Research on the Ethical Dilemmas of Medical Social Workers Involved in the Service Emergency Stranded Patients / 中国医学伦理学

The retention of emergency patients is a common problem faced by hospitals worldwide. In addition to medical problems, social, family, economic and other problems will also cause patients to stay in the emergency department. It not only brings challenges to patients’ own disease treatment and hospital operation and management, but also brings ethical dilemmas. Taking the service cases of medical social workers who involved in stranded patients in Shanghai E Hospital as an example, this paper analyzed 20 service records and interviews with social workers receiving cases, and combed the ethical dilemmas faced by medical social workers in the process of involving in emergency stranded patients. It was found that medical social workers faced many ethical dilemmas in the process of involving in emergency stranded patients, such as interpersonal relations and relevant legal regulations, the right to life and health and the right to informed consent, the self-determination of case owners and the allocation of medical resources. In this regard, it is suggested to solve the problem of patient retention by advocating the improvement of relevant systems and policies, building cooperative teams to smooth referral channels, strengthening education, and promoting family shared decision-making.

The effect of medical social workers combined with ICU diary on the prevention and treatment of post-traumatic stress disorder in ICU traffic accident patients / 中国实用护理杂志

Objective:To study the effect of medical social workers combined with ICU diary on the prevention and treatment of post-traumatic stress disorder in ICU traffic accident patients, and to explore the application of continuing nursing services and ICU diary to ICU traffic accident patients.Methods:A total of 47 patients who were admitted to the ICU of Suzhou Science and Technology City Hospital from January to December 2019 due to traffic accidents were selected by convenient sampling method. Twenty-three patients admitted to the hospital in the first 6 months were selected as the control group (before the introduction of medical social workers and ICU diaries) for routine ICU treatment and nursing mode. Twenty-four patients admitted to the hospital in the last 6 months were selected as the experimental group (after the introduction of medical social workers and ICU diaries), and the medical social workers combined with the ICU diary were intervened. The scores of the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were compared between the two groups of patients when they were admitted to the ICU, stayed in the ICU for a week, and transferred out of the ICU. The incidence of post-traumatic stress disorder was evaluated and compared by the scores of the Impact of Event Scale-Revised of the two groups of patients one month after leaving the ICU, three months after leaving the ICU, and six months after leaving the ICU.Results:The scores of SAS in the experimental group were 58.67 ± 7.45, 44.13 ± 5.47 and 39.08 ± 5.52 when they were admitted to the ICU, stayed in the ICU for a week, and transferred out of the ICU, and were 58.17 ± 6.75, 50.87 ± 6.35 and 42.74 ± 4.85, respectively in the control group. There was no statistical difference in the scores of the SAS between the two groups of patients when they were admitted to the ICU ( P>0.05), but there was a time difference between the two groups with time changes and different interventions ( Ftime = 110.98, P<0.01), there were also differences between groups ( Fbetween groups = 5.91, P<0.05). Compared with the control group, the SAS score of the experimental group decreased more significantly( Finteraction = 0.28, P<0.05). The scores of SDS in the experimental group were 57.75 ± 4.06, 45.29 ± 3.39 and 36.63 ± 3.49 when they were admitted to the ICU, stayed in the ICU for a week, and transferred out of the ICU, and were 57.48 ± 2.29, 49.04 ± 5.65 and 43.57 ± 4.07 respectively in the control group. There was no statistical difference in the scores of the SDS between the two groups of patients when they were admitted to the ICU ( P>0.05), but there was a time difference between the two groups of patients with time changes and different interventions ( Ftime = 248.24, P<0.01), there are also differences between groups ( Fbetween groups = 24.39, P<0.05). Compared with the control group, the SDS score of the experimental group decreased more significantly ( Finteraction=10.44, P<0.05). The incidences of post-traumatic stress disorder in the experimental group were 9, 8, 6 cases at one month, three months and six months after leaving the ICU, which were lower than 12, 11, 8 cases in the control group. The generalized estimation equation showed that the difference was statistically significant ( χ2=4.21, P<0.05). Conclusions:The intervention model of medical social workers combined with ICU diary is conducive to the use of ICU diary and the development of continuous nursing, which improves patients′negative emotions and reduces the incidence of post-traumatic stress disorder.

The Role of Medical Social Worker Engaging in Diabetes Management / 임상당뇨병

Diabetes is a chronic disease that requires patient self-management. Successful self-care by diabetics includes accepting their diabetes status and learning proper diabetes management, as well as creating and maintaining a lifestyle that enables diabetes management.Recently, in order to improve diabetics’ self-care capability, health education has been shared by trained specialists (doctors, nurses, nutritionists, and medical social workers, etc.) through team access. Under these circumstances, the medical social worker acts as a member of the treatment team and plays a role in helping patients’ stabilize treatment and return to society smoothly by training them in psychological, economic, and social issues that make living with diabetes treatment difficult.The purpose of this study was to examine the role of medical social workers engaged in the treatment of diabetics based on their clinical work.

Research on the full-time model for healthcare social workers / 中华医院管理杂志

The paper introduced the present full-time practice of medical social workers in China, with in-depth analysis of the roadblocks encountered.The problems include but are not limited to multiple stakeholders without a healthy resources relationship network, lack of powerful government support in policy and resource orientation, absence of drivers for hospitals to deliver social service, immature social organizations, and poor capacity to link resources.Based on such, the authors explored the establishment of a development model for full-time medical social workers on a multiple cooperation platform, in such perspectives as the government, social worker organizations, hospitals, and third-party performance appraisal.

Feasibility Analysis and Mode Discussion of Introducing Medical Social Workers into Family Doctor Service / 中国医学伦理学

The family doctor service is an important measure to transform primary health care mode,makes the community health service institutions to take on the gatekeeper role of residents' health and health care costs,and promotes the achievements of hierarchical diagnosis and treatment.At present,there are some difficulties in the process of family doctor service.For example,the construction of the general practitioner team is lagging behind and the residents don't understand the specific contents of the family doctor service well.Medical social workers have both the social work professional skills and medical literacy,which makes them become the effective strength of community health service.Introducing medical social workers by the purchase of the governments,volunteer training,and job settings mode can meet the needs of the development of family doctor service to some extent,and bring in new ideas to the implementation of the family doctor service.

Comparative Analysis of the Values between Medical Social Workers and Nurses / 中华医学教育探索杂志

With the gradual intervention of medical social workers in the hospitals,medical social workers have been concerned by people and have conflicted with nurses due to their different values.The article analyzes deeply the origin and meaning of altruistic values both in China and West and the common basic values shared by medical social workers and nurses as well as their own distinctive values.

Roles of Medical Social Workers in Doctors' Social Support System / 中国医学伦理学

The current complex medical environment has a negative influence on doctors and also hinders the further development of healthcare industry in China.By analyzing the problems of medical social workers in doctors' social support system,this paper proposes the roles medical social workers should play in constructing a new social support system of doctors.