Актуальность: Сердечно-сосудистые заболевания (ССЗ) занимают устойчивые лидирующие позиции среди причин смертности населения большинства стран мира, в том числе и Казахстана. Согласно информации из статсборника «Естественное движение населения Республики Казастан» за январь-декабрь 2020 года Бюро нацстатистики агентства (БНС) по стратегическому планированию и реформам РК, среди причин смертности на первом месте стоит летальность из-за болезней системы кровообращения (36,6 тыс. человек). Она занимает долю 22% в общей смертности. В сравнении с 2019 годом количество смертей от инфарктов, инсультов, ишемической болезни сердца, стенокардии увеличилось на 6,3 тыс. (+ 20,6%). Реабилитации больных на этапе остаточных явлений инсульта не придается большого значения, так как считается, что восстановительные процессы к этому периоду уже завершены. Однако имеются научные данные, свидетельствующие о достаточной эффективности реабилитационных мероприятий у больных, перенесших инсульт 2 года назад и более, при условии такого же активного применения реабилитационных мероприятий, как в остром и раннем восстановительном периодах инсульта [43]. Цель исследования. Провести анализ данных литературы по реабилитации больных трудоспособного возраста после инсульта. Стратегия поиска. В исследовании изучены полнотекстовые публикации на английском и русском языках, которые посвящены реабилитации больных трудоспособного возраста после инсульта. В процессе поиска литературы использованы следующие поисковые системы: Pubmed, Web of Science Core Collection, Cyberleninka, Google Scholar по ключевым словам сердечно-сосудистые заболевание, инсульт, смертность, инвалидность, реабилитация, организация реабилитации. Временной период был обозначен 2011-2021 годами. По данной теме выявлено 956 публикаций. Из них цели нашего исследования соответствовало 43 публикаций. Результаты и выводы. Многочисленные публикации показывают, что, к сожалению, на современном этапе не хватает мер организационного характера, которые позволили бы улучшить показатели здоровья пациентов перенесших инсульт, улучшить качество жизни, снижение ограничений жизнедеятельности. Introduction. Cardiovascular diseases (CVD) occupy a stable leading position among the causes of mortality in most countries of the world, including Kazakhstan. According to the information from the state collection "Natural movement of the Population of the Republic of Kazakhstan" for January-December 2020, the Bureau of National Statistics of the Agency for Strategic Planning and Reforms of the Republic of Kazakhstan, among the causes of mortality in the first place is mortality due to diseases of the circulatory system (36.6 thousand people). It accounts for 22% of the total mortality. In comparison with 2019, the number of deaths from heart attacks, strokes, coronary heart disease, angina increased by 6.3 thousand (+ 20.6%). Rehabilitation of patients at the stage of residual stroke phenomena is not given much importance, since it is believed that the recovery processes have already been completed by this period. However, there are scientific data indicating that rehabilitation measures are sufficiently effective in patients who had a stroke 2 years ago or more, provided that rehabilitation measures are used as actively as in the acute and early recovery periods of stroke [43]. The purpose of the study: To analyze the literature data on the rehabilitation of patients of working age after a stroke. Search strategy: The study examined full-text publications in English and Russian, which are devoted to the rehabilitation of patients of working age after a stroke. In the process of literature search, the following search engines were used: Pubmed, Web of science, Cyberleninka, Google Scholar by keywords cardiovascular disease, stroke, mortality, disability, rehabilitation, rehabilitation organization. The time period was designated 2011-2021. 956 publications have been identified on this topic. Of these, 43 publications corresponded to the purpose of our study. Results and conclusions. Numerous publications show that, unfortunately, at the present stage there are not enough organizational measures that would improve the health indicators of stroke patients, improve the quality of...

Tuberculosis (TB) remains a major public health challenge globally and in Kazakhstan, despite progress in reducing incidence. Increasing evidence highlights the role of social and structural determinants in shaping TB risk, disease progression, and treatment outcomes. However, limited research has explored how decision-makers conceptualize these factors and identify system-level gaps in TB control. This study aimed to examine regional decision-makers' perspectives on TB burden, social protection, health system capacity, and governance in Kazakhstan. A qualitative study was conducted using in-depth, semi-structured interviews with 12 decision-makers from six regions of Kazakhstan, including representatives of regional health authorities and local governance structures. Participants were purposively sampled to ensure diversity in institutional roles and geographic context. Interviews were conducted between August and December 2020, audio-recorded, transcribed verbatim, and analyzed using inductive codebook thematic analysis supported by ATLAS.ti software. The study followed COREQ guidelines. Six major themes were identified. Participants consistently framed TB as a condition closely linked to structural inequality rather than solely a biomedical issue. Risk was perceived as concentrated among socially and geographically vulnerable populations, particularly in rural areas with limited access to care. A key finding was the identification of a "biomedical-social gap," whereby strong diagnostic and treatment capacity was perceived as insufficiently connected to social protection, outreach, and governance mechanisms. Participants attributed this gap to fragmented social assistance, uneven support for transport, food, and income-related needs, workforce and infrastructure constraints, inequities in rural access, and insufficient institutionalization of NGO involvement. Sustaining political commitment and non-stigmatizing public awareness was also identified as important for long-term TB control. Regional decision-makers perceived TB control in Kazakhstan as constrained by fragmented linkages between biomedical services, social protection, NGO outreach, rural access support, and intersectoral governance mechanisms. Strengthening patient-centered social support and coordination across clinical, social, and civil society sectors may help reduce perceived fragmentation and support more equitable TB control.

Background: Patient-reported outcome measures are increasingly used to evaluate the quality of palliative care. However, evidence from Kazakhstan remains limited. This study aimed to assess palliative care outcomes among adult patients in Kazakhstan using the Palliative Outcome Scale (POS). Methods: A cross-sectional study was conducted among 134 adult patients receiving palliative care in East Kazakhstan. Data were collected using a socio-demographic and clinical questionnaire and the 10-item POS. Descriptive statistics, Cronbach’s alpha, Spearman correlation, nonparametric tests, and multiple linear regression were performed using IBM SPSS Statistics 26.0. Results: The mean total POS score was 10.13 ± 5.05, indicating a moderate burden of palliative care-related problems. The highest mean scores were observed for self-worth, meaning in life, anxiety, and pain. The POS demonstrated moderate internal consistency (Cronbach’s α = 0.641). Significant differences in total POS scores were found across disease profiles (p < 0.001), whereas no significant differences were observed by gender or age. In multiple linear regression, disease profile was the only variable significantly associated with the total POS score (B = 0.688, β = 0.292, p = 0.001). Conclusions: Patients receiving palliative care in Kazakhstan experience a moderate burden of physical, emotional, and existential concerns. Disease profile was significantly associated with patient-reported outcomes and may represent one of several factors influencing palliative care needs. The POS may be a useful tool for assessing patient-reported palliative care outcomes in Kazakhstan; however, further formal psychometric validation in the local population is required before routine implementation.

Введение.По данным Всемирной организации здравоохранения (ВОЗ) в 2019 г. от сердечно-сосудистых заболеваний (ССЗ) умерло 17,9 млн человек, что составило 31% от общего числа причин смерти, в 2000 г. этот показатель составлял 16%, 85% этих смертей связаны с инфарктами и инсультами. Одной из актуальных проблем современной медицины является организация медицинской помощи больным, перенесшим инсульт. В 2004 г. ВОЗ объявила инсульт опасной для жизни глобальной эпидемией [6]. Целью исследования является разработка мер по совершенствованию организации реабилитационных мероприятии пациентов после инсульта и тем самым повысить качества жизни пациентов перенесший инсульт. Метод / дизайн. Выбран тип исследования: Количественный, обсервационный, поперечный, аналитический, описательный. Выводы. Разработанные меры по оптимизации проведения реабилитационных мероприятий позволят повысить качество жизни пациентов и сократить время возвращения к трудовой деятельности. Introduction. According to the World Health Organization (WHO), in 2019, 17.9 million people died from cardiovascular diseases (CVD), which accounted for 31% of the total number of causes of death, in 2000 this figure was 16%, 85% of these deaths are associated with heart attacks and strokes. One of the urgent problems of modern medicine is the organization of medical care for patients who have had a stroke. In 2004, WHO declared stroke a life-threatening global epidemic [6]. The aim of the study is to develop measures to improve the organization of rehabilitation measures for patients after a stroke and thereby improve the quality of life of patients who have undergone a stroke. Method / design. Study type selected: quantitative, observational, cross-sectional, analytical, descriptive. Conclusions. The measures developed to optimize the implementation of rehabilitation measures will improve the quality of life of patients and reduce the time to return to work. Кіріспе. Дүниежүзілік денсаулық сақтау ұйымының (ДДСҰ) мәліметтері бойынша2019 жылы жүрек-қан тамырлары ауруларынан (ЖҚА) 17,9 миллион адам қайтыс болды, бұл инфаркт пен инсультпен байланысты өлім-жітім себептерінің жалпы санының 31%-ын құраса, 2000 жылы бұл көрсеткіш 16%-ды, олардың 85%-ын құрады. Қазіргі заманғы медицинаның өзекті мәселелерінің бірі - инсульт алған науқастарға медициналық көмек көрсетуді ұйымдастыру. 2004 жылы ДДҰ инсультты өмірге қауіпті жаһандық эпидемия деп жариялады [6]. Зерттеудің мақсаты - инсульттан кейін пациенттерді оңалту шараларын ұйымдастыруды жетілдіру және сол арқылы инсультке ұшыраған науқастардың өмір сүру сапасын жақсарту бойынша шараларды әзірлеу. Тәсіл/ дизайн. Таңдалған зерттеу түрі: сандық, бақылау, көлденең бақылау, аналитикалық, сипаттама. Қорытынды. Оңалту шараларын жүзеге асыруды оңтайландыру бойынша әзірленген шаралар пациенттердің өмір сүру сапасын жақсартуға және жұмысқа қайта оралу уақытын қысқартуға мүмкіндік береді.

Background/Objectives: Evidence-based clinical guidelines and standardized nursing documentation are essential for healthcare quality and safety, yet evidence on their use by nurses in Kazakhstan is limited. This study assessed the reported use of clinical guidelines and nursing documentation checklists. Methods: A cross-sectional online survey with convenience sampling was conducted from December 2021 to February 2022; 2263 practicing nurses were analyzed. “Use” meant self-reported use in routine practice. Proportions with 95% confidence intervals were calculated for the whole sample. Results: Reported use varied across clinical areas. Pressure ulcer guidelines were used most often (39.0%; 95% CI 37.0–41.0), followed by patient- and family-centered care (37.1%), fall prevention (34.3%), and anti-smoking interventions (31.3%). Among documentation checklists, reported use was highest for allergic reaction care (40.3%) and preventing injuries and falls (34.5%) and below 15% for care after a tracheostomy, duodenal probing, and gastric tube insertion in neonates and premature infants, which apply only to specific patient groups. Conclusions: In this convenience sample, reported use of guidelines and checklists was low to moderate and uneven. The findings are not national implementation rates. The study design does not allow the causes of this variability to be identified; the role of education, organizational support, and electronic documentation should be examined in future research.

Introduction. According to WHO, in 2019, 17.9 million people died from cardiovascular diseases (CVD), which accounted for 31% of the total structure of causes of death, in 2000 this figure was 16%. 85% of these deaths are related to heart attacks and strokes. The costs of noncommunicable diseases represent a global barrier to economic and social development. According to calculations, with an increase in mortality by 10%, economic growth decreases by 0.5%[3]. By 2030, deaths from CVD are projected to increase by more than 23.6 million people. In addition to cardiovascular disease, stroke is the 5th leading cause of death in the world after heart disease, cancer, respiratory disease and unintentional injury. Aim. To study the incidence and mortality of stroke in Kazakhstan. Materials and methods. A comparative retrospective analysis of the incidence and mortality from stroke in the context of the regions of the Republic of Kazakhstan for 2010-2020 was carried out according to the statistical collections "Health of the population of the Republic of Kazakhstan and the activities of healthcare organizations". Results. Incidence of stroke in the Republic of Kazakhstan increases 2.3 times from 189 in 2011 to 433.7 per 100,000 population in 2020. In 2020, the average republican incidence rate was 433.7 per 100,000 population. The incidence of stroke per 100,000 population by region prevails in the East Kazakhstan region (625). And the lowest rate was recorded in Atyrau (221), Aktobe (249) and Almaty (279) regions. It can be seen that the dynamics of the mortality rate has relatively decreased. By the way, compared to 2011, in 2020 (78.49) there was a decrease of 15%. In 2011, death rates were registered 92.36 per 100,000 population. This is the maximum point of the studied time interval. The lowest death rate was recorded in 2012 (51.53). Conclusion. Thus, in Kazakhstan for the study period (2011-2020), there is a decrease in mortality from stroke in dynamics. Thanks to the introduction of a screening program for the detection of arterial hypertension, diabetes mellitus in Kazakhstan, the detection rate of the incidence of stroke has sharply increased. Введение. По данным ВОЗ, в 2019 году от сердечно-сосудистых заболеваний (далее - ССЗ) умерло 17,9 млн человек, что составило 31% в общей структуре причин смерти, в 2000 году этот показатель составлял 16%. 85% случаев смертей связаны с сердечными приступами и инсультами. Экономические издержки неинфекционных заболеваний представляют собой глобальные препятствия для социально-экономического развития. Согласно расчетам, при увеличении смертности на 10% экономический рост снижается на 0,5% [3]. По прогнозам, к 2030 году смертность от ССЗ увеличится более чем на 23,6 миллиона человек. Помимо ССЗ, инсульт занимает 5-е место среди причин смерти в мире после болезней сердца, рака, респираторных заболеваний и непреднамеренных травм. Цель исследования: Изучить первичную заболеваемость и смертность от инсульта в Республике Казахстане. Материалы и методы исследования. Сравнительный ретроспективный анализ первичной заболеваемости и смертности от инсульта в разрезе регионов Республики Казахстан за 2010-2020 годы проведен по данным статистических сборников «Здоровье населения Республики Казахстан и деятельность организаций здравоохранения». Результаты. Заболеваемость инсультом в Казахстане увеличивается в 2,3 раза со 189 в 2011 году до 433,7 на 100 000 населения в 2020 году. Заболеваемость инсультом на 100 000 населения по регионам преобладает в Восточно-Казахстанской области (625). А самый низкий показатель зафиксирован в Атырауской (221), Актюбинской (249) и Алматинской (279) областях. Видно, что динамика смертности относительно снизилась. По сравнению с 2011 годом, в 2020 году (78,49) произошло снижение на 15%. В 2011 году смертность составила 92,36 на 100 000 населения. Это максимальная точка исследуемого временного интервала. Самая низкая смертность была зафиксирована в 2012 году (51,53). Заключение. Таким образом, в Казахстане за исследуемый период (2011-2020 год) в динамике отмечается снижение смертности от инсульта. Благодаря внедрению скрининговой программы по выявлению артериальной гипертензии, сахарного диабета в Казахстане резко повысилась выявляемость заболеваемости инсультом. Кіріспе. ДДҰ деректері бойынша...