Introduction: Studying the prevalence of anxiety, depression, and insomnia among medical workers in emergency medical services is a relevant task that will improve our understanding of scope of the problem and develop effective strategies to support and prevent psychological problems among medical staff. Insomnia is closely linked to anxiety and depression, as sleep disturbances can exacerbate emotional distress, while persistent anxiety and depressive symptoms contribute to sleep disruptions. Individuals suffering from insomnia are at a higher risk of developing anxiety and depression, creating a bidirectional relationship that negatively impacts overall mental well-being. This raises a crucial question: “What specific measures and intervention strategies can be implemented to reduce the levels of anxiety, depression, and insomnia among EMS personnel?” Methods: A cross-sectional study was conducted with the participation of 592 medical workers employed in emergency medical services in the East Kazakhstan and Abay regions of the Republic of Kazakhstan. This study included questions regarding the socio-demographic data of the respondents, questions assessing the severity of insomnia using the Insomnia Severity Index (ISI), and questions from the Hospital Anxiety and Depression Scale (HADS) scale assessing the level of anxiety and depression among the participants. Results: Nearly a third of the EMS personnel reported symptoms of insomnia (28.2% subthreshold, 16.2% insomnia, and 3.0% severe), anxiety (22.1% subclinical, and 13.0% clinical), or depression (20.4% subclinical, and 9.8% clinical). Feldshers (nursing staff) and those with higher education had elevated levels of these conditions. The insomnia was strongly correlated with anxiety (r = 0.539, p < 0.001) and depression (r = 0.415, p < 0.001), emphasizing the need for targeted mental health interventions. Conclusions: This study found elevated levels of insomnia, anxiety, and depression among emergency medical service (EMS) personnel—especially nursing staff and those with higher education. We recommend comprehensive mental health support, routine screenings, stress management training, and integrating sleep hygiene into wellness programs.

Intrduction. Studying the prevalence of anxiety, depression and insomnia among medical workers of Emergency medical service is a relevant task that will allow us to better understand the scope of the problem and develop effective strategies to support and prevent psychological problems among medical staff. Methods. A cross-sectional study was conducted with the participation of 592 medical workers employed at emergency medical service in the East Kazakhstan and the Abay regions of the Republic of Kazakhstan. The study included questions regarding socio-demographic data of the respondents, questions aimed at assessing the severity of insomnia using the Insomnia Severity Index (ISI) and questions from the HADS scale to assess the level of anxiety and depression among the participants. Results. Nearly half of healthcare workers reported symptoms of insomnia (28.2% subthreshold, 16.2% insomnia, 3.0% severe), anxiety (22.1% subclinical, 13.0% clinical), or depression (20.4% subclinical, 9.8% clinical). Feldshers (nursing staff) and those with higher education had elevated levels of these conditions. Insomnia severity strongly correlated with anxiety (r=0.539, p<0.001) and depression (r=0.415, p<0.001), emphasizing the need for targeted mental health interventions. Conclusion. The study revealed high rates of insomnia, anxiety, and depression among healthcare workers, with nursing staff and highly educated individuals most affected. Insomnia correlated strongly with anxiety and depression, highlighting the need for mental health support.

Background: The acquisition of drug resistance by microorganisms narrows the possibilities for the treatment of diseases that these microorganisms cause. The emergence of antimicrobial resistance is observed all over the world and in a wide range of microorganisms. The prevalence of this phenomenon is growing and threatens the health of both humans and animals. The immediate consequences of infection with resistant microorganisms can be serious, including a longer course of the disease, increased mortality, longer hospitalization, weaker protection of patients from infection during operations and other medical procedures, as well as an increase in the cost of treatment. Antimicrobial resistance has implications for all areas of health care and a wide variety of sectors, affecting society as a whole. Materials and Methods: A cross-sectional study of knowledge, attitudes and use of antibiotics was conducted among 727 people without medical education and over 18 years of age from October 2021 to March 2022 in East Kazakhstan region according to the WHO questionnaire «Antibiotic resistance: multi-country public awareness survey». Results: 20.2% of respondents took antibiotics over the past 6 months, 21.7% over the past month. 52% said they received a prescription for antibiotics from a doctor, 35% without a prescription and 13% did not remember. 28.3% of those surveyed believe that it is necessary to stop taking antibiotics when they feel better. 41% of residents said that when they get sick again with the same symptoms, they will buy or ask their doctor again for an antibiotic that has helped them last. Conclusion: According to the results of the respondents' responses, it can be concluded that the knowledge of the population about antibiotics is insufficient and it is necessary to increase public awareness of these drugs both by public health specialists and at the primary level. Введение. Приобретение микроорганизмами устойчивости к лекарственным средствам сужает возможности для лечения болезней, которые эти микроорганизмы вызывают. Возникновение устойчивости к противомикробным препаратам наблюдается во всем мире и у широкого спектра микроорганизмов. Распространенность этого явления растет и угрожает здоровью как людей, так и животных. Непосредственные последствия инфицирования резистентными микроорганизмами могут быть серьезными, включая более длительное течение болезни, повышенную смертность, более длительную госпитализацию, более слабую защиту пациентов от инфицирования во время операций и других медицинских процедур, а также увеличение стоимости лечения. Устойчивость к противомикробным препаратам имеет последствия для всех областей здравоохранения и самых разных секторов, влияет на общество в целом. Материалы и методы исследования: В период с октября 2021 года по март 2022 года было проведено перекрестное исследование знаний, отношения и использования антибиотиков среди 727 жителей Восточно-Казахстанской области без медицинского образования и старше 18 лет в в соответствии с вопросником ВОЗ «Устойчивость к антибиотикам: многострановое исследование осведомленности общественности». Результаты: 20,2% респондентов принимали антибиотики за последние 6 месяцев, 21,7% - за последний месяц. 52% сказали, что получили рецепт на антибиотики от врача, 35% - без рецепта и 13% ответили,что не помнят. 28,3% опрошенных считают, что необходимо прекратить прием антибиотиков, когда они почувствуют себя лучше. 41% жителей заявили, что, когда они снова заболеют с теми же симптомами, они купят или снова попросят у своего врача антибиотик, который помог им в прошлом. Вывод: По результатам ответов респондентов, можно сделать вывод, что знания населения об антибиотиках недостаточны и требуется повышения осведомленности населения об этих препаратах как со стороны специалистов общественного здравоохранения, так и на уровне первичного звена. Кіріспе. Микроорганизмдердің дәрілік заттарға төзімділігін алу осы микроорганизмдер тудыратын ауруларды емдеу мүмкіндіктерін тарылтады. Микробқа қарсы тұрақтылықтың пайда болуы бүкіл әлемде және микроорганизмдердің кең ауқымында байқалады. Бұл...

Background: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory condition that substantially impairs patients’ health-related quality of life (HRQoL). Beyond lung function deficits, a variety of clinical, psychological, and social factors influence how COPD patients experience their daily lives. Over the past decade, research has increasingly focused on identifying key determinants of QoL in COPD, recognizing that improving QoL is a primary goal of COPD management. This narrative review summarizes evidence (2015–2025) on major factors affecting QoL in COPD patients, including disease severity, comorbid conditions, psychological status, physical activity, exacerbation frequency, social support, access to care, and treatment adherence. Consistent themes and gaps in the literature are highlighted, and we conclude by discussing how these factors interact to shape patient outcomes and where future research is needed. Objective. The primary objective of this review was to summarize and analyze modern approaches aimed at improving the quality of life in patients with chronic obstructive pulmonary disease (COPD). Specific focus was placed on pharmacological therapies, pulmonary rehabilitation, psychosocial interventions, telehealth, self-management education, lifestyle modifications, and integrated care models. Search strategy. A narrative literature review was conducted using electronic databases including PubMed, Scopus, and Cochrane Library. The search included studies published from 2015 to 2025 using keywords such as:“COPD”, “quality of life”, “pulmonary rehabilitation”, “self-management”, “psychological interventions”, “digital health”, “triple therapy”, and “integrated care”.Preference was given to systematic reviews, randomized controlled trials, and high-quality cohort studies published in peer-reviewed journals in English. Results and conclusions. Recent studies confirm that various modern interventions can significantly improve the quality of life in COPD patients. Optimized pharmacological treatments, particularly triple inhaler therapy, help reduce symptoms and exacerbations. Pulmonary rehabilitation consistently enhances physical function and well-being. Psychological support, including cognitive-behavioral therapy, reduces anxiety and depression, positively affecting emotional health.Telehealth and mobile tools improve patient engagement and self-management, while structured education programs lead to better disease control and reduced hospital visits. Nutritional support and regular physical activity improve strength, endurance, and daily functioning. Integrated, multidisciplinary care models have shown the strongest overall impact, improving both quality of life and healthcare outcomes when delivered in a coordinated and patient-centered manner. Введение: Хроническая обструктивная болезнь легких (ХОБЛ) - это прогрессирующее респираторное заболевание, которое существенно ухудшает качество жизни пациентов, связанное со здоровьем. Помимо нарушения функции легких, на повседневную жизнь пациентов с ХОБЛ влияют различные клинические, психологические и социальные факторы. В течение последнего десятилетия исследования все больше фокусировались на выявлении ключевых факторов, определяющих качество жизни при ХОБЛ, признавая, что улучшение качества жизни является основной целью лечения ХОБЛ. В этом обзоре обобщены фактические данные (2015-2025 гг.) об основных факторах, влияющих на качество жизни пациентов с ХОБЛ, включая тяжесть заболевания, сопутствующие состояния, психологический статус, физическую активность, частоту обострений, социальную поддержку, доступ к медицинской помощи и приверженность лечению. Выделяются общие темы и пробелы в литературе, и в заключение мы обсуждаем, как эти факторы влияют на результаты лечения пациентов и где необходимы будущие исследования. Цель. Основной целью данного обзора было обобщение и анализ современных подходов, направленных на улучшение качества жизни пациентов с хронической обструктивной болезнью легких (ХОБЛ). Особое внимание было уделено фармакологической терапии, легочной реабилитации, психосоциальным вмешательствам, телемедицине, обучению самоуправлению, изменению образа жизни и моделям комплексного ухода. Стратегия поиска. Обзор научной литературы был проведен с использованием электронных баз данных, включая PubMed, Scopus и Кокрановскую библиотеку. Поиск включал исследования, опубликованные с 2015 по 2025 годы, с использованием таких ключевых слов, как “ХОБЛ”, “качество жизни”,...

Introduction. According to the 2022 global fact sheet of the World Stroke Organization, more than 12.2 million new cases of acute cerebrovascular accidents (stroke) are registered annually. Worldwide, one in four individuals over the age of 25 experiences a stroke during their lifetime. Currently, more than 101 million people globally have survived a stroke. Approximately 6.5 million people die from stroke each year [Feigin, V.; Brainin, M.; Norrving, B. World Stroke Organization (WSO): Global Stroke Fact Sheet 2022. Int. J. Stroke2022, 1, 18–29]. Materials and Methods. The study was conducted using a sociological research method. Research design: cross-sectional, analytical, descriptive. The sample size was calculated using a sample size calculator for cross-sectional studies (SampleXS), with a total of 147 participants. The study population consisted of patients residing in the East Kazakhstan Region and the Abai Region who had undergone the second and third stages of rehabilitation following acute cerebrovascular accidents, as well as their caregivers involved in the rehabilitation process. The SF-36 questionnaire was selected as the assessment tool, allowing evaluation of patients’ physical and emotional состояния, general well-being, and the degree of satisfaction with these aspects of life that influence overall health. Results. The findings demonstrated that the psychological component of quality of life in post-stroke patients was below average (49.9 ± 10.03 points), while the physical component was at an average level (51.35 ± 10.01 points). Gender-based analysis revealed that certain quality-of-life indicators were lower in men, particularly in the domains of role-physical functioning and mental health, by 16.66 points (p = 0.002) and 21.48 points (p = 0.022), respectively. Conclusion. The SF-36 was administered as an internationally standardized instrument for comprehensive assessment of quality of life. The evaluation of non-specific quality of life in patients with stroke revealed the highest score on the “social functioning” scale (45.1 points), while the lowest scores were observed for “mental health” (25.1 points) and “vitality” (27.1 points). These findings indicate a predominance of symptoms such as emotional burnout, decreased motivation, and fatigue. Введение. Согласно глобальному информационному бюллетеню Всемирной Организации по борьбе с инсульт за 2022 год, ежегодно регистрируется более 12,2 миллиона новых случаев ОНМК. В мире каждый четвёртый человек старше 25 лет в течение жизни страдает ОНМК. В настоящее время в мире насчитывается более 101 миллиона человек, перенёсших ОНМК. Шесть с половиной миллионов человек ежегодно умирают от ОНМК [Фейгин, В.; Брейнин, М.; Норрвинг, Б. Всемирная организация по борьбе с ОНМК (WSO): глобальный информационный бюллетень по инсульт 2022. Int. J. Stroke 2022, 1, 18–29]. Материалы и методы. Исследование проводилось с помощью социологического метода. Дизайн исследований: поперечный, аналитический, описательный. Размер выборки был рассчитан с помощью калькулятора размера выборки для поперечных исследований (SampleXS), количество – 147 человек. Объектом исследования являются пациенты, проживающие в Восточно-Казахстанской области и Абайской области, прошедшие второй и третий этап реабилитации с острым нарушением мозгового кровообращения и лица, осуществляющие уход за ними в реабилитации. Был выбран инструмент опроса SF-36, с помощью которого можно оценить физическое и эмоциональное состояние пациента, общее самочувствие и степень удовлетворенности этими аспектами жизни человека, влияющими на состояние здоровья. Результаты. Результаты исследования выявили, что психологический компонент качества жизни пациентов после перенесенного ОНМК был ниже среднего (49,9 ± 10,03 балла), а физический – на среднем уровне (51,35 ± 10,01 балла). Результаты гендерного анализа показали, что некоторые показатели качества жизни были ниже у мужчин, особенно в сферах ролевой физической активности и психического здоровья, на 16,66 балла (p = 0,002) и 21,48 балла (p = 0,022) соответственно. Заключение. SF-36 был реализован с помощью международного стандартизированного опроса для комплексной оценки качества жизни. В результате оценки неспецифического качества жизни больных с ОКР наибольшее значение зафиксировано по шкале «социальное обслуживание»...

Background: Urinary incontinence (UI) is a common condition that affects women’s physical, psychological, and social well-being. Evidence from Central Asia remains limited. This study assessed factors associated with UI, its subtypes, and quality-of-life impairment among women in Kazakhstan. Methods: A multicenter age-matched case–control study was conducted from February to May 2025 in healthcare facilities across Kazakhstan. The study included 2061 women. Sociodemographic, obstetric, lifestyle, comorbidity, and symptom data were collected using a structured questionnaire. Quality of life was assessed using Kazakh and Russian versions of the Incontinence Quality of Life Questionnaire (I-QOL). Multivariable logistic regression with backward elimination identified factors independently associated with UI. Results: UI was identified in 687 women (33.3%). Stress urinary incontinence (SUI) was the most common subtype (n = 356; 51.8%), followed by urgency urinary incontinence (UUI) (n = 191; 27.8%) and mixed urinary incontinence (MUI) (n = 140; 20.4%). UI was independently associated with vaginal delivery (OR = 1.48), multiple birth (OR = 2.26), macrosomia (OR = 1.83), and BMI ≥ 25 kg/m² (OR = 2.08). UUI showed the greatest burden, including the lowest total I-QOL score [36.4 (23.9–88.6)]. Conclusions: UI in Kazakhstan was mainly associated with obstetric and metabolic factors, supporting targeted prevention through weight management, antenatal care, and early pelvic floor assessment.