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Vol 20, No 2 (2021)

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Values of medical leaders in perspective of value-oriented approach

Zuenkova Y.A., Kicha D.I.


BACKGROUND: Modern healthcare is based on a value approach and focuses on improving results that are important to patients. The successful implementation of pilot projects at hospitals depends on the motivation of medical stuff and endorse values of the entire team, their readiness to implement management innovations. Team management skills is an important competence of a leader and should be based unique values.

AIMS: to investigate doctors’ understanding of the value-based approach and their attitude to the concept for the subsequent development of educational programs and methodological approaches to the management of employees in order to implement value-oriented healthcare programs.

MATERIALS AND METHODS: A content analysis of publications of the understanding of the term “value” was carried out and key ideas were identified. The author’s questionnaire contained twenty closed questions with simple and ordered nominal scales. The survey included managers with more than 5 years of experience, involved in managerial and clinical practice. 69 specialists from Moscow and the Moscow region, working in public or private hospitals took part in the study.

RESULTS. There is a need to develop additional professional education programs on the topic of value-based healthcare — 84% (n=58) of doctors need it. According to medical managers, the main values for the patient are the availability of medical care, its quality and the responsible attitude of medical personnel to their duties. 95.6% (n=66) of doctors consider important to create values (decent pay for the work, respect for patients, the possibility of professional self-improvement) not only for patients, but also for medical personnel. The values of a clinician and a doctor-manager may not coincide. The problem of the discrepancy between the effectiveness and quality of treatment is felt by 84% (n=58) of respondents. The patient’s subjective assessment should not serve as the only guideline for creating the value of his treatment. It is important to train doctors in the formation of patients’ adherence to treatment and the factors that determine it — joint discussion of treatment options, medical technologies convenient for the patient.

CONCLUSION. The new and important aspects of the doctors’s values and their attitude to the value-oriented approach were identified as well as their attitide to the problems of effectiveness and quality of treatment, patient experience indicators, the role of independent assessment of the quality of medical services, ways and means of achieving patient adherence to treatment, barriers to the implementation of this approach in practical healthcare. In order to identify the profile of potential project leaders, a semantic differential describing key personality parameters is proposed. Orientation to the values of the patient is impossible without taking into account the value system of other participants. Understanding the system of values and expectations of a doctors, their attitude to new ideas, is important in the implementation of a new value-oriented approach and avoids value conflicts.

Sociology of Medicine. 2021;20(2):5-20
pages 5-20 views

Medical personnel potential of the regional healthcare system: risks and development opportunities

Eremina M.G., Kovalev E.P., Krom I.L., Erugina M.V., Lipchanskaya T.P.


The current period of development of the Russian healthcare system is characterized as a crisis, which is primarily due to the personnel imbalance. The authors, on the basis of a medical and statistical study of the staffing of medical organizations in the Saratov region, revealed the presence of structural imbalances: both between the actual population of the region and the staffing of the healthcare system with medical personnel in general, and between the indicators that characterize the staffing of organizations providing primary healthcare and specialized medical care with medical personnel. In regional healthcare, with a general shortage of medical personnel in the state health system (-986 doctors), there is a particularly pronounced shortage of polyclinic doctors (-986 doctors, mostly district pediatricians and internists), with a slight surplus of doctors in inpatient medical organizations (+91 people). The personnel shortage in the primary health care system determines a decrease in the level of its availability and quality and is a key risk factor for the reputational losses of the regional health care system.

Sociology of Medicine. 2021;20(2):21-25
pages 21-25 views


Pediatric oncology: diagnosis as stigma in parents’ opinion

Gevandova M.G.


The problem of pediatric oncology is central to the structure of the problems of world clinical medicine, while the improvement of oncological care for children at the present stage is associated not only with early diagnosis, successes in the treatment of oncopathologies of different etiologies, the introduction and dissemination of high-tech medical care, the expansion of rehabilitation measures – but also with the development of accounting systems (oncology registers), the growth of research aimed at identifying cancer risk factors in the child population, as well as the role of social agents (family, social environment, school, etc.) in maintaining social activity and overcoming the stigma of children suffering from cancer at the stage of detection, therapy and rehabilitation.

The author, based on the results of a medical and sociological survey of parents of children with an oncological diagnosis, notes the prevalence of negatively labeling images of the disease in the structure of respondents’ associative ideas about the problem of pediatric oncology. Taking into account that the diagnosis of the child often acts as a trigger and predictor of the formation of self-stigma practices in parents, the author points out the need to improve measures of psychological and social support for parents of cancer children, as well as to expand the vectors of information work with the population to increase tolerance to children with oncopathology and their families.

Sociology of Medicine. 2021;20(2):27-35
pages 27-35 views

Aspects of the quality of life of military pensioners, defining their resocialization

Agapova E.G., Dubogray E.V.


The article examines the main indicators of the quality of life of military pensioners and their relationship with re-socialization after retirement. The results of a medico-sociological study, using the questionnaire method (n=413), using the standard SF-36 questionnaire who were dismissed from military service no more than five years ago. Military retirees with high rates of the physical component (according to the SF-36 scales) receive less information from doctors about vaccinations and other preventive measures, so it is necessary to optimize this work with them. The size of the scale of vital activity was significantly influenced by the fact of employment, living conditions, and financial satisfaction.

In this regard, it is advisable to develop medical and social programs in three main areas: optimization of treatment and prophylactic measures (talks about the need to quit smoking, timely vaccination, the presence of moderate regular physical activity, improvement of medical care); development of employment assistance programs (expansion of the list of retraining courses in specialties in demand in the region, presentation in the media of the image of a military pensioner as a promising employee); functioning of psychological support rooms for those dismissed from military service.

Sociology of Medicine. 2021;20(2):37-42
pages 37-42 views

Formation of family health through the implementation of priority functions of the population

Pogodina V.A., Polovnikova A.V.


The physical condition, the factors of the population’s existence, model the well-being of the basic cell of society, where its members perform certain roles.

OBJECTIVE: To study the process of forming family health through the implementation of priority functions of the population in a developing society.

METHODS: We studied the data of statistical accounting forms on the physiometric indicators of persons aged 5–70 years, questionnaires of the contingent from 18 to 70 years of the city of Novosibirsk. Theoretical reflection, qualitative content analysis, and interdisciplinary methods (assessment of physical condition, Student’s criterion, Pearson’s χ2, comparative analysis of the point of view of the 18–70-year-old population about the priority of activity) are used to create an algorithm of actions.

RESULTS: The main roles were developed taking into account the anatomical and value characteristics of respondents aged 5–70 years. The main, important functions, the increased degree of their execution are established. The younger (from 18 to 29 years) the adult population, the need for reproductive and sexual opportunities is higher (36.4–42.6%). In persons aged 30–44 and 45–59, respectively, only educational and educational activities (46.8-56.4%) and household activities (38.0–38.9%) were highly significant. Psychoemotional (37.0%) and economic (35.7%) functions were performed by the population aged 60–70. Models were created through an increased degree of performance of the roles of respondents from 18 to 70 years old. For a contingent of 18–44 years old, a well-maintained life is necessary. The older (45–59 years) and older (60–70 years) generations are not dependent on the comfort of housing. At the same time, respondents from 18 to 70 years of age require the absence of harmful working conditions. At the same time, a balanced, irrational diet was observed in individuals aged 18–29 and 30–59, respectively. Whereas, for the contingent over 60 years old, the presence/ absence of rationality in the composition of dishes is not important.

CONCLUSIONS: The population, through its age-related priority functions, interacts with social institutions (health care system, economy-production, education), forms the health of the family, strengthens the national security of the country in the situation of modernization of medical structures.

Sociology of Medicine. 2021;20(2):43-54
pages 43-54 views


Sport in the life of students of medical universities in Russia

Reshetnikov A.V., Prisyazhnaya N.V., Reshetnikov V.A., Mikhailovsky V.V.


Sport is an integral part of a healthy lifestyle and has a direct and indirect impact on the quality of life of the population. The authors, within the framework of a sociological survey, consider the features of the ideas and motivational attitudes of students of eight Russian medical universities that determine their commitment to sports and identify a number of factors that affect the involvement of respondents in sports life at the stage of higher education. According to the survey results, respondents changed the structure of their sports activity downward after entering a medical university, which is primarily due to a high level of academic load, lack of finances and a decrease in motivation to play sports. There is a contradiction: medical students have knowledge about the role of sports in preserving health — however, they record a low level of their personal involvement in sports. However, the “saving” of time due to the reduction / refusal of respondents from sports and the priority of the vector of efforts formed in the study group to obtain professional knowledge, skills and abilities to provide highly qualified assistance to the population (even taking into account the risks to their own health), in the opinion of the authors, indirectly confirms the preservation of the altruistic component of medical activity and the readiness of medical university students to the special requirements and risks of the chosen profession.

Sociology of Medicine. 2021;20(2):55-63
pages 55-63 views


The use of digital devices as a risk factor for the health of schoolchildren and students: literature review

Ivanova L.Y.


The review reflects the research of specialists in the field of hygiene on the problem of the impact of the use of digital devices on the health of schoolchildren and students (the research used the survey method and medical methods). The relevance of the topic is determined by the fact that, firstly, the child and adolescent population and young people have become active users of TS, and secondly, the emerging body of adolescents and especially children is more susceptible to external negative influences. Another important reason is the intensification and digitalization of the educational process. The review presents works that study: 1) the impact of the use of CU by students on their well-being and the appearance of complaints (from the side of vision, musculoskeletal system, nervous system, etc.) and on their morbidity; 2) the knowledge of students about hygiene recommendations and their assessment of the health risks of uncontrolled use of CU; 3) the prevalence of the use of CU that creates health risks. Statistically significant links were found between the increase in the duration of the use of CU and the appearance of various complaints about the state of health in schoolchildren and students. The risks to health are shown with frequent use of various data centers. It is noted that there is a need for state measures aimed at preserving the health of students in the digital environment and the participation of all socialization institutions in the formation of healthy lifestyle skills and the safe use of TSU in the younger generation. The review may be of interest to specialists in the field of health sociology.

Sociology of Medicine. 2021;20(2):65-74
pages 65-74 views


Poetry of sociology. 85 years are executed to honored professor of Moscow state University, doctor of philosophical sciences, professor Antonov Anatoly Ivanovich

Lebed O.L., Prisyazhnaya N.V.


The article is dedicated to the anniversary of the leading specialist in the field of family sociology and demography, Doctor of Philosophy, Honored Professor, Head of the Department of Family Sociology and Demography of the Federal State Budgetary Educational Institution of Higher Education “Moscow State University named after M.V. Lomonosov “Anatoly Ivanovich Antonov. The long-term, active scientific and educational work of A.I. Antonov led to the emergence of a whole scientific direction in the field of family sociology — familism (pro-family sociology). The authors note that the teaching, organizing and research work of Anatoly Ivanovich served to strengthen the position of the sociology of the family in science and the socio-demographic policy of the country, and is also an inspiring example for the professional formation of domestic and foreign sociologists.

Sociology of Medicine. 2021;20(2):75-82
pages 75-82 views

Medical law as the basis for the formation of legal medicine

Pavlova Y.V., Pospelova S.I.


The article is devoted to the results of the section “Medical law as the basis for the formation of legal medicine”, which was organized within the framework of the XII All-Russian conference with international participation “Week of medical education” on the initiative of the academician of the Russian Academy of Sciences, Doctor of Medical Sciences, Doctor of Social Sciences, Professor, Director of the Institute of Social Sciences of the Sechenov University Andrei Veniaminovich Reshetnikov. A summary of the reports of the participants is presented, the role and place of medical law in the modern healthcare system of Russia is determined.

Sociology of Medicine. 2021;20(2):83-86
pages 83-86 views

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