Social Services Involvement Research Articles

The meaning of organizational culture and structure for interprofessional collaboration

Abstract In Germany, early neurological rehabilitation (ENR) acts as a link between acute inpatient care and rehabilitation, aiming to restore patients’ ability to rehabilitate amid their complex clinical conditions. Interprofessional cooperation (IPC) is crucial for harmonized treatment due to patients’ vulnerability. An interprofessional team comprising medical, nursing, and various therapy professionals is essential for this purpose. To explore the meaning of organizational culture and structure to IPC, 15 group discussions in 5 clinics were conducted with n = 76 participants. 1. Weekly team meetings are used to coordinate treatment goals and outcomes, but their implementation varies from clinic to clinic. Two types of meetings were identified: those that focus primarily on billing compliance and others that address patients’ long-term perspectives. However, both require additional social service involvement and are not sufficient to adequately address daily tasks, requiring additional IPC coordination. Some clinics have therefore introduced daily meetings to improve the coordination of IPC tasks. 2. Therapy planning and therapist assignment shape IPC and task fulfillment. Three therapy planning methods were observed: centralized, block-based, and flexible, each with different therapist allocation strategies. Centralized planning with flexible allocation leads to appointment pressure and interprofessional communication challenges. Block therapy reduces therapist turnover and promotes better interprofessional coordination in patient care. Flexible therapy planning is conducted through daily interprofessional meetings with shared task allocation and planning leads to a shared understanding. Initial analysis underscores the meaning of organizational structure on interprofessional task fulfillment in ENR, emphasizing the importance of enhancing different cooperation formats which can balance stability and flexibility and integrate social services effectively in patientcare. Key messages • Morning interprofessional meetings on the ward facilitate flexible responses to daily changes in patients’ health conditions and promote interprofessional collaboration. • The consideration of occupational group-specific processes in ward organization is a necessary structural prerequisite for successful interprofessional collaboration.

The Visibility of a Socio-Economic Dimension in Day-to-Day Child and Family Social Work Practice in Wales

Abstract This study explored how day-to-day social work practice with children and families in Wales responds to poverty, building on case studies already published in the other three UK nations. A case study design was used. The sites were locality teams in two local authorities, differing in their children looked after rates and trajectories of these over time. Qualitative research methods included practice observations; interviews with staff; focus groups; mapping of decision-making processes; and a sample of family case narratives. In one local authority, the range of data was similar to the other UK nation case studies. However, in the second, data collection was adapted to the coronavirus disease-19 (COVID-19) lockdown context. Some evidence was found of narratives that emphasised the cultural, rather than material, aspect of poverty, and blamed parents for making inappropriate spending choices. Poverty alleviation was generally seen as outside of social workers’ control and requiring earlier help before social services involvement. In one of the local authorities, there was some awareness shown of the impact of poverty on parenting. In the other, that took part in the study during 2020, the exacerbating effects of families in lockdown were described, including the lack of family support due to pandemic restrictions.

‘The worst day of my life’: Foster carers’ experiences of allegations

Appropriate allegation investigations within social care are paramount to protect children. However, many allegations are unsubstantiated ( Biehal et al., 2014 ) and result in stress and anxiety for fostering families ( Adams, Hassett and Lumsden, 2018 ), financial uncertainty ( Boffey, Stanton and Thomas, 2019 ), unplanned endings and foster carers leaving their role ( Adams, Hassett and Lumsden, 2018 ). There is little research into the prevalence, nature and outcomes of allegations against foster carers. This UK-based study uses The Fostering Network’s State of the Nation’s Foster Care (SOTN) 2021 survey and analyses responses from 3,352 UK foster carers and 99 fostering service staff. Qualitative findings reflect six themes: (1) emotional impacts, (2) financial implications, (3) independent support, (4) social services involvement, (5) understanding allegations, and (6) children being removed or foster carers leaving their role. Quantitative findings show only 25% of those experiencing an allegation believed they were sufficiently communicated with, only 20% believed specified timescales were adhered to, 57% did not receive independent support, and 36% said no support was offered to children in their home. Poor information-sharing and lack of support were found to have exacerbated the stress experienced.

Co-development of client involvement in health and social care services: examining modes of interaction

PurposeThe involvement of clients in service encounters and service development has become a central principle for contemporary health and social care organizations. However, in day-to-day work settings, the shift toward client involvement is still in progress. We examined how health and social care professionals, together with clients and managers, co-develop their conceptions of client involvement and search for practical ways in which to implement these in organizational service processes.Design/methodology/approachThe empirical case of this study was a developmental intervention, the client involvement workshop, conducted in a Finnish municipal social and welfare center. The cultural-historical activity theory (CHAT) framework was used to analyze the development of client involvement ideas and the modes of interaction during the intervention.FindingsAnalysis of the collective discussion revealed that the conceptions of client involvement developed through two interconnected object-orientations: Enabling client involvement in service encounters and promoting client involvement in the service system. The predominant mode of interaction in the collective discussion was that of “coordination.” The clients' perspective and contributions were central aspects in the turning points from coordination to cooperation; professionals crossed organizational boundaries, and together with clients, constructed a new client involvement-based object. This suggests that client participation plays an important role in the development of services.Originality/valueThe CHAT-based examination of the modes of interaction clarifies the potential of co-developing client-involvement-based services and highlights the importance of clients' participation in co-development.

Analisis SWOT Strategi Pelayanan Gereja Masehi Advent Hari Ketujuh Jemaat Banjarmasin Di Masa Pandemi Covid-19

This research aims to explore and analyze the service strategy of the Seventh-day Adventist Church (GMAHK) in the Banjarmasin Congregation. Using a qualitative approach, this research explores various aspects of ministry strategies, including teaching, social service, and community involvement, to understand their impact on congregational growth and relationships with the community. The research population includes members of the GMAHK Banjarmasin congregation who are involved in church services. Data was collected through direct observation, interviews with church leaders, congregation members, and volunteers, as well as analysis of church documents. A thematic analysis approach is used to identify patterns and meaning related to service strategies. It is hoped that the results of this research will provide new insights that can increase the effectiveness of church services, especially in the context of the local culture and environment of the Banjarmasin congregation. By focusing on developing relevant and significant services, this research has the potential to make a positive contribution to the congregation's spiritual growth and positive interactions with the surrounding community.

At the Edge of Care: A Systematic Review and Thematic Synthesis of Parent and Practitioner Views and Experiences of Support for Parents with Mental Health Needs and Children’s Social Service Involvement

A range of professionals and services are often involved in supporting parents with mental health needs where there are child protection concerns. However, they do not always meet the needs of this population who tend to experience inadequate support and mistrust of services. This review aimed to synthesize parent and practitioner experiences of support for parents with both mental health needs and children’s social services involvement. We performed electronic searches of the following databases: PsycINFO, CINAHL, HMIC, MEDLINE, Embase, Social Policy and Practice, Social Services Abstracts, Social Science Citation Index, OpenGrey, Social Care Online, and ProQuest. Following searching and screening, 41 studies were identified including 359 parents and 1370 practitioners. We worked with a Lived Experience Advisory Group to develop the following themes: (1) a downward spiral of service intervention; (2) working with parents, not against them; (3) support wanted versus support provided; and (4) constrained by service rigidity. We found that families were often parenting amidst trauma and adversity. However, service involvement could trigger a “downward spiral” of stressful processes over which parents felt they lacked control. Instead of improving their situations, support sometimes added to families’ difficulties, worsening parents’ mental health and making them feel marginalised, criticised, and retraumatised. There were, however, also examples of positive practice, where practitioners and parents developed trusting, open, and mutually respectful relationships. Practitioners often felt that they were limited in their ability to offer collaborative, holistic care because services were fragmented, underfunded, crisis driven, and inflexible. Difficulties mentioned most often by parents, such as financial issues, tended not to be a focus of available interventions. We conclude that the key issues identified must be targeted to improve support.

Effect of Neonatal Drug Screen on Monitoring and Management of Neonatal Opiate Withdrawal Syndrome [ID: 1376913

INTRODUCTION: Neonates exposed to opiates in utero are at risk for developing neonatal opiate withdrawal syndrome (NOWS), which may require pharmacologic therapy if severe. Neonatal drug screening has been proposed to identify at-risk neonates that require extended monitoring for NOWS. We hypothesized that documented maternal history of opiate use would be prevalent and better predict the need for monitoring at our institution. METHODS: Retrospective chart review was conducted for 342 neonates with documented NOWS scores at the University of Maryland Medical Center in Baltimore, Maryland, from January 1, 2017 to January 1, 2022. Institutional review board approval was obtained prior to initiation of the study. Maternal medical history was reviewed in addition to neonatal drug screen, NOWS scores, and need for pharmacologic treatment. The primary objective was to determine the proportion of neonates for which neonatal drug screening was the only indicator that the neonate required monitoring for NOWS. RESULTS: There was a maternal indication for NOWS monitoring present at time of delivery for 85.4% of neonates. Of the remaining 50 (14.6%), 13 tested positive for opiates; however, only 3 of these neonates required pharmacologic treatment for NOWS. Seven neonates required treatment after negative opiate screening. Overall, the sensitivity of neonatal drug testing for NOWS requiring pharmacologic therapy was 76.3% with a positive predictive value of 55.8%. CONCLUSION: Maternal history of opiate use is present for most neonates monitored for NOWS, and neonatal drug screening incompletely predicted severe NOWS. Universal neonatal drug screening may not identify additional neonates at risk of NOWS with possible unforeseen risks including unnecessary monitoring or social services involvement.

Parental Involvement in Child Protection Services and Parenting Experience as Alcohol and Other Drug Use: An Interpretative Phenomenological Analysis

Abstract This article explores the emotional experiences of drug- and/or alcohol-using parents who have child protective Social Services involvement. Research suggests that protective processes can reduce children’s experience of poor outcomes whilst parents undergo treatment for substance misuse. Semi-structured interviews combined with photovoice and journal writing were used to generate data. Eight UK-based parents participated. Each was accessing drug or alcohol treatment and had a child who was the subject of a child protection intervention. The resulting data from the seventeen interviews were analysed using Interpretative Phenomenological Analysis (IPA). Key findings are presented within four themes. The first two outline parents’ perceptions of themselves and how they felt they were viewed by others. Themes 3 and 4 focus on specific emotions: anger and frustration; fear and guilt. The research identifies the complex nature of parental emotions surrounding drug/alcohol misuse when social care services are involved. Parents conceptualised their experience as psychological trauma. They discussed the emotional roller-coaster of the effects of having combined interventions. The research provides insights into how drug/alcohol use can influence parenting. It also highlights issues for professional practice, including developing successful treatment models for substance-using parents.

What Are the Sociodemographic and Clinical Characteristics and Needs of Mothers Who Access Acute Postpartum Psychiatric Care and Have Children’s Social Care Involvement?

Mothers with severe postpartum psychiatric diagnoses are more likely to have children’s social care involvement with their infants, but little is known about the needs or experiences of this group of women. With input from a lived experience advisory group, we carried out secondary analysis of data collected from 278 mother-infant dyads where the mother accessed acute psychiatric care in England or Wales postnatally. We explored the characteristics, needs, and service use experiences of mother-infant dyads with (n = 99) and without (n = 179) children’s social care involvement. We found that mothers with social care involvement were often experiencing wider adversity and inequity across multiple areas of their lives. These mothers were also less satisfied with their mental health care and had more unmet needs after discharge from acute services. We built multivariable logistic regression models to examine factors associated with children’s social care involvement during the acute admission and one year later. We found that having social care involvement during an acute postpartum admission was associated with being deprived, reporting a maternal history of childhood trauma, experiencing domestic abuse, having a diagnosis of personality disorder or schizophrenia, and having a history of previous psychiatric admissions. At one-year follow-up, factors associated with children’s social care involvement included deprivation, experiencing childhood trauma, having been single at the time of the postpartum admission, and having been readmitted to acute psychiatric services following the postpartum admission. Our findings suggest that mothers with children’s social services involvement in the context of an acute postpartum psychiatric diagnosis may have high levels of support needs, but services may struggle to meet their needs fully. We argue that an increased focus on supporting mothers with histories of trauma, adversity, and deprivation, along with greater collaboration between mental health, children’s social care, and third sector services may help improve experiences and outcomes.

Christian churches and social welfare in secular times: How goal congruence shapes religious involvement in morality-based social services

AbstractWe study the extent and nature of Christian engagement in morality policy implementation by means of a comparative case study in Germany. In particular, we observe that the nature of engagement varies between unconnected and corresponding types of activities, and we explain this variation with the policy-specific goal congruence between religious organizations (ROs) and the state. Goal congruence, in turn, can be linked to Catholic and Protestant moral doctrines that tell us about ROs' position on morality issues. The study contributes to the literature on faith-based welfare by highlighting the role of moral doctrines as drivers of ROs' social engagement.

Patterns and Characteristics of Intentional Self-inflicted Hand Injuries among Military Personnel: A Retrospective Study and Proposal of Treatment Algorithm.

This retrospective chart review study was conducted at a tertiary hospital in Riyadh, Saudi Arabia. Our inclusion criteria included military personnel patients who presented to the emergency department with intentional self-inflicted hand-related injuries between 2016 and 2018. A total of 274 cases were included; 241 (88%) were men. Injuries to the left hand (52.2%) were more common than injuries to the right hand. The most common injury site involved the little finger (45.6%). The majority were followed up (97.8%), and 28.8% of cases had a complication. The majority of fractures were managed with open reduction and internal fixation (63.9%). Moreover, the mean sick leave duration was 23 days. Self-inflicted injuries can be challenging to diagnose when patients are manipulative about the cause and mechanism. Most self-inflicted injuries involved the left little finger, and most were treated with open reduction and internal fixation. A self-inflicted injury is possible in the context of an unusual injury with a vague medical history.

The use of linked administrative data to explore the impact of formal social care services involvement in childhood on education and offending outcomes.

Young people who are care experienced are overrepresented in the criminal justice system and in general have worse outcomes in education than their non-looked after peers (DfE & Hinds, 2019; Prison Reform Trust, 2017). Recent evidence has reported that children who have a social worker (classified as child in need or those with a child protection plan), but who do not enter the care system, can have worse outcomes in education than those children who are looked after (DfE, 2019b). There remains little research evidence about the extent to which children with a social worker become involved with criminal justice services or how the age, duration and nature of formal social care service involvement may impact on education and offending outcomes. Researchers have been challenged by the lack of a sufficiently sized quantitative data, that crossed social care, education and offending domains. In work funded by ADR-UK, the present research project uses the newly linked DfE-MoJ administrative dataset to explore how different forms of formal social care services involvement impacts on education and criminal justice outcomes. Multi-level models will explore the role of formal child social care services amongst other multi-systemic risk and protective factors for education and offending. The presentation of his work will include preliminary statistics and insights into the challenges and potential further use of the linked dataset for researchers.

When does childhood dental caries become neglect or abuse: do parents think what we think?

Introduction Poor oral health in children may be a marker for wider neglect and abuse, but there is no universally recognised threshold for social services intervention.Aim To compare families' thresholds for referral for social services intervention with those of healthcare workers.Intervention Five standardised vignettes, used previously to investigate the views of healthcare workers on the need for social services intervention, were used to determine the threshold of 250 families for intervention.Results For an unkempt four-year-old girl with extensive dental caries frequently not brought to appointments, 63.6% families suggested a child in need (CIN) referral, against 9% (3/32) dental professionals (p <0.001) and 38% (38/100) paediatric healthcare professionals (PHCPs) (p <0.001). For a bullied, obese 14-year-old boy with extensive dental caries, similar proportions of families (37%; 93/250) and PHCPs (40%; 40/100) advised a CIN referral (p = ns); significantly fewer dental workers did (15.6%; 5/32; p = 0.017). Concerning a four-year-old boy with a bruised ear, over 64% of families and 68% of PHCPs correctly felt engagement with social services was necessary (p = ns) compared to just 12.5% (4/32) of dental practitioners (p <0.001).Conclusion Many parents felt social services involvement would be helpful in these hypothetical cases, often more frequently than healthcare workers.

When does childhood dental caries become neglect or abuse: do parents think what we think?

Introduction Poor oral health in children may be a marker for wider neglect and abuse, but there is no universally recognised threshold for social services intervention.Aim To compare families' thresholds for referral for social services intervention with those of healthcare workers.Intervention Five standardised vignettes, used previously to investigate the views of healthcare workers on the need for social services intervention, were used to determine the threshold of 250 families for intervention.Results For an unkempt four-year-old girl with extensive dental caries frequently not brought to appointments, 63.6% families suggested a child in need (CIN) referral, against 9% (3/32) dental professionals (p <0.001) and 38% (38/100) paediatric healthcare professionals (PHCPs) (p <0.001). For a bullied, obese 14-year-old boy with extensive dental caries, similar proportions of families (37%; 93/250) and PHCPs (40%; 40/100) advised a CIN referral (p = ns); significantly fewer dental workers did (15.6%; 5/32; p = 0.017). Concerning a four-year-old boy with a bruised ear, over 64% of families and 68% of PHCPs correctly felt engagement with social services was necessary (p = ns) compared to just 12.5% (4/32) of dental practitioners (p <0.001).Conclusion Many parents felt social services involvement would be helpful in these hypothetical cases, often more frequently than healthcare workers.

Shared decision making in social services – some remaining questions

ABSTRACT Recent years have seen increased emphasis on person-centring and user involvement in healthcare delivery and social services. In Sweden, the rights of users to participate in and influence care planning and services are stipulated in the Social Services Act, the Health Care Act and the Patient Law. Shared decision making (SDM) is presented as a supportive collaboration between users and staff, drawing on users’ preferences and values as well as the best available evidence to discuss options and reach a consensus on care decisions. However, studies on the implementation of SDM in somatic care illustrate challenges, such as staff trying to persuade users to agree to a particular option rather than offering opportunities to discuss various alternatives. The Swedish National Board of Health and Welfare recommend that SDM should be offered in social services support in relation to certain groups. However, the imperative that ‘SDM should be offered in the social services’ raises questions; in addition to the question of how SDM should be understood, we need to account for why SDM should be offered, who should offer SDM, when it should be offered, to whom and regarding which decisions. The questions concern justification as well as clarifications. The aim of this article is threefold: to discuss SDM and its components; to deliberate upon what SDM may imply to the social services and finally, to suggest some preconditions that should be present for an implementation of SDM.

Identifying Targets to Improve Antenatal Care for Substance Misuse in Pregnancy: An Observational Study

Background: Substance misuse in pregnancy contributes to increased maternal and fetal morbidity and mortality. Women who misuse drugs are, however, less likely to attend antenatal care. An observational study of the women who attended our substance misuse antenatal clinic was undertaken to identify targets for improving antenatal care for substance misuse in pregnancy derived from trends in maternal profiles, pregnancy outcomes and childhood consequences. Methods: Data were retrospectively analysed from computer records and patient notes of the women who attended substance misuse antenatal clinic (n=100) and children born from these pregnancies (n=99). Results: The women presented with complex heterogeneous substance misuse patterns. Attendance to the clinic was “good” in 73% with poor attendance in a sub-population with high alcohol use. Special care baby unit admissions (14% vs 6%, p=0.14) and length of hospital stay were greater than the non-substance misusing group (5.3 ± 7.4 vs 1.2 ± 1.3 days, p&lt;005). More premature infants in the substance-misuse group had birth-weights less than the tenth centile (86% vs 0%, p&lt;0.05). At five years, a higher percentage of children in substance-misuse group had an ocular diagnosis compared with the control (22% vs 4%, p=0.0029), and increased social service involvement and out-of-home care. Conclusions: We suggest better sexual health education for women in high-risk groups. This could be achieved by better integration between services. Antenatal care should target high-risk groups with earlier intervention and longer-term follow-up of children born to substance-misusing mothers.

Social Services Involvement in Care Transitions and Admissions in Nursing Homes

ABSTRACT Care transitions (CT) are critical junctures in the healthcare delivery process. Effective transitions reduce the need for subsequent transfers between healthcare settings, including nursing homes. Understanding social services (SS) involvement in these processes in nursing homes is important from a quality and holistic care perspective. Using logistic regression, this study examines structural and relational factors identified with higher involvement of SS in care transitions and admissions. SS directors from 924 nursing homes were evaluated in relation to SS involvement in care transitions and admissions processes. Results suggest the level of SS involvement in care transitions and admissions are associated with structural factors such as size of facility, geographical location, ratio of FTE’s to beds, ownership status, and standalone SS departments, as well as relational factors, including perceptions and utilization of SS staff by facility leadership, coworkers, and family. Additionally, SS staff with higher levels of expertise and with social work degrees are less involved in admissions tasks.

\u201cThe elephant in the room;\u201d a qualitative study of perinatal fears in opioid use disorder treatment in Southern Appalachia

BackgroundDiagnoses of perinatal opioid use disorder (OUD) continue to rise in the United States. Patients and providers report obstacles to OUD treatment access. Difficulties include legal ambiguity related to Social Services notification requirements following a birth to people using opioids or in medication-assisted treatment for OUD.MethodsThrough semi-structured interviews, participant-observation, and a focus group conducted in a mostly rural, region of the Southern United States (where perinatal OUD is more prevalent), patients’ and providers’ perspectives about perinatal substance use treatment were initially sought for a larger study. The findings presented here are from a subset analysis of patients’ experiences and perspectives. Following ethics review and exemption determination, a total of 27 patient participants were opportunistically, convenience, and/or purposively sampled and recruited to participate in interviews and/or a focus group. Data were analyzed using modified Grounded Theory.ResultsWhen asked about overall experiences with and barriers to accessing perinatal substance use treatment, 11 of 27 participants reported concerns about Social Services involvement resulting from disclosure of their substance use during pregnancy. In the subset analysis, prevalent themes were Fears of Social Services Involvement, Preparation for Delivery, and Providers Addressing Fears.ConclusionsPerinatal OUD patients may seek substance use treatment with existing fears of Social Services involvement. Patients appreciate providers’ efforts to prepare them for this potential reality. Providers should become aware of how their own hospital systems, counties, states, and countries interpret laws governing notification requirements. By becoming aware of patients’ fears, providers can be ready to discuss the implications of Social Services involvement, promote patient-centered decision-making, and increase trust.

The Connection of Social Services to Care Transitions and Discharge Planning in Nursing Home Settings

Care transitions are critical junctures in the healthcare delivery process. Effective transitions and discharge planning reduce the need for subsequent transfers between healthcare settings (Boutwell et al., 2015). Understanding social services (SS) involvement in these processes is important due to its key role in their success (Fabbre et al., 2011). Facility characteristics from 924 nursing homes were evaluated in relation to SS involvement in care transitions and discharge planning. Chi-square tests indicate associations between SS involvement and level of engagement of SS expertise by the nursing home administrator (p=.004), medical director (p=.002), nursing staff (p=.003), community physicians (p=.049), and family members (p<.001). An association between SS involvement and freestanding SS departments was also observed. Results suggest the level of SS involvement in care transitions and discharge planning relates to structural (i.e. SS positioning within the facility) and relational (i.e. perceptions and utilization of SS designees by key facility leadership) factors.

Exploring How Media Influence Preventive Behavior and Excessive Preventive Intention during the COVID-19 Pandemic in China.

In the context of global fighting against the unexpected COVID-19 pandemic, how to promote the public implementation of preventive behavior is the top priority of pandemic prevention and control. This study aimed at probing how the media would affect the public’s preventive behavior and excessive preventive intention accordingly. Data were collected from 653 respondents in the Chinese mainland through online questionnaires and further analyzed by using partial least squares structural equation modeling (PLS-SEM). Taking risk perception, negative emotions, and subjective norms as mediators, this study explored the impact of mass media exposure and social networking services involvement on preventive behavior and excessive preventive intention. Based on differences in the severity of the pandemic, the samples were divided into the Wuhan group and other regions group for multi-group comparison. The results showed that mass media exposure had a significant positive impact on subjective norms; moreover, mass media exposure could significantly enhance preventive behavior through subjective norms, and social networking services involvement had a significant positive impact on negative emotions; meanwhile, social networking services involvement promoted excessive preventive intention through negative emotions.