医务社会工作是社会工作的具体实践领域之一，是缓和医患关系、改善医疗环境、提升社会效益、促进社会和谐稳定的重要保证。近年来，国家先后出台了多个政策文件，标志着我国专业社会工作发展的顶层制度框架基本形成。在政府的大力推动下，各个地区的医疗机构都在积极探索以建立起自己的医务社会工作部门。

本文选用嵌入性理论的视角，以G省X医院为例，采用质性研究方法，通过半结构式访谈及参与式观察搜集相关研究资料，旨在呈现医务社会工作的嵌入性发展过程和发展中所面临的困境，并分析出现困境的原因，在此基础上提出针对性的建议，进而使我国医务社会工作能够实现长远、持续的发展。

研究发现，医务社会工作在嵌入医院后呈现出一种实践层面“脱嵌”的状态，嵌入主体与客体在双方的工作目标和理念、角色定位、权责职能、工作方法上产生分歧，嵌入主体与客体双方互动不良，从而导致嵌入无效的结果发生。造成医务社会工作嵌入性发展困境的原因主要有以下几点：一是医务社会工作的边缘性地位，表现在医务社会工作在医院内未能进入核心体系而缺少权威与资源、医疗市场化条件下嵌入主客体双方价值观念层面存在差异等；二是嵌入主体和嵌入客体双方互动不良，表现在医务社会工作面对医疗卫生服务领域主要参与者时产生的专业与身份双重认同困境，以及受行政部门领导的“行政本位”的影响下，专业性工作难以开展；三是嵌入主体自身专业性，表现在自身专业能力不强、缺乏完善的督导评价体系和考核晋升机制，部门内部发展动力不足。

基于以上研究发现，本论文最后就如何更好地促进医务社会工作的发展提出如下建议：（1）从外部环境着手，政府应从宏观层面建立健全医务社会工作相关的体制机制，明确其角色定位，同时医院应保障医务社会工作拥有足够的自主空间，推动院内多方参与合作；（2）从学科建设角度出发，以医务社会工作专业理论体系及实务模式建设为基础，提升其专业化、本土化水平；（3）加强内部专业建设，注重对医务社会工作者自身的能力建设培育，激发其内生发展动力。

Medical social work is one of the specific practice areas of social work, and it is an momentous guarantee for easing the relationship between doctors and patients, improving the medical environment, enhancing social benefits, and promoting social stability and harmony. In recent years, China has successively issued a number of policy documents, marking the basic formation of the top-level institutional framework for the development of professional social work in my country. Under the vigorous promotion of the government, various regions are actively exploring the establishment of their own medical social work departments.

This paper selects the perspective of embeddedness theory, takes X Hospital in G Province as an example, adopts qualitative research method, collects relevant research data through semi-structured interviews and participatory observation, and aims to present the embedded development process and development of medical social work. The difficulties faced, and the reasons for the difficulties are analyzed, and on this basis, targeted suggestions are put forward, so that the medical social work can achieve long-term and sustainable development.

The study found that medical social work showed a state of "de-embedding" at the practical level after it was embedded in the hospital. The embedded subject and object had differences in the work goals and concepts, role positioning, rights and responsibilities, and work methods of the embedded subject and the embedded subject. Poor interaction with both sides of the object, resulting in invalid embedding. The main reasons for the embedded development dilemma of medical social work are as follows: First, the marginal status of medical social work, which is manifested in the fact that medical social work fails to enter the core system in the hospital, lacks authority and resources, and under the conditions of medical marketization. There are differences in the values of the embedded subject and object; the second is the poor interaction between the embedded subject and the embedded object, which is manifested in the dual identity dilemma of professional and identity when medical social work faces the main players in the field of medical and health services, and is subject to administrative departments. Under the influence of the leadership's "administrative standard", professional work cannot be carried out; third, it is embedded in the main body's own professionalism, which is manifested in the lack of its own professional ability, lack of a perfect supervision and evaluation system and assessment and promotion mechanism, and insufficient development momentum within the department.

Based on the above research findings, this paper finally puts forward the following suggestions on how to better promote the development of medical social work: (1) Starting from the external environment, the government should establish and improve the system and mechanism related to medical social work from a macro level, and clarify its role positioning, At the same time, the hospital should ensure enough independent space for medical social work and promote multi-party participation and cooperation; (2) From the perspective of discipline construction, based on the construction of the professional theoretical system and practical model of medical social work, improve its professionalization and localization level; ( 3) Strengthen internal professional construction, pay attention to the cultivation of medical social workers' own capacity building, and stimulate their endogenous development momentum.