论社会工作理论在医务社会工作实务中的应用

作为一个全新领域的医务社会工作实务,亟需相应的理论进行指导,实现理论与实务相结合,更好地为有需要的医护人员和患者服务,但目前已有的文献基本上都是在一般通则的意义上探讨社会工作的基本理论,在医务社会工作中缺少实践意义。通过对社会工作文献中相关理论的梳理,挖掘适合在医务社会工作实务的运用的需要理论、生命周期理论、社会支持理论、认知行为理论、危机干预理论及增能等相关理论,并对在实践中哪些情境应该使用上述理论,如何运用上述理论,提出具体的指导方法,以帮助医务社会工作者在实务实践中的应用。     

叙事治疗在老年双心病患者中的实践

为研究叙事疗法作用,选取江苏省人民医院老年心血管科40名心血管疾病合并情绪障碍住院患者为研究对象,分为试验组和对照组。对照组20人给予常规治疗和常规人文关怀,试验组20人在常规服务的基础上增加多学科协作模式的叙事治疗个案服务,干预前后采用医院焦虑抑郁量表测量作为评估工具,旨在探索医务社工参与的“双心”医学多学科协作模式。结果显示,对照组与试验组分值均有下降,试验组患者的焦虑分值和抑郁分值下降幅度更大(P < 0.05),叙事疗法对双心病患者的干预效果显著。多学科协作模式下的叙事疗法可有效缓解双心病患者的心理障碍、提高科室满意度、提升医疗团队专业能力、创新学科建设与人文服务,具有可推广性。

     

失独者爱哀交加的情思活动及其反刍机制研究

通过扎根理论方法悬置失独研究中的哀伤视角,呈现失独心理的复杂内涵和动态机制。结果发现哀伤只是失独者的部分体验,失独心理是爱哀交加的复杂情思。失独者具有念好、牵挂和感伤三种情思活动,念好和牵挂均伴生爱体验,念好的基础思维是回忆,伴生爱惜之情,牵挂的基础思维是想象,伴生关爱之情;感伤的基础思维是比较,伴生哀体验。空闲、独处、旧环境是影响念好和牵挂的重要因素;人生期待、文化氛围、事件界定是影响感伤的重要因素。三种情思活动间存在反刍成瘾机制。

     

企业职工的工作价值观特征分析

企业管理者可以借助三种不同的力量来激励和影响职工的工作行为 ,一种是外在的经济力量 ,一种是与工作相关的内在激励 ,还有一种是以人的信念和价值观念为基础的影响力。前两种行为激励是组织行为学研究的传统领域 ,而工作价值观则是近来随着组织文化的兴起而提出的新课题。本研究以企业现场调查为基础 ,分析了企业职工的工作价值观的特点 ,指出工作价值观是由工作行为评价因素、组织集体观念因素和个人要求因素三个方面构成 ,它们与职工的工作动机有着显著的相关。职工的工作价值观还表现出年龄的差异 ,年轻职工 (3 0岁以下 )的工作价值观并不是与年长的职工 (3 0岁及以上 )完全不同 ,他们在工作行为评价因素、组织集体观念因素方面有着共同之处 ,但是他们在考虑问题和判断时 ,思想更复杂 ,更多地考虑个人要求因素。不同所有制企业中的职工 ,其工作价值观也存在着一定的差异 ,其中 ,国有 /集体企业职工的组织集体观念显著地高于外资 /合资企业职工。     

Dilemmas of Practice: Challenges to Program Quality Encountered by Youth Program Leaders

To create and sustain high quality youth development programs it is important to understand the challenging situations and dilemmas that emerge in program leaders’ daily work with youth. In this research the experiences of leaders in 12 programs were followed over a 2–9 month period, which led to the identification of 250 dilemma situations. Qualitative analyses identified 5 categories and 12 subcategories of dilemmas that reflected distinct types of considerations (e.g., youth’s personalities, relationships with the community). The analyses also found that the experienced leaders in the study typically responded to these dilemmas in ways that were youth-centered and that balanced multiple considerations. It is argued that researchers need to go beyond identifying features of high quality programs, and more fully examine how effective leaders create and sustain high quality in response to the challenging situations of practice.     

A Kenotic Struggle for Dignity

Although Booker T. Washington stands outside the theological canon, his writings offer a pragmatic theology that connects the desire for dignity to a kenotic Christology through an ethic of unceasing work. While Washington's project to improve the lives of African Americans in the Jim Crow–era South was severely compromised by political circumstances, problems within his theology of work made his project especially susceptible to those circumstances. The tragedy of Washington's theology stems from his making dignity contingent upon work being recognized as useful by a worker's community. His kenotic ideal of “Christlike” work can actually degrade workers, if their community refuses to recognize their work's merit. Workers’ anxiety about dignity causes them to pour themselves into their work, but a racist society sees African American workers as inherently undignified. Even without Jim Crow's pervasive violence, the postindustrial reappearance of economic doctrines that characterized Washington's era makes his theological ethic relevant again.     

Psychosocial work factors, physical work load and associated musculoskeletal symptoms among home care workers

This study was based on a questionnaire and included a group of home care workers (HCW) (n = 305) and a reference group of municipal employees (n = 694). The relationship between the work environment and musculoskeletal symptoms was analysed. The HCW were less satisfied with their control over their work and stimulus from their work and had a higher physical work load and prevalence of musculoskeletal symptoms, compared with the reference group. The Rate Ratio (RR) of neck and shoulder symptoms among HCW was 83 and 54 %, respectively, higher among those reporting a "high" psychological work load compared with those reporting a "low" load. The highest RR for a single risk indicator was 2.5, and this concerned low-back symptoms among HCW who often worked with twisted postures. A combination of "poor" psychosocial work environment and "high" physical work load produced the highest RR for work-related neck (RR = 2.57) and shoulder (RR = 2.13) symptoms.     

Safer sex: Lessons from the male sex industry

Discerning the complex factors influencing male sex work is an important element of understanding HIV transmission. The present study examines a sample of London-based masseurs and street workers' ideas concerning their sexual encounters, their partners and their role in society. Unsafe sex is associated with (1) a lack of perception of control in the sexual encounter, (2) attractive clients, and (3) loving relationships with non-clients. The ways in which personal needs and stigma influence sexual practices and the men's sense of identity are considered. For some of the men, unsafe sex demarcates a sphere containing a type of intimacy that is absent from their working life. Since working life is associated with negative social judgements, the importance of this separate sphere is heightened. The findings call into question models of health behaviour that are built on individualist, reason-based tenets and highlight the importance of social and emotional factors in safer sexual behaviour. The implications of the findings for prevention programmes and future research are discussed.