Social Care Workers Research Articles

Palliative Care Social Work State of the Science (SA303A)

Palliative Care Social Work State of the Science (SA303A)

Diagnosis-specific sickness absence among injured working-aged pedestrians: a sequence analysis

BackgroundThe knowledge about the long-term consequences in terms of sickness absence (SA) among pedestrians injured in a traffic-related accident, including falls, is scarce. Therefore, the aim was to explore diagnosis-specific patterns of SA during a four-year period and their association with different sociodemographic and occupational factors among all individuals of working ages who were injured as a pedestrian.MethodsA nationwide register-based study, including all individuals aged 20–59 and living in Sweden, who in 2014–2016 had in- or specialized outpatient healthcare after a new traffic-related accident as a pedestrian. Diagnosis-specific SA (> 14 days) was assessed weekly from one year before the accident up until three years after the accident. Sequence analysis was used to identify patterns (sequences) of SA, and cluster analysis to form clusters of individuals with similar sequences. Odds ratios (ORs) with 95% confidence intervals (CIs) for association of the different factors and cluster memberships were estimated by multinomial logistic regression.ResultsIn total, 11,432 pedestrians received healthcare due to a traffic-related accident. Eight clusters of SA patterns were identified. The largest cluster was characterized by no SA, three clusters had different SA patterns due to injury diagnoses (immediate, episodic, and later). One cluster had SA both due to injury and other diagnoses. Two clusters had SA due to other diagnoses (short-term and long-term) and one cluster mainly consisted of individuals with disability pension (DP). Compared to the cluster “No SA”, all other clusters were associated with older age, no university education, having been hospitalized, and working in health and social care. The clusters “Immediate SA”, “Episodic SA” and “Both SA due to injury and other diagnoses” were also associated with higher odds of pedestrians who sustained a fracture.ConclusionsThis nationwide study of the working-aged pedestrians observed diverging patterns of SA after their accident. The largest cluster of pedestrians had no SA, and the other seven clusters had different patterns of SA in terms of diagnosis (injury and other diagnoses) and timing of SA. Differences were found between all clusters regarding sociodemographic and occupational factors. This information can contribute to the understanding of long-term consequences of road traffic accidents.

Women and working in healthcare during the Covid-19 pandemic in Brazil: bullying of colleagues

BackgroundBased on a feminist approach, we analyzed the experiences of workplace bullying suffered by women front-line healthcare professionals dealing with the Covid-19 pandemic. We start from studies that show that women make up 70% of the global health workforce, 85% in the area of nursing, and 90% in the case of social care workers. An unequivocal need thus exists to address gender issues regarding the composition of the labor force in the health area. The pandemic has aggravated recurring problems involving healthcare professionals at the various caregiving levels, such as mental harassment (bullying) and its effects on mental health.MethodsData were gathered from an online survey of a convenience (non-probability) sample composed of 1,430 volunteer respondents, all women that work in the public health system in Brazil. The analyses and discussions involved the responses to a questionnaire containing 12 closed-ended questions and one open-ended question.ResultsThe results revealed a context of workplace bullying aggravated by precarious material, institutional and organizational conditions in the area of health services against the backdrop of the Covid-19 pandemic in Brazil. This context has variously led to aggression, isolation, heavy workloads, and invasion of privacy, humiliation, persecution and fear as it was possible to see, mainly, in the answers to the study’s open-ended question. This situation degrades both work relations and the integrity of the healthcare professionals who work on the front line to treat Covid-19 cases.ConclusionWe conclude that bullying is a psychosocial phenomenon that heightens the oppression and subordination still experienced by women in the contemporary context, but with new hues in a scenario of frontline response to Covid-19.

The Experience of Alcohol and Drug Recovery Service Staff Working with Mothers Who Have Had Their Children Removed

Parenting can be impacted by substance misuse, and children can be at risk of maltreatment, leading to their removal from their mothers. Successful treatment of substance abuse relies on these women gaining effective support from services. Previous research has demonstrated the impact working in this field can have on staff, including high staff turnover, vicarious trauma, and burnout. The present study further explores the experience of staff members working in a Drug and Alcohol Recovery Service in Scotland who work with mothers who have had their children removed. Six interviews with nurses and social care workers were analysed using interpretive phenomenological analysis (IPA). Two superordinate themes were developed from the data: (1) complexity and tension within working relationships and (2) emotional experiences and attempts to resolve them. Participants described the complexity of their roles, including the dual role of supporting mothers while also being involved in the child removal process by providing reports and evidence and how they respond and work with mothers after removal and conflicts with the wider system. They also highlighted their attempts to cope with the emotional impact of being part of this process and the empathy they have with mothers, especially when they are parents themselves, and described the complexities of trying to cope and manage when working in this challenging area. Clinical implications, including training needs and requirements, are discussed.

How did the COVID-19 Pandemic Affect Palliative Care Social Work Services? A Scoping Review

Abstract The SARS-CoV-2 coronavirus-19 (COVID-19) generated life-defining challenges on a global level, affecting healthcare professionals, who faced the same imminent public health threat as patients and families. Reduced face-to-face contact, wearing personal protective equipment and enforcing visitor restrictions generated moral distress in healthcare professionals, unable to provide holistic care. This scoping review explored the impact of the COVID-19 pandemic on palliative care social workers (PCSWs). PubMED, CINAHL and PsycINFO were systematically searched. Empirical studies and reflective articles about palliative care social work during the pandemic were screened. Data extraction used Arksey and O’Malley’s framework. Thematic analysis was underpinned by Braun and Clarke for identifying, analysing and reporting patterns. From 706 citations retrieved, 125 were selected for full-text review and 32 were included in the scoping review. Thematic analysis revealed three themes: (i) moral distress, (ii) transitioning and (iii) inequality. Implementing visitor restrictions caused moral distress and raised questions about their justification. Not being present at the time of death generated feelings of anger among bereaved family members. Virtual communication replaced face-to-face contact, yet improved access to Telehealth. Inequalities were illuminated and PCSWs advocated for disadvantaged populations, worked creatively to minimise suffering or stigma and supported peers.

Transforming the Welfare State, One Case at a Time: How Utrecht Makes Customized Social Care Work

Advanced welfare states are under pressure to customize services, promptly enough to prevent a cascade of harms. With these goals, the Netherlands in 2015 decentralized social care services to municipalities, and within municipalities to neighborhood teams in continuing contact with clients. The overall results have been disappointing. But the experience of Utrecht, the Netherlands’ fourth-largest city, has been strikingly different. By using hard-to-resolve cases to signal conflicts in rules, obstructive jurisdictional boundaries, and the shortcomings of private service providers, Utrecht is learning to customize and speed delivery of social care through incremental steps. This article explains how Utrecht's success addresses apparently intractable limits to the adaptability of the rule-bound welfare state, such as the problem of low-level discretion or street-level bureaucracy and the division of services into silos, in the process bridging, and perhaps effacing, the gap between the Habermasian life world and the system world of formal rules.

Beyond medicalized approaches to violence and trauma: Empowering social work practice

Summary Social workers are positioned to respond to clients with a history of trauma by practicing bio-psycho-social, trauma, and violence-informed care but frequently encounter systemic barriers to providing holistic care. The research presented in this article was initiated by a College of Social Work in Canada in response to concerns raised by social work providers that their practice was constrained by ideological, structural, and system limitations within publicly funded mental health and addiction services. Ideologically trauma-based social work care is defined by five principles of safety, trust, collaboration, choice, and empowerment and recognizes that what has happened to individuals, including early adversity, can influence their bio-psycho-social functioning across the lifespan. Structurally, trauma-based care recognizes the corrosive impact of poverty, systemic discrimination, and exclusion. Findings Our research included a literature review, an online survey (n = 115 completed surveys), individual interviews (n = 50), and three focus groups (n = 15). The findings consistently highlighted a dissonance between dominant bio-medical approaches and reliance on the Diagnostic Statistical Manual of Disorders and social justice–based practice. Primary themes included a recognition by social workers of the pervasive presence of trauma and its effects, including mental health and addiction challenges; intergenerational impacts of trauma; the limitations of the medical model; and the need to reposition social work practice. Applications Repositioning the role of social work within mental health and addiction settings to center social justice responses to trauma presents transformative opportunities to better meet the needs of service users and increase workplace satisfaction.

A qualitative interpretive meta-synthesis of social workers’ experience in end-of-life care

Summary Social workers are an integral part of end-of-life (EOL) care interdisciplinary services and provide comprehensive psychosocial support to dying people. However, despite the rewards, EOL care social work is wrought with challenges. There is currently limited research into the experience of EOL care social workers. Therefore, this qualitative interpretive meta-synthesis (QIMS) study examines the experience of EOL care social workers as revealed in existing literature. The QIMS methodology was used to synthesize and interpret findings from four original qualitative studies to elicit an in-depth response to the research question: What is the experience of social workers who work in EOL care? Findings The theme “EOL care social work is a privilege and a struggle” emerged, with six associated contributing factors: Privilege—(1) death is sacrosanct, (2) death is an opportunity for growth and healing, and (3) the religious/spiritual element of EOL care. Struggle—(1) ongoing pain and heightened emotions, (2) conflict of values, and (3) contextual challenges. This QIMS study serves as a preliminary phase to a subsequent, larger study. Applications This QIMS study provides a foundation for further narrative research into the experience of EOL care social workers. In addition, findings from this QIMS study highlights areas for further attention to foster the well-being of EOL care social workers. Finally, findings from this QIMS study could augment relevant EOL care content in undergraduate social work education.

Założenia organizacyjne żłobków dziennych w okresie międzywojennym według wytycznych Polskiego Komitetu Opieki nad Dzieckiem

The aim of this article is to present the main organizational assumptions of nurseries, which were just organized in the Interwar period and were to represent the first level of social care and educational work for mothers and children. The proposed issue is of contributory nature and is the first attempt to discuss the activities and operations of nurseries in the Interwar period, when their utility and significance were discussed. It is a description of the origins of the facility, which in the post-war period was a common element of childcare. As a result of the developing industry and the growing demand for workers, young mothers also took up paid jobs in order to improve their material status. Therefore, nurseries located near factories did not actually mushroom and the time of development of this institution was arrested in the post-war period.

Sex, Gender and Sexuality in the Context of Dementia: A Guide to Raise Awareness Amongst Health and Social Care Workers

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Learning from Fun Leadership Experiences

The low appeal of nursing is currently a challenge in Finland and many other countries. Retaining factors that would keep nurses within the field have been discussed, as have attracting factors that would draw new workers to the field. Finnish discourse often focuses on the heaviness of nursing, shift work, bad leadership and low work wellbeing. The last can be influenced by many things, such as the use of humor. Workplaces can learn to use positive humor, which raises spirits and increases a sense of community. The purpose of this study was to survey fun workplace experiences in the social and health care field and what was learned from them. As there has been little research on the use of humor in social and health care work in Finland, the aim of this study is to increase knowledge and discussion of the topic. The study was conducted in 2016-2017 by collecting narratives (N=34) from master’s degree students in Leadership. The data were analyzed through inductive content analysis. Fun experiences in personnel leadership showed and reinforced social capital and a sense of community at the workplace. The sense of community included developing workplace community skills, maintaining a sense of togetherness, advancing workplace well-being and doing activities, spending time and using professional skills together. Learning from fun experiences through reflection was formed from leadership that increases workplace well-being. This consisted of four categories: reinforcing a fun work atmosphere, reinforcing togetherness, appreciative leadership and the multiplicity of the supervisor’s role. Positive humor can be used to advance workplace well-being and personnel retention. Keywords: leadership, humor, work well-being, experience-based learning, Finland

‘I have enough pressure as it is, without the worry of doing something wrong because of ignorance’: The impact of Covid-19 on people who employ social care personal assistants

AbstractPeople with care and support needs were often badly affected by Covid-19, although the impact on people employing Personal Assistants (PAs) has not been addressed. We aimed to explore the experiences of people employing PAs during the pandemic to inform care systems and social work practice. Remote qualitative interviews were conducted with seventy PA employers across England in 2021–2022. Data were analysed thematically to explore salient themes. The Covid-19 pandemic elucidated role tensions of PA employers: Navigating care arrangements during a time of unprecedented uncertainty reinforced participants’ role as an employer, but exposed some aspects of employment responsibilities and legal obligations that participants felt ill-equipped to manage. Reports of contact with or by social workers were few and not perceived as helpful. The often-informal nature of PA arrangements and its blurred relational boundaries affected participants’ expectations of their PAs. PA employers would welcome support from social workers in their employment role and flexibility with care plans, albeit with greater autonomy over their Direct Payment (DP) budget to enhance the potential of this arrangement. In the context of declining DP uptake in England, our study offers some potential explanations for this, with suggestions for systemic change and social work practice.

COVID-19 in people aged 18-64 in Sweden in the first year of the pandemic: Key factors for severe disease and death.

Studies on risk factors for severe COVID-19 in people of working age have generally not included non-working persons or established population attributable fractions (PAFs) for occupational and other factors. We describe the effect of job-related, sociodemographic, and other exposures on the incidence, relative risks and PAFs of severe COVID-19 in individuals aged 18-64. We conducted a registry-based study in Swedish citizens aged 18-64 from 1 January 2020 to 1 February 2021 with respect to COVID-19-related hospitalizations and death. Of 6,205,459 persons, 272,043 (7.5%) were registered as infected, 3399 (0.05%) needed intensive care, and 620 (0.01%) died, with an estimated case fatality rate of 0.06% over the last 4-month period when testing was adequate. Non-Nordic origin was associated with a RR for need of intensive care of 3·32, 95%CI 2·19-3·36, and a PAF of 33·1% after adjustment for age, sex, work, region and comorbidities. In a second model with occupation as main exposure, and adjusted for age, sex, region, comorbidities and origin, essential workers had an RR of 1·51, 95%CI, 1·35-1·6, blue-collar workers 1·18, 95%CI 1·06-1·31, school staff 1·21, 95%CI 1·01-1·46, and health and social care workers 1·89, 95%CI 1·67-2·135) compared with people able to work from home, with altogether about 14% of the PAF associated with these occupations. Essential workers and blue-collar workers, but no other job categories had higher risk of death, adjusted RRs of 1·66, 95%CI 1·24-2·23 and 1·37, 95%CI 1·04-1·81, with adjusted PAFs of altogether 9%. Among people of working age in Sweden, overall mortality and case fatality were low. Occupations that require physical presence at work were associated with elevated risk of needing intensive care for COVID-19, with 14% cases attributable to this factor, and 9% of deaths.

In-service training programme for health and social care workers in the Philippines to strengthen interprofessional collaboration in caring for older adults: a mixed-methods study

BackgroundA growing number of older adults require complex care, but coordination among professionals to provide comprehensive and high-quality care is perceived to be inadequate. Opportunities to gain the knowledge and skills important for interprofessional collaboration in the context of geriatric care are limited, particularly for those already in the workforce. A short-term training programme in interprofessional collaboration for health and social care workers in the Philippines was designed and pilot tested. The programme was devised following a review of the literature about geriatric care education and group interviews about training needs. The objectives of this paper are to introduce the training programme and to evaluate its influence on attitudes and readiness to collaborate among participants using both quantitative and qualitative methodologies.MethodsA total of 42 community health workers and 40 health institution workers participated in the training in July 2019. Quantitative indicators were used to evaluate attitudes towards and readiness for collaboration before and after the training. Content analysis was performed of responses to open-ended questions asking participants to evaluate the training. A convergent parallel mixed-methods design was applied to determine the patterns of similarities or differences between the quantitative and qualitative data.ResultsSignificant improvements were seen in scores on the Attitudes Towards Health Care Teams Scale among community health (P < 0.001) and health institution (P < 0.001) staff after the training. Scenario-based case studies allowed participants to work in groups to practise collaboration across professional and institutional boundaries; the case studies fostered greater collaboration and continuity of care. Exposure to other professionals during the training led to a deeper understanding of current practices among health and social care workers. Use of the scenario-based case studies followed by task-based discussion in groups was successful in engaging care professionals to provide patient-centred care.ConclusionsThis pilot test of in-service training in interprofessional collaboration in geriatric care improved community and health institution workers’ attitudes towards such collaboration. A 3-day training attended by health and social care workers from diverse healthcare settings resulted in recommendations to enhance collaboration when caring for older adults in their current work settings.

Child, parent or family? Applying a systemic lens to the conceptualisations of Family Support in Europe

ABSTRACT This paper considers how Family Support is conceptualised in the European context with respect to its primary beneficiaries. The central question considers the focus of concern in a child welfare system and what it means when Family Support is focused on children, on parents, or involves the family unit as a whole. Informed by a body of relevant literature reviewed as part of a wider project, Family Support is seen as more often conceptualised as being targeted toward parents as the primary service user, and to a lesser extent described as being tailored toward children or whole families. This approach to Family Support provision is somewhat at odds with a systemic understanding of families, which is foundational to much social care and child welfare work, and which takes account of the multi-layered relationships between individuals within families, and between individuals, families and their social world. Applying an ecological systems perspective, this paper critically discusses the consequences for the involved stakeholders and the implementation of services at different system levels when support and interventions are targeted at the child, the parents or at the family as a whole.

Working Conditions and Well-Being across the COVID Pandemic in UK Social (Care) Workers

AbstractPrior to the COVID-19 pandemic, social work and social care practitioners had some the worst working conditions of any sector in the UK. During the pandemic, data revealed that social care occupations had higher COVID infection and mortality rates than the general population. The article reports the changing working conditions (measured via the Work-Related Quality of Life scale) and well-being (measured via the Short Warwich–Edinburgh Mental Well-being Scale) of UK social care and social workers across three timepoints between May 2020 and July 2021 through an online cross-sectional survey of working conditions and well-being. Analysis of variance demonstrated that both well-being and working conditions were significantly poorer in July 2021 (phase 3 [n = 1,606]) than the previous two phases (n = 2,523 and n = 2,424, respectively), suggesting that both working conditions and well-being worsened within the social care and social work workforce across the pandemic. Furthermore, each of career satisfaction, working conditions, control, general well-being and home–work interface predicted poorer well-being at Time 3. Whilst chronically poor working conditions can lead to poorer individual psychological and physiological health outcomes, our findings highlight continually poor conditions in this sector, with potential further impacts on organisations and the service users that social care workers support. It is therefore important that individuals, organisations and government develop mechanisms to support these critical workers during and following the pandemic.

The UK's points-based immigration system and its impact on the healthcare sector

Alex Christen, senior associate at Capital Law, explains how changes to the UK's points-based visa system impacts the eligibility of overseas health and social care workers, and how this could affect the NHS.

Comparing Psychological Wellbeing and Work-Related Quality of Life between Professional Groups within Health and Social Care during the COVID-19 Pandemic in the UK

This paper shared the compared results on the psychological wellbeing and work-related quality of life amongst health and social care workers during the COVID-19 pandemic in the UK. Health and social care professionals within nursing, midwifery, allied health professions, social care and social work occupations working in the United Kingdom (UK) during the pandemic were recruited. Repeated cross-sectional online surveys were conducted during two time periods of the pandemic (May–July 2020 and May−July 2021). A total of 4803 respondents completed the survey. The findings revealed that over the pandemic, psychological wellbeing (SWEWBS measure) and work-related quality of life (WRQoL scale) scores significantly decreased in all five occupations (p &lt; 0.001) with midwives having the lowest scores on both scales at all time points. Respondents were found to significantly (p &lt; 0.001) use of negative coping strategies such as behavioural disengagement and substance usage. Analysis of variance revealed a statistical difference between occupations and wellbeing across 2020 and 2021, while work-related quality of life was only statistically significantly different in 2021. The findings revealed that due to this decrease, there is a distinct need for more support services and flexible working conditions within health and social care services, to improve wellbeing and work-related quality of life.

Moral injury, PTSD, and complex PTSD among Israeli health and social care workers during the COVID-19 pandemic: The moderating role of self-criticism.

During the COVID-19 pandemic, health and social care workers (HSCWs) are facing morally challenging situations and life-threatening decisions. Following exposure to potentially morally injurious events (PMIEs) that undermine deeply held moral beliefs and expectations, HSCWs might experience moral injury (MI) and other deleterious psychiatric consequences. The present study examined associations between exposure to PMIEs, MI symptoms, posttraumatic stress disorder (PTSD), complex PTSD (CPTSD), and self-criticism among HSCWs. A sample of 296 Israeli HSCWs responded to online validated self-report questionnaires in a cross-sectional designed survey in February and March 2021. Participants' self-reported PTSD (8.9%) and CPTSD (4.8%) rates match the rates of Israel's general population. A moderated-mediation model shows that high self-criticism intensified the relations between exposure to PMIEs and MI symptoms, and between MI symptoms and CPTSD symptoms. Importantly, the indirect effect of exposure to PMIEs on both PTSD and CPTSD symptoms via MI symptoms existed only among those with high levels of self-criticism. The study's findings offer a novel overview of the associations between patterns of exposure to PMIEs, MI, PTSD, and CPTSD. Clinicians treating HSCWs coping with COVID-19-related moral injury should be aware of the importance of high self-criticism in the possible posttraumatic sequelae of exposure to PMIEs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Comparing the Mental Wellbeing and Quality of Working Life among Nurses and Social Care Workers in the UK and Japan in Older Adults’ Care Services during the COVID-19 Pandemic

This study explored and compared the psychological wellbeing, burnout, coping strategies and work-related quality of life amongst health and social care workers in older adults’ care homes and community settings during the COVID-19 pandemic in the United Kingdom (UK) and Japan. A cross-sectional online survey was conducted in the UK (May–July 2021) and a postal survey conducted in Japan (September–October 2021). Participants recruited were health and social care professionals within nursing, social care and social work occupations working in care home or community settings in the UK and Japan during the pandemic. Data were analysed using SPSS. 1327 respondents across the UK and Japan completed the survey. Respondents’ psychological wellbeing was significantly lower in Japan compared to the UK (p ≤ 0.001). UK respondents had significantly higher personal burnout (p &lt; 0.05) and work-related burnout (p &lt; 0.05) while those in Japan had significantly higher client-related burnout (p &lt; 0.001). The novelty of this study relates to exploring mental wellbeing and quality of working life in two culturally contrasting countries. The overall psychological wellbeing and work-related quality of life of staff who work with older adults in the UK and Japan during the COVID-19 pandemic were lower than the population norm. Greater support and flexible working conditions for this workforce are needed to reduce burnout by improving wellbeing and work-related quality of life.