The global telemedicine technology (TMT) regulatory landscape is currently evolving in a number of ways. The goal is to carry out an analytical examination of the institutional and legal frameworks for medical treatment including telemedicine consultation (TMC) in Russian Federation and foreign countries. The regulatory legal regulation of 22 international healthcare systems was included in the final version of the review. The review’s findings allow for the identification of the most important organizational and legal facets of delivering healthcare via TMC abroad: the majority of foreign nations lack comprehensive legal regulations governing the use of TMT in healthcare; the ability to establish a diagnosis within the context of TMC only follows an initial in-person consultation with a doctor; conducting TMC exclusively by licensed medical professionals and medical organizations; the option to conduct TMC via government-designed platforms and publicly accessible information platforms; requiring the patient to be informed about the benefits and drawbacks of TMT prior to consultation and to provide written or verbal informed consent; and requiring adherence to standards and recommendations during TMC, application, and in-person admission of the patient. The analysis demonstrates how commonplace TMC is abroad. However, there are currently no well-defined organizational or regulatory requirements for the use of TMC in the delivery of medical care, which calls for additional research into global experience and the identification of best practices that may be expanded throughout the Russian Federation.

The development of a human health culture is a complex health issue that requires the establishment of a system of health education and training from an early age. The duration and complexity of developing a culture of healthy living require scientifically based, targeted and systematic interventions on adolescents to develop behaviours that ensure a high level of health culture. The lack of a common definition of a health culture limits its quantification and comparison. In the course of the work, a theoretical analysis of the scientific literature was conducted to study the diversity of approaches to the evaluation of the culture of adolescent health. The most common methods of studying health culture are given. It has been revealed that to assess the level of health culture from the medical point of view there is a certain lack of complex theoretical approaches and instrumental methods that could allow to assess the studied phenomenon taking into account all its diversity. A synthesis of experiences and analysis shows that there is a need to develop a universal system of evaluation of adolescent health culture with a high adaptive capacity and the ability to adapt to any group of adolescents.

Results of foreign studies indicate a relatively high prevalence of smoking and alcohol consumption among healthcare workers, which can be explained by various socio-demographic and psycho-emotional characteristics, as well as stressinducing and psychological trauma factors related to their professional duties.

Aim. Analyse predictors of smoking and alcohol abuse among health care workers.

Materials and methods. The ASSIST screening test was used to assess the severity of clinically significant symptoms of substance abuse. The IES-R and K-10 questionnaires were used to evaluate psycho-emotional states.

Results. It was found that among men working in the “obstetrics and gynecology” specialty, a significant predictor of smoking was a high level of distress (p _≤ 0.05), and alcohol abuse was associated with the absence of a marital relationship (p _≤ 0.01). For women, alcohol abuse was related to increasing age (p _≤ 0.001), high income (p _≤ 0.01), living in a large urban area (p _≤ 0.05), and being married (p _≤ 0.01). Among men working in the “psychiatry and addiction medicine” specialty, alcohol abuse was associated with high income (p _≤ 0.01) and education levels (p _≤ 0.05). For women, there were associations between alcohol abuse and young age (p _≤ 0.01), high income (p _≤ 0.001) and education levels (p _≤ 0.01), distress (p _≤ 0.001), and post-traumatic stress disorder symptoms (p _≤ 0.05). For women, regardless of specialty, smoking and alcohol consumption were positively correlated (p _≤ 0.001).

Conclusion. The identified predictors of addictive behavior could become targets for targeted psychological and medical interventions.

The potential benefits of supportive care offer patients more than many “palliative” methods of anti-tumor treatment. It should be regarded as a necessary part of comprehensive disease therapy rather than just an additional service. However, the imperfection of regulatory and organizational issues, including financial support, limits patients’ access to supportive therapy.

Aim. To analyze regulatory legal documents governing the organization and financial provision of supportive therapy for oncological diseases and identify areas for optimization.

Materials and methods. Content analysis and comparative legal analysis. The content analysis method was applied to 26 directly regulating various organizational aspects of medical care, including oncological diseases from 2012 to the present. In regulatory legal acts, the issues of organization and financing of supportive therapy for oncological diseases were specifically analyzed in terms of how well this area of medical care is regulated.

Results. The current fundamental regulatory legal acts governing the organization and financial provision of supportive therapy for oncological diseases and controlling the quality of the provided medical care contain almost no clear provisions that specify practical issues related to supportive therapy.

Conclusion. The absence of an officially established definition of “supportive therapy” within the Russian healthcare system and the lack of clear distinctions between the terms “medical rehabilitation” and “palliative care” lead to misunderstanding about the importance of this area in comprehensive oncological therapy. This results in uncertainty in organizational and financial matters. To optimize regulatory oversight, ‘supportive therapy’ should become an integral component of modern oncological disease management, implying both interdisciplinary cooperation and a transparent financial system, the adequacy of which will depend on what is included in this concept.

In addition to officially authorized information resources, doctors of medical organizations widely use publicly available means of digital communication in professional communication with patients, which poses a threat to the disclosure of personal data and information about the patient’s health status.

Aim. To study the frequency of use of publicly available digital means of communication by doctors in professional communication with patients.

Materials and methods. A survey based on author’s questionnaires of 240 doctors, among whom 36.6 ± 3.1% worked in a polyclinic, 18.3 ± 2.4% – in a rural hospital, 45.1 ± 3.2% – in a multidisciplinary urban hospital. Among the respondents were representatives of various age groups and medical specialties.

Results. According to the survey results, only 18.2 ± 2.5% of respondents do not use publicly available digital technologies when communicating with patients. Doctors mainly use messengers (Whatsapp, Viber and others) (44.6 ± 3.2% of respondents), e-mail (24.5 ± 2.8%), less often social networks (12.6 ± 2.1%). As doctors move into older age groups, they use digital technologies less often to communicate with patients (p = 0.045), communication with patients using digital means of communication is more common among male doctors than among female doctors (p = 0.04). The number of doctors using digital technologies in communicating with patients in the city hospital turned out to be significantly higher compared to the central district hospital (p < 0.0001) and polyclinic (p < 0.0001). Doctors of therapeutic specialties are less likely to use digital technologies to communicate with a patient than specialists in surgical specialties (p = 0.04).

Conclusion. The results of the study indicate a high prevalence of the use of publicly available digital communication tools by doctors when communicating with patients: 81.8 ± 2.5% of respondents reported such a practice. At the same time, such unsecured communication channels as messengers and e-mail are the most in demand.