Background: Numerous healthcare services have been affected by the COVID-19 pandemic worldwide. Specialized healthcare services were postponed or canceled, potentially compromising regular services for hemato-oncology patients. The current study aimed to analyze the impact of the COVID-19 pandemic on access to hemato-oncology services in Almaty, the largest city in Kazakhstan. Methods: We retrospectively analyzed the socio-demographic characteristics of patients admitted to two large tertiary centers rendering hemato-oncology services, the City Clinical Hospital 7 (H7) and the Kazakh Institute of Oncology and Radiology (KazIOR). All data were retrieved for the period spanning from 1 March 2019 to 28 February 2022. The retrieved variables included age, gender, type of residence, hospitalization rate, treatment outcomes (discharged/deceased), bed days, diagnoses according to International Classification of Diseases (ICD-10) (acute leukemia and hematopoietic depression, lymphoproliferative diseases, and myeloproliferative diseases), and referral sources (ambulance, another hospital, consultative and diagnostic assistance, primary healthcare, self-referral, and referrals from hematologists’ offices). Results: In the 2019–2022 period, 6763 hemato-oncology hospitalizations were registered: 3583 in H7 and 3180 in KazIOR. The mean age at hospitalization was 55.04 (SD = 16.07) for females and 51.2 (SD = 16.7) for males. The proportion of hospitalized urban and rural patients differed significantly: 6191 (92%) and 571 (8,4%), respectively (χ² = 13.8, p = 0.001). In the 2020–2021 period, fewer patients were discharged (n = 2047) compared to 2019–2020 (n = 2387) and 2021–2022 (n = 2081) (χ² = 20.09, p = 0.003). However, the proportion of deaths in the 2020–2021 period (3.5%) was higher than in the 2019–2020 (3.2%) and 2021–2022 periods (2.6%) (χ² = 20.09, p = 0.003). A total of 403 (19%) hospital admissions were carried out by ambulance (emergency cases) in the 2020–2021 period, 368 (14.8%) in 2019–2020, and 394 (18.3%) in 2021–2022 (χ² = 2231, p < 0.001). The number of patients transferred from other hospitals to H7 and KazIOR increased by 12.4% in the 2020–2021 period. Conclusions: Our findings indicate a negative impact of the COVID-19 pandemic on access to hemato-oncology services, leading to increased mortality. Further studies are warranted to explore factors underlying the trends in hospitalizations and mortality of hemato-oncology patients during healthcare crises.

Background This article focuses on the importance of nurses’ work in the field of palliative care, emphasizing their role in providing comprehensive care and support to patients with incurable diseases. Purpose The researchers analyzed both international and local scientific articles over the past 15 years to assess the importance of nurses’ role in patient care in palliative medicine. Method and materials Then, in the period from September to November 2022, a crosssectional study was conducted.The aim of the study was to evaluate the activities of nurses in palliative care centers in Kazakhstan and determine the level of patient satisfaction with this care. Result To do this, 99 patients from three palliative care centers in Kazakhstan were interviewed.In the second stage, Pearson’s chi-squared (χ2) statistical method was used to analyze potential relationships between various variables and patient satisfaction levels in relation to the work of nurses in palliative care centers. The third stage included a binary logistic regression analysis to assess the impact of nurses’ behavior on patient satisfaction. The results of the statistical analysis indicate that the amount of information provided by nurses has an impact on the level of patient satisfaction with the quality of nurses’ work. This assistance includes an integrated approach, which includes both medical care and psychological, social and spiritual support, providing comprehensive care for the patient and his loved ones. Conclusion The results of this study can serve as a basis for strengthening the work of nurses, who are an integral element in the medical care system, playing a key role in supporting palliative patients at a difficult life stage. Bangladesh Journal of Medical Science Vol. 24 No. 01 January’25 Page : 136-144

Background: Postpartum depression (PPD) is a common mental health condition, and women with elevated prenatal anxiety are at increased risk. Evidence from Kazakhstan remains limited. This study aimed to describe postpartum depressive symptoms and associated factors among women with elevated prenatal anxiety who received routine perinatal care and participated in the PRISM prenatal psychoeducational program. Methods: This prospective single-arm cohort study with postpartum follow-up was conducted in Astana, Kazakhstan. Of 1232 pregnant women screened, 234 women with elevated prenatal anxiety participated in the PRISM program, and 226 completed the postpartum assessment. Because no control group was included, the study was not designed to evaluate the effectiveness of PRISM or establish causal effects. Postpartum depressive symptoms were assessed using the Postpartum Depression Screening Scale–Short Form (PDSS-SF). Descriptive statistics were calculated, and associations with age, parity, and postpartum assessment period were examined using Spearman’s rank correlation and non-parametric tests. Results: The mean PDSS-SF score was 20.65 ± 6.00. Using a cut-off score of ≥17, 158 of 226 participants screened positive for clinically significant depressive symptoms, corresponding to 69.9% (95% confidence interval (CI): 63.6–75.5%). Scores were highest among women assessed between 6 weeks and 6 months postpartum (p < 0.001). Age showed a weak negative correlation with depressive symptoms, whereas parity was not significantly associated. The most frequently reported symptoms were sleep disturbance, loneliness, and depressed mood. Conclusions: A substantial burden of postpartum depressive symptoms was observed in this high-risk cohort. The findings support early identification of prenatal anxiety, continued postpartum screening, and access to appropriate psychological and psychiatric care. Controlled studies are needed to evaluate PRISM and similar preventive programs.

Background Effective communication is a critical skill for nurses, particularly in palliative care, where emotional and complex patient interactions are common. Training nurses in communication skills may improve both their competence in patient interactions and their ability to manage the emotional demands of end-of-life care. Objective This study aimed to assess the impact of a training program on communication competencies and stress-coping strategies among nurses in two distinct regions, Shymkent and Astana, with a focus on palliative care settings. Methods A descriptive-analytical, cross-sectional study was conducted from January to December 2024 in two palliative care hospitals in Shymkent and Astana, Kazakhstan. Thirty nurses (15 from each hospital) participated. They completed a self-assessment of their communication skills before and after attending a communication skills training seminar, with follow-up assessments after six months. Two instruments were used: the Communicative Competence Scale (CCS) to measure communication skills and the Ways of Coping Questionnaire (WCQ) to assess coping strategies related to stress. Results Before training, nurses in Shymkent demonstrated significantly higher communication competence scores (M = 109.27) compared to those in Astana (M = 98.6). After training, both groups showed improvements in communication skills, with Astana nurses experiencing the most significant increase in their self-assessment scores (M = 106.13). Notably, nurses in Astana showed a marked improvement in coping strategies, including increased seeking of social support and decreased reliance on confrontational and distancing behaviors. Conclusion Communication skills training significantly enhances nurses’ communication competencies and coping strategies, particularly in regions where initial competencies were lower. These improvements may lead to better patient care and increased nurse well-being in palliative care settings. Further integration of communication training in nursing education is recommended. BJMS, Vol. 24 No. 03 July’25 Page : 957-966

The urgency of the problem lies in the changing demographic landscape of Kazakhstan, which is experiencing an increase in its aging population. According to projections from the Ministry of Economy and Budget Planning of the Republic of Kazakhstan and the Institute of Economic Research of the Republic of Kazakhstan, the proportion of elderly individuals will rise to 14% of the total population by 2030. This demographic shift necessitates adjustments to the societal development model, as outlined in the Concept of Social Development of the Republic of Kazakhstan. With a growing elderly population, there is an increasing demand for palliative care and long-term support for elderly patients coping with severe chronic illnesses, cognitive impairments, and other conditions. The challenges surrounding the organization of palliative care are becoming more pronounced globally and particularly in Kazakhstan as societal development progresses. It is imperative not to leave seriously ill individuals and their families to navigate their conditions alone; they require access to high-quality medical care. Palliative care is relevant across various medical specialties, not just oncology, underscoring the importance for all healthcare professionals to be knowledgeable about its principles and capable of providing such care. The necessity for the advancement of palliative medicine in contemporary society stems from several factors. These include the rising life expectancy, which presents challenges in caring for the elderly; increasing incidences of cancer and HIV/AIDS; the emergence of other socially significant diseases resulting from urbanization; and the accelerating pace of life. Addressing these challenges requires a concerted effort to improve the quality of life for terminally ill patients, ensuring they can experience dignity and comfort in their final days. Keywords: palliative care, elderly patients, healthcare, oncology, development prospects

Cancer treatment regimens are significantly more intricate than commonly perceived. Nonetheless, both immunotherapy and chemotherapy may produce adverse consequences. Immunotherapy represents a significant advancement in the battle against cancer; nonetheless, it is not devoid of challenges. This research elucidates the mechanisms underlying immunotherapy-induced cardiovascular damage, highlighting the significant role of immune regulators, such as soluble urokinase plasminogen activator receptor (suPAR), in inducing vascular leakage. We also examine the role of matrix metalloproteinase (MMP14/15) in this process, and antigens associated with cardiovascular illness and malignancies, including native proteins, mutated tumor antigens, and viral components. Besides, we studied predictive biomarkers, such as circulating T-cell populations associated with the probability of myocarditis. We discuss treatment approaches and strategies to mitigate these issues, particularly through the use of antihypertensive medications to reduce their impact. Losartan alters the tumor microenvironment (TME) to improve immunotherapy. It restores immune effector cells in triple-negative breast cancer (TNBC), overcomes resistance in unresponsive tumors, and modifies TMEs’ immune system suppression in ovarian cancer and melanoma. It is important to note that its effects differ by cancer kind. It may promote fibrosarcoma tumor growth and improve cholangiocarcinoma treatment. This shows that losartan’s dangers in cancer treatment should be carefully considered and that more research is needed. This suggests that there must be careful consideration of the potential risks associated with losartan use in cancer treatment and underscores the requirement for additional research on this topic. This study may enhance our comprehension and management of cardiovascular adverse effects in cancer immunotherapy by integrating novel insights on immunological predictors and vascular dysfunction. Experts assert that oncology programs must provide and promote continuous monitoring of cardiac health for breast cancer patients. To mitigate the risk of cardiovascular disease in this demographic, comprehensive patient care must be administered.