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Aim: This study aimed to assess the barriers and facilitators in practicing breast self-examination (BSE) in rural women of procreative age, for detecting breast cancer in a state of Eastern India. Methods: Considering the medical significance of breast cancer in society, a quasi-experimental study was designed, where a pre-test and post-test was conducted with a self-structured questionnaire and checklist, to explore facilitators and barriers and the effect of BSE in these women. This study conveniently sampled the rural women within the procreative age group of 15 to 50, according to selection criteria by trained nursing professionals. Initially, 553 women were selected in the study. However, only 502 of them were used for final analysis and the other 51 were excluded due to inadequate responses. Results: After the one-month study period, the results of the post-test study were statistically extremely significant when compared to the pre-test results regarding the knowledge and steps of BSE. No significant association was found between barriers, the facilitator of BSE and other demographic factors. Conclusions: This study concluded that BSE technique can be used by all rural women in the procreative age group - with the help of trained health care professionals and nurses - who can make them understand the importance of BSE in the detection of breast cancer.

Clinical risk management (CRM) is a specific method of risk management in hospitals that is directly focused on clinical procedures and indirectly on patient-related procedures. The goal of this study was to summarize the conclusions of the studies that deal with implemented instruments that have helped to decrease or eliminate clinical risk management in hospitals in the last ten years. The included full-text studies were searched for in electronic databases focused on management and healthcare: ECONLIB, ProQuest STM+ Hospital Collection - Medline, Science Direct, Web of Science, PubMed, Scopus and Google Scholar. The full-text studies were searched for after studying their abstracts and relevancy or potential relevancy. The selected studies were searched for using the keywords: management, clinical, risk, monitoring, instrument, hospital, as well as other established criteria (full text, reviewed periodicals, English language) and the publishing period of research conclusions in the last ten years, i.e. 2010-19. We finally included 10 studies that contained the required criteria. The developed CRM instruments are based on the studies of literature and expert knowledge. Hospitals often use existing risk analysis instruments for CRM. For higher efficiency of CRM, it is necessary to identify and analyze individual clinical risks and find suitable solutions. Clinical risks can be decreased by using suitable instruments. The total level of CRM in hospitals is possible to be measured, monitored and regularly assessed, which contributes to its efficiency increase.

Introduction: Preconception care practices include physical activity, which is identified as an important indicator of behavioural preconception health. A scoping review was conducted to examine the association between physical activity in preconception health and its long-term effects on the later life of the offspring. Methods: The literature was searched in databases CINAHL, ScienceDirect and PubMed, using keywords determined by the study objective. In total, 755 published manuscripts were identified. Two additional manuscripts were identified through manual searching. A total of 17 manuscripts was selected for the final analysis. The data were extracted and summarized using thematic analysis. Results: The selected studies were summarized in two categories: (1) studies associated with physical activity and preconception health behaviour (n = 8), and (2) studies associated with preconception physical activity, fertility, and pregnancy outcomes (n = 9). Conclusions: Despite limited evidence, other indirect scientific evidence shows that physical activity positively affects health, and is therefore strongly recommended during the preconception period. Policymakers, researchers, and healthcare professionals should join efforts in examining the impact of physical activity on preconception health, fertility and birth outcomes, and effectively translate the findings into preconception health guidelines and public policies.

Objectives: The aim of the paper is to describe cases of violent death in children up to five years of age, where the abuse of addictive substances by their mother or other caregiver was detected or could have been presumed. Based on the results, the aim is to discuss the possibilities of preventive protection of children under 5 years in families at risk. Theoretical base: A problematic lifestyle in childcare decreases the quality of care and can lead to the death of the child. Effective measures are especially necessary for children from families with risky behavior. Methods: Retrospective analysis of autopsy files (at 2 forensic medicine departments) of children under 5 years of age who died suddenly, unexpectedly, and violently (n = 192) between 2007 and 2016. Outcomes: There were 41 cases of violent deaths. In all cases there were families at risk and socially weak families. Control of the families by the Department of Social and Legal Protection of Children had been demonstrably conducted in 10 cases, which is 24% of the cases in the sample. Alcohol was present in 29% of cases, other illegal substances in 29% of cases. In total, the use of alcohol or illegal substances was found in 44% of violent child deaths. Conclusions: Early detection of risks, dispensarization of endangered children and rehabilitation of their families is advisable preventively. The prevention of families with risky behavior and the protection of their children should take both paths - preventive and restrictive. The necessary condition for the protection of children is functional multidiscipline cooperation of all participating institutions.

Aim: The aim of this study is to evaluate the available scientific knowledge on the assessment of pain in preschool children (aged 3-7). The information obtained will provide a basis for further research. Methods: The data were collected with the help of keywords by PCC and using Boolean operators that were searched for in scientific electronics databases. The data were collected using keywords that were selected based on a research question and targeted at a specific population, concept and context. Four scientific databases were included: PubMed, ProQuest, OVID, EBSCOhost. Results: A total of 243 articles were identified, plus another 10 records were identified from the reference list of retrieved articles. After analysis, 51 articles were subjected to a critical analysis and 14 studies were selected for final use for the scoping review. Conclusions: A literature review confirmed that the topic of pain assessment in childhood is becoming increasingly important. All the presented pain assessment tools assess pain in different ways, but always with the same goal: to properly assess a child's pain and then treat it as best as possible. Particularly with young children, it is advisable to include more methods of pain assessment and to assess more aspects of pain to provide them with the right treatment.

Introduction: Simulation strategy is a modern technique for teaching nursing around the world. One of its many benefits is the implementation of pre-prepared situations in a safe environment. The introduction of simulation into theoretical training is beneficial for students, lecturers, and the faculty. Goal: To investigate the effectiveness of the simulation process for teaching nursing. Methods: This paper is a literary review. It is processed using a four-step system. We used the acronym PECOT. We used online platforms for the research, such as PubMed, Web of Science, Science Direct, EBSCO, and Scopus. We visited the Academic Library of the University of South Bohemia in České Budějovice and the National Library in Prague. Results: We identified 7 studies (four experimental studies, two review studies and one quantitative-exploratory study) and included them in our study. The simulation process is considered a highly effective teaching method, which benefits the students, lecturers, and the faculty. Conclusions: The simulation process is one of the modern techniques of teaching nursing. The mentioned results indicate a high level of teaching effectiveness using this method. In all registered cases, the simulation strategy is assessed as more effective than other methods used so far, such as frontal teaching, video demonstrations, or simple demonstrations.

Introduction: The interaction between the doctor and the patient achieved when the physician is able to communicate effectivelywith the patient. Iowa Satisfaction with Anesthesia Scale is a tool for this purpose. Given that ISAS is originally in English and understudy inIran, we decided to translate this scale into Persian and evaluate its validity and reliability. Purpose: Our aim in this study is translating, validity and reliability of ISAS. Methods: This study is an observational study with a correlational design that adopts an analytical approach. The population consisted of all patients undergoing surgery at Imam Reza Hospital out of whom 162 patients met the inclusion criteria, i.e. aged 18 years and above, transferred from the OP to ICU, exposed to general anesthesia and signed the consent form. Results: Patients completed the questionnaire in 5 minutes. The mean (maximum-minimum) age of the patients was 57.39 (18-87). As for gender, 102 (63%) of patients were male and 56 (34.6%) were female. About 4 (2.5%) of the data went missing. Cronbach's Alpha was 0.85. The correlation analysis showed that Iowa scale was significantly correlated with RP (P = 0.007), BP (P = 0.002), RE (P = 0.007) and GH (P = 0.012). The PSQ questionnaire had a significant correlation with the LOWA questionnaire (p < 0.001). Conclusion: Validity and reliability of the Persian version of Iowa Satisfaction with Anesthesia Scale (ISAS) in Iran are excellent.

The goal of this study is to map the current trends in the care of seniors in residential facilities of social services. This study is based on academic articles found in the SCOPUS and Web of Science databases between 2014 and 2018. The search criteria were focused on keywords (residential care, senior, trends) and areas (social work, social sciences, psychology, geriatrics, gerontology, health care and social services). We also used the web portals of the Ministry of Labour and Social Affairs of the Czech Republic and the Czech Statistical Office, the official web pages of residential social services for seniors and the academic references available in the Czech Republic in the last 10 years. The total number of sources used for this study was 48. The results of the analysis show that the modern trends in the care of seniors in the residential facilities of social services are focused on various non-pharmacological approaches and very frequently connected to the total organization policy. The activities are related to the individual needs of seniors. The goal of these activities is preserving the seniors' independence for as long as possible, where dignity and autonomy are respected.

Introduction: Performing disinfection of reusable high-touch objects and surfaces is one of the important aspects in the prevention of healthcare-associated infections. It is also important for the quality and safe provision of medical services. Nurses should have the knowledge to perform mechanical cleaning and disinfection, and of disinfectants, including the range of effectiveness, preparation, and method of application of disinfectants. Design: Cross-sectional quantitative research using a questionnaire. Methods: Quantitative research using the questionnaire technique was used to determine the knowledge of nurses about the principles of mechanical cleaning and disinfection of repeatedly used non-critical objects and areas in clinical practice. The research group consisted of 184 nurses from a selected regional hospital in the Czech Republic. Respondents from standard internal medicine and surgical departments participated in the research. Data were analysed using descriptive statistics and a statistical test. Results: The research found that 68.5% of nurses knew the procedure for the decontamination of work surfaces without the presence of biological material, and 51.1% of nurses knew the procedure for the decontamination of work trays with the presence of biological material. 51.1% of nurses were aware of the interpretation of the range of the effectiveness of disinfectants, and 65.2% of nurses were aware of the dilution of disinfectant solution. Conclusions: Based on the results of the research, we can state that nurses have adequate knowledge in some areas, but even so, it is necessary to provide regular training in the principles of decontamination of selected objects and areas used in nursing practice. Infections associated with health care can be influenced by following established hygienic-epidemiological principles.

This article examines health literacy in the Roma population. The goal of the authors was to analyze, through a literature review, which aspects of health literacy of the Roma have been studied by researchers. The research was carried out as an analysis of original scientific papers examining "health literacy in the Roma" found via the EBSCO Discovery Service, PubMed and Scopus databases, based on a keyword search for "health literacy" and "Roma". Based on the analysis described above, the following topics were included: (1) perception of one's own health - subjective and objective criteria, subjective perception of one's own health; (2) the Roma concept of a "healthy person"; (3) objectively perceived health status of the Roma population; (4) health literacy; (5) education as a fundamental aspect of health literacy; (6) knowledge about health (also an aspect of health literacy) and preventive behaviors; (7) health care for Roma; (8) the experiences of Roma relative to healthcare and social care systems. The analysis of published papers showed that there are certain aspects of health literacy among Roma, which can be reorganized into fewer, but more inclusive, categories, i.e., (1) perception of one's own health (objective and subjective); (2) health literacy education; (3) knowledge about health and preventative behavior; (4) health care. It is obvious that the weakest link in health literacy among Roma is health literacy education, which is also the key to improving health literacy.

The entry of the Czech Republic into the European Union, globalisation effects and associated reduction in distances and increase in the human population mobility - these are only examples of factors affecting the varying structure of the population in our country. It is no more just a transit country for migrants, but it also becomes a target country. The majority society ever more comes in contact with migrants, who are members of other nations and ethnic groups (Ivanová et al., 2005). This brings enhanced requirements not only for individuals but also for the whole society in terms of the multicultural understanding and tolerance. The public meets foreigners in common life and members of helping professions meet them in the course of their work. However, they encounter much higher requirements, since they must be able to provide services and care in a culturally appropriate manner. This becomes a considerable demand at the moment when a foreigner, member of some minority or subculture, gets ill and thus, it is necessary to provide him/her with culturally competent and a considerate nursing and medical care (Tóthová et al., 2010).
Numerous theoretical sources are already currently available, dealing with the specification of particular minorities, but sole theoretical knowledge is insufficient to provide the culturally competent nursing care. The skill in its application is necessary. Thus, grant IGA MZ NS/9606-3 "Providing culturally differentiated nursing care in selected minorities occurring in the Czech Republic" was established and implemented with the aim to perform mapping of specific features of selected minorities living in the Czech Republic in terms of theory and research. The scope of the communication presented here is to acquaint the reader with specific features of the style of life in one of the minorities chosen, the Mongolian minority.
A questionnaire method was employed for the data accumulation. The questionnaire comprised total of 140 items and, in addition to identification data, it consisted of three parts. The second part of the questionnaire was focused on the style of life. The sample group included total of 3 258 respondents, 564 inquired persons being members of the Mongolian minority. The results obviously show that about half the total number of respondents adhere to the healthy style of life: sleeping for 7-8 hours, sufficient intake of liquids, taking regular meals and more than half of the respondents are non-smokers.

The target of the research was to establish needs of family members taking care of patients at terminal stage of their disease in association with the quality of their life; the further purpose was to determine differences in needs of family members depending on the site of dwelling of the patient. The sample group included 62 family members of patients at terminal stages of their diseases - Karnofski score

The study deals with the development and transformation of the family from the second half of 20th century till present and analyses the influence of transformation processes in a society. In the first part the author mentions the development trends and changes in the family during the second half of 20th century in Europe and confronts them with the situation in the Czech Republic. In a certain way the development of the family in the Czech Republic delayed copies the development trends coming from northern countries, however, with some dissimilarities in some ways. These changes happened in a considerably unstable environment, thereby natural processes in the process of reproduction were distorted. In the second part the author characterizes the family of the new century and mentions the demographic signs, processes of democratization of family life, disintegration, isolation, social-economic situation in families, lifestyle and movements toward functions. In all the cases there are evident movements toward another form and style of life in contemporary families with all the negative consequences for their members, first of all for children. It turns out that the post - modern society - typical with its individualization, rationalization, continuous rising needs is not good for a family life and family relations. The third part characterizes a family as a microsystem in terms of a social-ecological model of the development of human capital. Further problems with the conception of the family as a social institution today, problems with determination of the term a family are described and in connection with innovative manners coexistence and the life of "the singles" the author thinks about future of the family. The family seems to be a hard replaceable institution for the adults and above all an optimal environment for healthy development of children, however in a modified form and considering all the problems. Unfortunately, we do not do much for stabilization of its position.

Aims: The aim of this research is to examine what kind of socio-demographic factors may have an influence on the degree of a patients' anxiety. It also deals with how successfully nurses are able to judge the possible reasons and extent of the patients' anxiety, as well as what kind of similarities or differences are shown in the opinions of the nursing staff compared to the subjective judgement and opinions of the patients. Furthermore, it was also examined how often similar focus points might appear in case of nurses' and patients opinions in relationship to the treatment of stress and anxiety.
Methods: The method of this research is in the form of questionnaires (patients - np = 70, nurses - nn = 19). Patients filled in an individually designed questionnaire and a questionnaire of a Scale of Anxiety and Depression. The figures were analysed with descriptive and deductive statistical methods.
Results: In 67% of the cases the extent of the patients' anxiety was considered to be an abnormal rate. The degree of anxiety did not show any significant relationship with the ways of practising religion, with marital status and with previous surgeries, but it was connected with the fact with whom the patient was living together with (p ≤ 0.014). Nurses assessed the efficiency of applying the methods of reducing anxiety at a much better rate than the patients did.
Conclusions: The role of reducing the patients' preoperative anxiety must be emphasised and in which the appropriate family background also plays an important part. The period of hospital care before an operation is quite short and the nursing interventions become routine work. Nurses are not fully aware to what extent patients are consumed with anxiety in connection with nursing interventions.

The mental health of foreigners is crucial for successful integration into their new home country. Hospitalization caused by mental disorder is regarded as an indicator of the gravity of the mental illness. The aim of this paper is to describe and analyze the hospitalizations of foreigners diagnosed with F00-F99, according to ICD-10 in all psychiatric facilities in the Czech Republic. The foreigners' data were compared with the data of hospitalized Czech citizens. The methodology of choice included a retrospective study and secondary data analysis. The data were taken from the National Register of Hospitalized People, between 2007 and 2016 (10 years). The number of foreigners hospitalized for mental disorders in the Czech Republic is comparable to the Czech population. The index of masculinity of the hospitalized foreigners in all age cohorts is almost one third higher than in the Czech population. With respect to the patients hospitalized for mental disorder, the most frequent diagnosis for the Czech population is F102 (dependence syndrome) and for the foreigners F432 (adjustment disorder). 2014 was the year when the most Czech individuals were hospitalized with mental disorders; the number of hospitalized foreigners increased in 2016. The variations in the number of hospitalized people may be a result of the restructured psychiatric care and the rise of immigration from non-EU countries due to various reasons. The high level of masculinity index reveals that health-social care for foreigners needs to be adjusted with respect to gender. The social care for the foreigners should focus mainly on the reduction of risk factors, including unsuitable work conditions, discrimination, and insufficient social support.

Objective: The aim of the research was to determine the influence of selected determinants on the level of cognitive functions in seniors in long-term care and to verify the difference in the determination of cognitive deficits by MMSE and MoCA methods. Design: The work has the design of a cross-sectional quantitative study conducted on the basis of a questionnaire survey. Methods: The population surveyed consisted of 792 residents of long-term care facilities who were included in the sample on a deliberate basis. Quantitative research was conducted using two psychometric tests of MMSE and MoCA. The influence of selected determinants affecting the level of cognitive functions and the difference in cognitive deficit determination were verified by statistical tests: Pearson's chi-square test, Kruskal-Wallis test, Pearson and Spearman's correlation coefficient. Results: The results showed a statistically significant relationship between age (in men ρ = -0.244; Sig. < 0.01) and length of education (ρ = 0.164) and MMSE test results. In the MMSE test, it was also shown that males have a higher incidence of cognitive impairment than women and that more women than men fall into the normal range. The relationship between the results of the MoCA test and the selected variables was not confirmed. The results clearly demonstrated that there is a difference in determining the cognitive deficit between MMSE and MoCA. Conclusions: The research results point to the need to assess cognitive functions and to diagnose their disorders in seniors living in long-term care facilities, especially with reference to the selection of a suitable psychometric tool.

Leaders are in daily contact with subordinate employees, and through their leadership style they affect the day-to-day running of the organisation. Using the transformational leadership theory, this paper aims to explore the impact of leadership styles on organisational identification, i.e. on an important and complex variable that plays a key role in organisational effectiveness. We asked a sample of nurses from a medium-sized regional hospital to assess the prevailing leadership style of their head nurses along with the degree of their own identification with the hospital. The quantitative research design based on a questionnaire survey was applied in this study. The first part consisted of the Multifactor Leadership Questionnaire, which measures the applied leadership style and its components. The second part was formed by the Mael and Ashforth scale, which assesses the organisational identification of the employees. The relationship between the chosen variables was assessed by multiple linear regression with the inclusion of the employment length and department type as control variables. Our results show that the transactional style slightly prevails in this hospital, although only the transformational style and two of its components have an impact on the degree of organisational identification.

Purpose: The purpose of this study was to develop a patient safety round guideline for nurse managers, in an attempt to strengthen the care culture provided within the hospital. Methods: This study uses an action research approach, which involved 20 head nurses and the nursing team leaders as participants. In addition, data collection was performed using a qualitative approach, through focus group discussions (FGD) and observations, and quantitative assessment required questionnaires. The data obtained were evaluated using both content analysis and simple statistics. Results: The study outcome showed that a patient safety round guideline could be used by nurse managers during rounds within the in-patient ward. In addition, the head nurses and nursing team leaders had better knowledge on (1) the implementation of patient safety rounds and (2) the skills applicable in the in-patient ward. Conclusions: Heads of the nursing division are recommended to create policies that require nurse managers to operate patient safety rounds using a specific guideline at every in-patient ward. This practice ought to be conducted on a regular basis to ensure that all staff activities comply with patient safety.

The Covid-19 pandemic has been widely examined to be both an economic crisis and health with updates of increasing the mental health and well-being of university students. This study examines the relationships between physical health, social support, and mental health literacy with the mental well-being of Malaysian university students during the Covid-19 pandemic. The study population comprised 199 students. A cross-sectional survey was conducted with self-administered questionnaires that used the Short Warwick Edinburgh Mental Well-Being Scale (SWEMWBS), the Multidimensional Scale of Perceived Social Support instrument, and the Mental Health Literacy Scale. The survey also included items from the Global Physical Activity Questionnaire (GPAQ). The results of this study showed that physical health had a positive and strong relationship with mental well-being. Similarly, the results indicated that social support had a significant and positive relationship with mental well-being. However, mental health literacy was not significantly associated with mental well-being. The results of this research might provide policymakers, practitioners, and university management with useful insights that foster the positive outcome of conducting intervention programs to improve the mental well-being of students.

The aims of our study were to explore the burden of noncommunicable diseases and the physical demands of the job and their impact on intent to leave midwifery. A cross-sectional, correlational study was conducted among 231 midwives in hospital-based midwifery units in Hungary. Spearman rank correlation coefficients, Mann-Whitney test and Linear regression were performed for statistical analysis. Prevalence of noncommunicable diseases was over 30% for the top five diseases. Varicose veins and musculoskeletal problems were dominant symptoms. Smoking and alcohol consumption (often vs. sometimes) reached greater proportions (18.2% vs 12.6% smoking; 0.4% vs. 49.4% alcohol). Aspects of work-related physical burden were positively associated with intent to leave. Physical burden and noncommunicable diseases explained 26.2% of variance in staff turnover intentions, with diabetes making the biggest contribution. Physical burden and noncommunicable diseases explained over one-fourth of the variance in midwives' intent to leave the profession. Interventions aimed at reducing loss of midwives should address the physical burden of work as well as the impact of chronic symptoms developed as a consequence of high workloads.