Medical Social Workers Research Articles

Medical social workers as mediators between patients, physicians, and the court: the case of former ringworm patients

ABSTRACT Facilitating benefit and resource acquisition to assist clients is a major responsibility of medical social workers, requiring them to have a thorough knowledge of community resources, legislation, and regulations. The aim of the current study was to examine knowledge of the Law for Compensation of Scalp Ringworm Victims and ringworm-related irradiation damage among 101 social workers employed in diverse healthcare settings in Israel. We found that 65.3% of the social workers were aware of the law, but only 40.6% were aware of the health effects of scalp ringworm irradiation. Media coverage and clients who underwent scalp ringworm irradiation were social workers’ major sources of knowledge. Working with former ringworm patients had the strongest association with knowledge of the law and of ringworm-related irradiation damage. Results highlight the important contribution of exposure to clients’ experiences and knowledge to expand social workers’ knowledge of health issues.

A service evaluation of a Hospital In-reach Service for people who are homeless in South England

Abstract Background Homelessness has increased dramatically in the last decade, with an estimated 165% increase in rough sleeping alone in England since 2010. People experiencing homelessness can often have what is referred to as the tri-morbidity; mental health, substance and or alcohol misuse and physical health problems. Hospital admission presents a potential point of intervention to address the health problems people have been experiencing, to link them in with services and as a bridge to housing. This service evaluation explored the role of a Hospital In-reach Service team for safer hospital discharge. Methods A qualitative in-depth interview study was conducted with six participants related to a Hospital In-reach Service team in South England. The interviews were transcribed, and analysed following Burnard's fourteen stage method. The ethical approval was obtained from Brighton and Sussex Medical School Research Governance and Ethics Committee (ER/BSMS4284/2). Results Three key themes were identified; the role of the Hospital In-reach Service team, barriers to, and facilitators for advocating patients' needs. The results indicate that the service team works incredibly well, building strong and trusting relationships with patients, community and hospital teams, taking a holistic approach to patient care. However, the structural discrimination against this patient group is reiterated in this study. Despite progress, there are still problems with non-specialist staff understanding this patient group's needs. Conclusions There is a need for clarification within Adult Social Care regarding the distribution of responsibility between hospital and community social work teams. There also appears to be a need for expansion of training for non-specialist service staff, including ward staff, discharge teams and social workers. In-reach housing services and expansion of the service team would be invaluable Key messages Hospital In-reach Service team in South England works incredibly well taking a holistic approach to patient care. Clarification in role of hospital and community social work teams is required for better management of this issue.

Effect of Covid-19 on Nigerian Socio-economic Well-being, Health Sector Pandemic Preparedness and the Role of Nigerian Social Workers in the War Against Covid-19

ABSTRACT Covid-19 is a virus that has created tension and devastation around the globe. This study is designed to specifically find out the effect of Covid-19 on the socioeconomic well-being of Nigerians, the health sector preparedness to handle the pandemic, and the role of Nigerian social workers in the fight against Covid-19 in Nigeria. The study employed a phenomenological and exploratory research design in its inquiry. Sixteen respondents made up the sample size for the study. A Focus Group Discussion Guide and an In-Depth Interview Guide were the instruments for data collection. The result of the study shows that the Covid-19 pandemic has had a devastating impact on the socioeconomic well-being of Nigerians. Second, the Nigerian health system is ill equipped and underprepared to handle the Covid-19 pandemic. Third, Nigerian social workers, most especially medical social workers, have played a significant role in passing out information on Covid-19 preventive measures to the general public. The study recommends that the Nigerian government should wake up and fix the health sector and make it proactive to handle epidemics/pandemics in the future. Social work practice in Nigeria should be promoted by the government through institutionalization of the profession.

Investigating the benefits and challenges of including bereaved women in research: a multifaceted perinatal audit in a socially disadvantaged French district

ObjectivesTo describe experiences including interviews with bereaved women in a clinical audit.DesignThe data come from an audit of all stillbirths and neonatal deaths at ≥22 weeks of gestation in Seine-Saint-Denis,...

Prevalence of People without Health Insurance and Interventions of Hospital Social Work at the University Hospital of Essen

In Germany, a number of people remain without health insurance, thus unable to access the formal health care sector. Reliable statistics covering the prevalence and description of uninsured patients, especially in the inpatient health care sector, are still lacking. Our study therefore aimed to assess the prevalence of uninsured patients at University Hospital of Essen over a period of five years. Furthermore, we report rates of identification of cost providers and refunded disbursement. Uninsured patients from 2014-2018 were included. We defined the following subgroups for stratification according to the right of access to health insurance: patients with right of access to health insurance in Germany, EU citizens, patients from third countries, patients without residence permit status. Data of 918 uninsured patients (mean age 31.3±20.6 years, 52,1% men) from 2014 to 2018 were evaluated. Over five years, identification of cost provider was successful in 74% and yielded in a total refund of 7.5 million Euros. In most instances, patients were treated in the gynaecological and maternity clinic (20%), paediatric clinic (17%), orthopaedic clinic and trauma surgery (14%) and the clinic for internal medicine (13%). Our study shows that there are still people in Germany who do not have health insurance. Referring to the inpatient health care sector, results show that it is possible to calculate treatment costs, to identify cost providers and to refund medical costs. To apply target group-specific approaches in practice, more research is needed addressing both causes and risk factors. The availability of comprehensive data could improve discussions at a political level on medical compensation not available to patients.

Reflections on Israeli hospital-based social work with COVID-19 patients and their families

The COVID-19 pandemic created an unfamiliar and dynamic reality which posed many challenges for hospital social workers. This article presents the experience of the social work service at Tel-Aviv Sourasky Medical Center in Israel in answering the needs of COVID-19-hospitalized patients and their families.

Barriers to end-of-life discussion with advanced cancer patient as perceived by oncologists, certified/specialized nurses in cancer nursing and medical social workers.

The objectives of this study were to identify barriers to end-of-life discussion with advanced cancer patients and their families as perceived by oncologists, certified/specialized nurses in cancer nursing (hereafter, collectively referred to as 'nurses') and medical social workers, as well as to clarify their opinions about effective strategies to facilitate end-of-life discussion. A questionnaire survey was distributed to 4354 medical professionals working at 402 designated regional cancer hospitals in Japan. Responses were obtained from 494 oncologists (valid response rate 30.7%), 993 nurses (46.7%) and 387 medical social workers (48.1%). Among the barriers to end-of-life discussion with advanced cancer patients, factors related to patients and families, such as 'Family members' difficulty accepting loved one's poor prognosis', were recognized as the most important issues, which was the common view shared across the three types of medical professionals who participated in this study. Nurses and medical social workers were significantly more likely than oncologists to recognize as important issues 'Health care team disagreement about goals of care' and 'Lack of training to have conversations for end-of-life discussion'. To facilitate end-of-life discussion, 'providing mental and emotional support for the patients and their families after end-of-life discussion' was needed most as perceived by the respondents regardless of their profession. Barriers impeding end-of-life discussion were factors related to patients and their families, and oncologists' close cooperation with nurses and medical social workers is important in providing emotional support for patients and families. To facilitate end-of-life discussion, it is important to share information on patients' prognosis and goals for treatment among oncologists and other medical professionals, as well as strengthen communication skill of these medical professions.

The Clarity and Contribution of the Hospital Social Work Role: Observations on its Professional Identity

This review explores international practice in hospital social work with older people through the lens of four different aspects of professional identity (self-identity and reported practice; professional characteristics; patient perspectives, and professional authority or power). It highlights the skills needed for hospital social work and the challenges faced by practitioners following organisational change in acute hospital care. It offers an agenda for new research and for professional debates about what will be needed from hospital social workers in the future.

Present status of support for adolescent and young adult cancer patients in member hospitals of Japanese Association of Clinical Cancer Centers.

the proportion of adolescent and young adult cancer patients is relatively small, but they require age-specific support. We conducted a survey on the present status of support for adolescent and young adult cancer patients in the Japanese Association of Clinical Cancer Centers. in December 2018, the primary questionnaires were sent to 32 hospitals of Japanese Association of Clinical Cancer Centers regarding support for adolescent and young adult cancer patients. Secondary questionnaires were sent to doctors, nurses and medical social workers in 24 hospitals for the implementation rates of information provision and consultation on 17 unmet needs identified in the study by the Ministry of Health, Labour and Welfare, Japan. there were marked differences in support for adolescent and young adult cancer patients among hospitals. Only one hospital facilitated an adolescent and young adult department and ward. Thirteen hospitals cooperated with the paediatric cancer designated hospitals. A learning support for high school-aged patients was provided in 15 hospitals. Adolescent and young adult support teams were active in seven hospitals and staff training sessions were held in eight hospitals. Many hospitals had referrals for fertility preservation. The rates of information provision and consultation for more than 70% of adolescent and young adult patients showed statistically significant differences among the medical professions in most of the 17 items. support systems and activities for adolescent and young adult cancer patients vary extremely across hospitals. Information provision and consultation for unmet needs are still insufficient. Therefore, sharing information and experiences is required to enhance the support for adolescent and young adult cancer patients.

Sustainable implementation of advance care planning in Asia: An interpretive-systemic framework for national development.

A qualitative interpretive-systemic focus group study was conducted to examine the developmental and implementational underpinnings of Asia's first national Advance Care Planning (ACP) programme constituted in Singapore. 63 physicians, nurses, medical social workers, and allied health workers who actively rendered ACP were purposively recruited across seven major public hospitals and specialist centers. Framework analysis revealed 19 themes, organized into 5 categories including Life and Death Culture, ACP Coordination, ACP Administration, ACP Outcomes, and Sustainability Shift. These categories and themes formed an Interpretive-Systemic Framework of Sustainable ACP, which reflects the socio-cultural, socio-political, and socio-spiritual contexts that influence ACP provision, highlighting the need to adopt a public health strategy for enhancing societal readiness for end-of-life conversations. The Interpretive-Systemic Framework of Sustainable ACP underscores the importance of health policy, organizational structure, social discourse, and shared meaning in ACP planning and delivery so as to support and empower care decision-making among terminally ill Asian patients and their families facing mortality.

NHU CẦU TÀI LIỆU “CÔNG TÁC XÃ HỘI TRONG BỆNH VIỆN” CỦA NGƯỜI LÀM CÔNG TÁC XÃ HỘI TRONG BỆNH VIỆN TẠI VIỆT NAM

The material “Hospital Social Work” is essential in the process of professionalization of social work in Vietnam today. This study aimed to describe the demands for the material “Hospital Social Work” among social workers and health workers in hospital in Vietnam. On that basis, we recommended the content of this material. The study was conducted on 175 participants including 103 social workers and 72 health workers from seven hospitals at central levels. Our study showed that health workers had a higher demand for the content of “Basic information about hospital social work” (p = 0.018), while social workers had a higher demand for the content of “Intervention methods of hospital social work” (p = 0.004); “Social work skills in hospitals” (p = 0.028); “Mental health assessment instruments” (p = 0.007) and “Social work process in hospital” (p = 0.005). The study also made recommendations to the Ministry of Health and schools of social work in Vietnam to compile this material effectively and in accordance with reality.

What Have Hospital Social Workers Been Prepared for COVID-19 from SARS, MERS, and H1N1?

What Have Hospital Social Workers Been Prepared for COVID-19 from SARS, MERS, and H1N1?

Effect of the ASCENT Intervention to Increase Knowledge of Kidney Allocation Policy Changes Among Dialysis Providers

IntroductionThe Allocation System Changes for Equity in Kidney Transplantation (ASCENT) trial was a cluster-randomized pragmatic, effectiveness-implementation study designed to test whether a multicomponent educational intervention targeting leadership, clinic staff, and patients in dialysis facilities improved knowledge and awareness of the 2014 Kidney Allocation System (KAS) change.MethodsParticipants included 690 dialysis facility medical directors, nephrologists, social workers, and other staff within 655 US dialysis facilities, with 51% (n = 334) in the intervention group and 49% (n = 321) in the control group. Intervention activities included a webinar targeting medical directors and facility staff, an approximately 10-minute educational video targeting dialysis staff, an approximately 10-minute educational video targeting patients, and a facility-specific audit and feedback report of transplant performance. The control group received a standard United Network for Organ Sharing brochure. Provider knowledge was a secondary outcome of the ASCENT trial and the primary outcome of this study; knowledge was assessed as a cumulative score on a 5-point Likert scale (higher score = greater knowledge). Intention-to-treat analysis was used.ResultsAt baseline, nonintervention providers had a higher mean knowledge score (mean ± SD, 2.45 ± 1.43) than intervention providers (mean ± SD, 2.31 ± 1.46). After 3 months, the average knowledge score was slightly higher in the intervention (mean ± SD, 3.14 ± 1.28) versus nonintervention providers (mean ± SD, 3.07 ± 1.24), and the estimated mean difference in knowledge scores between the groups at follow-up minus the mean difference at baseline was 0.25 (95% confidence interval [CI], 0.11–0.48; P = 0.039). The effect size (0.41) was low to moderate.ConclusionDialysis facility provider education could help extend the impact of a national policy change in organ allocation.

واقع دور الأخصائی الاجتماعی الطبی فی تنمیة الوعی بثقافة التباعد الإجتماعی فی ظل أزمة فیروس کورونا (COVID19) من وجهة نظر الشباب السعودی

الملخص : هدف البحث الحالي إلى تحديد واقع دور الأخصائي الإجتماعي الطبي في تنمية الوعي بثقافة التباعد الإجتماعى في ظل أزمة فيروس کورونا COVID19 من وجهة نظر الشباب السعودى وقد تم إستخدام المنهج الوصفي التحليلى من خلال إستبانة إلکترونية تم إعدادها لهذا الغرض مکونة من (76) عبارة موزعة على أربعة محاور، وتم تطبيقها على عينة مکونة من (196) من الشباب السعودى بمدينة الرياض، وأشارت نتائج الدراسة إلى أن واقع الدور التنموي للأخصائي الإجتماعي في تنمية الوعي بثقافة التباعد الإجتماعي من وجهة نظر الشباب السعودي في ظل أزمة فيروس کورونا جاء في الترتيب الأول بمتوسط حسابي (2.76) , بينما جاء في الترتيب الثاني واقع الدور الوقائي للأخصائي الاجتماعي بمتوسط حسابي (2.73) و في الترتيب الثالث واقع الدور العلاجي للأخصائي الاجتماعي بمتوسط حسابي (2.72), وجاءت أهم الصعوبات من وجهة نظر الشباب السعودى في عدم التصديق المجتمعي بأهمية دور الأخصائي الإجتماعي الطبي في مثل تلک الأزمات ، وجاءت أهم مقترحات التحسين من وجهة نظر الشباب السعودى في تنمية وعي فريق العمل بأهمية الدور المهني للأخصائي الإجتماعي في تنمية ثقافة التباعد الإجتماعي ، وضع آلية للتعاون بين إدارة المؤسسة الطبية والأخصائي الإجتماعي في تنمية ثقافة التباعد الإجتماعي, الکلمات المفتاحية : الأخصائي الإجتماعي الطبي - ثقافة التباعد الإجتماعي - الشباب- فيروس کورونا This study aims to identify the real role of Medical Social Worker in developing cultural awareness of social distancing In light of the coronavirus crisis (Covid-19) from the point of view of the Saudi Youth. The descriptive-analytical approach was utilized by designing a 76-element questionnaire divided into four domains. The sample comprised (196) of the Saudi Youth in Al – Riyadh City. The results indicated that the reality of the developmental role of the Medical Social Worker in developing a culture of social distancing from the point of view of the Saudi Youth in light of the Coronavirus crisis came in the first -ranking with an arithmetic average (2.76), while it came in the second-ranking the preventive role of the Medical Social Worker with an arithmetic average (2.73), and in the third-ranking the therapeutic role of Medical Social Worker with an arithmetic average (2.72). The most important obstacles from the point of view of the Saudi Youth in Community disbelief came in the importance of the role of medical Social workers in such crises. The study recommended the need to improve the awareness of the working team about the importance of the professional role of the Social Worker in developing a culture of social distancing and setting up a mechanism for cooperation between the management of the medical institution and the social worker in developing a culture of social distancing. Keywords: Medical Social Worker - Culture of Social Distancing - The Youth – CoronaVirus Crisis (COVID-19).

Evidence-Based Review and Discussion Points

Evidence-Based Review and Discussion Points

Multidisciplinary management of chronic atopic dermatitis in children and adolescents: a prospective pilot study

Background Atopic dermatitis (AD) is a chronic, pruritic disorder affecting 10–20% of children and is associated with psychological issues and impaired quality of life (QoL). The role of psychosocial support in the treatment of AD is increasingly important. We studied the impact of a multidisciplinary clinic (MDC) in the management of AD in a tertiary children’s hospital in Singapore. Methods We performed a prospective pilot interventional study on 34 pediatric patients with AD and concomitant psychosocial impairment. Patients were recruited into an MDC, comprising a dermatologist, clinical psychologist and medical social worker. AD severity was scored using Scoring Atopic Dermatitis (SCORAD), while QoL was assessed using the Children’s Dermatology Life Quality Index Questionnaire (CDLQI) and Family Dermatology Life Quality Index Questionnaire (FDLQI). Biopsychosocial assessments and interventions were also performed. Eighty-three percent of patients received cognitive behavioral therapy, while 40% received social work intervention. Results There was an overall improvement in mean SCORAD, CDLQI, and FDLQI scores across MDC visits. A correlation between AD severity and QoL was established. A patient satisfaction survey showed improvement in severity, understanding, and control of the disease. Conclusion Our study suggests the effectiveness of a multidisciplinary approach in managing pediatric AD patients with psychosocial co-morbidities.

A narrative review of healthcare financing and reimbursement of nutritional support for patients in Singapore

AimsNutritional support is used frequently in Singapore’s healthcare settings, but limited research has been published on how it is financed. This paper aims to provide a narrative review on the financing of nutritional support in Singapore for acute care, step-down care, intermediate and long-term care (ILTC), community and home settings. MethodsA structured search strategy was applied to available electronic databases using selected search terms, with additional reports and grey literature identified using iterative searches. ResultsA limited number of publications were found via electronic databases. The majority of publications were from governmental reports/ press releases, and healthcare organizations’ websites. While funds are available via MediSave, MediShield Life, MediFund, and various other schemes, they may not be sufficient for individuals on long-term nutritional support. ConclusionsMore funding sources for nutritional support are urgently required for patients in ILTC. Means-testing mechanism and targeting may need to improve to ensure access to financial assistance for nutritional support and prevent poorer outcomes and higher medical costs. Medical providers, dietitians, pharmacists and social workers play a role in determining need, prescribing and accessing nutritional support for optimal care of individuals in hospitals and ILTC. Future policies will need to address the issues of access to nutritional support in the elderly and low-income populations.

Retrospective Report of Discharge Against Medical Advice and Emerging Roles of Medical Social Workers in Nigeria

The study presents a retrospective report of cases of DAMA and the emerging roles of Medical Social Workers in Nigeria using a teaching hospital as a case. Retrospective report of 553 DAMA cases were retrieved from social case-note of Medical Social Workers between a period of five years (June, 2015 to December, 2019) at University College Hospital, Ibadan Reasons for DAMA were mostly because of financial constraints. Medical Social Worker’s intervention were hovering around education and facilitating legal procedure to DAMA to prevent litigation to the hospital. There was an association between socio-demographic characteristics and rates of DAMA (p<0.05), diagnosis of patient was also significantly associated with rate of DAMA in the hospital(p<0.05) and there was an association between gender and social work interventions to cases of DAMA at the University College Hospital(p<0.05). The study concluded that high rate of DAMA in Nigerian hospital is as a result of differences in socioeconomic characteristics of patients and severity of their diagnosis. Therefore, hospital admission processes should be person-cantered care services and inclusion of Medical Social Workers in the flow-char of granting DAMA to patients

Improving the Service to Aboriginal and Torres Strait Islanders through Innovative Practices Between Aboriginal Hospital Liaison Officers and Social Workers in Hospitals in Victoria, Australia†

Abstract Aboriginal and Torres Strait Islanders have suffered violence and extreme prejudice in every walk of life as a result of the European colonisation of Australia. We acknowledge the ongoing colonial legacy to this suffering and discuss how cultural safety is a solution to overcoming some elements of the disadvantages that still beset Aboriginal and Torres Strait Islander people in terms of accessing health care. Accessible and culturally safe health services are critical in reducing health inequalities for First Nations’ people because of the burden of ill-health they experience. ‘Cultural safety’ in this context refers to approaches that strengthen and respectfully engage with Aboriginal and Torres Strait Islander cultures in mainstream services. Alongside holistic Indigenous health and primary prevention approaches, a broad range of medical, socio-cultural and allied health support is needed to alleviate these inequalities. In this article, we describe how the working relationship between Aboriginal Hospital Liaison Officers and Social Workers in public hospitals in Victoria, Australia, contributes to cultural safety, and thereby improves the quality of care and a reduction in discharges against medical advice by Aboriginal patients. We conclude that elements of this model may be applicable to improving care for First Nation peoples in other countries.

Fighting cancer in coronavirus disease era: organization of work in medical oncology departments in Emilia Romagna region of Italy.

Aim: To assess which and when measures were applied to reduce coronavirus disease (COVID-19) spreads have been applied in medical oncology departments. Materials & methods: We surveyed all medical oncology departments from the Italian Emilia Romagna region via a multidomain questionnaire. The questions covered items on patients, healthcare workers, risk reduction measure and clinical trials. Results: A total of 12 centers involving 861 healthcare members joined the survey. The measures applied to patients and health workers partially converged in all the departments while major divergences were found in the clinical trials domain. High rate of COVID-19 infection occurred among medical doctors (21/208, 10.1%) and social care workers (13/110, 11.8%). Rate of infection among nurses was 5.7% (24/418). Conclusion: All measures able to reduce risk of COVID-19 infection must be applied in medical oncology departments. Early introduction of risk reduction measures may be a critical issue.