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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences".

Deadline for manuscript submissions: 30 September 2026 | Viewed by 5810

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Special Issue Editor

Dr. Nikolina Farčić

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Guest Editor

Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
Interests: quality of life; nursing; clinical decision-making; evidence-based nursing; education; pain

Special Issue Information

Dear Colleagues,

Quality of life refers to an individual's ability to function normally in daily activities and feel satisfaction with their life. It is assessed at a given moment and can be defined as the level of enjoyment in available life opportunities. Numerous factors influence quality of life, including physical, mental, and spiritual health, interpersonal relationships, work environment, social status, sense of security, freedom and autonomy in decision making, sense of belonging, and physical surroundings.

In healthcare, the goal of treatment and patient care is to improve patients’ quality of life in all the above aspects. However, the level of improvement may vary depending on the illness and the patient's individual circumstances. Quality of life is not only affected by diseases but also by the way nurses perform their work. To provide high-quality care, nurses must also take care of their own health and quality of life. As an extremely demanding job, it can cause biological, physiological, and psychological changes that impact not only the well-being of nurses but also patient safety and quality of life. In this context, this Special Issue of IJERPH aims to share research examining the quality of life of patients and nurses, either independently or in relation to one another. In this Special Issue, original research articles and reviews are welcome, as well as descriptions of the development and/or validation of quality of life measurement instruments.

Dr. Nikolina Farčić
Guest Editor

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Keywords

quality of life
nurses
nursing
patients
education
health
pain

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Published Papers (5 papers)

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Research

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31 pages, 874 KB

Open AccessArticle

Impact of the Osijek Multidisciplinary Biopsychosocial Program on Chronic Low Back Pain: A Prospective Randomized Controlled Study

by Dijana Hnatešen, Ivan Radoš, Iva Dimitrijević, Dino Budrovac, Vanja Matković and Ivana Gusar

Int. J. Environ. Res. Public Health 2026, 23(3), 350; https://doi.org/10.3390/ijerph23030350 - 11 Mar 2026

Viewed by 473

Abstract

This study aimed to assess the relative impact of the Osijek multidisciplinary biopsychosocial program for chronic low back pain (CLBP) compared with standard multimodal care with respect to pain intensity, disability, health-related quality of life, anxiety, depression, stress, and sleep quality using standardized self-assessment questionnaires and a smartwatch. A total of 128 patients treated at the Department of Pain Management, University Hospital Osijek, were randomly allocated to two groups. The multidisciplinary biopsychosocial group participated in a structured four-week program combining education, exercise, and individualized multidisciplinary care, while the multimodal group received conventional conservative treatment including pharmacotherapy and selected physical therapy modalities. The four-week intervention included standardized self-report questionnaires, a sociodemographic data form, and a Fitbit Charge 3 smartwatch for objective monitoring of sleep and physical activity. A significant reduction in pain intensity was observed across numerical scales and most questionnaire measures (Wilcoxon test, p < 0.01), except for the subscale assessing difficulties in performing daily activities due to sleep deprivation. Participants who underwent the multidisciplinary biopsychosocial treatment exhibited significant improvements (p < 0.03) in pain intensity, disability, health-related quality of life, stress, anxiety, and sleep quality compared with those receiving multimodal treatment. In both groups, a weak negative correlation was found between sleep quality and daily step count (Spearman’s rho = −0.234, p = 0.04). A multidisciplinary biopsychosocial program was associated with greater improvements in health-related quality of life, psychological well-being, and sleep quality in patients with chronic low back pain compared with a multimodal conservative approach. Increased daily physical activity was linked to improvements in anxiety and sleep. Although this study was designed as a randomized controlled trial, certain baseline differences between groups should be considered when interpreting the findings. Full article

(This article belongs to the Special Issue Exploring Quality of Life in Nursing and Patient Care)

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10 pages, 266 KB

Open AccessArticle

Validation of the Croatian Version of the Eight-Item Chronic Pain Acceptance Questionnaire (CPAQ-8)

by Iva Dimitrijević, Ivan Radoš, Dijana Hnatešen, Vanja Matković and Dino Budrovac

Int. J. Environ. Res. Public Health 2026, 23(2), 145; https://doi.org/10.3390/ijerph23020145 - 23 Jan 2026

Viewed by 441

Abstract

Background: Chronic pain is a serious health issue associated with significant functional and emotional impairment. Chronic pain acceptance, which can be described as engaging in valued activities despite ongoing pain, is associated with better psychological adjustment and quality of life. This study aimed to translate the Eight-Item Chronic Pain Acceptance Questionnaire (CPAQ-8) into Croatian and investigate its reliability and validity. Methods: A total of 229 outpatients with chronic musculoskeletal pain completed the Croatian version of the CPAQ-8, as well as the SF-36 Health Status Questionnaire (SF-36), the Hospital Anxiety and Depression Scale (HADS), the Pain Catastrophizing Scale (PSC), and the Numeric Pain Rating Scale (NRS). Results: The Croatian version of the CPAQ-8 demonstrated good internal consistency for the total score and its subscales, and the exploratory factor analysis revealed the original two-factor structure. Concurrent validity was supported through theoretically consistent correlations with psychological distress, quality of life, and pain-related constructs. Conclusion: The Croatian version of the CPAQ-8 is a reliable and valid instrument for assessing pain acceptance in patients with chronic musculoskeletal pain and can be confidently used in both clinical practice and research settings. Full article

(This article belongs to the Special Issue Exploring Quality of Life in Nursing and Patient Care)

16 pages, 655 KB

Open AccessArticle

Sleep Quality in Shift-Working Nurses: Subjective and Objective Evaluation

by Željka Dujmić, Štefica Mikšić, Ivana Barać, Josip Samardžić, Lea Maršić, Petar Samardžić, Zvjezdana Gvozdanović, Ivana Jelinčić, Blaženka Kljajić Bukvić, Marija Barišić, Davorka Čavar-Lovrić, Ružica Mrkonjić, Ivica Mihaljević and Nikolina Farčić

Int. J. Environ. Res. Public Health 2026, 23(1), 64; https://doi.org/10.3390/ijerph23010064 - 31 Dec 2025

Viewed by 994

Abstract

Background: It is well-known that rotating shift work disrupts the circadian rhythm and sleep quality in nurses. With this study, we aimed to compare subjectively and objectively measured sleep quality in nurses, specifically focusing on any differences that arose in relation to shift work. Methods: This prospective, observational, cross-sectional study was conducted in 2025 in Croatia; a total of 140 nurses participated. Sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI) and FitBit Charge 3 smartwatch, which monitored sleep over an eight-day period. Results: Most nurses rated their sleep as good or very good, but according to the PSQI questionnaire, all participants were classified as poor sleepers (PSQI > 5). Objective smartwatch measurements showed that nurses working only day shifts had higher sleep scores (median 77, IQR 75–80 vs. 73, IQR 68–76; p < 0.001), significantly longer total sleep duration (median 6.4, IQR 6.3–7.1 vs. 5.5, IQR 5.2–6.2 h; p < 0.001), and longer durations of all sleep stages compared with those working rotating shifts. Conclusions: Most nurses subjectively rated their sleep as good or very good; however, according to the PSQI questionnaire results, all were classified as poor sleepers, with no significant difference related to shift work. Objective measurements using the smartwatch indicated that rotating shift work is associated with significantly poorer sleep quality. Full article

(This article belongs to the Special Issue Exploring Quality of Life in Nursing and Patient Care)

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15 pages, 305 KB

Open AccessArticle

Assessment of Quality of Life in the Early Postoperative Period in Patients with Lung Cancer

by Stana Pačarić, Tajana Turk, Ivan Erić, Marko Babić, Suzana Luketić, Nika Srb, Andrea Milostić Srb, Anamarija Petek Erić and Mario Duvnjak

Int. J. Environ. Res. Public Health 2025, 22(12), 1810; https://doi.org/10.3390/ijerph22121810 - 30 Nov 2025

Viewed by 838

Abstract

Measuring quality of life (QoL) in patients with early-stage lung cancer is an important aspect of treatment success. This study assessed QoL in the early postoperative period in patients with lung cancer, with regard to the type of cancer. This single-center study was conducted on 64 patients who underwent surgery for non-small cell (NSCLC) and small cell (SCLC) lung cancer. Quality of life questionnaires (QLQs) of the European Organization for Research and Treatment of Cancer (EORTC) were used. The EORTC QLQ-C30 questionnaire assesses the quality of life of cancer patients, and the EORTC QLQ-LC13 questionnaire is a lung cancer module. In the group of patients with NSCLC, the general health status (p < 0.001), physical functioning (p = 0.004), emotional functioning (p = 0.005) and total functional scale (p = 0.01) were significantly better assessed, fatigue was less pronounced (p = 0.005), nausea/vomiting (p = 0.04), pain (p = 0.004), breathing difficulties were less pronounced (p = 0.03), loss of appetite was less pronounced (p = 0.005), and the symptom scale was significantly less pronounced (p = 0.002) compared to patients with SCLC. In the QLQ-LC13 symptom scale, SCLC patients had more cough (p = 0.02), dyspnea (p = 0.03), dysphagia (p = 0.005), peripheral neuropathy (p = 0.04), chest pain (p < 0.001), arm or shoulder pain (p < 0.001), and pain in other parts of the body (p = 0.005) compared to NSCLC patients. Patients with NSCLC evaluated the functioning scales better and had less pronounced symptoms on the symptom scale, while patients with SCLC evaluated the treatment symptoms worse on the symptom scale, especially the symptom of pain, which had an impact on the quality of life of the patients. The results of this study could contribute to raising public awareness about the quality of life of lung cancer patients. Full article

(This article belongs to the Special Issue Exploring Quality of Life in Nursing and Patient Care)

Other

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17 pages, 515 KB

Open AccessSystematic Review

Validated Tools for Assessing Anxiety and Depression in Nurses: A Systematic Review

by Gabriel Reyes Rodríguez, Leticia Cuellar-Pompa, Natalia Rodríguez Novo, Miguel López Martínez and José Ángel Rodríguez Gómez

Int. J. Environ. Res. Public Health 2025, 22(11), 1714; https://doi.org/10.3390/ijerph22111714 - 13 Nov 2025

Cited by 1 | Viewed by 2223

Abstract

Background: Nurses experience substantial anxiety and depression; robust, validated instruments are needed. We aimed to identify tools used to assess these conditions in nurses. Methods: A systematic review was conducted in December 2024 and registered in OSF and PROSPERO. MEDLINE, Embase, CINAHL, and PsycINFO were searched for quantitative studies (2014–2024) in English/Spanish that included nurses only and used standardized measures. Two reviewers screened and extracted the data; quality was appraised with JBI checklists, narrative synthesis only. Results: Twenty-two studies (n = 10,710 nurses) met the criteria. Most were cross-sectional with non-probability sampling; the overall risk of bias was moderate in 19 studies and high in 3. The most frequently used instruments were PHQ-9, GAD-7, GHQ-28, and BDI; across versions, PHQ (PHQ-2/PHQ-9) predominated. Heterogeneity precluded meta-analysis. Discussion: The available tools support routine screening in nursing populations, but reliance on self-reports and scarce formal cross-cultural validation in practicing nurses limit inference and generalizability. Conclusions: Screening programs in nursing should pair brief self-report instruments with objective indicators and standardized protocols; future studies should prioritize contextualized validation and robust longitudinal designs. Full article

(This article belongs to the Special Issue Exploring Quality of Life in Nursing and Patient Care)

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