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  • Author: Brigita Savič x
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Peer support in patients with tipe 2 diabetes

Introduction: Type 2 diabetes affects people in their productive years and significantly influences their quality of life. Organized peer support provided by specially trained patients or volunteers who have experience with diabetes can be of crucial importance in supporting a patient's endeavours to lead a healthy lifestyle while managing the disease.

Objective: The aim of this research was to establish whether organized peer support exists in diabetes organizations of the Gorenjska region, Slovenia, and how patients feel about the usefulness of and the need for implementing a peer support system.

Methods: The sample included 78 respondents, accounting for 58.6% of all type 2 diabetes cases treated for the first time at the specialist diabetes clinic of the Jesenice General Hospital in 2009. The participants were given a questionnaire in which they indicated the level of agreement with the given statements on a five-point scale. The Cronbach alpha for all 18 statements was 0.71.

Results: Organized peer support is not yet available for members of diabetes organizations in the Gorenjska region. Most respondents do not perceive diabetes as a source of great emotional stress or as a reason for a lower quality of life. Patients receiving insulin therapy (p=.013), and those with chronic complications (p=.037), reported significant deterioration in quality of life. Women were more eager to learn how their peers manage their lives (p=.045), and to obtain information from experienced peers to help and support them (p=.032). A positive correlation was found between the respondents' opinion that diabetes presents a source of high emotional stress and that shearing experience with peers would help them reduce this stress (r=.517, p=.000); that peer experience would help them in everyday, practical situations (r=.306, p=.007); and that peer experience would help them manage their life with diabetes better (r=.447, p=.000).

Discussion: The research results stressed the need for introduction of peer support. We were surprised by the patients' low level of awareness regarding the benefits they could derive from talking to peers. Peer support interventions would bring the desired level of quality to the concept of personalization in diabetes care. Treatment practices for patients with diabetes in Slovenia have shown that organizing a peer support system is considered an option, but has not yet become a standard practice. Peer support can be a powerful source of empowerment and of individualisation of treatment. Its implementation, however, will have to involve the active participation of members of health care teams treating patients with diabetes.

Nursing knowledge as a response to societal needs: a framework for promoting nursing as a profession

Introduction: As the population needs for health care at the local level become integrated into the global context, nurses are given the opportunity to make a significant contribution to the modernization of the healthcare system and gain importance and recognition from the political perspective. Nursing today is confronted with the needs and demands of both healthy and ill populations — these can be the result of changing demographics, new technologies, a growing awareness of the rights and voiced expectations of service users etc. Slovenian nurses have the opportunity to make a significant contribution to the modernization of the Slovenian healthcare system. This can be achieved by learning from the experiences of other countries and by exploring and addressing existing aspects of the need to gain professional status.

Methods: A review of the international literature indexed in the CINAHL database was performed for the period January - August 2010. The key phrases used were: ‘nursing skills and knowledge’, ‘nursing future and politics’, ‘nursing future and responsibility’, ‘nursing future and leadership’. We used only abstracts in English. A total of 343 abstracts were retrieved and assessed. All abstracts that did not include issues related to the importance of nursing knowledge and the importance of connecting nursing knowledge with patient needs were excluded. Twenty-two articles in total were included. A qualitative synthesis of the conclusions from each of the articles included was conducted, from which content codes were generated. The codes were then placed into content categories.

Results: Forty-seven qualitative codes were identified and semantically divided into 7 categories: public perception of nurses and the importance of knowledge; awareness at the personal and professional levels; adapting health care skills and knowledge, and the number of health care professionals, to future needs; importance of new nursing skills and knowledge, and of skill transfer; research as the source of new knowledge and development; assuming responsibility for conducting evidence-based nursing; emphasizing cooperation and communication.

Discussion: Based on the established qualitative categories in our research, we developed an explanatory model that is a good starting point for reflecting on where nursing is today and where it should be heading in the future, and is recommended for nurses, nursing managers, deans of nursing colleges, officials in nursing associations and others. Research findings are especially relevant for countries in which nursing is currently a poorly developed scientific discipline and in which steps need to be taken fast to promote knowledge development and the role of nurses in society.



Surveys conducted among healthcare workers revealed that nursing staff often face various stressors associated with occupational activities, which reduce their work efficiency. The aim of the study was to establish the level of stress in nurses working at hospitals in Slovenia and to identify stress-related factors.


A cross-sectional epidemiological design and a standardized instrument called the “Nursing stress scale” were used. The sample included 983 nurses from 21 Slovenian hospitals. The research was conducted in 2016.


Prevalence of high level of stress was 56.5% of respondents (M (median)=75). Prevalence of high level of stress and stress factors may be statistically significant attributable to dissatisfaction at work (p<0.001), disturbing factors at work (p<0.001), inability to take time off in lieu after working on weekend (p=0.003), shorter serving (p=0.009), fixed-term work (p=0.007), and an increased number of workdays on Sunday (p=0.030).


The stress rate and stress factors are substantially influenced by variables reflecting work organization, competences and skills of healthcare management to work with people. Results reflect the need for nursing management and policy makers to design strategies to ensure adequate staffing, efficient organization and an encouraging work environment.



There is a limited body of research in the field of healthcare improvement science (HIS). Quality improvement and ‘change making’ should become an intrinsic part of everyone’s job, every day in all parts of the healthcare system. The lack of theoretical grounding may partly explain the minimal transfer of health research into health policy.


This article seeks to present the development of the definition for healthcare improvement science. A consensus method approach was adopted with a two-stage Delphi process, expert panel and consensus group techniques. A total of 18 participants were involved in the expert panel and consensus group, and 153 answers were analysed as a part of the Delphi survey. Participants were researchers, educators and healthcare professionals from Scotland, Slovenia, Spain, Italy, England, Poland, and Romania.


A high level of consensus was achieved for the broad definition in the 2nd Delphi iteration (86%). The final definition was agreed on by the consensus group: ‘Healthcare improvement science is the generation of knowledge to cultivate change and deliver person-centred care that is safe, effective, efficient, equitable and timely. It improves patient outcomes, health system performance and population health.’


The process of developing a consensus definition revealed different understandings of healthcare improvement science between the participants. Having a shared consensus definition of healthcare improvement science is an important step forward, bringing about a common understanding in order to advance the professional education and practice of healthcare improvement science.


Izhodišča: V šoli otroci preživijo velik del dneva, zato ima šola pomembno vlogo pri zdravju otrok in mladostnikov pa tudi pri sodelovanju z zdravstvenimi službami.

Namen: Ugotoviti stališče ravnateljev o pomenu, smotrnosti in o možnosti umestitve šolske medicinske sestre v osnovne šole.

Preiskovanci in metode: Podatki so zbrani s strukturiranim anketnim vprašalnikom. Vzorec zajema 55,6 % (n = 266) celotne populacije ravnateljev osnovnih šol. Uporabljena je deskriptivna statistika. Soodvisnost je analizirana z multiplo regresijsko in dimenzije odvisne spremenljivke s faktorsko analizo.

Rezultati: Na osnovnih šolah najpogosteje ukrepajo zaradi akutnega bolezenskega stanja (PV = 3,48), psihosomatskih (PV = 3,42) in kroničnih bolezni (PV = 3,22) (lestvica 1-6). Ravnatelji prepoznavajo potrebo po nalogah šolske medicinske sestre iz promocije zdravja in zdravstvenih storitev, saj je 11 od 13 predlogov dobilo v povprečju oceno nad 4 (lestvica 1-5). Najprimernejšo umestitev šolske medicinske sestre vidijo deloma v zdravstvenem domu, deloma v šoli (60,2 %); najprimernejši delodajalec je zdravstveni dom (59,4 %). Mnenja se ne razlikujejo glede na velikost šole in vključitev v mrežo Zdravih šol. Ravnatelji s šol, v katerih je telesnih poškodb učencev več, izražajo značilno večjo potrebo po šolski medicinski sestri (b = 0,208, p < 0,014), kar velja tudi za ravnatelje z mnenjem, da je usposabljanje učiteljev za prepoznavanje in ukrepanje ob zdravstvenih težavah v odgovornosti zdravstvenega doma (b = 0,270, p < 0,000).

Zaključki: Ravnatelji menijo, da se v šolah srečujejo z zdravstvenimi težavami učencev, a učitelji za ukrepanje nimajo dovolj znanja niti kompetenc. Pozitivno prepoznavajo umestitev šolske medicinske sestre v šolo.