Implementation of the classification of medical devices of Ukraine in international approaches.

OBJECTIVE: Aim: To study the level of compliance of the National Classifier of Ukraine ≪Classifier of Medical Devices of Ukraine NC 024: 2023≫ with international approaches to the classification and use of medical devices. PATIENTS AND METHODS: Materials and Methods: National Classifier of Ukraine ≪Classifier of Medical Devices of Ukraine NC 024: 2023≫ and the international nomenclature of medical devices Global Medical Device Nomenclature. Methods: bibliosemantic, of content analysis and of structural-and-logical analysis. CONCLUSION: Conclusions: In the course of the study, full compliance of the national classifier of medical devices of Ukraine NC 024: 2023 with the GMDN system was established.

THE ATTITUDE OF CERTAIN CATEGORIES OF THE POPULATION OF UKRAINE TO PERSONAL HEALTH DURING THE WAR AGAINST RUSSIAN AGGRESSION.

The aim: To study the self-assessment of personal social and medical well-being by certain categories of the population of Ukraine in the conditions of war. Materials and methods: The results of a sociological survey among 127 internally displaced persons from the war zone and the territory temporary occupied by the Russian invaders, as well as 122 permanent residents of the Transcarpathian region were used as the materials of the study. Bibliosemantic, sociological, medico-statistical methods and the method of structural and logical analysis were applied. Results: It was determined that personal health, as a priority, takes the fifth position among the surveyed population with a score of 9.0 points in the group of surveyed internally displaced persons and 9.2 points in the group of interviewed permanent residents of Transcarpathian region. At the same time, 66.2% of the surveyed internally displaced persons and 71.4% of permanent residents of the Transcarpathian region during the war of Ukraine against Russian aggression noted a decrease in attitude to their own health as a personal priority. Conclusions: The results of the study indicate a low level of health-preserving behavior of the surveyed population during Ukraine's war against Russian aggression. This situation in the future may lead to a deterioration in public health and an increase in the need for medical services.

MOTIVATION THEORIES AS THE KEY TO MANAGEMENT OF MEDICAL STAFF.

OBJECTIVE: The aim: To identify positions that are relevant for practical use in improving the process of human resource management in healthcare. PATIENTS AND METHODS: Materials and methods: Comparative analysis of motivation theories. CONCLUSION: Conclusions: Human resources are a key intangible resource of a society or any organization. In today's post-industrial society, the development of a knowl¬edge-based economy with the introduction of innovative technologies, principles of teamwork; improving the educational, cultural and qualification level of employees, democratization of socio-economic life in the country against the background of increasing population mobility and competition in the context of globalization, sets requirements for human resource management in such an important area as health care, in particular, in terms of activities to increase their motivation. Understanding the essence of motivation theories proves that people have different needs, so knowledge of different motivation theories can be used to manage medical staff.

PROSPECTIVE ANALYSIS OF THE EPIDEMIOLOGY OF CEREBROVASCULAR DISEASE AND STROKE AMONG THE ADULT POPULATION OF KYIV CITY, UKRAINE.

OBJECTIVE: The aim: We aimed to conduct a prospective analysis of the epidemiology of cerebrovascular disease and stroke among the adult population of Kyiv City, Ukraine the last 12 years. PATIENTS AND METHODS: Materials and methods: We analyzed sectoral statistical reports of cerebrovascular disease and stroke in Kyiv City for 2009-2020. The statistical method and the method of system approach were used in this study. RESULTS: Results: We established that during the last 12 years there was a decrease in the incidence of cerebrovascular disease and stroke among the adult population of Kyiv (reduction of 1.83 times (p <0.05) with t reliability criteria 26.89). However, the incidence remains high (476.62 per 100,000 population). At the same time, the prevalence of cerebrovascular isease remains stable, and among the working-age population tends to increase. The incidence of stroke indicates a positive trend (251.3 per 100,000 adult population of Kyiv in 2009 and 95.0 - in 2020, respectively). In particular, the number of primary registered strokes decreased 2.64 times (p ≤0.05) with a reliability criterion of 5.7 which is 1.94 (p≤0.05) times lower than in Ukraine generally. During the study period, 27,928 people died in Kyiv from a stroke. The mortality rate of stroke among the adult population in the city decreased from 96.14 per 100,000 in 2009 to 57.17 in 2020. This significant decline occurred over the past two years. CONCLUSION: Conclusions: A significant reduction in the incidence of cerebrovascular disease and stroke in the adult population of Kyiv during the last 12 years has been established. This might be caused by increased stroke prevention work, provided to the city population, and by a higher level of availability and quality of medical care in recent years.

The reporting of the mode of transmission among HIV-positive men who have sex with men in Lviv oblast, Ukraine, 2014-2018.

INTRODUCTION: Men who have sex with men (MSM) are one of the key populations driving HIV/AIDS epidemic globally. To date, MSM is the only population in Ukraine where the prevalence and incidence of HIV is increasing. As HIV-positive MSM might feel uncomfortable to report homosexual intercourses as a possible mode of transmission (MoT) of HIV, they prefer being registered as patients with heterosexual or non-defined MoT. This study aimed to calculate the proportion of misclassified MoT among HIV-positive MSM registered in Lviv oblast, Ukraine, during 2014-2018. METHODOLOGY: Cross-sectional study with 127 HIV-positive MSM patients from Lviv region for the period of 2014-2018. RESULTS: Out of 127 HIV-positive MSM included in the study, 110 (86.6%) were from urban areas. In addition, 52 patients (40.9%) were diagnosed with stage 1 HIV, 16 (12.6%) - stage 2, 19 (15%) - stage 3, and 36 (28.3%) - stage 4. CD4 count < 200 cells/µL was found in 35 (27.6%) patients. Mean time from registration to antiretroviral therapy initiation was 80 days. During the first visit to medical doctor out of those 48 patients who had previously reported "other modes" of HIV transmission, 33 patients (68.7%) disclosed homosexual MoT of HIV. The remaining 15 (31.3%) patients disclosed their homosexual MoT of HIV later - during their regular follow-up visits to the doctor. CONCLUSION: Special measures are needed to improve the reporting of homosexual MoT which can potentially strengthen the HIV care among MSM.

Dynamics of the number of persons with special needs living in zakarpattia oblast, Ukraine.

OBJECTIVE: The aim: To study and analyze indicators of the number of persons with special needs living in Transcarpathian region of Ukraine: disabled persons, orphans and children deprived of parental care. PATIENTS AND METHODS: Materials and methods: National statistical reports on the disability of the population, the number of orphans and children deprived of parental care for the period 2010-2019. Statistical method was applied in the course of study. RESULTS: Results: Analysis of the dynamics of the number of persons with special needs in Transcarpathian region for the period 2010-2019 showed an increase of the number of disabled persons by 27% with 75415 persons, 6826 disabled children, 2125 orphans and children deprived of parental care. The number of orphans and children deprived of parental care residing in the region have a tendency to reduce and in the year 2019 equals to 2125 orphans and children deprived of parental care.This requires improving of the system of social and medical care for persons with special needs for adults with the formation of a system of provision of services in accordance with the actual needs of the population with the maximum approximation of the service to the place of residence of the client with the maximum use of opportunities of the united territorial communities. CONCLUSION: Conclusions: The growth of the number of persons with special needs in Transcarpathian region and directly of the persons with disabilities with the tendency to reduce the number of orphans and children deprived of parental care is established.

CURRENT ISSUES ON PROVISION OF SERVICES TO WOMEN DURING PREGNANCY AND POSTPARTUM PERIOD BY FAMILY DOCTORS.

OBJECTIVE: The aim is to determine the types of medical services that family doctors should provide to women during pregnancy and in the postpartum period and the competencies they should have to provide these services and the most acceptable ways to acquire them. PATIENTS AND METHODS: Materials and methods: During the study, the method of expert assessment, statistical method and method of structural and logical analysis were used. 50 obstetricians and gynaecologists who provide women with outpatient care and 50 family doctors acted as independent experts in the study. RESULTS: Results: The types of medical services that family doctors should provide to women during pregnancy and in the postpartum period and the competencies that they should have to ensure the provision of these services were determined by experts. The most acceptable ways to acquire the necessary competencies, as well as the benefits and risks of providing these services at the primary level of health care were designated. CONCLUSION: Conclusions: The implementation of the proposed types of medical care by family doctors will increase the availability and quality of medical care for women during pregnancy and in the postpartum period.

[Addiction to alcohol and drugs among the population of transcarpathian region].

OBJECTIVE: Introduction: Alcohol and drugs are a factor that significantly affects the health of the population. The consequences of alcohol abuse and drug addiction are not only a medical, but also socio-economic problem. The aim: Study and analyze the morbidity indices of the population of Transcarpathian region for alcoholism, drug addiction and substance abuse and the prevalence of specified diseases. PATIENTS AND METHODS: Materials and methods: Statistical and bibliosemantic methods were applied in the course of study. The data of branch statistical reporting of Transcarpathian region for the period 2015-2017 were used as materials for research. RESULTS: Review: A trend towards decreasing the indices of morbidity for alcoholism, alcoholic psychosis, drugs addiction and substance abuse, as well as decreasing the indices of prevalence of alcoholism, drugs addiction and substance abuse was registered in the region with the growth of the index of alcoholic psychoses prevalence. The specified indices have proved differences in terms of administrative areas of the region. CONCLUSION: Conclusions: Indices of population morbidity for alcoholism, drugs addiction and substance abuse and the prevalence of specified diseases are the basis for the adoption of the target regional program with the given disease.

Special features of population morbidity of transcarpathian region as the mountainous territory of ukraine and the prevalence of diseases in the region.

OBJECTIVE: Introduction: The state of population health is the most important index of the nation well-being and the criterion for planning the health care system development. The aim: To determine the special features of population morbidity and the diseases prevalence in Transcarpathian region. PATIENTS AND METHODS: Маterials and methods: The following methods were applied in the course of the study: statistical, comparative and structural-and-logical analysis. The data of the branch statistical reporting were used. RESULTS: Results: It is revealed that the general indices of population morbidity in Transcarpathian region and the prevalence of diseases is lower than the corresponding indices in Ukraine in the whole, however the morbidity indices have the tendency to growth, and the indices of the diseases prevalence show the tendency to reduction. Proved differences in the indices by the classes of diseases in Ukraine and Transcarpathian region are revealed. CONCLUSION: Conclusions: The special features of population morbidity in Transcarpathian region and the diseases prevalence among the population were determined and they should be taken into account in the process of reforming the health care system in the region.

[The issue of communications in health care system].

OBJECTIVE: Introduction: The communication process is a prerequisite for the development and effective functioning of health care system, the safety and strengthening of population health. The aim: To develop and present the system of communications in health care. PATIENTS AND METHODS: Materials and methods: The following methods were applied in the course of research: bibliosemantic, of structural-and-logical analysis, of conceptual and descriptive modeling. Systemic approach composed the base for research. Методичною базою дослідження став системний підхід. RESULTS: Results: The system of communications in health care is presented which is directed to the formation of responsible attitude towards health among population and commitment to health care reform. The system includes a regulatory provision, availability the necessary organizational, personnel, logistical, financial resources, determination of authority, informational provision, modern technologies, efficient management, intersectional approach, monitoring and assessment of activities. It is planned to develop the strategy of the communicational policy and the segmentation and prioritizing of target groups of communicational influence. The competencies of health care personnel and ways of achieving them in the system of postgraduate education are determined. CONCLUSION: Conclusions: Presented system of communications is recommended for implementation in the health care of Ukraine.

[Characteristics of the reproductive health of female population in Ukraine].

OBJECTIVE: Introduction: The state of reproductive health of female population is an important factor of population reproduction. The aim: To study and analyze the dynamics of reproductive health indices of female population in Ukraine. PATIENTS AND METHODS: Materials and methods: Statistical and bibliosemantic methods were applied in the course of study. The data of branch statistical reporting of Transcarpathian region for the period 2000-2016 were used as materials for research. RESULTS: Review: A high incidence index of the following diseases is observed among women with positive dynamics: menstrual cycle disorder - 18.2 per 1000 women of fertile age, salpingitis, oophoritis - 16.1, inflammatory disease of the cervix - 12.2, erosions and ektopìon of the cervix - 18.2. The level of abortions reaches 9.38 per 100 women in fertile age. Oncoepidemiologic situation is characterized by high level of morbidity, high mortality from malignant neoplasms and a significant number of patients, found in hard cases. A tendency towards the growth of infertility indices is registered. The indices mentioned are significantly higher than the similar indices in the leading countries of the world. CONCLUSION: Conclusions: Low level of reproductive health of the female population is registered in Ukraine compared to the leading countries of the world, that can negatively impact upon the process of population reproduction in the country.