Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a long-term narrowing of the airways caused by emphysema or chronic bronchitis. In addition to physical symptoms, it affects psychological and social functioning.

Aim: This study aims to examine the correlation between specific aspects of the perceived health-related quality of life and the presence of negative emotional states – depression, anxiety and stress in individuals with COPD.

Methods: We conducted an observational cross-sectional study in 2023 on a convenience sample of patients with COPD who were treated at the Pulmonology Clinic of the General Hospital “Dr. Ivo Pedišić” in Sisak, Croatia. We collected data with a questionnaire that included questions on personal characteristics, general health status, and COPD burden, along with two standardized instruments: the Depression, Anxiety and Stress Scale (DASS) and the St. George’s Respiratory Questionnaire (SGRQ-S). Statistical analysis included descriptive statistics and parametric tests, specifically Pearson’s correlation coefficient.

Results: A total of 128 participants were included in the study. Limitations in health-related quality of life were significantly correlated with the level of stress (r=0.80; p<0.01), anxiety (r=0.83; p<0.01) and depression (r=0.80; p<0.01). Reduced quality of life was associated with participants’ age (r=0.49, p<0.01) and the duration of the disease (r=0.48, p<0.01). Low to moderate coefficients of Person correlation (0.35 to 0.41) point to a significant correlation between age, duration of the disease, and the appearance of negative emotional states.

Conclusion: The reduced health-related quality of life and the occurrence of negative emotional states in patients with COPD represent a significant problem in the patient’s life, especially in those with advanced disease. In the treatment of patients with COPD, in addition to assessing the physical condition, attention should also be paid to the psychosocial assessment. An interdisciplinary approach should be included in the assessment and treatment of people with COPD, to provide better quality of healthcare services.

Keywords: chronic obstructive pulmonary disease, health-related quality of life, stress, anxiety, depression

Abstract
Background: Job satisfaction can be defined as a feeling of fulfilment or happiness related to all or specific aspects of work. It is generally assessed through certain job characteristics such as compensation, benefits, interpersonal relationships, and work organization. Employee dissatisfaction can lead to burnout syndrome as well as other mental and physical illnesses that negatively affect their quality of life.

Aim: The aim of this study was to examine the degree of job satisfaction amongst nurses at primary, secondary and tertiary level of healthcare in the Republic of Croatia.

Methods: The study was conducted using an online survey distributed to respondents via social media and email. The Job Satisfaction Survey (JSS), with 36 items and nine facets created by Spector P.E., was used to assess job satisfaction amongst nurses. We added six sociodemographic items to this survey.

Results: A total of 372 nurses participated in this study. The highest score was obtained for the facet nature of work (M = 16.4; SD = 3.3) and lowest for pay (M = 9.3; SD = 3.4). Only 10% of respondents reported overall job satisfaction, 54% were ambivalent, and 36% expressed dissatisfaction. There was no statistical difference between job satisfaction and the level of education (P > 0.05). More than 50% of participants were dissatisfied with pay, promotion and fringe benefits (P < 0.001) while 56% of participants felt that their work was not adequately appreciated.

Conclusion: Considering the results obtained from this study, we conclude that many nurses in the Republic of Croatia are quite dissatisfied in some facets of their job such as pay, promotion and benefits and satisfied or ambivalent in others such as job characteristics or supervisors. It’s important to conduct job satisfaction studies and investigate the causes of dissatisfaction at a national level, involving a larger number of healthcare nurses, to proactively influence and prevent the consequences of dissatisfaction.

Keywords: job satisfaction, nursing, work environment

Abstract
Background: A proper diet plays a major role in preserving the quality of life and health for each individual. For healthcare workers, shift work can result in irregular and poor-quality dietary intake, which can lead to the development of health problems and chronic diseases.

Aim: This study aimed to analyse dietary habits among healthcare workers based on their work schedules (morning shifts vs. rotating/shift work) using validated dietary assessment tools.

Methods: A cross-sectional study was conducted from December 2023 to March 2024 in various departments of the Merkur Clinical Hospital. A total of 147 participants (physicians, nurses, and healthcare assistants) were surveyed using two validated instruments: the Mediterranean Diet Adherence Screener (MEDAS) and the Mediterranean Diet Serving Score (MDSS). Descriptive statistics and t-tests were used to compare dietary patterns between groups, with p-values <0.05 considered statistically significant.

Results: A statistically significant difference was observed in dessert consumption, with morning shift workers consuming sweets more frequently (M = 3.67, SD = 2.39) than shift workers (M = 2.70, SD = 2.21; p < 0.05). In contrast, shift workers consumed significantly more wine than morning shift workers (M = 1.04, SD = 1.71 vs. M = 0.41, SD = 0.75; p < 0.05).

Conclusion: The findings suggest that work schedules are associated with distinct dietary patterns among healthcare workers. Morning shift workers show a preference for sweets, while shift workers consume more alcohol. These results highlight the need for targeted workplace dietary interventions, including improved access to healthy meals and strategies to promote balanced eating across all shifts.

Keywords: dietary habits, healthcare workers, rotating/shift work, morning shifts, Mediterranean Diet

Abstract
Background: Malaria is a life-threatening parasitic disease transmitted by mosquitos which remains a major public health issue in Benin, leading to high consultation and
hospitalisation rates, especially among children under five and adults.

Aim: This study aims to assess the knowledge, attitudes, and practices of residents and health workers in southern Benin regarding malaria prevention and the factors influencing these aspects.

Methods: This was a cross-sectional study, conducted in Benin, in 2022. Data were collected using a Knowledge, attitudes and practice (KAP) questionnaire which was adapted to the needs of this study Participants included both residents and healthcare workers.

Results: A total of 529 respondents participated in the study, including 124 health workers and 405 non-health workers. Among them, 96% had heard of malaria, primarily through health facilities (53%) and schools (50%). The majority (63%) were aware of the National Malaria Control Programme, while 75% believed malaria could be prevented, and 88% reported using mosquito nets. The findings indicate a high level of knowledge about malaria, its symptoms, treatment, and prevention measures, with no statistically significant differences in overall malaria knowledge (r=0.11; p<0.01). However, participants from rural areas were more likely to rely on alternative treatments (r=0.14; p<0.01), whereas health professionals demonstrated greater knowledge of malaria and its prevention (r=0.15; p<0.01). Additionally, awareness of the National Malaria Control Programme was higher among more educated individuals (r=-0.28; p<0.01), healthcare workers (r=0.19; p<0.01), and urban residents (r=- 0.23; p<0.01).

Conclusion: Malaria remains a major health challenge in Benin. Strengthening professional efforts, continuous education of health workers, and targeted public awareness about the National Malaria Control Programme are essential for effective prevention and control.

Keywords: malaria, knowledge, attitudes, practices, Benin

Abstract
Background: The palliative care for individuals with life￾threatening illnesses and their families involves complex, ongoing interventions that require specific competencies
from both professionals and volunteers. In Croatia, the White Paper of the European Association for Palliative Care (EAPC) on education and core competencies has served as a key framework for training programs. Despite its broad application, variations in curricula and training approaches remain, underscoring the importance of adapting education to the specific needs of learners.

Aim: The aim of this study was to explore the educational needs in palliative care among nurses, physicians, psychologists, and social workers in order to develop training programs or modules tailored to the actual needs of these professionals.

Methods: Qualitative research was conducted in 2024 in the County of Međimurje, Croatia. Four focus groups were organised with each group representing a different
profession: 8 nurses, 4 psychologists, 6 social workers and 6 general practitioners. All the participants worked in general palliative care services. The data was analysed using thematic analysis.

Results: Two main themes emerged from the focus groups: 1) Challenges in working with patients and families facing life-threatening illness, and 2) Strengthening competencies through education. Key areas for improvement included communication, decision-making, coping with death and bereavement, and identifying palliative care needs. Healthcare professionals also highlighted pain management and self-care. Social workers emphasized family dynamics, while psychologists focused on bereavement and end-of-life support.

Conclusion: The study highlights the need for structured and targeted educational programs in palliative care, adapted to the distinct roles and responsibilities of various professionals. Emphasis should be placed on enhancing communication skills, addressing ethical dilemmas, and strengthening psychosocial competencies to ensure comprehensive and compassionate care.

Keywords: palliative care, patients, physicians, psychologists, social workers, knowledge, education

Abstract
Background: The increasing media presence of healthcare professionals significantly influences public health perception, trust in healthcare systems, and the spread of health information, necessitating a systematic approach to evaluate and optimize their communication strategies.

Aim: To develop and present an innovative methodological framework—the MECA (Media Exposure Content Analysis) matrix—for the systematic analysis of media appearances of healthcare professionals, integrating both qualitative and quantitative approaches to assess verbal, nonverbal, and paraverbal communication elements.

Methods: A total of 181 statements made by healthcare professionals—including physicians, nurses, medical technicians, pharmacists, and psychologists—were analysed. Statements by the Minister of Health were also included, given their systemic relevance. The dataset was compiled from television news reports aired on TV channels between January 1 and January 31, 2024. A comprehensive review of existing content analysis methodologies was conducted to inform the analytical framework. The MECA matrix was validated through rigorous procedures to ensure its reliability and consistency.

Results: The MECA matrix was designed and implemented to categorise and code media appearances. It integrates both qualitative and quantitative approaches to systematically assess communication elements across these dimensions to assess verbal, nonverbal, and paraverbal communication elements.

Conclusion: The MECA matrix offers a novel, multidimensional approach for evaluating healthcare communication in media settings, addressing a crucial gap in existing methodologies by including ethical criteria and enabling cross-modal analysis. While the model has limitations—such as the need for linguistic competence and the inability to analyse purely visual or non-contextual audio content—it significantly advances the systematic evaluation of public health communication, supporting professional development, trust-building, and public health policy formation.

Keywords: media appearances of healthcare professionals, content analysis, public appearance, rhetoric analysis

Abstract
Background: Numerous studies highlight the importance of monitoring the preparedness of final-year nursing students for entry into the profession. Although various questionnaires assessing professional preparedness among students have been developed, most of them have not yet been translated into Croatian or validated for use among Croatian nursing students.

Aim: The aim of this study was to present the Croatian translation of the Perceived Professional Preparedness of Nursing Students Questionnaire (PPPNS), evaluate its construct validity, and determine its reliability for application among Croatian nursing students in their final year of study.

Methods: A cross-sectional observational study was conducted among 200 final-year students of Bachelor of Nursing (BN) and Master of Nursing (MN) studies. Data were collected using the Professional Preparedness of Nursing Students questionnaire during January 2024. Confirmatory factor analysis was performed.

Results: The initial 19-item model did not demonstrate satisfactory fi t indices; therefore, four items with low factor loadings were removed. After revision, the modified 15-item questionnaire demonstrated good psychometric properties with acceptable model fit indices and high overall internal consistency.

Conclusion: The results indicate that the Croatian version of the PPPNS-15 questionnaire is a reliable and valid instrument for assessing nursing students’ perceived preparedness for independent clinical practice. Its use can significantly contribute to enhancing the quality of nursing education for future nurses in Croatia.

Keywords: professional preparedness, students, nursing, PPPNS

Abstract
Background: Cases of coexistence of a twin molar pregnancy with a living second fetus are known in the literature, with different outcomes and treatment options, from uterine preservation procedures and cesarean section to hysterectomy due to the vital threat to the pregnant woman. Later pregnancies are dependent on uterine preservation – evacuation procedures in the first pregnancy.

Aim: Obstetrics forensic commentaries on the management of two different trophoblastic diseases.

Methods: This extremely rare case of previal cervical molar pregnancy in a twin pregnancy and primary completion by laparotomy in the first pregnancy is directly related to the occurrence of placental percretism with hematoperitoneum at 30 weeks of pregnancy due to distension and rupture of a placental blood vessel and supracervical hysterectomy.

Conclusion: Thus, these problems became professional failures with an irreversible “domino effect”. After such decisions and treatment, menstruation and reproduction
were prevented by hysterectomy, and the possible treatment options for such conditions in the first and second pregnancies are discussed in the text with a forensic perspective.

Keywords: molar pregnancy, cervical pregnancy, placenta accreta spectrum, hysterectomy, treatment, medicolegality