Health Care Social Workers Research Articles

Implementation, Best Practices, and Challenges in Mental Health Strategies among Local Government Units in the Province of Negros Occidental, Philippines

One of the health priorities of the 2030 Sustainable Development Goals (SDGs) is to promote mental health and well-being. The mental health agenda of the ASEAN region include public health strategies at the community level. The study employed a descriptive design to assess the extent of implementation of mental health strategies, the best practices, and the challenges encountered in local government units. It was administered to a total population of 90 respondents comprising healthcare workers, responders, and social workers. The findings revealed a poor extent of implementation of mental health strategies which means that only some strategies are implemented. The area on treatment and recovery was rated highest, interpreted as poor extent, while capacity building for mental health program administrators was rated lowest, poor extent. It was found that local government units are implementing best practices in mental health. However, several challenges were noted, such as the lack of formally trained mental health experts, mental health professionals, mental health facilities, and financial resources, which are indicators of poor and weak implementation. These challenges require strict enforcement by its integration into the primary healthcare program, one of the objectives of the law. The study significantly contributes to the few existing literature on the implementation of mental health strategies at the local government level identified as necessary, especially at this time of the pandemic.

Determinants for Purchasing, Preparing, Consuming, and Feeding Practices Among Women of Reproductive Age With Low Socioeconomic Status in Two Secondary Cities in Rwanda

ObjectivesSecondary cities (SC) link rural food production with urban populations. SC are rapidly growing, lack of infrastructure and face changes in dietary patterns. Across women of reproductive age (WRA) all forms of malnutrition have been identified. SC offer an opportunity for food systems transformation. We argue to uncover the demand-related determinants of purchasing, preparing, consuming, and feeding practices among WRA with low socioeconomic status living SC in Rwanda to identify possible interventions to enhance the demand of agroecological produced food.MethodsThematic analysis is conducted among WRA with low socioeconomic status living in SC -Rubavu, and Rusizi- in Rwanda. Eighteen face-to-face, in-home observations were conducted in the manner of compact ethnographic research. These observations covered the participants’ way of living, home environment, shopping and cooking observation, a pantry/kitchen audit. Transcripts from the interviews are being coded with NVIVO software. Ethical consent was provided by the Rwanda National Ethics Committee.ResultsPreliminary findings show that most WRA involved in the interviews prepare two meals per day. The most commonly food items consumed are irish potatoes, bananas, rice, and flour, with women indicating little to no intention of trying out new dishes or new preparation type. The most common cooking method is boiling, salt and garlic being the primary spieces used. WRA do not consume special food items based on their current life stage (pregnancy or lactation). The household budget for purchasing food is provided and decided mainly by men; however, women make the purchase and cooking decisions. The purchase of foods is determined by price, owing to minimal purchase power. Health care professionals and social workers are the trusted source of information. Final results will be available by May 2022.ConclusionsOur findings will help design a social marketing campaign to promote the purchasing, consumption, and cooking practices of locally produced agroecological foods that is specifically targeted to WRA of low socioeconomic status living in those SC.Funding SourcesThe NICE project is supported by the Swiss Agency for Development and Cooperation and implemented by the Swiss Tropical and Public Health Institute, ETH Zürich, Sight and Life, and the Syngenta Foundation for Sustainable Agriculture.

Fear of contamination, perceived social support and physical health of health social workers in Hong Kong: A cross-sectional survey

ABSTRACT Hong Kong experienced the SARS pandemic in 2003. Seventeen years later, the Covid-19 pandemic now challenges Hong Kong and the world. This study aims to unveil the impact of the pandemic on health social workers. One hundred and sixty-six health care social workers in Hong Kong were recruited to join a cross-sectional online survey from November 2020 to March 2021. This paper includes the analysis of the demographic information, fear of contamination, resilience, perceived social support and physical health only. Irrespective of the demographic background, the level of fear of contamination, resilience, perceived social support and physical health were similar. The mean scores of the two dimensions of fear of contamination (Harm avoidance: m = 7.49, s.d. = 3.25; Disgust avoidance: m = 7.75, s.d. = 2.90) were higher than those of general public and clinical samples with Obsessive-Compulsive Disorder. No moderation effects were found in resilience and perceived social support in the relationship of fear of contamination and physical health. Instead, direct effects were shown.The impact of the pandemic on health social workers was universal. Psychoeducational programs to alleviate the fear of contamination and organizational-level interventions to improve workplace social support are highly needed.

Co-design, implementation, and evaluation of an expanded train-the-trainer strategy to support the sustainability of evidence-based practice guides for registered nurses and social workers in primary care clinics: a developmental evaluation protocol

BackgroundThe implementation of evidence-based innovations is incentivized as part of primary care reform in Canada. In the Province of Québec, it generated the creation of interprofessional care models involving registered nurses and social workers as members of primary care clinics. However, the scope of practice for these professionals remains variable and suboptimal. In 2019, expert committees co-designed and published two evidence-based practice guides, but no clear strategy has been identified to support their assimilation. This project’s goal is to support the implementation and deployment of practice guides for both social workers and registered nurses using a train-the-trainer educational intervention.Methods/designThis three-phase project is a developmental evaluation using a multiple case study design across 17 primary care clinics. It will involve trainers in healthcare centers, patients, registered nurses and social workers. The development and implementation of an expanded train-the-trainer strategy will be informed by a patient-oriented research approach, the Kirkpatrick learning model, and evidence-based practice guides. For each case and phase, the qualitative and quantitative data will be analyzed using a convergent design method and will be integrated through assimilation.DiscussionThis educational intervention model will allow us to better understand the complex context of primary care clinics, involving different settings and services offered. This study protocol, based on reflective practice, patient-centered research and focused on the needs of the community in collaboration with partners and patients, may serve as an evidence based educational intervention model for further study in primary care.

The Courage to Continue: Healthcare Social Worker’s Resilience During COVID-19

The COVID-19 pandemic has exacerbated disparities in access to healthcare and mental health, often forcing healthcare social workers into ethical and moral dilemmas as they endeavor to provide equitable, humanistic care to their patients and caregivers. The purpose of this mixed method study was to explore how COVID-19-related personal and professional grief and losses impacted healthcare social worker’s distress and resilience. Participants were recruited through healthcare social work professional organizations from September-November 2020. Participants (N = 246) completed an online survey capturing sociodemographic variables, as well as mental distress, pandemic-related meaning-making, and resilience. Data analysis included correlations and regressions pertaining to meaning-making, emotional distress, and resilience, as well as thematic analysis of participants’ open-ended survey responses. Approximately one-third of participants reported emotional distress and difficulty in finding meaning from their pandemic-related losses. Participants reported a lower level of resilience when compared with the United States general population. Three themes emerged from social workers’ qualitative responses: the hardest year of my career; the collective loss of our normal; and we were built for this. Pandemic-related grief permeates social workers’ daily lives; yet their training and resilience foster hope to positively impact their clients, communities, and families.

‘We are essential:’ Pediatric health care social workers’ perspectives on being designated essential workers during the COVID-19 pandemic

ABSTRACT Continued provision of essential services is critical to maintaining society’s functioning during a crisis. During COVID-19, lockdowns and restrictions designed to preserve the public’s health forced an examination of what it means to be an essential worker. Drawing from thematic analyses of focus group data from 55 social workers employed in a large, urban, pediatric, quaternary hospital, this study examines the perspectives of hospital social workers on the meaning of the essential status designation of social work. Findings revealed themes pertaining the substance of social work, the ways in which essential status is carried out, and implications of the designation not only for the future of the profession but also for the populations who receive social work services. The discussion raised important questions about the essential role of social workers in broader health care settings. Our findings suggest that health care systems need to engage in ongoing discussions of how to maximize the efficacy of the social work workforce, both in terms of integration with medical teams and recognition of the important roles social workers play across the hospital system, and facilitate the performance of their essential functions.

THE SOCIAL DEVELOPMENT APPROACH TO SOCIAL WORK IN HEALTH CARE

Social work in health care delivers essential services to South Africa’s vulnerable populations. The social development approach attempts to address inequalities and uplift vulnerable people. An explanatory-sequential mixed methodological study explored the application of the social development approach to social work in health care in the Gauteng Department of Health. The findings indicated that social workers in health care deliver a diverse service in attending to patients’ needs and are ideally situated to address and implement the social development approach. However, challenges are experienced in the absence of strategic policies regarding the implementation of the social development approach in health care. Keywords: Gauteng Department of Health, health care reform, health care settings, social development approach, social work in health care, transformation

The Experience of Health Care Workers Caring for Older Adults During the COVID-19 Pandemic

Older adults are at increased risk for COVID-19 illness, hospitalization, and mortality. Essential health care workers became the backbone of their care during the pandemic, and their experiences are worthy of discussion. This symposium will highlight the emotional impact of COVID-19 on health care workers, and their scope of practice in various health settings. Using data from a cross-sectional survey, presenter one will describe concerns and coping strategies among nursing home social workers during COVID-19. Next, presenter two will present findings on the emotional health and wellbeing of home care workers. Then, presenter three will describe the experience of the VA’s strike teams sent into 82 Florida nursing homes most impacted by COVID. Presenter four will describe findings from a qualitative study on emotional distress experienced by hospital-based medical directors, nurse practitioners, and other health care workers. Finally, presenter five will describe findings from a scope of practice among health care social workers study, with an emphasis on how policies in their respective settings impacted their work. Taken together, the presenters’ findings in this symposium have implications for practice and policy recommendations to improve the experience of health care workers during pandemics.

Shaping the Future of Social Work Practice in Healthcare: Addressing COVID-19 Needs through Integrated Primary Care.

COVID-19 has illustrated the urgency of promoting integrated healthcare as the model of the future, with social workers not only supporting the physical and mental health of providers and patients, but also leading efforts to transform systems, policies, and social work education. Primary care, where the role of social workers is continuing to grow, is a central location for integrating the treatment of medical, social, and behavioral problems. In these settings, social workers can take the lead to meet community needs, assist in public health efforts, and bolster the frontline medical workforce. The following article reflects upon what we as social workers have learned a year into the global pandemic and how we can apply this knowledge to shaping the future of social work in primary care. Authors consider how the multiple medical and psychosocial needs of patients affected by COVID-19 are addressed in primary care through three core functions of social work: providing behavioral healthcare, coordinating care, and undertaking population health-based interventions. Article ends with a discussion about how social work can respond to the urgent task of transforming health within the context of social work practice, policy, and education for the next generation of healthcare social workers.

Social work in health care in Canada

The article examines social work from the standpoint of the activities of a social worker in health care in Canada. It is mentioned how social work was formed in this sphere. The role of professional organizations in Canada in the formation of this area of activity was noted. Some of the challenges faced by social workers in health care in Canada at different times are considered. The current state of social work in Canada is analyzed.

Middle Managers’ Views on Participation in a Home Visiting Program for First-Time Parents in Scania, Sweden

Family home visiting programs delivering early childhood services are supported by politicians and policy makers in many countries. This study focuses on a home visiting program for first-time parents in a county in Sweden. The program comprises six home visits conducted by interprofessional teams, including child healthcare nurses, midwives, social workers and dental hygienists, with the aim to increase accessibility to child healthcare and to promote more equal health in young children. Child healthcare, maternal care, social services and dental care organisations participated voluntarily in the program. This study explores how middle managers of the participating organisations view the program. Data were collected from semi-structured interviews with ten middle managers. The interviews were analysed using qualitative content analysis as a method. The results show that the middle managers saw the home visiting program as beneficial for society, parents and children, and the participating organisations and professionals. In other words, they expressed both altruistic goals and a self-interest in participating. The study is of importance as middle managers’ decision to participate in a home visiting program might be grounded on their perceptions of the program.

Provider perspectives on the provision of safe, equitable, trauma-informed care for intimate partner violence survivors during the COVID-19 pandemic: a qualitative study

BackgroundEarly research suggests the COVID-19 pandemic worsened intimate partner violence (IPV) in the US. In particular, stay-at-home orders and social distancing kept survivors in close proximity to their abusers and restricted access to resources and care. We aimed to understand and characterize the impact of the pandemic on delivery of IPV care in Boston.MethodsWe conducted individual interviews with providers of IPV care and support in the Greater Boston area, including healthcare workers, social workers, lawyers, advocates, and housing specialists, who continued to work during the COVID-19 pandemic. Using thematic analysis, we identified themes describing the challenges and opportunites providers faced in caring for survivors during the pandemic.ResultsAnalysis of 18 interviews yielded four thematic domains, encompassing 18 themes and nine sub-themes. Thematic analysis revealed that the pandemic posed an increased threat to survivors of IPV by exacerbating external stressors and leading to heightened violence. On a system level, the pandemic led to widespread uncertainty, strained resources, amplified inequities, and loss of community. On an individual level, COVID-19 restrictions limited survivors’ abilities to access resources and to be safe, and amplified pre-existing inequities, such as limited technology access. Those who did not speak English or were immigrants experienced even more difficulty accessing resources due to language and/or cultural barriers. To address these challenges, providers utilized video and telephone interactions, and stressed the importance of creativity and cooperation across different sectors of care.ConclusionsWhile virtual care was essential in allowing providers to care for survivors, and also allowed for increased flexibility, it was not a panacea. Many survivors faced additional obstacles to care, such as language barriers, unequal access to technology, lack of childcare, and economic insecurity. Providers addressed these barriers by tailoring services and care modalities to an individual’s needs and circumstances. Going forward, some innovations of the pandemic period, such as virtual interactions and cooperation across care sectors, may be utilized in ways that attend to shifting survivor needs and access, thereby improving safe, equitable, and trauma-informed IPV care.

Two sides of the same coin – Oncology social workers’ experiences of their working life and its pros and cons

ABSTRACT From the literature we learn that social workers in health care are exposed to different stressors connected to the risk for the development of burnout or traumatization. However, there is a lack of studies that focuses on the social workers’ own narratives on the burdensome, but also the rewarding aspects, of social work in health care. This study focuses on social work in oncology. Thematically structured qualitative interviews were conducted in a narrative form with 20 oncology social workers, half of whom were less experienced and half of whom were more experienced and with additional training in psychotherapy. The interviews focused on ‘pros and cons of practicing social work’ and the results were categorized by means of the similarities-differences technique. The burdensome cons concerned ‘Organizational and professional barriers’ and ‘Demanding cases’, with the latter divided into ‘Impasse because of hopelessness’ and ‘Impasse because of helplessness’. The rewarding pros categories all concerned meaningfulness including ‘Organizational meaningfulness’, ‘Meaningfulness from giving’, ‘Meaningfulness from receiving’, and ‘Meaningfulness from personal development’. Our findings indicate that the burdensome and rewarding aspects are two sides of the same coin. They are interconnected in the sense that the strain and challenge of being in situations of psychological despair also imply emotional satisfaction due to an experience of meaningfulness.

Israeli Health Care Social Workers' Personal and Professional Concerns during the COVID-19 Pandemic Crisis: The Work-Family Role Conflict.

This exploratory study focuses on the personal and professional concerns of Israeli social workers in hospitals and community health settings during the coronavirus (COVID-19) pandemic. Other studies omitted health care social workers’ needs and concerns. Participants included 126 social workers (120 females, 5 males and 1 other gender identity) in hospitals and community health settings who completed an online survey during the height of the first wave of COVID-19 in Israel. Measures included questions on exposure to COVID-19, sense of safety at work, perceived support, and personal and professional concerns. Two open-ended questions about the social workers’ concerns and the perceived concerns of their patients were included. The results showed that 17 per cent reported one of their inter-disciplinary team testing positive for COVID-19. Only one-third of the social workers felt safe from COVID-19 infection in their workplace. Mothers of dependent children were more concerned about income loss and about balancing work and family requirements than mothers of older children. ‘Home–work conflict’ was also a main theme in the qualitative data. In conclusion, the work–home role conflict took an especially heavy toll during the COVID-19 pandemic on social workers who were mothers to dependent children.

Development and validation of INTENSS, a need-supportive training for nurses to support patients' self-management

BackgroundThe growing prevalence of chronic illnesses requires nurses to support self-management and help patients integrate the chronic illness into their life. To our knowledge there are currently no training programs that combine the necessary components to adequately enhance nurses' competencies in self-management support. ObjectiveThe systematic development and validation of a need-supportive training in self-management support for nurses. DesignA three-phased study, according to van Meijel et al. (2004), with collection of building blocks, design, and validation of the need-supportive character of the training. Setting and participantsEight training groups with 30 nurses, 34 nursing students and nine social healthcare workers from different nursing colleges in Flanders, Belgium. MethodsIn phase one a literature review, current practice analysis, and problem and needs analysis were performed. In phase two, the INTENSS training intervention was developed, framed within the Self-Determination Theory and the 5A’s-Model. The training consisted of a basic training module and a video-interaction guidance module. The intervention was subsequently tested in eight training groups (N = 73). Participants provided feedback during focus group discussions. The intervention was cyclically adapted to trainees' experiences and suggestions. In phase three, we evaluated the need-supportive character of the training intervention. ResultsPhase one indicated the need for training, since nurses' application of self-management support was limited and practiced from a narrow medical point of view. In phase two we developed a theory-driven and multifaceted training, building on attitude, knowledge, skills and reflection in the training. The training was framed within the Self-Determination Theory both at the didactical level as well as on content and format. Overall, participants appreciated the building blocks of the training as supporting their basic needs for autonomy, relatedness and competence. ConclusionsINTENSS, a multifaceted need-supportive training in self-management support was developed, successfully taking into account participants' needs.

A Collaborative Assessment of Barriers to Oral Health Care

Oral health disparities are pervasive. Interprofessional education and collaborative practice experiences may be a means to address this problem in oral healthcare settings. This project aimed to determine: (1) barriers involved in patients’ access to oral health care at an academic dental school clinic, (2) dental students’ perceived ability to address patients’ needs and/or care barriers, (3) the ability of current clinical operations’ to address access to care issues, and (4) the potential role of a licensed health care social worker integrated into the clinic. Investigators conducted three focus groups –one student group (n=5), one clinical staff group (n=7), and one clinical faculty group (n=5). Further, investigators administered two needs assessment surveys in the dental school – one with students, staff, and faculty (n=144) and the second with the school’s dental patients (n=150). Investigators employed descriptive and inferential statistical analyses to evaluate the survey data. Five principal barriers to oral health care for dental patients were identified from focus group and survey data, inclusive of patients, students, staff and faculty perspectives: (1) lack of financial means, (2) lack of/inadequate insurance, (3) limited/no transportation, (4) general health problems, and (5) language barriers. More female patients (38.7%) than male patients (8.1%) reported financial barriers to accessing oral care. Including licensed social workers in an academic dental clinic may help address patient barriers to care and support interprofessional collaborative practice.

A case study of care co‐ordination between primary care providers and nurse home visitors to serve young families experiencing adversity in the Northwestern United States

Nurse home visitors in Nurse-Family Partnership® (NFP) work with mothers experiencing social and economic adversities to improve their and their children's health. Collaboration between nurse home visitors and primary care providers (PCPs: healthcare providers and social workers embedded within obstetrics, paediatrics and family medicine practices) can improve service delivery for families experiencing the greatest adversities. However, little is known about how and to what extent PCPs collaborate with home visiting nurses. We conducted a single exploratory case study between April 2019 and February 2020 to better understand how PCPs collaborate with home visiting nurses to meet family needs in one NFP site, purposefully selected for strong collaboration. We conducted in-depth qualitative interviews with 22 PCPs, including 5 nurses, 7 physicians, 7 social workers and 3 non-direct care professionals, including patient navigator and hospital executives. Interviews were recorded, transcribed, validated and coded inductively. Codes were grouped into broader categories and thematic memos across provider role were written to triangulate perspectives. Healthcare providers interacted with home visiting nurses mainly during the referral process, while social workers provided more specific examples of service co-ordination. In this case study, we saw mutual awareness, co-operation and collaboration to serve families with high needs. Even in this case, purposefully selected to represent strong collaboration, there were opportunities to enhance co-ordination to improve the health and social needs of young families experiencing adversity.

Simulation-Based Continuing Education in Health Care Social Work: A Case Study of Clinical Training Innovation.

Health care social workers practice in a fast-paced, demanding work environment, and do not always have the opportunity to reflect meaningfully on their work or to practice new skills. This article describes an innovative program, the Partnership for Excellence in Social Work Practice in Health Care (“the Partnership”), which provides a professional development opportunity for health care social workers and contributes to the larger mission of providing comprehensive and coordinated care to high-risk populations. The Partnership aims to help social workers respond to the current challenges of health care practice through simulation learning as an educational reflective practice technique. Through this program, social workers at all levels of experience have the opportunity to practice real-world scenarios in a safe and structured space, receive feedback, and reflect on their skills. The Partnership utilizes professional actors who portray patients, doctors, and care partners (formal or informal caregivers) in case examples that explore key issues in the field. This enables learners to be exposed to a representative set of patient experiences, expediting the development of their skills, enhancing their competence, and facilitating the habit of ongoing reflection in practice and in the development of one’s professional identity. Implications of the program for clinical social work practice and directions for future study are discussed.

Understanding professional distress through social representations: Investigating the shared experience of healthcare social workers in Canada

Our study sought to refine our understanding of professional distress by examining the experience of healthcare social workers in the following three Canadian provinces: Manitoba, Ontario and New Brunswick. Thirty semi-directed interviews were conducted to explore the social workers’ social representation of professional distress and its ties to professional identity and growing organizational constraints. Attitudes, work–life imbalances, and negative workplace experiences were found to increase the subjective experience of distress. Current psychosocial and organizational contexts of front-line practitioners are contributors to their professional distress, a matter further exacerbated by the misrepresentation of social work by colleagues and service beneficiaries.

Improving mental health and wellbeing in elderly people isolated at home due to architectural barriers: A community health intervention

ObjectivesTo explore the health effects of a community health intervention on older people who are isolated at home due to mobility problems or architectural barriers, to identify associated characteristics and to assess participants’ satisfaction. DesignQuasi-experimental before–after study. SettingFive low-income neighbourhoods of Barcelona during 2010–15. Participants147 participants, aged ≥59, living in isolation due to mobility problems or architectural barriers were interviewed before the intervention and after 6 months. InterventionPrimary Health Care teams, public health and social workers, and other community agents carried out a community health intervention, consisting of weekly outings, facilitated by volunteers. MeasurementsWe assessed self-rated health, mental health using the General Health Questionnaire (GHQ-12), and quality of life through the EuroQol scale. Satisfaction with the programme was evaluated using a set of questions. We analysed pre and post data with McNemar tests and fitted lineal and Poisson regression models. ResultsAt 6 months, participants showed improvements in self-rated health and mental health and a reduction of anxiety. Improvements were greater among women, those who had not left home for ≥4 months, those with lower educational level, and those who had made ≥9 outings. Self-rated health [aRR: 1.29(1.04–1.62)] and mental health improvements [β: 2.92(1.64–4.2)] remained significant in the multivariate models. Mean satisfaction was 9.3 out of 10. ConclusionThis community health intervention appears to improve several health outcomes in isolated elderly people, especially among the most vulnerable groups. Replications of this type of intervention could work in similar contexts.