"We're kind of on the back burner": Psychological distress and coping among medical social workers during the COVID-19 pandemic.

Medical social workers are essential members of healthcare teams, especially during a pandemic. Their scope of practice includes conducting psychological assessments, coordinating social services, connecting patients to resources that address social determinants of health, discharge planning, and patient advocacy. Social workers' experiences of psychological distress were unique even before the COVID-19 pandemic; their work demands a high amount of emotional investment as they frequently witness others' pain and suffering and navigate various daily challenges and crises. This study explores psychological distress experienced by medical social workers and the coping strategies used by these professionals during the pandemic prior to the COVID-19 vaccine rollout. Faced with conflicting information from state and federal agencies, social workers dealt with resource shortages, took on additional roles and responsibilities, and contended with regular value conflicts and ethical dilemmas. Our findings indicate that medical social workers are not sufficiently protected or prioritized in their workplaces and that infrastructure to support social workers' emotional wellbeing is lacking. Distinct themes that emerged from the data under the umbrella of psychological distress include feeling unprotected, overburdened, and undervalued. We discuss a need for targeted policy and sustainability-oriented solutions to improve coping and resilience, mitigate psychological distress, and prevent burnout among medical social workers.

Moral Distress Among Oncology Social Workers.

PURPOSE: Literature on moral distress among oncology social workers (OSWs) is sparse. The aim of the current study was to examine the prevalence of moral distress and its domains of influence, and to identify demographic and work-related characteristics associated with moral distress among OSWs. METHODS: Data came from the Oncology Social Work Competencies, Opportunities, Roles, and Expertise survey, conducted from August to September 2020 (during the COVID-19 global pandemic). Data collected included demographic information (eg, age, sex, and race) and work-related characteristics (eg, job position, organization type, work setting, employment status, salary, years in the profession, and OSW-C certification). Moral distress was measured using the Measure of Moral Distress for Healthcare Professionals. Tests of association, including multivariate linear regression, were conducted to achieve the research aims. RESULTS: Total moral distress scores on the Measure of Moral Distress for Healthcare Professionals (range 0-432) for 745 OSWs ranged from 1 to 273, with an average score of 74.0. The three highest indicators of moral distress were observed in the patient or family experience domain. Higher levels of moral distress were associated with younger age, being a direct service provider, provision of inpatient cancer care, and more years in the profession. CONCLUSION: OSWs are experiencing moral distress. Institutional investments in professional education and support of OSWs are needed to mitigate and possibly prevent moral distress experienced by cancer care providers and thus ensure the delivery of quality psychosocial care for patients with cancer and their families.

"The Yo-Yo Effect": U.S. Department of Veterans Affairs Social Workers' Experiences with Job Flexibility during the Pandemic.

Social work turnover from the emotional overload of providing care during the pandemic has created staff shortages and exposed many gaps in service delivery. Those social workers who sustained employment during this pandemic are asked to take on flexible/additional roles to fill in those gaps in services to their most vulnerable clients. This qualitative study (N = 12) of U.S. Department of Veterans Affairs (VA) inpatient social workers at two sites across the country assesses their experiences of taking on additional roles at their respective VA facility. Three research questions were addressed to the participants: (1) Describe your roles and responsibilities during the COVID-19 pandemic? (2) How did those responsibilities change/evolve over time? and (3) Did you receive training for your new roles or tasks? Thematic analysis revealed six themes that would facilitate effectiveness and continuity of care: (1) recognizing insufficient training to handle a pandemic, (2) meeting the demand for care, (3) responding to unexpected aspects of flexibility, (4) adjusting to new roles over time, (5) adaptation and support, and (6) additional resources to simplify efforts. With COVID rates stabilizing across much of the United States, now is the time to implement trainings and education about job flexibility in the future instance of a pandemic.

Taking Care of Forced Migrants Together: Strengths and Weaknesses of Interorganizational Work from the Perspective of Social Workers.

The reception and taking care of forced migrants with mental health issues is undoubtedly a very complex task. The literature shows that reception systems are characterized by a high level of fragmentation due to poor collaboration among services that are required to respond to complex and multidimensional needs brought by forced migrants. Starting from the need to deepen what elements support or hinder the implementation of the services' networks for the care and management of forced migrants, qualitative research was conducted within a constructivist paradigm. As the literature reveals a lack of studies considering the perspective of practitioners, we decided to explore the representations of professionals working with migrants in northern Italy in four different service areas (health and psychological well-being, reception, family, and legal areas). A total of 24 professionals (13 F and 11 M) with an average age of 42.4 years were involved in four focus groups according to the four areas. A paper-pencil content analysis was conducted following IPA guidelines. The results show strengths, weaknesses, and elements of improvement for service network implementation. The needs of forced migrants seem to be effectively met only through a service network that takes shape in the interweaving of social, organizational, group, and individual levels.

Race and COVID-19 among Social Workers in Health Settings: Physical, Mental Health, Personal Protective Equipment, and Financial Stressors.

Social work is an essential workforce integral to the United States' public health infrastructure and response to COVID-19. To understand stressors among frontline social workers during COVID-19, a cross-sectional study of U.S-based social workers (N = 1,407) in health settings was collected (in June through August 2020). Differences in outcome domains (health, mental health, personal protective equipment [PPE] access, financial stress) were examined by workers' demographics and setting. Ordinal logistic, multinomial, and linear regressions were conducted. Participants reported moderate or severe physical (57.3 percent) and mental (58.3 percent) health concerns; 39.3 percent expressed PPE access concerns. Social workers of color were more likely to report significantly higher levels of concern across all domains. Those identifying as Black, American Indian/Alaska Native (AIAN), Asian American/Pacific Islander (AAPI), multiracial, or Hispanic/Latinx were over 50 percent more likely to experience either moderate or severe physical health concerns, 60 percent more likely to report severe mental health concerns, and over 30 percent more likely to report moderate PPE access concerns. The linear regression model was significantly associated with higher levels of financial stress for social workers of color. COVID-19 has exposed racial and social injustices that that hold true for social workers in health settings. Improved social systems are critical not just for those impacted by COVID-19, but also for the protection and sustainability of the current and future workforce responding to COVID-19.

Scoping Review: Medical Education Interventions Optimizing Social Workers in the Emergency Department.

INTRODUCTION: As the significance of social workers (SW) in improving healthcare delivery in the emergency department (ED) continues to expand, emergency physicians will increasingly be expected to effectively partner with SWs in both academic and community settings. In this scoping review we sought to provide evidence-based recommendations for effective emergency clinician educational interventions on how to incorporate SWs in the ED to address health-related social needs while also identifying directions for future research. METHODS: We conducted a systematic literature review of publications in PubMed, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, and APA PsycINFO. A search strategy was designed in accordance with Peer Review of Electronic Search Strategies (PRESS) guidelines. Using the scoping review framework by Arksey and O'Malley, we applied consensus-based inclusion and exclusion criteria to guide study selection. A Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) flow chart delineating the selection process was generated using Covidence. RESULTS: Our search strategy identified nine qualifying articles for further analysis out of an initial sample of 2,119 articles. Of the nine articles that underwent full text review, 89% (8/9) evaluated a short educational didactic with or without a hands-on component to reinforce learning. Barriers to successful implementation of curricula discussed in all articles included time constraints, lack of buy-in from clinical faculty, lack of knowledge of appropriate referral sources once a problem is identified, and perceived distraction of the training from more standard clinical topics. Facilitators of curricula implementation and training success included the presence of a pre-existing and structured weekly conference schedule, ability to complete the training in a relatively short time frame or during intern orientation, presence of simulation resources, and residents' overall perceived interest in the topics. CONCLUSION: Ultimately, we found that interdisciplinary learning with SWs is generally well received by participants, and we offer various suggestions on incorporation into student and resident education. Moving forward, we recommend that a standardized curriculum of working with SWs be developed using didactic sessions, simulation, and/or direct observation with feedback.

Stress and Depression in Ohio Social Workers during the COVID-19 Pandemic: The Buffering Role of Social Connectedness.

Although social workers have an elevated risk of infection with COVID-19, no previous studies have investigated the virus's impact on practitioners. Using survey data (N = 441), this study identified associations between stress, depression, and COVID-related factors and explored the role of social connectedness as a moderator for mental health among Ohio social workers. The results of the study showed that among social workers with a positive COVID-19 diagnosis, 70 percent experienced moderate/high levels of stress, and 37 percent met the criteria for clinical depressive symptoms. Results from the multiple regression analyses showed that perceived stress was positively associated with a positive COVID-19 diagnosis for social workers, and depression was positively associated with working with a client with a positive COVID-19 diagnosis. An interaction effect was also identified between social connectedness and social workers' mental health. These findings suggest that the provision of individual or organizational interventions that emphasize social connectedness can help to protect social workers' mental health.

"A breath of fresh air": mindfulness training for early-career mental health social workers in Israel during COVID-19.

The present study examined the effectiveness of participation in a mindfulness group for Israeli early career social workers during the COVID-19 period. Eleven participants conducting fieldwork in a mental health rehabilitation center were interviewed. The participants described a variety of benefits from their mindfulness training, in three main areas: (1) Personal: applying mindfulness in their daily life; (2) Family: improved work-life balance and family relationships; and (3) Professional: applying mindfulness in their work with mental health clients. Mental support and self-care tools provided to early-career social workers were perceived by the participants as helping them overcome uncertainty, fatigue, and overwork.

INTERNATIONAL YEAR OF MEDICAL AND SOCIAL WORKERS IN UKRAINE: RECOGNITION OF THE ROLE IN THE FIGHT AGAINST THE COVID-19 PANDEMIC AND PROTECTING HEALTH AND WELL-BEING.

OBJECTIVE: The aim: Defining the role of health workers and problems in combating the COVID-19 pandemic, outlining ways to protect health and safety in the workplace. PATIENTS AND METHODS: Materials and methods: The following methods were used: content analysis of international and domestic legal documents of state and sectoral level on the problem of functioning and social protection of medical and social workers in the COVID-19 pandemic and statistical reporting on the dynamics of their number and wages. CONCLUSION: Conclusions: With the advent of COVID-19, tensions in the work of medical staff have increased, which has contributed to a reduction in the number of health workers in Ukraine due to death, permanent disability, termination / change of professional activity and migration of medical personnel. It has been found that the slow growth of wages is inadequate to carry out socially necessary activities with a risk to life and health. Fair pay for health and social workers is a necessary but not sufficient component of measures to combat the COVID-19 pandemic at the present stage. The International Year of Health and Social Workers should be an opportunity to draw attention to the need to increase investment in education, training and social protection of these professionals and to minimize the risks posed by the pandemic to the economy and development of countries and people's lives.

Building Emergency Response Capacity: Multi-Career-Stage Social Workers' Engagement with Homeless Sector during the First Two Waves of COVID-19 in Halifax, Nova Scotia, Canada.

The dramatic increase of global extreme events (e.g., natural, technological, and willful hazards) propels social workers to be equipped with emergency response capacity, supporting affected individuals, families, and communities to prepare, respond, and recover from disasters. Although social workers have historically been engaged in emergency response, social work curriculum and professional training remain slow to adapt, jeopardizing their capacity to support the vulnerable and marginalized populations, who have always been disproportionately affected by extreme events. In response to this deficit, this article utilizes a critical reflection approach to examine three social workers' (a senior faculty, a junior faculty, and a social work student) interventions and challenges in their emergency response to persons experiencing homelessness (PEHs) during the first two waves of COVID-19 in Halifax, Nova Scotia, Canada (March 2020 to March 2021). The cross-career-stage reflections and analyses exhibit these three social workers' COVID-19-specific emergency response efforts: a top-down advocacy effort for social development and policy, a bottom-up cognitive effort to comprehend the community's dynamics, and a disaster-driven self-care effort. These three types of effort demonstrate a greater need for social work education and professional training, to develop more disaster-specific components to contribute to building the emergency response capacity of the next generation of social workers through in-classroom pedagogical enhancement and on-site field education training, better supporting PEHs and other vulnerable and marginalized groups living in the diverse context of extreme events in Canada and internationally.

"We Are Not Taking a Backseat": Health Social Workers' Perspectives on COVID-19 Response and Recovery.

The COVID-19 pandemic has wrought widespread devastation across the United States, exacerbating existing health inequities rooted in the social determinants of health. Social work is the key workforce tasked with providing social care in healthcare settings. In September 2019, the National Academies of Science, Engineering, and Medicine released a landmark Consensus Study Report, Integrating Social Care into the Delivery of Health Care: Moving Upstream to Improve the Nation's Health. The report describes a framework for addressing key care needs that articulates five "As for action" (5As)-awareness, alignment, assistance, adjustment, and advocacy-that are critical to social care. Drawing from a series of focus groups conducted with 55 social workers employed in a large urban pediatric quaternary hospital, this study qualitatively examines the utility of this framework in characterizing social care activities during the pandemic response and recovery efforts. Findings suggest that the 5As framework is both applicable to pandemic social work practice and an accurate encapsulation of the core elements of hospital social work practice, even if social workers themselves may not necessarily be aware of that conceptualization. Future implications for social work practice in arenas of awareness, adjustment, assistance, alignment, and advocacy are also discussed.

Reflections of Moral Suffering, Resilience, and Wisdom of Pediatric Oncology Social Workers during the COVID-19 Pandemic.

BACKGROUND: The COVID-19 pandemic has significantly altered the lives of pediatric oncology social workers. Challenges include difficulty building rapport with the use of telephone/computers, lack of clarity around who is designated as "essential", structural challenges, isolation, and witnessing distress. This study aimed to describe the ways that the pandemic has personally impacted pediatric oncology social workers. METHODS: Participants were recruited through the Association of Pediatric Oncology Social Workers (APOSW) listserv. In total, 101 participants from 31 states and the District of Columbia completed an online survey containing quantitative and open-ended questions. Qualitative data analysis included thematic analysis of participants' optional survey responses to three open-ended questions. RESULTS: Fifty-seven of the participants provided responses that revealed 3 first level codes and 11 second level codes. First level codes were developed a priori from the questions: Experiences that stay with you, Wisdom gained and Impact on your work. Pandemic-related challenges caused moral suffering and professional challenges for participants but also created opportunities to find meaning in their work. CONCLUSION: Data illuminated moral suffering, unrecognized resilience, new ways of maintaining self-and family care, and creative approaches to care of children with cancer and their families at diagnosis, during treatments and at the end of life.

Promoting psychosocial environments in Norwegian primary schools: a scoping review protocol exploring the roles and responsibilities of school social workers.

INTRODUCTION: Early intervention by identifying children at risk and providing necessary support is vital to prevent stunted psychosocial development and mental health issues. In this regard, schools are important intervention arenas, reaching all students at a universal level. The need for enhanced efforts is well recognised in Norwegian policy documents, whereas school social workers can represent significant roles in supporting teachers with expanded knowledge on psychosocial factors, mental health and relevant interventions. Despite the clearly stated needs for interprofessional competence in school, limited research has been conducted, and there are no national standards or guidelines for school social workers' practice. Thus, this scoping review's overall objectives are to systematically map the existing research on social workers' roles and responsibilities in Norwegian primary schools. METHODS AND ANALYSIS: A scoping review will be conducted, using the methodological framework of Arksey and O'Malley. Four of their defined goals will be of significance: (1) examine the extent, range and nature of the research activity; (2) determine the value of undertaking a full systematic review; (3) summarise and disseminate research findings; (4) identify research gaps in the existing literature. Systematic searches will be conducted in relevant databases and search portals, including snowballing and manually searching reference lists. Publication language is restricted to English and Norwegian, the date range is from 1 January 2000 until 31 October 2022, and inclusion requires focus on social workers in a Norwegian primary school context. The data will be screened using the screening data extraction software Covidence. A thematic analysis of the literature will be carried out. ETHICS AND DISSEMINATION: Ethical approval is not considered necessary as the aim of this scoping review is to investigate already published materials. Findings will be submitted as scientific papers and at conferences as part of the main project.

You Are Not Alone: The (In)Visible Homeless and the Role of Social Workers and Related Professionals.

The scientific literature has already shown that health information is a factor that contributes to reduce health disparities, improving the situation of vulnerable groups, such as homeless people. However, less is known about the ways that health information has been spread by social workers and related professionals to homeless people in the first moments of the COVID-19 pandemic. This work analyses some social work actions related to health information addressed to homeless people and to identify its impact during the lockdown in Barcelona. This qualitative study is based on semi-structured interviews with social workers and related professionals involved in developing interventions related to health information with homeless people in Barcelona. The data analysis is based on the communicative methodology to identify exclusionary and transformative dimensions. The results show the improvement in the health information of homeless people during the pandemic through the design and development of actions facilitated and promoted by some social workers and related professionals. The findings demonstrate the role that some social workers and related professionals have played in the improvement of health information of homeless people during the lockdown in Barcelona.

When Pandemic Interferes with Work: Psychological Capital and Mental Health of Social Workers during COVID-19.

The impact of the COVID-19 pandemic is not only limited to physical health but also extends to various aspects of everyday life. The present study proposes that the prolonged pandemic can lead to pandemic-work conflict (PWC). The article examines how the pandemic interferes with work, the association between PWC and mental health, and the underlying mechanism of this process. A total of 303 full-time social workers in Hong Kong responded to measures on PWC, psychological capital (PsyCap), and anxiety and depressive symptoms. Data were collected between February and April 2020, when the COVID-19 outbreak was beginning to worsen; 15.8 percent and 14.9 percent of the participants reported mild to severe anxiety and depression, respectively. Time-based PWC was positively associated and strain-based PWC was negatively associated with PsyCap, which was in turn negatively associated with anxiety and depressive symptoms. PsyCap was a significant mediator of these relationships. The findings suggest that the relationship between strain-based PWC and psychological distress can be explained by PsyCap, whereby the depletion of psychological resources may contribute to anxiety and depressive symptoms. Positive psychological resources may be an intervening point for promoting mental health among the social services workforce.

What did Chinese Social Workers Do at the Worst Moment? --A Research Based on Social Workers' Participation in the Fight against COVID-19 at Guangzhou.

The prevention and control of COVID-19 was the first time that Chinese professional social workers formally demonstrated their unique ability and role in public health emergencies. To explore the contribution of Chinese social workers in fighting against COVID-19, this study has surveyed the practical experience of 179 Chinese social workers who participated in public health emergencies for the first time. According to the findings of the investigation, the prevention and control from social workers were active and timely. As a professional group, social workers have played many roles in the pandemic which further helped form coupling effects with other professional departments and build a solid pandemic prevention network. In this process, social workers have retrieved their sociality by taking root in the grass-roots units to build social support networks, link resources and help the vulnerable groups. Meanwhile, social workers still worked based on the national conditions of China's statism and collectivism. They have taken on the roles of coadjutant and propagandist as well as embedded their work in the discourse system with Chinese characteristics when completing the work of policy propaganda, national and social mobilization, and ideological construction. Besides discussing the above content, this exploratory study also points out some difficulties in the aspects of policy support and the practice of China's social work in public health emergencies.

Resilience, perceived social support and professional quality of life among medical social workers during COVID-19 pandemic in Mainland China: A cross-sectional survey.

As COVID-19 rapidly overwhelmed the world in 2020, medical social workers have fought against the disease on the front lines as a member of medical teams, but little is known about the impact of the pandemic on their mental health. This study investigated the resilience, perceived social support and professional quality of life of medical social workers in Mainland China under the influence of the COVID-19 pandemic. An online questionnaire survey was applied to 319 respondents and the results showed that informal support was positively related with compassion satisfaction (r = 0.67, p < .01) and negatively correlated with job burnout (r = -0.51, p < .01) while formal support was positively associated with compassion satisfaction (r = 0.61, p < .01) and negatively associated with job burnout (r = -0.44. p < .01). Resilience was positively correlated with compassion satisfaction (r = 0.56, p < .01) and negatively correlated with job burnout (r = -0.49, p < .01). Nevertheless, neither perceived social support nor resilience was associated with secondary traumatic stress. The regression results further highlighted the role of informal social support on job burnout. Measures should be taken to enhance the professional quality of life for medical social workers during a public health crisis .

Resilience and adaptability of social workers in health care settings during COVID-19 in Australia.

In 2020 Coronavirus disease (COVID-19) was identified in Australia. During the pandemic, as essential workers, hospital-based social workers have been on the frontline. This cross-sectional study examines the resilience of social workers during the COVID-19 pandemic, how the pandemic impacted on social work and lessons learnt. Hospital social workers working in three states, namely Victoria, Queensland, and New South Wales were invited to participate in an online web-based survey, providing non-identifiable demographic details and information a) relating to their proximity to COVID-19, b) their degree of resilience (CD-RISC-2), c) professional quality of life, d) perceived social support, e) physical health, f) professional and personal growth during the pandemic, and g) impacts of COVID-19 on their practice. Basic descriptive statistics were computed for variables of interest. Within group, comparisons were made using paired t-tests or one-way ANOVAs for continuous variables as appropriate to investigate possible interstate differences. Regression analyses were conducted to determine which factors contribute to resilience. Social workers, during the pandemic, whether working under the constraints of lockdown or not, demonstrated high levels of resilience. These levels were similar across the three states, unaffected by the degree of infection in the community, indicating that as a group, social workers have high innate levels of resilience. This study provides an in-depth understanding of the impact of COVID-19 on hospital social workers, the long-term impact of the pandemic on social work practice, and potentially useful lessons learnt for the future.

COVID 19 pandemic: Impact of changes experienced on social workers' professional quality of life in Singapore.

COVID-19 has impacted all spheres of life massively. Among the emerging studies on the psychosocial impact of the pandemic, few studies look specifically at how social workers are impacted. To understand this gap, this study surveyed 337 social workers. The findings showed that changes experienced in the workplace were enormous and caused secondary traumatic stress while engendering compassion satisfaction among social workers, but the presence of social support moderated to keep the secondary traumatic stress at bay. Resilience mediated association between social and workplace support and compassion fatigue. Social support seemed to have the largest effect on reducing stress through resilience. Workplace support also helped mitigate burnout. In conclusion, continued social and workplace support will be key to supporting social workers during a pandemic.