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Ufere NN, Hinson J, Finnigan S, Powell EE, Donlan J, Martin C, Clark P, Valery PC. The Impact of Social Workers in Cirrhosis Care: a Systematic Review. CURRENT TREATMENT OPTIONS IN GASTROENTEROLOGY 2022; 20:160-176. [PMID: 35676928 PMCID: PMC9167183 DOI: 10.1007/s11938-022-00381-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/15/2022] [Indexed: 01/23/2023]
Abstract
Purpose of review To report social workers' involvement in supporting patients with cirrhosis. Recent findings Six intervention studies (three published in the past 3 years) highlighed the potential role of social worker-led interventions to improve the outcomes of patients with cirrhosis. In studies of patients with alcohol-related liver disease (n = 4), social workers conducted psychosocial assessments, screened for substance use disorder and psychological distress, coordinated referrals to addiction services, and provided relapse prevention therapy. In studies including transplant recipients or candidates (n = 2), social workers focused on psychosocial interventions. In two studies (n = 1 patient with alcohol-related liver disease; n = 1 transplant recipients), social workers provided practical support (e.g., housing, transportation). Most articles provided limited information about the intervention and the role of the social worker, making comparisons of the studies difficult. Summary More high-quality evidence is needed to formally assess the impact of social workers in improving the outcomes of patients with cirrhosis. Supplementary Information The online version contains supplementary material available at 10.1007/s11938-022-00381-2.
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Affiliation(s)
- Nneka N Ufere
- Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 USA
| | - Jan Hinson
- Faculty of Health Sciences, School of Allied Health, Social Work Discipline, Australian Catholic University, Brisbane Campus (McAuley), 1100 Nudgee Road, Banyo, QLD 4014 Australia
| | - Simon Finnigan
- Centre for Functioning and Health Research, Metro South Health, Level 3, Buranda Village, Buranda, QLD 4102 Australia.,Department of Social Work, Princess Alexandra Hospital, 199 Ipswish Road, Woolloongabba, QLD 4102 Australia.,UQ Centre for Clinical Research, The University of Queensland, Herston, QLD 4029 Australia
| | - Elizabeth E Powell
- Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, 199 Ipswish Road, Woolloongabba, QLD 4102 Australia
| | - John Donlan
- Harvard Medical School, 25 Shattuck St, Boston, MA 02115 USA
| | - Cathy Martin
- Queensland Liver Transplant Service, Princess Alexandra Hospital, 199 Ipswish Road, Woolloongabba, QLD 4102 Australia
| | - Phil Clark
- Faculty of Health Sciences, School of Allied Health, Social Work Discipline, Australian Catholic University, Brisbane Campus (McAuley), 1100 Nudgee Road, Banyo, QLD 4014 Australia
| | - Patricia C Valery
- Population Health Department, QIMR Berghofer Medical Research Institute, 300 Herston Road, Herston, QLD 4006 Australia
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Hansen MS, Tesfaye W, Sewlal B, Mehta B, Sud K, Kairaitis L, Tarafdar S, Chau K, Zaidi ST, Castelino RL. Psychosocial factors affecting patients with end-stage kidney disease and the impact of the social worker. J Nephrol 2021; 35:43-58. [PMID: 34181197 DOI: 10.1007/s40620-021-01098-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 06/10/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND End-stage kidney disease (ESKD) incidence has been increasing over time, contributing significantly to morbidity and mortality. However, there is limited data examining the psychosocial factors affecting people with ESKD and how the social worker fits within the multidisciplinary CKD care. This integrative systematic review aims to summarise the existing evidence on psychosocial determinants of outcomes in ESKD and the role of the social worker in nephrology care. METHOD The literature search was conducted using PubMed and MEDLINE, targeting articles published from database inception until May 2021. This systematic review was performed in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The Joanna Briggs Institute tools were employed to assess the quality of included studies. RESULTS Of the 397 citations, 13 studies applicable to 1465 patients met the inclusion criteria. The studies were of cross-sectional, experimental, and exploratory qualitative design in nature. The findings of the studies were summarised into three major themes-psychosocial factors, role of the renal social worker, and impact of the renal social worker. The studies demonstrated that concerns related to adjustment, death and dying, family and social functioning, and loss were common amongst participants of the included studies indicating the need for a social worker. Three studies explored the impact of social workers in ESKD, revealing that people who received support from social workers had an improved quality of life, lower depression scores, and reduced hospitalisations and emergency room visits. CONCLUSION This review summarizes the multitude of physical and psychological stressors that patients with ESRD face, and highlights the positive role social workers can play in improving the psychosocial stressors in this patient group, and the need for large-scale randomised trials to understand the role of social workers as part of a multidisciplinary nephrology care.
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Affiliation(s)
- Micaella Sotera Hansen
- Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Wubshet Tesfaye
- Health Research Institute, University of Canberra, Canberra, Australia.
| | - Beena Sewlal
- Blacktown Hospital Western Sydney Local Health District (WSLHD), Blacktown, Australia
| | - Bharati Mehta
- Blacktown Hospital Western Sydney Local Health District (WSLHD), Blacktown, Australia
- Westmead and Blacktown Hospitals, Western Sydney, Local Health District (WSLHD), Blacktown, Australia
| | - Kamal Sud
- Department of Renal Medicine, Nepean Hospital, Nepean and Blue Mountains Local Health District, Kingswood, Australia
- Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Lukas Kairaitis
- Department of Renal Medicine, Blacktown Hospital, WSLHD, Blacktown, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Surjit Tarafdar
- Department of Renal Medicine, Blacktown Hospital, WSLHD, Blacktown, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | - Katrina Chau
- Department of Renal Medicine, Blacktown Hospital, WSLHD, Blacktown, Australia
- School of Medicine, Western Sydney University, Sydney, Australia
| | | | - Ronald Lynel Castelino
- School of Pharmacy, University of Sydney, Sydney, Australia
- Pharmacy Department, Blacktown Hospital, WSLHD, Blacktown, Australia
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Killian MO, Schuman DL, Mayersohn GS, Triplett KN. Psychosocial predictors of medication non-adherence in pediatric organ transplantation: A systematic review. Pediatr Transplant 2018; 22:e13188. [PMID: 29637674 DOI: 10.1111/petr.13188] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/12/2018] [Indexed: 12/27/2022]
Abstract
Adherence to immunosuppressant medication is critical to health and quality-of-life outcomes for children who have received a solid organ transplant. Research on the psychological and social predictors of medication adherence is essential to the advancement of pretransplant assessments and transplant psychosocial services. Despite the importance of identifying risk factors, the literature remains limited regarding psychosocial predictors of non-adherence. A systematic search was conducted to identify studies of the psychosocial predictors of post-transplant medication non-adherence in pediatric solid organ transplantation. From 1363 studies identified in searches of empirical literature, a final sample consisted of 54 publications representing 49 unique studies. Findings regarding psychosocial predictors were inconsistent with non-adherence associated largely with adolescence, racial/ethnic minority status, and presence of mental health issues. Familial predictors of non-adherence problems included single-parent households, lower socioeconomic status, lower family cohesion, presence of family conflict, and poor family communication. Several studies reported an association between non-adherence and social pressures (eg, peer social interaction, wanting to feel normal) among adolescent transplant recipients. While significant methodological and substantive gaps remain in this body of knowledge, this review synthesizes current evidence for assessment for transplant clinicians and researchers.
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Affiliation(s)
- Michael O Killian
- School of Social Work, University of Texas at Arlington, Arlington, TX, USA.,Children's Health, Children's Medical Center Dallas, Dallas, TX, USA
| | - Donna L Schuman
- College of Social Work, University of Kentucky, Lexington, KY, USA
| | | | - Kelli N Triplett
- Children's Health, Children's Medical Center Dallas, Dallas, TX, USA.,University of Texas - Southwestern Medical Center, Dallas, TX, USA
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4
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Killian MO. Psychosocial predictors of medication adherence in pediatric heart and lung organ transplantation. Pediatr Transplant 2017; 21. [PMID: 28198130 DOI: 10.1111/petr.12899] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/13/2017] [Indexed: 11/30/2022]
Abstract
Few studies have identified the psychosocial characteristics of those children and their families associated with future non-adherence to immunosuppressive medications following a heart or lung transplant. UNOS data and medical records information were used to test the association between patient and family psychosocial characteristics and medication adherence. Medication adherence outcomes were obtained using the physician assessments in the UNOS data and measured through patient-level standard deviation scores of immunosuppressive medication blood levels. Complete data were collected on 105 pediatric heart and lung transplant recipients and their families. Multivariate, stepwise analyses were conducted with each adherence outcome. Physician reports of adherence were associated with age of the child at transplantation, parental education, two-parent families, significant psychosocial problems, and the pretransplant life support status of the child. The resulting model (χ2 =28.146, df=5, P<.001) explained approximately 39.5% of the variance in physician reports of adherence (Nagelkerke r2 =.395). Blood level standard deviation scores were predicted by age at transplant (F=5.624, P=.02, r2 =.05). Results point to the difficulties experienced by children and families when undergoing a heart or lung transplantation. Efforts to develop standardized and evidence-based pretransplant psychosocial assessments in pediatric populations are suggested, especially those surrounding familial risk factors.
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Affiliation(s)
- Michael O Killian
- School of Social Work, University of Texas at Arlington, Arlington, TX, USA
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Schnurman KK, Zilberfein F, Augurt A, Brosnan M, Song YM. Social Work Interventions with Living Related Liver Donors: The Implications for Practice. Prog Transplant 2016; 15:353-62. [PMID: 16477818 DOI: 10.1177/152692480501500407] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Living related liver donations are increasingly used to address the lack of organs available to patients faced with end-stage liver disease. A significant need exists for enhanced psychosocial intervention for donors. We sought to explore donor reactions by assessing psychosocial issues after donation. A descriptive review of donors was undertaken. The overall incidence of psychosocial issues after donation was examined by using a uniform interview questionnaire and by anecdotal case studies. Responses tend to indicate a general positive reaction to donation; yet, findings suggest a need for more preparation in the predonor stage, 100% social work follow-up after donation to provide needed support services, and inclusion of the donor as a critical partner in organ transplant treatment. A more extensive study drawing on the questionnaire may offer a standardized approach to the treatment of organ donors.
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Bramstedt KA, Chalfant A, Wright C. Emergency Consults in the Setting of Transplant Medicine: Dilemmas for Social Workers and Bioethicists. Prog Transplant 2016; 17:36-9. [PMID: 17484243 DOI: 10.1177/152692480701700105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Transplant medicine is a setting filled with emotions and uncertainty. The clinical cases are frequently complex and affected by psychosocial and ethics variables as well as time constraints. For the nonurgent patient, there is usually ample time to complete the necessary evaluations. In urgent situations, however, time is limited and social workers and ethicists often find themselves racing to conduct assessments that provide information that is important for decision making regarding a patient's suitability for organ transplantation. The same can be said for decisions about insertion of ventricular assist devices and living organ donation. Using 2 cases, we explore the practice of emergency consultation (distinguished from “curbside consultation”) and offer guidance for conducting these assessments.
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Pockett R, Dzidowska M, Hobbs K. Social Work Intervention Research With Adult Cancer Patients: A Literature Review and Reflection on Knowledge-Building for Practice. SOCIAL WORK IN HEALTH CARE 2015; 54:582-614. [PMID: 26317763 DOI: 10.1080/00981389.2015.1046577] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The results of a literature review of social work intervention research with adult cancer patients found only a small number of studies conducted by social work researchers. The findings of the review are presented followed by a reflective discussion on the nature of knowledge-building and research knowledge for practice. Knowledge building is considered as a continuous, negotiated process within communities of practice focused on psychosocial perspectives that draw on a range of knowledge sources. Epistemology, worldviews and research orientations are considered along with the values and stance of social work, all of which create the domain of the practice-researcher.
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Affiliation(s)
- Rosalie Pockett
- a Social Work & Policy Studies, Faculty of Education and Social Work , University of Sydney , Sydney , NSW , Australia
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Nilsson D, Joubert L, Holland L, Posenelli S. The why of practice: utilizing PIE to analyze social work practice in Australian hospitals. SOCIAL WORK IN HEALTH CARE 2013; 52:280-295. [PMID: 23521389 DOI: 10.1080/00981389.2012.737901] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This research used a collaborative approach to gain a comprehensive, quantitative understanding of the breadth and depth of the social work role in health care. Data was collected from individual interviews with all employed hospital social workers (N = 120) across five Melbourne, Australia health networks about their most recently completed case. This data was coded using a revised version of the Karls and Wandrei (1994) Person-in-Environment (PIE) tool to retrospectively analyze the reasons for social work involvement over the course of the case. The findings demonstrate that the hospital social work role is multidimensional across a number of domains but centers predominantly on assisting clients and their significant others with issues of altered social roles and functioning; particularly in relation to role responsibility, dependency, and managing associated role-change losses. The findings of this study will assist hospital social workers, managers, and academics to better describe and effectively undertake this complex work. These findings will also assist in the development of professional training and education to up-skill social workers who operate within this complex setting.
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Affiliation(s)
- David Nilsson
- Department of Mental Health, Social Work & Inter-Professional Learning, School of Health and Education, Middlesex University, London, UK.
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Chow AYM. Optimizing the use of video-tapes of clinical sessions: the data-mining approach for scale construction and theory building for bereaved persons in Hong Kong. SOCIAL WORK IN HEALTH CARE 2010; 49:832-855. [PMID: 20938878 DOI: 10.1080/00981389.2010.494954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Video-taping clinical sessions is a common practice among social workers so that the tapes may be used for clinical supervision and reviewed with the individuals or families involved. They are usually underused for research purposes. This article reports on an innovative research method using such tapes as a basis for clinical data mining to explore the bereavement experience of Chinese people in Hong Kong. Using this data, a rich item pool, containing both negative and positive reactions, was generated to allow the development of a culturally relevant measurement tool of grief reactions. The data also facilitated theory building in the area of grief and bereavement. This study extended the use of video-tapes in clinical sessions for research purposes and helped to collect reliable and timely data in a non-intrusive way. It has also advanced the use of quantitative data in the clinical data-mining approach. The study encouraged collaboration between clinicians and researchers to develop knowledge and skills about their special target group of clients.
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Affiliation(s)
- Amy Yin Man Chow
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong.
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Flamme NE, Terry CL, Helft PR. The influence of psychosocial evaluation on candidacy for liver transplantation. Prog Transplant 2008. [PMID: 18615973 DOI: 10.7182/prtr.18.2.675mqnw48nn72600] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONTEXT Although medical factors clearly dominate the evaluation of appropriateness for liver transplant, psychosocial factors are an important dimension in the evaluation process. OBJECTIVE To understand more about the weight assigned to psychosocial factors in the decision to list patients for liver transplant and about whether such differences create hidden inequities in the transplant allocation system. DESIGN We conducted a mail survey of liver transplant surgeons and psychosocial evaluators at busy transplant centers assessing the importance these professionals assigned to psychosocial factors in evaluations for liver transplant candidacy. PARTICIPANTS Liver transplant surgeons and psychosocial evaluators from the highest volume liver transplant centers in the United States. INTERVENTION Mail survey. RESULTS Psychosocial evaluators assigned greater importance to availability of transportation, adaptation to stress, and coping skills than did surgeons. Transplant psychosocial evaluators were less likely than transplant surgeons to recommend that a patient with a history of poor social support be listed for liver transplant. We found no correlation between relative weight assigned to psychosocial factors and median wait times at transplant centers. These differences suggest that the relationship between the factors identified by psychosocial evaluators as important and transplant outcomes should be studied. Overall, more research into the predictive and ethical aspects of psychosocial evaluation for liver transplant is needed.
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Affiliation(s)
- Nancy E Flamme
- Charles Warren Fairbanks Center for Medical Ethics, Indianapolis, Indiana, USA
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Cetingok M, Winsett R, Russell C, Hathaway D. Relationships between sex, race, and social class and social support networks in kidney, liver, and pancreas transplant recipients. Prog Transplant 2008. [DOI: 10.7182/prtr.18.2.d3m188580868932p] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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12
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Bramstedt K, Chalfant A, Wright C. Emergency consults in the setting of transplant medicine: dilemmas for social workers and bioethicists. Prog Transplant 2007. [DOI: 10.7182/prtr.17.1.q875180661266748] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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13
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Schnurman K, Zilberfein F, Augurt A, Brosnan M, Song Y. Social work interventions with living related liver donors: the implications for practice. Prog Transplant 2005. [DOI: 10.7182/prtr.15.4.j456q6xmt1741033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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