ПАТЕРНАЛИСТСКИЕ ОРИЕНТАЦИИ В СИСТЕМЕ МЕДИЦИНСКОГО ОБСЛУЖИВАНИЯ НА СЕЛЕ

The article analyzes modern interactions between the patients and medical personnel as the members of healthcare system in rural areas. Based on the finding of sociological research carried in Kurgan and Sverdlovsk Oblast, the authors claim that both medical workers and patients are focused on the reproduction of paternalistic model of interaction. Thus, a doctor acts as a father taking responsibility for a patient's health. Basic principles of paternalism include the leading role of a medical worker along with the strict control of all the instructions and recommendations to be fulfilled. The survey data from 300 patients' responses show that 64.8 % of village residents consider doctors and nurses to act as mentors, 54 % demand strict regulation from medical staff, 58.3 and 52.0 % respectively expect care and support from medical workers, while 78.7 and 34.8 % are sure that medical staff should be demanding as well as respectful. The results of a standardized interview of medical personnel ( n = 16) working in rural areas showed the relevance of respectful attitude to the professional activity for most of the respondents, as it appears a key factor to the effective interaction with the patients. The results obtained revealed the influence of gender, age, level of education and health self-esteem on the paternalistic orientations in the sphere of medical service. The role of a father, guardian and mentor is often attributed to the medical staff by women, elderly patients, patients having general secondary and secondary vocational education, as well as the patients with a low level of health self-esteem.