Andrea Solgajová

Kontakt is a platform for publishing contributions on the complexity of interactions between clinical and social actions in the context of health improvement.

Background/Objectives: Obesity is a complex systemic condition driven by interactions between biological mechanisms and environmental factors. This retrospective, uncontrolled, completer study aimed to evaluate changes in body composition and long-term weight maintenance, as well as the impact of comorbidities, in adult patients undergoing personalised dietary and behavioural interventions. Methods: A retrospective analysis of outpatient medical records (2018–2024) was conducted. Of the 1416 patients analysed, 267 overweight or obese adults completed the active treatment phase and a one-year post-intervention follow-up period. The primary endpoints were absolute changes in body weight, BMI, and body fat mass (BFM), as measured by bioelectrical impedance analysis (BIA), as well as the maintenance of ≥10% weight loss after one year. The intervention consisted of a personalised diet based on a food-exchange system, combined with psychodietetic support. Results: Participants achieved a mean weight loss of 10.45 ± 7.56 kg, which was associated with significant decreases in BMI and BFM. The average loss of fat-free mass and skeletal muscle mass was 1.72 ± 2.20 kg and 1.11 ± 1.36 kg, respectively. Weight maintenance, defined as maintaining a weight loss of at least 10% of baseline body weight after a one-year follow-up period, was achieved by 23.2% of participants who completed the study. Conclusions: Participants experienced significant reductions in body weight and body fat while preserving lean body mass to a moderate extent. However, long-term maintenance of weight loss was achieved by less than a quarter of participants after one year, highlighting the ongoing challenge of weight regain.

This qualitative study explores the experiences of psychiatric nurses with missed nursing care in an acute inpatient setting. Missed care, defined as any aspect of required care that is omitted or delayed, poses significant risks to patient safety and care quality yet remains under-researched in psychiatric contexts. Using semi-structured interviews with eight nurses from a Slovak psychiatric clinic and reflexive thematic analysis, the study identified key systemic and organizational barriers contributing to missed care. Findings revealed that nurses frequently lack time, resources, and support to provide therapeutic communication, emotional support, and comprehensive patient assessments. These omissions were not due to negligence but to chronic workforce shortages, limited material conditions, and insufficient managerial support. Nurses expressed feelings of moral distress and professional frustration, highlighting a disconnect between institutional expectations and their capacity to deliver holistic, person-centred care. The study underscores the need to recognize relational and psychosocial aspects of psychiatric nursing as essential, not optional. Implications for practice include investing in workforce capacity, improving communication systems, enhancing psychiatric-specific education, and fostering supportive leadership. By addressing these systemic issues, psychiatric services can move closer to delivering safe, recovery-oriented care that values both patients' needs and nurses' professional integrity.

Investigating the predictors of moral distress is particularly important for protecting nurses’ mental health and professional satisfaction, thereby preventing burnout and attrition from the profession. The primary aim of this study was to evaluate the predictors of moral distress among nurses. A cross-sectional study design was used. The sample consisted of 412 nurses from 11 hospitals across Slovakia. The mean age of the respondents was 40.48 years (SD = 10.92). Moral distress was assessed using the Modified Moral Distress Scale. Linear regression analysis was used to evaluate predictors of moral distress. Personal accomplishment, the maladaptive coping strategy of self-distraction, continuous shift operation, and emotional burnout emerged as significant predictors of the frequency of moral distress among nurses (AdjR² = 15.5%; R² = 0.155). Regarding the intensity of moral distress, significant predictors included personal accomplishment, the maladaptive strategy of self-distraction and the adaptive strategy of religiosity and spirituality (AdjR² = 14.0%; R² = 0.140), which appear to function as adaptive coping mechanisms for dealing with the intensity of moral distress. Systematic investigation of predictors of moral distress among nurses may contribute to the development of interventions and programs that support nurses, thereby improving not only their job satisfaction but also the quality of patient care.

Aim. Preoperative anxiety is a risk factor for various psychophysiological reactions in patients, which increases need for anaesthesia, prolonged hospitalisation, and overall convalescence. The purpose of the study was to detect the incidence of anxiety in patients before neurosurgical operations and assess the impact of time to operation and selected demographic factors on the occurrence of anxiety. Material and methods. The study was approved by the Hospital Ethics Committee. A cross-sectional study design was used. The sample consisted of 108 respondents. The average age was 58.16 years (SD = 12.49). Data were collected in a preoperative period in patients before their planned operations. Preoperative anxiety was assessed by the Amsterdam Preoperative Anxiety and Information Scale. The data were analysed with the IBM SPSS Statistics 22, the Mann-Whitney U test, the Wilcoxon test, and the Pearson correlation coefficient. Results. Anxiety and need for information varied over time to the date of operation with an increasing trend between Measurements 1 and 2 (p < 0.001) and between Measurements 1 and 3 (p < 0.001), with a greater increase in females. No statistically signifi cant relationship between preoperative anxiety and age was found. Conclusions. The fi ndings support the need for preoperative anxiety assessment in neurosurgical patients.

Patient safety is a global priority and a core component of nursing education. Competence in this area encompasses cognitive, behavioral, and sociocultural

Introduction: Safe care provision is a critical global healthcare issue. Nurse educators play a vital role in identifying strengths and weaknesses in patient safety education across academic and clinical settings. Aim: To explore nurse educators’ opinions and experiences with patient safety education in academic and clinical settings. Materials and methods: Thirteen nurse educators from two nursing faculties participated in the study. Data were collected via an online self-designed survey using Google Forms in February 2024 and analyzed through content analysis. Results: Three key themes emerged: the interpretation of safe nursing care, teaching patient safety–characteristics and requirements, and reflections on patient safety education. Conclusions: Integrating patient safety education into nursing curricula and ensuring practical, hands-on learning experiences are essential to prepare students for real-world challenges.

While teamwork is widely recognized as essential to safe and high-quality nursing care, its evaluation has been underexplored in Central and Eastern Europe. This study offers original insights by systematically assessing nursing teamwork in Slovak public hospitals. By identifying strengths and weaknesses in team dynamics through structured evaluation, it becomes possible to implement targeted, context-specific improvements that reflect the realities of the local healthcare system. This study aimed to explore how registered nurses (RNs) perceive the level of teamwork in selected public hospitals in Slovakia and to identify key factors that influence these perceptions, addressing a significant gap in research within the Central and Eastern European healthcare context. The cross-sectional study. The study included 346 RNs from four selected hospitals in the Slovak Republic. Data were collected using the Nursing Teamwork Survey (NTS) instrument between April 2022 and February 2023 and analyzed using descriptive and inferential statistics. Registered nurses perceived moderate teamwork during their last working shift. Perceived level of teamwork was significantly influenced by the unit type, the number of overtime hours in the past month, and the intention to leave the position. The results show significant associations between the perceived level of teamwork and overall job satisfaction, job satisfaction in the current position, satisfaction with teamwork, and overall patient safety level. Several variables were found to be significant predictors of teamwork among RNs (p ≤ 0.05). Effective teamwork among nurses is crucial for optimal patient outcomes. The study highlights the importance of enhancing teamwork in the Slovak healthcare setting and identifies factors influencing nurses' perceptions of teamwork. Addressing these factors can lead to a more positive teamwork environment and improved work satisfaction among nursing professionals. Targeted interventions based on identified predictors could be beneficial in achieving this goal.

Aim: To identify and compare the digital competence profiles of nurse educators, the background variables associated with profiles, and the self‐assessed level of digital competence in four European countries. Design: A descriptive comparative cross‐sectional study. Methods: Data were collected from nurse educators ( n = 263) in 36 nursing education organisations in Finland, Malta, Slovakia and Spain. Partitioning around medoids (PAM) clustering was used to identify competence groups, and descriptive and inferential statistics were used to examine the association of nurse educators' background variables. Results: The clustering analysis resulted in two nurse educator digital competence profile groups: high and moderate. The profiles differed based on completed pedagogical studies and teaching experience, with an emphasis on the high competence profile. Educators in the high competence profile group showed greater interest in using educational technology and self assessed their digital competence at a higher level compared to educators in the moderate competence profile group. Nurse educators' lowest digital competence was in the safe and responsible use of technology, such as knowing copyright laws. Conclusion: Despite the heterogeneous background of nurse educators, international continuing professional development needs in digital competence are identified. Nurse educators' continuing education should support the utilisation of technology through pedagogical approaches, and educators' competence in the safe and responsible use of technology (e.g., how to protect digital materials) must be enhanced in nursing education organisations. Implications for the Profession: This study highlights the need to further develop nurse educators' digital competence. Continuing professional development should target preparation in safe and responsible technology use and include pedagogical studies and mentoring from experienced peers. Reporting Method: The STROBE checklist was adhered to in reporting the results. Patient or Public Contribution: Each participating educational organisation assigned a contact person to distribute the survey to the nurse educators.