基于先天性心脏病患儿家庭需求的医务社会工作困境及对策  

Medical Social Work Dilemmas and Countermeasures Based on the Demand of Families of Patients with Congenital Heart Disease

作　　者：戴遥 万子瑾 周红萍 李筠[2] 陶红兵[1] Dai Yao;Wan Zijin;Zhou Hongping;Tao Hongbing(School of Medicine and Health Management,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei,430030,China)

机构地区：[1]华中科技大学同济医学院医药卫生管理学院,湖北武汉430030 [2]武汉亚洲心脏病医院,湖北武汉430030

出　　处：《中国医院管理》2022年第12期77-81,共5页Chinese Hospital Management

摘　　要：目的应用扎根理论的方法,从供方视角分析先天性心脏病患儿家庭社会心理服务需求驱动下医务社会工作现状,探讨现存于内外部环境下的医务社会工作困境,并提出相应对策。方法于2019年12月—2020年2月采取目的抽样方法对武汉市某心脏病专科医院社会工作部、先心病区护理部和行政管理部门共13名人员进行半结构式访谈,借助扎根理论研究方法对相关主体访谈记录和政策文本资料进行编码、分析和整合。结果经开放式编码、主轴编码及选择性编码,最终梳理出与医务社会工作相关的91个概念、19个范畴、4个主范畴和1个核心范畴,形成社会心理服务需求驱动下医务社会工作障碍关系模型。结论医务社会工作存在需求认知型困境、素质能力型困境、交互衔接型困境和管理保障型困境的4个核心困境。基于整合型医疗服务视角提出提高需求认知、强化人才队伍、促进整合协调合作、健全制度和支持保障等多角度对策。Objective Based on Grounded Theory,it analyzes the current situation of medical social work driven by family social psychological service demand for children with congenital heart disease from the perspective of the supplier,discusses the dilemmas and corresponding countermeasures of medical social work under the existing internal and external environment.Methods From December 2019 to February 2020,objective sampling was adopted to conduct semi-structured interviews with 13 staff and management personnel in the Department of Social Work,the Department of Nursing in the Congenital Heart Disease area and the Administrative department of a heart hospital in Wuhan.The interview records and policy text data of relevant subjects were coded,analyzed and integrated with the method of grounded theory.Results Through open coding,spindle coding and selective coding,91 concepts,19 categories,4 main categories and 1 core category related to medical social work are finally sorted out,forming the relationship model of medical social work barriers driven by social psychological service demand.Conclusion There are four core dilemmas in medical social work:the dilemma of demand cognition,the dilemma of quality and competence,the dilemma of interaction and articulation,and the dilemma of management and guarantee.Based on the perspective of integrated medical services,multi-faceted countermeasures such as improving demand cognition,strengthening the talent team,promoting integration and coordination,and improving the system and support guarantee are proposed.

关 键 词：先天性心脏病 家庭需求 医务社会工作 扎根理论 

分 类 号：R197.323.2[医药卫生—卫生事业管理]