The aim of this study is to examine the influence of nurses’ self-concept (NSC) on clinical decision-making (CDM) among nursing students and hospital nurses. A further aim is to examine whether there is a difference in CDM and NSC between hospital nurses with various levels of experience and nursing students. A cross-sectional study was conducted during 2018 in the Faculty of Dental Medicine and Health and the University Hospital Center, in Osijek, Croatia, EU. The respondents consisted of 568 hospital nurses, and 129 BSc nursing students. Data were collected with the clinical decision-making in nursing scale (CDMNS) and the nurses’ self-concept questionnaire (NSCQ). There was no correlation between CDM and NSC in either students or hospital nurses. Hospital nurses generally had significantly higher scores in CDM than nursing students. On the other hand, students had a significantly higher total NSC level. The results of this study suggest that experience has a positive impact on nurses’ CDM skills. The high NSC estimated by students enables them to easily take up their clinical roles and approach the patient in a holistic manner, which is an attitude that gradually develops during studies and with clinical experience.

The World Health Organisation predicts a lack of 15 million health professionals by 2030. The lack of licenced professionals is a problem that keeps emerging and is carefully studied on a global level. Strategic objectives aimed at stimulating employment, improving working conditions, and keeping the nurses on board greatly depends on identifying factors that contribute to their turnover. The aim of this study was to present a conceptual model based on predictors of nurses’ turnover intention. Methods: A quantitative, non-experimental research design was used. A total of 308 registered nurses (RNs) took part in the study. The Multidimensional Work Motivation Scale (MWMS) and Practice Environment Scale of the Nursing Work Index (PES-NWI) were used. Results: The conceptual model, based on the binary regression models, relies on two direct significant predictors and four indirect significant predictors of turnover intention. The direct predictors are job satisfaction (OR = 0.23) and absenteeism (OR = 2.5). Indirect predictors that affect turnover intention via job satisfaction are: amotivation (OR = 0.59), identified regulation (OR = 0.54), intrinsic motivation (OR = 1.67), and nurse manager ability, leadership and support of nurses (OR = 1.51). Conclusions: The results of the study indicate strategic issues that need to be addressed to retain the nursing workforce. There is a need to ensure positive perceptions and support from managers, maintain intrinsic motivation, and promote even higher levels of motivation to achieve satisfactory levels of job satisfaction.

Background: The aim of this study was to examine the impact of education, coronavirus disease 2019 (COVID-19), and risk factors on the quality of life in patients with type 2 diabetes. Methods: A prospective study was conducted in three phases: before education, after education, and in the period of pandemic coronavirus disease 2019 (COVID-19). The subjects were diabetics on oral therapy. To determine the quality of life index, a standardized Ferrans and Powers survey questionnaire was used. Results: A total of 205 participants took part in the study, of which 111 (54.1%) were men and 94 (46%) women. Participants were enrolled in the study between January 2019 and September 2020. Glycated hemoglobin values were significantly higher before education compared to post-education and at the time of COVID-19 (Friedman test, p = 0.002), and body mass index was significantly lower after education compared to values before education (Friedman test, p = 0.008). The quality of life was significantly lower in all domains in the COVID-19 period (Friedman test, p < 0.001). Conclusions: A significant predictor of worse assessment of overall quality of life was male gender and rural place of residence. Disease duration of up to 5 years was a significant predictor of worse assessment in the psychological/spiritual domain, while being married was a predictor of better assessment of the quality of life in the family domain. The education of diabetics brought an increase in the health and quality of life while the coronavirus disease pandemic had negative consequences on the same parameters. We consider it necessary to systematically educate diabetics about the comorbidity of COVID-19.

Background: The aim of this study was to examine the effect of dietary education on glycemic control in patients with any type of diabetes at four-week and two-year follow-ups. Methods: A two-year prospective study was conducted in three phases: before, four weeks after, and two years after an educational program. The participants were patients diagnosed with diabetes who were receiving insulin or oral hypoglycemics and who attended the Diabetes Clinic of the General County Hospital Našice, Croatia to receive their treatment. The questionnaire and educational program were created for the purpose of this study. Measurements were made (fasting blood glucose, glycated hemoglobin, body mass index, blood pressure, knowledge test) at baseline, four weeks and two years after education. Results: A total of 109 participants took part in the study, of which 56 (51.4%) were on insulin therapy and 53 (48.6%) were on oral therapy, after two years, 78 (72%) subjects were followed up with. There was no control group. At the two-year follow-up, participants with insulin therapy had significantly higher glycated hemoglobin (Mann–Whitney U test, p = 0.035). Significant differences were observed in fasted blood glucose (Friedman’s test, p = 0.001), diastolic pressure (Friedman’s test, P = 0.018), and glycated hemoglobin (Wilcoxon test, p < 0.001) between Phase 1 and Phase 3. Conclusions: Education has a positive effect on adherence to recommended diet and glycemia regulation in diabetes patients after four-week follow-ups. However, after two years, participants showed a decrease in adherence to recommended diet and increased glycemia.

Background: It is well-known that rotating shift work disrupts the circadian rhythm and sleep quality in nurses. With this study, we aimed to compare subjectively and objectively measured sleep quality in nurses, specifically focusing on any differences that arose in relation to shift work. Methods: This prospective, observational, cross-sectional study was conducted in 2025 in Croatia; a total of 140 nurses participated. Sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI) and FitBit Charge 3 smartwatch, which monitored sleep over an eight-day period. Results: Most nurses rated their sleep as good or very good, but according to the PSQI questionnaire, all participants were classified as poor sleepers (PSQI > 5). Objective smartwatch measurements showed that nurses working only day shifts had higher sleep scores (median 77, IQR 75–80 vs. 73, IQR 68–76; p < 0.001), significantly longer total sleep duration (median 6.4, IQR 6.3–7.1 vs. 5.5, IQR 5.2–6.2 h; p < 0.001), and longer durations of all sleep stages compared with those working rotating shifts. Conclusions: Most nurses subjectively rated their sleep as good or very good; however, according to the PSQI questionnaire results, all were classified as poor sleepers, with no significant difference related to shift work. Objective measurements using the smartwatch indicated that rotating shift work is associated with significantly poorer sleep quality.

(1) Background: Short Assessment of Health Literacy for Spanish Adults (SAHLSA-50) was originally designed for Spanish-speaking regions, and translations validated for several languages. The aim of the study was to adapt and verify the psychometric characteristics of SAHLSA-50 in the Croatian context; (2) Methods: The cross-sectional study included 590 respondents from the general population older than 18 years of age. Health literacy was measured by two scales: SAHLCA-50 and the Croatian version of the Newest Vital Sign screening test (NVS-HR), which was used as a measure of concurrent validity. Subjective Health Complaints (SHC) and Satisfaction with Life Scale (SWLS) questionnaires were also used to assess convergent validity; (3) Results: Internal consistency reliability of SAHLCA-50 was high and corresponds to the findings of the authors of the original research. The Cronbach alpha coefficient for SAHLCA-50 version was 0.91. The correlation of SAHLCA-50 with the NVS-HR test speaks in favor of concurrent validity. Correlation between health literacy and SHC speaks for convergent validity, just as was expected, while correlation with life satisfaction was not observed; (4) Conclusions: The SAHLCA-50 test can be a good and quick tool to assess health literacy of the adult population in the Croatian language. HL can affect the health and quality of life of the individual and the wider community.