Sociology of Medicine

The article presents a scientific review of the formation of the sociology of medicine in the Republic of Belarus, which was largely based on the experience of Russia, primarily the experience of the Russian scientific school of Sociology of Medicine of academician of the Russian Academy of Sciences A.V. Reshetnikov. A comparison of specialty passports in these countries, the formulas of which, in general, are not identical, but cover the same areas of research and emphasize the general subject field of the specialty, revealed that differences in specialty passports are determined by different models of healthcare financing, as well as the specifics of the medical, social and medical organizational situation in the Republic of Belarus and Russia. It is premature to assert the existence of a scientific school of sociology of medicine in the Republic of Belarus. However, the documents fundamental for the development of the scientific specialty (the passport of the specialty 14.02.05. and the candidate's minimum program) have been approved, and its dynamic development is confirmed by the implementation of international conferences, symposiums, round tables on the problems of sociology of medicine, the implementation of funded scientific projects (grants), the presence of established international scientific cooperation, the formed base of Belarusian scientific and scientific-practical peer-reviewed publications (monographs, practical manuals), the implementation of training programs for highly qualified scientific personnel. Taking into account the common history of the two friendly countries and stable cultural, socio-economic, and scientific ties, it currently seems to be a promising direction to conduct Russian-Belarusian scientific research on a wide range of issues related to the phenomena of health and disease, social aspects of medicine, modern global challenges to public health and the experience of overcoming them, the peculiarities of the formation of professional cultures (including cultural codes) in medicine, as well as digitalization trends not only in the sphere of public health protection but also the social space as a whole. In this regard, the primary task of sociologists of medicine today seems to be the need to fix the social facts of a new reality in the space of medicine and rethink them in the context of determining the current vectors of the strategy for the development of the sociology of medicine as a science.

BACKGROUND: Oncological diseases are one of the leading causes of death in the world, which determines the fundamental importance of efforts to improve measures aimed at early detection of oncopathology in the population. The strategy for the development of oncological medical care includes the implementation of a wide range of measures to improve the therapeutic and diagnostic, organizational, personnel, technological, and other components of the activities of a specialized oncological medical service aimed at early detection of diseases, reducing mortality and improving the quality of life of patients.

AIM: The study of patients' opinions on various components of the oncological service of the Moscow region.

METHODS: The medical and sociological study "Analysis of patients' opinions on the state of the oncological service of the region and proposals for its optimization" was implemented in 2022 on the basis of the Moscow Regional Research and Clinical Institute. The research method was a questionnaire survey, the sample included 369 patients with oncological diseases who were treated at the clinic.

RESULTS: The study revealed a fairly high level of satisfaction with medical care for patients with oncological diseases, showed the need to strengthen the personnel and logistical component of its activities, as well as the formed request for optimizing patient routing algorithms during treatment and strengthening the humanistic component of the regional health system.

CONCLUSION: Oncological diseases are not only a medical problem, the solution of which requires significant financial, personnel, and organizational resources, but also a special area of social interaction in the professional space of medicine. This determines the need for regular monitoring of patients' opinions on the quality of medical care and related social aspects in its provision, expansion of information and preventive work with the population, as well as strengthening the social component — first of all, supporting communication between a doctor and a patient in oncological practice.

BACKGROUND: The morbidity and mortality rates of oral cavity cancers have increased in recent years. Numerous publications establish the impact of disease and treatment on the quality of life of patients with this pathology. Only few studies of the relationship between overall quality of life and quality of life relevant to oral health are known.

AIM: A study of health-relevant quality of life in patients with the terminal stages of oral oncological diseases.

METHODS: The study of the quality of life of patients with oral oncological diseases was performed using questionnaires «Functional assessment of cancer therapy — head and neck, version 4» (FACT-H&N 4) and «The World Health Organization Quality of Life 100» (WHOQOL-100). The study included 112 patients based on random sampling. The mean age was (66.5±3.5) years (p <0.05), most of them were men (76.7%). All respondents were diagnosed at late (III–IV) stages of the disease.

RESULTS: When assessing physical well-being using the FACT-H&N 4 questionnaire, the majority of respondents showed decreased scores in the domains: Physical well-being, Emotional well-being, Well-being in daily life. When assessing quality of life using the WHOQOL-100 questionnaire, there is a decrease in the average values of quality of life indicators in the domains and subdomains of the questionnaire, determined by the somatic state of the respondents. Respondents recorded higher average values of quality of life indicators in the areas and sub-areas where quality of life was determined by personal characteristics of the patient and social support available to the patients.

CONCLUSION: The somatic and social determinism of the patients' quality of life indicators, using FACT-H&N 4 and WHOQOL-100 questionnaires was established. The authors revealed the correspondence between the quality of life indicators of patients using the FACT-H&N 4 and the WHOQOL-100 questionnaires.

For modern national healthcare systems, the problem of personnel crisis and shortage of medical personnel is relevant. In recent decades, the professional activities of physicians in healthcare systems have become more complex. Social requirements for physicians are increasing, regulation of professional activities of physicians is becoming more and more rigid, and responsibility is increasing. However, the topic of professionalization of physicians of older working age in modern health care systems has so far remained on the periphery of research interests.

The study aims to typologize the limitations of the professionalization of doctors over working age in modern healthcare systems.

Due to the trend of demographic shift common to developed countries and the increase in the age range of professional life of the population in national health care systems, there is an increase in the number of working doctors of pre-retirement and retirement age. Physicians over working age of various medical specialties often face age-related problems of professional life, deteriorating health, and cognitive problems.

The typology developed by the authors examines 2 groups of predictors of restrictions on the professionalization of doctors over working age: institutional (legislative decisions defining age restrictions on professional activity, conditions of professional activity, relationships in the team and with patients) and individual-personal (gender and age characteristics of doctors, somatic, cognitive and professional deprivation, psycho-emotional stress, financial ability to complete work, desire to change lifestyle and family circumstances).

In the conditions of deficit and suboptimal structure of medical personnel in the Russian health care system, prolongation of effective professionalization of doctors is discussed as one of the directions of overcoming the personnel crisis. The development and adoption of managerial decisions aimed at overcoming the limitations of professionalization of doctors older than working age seems relevant. In this regard, the typology of predictors of the limitations of professionalization of physicians over working age is an important theoretical and applied task.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has demonstrated the low preparedness of most modern healthcare systems to respond rapidly to emerging threats. For many years they were aimed mainly at planned medical care and could not quickly reorganize themselves to organize one-time medical care for a large number of patients with a severe course of coronavirus infection. By the beginning of the epidemic, there was a staff shortage in the Russian healthcare system, and the workload of the remaining staff increased significantly.

According to the authors, it seems relevant to study the opinion of doctors of territorial polyclinics of the regional health care system about changes in their professional activities in the conditions of coronavirus infection.

AIM: To study the peculiarities of the professional activity of primary care physicians of the regional healthcare system in the conditions of the COVID-19 pandemic.

METHODS: The study involved 171 physicians from territorial polyclinics of the Saratov region. The study of the professional activity of primary care physicians of the regional health care system in the conditions of the COVID-19 pandemic was conducted using the questionnaire developed by the academician of the Russian Academy of Sciences A.V. Reshetnikov. Part of the questions of the questionnaire assumes the possibility of several alternative and free answers.

RESULTS: The main problem in rendering care to patients in conditions of COVID-19 pandemic respondents considers the limitation of availability of planned medical care to patients with chronic diseases. The reasons for the reduction of quality and availability of medical care to patients 100% of respondents consider the workload of medical personnel with COVID-19 patients, staff shortage due to their dismissal and high incidence of COVID-19 infection among doctors themselves, reduction of bed capacity of specialized hospitals due to conversion to COVID departments.

CONCLUSION: Since 2020, in the situation of the COVID-19 pandemic, additional conditions of limitation of accessibility of medical care to patients with chronic diseases in medical organizations of the region have arisen. Thus, in the period of the COVID-19 pandemic, we record the "actual decrease in the availability of medical care to the population" noted by academician of the Russian Academy of Sciences A.V. Reshetnikov.

BACKGROUND: Medical education is one of the most prestigious and in demand at the present stage, which, first of all, is reflected in the high competition rates for admission to a medical university. At the same time, the digital development of the Institute of Medicine determines the increasing academic load and the need to expand the range of disciplines studied at a medical university.

AIM: To study of the trajectories of professional development of a young doctor in the Russian healthcare system in modern conditions.

METHODS: The study of the trajectories of professional development of young doctors was carried out by the method of narrative interview (n=52) in September–December 2022 on the basis of the Institute of Social Sciences of Sechenov University. The study involved young internists (n=11), pediatricians (n=11), obstetricians and gynecologists (n=10), dentists (n=10), surgeons (n=10).

RESULTS: The analysis of the array of narratives allowed us to identify three key semantic and semantic data blocks (including seven subgroups), which served as the empirical basis of the standard narrative plot: the pre-university stage ["playing the profession" (3–7 years), "premonition" of professional choice (8–11 years), professional self-determination or the formation of professional intentions (12–17 years)]; university stage [obtaining medical education as the "foundation" of professional socialization (1–2 years), determining the desired trajectory of the professional path (3–6 years)]; postgraduate stage [debut of professional activity (residency), "challenges of professional autonomy"].

CONCLUSION: The analysis of the corpus of narratives of young doctors made it possible to identify the key temporal points of the trajectory of their professional formation in the modern situation, and showed that the formation and professional self-determination of a medical specialist is determined not only by internal motivation, but also by the influence of social agents (specific for each stage), the conditions of the social and professional environment.

BACKGROUND: Artificial intelligence, like medicine, is a dynamically developing field that can be considered both a science and an art. This makes it much more difficult to use artificial intelligence compared to other technologies that come with a user manual.

Research and start-ups in the field of medical artificial intelligence are rapidly multiplying: the popularity of smart mobile devices, networked applications and remote digital services is growing. However, there are still some problems that complicate the widespread use of artificial intelligence algorithms in everyday clinical practice. The reasons for this are the high cost of operating neural network platforms and the limited qualifications of some medical professionals in the field of computer technology. These are only temporary difficulties, though, which should and will be gradually resolved.

CONCLUSION: This article focuses on the most sensitive points that are currently hindering the accelerated progress of machine learning in healthcare.

BACKGROUND: An insufficiently high level of public health has a negative impact on social, economic, and political processes in the country and the social structure of Russian society as a whole. Social media institutions (traditional media: television, periodicals, radio) and the Internet are important sources of forming attitudes to health today. The main mass media are television, radio, and periodicals. Currently, the issue of classifying the Internet as a media outlet is being raised, but it has not been definitively resolved.

AIM: The aim is to identify the specifics and significance of the influence of the Internet and traditional media (television, radio, periodicals) on the formation of Russians' value attitude toward their health.

METHODS: The basis was the sources of relevant information: 1) 5 800 web-sites; 2) scientific publications (n=68) of the Russian Science Citation Index, Scopus, Pubmed databases. The sociological method of traditional internal analysis of scientific documents was used to study the empirical material.

RESULTS: In recent years, scientists, both here and abroad, with the help of sociological research, have been trying to find out which sources are most popular among different socio-demographic groups of the population when receiving information. It turned out that for the Russian population as a whole, the most priority source for obtaining general information is television, and the main source of information on the topic of health for Russians is the Internet. The largest number of health websites in the Russian Internet space today is devoted to the topics of cardiovascular, oncological, gastrointestinal, neurological diseases, colds, and influenza. The article analyses in detail the participation of traditional media in the process of forming a caring attitude toward their well-being among Russians. In particular, it is shown that medical issues are currently quite widely represented on television and in print media, and radio is poorly involved in this process. Attention is also paid to the fact that the Internet and domestic mass media can have both positive and negative effects on the dissemination of health information.

CONCLUSION: One of the main conclusions of the article is that the Internet is the most preferred source of health information for Russians today, especially for young people.

BACKGROUND: To improve the anti-smoking policy, it is important to analyze long-term public surveys on the prevalence of smoking and consumption of other nicotine-containing products, the attitude of the population to legislative initiatives, and current standards in the field of protecting citizens' health from ambient tobacco smoke, the consequences of tobacco consumption or consumption of other nicotine-containing products.

AIM: Analysis of the results of various monitoring of tobacco and other nicotine-containing products in the Russian Federation in the 21st century and the study of Russians' opinions on anti-smoking measures.

METHODS: The results of 5 monitoring studies and scientific publications from the RSCI database; the traditional classical method of analyzing and summarizing information, IBM SPSS Statistics program 26.

RESULTS: The periodization of the fight against smoking corresponds to the adoption of documents defining policy in this area. The success and achievements of the anti-smoking policy at each stage are considered through the dynamics of the prevalence of smoking and the attitude of the population to the anti-smoking measures taken. Surveys show that 1) the policy of countering the consumption of tobacco and other nicotine-containing products is approved by Russians; 2) on some issues, lawmaking lags behind public inquiries; 3) on some issues, the majority of respondents are more radical than legislators. This applies, in particular, to bans on the sale of tobacco products to persons under the age of 21, and to persons born after 2014, when they reach adulthood (these initiatives have not been translated into laws).

CONCLUSION: In strategies to counter tobacco use, it is important to take into account the peculiarities of the response of smoking Russians from various socio-demographic groups to anti-smoking measures, in particular, female smoking remains a serious problem. It is also important to take into account the lack of awareness among Russians about the legislative norms governing the consumption of alternative nicotine-containing products. Methodological support is required for the prevention of the use of new types of nicotine-containing products among the population, especially among young people.

BACKGROUND: Currently, public associations have become an effective tool for involving civil society to solve socially significant problems. They can support the government in achieving priority public health goals. However, in modern conditions of the development of civil society, when providing government support measures, non-profit organizations face barriers that impede the implementation of their tasks, which determines the need to formulate proposals for improving their activities.

AIM: To study the attitude of medical workers to public movements in the field of protecting and promoting the health of the population in the Russian Federation, to identify current problems in the implementation of their activities, to determine priority areas of work, to form recommendations for the development of public associations to improve the efficiency of the healthcare system.

METHODS: The sociological study has been carried out by the questionnaire method based on the public movement «NATIONAL FRONT «FOR RUSSIA» in which 24,907 medical workers from 85 subjects of the Russian Federation took part.

RESULTS: Insufficient awareness of medical workers about the activities of public movements in the field of public health and healthcare in the Russian Federation was revealed (25.5% of respondents know nothing about such movements), about half (43.4%) believe that their activities have a positive impact on development healthcare, one-third of the respondents (34.9%) approve of their activities. About half (46.3%) noted that the greatest contribution to healthcare should be made by the state together with public movements, while it is necessary to enhance the control of citizens and their associations over the performance of their duties by authorities (39.5%).

CONCLUSION: The effectiveness of public associations and their development depends on political, economic, and social factors. To increase the role of public associations in the field of health protection and promotion, more active participation of citizens in their activities is required. To do this, it is necessary to increase public awareness about the main activities of public associations, legislatively expand their powers, increase government support, etc.