Mario Marendić

Ime i prezime: dr. sc. MARIO MARENDIĆ, mag. med. techn.
 
Naslov disertacije: „MEDITERANSKA PREHRANA, PERCEPCIJA STRESA I BLAGOSTANJA U STUDENATA ZDRAVSTVENOG USMJERENJA“
 
Mentorica: izv. prof. dr. sc. IVANA KOLČIĆ
 
Datum obrane: 9. svibnja 2022.
 
Poveznnica:
https://repozitorij.mefst.unist.hr/islandora/object/mefst%3A1408/datastream/PDF/view
 
Kvalifikacijski znanstveni radovi za doktorsku disertaciju:


Marendić M, Polić N, Matek H, Oršulić L, Polašek O, Kolčić I. Mediterranean diet assessment challenges: Validation of the Croatian Version of the 14-item Mediterranean Diet Serving Score (MDSS) Questionnaire. PLoS One. 2021;16(3):e0247269.
 
https://doi.org/10.1371/journal.pone.0247269
 
Marendić M, Bokan I, Buljan I, Dominiković P, Suton R, Kolčić I. Adherence to epidemiological measures and related knowledge and attitudes during the coronavirus disease 2019 epidemic in Croatia: a cross-sectional study. Croat Med J. 2020;61(6):508-17.
 
https://doi.org/10.3325/cmj.2020.61.508
 
SAŽETAK:
CILJ: Cilj ovog istraživanja je bio istražiti učestalost mediteranske prehrane te procijeniti pouzdanost i valjanost hrvatske inačice kratkog Indeksa konzumiranja mediteranske prehrane u uzorku studenata zdravstvenih usmjerenja sa Sveučilišta u Splitu.
METODE: Presječno istraživanje je provedeno u razdoblju od prosinca 2018. do prosinca 2019. godine. Studenti Medicinskog fakulteta Sveučilišta u Splitu (N = 360) su predstavljali inicijalni uzorak koji se koristio u svrhu procjene pouzdanosti te kriterijske i konstruktivne valjanosti kratke inačice Indeksa konzumiranja mediteranske prehrane (engl. Mediterranean Diet Serving Score; MDSS), a kao referentna metoda se koristio Upitnik za pridržavanje mediteranske prehrane (engl. Mediterranean Diet Adherence Screener; MEDAS). Studenti Sveučilišnog odjela zdravstvenih studija (N = 299) su predstavljali potvrdni uzorak koji se koristio u svrhu procjene prediktivne valjanosti hrvatske inačice MDSS upitnika. U oba uzorka se naposljetku utvrđivala učestalost mediteranske prehrane. Nadalje, percepcija stresa je procijenjena pomoću Ljestvice doživljenog stresa (engl. Perceived Stress Scale - 10; PSS-10), a mentalno blagostanje je procijenjeno korištenjem Warwick-Edinburgh ljestvice mentalnog blagostanja (engl. Warwick-Edinburgh Mental Well-being Scale; WEMWBS). Životne navike studenata su ispitane pomoću upitnika koji je sadržavao pitanja o dobi, spolu, ITM-u, vremenu proteklom od posljednjeg vaganje tjelesne mase, pušenju, navikama spavanja, prehrambenim navikama (samostalnost u pripremi obroka, broju obroka u danu/tjednu, učestalosti doručkovanja), tjelesnoj aktivnosti (uključenost u sport i korištenje teretane), zadovoljstvo izgledom, kvaliteti života te razini tjeskobe, sreće i optimizma. Za procjenu pouzdanosti za MDSS i MEDAS upitnik korišten je koeficijent korelacije unutar klase (ICC) i Spearmanov koeficijent korelacije (ρ), a za slaganje između pojedinih skupina namirnica unutar MDSS i MEDAS upitnika korišten je Cohenov koeficijent (κ). Multivarijatnom linearnom regresijom je ispitana povezanost između mediteranske prehrane i doživljenog stresa te blagostanja.
REZULTATI: Analiza podataka na uzorku studenata medicine je ukazala na dobru pouzdanost MDSS upitnika kad je rezultat izražen kao ukupni zbroj bodova (ICC = 0,881,95% CI 0,843-0,909; ρ = 0,627; P < 0,001) i umjerenu razinu pouzdanosti kada je rezultat izražen kao binarna varijabla (κ = 0,584). U analizi valjanosti MDSS upitnika naprema MEDAS upitniku, valjanost je također bila bolja kada je korištena brojčana varijabla, tj. ukupan zbroj bodova (ICC = 0,544; 95% CI 0,439-0,629; P < 0,001), dok je korištenjem binarne varijable dobiveno slabo slaganje (κ = 0,223). Sličan rezultat je dobiven i u potvrdnom uzorku studenata zdravstvenih studija (ICC = 0,510; 95% CI 0,384-0,610; κ = 0,216). Nažalost, samo se 13,6% studenata medicine i 9,4% studenata zdravstvenih studija pridržavalo preporuka mediteranske prehrane prema MDSS upitniku (11,7% studenata u ukupnom uzorku). Studenti koji su se pridržavali mediteranske prehrane su imali prosječnu vrijednost od 20 bodova (IKR 10,5) od maksimalnih 40 bodova na ljestvici stresa, dok su studenti koji se nisu pridržavali mediteranske prehrane postigli prosječnu vrijednost od 21 boda (IKR 10,8), što nije bila značajna razlika. Prosječni zbroj bodova na ljestvici blagostanja je iznosio 56 bodova (IKR 17) u studenata koji su se pridržavali i 53 boda (IKR10) u studenata koji se nisu pridržavali mediteranske prehrane (P = 0,048), što ukazuje na umjerenu razinu mentalnog blagostanja u oba poduzorka studenata. Pridržavanje mediteranske prehrane prema MDSS upitniku je bilo u pozitivnoj korelaciji s dobi (ρ = 0,179: P = 0,003), samo-procijenjenom percepcijom zdravlja (ρ = 0,123; P = 0,047) i mentalnim blagostanjem (ρ = 0,139; P = 0,022). Međutim, pridržavanje mediteranske prehrane nije bilo povezano s percepcijom stresa i mentalnim blagostanjem u regresijskoj analizi. Studentice su imale veću vjerojatnost za višu percepciju psihološkog stresa u odnosu na studente (β = 2,29; 95% CI 0,55-4,03; P = 0,010) te je utvrđena negativna povezanost između stresa i mentalnog blagostanja (β = - 0,42; 95% CI -0,49 - -0,36; P < 0,001). Pozitivna povezanost je identificirana između razine mentalnog blagostanja i dobi studenata (β = 0,17; 95% CI 0,05-0,028; P = 0,006), kao i trajanja spavanja radnim danom (β = 0,84; 95% CI 0,11-1,58; P = 0,025).
ZAKLJUČAK: MDSS upitnik je kratak, pouzdan i valjan mjerni instrument za procjenu pridržavanja mediteranske prehrane u Hrvatskoj. Osim toga, ovo je istraživanje ukazalo na nisku učestalost mediteranske prehrane u studenata zdravstvenih usmjerenja, umjerenu razinu percepcije stresa i umjerenu razinu mentalnog blagostanja. Stoga je potrebno uložiti napore u provedbu intervencije s ciljem poboljšanja prehrambenih navika studenata u smjeru promicanja i poticanja mediteranske prehrane, što će rezultirati zaštitom njihova zdravlja i zdravlja njihovih budućih pacijenata.
Ključne riječi: mediteranska prehrana, mentalno zdravlje, pouzdanost upitnika, valjanost upitnika, studenti, životne navike, Hrvatska
SUMMARY:
“Mediterranean diet, perception of stress and well-being in health sciences students”
AIM: The aim of this study was to investigate the prevalence of the Mediterranean diet and to evaluate the reliability and validity of the Croatian version of the short Mediterranean Diet Serving Score (MDSS) questionnaire in a sample of health sciences students from the University of Split.
METHODS: The cross-sectional study was conducted from December 2018 to December 2019. Students from the University of Split School of medicine (N = 360) constituted the initial sample used to assess the reliability and criterion and construct validity of the short version of the Mediterranean Diet Serving Score (MDSS), while the Mediterranean Diet Adherence Questionnaire (MEDAS) was used as the reference method. Students from the University Department of Health Studies (N = 299) presented a confirmatory sample used to assess the predictive validity of the Croatian version of the MDSS questionnaire. The prevalence of the Mediterranean diet was assessed in both samples. In addition, stress perception was assessed with the Perceived Stress Scale (PSS- 10), and psychological well-being was assessed using the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Students' lifestyle habits were assessed using a questionnaire that included questions on age, gender, BMI, time since last weighing, smoking, sleeping habits, eating habits (independence in preparing meals, number of meals per day/week, frequency of breakfast), physical activity (involvement in sports and gym use), satisfaction with physical appearance, quality of life, and levels of anxiety, happiness, and optimism. The intraclass correlation coefficient (ICC) and Spearman correlation coefficient (ρ) were used to assess the reliability of the MDSS and MEDAS questionnaires, and the Cohen coefficient (κ) was used to assess the agreement between food groups within the MDSS and MEDAS questionnaires. Multivariate linear regression was used to examine the association between the Mediterranean diet and perceived stress and well-being.
RESULTS: Data analysis on a sample of medical students revealed good reliability of the MDSS questionnaire when the result was expressed as a total score (ICC = 0.881, 95% CI 0.843-0.909; ρ = 0.627; P < 0.001), and a moderate reliability when the result was expressed as a binary variable (κ = 0.584). When analyzing the validity of the MDSS questionnaire versus the MEDAS questionnaire, validity was also better when the numeric variable was used, ie, the total score (ICC = 0.544; 95% CI 0.439-0.629; P < 0.001), whereas fair agreement was obtained when the binary variable was used (κ = 0.223). A similar result was obtained in the confirmatory sample of health studies students (ICC = 0.510; 95% CI 0.384-0.610; κ = 0.216). Unfortunately, only 13.6% of medical students and 9.4% of health studies students adhered to the Mediterranean diet recommendations according to the MDSS questionnaire (11.7% of students in the total sample). Students who adhered to the Mediterranean diet scored an average of 20 points (IKR 10.5) out of a maximum of 40 points on the perceived stress scale, while students who did not adhere to the Mediterranean diet scored an average of 21 points (IQR 10.8), which was not a significant difference. The mean score of the well-being scale was 56 points (IQR 17) in students who adhered to the Mediterranean diet and 53 points (IQR 10) in students who did not adhere to the Mediterranean diet (P = 0.048), indicating moderate levels of psychological well-being in both subgroups of students. Adherence to the Mediterranean diet according to the MDSS questionnaire was positively correlated with age (ρ = 0.179; P = 0.003), self-rated perception of health (ρ = 0.123; P = 0.047), and psychological well-being (ρ = 0.129; P = 0.022). However, adherence to the Mediterranean diet was not associated with perceived stress and psychological well-being in the regression analysis. Female students were more likely to perceive psychological stress compared to male students (β = 2.29; 95% CI 0.55-4.03; P = 0.010), and a negative association was found between stress and psychological well-being (β = -0.42, 95% CI - 0.49 - -0.36, P < 0.001). A positive association was found between the level of psychological well-being and the age of the students (β = 0.17; 95% CI 0.05-0.028; P = 0.006), as well as between well-being and the duration of sleep on weekdays (β = 0.84; 95% CI 0, 11-1.58; P = 0.025).
CONCLUSION: The MDSS questionnaire is a brief, reliable, and valid measurement tool to assess adherence to the Mediterranean diet in Croatia. In addition, this study found a low prevalence of the Mediterranean diet among health sciences students, a moderate level of stress, and a moderate level of psychological well-being. Therefore, it is necessary to initiate an intervention aimed at improving the dietary habits of students in the direction of promoting and supporting the Mediterranean diet, which will lead to the protection of their health and the health of their future patients.
Keywords: Mediterranean diet, mental health, reliability of the questionnaire, validity of the questionnaire, students, lifestyle habits, Croatia Ispiši stranicu