Social medicine in social work--a key for improving health-related social work

The relation between social work and social medicine is the subject of this article. Social work is an independent discipline creating its own knowledge in scientific cooperation with other disciplines. Social Medicine is outlined with its special features as a field and as a medical discipline. The traditional relation between social work and the discipline of Social Medicine operates side by side. Since Social Medicine and social work refer to each other, new perspectives for the development of health-related social work arise. Social Medicine appeared in social work can help in elaborating a sociogenetic model of understanding health and illness as well as the development of sociotherapy in social work. Health-related social work will gain more significance in the treatment of health-related and disease-related questions.     

Working process in health and nursing at a neonatal ICU

This paper aims to analyze the work process at a university hospital neonatal ICU in Cuiabá-MT. The data were collected through participant observation and documents. The results showed that concerning collective work, the main aim is diagnosis and therapy, with the medical act as its central nucleus, since this professional detains the work rationality. Situations of complementarity and interdependence were observed in the team's work, with moments of negotiation among nursing agents and physicians. The technological work organization at the neonatal ICU still shows in its daily life the images of a routine and technical work, marked by the preterm weak body appropriation, which characterizes the biologist and cure model of care.     

甘肃省城市社区卫生服务中心业务用房调查分析

目的了解甘肃省城市社区卫生服务中心业务用房基本现状,为科学合理地配置甘肃省卫生资源提供决策依据。方法采用统一问卷,调查分析甘肃省98个城市社区卫生服务中心业务用房基本情况。结果甘肃省57.14%的市（州）社区卫生服务中心业务用房平均面积不足,全省城市社区卫生机构业务用房配置不平衡。结论建议加大对城市社区卫生机构的财政投入和政策支持,将其业务用房纳入城市建设发展规划,国家对西部城市社区卫生机构基础设施建设给予一定倾斜政策。     

Theoretical and conceptual considerations about the work in sanitary surveillance, as a specific field of the work in health

This paper discusses some of the theoretical-conceptual presupposes to the analysis of the work in sanitary surveillance in a social and historical perspective. As a work in health, the sanitary surveillance presents particularities that are inherent to the elements that are part of its process of work. These elements are inserted in the space of the production-consumption relationships, under the regulatory action of the State. The problematic of the work in sanitary surveillance occurs due to the specificities of its objects. It is identified in these objects a double dimension, at the same time as a "way of life" and "commodity". This confers to its working process a provisory and historical character, permeated by contradictions. The technical and social division of the work determines the organization of the working process in its "technical-scientific" and "political-administrative" organization, taking in account the necessity to guarantee the integrality in the actions of the health protection. It is expected that the sanitary surveillance should be organized and acting in several phases of the productive chain. It is identified and discussed the concepts of inter-dependence and inter-complementary as the principles to build the practices of sanitary control.     

健康素养的进展、挑战及展望

本文阐释了健康素养的概念、涵义、意义及健康素养的影响因素和评估方法,对国内外健康素养的研究和工作进展情况进行了介绍,提出了我国健康素养工作面临的挑战和今后开展健康素养工作的建议,希望能够为今后的健康素养工作提供参考。     

Autonomy and work in medicine

We discuss autonomy in medical work as resulting from two basic moments: as social work consuming and producing goods and services, reproducing the dominant mode of production and its ethical foundations; and as a service in which autonomy, limited as social work, expresses some attributes acquired by medical work (technical independence and self-regulation) as a result of the monopoly in the use of science to deal with individually perceived health-related needs. These moments are expressed in the doctor-patient relationship, which makes uncertainties surrounding that relationship more evident. From this understanding about medical work and its autonomous condition, we discuss some theoretical concepts related to the study of labor and/or services in contemporary society and which provide us with an epistemological basis for more adequate approaches to scientific research concerning that object.     

不同职业人群的工作能力及其影响因素

目的 研究不同职业人群的工作能力及其影响因素。方法 采用芬兰赫尔辛基职业卫生研究所研制的工作能力指数（work ability index,WAI)表，对4种职业人群（营业员、公务员、化工操作员、电业人员）4883名职业人员进行了调查，用协方差分析方法研究不同职业、背景因素对工作能力的影响。结果 不同职业人群的工作能力不同。性别、年龄、婚姻状况、文化程度、体育锻炼、业余爱好及经济收入等7种背景因素中，年龄、体育锻炼和经济收入对工作能力有明显的影响。结论 由于不同职业人群的工作制度、工作环境和健康干预措施以及个人背景因素的不同，导致工作能力存在差异。     

四川省二类经济区县级公立医院医生工作满意度调查

目的 探讨在县级公立医院改革背景下,四川省二类经济区县级公立医院医生的工作满意度及影响因素,为提升医生工作满意度提供参考。方法 采用随机抽样的方法对四川省二类经济区县级公立医院医生进行问卷调查,问卷内容包括个人基本信息及工作待遇与报酬、人身安全、社会认可、工作成就、工作环境、组织管理、领导认同与支持、工作压力等满意度的8个维度。采用t检验和方差分析来研究医生工作满意度及影响因素。结果 回收有效问卷337份。医生总满意度评分为3.05。各维度中,人身安全维度的得分均值最低（2.21）,不满意率最高（75.7%）;其次是工作压力,得分均值为2.53,不满意率为54.0%;对领导认同与支持维度的评分最高（3.64）,满意率也最高（92.3%）。结论 新医改以来发布的与县级公立医院改革相关的政策取得了一定成效,但目前医生的总满意度水平依然较低。建议采取具有针对性的有效措施,建立综合、科学的管理机制,提高工作待遇与报酬,降低医生执业风险,将工作压力维持在适度水平。     

The politics of interprofessional working and the struggle for professional autonomy in nursing

This study of interprofessional work relations in a Canadian mental health team examines how nursing deployed different forms of power in order to alter the mental health division of labour, to gain administrative, organizational and content control over its own work, expand its jurisdictional boundaries by expropriating the work of other professionals, and exclude others from encroaching on its old and newly acquired jurisdictions. This is set against the context of nursing's long-standing professional project to consolidate and expand its professional jurisdiction. Using an ethnographic study of a single interprofessional mental health team in a psychiatric hospital in Canada, the paper attempts to understand the politics and paradoxes involved in realizing nursing's professional project and how the politics of professional autonomy and professional dominance are actually conducted through micro-political struggles. The data demonstrates the effects of the political struggles at the organizational and work process levels, particularly in the forms of collaboration that result. Nurses gained substantial autonomy from medical domination and secured practical dominion over the work of non-medical professionals. New forms of interprofessional collaboration were accomplished through both simultaneous and sequential micro-political struggles with psychiatrists and non-medical professionals, and the formation of political alliances and informal agreements. Nursing solidarity at the elite level and substantial effort by the elite nurses and their committed colleagues to mobilize their less enthused members were fundamental to their success. The nurses deployed political (power) strategies and tactics to organize and reorganize themselves and other professionals on multiple levels (politically, organizationally, ideologically, socially and culturally). This study reveals the complexity and robustness of micro-political dynamics in the constitution of professional and collaborative interprofessional work relations.     

Pain: its experience and treatments

Recent sociological research about pain, in particular chronic pain, is part of a broader current of sociological inquiry into the problems raised by chronic illnesses. This inquiry is organized around two major axes: the relationship between chronic illnesses and medical work and the patient's experience of chronic illness. The first two parts of this article examine the place of research on pain in, and its contribution to, the sociological literature. The third part, based on personal field work, indicates how reflection on chronic pain and its medical treatments helps an understanding of the relationship between medical work and subject experience; and paths of possible research are pointed out.     

Medial epicondylitis in occupational settings: prevalence, incidence and associated risk factors

Because medial epicondylitis has not been studied alone, we investigated its links between personal and occupational factors in repetitive work and its course. A total of 1757 workers were examined by an occupational health physician in 1993-1994. Five hundred ninety-eight of them were reexamined 3 years later. Prevalence was between 4% and 5%, with an annual incidence estimate at 1.5%. Forceful work was a risk factor (odds ratio [OR], 1.95; confidence interval [CI] = 1.15-3.32), but not exposure to repetitive work (OR, 1.11; CI = 0.59-2.10). Workers with medial epicondylitis had a significantly higher prevalence of other work-related upper-limb musculoskeletal disorders (WRMD). Risk factors differed for medial and lateral epicondylitis. The prognosis for medial epicondylitis in this population was good with a 3-year recovery rate at 81%. Medial epicondylitis was clearly associated with forceful work and other upper-limb WRMD, and its prognosis was good.     

ICU护士工作压力现状及其影响因素

目的了解ICU护士工作压力现状及其影响因素,为减轻ICU护士工作压力提供科学依据。方法 2013年10月,对唐山市工人医院13个重症监护室的204名护士进行问卷调查。结果护士工作轻度压力41人,占20.1%;中度压力144人,占70.6%;重度压力19人,占9.3%。多元回归分析发现,ICU护士工作压力受医院待遇满意度、对工作环境满意度、社会支持和患者病情的影响（P〈0.05）。结论 ICU护士工作压力呈中度水平,应引起高度重视。     

Tacit knowledge

Information that is not made explicit is nonetheless embedded in most of our standard procedures. In its simplest form, embedded information may take the form of prior knowledge held by the researcher and presumed to be agreed to by consumers of the research product. More interesting are the settings in which the prior information is held unconsciously by both researcher and reader, or when the very form of an “effective procedure” incorporates its creator’s (unspoken) understanding of a problem. While it may not be productive to exhaustively detail the embedded or tacit knowledge that manifests itself in creative scientific work, at least at the beginning, we may want to routinize methods for extracting and documenting the ways of thinking that make “experts” expert. We should not back away from both expecting and respecting the tacit knowledge the pervades our work and the work of others.     

The key to the growth of social work in Broadmoor

Social work is a relatively new discipline at Broadmoor. Author examines the role of social work in special hospitals and contends that its intervention with patients is influenced not only by the limitation of the institutions but also by the need to educate outside agencies about the special problems involved.     

The proper contributions of social workers in health practice

Current and potential future contributions of social workers to health practice are considered at the three levels of direct service to patients, influence on the processes and procedures of the health setting and influence on its future planning and service development. The capacity of U.S.A. and U.K. social work to contribute at these levels is compared in the light of their contrasting relationships to the health system. U.S.A. social work in health care is practised as employees of the health setting or as private practitioners and contains the majority of U.S.A. social workers. It remains a specialism that sustains a major body of published work, commitment to knowledge-building, standard setting and performance review, and a psycho-social orientation shared by a growing number of medical and nursing professionals. Its approach to the health system is that of the pursuit of professional credibility in the secondary setting by adopting the professional-technical practice model of the clinician. U.K. social work since the early 1970s has been committed to generic education and practice and to the development of its own primary setting in social services departments which now employ almost all U.K. social workers. Area team social work in these departments, typified by statutory work with the most deprived sections of the population, has become the dominant culture of British social work, with implications for the occupational identity and career prospects of those social workers who are outposted or attached to health settings but no longer employed by them. British social work and its management now approach the health system from a position of organizational independence which should strengthen their capacity to influence the health system. The cultural differences between social work and medicine, however, are experienced more keenly than ever as many social workers adopt a socio-political practice model that is at odds with the professional-technical model of the clinician. Provision of social work services to the health system has become a questionable priority and raises the issue of whether much of what is now termed "health care' could more appropriately be termed "social care' and provided in a primary social work setting to which medicine and nursing would make their "proper contributions'.     

Professional project for wound healing clinicians

This article explores the professional project for an emergent subaltern specialist community of wound healing clinicians. Drawing on the literature on professions and boundary work, it examines how wound healing clinicians challenge the perception of their work as ‘dirty’ and seek its transformation into a specialism of ‘woundology’. The article is based on an ethnography of a UK multidisciplinary team of doctors and nurses with an interest and expertise in wound healing, who work as clinical academics and provide wound care services in outpatient clinics. It demonstrates that wound healing clinicians vindicate their professional status by seeking to enthral the medical community in ‘dirty wound care’ as a focused clinical specialty of ‘woundology’. Through training nurses to do medical wound care work, educating clinicians from other specialties about wounds and undertaking wound research, wound healing clinicians assert the professional boundaries of their specialism and its fit with mainstream medicine without embellishing the dirty aspects of their work.     

上海市继续医学教育调查及对策研究

１９９９年随机抽取上海市三级、二级、一级医院各１０年,开展了继续医学教育的现况调查,找出了存在的主要问题,提出了医学教育的发展方向：（１）继续医学教育培训还需加强管理和规范;（２）继续医学教育还需注重实效,（３）继续医学教育应注意完善学分制。     

The Future of Work - Trends, Options, Problems

Work - its availability, quality and conditions - is a majordeterminant of psychic and somatic health. Health in turn isa prominent social good that tends to be unequally distributedin the population in function of its accessibility and the conditionsof its social production. Its evolution depends, among otherthings, on the evolution of work. This sketch starts with ashort recall of some aspects of our socio-economic system'smeso- and macrohistory, distinguishes three models of macro-economicorganization that coexist unequally in present-day industrializedcountries, and finally zooms in on some aspects of work organizationand worker qualification. Although it focuses on work and someof its economic conditions, its approach will be mainly sociological.     

Comprehensive assessment of the work of physicians of the therapeutics profile

A system for comprehensive evaluation of the work of hospital therapists, based on the qualimetric principles and methods, is presented. Comparative quantitative analysis of data characterizing the physical activity of a physician and the normative standard parameters are used. The work is evaluated by its chief characteristics: quantity, complexity, and quality. Other signs of labor, significant for its type and results, are taken into consideration. The system is relatively easy to use and optimizes the management of labor.     

Sentimental work in the technologized hospital

Abstract Sentiment is frequently involved in work either to get work done efficiently or because of humanistic considerations. This paper explores several questions: Are there different kinds of sentimental work? How is sentimental work carried out? When and where is it done; when not? Who does it? What is its relation to other types of work? When is it likely to be in focus for the workers? When is it visible, when invisible and to whom? What are its consequences: for work, staff, client and organization? The illustrative materials used in this paper are taken from research on the impact of technology on medical work in hospitals.