The aim of this work - to estimate an association of metabolic syndrome (MS) with ischemic heart disease (IHD) in middle-aged Kaunas population and to propose the model for preventing prevalence of MS. Material and methods. Analysis was performed for 1336 persons aged 35-64 years (603 men and 733 women) - the participants of health survey which has been carried out according to the MONICA study protocol. MS was defined by Adult Treatment Panel III criteria for the presence of three or more from five components: central obesity (waist circumference >102/88 cm (men/women)); fasting plasma glucose ≥6.1 mmol/l; triglycerides ≥1.7 mmol/l; high density lipoprotein cholesterol <1.04/1.3 mmol/l (men/women); systolic/diastolic blood pressure ≥130 and/or 85 mmHg. IHD was diagnosed as previous myocardial infarction, angina pectoris or ischemic changes in electrocardiogram. Lifestyle habits were evaluated using frequency questionnaire. The relationship between MS and IHD in consideration of age and smoking habits was estimated using logistic regression. Results. Prevalence of MS in the study population was 19.4 percent for men and 26.3 percent for women. Prevalence of MS among men and women increased with age. Hypertension was the most frequent component of MS (64.1 percent for men and 54.2 percent. for women). The rate of IHD was 14.3 percent for men and 19.4 percent for women. Risk of IHD in subjects with MS in comparing to subjects without MS was higher: odds ratio 1.98 (95 percent... [to full text]

Aim of the paper: to analyze performance peculiarities of primary health care organizations (PHCO) and to propose possible ways for improvement. Methods: the analysis of scientific literature of Lithuanian and foreign authors, analysis of legal regulating documents, analysis of the results of the questionnaire of managers of PHCO, analysis of the results of the interview with experts. The object of research: performance assessment of primary health care organizations. Results: PHCO quality assessment and assessment performed by administrative organizations are the most often types of PHCO assessment in Lithuania. The results of the research show that data evaluating PHCO performance are fragmented and reflect only certain areas of PHCO activities. The quantity of the data does not correspond to the needs of PHCP managers in the strategic planning and implementation process. The assessment of PHCO performance is not dynamic and adjusted to the changing environment conditions. Experts unanimously pointed the need for the development of present PHCO performance assessment system and the need for its unification. Conclusions and practical recommendations: 1. Having done the analysis of scientific literature, we may conclude that problems of performance assessment are most often analyzed in business than in public sectors. The complex view to organization activities allows to analyze not only results of the organization, quality of performance but also to identify areas for... [to full text]

Aim of the study: – investigate and compare the satisfaction of work of the personnel working in the Kaunas Centre of Public Health (KCPH) and its subsidiaries. Methods: - The personnel of KCPH and its subsidiaries took part in the inquiry. There were 193 questionnaires distributed, 150 of them were completed and returned. The response rate was 77.7%. The 7 – point Likert scale was used in the survey where 1 point stood for “totally disagree”, and 7 points for “totally agree”. The acquired inquiry results data were then processed and analyzed using SPSS version 9.0 Statistical software package. Hypothesis about the absence of interdependence between the two indicators were verified using the chi-square (χ2) criterion. Results differences at p < 0.05 level were considered as statistically significant. Means, standard deviations (SD) and confidence intervals (CI) were also calculated. The strength of relation among the rating variables was verified using Spirmen coefficient of correlation. Results: - In the KCPH subsidiaries 50% of the personnel are elder than 50 years of age. 49.1% of the KCPH subsidiaries employees have secondary education. General satisfaction with the work, independently of working place, is higher than average (4.98). The most satisfied with the work are the ones who have secondary education (5.33), elder than 50 years of age (5.31) and the ones who have 26 or more years of previous experience in the field (5.52). The motivation actions were identified... [to full text]

Results: QMS have been implemented in 63.9 per cent of the Lithuanian general hospitals. This system is currently under implementation in 22.2 per cent of the hospitals mentioned, and no QMS have been implemented so far in 13.9 per cent of the Lithuanian general hospitals. More than one third of institutions have implemented the ISO standard. Institutions wich have alredy implemented the QMS enjoy higer patient satisfaction (accordingly 5,36 (1,05) and 4,18 (2,14)), improved quality of the services provided (accordingly 6,09 (0,32) ir (4,83 (1,64)). The functioning QMS improves motivation of the employees (4,60) and the patient safety (5,83). Hospitals with the well-functioning QMS more actively record (accordingly 4,78 (2,19) and 2,73 (1,62)) and analyse adverse events (accordingly 5,41 (2,01) and 3,09 (1,97)). Recording of adverse events helps to identify problems (6,41), improve the quality of the services provided (6,13). Conclusions: 1. QMS have been implemented in more than a half of the Lithuanian general hospitals. The hospital managers and the managers of the local medical audit group acknowledge important role of the QMS. 2. Hospital managers and managers of the local medical audit group implementing the QMS in hospitals have encountered with the following problems: the employees avoid recording adverse events, the staff lacks motivation to engage in implementation of the quality management system, hospitals lack employees competent in the field of quality... [to full text]

People psychological health is undoubtedly the question of the day in nowadays society. Factors of ill adults’ psychical health, its relationships, and view to their health condition are analyzed in this work. 70 patients from Rokiškis psychiatry hospital, who have slight psychical disability, have attended in this research. 70 healthy adults, who haven’t treat their selves is same sort institutions, formed auditorial group. All the respondents are 20-55 years old. In our research we used the technique of K. Wallston (1978) – Multidimensional health locus methodology, which is intended to assess the different people views to important problems, which are associated with their health; the result of assigned project was expressed indicators: internality(HLC), chance (CHC), powerful others (PHLC). The health of respondents was evaluated by Ch. Spielberger scale (2000) of anxiety and worry (how they feel now and generally).

Kokybė apima kiekvieną ir visas veikas, atliekamas sveikatos priežiūros įstaigoje. Šio darbo tikslas yra iš įvertinti sveikatos priežiūros kokybės sistemų diegimo aspektus privačioje gydymo įstaigoje medicinos darbuotojų požiūriu. Sveikatos priežiūros kokybę užtikrinančių sistemų diegimas – pagrindinė įstaigos sritis, siekiant pelningos veiklos. Baigiamajame darbe, analizuojami Lietuvos Respublikos teisės aktai, įvairi mokslinė literatūra bei anketinės apklausos metodu vertinama UAB „Kardiolita“ medicinos darbuotojų požiūrį apie šios įstaigos kokybės vadybos sistemų diegimą. Išnagrinėta, jog privačios sveikatos priežiūros įstaigos akcininkai bei vadovai suinteresuoti diegti sėkmingas kokybės vadybos sistemas, tačiau dėl nepakankamo dėmesio atskiriems etapams – informacijos darbuotojams stokos, kontrolės organizavimo, nepakankamo darbuotojų mokymo bei supažinimo su kokybės vadybos sistemos nauda bei neanalizuojant kokybės kaštų – aptinkami trūkumai, kurie trukdo gerinti kokybę minimaliomis išteklių sąnaudomis. Efektyvus sveikatos priežiūros kokybės vadybos sistemos valdymas pasiekiamas, kai dalyvauja visų lygių darbuotojai ir analizuojami kokybės kaštai, o visam procesui vadovauja atatinkamą išsilavinimą turinti sveikatos vadybininkas. / The title of the final work – is implementation of the system of quality management with the attitude towards the workers of private medical institution. Key words: quality, quality of medical care, systems of quality management, quality management, the rate of medical workers, education of workers, quality cost outlay. Summary. Quality covers all and each action performed at a medical institution. The aim of this work is to evaluate the aspects of the quality of implementation of the system in medical care with the attitude towards the workers of medical institution. The implementation of the systems which quarantee the quality of medical care – is the main sphere of the institution in order to reach profitable activy. The acts of Lithuanian Republic law are being analysed in the final work as well as a varied scientific literature. The system of the implementation of quality management at the stock company „Cardiolita“ was evaluated by a survey with the attitude of its workers. It was analysed that the shareholders and managers are interested in the successful implementation of the quality management system.

Master’s theses are carried out at Vilnius Pedagogical University, at the faculty of Pedagogy and Psychology department of Psychological didactics. The investigation is based on K. Wallston’s 1978 methodology of Multidimensional scale of Health locus control and on A. Petrulyte 1985 self evaluation scale. The main purpose of the work is to analysis specific features of health locus control and self - evaluation of soldiers of compulsory military service. In research involvement 239 soldiers of compulsory military service and 240 students of Klaipėda University. The investigation showed that the average of soldiers of compulsory military service and students health locus control index is different. The soldiers and students is rely on HLC ( = 24,80), but there is a tendency that the PHLC ( = 22,20) is higher than CHC ( =20,26). The analysis showed that solders and students CHC negatively and statistically correlates with cognitive self – evaluation (r = -0,119 p = 0,009). Students HLC positively and statistically correlates with emotional self – evaluation (r = 0,130 p = 0,045), students CHC negatively and statistically correlates with cognitive self – evaluation (r = -0,205 p = 0,001). Soldiers of compulsory military service HLC, CHC and PHLC health locus of control did not statistically correlates with cognitive and emotional self – evaluation.

SUMMARY Management of Public Health ORGANIZATION OF DISEASES PREVENTION IN PRIMARY HEALTH CARE Raminta Gečaitė Supervisor Skirmantė Starkuvienė, MD, PhD, Lecturer, Department of Social Medicine, Faculty of Public Health, Kaunas University of Medicine. – Kaunas, 2005. - P.56. Aim of the study – to evaluate patients’ attitude towards the non-communicable diseases (NCD) prevention in primary health care and to clarify the differences of the prevention between general practitioners (GP) and therapeutists. Methods. The anonymous questionnaire survey was performed among adult patients, who visited their family doctor in Kaunas Kalniečiu outpatient clinic, at the Department of General Practitioners and General clinic (the work is organized in a team principal). There were 120 questionnaires distributed to the patients of GP and 101 of them were fulfilled and returned back (response rate – 84.2%). There were also 120 questionnaires delivered to the patients, who visited therapeutists and 98 of them were filled in (response rate – 81.7%). The data was analyzed by the application of statistical package SPSS 11.03 for Windows. The associations between the variables were measured using the Chi-squared and the Student tests. Results. The survey disclosed that 15.6% of the respondents visited the family doctor in order to examine their health preventively. More than half (51.8%) of the patients were satisfied with the organization of diseases prevention carried out by their family... [to full text]

SUMMARY Management of Public Health JOB SATISFACTION AMONG COMMUNITY NURSES Danutė Adomavičiūtė Supervisor Jurgita Vladičkienė, Dr.Sc., Department of Social medicine. Faculty of Public Health, Kaunas University of Medicine.- Kaunas, 2005.- P.71 Primary health care is a priority field of health care in Lithuania. Community nursing as a part of primary health care meets with development difficulties. First of all, is paid too few attention to community nurses, in primary health care institutions is a shortage of them, but customers wishes more of community nurses lent services. Aim of the study is to investigate job satisfaction level among community nurses in Kaunas primary health care institutions. Objectives are to evaluate general job satisfaction level among community nurses, to establish relationship between job satisfaction and work factors, and relationship between job satisfaction and nurse’s efforts better to work, to establish needs of community nurses. Methods. Object of study is community nurse’s job satisfaction. A sample of 174 nurses was questioned with the aid of anonymous questionnaire. Statistic data reliability was tested by Chi square test of independence, degrees of freedom quantity (df) and statistical significance (α=0,05). Results. There was established, that 60,3% nurses are content with their own job and 39,7% - unsatisfied. Calculated common average of job satisfaction grade was 2,63 (±0,770), by evaluating in scale from 1 to 4 (where 1 is... [to full text]

The beginning of the XX century brought many changes in distinct spheres of life including the women movement which in Lithuania rezultated into the social care for children and their mothers as one of the women organizations’ work field. The notion care in this work is treated as the work done by Lithuanian women organizations to decrease the rate of infant mortality though this process in Western countries was noticed much earlier still in Lithuania this problem became serious at the examined period. The main aim of this work is to analyze the basic public social care features in the First Republic of Lithuania disclosing them trough the aspects of the social care work done by the Lithuanian women organizations. The geographical area – Lithuania without the Vilnius and Klaipeda territory, the chronology is 1918 – 1940 – the period of the First Republic of Lithuania. There are few methods used: analytical and comparison. Work deals with these problems: 1. the preconditions for the women organizations’ social work, 2. the preconditions and functioning of the social welfare centers, 3. the types and work for patronage houses, 4. relationship between the women organizations and the State, 5. education of the women in villages and towns. There are two women organizations that are being examined: “The Lithuanian Catholic Women Association” and “The Association for the care for Lithuanian Women”. These organizations belonged to the different Unions. “The Lithuanian Catholic Women... [to full text]