rehabilitation. In order to specify patients' age, residency and diagnosis of the disease, complications, the duration of rehabilitation and a complex rehabilitation programs, the prospective analysis was performed on rehabilitated patients' medical history while they were treated in-patient base. Results and conclusions: At the start of rehabilitation, the mean Barthel score for the patients' dysfunction of a daily living, was 52,9, after rehabilitation -74,5. During the rehabilitation period the mean Barthel score raised up to 21,6 (p<0,001). After completing the complex rehabilitation programs the cognitive functions' change was 4,8 (p<0,001) by the end of inpatient rehabilitation. A complex rehabilitation helped to reduce anxiety and depression levels (15% and 10%, respectively), but difference is not statistically significant. During the inpatient rehabilitation encountered complications reduced the efficacy of the rehabilitation.4

SantraukaGerėjant sveikatos priežiūros kokybei, didėja pacientų reiklumas medikams ir sveikatos priežiūros organizacijoms. Nuolatinis kaštų augimas ir išteklių ribotumas verčia ieškoti naujų šių problemų sprendimų galimybių. Nepakankama sveikatos priežiūros įstaigos vadovybės kompetencija sveikatos priežiūros kokybės vadybos klausimais bei žema personalo motyvacija darbui lemia pacientų ir personalo nepasitenkinimą teikiamomis paslaugomis. Suplanuoti ir vykdyti du tyrimai. Pirmas tyrimas -pacientų nuomonei išsiaiškinti, o antras tyrimas -ligoninės personalo: administracijos, gydytojų ir slaugos specialistų nuomonei ištirti. Tyrime dalyvavo 125 ligoninės personalo darbuotojai ir 138 ligoninėje besigydantys pacientai, kurie pagal savo charakteristikas reprezentavo visus X ligoninėje per metus gydytus pacientus. Pacientų apklausai naudota Tarptautinio Picker instituto (Picker institute Europe) sudaryta anketa. Personalo apklausai buvo naudota originali anketa modifikuota remiantis Tarptautinio Picker instituto (Picker institute Europe), sudaryta anketa ir atlikta literatūros analizė. Tyrimo duomenų analizei naudotos Microsoft Office Excel 2010 ir SPSS Statistics 17,0 versijos programos. Nustatyta, kad bendrą slaugos paslaugų kokybę ligoninėje didžioji dalis pacientų įvertino labai gerai arba gerai. Teigiamą pacientų nuomonę nulėmė glaudus pacientų bendravimas su medikais. Vertinant bendrą pacientų ir ligoninės personalo nuomonę apie teikiamų paslaugų kokybę, nustatyta, jog patys medikai kritiškiau vertina paslaugų kokybę nei pacientai. Nustatyta, kad per didelis pacientų skaičius, skiriamų lėšų slaugos priemonėms, medicinos technologijoms įsigyti trūkumas, nepakankamas darbo užmokestis buvo svarbiausi veiksniai, trukdantys efektyviam darbui ir paslaugų kokybės gerinimui ligoninėje. Slaugos kokybės užtikrinimas priklauso ne tik nuo teisinių ar organizacinių normų, kokybės SLAUGOS KOKYBĖS GERINIMO GALIMYBĖS MIESTO LIGONINĖJEGeriuldas Žiliukas, Danguolė Drungilienė, Rima Užkurėlytė Klaipėdos universitetas vertinimo funkcijų atlikimo, bet ir nuo pačių slaugytojų požiūrio į savo veiklą ir jos pažangą, nuo geros patirties pritaikymo, profesinių gebėjimų tobulinimo bei nuo tinkamo slaugytojų darbo organizavimo, jų mokymo. * statistiškai reikšminga, kai reikšmingumo lygmuo p=0,05 ** statistiškai reikšminga, kai reikšmingumo lygmuo p=0,01

As the quality of health care is getting better, patients’ demands for medics and health care organizations are getting higher. The permanent growth of costs and limited resources force to look for new possibilities of problem solving. Insufficient capacity of the leaders of a health care institution in matters of health care management and low motivation of the personnel leads to dissatisfaction by the provided services to patients and personnel. There was a patient opinion research made, a Picker Institute Europe questionnaire was used for the survey. 138 patients were interviewed, who, by their characteristics, represented all patients, treated in Hospital X all year round. Microsoft Office Excel 2010 and SPSS Statistics version 17.0 programs were used for the analysis of research data. During the research, it emerged that the majority of patients (78,7 percent) rated the conditions of care in the hospital as very good or good. Most of patients are satisfied with provided services of the hospital. Positive opinion of the patients on the care quality in the hospital was influenced by close communication with medics, providing clear information about their health situation and treatment, the respect shown by the personnel determined the trust in medics. Although, patients were actively involved in the treatment process, about one third of them did not participate in making decisions about their health situation or treatment; every fifth hospitalized patient by a planned order did not have an ability to choose a treatment institution. More than a half of patients, who participated in the research, did not have an opportunity to choose their doctor, or did not know about this opportunity. The development of patient’s and juridical knowledge creates preconditions to improve the quality of health care services.

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Very often conscripted soldiers experience heavy physical loads and mental shocks and challenges. The goal of this thesis was to analyse and to compare the factors triggering the stress to soldiers of compulsory conscription and professional military service and the ways to cope with it. Methods applied in this thesis were as follows: investigation conducted in 2010-2011 applying quantitative data accumulation and data processing methods. 233 soldiers of compulsory conscription and professional military service that were in the service in the aircraft base of Military Air Force and were selected applying the targeted sampling method participated in the inquiry. The statistic program package „SPSS 17 for Windows” was applied for data analysis. Levels of significance of statistical hypotheses were applied: where p&lt;0,05 was statistically significant, p&lt;0,01 was statistically very significant and p&lt;001 was extremely statistically significant. The participants were acquainted with investigation goal and the consent of a uniformed person was received. The results of the investigation revealed that such factors as everyday routine, military discipline, constant tiredness, impossibility to change the established day time schedule, negative emotions of other soldiers and strict particular requirements triggered stress significantly more often to the soldiers of compulsory conscription service than to the soldiers of professional service. The more strong reaction of soldiers of compulsory conscription service to stress provoked the feeling of loneliness and physical and emotional exhaustion at the end of the service day, meanwhile the soldiers of professional service had some difficulties with sleep at night and emotional exhaustion. While trying to combat the stress the soldiers of professional service significantly more often than the soldiers of compulsory conscription service used the conversation with a good friend and long walks, meanwhile the soldiers of compulsory conscription service trying to suppress the stress used to smoke significantly more often than the soldiers of professional service. Smoking as the method to conquer the stress was preferred more often by the soldiers from smaller townships.