Enhancing nursing documentation in Kazakhstan: assessing utilization and standardization for improving patient care.

Background and aim: This article stresses the importance of comprehensive nursing documentation in scientific medicine and discusses the adoption of standardized terminologies in Europe. The study also presents findings from a cross-sectional study conducted in Kazakhstan, assessing the utilization of standard operating procedures and nursing documentation in various clinical scenarios. The aim was evaluate the level of use of the form of nursing documentation and Standard Operating Procedure within the framework of reforming the Republic of Kazakhstan. Materials and methods: During the period from December 2021 to February 2022, a cross-sectional study was conducted in Kazakhstan, involving a randomly selected sample of nurses with technical and vocational education as well as those with applied/academic baccalaureate degrees in nursing. Results: In this cross-sectional study of 2,263 female nurses, 75.3% were nurse practitioners, and 44% held the highest qualification category. Awareness levels varied, with around 64.7% aware of the pilot program for care services, 65.8% aware of the deputy head position, and 73.8% familiar with the "extended practice nurse" role. Only 55.2% knew about the International Clinical Nursing Classification, and 54.5% observed changes in their nursing approach due to education. The limb edema measurement checklist was not used by the majority (88.4%) of respondents, and 68% did not utilize the antibiotic susceptibility testing checklist. Various other checklists and algorithms had limited utilization, with percentages ranging from 9.1 to 69.3%, indicating varying levels of adoption among participants. For assisting children with cerebral palsy, the "Assessment of hand use capacity according to the MACS classification system" was utilized by 9.1%, while 90.9% did not employ it. In the context of communication, 30.7% of the respondents utilized the "Algorithm of actions of a medical registrar when communicating with a patient," while 69.3% did not use it. These findings highlight variable adoption rates among participants for these medical procedures and protocols. Conclusion: In Kazakhstan, nursing documentation forms and Standard Operating Procedures face challenges and limited utilization, but their implementation has shown positive impacts on patient care and healthcare outcomes. Overcoming resistance to change, increasing awareness, and addressing resource constraints are essential for further improvement.

Examining disparities in cardiovascular disease prevention strategies and incidence rates between urban and rural populations: insights from Kazakhstan.

Kazakhstan is experiencing a high burden of cardiovascular disease (CVD), and the country has implemented a range of strategies aimed at controlling CVD. The study aims to conduct a content analysis of the policies implemented in the country and augment it with an analysis of official statistics over a 15-year period, from 2006 to 2020. The study also includes comparisons of incidence rates between urban and rural areas. A comprehensive search was conducted to identify policy documents that regulate the provision of primary, secondary, and tertiary prevention of cardiovascular diseases. Additionally, official data on the incidence of arterial hypertension, ischemic heart disease, acute myocardial infarction, and cerebrovascular disease were extracted from official statistics, disaggregated by urban and rural areas. Forecast modeling was utilized to project disease incidences up to 2030. The study reveals that Kazakhstan primarily focuses on tertiary prevention of cardiovascular diseases, with less attention given to secondary prevention, and primary prevention is virtually non-existent. In general, screening for arterial hypertension appears to be more successful than for ischemic heart disease. The incidence of arterial hypertension has increased threefold for urban residents and 1.7-fold for rural residents. In urban areas, residents saw a twofold increase in ischemic heart disease incidence, while it remained the same in rural areas. The findings of this study have practical implications for decision-makers, who can use the results to enhance the effectiveness of existing CVD prevention strategies.

Prevalence and genotypes distribution of virus hepatitis B and hepatitis delta virus in chronic liver diseases in Kazakhstan.

BACKGROUND: The geographical distribution of hepatitis B virus (HBV) and hepatitis D virus (HDV) genotypes is uneven and has its own clinical and organizational implications for health systems. Despite the introduction of vaccination and successful antiviral therapy the prevalence of chronic hepatitis B (with or without delta agent) increased over the past 5 years. This study aimed for the first time to investigate the molecular epidemiology of HBV and HDV in Kazakhstan. METHODS: Total 834 chronic hepatitis B (with or without delta agent) patients were included to the study from November 2017 to June 2019. The material was collected from the regional hepatological сenters from 13 cities of Kazakhstan. Genotyping of HBV/HDV isolates was carried out using phylogenetic analysis of null-binary sequences of Kazakhstani isolates, in comparison with the reference sequences. Nucleotide sequence alignment was performed using the ClustalW algorithm, the "neighbor-joining" method was used for the construction of phylogenetic trees and subsequent analysis. RESULTS: Overall 341 samples were PCR-positive and genotyped for HBV. Comparison and phylogenetic analysis of nucleotide sequences of HBV isolates showed that they were represented by genotypes HBV-D (95.9%), HBV-A (3.5%) and HBV-C (0.6%). At the same time, the identity of the nucleotide sequences of Kazakhstani isolates were: HBV-D (95-100%); HBV-A (97.2-100%) and HBV-C (99%). 256 samples were PCR positive and genotyped for HDV, all of them belonged to genotype 1. CONCLUSION: This study describes for the first time the molecular epidemiology of HBV and HDV in Kazakhstan. The data obtained expand the knowledge of the global epidemiology of viruses; have potential implications for public health policy and for further clinical research on chronic hepatitis in Kazakhstan. TRIAL REGISTRATION: ClinicalTrials.gov NCT05095181 (registered on 27/10/2021).

Prevalence of Smoking Various Tobacco Types in the Kazakhstani Adult Population in 2021: A Cross-Sectional Study.

Tobacco use was the second-leading risk factor for death, accounting for 15.4% of total deaths in 2019. In 2019, 20.4% (2.7 million) of the adult population in Kazakhstan, 36.5% of men, and 6.0% of women smoked tobacco. A cross-sectional study of a random sample (n = 1201) was conducted between October and December 2021 in accordance with the STEPwise approach. The tobacco-use questions were focused on current and previous smoking status, initiation and duration of smoking, amount of tobacco use, exposure to secondhand smoke, and information related to quitting smoking. From 20.8% of smokers, 93.8% of men and 80.2% of women use tobacco products daily, χ2 = 10.983, p-score < 0.001. The earliest initiation of smoking was 6 years old. The prevalence of smoking tobacco products in Kazakhstan is 20.8%, which means that every fifth adult smokes. In addition, the proportion of smokers among men was 38.5%, and among women, it was 10.1%. A total of 93.8% of men and 80.2% of women smoked daily. The role of healthcare professionals in smoking prevention is very low, and only 16.9% of respondents have been advised to quit smoking in the last 12 months. New interventions for tobacco smoking prevention are urgently needed in Kazakhstan.

Early integration of palliative care into oncological care: a focus on patient-important outcomes.

BACKGROUND: Globally, cancer remains one of the leading causes of mortality. Palliative care is designed to meet a range of cancer patients' priority issues, including the management of pain and other cancer-associated symptoms. Routine palliative care envisages the provision of not just medical therapy, but also psychological support, social support and spiritual assistance. What constitutes the best model for palliative care remains a matter of debate. AIM: This review was undertaken with the aim to discuss different aspects of early integration of palliative care into oncological care, with a focus on patient-important outcomes. METHODS: A comprehensive search of publications was conducted with a focus on integrative palliative care for incurable cancer patients. For this purpose, the following databases and search engines were used: Scopus, PubMed, Cochrane Library, Research Gate, Google Scholar, eLIBRARY and Cyberleninka. RESULTS: A comprehensive approach with early integration of different medical services appears to be the most promising. Integrative palliative care is best provided via specialised interdisciplinary teams, given that all members maintain systemic communications and regularly exchange information. This model ensures that timely and adequate interventions are provided to address the needs of patients. CONCLUSION: Further research is needed to pinpoint the most optimal strategies to deliver palliative care and make it as tailored to the patient's demands as possible.

Burnout syndrome among medical students in Kazakhstan.

BACKGROUND: Burnout is a serious problem in the training and professional development of medical students. However, there is no known data on the prevalence of burnout among medical students in Kazakhstan. This study aims at investigating burnout and associated factors in a sample of students from Astana Medical University. METHODS: The study included socio-demographic and personal questions, Oldenburg Burnout Inventory for college students (OLBI-S) and Copenhagen Burnout Inventory-Students survey (CBI-S) to measure burnout. Statistical analyses included measures of descriptive statistics and regression analysis for evaluating burnout-associated factors. RESULTS: In total, 736 medical students responded. The prevalence of burnout syndrome was 28% (CBI-S) and 31% (OLBI-S). There was a significant association between the prevalence and the level of burnout and student's gender, year of study, thoughts of dropping out, suicidal ideation, satisfaction with the chosen profession and academic performance, interpersonal relationship problems, the decision to study in medical school, smoking, accommodation, parental expectations, alcohol use, extracurricular activities, part-time job, somatic symptoms, depression, and anxiety. CONCLUSIONS: The factors associated with burnout were identified, which complements and expands the existing data on academic burnout. The data obtained can help in organizing psychological assistance for medical students in Kazakhstan.

Psychometric Properties of the Copenhagen Burnout Inventory in a Sample of Medical Students in Kazakhstan.

Background: The Copenhagen Burnout Inventory (CBI) has demonstrated good psychometric properties among different populations, but there is no known data on its validity among Russian-speaking medical students. The CBI-Student Survey focuses only on fatigue, but measures exhaustion in four different life domains: Personal Burnout (PB), Studies-Related Burnout (SRB), Colleague-Related Burnout (CRB), and Teacher-Related Burnout (TRB). Objective: To investigate the psychometric properties of the Russian version of the Copenhagen Burnout Inventory-Student Survey (R-CBI-S). Design: A cross-sectional study was carried out among 771 medical students at Astana Medical University (Nur-Sultan, Kazakhstan). Statistical analyses included test-retest reliability, internal consistency, item analysis, convergent and concurrent validity, and confirmatory factor analysis. Concurrent validity was evaluated by bivariate correlations of R-CBI-S with anxiety, depression, and satisfaction with the study. Results: Test-retest reliability showed an ICC of 0.81. All item-total correlations for the total scale were positive (range 0.31-0.76). The Cronbach's alpha coefficient was 0.94 (0.896 for PB, 0.884 for SRB, 0.874 for CRB, and 0.926 for TRB). The Barlett's sphericity test result was significant (p < 0.001), and the KMO measure of sampling adequacy exceeded 0.947. Convergent validity analysis results: PB (AVE = 0.52, CR = 0.87), SRB (AVE = 0.50, CR = 0.87), CRB (AVE = 0.51, CR = 0.86), TRB (AVE = 0.56, CR = 0.88). The R-CBI-S achieved good levels of goodness-of-fit indices (RMSEA = 0.0611; CFI= 0.940; TLI = 0.933). Conclusion: The test results indicated that the R-CBI-S scale appears to be a reliable and valid instrument. The R-CBI-S may be a useful tool in future research to identify burnout factors based on specific life domains for developing effective prevention measures among medical students.

Online-Learning due to COVID-19 Improved Mental Health Among Medical Students.

In reference to the announcement of the pandemic of the new coronavirus 2019-(nCoV), all educational institutions in the Republic of Kazakhstan have switched to online learning (OL). The purpose of this study was to investigate the mental state of the medical students switching to OL in comparison with the mental state of the students who had traditional learning (TL). A repeated questionnaire-based cross-sectional study was conducted among medical students ranging from 1st year to 5th year at Astana Medical University in the 2019-2020 academic year. The first study was conducted during the TL (October-November 2019, N = 619), and the second study was conducted during the OL period (April 2020, N = 798). Burnout syndrome, depression, anxiety, somatic symptoms, and satisfaction with academic performance have been studied. The findings revealed that prevalence of the burnout syndrome, depression, anxiety, and somatic symptoms decreased after transitioning from TL to OL. However, during the OL period, the prevalence of colleague-related burnout increased, which tells us about the negative impact of OL on students' communication and interpersonal relationships. The most common depression and anxiety symptoms, dissatisfaction with academic performance were among students who indicated a decrease in academic performance during OL. Students who lived alone during the quarantine were more prone to depression during OL. In conclusion, during the quarantine period after the transition from TL to OL, the mental health state of medical students improved, despite the severe conditions of the pandemic. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-020-01165-y.

Epidemiological and Economic Evaluation of a Pilot Prostate Cancer Screening Program.

Background. Prostate cancer (PCa) is the second most commonly diagnosed cancer, and the sixth most common killer among men worldwide (Aubry et al., 2013). This research was motivated by the fact that PCa screening continues to be a controversial topic in the Kazakh medical community. This study aimed at description of how newly diagnosed PCa patients are managed in Pavlodar region of the Kazakhstan Republic and at presentation of a budget impact analysis (BIA) for PCa screening program. Also, we aimed to provide a comparative analysis of pricing system on medical services applied in both private and public healthcare sectors of the Kazakhstan Republic. Methods. New cases of PCa have been retrospectively analyzed for the period from January 2013 to December 2017 based on the information obtained from information system "Policlinic" maintained by the Pavlodar regional branch of the Republican Center for Electronic Health and from Cancer Registry of Pavlodar Regional Oncology Center. All data were analyzed with the help of SPSS 20.0 software. Results. The mean age of PCa patients was 68.34 years (SD = 8.559). The government of Kazakhstan invested 20,437,000 KZT (Kazakhstani tenge) in 2017 equivalently 61,188 USD-to fund a pilot study for examination of 9638 men. From 2013 to 2017, out of 49,334 men residing in Pavlodar region of Kazakhstan 1,248 men were diagnosed with prostate diseases, including 130 PCa cases. The PCa detection rate was equal to two cases per month. Only 22.8% of all PCa cases identified in the region within specified time period were revealed as a result of the government-funded PCa screening program. The average prostate cancer detection rate among the target group of Pavlodar region within the period of 5 years was equal to 0.23%. Conclusion. Based on the fact that the PCa screening program failed to enable adequate detection of new PCa cases, we would not recommend to continue this type of screening unless it is undergone careful revision and replanning.

Epidemiology of Prostate Cancer in the Republic of Kazakhstan.

BACKGROUND: The incidence and mortality from prostate cancer in most native Asian populations remain low although a gradual increase is observed over the last years. METHODS: The statistical analysis of official data on prostate cancer mortality and morbidity was performed for the whole country and for Pavlodar Region. RESULTS: The increase in the incidence of prostate cancer among the population of Kazakhstan is observed, which may be attributed to the introduction of screening program based on serum PSA. Still, the crude incidence rates in Kazakhstan are below world indices. Over the last few years, the decreasing prostate cancer mortality is observed that might be influenced by early diagnosis. The age-standardized incidence rates show that the majority of prostate cancer cases occur in advanced ages (70 years and older). CONCLUSION: More research is needed to determine the risk factors for prostate cancer, as well as ethnic and geographical trends for the population of Kazakhstan.