using the PeTh system at home could have a great effect on maintaining an active lifestyle and preserving psychophysical functions.

Introduction: In spite of the exponentially increasing interest and use of Complementary and Alternative Medicine (CAM) among patients over the previous decades in Croatia, there are still no data about the attitudes and beliefs of health care professionals in Croatia about the possibility and necessity to incorporate CAM into traditional medical education. Patients are trapped into ideological and professional disputes between the majority of allopathic establishment and CAM advocates and promotors or/and CAM practitioners and forced to seek help in both systems surrounded with health care professionals without sufficient knowledge to advise them which way to go. Methods: The study was conducted on a sample of 569 participants (173 nurses, 312 physiotherapists and 84 sanitary engineers) by using a random sample method from the total number of enrolled students at the University of Applied Health Sciences in Zagreb in the academic year 2017/2018. The sample represented one fifth of the total number of students enrolled in the observed period. Among 569 participants there were 138 male and 431 females. The average age was 23.7 +- 6.51 years. Results: Sample analysis has shown that 58.52% of the participants themselves, or some of their family members, have used one of the methods at least once in their lifetime ; 65.38% of the participants confirmed that they met at least one patient who used one of the CAM methods ; 66.96% of the participants confirmed that if they were seriously ill they would be ready to seek help from a CAM therapist ; 72.04% of the participants confirmed that they would be interested in CAM if such training was organized. Only 22.8% of the participants confirmed that during their previous training in the field of health care through verified curricula they were informed about various CAM topics. 59.7% of the participants agreed about the academic allopathic society not having any knowledge about CAM and CAM not being included in the training programs for health care professionals. At the same time, 39.7% of participants expressed their need to obtain formal education in CAM. 61.7% of all participants would like to acquire sufficient knowledge through formal education programs so that the interested patient could be properly informed about the possibilities of application and effectiveness of CAM. The majority of participants (56.9%) have expressed positive attitudes about incorporating CAM into the curricula through supporting the statement that CAM should be integrated into various classical health care facilities (from anatomy to internal medicine and health care) to all the levels of education, both theoretically and practically. Discussion and conclusions: The truth is that in the official nursing curriculum there is not a single word about the CAM philosophical background, practical use or research data. Health care professionals perceived that they had very little knowledge of complementary and alternative medicine, but they seek organized education within regular university curricula and the advocate for the integration of CAM education into the training programs for health care professionals in Croatia. Setting educational standards and developing consistent curricula for CAM will help students emerge from academic programs prepared for safe and effective practice and with skills to evaluate the effectiveness and participate in the research on CAM therapies.