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Thibodeau P, Arena A, Wolfson H, Talamantes M, Albright K. "Working within broken systems": Social workers bridge the fractures of U.S. healthcare: A qualitative inquiry on moral injury. Soc Sci Med 2024; 358:117262. [PMID: 39208704 DOI: 10.1016/j.socscimed.2024.117262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 07/16/2024] [Accepted: 08/19/2024] [Indexed: 09/04/2024]
Abstract
Healthcare social workers (HSWs) in the United States are integral to interdisciplinary teams and health services. HSWs have a unique role in healthcare, as they care for their patients' psychosocial needs, through case management and clinical services. There is a gap in understanding how HSWs are impacted by their healthcare work. This study aims to understand the experience of moral injury, a marker of well-being, amongst HSWs in one state in the United States. Moral injury is the moral transgression (or boundary breaking) by oneself or someone in a position of power in high stakes situations and the negative outcomes of those experiences. Using a qualitative approach, semi-structured interviews were conducted with 24 HSWs in August of 2022. Thematic analysis was used to understand the lived experience of moral injury for HSWs. Three themes emerged: 1) HSWs' definition and examples of moral injury; 2) HSWs situated in the "in-between" of policy and practice; and 3) upholding social work values within the medical model. These findings impact healthcare practice and policy, in delineating what falls within the bounds of social work, changing the workflow of health services, and creating further opportunities for interdisciplinary training, well-being initiatives, and systems-level changes. The findings from this work highlight the importance of understanding the moral impact of healthcare work on social workers, which should be further examined in depth not only amongst HSWs but also across the healthcare workforce.
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Affiliation(s)
- Pari Thibodeau
- University of Colorado, School of Medicine, Department of Psychiatry, 1890 N. Revere Court, Aurora, CO, 80112, USA.
| | - Aprille Arena
- Graduate School of Social Work, University of Denver, 2148 S. High Street, Denver, CO, 80210, USA
| | - Hannah Wolfson
- Graduate School of Social Work, University of Denver, 2148 S. High Street, Denver, CO, 80210, USA
| | - Michael Talamantes
- Graduate School of Social Work, University of Denver, 2148 S. High Street, Denver, CO, 80210, USA
| | - Karen Albright
- Division of General Internal Medicine, University of Colorado School of Medicine, 12631 East 17th Avenue, Aurora, CO, 80045, USA; OCHIN, Inc, PO Box 5426, Portland, OR, 97228, USA
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Sivertsen DM, Becker U, Andersen O, Kirk JW. Between acute medicine and municipal alcohol treatment: Cross-sectoral collaborations regarding patients with alcohol problems. NORDIC STUDIES ON ALCOHOL AND DRUGS 2024; 41:403-425. [PMID: 39309201 PMCID: PMC11412477 DOI: 10.1177/14550725241252256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 04/17/2024] [Indexed: 09/25/2024] Open
Abstract
Aim: The aim was to examine cross-sectoral collaborations of a Danish emergency department (ED) and two municipal treatment centres in the uptake area regarding patients with alcohol problems. Methods: The study was a qualitative exploratory study. We conducted individual interviews with ED nurses and secretaries (n = 21) and group interviews (n = 2) in municipal alcohol treatment centres with three and four participants, respectively. Interviews were analysed, first with qualitative content analysis, then by applying the analytical concept "boundary object". Results: Three themes emerged: (1) Responsibilities in practice; (2) Professional contrasts; and (3) The social nurse in a unique position. Themes illuminated a low degree of collaboration characterising the intersectoral work. Blurred responsibilities, challenged communication and acute versus long-term focus were some of the factors not supporting cross-sector collaborations. However, the function of the social nurse was highly appreciated in both sectors and plays a central role. Nonetheless, implicit limitations of this function entail that not all patients with alcohol problems are referred and handled within an ED setting. Conclusions: Overall, we found a lack of collaborative work between healthcare professionals in ED and municipalities for patients with alcohol problems. However, the "social nurse" function was greatly valued in both sectors due to a mediating role, since healthcare professionals in both sectors experienced lack of organisational structures supporting collaborative network, perceived temporal barriers, limited knowledge exchange and differences in approaches to patients.
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Affiliation(s)
- Ditte Maria Sivertsen
- Copenhagen University Hospital, Denmark; Capital Region of Denmark Psychiatry, Denmark
| | - Ulrik Becker
- National Institute of Public Health, University of Southern Denmark, Denmark
| | - Ove Andersen
- Copenhagen University Hospital Amager Hvidovre, Denmark; University of Copenhagen, Denmark
| | - Jeanette Wassar Kirk
- Copenhagen University Hospital, Denmark; National Institute of Public Health, University of Southern Denmark, Denmark
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Buitron de la Vega P, Dimitri N, Araujo Brinkerhoff C, Stern A, Damus K, Miselis H, Garg PS, Sarfaty S, Sprague Martinez L. Virtual Reality Simulated Learning Environments: A Strategy to Teach Interprofessional Students About Social Determinants of Health. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1799-1803. [PMID: 35703204 DOI: 10.1097/acm.0000000000004776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Physician assistants (PAs) and medical degree students (MDs) often lack training in addressing the social determinants of health (SDOH). Social work students (SWs), meanwhile, have extensive SDOH training; however, few medical professionals have opportunities to engage in interprofessional training with SWs. This study examined the feasibility, acceptability, and students' perceptions of an interprofessional virtual reality (VR) simulated learning environment (SLE) for teaching health professions students about the SDOH. METHOD In January 2020, 15 students at Boston University School of Medicine attended web-based video conferences focused on SDOH, health equity, and team-based care. Subsequently, student dyads participated in a case-based learning activity using an immersive VR SLE to develop teamwork skills. Evaluation included a postsurvey and a focus group examining their experiences in the course to gauge feasibility and acceptability. Thematic analysis of open-ended survey responses from the postsurvey and focus group data was conducted. RESULTS A total of 8 VR simulations were run. Findings indicated both MD and PA students learned patient engagement strategies from SW students, who enhanced their health care leadership capacity. Participants found the means of instruction acceptable, valued the hands-on VR interprofessional training, and expressed interest in learning more about the scope of one another's roles and the community resources available to patients. CONCLUSIONS VR SLE is a feasible and acceptable means of instruction. It allowed students to connect across programmatic and geographic boundaries in a collaborative working environment mimicking the team approach to care they will use in their professional life. This experience illustrated for students the strengths a multidisciplinary team has to offer.
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Affiliation(s)
- Pablo Buitron de la Vega
- P. Buitron de la Vega is assistant professor of medicine, Boston University School of Medicine, Boston, Massachusetts; ORCID: https://orcid.org/0000-0001-8359-8906
| | - Noelle Dimitri
- N. Dimitri is assistant professor of social work, Simmons University, Boston, Massachusetts. At the time this study was conducted, she was a doctoral student, Boston University School of Social Work, Boston, Massachusetts
| | - Cristina Araujo Brinkerhoff
- C. Araujo Brinkerhoff is a doctoral candidate, Boston University School of Social Work, Boston, Massachusetts
| | - Aliza Stern
- A. Stern is assistant professor of dermatology and director of didactic education, Boston University Physician Assistant Program, Boston, Massachusetts
| | - Karla Damus
- K. Damus is an administrator, Office of Human Research Affairs, Boston University School of Medicine, Boston, Massachusetts
| | - Heather Miselis
- H. Miselis is assistant professor of family medicine, Boston University School of Medicine, Boston, Massachusetts
| | - Priya S Garg
- P.S. Garg is assistant professor of pediatrics and associate dean of medical education, Boston University School of Medicine, Boston, Massachusetts; ORCID: https://orcid.org/0000-0002-7219-476X
| | - Suzanne Sarfaty
- S. Sarfaty is associate professor of medicine and assistant dean of medical education, Boston University School of Medicine, Boston, Massachusetts
| | - Linda Sprague Martinez
- L. Sprague Martinez is associate professor and chair, Macro Department, and a research affiliate, Center for Innovation in Social Work and Health, Boston University School of Social Work, Boston, Massachusetts; ORCID: https://orcid.org/0000-0002-5070-7640
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4
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Zhang H, Xie Q, Zou J. How cynicism and exhaustion influence the turnover intention of medical social workers: moderation effect of social work educational background and organizational type. SOCIAL WORK IN HEALTH CARE 2022; 61:412-427. [PMID: 36259560 DOI: 10.1080/00981389.2022.2134273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/27/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
Although exhaustion and cynicism are two dimensions of burnout, due to professionalism, they have different influence on the turnover intentions of medical social workers. Using a sample of 405 medical social workers in China, this study found that the influence mechanisms of exhaustion and cynicism on turnover intention are different. Social work educational background has a significant moderation effect on the relationships between exhaustion, cynicism, and turnover intention. A moderation effect of organizational type was also observed, although it was not significant.
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Affiliation(s)
- Huan Zhang
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
| | - Qiong Xie
- School of Sociology, Beijing Normal University, Beijing, China
| | - Jiachen Zou
- School of Social Development and Public Policy, Beijing Normal University, Beijing, China
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Taels B, Hermans K, Van Audenhove C, Cohen J, Hermans K, Declercq A. Development of an intervention (PICASO) to optimise the palliative care capacity of social workers in Flanders: a study protocol based on phase I of the Medical Research Council framework. BMJ Open 2022; 12:e060167. [PMID: 36220327 PMCID: PMC9558801 DOI: 10.1136/bmjopen-2021-060167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION An important challenge for future palliative care delivery is the growing number of people with palliative care needs compared with the limited qualified professional workforce. Existing but underused professional potential can further be optimised. This is certainly the case for social work, a profession that fits well in multidisciplinary palliative care practice but whose capacities remain underused. This study aims to optimise the palliative care capacity of social workers in Flanders (Belgium) by the development of a Palliative Care Program for Social Work (PICASO). METHODS AND ANALYSIS This protocol paper covers the steps of the development of PICASO, which are based on phase I of the Medical Research Council framework. However, additional steps were added to the original framework to include more opportunities for stakeholder involvement. The development of PICASO follows an iterative approach. First, we will identify existing evidence by reviewing the international literature and describe the problem by conducting quantitative and qualitative research among Flemish social workers. Second, we will further examine practice and identify an appropriate intervention theory by means of expert panels. Third, the process and outcomes will be depicted in a logic model. ETHICS AND DISSEMINATION Ethical approval for this study was given by the KU Leuven Social and Societal Ethics Committee (SMEC) on 14 April 2021 (reference number: G-2020-2247-R2(MIN)). Findings will be disseminated through professional networks, conference presentations and publications in scientific journals.
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Affiliation(s)
- Brent Taels
- LUCAS Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
| | - Kirsten Hermans
- LUCAS Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
| | - Chantal Van Audenhove
- LUCAS Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
- Academic Center for General Practice, KU Leuven, Leuven, Belgium
| | - Joachim Cohen
- End-of-Life Care Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Koen Hermans
- LUCAS Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
- CESO Centre for Sociological Research, KU Leuven, Leuven, Belgium
| | - Anja Declercq
- LUCAS Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
- CESO Centre for Sociological Research, KU Leuven, Leuven, Belgium
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Craig SL, Kourgiantakis T, Kirkland A, Muskat B, Sur D. Riding the wave: pandemic social work in hospitals. SOCIAL WORK IN HEALTH CARE 2022; 61:323-337. [PMID: 35786167 DOI: 10.1080/00981389.2022.2085232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 05/13/2022] [Accepted: 05/27/2022] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic significantly impacted social work practice globally. Using a cross-sectional survey, we examined the experiences of hospital social workers (N = 230) in Ontario, Canada during the second wave of the pandemic. Nearly three quarters (73%) of respondents reported workload changes, and 82% had increased responsibilities due to patient care demands. Hospital social workers adapted and made an important contribution to health care during the pandemic by employing virtual resources, supporting interprofessional colleagues, focusing on advocacy, and providing mental health and trauma-focused care. They sought educational opportunities and contributed to the development of procedures. Recommendations to strengthen hospital pandemic social work practice are provided.
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Affiliation(s)
- Shelley L Craig
- Faculty of Social Work, University of TorontoFactor-Inwentash, Ontario, Canada
| | - Toula Kourgiantakis
- Faculty of Social Work, University of TorontoFactor-Inwentash, Ontario, Canada
| | - Alexa Kirkland
- Faculty of Social Work, University of TorontoFactor-Inwentash, Ontario, Canada
| | - Barbara Muskat
- Faculty of Social Work, University of TorontoFactor-Inwentash, Ontario, Canada
| | - Deepy Sur
- Ontario Association of Social Workers, Toronto, Ontario, Canada
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Wong KLY. How Do Social Workers Working in Long-term Care Understand Their Roles? Using British Columbia, Canada as an Example. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2021; 64:452-470. [PMID: 33749532 DOI: 10.1080/01634372.2021.1900479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 06/12/2023]
Abstract
A common problem faced by social workers working in long-term care is that they are not given the opportunity to tell how they understand their roles and thus their roles are neither understood nor recognized by other professionals. There is a need for social workers to tell how they understand their roles so that their roles can be better understood and recognized. A research study was conducted in the province of British Columbia in Canada to explore how social workers working in long-term care understand their roles. Fourteen semi-structured interviews were conducted. Five themes were identified, including advocating for the most vulnerable, humanizing long-term care, balancing between self-determination and safety, dancing with the systems, and facilitating collaboration. The results reiterated but also supplemented the existing literature. This research study also proposes future research studies on the roles of social workers working in long-term care.
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Affiliation(s)
- Karen Lok Yi Wong
- School of Social Work, University of British Columbia, Vancouver, Canada
- Department of Social Work, Providence Healthcare, Vancouver, Canada
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8
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Adamson K, Bliss R, Shahab R, Sengsavang S, Craig S, Rankin V, Sur D. The SCOPE Intervention: Impact of a Social Care Optimization Pilot Initiative in the Emergency Department. HEALTH & SOCIAL WORK 2021; 45:284-288. [PMID: 33313754 DOI: 10.1093/hsw/hlaa021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 04/21/2020] [Accepted: 07/02/2020] [Indexed: 06/12/2023]
Affiliation(s)
- Keith Adamson
- assistant professor, Department of Social Work, University of Toronto, 246 Bloor Street West, Toronto, Ontario M5S 1V4 Canada
| | - Rebecca Bliss
- social worker, McMaster Children's Hospital, Ontario, Canada
| | - Ramish Shahab
- research assistant, Ontario Association of Social Workers, Toronto
| | - Sonia Sengsavang
- research coordinator, Ontario Association of Social Workers, Toronto
| | - Shelly Craig
- professor, Faculty of Social Work, University of Toronto
| | - Vanessa Rankin
- research and policy manager, Ontario Association of Social Workers, Toronto
| | - Deepy Sur
- chief executive officer, Ontario Association of Social Workers, Toronto
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Bako AT, Taylor HL, Wiley K, Zheng J, Walter-McCabe H, Kasthurirathne SN, Vest JR. Using natural language processing to classify social work interventions. AMERICAN JOURNAL OF MANAGED CARE 2021; 27:e24-e31. [PMID: 33471465 DOI: 10.37765/ajmc.2021.88580] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Health care organizations are increasingly employing social workers to address patients' social needs. However, social work (SW) activities in health care settings are largely captured as text data within electronic health records (EHRs), making measurement and analysis difficult. This study aims to extract and classify, from EHR notes, interventions intended to address patients' social needs using natural language processing (NLP) and machine learning (ML) algorithms. STUDY DESIGN Secondary data analysis of a longitudinal cohort. METHODS We extracted 815 SW encounter notes from the EHR system of a federally qualified health center. We reviewed the literature to derive a 10-category classification scheme for SW interventions. We applied NLP and ML algorithms to categorize the documented SW interventions in EHR notes according to the 10-category classification scheme. RESULTS Most of the SW notes (n = 598; 73.4%) contained at least 1 SW intervention. The most frequent interventions offered by social workers included care coordination (21.5%), education (21.0%), financial planning (18.5%), referral to community services and organizations (17.1%), and supportive counseling (15.3%). High-performing classification algorithms included the kernelized support vector machine (SVM) (accuracy, 0.97), logistic regression (accuracy, 0.96), linear SVM (accuracy, 0.95), and multinomial naive Bayes classifier (accuracy, 0.92). CONCLUSIONS NLP and ML can be utilized for automated identification and classification of SW interventions documented in EHRs. Health care administrators can leverage this automated approach to gain better insight into the most needed social interventions in the patient population served by their organizations. Such information can be applied in managerial decisions related to SW staffing, resource allocation, and patients' social needs.
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Affiliation(s)
- Abdulaziz Tijjani Bako
- Department of Health Policy and Management, Richard M. Fairbanks School of Public Health, Indiana University-Purdue University Indianapolis, 1050 Wishard Blvd, Indianapolis, IN 46202.
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Even D, Shvarts S, Segal-Engelchin D. Medical social workers as mediators between patients, physicians, and the court: the case of former ringworm patients. SOCIAL WORK IN HEALTH CARE 2020; 59:575-587. [PMID: 32942962 DOI: 10.1080/00981389.2020.1822488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 08/06/2020] [Accepted: 09/08/2020] [Indexed: 06/11/2023]
Abstract
Facilitating benefit and resource acquisition to assist clients is a major responsibility of medical social workers, requiring them to have a thorough knowledge of community resources, legislation, and regulations. The aim of the current study was to examine knowledge of the Law for Compensation of Scalp Ringworm Victims and ringworm-related irradiation damage among 101 social workers employed in diverse healthcare settings in Israel. We found that 65.3% of the social workers were aware of the law, but only 40.6% were aware of the health effects of scalp ringworm irradiation. Media coverage and clients who underwent scalp ringworm irradiation were social workers' major sources of knowledge. Working with former ringworm patients had the strongest association with knowledge of the law and of ringworm-related irradiation damage. Results highlight the important contribution of exposure to clients' experiences and knowledge to expand social workers' knowledge of health issues.
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Affiliation(s)
- Dan Even
- Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva, Israel
| | - Shifra Shvarts
- Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva, Israel
| | - Dorit Segal-Engelchin
- The Spitzer Department of Social Work, Ben-Gurion University of the Negev , Beer-Sheva, Israel
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Friedrich AB. Addressing complex hospital discharge by cultivating the virtues of acknowledged dependence. THEORETICAL MEDICINE AND BIOETHICS 2020; 41:99-114. [PMID: 32754801 DOI: 10.1007/s11017-020-09525-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Every day around the country, patients are discharged from hospitals without difficulty, as the interests of the hospital and the patient tend to align: both the hospital and the patient want the patient to leave and go to a setting that will promote the patient's continued recovery. In some cases, however, this usually routine process does not go quite as smoothly. Patients may not want to leave the hospital, or they may insist on an unsafe discharge plan. In other cases, there may simply be no good place for the patient to go. These complex hospital discharge situations often involve ethical, legal, financial, and practical considerations, but the ethical issues inherent in these dilemmas have received only sporadic attention from clinical ethicists at best, leaving patients, providers, administrators, and caregivers unsure about what to do. When the ethical issues are in fact brought to light, analysis usually proceeds based on a consideration of the principles of autonomy, beneficence, nonmaleficence, and justice. However, principled analysis often fails to present patients and providers with a satisfactory solution, as the principles inevitably conflict (for example, when the patient's autonomous desire to remain in the hospital conflicts with the principles of beneficence and justice). In this paper, I argue that difficult discharges are ethical dilemmas worthy of scholarly attention that goes beyond principlism, and I argue that providers and those involved in discharge planning ought to cultivate what philosopher Alasdair MacIntyre calls "virtues of acknowledged dependence" in order to care for these patients and their families. I first trace the current conversation about difficult discharge and show that the principled approach to resolving discharge dilemmas is not sufficient. I then argue that a new approach is needed, and to that end, I offer practical ways in which MacIntyre's account of the virtues of acknowledged dependence may help patients, providers, and family members to navigate issues of difficult discharge.
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Affiliation(s)
- Annie B Friedrich
- Saint Louis University, 3545 Lafayette Avenue, St. Louis, MO, 63104, USA.
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Chung GKK, Dong D, Wong SYS, Wong H, Chung RYN. Perceived poverty and health, and their roles in the poverty-health vicious cycle: a qualitative study of major stakeholders in the healthcare setting in Hong Kong. Int J Equity Health 2020; 19:13. [PMID: 31992307 PMCID: PMC6986077 DOI: 10.1186/s12939-020-1127-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 01/13/2020] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Poverty and ill-health are closely inter-related. Existing studies on the poverty-health vicious cycle focus mainly on less developed countries, where the identified mechanisms linking between poverty and ill-health may not fit the situations in developed Asian regions. This study aims to qualitatively explore the perceived mechanisms and drivers of the poverty-health vicious cycle among major stakeholders in the healthcare setting in Hong Kong. METHODS Data were collected via focus group interviews with social workers (n = 8), chronically ill patients (n = 8), older adults (n = 6), primary care doctors (n = 7) and informal caregivers (n = 10). The transcribed data were then closely read to capture key themes using thematic analyses informed by social constructivism. RESULTS In this highly developed Asian setting with income inequality among the greatest in the world, the poverty-health vicious cycle operates. Material and social constraints, as a result of unequal power and opportunities, appear to play a pivotal role in creating uneven distribution of social determinants of health. The subsequent healthcare access also varies across the social ladder under the dual-track healthcare system in Hong Kong. As health deteriorates, financial hardship is often resulted in the absence of sufficient and coordinated healthcare, welfare and labour policy interventions. In addition to the mechanisms, policy drivers of the cycle were also discussed based on the respondents' perceived understanding of the nature of poverty and its operationalization in public policies, as well as of the digressive conceptions of disease among different stakeholders. CONCLUSIONS The poverty-health vicious cycle has remained a great challenge in Hong Kong despite its economic prosperity. To break the cycle, potential policy directions include the adoption of proportionate universalism, social integration and the strengthening of medical-social collaboration.
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Affiliation(s)
- Gary Ka-Ki Chung
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Dong Dong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Samuel Yeung-Shan Wong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Hung Wong
- Department of Social Work, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Roger Yat-Nork Chung
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong.
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13
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Nicholas DB, Jones C, McPherson B, Hilsen L, Moran J, Mielke K. Examining professional competencies for emerging and novice social workers in health care. SOCIAL WORK IN HEALTH CARE 2019; 58:596-611. [PMID: 30958110 DOI: 10.1080/00981389.2019.1601650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 03/06/2019] [Accepted: 03/26/2019] [Indexed: 06/09/2023]
Abstract
This participatory project identified competencies of social workers in health care, with a focus on entry to the field. Findings reflected discussion groups with n = 24 social workers in health care settings. Identified core competencies were: (a) a core base of knowledge specific to social work in health care, (b) understanding of the health care system and implications for practice, (c) a strong work ethic and confidence working with limited supervision, (d) interpersonal skills for multi-disciplinary teamwork, (e) understanding about complex role and power dynamics, (f) accountability for one's own work/practice and commitment to professional development, (g) reflectiveness on practice, and (h) an organizational commitment to capacity building.
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Affiliation(s)
- David B Nicholas
- a Faculty of Social Work, Central and Northern Alberta Region , University of Calgary , Edmonton , Alberta , Canada
| | - Catherine Jones
- b Department of Social Work , Glenrose Rehabilitation Hospital , Edmonton , Alberta , Canada
| | - Barbara McPherson
- c Department of Social Work , Royal Alexandra Hospital , Edmonton , Alberta , Canada
| | - Leeann Hilsen
- a Faculty of Social Work, Central and Northern Alberta Region , University of Calgary , Edmonton , Alberta , Canada
| | - Jennifer Moran
- c Department of Social Work , Royal Alexandra Hospital , Edmonton , Alberta , Canada
| | - Kent Mielke
- b Department of Social Work , Glenrose Rehabilitation Hospital , Edmonton , Alberta , Canada
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14
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Eaton CK. Social workers, nurses, or both: Who is primarily responsible for hospital discharge planning with older adults? SOCIAL WORK IN HEALTH CARE 2018; 57:851-863. [PMID: 30300115 DOI: 10.1080/00981389.2018.1521892] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This study examines the profession primarily responsible for discharge planning in all hospitals serving older adults in Minnesota. Quantitative analyses determined that the majority of hospitals in Minnesota serving older adults are small, rural hospitals with critical access designations, are private nonprofit, and are affiliated with a health care system. Social workers are primarily responsible for discharge planning in half of the hospitals, nurses in a quarter and either a nurse/social worker team or both nurse and social worker separately in the remaining quarter. Multinomial logistic regression determined that in critical access hospitals nurses are more likely than social workers to be the profession primarily responsible for discharge planning.
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Affiliation(s)
- Charissa K Eaton
- a Department of Social Work , Winona State University , Winona , MN , USA
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Bryson SA, Bosma H. Health social work in Canada: Five trends worth noting. SOCIAL WORK IN HEALTH CARE 2018; 57:1-26. [PMID: 29847225 DOI: 10.1080/00981389.2018.1474161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Highlighting a strong human rights and social justice orientation underlying health social work in Canada, this paper describes recent contributions of Canadian health social work practitioners and scholars to five areas identified by Auslander (2001) in a delphi study of health social work in its first century. Five current 'trends' are discussed which correspond with Auslander's themes of professional legitimacy and scope, social causation, dissemination of knowledge, interventions, and cultural appropriateness. These trends are: 1) defining the scope of health social work practice; 2) addressing the social determinants of health; 3) promoting evidence-based practice in health social work; 4) delivering client and family-centered care; and 5) implementing cultural safety and trauma-informed practice. Suggestions are made to further strengthen the position of health social work in Canada.
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Affiliation(s)
- Stephanie A Bryson
- a School of Social Work , Portland State University , Portland, Portland, OR, USA
- b School of Social Work, University of British Columbia , Vancouver, BC, Canada
| | - Harvey Bosma
- b School of Social Work, University of British Columbia , Vancouver, BC, Canada
- c Social Work Department, Providence Health Care , Vancouver, BC, Canada
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Peterson EB, Chou WYS, Falisi A, Ferrer R, Mollica MA. The role of medical social workers in cancer clinical trial teams: A group case study of multidisciplinary perspectives. SOCIAL WORK IN HEALTH CARE 2018; 57:688-704. [PMID: 29856290 DOI: 10.1080/00981389.2018.1477899] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Social workers collaborate with a wide range of healthcare providers in clinical trial teams, yet their roles may not always be understood or supported by team members. It is currently unknown how social workers and multidisciplinary team members perceive social workers' roles in the clinical trial context. METHODS Using a group case-study approach, social workers, core medical team members, and allied healthcare workers (n = 19) completed in-depth interviews to discuss the roles of social workers in a cancer clinical trial setting. FINDINGS Social workers discussed their role as primarily patient-centered, perceiving themselves to be a counselor, patient advocate, and conduit. They also described areas of perceived limited role contribution. Other members of the multidisciplinary teams viewed the roles of social workers to be focused on being a conduit and coordinator. DISCUSSION We found discordance in the way that social workers and their team members view the roles of social workers in clinical trials. Our data suggest that structural and interpersonal barriers may prevent social workers from working to the full extent of their license in a clinical trial context. Implications, future research, and suggestions for interventions to more fully integrate social workers into clinical trial settings are discussed.
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Affiliation(s)
- Emily B Peterson
- a Division of Cancer Control and Population Sciences , National Cancer Institute , Rockville , MD , USA
| | - Wen-Ying Sylvia Chou
- a Division of Cancer Control and Population Sciences , National Cancer Institute , Rockville , MD , USA
| | - Angela Falisi
- a Division of Cancer Control and Population Sciences , National Cancer Institute , Rockville , MD , USA
| | - Rebecca Ferrer
- a Division of Cancer Control and Population Sciences , National Cancer Institute , Rockville , MD , USA
| | - Michelle A Mollica
- a Division of Cancer Control and Population Sciences , National Cancer Institute , Rockville , MD , USA
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González-Martínez E, Bulliard C. [Interprofessional collaboration between new nursing graduates and social workers: Hospital discharge planning telephone calls.]. Rech Soins Infirm 2018:15-36. [PMID: 30066504 DOI: 10.3917/rsi.133.0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION In hospitals, the discharge of patients needing home care or going to a care facility is planned interprofessionally, in particular via telephone calls between nurses and social workers. CONTEXT During discharge planning, the collaboration between a nurse and a social worker is fraught with tension. When this planning is conducted over the phone and the nurse is a new graduate, the tension can be heightened. METHOD Sociological study in an acute-care hospital in French-speaking Switzerland based on analyses of telephone conversations between new nursing graduates and social workers, in addition to observations, interviews and document-gathering. RESULTS Discharge planning is fraught with tension related to the timing of the planning and the care requested. The telephone calls are opportunities for new nurses to learn how to present cases, the procedures to follow for discharge planning, and the work logics of the individuals involved. DISCUSSION The study confirms the need to prepare new nurses to work with social workers on discharge planning and recommends offering training in this, both in nursing school and in the workplace. CONCLUSION Research documenting real work practices provides the keys to perfecting them.
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Morris R, Muskat B, Greenblatt A. Working with children with autism and their families: pediatric hospital social worker perceptions of family needs and the role of social work. SOCIAL WORK IN HEALTH CARE 2018; 57:483-501. [PMID: 29667506 DOI: 10.1080/00981389.2018.1461730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Social workers with knowledge of autism can be valuable contributors to client- and family-centered healthcare services. This study utilized a qualitative design to explore pediatric hospital social workers' experiences and perceptions when working with children and youth with autism and their families. Interviews with 14 social workers in a Canadian urban pediatric hospital highlighted perceptions of the needs of families of children with autism in the hospital and challenges and benefits related to the role of social work with these families. Results suggest that pediatric social workers may benefit from opportunities to develop autism-relevant knowledge and skills.
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Affiliation(s)
- Rae Morris
- a The Redpath Centre , Toronto , Canada
- b School of Social Work , University of British Columbia , Vancouver , Canada
| | - Barbara Muskat
- c Department of Social Work , The Hospital for Sick Children , Toronto , Canada
| | - Andrea Greenblatt
- c Department of Social Work , The Hospital for Sick Children , Toronto , Canada
- d Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
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Evans EJ. Blended Roles under Health Reform: Where Does Social Work Fit? HEALTH & SOCIAL WORK 2018; 43:141-144. [PMID: 29878191 DOI: 10.1093/hsw/hly016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Ethan J Evans
- Ethan J. Evans, PhD, MSW, is assistant professor, Division of Social Work, California State University, Sacramento, and research affiliate, Center for Healthcare Policy and Research, University of California, Davis
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20
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Ciocănel A, Lazăr F, Munch S, Harmon C, Rentea GC, Gaba D, Mihai A. Helping, mediating, and gaining recognition: The everyday identity work of Romanian health social workers. SOCIAL WORK IN HEALTH CARE 2018; 57:206-219. [PMID: 29351505 DOI: 10.1080/00981389.2018.1426674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Health social work is a field with challenges, opportunities, and ways of professing social work that may vary between different national contexts. In this article, we look at how Romanian health social workers construct their professional identity through their everyday identity work. Drawing on a qualitative study based on interviews with 21 health social workers working in various organizational contexts, we analyze what health social workers say they do and how this shapes their self-conception as professionals. Four main themes emerged from participants' descriptions: being a helping professional, being a mediator, gaining recognition, and contending with limits. Through these themes, participants articulated the everyday struggles and satisfactions specific to working as recently recognized professionals in Romanian health and welfare systems not always supportive of their work.
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Affiliation(s)
- Alexandra Ciocănel
- a Faculty of Sociology and Social Work , University of Bucharest , Bucharest , Romania
| | - Florin Lazăr
- a Faculty of Sociology and Social Work , University of Bucharest , Bucharest , Romania
| | - Shari Munch
- b School of Social Work, Rutgers , The State University of New Jersey , New Brunswick , New Jersey , USA
| | - Cara Harmon
- b School of Social Work, Rutgers , The State University of New Jersey , New Brunswick , New Jersey , USA
| | | | - Daniela Gaba
- a Faculty of Sociology and Social Work , University of Bucharest , Bucharest , Romania
| | - Anca Mihai
- a Faculty of Sociology and Social Work , University of Bucharest , Bucharest , Romania
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Muskat B, Craig SL, Mathai B. Complex families, the social determinants of health and psychosocial interventions: Deconstruction of a day in the life of hospital social workers. SOCIAL WORK IN HEALTH CARE 2017; 56:765-778. [PMID: 28696836 DOI: 10.1080/00981389.2017.1339761] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The roles of hospital social workers are delineated in the literature; however, their daily interventions have only been described anecdotally. This study analyzes the daily work of social workers in a pediatric hospital through a survey completed which examined factors related to interventions utilized and time spent per case over a 1-day period. Length and types of interventions were associated with the social determinants of health, time since diagnosis, biopsychosocial issues, and perception of complexity. The study offers a snapshot of the personalized expertise, provided by social workers that addresses complex contextual and biopsychosocial concerns of patient and families.
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Affiliation(s)
- Barbara Muskat
- a Department of Social Work , The Hospital for Sick Children , Toronto , Ontario , Canada
| | - Shelley L Craig
- b Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Ontario , Canada
| | - Biju Mathai
- c Acute Care of the Elderly Unit and Inpatient Mental Health, Rehabilitation Social Worker Queensway Carleton Hospital , Ottawa , Ontario , Canada
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Miller VJ, Fields NL, Adorno G, Smith-Osborne A. Using the Eco-Map and Ecosystems Perspective to Guide Skilled Nursing Facility Discharge Planning. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2017; 60:504-518. [PMID: 28463059 DOI: 10.1080/01634372.2017.1324548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Growing numbers of seniors across the United States require skilled nursing facility care after an inpatient hospital stay. Previous studies indicate that roughly 20 percent of all hospitalized Medicare beneficiaries are admitted to a skilled nursing facility following a qualifying hospital stay. Social workers address psychosocial problems, social support, networks, and healthcare needs during transitions in care, particularly discharge planning. Ecosystems perspective and the eco-map as a discharge planning tool is presented. Social workers can use these tools to examine the patient with respect to their transactional relationships with systems. This will further will facilitate provision of wrap-around services upon discharge.
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Affiliation(s)
- V J Miller
- a University of Texas at Arlington , School of Social Work , Arlington , Texas , USA
| | - N L Fields
- a University of Texas at Arlington , School of Social Work , Arlington , Texas , USA
| | - G Adorno
- a University of Texas at Arlington , School of Social Work , Arlington , Texas , USA
| | - A Smith-Osborne
- a University of Texas at Arlington , School of Social Work , Arlington , Texas , USA
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Burnham Riosa P, Greenblatt A, Muskat B. An online ASD learning module for pediatric health care professionals. ADVANCES IN AUTISM 2017. [DOI: 10.1108/aia-03-2017-0007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
Youth with autism spectrum disorder (ASD) often have co-occurring health care needs and are likely to come into contact with several health care professionals over their lives. At the hospital, youth with ASD may require specialized supports to optimize health care experiences and for medical services to be delivered safely. At present, there is a limited understanding of how to best support this patient population. The purpose of this paper is to develop, implement, and evaluate an online training module for hospital staff about ASD.
Design/methodology/approach
To evaluate participants’ perceived utility of the learning tool, a post-module survey was administered.
Findings
In all, 102 health care professionals and other hospital staff completed the training and evaluation measure. Majority of participants had prior ASD-focused education (66 percent) and had experience working with at least 20 youths with ASD (57 percent). Majority of participants (88 percent) perceived the information from the module to be helpful in their daily work and reported that they learned something new (63 percent). Participants were interested in receiving additional ASD online module training opportunities on topics including: hands-on behavior management strategies, in-hospital resources, guidance on treatment adherence, and ASD training geared specifically to protection services staff.
Originality/value
The results from this evaluation have important practice implications for hospital staff working with patients with ASD and their families. Evidence-based strategies were easily accessible for staff and the module can be feasibly built upon and expanded as well as disseminated beyond the current hospital setting.
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Muskat B, Brownstone D, Greenblatt A. The experiences of pediatric social workers providing end-of-life care. SOCIAL WORK IN HEALTH CARE 2017; 56:505-523. [PMID: 28398174 DOI: 10.1080/00981389.2017.1302034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pediatric social workers working in acute care hospital settings may care for children and their families in end-of-life circumstances. This qualitative study is part of a larger study focusing on the experiences of health care providers working with dying children. This study consisted of 9 semi-structured interviews of acute care pediatric social workers who work with dying children and their families. Themes included the role of social work with dying children, the impact of their work and coping strategies. Authors suggest a hospital-worker partnership in supporting staff and promotion of supportive resources.
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Affiliation(s)
- Barbara Muskat
- a Social Work , Hospital for Sick Children , Toronto , Ontario , Canada
| | - David Brownstone
- a Social Work , Hospital for Sick Children , Toronto , Ontario , Canada
| | - Andrea Greenblatt
- a Social Work , Hospital for Sick Children , Toronto , Ontario , Canada
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25
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Delany C, Richards A, Stewart H, Kosta L. Five challenges to ethical communication for interprofessional paediatric practice: A social work perspective. J Interprof Care 2017; 31:505-511. [PMID: 28287850 DOI: 10.1080/13561820.2017.1296419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In paediatric clinical care, what is said to a parent or carer as well as when, where, and how it is said, directly advances or diminishes parents' capacities to understand available options and to contribute to decisions about treatment for their child. This makes interprofessional and patient communication an ethical endeavour. Social workers are uniquely situated to observe, participate in, and provide an active link in the communication between families and other health team members. This article reports phenomenological research exploring ethical issues encountered by social workers in their everyday practice communicating with families and other health professionals in a paediatric hospital context in Australia. Data were collected via semi-structured interviews with nine social workers and analysed thematically. Participants described two main communication-based roles: to support families through information provision and to contribute collaboratively to the interprofessional team involved in caring for a child and family. We grouped participants' descriptions of conflict between these roles into five main "communication challenges": (1) holding troublesome knowledge; (2) the need for diplomacy; (3) conciliation; (4) every man and his dog in family meetings; and (5) systems and processes presenting a brick wall. The five communication challenges provide empirically derived examples of how communication occurring within interprofessional health teams and between individual clinicians and parents can act to diminish or enhance parents' experience of care for their hospitalised child. Identifying these challenges may help to inform how communication within interprofessional teams and between clinicians and patients can benefit children and their parents.
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Affiliation(s)
- Clare Delany
- a Children's Bioethics Centre , Royal Children's Hospital , Melbourne , Victoria , Australia.,b Medical School , The University of Melbourne , Melbourne , Victoria , Australia
| | - Angela Richards
- c Social Work , Royal Children's Hospital , Melbourne , Victoria , Australia
| | - Helen Stewart
- c Social Work , Royal Children's Hospital , Melbourne , Victoria , Australia
| | - Lauren Kosta
- d Department of Social Work , The University of Melbourne , Melbourne , Victoria , Australia
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26
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Vungkhanching M, Tonsing KN. Social Workers' Perceived Role Clarity as Members of an Interdisciplinary Team in Brain Injury Settings. JOURNAL OF SOCIAL WORK IN DISABILITY & REHABILITATION 2016; 15:370-384. [PMID: 27646459 DOI: 10.1080/1536710x.2016.1220887] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study investigated social workers' role clarity as members of an interdisciplinary team in traumatic and acquired brain injury treatment settings. A total of 37 social workers from 7 Western countries completed an anonymous online survey questionnaire. The majority of participants have more than 10 years of experience working in brain injury treatment settings (59.5%), and about 54% have been in their current employment for more than 10 years. Findings revealed that there were significant positive correlations between perceived respect, team collaboration, and perceived value of self for team with role clarity. Multiple regression analysis revealed that perceived value of self for team was a significant predictor of role clarity (p < .05).
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Affiliation(s)
- Martha Vungkhanching
- a Social Work Education , California State University-Fresno, Fresno , California , USA
| | - Kareen N Tonsing
- b Department of Sociology, Anthropology, Social Work and Criminal Justice , Oakland University , Rochester , Michigan , USA
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27
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Baum N, Shalit H, Kum Y, Tal M. Social workers' role in tempering inequality in healthcare in hospitals and clinics: a study in Israel. HEALTH & SOCIAL CARE IN THE COMMUNITY 2016; 24:605-613. [PMID: 25810328 DOI: 10.1111/hsc.12234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/25/2015] [Indexed: 06/04/2023]
Abstract
The paper presents an empirical examination of the role social workers play in tempering inequality in medical care. Data were collected in 2011 through face-to-face, semi-structured, in-depth interviews with 60 social workers employed in hospitals and clinics in Israel and selected through purposive sampling. The interviews probed the social workers' perceptions of the scope, causes and manifestations of inequality in health and healthcare and the actions they took to ameliorate it. The interviews were analysed using grounded theory. The findings show that all the social workers were acutely aware of the inequalities in their places of work, regarded reducing the inequalities as a major part of their role and made efforts to do so. They facilitated communication between doctors and patients of low socioeconomic status and advocated for such patients with medical staff and administration, as well as with the country's medical and social welfare bureaucracies. The paper details the means they used and the challenges they faced. The study highlights the important role that social workers play in reducing inequality in healthcare.
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Affiliation(s)
- Nehami Baum
- The Louis and Gabi Weisfeld School of Social Work, Bar Ilan University, Ramat Gan, Israel
| | - Hani Shalit
- Social Work Services, Clalit Health Services, Tel Aviv, Israel
| | - Yishay Kum
- Social Work Services, Meuhedit Health Services, Tel Aviv, Israel
| | - Malka Tal
- National Social Work Services, Ministry of Health, Tel Aviv, Israel
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Craig S, Frankford R, Allan K, Williams C, Schwartz C, Yaworski A, Janz G, Malek-Saniee S. Self-reported patient psychosocial needs in integrated primary health care: A role for social work in interdisciplinary teams. SOCIAL WORK IN HEALTH CARE 2016; 55:41-60. [PMID: 26727556 DOI: 10.1080/00981389.2015.1085483] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Despite being identified as significant determinants of health, depression and anxiety continue to be underdiagnosed and undertreated in primary care settings. This study examined the psychosocial health needs of patients at four urban interdisciplinary primary health teams. Quantitative analysis revealed that nearly 80% of patients reported anxiety and/or depression. Self-reported anxiety and depression was correlated with poor social relationships, compromised health status and underdeveloped problem-solving skills. These findings suggest that social workers have a vital role to play within interdisciplinary primary health teams in the amelioration of factors associated with anxiety and depression.
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Affiliation(s)
- Shelley Craig
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Ontario , Canada
| | | | - Kate Allan
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Ontario , Canada
| | - Charmaine Williams
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Ontario , Canada
| | | | - Andrea Yaworski
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Ontario , Canada
| | - Gwen Janz
- b St. Michael's Hospital , Toronto , Ontario , Canada
| | - Sara Malek-Saniee
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Ontario , Canada
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Sims-Gould J, Byrne K, Hicks E, Franke T, Stolee P. "When Things Are Really Complicated, We Call the Social Worker": Post-Hip-Fracture Care Transitions for Older People. HEALTH & SOCIAL WORK 2015; 40:257-265. [PMID: 26638501 DOI: 10.1093/hsw/hlv069] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Social workers play a key role in the delivery of interdisciplinary health care. However, in the past decade, concerns have been raised about social work's sustainability and contributions in a changing health care sector. These changes come at a time when older patients are more complex and vulnerable than ever before. In this article, using a strengths-based approach, the authors examine the key contributions made by social workers working with older patients with hip fracture as they strive to achieve successful care transitions. Twenty-five interviews with health care professionals (HCPs) were conducted and then analyzed using an analytical coding framework. Although social workers are vital, they are often underused and overlooked in the care of hip fracture patients. The authors sketch the important contributions that social workers make to care transitions after hip fracture, specifically informational continuity; patient-HCP relational continuity; conflict resolution; mediation among family, patient, and HCP (for example, doctors and nurses); collaboration with family caregivers and community supports; and relocation counseling.
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Linton KF, Ing MM, Vento MA, Nakagawa K. From discharge planner to "concierge": recommendations for hospital social work by clients with intracerebral hemorrhage. SOCIAL WORK IN PUBLIC HEALTH 2015; 30:486-495. [PMID: 26252181 PMCID: PMC5022556 DOI: 10.1080/19371918.2015.1058730] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
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.
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Affiliation(s)
- Kristen F. Linton
- Assistant Professor, Health Sciences Program, California State University, Channel Islands, One University Drive, Camarillo, CA, 93012
| | - Marissa M. Ing
- Neuroscience Institute, The Queen’s Medical Center, Honolulu, HI
| | - Megan A. Vento
- Neuroscience Institute, The Queen’s Medical Center, Honolulu, HI
| | - Kazuma Nakagawa
- Neuroscience Institute, The Queen’s Medical Center, Honolulu, HI
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI
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Jansson BS, Nyamathi A, Heidemann G, Duan L, Kaplan C. Predicting Patient Advocacy Engagement: A Multiple Regression Analysis Using Data From Health Professionals in Acute-Care Hospitals. SOCIAL WORK IN HEALTH CARE 2015; 54:559-581. [PMID: 26317762 DOI: 10.1080/00981389.2015.1054059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Although literature documents the need for hospital social workers, nurses, and medical residents to engage in patient advocacy, little information exists about what predicts the extent they do so. This study aims to identify predictors of health professionals' patient advocacy engagement with respect to a broad range of patients' problems. A cross-sectional research design was employed with a sample of 94 social workers, 97 nurses, and 104 medical residents recruited from eight hospitals in Los Angeles. Bivariate correlations explored whether seven scales (Patient Advocacy Eagerness, Ethical Commitment, Skills, Tangible Support, Organizational Receptivity, Belief Other Professionals Engage, and Belief the Hospital Empowers Patients) were associated with patient advocacy engagement, measured by the validated Patient Advocacy Engagement Scale. Regression analysis examined whether these scales, when controlling for sociodemographic and setting variables, predicted patient advocacy engagement. While all seven predictor scales were significantly associated with patient advocacy engagement in correlational analyses, only Eagerness, Skills, and Belief the Hospital Empowers Patients predicted patient advocacy engagement in regression analyses. Additionally, younger professionals engaged in higher levels of patient advocacy than older professionals, and social workers engaged in greater patient advocacy than nurses. Limitations and the utility of these findings for acute-care hospitals are discussed.
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Affiliation(s)
- Bruce S Jansson
- a School of Social Work , University of Southern California , Los Angeles , California , USA
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Craig SL, Betancourt I, Muskat B. Thinking big, supporting families and enabling coping: the value of social work in patient and family centered health care. SOCIAL WORK IN HEALTH CARE 2015; 54:422-443. [PMID: 25985286 DOI: 10.1080/00981389.2015.1017074] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Patient and family-centered care has become a focus in health services. Social work has a rich history of providing responsive patient care. This study identified the contribution and value of social work to PFCC from the key stakeholder perspectives of health social workers (n = 65). Utilizing interpretive description, four themes emerged: (1) Thinking big and holistically, (2) Intervening with families, (3) Enabling patient and family coping, and (4) Maximizing hospital and community resources. Barriers included a lack of power, professional isolation and role creep. Implications for research and practice are provided.
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Affiliation(s)
- Shelley L Craig
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Ontario , Canada
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Chapin RK, Chandran D, Sergeant JF, Koenig TL. Hospital to community transitions for adults: discharge planners and community service providers' perspectives. SOCIAL WORK IN HEALTH CARE 2014; 53:311-329. [PMID: 24717181 DOI: 10.1080/00981389.2014.884037] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Discharges from the hospital to community-based settings are more difficult for older adults when there is lack of communication, resource sharing, and viable partnerships among service providers in these settings. The researchers captured the perspectives of three different groups of participants from hospitals, independent living centers, and Area Agencies on Aging, which has rarely been done in studies on discharge planning. Findings include identification of barriers in the assessment and referral process (e.g., timing of discharge, inattention to client goals, lack of communication and partnerships between hospital discharge planners and community providers), and strategies for overcoming these barriers. Implications are discussed including potential for Medicaid and Medicare cost reductions due to fewer re-hospitalizations.
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Affiliation(s)
- Rosemary Kennedy Chapin
- a Office of Aging and Long Term Care, School of Social Welfare , University of Kansas , Lawrence , Kansas , USA
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Craig SL, Bejan R, Muskat B. Making the invisible visible: are health social workers addressing the social determinants of health? SOCIAL WORK IN HEALTH CARE 2013; 52:311-331. [PMID: 23581836 DOI: 10.1080/00981389.2013.764379] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study explored the ways in which health social workers (HSW) address the social determinants of health (SDH) within their social work practice. Social workers (n = 54) employed at major hospitals across Toronto had many years of practice in health care (M = 11 years; SD = 10.32) and indicated that SDH were a top priority in their daily work; with 98% intentionally intervening with at least one and 91% attending to three or more. Health care services were most often addressed (92%), followed by housing (72%), disability (79%), income (72%), and employment security (70%). Few HSW were tackling racism, Aboriginal status, gender, or social exclusion in their daily practice.
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Affiliation(s)
- Shelley L Craig
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
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