Purpose: Previous research has shown that poor health-related quality of life (HRQOL) is associated with adverse long-term prognosis in patients with heart failure (HF); however, there have been inconsistencies among studies and not all of them confirmed the prognostic value of HRQOL. In addition, few studies involved elderly patients and most focused on all-cause mortality and HF-related hospitalization as outcomes. The aim of our study was to determine whether HRQOL is a predictor and an independent predictor of long-term cardiac mortality, all-cause mortality, and HF-related rehospitalization in elderly patients hospitalized with HF. Patients and methods: This prospective observational study included 200 elderly patients hospitalized with HF in Serbia. HRQOL was measured using the Minnesota Living with Heart Failure questionnaire (MLHFQ). The median follow-up period was 28 months. The primary outcome was cardiac mortality, and all-cause mortality and HF-related rehospitalization were secondary outcomes. Survival analysis was conducted using the Kaplan–Meier method and Cox-proportional hazards regression. Results: Subjects with poor HRQOL (higher than the median MLHFQ score) had a higher probability of cardiac mortality (P=0.029) and HF-related rehospitalization (P=0.001) during long-term follow-up. Poor HRQOL was an independent predictor of cardiac mortality (HR: 2.051, 95% CI: 1.260–3.339, P=0.004), all-cause mortality (HR: 1.620, 95% CI: 1.076–2.438, P=0.021), and HF-related rehospitalization (HR: 2.040, 95% CI: 1.290–3.227, P=0.002). Conclusion: HRQOL is an independent predictor of long-term cardiac mortality in elderly patients hospitalized with HF. It also independently predicts all-cause mortality and HF-related rehospitalization. HRQOL could be used as a complementary clinical predictive tool in this patient population.

Objective: To determine whether arm and upper body exercises in addition to the standard rehabilitation programme improve outcomes after hip arthroplasty. Design: Prospective, parallel, randomized, controlled trial. Setting: Orthopaedic and rehabilitation departments. Subjects: A total of 70 patients >60 years of age, who underwent hip replacement, out of 98 eligible candidates after exclusion criteria were implemented. Interventions: The study group took part in the supplementary arm and upper body exercise programme to be compared with the standard rehabilitation programme group. Main outcome: The primary outcome was a Harris Hip Score. Secondary outcomes were: Hand grip strength and Medical Outcomes Study 36-Item Short-Form Health Survey. Outcomes were assessed preoperatively, two weeks after surgery and at 12 weeks follow-up. Results: In the intervention group, significant improvements were found: in functional ability – Harris Hip Score after two (mean difference = 4.7 points) and 12 (mean difference = 5.85 points) weeks; in muscle strength – handgrip for both hands (mean difference for dominant hand = 4.16 and for the other hand = 2.8) after 12 weeks; and in role–physical dimension SF-36 Health Survey (mean difference = 6.42 points) after 12 weeks. Conclusion: Results of this study indicate that arm and upper body exercises in addition to the standard rehabilitation programme improve outcomes 12 weeks after hip arthroplasty.

Background/Objectives. ICD–11 classifies burnout as a work-related issue arising from chronic workplace stress that has not been successfully managed. According to the Job Demands/Resources Model, job demands represent sources of stress and job resources may buffer the impact of job demands on job strain. Since every profession has its specific spectre of work demands/resources related to stress development, the aim of this study was to examine a model predicting workplace burnout dimensions (emotional exhaustion—EE, depersonalisation—DP, personal accomplishment—PA) in special educational needs (SEN) and general education (GE) teachers, with job demands representing potential “risk factors” and job resources potential “protective factors”. Methods. The study involved 116 SEN teachers from eight primary schools for children with learning difficulties and a sample of 145 teachers from general primary schools in the Belgrade region, which was balanced according to the representation of the main demographic variables in the SEN group. The Maslach Burnout Inventory and Job Characteristics Questionnaire were the instruments employed. Results. No difference was found between SEN and GE teachers in the intensity of burnout dimensions. In the SEN group, Changes were the predictors of all three burnout dimensions, Work environment for EE and DP, Emotional demands and Support from colleagues for EE, Cognitive/Quantitative for PA, and Job control for PA. Concerning the GE group, Support from colleagues predicted all three dimensions, Job control EE and DP, Cognitive/Quantitative DP and PA, Changes DP, and Role conflict and Seniority EE. Conclusions. The results of the study provide a foundation for further testing of a hypothetical predictive model of burnout with job demands as direct predictor and job resources as mediators of this relation.

Introduction/Objective. The aim of this study is to identify and evaluate the use of New Mobility Score (NMS) in estimating functional recovery three months after total hip arthroplasty (THA). Methods. In total, 70 patients, aged > 60 years, underwent THA. Treatment group was subjected to the comprehensive rehabilitation program and control group to the standard one. Primary outcome was assessed with Harris Hip Score (HHS) and NMS, and secondary one by Medical Outcomes Health Survey (Short-Form Health Survey ? SF-36). Questionnaires were collected before and three months after hip surgery. Results. Treatment group showed significant improvement three months postoperatively. The correlation in both groups between HHS and NMS was very strong (r > 0.700). Treatment group following surgery showed strong correlation between Recovery through Personal Care Services (PCS) and HHS and NMS (r > 0.700), moderate to strong between pain categories and HHS (r = 0.380; r = 0.583) and NMS (r = 0.424). Control group showed strong correlation between PCS and HHS (r = 0.704), and NMS (r = 0.568) and moderate to pain categories and HHS (r = 0.546; r = 0.466). The area under the curve (AUC) described the inherent validity of all measurement used AUCNMS = 0.724, p = 0.001, AUCHHS = 0.788, p = 0.000 and AUCPCS = 0.747, p = 0.001. Conclusion. The NMS could be successfully used in routine clinical assessment of elderly patients following THA. The trial is registered in ISRCTN Register with https://doi.org/10.1186/ISRCTN73197506.

Depression is a mood disorder characterized by the presence of unexplained sadness, loneliness, and hopelessness. In order to ensure the highest possible quality of care for patients with depression, a holistic approach is applied. The aim of this review was to assess the importance of applying a holistic approach in the nursing care of patients with depression, as well as nursing activities in the destigmatization of these persons. This review includes research published in English, based on the search of the PUBMED database, for the last 20 years, using the following keywords: holistic approach, mental health, depression, health care, nurses. A large number of o studies deal with a holistic approach in the nursing care of people with depression. The holistic approach represents the observation of the being as a whole, care for the human body, mind and spirit. The care needs of persons with depression are numerous, and therefore, it is important to plan and systematically assess their needs from a holistic aspect in order to plan the most adequate interventions to solve or reduce them. A special emphasis is placed on improving the lifestyle -healthy diet, good sleep, daily physical activity, as well as on improving social life aspects through socializing and organizing various activities. Nurses make a significant contribution to destigmatization, by educating the population, especially young people. Nurses should focus their activities on applying the holistic approach in the health care and treatment of patients with depression, accepting the documenting of health care process as a standard method in nurses' work which ensures the complete implementation of a holistic approach to health care, conducting research on the significance of implementing a holistic approach in the professional nurses' work, educating the future personnel, destigmatizing the patients with depression, as well as on mental health promotion.