Future trends in health and health care: implications for social work practice in an aging society

NEEDS AND POSSIBILITIES OF SOCIAL WORK IN IMPLEMENTING SOCIAL INCLUSION WITH THE TOOLS OF ADAPTIVE PHYSICAL ACTIVITY

OBJECTIVE

Aim: reveal in social work the possibilities of applying adaptive physical activity in the process of social inclusion of persons with disabilities.

PATIENTS AND METHODS

Materials and Methods: To obtain factual information, the survey method (questionnaire) and a complex of mathematical statistics methods were used: methods of descriptive statistics and correlation analysis. Statistical analysis was performed using SPSS Statistics 24.0.0. A total of 102 anonymous respondents took part in the focus groups.

RESULTS

Results: The connection between adaptive physical activity and the increase in the level of social inclusion of persons with disabilities, in particular, former military personnel and war veterans, was investigated. It was determined that social work professionals can use adaptive physical activity tools to promote the social inclusion of persons with disabilities and other low-mobility population groups.

CONCLUSION

Conclusions: It was established that the ways of using adaptive physical activity tools by social workers for the social inclusion of persons with disabilities are most often socio-psychological, physical, professional rehabilitation, social support, and preventive activities. New opportunities for the implementation of social inclusion by means of adaptive physical activity of persons with disabilities as a result of military operations are opened in connection with the introduction of the position of «helper (assistant) of a veteran in the community», which will be held by a social worker.

The value that social workers' competencies add to health care: An integrative review

Health and social care professionals' competencies have traditionally been separated because of the different aims of the two professions. These competencies need to be integrated, to make sure that seamless services are provided that meet the often complex needs of patients and clients in a coordinated and timely way. The aim of this integrative review was to identify, describe and synthetise previous studies on integrated competencies in health and social care. Electronic literature searches were carried out on the CINAHL, ProQuest, PsycInfo, PubMed, Scopus and SocIndex databases for peer-reviewed scientific papers that were published in English between 1 January 2007 and 31 December 2019. This identified 3,231 papers, after duplicates were removed, and 18 focused on the integration of social workers' competencies with health care. Other types of integration were not found. The value added by integrating social workers' competencies with health care focused on engaging working orientation, improving communication with family members, increasing understanding of service resources and mastering successful discharge procedures so that they met comprehensive, complex health and well-being needs. Social workers added value when they worked with multi-professional teams, but there were challenges to integrating competencies and these were related to professional collaboration and fragmented leadership. In future, more attention needs to be paid to diversifying and optimising the integration of professional health and social care competencies that meet clients' and patients' care and service needs. It is also vital to focus on developing the professional and leadership strategies that are needed to combine those competencies.

International R&D Collaboration for a Global Aging Society: Focusing on Aging-Related National-Funded Projects

An international research and development (R&D) collaboration for aging-related projects is necessary to alleviate the severe economic/healthcare/humanitarian challenges of a global aging society. This study presents a practical/systematic framework that enables the provision of information on the research goals, the status of science and technology, and action plans of aging-related program development processes. We used data on aging-related national-funded projects from the United States of America, the European Union, the United Kingdom, Japan, and Korea. We collected data on 6318 national-funded projects, subsequently designating research fields to each project. By analyzing the content of the projects, their representative research fields, and the associated keywords, we assessed the general goals of six different research fields. To recognize the current scientific capabilities of these research fields, we divided the projects by clusters. We provided information on research organizations, specific goals (i.e., project title), project periods, and the funding related to the projects. These may be used by stakeholders in various governments/institutions/industries during future discussions regarding the establishment of an international R&D collaboration strategy. The approach we proposed may facilitate the linkage between knowledge and action during strategy development by maximizing scientific legitimacy, developing consensual knowledge, and minimizing diverging opinions among stakeholders.

The Social Platform: Profiling FHIR to Support Community-Dwelling Older Adults

The care networks of community-dwelling older adults require cooperation between different actors, including health and social caregivers, assistant providers, care receivers, and their informal caregivers (e.g. relatives or friends), across time, space, and organizational boundaries. In this context, the project Social Cooperation for Integrated Assisted Living (SOCIAL) aims at the development of a platform of services to support the care networks of community-dwelling older adults. Therefore, the study reported in this article assess the adequacy of the Fast Healthcare Interoperability Resources (FHIR) to guarantee the interoperability of the relevant information related to the assisted persons of the SOCIAL platform, which are mainly older adults that need care and assistance services.

Clinical social work in the care of Parkinson's disease: role, functions, and opportunities in integrated health care

Healthcare reform, including the focus on chronic illness, the growing role of neuroscience, the emphasis on collaborative interprofessional care, and more recently, on integrated medical and behavioral healthcare, have important implications for social work education and practice. Parkinson's disease, a chronic neurodegenerative illness exemplifying these trends, is an area in which social workers are increasingly involved. This paper provides (1) an overview of Parkinson's disease and its complexity, (2) a summary of role and functions identified in a survey of health social workers working with Parkinson's disease and/or neurology, and (3) education and practice recommendations for the social work profession.

Health-Sector Responses to Intimate Partner Violence: Fitting the Response Into the Biomedical Health System or Adapting the System to Meet the Response?

This study aims to analyze how middle-level health systems' managers understand the integration of a health care response to intimate partner violence (IPV) within the Spanish health system. Data were obtained through 26 individual interviews with professionals in charge of coordinating the health care response to IPV within the 17 regional health systems in Spain. The transcripts were analyzed following grounded theory in accordance with the constructivist approach described by Charmaz. Three categories emerged, showing the efforts and challenges to integrate a health care response to IPV within the Spanish health system: "IPV is a complex issue that generates activism and/or resistance," "The mandate to integrate a health sector response to IPV: a priority not always prioritized," and "The Spanish health system: respectful with professionals' autonomy and firmly biomedical." The core category, "Developing diverse responses to IPV integration," crosscut the three categories and encompassed the range of different responses that emerge when a strong mandate to integrate a health care response to IPV is enacted. Such responses ranged from refraining to deal with the issue to offering a women-centered response. Attempting to integrate a response to nonbiomedical health problems as IPV into health systems that remain strongly biomedicalized is challenging and strongly dependent both on the motivation of professionals and on organizational factors. Implementing and sustaining changes in the structure and culture of the health care system are needed if a health care response to IPV that fulfills the World Health Organization guidelines is to be ensured.

Health in All Social Work Programs: Findings From a US National Analysis

OBJECTIVES

To establish a baseline of health content in 4 domains of US social work education-baccalaureate, master's, doctoral, and continuing education programs-and to introduce the Social Work Health Impact Model, illustrating social work's multifaceted health services, from clinical to wide-lens population health approaches.

METHODS

We analyzed US social work programs' Web site content to determine amount and types of health content in mission statements, courses, and specializations. Coding criterion determined if content was (1) health or health-related (HHR) and (2) had wide-lens health (WLH) emphasis. A second iteration categorized HHR and WLH courses into health topics.

RESULTS

We reviewed 4831 courses. We found broad HHR content in baccalaureate, master's, and continuing education curricula; doctoral programs had limited health content. We identified minimal WLH content across all domains. Topical analysis indicated that more than 50% of courses concentrated on 3 areas: mental and behavioral health, abuse and violence, and substance use and addictions.

CONCLUSIONS

As a core health profession, social work must strengthen its health and wide-lens content to better prepare graduates for integrated practice and collaboration in the changing health environment.

A History of Social Work in Public Health

Social work is a core health profession with origins deeply connected to the development of contemporary public health in the United States. Today, many of the nation's 600 000 social workers practice broadly in public health and in other health settings, drawing on a century of experience in combining clinical, intermediate, and population approaches for greater health impact. Yet, the historic significance of this long-standing interdisciplinary collaboration-and its current implications-remains underexplored in the present era. This article builds on primary and contemporary sources to trace the historic arc of social work in public health, providing examples of successful collaborations. The scope and practices of public health social work practice are explored, and we articulate a rationale for an expanded place for social work in the public health enterprise.

Considerations on glycaemic control in older and/or frail individuals with diabetes and advanced kidney disease

The increasing prevalence of chronic kidney disease (CKD) and diabetes over the last decade has resulted in increasing numbers of frail older patients with a combination of these conditions. Current treatment guidelines may not necessarily be relevant for such patients, who are mostly excluded from the trials upon which these recommendations are based. There is a paucity of data upon which to base the management of older patients with CKD. Nearly all current guidelines recommend less-tight glycaemic control for the older population, citing the lack of proven medium-term benefits and concerns about the high short-term risk of hypoglycaemia. However, reports from large landmark trials have shown potential benefits for both microvascular and macrovascular complications, though the relevance of these findings to this specific population is uncertain. The trials have also highlighted potential alternative explanations for the hazards of intensive glycaemic control. These include depression, low endogenous insulin reserve, low body mass index and side effects of the medication. Over the last few years, newer classes of hypoglycaemic drugs with a lower risk of hypoglycaemia have emerged. This article aims to present a balanced view of advantages and disadvantages of intense glycaemic control in this group of patients, which we hope will help the clinician and patient to come to an individualized management approach.

Opportunities for social work under the Affordable Care Act: A call for action

The Affordable Care Act (ACA) has profoundly restructured American health care. Numerous social work authors have commented on the importance of the ACA's reforms to social work practice, education, and research. This article summarizes the literature, adds relevant information, and makes recommendations for future actions. The policy, opinion, and peer-reviewed literatures were systematically reviewed. Sixty-three publications appeared between 2010 and 2015 are included. Five themes emerged, as follows: 1) the crucial provisions of the ACA, 2) the natural affinity of social work and the ACA reforms, 3) curricular adaptations needed to address changing workforce needs, 4) areas for continued social work advocacy, and 5) opportunities for high-impact social work research. This article provides a comprehensive introduction to the ACA, its reforms, and opportunities for social work to assume a high visibility leadership role in implementing the reforms, with particular emphasis on needed curricular changes and opportunities for research.

Motion control for a walking companion robot with a novel human–robot interface

A walking companion robot is presented for rehabilitation from dyskinesia of lower limbs in this article. A new human–robot interface (HRI) is designed which adopts one-axis force sensor and potentiometer connector to detect the motion of the user. To accompany in displacement and angle between the user and the robot precisely in real time, the common motions are classified into two elemental motion states. With distinction method of motion states, a classification scheme of motion control is adopted. The mathematical model-based control method is first introduced and the corresponding control systems are built. Due to the unavoidable deviation of the mathematical model-based control method, a force control method is proposed and the corresponding control systems are built. The corresponding simulations demonstrate that the efficiency of the two proposed control methods. The experimental data and paths of robot verify the two control methods and indicate that the force control method can better satisfy the user’s requirements.

Social Work Leadership as Ambassadors of Health Care Reform: Developing and Implementing a Health Home Program Within a Large Urban Health System

Beginning in 2011, The Mount Sinai Hospital participated in the New York State Department of Health Medicaid Health Home (HH) program, evolving into what is now the Mount Sinai Health Home (MSHH). The lead HH designation required social work leadership to develop and implement this initiative within a large health system, consisting of five New York City area hospitals. Additionally, strategic partnerships with sub-contracted, community based organizations and Medicaid Managed Care Organizations (MCOs) were essential to the HH's success, and were facilitated by inter- and intra-organization collaboration. This article provides an overview of the HH model and discusses the process by which MSHH was formed, the integral role of social work in its development and success, challenges and lessons learned, and recommendations for the development of the profession's future workforce. The authors intend to leave the reader with a model of social work leadership within the current environment of health care reform, and to exemplify social work care coordination and engagement of a hard to reach patient population.

From discharge planner to "concierge": recommendations for hospital social work by clients with intracerebral hemorrhage

The Affordable Care Act and budget cuts have changed the role of hospital social workers by placing pressure on them to conduct speedy discharges and decrease readmission rates. This qualitative study aimed to assess if hospital social work is meeting the needs of clients in the hospital and postdischarge. Semistructured interviews with 10 clients with intracerebral hemorrhage (ICH) and 11 caregivers were conducted. Participants reported that social work services were not meeting their needs. Clients with ICH and their caregivers expressed needs from social workers that surpassed their roles as discharge planners, including counseling, help with finances and insurance, and advocacy. Participants wanted social work services to begin early in acute treatment with continuity postdischarge. Social workers should conduct ethical social work by meeting clients where they are, addressing needs as prioritized by the client, and advocating individually and organizationally for clients.

Information persistence services designed to support home care

Background

Due to the challenges faced by health and social care systems, in particular those related to actual demographic trends, home care emerges as a potentially cost-effective solution to answer the needs of citizens, and to allow the reallocation of resources to alternatives to hospitalization or institutionalization.

Objective

Home care services require cooperation between different actors, including health and social caregivers, care receivers, and their informal caregivers (eg, relatives or friends), across time, space, and organizational boundaries. Therefore, it is foreseeable that eHealth services can contribute to their improvement. The aim of this study is to evaluate information persistence services based on the Reference Information Model (RIM) of the Health Level Seven (HL7) version 3 to support formal caregivers, both health and social care providers, and informal caregivers in the context of home care services.

Methods

A pilot study was set up involving two Portuguese institutions that provide home care services for the elderly. Defining of information requirements was performed according to a comprehensive process. This included a review of the literature, observations of work activities, interviews with caregivers, care receivers and their relatives, analysis of paper documentation related to care receivers’ histories, health conditions and care plans, and brainstorming groups involving specialized professionals. Following this, information objects were implemented and validated.

Results

The methodological approach, as well as the information persistence services, proved to be robust and adequate to specify, implement, and validate different types of information objects related to home care services for the elderly. This study also reinforces the application of the RIM of the HL7 version 3 beyond the strict scope of health care, allowing the persistence of not only health care information, but also information related to social assistance activities.

Conclusions

This study contributes to the ongoing efforts related to the development of eHealth applications to improve the cooperation among formal health care and social caregivers, as well as care receivers and their informal caregivers.

Toward instrument-free digital measurements: a three-dimensional microfluidic device fabricated in a single sheet of paper by double-sided printing and lamination

This study demonstrates a simple approach for fabricating a 3D-μPAD from a single sheet of paper by double-sided printing and lamination. First, a wax printer prints vertically symmetrical and asymmetrical wax patterns onto a double-sided paper surface. Then, a laminator melts the printed wax patterns to form microfluidic channels in the paper sheet. The vertically symmetrical wax patterns form vertical channels when the melted wax patterns make contact with each other. The asymmetrical wax patterns form lateral and vertical channels at the cross section of the paper when the printed wax patterns are melted to a lower height than the thickness of the single sheet of paper. Finally, the two types of wax patterns form a 3D microfluidic network to move fluid laterally and vertically in the single sheet of paper. This method eliminates major technical hurdles related to the complicated and tedious alignment, assembly, bonding, and punching process. This 3D-μPAD can be used in a multiplex digital assay to measure the concentration of a target analyte in a sample solution simply by counting the number of colored bars at a fixed time. It does not require any external instruments to perform digital measurements. Therefore, we expect that this approach could be an instrument-free assay format for use in developing countries.

Moving toward integrated health: an opportunity for social work

With the passage of the Patient Protection and Affordable Care Act (PPACA) and ongoing health care reform efforts, this is a critical time for the social work profession. The approaches and values embedded in health care reform are congruent with social work. One strategy is to improve care for people with co-morbid and chronic illnesses by integrating primary care and behavioral health services. This paper defines integrated health and how the PPACA promotes integrated health care through system redesign and payment reform. We consider how social workers can prepare for health care reform and discuss the implications of these changes for the future of the profession.

Mapping Dual-Degree Programs in Social Work and Public Health: Results From a National Survey

Dramatic changes in the health system due to national health reform are raising important questions regarding the educational preparation of social workers for the new health arena. While dual-degree programs in public health and social work can be an important response to what is needed educationally, little is known about them. The National MSW/MPH Programs Study surveyed MSW/MPH program administrators to better understand the prevalence, models, structure, and challenges of these dual-degree programs. Forty-two programs were identified, and 97.6% of those contacted participated (n=41). Findings indicate that MSW/MPH programs are popular, increasing, geographically dispersed, and drawing talented students interested in trans-disciplinary public health social work practice. Challenges for these programs include the need for greater institutional support, particularly funding, and a general lack of best practices for MSW/MPH education. While findings from this study suggest graduates appear especially well-prepared for leadership and practice in the new health environment, additional research is needed to assess their particular contributions and career trajectories.

From organizational awareness to organizational competency in health care social work: the importance of formulating a "profession-in-environment" fit

Today's health care environments require organizational competence as well as clinical skill. Economically driven business paradigms and the principles underlying the Patient Protection and Affordable Care Act of 2010 emphasize integrated, collaborative care delivered using transdisciplinary service models. Attention must be focused on achieving patient care goals while demonstrating an appreciation for the mission, priorities and operational constraints of the provider organization. The educational challenge is to cultivate the ability to negotiate "ideology" or ideal practice with the practical realities of health care provider environments without compromising professional ethics. Competently exercising such ability promotes a sound "profession-in-environment" fit and enhances the recognition of social work as a crucial patient care component.

Social service counseling in cancer centers certified by the German Cancer Society

Social workers are an integral part of care provided in cancer centers that are certified according to the requirements of the German Cancer Society. This article reports on the tasks of social workers in German cancer care and on the proportion of patients that receives social service counseling (SSC) in breast, lung, colorectal, skin, gynecological, prostate, pancreas, neurological, and head and neck cancer centers based on data from 367,297 patients treated between 2009 and 2012. The highest proportions of patients (median >75%) are provided with SSC in breast and colorectal cancer centers, whereas the median is below 30% in skin cancer centers. Variation between centers and center types is high.

The impact of poverty, chronic illnesses, and health insurance status on out-of-pocket health care expenditures in later life

This study aims to examine poverty, chronic illnesses, health insurance, and health care expenditures, within the context of a political economy of aging perspective. Subsamples of 1,773 older adults from the Medical Expenditure Panel Survey were selected for analyses. The results showed that chronic illnesses influenced out-of-pocket health care costs. Older persons with more than one health insurance spent less on out-of-pocket health care costs. The results have implications for health care social workers concerned with the growing costs of chronic illnesses, implementing integrated care, and advocating for extending public health insurance coverage especially for our most impoverished older adults.