The article discusses ways to improve medication adherence using electronic devices. Applications for medication monitoring, currently available in the Russianlanguage Internet segment for Android OS devices in the Google Play Store is analyzed. For analysis, the main functional characteristics, determined by representative reviews of applications, and classification are given; selected applications were tested for core functions. The main features of Russian-language segment applications are established: insufficient Russian language support, high application versatility, frequent advertising, and the relative simplicity of most applications. Only a relatively small number of applications have a wide range of specific functions. In addition, research data is provided on the effectiveness of using applications to improve medication adherence and prognosis. A practitioner ability to increase medication adherence is raised with the implementation of functional programs that are consistent with the aims.

Aim. To analyze the functionality and characteristics of quit smoking applications available to Russian-speaking users using validated scales for its evaluation.Material and methods. Applications were searched in the App Store and Google Play, and a specialized MARS scale was used to evaluate applications. A total of 598 applications were found, of which 54 applications met the inclusion criteria and were included in the study.Results. It was found that 54% of applications use short- and medium-term goals as methods and techniques to increase the likelihood of quitting tobacco, while 31% of applications use various educational materials in order to form a negative attitude towards smoking. In addition, 22% of applications use cognitive and behavioral techniques of cognitive behavioral therapy. A negative moderate correlation was established between the application user rating and MARS score (r=-0,32).Conclusion. The Russian-language anti-smoking mobile applications included in this study demonstrated satisfactory quality on average. A significant number of applications use proven effective cognitive behavioral therapy techniques. At the same time, mobile applications in healthcare has shortcomings, especially in terms of compliance with guidelines, and needs to be further improved.

Moral distress is an actual problem of medical ethics, psychology and healthcare. Its direct effects are the persistence of negative affect, emotional burnout, doctors leaving the profession; indirect damage from moral distress includes a significant worsening of medical care, a decrease in the quality of life of patients and physicians. Pediatric palliative care is a particularly sensitive area to moral distress, rich in severe, intractable existential and moral problems. The article examines the basic concepts of the nature of moral distress in medical care in general and palliative care for children in particular, and analyzes the structure of the experience of moral distress by healthcare professionals. Based on the data of modern psychometric and phenomenological studies, the causes of experiencing moral distress are identified and generalized. The phenomenon of moral distress among patients of palliative care for children and their family members, which has so far rarely been in the focus of researchers, is considered separately. The study of moral distress is based on the sometimes antagonistic interaction of two research paradigms — phenomenological, focused on the analysis of people's experiences and psychometric, objectified; their correlation and the possibility of integrating the results obtained into healthcare practice are also discussed in this article.

Несмотря на успехи детской кардиологии и кардиохирургии в лечении тяжелых заболеваний сердца у детей, значительное увеличение средней продолжительности и качества жизни пациентов, заболевания сердечно-сосудистой системы остаются одной из ведущих причин, приводящих к необходимости оказания паллиативной помощи. Ряд психологических и этических аспектов в детском кардиологическом паллиативе нельзя назвать достаточно разработанными. Кардиозаболевания, требующие паллиативной помощи, затрагивают физиологические, психологические и социальные аспекты жизни пациентов и предполагают особое внимание к их жизненному миру. Предлагается использовать "методы второго лица" в клинической коммуникации на основе биопсихосоциального подхода кардиофеноменологии в целях создания пациент-центрированной среды в ситуации паллиативной помощи детям, страдающим тяжелыми заболеваниями сердца. Кардиофеноменология может обеспечить концептуальную рамку и набор приемов коммуникации для выстраивания непатерналистских отношений в паллиативной помощи кардиологическим пациентам-детям в целях повышения качества жизни, зависимого от здоровья (HRQoL).Ключевые слова: врожденные пороки сердца, качество жизни, пациент-центрированная медицина, отношения "врач-пациент", паллиативная помощь детям, кардиофеноменология. Отношения и деятельность. Исследование выполнено за счет гранта РНФ № 20-78-10117 по теме "Модели взаимодействия врачей и пациентов в институциях паллиативной помощи детям". ФГАОУ ВО Российский национальный исследовательский медицинский университет им. Н. И. Пирогова, Москва, Россия. Мирошниченко М. Д.* -к.филос.н., старший преподаватель кафедры биоэтики и международного медицинского права ЮНЕСКО международного факультета, ORCID: 0000-0003-1374-1599, Ноздрачев Д. И. -старший лаборант кафедры биоэтики и международного медицинского права ЮНЕСКО международного факультета, ORCID: 0000-0003-3269-7917.

Aim. To collect and analyze currently available clinical studies on the effectiveness of mindfulness-based stress reduction (MBSR) for lowering blood pressure in individuals with normal, high normal blood pressure and hypertension.Material and methods. The systematic review was prepared according to the PRISMA algorithm with minor modifications. The search algorithm included articles in Russian and English, indexed in the Pubmed/MEDLINE and Cochrane Library databases. The study included studies on the impact of mindfulness interventions on blood pressure levels in individuals aged ≥18 years with an established diagnosis of hypertension, with normal (120-129/80-84 mm Hg) and high normal office blood pressure (130-139/85-89 mm Hg).Results. A total of 4785 publications were identified and included in the study, of which, after a multistage sampling, including screening of articles, 6 studies were included in a qualitative systematic review.Conclusion. Qualitative synthesis of the results of clinical studies revealed that the evidence currently available indicates a possible positive effect of mindfulness interventions on blood pressure levels in individuals with normal, high normal blood pressure and hypertension. However, further studies with larger samples and measurement of more primary and secondary endpoints are required.