改革下医护人员的适应性实践

IF 0.3 Q4 SOCIOLOGY
L. Temnova, E. G. Bapinaeva
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引用次数: 0

摘要

高现代主义理论和J.Scott的“metis”概念确定了各个领域国家改革失败的原因之一:在准备变革时,往往忽略了当地的实践经验,但整个改革的成功可能恰恰取决于这些知识。该系统忽略了工人对即将到来的变化的抵抗可能的策略,其中许多是无意识的。包括俄罗斯在内的医疗保健领域的改革表明,医生仍然是受变化影响最脆弱的群体。正在进行的改革的一个副作用是,医生专业团体发展了某些适应性做法,旨在适应个人和专业活动损失最小的变化。为了确定医务工作者对改革及其后果的适应性做法,作者检查了现有数据,并采访了各个专业的医生。因此,医生在专业活动中的适应性实践被系统化,并提出了其分类:偏离/非偏离和主动/被动。积极的适应性实践盛行,并在三个子系统中实施:医生管理、医生-医生和医生-患者。大多数医生倾向于接受增加新做法的改变,而不是改变传统做法。所有受访者都积极评价新技术,但消极评价限制他们职业自由的严格标准。适应性做法的发展取决于各种因素——性别、年龄、服务年限、专业化和职位。这种做法有助于医生保持习惯性的职业生活方式,并适应新的工作条件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Adaptive practices of healthcare workers under the reforms
The theory of high modernism and the concept ‘metis’ by J. Scott identify one of the reasons for unsuccessful state reform in various areas: when preparing changes, local practical experience is often neglected, but the success of the reform as a whole may depend exactly on such knowledge. The system ignores the possible strategies of workers’ resistance to the coming changes, many of which are unconscious. The reforms in the field of healthcare, including in Russia, have shown that doctors remain the most vulnerable group affected by changes. A side effect of the ongoing reforms is the development by the professional community of doctors of certain adaptive practices aimed at adaptation to changes with the least losses for the individual and professional activity. To identify the adaptive practices of medical workers in response to the reforms and their consequences, the authors examined the available data and conducted interviews with doctors of various specialties. As a result, adaptive practices of doctors in their professional activities were systematized, and their classification was proposed: deviant/non-deviant and active/passive. Active adaptive practices prevail and are implemented in three subsystems: doctor-administration, doctor-doctor and doctor-patient. Most doctors tend to accept changes that involve adding new practices rather than changes removing traditional practices. All respondents positively assessed new technologies, but negatively assessed rigid standards that limit their professional freedom. The development of adaptive practices depends on various factors - gender, age, length of service, specialization, position. Such practices help doctors to keep the habitual way of professional life and to adapt to new working conditions.
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来源期刊
CiteScore
0.80
自引率
20.00%
发文量
53
审稿时长
12 weeks
期刊介绍: The mission of the Journal is a broad exchange of scientific information, and of the results of theoretical and empirical studies of the researchers from different fields of sociology: history of sociology, sociology of management, political sociology, economic sociology, sociology of culture, etc., philosophy, political science, demography – both in Russia and abroad. The articles of the Journal are grouped under ‘floating’ rubrics (chosen specially to structure the main themes of each issue), with the following rubrics as basic: Theory, Methodology and History of Sociological Research Contemporary Society: The Urgent Issues and Prospects for Development Surveys, Experiments, Case Studies Sociology of Organizations Sociology of Management Sociological Lectures. The titles of the rubrics are generally broadly formulated so that, despite the obvious theoretical focus of most articles (this is the principal distinguishing feature of the Series forming the image of the scientific journal), in each section we can publish articles differing substantially in their area of study and subject matter, conceptual focus, methodological tools of empirical research, the country of origin and disciplinary affiliation.
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