Background Dementia is a growing public health problem, particularly in low- and middle-income countries. Bosnia and Herzegovina (BiH), as a post-conflict LMIC with a complex administrative structure, currently lacks national guidelines, epidemiological data, and systematic approaches for dementia care. This study investigates healthcare workers’ attitudes toward dementia care and identifies both obstacles and practical opportunities for improving practice within BiH’s unique healthcare system. Methods A qualitative cross-sectional study was conducted in primary healthcare settings across Bosnia and Herzegovina, with 25 participants, including family medicine doctors (n = 10), nurses (n = 10), and psychologists (n = 5). The data were analyzed using thematic analysis guided by the Consolidated Framework for Implementation Research (CFIR). Results Dementia care in BiH is predominantly reactive, with healthcare professionals typically responding only after families have expressed concerns. Participants reported inconsistent use of cognitive screening tools (e.g. MMSE, MoCA), largely due to insufficient training, lack of clear national guidelines, and varying institutional practices. Many clinicians felt unprepared and unsupported in managing dementia cases. Cultural stigma and widespread misperceptions of dementia as a normal part of aging contribute to delays in diagnosis and reduce the likelihood that families will seek help early. These barriers are exacerbated by a lack of national prevalence data and fragmented care pathways. Conclusions The findings of this study indicate the need to change the approach to dementia care in BiH through concrete and realistic measures within the existing systemic frameworks. Practice-based guidelines, culturally adapted tools for early detection, reactivation of community-based care, accessible education, a pragmatic approach to prevention, and local initiatives for awareness-raising and multidisciplinary care are recommended. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-025-12958-5.

<p><strong>Introduction.</strong> With the development of medical and health sciences, research problems have become more complex, and relying solely on quantitative or qualitative research approaches is no longer sufficient. The aim of this paper was to map the progress and trends in the scientific literature regarding the application of mixed studies in medical and health sciences.</p> <p><strong>Methods.</strong> Bibliometric analysis was applied to meet the established goals. The Dimensions database was selected for literature search. The analysis unit consisted of 485 publications of various types, and the VosViewer program was employed for the analysis.</p> <p><strong>Results. </strong>The results have shown that this topic in science has experienced an exponential decline in the last year. Additionally, the most productive authors, journals, and countries have been identified, along with their collaborative networks through visual co-citation analysis. Based on the analysis of word co-occurrence, we can conclude that words like &ldquo;combined studies,&rdquo; &ldquo;problem,&rdquo; &ldquo;factors,&rdquo; &ldquo;community&rdquo; are most frequently repeated, indicating that the topics addressed in this domain mainly focus on investigating and addressing numerous issues in the field of medical and health sciences.</p> <p><strong>Conclusion. </strong>Although the results indicate a decreased interest in this topic in the last year, it does not diminish the significance of this research. Progress in medical and health sciences requires a comprehensive approach to research, which includes both quantitative and qualitative methods, such as mixed studies. Understanding the current trends and available resources for researchers assists in achieving better outcomes and improving the quality of healthcare practice.</p>

<p><strong>Introduction. </strong>Frailty is common in elderly persons and carries a high risk of poor health outcomes, including increased mortality, institutionalization, falls, and hospitalization. The aim of the work was to determine the risk factors for frailty in elderly persons.</p> <p><strong>Methods. </strong>The research was conducted in Bijeljina and Foča, in the period from February to June 2022, and was approved by the Ethics Committee of the Faculty of Medicine in Foča. A total of 243 respondents over the age of 65 took part in the research. When it comes to the instruments, the sociodemographic questionnaire, the EQ-5D-5L health questionnaire, the general sarcopenia rapid screening questionnaire SARC-F and the Kessler scale for the assessment of psychological distress were used.</p> <p><strong>Results.</strong> There were 43.6% of males and 56.4% of females participating in the research. One quarter (25%) of respondents evaluated their health as weak. Sarcopenia was identified in 28% of respondents, while 18.1% had a moderate and 11.9% a serious disorder in the field of psychological distress.</p> <p><strong>Conclusion. </strong>The presence of psychological distress and sarcopenia in a high percentage, as well as weak health status in the people over 65, is evident, which represents potential risk factors for frailty.</p>

AIMS The aim of this study was to estimate cutoff values of mid-upper arm circumference (MUAC) and calf circumference (CC) for reduced muscle mass and analyze their accuracy in identifying malnutrition among individuals of 65 years of age or older in Bosnia and Herzegovina. MATERIALS AND METHODS The study is a secondary analysis dataset assessing nutritional risk and malnutrition among 446 community-dwellers and nursing home residents in Bosnia and Herzegovina. Malnutrition assessment included phenotypic criterions (weight loss, low body mass index, and reduced muscle mass) and etiologic criterions (inadequate food intake, disease-related inflammation, or albumin levels) according to recommendations of the Global Leadership Initiative on Malnutrition (GLIM). Receiver operating curves were used to calculate MUAC and CC's cutoff values as compared to the Mini Nutritional Assessment (MNA). RESULTS The optimal cutoff value for MUAC in men was 24 cm (AUC = 0.910, sensitivity 100%, specificity 77%), and in women 23 cm (AUC = 0.792, sensitivity 64%, specificity 83%). Optimal cutoff value of CC in men was 31 cm (AUC = 0.818, sensitivity 100%, specificity 67%) and in women 29 cm (AUC = 0.882, sensitivity 86%, specificity 74%). Two hundred fifty nine elderly individuals were categorized as malnourished/at risk for malnutrition per MNA. The prevalence of malnutrition based on GLIM criteria ranged from 19% to 30%. CONCLUSIONS The study suggested that MUAC and CC may be used as the alternative indicators of muscle mass when other assessment methods are unavailable. Future validation and reliability studies for GLIM using anthropometric parameters as a proxy of reduced muscle mass are needed.

Psychological care involves caring for the patient's psychological needs using a range of skills such as listening, perceiving, communicating, and empathizing, with the ultimate res of alleviating human suffering. The nurse spends the most time with the psychiatric patient; she is with the patient from his admission to the hospital, during his stay, until he leaves the hospital. Observing the patient's behavior, she determines problems in health care. In order for a nurse to solve this problem, she must be educated, experienced in her professional vocation, and have a good knowledge of the healthcare process, because that is the only way she can make an appropriate plan and choose the most appropriate interventions. In addition to knowing the process of health care, a nurse must also be extremely patient and possess certain communication skills due to the nature of the illnesses of patients suffering from psychiatric disorders. Therapeutic communication is actually the core and essence of all interactions between a nurse and a patient. It is often stated that it is the nurse who takes care of the psychiatric patient and who has the most face-to-face contact with patients. The nurse deals with the total personality of the psychiatric patient, and therefore she applies models that make the assessment of the patient's needs the basis of health care. The main goal of this scientific review is to investigate and analyze the role of psychiatric nursing as an indispensable element in nursing practice, explore its importance for improving the quality of health care and patient well-being, and provide guidelines for the integration of psychiatric nursing in nursing practice.

Objective. Aging is characterized by the loss of abilities in the psychological and physical sense. Detailed assessment of cognitive status may enable early identification of high-risk patients who are candidates for dementia. The aim of this research was to examine the cognitive status of elderly people over 65 years of age living in the community and potential risk factors that contribute to the onset of dementia. Methods. The research was designed according to the principle of a cross-sectional study. The research used a general questionnaire, subjective and objective assessment of respondents, Mini Kog assessment. The ch2 square test was used for statistical tests. The usual value of p<0.05 was taken as the level of statistical significance. Results. Females (80.2%) had better cognitive status than males (84.6%) (ch2 =0.189; p=0.664). Respondents with the lowest level of education (primary school) had a worse cognitive status (23.5%) compared to 13.3% of respondents with an intermediate level of education (ch2 =9.139; p=0.010). 8.8% of respondents who socialize with friends had a good cognitive score compared to 0% of respondents with a good cognitive score who do not socialize with friends (ch2 =18.243; p=0.000), also, the cognitive status was worse in those respondents who used different aids (75%) versus 17% of those who do not use different aids for their functional mobility (ch2 =8.832; p=0.003). Conclusion. Dementia is present in a high percentage among elderly people. The level of education and the use of aids are potential risk factors for the onset of dementia.

Aging implies a process during which changes occur in the function of all organic systems in the human body. For a detailed assessment of the health status of an elderly person, a comprehensive geriatric assessment (CGA) is recommended. CGA is defined as a multidisciplinary diagnostic and therapeutic approach that enables the identification of medical, psychosocial and functional limitations of an elderly person, all with the aim of developing a coordinated plan to improve the health of the elderly person. The aim of this review was to point out the significance, comprehensiveness, applicability and prognostic significance of geriatric assessment based on data from recent literature and by searching available electronic databases. Studies were collected from the electronic databases MEDLINE (via Ovid), Pubmed, COBSON database and Google Scholar database, as well as by manual search of relevant studies cited in the references of key articles. The search for papers as a whole is limited to the English language. All studies that used a comprehensive geriatric assessment in their methodology, in elderly people over 65 years of age, were included. CGA is very important for the elderly, for their families, health systems of countries, health professionals as well as the social community. Interventions resulting from a CGA are one way to improve the performance of activities of daily living in elderly patients. CGA has numerous advantages in practice, it is comprehensive, applicable, economically relatively acceptable and as such can be routinely implemented at different levels of health care. CGA has a high prognostic significance for the early detection of multimodal problems in the geriatric population.

Objective. Long-term care represents a series of health and social care services that are provided at home or in an institutional environment to people with reduced functional capacity (reduced physical and/or cognitive abilities) who need support in performing daily activities, and who depend on the help of others for a long time period. The goal of the research was to examine the quality of life of users with long-term health care, with a special focus on comparing the quality of life between people placed institutionally and outside of the institution. Methods. The research was designed according to the principle of a cross-sectional study. In the research, a general questionnaire and a scale for assessing the quality of life Short Form 36 Health Survey (SF-36) were used. Among the statistical tests, the ch2 square test was used. The usual value of p<0.05 was taken as the level of statistical significance. Results. Subjects who were institutionalized had statistically significantly lower values of domains and summary scores of quality of life compared to subjects whose health care took place outside of institutions, whereby the difference was observed in physical functioning (p<0.001), social functioning (p=0.003) and mental health summary score (p=0.015). Conclusion. Users of long-term health care placed in an institution had significantly worse physical functioning, a higher level of limitations due to physical problems, worse general health, a lower level of social functioning, as well as mental health.

Introduction/Aim: The problems facing the health sector in the Balkans, but also in most European Union countries (especially highly developed countries) is the lack of university-educated nurses in the labor market. The aim of the paper was to examine the attitudes of health professionals about the importance and possibilities of academic education of nurses. Methods: The cross-sectional study was conducted on 233 health workers in the period from July 10, 2019 to August 31, 2019 in the Public Health Institution (PHI) Health Center Zvornik, PHI Health Center Foca, PHI General Hospital Zvornik, PHI University Hospital Foca. All respondents filled out a questionnaire, which was previously culturally adapted. ch2 was used in the statistical analysis of the data. Results: The majority of health workers (73.8%) were women. There were slightly more women under the age of 50, and men over the age of 50. There were 41.3% of doctors/specialists, 42.2% of nurses with secondary education, and 16.4% of nurses with post-secondary and higher education. The largest percentage of health workers (91.4%) state that they are familiar with the possibilities of nursing education, while 69.5% are of the opinion that thorough secondary education and specialization is enough for nurses. About half of health workers (50.2%), regardless of the level of education, states that there is no need for the education of nurses at the level of doctoral studies, and ¼ abstained on this issue. Doctors of medicine and specialist doctors and nurses with secondary education were statistically significantly more likely (ch2 = 10,151; p = 0.038) to consider that there is no need for education of nurses at the level of doctoral studies than nurses with post-secondary and higher education. The largest percentage of health workers (66.6%) have the opinion that the nurse has the same authority as other team members, 86.3% agree with the statement that the development of the nursing profession will affect the quality of health care, and 55.8% believe that nurses have the professional capacity, knowledge and experience to innovate solutions and manage the inevitable changes on the pathway to modern nursing. Conclusion: In order to raise the reputation of the nursing profession, it is necessary to define the scope of work and set clear boundaries between the competencies of nurses of different levels of education at the level of the whole of Bosnia and Herzegovina. In order to further develop the nursing profession, better promotion of new postgraduate programs is necessary.

Introduction. A specific characteristic of the elderly is brittleness or fragility, and due to its prevalence, fragility needs to be understood as a public health priority. The aim of the study was to examine the association of functional and anthropometric parameters with fragility in persons over 65 years of age. Method. The study was designed as a cross-sectional study and included 446 elderly people. As research instruments, a general questionnaire was used to assess the functional status of the Tinetti test and, of anthropometric parameters, the circumference of the upper arm and the circumference of the middle part of the lower leg. We used the ch2 test and Pearson's correlation analysis as statistical tests. Results. Females had poorer functional status, walking, and balance compared to males (ch2 = 4.125; p <0.127). It was observed males subjects had higher values of upper arm circumference (26.96 ± 3.44) compared to females, while females had higher values of the middle circumference of the lower leg (32.66 ± 6.29). Analyzing the correlation of anthropometric measurements with the total score of the Tinetti test and in relation to subjects' gender, it was noticed there is a correlation analysis between the parameters. Conclusion. A high percentage of people over the age of 65 have poor functional status, as well as lower values of anthropometric markers, suggesting that they may be potential risk factors for the fragility in the elderly.

Objective. Proper nutrition means satisfying organism's needs for daily intake of energy and adequate amount of nutritional and protective substances which are essential for maintenance of physiological functions of organism and health. The aim of this study was to determine eating habits and nutritional status of school children. Methods. The research was designed as a cross-section study. It was carried out in primary school "Sveti Sava'' in Foča and primary school "Sveti Sava'' in Gacko, branch in Avtovac. The study included 110 pupils aged from 10 to 14 years. As a measuring instrument, anthropometric measurements (height and weight) were used as well as a questionnaire. Results. The questionnaire included primary school pupils of different gender and age. Among the respondents, there were 66 (60%) boys and 44 (40%) girls. Most of the pupils (80,9%) had normal body weight, 48 (43,6%) boys and 41 (37,3%) girls. Among overweight pupils, there was statistically significant larger number of male pupils who were overweight in comparison with female pupils (=8,490; p=0,037). Also, there was statistically significant larger number of overweight pupils from urban environment in comparison with pupils from the rural one (ch2=8,614; p=0,035). Most of the pupils regularly have breakfast (50,9%). There is statistical significance in that larger number of children from urban environment consume fast food daily in comparison with children from rural environments (ch2=10,187; p=0,006). Conclusion. Eating habits of the elementary school children are not satisfying, being reflected in frequent skipping of breakfast, overconsumption of sandwiches, snacks and candies, while healthy foods, such as fish and vegetables are deficient in nutrition.

The concept of proper nutrition implies meeting the needs of the body concerning daily energy intake and a sufficient amount of nutrients and protective substances necessary to maintain the physiological functions of the body and its health. Nutrients are divided into macronutrients (proteins, carbohydrates and fats) and micronutrients (vitamins and minerals). Accelerated growth and development during adolescence increase nutrient requirements. Therefore, energy and nutrition requirements must meet the needs of adolescents. During their growth and development, there is an increased need for vitamins and minerals, especially for calcium, iron, zinc and vitamin D. During intensive growth, adolescents require more vitamins, especially B-complex vitamins and vitamin C, the intake of calcium and phosphorus is necessary as well, and the insufficient needs for proteins affect the development of muscles and energy levels. Proper nutrition and eating habits during the period of growth are of the utmost importance for the appropriate physical, psychosocial and cognitive growth and development of a child. Eating disorders usually occur as a result of low or high energy intake, and the most common types of these disorders are anemia, anorexia and bulimia, obesity and comorbidities, and poor eating habits. When it comes to the implementation of various programs concerning the prevention of bad eating habits and eating disorders, the school management, expert teams and student parents should bear the overall responsibility. Once or twice a year, preventive check-ups and BMI measurements are recommended to identify eating disorders.

INTRODUCTION Numerous challenges and barriers have emerged since changing the minimum requirement for those interested in pursuing employment as a nurse in Europe to a baccalaureate degree. To analyze the perceptions of baccalaureate nurses regarding the current status of their profession and the issues involved in implementing the prerequisite of earning a baccalaureate degree in order to practice as nurses in Bosnia and Herzegovina. METHODS A series of six focus groups were undertaken with 49 baccalaureate nurses employed in primary health care centers and regional hospitals. The focus groups were recorded and transcribed verbatim. Data collected were analyzed using conventional content analysis approach. RESULTS Baccalaureate nurses report dissatisfaction with their level of autonomy and anxiety over their limited career opportunities. They expressed concern over difficult working conditions, inadequate financial compensation, and ongoing resistance by physicians as the primary barriers to implementing advanced nursing education and professional reform. The global image of the nursing profession is negative. CONCLUSION The perception is that revising the legal framework regarding nursing qualifications, duties, and standards will result in reform necessary to positively affect the during profession. Progress toward implementing reform of the nursing profession is negligible. Addressing barriers such as work environment, lack of job classification, fair payment, autonomy, and interdisciplinary collaboration toward the competences of baccalaureate nurse is essential if successful reform is to occur.

INTRODUCTION The literature indicates different factors influencing recruitment of health professional students to work in rural areas. The purpose of this study is to explore the willingness of health profession students in the Faculty of Medicine Foca, University of East Sarajevo, Bosnia and Herzegovina to work in a rural area following graduation and the factors influencing incentives to pursue a rural career. METHODS The cross-sectional study included first-year through sixth-year students aged 18 years or older and enrolled in one of three study programs at the Faculty of Medicine: medicine, dentistry and nursing. The questionnaire was distributed at the beginning of the winter semester during the first required lecture for each year and study program class. Data was analyzed using student t-test, analysis of variance when appropriate, Kruskal-Wallis test and multivariate logistic regression analysis. RESULTS A total of 519 students participated, an 88.3% response rate. Three hundred and ninety-nine (77%) participants responded positively to the question 'When you complete your studies, would you be inclined to accept a job in a rural region?' Factors associated with willingness to practise in rural areas included being female (p=0.027) and having a rural upbringing (p=0.037). Significant differences between medicine, nursing and dentistry students were found in their opinion that willingness to work in rural practice depends greatly on the possibility to get residency more easily (p=0.001). Compared to their peers, nursing students had better opportunities to attend national courses cost-free (p=0.027) and to be involved in the education of new generations of health profession students (p=0.001). Getting a post in an urban area after a work period in a rural area was most valued as an incentive by dentistry students (p=0.037). The multivariate logistic regression model was used to analyze predictors of willingness to practise in rural areas. Students who had been raised in a rural community (p=0.042) as well as female students (p=0.016) were more likely to accept rural practice. Statistical significance at an alpha level of 0.05 was not reached for study program and year of study. CONCLUSIONS The results of the study showed a high willingness of medicine, dentistry and nursing students to work in rural areas following graduation. Female students and students who were raised in a rural community were more likely to choose a rural career. Stakeholders should be committed to strengthening the rural deployment of health professionals by creating a more attractive, rural environment.