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At present, a number of health care institutions focus on increasing the quality of care for patients. Quality is built, introduced, controlled, managed and certificated. Therefore it is strategically important for each health care institution to introduce the quality management system into practice. Nurses constitute the biggest group of employees in health care institutions, and therefore the key role of nurses in leading positions of hospitals in quality program application must be pointed out. The aim of this article is to define the health quare quality. To outline the issue of quality measuring of nursing care with the help of quality indicators, which include the results of nursing audits. To point out the significance of creation of standards that determine the minimum quality level, the observance of which is ensured by control system of the provider of this service. To point out the importance of hygienic ensuring of hands in health care institutions. The authors D. Pittet, RW. Haley address communication of nosocomial infections and insufficient hygiene of hands in health care workers in their studies. And last but not least the article should familiarize the reader with the methodology and implementation of nursing audit of "Hands washing" in the hospital of České Budějovice, the sense of which was not to seek errors of individuals, but to find "weak points" in the system and to provide rectification as soon as possible.

Deterioration of the olfaction reduces the safety and quality of human life. Olfaction disorders occur more frequently at old age but effects of the age on perceiving the pleasant quality of substances determining the odour has not yet been completely investigated. The target of the study presented here was an evaluation of the olfaction in seniors by using a standard method of subjective olfactometry and comparing the assessment of the pleasant nature of odours with a younger age group.
Total of 79 persons (30 men and 49 women) aged 53 years on average were examined. Forty of them belonged to an age group of 65 years plus. The control group included 39 persons aged 31 years on average.
For the olfaction evaluation, we employed the Odourized Markers Test (OMT). The pleasant nature of substances determining the odour was evaluated with the use of the Test of Odour Pleasantness (TOP) including considerably hedonically biased consideration of pleasant and unpleasant odours. The persons were supposed to express whether the substance exerts pleasant, neutral, unpleasant or considerably unpleasant odour. Normal values were established based on answers of control persons.
In the OMT test, the median numbers of points acquired were of 9 points in seniors and 10 points in controls. A lower gain of points was acquired by seniors in the number of most frequent answers in the TOP test. Median numbers of points acquired in the Test of Odour Pleasantness were of 17 points in seniors and 21 points in controls. Seniors, compared to controls, almost did not use indication of substances as neutral and strongly unpleasant. The correlation between the TOP and age suggest that there is a decrease in the olfaction capability with increasing age.
The Odourized Markers test as well as the Test of Odour Pleasantness demonstrated lower olfaction capability in seniors. Considerably unpleasant odours were indicated by seniors as mild, which can indicate risks associated with the safety of elderly persons, for example due to ingestion of bad food.

The social work, as a branch of theory and practice renewed in the Slovak Republic 20 years ago, searches for its identity, providing that the existing discourse oscillates between attempts to define it as a scientific discipline, which is associated with efforts aimed at a consensus concerning paradigm or paradigms of the social works, and attempts to establish the social work just as a specific field of practice, which does not call for its own scientific and research basis. In this quarrel, domestic authors support their opinions by scientific authorities and widely accepted foreign theoretical sources, which is legitimate, since there is still a lack of sufficient domestic sources on the one hand, and if we try to establish the modern Slovak social work, we cannot do so without reflecting the foreign discourse in this field on the other hand. The "fairness" in the social work should suggest us that we have to admit that the authorities and sources chosen here do not always represent most objective knowledge in the social work and that they can sometimes be just opinions of an individual foreign colleague, even if he/she is a known and accepted professional. In our uncertainty, we tend to consider one clear fact and refuse everything else instead of bringing and offering different views as educators. In her efforts to change this condition, the author offers a view of the biomedical discourse upon the social work in Slovakia rather known as a social work model, which is one of ever topical theoretical discourse upon the social work. After a period of a certain decline accompanying the discourse in the 1970's to 1980's, a new revival was experienced just at the end of the last millennium. This new wave of the biomedical discourse has been particularly induced by the following facts: population changes (ageing of the population), increase in the occurrence of mental diseases in the population, increase in the incidence of civilisation diseases, inter alia those caused by unsound style of life, etc. These diseases have not already been solely considered as an issue of medical interest for a long time, since they also exert impacts in the field of national economies of particular countries because of their associations with costs of the medical care, and long-term sick leave and subsequent disability negatively affecting public finances.

Personality characteristics might be important factors influencing an individual's ability to cope with burnout syndrome. The aim of the study was to examine the relationship between personality factors such as self-evaluation and a sense of coherence and burnout syndrome among students of nursing. The study involved a total of 190 university students of the study programme Nursing and Midwifery (average age 20.66 ± 3.01; 98.4% females). Scale Burnout Inventory (SBI) in the school was used for assessing the burnout levels. A Sense of Coherence Questionnaire (SOC) and Rosenberger's Self-Esteem Scale (SES) were used as well. A significant negative relationship was found between burnout syndrome and self-esteem (p ≤ 0.01), as well as sense of coherence (p ≤ 0.01); it means that higher levels of self-esteem and sense of coherence were associated with lower burnout syndrome levels among students. Personality factors are strongly linked to burnout among students. Therefore it is important to observe and guide the students and appropriately utilize their predispositions in the management of the demanding study, as they tend to persist after a period of professional practice. It is therefore considered, that improving the skills of coping with stress among students is beneficial in preventing the subsequent occurrence of burnout in the profession of a nurse.

Based on research findings on the experience of homeless people living in shelters with the use of health care services, this article shows how oppression can negatively affect the access of the homeless to health care. The acquired data shows that oppression associated with the status of a shelter user creates barriers to health care access - and not only in terms of financial barriers. In their narratives, the communication partners verbalized the oppression by doctors, other health care staff and patients. The aim of this paper is, on the basis of partial data from research, to discuss the possibilities of using anti-oppressive social work as a way to reduce the barriers to access to health care services in a given target group. The output of our article consists of proposed implications for social work practice.

The target of the work was mapping selected components of the style of life of families in the Kysuce area. The sample group examined included 174 respondents (women (n = 34) working in selected companies in Čadca, their husbands (n = 31) and secondary school students (n = 109)). The basic method of the work was the use of a questionnaire for women, men and children/students. The statistical processing was carried out with the help of the squared chi test. We found dependence between the style of life of parents and children. It was shown that n = 88 (80.73%) children/students made themselves drunk before reaching their adulthood, of them n = 63 (57.80%) children as soon as before the 15th year of their age. Only n = 21 (19.26%) children/students reported that they have never been drunk. As much as n = 81 (74.31%) children/students tried to smoke before reaching 18 years of age. Only n = 30 (27.52%) children/students regularly take their breakfast; n = 39 (35.78%) do not take breakfast at all. We are pointing out the observed problems of the style of life in a group of the population studied, which consisted of families in the Kysuce area.

The article acquaints readers with results of research examination, which was implemented form March to April 2008. The main intention was mapping of adhering to national accreditation standards concerning rights of patients in the Hospital České Budějovice, a. s. The research examination was aimed at four areas of patient rights: acquainting patients with their rights, information of patients about their health condition, education of patients by a nurse and limitation and immobilization of patients. The research was carried out by a quantitative method with the use of the questionnaire examination technique. The research was performed in Hospital České Budějovice, a. s. Patients (45) and nurses (41) in the Hospital České Budějovice participated in the research. The results of the research examination demonstrated that patients wee acquainted with their rights after their admission to the hospital. This fact was supported by 80% of patients inquired. 64.4% of them were acquainted with their rights just during the admission and 15.6% in the course of the hospitalization. The Code of Patient Rights is available to patients in written form at each department of the hospital. The Charter of Rights of Hospitalized Children is displayed at the department of paediatrics of the hospital. The patients were informed about all the facts concerning their health condition. Within an evaluation scale (where value 4 corresponded to full degree of information of the patient in this field and value 1 to lack of information) the patients most positively evaluated information about their health condition (value of 3.78) and about the treatment method proposed (value 3.76). The nurses most frequently performed the education according to the need of patients (46.3%) and continuously for the whole period of the hospitalization (17.1%). 73.2% of nurses are convinced of the importance of the education process documentation. Within the evaluation scale (where value 4 means the highest satisfaction and value 1 the lowest one), the patients were most satisfied with the willingness of the nurse to answer their questions (value 3.76) and with education concerning adhering to diet principles (value 3.48). The Hospital České Budějovice has a standard named "Limitation of patients in the bed". This was supported by 92.7% of nurses interviewed and 95.1% of nurses mentioned that the limitation is implemented in appropriately justified and documented cases.

The human being does not loss his/her dignity in the process of dying. The hospice movement attempts to provide the humanization of the dying process. The ambition of the state healthcare system should be providing the quality and appropriately affordable care for dying people. Dying is a process, in which healthcare professionals and relatives of the dying person play their important roles. The quality of taking care of the dying person on the one hand affects accepting the fact of the approaching death and, on the other hand, reduces the emotional load to the relatives.
In the research, contemporary opinions concerning dying and quality of taking care of dying people in the present and future healthcare professionals were determined. The target of this was to determine opinions concerning the quality of care and fears and desires associated with dying. The research mapped opinions in two research groups based on a questionnaire compiled. The first research group were students of the second, third and fourth years of the branch nursing and public health and of the branch of medicine at the Jessenius Medical Faculty in Martin. The second research group were staff members of hospices and palliative institutions from the whole Slovakia.
The results of the research of opinions may be analyzed and interpreted in particular regions investigated:
- evaluation of taking care of dying people,
- fears and desires associated with dying.
Results of the evaluation of taking care of dying people indicate that the respondents consider the currently existing level of taking the health care of dying people as rather insufficient. More than half the respondents considered the level of information of the patient about his/her terminal stage as rather insufficient. A high level of satisfaction with the inhibition of pains in dying people is demonstrated. Half the respondents consider satisfaction of spiritual needs as good; the level of the interest of relatives in the patient at terminal stage is evaluated by respondents as rather good. The research supported a considerable difference in the evaluation of taking care of mental requirements compared to the attention paid to relatives among students and staff members in the palliative and hospice care. There is the most significant difference in the evaluation between students and staff members in the field of taking care of spiritual needs. Taking care of mental needs is negatively evaluated by students as well as staff members in the palliative and hospice care.
In the field of rights, fears and desires associated with dying, the results of the research support the fact that there is a significant desire of respondents to die at home. The respondents considered the fear of separation from their relatives and loneliness as the most important factor.

Worldwide modernization effects also affect providing of the quality of nursing care with the use of new procedures. The development and use of standard terminology through the mediation of classification systems in nursing belongs to principal features of the nursing profession in the 21st century. The purpose of its use is accurate delimitation and expression of activities performed by nurses in relation to patient needs to achieve certain results. In the present contribution, we considered problems of taking care of oncological patients, in which conflict in decisions occurred in association with the health care. We emphasize the priority role of nurses in solving the nursing diagnosis Conflict in decisions (to be specified) 00083 in terms of the assistance provided for patients and their families during the decision process by forming a mutual logical decision and not by a propagation of a certain decision. The fact is of importance that the nurses should be capable of empathy towards the patient topical condition and to work by the nursing process methods providing the procedure established. The methods used were the non-structured interview, experiment and contents analysis of documents. The methods of mathematical statistics were as follows: the Student t-test - for the verification of the selected group of the classification system of nursing activities at the NIC (Nursing Interventions Classification) level for two independent sample groups and at the NOC (Nursing Outcomes Classification) level we compared the results of respondents with the help of the Student t-test for two dependent sample groups. The research was implemented between 2007 and 2009 in the Faculty Hospital in Nitra and in the Saint Svorada Zobor Specialized Hospital in Nitra. The results of the research demonstrate positive effects of the use of selected groups of classification systems of nursing in the process of making decisions by oncological patients. The comparison between the experimental and control groups demonstrated significant differences in nursing activities performed in the selected group of the NIC classification system. In comparison of values of parameters in the selected NOC groups, there are significant differences between input and output measurements in terms of making decisions by patients and achieving the target. Classification systems of nursing can be considered positively in the management of patients with the nursing diagnosis conflict in decision (to be specified).

Social support was one of the first factors identified as factors moderating the influence of adverse life events on psychic well-being and health of human. Social support is also an important factor in the process of the immigrants' integration (as a part of adaptation process) and at the same times also a significant determinant of their health. Immigrants constitute a vulnerable social group with specific health needs and their health condition is influenced by a lot of factors. The article submits a survey of studies dealing with social support and its relation to the immigrants' mental and physic health and also to integration. The goal of this study is to describe functions of social support of immigrants, to monitor the connections between migration (and integration) and access to social support and the relation of social support to the immigrants' mental and physical health.
Methodology of research activity: The source of information consisted of publications in databased journals (Scopus, Ebsco and Medline databases) and monographs related to the topic.
Conclusion: Social support has three main functions: 1. promotion of physical health, 2. promotion of mental health and 3. development of integration - as a growing into democratic society. The information obtained can help us to find ways to strengthen specific immigrant supporting system.

Objectives: Nursing education is a process that includes theoretical and practical learning and requires the acquisition of theoretical knowledge and skills. Nursing students need a positive clinical practice environment in order to apply their knowledge and skills, due to the fact that the clinical practice settings play an important role in the nursing profession. This study was carried out to explore the relationship of clinical learning environment to nursing students' academic motivation.
Methods: One hundred and twenty seven (127) nursing students who had been training at Giresun University, Faculty of Health Sciences, were enrolled in this descriptive study. The data were collected using the 'Clinical Learning Environment Scale' and the 'Academic Motivation Scale'.
Results: In this study, 34.6% second class, 37% third class and 28.4% fourth class of nursing students were surveyed. The mean scores of clinical learning environment and academic motivation were 66.7 ± 8.7 and 68 ± 10.9, respectively. There was a statistically significant difference between the scales (r = 0.254, p < 0.05).
Conclusion: One of the prerequisites for the training of qualified students is to provide nursing students with a qualified clinical environment. It was found that nursing students' academic motivation increased as the quality of their clinical learning environment improved.

Introduction: Based on both international and national health statistics, accidents from various mechanisms are among the most common causes of death in childhood. Our aim was to examine the first aid and accident prevention knowledge and attitudes of parents.
Materials and methods: In this study, parents of 3-7 years old children were involved in six kindergartens located in Hungary. A self-fill-in questionnaire applying standardized items was used to collect data. In the investigation, 307 parents (N = 307) were included. Out of them, 234 persons filled out the questionnaire correctly (n = 234). The statistical analysis was made with SPSS 20.0 statistical software. For analysis descriptive statistics, Chi-square-test and ANOVA were used.
Results: Three-quarters of the children have suffered at least one accident in their past life (74.3%). A total number of 174 parents attended first aid courses earlier (74.4%). The previous knowledge is based mainly on the personal information on their driving license (81.6%). Based on parent's results, there is a need for teaching first aid (70.5%) and accident prevention (89.7%) to children in kindergarten. There were only 10 parents, who answered all the featured first aid situations correctly (4.3%). Between the subjective judgment of the financial status and the correct answers we found a significant correlation (p = 0.03). The previously accomplished first aid training (p < 0.05) and the educational attainment (p = 0.029) had a positive impact regarding the correct answers.
Conclusion: The level of first aid knowledge among the parents of kindergarten children was lower than expected. With an offer to participate in a first aid course the level of knowledge from both sides (children and parents) could be increased. This could contribute to a better accident prevention andfirst aid practice among parents.

Cardiovascular diseases remain the leading cause of deaths and one of the most common causes of hospitalization in the Czech Republic. Due to the high increase in cardiovascular diseases, preventive measures to eliminate them were defined. One of the methods of prevention is the systematic clinical practice guideline focused on identifying and influencing cardiovascular risks. The aim of the survey study is to analyze the existing clinical practice guidelines aimed at preventing cardiovascular diseases. On the basis of keywords and specific criteria for the research strategy and classification, the researchers searched in electronic databases and websites of professional companies systematically all available clinical practice guidelines aimed at preventing cardiovascular diseases published between the years 2003-2013. Defined entry criteria were met by twelve clinical practice guidelines. There were four documents excluded on the basis of the specific exclusion criteria. The process of analysis was applied to eight clinical practice guidelines. The analysis was performed in preventive measures, methods of determining and influencing cardiovascular risk, implemented scoring system, sub-components of non-pharmacological interventions, the level of evidence, grades of recommendation and scope of the document. Given the socio-economic and organizational conditions in the Czech Republic, the most appropriate seem to be the clinical European guidelines on cardiovascular disease prevention in clinical practice (European Society of Cardiology), which were primarily designed for European countries. The European recommendations are also reflected by the Czech Clinical Guidelines for Prevention of Cardiovascular Diseases with a specific algorithm for determining cardiovascular risk in Czech population.

The rising number of patients with the arthroscopic removal of calcium deposits in the shoulder joint has increased the need for high-quality post-surgical rehabilitation care. The aim of the survey was to identify the effectiveness of physical therapy following the arthroscopic removal of calcification from the shoulder joint and to compare the impact of the physical therapy on painfulness.
The survey was conducted on 24 patients that had been intentionally selected. They were divided into two groups according to their physical therapy. One group was treated by means of ultrasound, and the other by 4-week magnetotherapy. The patients had an average age of 52.54 years. For the purposes of the summary of statistics we used Chi-squared test. Table values of chi-square were calculated on a standard level of significance 0.05.
Statistically verified results showed that the influence of the ultrasound on painfulness was better when compared with magnetotherapy. Two patients treated by ultrasound claimed difference in painfulness by two degrees. Eight patients claimed 8 degrees and 2 claimed 4 degrees. As for magnetotherapy, 1 patient claimed 1-degree difference, 10 patients claimed 2 degree and there was just one who claimed 3-degree difference. Magnetotherapy did not see a single patient claiming 4-degree difference in painfulness. The survey confirmed the positive effects of physical therapy. It is necessary to instruct patients properly and encourage them to have positive approach to physical activity at home. Since its extent and performance are limited due to painfulness, physical therapy is recommended, especially an ultrasound that has proven itself in practice.

The amendment to the pension scheme that remains a part of the third pillar of the pension system even after its reform, valid since 2013, has brought many serious changes. Except for the alteration of the state contribution, there is in particular the fact that the newly established so-called participation funds do not guarantee a non-negative evaluation of the paid funds which allows choosing a more dynamic strategy with the hope of a higher yield under higher risks. At the same time an opportunity to continue in the so-called transformed funds (previous pension funds) and continue having a guarantee of a non-negative yield has been preserved.
An analysis of development of the pension scheme and an additional private pension scheme after reform shows that these products have not fulfilled their primary function, i.e. to strengthen the role of the third pillar at the system of creation of the total savings for the period of old age, and they are not even able to compete with share funds or with other substitutes offered at the financial market without significant state support.

The report deals with empirical study of the relationships between work and life satisfaction and perception of the development of profession competencies in the group of social workers. The work satisfaction, as well as all components of life satisfaction in the group of social workers have globally average level, lower level can be stated only in the sphere of satisfaction with health, financial situation and own person. Social workers more satisfied in work differ from less satisfied social workers in general life satisfaction and in that they perceive higher level of all observed work competencies in themselves.

The contribution deals with a view of social welfare professionals in medical institutions on their professional activities focused on small hospitalized children of mothers addicted to alcohol. The dependence on alcohol currently brings a severe social problem encountered in our everyday life. Not only the addicted person but also an individual, a small child in the case considered here, who is most involved by the given social-pathological phenomenon, becomes an object of the social work. The welfare professional as a member of a multidisciplinary team in the medical institution enters interactions not only with healthcare professionals but also with patients with the aim to provide the professional and humanitarian quality of the given institution and application of methods of the social work to hospitalized patients. In the contribution presented here, a case report method is employed to present problems of work with hospitalized children of mothers addicted to alcohol. Our considerations are based on practical experience of social welfare professionals in medical institutions, who analyze and establish the plan of the social help under conditions of active attitude of the child mother and other family members to the cooperation with different institutions. The social work is an integrated discipline capable of multidisciplinary cooperation with other scientific disciplines, and deals with problems of social pathology not only at a theoretical level. It also enters the practice as an activity willing to help in the solution of individual problems of the whole society, including social-pathological phenomena, such as the addiction of the mother to alcohol and its consequences to the child himself/herself, who comes to the medical institution and needs a help of specialists. The contribution conclusively indicates possibilities of social welfare professionals in the analysis and solution of these serious problems, encountered for the period of their professional practice.

The purpose of the study presented here was to use the AGREE instrument for the implementation of the methodological analysis of the quality of processing selected clinical practice guidelines focused on problems of pressure ulcers, and furthermore to find differences between particular recommended clinical procedures in the field of prevention of the decubitus development and recommended preventive strategies.
The clinical practice guidelines (CPG) were searched for in electronic databases (G-I-N, Medline, Embase, ProQuest, Science Direct, Web of Knowledge) based on the following key words: pressure ulcers, pressure sore, decubitus, prevention, clinical practice guidelines. After subsequent classification and analysis of five foreign recommended clinical procedures and two Czech standards, the CPG methodological quality was evaluated and recommended preventive nursing strategies of prevention and taking care of pressure ulcers were compared.
In terms of methodology, the clinical practice guideline Risk Assessment & Prevention of Pressure Ulcers of the group Registered Nurses Association Ontario (RNAO) exerted the highest quality of processing. Most CPG evaluated mentioned similar recommendations of nursing interventions in the prevention and taking care of pressure ulcers. Differences were particularly found in recommendations of scales for the determination of the measure of risk of the pressure ulcers development, where the scale Braden, and under Czech conditions the scale Norton, were preferred.
Our study demonstrated considerable differences in processing of foreign CPG and Czech local standards of taking care of pressure ulcers, mainly in the compilation and implementation of recommendations - participation of multidisciplinary teams including patients, recommendations supported by research demonstrations, availability of professional as well as lay public.

In association with membership conditions of countries in the European Union, which prefers national politics of the health care in certain topics, a situation can be encountered where some European Union countries are bound by the ratification of international conditions on human rights in addition to their national protection, which does not hold for some other countries. This also concerns the implementation and introduction in practice of the Convention on Human Rights and Biomedicine. Whereas the Czech Republic and Slovakia signed and ratified this international convention, Austria has not yet given their signature and ratification. Article 3 of the Convention on Human Rights and Biomedicine "Equal accessibility of the health care" obliges the ratifying countries to develop as large effort as possible to provide the accessibility for all the inhabitants. The target is implementing fair attitude to the health care depending on needs of the medical treatment and providing sufficient prevention. The article presented here deals with legislative provisions on the part of the state aimed at equal access to the preventive care for children and youth in the above mentioned countries. The scope of the research was to find whether the states, particularly the Czech Republic, Slovakia and Austria, provide their citizens with full access to the health care in the field of preventive medical examinations for children and youth. The methods and techniques employed were as follows: secondary and primary sources, comparison and data analysis. The results demonstrated that on the part of states, the accessibility of the preventive health care for children and youth is provided in a comparable way in terms of the legislation.

The third call of the Ministry of Interior of the Czech Republic concerning the support of research, experimental development and innovation, was announced for the period 2013-2015. The Institute of Radiology, Toxicology and Civil Protection of the Faculty of Health and Social Sciences of the University of South Bohemia in Ceske Budejovice submitted an application for research focused on population protection according to population differentiation. The aim of the project was to analyze the current status of evacuation planning from the emergency planning zone according to population differentiation. This article discusses the issue of social institutions preparedness for evacuation from emergency planning zones. Evacuation planning is one of the most important parts of population protection. It has its own specifics and it is necessary to consistently perceive all of the aspects that evacuation includes. Social institutions are one of the important aspects which must be considered. In the emergency planning zones of nuclear power plants there are a total of 10 social institutions.

One of the main strategies that healthy universities implement among their students is that of promoting healthy lifestyles. However, behind these healthy lifestyles, there may be some aspects related to family functioning that favour or limit its implementation. Consequently, the objective of this study is to establish whether there is a relationship between lifestyles and family cohesion, family ethnic socialization and the affective behaviour of the father and the mother. A cross-sectional study was conducted with a representative sample of 159 female university students from an indigenous area of Oaxaca, Mexico. The Healthy Lifestyle Scale for University Students, the Self-Assessment Scale of Affective Behaviour (with regard to the father and the mother) and the Family Cohesion Scale were used. Family ethnic socialization revealed a significant interrelationship with lifestyles in all ethnic groups. However, these scores were higher in the indigenous groups. Although the moderate hostility from the father did not show any relationship with lifestyles in either ethnic group, the scores for hostility from the father were higher in indigenous groups than in the mestizo group. A multivariate analysis confirmed better lifestyles when better family cohesion and greater warmth of the father were observed.

Saving in the third voluntary pillar of the pension system is very popular in the Czech Republic. At the end of 2016, a total of 4 518 832 citizens had savings accounts. Total savings were 383,032.01 million CZK. One of the fundamental problems of the third pillar, which does not contribute to its popularity (especially in young generations), is a low deposit valorisation. The reason is that the valorisation often covers only the inflation and sometimes, not even as much. The situation would be even worse if there were not financial support from the state in the form of contributions and tax reliefs or from employees.

Objectives: The goals of this study were to examine the feasibility of using ontology-based text mining with CaringBridge social media journal entries in order to understand journal content from a whole-person perspective. Specific aims were to describe Omaha System problem concept frequencies in the journal entries over a four-step process overall, and relative to Omaha System Domains; and to examine the four step method including the use of standardized terms and related words.
Design: Ontology-based retrospective observational feasibility study using text mining methods.
Sample: A corpus of social media text consisting of 13,757,900 CaringBridge journal entries from June 2006 to June 2016.
Measures: The Omaha System terms, including problems and signs/symptoms, were used as the foundational lexicon for this study. Development of an extended lexicon with related words for each problem concept expanded the semantics-powered data analytics approach to reflect consumer word choices.
Results: All Omaha System problem concepts were identified in the journal entries, with consistent representation across domains. The approach was most successful when common words were used to represent clinical terms. Preliminary validation of journal examples showed appropriate representation of the problem concepts.
Conclusions: This is the first study to evaluate the feasibility of using an interface terminology and ontology (the Omaha System) as a text mining information model. Further research is needed to systematically validate these findings, refine the process as needed to advance the study of CaringBridge content, and extend the use of this method to other consumer-generated journal entries and terminologies.