Medicină socială Şi management sanitar
Беляев М. К., Прокопенко Ю.Д., Федоров К К К вопросу о выборе лечебной тактики при метафизарном oстеомиелите. Детская хирургия, 4, 2007, стр. 27 – 29
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- Quality management of Aspects of family medicine Piotr Manastîrlî
- Rezumat A spectele managementului calităţii a medicinii de familie
- Comparison of value of indicators of measurement of medical aid
- Быстровский В.Ф.
- Aspects of diagnostic of ORL-pathology among the pre-school children in Moldova, Republic of Nina Capitan
- Rezumat
- Conţinutul intenţiilor autoeducative la studenţi Valeriu Fortuna
- Materiale şi metode de cercetare
2. Беляев М. К., Прокопенко Ю.Д., Федоров К К К вопросу о выборе лечебной тактики при метафизарном oстеомиелите. Детская хирургия, 4, 2007, стр. 27 – 29.3. Гумеров А.А., Лапиров С.Б., Гайнанов Ф.Х. и др Актуальные вопросы хирургической инфекции у детей Материалы Всеросийского симпозиума детских хирургов. Воронеж, 2004, стр. 73 – 74. 4. Морозова О.Л., Чеснокова Н.П., Морозов Д. А., Филиппов Ю.В. Общие закономерности развития системных метаболических и функциональных сдвигов при остром гематогенном остеомиелите. Детская хирургия, 4, 2006, стр. 42 - 45. 5 Румянцева Г. Н., Портенко Ю. Г., Сергеечев С. П. Острый гематогенный остеомиелит у детей Тезисы докладов Рос. симпозиума по детской хирургии с международным участием. Ижевск, 2006, Ч.1, стр..216 - 218.
(Coordonator ştiinţific: Eţco Constantin, prof. univ., Dr. habilitat, Zabrailov Natala, conf. univ., Dr., Ferdohleb Alina, asist. univ.) Catedra Economie, Management şi Psihopedagogie, Catedra Medicina de Familie, USMF „N. Testemiţanu”
Asistenţa medicală primară a constituit una din priorităţile iniţierii reformelor în sistemului de sănătate. Consolidarea managementul calităţii a medicinii de familie este parte componentă a politicii social-economice a statului, şi este bazată pe metode şi tehnologii practice de ultimă oră accesibile societăţii în condiţiile actuale. Summary The primary medical service represents one of priority, in development of reforms of system of public health services. Strengthenings of a quality management of family medicine - a componental part of a social and economic policy of the country, both modern methods and practical technologies accessible to a society in modern conditions. Introduction Arrival of family medicine to Republic Moldova is a process natural and rather important. First, the family medicine, is the most economic and rational way of the organisation of medical aid. Excessive specialisation leads to decrease in availability of medical aid and as causes increase in expenses, both from the state, and from citizens. Studying this question, experts in the USA have come to conclusion, that the family medicine is the most accessible and economically-profitable medical service. The program of transition of system of medical services on level of family practice in the USA has allowed to save some tens billions dollars which have been enclosed in public health services system (СЗ) for 2 years. And it in the country where for medical branch it is allocated about 14 % from a total national product. This experience - management of changes is very necessary in Republic Moldova. It is not necessary to consider transition to family medicine, only as the most economic way of the organisation of medical services at primary level of services, but also as search of integrated supervision over the patient (in a condition of full health and in an illness condition). Doctors are not disturbed by level of economic expenses, their basic purpose: preventive maintenance, restoration, long remission of patients and reduction of complications. And usual measures of efficiency are not comprehensible to medicine - «Cost of a human life to measure it is impossible». In spite of the fact that formation of family medicine in our country proceeds already throughout 10-15 years, the problem of quality of health services disturbs not only the medical public, but also all civil society as a whole as this problem has key value for the further functioning and development of system of public health services.
In scientific work we have carried out the analysis of separate aspects of a quality management and management of changes in area of seed medicine and have tried to allocate profitability of the mentioned. And as to give reason for legislative changes at level of primary medical services - family medicine. Material and methods We used in this working out: historical, analytical, methods of scientific research. Factors which make the base of quality of medical services have been analysed; and indicators for definition of a quality management and management of changes in area of seed medicine. Results and Discussion The standard definition of qualitative granting of medical services in family medicine still is absent, but the techniques, called to estimate quality of given services already are developed and extend. Structure of qualitative granting of medical services (a figure 1), according to concept Avedis Donabedian formulated still in 1966, but actual, and today, distinguish three aspects [2].
The structure includes characteristics of means of rendering assistance, including: material resources (for example, adaptations and the equipment), the personnel (for example, its number, professional suitability and qualification), and also organizational characteristics (for example, methods of returning of expenses, system of an assessment of works of doctors other doctors). It is constant criterion into which structure enter:
II. Quality of process Technological criterion which considers not only medical, but also administrative methodology. Medical aid rendering is extremely difficult process, with application of a large quantity of resources, technics, therefore there is a necessity for standardization of rendering of medical aid. At a technology estimation it is considered and analyzed, both actually medical technology, and the mechanisms providing managerial process. Process is meant as characteristics of the given help, including, its validity, adequacy of volume, display of the competence of carrying out of techniques of treatment, a coordination of actions and continuity.
Criteria of efficiency which consider indicators of volume of activity and productivity indicators (medical, economic, social). Medical productivity: recover, improvement, without improvement, physical inability, death.
Social productivity (it is characterised by 2 groups of indicators):
Advantages and lacks of indicators of quality of each of three listed areas are compared among themselves in table 1 [9]. Contrary to a structure and process estimation, the outcome estimation as especially draws of a quality indicator to itself attention as it reflects the primary goal of health services - to help the patient. Actually, outcomes include influence of structure and process on quality even if key aspects of these two last areas are not specified yet and are not estimated. Besides, outcomes as a whole are easier clear and represent importance for patients and buyers of medical services who, not having essential preparation in the field of medicine, often hardly understand or estimate the majority of aspects of structure and process. For this purpose, what to define root problems of poor quality of rendered services and as that it was possible to take remedial measures, it is possible to resort to the help of diagramme Ishikawa or «the fish bone» which represents mutual relation between a consequence and its reasons. Table 1
Comparison of value of indicators of measurement of medical aid
*Structure means characteristics of adaptations used for medical aid, the equipment, the personnel and administration. ** Process includes characteristics of the rendered help *** the Outcome describes results of the help concerning a state of health of patients. * - has no value; + - low value; ++ - average value; +++ - high value. Let's consider the principal causes leading to decrease of quality in family medicine. In the practical activities the family doctor faces all age, sex, diseases. On one family doctor it is necessary from 850 inhabitants in Austria, 975 - in Spain to 1600 in РМ and 2430 inhabitants in Sweden. The quantity of business hours of the family doctor for a week fluctuates from 25 o'clock in France to 57 in Japan. For one reception hours the doctor spends from 2,4 consultations in Sweden to 5,7 in Japan [7]. 
Figure 2 Diagram Ishikawa/ «the fish bone» Quality management in Family Medicine
That fact is very important, that family doctors should learn to define sphere of the competence - that they can or cannot do and in what cases should address for consultation to corresponding expert. As one of the main problems, is a financing problem. At level of family doctors begin and finish treatment almost 80 % of patients, but the financing volume makes only 24 % (not including the free and compensated medicines) [1]. Reorganisation in a direction of transition from payment of the fact of existence of establishment and a post for payment qualities and to volumes of services really rendered to the population is necessary. In this direction the government has made very important step: the order № 404 from 30.10.2007 about legal differentiation of primary medical service at level of areas [4]. Limited financings are slowed down by development of material base. A weak place till now there is an equipment problem. A considerable role deterioration of the basic production assets and the process equipment, appreciable reduction of volumes of capital and preventive repair of buildings, constructions, the medical equipment that is one of the reasons of deterioration of working conditions of the family doctor has played also. Thanks to the decision of the government and Ministry of Health with 2008 the family medicine will have the own budget that will allow to concentrate here the increasing part of financial resources. But efficiency depends not only and not so much on material inputs, how many from the organisation of medical process and quality of preparation of experts as human resources - the most expensive in public health services, and their cost increases in process of accumulation by workers of professionalism and experience. First, the most part of family doctors working for today have passed only semi-annual course of post-degree preparation from doctors of narrow specialities - pediatrists, therapists, accoucheurs etc. Secondly, character and depth of preparation of experts mismatches requirements of practical public health services. The tendency of shots to narrow specialisation remains. Medical shots are non-uniformly distributed inside РМ: the qualified experts concentrate in municipal zones of residing in comparison with area. Thirdly, the parity of number of doctors and average medical workers does not meet modern requirements. Even for doctors of the general practice (family) it makes 1:0,8-1,5 instead of 1:2-3 [11]. Improvement of professional skill of medical workers is so profitable, as well as equipment modernisation. Representatives of the American academy of family doctors one of the first recognised, that modern doctors require continuation of formation during all professional life and mastering by new scientific data and treatment methods. The academy has developed key rules of a continuous medical education (НМО). Almost right after creations of the American committee on family practice in 1969 the decision obliging doctors to pass certification not once in the beginning of career was accepted, and is regular, through certain time intervals (re-certification) [9]. One more serious problem brightly reflected in quality of medical services and demanding the decision, the problem of economic motivation of work of family doctors is. The levelling system of a payment where the goods is time, instead of the rendered medical service, aggravates negative processes in public health services. The low estimation of services given by the medical worker does not provide due motivation to growth of quality of medical service. Because of low salaries many experts are compelled to leave republic. At the same time the newly made doctors who have just received diplomas of medical university, do not hasten to take the professional places. They prefer to be arranged in other branches of economy or at all to leave «in anywhere», recruiting of ranks of the unemployed. The differentiation an estimation can change and add existing system of payment taking into account volume of work and quality of the rendered medical aid. The primary goal of reforming of system of a payment in public health services should become refusal from аccount maintenance and creation of such system of financing which would interest the worker in a work intensification, in introduction of the newest medical technologies, in improvement of quality of rendering of medical aid and reduction of time of treatment of patients. But only one financial motivation has enough. Many problems, first of all, are connected with considerable decrease in prestigiousness of a trade, sharp increase in loading and social vulnerability of workers. It is necessary to raise prestige and authority of the given speciality. It is necessary to explain, that the family doctor is the same expert, but focused not on the single patient, and on a family as a whole for what additional knowledge on the general and medical psychology is necessary to it, to planning of a family and many other things to questions. Experience in the countries of the European commonwealth has underlined authority of doctors of the general practice on the medical world. It is enough to tell, that the family medicine spends for a professional training the largest financial investments into comparison with others medical directions. This sphere and as a scientific direction becomes stronger; it is spent more and more research works that raises prestige of family medicine in the academic circles. It is necessary to notice, that there are problems not only connected with quality of given medical services, but as absence methodical the recommendation adapted of the medical documentation, according to last reforms in the organisation of system of public health services. As there is a necessity for revision of technology of realisation of examination of quality and the analysis of its results which remain not claimed from heads of medical institutions and further estimations of completeness and efficiency of realisation of the planned actions are not used by them for acceptance of administrative decisions. There is no legal institute of experts of quality of medical aid. For granting of qualitative medical services introduction of main principles TQM (Total quality management), creation and application of system of the quality management, based on elements of requirements (ISO 9000:2001) is necessary. There is a number of problems on a way to general quality. Here some of them.
Conclusion There are more many difficulties and the problems connected with quality of given medical services. The science of an estimation of quality still does the first steps. Though it has a more potential but that its techniques became effective in improvement of health of separate people and the population as a whole, the further efforts to several fronts are necessary. These efforts should be directed on working out of reasonable conceptual structure of such techniques, on working out and check of advanced ways of an estimation of quality. It is necessary to achieve integration of efforts according to quality in the work directed on perfection of health services, - both in each separate establishment, and in wider scale. It is necessary to watch also what contribution to population health is brought by techniques of an estimation of quality: their advantage should justify expenses. Bibliography
Aspects of diagnostic of ORL-pathology among the pre-school children in Moldova, Republic of Nina Capitan (Coordonator ştiinţific: Eţco Constantin, prof. univ., Dr. habilitat, Ferdohleb Alina, asist. univ.) Catedra Economie, Management şi Psihopedagogie USMF „N. Testemiţanu”
Consecinţele diagnosticului tardiv al patologiei ORL reprezintă nu numai probleme somatice, dar şi sociale. În procesul cercetărilor descriptive, transversale a fost elaborat: un algoritm de diagnostic la copii a patologiei auditive şi un chestionar „Are oare Copilul D-voastră probleme cu auzul ?!”. Rezultatele examenelor profilactice au marcat una din cele mai vulnerabile grupe ale populaţiei pediatrice – copii de 7 ani. În anul 2006 acest grup de vârstă a prezentat o incidenţa a patologiei ORL de 1,8 ori mai mare, comparativ toată populaţia pediatrică (sub 7 ani– 4,7‰ şi respectiv sub 18 ani - 2,6‰) din republică. Summary Consequences of later diagnostics of ORL pathologies are not only physiological but and sociological problem. In the process of descriptive and transversal researches an algorithm of diagnostics with hearing acuity loss and questioare -test for parents "Yours Child has problems with hearing, doesn't he?! “ were elaborated. The results of prophylactic examinations have pointed to one of vulnerable group of pediatric population- children- below -seven .In 2006 this age group in 1.8 times exceeds general sickness rate ORL pathology in comparison with all population of children (below 7 years - 4.7 ‰ and accordingly below 18 - 2.6‰) in republic. Introduction The hearing takes one of the important places in our life and helps us to accumulate more information about the environment. To hear the sounds is the vital necessity in the harmonious development of childhood [4]. The hearing acuity loss is the worldwide pathology. The statistic shows that among 1000 of newborns there are 3 ill children with hearing loss. In Moldova the early diagnostic and rehabilitation of the hearing acuity loss is done by Republican Center of Audiology, Hearing Protease and Medical-Pedagogical Rehabilitation on the base of “E. Cotaga” - the main and highest category of public health service. The center has modern diagnostic equipment, which give the opportunity for patient's hearing investigation, including newborns [1]. The external and internal factors influence directly or indirectly on the process of the hearing. It is noticed, that the negative effect has not only the one external/ internal factor, but also their association [4]. Therefore early diagnostics of children’s hearing loss take a great attention in the medicine. The prophylactic work means not only the excluding negative factors of the environment, place of residence, bad habits, foodstuffs, but it is something more: to change the public opinion about life style and state of health [5]. It realizes only on the cooperation between the ORL - specialists and the Primary Medical Service (Family Medicine).
The marking and study the peculiarities of the external factors, which go to the appearance of children’s hearing acuity loss on the conductive type and producing the annual events with informational aspects for parents and relatives of ill children . Material and methods The integral, transversal, descriptive researches have been made during this scientific work – which is based on the indirect selection, analysis and synthesis of information from the official medical statistics “Public Health in RM 2003 – 2007” [3]. They reflect the demographical indices – the results of children’s ORL-examinations on the level of Primary Medical Service (Family Medicine). During this research project a special questionnaire-test, which is named “Yours Child has problems with hearing, hasn’t he?!” is produced. The test is divided into the same parts of child’s age (from 0 to 7 years) and includes the simple skills. Parents and persons, who take care and are in the direct contact with their children with the hearing acuity loss, can test them easy. The applied meaning is realized during the selective research, which is named “research-case” – the specific method, which is implemented on the base of the Republican Center of Audiology. It is formed on the interview with parents and relatives. A special form is filled to every child during the research-case. The cards reflect the etiology of the hearing loss, family’s medium and educational consulting with the questionnaire-test. According to the research project the unit measure is pre-school child with hearing acuity loss. The base of investigation is Republican Center of Audiology. Discussion According the literature, we have found 5 main groups of hearing loss on conductive type (foreign bodies of external acoustic duct (including earwax); diseases of nasal cavity, nasal sinus appendage and naropharynx; inflammatory and non inflammatory diseases of acoustic duct, ear drum and ear trumpet; traumatic factors; burn) [2, 6]. The conclusion is made, that all these causes lead to the complete or partial close of an ear-trumpet, also the aeration of ear cavity breaks, which in the same way leads to activity limitation of an ear-drum and to the sound-transmission breach. Practically in conformity with National Insurance Service the first children’s ORL-examination realizes in the age of 1 year. If child has not any audiological problems, the next children’s ORL-examination makes in the preschool age. The children before 7 years old are the most vulnerable group of the population in conformity with the statistic information (figure 1, 2) [3].
Fig.1 The dynamics of children with hearing loss (‰) in 2003 -2004 It may be so because the character of installation in the hearing’s pathology appears differently. Sometimes the debut of the hearing loss begins very slowly and has negative tendency. The small child cannot express the symptoms as the adults, and parents only may guess about the diseases. It happens so that in many cases the result of hearing acuity loss leads to children's helpless in simple situations. Such children have a feeling of full isolation, anxiety and loneliness. Sometimes the hearing breach is taking as the sign of silliness or such children seem to be mentally-retarded, this all has negative influence on their life (eg: difficulties in school, especially with grammar and reading) [4].
Fig.2 The dynamics of children with hearing loss (‰) in 2005 -2006 Results
Conclusion Children, who are surrounded by their family, and are under the permanent control of the family doctor and specialists, will live in the medium with the minimal risks to the health. The medical service will become more effective and qualitative, if we prognoses, organize, coordinate and control negative factors, which go to children`s hearing loss in RM. Bibliography
Conţinutul intenţiilor autoeducative la studenţi Valeriu Fortuna (Conducător ştiinţific: dr. în psihologie Mariana Cerniţanu) Catedra Economie, Management şi Psihopedagogie
In a young age (students’ period) there are a great number of opportunities for self-knowledge and for self - formed potential fulfillment. The study of self - foster intentions reveals some results, for example 49 (49%) of investigated students consider the presence of the psycho-moral qualities, the most important conditions for achievement of their aims and for personal self-actualization. For the same aims, 43 (43%) of investigated students believe in predominance of the intellectual and professional qualities. But 6 (6%) consider that they may obtain the self-actualization by means of the physical qualities exploitation. A few students, 2 (2%), invoke other qualities instead of the proposed ones. Rezumat În perioada tinereţei (studenţiei) sunt create cele mai multe oportunităţi pentru cunoaşterea de sine şi pentru realizarea potenţialului autoformativ la persoană. Cercetarea conţinutului preocupărilor autoeducative ale tinerilor (studenţilor) s-a soldat cu obţinerea unor date precum că: 49 (respectiv- 49%) de studenţi cercetaţi, consideră prezenţa şi dezvoltarea calităţilor psihice şi morale drept cele mai importante în obţinerea scopului de viaţă propus şi respectiv realizarea Eu-lui potenţial. Calităţile intelectuale şi profesionale, drept condiţii primordiale în realizarea personală au fost alese de către 43 (respectiv- 43%) de studenţi. Iar 6 persoane (respectiv- 6%), cred că şi-ar putea realiza Eu-l lor potenţial în primul rînd prin valorificarea calităţilor fizice. Şi mai puţini studenţi, 2 (respectiv- 2%), invocă altele pe primul loc decît calităţile propuse. Actualitatea cercetării Studiul lucrărilor despre autoeducaţie şi analiza de conţinut a definiţiilor ne-au permis să identificăm anumite caracteristici pentru această preocupare superior umană. Astfel, pentru procesul de autoeducaţie S. Toma, consideră ca definitorii următoarele trăsături: Este activitate conştientă, constantă, sistematică, direcţionată spre perfecţionarea propriei personalităţi, este scop, în baza unei decizii personale şi este activitate de autoangajare şi depunere a unui efort propriu. Condiţiile necesare pentru realizarea oportună a acestei activităţi, după acelaşi autor sunt: cunoştinţe şi modalităţi de gîndire cu valoare instrumental-operatorie, tehnici ale muncii intelectuale, priceperi şi deprinderi de muncă independentă, conştiinţă de sine, motivaţie interioară, persistenţă, calităţi volitive, autocontrol, capacitate de analiză şi reglare a propriei activităţi, cunoştinţe, însuşirea criteriilor de distingere şi ierarhizare a valorilor social – morale şi a criteriilor de autoapreciere, capacitate de selectare, capacitate de a fixa un ideal de viaţă mobilizator, capacitate de a evalua critic diferite sugestii, idei şi posibilităţi, capacitate de autoanaliză, de concretizare a valorilor dorite şi de elaborare a unui program de acţiuni imediate, capacitate de automobilizare, voinţă, capacitate de a depune efort personal, maturitate fizică şi psihologică, energie morală şi voinţă pentru a rezista diferitor tentaţii, capacitatea de a acţiona potrivit unor norme proprii de muncă şi viaţă, capacitatea de a formula principii morale care să ghideze activitatea şi comportamentul persoanei (Toma, 1983, p. 21). Specialiştii în domeniu consideră că autoeducaţia are aceleaşi elemente structurale ca şi educaţia (scop, subiect, mijloace, metode). Diferită este doar poziţia subiectului. In educaţie ea este exterioară, pe cînd în autoeducaţie este interioară. Educaţie inseamnă ajutor pentru autoajutor – spunea Pestalozzi. Motivul acţiunii autoformative se caracterizează prin deliberare şi responsabilitate. Astfel pe fondul unei stări emoţionale specifice, mai mult tensionată decît relaxată – se pot semnala chiar situaţii conflictuale – se intensifică operaţiile de filtrare şi selecţie a informaţiei despre sine (autoevaluare), despre idealul propriu, despre cerinţele exterioare, despre parametrii acţiunii şi efectul ei, se dezvoltă procedee evoluate de analiză şi sinteză. Problema apariţiei preocupărilor autoeducative se plasează încă pe terenul unor discuţii contradictorii. Unii autori le consideră ca fiind prezente la toate vîrstele, alţii le atribuie perioadei de vîrstă cînd se dezvoltă dorinţa şi capacitatea de a desfăşura munca cu tine însuţi (această perioadă după părerea lor ar fi sfîrşitul preadolescenţei şi începutul adolescenţei). Adolescenţa însă, este considerată de majoritatea autorilor ca fiind perioada de vîrstă caracteristică raportării la propriul univers şi a intensificării procesului de constituire a idealului de viaţă al personalităţii, ca „vîrstă a marilor idealuri”. Alegerea unui ideal, înfiriparea şi conturarea lui precisă se realizează ca fiind dinamizată de un model. Din investigaţiile S., Toma, D., Bazac, V., Popescu, se conturează ideea că: „... o astfel de preocupare conştientă pentru alegerea şi nu „adoptarea” unui model de viaţă devine prezentă în preadolescenţă (12-14 ani), cînd tînărul capătă perspectiva propriului progres şi evoluază de la alegerea unui model concret (o persoană anumită) la modelul abstract (o personalitate ideală), iar după 18-20 ani căpătînd preponderenţă modelul propriu” (Toma, 1983, p. 55). G. W. Allport, arată că în diferite stadii ale vieţii apar diferite aspecte ale conştiinţei de sine, iar adolescenţa este perioada acelui salt calitativ în dezvoltarea conştiinţei de sine care permite şi totodată stimulează declanşarea preocupărilor de autoperfecţionare (Allport, 1981, p. 119-127). De altfel, intenţia autoeducativă se dovedeşte a fi principalul mijloc prin care adolescentul, consideră că-şi va putea satisface dorinţele pe viitor. În acest sens, autoeducaţia dobîndeşte o funcţie instrumentală reală, devenind factor de reglare a comportamentului şi activităţii. În linii mari putem afirma că, pragul marcat de apariţia nevoii de autoeducaţie ar fi acela în care mecanismele spontane de reglare şi influenţele educative exterioare sînt progresiv înlocuite cu mecanismele conştiente de organizare şi de elaborare a propriilor strategii de intervenţie şi autoreglare. Perioada de maximă importanţă pentru realizarea educaţiei de sine este considerată a fi studenţia. La această etapă sunt create cele mai multe oportunităţi pentru cunoaşterea de sine, pentru dezvoltarea cognitivă şi pentru realizarea potenţialului autoformativ a personalităţii. Dorinţa de a şti, de a cunoaşte cauzele reale ale lucrurilor, de a avea certitudinea cunoaşterii şi a criteriilor de orientare, de a avea o formaţie de om cult, bine pregătit în profesia aleasă stă la baza intenţiilor autoeducative orientate spre achiziţionarea şi formarea unor calităţi intelectuale şi profesionale. O particularitate distinctivă a autoeducaţiei este motivaţia intrinsecă. În acest fel, scopul autoeducaţiei este trăit de individ ca ceva propriu, acceptat şi dorit, nu ca ceva exterior şi impus. Acest scop însă, trebuie să fie suficient de înalt şi atrăgător pentru a mobiliza şi întări eforturile care nu –s deloc mici în munca îndreptată spre propria perfecţionare. După S. Toma, stabilirea unui program de activitate proprie, imediată, care să facă posibilă o anumită evoluţie viitoare – ca o primă caracterisitcă a procesului de autoeducaţie – presupune totdeauna selecţie, structurare, opţiune şi decizie între valori. Această raportare conştienă, critică, şi activă la norme şi valori se concretizează în modelele şi idealul de viaţă ales Individul îşi stabileşte idealul sub influenţa factorilor de educaţie, pe baza propriei experienţe de viaţă, a tipului de societate, a activităţii sociale şi productive, a direcţiilor de afirmare individuală şi a sistemului de valori şi norme, în funcţie de particularităţile sale individuale, de vîrstă şi de cunoaştere (Toma, 1983). O cercetare realizată de S. Toma demonstrează faptul că intenţii autoformative (mai mult sau mai puţin), au majoritatea (93,5 %) dintre cei 451 de adolescenţi cercetaţi de vîrsta 15-19 ani. În special, preferinţele lor se îndreaptă spre o pregătire profesională superioară, condiţionată de interesul pe care îl au spre meseriile respective, de gradul de noutate şi perspectivele de viitor pe care le oferă anumite domenii de activitate, de posibilitatea unei dezvoltări intelectuale creatoare. În procesul de analiză a datelor s-a stabilit că prezenţa unor preocupări autoeducative se constată numai la subiecţii care şi-au ales un model de viaţă sau şi-au precizat idealul de viaţă. Fenomenul depistat ni se pare firesc. Modelul şi idealul de viaţă ales îl face pe subiect să se vadă mai responsabil şi mai puternic angajat în munca cu sine. La subiecţii care şi-au formulat clar idealul, există o mai mare stabilitate a preocupărilor afirmative faţă de cei care sunt în faza modelelor concrete (o anumită persoană este percepută ca model). Acest fapt, autorul îl explică prin aceea că idealul însăşi este mai stabil decît modelul, iar valorile cuprinse în el dau constanţă preocupării autoeducative. Idealul, spune ea, îi face pe cei care-l urmează să rămînă fideli anumitor valori (Toma, 1983, p. 67). Deoarece autoeducaţia este un mijloc de realizare a autoactualizării, (care la rîndul său e subiectul nostru de cercetare), am fost tentaţi să stabilim care este conţinutul intenţiilor autoeducative prin care studenţii întrevăd realizarea potenţialului său, sau atingerea idealului propus. În cercetarea dată ţinem să clarificăm care este conţinutul preocupărilor autoeducative ale tinerilor (studenţilor). Pentru aceasta am intenţionat să analizăm în special premisele motivaţionale ale acestor preocupări. Adică, ce măsuri autoeducative studenţii consideră importante pentru atingerea idealului propus.
Scopul cercetării pe care ni l-am propus constă în obţinerea informaţiei noi privitor la intenţiile autoeducative ale studenţilor. Subiecţii cercetării Lotul de subiecţi supuşi cercetării a fost alcătuit din 100 studenţi dintre care: 59% în anul II de studii la USMF „N. Testemiţanu” iar 41% în anul I de studii la USM . Materiale şi metode de cercetare A fost elaborată o anchetă ce constă dintr-o întrebare cu 4 variante de răspuns, corespunzător scopului propus: Pentru aţi realiza Eu-l potenţial (ceea ce ai putea fi) pe deplin, de ce calităţi ai nevoie în primul rînd, în al doilea, în al treilea şi al patrulea rînd?
Studenţii trebuiau să marcheze cu 1;2;3;4; în dreptul aliniatului corespunzător, în dependenţă de gradul de importanţă a calităţilor date. Rezultatele obţinute Locul întîi dintre calităţile prezentate studenţilor pentru a fi aranjate după ierarhia lor de priorităţi, îl deţin calităţile psihice şi morale. 49 (respectiv - 49%) din studenţii cercetaţi, consideră prezenţa şi dezvoltarea acestor calităţi drept cele mai importante în obţinerea scopului de viaţă propus şi respectiv realizarea Eu-lui potenţial. Calităţile intelectuale şi profesionale au fost alese drept condiţii primordiale în realizarea personală de către 43 (respectiv - 43%) de studenţi. Şi mai puţini studenţi 6 (respectiv- 6%), cred că şi-ar putea realiza Eu-l lor potenţial în primul rînd prin valorificarea calităţilor fizice. Iar 2 studenţi (respectiv - 2%) invocă altele pe primul loc decît calităţile propuse anterior. Rezultatele obţinute pot fi reprezentate prin următoarea diagramă: 
Figura I. Ierarhia calităţilor alese de către studenţi (%). Analizînd rezultatele obţinute se conturează ideea că numărul relativ mare de studenţi care au ales dezvoltarea calităţilor psiho-morale drept condiţie primordială pentru dezvoltarea Eu-lui potenţial este în legătură directă cu particularităţile psihoindividuale şi de vîrstă ale studenţilor. La această etapă de vîrstă, ei sunt preocupaţi de conturarea unei concepţii integre despre lume, de formarea convingerilor morale şi par mai interesaţi de problematica relaţiilor dintre oameni. Pe de altă parte, ei conştientizează o oarecare criză de valori din societate şi încearcă să-şi elaboreze propriile sisteme de convingeri şi principii după care se vor călăuzi în viitor. Fiind însă încă destul de labili emoţional şi psihologic, ei uşor pot fi supuşi unor influenţe atît pozitive cît şi negative. În acest sens, crearea unui mediu academic optimal bazat pe valori autentice umane, pe stimularea creativităţii şi valorificarea potenţialului autorealizator - par a fi cele mai optimale condiţii pentru autoactualizarea personalităţii studentului. Concluzii Datele prezentate argumentează semnificativ presupunerea precum că stabilirea unor directive clare de viaţă (idealul de viaţă), servesc ca premise motivaţionale esenţiale în declansarea preocupărilor autoeducative. Intenţiile autoeducative cresc proporţional în intensitate şi frecvenţă pe măsura precizării idealului de viaţă, care le conferă constanţă şi continuitate. Idealul reprezintă motivul esenţial al acţiunii autoformative, factorul dinamizator care orientează şi susţine energetic efortul propriu, este criteriul de apreciere, de autoevaluare a posibilităţilor actuale şi a liniilor de evoluţie şi afirmare personală. El deasemenea este factorul care angajează efectiv individul la munca cu sine. Conţinutul intenţiilor autoeducative depistat relatează despre orientarea conştientă a studenţilor la munca cu sine şi despre asumarea de către ei a unor responsabilităţi privind realizarea sa ca personalitate autoactualizatoare. În condiţiile în care circuitul valorilor şi ideilor înregistrează un ritm vertiginos, este firesc că tinerii au înţeles că, pentru a fi la nivelul cerinţelor vieţii contemporane, este nevoie de o pregătire foarte serioasă şi completă, în special în arta comunicării şi conveţuirii cu ceilalţi. Yüklə 498,38 Kb. Dostları ilə paylaş:
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