(1) Background: The nursing profession has undergone a significant transformation not only in a formal context but also in terms of the increased educational competencies required of nurses and their preparedness to adapt to evolving roles and statuses. The aim of our study was to examine the experience of advanced practice nurses who conduct independent consultations on patients and to identify the main challenges they face in their practice. (2) Methods: We carried out 22 semi-structured interviews with nurses responsible for conducting independent consultations across three urban polyclinics located in Aktobe, Almaty, and Astana. All interviews were audio-recorded, transcribed verbatim, and subjected to qualitative content analysis. (3) Results: The content analysis revealed three main themes: “People awareness of the role of an independent nursing appointment”, “Adaptation of the work environment”, and “Confidence of nurses to provide independent services”. (4) Conclusions: Limited competency among nurses and the absence of quality metrics for autonomous nursing consultations present substantial obstacles to assessing and enhancing the quality of care delivered by nurses in their independent roles. Developing and implementing quality indicators for independent nursing appointment, as well as additional training within the framework of interprofessional continuous education for nurses, are important steps toward enhancing the effectiveness, safety, and accessibility of nursing care.

Purpose: The medical students’ attitude toward pain in people with advanced dementia, while constituting an important factor in care, has rarely been assessed to date. The aim of our study was thus to perform such assessment in medical students in Kazakhstan, to enable an improvement of the existing curriculum (like we previously did in Poland). Materials and Methods: We analyzed the knowledge about pain using a short anonymous questionnaire, which was completed by 112 students of the Medical University of Aktobe, Kazakhstan. Results: On average, students listed symptoms of 1.4 ± 1.2 (out of 6 analyzed) pain areas (median 2.0). The symptoms related to changes in mental status were suggested the most often (57 students: 50.9%). The students who indicated these symptoms also listed a higher number of symptoms from the remaining domains (1,1 ± 1.0 [median 1.0] vs 0.6 ± 0.8 [median 0.0]; p< 0.01). Observational methods in the assessment of the severity of pain in people with dementia were indicated by 44 students (39.3%), but only one participant (0.9%) was able to name an observational scale for pain assessment. Correct answers regarding pain treatment rules were presented by 18 students (16.0%), and the answers of the next 47 participants (42.0%) were very general but suggested the same treatment no matter what the cognitive status. Conclusion: The study revealed gaps in the knowledge of Kazakh medical students regarding pain in advanced stages of dementia. Demographic changes, combined with the coexistence of pain with dementia, indicate that medical students worldwide must have sufficient knowledge and skills to adequately care for the continually growing number of people with these conditions. It is imperative in countries like Kazakhstan, where the dementia burden was unrecognized until now, but it will blow up in the near future.

Gestational diabetes mellitus (GDM) represents a significant medical complication during pregnancy, with a global prevalence ranging from 2% to 26% and increasing by over 30% in recent decades. Therefore, the aim of our study is to assess the trends and distribution of published studies, as well as the contributions of countries, institutions, journals, and authors to the development of primary care for pregnant women with gestational diabetes. In this bibliometric analysis, we examine the role of primary health care in GDM from 1991 to 2024. The data were sourced from Scopus and Web of Science, encompassing 276 articles from 150 sources and involving 1375 authors. The analysis reveals a steady increase in publications, with a 4.29% annual growth rate. This study identifies the USA and UK as leading countries in GDM research, and there are significant international collaborations, with the USA having 17 joint articles with other countries. The University of Eastern Finland, Ohio State University, and Harvard University are noted as the most prolific institutions, with 23, 17, and 16 articles, respectively. Additionally, the journal Diabetes Care published the highest number of articles, totaling 635. Prominent authors such as Bernstein J. and McCloskey L., with seven articles each, have made substantial contributions to the field. Our work highlights the need to pay special attention to primary care for gestational diabetes, as many negative consequences of the disease can be prevented at this stage. Innovative approaches to screening for GDM can significantly improve treatment outcomes and reduce health risks, which will have long-term positive effects both for individual patients and society as a whole.

Background: Human immunodeficiency virus (HIV) remains a major global public health challenge, with eastern Europe and central Asia experiencing a rapid rise in new infections. In Kazakhstan, structural barriers and substance use complicate prevention and care. This study aimed to determine the socio behavioral determinants of recent vs. long term HIV infection and identify predictors of baseline viral load and CD4 count among newly diagnosed adults. Methods: We conducted a retrospective cross-sectional study of 452 adults diagnosed with HIV in 2023–2024 at the Kostanay Regional Center for Prevention and Control of AIDS. Clinical data were extracted from medical records and behavioral information collected via structured questionnaires. Infection stage was defined as recent (< 6 months) or long term (>6 months). Logistic regression identified factors associated with infection stage; linear regression assessed predictors of log10 viral load and CD4 count. Results: Participants were predominantly married (63.3%) and middle aged (mean 41.5 years). Self reported alcohol (80.8%) and drug use (67.5%) were common, and 80.8% had used an HIV self test prior to diagnosis. Early infection declined from 27.4% in 2023 to 16.2% in 2024. Logistic models showed that male gender, any alcohol use and lifetime drug use were associated with higher odds of recent infection, while each additional sexual partner increased the odds of long term infection. Early cases were more likely to have self tested and to report recent sexually transmitted infections. Older age predicted higher viral load and lower CD4 count, whereas recent infection was associated with better immunological status. Conclusion: Early detection is occurring among substance users through self testing and harm reduction programs, yet older adults and those with multiple partners remain at risk for delayed diagnosis. Integrated interventions that couple self testing with substance use services and targeted outreach to older individuals could accelerate progress toward epidemic control.

Background/Aim of Study: Cardiovascular diseases (CVDs) are the leading cause of morbidity and mortality globally. Cardiac rehabilitation (CR) plays a pivotal role in the recovery of post-acute myocardial infarction (AMI) patients. Despite evidence supporting its clinical benefits, CR remains underutilized, especially in middle-income countries like Kazakhstan. This study aimed to evaluate the clinical effectiveness and economic impact of phase II CR among patients with AMI treated at the Almaty City Cardiology Center between 2018 and 2022. Methods: A retrospective cohort study was conducted using data from 2672 AMI patients. Two cohorts were compared: those who participated in phase II CR and those who did not. Primary outcomes included changes in left ventricular ejection fraction (LVEF), rehospitalization rates, and return to active work. Results: Economic outcomes involved direct medical costs related to initial hospitalization and follow-up care. CR participants showed significant improvements in LVEF (53.7% vs. 49.0% in non-CR patients, p < 0.001). Despite these clinical benefits, there was no significant reduction in long-term treatment costs between the CR and non-CR groups. CR users had slightly higher initial treatment costs but similar cumulative costs for subsequent treatments over two years. Importantly, government funding limitations were found to hinder the full effectiveness of CR programs in Kazakhstan. Conclusions: Phase II CR improves cardiac function in AMI patients but does not reduce long-term treatment costs. The current insufficient government funding for CR limits its broader impact. Expanding CR services and increasing funding are essential to maximize its benefits within Kazakhstan’s healthcare system.

Background/Objectives: The implementation of advanced practice nursing in Kazakhstan is aimed at improving the accessibility and quality of primary healthcare. One of the key indicators of the effectiveness of this model is patient satisfaction, which reflects the perceived quality of care and directly influences treatment adherence. The aim of the study was to assess patient satisfaction with nurse-led consultations in primary healthcare institutions in Kazakhstan. Methods: A cross-sectional study was conducted using a questionnaire developed on the basis of Karin Bergman’s instrument and adapted to the Kazakhstani context. A total of 621 patients who attended independent nursing consultations in polyclinics in Aktobe, Almaty, Astana, and the village of Merke participated in the survey. Descriptive statistics and Pearson’s χ² test were applied, with statistical significance set at p < 0.05. Results: The majority of respondents were women, with a median age of 61 years. Awareness of independent consultations was higher among patients who regularly visited nurses (97.1% vs. 86.9%; p < 0.006). High satisfaction levels were associated with service accessibility, quality of examination, and clarity of recommendations. Among regular visitors, 99.2% reported satisfaction with the nurse’s work, and 76.6% rated the service as “excellent”. In contrast, patients with irregular visits more often reported dissatisfaction due to insufficient attention and limited knowledge of nurses. Conclusions: The findings confirm a high level of patient satisfaction with advanced practice nursing services and highlight the importance of this model in strengthening primary healthcare in Kazakhstan.