JUSTIFICATION OF THE COMPREHENSIVE PROGRAM OF PREVENTION OF HYPERTENSION DISEASE IN MEDICAL WORKERS.

In the current conditions of the Covid-19 pandemic, which has largely affected medical personnel, the issue of preserving their health and working capacity has become more relevant than ever. In recent years, the number of medical personnel has decreased significantly (almost by a quarter in 5 years), and the workforce has aged even more (persons of senior age make up more than 20%). Analysis of the structure of morbidity among medical workers indicates its nature caused by stress, especially in relation to hypertension, heart attacks, strokes, neuroses, etc. Therefore, it is necessary to provide doctors with special opportunities to receive medical assistance, to create a comprehensive program for the prevention of hypertension. The creation of a complex functional and organizational model of prevention of arterial hypertension among medical workers was to increase the quality and effectiveness of prevention of hypertension for the specified contingent, taking into account its specificities. The model is aimed at identifying and preventing risk factors for the development of hypertension and its complications. Thanks to the implementation of primary and secondary prevention measures, it is expected to mitigate the medical and social consequences of hypertension - a decrease in morbidity, mortality, disability, an increase in the average life expectancy, and an increase in the working capacity of medical personnel. The subject of the prevention of hypertension is the management of the medical institution. The organizational and managerial function is entrusted to the management, which must supervise the organization and conduct of preventive medical examinations, ensure proper working conditions, promote the creation of an electronic register of medical personnel, and provide conditions for their recovery. A trusted doctor (therapist) of the institution communicates directly with the staff of the medical institution, who must take care of their state of health. According to the proposed model, a trusted (therapist) doctor, who has the most complete information contained in the medical cards of the staff, creates an electronic register of doctors and nurses. The information-analytical function of a trusted (therapist) doctor, psychologist is carried out with the participation of the information-analytical department of the institution, which helps in the development of the register of medical workers, the formation of a list of quality indicators for the analysis of the effectiveness of preventive measures. Summarizing the results of own research and data from the literature made it possible to outline conceptual approaches and promising directions for optimizing the prevention of the development of hypertension and its complications in medical workers. The basis for creating an organizational and functional model of prevention of hypertension was the following conceptual components: Normative and legal, which provides for strict compliance with the orders of the Ministry of Health regarding preventive medical examinations of medical workers; European recommendations on the prevention of cardiovascular diseases and 2016 and the domestic unified clinical protocol of medical care "Prevention of cardiovascular diseases" of 2016. Personnel and organizational, which provides for the presence in the medical institution of a trusted doctor (therapist), a psychologist, who must rely on the control of the health of the medical staff of the institution, the organization of preventive measures and the provision of appropriate medical assistance to medical workers if necessary. Material and technical, which involves the creation of conditions for the implementation of preventive and curative measures (availability of relaxation rooms, provision of personnel with material assistance, sanatorium-resort treatment). Informational and communicative, which involves informing all branches of the medical institution, and first of all, their management, about the problems of the medical staff (material, social, household, etc.) with the aim of creating proper working conditions for the medical staff, a favorable psychological microclimate. Control and monitoring, which involves the use of indicators of the quality of the provision of medical care to assess the effectiveness of treatment and preventive measures for the prevention of hypertension in medical workers. The main approaches to the prevention of arterial hypertension (or hypertensive disease) are well-known and outlined in many scientific works and guidance documents. But the general scheme of prevention of hypertensive disease needs some correction and the creation of an organizational and functional model of prevention of hypertensive disease specifically for medical workers in view of the specifics of their profession.