NURSES' PERCEIVED PROFESSIONAL PERFORMANCE IN PRIMARY HEALTH CARE: A NATIONAL STUDY OF ORGANIZATIONAL AND WORKFORCE DETERMINANTS.

AIM: To examine perceived professional competence of nurses in Kazakhstan's primary health care system and identify organizational and workforce factors associated with competence and collaboration.

METHODS

Between April and June 2022, primary health care nurses in urban and rural Kazakhstan completed a 64-item questionnaire assessing perceived professional competence, nurse-physician collaboration, availability of resources, and preparedness for epidemic conditions. A context-specific instrument was developed based on national PHC regulations and COVID-19 protocols. Data were analyzed using descriptive statistics, Spearman correlation, multiple linear regression, and exploratory factor analysis.

RESULTS

A total of 1,134 nurses participated, with 56.66% holding technical or vocational qualifications. Most respondents rated nurse-physician collaboration positively (80% "Yes"). Higher perceived competence was associated with preparedness for pandemics, regulatory knowledge, and use of triage algorithms. Three factors explained 65% of the variance: organizational effectiveness, workforce characteristics, and epidemic-related conditions.

CONCLUSIONS

Nurses' perceived competence in Kazakhstan is shaped by organizational readiness, particularly in rural areas. Strengthening preparedness and regulatory literacy is key to enhancing resilience in PHC.