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Всего публикаций в данном разделе: 21

Последние поступления:

Опубликовано на портале: 15-09-2007
Елена Ростиславовна Ярская-Смирнова, О. Григорьева Журнал социологии и социальной антропологии. 2006.  Т. 9. № 1. С. 151-170. 
Статья посвящена анализу способов идентификации народных целителей в условиях современного российского провинциального города и в контексте мировых процессов интеграции медицинских систем. В современных поликультурных обществах данные процессы востребованы плюрализацией жизненных стилей, усложнением спроса и потребления в поле медицинских услуг, различные агенты которого обладают неравным статусом и степенью легитимности. Исходя из данных контент-анализа научно-популярных журналов и качественных интервью, авторы обсуждают противоречивость дискурсивного пространства суждений о народной медицине, приводят комплекс элементов самоидентификации народных целителей, показывая амбивалентность их статуса. Аргументируется прикладное значение этномедицинских исследований в антропологической перспективе.
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Опубликовано на портале: 25-03-2007
Ред.: Jonathan Gabe, David Kelleher, Gareth Williams
London: Routledge, 1994
Modern medicine is a powerful institution. With the help of highly-developed drugs and surgical techniques, it promises to relieve suffering, improve the quality of life and extend the life-span. Conversely, it is expensive for the governments, insurance companies and individuals who pay for it and sometimes appears to be insensitive to the needs of those for whom it provides. And while recent restructuring of health care delivery services has provided medical practitioners with new challenges, there has been very little consideration of the range of pressures that they now face. Challenging Medicine offers a lively appraisal of the current changes to the health service and analyzes their effects on the status and practice of health professionals. It also provides original debate on the challenges posed from within medicine from the nurses, managers, alternative practitioners and self-help groups and beyond to the women's movement and the media.
ресурс содержит графическое изображение (иллюстрацию)

Опубликовано на портале: 23-03-2007
Renee R. Anspach Journal of Health and Social Behavior. 1988.  Vol. 29. No. 4. P. 357-375. 
This paper examines a segment of medical social life that has not been studied extensively: formal presentations of case histories by interns, residents, and fellows. Because they are presented by physicians in training to their status superiors, who are evaluating them, case presentations are exercises in self-presentation which serve as a vehicle for professional socialization. This analysis of the language of case presentation is based on case presentations collected in two intensive care nurseries and an obstetrics and gynecology service. Four features of case presentation are identified: 1) the separation of biological processes from the person (de-personalization); 2) omission of the agent (e.g., use of the passive voice; 3) treating medical technology as the agent; and 4) account markers, such as "states," "reports," and "denies," which emphasize the subjectivity of patients' accounts. The language of case presentation has significant, if unintended, consequences for those who use it. First, some features of case presentation eliminate the element of judgment from medical decisions and mitigate responsibility for medical decision making. Second, some are rhetorical devices which enhance the credibility of the findings that are presented. Third, the language of case presentation minimizes the import of the patient's history and subjective experience. Finally, case histories socialize those who present them to a culture or world view which may contradict the explicit tenets of medical education.
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Опубликовано на портале: 23-03-2007
Michael S. Goldstein Journal of Health and Social Behavior. 1984.  Vol. 25. No. 2. P. 211-229. 
This is a study of physicians in Los Angeles who made the performance of abortions a major or sole component of their practice in the five years (1967-72) subsequent to the legalization of abortion in California. A semistructured interview was used to obtain data on the attitudes, values, and experiences of 42 such physicians. Four distinct career patterns (entrepreneurs, academics, workers, and community physicians) were found. As expected, the physicians tended to be specialists in OB-GYN, concerned about financial rewards, and influenced by past observation of negative consequences of illegal abortions. The major finding is the existence of a subgroup of physicians whose primary identity is businessman or entrepreneur; these fit into the pattern of "outsider entrepreneurs." Elements of this pattern were also found among other types of physicians to varying degrees. There is a need to recognize entrepreneurial elements as part of the conceptualization of physicians and other professionals.
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Опубликовано на портале: 23-03-2007
Catherine Ross, John Mirowsky, Raymond S. Duff Journal of Health and Social Behavior. 1982.  Vol. 23. No. 4. P. 317-329. 
Authors developed and tested a model of client satisfaction with medical care in which sociodemographic characteristics of the physician affect client satisfaction under conditions of unmet expectations and a lack of choice. They hypothesized that in small fee-for-service practices such as solo practice, where the client chooses his or her physician, status characteristics of the doctor would be unrelated to client satisfaction. Conversely, in large prepaid group practices where the client is assigned a physician, nonnormative physician status characteristics would create lower client satisfaction. Because expectations are based on statistical norms, it was hypothesized that clients in large prepaid multispecialty groups would be most satisfied with physicians who fit the norm-middle-aged white males from higher status Protestant or Jewish backgrounds. In a sample of pediatricians and their clients, authors found their hypotheses to be strongly supported, with one modification-the relationship between client satisfaction and the physician's socioeconomic background is parabolic. Furthermore, the negative effect of nonnormative physician religious status on client satisfaction in large prepaid groups is offset by the client-physician match and by experience with the physician.
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Опубликовано на портале: 23-03-2007
Catherine Ross, Raymond S. Duff Journal of Health and Social Behavior. 1982.  Vol. 23. No. 2. P. 119-131. 
Although a number of policy-makers have suggested that previous experiences with medical care affect subsequent use of physician services, few researchers have examined the issue empirically. Authors divide the determinants of revisiting the doctor in pediatric practice into three categories: client characteristics, organizational characteristics, and characteristics of the doctor-client interaction; and we develop a causal model. Although race, income, and education have no direct effects on the frequency of returning to the doctor, they have indirect effects through the organization of health care and experiences within the health care system. Clients who are poorly educated tend to have consistently negative experiences with the health care delivery system. These experiences affect subsequent use of services. Positive experiences with the interpersonal, psychosocial aspects of the doctor-client interaction increase a client's proclivity to return to the doctor, while negative doctor-client interactions decrease the probability of returning to the doctor.
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Опубликовано на портале: 23-03-2007
Joan R. Bloom, Jeffrey C. Alexander Journal of Health and Social Behavior. 1982.  Vol. 23. No. 1. P. 84-95. 
Nursing teams are conceptualized as coordination mechanisms that respond to task interdependence within the hospital unit. The form of coordination is predicted to result from organizational decision makers' conceptions of the work to be performed as well as the more objective characteristics of the work. The effects of these technological variables on coordination are mediated by the size of the unit and the degree of professionalism exhibited by the nursing staff. A path model is constructed and tested using a sample of 146 patient care units from a national sample of 17 hospitals. In general, the results are supportive of the model: both conceptions of a task and task predictability (or known technology) appear to affect coordination through other structural characteristics of the unit. On larger units the nursing team provides a hierarchical control mechanism, whereas teaming in units characterized by greater staff professionalism provide a means of lateral coordination as well as hierarchical control.
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Опубликовано на портале: 23-03-2007
John Germov Sociology of Health and Illness. 2005.  Vol. 27. No. 6. P. 738-758. 
This paper draws on qualitative case-study research to discuss the impact of managerialism on the work organisation of public sector health professionals in Australia. The case studies included 71 semi-structured interviews with a broad range of public sector health professionals (predominantly nursing and allied health professionals, with some doctors and managers). The data are used to examine the implications of managerialism for the organisation of professional (public) bureaucracies. The findings show that while health professionals were able to exert their agency to influence managerial processes, the incorporation of managerial strategies into professional practice placed constraints upon professional autonomy. The impact of managerialism on professional bureaucracies is examined using the neo-Weberian framework of hyper-rationality, an ideal type derived from a combination of four forms of rationality identified in Weber's work: practical, formal, substantive and theoretical rationality. Applied to the social organisation of health-care work, this paper critically examines the utility of the hyper-rationality ideal type, noting its limitations and the insights it provides in conceptualising the impact of managerialism on professional (public) bureaucracies.

Опубликовано на портале: 22-03-2007
Carl May Sociology of Health and Illness. 2006.  Vol. 28. No. 5. P. 513-533. 
Conventional models of 'evidence' for clinical practice focus on the role of randomised controlled clinical trials and systematic reviews as technologies that promote a specific model of rigour and analytic accountability. The assumption that runs through the disciplinary field of health technology assessment (HTA), for example, is that the quantification of evidence about cost and clinical effectiveness is central to rational policy-making and healthcare provision. But what are the conditions in which such knowledge is mediated into decision-making contexts, and how is it understood and used when it gets there? This paper addresses these questions by examining a series of meetings and seminars attended by senior clinical researchers, social care and health service managers in the UK between 1998-2004, and sessions of the House of Commons Health Committee held in 2001 and 2005. These provide contexts in which questions about the value and utility of evidence produced within the frame of HTA were explored in relation to parallel questions about the design, evaluation and implementation of telemedicine and telecare systems. The paper points to the ways that evidence generated in the normative frame of HTA was increasingly seen as one-dimensional and medicalised knowledge that failed to respond to the contingencies of everyday practice in health and social care settings.

Опубликовано на портале: 04-03-2007
Stefan Timmermans Sociology of Health and Illness. 2005.  Vol. 27. No. 7. P. 993-1013. 
Death brokering refers to the activities of medical authorities to render individual deaths culturally meaningful. Social scientists and others agree that mortality provokes existential ambiguity in modern life requiring cultural coping mechanisms. In contemporary Western societies, medical professionals have sequestered the dying in institutions, and have classified the causes of death to explain suspicious death. Over the last decades, the institutionalisation of the dying process has been challenged by social movements and the sudden onset of some deaths while forensic medicine has struggled for professional legitimacy in the borderland between mainstream medicine and the legal system. In this article it is argued that medical death brokering persists in spite of challenges because medical experts offer increasingly flexible cultural scripts to render the end-of-life socially meaningful while accentuating death's existential ambiguity. Medical professionals help create the ambiguity they promise to resolve, reinforcing the cultural need for more expert death brokering.

Опубликовано на портале: 04-03-2007
Susan A. Nancarrow, Alan M. Borthwick Sociology of Health and Illness. 2005.  Vol. 27. No. 7. P. 897-919. 
The healthcare professions have never been static in terms of their own disciplinary boundaries, nor in their role or status in society. Healthcare provision has been defined by changing societal expectations and beliefs, new ways of perceiving health and illness, the introduction of a range of technologies and, more recently, the formal recognition of particular groups through the introduction of education and regulation. It has also been shaped by both inter-professional and profession-state relationships forged over time. A number of factors have converged that place new pressures on workforce boundaries, including an unmet demand for some healthcare services; neo-liberal management philosophies and a greater emphasis on consumer preferences than professional-led services. To date, however, there has been little analysis of the evolution of the workforce as a whole. The discussion of workforce change that has taken place has largely been from the perspective of individual disciplines. Yet the dynamic boundaries of each discipline mean that there is an interrelationship between the components of the workforce that cannot be ignored. The purpose of this paper is to describe four directions in which the existing workforce can change: diversification; specialisation and vertical and horizontal substitution, and to discuss the implications of these changes for the workforce.

Опубликовано на портале: 04-03-2007
Robert E. Clark, Emily E. LaBeff Journal of Health and Social Behavior. 1982.  Vol. 23. No. 4. P. 366-380. 
This research focuses on the strategies used by various professionals in delivering news of death. The lack of well defined, normative guidelines for such deliveries adds to the problematic nature of the interaction. From in-depth interviews with physicians, nurses, law enforcement officers, and clergy, a loose framework based on common themes was generated providing a processual view of death telling. Five distinct strategies of delivery developed within the framework. Discussion of each strategy indicates the significance of situational and occupational factors in delivering news of death. This study, though exploratory in nature, clarifies some of the processes involved in the delivery of bad news, and identifies several important problems surrounding death telling, such as lack of training and preparation among professionals for this role and their dislike for this aspect of their work.
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Опубликовано на портале: 28-11-2006
Renee R. Anspach
USA: University of California Press, 1993
In this powerful and probing look at the reality of everyday choices in neonatal intensive care units, Renée Anspach explores the life-and-death dilemmas that have fueled national debate. Using case studies taken during sixteen months of extensive interviewing and observation, Anspach examines the roles of parents, doctors, nurses, and bioethicists in deciding whether critically ill newborns--be they premature, terminally ill, or severely malformed--should be saved by medical technology, or at least kept alive a little longer.
ресурс содержит гиперссылку на сайт, на котором можно найти дополнительную информацию ресурс содержит графическое изображение (иллюстрацию)

Опубликовано на портале: 28-11-2006
Maureen A. Coombs
New-York: Routledge, 2004, 148 с.
Through observations in three intensive care units, this book draws on the reality of practice to explore how nurses and doctors work in intensive care settings. It examines: the power held by the competing knowledge bases; the roles of the different professions; the decision-making process; the sources of conflict; the need for change. Drawing together sociological theories and clinical practice, Power and Conflict Between Doctors and Nurses explores the role of nurses in delivering contemporary health care. It makes a strong case for interdisciplinary working and is particularly timely when health care policy is challenging work boundaries in health care.
ресурс содержит графическое изображение (иллюстрацию)

Опубликовано на портале: 28-11-2006
Ред.: David Mechanic, Marian Osterweis, Arthur Kleinman
USA: National Academy Press, 1987
Pain--it is the most common complaint presented to physicians. Yet pain is subjective--it cannot be measured directly and is difficult to validate. Evaluating claims based on pain poses major problems for the Social Security Administration (SSA) and other disability insurers. This volume covers the epidemiology and physiology of pain; psychosocial contributions to pain and illness behavior; promising ways of assessing and measuring chronic pain and dysfunction; clinical aspects of prevention, diagnosis, treatment, and rehabilitation; and how the SSA's benefit structure and administrative procedures may affect pain complaints.
ресурс содержит гиперссылку на сайт, на котором можно найти дополнительную информацию ресурс содержит графическое изображение (иллюстрацию)

Опубликовано на портале: 08-09-2006
The author examines the evolution of the practice and the culture of medicine in the United States from the end of the colonial period into the last quarter of the twentieth century. His major concerns are with the development of authority, and the Janus image of professionalization as medicine has gained power, technical expertise, and effective modes of diagnosis and treatment and at the same time seems to be getting further from the patient.
ресурс содержит гиперссылку на сайт, на котором можно найти дополнительную информацию ресурс содержит графическое изображение (иллюстрацию)

Опубликовано на портале: 07-09-2006
Few large institutions have changed as fully and dramatically as the U.S. healthcare system since World War II. Compared to the 1930s, healthcare now incorporates a variety of new technologies, service-delivery arrangements, financing mechanisms, and underlying sets of organizing principles.
This book examines the transformations that have occurred in medical care systems in the San Francisco Bay area since 1945. The authors describe these changes in detail and relate them to both the sociodemographic trends in the Bay Area and to shifts in regulatory systems and policy environments at local, state, and national levels. But this is more than a social history; the authors employ a variety of theoretical perspectives—including strategic management, population ecology, and institutional theory—to examine five types of healthcare organizations through quantitative data analysis and illustrative case studies.
ресурс содержит графическое изображение (иллюстрацию)

Опубликовано на портале: 24-01-2006
Михаил Давидович Розенбаум Социологические исследования. 1993.  № 3. С. 36-40. 
В статье ставится вопрос: каким образом можно наладить контроль за качеством лечения и кому заниматься оценкой работы медиков? Ответ на него автор пытается вывести из результатов опросов, проведенных в 1991 г. в 20 лечебных учреждениях Киева и 20 – Москвы. Приводятся выраженные в баллах суммарные показатели профессиональных качеств, определяющих квалификационную дифференциацию врачей; оценки эффективности труда руководящего медицинского персонала. Сопоставляются уровни квалификации врачей и оплаты их труда (в соотношении с ростом оплаты труда в научной сфере). Автор полагает, что полученный по его методологии материал дает ориентиры при назначении на врачебные и научные должности.
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Опубликовано на портале: 24-06-2005
Валерий Андреевич Мансуров, Олеся Викторовна Юрченко Социологические исследования. 2005.  № 1. С. 66-77. 
Авторы отмечают, что в индустриально развитых странах (включая и Россию) медицинская профессия требует длительной подготовки и высокой квалификации. Теоретико-методологические подходы к исследованию различных сторон профессиональной деятельности врачей в отечественной и западной социологии различаются. В отечественных работах врач традиционно рассматривается как представитель «интеллигенции», преобладает социально-психологический анализ, тогда как в западной социологии врачи изучаются в русле социологии профессий и в управленческом ракурсе. Так, в англо-американской традиции врачи чаще всего рассматриваются как корпоративная группа, которая наравне с государством через профессиональные ассоциации включена в управление отраслью здравоохранения. В России – напротив, она остается подчиненной сильному контролю со стороны государственной бюрократии. В рамках российско-британского проекта "Российские врачи: социальные установки и стратегии адаптации" в 2001 г. авторами проведено сравнительное исследование, которым охвачены Москва, Кировская область и Республика Коми. Разработка анкеты и анализ данных основаны на теоретической базе англо-американской социологии профессий. Выводы исследования: в российской системе здравоохранения продолжает воспроизводиться советская модель управления на основе единоначалия. Отношения администрации лечебных учреждений и руководства Минздрава РФ авторы характеризуют как жесткую иерархию, в которой администрация ЛПУ ничего существенного не может сделать самостоятельно без "ходатайств" перед министерством. Контроль за деятельностью частного врача государственные инстанции осуществляют не менее интенсивно, чем в отношении врача государственной медицины. Зарплата работников государственной системы здравоохранения по-прежнему низкая.
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Опубликовано на портале: 15-10-2004
Роман Николаевич Абрамов
Избранная аннотированная библиография по направлению "социология профессий" включает описание более 40 русскоязычных и англоязычных работ по данному направлению социологического знания, а также по ряду смежных дисциплин. Особый акцент при составлении библиографии делался на работы, не получившие достаточного отражения в российском социологическом дискурсе. В библиографии приводится описание статей и книг следующих авторов: М.Вебер, А.Вебер, Д.Белл, П.Бурдье, Г.Беккер, Т.Веблен, Ч.Р.Миллс, Дж.Гелбрейт, Т.Парсонс, Г.Браверман, П.Уилсон, А.Карр-Саундерс, Р.Коллинз, Е.Фрейдсон, У.Гуд, Е.Гринвуд, а также Г.С.Батыгин, В.И.Ильин, О.В.Крыштановская, В.В.Радаев, П.В.Романов, А.Ю.Согомонов и другие. Уникальность библиографии заключается в отсутствии аналогичных ресурсов на русском языке.
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