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Vol 19, No 1 (2020)

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Articles
Russian adaptation of “questionnaire for doctors and nurses’ views on people living with HIV/AIDS” and “comprehensive health staff questionnaire (for sentinel surveillance)” for russian-speaking medical professionals
Suturina L.V., Kuzmin M.Y., Markova D.P., Atalyan A.V.
Abstract

This study presents a step-by-step Russian adaptation of the “Questionnaire for doctors and nurses’ views on people living with HIV/AIDS” and “Comprehensive Health Staff Questionnaire (for sentinel surveillance)” for Russian-speaking audience of medical professionals. Based on the analysis of foreign and domestic studies, it is concluded that no specialized questionnaires on the stigmatization of people living with HIV (PLHIV) for health professionals are available. A sample of 250 medical workers of different levels (doctors and nurses) of Eastern Siberia is used for the step-by-step adaptation of questionnaires indicating the procedures for the compliance with the content validity, criteria validity, reliability, and reproducibility. Overall, the findings of this study indicate that the level of reliability of the Russian language version of the “Questionnaire for doctors and nurses’ views on people living with HIV/ AIDS” is sufficient: Cronbach’s alpha for this questionnaire was 0.72, and that of the “Comprehensive Health Staff Questionnaire (for sentinel surveillance)” was 0,77. At the same time, the high criteria validity of both questionnaires was established based on the correlation of the obtained questionnaire results. Therefore, these questionnaires can be used to evaluate the level of stigmatization of PLHIV among health professionals.

Sociology of Medicine. 2020;19(1):4-10
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Prospects for the realization of reproductive installations of russian families in 2021–2025 based on the data from the sociological-demographic research
Antonov A.I., Karpova V.M., Lyalikova S.V., Lebed’ O.L.
Abstract

The article shows the characteristics of the changes in demographic structures and processes, as reflected in various configurations of sex and age pyramids, changing under the influence of a wide range of factors. The current trends in reproductive behavior are being considered. Based on the data from the sociological and demographic study (SeDOJ-2019), an analysis was conducted concerning the pregnancy history of women who participated in the survey, the probabilities of the reproductive events were investigated depending on the socio-demographic characteristics of the respondents in situations of reproductive choice, and the role of the reproductive attitudes in the context of reproductive behavior was determined. Furthermore, the results show that the use of contraception before pregnancy is not an unconditional indication for an induced abortion but only reduces the likelihood of having a baby. The presence of the interconnections between the level of need for children and the number of socio-demographic parameters (gender, age, education, number of children in the parental family, age of birth of the firstborn, etc.) is recorded, which can be used as reference in the establishment of the family-demographic policy, to effectively improve, with proper stimulation, the effectiveness in the realization of reproductive potential.

Sociology of Medicine. 2020;19(1):11-17
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Social capital as a factor of children’s and adolescent’s healthy lifestyle formation
Lebedeva-Nesevria N.A., Eliseeva S.Y.
Abstract

The family social capital is determined based on social control (the presence of intra-family norms and sanctions), social involvement (based on intra-family ties), and social support (based on trust) and plays a significant role in the family’s socio-psychological climate and minimizing the risks of deviant behaviors of the younger generation. The hypothesis on the positive impact of the inclusion of relatives in the care of children up to 14 years (“social support”) into children’s healthy lifestyle formation is tested on the materials of the 27th wave of The Russian Longitudinal Monitoring Survey–Higher School of Economics (2018, n = 1941). Furthermore, it is shown that the relatives’ social support has a positive effect on preschool-age children’s physical activity as well as school children’s compliance with the rules of balanced nutrition and the use of vitamins.

Sociology of Medicine. 2020;19(1):18-24
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Studying the nature of social orphanhood in correlation with status characteristics and personal health
Reshetnikov A.V., Prisyazhnaya N.V.
Abstract

Health is an integral characteristic of a person’s quality of life, a primary indicator of their social and familial well-being. The opposite is also true: one’s social and familial status and the main aspects of their daily activities can affect their health. When one grows up in conditions of extra-family education, a special habitus is formed among graduates of orphanages, with experiences of negative family life or none at all, adverse models of relationships and social attitudes, as well as distorted ideas about social, professional, and family self-realization.

Sociology of Medicine. 2020;19(1):25-31
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The role of the family in developing attitudes toward health and the home environment
Zhuravleva I.V., Lakomova N.V.
Abstract

The current study analyzes the role of the family as social institution in the process of forming adolescent attitudes to health and the home environment. The relevance of this topic is related to the need for society to significantly improve the health of adolescents. Two parameters pertain: the socioeconomic status of the parents and the type of family. The empirical basis for the analysis was mainly the result of two cohort studies, called “Adolescent Health and the Environment,” conducted by the Institute of sociology of the Russian Academy of Sciences, that used a single methodology in 1996 and in 2017. Research has shown that increasing the socioeconomic status and level of education of parents has a positive impact on the share of adolescents who care about their health, the environment, and on their level of concern for serious international problems. But the socioeconomic parameters of parents are insignificant when teenagers choose motives and factors of health care. The type of family with whom the adolescent lives and the number of children in the family does not affect the self-assessment of the adolescent’s health, the choice of factors and motives for health care, or concern for environmental problems. Comparing the results of two studies, conducted 20 years apart, under a single program sponsorship, shows a small number of changes associated with the formation of adolescent attitudes to health and the environment within the family. This process in the family occurs spontaneously, with much depending on the cultural and educational level of the parents. Such stability could be considered positive if it were not for the progressive deterioration of adolescent health recorded by statistics. The main differences between the two studies in the time context recorded were, first, a significant increase in the response rate of respondents with a “good” health self-assessment, which is associated with changes in social norms in the field of health. Second, with the violation of habitual dependence — the higher the social status and higher parent level of education — the better the children’s self-assessment of their health. This can be explained by the decline in the economic status of specialists with higher education in recent years, as well as the leveling of the General level of health culture in all status groups of society. In addition, the results indicate an increased environmental culture of behavior among adolescents over the decades.

Sociology of Medicine. 2020;19(1):32-42
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Optimization of the quality of life of patients who need palliative care introduction
Ertel L.A.
Abstract

People suffering from chronic progressive diseases of non-infectious and infectious nature need palliative care. When a condition with an unfavorable prognosis occurs, an integrated approach is required, which involves patient care in the medical, psychological, social, and spiritual aspects. This assistance is aimed at improving the quality of life of such patients and implemented in Russia as part of the provision of palliative care, which aims to improve the quality of life of not only the patient himself but also his family members. This study aims to examine the impact of legal regulation of palliative care as well as the medical, psychological, social, and spiritual aspects of palliative care on the quality of life and needs of the patients and their families. Using content analysis and documentary observation, the results regarding the impact of legal, medical, psychological, social, and spiritual aspects combined in the provision of palliative care on the quality of life of patients in need were examined. The study revealed gaps in the legal regulation of the provision of palliative care for patients, particularly HIV-infected patients and those with chronic tuberculosis. As part of optimizing the provision of palliative care, creating a vertically integrated information system for palliative care (VIMIS Palliative) is necessary. To improve the professional stability of medical staff groups providing palliative care and preventing suicidal behavior among patients, health care organizers should improve the mechanisms of psychological interaction among all the participants in the palliative care system. Organizational and methodological approaches in administering anesthesia must be improved, and the knowledge of medical workers on the theoretical foundations of the formation of pain syndromes and the modern methodology for analgesic treatment is required. The organization of the state system of the artificial ventilation of the lungs at home is required with the aim of long-term respiratory support for patients in need. Additionally, further research is needed to determine the impact of nutritional support as a supportive therapy on the course of treatment and the results of palliative care, allowing to optimize the quality of life of patients in need. Optimization of the quality of life of incurable patients depends on the level of palliative care to achieve and maintain the maximum of their physical, psychological, social, and spiritual potential. Furthermore, palliative care should meet the following requirements: early-onset, continuity, succession, comprehensive, phased, and individual approach. Despite certain existing common problems in the implementation of palliative care and the difficulties caused by the restructuring of the health care system in the fight against coronavirus infection, the system is functioning and has the necessary resources to ensure the quality of life and alleviate persistent painful symptoms of patients.

Sociology of Medicine. 2020;19(1):43-52
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Medico-social study on the opinions of parents on the problems of organizing medical care for children with cancer in the Russian Federation
Rykov M.Y., Manerova O.A., Turabov I.A., Kozlov V.V., Reshetnikov V.A.
Abstract

To study the opinions of parents (legal representatives) on the problems of organizing medical care for children with oncological diseases, a medical and social study was conducted. This study aims to examine the opinions of parents on the problems of organizing medical care for children with oncological diseases. This study was conducted based on the developed questionnaire for recording the opinions of parents (legal representatives) on improving the organization of medical care for children with cancer. The questionnaire comprised 27 questions, in which the respondents were asked to choose one or more answer options for each of them. For objectivity, the questionnaires were filled in anonymously. This medical and social study showed that 81.1 ± 1.9% of the respondents are not satisfied with the attitude of doctors and nursing staff toward them and their children, 15.9 ± 1.8% are only partially satisfied, and 3 ± 0.8% are fully satisfied (roughness in communication (35.8 ± 2.4%), lack of sufficient attention from medical personnel (21.3 ± 2.0%), and lack of interest in the success of treatment (19.7 ± 2.0%)). The combination of these options was noted by 23.2 ± 2.0% of respondents. As the preferred treatment site for their children, 63.7 ± 2.4% of the respondents indicated a medical organization of federal subordination and 33.9 ± 2.4% a medical organization located outside the territory of the Russian Federation, in which 57.4 ± 2.4 % of the respondents mentioned the possibility of receiving a patient-oriented service and complex routing during treatment between the medical organizations in the Russian Federation as a reason for choosing. Furthermore, 12.7 ± 1.6% of the respondents indicated a lack of confidence in the qualifications of medical personnel in the Russian Federation; 11.8 ± 1.6%, the lack of comfortable conditions for examination and treatment; 5.3 ± 1.1%, the lack of necessary diagnostic and treatment methods; and 12.8 ± 1.6%, a combination of the listed options. Overall, the findings of this study indicate the need to further improve the organization of medical care for children with cancer: introducing patient-oriented approaches and improving patient routing to create a patient-centric health care system for organizing medical care for children with cancer are necessary.

Sociology of Medicine. 2020;19(1):53-59
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Content of rehabilitation in the continuum of cancer care for patients in disease situations
Shmerkevich A.B., Krom I.L., Erugina M.V., Balakina D.D.
Abstract

Because of the optimization of the clinical and social prognosis of patients with cancer in recent decades, the possibility of incorporating rehabilitation in the continuum of cancer care is considered. Therefore, this study presents a comparative analysis of the quality of life among 427 working-age respondents with breast cancer in disease situations using the WHO QOL 100 questionnaire. Based on the results, a statistically significant decrease in the quality of life among the respondents in the “physical” and the “level of independence” spheres in the non-terminal situation of the disease was found, whereas in the group of incurable patients, a statistically significant decrease in the quality of life among the respondents in the “physical,” “psychological,” and “level of independence” spheres was found. Through the findings of this study, the rehabilitation of cancer patients in disease situations can be personified, and recommendations for improving the continuum of cancer care can be developed.

Sociology of Medicine. 2020;19(1):60-64
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Results of the sociological research on the aspects of professional orientation of medical personnel
Kaspruk L.I.
Abstract

In the training of medical personnel, determining the need for specialists with medical education is necessary. Furthermore, the future of the health care industry depends on those professionals who will soon fill the “labor market.” In this regard, the issues encountered in the optimization of personnel policy are relevant, e.g., solving the problem of discrepancy between the number and structure of personnel to the volume of activity, which is considered as an imbalance in the structure of “doctors: nursing staff.” Improving the professional orientation toward the personnel needs of practical health care is necessary. In the process of creating models for professional orientation, fixing the staffing situation regarding primary health care in the area of general medicine should be considered, focusing especially on the establishment of social order in terms of training specialists at public expense. Furthermore, one of the models (market) involves the choice of specialty and labor route specialist. The partnership of medical educational institutions with pre-university training institutions is relevant, when cooperation is based on a contractual basis approved by the health and education authorities of the region.

Sociology of Medicine. 2020;19(1):65-70
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Perfected value of the medical service: feature of formation
Kalenskaya N.V.
Abstract

The study presents the results of the studies and observations of the process of forming the value of a medical service, on the basis of the application and description of the methodology of behavioral economics. Furthermore, it describes the behavioral approach of consumer behavior, their incentives, and reactions, as well as the stages of forming a contact of the consumers of a medical service.

Sociology of Medicine. 2020;19(1):71-74
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Attitude of regional university students toward life and study in the conditions of self-isolation
Romanov A.S.
Abstract

This study discusses the attitude of students considering the restrictive measures implemented during the period of quarantine amid the coronavirus pandemic. Based on a survey including 65 students, their attitudes toward the changes in lifestyle and educational forms were analyzed. Overall, the findings of this study show that the students are compliant with the restrictive measures. However, the quality of distance learning is considered to be lower.

Sociology of Medicine. 2020;19(1):75-77
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Social mood of the residents of Moscow city at the beginning of the novel coronavirus pandemic (covid-19): possibilities of medical and sociological analysis
Reshetnikov A.V., Prisyazhnaya N.V., Pavlov S.V., Vyatkina N.Y.
Abstract

A new coronavirus infection, which affected most countries in the world, besides the “direct” risk to the health and socio-economic well-being (stability) of the population, determined the large-scale coverage of states and societies with associated risks, including the observed transformation of social space, the increase in the phenomena of voluntary social isolation and “encapsulation” of part among the population, and the revision of the value of social ties. In temporal terms, the density of the observed changes in the social sentiments of society and the socio-structural characteristics of this period need both retrospective reflection and sociological analysis, as foresight analysis appears to be applicable to the current social situation. This study presents the results of a medical and sociological study (questionnaire survey), implemented during the beginning of the spread of the COVID-19 pandemic in Russia on a sample of residents of Moscow. According to the study, despite the high level of awareness of Muscovites about the immediate risk and consequences of the coronavirus infection on their health, the respondents are mainly concerned about the socio-economic consequences of the pandemic. At the same time, the ideas of the respondents about the “post-pandemic world” include a large-scale economic decline, a violation of the functionality of the health system, and an increase in social conflicts and social disunity in the society. The main difficulties of medical and sociological research (respondent recruitment and data collection) were determined by epidemiological conditions. The study toolkit was developed considering the main trends in the spread of infection in the country and the observed social sentiment of Russians, but the high dynamics of changes did not allow to cover a wider range of issues that became relevant for Muscovites in the self-isolation period (April–May), which determined the understanding of the need for a second wave of research (planned for autumn 2020).

Sociology of Medicine. 2020;19(1):78-88
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