BACKGROUND: Palliative care is an interdisciplinary activity that focuses on providing physical, mental, social, and spiritual support. In situations of uncertainty associated with life-threatening conditions, spiritual and religious support for patients is a central component of palliative care. AIM: This study aimed to analyze regional aspects of inter-institutional interaction between medicine and religion (using the example of the Russian Orthodox Church) in the context of palliative care. METHODS: To examine the trends in inter-institutional interaction between medicine and religion in the provision of palliative care to patients, the method of narrative interview (n = 7) was used, conducted in 2025. The sociological study on Trends in Inter-institutional Interaction Between Medicine and Religion (using the example of the Russian Orthodox Church) in the Region analyzed the narratives of priests from hospital churches in the Saratov region. RESULTS: Analysis of the narrative interviews revealed several key thematic narratives: low social efficiency and the need for reform of the current healthcare system; a low level of spirituality within the medical community; the consideration of spirituality in the context of religiosity, which aids patient recovery; the regulation of interaction between the Church and medical organizations through regulatory documents; and restrictions on patients' rights to visits from priests in medical organization inpatient settings, stemming from the lack of faith among medical staff, non-believing relatives of the patient, and non-believing patients sharing the same room. CONCLUSION: In modern Russia, religious organizations, primarily the Russian Orthodox Church, interact with the healthcare system in the provision of palliative care. A legal framework regulating the inter-institutional interaction between medicine and religion has been developed. Limitations in the interaction between medicine and religion in providing palliative care within medical organizations will have an adverse impact on patients' quality of life and life prospects.

BACKGROUND: The current Russian demographics is characterized by a declining birth rate and a high rate of complications during pregnancy and childbirth. Choosing the best pregnancy management and childbirth method is impossible without due consideration of perinatal risk factors. AIM: To determine the perinatal risk of complicated pregnancy in women with premature birth using social predictors. METHODS: The study conducted in 2024 included 118 women admitted to the maternity wards of the Clinical Perinatal Center of the Saratov Region for complicated pregnancies that ended in premature birth. The control group included 385 women with complicated pregnancies ended in term births. In both groups, respondents were differentiated by the degree of perinatal risk during pregnancy using the scale of perinatal risk factors proposed by Radzinsky et al., which includes additional social parameters of pregnant women. The survey of respondents was analyzed using standard algorithms in SPSS Statistics and Microsoft Excel. Correlation analysis was performed by calculating the Spearman’s rank correlation. A combination of factor and discriminant analyses was used to predict a pregnancy outcome. RESULTS: In the premature birth group, the perinatal risk of pregnancy complications was low and medium in 53.8% of women, who underwent regular medical checkups in antenatal clinics, indicating that the perinatal risk of the respondents was underestimated. A combination of factor and discriminant analysis based on the respondent’s age, husband’s age, marital status, family size, number of children, number of minor children, average monthly income per family member, number of pregnancies, number of sexual partners, smoking, chronic and hereditary diseases allowed to accurately predict the pregnancy outcome in 92.4% of cases. CONCLUSION: The study verified the social profile of pregnant women, which are significantly associated with the degree of perinatal risk of complicated pregnancy and childbirth.

Objective: to verify the characteristics of the social portrait of pregnant women with complicated pregnancies associated with prenatal risk. Material and methods. The study included 385 pregnant women. The average age is 29.0±0.5 years. Questionnaire and differentiation of respondents according to the degree of prenatal risk were carried out using the scale of prenatal risk factors V. E. Radzinsky et al., According to which respondents are divided into low, medium and high prenatal risk groups. Spearman's correlation coefficient was used for correlation analysis of the characteristics of the social portrait of respondents and the degree of prenatal risk of complicated pregnancy. Results. The characteristics of the social portrait of pregnant women associated with prenatal risk include: age and education of respondents, age and education of the husband of respondents, family composition, number of children, number of minor children, number of previous pregnancies, smoking and alcohol consumption. The most correlated with the degree of prenatal risk: the number of previous pregnancies +0.45 (p<0.001), the age of the husband +0.39 (p<0.001), the age of the woman +0.34 (p<0.001). Conclusion. The study verified the characteristics of the social portrait of pregnant women associated with the prenatal risk of complicated pregnancy. The relationship between the social characteristics of respondents and the degree of prenatal risk of complicated pregnancy was established.

Introduction. Cardiovascular diseases define the pathological landscape of the 21st century. Personal characteristics of patients with cardiovascular diseases who have undergone stenting and bypass surgery are among the main factors in the success of their rehabilitation or, on the contrary, in determining the deterioration of their health. Regarding prevention of postoperative complications, taking into account the personal characteristics of patients is of primary importance. The study compared groups of patients (based on the level of depression) with various forms of cardiovascular diseases: acute coronary syndrome and chronic ischemic heart disease; types of surgical intervention – stenting or bypass surgery.Aim. To describe and explain the differences in depression levels in patients with different forms of cardiovascular disease who have undergone stenting and bypass surgery.Materials and methods. The study included 123 patients of both sexes (34–85 years old). The patients were divided into 3 groups: group 1 – 26/123 (21.1%) patients with HIHD who underwent bypass grafting; group 2 – 45/123 (36.6%) patients with HIHD who underwent stenting; group 3 – 52/123 (42.3%) patients with ACS who underwent stenting. The average age of the patients was 61 years ± 6 years. The severity of depression in patients was assessed using the Zung Self-Rating Depression Scale. ANOVA analysis of variance (p < 0,05) was used to compare the mean values of quantitative data.Results. In Group 1, according to the Zung Depression Self-Rating Scale, the average depression score was 35.5 points; in Group 2, the average depression score was 39.3 points; in Group 3, the average depression score was 42.1 points. There was a statistically significant difference in the severity of the average depression scores between Groups 1 and 3 according to the Scheffe method (p < 0,05).Conclusion. Patients with ACS who underwent stenting are characterized by a greater tendency to develop depressive disorder than patients with HIHD who underwent bypass. The obtained result indicates greater anxiety in patients with ACS, most probably, due to the unexpected manifestation of symptoms of the disease and an emergency decision to perform surgery.

Aim. To analyze the cognitive status (thinking style and nature of stress experience) in patients with coronary artery disease (CAD) who underwent myocardial revascularization.Material and methods. The study involved 150 patients with the average age of 54 years. The study sample included three following groups of respondents: patients with CAD who underwent myocardial revascularization 1,5 months before the study (n=50); patients with cerebral ischemia (n=50); conditionally healthy respondents who underwent routine medical examination (n=50). The following were used: the Cognitive Mistakes Questionnaire by A. Freeman, R. DeWolf (in the Russian adaptation by A.E. Bobrov, E.V. Fayzrakhmanova); the Questionnaire of Styles of Explanation of Successes and Failures by T.O. Gordeeva, O.A. Sychev, E.N. Osin, V.A. Titova Gransham; the Brief Resilience Scale by B. Smith, et al. (in the Russian adaptation by V.I. Markova, L.A. Alexandrova, A.A. Zolotareva); the State-Trait Anxiety Inventory by C. D. Spielberger (in the Russian adaptation by Yu.L. Khanin). To assess the significance of differences in cognitive status and the nature of stress experience between the above-mentioned groups, Student's t-test (t) was used. Statistical analysis was performed using SPSS Statistics ver. 27.0.1.Results. Patients with CAD who underwent myocardial revascularization differ from conditionally healthy patients who underwent routine medical examination, in higher expression of following cognitive status indicators: "catastrophizing" (t=-6,718 at p<0,01), "stability of failures" (t=-3,092 at p<0,01), high expression of personal anxiety (t=-5,238 at p<0,01) and low expression of resilience (t=3,163 at p<0,01). In addition, CAD patients differ from patients with cerebral ischemia in higher expression of the cognitive status parameter "exaggeration of danger" (t=-6,292 at p<0,01).Conclusion. In patients with CAD, the indicators of cognitive status and ability to recover after revascularization may indicate chronic traumatization caused by disease and surgery as the trigger event. The data obtained may be important for the development of prevention and rehabilitation programs.

Introduction. Incurable illness causes physical, emotional, social and spiritual suffering in patients. In the uncertainty associated with life-threatening conditions, the assessment of spiritual suffering and the provision of care is a central component of palliative care. Methods. Analysis of normative-legal acts regulating inter-institutional interaction between medicine and religion in modern Russia. Results and Discussion. Interactions between medicine and the Church are regulated by Russian legislation and inter-institutional normative acts on co-operation between the Ministry of Health of the Russian Federation and the Russian Orthodox Church. One form of interaction between the health care system and the Russian Orthodox Church is the participation of representatives of the Russian Orthodox Church in providing palliative care to patients with life-threatening illnesses. Conclusion. When analyzing normativelegal acts it was established that there is a legal framework regulating the inter-institutional interaction between medicine and religion in modern Russia.

The article analyzes the experience of using digital technologies in the prevention and rehabilitation of persons with suicidal behavior in Russia and abroad. Potential dangers and opportunities when using Internet resources in matters of suicidology have been identified. Against the background of a large amount of information about destructive behavior, there is a general lack of Internet resources based on the recommendations of the World Health Organization (mandatory content of information on the provision of psychological and psychotherapeutic assistance, warning about the features of the content, the absence of cultural and religious stereotypes, the absence of devaluation of factors of suicide focused on myths and stereotypes). Online communication is an adequate tool for solving the problem of rehabilitation of young people with suicidal behavior in connection with its actual role of socialization. A review of special sites and applications in the Internet space indicates an acute shortage of resources for persons prone to auto-aggressive behavior, which determines the tasks of digital support of the rehabilitation process. The analysis of the resources showed the absence of web platforms based on official providers of medical and social assistance, which is an important medical and social problem, defining the primary state task in the healthcare sector.

Aim: the paper aims to identify medical, social and psychological reasons for playing tennis after total hip and knee replacements. Materials and methods. Semi-structured interviews were carried out during tennis tournaments in Saratov in 2018-2019 by the experts of Scientific Research Institute of Traumatology, Orthopedics and Neurosurgery (Saratov State Medical University) to evaluate tennis performance in persons after total hip and knee replacements. The results obtained were analyzed together with the data of examination protocols. Results: the clinical and radiological data of long-term observations and the findings obtained during tennis tournaments indicate the absence of negative consequences from regular tennis training sessions in amateur athletes after total hip and knee replacements. The main social factors were defined as the social role and practical activity. The first factor describes sports activity after joint replacement as the correlation between physical limitations and personal traits. The second factor includes common motivation for sports and work activities. Conclusion: tennis tournaments among persons after total joint replacement can be considered as an example of self-management and goal-oriented activity that is similar to their daily routine before the surgery; persons accustomed to competitive activities overcome potential health risks. The study proposes a new medical and social technology based on the interaction of experts who take responsibility for monitoring sports performance in persons after joint replacement.

The issue of digital technologies implementation in practice of health care becomes one of the priorities in the conditions of resources deficiency. The digitalization of health care system is economically expedient as it allows achieving particular medical and social results without significant infrastructural investments. The on-line communication possesses significant potential in this regard. The digital health care using on-line communication democratizes access to medical services and allows to qualitatively remodel the existing model of interaction between patient and health care system. In the sociology of medicine, the sociology of rehabilitation is selected to investigate such issues as social and organizational context of rehabilitation, social orientation of medical care, role of health care personnel and other interested specialists. The article substantiates the efficiency of on-line communication in management of rehabilitation of patients as exemplified by the Monitoring and Feedback System designed and introduced in the Research Institute of Traumatology, Orthopedics and Neurosurgery of V.I. Razumovsky Saratov State Medical University.

.The goal of the workwasto determine on the basis of sociological research the representation of medical students about the possible risks of sexual relations. Materials and methods. The survey of 659 students of medical and pediatric faculties of Saratov State Medical University n.a. V. I. Razumovsky and Volgograd State Medical University. Results of the research demonstrate that the most significant risks of sexual relations considered by the students are sexually transmitted infections and unwanted pregnancy. However, despite a high level of awareness of probability of their occurrence less than a half of the students always use necessary remedies to avoid these risks, this fact allows to refer students to a group with an increased risk of STI and unwanted pregnancy. It is determined that self-treatment practice in regard to STI is not wild-spread among medical students due to the presence of deeper knowledge about reproduc- tive health. Conclusion. The analysis of author's research data and the works devoted to the problem of sexual relations risks among youth allows to state the imbalance between students' knowledge of sexual contacts risks and their real behavioral practices, and a significant decrease in the level of preventive work. Medical students can be considered as a resource for optimizing this type of work with students of high schools, colleges and other universities.

The article deals with the problem of ethical conflicts in medicine. The growth of legal conflicts in medical practice is largely conditioned by increase of ethical conflicts.As the leader of a medical staff is the central figure, we’ve conducted the research of his/her personal features with the aim to reveal risk factors of ethical conflicts. The carried out literature review of the mentioned problem defined that leadership in medicine has its own peculiarities, connected with specificity of activity, gender asymmetry of a professional sphere. Theresearch of role-playing features of a head in the medical staff was conducted on the example of physicians who performed leading duties with work experience in a senior post of 7±1,3 years. The research was carried out in the categorical field of sociology of medicine using methods of content-analysis, participant observation, sociological inquiry and interviewing, and psycho-diagnostic techniques (by Sinyavsky V.V. and Fedorishina B.A., Raygorodsky D.Y., Shubert, Boiko B.B., Snider M. etc.). The research results made it possible to determine ethical risk factors in 20-25% of leaders. It was concluded that there is a need to institute a bioethical methodical block to the system of continuing professional education of medical specialists, which can make it possible to form leader’s necessary ethical values and attitudes in conditions of educational sphere. Key words : leadership, ethical conflicts, personal features, medical staff, style of leadership, bioethics.

The article presents social and role peculiarities of professional interaction in the system "doctor— patient" in the retrospective, various factors influencing the downfall in the social significance of doctor role at the present stage of medicine development from the point of view of a number of theoretical approaches. On the basis of literature review we outlined the necessity of medical sociological investigation for the study of professional practices in medical institutions with various social and role structure and indicated the importance of the development of medical and sociological tools for the assessment of interaction efficiency stipulated by the impact of social and role factor. was performed in the following databases: Web of Science, CyberLeninka, PubMed.

The aim of the article is to consider the main theoretical and practical aspects of implementation the program of youth policy in the Saratov State Medical University n.a. V. I. Razumovsky. Authors analyze the educational system and the way it correlates to modern challenges of the Russian society. Special attention is paid to the main conditions of realization and the directions of youth policy in the Saratov State Medical University. The conceptual principles of youth policy of higher school have been worked out by the authors.

Beginning with the XX century health care is considered to be the largest social institution with the delegated strategic objectives. In the authors' opinion, four subinstitutions can be distinguished in the social Institute of Health Care, according to the functions they perform: "Primary health care", "Ambulance", "Specialized medical care", "Palliative medical care". The analysis of trends of the institutionalization of subinstitute "Palliative medical care" is presented by the authors in the methodological plane of the system of social and structural functions, proposed by T. Parsons. In the adopted legislative documents in Russia, palliative care is considered as a palliative medical care, which determined the nature and content of palliative care to patients with chronic diseases. The medicalization of palliative care is discussed by the authors from the perspective of the dysfunctional practices of a forming in Russia subinstitute of palliative care.

The goal was to determine psychological predictors of reproductive attitudes among medical students. Material and Methods. The survey of 84 students (of the 3rd and the 5th year of medical faculty of Saratov State Medical University n.a. V. I. Razumovsky) was carried out using a combination of methods (questionnaire, testing) aimed to achieve the research goal. Results. Features of reproductive attitudes and reproductive intentions of students, as well as psychological characteristics of youth, such as personal maturity, belief in people and value orientations were studied. Psy- chological predictors of reproductive attitudes among medical students were determined. Conclusion. It was revealed that reproductive attitudes among students of the 5th year were higher than those of the 3rd year. There were gender differences in psychological predictors of reproductive attitudes among students. It was experimentally established that existence of faith in people, high level of personal maturity, high importance of personal values, altruistic values and values of acceptance of others had a positive impact on reproductive attitudes among young people. Based on the results of the study, recommendations were developed with the aim to improve reproductive attitudes and psychological readiness for parenting of medical students.

Based on the performed functions, four sub-institutions have been distinguished by the authors in the system of the Russian Institute of Health, which is one of the basic social institutions. The role of palliative care in health care makes it possible to determine its status as sub-institutional. The subinstitute is subordinate to the general purpose of the institution and ensures the implementation of one of the functions. The authors discussed the medicalization of palliative care in the perspective of dysfunctional practices of the subinstitute which is now forming in Russia. The risk of medicalization of palliative care for patients with chronic diseases leading to a decrease in the functional effectiveness of the palliative care sub-institution, is caused by inadequate medical care. The articles provided evidence which proves the danger of medicalization of palliative care for patients with chronic, life-threatening diseases. According to the functions they implement, the four sub-institutions are distinguished by the authors in the system of the Russian Institute of Health, which is one of the basic social institutions. The role of palliative care in the institution of health make it possible to determine its status as a sub-institutional. The sub-institute is subordinated to the general purpose of the institution and ensures the implementation of one of the functions.

The objective of the study: to identify the attitudes towards elderly among the students and residents of SSMU n.a. V. I. Razumovsky. Material and Methods. Students of 3d and 6th courses and interns of 1st and 2d years (N=85) enrolled in the SSMU n.a. V. I. Razumovsky were involved in the research. The average age of respondents was 21 ±1.8 years. We used the technique of unfinished sentences, which allowed us to measure emotional load of the semantic field of the phenomenon of old age. Results. Among the respondents, most commonly old age is associated with responsibilities in the upbringing of grandchildren, wisdom and pension. The main reasons that hamper the interaction with the elderly respondents emphasized the conflict of older people and a decrease in cognitive functions. Conclusions. In the researched population there is mainly a positive image of old age. Medical students should be prepared to work with older people and a tolerant attitude to old age should be formed

The health care is considered as a social institution since XX century. The main purpose of health care is in amelioration, rehabilitation and promotion of health. This social institution, according to its implementing functions, comprises four sub-institutions. The analysis of trends of institutionalization of the sub-institution «Palliative medical care» is presented in methodological plane of system of social structural functions (AGIL). From the perspective of dysfunctional practices of sub-institution of palliative medical care developing in Russia, a medicalization of palliative care is discussed.

The aim: research of medical and social issues of rehabilitation after hip and knee joints replacement. Material and Methods. Sociological study of 1175 patients who have undergone in 2015-2016 total hip and knee joints replacement was conducted. Results. Within the scope of medical surveillance after the surgery 69.8% of patients made regular visits to orthopedic specialists after joint replacement, but only 9.4% of surveyed patients confirm the practice of active monitoring of rehabilitation on the part of health services. There had been determined a high level of declared patients satisfaction (more than 80%) with weak health managers activities argue considerable informational gap between the key parties of rehabilitation. Conclusion. Provided study has designated problem areas of patient and health system communication in rehabilitation after hip and knee joints replacement.