Vol 15, No 1 (2016)

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The analysis of actual interpretations of palliative care from perspective of multi-professional and multi-disciplinary approach is presented. The main trajectories of chronic diseases determining modern strategies of palliative care are considered. The main tasks and directions of palliative care are indicated. According the authors, the normative legal support of provision of palliative medical care of population permits planning and developing of the mentioned type of care in Russia. To provide availability of palliative medical care scientific methodical substantiation is required and as well development of unified classification of conditions requiring indication and organization of palliative care. The standards of provision of palliative care are to be adjusted to the mentioned classification. The article mentions that the legal documents adopted in Russia determine palliative care as palliative medical care. The medicalization of palliative care in Russia is considered from perspective of dysfunctional practices of social institution of health care.

The article analyses recent serious alterations in cause-and-defect relationships characteristic to process of new wave of narcotization. The new tendencies and in drug situation in Russia are established. The new factors explaining increase of involvement into new drugs abuse are analyzed. It is demonstrated that in actual Russian conditions drug abuse in included into common social context of human life.

The approaches to concept of health “risk factors” and its interpretation in works of different sociologists are found out on the basis of foreign sociological literature. Two main tendencies in considering of this issue are marked out - priority of unhealthy forms of behavior and unfavorable conditions of environment. The critical evaluation of this trends is given in context of their subjective objective character.

The problem of detection, measurement, evaluation and elimination of inequity and injustice related to health continues to be unresolved in all countries. The study was carried out to evaluate situation related to quality of medical care in primary health care at the regional level and to determine means of its amelioration on the basis of humanitarian model of system of quality management from positions of sociology of medicine. The materials of territorial foundation of mandatory medical insurance of the Chelyabinskaia oblast were taken as basis for analysis. The sampling consisted of 54 383 acts of expertise of quality of medical care, including 42 998 expertises of medical care provided by pediatricians and 61 860 by therapists. The design related to type of clinical audit of medical documentation of completed case in polyclinic practice. The significant differences were established concerning rate of defects of quality of medical care in oblast centers, large cities, towns ans rural regions. The phenomenon of sub-optimization of quality of medical care in towns, and rural districts during period of financing increase of health care is established. The results of study testify availability of injustice in issues of health care of population residing in unfavorable social economic conditions. To support justice related to health the concept of humanitarian model of system of management of quality from positions of sociology of medicine was developed.

The article presents the results of medical sociological study of quality of life of oncologic patients. Among them, 96% suffered from cancer stage III-IV of various localization and were applied therapy with nationally manufactured cytokines. From the basis of study data it is marked that overwhelming majority (80.3%) of patients involved into study noted amelioration of their quality of life after inception of treatment with pharmaceuticals "Refnot" (tumor necrosis factor a-timosine-a1) and "Ingaron" (interferon gamma). At that, duration of intake of pharmaceuticals occurred directly related to positivisation not only of physical condition but also as sequence of this process quality of life of patients. The increasing of quality of life related to intake of pharmaceuticals "Refnot" and "Ingaron" is clearly demonstrated by answers of patients to question about changes occurred in their life from the moment of inception of treatment. So, 48.6% of participants of survey declared about amelioration of symptomatic, 27% - about amelioration of general condition, 20.5% - about increasing of capacity for work. the increasing of physical activity was marked by 18.9% of respondents and 13,5% indicated to increasing of their social activity. The scheme of intake of pharmaceuticals, convenience of therapy, and confidence of patient in effectiveness of action of these pharmaceuticals undoubtedly enhance preservation of social activity of respondents and permit them to focus besides process of treatment, on other spheres of life activity that positively reflects on total level and quality of their life. The carried out medical sociological study demonstrated that intake of nationally manufactured recombinant gene engineering cytokines in oncologic practice permit, at high indices of effectiveness in target group, to preserve physical, social and professional activity of patients.

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