The Family Talk Intervention Among Families Affected by Severe Illness: Hospital Social Workers' Experiences of Facilitators and Barriers to its Use in Clinical Practice.

Hospital social workers (HSW) play an important role in health care, providing psychosocial support to families affected by severe illness, and having palliative care needs involving dependent children. However, there are few evidence-based family interventions for HSWs to apply when supporting these families. The Family Talk intervention (FTI), a psychosocial family-based intervention, was therefore evaluated in an effectiveness-implementation study. Within the study, HSWs were educated and trained in the use of FTI in clinical practice. This study examined HSWs' experiences of barriers and facilitating factors during their initial use of FTI in clinical practice. Altogether, 10 semi-structured focus groups were held with HSWs (n = 38) employed in cancer care and specialized palliative home care for adults, pediatric hospital care, and a children's hospice. Data were analyzed using content analysis. HSWs considered FTI to be a suitable psychosocial intervention for families affected by severe illness with dependent children. However, the way in which the care was organized acted either as a barrier or facilitator to the use of FTI, such as the HSWs' integration in the team and their possibility to organize their own work. The HSWs' work environment also impacted the use of FTI, where time and support from managers was seen as a significant facilitating factor, but which varied between the healthcare contexts. In conclusion, HSWs believed that FTI was a suitable family intervention for families involving dependent children where one family member had a severe illness. For successful initial implementation, strategies should be multi-functional, targeting the care organization and the work environment.

The effectiveness of the mental health social worker-led multiprofessional program in preventing long-term hospitalization and readmission in acute psychiatric inpatients in Japan: A retrospective analysis.

Aim: The large number of new long-stay (NLS) patients and high readmission rates in psychiatric hospitals are longstanding concerns in Japan despite reforms to encourage multidisciplinary support of such patients. Staffing shortages of specialists, especially mental health social workers (MHSWs), may be one of the reasons for these problems to remain unsolved. Methods: The authors examined the effectiveness of the MHSW-centered multidisciplinary care model in preventing NLSs and rehospitalization in terms of both patient dynamics and cost by retrospective comparison of before and after program implementation. Results: After our program was introduced, NLS was almost completely prevented. In addition, a significant decrease in readmissions of involuntarily admitted patients was also observed. On the other hand, the resulting decrease in treatment costs and hospital revenues was mismatched by an increase in personnel costs. Conclusion: While MHSW-centered multidisciplinary care is effective for the community integration of patients, there are cost challenges. State policy changes are needed to resolve staffing problems, along with the introduction of appropriate indicators of community integration.

Caregiver interactions, perceived control, and meaning in life of elderly: the moderating effect of the elderly-to-social worker ratio.

BACKGROUND: Meaning in life is a widely accepted aim in promoting psychosocial health in institutional care. However, how caregiver interaction and perceived control impact meaning in life among the elderly remains unclear. This study explores the effect of institutional caregiver interaction, family caregiver interaction, and perceived control on meaning in life among elderly residents in China, and the potential moderating effect of elderly-to-social worker ratio in these associations. METHODS: Multistage random sampling was used to recruit a sample of 452 elderly residents from 4 elderly care homes in urban China. A structural equation model was used to test the study hypothesis. RESULTS: Institutional caregiver interaction is positively related to meaning in life, and perceived control among elderly residents has a positive impact on meaning in life. Moreover, the elderly-to-social worker ratio moderated the relationship between institutional caregiver interaction and meaning in life, as well as between family caregiver interaction and meaning in life. CONCLUSIONS: Increase elderly's meaning in life is an important service target for the caring professions in institutional care. Social workers affect the effectiveness of interventions on elderly's meaning in life in institutional care. A higher elderly-to-social worker ratio could improve the effectiveness of interventions on meaning in life for elderly residents.

Changes in the Clinical Practice of Mental Health Service Providers Throughout the COVID-19 Pandemic: Longitudinal Questionnaire Study.

BACKGROUND: The COVID-19 pandemic impacted the practices of most mental health providers and resulted in a rapid transition to providing telemental health services, changes that were likely related to stay-at-home policies as well as increased need for services. OBJECTIVE: The aim of this study was to examine whether these changes to practice have been sustained over time throughout the course of the COVID-19 pandemic and whether there are differences among mental health provider type and setting. We hypothesized that there would be an increase in the number of patients seen in person after the initial surge of the pandemic in spring 2020 and subsequent discontinuation of stay-at-home policies, though with continued implementation of telemental health services across settings. METHODS: This study surveyed 235 of the 903 mental health providers who responded to a survey in spring 2020 (Time point 1) and at a 1-year follow-up in spring 2021 (Time point 2). Differences in practice adjustments, factors related to telemental health, and number of patients seen were examined across provider type (social worker, psychologist, neuropsychologist) and setting (academic medical center [AMC], community mental health, private practice, and Veterans Affairs hospital). RESULTS: From Time point 1 to Time point 2, there was a small but significant increase in the overall number of providers who were implementing telehealth (191/235, 81% to 204/235, 87%, P=.01) and there was a significant decline in canceled or rescheduled appointments (25%-50% in 2020 to 3%-7% in 2021, P<.001). Psychologists and providers working at AMCs reported decreased difficulty with telehealth implementation (P<.001), and providers working at AMCs and in private practice settings indicated they were more likely to continue telehealth services beyond spring 2021 (P<.001). The percent of time working remotely decreased overall (78% to 59%, P<.001), which was most notable among neuropsychologists and providers working at an AMC. There was an overall increase in the average number of patients seen in person per week compared with earlier in the pandemic (mean 4.3 to 8.7, P<.001), with no change in the number of patients seen via telehealth (mean 9.7 to 9.9, P=.66). CONCLUSIONS: These results show that the rapid transition to telemental health at the onset of the COVID-19 pandemic in spring 2020 was sustained over the next year, despite an overall increase in the number of patients seen in person. Although more providers reported returning to working on-site, over 50% of providers continued to use a hybrid model, and many providers reported they would be more likely to continue telemental health beyond spring 2021. This suggests the continued importance and reliance on telemental health services beyond the acute pandemic phase and has implications for future policies regulating the availability of telemental health services to patients.

Pharmacist-social worker interprofessional relations and education in mental health: a scoping review.

Background: One in eight patients is affected by a mental health condition, and interprofessional mental health teams collaborate to improve patient care. While pharmacists and social workers are recognized as mental health team members, there is a lack of literature describing interprofessional relations and education between these professions, especially as it pertains to mental health. The purpose of this review was to identify and characterize reports describing pharmacist-social worker interprofessional relations and education within mental health. Methodology: To address this knowledge gap, this scoping review was conducted to collect and characterize reports published between January 1, 1960 and August 18, 2023 describing pharmacist-social worker interprofessional relations and education within the field of mental health. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines were followed. Ovid MEDLINE, CINAHL, and Social Work Abstracts were searched using keywords "pharmacy student," "pharmacist," "social work student," "social worker," and "social work." Reports were included if they were published in English and interprofessional relations or education occurred directly between (student) pharmacists and social workers. Results: Three hundred twenty records were identified and three records were included: one cross sectional study, one qualitative educational project, and one case report. Each record suggested positive patient and/or educational outcomes developing from pharmacist-social worker interprofessional relations and education. In clinical practice, pharmacist-social work teams identified mental health risk factors, reduced 30-day readmissions, and improved post-discharge telehealth care. In the classroom, a social worker improved pharmacy students' confidence assessing patient suicidal ideations. Conclusions: This scoping review identified needs and areas for future research: pharmacist interprofessional education with Master of Social Work and Doctor of Social Work degree students, transitional care and mental health outcome measure reporting using evidence-based outcomes, and development of scholarly teaching projects utilizing higher-level educational frameworks beyond learner reactions.

Patient navigation job roles by levels of experience: Workforce Development Task Group, National Navigation Roundtable.

PLAIN LANGUAGE SUMMARY: Cancer patient navigators work in diverse settings ranging from community-based programs to comprehensive cancer centers to improve outcomes in underserved populations by eliminating barriers to timely cancer prevention, early detection, diagnosis, treatment, and survivorship in a culturally appropriate and competent manner. This article clarifies the roles and responsibilities of Entry, Intermediate, and Advanced level cancer patient navigators. The competencies described in this article apply to patient navigators, nurse navigators, and social work navigators. This article provides a resource for administrators to create job descriptions for navigators with specific levels of expertise and for patient navigators to advance their oncology careers and attain a higher level of expertise.

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

OBJECTIVE: Aim: reveal in social work the possibilities of applying adaptive physical activity in the process of social inclusion of persons with disabilities. PATIENTS AND METHODS: Materials and Methods: To obtain factual information, the survey method (questionnaire) and a complex of mathematical statistics methods were used: methods of descriptive statistics and correlation analysis. Statistical analysis was performed using SPSS Statistics 24.0.0. A total of 102 anonymous respondents took part in the focus groups. RESULTS: Results: The connection between adaptive physical activity and the increase in the level of social inclusion of persons with disabilities, in particular, former military personnel and war veterans, was investigated. It was determined that social work professionals can use adaptive physical activity tools to promote the social inclusion of persons with disabilities and other low-mobility population groups. CONCLUSION: Conclusions: It was established that the ways of using adaptive physical activity tools by social workers for the social inclusion of persons with disabilities are most often socio-psychological, physical, professional rehabilitation, social support, and preventive activities. New opportunities for the implementation of social inclusion by means of adaptive physical activity of persons with disabilities as a result of military operations are opened in connection with the introduction of the position of «helper (assistant) of a veteran in the community¼, which will be held by a social worker.

A qualitative exploration of the drivers for the transfer of foster children in Gauteng, South Africa.

BACKGROUND: Many children in South Africa are orphaned or subjected to maltreatment, leaving them in need of care and protection. Foster care is one form of alternative care for such children. Retention of foster parents, or foster care placement stability, is one of the many challenges related to foster care, globally and in South Africa. This instability can have an adverse impact on children, and although some research speaks to the problem, the experiences of South African role players regarding this problem have not been documented, to date. To improve foster care retention in South Africa, local, contextualized studies exploring the drivers of foster care placement instability are required. AIM: The aim of this qualitative study was thus to explore designated social workers' (DSWs) and foster parents' experiences about the reasons prompting foster care transfers. PARTICIPANTS AND SETTING: A purposively selected sample of ten foster parents and ten DSWs in the Gauteng province of South Africa took part in the study. METHODS: A descriptive qualitative study was adopted as basis for this study, which entailed thematic analysis of 20 semi-structured interviews. RESULTS: It was found that children's behavioural problems, a shortage of resources, a lack of parenting skills, problematic relationships between foster parents and foster children, and previous traumatic events, led to most foster care transfers. A key finding from this study, which appears not to be evident in previous studies, centres on the critical role played by money, or rather its absence, in contributing to foster care placement instability. CONCLUSIONS: When considered in conjunction with findings emerging from previous studies, our findings underscore the importance of obtaining a contextualized understanding of local, cultural factors at play in foster care delivery. To improve foster care retention in South Africa, which is fraught with challenges not yet reported elsewhere, it is recommended that screening procedures for foster parents be revised, and that allocation of resources to DSWs be prioritized.

Use of Care Guides to Reduce Emergency Department Visits by High-Frequency Utilizers.

BACKGROUND: High-frequency utilizers are defined as patients who present 10 or more times to the emergency department in a rolling 12-month period. High-frequency utilizers contribute to emergency department overcrowding and misuse of resources, and reduce the efficiency of health care systems. Care guides have proven to be an effective tool in reducing high-frequency utilizers. OBJECTIVE: The objective of this quality improvement project was to determine if implementing a care guide for high-frequency utilizers to address the core needs of the patient and facilitate resources through case management consultation decreases the number of visits and the cost of unreimbursed care to the emergency department from high-frequency utilizers. METHODS: We implemented care guides for high-frequency utilizers in September 2014. Prior to initiating the care guides, we educated the physicians, nurses, case managers, and social workers in the emergency department. RESULTS: Following the implementation of the care guides, there was a steady decline in the number of high-frequency utilizers (338 in 2013-68 in 2021), the number of total emergency department visits by high-frequency utilizers (6025 in 2013-1033 in 2021), and unreimbursed care ($2,068,063 in 2013-$589,298 in 2021). CONCLUSION: The use of care guides was a successful strategy in reducing emergency department visits and the cost of unreimbursed care by high-frequency utilizers by providing them with the education and resources they require to receive health care services in appropriate settings.

An ecological systems approach to the difficulties faced by social workers in community home-based care organisations for people living with HIV.

Background: Social workers play an instrumental role in supporting vulnerable populations by among others, designing and implementing support programmes such as community home-based care (CHBC) for People Living with HIV (PLWHIV). Existing research studies have demonstrated their role in championing programmes like support groups, counselling services and material support to PLWHIV and their caregivers as well as the HIV prevention and other advocacy programmes across communities. Within the CHBC programmes for HIV, social workers' roles include supporting caregivers who care for PLWHIV to manage complex cases that are beyond their competencies and offering the necessary training on patient support. Although the contributions made by social workers in the field of HIV have immensely been documented in various parts of literature, less substantial attention has been given to their challenges particularly when working with PLWHIV through CHBC programmes. Methods: This qualitative research study was designed from exploratory and descriptive strategies and grounded on ecological systems theory to explore the challenges faced by social workers working with PLWHIV through the CHBC programmes. Thirteen social workers were sampled from South Africa's City of Tshwane Municipality (CTMM) through purposive and snowball techniques, to participate in semi-structured interviews of which the data were analysed thematically and verified according to Lincoln and Guba's data qualitative data verification strategies. Findings: The findings highlighted several difficulties faced by social workers including difficulties associated with managing challenges faced by PLWHIV, dealing with uncooperative PLWHIV and lack of resources to effectively respond to their clients' needs. Conclusions: The conditions in which social workers render services to PLWHIV were highlighted by pointing to the complexities resulting from these challenges which further compromises the quality of services rendered to PLWHIV. For the success of HIV programmes, it is essential to support social workers through training, resources, community awareness and income-generating projects.

The Experience of Living with a Chronic Illness: A Qualitative Study among End-Stage Renal Disease Patients.

The prevalence of End-Stage Renal Disease (ESRD) has been rising over time and substantially affects morbidity and mortality. ESRD requires lifelong treatment, and as a result, patients experience multiple physical and psychosocial stressors. ESRD patients struggle to retain their jobs, social lives, financial flexibility, and diet restrictions of liquids and solid foods. The present study aims to understand the experiences of ESRD patients undergoing hemodialysis. The study was conducted at Eldho Mor Baselious Dialysis Center in Perumbavoor, Kerala, in the hemodialysis outpatient unit. The Biopsychosocial model was used as the theoretical framework of the study. As the goal of the study was to investigate the inner experiences of ESRD patients, a qualitative research approach was employed. Twelve respondents were selected for the study using purposive sampling, and the data were organized and analyzed using Colaizzi's descriptive phenomenological method. Four theme categories emerged from data analysis: decline in physical function, psychosocial distress, economic hardships, and impact on the support system. The study shows that ESRD patients experience significant psychosocial and health-related issues. The role of the clinical social worker is vital as there is a need for social work interventions to resolve the psychosocial issues of patients with ESRD.

Defining Neonatal Serious Illness: Perspectives of Nurses and Social Workers.

Objectives: To explore (1) how neonatal nurses (NN) and social workers (SW) define serious illness and (2) how physician, nurse, and SW perceptions of serious illness differ. Design: Prospective survey study. Setting/Subjects: Members of the National Association of Neonatal Nurses or the National Association of Perinatal Social Workers. Measurements: We circulated a modified version of a previously developed survey. Participants were given a list of definition components and asked to rank components by importance and to suggest modifications. Results: Eighty-eight percent of participants agreed with our definition of neonatal serious illness. NN and SW differ in important ways in their views of neonatal serious illness when compared with physicians and parents. Conclusions: Our definition of neonatal serious illness has broad acceptability and may be useful for clinical care and research. Future work should prospectively identify patients with neonatal serious illness and establish the usefulness of our definition in real time.

Experiences of patients at high risk of opioid overdose accessing emergency department and behavioral health interventions: a qualitative analysis in an urban emergency department.

BACKGROUND: Emergency Departments (EDs) have become critical 'touchpoints' for the identification and early engagement of patients at risk of overdose or who have an opioid use disorder (OUD). Our objectives were to examine patients' ED experiences, identify barriers and facilitators of service uptake in ED settings, and explore patients' experiences with ED staff. METHODS: This qualitative study was part of a randomized controlled trial that evaluated the effectiveness of clinical social workers and certified peer recovery specialists in increasing treatment uptake and reducing opioid overdose rates for people with OUD. Between September 2019 and March 2020, semi-structured interviews were conducted 19 participants from the trial. Interviews sought to assess participants' ED care experiences across intervention type (i.e., clinical social worker or peer recovery specialist). Participants were purposively sampled across intervention arm (social work, n = 11; peer recovery specialist, n = 7; control, n = 1). Data were analyzed thematically with a focus on participant experiences in the ED and social and structural factors shaping care experiences and service utilization. RESULTS: Participants reported varied ED experiences, including instances of discrimination and stigma due to their substance use. However, participants underscored the need for increased engagement of people with lived experience in ED settings, including the use of peer recovery specialists. Participants highlighted that ED provider interactions were critical drivers of shaping care and service utilization and needed to be improved across EDs to improve post-overdose care. CONCLUSIONS: While the ED provides an opportunity to reach patients at risk of overdose, our results demonstrate how ED-based interactions and service provision can impact ED care engagement and service utilization. Modifications to care delivery may improve experiences for patients with OUD or at high risk for overdose. TRIAL REGISTRATION: Clinical trial registration: NCT03684681.

Relationship between Experience of Client Violence and Turnover Intention among Workers in Long-Term Care Facilities for Older Adults: Focusing on Nurses, Social Workers, and Care Workers.

To prevent discontinuity of long-term care service and guarantee the quality of care, it is important to clarify the determinants of turnover intentions of long-term care workers. They are at a higher risk of experiencing violence-including physical, emotional, and sexual-from patients or their families, possibly leading to high turnover intention. This study aims to verify how having experienced client violence affect turnover intention of long-term care workers and to suggest implications to prevent frequent turnover in long-term care field. Logistic regression analysis was conducted between groups who have experienced client violence and who have not, using 2019 Korean LTC Survey data. Results revealed that, first, there were differences in determinants of turnover intention depending on groups. Second, having experienced client violence had a different effect on turnover intention based on personal characteristics. Third, gender and occupational differences were found. Based on our results, we highlighted the need for discussions on interventions to address client violence exposure among long-term care workers.

NASW's Supervisory Leaders in Aging: One-year practice change outcomes of an innovative training program for social work supervisors.

Social work supervision addresses professional development, staff support, and management of direct service workers. It is important in aging-services settings because of the impacts of complex and evolving biopsychosocial forces in clients' lives. This article presents findings of the Supervisory Leaders in Aging (SLA) study based on data available one-year post completion. SLA is a 30-hour certificate program for supervisors from aging-services settings addressing best practices in supervision of gerontological practice. The study compares participants' self-assessment of use of supervisory best practices before attending a 3-month workshop series and at two times following graduation. This article reports findings from the analysis of data provided by 114 out of 129 supervisors who completed the program. Participants increased the frequency of use of best practices at both three and 12 months after graduation. These increases were conceptually meaningful and statistically significant among participants who were low users of best practices prior to the program. SLA has led to significant adoption and maintenance of supervisory best practices among participating social work supervisors and especially among those who have not previously adopted routine use of best practices. The interactive small-group learning activities of SLA's educational model should be promoted and the curriculum of best practices should be further refined and tested as SLA is implemented in other communities.

Career outcomes and satisfaction among graduates of a 4-year oral health and welfare baccalaureate program at Niigata University, Japan: A cross-sectional study.

OBJECTIVE: Globally, baccalaureate programs in dental hygiene are increasingly established. In addition, in Japan, many dental hygienists (DHs) and social workers (SWs) are prematurely leaving the workforce. This study aimed to investigate the most recent employment, career outcomes, reasons for a job change, and satisfaction with the job and undergraduate curriculum among graduates of the baccalaureate program at the Department of Oral Health and Welfare (DOHW), Faculty of Dentistry, Niigata University. METHODS: All 262 graduates (graduating classes 1-10) of the DOHW were invited to participate in this survey; an original self-administered questionnaire was distributed to those who consented. Responses were received from 114 (43.5%) graduates. RESULTS: Almost all respondents (89.5%) had dual licensure as both DH and certified SW. They were employed immediately after graduation (99.1%) and at the time of the survey (96.5%). Over 60% of them worked as DHs, mainly in hospitals. SWs mainly worked in administration. Among the 113 respondents who were employed, 39.8% changed jobs at least once. The main reasons for job selection were 'interest in job content' and 'flexible working hours'. Nearly 90% of the respondents felt satisfied or fairly satisfied with their job and their undergraduate education. CONCLUSIONS: A quality 4-year baccalaureate degree program in dental hygiene and social welfare positively influenced graduates' work continuity. Most graduates felt satisfied or fairly satisfied with their job and the undergraduate curriculum. Employment rates within each profession and the prevalence of hospital and administrative roles were higher than national averages. Long-term studies of graduates' career outcomes are warranted.

The Association Between Work Environment, Work Attitudes, and Turnover Intentions Among Geriatric Social Workers in China.

The psychological state of geriatric social workers affects the intention to leave and thus the quality of services provided to older adults. This study explored the relationship between the work environment, work attitudes, and turnover intentions of geriatric social workers. This study obtained an analytic sample comprising 999 geriatric social workers from the 2019 Longitudinal Study of Social Work in China. Multivariate regression techniques combined with a mediation analysis was performed to explore the relationships. The study results provided preliminary evidence on the complex associations between and among work environment, work attitudes, and turnover intentions of geriatric social workers in China. We demonstrated that perceived organizational support reduced the turnover intentions of geriatric social workers through increased collective psychological ownership and reduced burnout. Regular inter- and intra-agency communication between social workers and their supervisors and colleagues have important roles in reducing turnover by enhancing support and emotional commitment to organizations. Policy decision-makers are suggested to clearly define the roles and responsibilities of geriatric social works to release their administrative burdens, which may help to reduce their burnout level and improve the stability of the geriatric social work force.

Salary and student loan debt for oncology social workers: Findings from the oncology social work competencies, opportunities, roles and expertise (CORE) survey.

PURPOSE: To better understand the current salaries and student loan debt levels among oncology social workers (OSWs). DESIGN: Cross-sectional study using online survey. SAMPLE: OSWs across a variety of cancer care settings in the U.S. (n = 1055). METHODS: Salary and debt were collected via single ordinal variables. Crosstabs and chi-square tests were used to examine whether salary and debt differ by demographic and work-related characteristics. FINDINGS: Median OSW salaries ranged from $60,001 to $70,000. Three-fourths of OSWs reported having student loan debt. Younger and recently graduated OSWs and OSWs of color were more likely to have greater student loan debt than their counterparts. CONCLUSIONS: Relative low salary and debt burden have important implications for securing a current and future OSW workforce. IMPLICATIONS FOR PSYCHOSOCIAL POLICY: Adequate reimbursement and loan repayment opportunities for frontline OSWs will better secure this workforce. Advocacy efforts to identify OSWs qualified for loan forgiveness programs are warranted.

The 6 A's model of social worker associations and COVID-19: A preliminary insight.

This paper offers the 6 A's model of social worker associations and COVID-19, which includes (i) 'Apprehend', (ii) 'act', (iii) 'advocate', (iv) 'alliance', (v) 'an emphasis on solidarity and resilience' and (vi) 'a future prospect'. The model is based on the findings of qualitative analysis of social worker associations' reports on COVID-19. It also offers insights that can be utilised in similar crises in the future.

Study on the Role of Medical Social Work in Organ Donation after Citizen’s Death / 中国医学伦理学

The development of human organ transplantation technology has brought the hope of rebirth to countless patients with organ failure. Human organ donation and transplantation need the joint efforts of various levels of Red Cross societies, human organ procurement organizations, medical institutions, etc. Medical social workers, as new forces, are gradually playing their own role. By summarizing the professional advantages of medical social work in organ donation after citizen’s death, this paper proposed that medical social workers can provide professional services for donors and their families through practical work, such as clarifying their willingness to donate and providing crisis intervention services to their families, assisting them in completing donation matters and holding farewell ceremonies, and following up and carrying out grief counseling activities. Regarding the problems encountered in practice process, suggestions were proposed to expand the scale of medical social workers and improve their management, increase social awareness of medical social work, and provide all-round support for the implementation of later service.