A Study On The Practical Path Of The Medical-patient Co-construction Model Of Social Work Intervention In Narrative Medicine ——A Case Study Of The Hematological Oncology Department Of M Hspital In Shanghai

At present,the equal cooperation between doctors and patients has become a general consensus.However,in real social life,the number of doctor-patient disputes caused by bad doctor-patient interaction remains high.However,the emergence of narrative medicine in the field of medical humanities and the development of medical social work provide a new direction for the solution of doctor-patient interaction.In this study,the semi-structured interview method,participatory observation method and text analysis method in qualitative research were used to collect data.Taking the Blood Oncology Department of M hospital as the research field,the actual situation of doctor-patient interaction in clinical departments and the practical process and effect of narrative medical doctor-patient co-construction model involving medical social workers were investigated.On this basis,it explores the reasons for the problems of doctor-patient interaction and the reasons for the effects and difficulties of medical social workers' intervention in practice under the concept of narrative medicine,and finally reflects and summarizes the feasible path of medical social workers' intervention in doctor-patient co-construction mode.The study found that insufficient doctor-patient interaction is the result of the long-term role function limitation of both doctors and patients:the role of doctor caregiver is bound by the negative presupposition of poor disease prognosis before diagnosis and treatment,professional authority and value ethics in diagnosis and treatment,as well as the rational role and professional relationship after diagnosis and treatment;The function of the patient's independent role is limited by the lack of disease knowledge before diagnosis and treatment,the suppression of misplaced goals and disease and pain experience in diagnosis and treatment,and the weakening of daily living environment after diagnosis and treatment.Under the guidance of the concept of narrative medicine,medical social workers play the role of advocate,educator and resource linker in the practice of doctor-patient co-construction model.With the help of fine reading and reflection writing tools commonly used in narrative medicine,medical social workers carry out practice from four aspects:concept establishment,ability training,platform construction and environment construction through various practical methods such as case work and group work.The practice results show that the concept and method of narrative medicine and the role and function of medical social workers play a two-way role in promoting the operation of doctor-patient co-construction mode.However,it can also be seen that the current medical social workers are still difficult to become the leading role in the doctor-patient co-construction model due to the lack of main force:the unclear role orientation of medical social workers leads to difficulties when they enter the Department;At the same time,due to its lack of strength to integrate multi-disciplinary teams,professional actions are not easy to spread;In addition,the solidification of employees and the low public recognition of professional ideas also lead to the practical experience of medical social workers in implementing the doctor-patient co-construction model.Based on the above analysis,the author puts forward that medical social workers can deeply practice by giving full play to their professional advantages,forming demonstration effect,providing support in multiple directions,creating multiple platforms and taking into account environmental improvement,so as to promote the establishment of doctor-patient co-construction mode;In the future work,we try to improve the cognitive popularity and practical influence of medical social workers by expanding the scope of practice and cooperating with clinical departments in scientific research,so as to optimize the actual effect of medical social workers' intervention in narrative medical doctor-patient co-construction mode,and finally realize the harmonious co-construction between doctors and patients.