Background: Social environment and type of care may influence mental health in late life. The aim of this study was to assess the associations between depression, anxiety, and self-esteem in older people. Methods: The study evaluated mental health in people older than 65 years of age in Zadar County, Croatia. The participants were interviewed using the Patient Health Questionnaire, the Generalized Anxiety Disorder Scale, and the Rosenberg Self-Esteem Scale. Multiple linear regressions were used to assess the correlations between depression, anxiety, and self-esteem. Results: Compared with elderly people living in their own homes, elderly people in nursing homes reported lower self-esteem, higher depression, and higher anxiety. The level of self-esteem decreased with increased levels of depression. Anxiety was significantly associated with depression, while depression strongly increased with an increase in anxiety. Older age was associated with depression, while widowhood was a negative predictor of self-esteem. Institutionalization was borderline significantly associated with anxiety, while gender was associated with anxiety. Conclusions: The study found associations between self-esteem, anxiety, and depression in the elderly. The strategy of humanization in nursing care for older people should be applied equally in nursing homes and in community-dwelling states. Public health programs aimed at maintaining the mental health of older people are needed.

Despite world-level efforts and the endeavors of scientists and medical professionals in suppressing the COVID-19 pandemic, inadequate levels of vaccine literacy of the general population can represent a grave obstacle. The aim of this study was to evaluate COVID-19 vaccine literacy in the Croatian adult general population before vaccination began. The specific objectives were to test differences regarding socio-demographic characteristics and to examine perceptions and attitudes about vaccination against COVID-19 considering the level of VL against COVID-19. A cross-sectional study with a translated and psychometrically tested questionnaire was conducted in 1227 participants before the start of vaccination, from 15 to 31 January 2021. The results show a medium level of vaccine literacy (M = 2.37, SD = 0.54) and a significant difference between functional and interactive-critical vaccine literacy (p < 0.001). The level of vaccine literacy grew with the level of education (p = 0.031) and reduced with age (p < 0.001). Participants who were employed, had chronic diseases, took medicine, or consumed alcohol daily had a lower level of vaccine literacy. There is room for progress in the COVID-19 VL level for the adult population in Croatia, especially at the interactive-critical VL, which could have an important role in people accepting the vaccine against the COVID-19 disease. A satisfactory level of vaccine literacy in the population is necessary because it can contribute to the fight against the pandemic.

The aim of this study was to examine the levels of health-related quality of life (HRQoL), pain intensity, and mental distress in participants with chronic low back pain (CLBP), and to examine the differences in the HRQoL of participants with respect to mental distress and the correlations of the examined variables. Data were collected from 148 patients using the SF-36 Health Status Questionnaire (SF-36), the Clinical Outcomes in Routine Evaluation–Outcome Measure (CORE-OM) questionnaire, and the visual-analog pain scale (VAS). The results indicate poorer self-assessment of physical health (M_e = 28.1) compared to mental health (M_e = 39.4). Participants with higher levels of mental distress reported significant emotional limitations (p = 0.003), lower energy (p < 0.001), poorer psychological health (p < 0.001) and social functioning (p < 0.001), more pain (p = 0.007), and, ultimately, poorer general health (p < 0.001). The level of mental distress was related to the level of HRQoL, while a correlation with the level of pain of the participants was not found. The study results indicate a connection between the presence of mental distress and almost all aspects of HRQoL in participants with CLBP.

Background and Objectives: Moving nurses to a COVID-19 department may cause the phenomenon of transition shock, which occurs when already employed nurses change jobs. A set of confusing and uncertain feelings arise due to the unfamiliar work environment, which may lead to their intention to leave the nursing profession. The aim of this study was to examine transition shock and the contribution of both the respondents’ characteristics and the presence of stressors to the occurrence of transition shock in nurses assigned to work in COVID-19 departments. Materials and Methods: A cross-sectional study with 120 nurses employed in COVID-19 departments was conducted. Several linear regression models were used to assess the association between transition shock, personal and professional COVID-19 stressors, and the intention to leave the nursing profession. Results: Nurses who intended to leave the profession showed higher transition shock and higher personal and professional stressors (p < 0.001). Female nurses had lower transition shock (β = −0.16; p = 0.036) and higher personal COVID-19 stressors (β = 0.27; p < 0.001). University education contributes to the lowering of nurses’ transition shock (β = −0.16; p = 0.038). Nurses who did not intend to leave the nursing profession had lower personal COVID-19 stressors (β = −0.15; p = 0.044). Transition shock was associated with personal COVID-19 stressors (β = 0.39; p < 0.001) and professional COVID-19 stressors (β = 0.29; p < 0.001), and vice versa. Conclusions: The phenomenon of transition shock was present after nurses transitioned to working in COVID-19 departments. Transition shock may cause more nurses to leave the profession, which may have a strong impact on the health system in many countries that are already facing a shortage of nurses. Additional education on and preparation for adapting to new working conditions with psychological support could have an influence by lowering the level of nurses’ transition shock.

Introduction: The identification of nursing students with their profession, as well as gained professional competencies, are the crucial factors of the quality of their future work activities and the level of safety of the patient they are taking care of. Therefore, it is of utter importance to estimate the nursing students’ professional identity during their education. Objectives: The purpose of this study was to translate Professional Identity Five-Factor Scale and Identity questionnaire, to test their psychometric properties in Croatian practice and to identify more suitable instrument of measuring the level of nursing students' professional identity in Croatian context. Methods: Quantitative, cross-sectional two-phase study was performed. In the first phase translated questionnaires were administered to a sample of 432 nursing students. Based on the confirmatory factor analysis (CFA), which revealed poor model fit, the principal component analysis was conducted. In the second phase, CFA was used to test the Croatian version of the instruments' factor structure on a sample of 222 students with different study orientations. Results: The CFA results, conducted in first phase, do not support the original version of the factor structures of the Professional Identity Five-Factor Scale and Identity models. The exploratory approach showed that the translated Professional Identity Five-Factor Scale had three factors with good psychometric properties explaining 49.35% of the variance. Translated Identity questionnaire had a two-factor structure (63.46% explained variance) with good reliability properties. In the second phase, on another heterogeneous sample of students, the described factor structure was found to have a good model fit obtained by CFA. Conclusions: According to the findings, Professional Identity Five-Factor is more appropriate for evaluating professional identity of nursing students, and Identity is probably better suited to measure professional identity among working professionals.

This prospective study aimed to determine the cognitive and emotional status among patients with chronic pain and to examine the potential influence on the treatment success, measured by the reduction in pain intensity and adherence to pharmacotherapy. A total of seventy patients were followed for two months. The results of the comparison between patients who did and did not follow the physician’s instructions regarding adherence to pharmacotherapy showed a significant difference in cognitive status and a reduction in pain intensity. Patients who followed the physician’s instructions on taking analgesics had significantly higher scores on the Montreal Cognitive Assessment (MoCA) of cognitive status and a substantially higher reduction in pain intensity. Scores on the MoCA test provide statistically significant indications regarding patients’ decision to follow instructions regarding adherence to pharmacotherapy. Scores on the MoCA test, anxiety, age, and pain intensity (measured with a numeric rating scale—NRS) on admission were identified as potential predictors for the reduction in pain intensity. The linear regression model was statistically significant (χ² = 40.0, p < 0.001), explained between 43.5% and 61.1% of variance regarding the reduction in pain intensity. The findings of this study show that cognitive status, measured with MoCA, and emotional status, measured with the Depression, Anxiety, and Stress Scale (DASS-21), significantly influence the reduction in pain intensity and adherence to pharmacotherapy. The results suggest that cognitive and emotional status may be potential predictors of treatment success. This finding points to the importance of a biopsychosocial approach in the treatment of chronic pain, where an important emphasis can be placed on the psychosocial determinants of pain.