疾病管理还是健康管理——健康照顾社会工作实践的批判与反思

Disease Cure or Health Treatment?——An Reflection on the Social Work Practice in Health Care

一百年来,健康照顾社会工作(health care social work)一直以疾病管理为主导,但是注重患者自身经验的健康管理的呼声却一直没有停止过。通过对医学人类学、第二代女性主义和身体社会学的文献梳理发现,疾病与经验两者之间存在不可分割的联系,而医学的疾病治疗就是一种建立在疾病管理上的"专家"经验,对这种"专家"经验的过分依赖必然导致对患者自身健康经验的忽视,从而出现用疾病管理替代健康管理的现象。这一发现将有利于社会工作者重新审视健康照顾社会工作的基本定位,找回患者自身所拥有的健康经验,把健康归还给患者。

Health care social work has been traditionally regarded as an aid to medical work for ahundred years. But the voice to pay attention to the client＇s own experience has never gone. This article isintended to show a close relationship between disease and its related subjective experience through theliterature review of Medical Anthropology, the Second Feminism and Body Sociology. It stresses that themedical model to regard disease as medical failure is based on the observation and analysis by the role ofexpert at expense of client＇ own experience. The conclusion of this article will help the social worker toreconsider his or her role in the health care field, revisit the client？s own inner experience related to thedisease, and return the health back to client＇s hand.