Damjan Dušević

Background: High-intensity interval training (HIIT) is increasingly used in exercise-based cardiac rehabilitation (ebCR) after myocardial infarction (MI), yet the temporal sequence of physiological, cardiac, biochemical, and functional adaptations remains incompletely characterized. Methods: Stable post-STEMI (ST-segment elevation myocardial infarction, MI-group) and previously inactive participants without known cardiovascular, metabolic or systemic disease (CTRL group) completed 12-week supervised outpatient HIIT (4 × 4 min intervals at 85–90% HRpeak (peak heart rate), ~80–90% of VO₂peak, 3 sessions/week). Assessments were performed at baseline (T1), 4 (T2), 8 (T3), and 12 weeks (T4), including cardiopulmonary exercise testing (CPET), echocardiography, blood biomarkers, body composition, six-minute walk test (6MWT), and RAND-36. Longitudinal changes were analyzed using Friedman tests with Dunn post hoc comparisons; between-group differences used Mann–Whitney U tests with Holm correction. Results: VO₂peak increased significantly in both groups (p < 0.001), increasing by ~22% from T1 to T4 in MI (median 20.1 to 24.5 mL·kg⁻¹·min⁻¹) and ~23% from T1 to T4 in CTRL (median 22.3 to 27.6 mL·kg⁻¹·min⁻¹). LVEF (left ventricular ejection fraction) improved early in MI, increasing from 52.5% (50.0–55.0) at T1 to 57.5% (55.2–58.7) at T2 and up to 60% (55.8–60.0) at T4 (all p < 0.001), while LV dimensions remained stable. NT-proBNP (N-terminal pro-B-type natriuretic peptide) showed no significant longitudinal change (p = 0.510), and CRP (C-reactive protein) decreased from 2.1 to 0.7 mg·L⁻¹ (p = 0.008) in MI. Both groups improved body fat % and 6MWT distance (p < 0.001). Conclusions: In low-risk stable post-STEMI patients, longitudinal changes during supervised HIIT-based ebCR were consistent with improved VO₂peak and LVEF, without clinically relevant increases in cardiac stress biomarkers. However, due to the observational design and absence of clinical comparator groups, these findings should be interpreted as descriptive and support further evaluation in larger randomized studies.

Profesionalno sagorijevanje savjetovatelja i psihoterapeuta definira se kao neuspjeh u adekvatnome izvršavanju kliničkih zadataka zbog osobne obeshrabrenosti, ravnodušnosti prema stresu zbog rada u sustavu te emocionalne i fizičke iscrpljenosti, a zastupljeno je kod 40-ak % stručnjaka za mentalno zdravlje. Cilj je ovoga rada validirati hrvatsku verziju Upitnika profesionalnoga sagorijevanja savjetovatelja (engl. Counselor Burnout Inventory – CBI; Lee i sur., 2007) koji sadrži 20 čestica grupiranih u pet faktora. Istraživanje je provedeno na uzorku od 242 savjetovatelja i psihoterapeuta s područja Republike Hrvatske (93.4 % žena, 72.7 % psihologa) s prosječnom duljinom savjetodavnoga staža od 12.22 godine. Sudionici/sudionice ispunili su upitnik CBI, Ljestvicu sagorijevanja na poslu (BAT-23) i Upitnik depresivnosti, anksioznosti i stresa (DASS-21). Konfirmatorna faktorska analiza (CFA) upućuje na opravdanost korištenja originalne petofaktorske strukture koju sačinjavaju iscrpljenost, nekompetentnost, negativno radno okruženje, devaluacija klijenata i deterioracija privatnoga života. Navedene supskale imaju zadovoljavajuće deskriptivne parametre i pouzdanosti tipa unutarnje konzistencije. Također su dobivene adekvatne konstruktna, konvergentna i kriterijska valjanost. Utvrđene su značajne umjerene do visoke pozitivne korelacije upitnika CBI s već postojećom mjerom profesionalnoga sagorijevanja (BAT-23) te umjerene korelacije s mjerama depresivnosti, anksioznosti i stresa. Rezultati istraživanja upućuju na to da je Upitnik profesionalnoga sagorijevanja savjetovatelja valjana mjera za ispitivanje profesionalnoga sagorijevanja savjetovatelja i psihoterapeuta na području Republike Hrvatske.