Medical Social Workers Research Articles

Detection and management of localized prostate cancer in Nigeria: barriers and facilitators according to patients, caregivers and healthcare providers

BackgroundProstate cancer mortality rates are high in Nigeria. While prostate cancer is highly curable with early detection and effective multidisciplinary management, the quality of care is suboptimal in this setting. Sustainable delivery of high-quality care for patients with localized prostate cancer is needed to save more lives. To inform future interventions to improve care, this study aimed to identify barriers and facilitators that influence prostate cancer detection and management in Nigeria.MethodsSix focus group discussions (FGDs), stratified by stakeholders were conducted with a purposive sample of prostate cancer patients (n = 19), caregivers (n = 15), and healthcare providers (n = 18), in two academic tertiary hospitals in northern and southern Nigeria. A discussion guide organized based on the socio-ecological model was used. FGDs were recorded, transcribed, and analysed using the framework technique.ResultsBarriers and facilitators were identified at the individual, interpersonal, and organizational levels. Barriers to detection included limited knowledge and misperceptions among patients, caregivers, and community-based non-specialist healthcare providers, and limitations of centralized opportunistic screening; while facilitators included the potential for religious institutions to encourage positive health-seeking behaviour. Barriers to management included non-uniformity in clinical guideline usage, treatment abandonment amidst concerns about treatment and survival, absence of patient interaction platforms and follow-up support systems, difficulty in navigating service areas, low health insurance coverage and limited financial resource of patients. Facilitators of management included the availability of resource stratified guidelines for prostate cancer management and the availability of patient peers, caregivers, nurses, and medical social workers to provide correct medical information and support patient-centred services. Participants also provided suggestions that could help improve prostate cancer detection and management in Nigeria.ConclusionThis study identified multiple determinants affecting the detection and management of localized prostate cancer. These findings will inform the refinement of implementation strategies to improve the quality of prostate cancer care in Nigeria.

Instructor led rotational model: An innovative approach to social work practicums in hospital environments

With the saturation of student practicum placements requests in urban centres, job vacancies, budgetary restraints, and social workers’ intensive workloads, field education coordination teams are increasingly challenged to find social workers who are able to supervise student practicums and secure educational partnerships with organizations willing to support their staff in doing so. This is especially true in hospital settings, where social workers are still feeling the effects of the Coronavirus (COVID-19) pandemic in their daily work lives. Hospital practicums are highly sought out by social work students and yet there are few practicum opportunities for students compared to the demand. Social workers are employed in various practice settings, including hospital social work. As social workers are Canada's largest group of mental health professionals within the hospital system, having robust and sustainable practicum opportunities is critical to the training and development of future social workers. To address these ongoing challenges in social work field education, the University of Calgary, MacEwan University, and Alberta Health Services worked together to develop and pilot a new practicum model at the Bachelor of Social Work level. This practicum model, titled the ‘Instructor Led Rotational Model’, was implemented as a pilot project during the winter 2023 semester. This article provides an overview of this initiative, including a description of innovative practice education components and discussion of the challenges in field education that the model aims to address. Considerations for revisions and future offerings of the instructor led practicum model are also identified.

2347 EXPEDITE: a sustainable initiative to improve average length of stay (ALOS) in an acute geriatric Ward in Singapore

Abstract Introduction Prolonged hospitalisation is associated with increased mortality, increased risk of hospital acquired infections, functional decline and institutionalisation in older adults. Baseline data collected for patients admitted to the Acute Geriatric ward of Alexandra Hospital, a tertiary hospital in Singapore, from 28 Feb to 31 Aug 2022 (n = 299, age > 65 years) revealed an average LOS of 12.3 days. Potential contributing factors identified • 98% did not have a documented medical clearance date • 3.54 days required to decide for medical social worker referral • 9 days before discharge plans are communicated to family. Aim: To reduce average length of stay (ALOS) from 12.3 days in Aug 2022 to 9.81 days by Aug 2023. This was a target set at the hospital level on our Geriatric service in the setting of a rising national pressure for inpatients beds. Method The EXPEDITE Huddle was a regular 30 minute huddle introduced, in addition to the existing weekly multidisciplinary meeting. It was developed based on the QI methodology and streamlined from 3x/week frequency to 1x/week following PDSA cycles. A chat group on the secure hospital mobile phone messaging system was also created for ease of communication among stakeholders. Results • ALOS reduced from 12.3 days to 9.1 days (3.4 days) • 91.8% of patients (n = 154) now have a documented medical clearance date • Communication on discharge plans initiated within 3 days from admission • Sustainability: -In light of positive results, a discharge care navigator (DCN) to lead the discharge planning efforts was offered by the hospital to the Geriatric service. -The EXPEDITE huddle (now led by the DCN) continues and ALOS has remained within target. Conclusion(s) Early discharge planning with a focus on system level factors that contribute to delayed discharge can help reduce ALOS in hospitalised older adults.

Addiction Consultation Services for Opioid Use Disorder Treatment Initiation and Engagement

Medications for opioid use disorder (MOUD) are highly effective, but only 22% of individuals in the US with opioid use disorder receive them. Hospitalization potentially provides an opportunity to initiate MOUD and link patients to ongoing treatment. To study the effectiveness of interprofessional hospital addiction consultation services in increasing MOUD treatment initiation and engagement. This pragmatic stepped-wedge cluster randomized implementation and effectiveness (hybrid type 1) trial was conducted in 6 public hospitals in New York, New York, and included 2315 adults with hospitalizations identified in Medicaid claims data between October 2017 and January 2021. Data analysis was conducted in December 2023. Hospitals were randomized to an intervention start date, and outcomes were compared during treatment as usual (TAU) and intervention conditions. Bayesian analysis accounted for the clustering of patients within hospitals and open cohort nature of the study. The addiction consultation service intervention was compared with TAU using posterior probabilities of model parameters from hierarchical logistic regression models that were adjusted for age, sex, and study period. Eligible participants had an admission or discharge diagnosis of opioid use disorder or opioid poisoning/adverse effects, were hospitalized at least 1 night in a medical/surgical inpatient unit, and were not receiving MOUD before hospitalization. Hospitals implemented an addiction consultation service that provided inpatient specialty care for substance use disorders. Consultation teams comprised a medical clinician, social worker or addiction counselor, and peer counselor. The dual primary outcomes were (1) MOUD treatment initiation during the first 14 days after hospital discharge and (2) MOUD engagement for the 30 days following initiation. Of 2315 adults, 628 (27.1%) were female, and the mean (SD) age was 47.0 (12.4) years. Initiation of MOUD was 11.0% in the Consult for Addiction Treatment and Care in Hospitals (CATCH) program vs 6.7% in TAU, engagement was 7.4% vs 5.3%, respectively, and continuation for 6 months was 3.2% vs 2.4%. Patients hospitalized during CATCH had 7.96 times higher odds of initiating MOUD (log-odds ratio, 2.07; 95% credible interval, 0.51-4.00) and 6.90 times higher odds of MOUD engagement (log-odds ratio, 1.93; 95% credible interval, 0.09-4.18). This randomized clinical trial found that interprofessional addiction consultation services significantly increased postdischarge MOUD initiation and engagement among patients with opioid use disorder. However, the observed rates of MOUD initiation and engagement were still low; further efforts are still needed to improve hospital-based and community-based services for MOUD treatment. ClinicalTrials.gov Identifier: NCT03611335.

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.

Interventions for professional trauma caregivers: A meta-analysis.

The present meta-analysis aimed to investigate which are the most efficient psychological and physical interventions for professional caregivers. The study was realized using information extracted from 28 randomized controlled trials, totaling 2,168 participants, with mean ages between 22.88 and 48.54, of which 64.7% were females. The records were identified in relevant international databases of scientific articles, such as Web of Science, PubMed, Scopus, Science Direct, and Cochrane, and dissertation databases ProQuest Dissertations, DART-Europe E-theses Portal, and EThOS, for gray literature. The targeted population was represented by professional trauma caregivers, a group consisting of medical personnel, psychologists, and social workers. Out of the 28 trials included, 16 studies were performed on medical personnel, four on mental health personnel, two on social workers, and six on mixed groups. The statistical analysis revealed a main effect size of g = 0.541, 95% CI [0.383, 0.700], p < .001, which indicates an overall medium effect of the interventions. Effect sizes were compared and analyzed based on continuous and categorical moderators, which did not prove significant except for the female percentage. The current findings support that all interventions are adequate and outperform control groups. Based on the literature review that was made before the onset of this meta-analysis, there seems to be no other study realized in such an exhaustive format. The implications predominantly target practitioners in how to approach professional trauma caregivers who seek treatment. Future research should further investigate this population as a whole and consider including culture as a moderator. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Psychological state, self-assessment y emotional stability of a severely wounded combatant

The article presents a comprehensive analysis of the peculiarities of the psychological state, self-esteem and emotional stability of severely wounded combatants who returned from combat. The research is based on the study of the psychological well-being of this category of victims, their adaptation and rehabilitation after severe physical injuries. The main focus is on identifying the manifestations of post-traumatic stress disorder (PTSD), depressive and anxiety symptoms in severely wounded combatants. It was found that severe combat trauma significantly increases the risk of developing mental disorders in victims, significantly complicating their recovery and return to a full-fledged peaceful life.The main factors that affect the emotional stability and general psychological state of severely wounded combatants are analyzed. These factors include physical pain and limitations, loss of functional capabilities, psychological trauma, social isolation, feelings of loss and helplessness, as well as problems with employment and financial stability. The role and importance of family care in supporting the psychological well-being of severely wounded combatants is considered. It is noted that effective rehabilitation requires close cooperation between medical professionals, psychologists, social workers and families of the victims. An important aspect is raising public awareness of the problems faced by severely wounded combatants and developing social support and adaptation programs for this category of people. Based on the results obtained, the article outlines the main areas of psychological assistance to severely wounded combatants. The author emphasizes the need for a comprehensive psychological rehabilitation program aimed at processing traumatic experiences and restoring self-esteem.

Effects of Organizational Support and Professional Identity on Job Satisfaction Among Medical Social Workers in China

The current status of job satisfaction among Chinese medical social workers and the impact of organizational support and professional identity on job satisfaction among Chinese medical social workers were investigated in the context of the Healthy China Initiative. This article used quantitative research methods, and the data were drawn from the China Social Work Longitudinal Study (CSWLS). The article’s sample comprises 218 medical social workers who participated in a medical social work module survey and who are directly engaged in social service practices in hospitals in China. The results showed that the job satisfaction score of Chinese medical social workers was 3.58, which was considered good. Professional identity can significantly and positively predict and impact job satisfaction, and as a dimension of professional identity, professional enthusiasm has a significant impact on job satisfaction. Organizational cultural support significantly affects job satisfaction and organizational support mediates this relationship between professional identity and job satisfaction among medical social workers. Together, these findings suggest that organizational support and professional identity significantly impact the job satisfaction of medical social workers in China. Future studies should aim to promote professional enthusiasm and enhance organizational culture support to improve job satisfaction among medical social workers.

Linking in with advice and supports for men impacted by metastatic cancer: The LIAM Mc trial (NCT05946993).

TPS1646 Background: Multidisciplinary supportive care interventions are key to preventing and managing adverse effects of cancer and its treatment for patients, reducing symptom and psychological burdens and enhancing quality of life (QoL). However, the optimal composition of these interventions for men with genitourinary (GU) cancers is poorly understood. The LIAM Mc Trial is an enhanced supportive care programme, funded by the Irish Cancer Society and designed with the input of patient representatives who highlighted the unmet needs of cancer survivors. An important aspect of the trial is to demonstrate how to improve the survivorship supports and services for underserved communities of men who experience disparities in cancer incidence, prognosis, outcome and QoL, and have not traditionally been the focus of such initiatives. Methods: Using an embedded mixed-method process evaluation this prospective trial aims to assess the feasibility and impact of a holistic 12-week survivorship programme amongst men with advanced GU cancers at an Irish Cancer Centre. The programme involves twice-weekly sessions with input from a dedicated physiotherapist, dietitian, and nurse specialist, along with education sessions from medical social worker and psycho-oncology specialists, and programme oversight provided by medical oncologists. Outcomes are measured at three timepoints; pre-intervention, immediately post-intervention and at 6 months post intervention, and will include EORTC QoL; muscle strength; body composition through bioelectrical impedance analysis and ultrasound; diet quality; cancer related symptom control; cancer related fatigue scores; feasibility outcomes, qualitative interviews and a process evaluation. Any man with a locally advanced or metastatic GU cancer who has recently completed a course of treatment or is stable on active anti-cancer treatment is eligible for the programme. Over the two-year study period the sample size target is 72 participants. The primary endpoint of the study is to evaluate the feasibility of introducing an enhanced supportive care programme as part of routine management for male cancer patients with metastatic disease. Acceptability, satisfaction with the programme and QoL changes are key secondary endpoints. Barriers to participation are also a key outcome under investigation. The study was activated in May 2023 with the first participants enrolled in June 2023. To date 17 men have enrolled with accrual completion anticipated in June 2025. Clinical trial information: NCT05946993 .

A study on awareness and perception about perinatal death auditing among health care workers in two districts of Karnataka State, India

ABSTRACT Background: To start perinatal death auditing, doctors should have good knowledge about it. Objectives: To know the awareness and perceptions of doctors about different aspects of perinatal death auditing like 1) different types of contributors; 2) high-risk approach; 3) consequences; 4) documentary requirements; and 5) existing system of mortality meeting/child death reviews. Methodology: The perinatal death auditing project was implemented in two districts of Karnataka state. As a part of the pre-intervention survey, awareness and perceptions of doctors and a few health care administrators were explored. They were requested to participate in the study. Those who consented were approached in their hospitals and interviewed. Trained medical social workers conducted the interviews. Awareness was scored from 0 to 3 with 0 being no knowledge and 3 being good knowledge. Perceptions were scored from 0 to 3 with 0 being no negative perceptions and 3 being fear of legal consequences. The responses were documented, scored, and described. Results: Though 22 doctors were eligible, only 16 consented to participate in the study. Knowledge of doctors about different contributors was inadequate. They were apprehensive about legal consequences. They knew that documentation could protect them and be useful in a court of law. They were not clear about the conduct of mortality meeting/existing system of child death reviews. Conclusion: Knowledge was inadequate. They were apprehensive about legal consequences. Training of doctors and allaying apprehensions are required for starting perinatal death auditing.

#1899 Transitional care clinic for incident hemodialysis patients : the Singapore experience

Abstract Background and Aims The period of transition from chronic kidney disease (CKD) to End stage kidney disease (ESKD) presents significant morbidity and mortality risk to the patients. This higher mortality risk is largely contributed by cardiovascular factors and infection. The last 2 decades have seen a remarkable succession of programs to improve outcome in incident dialysis patients. One such initiative is the use of ‘fistula first’ policy. In Singapore, pre-emptive access creation among ESKD patients continues to be low, with up to 80% of incident dialysis patients being commenced on hemodialysis (HD) via a dialysis catheter. Ensuring that incident dialysis patients have definitive vascular access, early referral to transplantation and adequate psychosocial support, amongst other factors, is an important consideration in their journey towards improved health outcomes. In order to achieve this, meticulous care coordination and a multifaceted approach is required. This realization is what led to the inception of our transition care clinic (TCC) in 2019. Conducted bi-monthly by a multidisciplinary team of nephrologists and renal coordinators, with inputs from pharmacists and medical social workers as needed, the TCC engages patients within 4-6 weeks post-hospital discharge. Its focus includes vascular access, dietary and fluid compliance, blood pressure control, HD adherence, transplantation referral, and medication reconciliation. Method A retrospective analysis of 314 ESKD patients who initiated HD between September 2019 and September 2022 compared outcomes between TCC attendees (n=164) and non-attendees Results TCC attendees exhibited a lower 1- year mortality rate (p=0.002) and higher rates for vascular access creation within first 6 months (p=0.001) as compared to non-attendees. However, no statistical differences were observed in hospitalization rates in the first year (p=0.760) and kidney transplantation referrals (p=0.20) between the two groups. Conclusion While notable improvements were observed in mortality rates and vascular access creation, there was no significant difference in hospitalization rates or kidney transplantation referrals between the two groups. In spite of the limitations due to its retrospective nature, this study clearly demonstrates the effectiveness of TCC in enhancing patient outcomes during the critical initial phase of hemodialysis. The study highlights the importance of setting up, refinement and expansion of such services in improving the outcome of this vulnerable patient group.

Abstract PO3-09-08: Using Social Determinants of Health to Improve Surgical Delays for Breast Cancer Patients at Rush University Cancer Center

Abstract Introduction Delays to surgery in the treatment of breast cancer can lead to worse disease specific mortality and overall survival. Previous work has shown a woman’s time to surgical treatment is influenced by income, which may be secondary to social determinants of health (SDOH) including health literacy, safety, stress, access to health care and transportation, housing, and ability to pay utilities. This study sought to evaluate a screening process for SDOH to assess and address barriers to care for women newly diagnosed with breast cancer. Methods A SDOH screening tool consisting of 7 yes/no questions was developed and used by trained breast oncology nurses via phone call made to all new patients prior to their first visit. Based on patient response, patients are provided with community resources or referred to the hospital social work team. Primary outcome included the SDOH screening results, and secondary outcome included time to surgery. Results 118 patients were screened, of which 60 patients had surgery as their first treatment and were included in this analysis. Twenty-seven patients screened positive for SDOH need. Ten patients reported &amp;gt;3 SDOH concerns and were referred to social work. The most common concerns were food insecurity and trouble paying utilities. Of the 27 patients who screened positively, 18 identified as Black or African American, 3 were Hispanic, 1 Asian and 5 White. The mean household income for these patients based on their reported zip codes was $55,615.78. Average time to surgery for patients with a positive SDOH screen was 37.7 days and negative SDOH screen was 42 days. For patients with a positive SDOH screen, those with 2 or fewer SDOH needs had an average time to surgery of 41.9 days and those with 3 or more SDOH needs had an average 30.6 days until surgery. Discussion Patients who screened positive for SDOH need and were provided resources had a faster time to surgery than patients who initially screened negative for SDOH. Patients referred to social work had the fastest time to surgery. Early identification of SDOH is necessary for all patients to improve equity and outcomes in breast cancer treatment. Citation Format: Hilary Tingley, Madeline McIntosh, McKenzie Klee, Margaret Gladman, Alison Coogan, Andrea Madrigrano. Using Social Determinants of Health to Improve Surgical Delays for Breast Cancer Patients at Rush University Cancer Center [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-09-08.

Contributors to Electronic Health Record-Integrated Secure Messaging Use: A Study of Over 33,000 Health Care Professionals.

Electronic health record (EHR)-integrated secure messaging is extensively used for communication between clinicians. We investigated the factors contributing to secure messaging use in a large health care system. This was a cross-sectional study that included 14 hospitals and 263 outpatient clinic locations. Data on EHR-integrated secure messaging use over a 1-month period (February 1, 2023, through February 28, 2023) were collected. A multilevel mixed effects model was used to assess the contribution of clinical role, clinical unit (i.e., specific inpatient ward or outpatient clinic), hospital or clinic location (i.e., Hospital X or Outpatient Clinic Building Y), and inpatient versus outpatient setting toward secure messaging use. Of the 33,195 health care professionals who worked during the study period, 20,576 (62%) were secure messaging users. In total, 25.3% of the variability in messaging use was attributable to the clinical unit and 30.5% was attributable to the hospital or clinic location. Compared with nurses, advanced practice providers, pharmacists, and physicians were more likely to use secure messaging, whereas medical assistants, social workers, and therapists were less likely (p < 0.001). After adjusting for other factors, inpatient versus outpatient setting was not associated with secure messaging use. Secure messaging was widely used; however, there was substantial variation by clinical role, clinical unit, and hospital or clinic location. Our results suggest that interventions and policies for managing secure messaging behaviors are likely to be most effective if they are not only set at the organizational level but also communicated and tailored toward individual clinical units and clinician workflows.

Empowering Hospital Social Workers with Goals-of-Care Skills Training Using Simulation

Empowering Hospital Social Workers with Goals-of-Care Skills Training Using Simulation

Enhancing Efficiency, Improving Care: Exploring Patient Opinions on Hospital Social Work

Purpose: This study investigates patient perceptions of factors influencing the efficiency of hospital social work services. Specifically, it explores the perceived role of social workers in addressing patients' psychosocial needs and identifies potential strategies for enhancing service efficiency. By understanding the patient perspective, this research aims to illuminate the impact of various factors on social work effectiveness and ultimately contribute to improved patient care delivery. Methods: A convenience sampling technique was employed to recruit 130 patients from Trung Vuong Hospital who participated in a self-administered survey assessing their perspectives on hospital social work services. The survey comprised two scales: one evaluating factors affecting social work efficiency and another proposing measures for improvement. Descriptive statistics were utilized for data analysis. Results: Patient perceptions identified "patient needs" and "knowledge and skills of medical staff, doctors, and social workers" as the most critical factors impacting hospital social work efficiency. This underscores the importance of ongoing professional development for social workers and ensuring adequate staffing levels. Proposed strategies for improvement included: enhanced professional training for social workers, fostering effective communication regarding social work services available to patients, and the expansion of external resource networks to provide comprehensive support for patients facing complex challenges. Conclusion: This study sheds light on critical areas for optimizing hospital social work efficiency, highlighting the importance of strategic staffing decisions, fostering interdisciplinary collaboration, and prioritizing continuous professional development for social workers. By integrating patient feedback into service delivery models, social work departments can enhance patient support and contribute to improved healthcare outcomes. Future research efforts should strive for broader generalizability by incorporating diverse healthcare settings and soliciting the perspectives of a wider range of stakeholders. This will provide a more comprehensive understanding of social work effectiveness in the evolving landscape of healthcare delivery.

Contextual barriers and enablers to establishing an addiction-focused consultation team for hospitalized adults with opioid use disorder

BackgroundHospitalization presents an opportunity to begin people with opioid use disorder (OUD) on medications for opioid use disorder (MOUD) and link them to care after discharge; regrettably, people admitted to the hospital with an underlying OUD typically do not receive MOUD and are not connected with subsequent treatment for their condition. To address this gap, we launched a multi-site randomized controlled trial to test the effectiveness of a hospital-based addiction consultation team (the Substance Use Treatment and Recovery Team (START)) consisting of an addiction medicine specialist and care manager team that provide collaborative care and a specified intervention to people with OUD during the inpatient stay. Successful implementation of new practices can be impacted by organizational context, though no previous studies have examined context prior to implementation of addiction consultation services (ACS). This study assessed pre-implementation context for implementing a specialized ACS and tailoring it accordingly.MethodsWe conducted semi-structured interviews with hospital administrators, physicians, physician assistants, nurses, and social workers at the three study sites between April and August 2021 before the launch of the pragmatic trial. Using an analytical framework based on the Consolidated Framework for Implementation Research, we completed a thematic analysis of interview data to understand potential barriers or enablers and perceptions about acceptability and feasibility.ResultsWe interviewed 28 participants across three sites. The following themes emerged across sites: (1) START is an urgently needed model for people with OUD; (2) Intervention adaptations are recommended to meet local and cultural needs; (3) Linking people with OUD to community clinicians is a highly needed component of START; (4) It is important to engage stakeholders across departments and roles throughout implementation. Across sites, participants generally saw a need for change from usual care to support people with OUD, and thought the START was acceptable and feasible to implement. Differences among sites included tailoring the START to support the needs of varying patient populations and different perceptions of the prevalence of OUD.ConclusionsHospitals planning to implement an ACS in the inpatient setting may wish to engage in a systematic pre-implementation contextual assessment using a similar framework to understand and address potential barriers and contextual factors that may impact implementation. Pre-implementation work can help ensure the ACS and other new practices fit within each unique hospital context.

AN ANALYSIS OF THE IMPACT OF PEER SUPPORT GROUPWORK ON THE PSYCHOLOGICAL WELLBEING OF THE LIMB RECONSTRUCTION PAEDIATRIC PATIENTS ATTENDING THE NATIONAL ORTHOPAEDIC HOSPITAL CAPPAGH, DUBLIN

AN ANALYSIS OF THE IMPACT OF PEER SUPPORT GROUPWORK ON THE PSYCHOLOGICAL WELLBEING OF THE LIMB RECONSTRUCTION PAEDIATRIC PATIENTS ATTENDING THE NATIONAL ORTHOPAEDIC HOSPITAL CAPPAGH, DUBLIN

Talk to the Tablet: Technology’s Impact on Medical Social Work Practice during COVID-19

Medical social workers (MedSWs) responded quickly to the call for virtual health care delivery driven by the COVID-19 pandemic. This study employed the social presence theory to investigate how technology impacted MedSW interactions during COVID-19. Qualitative thematic analysis on MedSW interviews (N = 54) revealed three themes: shifting social presence, adapting to virtual social work practice, and confronting equity and ethics. The findings suggest how technology-mediated practice contributed to feelings of professional dissonance from the discrepancy between MedSW professional values and the virtual delivery of job tasks. Education and research on virtual best MedSW practice is warranted to protect against professional dissonance.

IJCM_231A: Barriers and Facilitators for Integrating Screening and Brief Intervention for Quitting Substance Use in Primary Care Settings

Background: Substance Use disorders (SUD) are commonly encountered in general medical practice which include people of all ages and socioeconomic groups. In these circumstances, Screening and Brief Intervention (SBI) can be a useful tool for managing the disease burden in primary care setting. There is a need to investigate the hurdles and enablers that act as a catalyst for integrating Screening and Brief Intervention in primary health care practice Objectives: To explore the barriers and facilitators for implementing screening and brief intervention (SBI) for SUD at primary health care settings Methodology: A written informed consent was obtained from the subjects after briefing about the topic and interview was initiated with the help of an interview guide. The interview was recorded using an audio recorder. The discussion was written in the vernacular language and translated verbatim. Inductive thematic coding was applied to analyse the data Results: A total of 10 participants were interviewed which included four Medical Officers (MO), two Auxiliary Nurse Midwives (ANMS), one each Medical Social Worker (MSW), Tobacco Cessation Cell Consultant, Counsellor and substance user. Some challenges to integrating screening services included lack of manpower, hesitance to reveal substance use by women and identifying trained health care providers to seek assistance for quitting. Facilitators of Screening and brief intervention delivered at Primary Care level includes a favourable attitude of the health care provider, awareness among doctors about harmful effects of substance use and patients’ good rapport with field workers Conclusion: This study’s results point towards a multi-pronged approach like involvement and capacity building of different health care providers like Accredited Social Health Activist (ASHA), ANMs and MO along with encouraging community participation for integrating Screening and Brief Intervention in this setting.

Interdisciplinary team members’ experiences of family meetings in an Irish rehabilitation hospital: a social work action-research project

This study set out to gain a better understanding of how family meetings are facilitated and experienced in an Irish rehabilitation hospital setting from the perspectives of interdisciplinary team (IDT) members, patients and their family members. This article reports the findings from IDT members’ perspectives. A critical-realist action-research approach was utilised that involved medical social workers (N = 15) and a social work academic. A quantitative, descriptive study design was adopted, which utilised a cross-sectional survey of IDT members. A total of 85 clinical staff responded to the questionnaire, of which 69 were fully completed. Four key themes emerged: pre-meeting engagement and preparation – a critical step; the impact of organisational structures; supporting participation; and mechanisms for effective family meetings. Findings indicate the importance of pre-meeting preparation, the mutuality of the relationships between participants, a standardised approach and the use of patient-centred and inclusive practices to achieve truly participatory family meetings. Family meetings involve complex processes in which mutual influence, context, preferences, values, information shared, the nature of the relationships involved and the communicative style of participants all play significant roles in both the process and decision-making outcomes. This study concluded that social workers are perhaps in a unique position to work with IDTs in clarifying the reality of the limits of choice and the involvement of the patient and family in rehabilitation hospital settings. In preparation for the role of family-meeting facilitation, the implementation of education and training programmes for IDT members is strongly recommended.