Ukraine. Nation’s Health

Continuous professional development in nursing: current state and prospects (on the example of Zhytomyr Medical Institute ZhRC)

S.V. Hordiichuk — Tue, 25 Feb 2025 00:00:00 +0200

Purpose: the purpose of the study is the state of implementation of educational programs and the process of assessing the quality of postgraduate education within the framework of BPR. Materials and methods. The study was conducted at the Center for Continuous Professional Development of the Zhytomyr Medical Institute (BPR ZhMI). Used methods: bibliosemantic, testing, interviews in focus groups, mathematical, system analysis and logical generalization. The results. The BPR center of the media actively implements modern models and methods focused on the needs of medical workers. Among innovative approaches, an educational and training center, a training and resource center, as well as specialized offices and laboratories have been created. Modern educational platforms using information technologies are being implemented. There is active international cooperation in educational activities, in particular at the level of postgraduate education. The results of the test of knowledge control at the beginning of the courses and at the end of the training among 171 students of advanced training courses in the specialty “Nursing” confirm the sufficiently high quality results of the educational process in postgraduate education within the framework of BPR in ZMI. Test control of knowledge and skills in postgraduate education courses showed an increase in the qualitative indicator of qualification by 27.0 %, as well as an increase in the number of correct answers from 67.7 % to 94.6 %. Conclusions: The integration of the latest technologies in continuous professional development in postgraduate medical education using input and output control of knowledge, combined with focus group interviews, are important tools for creating an effective, targeted and quality professional development process that ensures the relevance of knowledge and skills to modern international standards and needs of the healthcare industry.

Sleep in the conditions of noise pollution of student youth (based on the results of a sociological study)

A.O. Lepkanych, I.S. Myronyuk — Tue, 25 Feb 2025 00:00:00 +0200

Purpose. To study the impact of noise pollution on the quality of sleep of students and to assess the prevalence of sleep disorders in this population group due to external noise irritants in a region remote from the territories of active combat lines. Materials and methods. A special sociological study was conducted using an original questionnaire in the format of a Google form. The target group of the study is students of the State Higher Educational Institution “Uzhhorod National University”. The following methods were used in the study: bibliosemantic, content analysis and sociological. The methodological basis of the study was a systematic approach. Results. In general, respondents living far from the territories of active hostilities have sufficient or close to sufficient daily sleep – 59.7 % of respondents sleep 6–8 hours a day, 35.7 % sleep 4–6 hours a day. The vast majority of respondents (81.4 %) report a high level of satisfaction with their sleep. The majority of respondents do not feel that noise interferes with their sleep (45.7 % of respondents), with the situation being identical among women and men (45.9 % of female and 45.2 % of male respondents); a significant proportion (36.4 %) of surveyed students of both sexes indicate that external noise rarely affects their sleep. There are grounds to suggest that the impact of noise pollution on the quality of sleep of students may have peculiarities depending on age and gender. Conclusions. In general, the assumption that noise pollution (alarms, sirens, etc.) significantly affects the quality of sleep of students living in a region far from the territory of active hostilities has not been confirmed. At the same time, there is a need for a detailed study of the peculiarities of noise pollution, its nature and type on the quality of sleep of student youth, depending on a number of other modifiable and sustainable factors of pollution influence.

Features of the processes of formation of properties of temperament and anxiety of students, who acquire specialties I2 “Medicine” and I7 “Therapy and Rehabilitation”, in the dynamics of study in a modern medical institution of higher education

O.V. Marchuk, I.V. Serheta — Tue, 25 Feb 2025 00:00:00 +0200

Purpose: to carry out a comprehensive assessment of the features of the processes of formation of properties of temperament and anxiety of students, who acquire specialties I2 “Medicine” and I7 “Therapy and Rehabilitation”, in the dynamics of study in a modern medical institution of higher education. Materials and methods. Studies based on the use of psychodiagnostic techniques were conducted on the basis of National Pirogov Memorial Medical University. The comparison groups included 49 female students (specialty I1 “Medicine”) and 50 female students (specialty I7 “Therapy and Rehabilitation”). Results. It is revealed that if the first group of comparison (specialty I1 “Medicine”) is characterized by an increase in the level of their expression, then for the applicants for education of the second comparison group (specialty I7 “Therapy and Rehabilitation”) is characterized decrease in their level of expression of the established changes shows the presence of problems in the development of communication with patients who are extremely important for representatives of an interdisciplinary rehabilitation team. It is determined that the students whose medical profile are in the center of education are characterized by a decrease in the level of expression of trait anxiety. Among the students of the rehabilitation profile there are processes of reverse content and, thus, the degree of anxiety, concern and nervousness of personal genesis is gradually increasing. Conclusions. The features of the processes of formation of properties of temperament and anxiety of students who acquire specialties I2 “Medicine” and I7 “Therapy and rehabilitation” are established in the dynamics of study in a modern medical institution of higher education.

Current state of syphilis incidence in Lviv region

N.F. Timchenko, I.V. Hupalo, Y.I. Muzychka, A.K. Kucherova, O.-R.V. Lafarenko — Tue, 25 Feb 2025 00:00:00 +0200

Purpose: to analyze and summarize statistical data on syphilis incidence in Ukraine and the Lviv region over the past 10 years, considering age, gender, and place of residence to predict further and develop preventive measures to combat the spread of sexually transmitted diseases and syphilis in particular. Materials and methods. The study used medical statistical data on syphilis incidence and demographic data for the ten-year period from 2014 to 2023. It calculated prevalence rates, frequency, structure, and trends in morbidity. Bibliosemantic method and methods of structural and logical analysis, and medical and statistical analysis were applied. Results. Analysis of statistical data revealed the following patterns of syphilis incidence in the Lviv region: syphilis incidence rates in the Lviv region per 100 000 population over the past ten years are significantly (p < 0,001) lower than the national rates in Ukraine; in terms of age distribution of the incidence of syphilis, the 40–59 age group predominates among both men and women. Gender differences in the number of registered cases of syphilis are significantly higher in the Lviv region compared to Ukraine as a whole with a tendency to increase disparity over the last decade, rising from 1,2:1,0 in 2014 to 9,2:1,0 in 2022. Relative incidence rates of syphilis among men were significantly higher than among women (p < 0,001). The difference in syphilis incidence rates between urban and rural populations has shown a downward trend in recent years (2018–2022), reaching 1,14 cases per 100 000 rural residents versus 3,30 cases per 100 000 urban residents in 2022. Conclusions. The obtained data must be used to predict and develop preventive measures for the spread of sexually transmitted diseases, particularly syphilis.

The assessing results comparison of the multiple organ failure severity in patients with polytrauma

P.O. Boldizhar, Yu.Yu. Kampi, V.V. Avdeev, I.I. Mygovych — Tue, 25 Feb 2025 00:00:00 +0200

Purpose. To assess and compare the severity of organ failure in patients with polytrauma. To establish the current mortality rate from organ failure in a homogeneous population of critical patients with polytrauma. Materials and methods. Adult trauma patients admitted to intensive care units were evaluated prospectively. Patients were evaluated for organ failure, including organ dysfunction and disease severity scores. These included lung damage scores, APACHE II and III chronic pathology scores, ISS injury severity scores, and multiple organ dysfunction scores. Results. 120 patients with injuries who lived longer than 48 hours were admitted to the intensive care unit. The data were analyzed from 2017 to 2022. The mean APACHE II and APACHE III rates at hospitalization and the assessment of injury severity were 12.2; 22; 30.5; 22.7 and 19; 10. Insufficiency of one organ occurred in 68 patients (56.6 %), multiple organ failure – in 41 patients (34.2 %) and patients with absent organ pathology – 11 (9.2 %). All uniorgan failures were caused by respiratory failure. The mortality rate was 4.3 % with insufficiency of one organ system, 32 % with insufficiency of two, 67 % with three, and 90% with failure of four organ systems. A multi-step retrospective analysis was performed to determine which is associated with risk factors for organ failure: mechanism of injury, lactate after 24 hours, ISS, APACHE II, APACHE III, assessment of acute respiratory distress syndrome at hospitalization, assessment of multiple organ dysfunction at hospitalization, and total blood transfusions transfused in 24 hours. Conclusions. Mortality in uniorgan failure is low and is associated primarily with the patient’s main injuries, and not with organ failure. Mortality among patients with four or more organ system deficiencies remains high, approaching 90 %.

Correction of the platelet link of hemostasis in patients with metabolic syndrome through dietary nutrition

V.N. Kramarova, Yu.V. Tyravska — Tue, 25 Feb 2025 00:00:00 +0200

Purpose. To investigate the effect of following a low-carbohydrate diet on platelet link of hemostasis in patients with metabolic syndrome (MS), as well as to evaluate the effect of following this diet on the course of the disease. Materials and methods. 76 patients aged 27 to 64 years with MS were examined. All patients gave written informed consent to participate in the study. A low-carbohydrate diet (restriction of carbohydrates to 250 g per day) was prescribed to 50 patients for 12 weeks in addition to standard antihypertensive therapy (main group). 25 patients (control group) received standard antihypertensive therapy. Systolic and diastolic blood pressure (SBP and DBP) were measured with a cuff of the appropriate size, body mass index (BMI) was calculated using a standard generally accepted formula, fasting glucose levels was determined using glucose oxidase, basal insulin levels in the blood was measured using a radioimmunoassay method, platelet aggregation (PA) with different inducers was examined spectrophotometrically on an aggregometer using aggregation inducers (adenosine-5-diphosphate disodium salt (ADP) and ristocetin). Abovementioned parameters were registered twice (before the start of the study and after 12 weeks). Statistical analysis was performed using the SPSS statistical program (version 22.0, IBM Corp, USA). Results. In patients in the main group (standard antihypertensive therapy and low-carbohydrate diet), after 12 weeks, a statistically significant decrease in the levels of SBP (p=0.001), DBP (p=0.005), basal insulin (p=0.02), improvement in ADP-induced (p=0.01) and ristocetin-induced PA (p=0.01) were registered, while in patients in the control group, only a decrease in the levels of SBP (p=0.002), DBP (0.004), and improvement in ADP-induced PA (p=0.02) were noticed. Conclusions. A carbohydrate-restricted diet is advisable to recommend to patients with metabolic syndrome.

Bioelectrical phase angle in young people with overweight

Tue, 25 Feb 2025 00:00:00 +0200

Purpose: to determine the diagnostic value of the phase angle (PA) in young people with overweight and normal body weight based on its correlation with body composition indicators. Materials and methods. Bioimpedance analysis data and correlation analysis were used. Results. It was found that in the examined individuals with excess body weight, PA was significantly lower than in the control group. In women, this difference was 0.66о (p<0.05), and in men - 0.74о (p<0.05). In terms of body fat index (BF), women in the main group significantly differed from the control group (+7.2 %, p<0.05), while in men no significant differences were found. Similar ratios were observed in the groups of women and men regarding the percentage of skeletal muscles (SM). In women in the main group it was 4.9 % (p<0.05) lower than in the control group, and in men it did not differ statistically. The largest difference in body composition indicators was observed in relation to the sarcopenic index (SI), which was significantly lower in the main group in both women and men, respectively, by 0.98 kg/m2 (p<0.01) and 0.83 kg/m2 (p<0.01). No significant difference was observed in body hydration as measured by total body water (TBW, %) in both girls and boys when comparing the main and control groups. As for the assessment of the relationship between PA and body composition indicators, a strong positive correlation was observed only between PA and SI. The correlation coefficients in women and men were r=0.53 (p=0.002) and r=0.61 (p=0.001) respectively. Conclusions. The strong positive correlation between PA and sarcopenic index indicates the potential informativeness of РА for assessing the state of skeletal muscles in order to prevent the development of sarcopenia or its correction in young people.

Outcomes of treatment for multiple cerebral aneurysms

Y.O. Solodovnikova, A.S. Son — Tue, 25 Feb 2025 00:00:00 +0200

Purpose: to analyze the outcomes of treating the acute phase of subarachnoid hemorrhage (SAH) depending on the number of multiple cerebral aneurysms (MCA). Materials and methods. The study included medical records of 89 patients divided into two groups: group 1 included patients with two arterial aneurysms (AAs), while group 2 consisted of patients with three or more AAs. Results. In the overall cohort, as well as in the group 1, surgical treatment significantly reduced the risk of mortality (overall cohort: Fisher’s exact test p = 0,008; group 1: Fisher’s exact test p = 0,011). However, surgical treatment did not demonstrate a statistically significant effect on other treatment outcomes. Notably, even patients presenting with a substantial burden of MCA could achieve favourable clinical outcomes following surgical intervention, with either no neurological deficit or only minimal residual impairment. However, the choice of treatment modality did not have a statistically significant influence on achieving any specific clinical outcome in the group 2 (Fisher’s exact test p = 0,248). Conclusions. Overall, a higher number of AAs did not significantly affect in-hospital treatment outcomes. Surgical treatment in the group 1 significantly reduced the risk of mortality compared to the group 2. Patients with a high burden of AAs require individualised approaches and combined treatment strategies due to an increased risk of complications. The limited number of observations highlights the need for further research to optimise treatment strategies and mitigate the risk of complications.

Early rehabilitation of patients under martial law

O.S. Blaga, M.V. Hyryavets — Tue, 25 Feb 2025 00:00:00 +0200

Purpose: Determine the place of early rehabilitation in the provision of medical care under martial law. Мaterials and methods: To implement the research objective, the PubMed, Scopus, Cochrane and PEDro (Physiotherapy Evidence Database) databases were analyzed. Research methods: structural and logical analysis. Results. The features and main problems related to the provision of early rehabilitation in the conditions of emergency medical care are presented. Traumatic injuries sustained in martial law can cause devastating and long-lasting physical and psychological impairments, requiring quality early and specialized rehabilitation interventions and long-term follow-up to reduce complications and optimize patients' functioning and quality of life. Conclusions. In the conditions of martial law, early rehabilitation is an important component of clinical care and its provision from the beginning of the event and is important to reduce the significant number of people with life limitations after the surge of traumatic injuries and exacerbation of chronic diseases as a result of insufficient access to early rehabilitation opportunities for patients.

Occupational therapy for children with autism spectrum disorder in wartime contexts

M.S. Vynohradova — Tue, 25 Feb 2025 00:00:00 +0200

Purpose: To analyze the effectiveness of occupational therapy for children with ASD and identify the specific features of therapeutic interventions in the context of war. Materials and methods: Analysis of contemporary scientific and methodological literature on occupational therapy for children with ASD, as well as the specific features of occupational therapy interventions for this client/patient category in wartime conditions. To achieve the stated goal, a theoretical analysis of scientific and methodological literature related to the research problem was conducted, along with the systematization of the obtained data. Sources were selected based on their relevance, novelty, and alignment with the research topic. The materials were retrieved using the PEDro, Scopus, PubMed, and Google Scholar databases. Results: The war significantly affects the psychosocial state of children with ASD and their families. Stress, loss of stability, and environmental changes lead to worsening behavioral manifestations, skill regression, and decreased quality of life. Parents also exhibit elevated levels of anxiety, depression, and stress, negatively impacting their ability to support their children. It has been established that sensory integration therapy, environmental adaptation, activity modification, and family support are key elements of effective occupational therapy programs. Special attention should be given to telehealth technologies, which offer new opportunities for service delivery in conditions of limited access. Conclusions: Occupational therapy is a crucial tool for improving the quality of life of children with ASD in wartime conditions. Adapted interventions help reduce anxiety and improve social skills. However, achieving sustainable results requires a comprehensive approach, including psychosocial support, the integration of art therapy and technologies, and active family involvement in the therapeutic process.

Comparison of the physical therapy program for acute disorders of cerebral circulation

L.R. Kozibroda, A.O. Golyachenko — Tue, 25 Feb 2025 00:00:00 +0200

Purpose: to compare the effect of gait training on a treadmill with body weight maintenance in a Guldmann device with gait therapy on a conventional surface in patients in the early phase of stroke. Materials and methods: 42 patients at an early stage of stroke (two to six weeks after stroke onset) were randomized into two therapeutic groups. The first to be given treadmill gait therapy in the Guldmann Weight Loss Device (BWSTT) and the comparative group to be given walking on a natural surface. Results: The Berg Equilibrium Scale, the difference between the score at the first examination (before therapy) and the score obtained after the end of therapy, averaged 8 points in both groups. The average time improvement obtained in the BWSTT group was 4.0 ± 3.30 seconds, and in the comparison group – 2.2 ± 1.90 seconds. Estimation of gait speed. The difference in gait speed between the baseline value and the value obtained after therapy in the BWSTT group was 0.38 ± 0.20 m/s, while in the comparison group it was 0.2 ± 0.10 m/s. Evaluation of the gait function. After the therapy, the average value of this indicator in the BWSTT group increased to 338.90 ± 107.70 meters, and in the comparison group – to 253.80 ± 125.50 meters. Conclusions: Walking training on a treadmill with body weight maintenance has a more beneficial effect on functional improvement (balance, speed and gait distance) in patients in the early phase of stroke, compared to gait therapy on a normal surface.

The effect of rehabilitation and physical therapy on the functional state of elderly patients with intracerebral stroke

K.A. Tymruk-Skoropad — Tue, 25 Feb 2025 00:00:00 +0200

Purpose: to investigate the effect of rehabilitation and physical therapy on haemodynamic parameters, functional state of the musculoskeletal system, and the level of independence and activity of daily living in post-stroke patients. Materials and methods. An experimental group of patients was formed (n = 10, mean age 66 ± 5,5 years, 70% men and 30% women) who underwent a rehabilitation programme after acute cerebrovascular accident. In all patients, the ischaemic lesion was localised in the cerebral hemispheres. The duration of the rehabilitation programme was 30 days. A feature of the programme was the use of proprioceptive neuromuscular facilitation (PNF). Classes with a physical therapist were conducted on an individual basis. In the course of the study, the following tests and scales were used to assess the functional state: Barthel Index; Rivermead Index; Hauser Walking Index; Rankin Disability and Stroke Recovery Scale; spasticity level according to the modified Ashworth Scale; MRCS; ROM. Results. The study examined the effect of the rehabilitation programme on the haemodynamic parameters of patients who had suffered acute cerebrovascular accident. No deterioration in haemodynamic parameters was observed during the entire rehabilitation period. Despite the presence of motor impairment, haemodynamic parameters in most patients were stable, indicating an adequate response of their cardiovascular system to the implementation of the rehabilitation programme. Conclusions. After the rehabilitation, the patients needed less assistance with activities of daily living, and restored and improved their walking skills.

Providing reformed healthcare institutions with medical devices during the war against russian military aggression

V.D. Beliaiev, R.L. Kartavtsev — Tue, 25 Feb 2025 00:00:00 +0200

Purpose: to study and assess the level of provision of health care institutions created in the course of reforming the health care system with medical devices to provide medical care to the population during the war against Russian military aggression. Materials and methods. Materials: results of a sociological study among 38 health care organizers, 37 heads of departments and 32 practicing physicians of newly established health care institutions from different regions of Ukraine. The study was conducted in November – December 2024. Methods: bibliosemantic, sociological, medico-statistical, of structural-and-logical analysis. During the study, the confidentiality of information about respondents was preserved. Results. It was found in the course of the study that in super-cluster health care institutions, the level of provision of health care facilities with medical devices, which fully meets the need for laboratory diagnostics is 62.5 %, functional diagnostics 66.6 %, radiation diagnostics 50.0 % and the need for therapeutic 62.5 % and rehabilitation 37.5 % of processes. In cluster health care institutions, the level of provision of health care institutions with medical devices, which fully meets the need for laboratory diagnostics, is 52.6 %, functional diagnostics 56.1 %, radiation diagnostics 52.6 % and the need for therapeutic 77.2 % and rehabilitation 33.3 % processes. In general health care institutions, the level of provision of health care facilities with medical devices, which fully meets the need for laboratory diagnostics is 26.9 %, functional diagnostics 73.1 %, radiation diagnostics 57.7 %, and the need for therapeutic 77.2 % and rehabilitation 26.9 % processes. At the same time, it was established that in health care institutions located in the zone of active hostilities, the level of provision with medical devices that does not meet the minimum need for diagnostic examination of patients and composes in: laboratory diagnostics – 16.7 %, functional diagnostics – 12.5 %, radiation diagnostics – 20.8 %. Conclusions. The level of provision of reformed healthcare institutions with medical devices during the war against Russian military aggression is insufficient, especially in the zone of active hostilities, which requires determining the optimal medical routes for patients to ensure medical care of the required quality.

Conducting the first stage of clinical audit – “Problem Diagnosis” (based on the example of urology patients)

T.G. Gutor, A.B. Zimenkovsky — Tue, 25 Feb 2025 00:00:00 +0200

Purpose. To conduct the first stage of clinical audit (CA) – "Problem Diagnosis" among urology patients. Materials and methods. A survey was conducted among 405 respondents, patients of Lviv hospitals' urology departments. The study employed a sociological method, as well as methods of systematic approach, structural and logical, and medical and statistical analysis. Results. As a result of the first stage of the clinical audit – “Problem Diagnosis”, conducted among urology patients, it was established that nearly 10% of patients were dissatisfied with the medical services provided. The main concerns included: insufficient scope of laboratory and instrumental examinations (9.14 %), lack of comprehensive information about their test results (4.69 %), lack of involvement in decision-making regarding the treatment they were prescribed (7.16 %), the treatment they received did not eliminate the primary reason for seeking medical care (2.72 %), and lack of trust and confidence in the attending physician and their actions (3.95 %). Conclusions. The results of the first stage of the clinical audit made it possible to identify and form focus groups of dissatisfied patients for a more in-depth study of the moral, ethical, and financial aspects of their medical care. It is assumed that this approach will improve the quality of medical services by incorporating personalization in healthcare delivery for the identified patient group.

Provision of medical care for rectal cancer by general practitioners-family doctors

Yu.Yu. Kozar — Tue, 25 Feb 2025 00:00:00 +0200

Objective: to define the scope of coverage by general practitioners-family doctors of the population with targeted preventive examinations and the provision by them of medical care to the population in case of rectal cancer. Materials and methods. In the course of the study, 137 general practitioners-family doctors were interviewed. Statistical processing of the primary data obtained was carried out with the use of modern methods of medical statistics. In the course of the study, the following methods were used: bibliosemantic, sociological, medico-statistical, of structural-and-logical analysis. Results. It was found in the course of the study, that all the surveyed general practitioners-family doctors keep records of the population over the age of 40 persons subject to targeted oncological preventive examinations, but only 17.5% draw up schedules for conducting targeted preventive examinations of the population. Screening examinations of the population for the detection of rectal cancer are carried out by less than 20.0% of respondents. At the same time, only 15.3% of respondents keep records of the population examined for early detection of rectal cancer, and 6.6% keep records of the population with risk factors for the development of rectal cancer. In addition, 34.3% performed the prescriptions of doctors- specialists. Conclusions. The data obtained in the course of sociological research indicate that for general practitioners-family doctors screening examinations of the population over the age of 40 for early detection of rectal cancer are not a priority in their preventive activities. This requires in modern conditions a change in organizational approaches and their motivation and strengthening theoretical and practical training for this type of activity.

Results of retrospective analysis changes of population in the world, predictive assessment and comparison with the trends formed in Ukraine

N.V. Medvedovska, I.V. Stovban, M.P. Stovban — Tue, 25 Feb 2025 00:00:00 +0200

Purpose. The article implements the set goal and presents the results of a retrospective study of the dynamics of population formation in Ukraine for the period 1992–2021. In comparison with the indicators on average in the world and for the main parts of the world with a forecast assessment of their changes for 2022–2031. Materials and methods. The data of the State Statistics Service of Ukraine, as well as the statistical data of the World Bank on population indicators with a forecast assessment of their value for the period 2022–2031 served as materials for the study of the formation of population indicators in Ukraine for a 30-year period (from 1992 to 2021 years). Research methods included: system approach and system analysis, graphical analysis, medical statistical and content analysis. To establish the reliability of the difference between the compared groups, the Student's t-test was used, differences at p<0.05 were considered reliable. The graphic analysis of the formation of the dynamics of the indicator was supplemented by the construction of a logarithmic predictive trend. Software included computer statistical packages Statistica 8.0 and Microsoft Excel. The results of the study showed that over the specified period (1992–2021), the number of people on the planet continued to grow (growth rate +44.21 %). For Ukraine, as a country in the European region, the opposite trend towards a decrease in the population (–20.1 %) was typical for the same period. The further decrease of the population in Ukraine as of 2021, predicted by the World Bank, was due, among other things, to the increase in the absolute number of deaths (+16.01 %), the mortality rate (+38.06 %), and the decrease in the birth rate (–31, 74 %). During the specified period, there was a deepening of negative natural growth, which according to the results of 2021 was –11.2 per 1,000 population, its essential regional features were revealed. Conclusions. With global population growth trends, the population continues to decrease in Ukraine, the trends of which have been found to be stable as of 2021. With the preservation and growth of the identified trends, and especially in the conditions of armed conflict on the territory of our country, the threat of the impossibility of reproducing the population naturally, conditions for the further growth of depopulation, which requires systematic state measures to overcome the negative trends that have formed.

The impact of the war against russian military aggression on the structure of the network of units of general health care institutions for the provision of specialized oncological care

H.O. Slabkiy, Yu.М. Shen, P.T. Fitsay — Tue, 25 Feb 2025 00:00:00 +0200

Purpose: to study the impact of the war against Russian military aggression on the structure of the network of units of general health care institutions for the provision of specialized oncological care. Materials and methods. Materials: data of sectoral statistical reporting of the Ministry of Health of Ukraine for the years 2020, 2022, 2023. Processed statistical data from the territories controlled by Ukraine. Methods: bibliosemantic, medico-statistical, and of structural-and-logical analysis. Results. During the study period, the number of specialized departments (offices) for the provision of oncological care in general health care institutions was reduced by 97 and in 2023 amounted to 385. The number of examination rooms was reduced by 279 (38,0%) and in 2023 amounted to 484. Conclusions. The negative impact of the war against Russian military aggression on the network and organizational structure of specialized oncological care in Ukraine is shown.

Development of the private sector in primary healthcare in the Zakarpattia region

S.V. Feysa, M.V. Smiianova — Tue, 25 Feb 2025 00:00:00 +0200

Purpose: to study the development of the structure and personnel of the private sector in primary healthcare in the Zakarpattia region. Materials and methods. Materials: Statistical data from the National Health Service of Ukraine for the period 2020–2023. Methods: Bibliosemantic method, content analysis, medical-statistical method, structural-logical analysis. Results. During the study period (2020–2023), the number of primary healthcare providers doubled to 22, including 3 in rural areas. The number of doctors increased 1,9 times to 100, with 11 in rural areas. Patient declarations with private doctors grew 2,9 times, reaching 44 099, including 3 601 in rural areas. Conclusions. During the study period, the private sector’s development in primary healthcare was witnessed. This was reflected in the growth of both the number of healthcare providers and primary care physicians in urban and rural areas, as well as a significant increase in the number of contracts to provide medical services signed by people of different age groups with doctors working in private healthcare facilities.

The impact of physical activity on the mental health of adolescent: analysis of scientific information sources

V.Y. Bilak-Lukianchuk, A.M. Horvat, Y.V. Mytrovka — Tue, 25 Feb 2025 00:00:00 +0200

Objective: analysis of the impact of physical activity, in particular sports, on the mental health of adolescents, as well as outlining the risks associated with excessive sports loads and psychological pressure in a sports environment. Materials and methods. Materials are scientific and information sources. Methods: bibliosemantic, of structural-and-logical analysis. Results. It has been established that sport, as a regular form of physical activity, contributes to the improvement of the psychoemotional well-being of adolescents, reducing the level of stress, anxiety and depression. The positive impact of physical exercise on cognitive functions and social interactions, as well as on the development of self-esteem and interpersonal communication skills, has been emphasized. Particular attention has been paid to the vulnerability of the mental health of adolescents due to the physiological and psychological changes that occur at this age, emphasizing the critical importance of physical activity during this period. Several tools and approaches have been proposed for an effective impact on the psychological well-being of adolescents through physical activity. It has been emphasized that excessive physical activity, as well as psychological and physical trauma, can lead to negative consequences for mental health. The importance of a balanced approach to the educational process and psychological support, an individual approach to each teenager, as well as the need for adequate physical activity to achieve optimal results without harming mental health, has been emphasized. Conclusions. Regular physical activity in adolescents has been shown to have a positive effect on their mental health, emotional stability and social adaptation, reducing the risk of isolation. However, excessive stress and psychological pressure can be harmful. Therefore, an individual approach to sports, balanced training and psychological support are important to avoid injuries and stress.

Mastering the basic skills of insurance, movement and positioning – the key to successful physical therapy (analytical review of scientific information sources)

V.I. Boiko, D.V. Popovych, U.P. Hevko, A.V. Havrylenko, V.L. Nazaruk — Tue, 25 Feb 2025 00:00:00 +0200

Mastery of basic securing, moving, and positioning skills is driven by current challenges in healthcare and rehabilitation, including the growing number of patients with injuries and illnesses, patient safety, physical therapy effectiveness, professional training, and innovations in physical therapy. Purpose: To form a holistic view of the physical therapy methodology aimed at using aids to master the skills of moving, securing and positioning patients. Materials and Methods. A bibliosystematic review of scientific information sources was carried out using Internet search databases. The methods of the study were content analysis, structural and logical analysis. Results. Mastering the basic skills of insurance, movement and positioning is an integral part of physical therapy, which is critical for the recovery of patients after injuries, surgeries or congenital defects of the musculoskeletal system. These skills not only ensure safety during therapeutic procedures, but also contribute to the effectiveness of rehabilitation, making it easier for patients to adapt to new living conditions. Successful implementation of these skills training requires an individual approach, taking into account the patient’s physical condition, psychological characteristics and motivation. Thus, the development of insurance, movement, and positioning skills becomes a key step in providing quality physical therapy, which leads to an improvement in the quality of life of patients and their independence. Positioning is one of the most important elements of successful physical therapy. Correct body positioning during rehabilitation not only helps to achieve effective results, but also prevents possible complications such as pain, contractures, or skin damage. Mastering the skills of insurance, movement and positioning is a critical element of physical therapy, which significantly increases the quality of recovery and improves patient independence. Conclusions. It has been established that the correct choice and use of mobility aids, such as canes and crutches, not only ensures the patient's safety during rehabilitation, but also prevents possible complications.

The use of Blood-Flow Restriction in physical therapy: mechanisms of action and rehabilitation prospects for patients with neurological and orthopedic disorders: analytical review of scientific information sources

S.A. Volkova, K.L. Kalinkin, O.D. Kalinkina — Tue, 25 Feb 2025 00:00:00 +0200

Purpose: To evaluate the effectiveness of using Blood-Flow Restriction in physical therapy for patients with neurological and orthopedic conditions. Materials and Methods: Analysis of scientific and methodological literature and internet resources, synthesis, and generalization of the obtained information on the application of a pneumatic cuff in the process of physical therapy for patients with neurological and orthopedic conditions. The following methods were used: bibliosemantic method and structural-logical analysis method. Results: The process of physical therapy using Blood-Flow Restriction significantly improves muscle strength, endurance, and functional status of patients. Studies have demonstrated significant muscle hypertrophy with low-intensity loads, making the method safe for individuals with limited physical abilities. Patients with stroke, Parkinson's disease, and multiple sclerosis reported improvements in coordination, balance, and gait. Orthopedic patients experienced a reduction in pain syndrome, an increase in active range of motion, and restoration of functional status. Training with Blood-Flow Restriction activates mechanisms of metabolic stress, promotes the release of anabolic hormones such as growth hormone and insulin-like growth factor, and stimulates myogenic stem cells, accelerating tissue regeneration. The use of this technique reduces the load on the joints and cardiovascular system, making physical therapy safer and more effective for a wide range of patients. Conclusions: The use of Blood-Flow Restriction is an effective rehabilitation strategy that enables significant improvement in physical parameters with minimal risk to patients. Further research is needed to optimize application protocols for Blood-Flow Restriction use in physical therapy for patients with neurological and orthopedic conditions.

Spatial organization of the body of young athletes in the discursive field of scientific knowledge: analytical review of scientific information sources

I.M. Grygus, T.V. Zeiser — Tue, 25 Feb 2025 00:00:00 +0200

Disorders in the spatial organization of the young athletes body, in a wide spectrum of which changes in the biomechanical characteristics of the segments of the musculoskeletal system are quantitatively and qualitatively outlined, are often accompanied by functional disorders of the musculoskeletal system that are dangerous for health, a decrease in muscle strength and tone, and a loss of the ability to move normally. The aim of the research was to study and systematize scientific researches aimed at determining the state of spatial organization of the body of young athletes. Research methods: theoretical analysis and generalization of literary sources. Results. According to the scientific community, the intensification of the educational and training process, aimed at achieving high sports results, which is characteristic of modern children's and youth sports, leads to an increase in the load on the child's body and can cause metabolic, morpho-functional disorders, prenozological conditions and diseases of young athletes. Analysis of special scientific and methodological literature, domestic practical experience, indicates the presence of a large mass of theoretical and empirical knowledge about the health of athletes. It should be noted that a number of specialists consider the health of athletes as a professionally significant value, which is the basis of their reliability in the sports competitions activity and prospects at the stages of the process of long-term training. A systematic analysis of special scientific and methodological literature, united by the problem of athletes health protection during the period of the first stage of long-term training, indicates the unity of opinion of specialists regarding such issues as an increase in the number of negative tendencies in the state of somatic health of young athletes, which are due to the dissonance between the functional reserves of the organism developing and the factors of training activity; an increase in the prevalence of pathological disorders in the activity of the leading somatic systems of the organism. It was determined that close attention is paid to the problem of disorders of the spatial organization of the body of young athletes in sports practice. Conclusions. The theoretical and practical experience of many specialists in the field of physical education and sports confirms the close connection between the state of the spatial organization of the human body and its health, in particular, the fact that disorders of the values of the physiological curvatures of the spine, transverse and longitudinal arches of the foot are markers of connective tissue dysplasia, as significant causes of overloading of various parts of the musculoskeletal system of athletes, and therefore – determinants of the occurrence of injuries, diseases of the musculoskeletal system and internal organs.

Chronic low back pain, a review of the problem from the perspective of the biopsychosocial model: an analytical review of the scientific literature

M.O. Ovdii, V.М. Korshak — Tue, 25 Feb 2025 00:00:00 +0200

Chronic low back pain is one of the most common problems of the musculoskeletal system, which leads to a deterioration in functioning and quality of life, and is the main cause of disability. The biopsychosocial model has been widely used in studies of complex medical interventions and is the basis of the World Health Organization’s International Classification of Functioning, is used in clinical practice, and is also used to structure clinical guidelines. This model is based on the understanding that disease and health are the result of the interaction between biological, psychological and social factors. The purpose of the study was to analyze the literature on the biopsychosocial model of chronic low back pain with further systematization and integration of this knowledge into preventive and rehabilitation strategies to overcome this problem. Materials and methods. To achieve this goal, a literature search was conducted for 2014–2024 in the online databases PubMed, Web of Science and Google Scholar. A total of 25 scientific and information sources by foreign authors were analyzed. The following methods were used: bibliosemantic, structural and logical analysis. Results. The main principles of the biopsychosocial model are to take into account the biological, psychological and social aspects of human life. This model has gained considerable relevance in the field of rehabilitation as it allows for a multifactorial description of patient dysfunction and focus on the necessary interventions. The biological aspects of chronic low back pain include the nature of the pain, the range of motion in the spine, the degree of dysfunction, genetics, comorbidities, overweight, physical inactivity, and bad habits. Psychological factors include distress, anxiety, depression, kinesiophobia, and catastrophizing. Among the social factors, the leading place is occupied by socioeconomic status, education, marital status, work environment and cultural beliefs. Conclusions. The biopsychosocial model considers chronic low back pain as a state of complex interaction of biological, psychological and social factors that have a direct and indirect effect on the formation of pain. Rehabilitation strategies based on the biopsychosocial model have a number of advantages for patients with chronic low back pain.

Factors determing quality of life of nurses: analytical rewiev of research sources

N.I. Smoliuk, A.G. Shulhai — Tue, 25 Feb 2025 00:00:00 +0200

Purpose: to define the main factors that affect nurses’ quality of life working at different levels of health care. Materials and methods. The bibliometrics analysis was conducted using the scientific search databases (Scopus, Web of Science, PubMed, Google Scholar, MEDLINE), to identify the relevant studies about the peculiarities of the quality of life of nurses working in different departments and at different levels of health care. The main factors that determine the nurses’ quality of life were carried out. Results. The analysis of studies on the factors influencing the quality of life of nurses has shown that they are interrelated with both work and personal characteristics. The factors related to professional activity include job satisfaction, the nature of relations with colleagues, the clarity of defined responsibilities, the presence of traumatic stress at work, the level of support from management, and the availability of social support. Personal characteristics include personal physical health, professional burnout, level of psychological stability, and moral stability. We identified that socio-demographic factors such as gender and family have a direct relationship with the quality of life of nurses. Conclusions. The quality of life of nurses depends on the influence of many interrelated factors, the most common of which are traumatic stress, peculiarities of perceived stress, compassion satisfaction, professional burnout, psychological stability, moral stability, availability of social and material support, level of recognition by the management of the department and health care institution.

Ultrasound in rheumatology – beyond articular syndrome: analytical review of scientific literature

A.P. Stakhova — Tue, 25 Feb 2025 00:00:00 +0200

Purpose: is to summarize data on the possibilities of ultrasound in rheumatology in patients outside the articular syndrome and to describe modern recommendations for the assessment of certain ultrasound changes. Materials and methods. In-depth analysis of scientific articles indexed in the databases SCOPUS, Web of Science, UpToDate, Google Scholar, MEDLINE, ResearchGate. The search in scientific metric databases was carried out using the keywords: “giant cell arteritis”, “nerve compression”, “polymyalgia rheumatica”, “tendon rupture”, “Sjögren’s syndrome”, “ultrasound”. A total of 36 scientific and information sources of foreign authors were analyzed. The following methods were used: bibliosemantic, structurallogical analysis. Results. An analysis of modern literature shows that ultrasound in the practice of a rheumatologist can be used in polymyalgia rheumatica or in the prediction of giant cell arteritis, in the examination of salivary glands in a patient with possible Sjögren’s syndrome or in the determination of such complications of inflammatory arthritis as nerve compression or tendon rupture. In polymyalgia rheumatica, bursitis and synovitis of the shoulder joint, biceps tenosynovitis, bursitis and synovitis of the hip joint can be determined. The “halo” sign is typical in giant cell arteritis. In ultrasound of the parotid and submandibular glands, the emphasis is on their homogeneity and echogenicity. Carpal nerve compression syndrome is characterized by typical changes in the thickness and echostructure of the nerve in the form of edema at the entrance and exit from the carpal canal and flattening inside, and measurement of the cross-sectional area of the median nerve at the entrance to the carpal tunnel corresponds to the degree of its compression. On ultrasound, a partially torn Achilles tendon, as the most common pathology, may appear thickened with a violation of the fibrillar echotexture and a gap between the fibers, and in the case of a complete rupture, the proximal and distal ends of the tendon will not appear continuous on ultrasound along the long axis and a violation of the fibrillar architectonics with a focal defect will be noted. The creation of national recommendations for ultrasound of the indicated pathologies can be a convenient and effective addition to the clinical examination of patients in the practice of a rheumatologist. Conclusions. Ultrasound in rheumatology has a wide application. This technique allows you to identify possible complications outside the joint cavity, identify specific signs of polymyalgia rheumatica and giant cell arteritis, as well as evaluate the parotid and submandibular glands in case of suspicion of Sjögren’s syndrome. Systematization and creation of clear algorithms for ultrasound of rheumatological patients allow optimizing their examination.

A literature review on the impact of prolonged armed conflict and related post-traumatic stress disorder (PTSD) on the risk of developing metabolic syndrome among the civilian population: a literature review

T.P. Yurochko, M.V. Shevchenko, Y.G. Vernyhor, P.O. Maistruk, O.S. Skrypnikova — Tue, 25 Feb 2025 00:00:00 +0200

The aim of the study is to determine the impact of post-traumatic stress disorder (PTSD) on the risk of developing metabolic syndrome (MetS) among the civilian population in countries experiencing prolonged armed conflicts. PTSD is a significant mental health disorder resulting from exposure to extreme stressors, and its impact on physical health, particularly MetS development, requires detailed examination. Materials and methods include a systematic review of scientific publications in Medline, PubMed, Scopus, and Web of Science databases. The analysis was based on data from longitudinal studies and meta-analyses covering a wide range of demographic and social groups. The study results reveal a strong association between PTSD and components of MetS, such as abdominal obesity, arterial hypertension, hyperglycemia, insulin resistance, and dyslipidemia. The highest risk was identified among veterans and individuals residing in prolonged conflict zones. Chronic stress induced by PTSD activates the hypothalamic-pituitary-adrenal axis, contributing to metabolic disruptions. The study’s conclusions emphasize the need to integrate preventive measures into public health programs. This includes PTSD screening for individuals at risk of MetS and developing interdisciplinary approaches to treatment and prevention. Future research should focus on long-term monitoring of affected populations.