近年の医療ソーシャルワークのマネジメント重視＝内向き姿勢への疑問を呈し、(1)業務のマネジメント化への背景を探り、(2)歴史的資料の検討や医療従事者への質的調査を通し，それを克服する方途を探った。知見として，共感的対話，対象認識の重要性を得，①【業務を超えたつながり】が組織化への一歩，②【ソーシャルワーク経験・体験、覚悟】ができる環境と仕掛けづくり、③患者と【外来での継続的関わり】の三方法を示した． / Starting from the question of the recent management-oriented (inward-looking) attitude of medical social work, we explored (1) the background to the shift to management of work and (2) ways to overcome it through a review of historical data and qualitative surveys of medical professionals. The findings showed the importance of empathetic dialogue and recognition of the subject, and the three methods of 1) [connections beyond work] as a step toward organization, 2)creation of an environment and mechanism for [social work experience, and preparedness], then 3) [continuous involvement with patients in the outpatient setting]. / 博士(社会福祉学) / Doctor of Philosophy in Social Welfare / 同志社大学 / Doshisha University