Medical Social Workers Research Articles

Medical Social Work in Pre-Hospital Emergency Health Services: A Model Proposal for Türkiye

Hastane öncesi acil sağlık hizmetleri sağlık hizmetlerinin temel yapı taşlarından birini oluşturur. Yaşamı tehdit eden hastalık, kaza veya yaralanmaya maruz kalan insanlar için çoğunlukla ilk temas noktasıdır. Hastane öncesi acil sağlık hizmetlerinden yararlananların sağlık hizmetine olan ihtiyacı, sadece fiziksel olarak tıbbi boyutta değil, bununla birlikte acil ve krizin doğası gereği sağlığın psikolojik ve sosyal boyutunu da içermektedir. Aşırı iş yükü olan ve sürekli travmatik olaylara maruz kalan sağlık çalışanları ambulansla olay yerine gittiklerinde hızlı bir şekilde tıbbi müdahaleye odaklanırlar ve ortaya çıkan psikososyal ihtiyaçlar göz ardı edilir. Bu durumda hem hastaların hem de ailelerinin acil psikososyal sorunları ve takibi için sosyal hizmet uzmanlarının becerilerine ihtiyaç vardır. Bu çalışmada hastane öncesi acil sağlık hizmetlerinin yapısı düşünüldüğünde, sağlığın göz ardı edilen psikososyal boyutuna vurgu yapılarak sağlığa yönelik bütüncül bir yaklaşım hedeflenmektedir. Bu kapsamda, hastane öncesi acil sağlık hizmetleri, tıbbi sosyal hizmet, hastane öncesi acil sağlık hizmetlerinde tıbbi sosyal hizmetin önemi ve aralarındaki ilişki ele alınarak daha kaliteli ve etkin bir sağlık hizmeti sunumu için hastane öncesi acil sağlık hizmetlerinde tıbbi sosyal hizmet birimi modeli önerilmektedir. Bu model önerisinin hem bütüncül bir yaklaşımla erken psikososyal müdahale ile tedavi planlarına yardımcı olabileceği hem de psikososyal nedenlerle yapılan aramalara çözüm üreterek sisteme olan bağımlılığı azaltabileceği düşünülmektedir.

Psycho-Social and Financial Problems of Cancer Patients: An Empirical Study

Cancer is one of the major non-communicable diseases which increase morbidity and mortality in India. Many people become victims due to Cancer. WHO (2008) define Cancer as a disease in which some of the body’s cells grow uncontrollably and spread to other parts of the body. Cancer can start almost anywhere in the human body, which is made up of trillions of cells. The present study is conducted to understand the psycho-social and financial problems of Cancer patients and find out the responsibilities of medical and psychiatry social workers in cancer settings. It is a quantitative study that adopted the descriptive research design. The purposive sample is employed and collected data from 50 cancer patients through a structured interview schedule. The study found that 27.5% of the respondents were diagnosed with blood cancer, followed by 25.5 per cent of the respondents diagnosed with breast cancer, and 13.7 per cent of the respondents diagnosed with lung cancer. It is observed that in many (70.6%) patients’ history or family history one was affected with cancer or died with cancer. It is found that 30 per cent of the respondents have weakness of the body, (25%) fear the future, (25%) fear the treatment, (16%) have depression and (15%) have anxiety, (12%) have Distress, (8%) isolation, (5%) loss of focus and (4%) self-Harm. This shows that the majority have weakness of the body followed by fear of the future and treatment, anxiety and Depression. The majority of respondents or patients lost jobs (25.5%) followed by (23.5%) of respondents who stopped business and lost attachment to their families and the least stopped farming after being admitted to hospital because of cancer. The study suggested that the government should initiate more cancer treatment centers because is a costly treatment in the private sector.

291 Improving the collateral history for older people admitted to hospital: the 6 Cs

Abstract Background Despite its central role in diagnostic formulation in unwell older adults, particularly those with memory problems, little scrutiny has been applied to Collateral History (CH) taking from how/when it should be performed, what information should be gathered and how it should be assimilated. This quality improvement project aims to address this by improving processes around collateral history taking for older patients. Methods The objectives of this project were to: (i) Establish information that should be included in the CH, (ii) Assess if this information is currently being collected and (iii) Use this to inform a proforma to assist with CH taking. Health-Care Professionals (HCPs) involved in the care of older people ranked information from CH in terms of relevance/importance (online survey). An audit was performed on a sample of consecutive patients aged ≥65 years admitted under the geriatric medicine service from 01/02/2023–17/02/2023, to assess compliance with and content of collateral histories against our HCP survey. Results 41 HCPs (13/41 (32%) medical, 6/41 (15%) nurse specialists, 15/41 (37%) physiotherapists/occupational therapists, 7/41 (17%) medical social workers) were surveyed. They ranked baseline and recent changes in cognition, function and mobility as key features of the CH. CHs were completed in 70% (35/50) of admissions (n = 50, mean 83 years, 42% documented cognitive impairment). Baseline cognition and function were documented in less than half of collateral histories, change in cognition in 18/35 (51%); change in function in 10/35 (29%). Baseline mobility was documented in 20/35 (57%); change in mobility in 9/35 (26%). Findings then informed an electronic patient record (EPR) proforma: ‘The 6 Cs of the Collateral History’ (Consent, Contact, Cognition, Change (Function/Mobility), Communication, Conclusion). Conclusion Compliance with, and content of, CHs vary widely. This QI project aims to address this by using an EPR proforma, co-designed by clinicians involved in the care of older people, to prompt/structure CH taking.

58 Review of a pilot Reablement Team service

Abstract Background A Reablement Team (RT) was established in a level two hospital for patients who are medically fit for discharge from either Medical Assessment Unit (MAU) or in-patient care, to prevent hospital admission and to support early discharge, through the provision of home rehabilitation. The team consists of senior grade medical social worker, occupational therapist, speech and language therapist, physiotherapist and a rehabilitation assistant. Intensive rehabilitation is provided in the home for up to 6 weeks. This study sought to evaluate service impact and performance in 2022. Methods A mixed method design was employed. Quantitative data was used by analysing number and nature of patients seen, discharge outcomes and pre and post outcome measures to determine goals achieved, quality of life and independence levels. Qualitative data included patient satisfaction questionnaires. Results In 2022, 78 patients were seen, 41 female and 37 male. Mean age of 79 years. Of the total number of patients, 59 (76%) were discharged early from hospital and 19 (24%) avoided hospital admission after attending the MAU. Underlying diagnosis of patients comprised Stroke (n = 29), progressive neurological disorders (n = 11), respiratory disorders (n = 2) orthopaedic/musculoskeletal (n = 13), falls (n = 20), patients medically unwell (n = 3). Of the patients discharged, 86% remained at home (n = 67), while 14% were readmitted. Using pre/post outcome measures, 89% reported an improvement in quality of life as measured by the ICECAP assessment and the mean increase of all patients in independence was 5.4% measured on the modified Barthel index. 91% of patients achieved one or more primary rehabilitation goals. All patients rated service satisfaction as high. Conclusion Findings indicate that a RT service can reduce LOS and prevent unnecessary admissions when intensive rehabilitation is provided by a dedicated team of HSCPs in the home. Additional benefits include reduction of primary care waiting list and integrated home care.

15 Hospital at home—a potential alternative option to acute hospital admission for older adults

Abstract Background Novel ways to respond to the acute care needs of older adults are needed. Hospital at Home (H@H) could be a viable alternative to emergency hospitalisation. We developed inclusion and exclusion criteria for selected medical conditions that could theoretically be treated in a hospital at home setting if supported by a geriatric medicine multidisciplinary team with a consultant, Advanced Nurse Practitioner (ANP), Physiotherapist (PT) and Cccupational Therapist (OT). Methods We completed a retrospective cohort study of unselected medical admissions over a two week period in a level four hospital. We developed illness specific criteria for stable patients that if met could allow a patient to be treated in a hospital at home environment. These conditions included community acquired pneumonia, congestive cardiac failure, COPD exacerbation and urinary tract infection. Results There were 307 medical admissions over the study period, with 144 over the age of 75 (47%). Mean age 83.2. 59 patients met our inclusion criteria for a potential H@H service (41%). All patients were clinically stable based on admission vital signs. The mean length of stay was shorter for patients eligible for H@H than patients who did not meet the criteria (9 days vs 14 days, p 0.01), and patients meeting the H@H criteria were more likely to be discharged home directly. They were less likely to have needed occupational therapy (32% vs 52%, p = 0.02) or medical social worker input (22% vs 42%). There was no difference in frailty category or readmission rates by whether or not a patient met the H@H criteria. Conclusion Over 40% of unselected medical take patients were of a low acuity that could have theoretically met our inclusion criteria for a supported hospital at home model. Strategies are needed to support expansion of this model of care.

260 Using participatory action research to examine attitudes and awareness of adult safeguarding practices in the acute hospital context

Abstract Background The investigation of, and interventions on, the alleged abuse of vulnerable adults has become an important feature of social work and other professional practices in Ireland. This implies important organisational challenges in ensuring that adult safeguarding responsibilities are delivered in ways that ensure positive outcomes for all stakeholders. Many factors can influence staff responses to concerns in acute care contexts. This can relate to awareness of the many forms of abuse and reporting obligations, attitudes to adult safeguarding and understanding the impact of abuse. Acute hospitals offer unique opportunities to intervene in abusive situations and to offer support to those at risk. This study set out to explore the awareness, understanding and attitudes towards safeguarding practices of staff in a large Dublin teaching hospital using a Participatory Action Research Approach (PAR). Methods A PAR methodology was utilised involving a social work academic and six members of the Medical Social Work team as co-researchers in the study design, data collection and data analysis. A quantitative, descriptive study design was adopted, which utilised a cross-sectional online survey of hospital staff which generated 100 responses from a variety of hospital staff including nurses, doctors and health and social care professionals. Results Findings indicate that acute care staff have varying levels of awareness of different categories of abuse. 59% of respondents reported being ‘somewhat confident’ in recognising and reporting suspected harm, neglect or abuse of a patient they were treating. 66% of respondents reported being aware of their mandated reporting requirements under the Criminal Justice (Withholding of Information on Offences against Children and Vulnerable Persons) Act 2012. Conclusion Many staff in acute care contexts lack confidence and knowledge in detecting and reporting the abuse of adults at risk, including their mandated reporting obligations with 90% of respondents stating that they need further training in this area.

3. Interprofessional Work in Community Medicine: A Medical Social Worker's Perspective

3. Interprofessional Work in Community Medicine: A Medical Social Worker's Perspective

Mortality among registered tuberculosis patients in Pune Municipal Corporation area, India

BackgroundDeaths among tuberculosis patients due to varied causes are frequently reported. Usually, the death rate is high during the first six to eight months, i.e., the intensive phase of treatment. The healthcare personnel working under National Tuberculosis Elimination Program are reluctant to ascribe death to tuberculosis and may prefer to attribute the death to other causes. On the other hand, in hospitals, most death are attributed to tuberculosis without careful death audits and reasonable investigations. Comorbidities like diabetes, HIV, drug resistance, and drug-induced toxicity consequent to administering secondary lines of drugs need due consideration while ascertaining the cause of death. The study aimed to measure mortality within one year and a maximum of two years after registration. We also determined the cause of death by conducting a verbal autopsy by medico-social workers using the WHO modified autopsy tool. Two pairs of physicians ascertained cause of death by reviewing the collected information. We obtained the consensus opinion of a pair of physicians. In case of disputed opinion, opinion of senior physician from the other group was considered final. Material and methodsWe obtained the list of registered tuberculosis patients in 2019–2020 in Pune Municipal Corporation. The authors conducted the study in 2021–22. The authors prepared a verbal autopsy tool based on the WHO tool. We trained the experienced medical social workers. They called registered phone numbers to know the patient's present status. The social workers paid home visits and confirmed the present status if the phone was not connected even after repeated calls. They collected all the required details, reviewed information and decided the cause of death. The collected detailed information was shared with pairs of senior physicians who ascertained the cause of death. We calculated standardized mortality ratio and Kaplan-Meier survival analysis. ResultsThe eligible patients were 7461, and there were 506 deaths. The death rate among males was higher (8.29%) compared to females (5.02%) [χ2 (with Yates correction) = 30.73; p < 0.00001]. The mean age of deceased and living patients was 42.77 (S.D. = 18.07) and 38.46 (S.D. = 17.54) years, respectively (t = 5.33; p < 0.0001). The death rate was 3.88 per 1000 person-months. More than 60% of patients died within six months of initiation of treatment. The overall standardized mortality ratio was 9.61; it decreased as the age advanced. Kaplan-Meier survival analysis showed that the overall survival for two years was 92.7%. The common causes were pneumonia, pulmonary tuberculosis, acute coronary syndrome, and some liver injury/disease. ConclusionsThe standardized mortality ratio due to tuberculosis is high. The common causes of death are pneumonia and acute coronary syndrome.

Palyatif Bakımda Sosyal Çalışmacı Varlığı

The employment of social workers in the health sector, who work in different institutions in terms of service areas, increased with the Health Transformation Program that started in the 2000s. There are some regulations that are accepted as a turning point in terms of the existence of social work in health institutions. The Patient Rights Regulation published in 1998 is one of them. Between 1998 and 2011, social workers were actively engaged in patient rights practices. In the process that started with the publication of the Medical Social Work Implementation Directive in 2011, the way for social workers to engage in professional interventions within the scope of medical social work has been paved. Today, there are issues regarding the units that social workers will take part in, in the published guidelines for the delivery of specific health services and in the standards determined for total quality management in health. Therefore, the need for specialization in the field of medical social work is increasing day by day. In this study, explanations about the field in the medical social work literature, the legislation on palliative care services and the standards regarding total quality management practices were examined. With this study, it is aimed to bring up the specialization and supervision needs of the social work profession, whose existence is accepted in the field of palliative care, and to emphasize the necessity of improving the professional infrastructure for the planned services. Keywords: Medical Social Work, Palliative Care, End of Life Care, Quality Standards in Health

Medical social worker support for elderly patients in a tertiary care hospital in Japan

Summary When elderly patients are admitted to a hospital, they may require support from medical social workers during hospitalization. This study examined the association between patient characteristics and support provided by medical social workers in applications for social welfare benefits during hospitalization. We conducted a retrospective observational study of patients aged 65 years or older between October 2018 and September 2021 who had involvement by a medical social worker during their hospitalization at a tertiary care hospital in Japan. We evaluated associations between background factors and support in applying for social welfare benefits by medical social workers using logistic regression analysis. Findings Among 485 eligible patients, 79 (16.3%) received support from a medical social worker in an application for social welfare benefits. Early elderly age (65–74 years) and living alone were independently associated with receiving support from medical social workers (adjusted odds ratio [OR] 1.98, 95% confidence interval [CI] 1.16–3.37, P = .012; 3.86, 95% CI 2.26–6.62, P &lt; .001, respectively), regardless of sex, activities of daily living before admission, and presence of a regular doctor. Application The findings suggest that early elderly individuals who live alone may not be able to utilize the available welfare benefits and not have adequate support from family members when admitted to a tertiary care hospital, even if they have adequate activities of daily living and a regular doctor. Early intervention to improve social vulnerability may be required for early elderly individuals who live alone.

Exploring professionals' views regarding prenatal counselling in congenital diaphragmatic hernia.

Congenital diaphragmatic hernia (CDH) is a congenital malformation in which the diaphragm and lungs are underdeveloped, leading to cardiorespiratory and other problems. This study aimed to explore professionals' views regarding prenatal counselling in CDH. A qualitative study was performed among healthcare professionals involved in the care of CDH patients in Radboud university medical center Amalia Children's Hospital. Semi-structured interviews were conducted until saturation was achieved. Transcripts were qualitatively analysed to gain insight into professionals' views regarding counselling. Eighteen professionals with various backgrounds were included. The professionals agreed that the first counselling session should be soon after diagnosis and additional sessions should be offered. Concerning counselling content, participants considered explanation of the diagnosis, prognosis, short- and long-term consequences, treatment options and practical aspects important. As for decision-making about possible termination of pregnancy, all professionals emphasised the importance of the parental role, but the preferred parental involvement varied. Regarding practical aspects, preferred counsellors were a neonatologist, obstetrician, paediatric surgeon and/or medical social worker. Participants emphasised that the counselling should be adjusted to parents' needs. This study gained insight into professionals' views regarding the timeline, content, decision-making process, and practical aspects of prenatal counselling in CDH.

Fact-finding survey of doctors at the departments of pediatrics and pediatric surgery on the transition of patients with childhood-onset chronic disease from pediatric to adult healthcare.

The number of adult patients with childhood-onset chronic diseases is increasing. However, the process of transitioning these patients from child- to adult-centered medical services faces many difficulties. Despite the key role that doctors in the pediatric field are considered to play in transition, few fact-finding surveys about transition have been conducted among these doctors. The aim of this study was to demonstrate the current status and challenges in the transition of patients with childhood-onset chronic diseases by a fact-finding survey of pediatricians and pediatric surgeons at a university hospital. A cross-sectional survey was performed using an anonymous self-administered questionnaire. Seventy-six doctors of pediatrics and pediatric surgery (excluding junior residents) in a university hospital were asked to answer an anonymous self-report questionnaire. A multidisciplinary research team selected items related to the transitional process. Sixty (79%) doctors participated, of whom 52 (87%) showed awareness of transition. No doctor answered that "Transition is conducted smoothly." Doctors with shorter pediatric department experience had lower awareness and poorer experience with transition. In contrast to pediatric surgeons, pediatricians explained "job-seeking activities" and "contraceptive methods" to the patient, and reported a higher patient age at which to initiate explanation of transition to the patient and his/her family. Among factors inhibiting transition, 39 (65%) respondents selected "The patient's family members do not desire transition" and 34 (57%) selected "Although a relevant adult healthcare department is available, it will not accept the patient." The medical providers most frequently considered to have responsibility for playing a central role in the transition process were "pediatrician/pediatric surgeon," "medical social worker," and "regional medical liaison office." To promote transition, pediatric and adult healthcare departments should share concerns about and cooperate in the establishment of more effective methods of transition, and provide multidisciplinary collaboration to support patients and their families.

Organisational contextual aspects among medical social workers.

Since the recognition of social work in health care, the number of social workers has dramatically increased. The proved association between psychosocial conditions and biophysical features encouraged in social work drove its professionalism and made social workers an essential part of the health care team in hospitals. Today, social workers are involved in medicine as specialised practitioners who share their knowledge and care along with other professionals to provide multi-disciplinary interventions and services to people in need. Using a self-administered questionnaires, this study aims to examine the relationship between two organisational-contextual aspects (i.e., organisational structural, and organisational resources) among social workers in health care in Saudi Arabia.

Job Performance Evaluation of Medical Social Workers during Covid-19 Crisis: Tasks, Attitudes, and Difficulties

Job Performance Evaluation of Medical Social Workers during Covid-19 Crisis: Tasks, Attitudes, and Difficulties

Exploring Fear of Cancer Recurrence (FCR) in cancer survivors from a medical social work perspective: A qualitative study of medical social workers in South Korea

Background Fear of Cancer Recurrence (FCR) in cancer survivors has been insufficiently addressed despite its imperativeness in cancer journey. Although several studies have investigated healthcare professionals’ experience with FCR in cancer survivors, a medical social work perspective has rarely been reflected. This study aimed to explore Korean medical social workers’ experience with intervening FCR in cancer survivors. Methods Snowball sampling recruited 12 experienced medical social workers intervening with cancer survivors at tertiary or university cancer hospitals in South Korea. Individual and focus-group interviews (FGI) were conducted with the medical social workers. The interviews were recorded, transcribed, and analyzed by using an inductive qualitative content analysis. Results Content analysis of the interviews extracted the following major themes regarding FCR in cancer survivors. First, when and how FCR among cancer survivors emerged at the early stage of medical social work interventions was identified. Second, how medical social workers dealt with FCR in cancer survivors was illustrated. Third, the responses of cancer survivors to medical social work interventions for FCR were assessed. Finally, the internal and external issues underlying the medical social work interventions for FCR among cancer survivors were revealed and discussed. Conclusion Based on the results, this study suggested the implications on dealing with FCR in cancer survivors in the realm of medial social work profession. Furthermore, it expanded the discussion about FCR in cancer survivors from cancer hospitals to community.

“A million other factors killing us”: Black women's health and refusing necropolitics-as-usual during COVID-19

Ongoing social, economic, and political marginalization combined with racialized gender violence has sentenced Black women in the United States to disproportionate harm in the form of premature illness and death. Despite widespread recognition within the medical social sciences, public health, and social work of the health inequities that unevenly impact Black women, as a population, their suffering continues to be overlooked and marginalized in biomedical research, healthcare institutions, and health policy. This omission contributes to the naturalization and normalization of heightened morbidity and mortality of Black women. In this article, we draw from theory on necropolitics, misogynoir, and Black ecologies of care in analyzing findings from semi-structured interviews conducted between February and June 2021 with African American women (n = 16) who were experiencing a chronic health condition or caring for someone with a chronic health condition in Tucson, Arizona. Interviews explored women’s healthcare-seeking behaviors, experiences with healthcare providers, and self-care and caregiving during the COVID-19 pandemic. Our findings suggest that necropolitical logics in the form of naturalization and normalization of Black women's suffering – and of the structures that render such suffering – permeated but did not entirely define women's experiences of the pandemic, including how they navigated biomedical spaces and negotiated interactions with healthcare providers, engaged in practices of care (including self-care), and perceived and made meaning of their own health statuses. We advance a Black ecologies of care framework: (1) to make visible and hold accountable necropolitical structures in tabulations of morbidity and mortality; and (2), despite the myriad harms represented in logics of necropolitics-as-usual, to foreground the life-affirming practices by women that persist nevertheless.

“We’re kind of on the back burner”: Psychological distress and coping among medical social workers during the COVID-19 pandemic

ABSTRACT Medical social workers are essential members of healthcare teams, especially during a pandemic. Their scope of practice includes conducting psychological assessments, coordinating social services, connecting patients to resources that address social determinants of health, discharge planning, and patient advocacy. Social workers’ experiences of psychological distress were unique even before the COVID-19 pandemic; their work demands a high amount of emotional investment as they frequently witness others’ pain and suffering and navigate various daily challenges and crises. This study explores psychological distress experienced by medical social workers and the coping strategies used by these professionals during the pandemic prior to the COVID-19 vaccine rollout. Faced with conflicting information from state and federal agencies, social workers dealt with resource shortages, took on additional roles and responsibilities, and contended with regular value conflicts and ethical dilemmas. Our findings indicate that medical social workers are not sufficiently protected or prioritized in their workplaces and that infrastructure to support social workers’ emotional wellbeing is lacking. Distinct themes that emerged from the data under the umbrella of psychological distress include feeling unprotected, overburdened, and undervalued. We discuss a need for targeted policy and sustainability-oriented solutions to improve coping and resilience, mitigate psychological distress, and prevent burnout among medical social workers.

Examining experiences of African American patients with breast cancer in a multidisciplinary survivorship clinic.

e18621 Background: Breast cancer (BC) is the most commonly diagnosed cancer in women. More effective therapies have led to improved survival rates, yet, the survival benefit is not shared across all patient (pt) populations, with worse breast cancer outcomes among African American (AA) pts. The American College of Surgeons has mandated that accredited sites have a cancer survivorship program. At the Cardinal Bernardin Cancer Center (CBCC), there remain disparities in access and utilization of the survivorship clinic, especially by AA BC survivors. Of the 385 new BC analytic cases CBCC treated between March 1, 2020, and March 1, 2021, 72 of these were AA pts. Unfortunately, less than 10% of AA BC pts who received curative intent therapy attended the CBCC Survivorship Clinic. As part of the "Bringing Quality Care Training to Komen’s African American Health Equity Initiative" in collaboration with ASCO, CBCC remodeled its survivorship program into a multidisciplinary clinic staffed by medical oncology, oncologic psychology, genetic counselor, nutritionist and social worker in order to provide comprehensive care to pts following diagnosis and treatment. Methods: The CBCC team performed the following: construction of a process map outlining the current pathway for referring pts to the survivorship clinic; creation of a fishbone cause and effect diagram highlighting factors contributing to poor utilization of the clinic; implementation of faculty surveys to assess reasons for lack of referral to survivorship clinic; development of pt experience surveys; and identification of countermeasures. Tumor registry identified BC pts by stage, race, and ethnicity. Results: Review of the CBCC BC registry showed a low attrition rate among 72 AA pts, with only 1.4% (n = 1) of AA pts diagnosed at CBCC treated elsewhere. AA pts made up a disproportionate number of stage IV diagnoses comprising 40% (n = 8). Surveys demonstrated the following reasons for poor utilization of the survivorship clinic by faculty in order of descending importance: providers felt they were providing survivorship care to their pts; pts declined referral due to appointment fatigue; lack of understanding to make referral; no outcomes data to support survivorship clinics; pt misunderstanding the purpose; fear of losing the pt; pt financial burden. Pt surveys (n = 20) showed high pt satisfaction, with an average rating of 4.8 out of 5 for overall care. Conclusions: Lack of utilization of the cancer survivorship clinic among AA BC pts leads to inefficient application of resources, decreased survivorship care, reduced pt experience, and diminished opportunity for survivorship education and increased health literacy. Paths for the future include increased faculty and pt education, faculty engagement, designated scheduler for survivorship clinic, and increased promotional and marketing work.

Investigating factors related to social workers’ job satisfaction: Government and private hospitals in Tehran and Karaj Provinces

The job takes up more of an individual’s time than any other activity and gives meaning to people. Various factors interact with each other to make someone satisfied or dissatisfied with the job. This study aims to identify the factors related to social workers’ job satisfaction based on Herzberg's motivation-hygiene theory. The target population includes a total of hospitals located in Tehran and Karaj Provinces, Iran. 108 hospital social workers participated in the study, and the data were gathered through a job satisfaction questionnaire. As a result of this research, the overall level of social workers’ job satisfaction is average. A significant positive correlation was identified between motivational and hygiene factors, and job satisfaction. Among the variables of motivational factors, recognition, achievement, growth, and responsibility, and among the components of hygiene factors, supervision, workplace policy, and interpersonal relationships correlated significantly and positively with job satisfaction. In addition, a statistically significantly greater role of motivational factors in explaining social workers’ job satisfaction compared to hygiene factors has been proved.

Guaranteed Income and Financial Treatment Trial (GIFT Trial or GIFTT): a 12-month, randomized controlled trial to compare the effectiveness of monthly unconditional cash transfers to treatment as usual in reducing financial toxicity in people with cancer who have low incomes.

Cancer-related financial hardship (i.e., financial toxicity) has been associated with anxiety and depression, greater pain and symptom burden, treatment nonadherence, and mortality. Out-of-pocket healthcare costs and lost income are primary drivers of financial toxicity, however, income loss is a pronounced risk factor for cancer patients with low incomes. There has been little progress in developing an income intervention to alleviate financial toxicity cancer patients with low incomes. Unconditional cash transfers (UCT), or guaranteed income, have produced positive health effects in experiments with general low-income populations, but have not yet been evaluated in people with cancer. The Guaranteed Income and Financial Treatment (GIFT) Trial will use a two-arm randomized controlled trial to compare the efficacy of a 12-month UCT intervention providing $1000/month to treatment as usual on financial toxicity, health-related quality of life and treatment adherence in people with cancer who have low-incomes. The study will recruit 250 Medicaid beneficiaries with advanced cancer from two comprehensive cancer centers in Philadelphia, obtain informed consent, and randomize patients to one of two conditions: (1) $1,000/month UCT or (2) treatment as usual. Both arms will receive information on financial toxicity and the contact information for their hospital social worker or financial advocate upon enrollment. Participants will complete online surveys at baseline, 3, 6, 9, and 12 months from enrollment to collect patient-reported data on primary (i.e., financial toxicity, health-related quality of life, and treatment adherence) and secondary outcomes (i.e., anxiety, depression, food insecurity, housing stability). Social security records will be used to explore the effect on mortality at 2, 3, and 5 years post-enrollment. Linear mixed-models will be used to analyze all primary and secondary continuous outcomes over time and general estimating equations with a logit link and binary distribution for all binary outcomes over time. Differences between treatment and control groups and treatment effects will be determined using models that control for age, gender, race, baseline food security, baseline housing stability, and baseline ECOG. Findings from this study will have significant implications for the development and implementation of programs and policies that address the financial burden of cancer and other serious illnesses.